How To Play The Diabetes Diet Game and Win!! Your Ultimate Guide to Diabetes, Health and Wellness …Without Drugs Table of Contents Table of Contents……………………………………………………………………. Introduction………………………………………………………………………….. Why Do I Need This Book?......................................................................................... Before Diabetes…………………………………………………………………….... Diabetes Through Time…………………………………………………………….... The High Cost of Low Insulin……………………………………………………….. What is Diabetes?......................................................................................................... The Myths and Truth About Diabetes……………………………………………….. The Different Types of Diabetes……………………………………………………... Who Gets Diabetes and Why?..................................................................................... Risk Factors………………………………………………………………………….. Celebrity Diabetics…………………………………………………………………… Symptoms of Diabetes……………………………………………………………….. Diagnosing Diabetes…………………………………………………………………. Treatment and Management………………………………………………………..... You, Your Partner and Diabetes…………………………………………………...... Common Medications Prescribed in Diabetes………………………………………. The Downside of These Chemical Compositions…………………………………… Fighting Type 2 Diabetes, Naturally………………………………………………… Food and Diabetes…………………………………………………………………… A Matter of Fat………………………………………………………………………. Understanding Carbohydrates……………………………………………………….. Foods to Enjoy and Avoid…………………………………………………………… Mind and Body………………………………………………………………………. All That You Must Know About Food Labels………………………………………. Alcohol, Smoking and Diabetes……………………………………………………... Exercise—a MUST………………………………………………………………….. Herbs – Do’s and Don’ts…………………………………………………………….. Complementary Care………………………………………………………………… End Notes…………………………………………………………………………….. A Dummies Guide for Diabetes……………………………………………………… Recipes for Diabetes…………………………………………………………………. Glossary……………………………………………………………………………… Bonus Sections……………………………………………………………………….. 2 3 6 8 9 13 16 18 21 25 27 30 31 35 37 39 46 48 53 56 60 68 72 74 80 87 90 94 105 106 108 110 121 122 Introduction I t’s a fact! Diabetes can be reversed. My husband, Tim Hanf, is living proof! When he collapsed due to a spike in his glucose levels on the day of our wedding, I was determined to find a way to beat this disease. According to a groundbreaking study conducted by researchers at UCLA, changes in diet and moderate exercise can actually reverse diabetes in at least 50% of patients in just three weeks! Imagine, in just three weeks; the amount of cholesterol and free radicals in the blood could be lower and the nitric oxide levels could be made higher ---- both key factors in arresting the deadly disease before it begins to take its toll on our limbs and life. Diabetes is the number one cause of leg amputations in the United States. StatsSpeak The American Diabetes Association estimates that about 15.7 million Americans have diabetes (see Box 7.2), with most having Type 2 diabetes and the others having Type 1. About 10.3 million are aware of the disease, and 5.4 million are not. Half of the 16 million have the disease but are unaware of it, and people from minority groups are more likely to go undiagnosed. The disease itself may go undetected for years because the symptoms are sometimes so mild. Diabetes increases in frequency with aging so that about 18.4 percent of all Americans over 65 may have it. "Sixteen million Americans --- 6% of the population --- have diabetes, and one third of them don’t even realize it; 800 000 will be diagnosed this year. It is the leading cause of blindness, end stage renal disease, and leg amputations and the seventh leading cause of death," Dr Susan Hershberg Adelman told a seminar in New York . We can prevent all this and more with this e-book. In fact, with this e-book I will show you not only how to beat diabetes but teach you how you can learn to stave off heart disease, strengthen your central and peripheral nervous system and cause natural reduction of the excess fat accumulated in your body. These are just some of the many positive, health-promoting tips that you are going to learn from this e-book. Believe it or not, one strategy revealed here eliminates the need for taking an Insulin shot in 70% diabetic patients! My husband is now diabetes free using this strategy. Other amazing tips will help you halt erratic fluctuations in your blood sugar level, reduce stress on your pancreas and help return your body to its normal, healthy state of blood sugar management. The most amazing thing of all: You will accomplish all this and more with minimum hassle, expenses, side-effects or toxicity that is normally brought about with the use of prescription drugs and over-the-counter Allopathic medications. How Long, Oh Lord, How Long! This, believe me, is the century of instant gratification, instant oatmeal, instant downloads, and even instant millionaires! Unfortunately, no one has yet found the key to instant health or the secret to curing diabetes instantly! But there’s a saying, “Easy come, easy go.” So if you want to seriously create an effective plan to achieve long-lasting health and wellness, acknowledge to yourself that it’s going to take some amount of time; weeks, months or even a year for the new habits to take firm hold in your life. Further, the information shared in this guide does not imply a �magic pill’ or �miracle cure’ --- although the results you can achieve with these natural interventions are, indeed, miraculous --- you will still need to go that extra mile in order to internalize specific, natural health strategies that would be �at war’ with a lot of your old, debilitating, disease-inducing habits. The destination is important, but so is the journey. As long as you're making forward progress, that's what counts. My goal is that you will start to challenge yourself to make forward progress, day after day, and eventually bring yourself one step closer to a life that is not marred by a devastating disease. It's not important how long it takes, what is important is that you would have learned the secret to halting your diabetes --- permanently, and naturally. That day will mark a new beginning, a new dawn in your life, when you will wake up to feel the sensation of a new body, a new mind, and a whole new you! It would signify a life without prescription drugs, without insulin injections, and without those frustrating, routine blood sugar tests. You can do it. Why Do I Need This Book? W hy indeed? Because, although it may be hard for you to digest it, diabetes treatment is both a science and a commercial industry. And like any industry driven by profits, greed and dishonest science, this industry also is based on questionable worldwide practices that focus merely on alleviating the symptoms of diabetes, rather than eradicating them permanently or uprooting the real cause of the disease. Ask any diabetic. The suffering, the discomfort and the excruciating pain of diabetic symptoms and the fear of future complications, returns time and again to hurt torture and haunt them. The wounds may temporarily heal but the scars remain and below the scars they fester indefinitely. However, in our experience and through my interaction with thousands of diabetes patients, I know honesty and good science can reverse diabetes. All it takes is a natural process of restoring the body's blood-sugar control mechanism. Insulin Is Not a Miracle Potion For decades, diabetics have been told that they can take any amount of sugar and sugarbased food products, so long as they continue with their insulin therapy --- but nothing can be farther from the truth. High levels of insulin can be as dangerous to the body as sugar to a diabetic. Repeat and prolonged exposure to insulin in fact, is positively detrimental. On the other hand, glucose-lowering drugs may temporarily succeed in lowering blood sugar levels, but eventually increase the risk of death from cardiac arrest. These drugs also are associated with innumerable unpleasant and often painful side effects including: weight gain, elevated cholesterol and triglyceride levels, nausea, diarrhea, constipation, stomach pain, drowsiness and headaches. What Comes Naturally To avoid all these negative effects, we can gradually improve our diabetic condition with what are known as natural remedies. The methods I discovered through my husbands journey to living diabetes free, are intended to help you develop your own customized system for treating, curing, and preventing diabetes -- all by yourself. But first, I will begin by giving you a basic understanding of your diabetes. Over the next few pages, we’ll explore the causes and symptoms of diabetes and then move on to a discussion of the various time-tested traditional methods that can be used to not just manage but also eventually and permanently cure the disease. All this will take is commitment, a few dietary changes and lifestyle management including a daily regimen of exercise and stress reduction, as well as a smart and easy program of nutritional supplementation and herbal remedies. Good health is closer than you think! Before Diabetes B efore people develop Type 2 Diabetes, most suffer from a condition known as "pre-diabetes.” It is a condition where in blood glucose levels can shoot to a higher than normal level but yet is not high enough to be diagnosed as diabetes. In the U.S., pre-diabetes affects about 41 million people, most of them between the ages of 40 and 74. Some long-term damage, especially to the heart and circulatory system, can begin to occur during undetected pre-diabetes stage. However research shows that if you take action and are able to control your blood glucose level at the pre-diabetes stage, you can delay or altogether prevent Type 2 diabetes from ever developing in your body1. Testing, Testing, 1-2 There are two different tests you can take to determine whether you have a pre-diabetes condition. The first is the Fasting Plasma Glucose Test (FPG) and the second is the Oral Glucose Tolerance Test (OGTT). Both these tests help determine whether you have normal metabolism, or pre-diabetes or diabetes condition. If your blood glucose level is found to be higher than normal with an FPG, the implication would be that you have Impaired Fasting Glucose (IFG) condition and if your blood glucose level turns out to be abnormal following an OGTT, the conclusion would be that you have Impaired Glucose Tolerance (IGT). Either way, you would be at risk of developing a chronic illness that has been a blight on humanity since ancient times, as chronicled in the Egyptian history. Diabetes Through Time U nlike many of the diseases and health challenges we face today, Diabetes has been with us for centuries. B.C. • 1552 – The earliest recorded reference to Diabetes, mentioned on 3rd Dynasty Egyptian papyrus by a physician by the name of Hesy-Ra; refering to frequent urination as one of the major symptoms of diabetes. A.D. • 100 – The condition was described by Arateus as 'the melting down of flesh and limbs into urine.' • 164 - Greek physician mistakenly diagnoses diabetes as an ailment of the kidneys. Until 1200 A.D., water-tasters, people who drank urine of those suspected of having diabetes, were invited to make the diagnosis. The Latin word for honey is mellitus and because the urine of diabetics is �sweet’ the condition later came to be known as Mellitus Diabetes. • 1600's – For the first time, Paracelsus, a renowned physician identifies diabetes as a serious general disorder. • 1800's - Chemical tests were created to measure the presence of sugar in urine. Diabetes in the 1800’s In the 19th Century, research into diabetes actually began to boom. Around the world, especially in Europe, doctors and scientists began to look for answers and insights which could lead to an effective treatment of this debilitating disease. In France, one physician (Priorry), advised diabetes patients to consume more sugar as an effective means of treatment. His colleague, Dr. Bouchardat, noticed the disappearance of glycosuria during the rationing of food in Paris during the Franco-Prussian War. This caused him to pioneer the idea that diabetic diets need to be individualized. In Germany, a medical student discovered that the pancreas contains two systems of cells --- one set secretes normal pancreatic juice, while the function of the other was yet unknown. Several years later, these cells were identified as the 'islets of Langerhans.' It was a German scientist, Georg Zuelzer who developed the first injectible pancreatic extract to suppress Glycosuria. Unfortunately, there were extreme side effects to the treatment, so its use was discontinued later. 20 th Century Treatment Many fad diabetes diets became popular in the early part of the century. Among the first and most popular was: the 'oat-cure', milk diet, rice cure, and 'potato therapy’. At one point, even opium was proposed as a �dietary supplement’ for people identified with diabetes. One of the most important findings of the early 20th Century emerged from the work of Frederick Madison Allen. He published Studies Concerning Glycosuria and Diabetes, a book on which the contemporary treatment of diabetes is based. Other milestones in this timeline include: • 1921 – The discovery of insulin as a treatment after a dog, whose pancreas was removed, was successfully treated with it. • The 1940’s were pivotal years in diabetes research. Researchers discovered a vital link between diabetes and long-term health complications such as kidney and eye disease. Concurrently, Diabetes management was standardized with the development of a uniform insulin syringe. • 1955 – The first oral drugs to help lower blood glucose levels became available to patients. • 1959 – Diabetes was broken down into two types: Type 1 (insulin-dependent) and Type 2 (non-insulin-dependent) • The 1960’s and 1970’s saw significant progress in Diabetes treatment �technology.’ The purity of insulin was improved. Advancements in home testing for sugar levels in urine gave people greater control over their bodies and the disease. Blood glucose meters and insulin pumps were developed and laser therapy was first used to help slow or prevent blindness in some people with diabetes • 1983 - First biosynthetic human insulin was introduced • 1986 - Insulin pen delivery system was introduced • With the 1990’s, came the realization that more frequent insulin doses and personalized treatment regimens based on a patient’s activity level and eating patterns can delay the onset and progression of long-term complications in individuals with Type 1 Diabetes. The importance of good glucose and blood pressure control in the delay and/or prevention of complications in Type 2 Diabetes was also recognized. 21 st Century Scientists began investigating various means of administering insulin without the use of a syringe. Reports of the first major clinical trials successfully using a new inhaled form of insulin were published. This insulin device is similar to an asthma inhaler. It delivers a dose of insulin in a dry powder form through the mouth directly into the lungs from where it easily enters the bloodstream. Scientists have also begun experimenting with an in-the-cheek (buccal) insulin product. This insulin is sprayed into the mouth and is primarily absorbed through the inner cheek walls. But perhaps the most revolutionary advancement during this time comes from genetic research. This includes islet cell transplantation (islet cells produce insulin), and genetic manipulation. Looking Back Despite advancements in science, medicine, and technology, the 21st Century seems to be a time when “everything old is new again.” So, while people across the world continue to embrace progress, they are also beginning to reconsider alternative health strategies and starting to prefer a more natural approach to health and healing. The High Cost of Low Insulin D iabetes affects approximately 17 million people (about 8% of the population) in the United States. More than a trillion dollars - $1.2 trillion to be exact -- is spent in the United States on health care, 75% by people with chronic health conditions like diabetes. Also, an estimated additional 12 million people in the United States have Diabetes and remain undiagnosed. Diabetes is in fact, the third leading cause of death in the United States after heart disease and cancer. Over time, diabetes can lead to blindness, kidney failure, and nerve damage. Diabetes is also an important factor in accelerating the hardening and narrowing of the arteries (arteriosclerosis), leading to strokes, coronary heart disease, and other large blood vessel diseases. Globally, the statistics are staggering. The number of people around the world suffering from diabetes has skyrocketed in the last two decades, from 30 million to 230 million. China now has the largest number of diabetics over age 20, nearly 39 million people. India has the second largest number of cases with an estimated 30 million suffers, a staggering 6% of the adult population. The Prime of Life Unfortunately, this disease affects people in their most productive age. According to the statistics published by The Diabetes Atlas the largest number of people affected by Type 2 Diabetes is between the ages of 40 and 59. Once regarded as a �mature’ person’s disease, the Atlas reports that today, the age of onset for Type 2 diabetes has drastically dropped so people are getting sick in the prime of their life. Long-term health problems are also common in people who have poor blood sugar control. Some of these complications include: • Heart disease - Heart disease is the leading cause of diabetes-related deaths. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. • Stroke - The risk of stroke is two to four times higher in people with diabetes • Kidney failure - Diabetes was a leading cause of end-stage renal disease in 2002. • Blindness -Diabetes is the leading cause of new cases of blindness in adults 20 to 74 years old. There are 12,000 to 24,000 new cases of diabetes-associated blindness each year. • Amputations – Diabetics account for more than 60% of lower limb amputations in the U.S. • Nervous system disease - 60-70% of diabetics suffer from sort form of nervous system damage, which includes decreased sensation in feet or hands (neuropathy), slowed digestion in the stomach, and carpal tunnel syndrome. • Dental disease - 33% of Diabetics suffer from severe periodontal disease with loss of attachment of the gums to the teeth Diabetes Kills Diabetes claims millions of lives and taxes the ability of health care organizations the world over, according to data published by the International Diabetes Federation. Already, each year some 3 million deaths are tied directly to diabetes, with death rates expected to rise 25% over the next decade. Even more frightening, the number of people with diabetes throughout the world is expected to double by 2030, according to a new study published by the World Health Organization. This can change. Like my husband and me, you can make a difference in your life and in the life of someone you love. Don’t remain a cold statistic. Instead, choose to be on the leading edge of a new wave of health. On the following pages, you will learn about a new and natural way to giving diabetes the boot for good! What is Diabetes? D iabetes mellitus is a disease which prevents your body from properly using the energy from the food you eat. Diabetes occurs when • The pancreas (an organ behind your stomach) produces no insulin • The pancreas produces too little insulin • The pancreas makes insulin, but the insulin made does not work as it should. (This condition is called insulin resistance.) At this point, you’re probably asking, “What is insulin?” Good question! Insulin is a naturally-occurring hormone, produced by the beta cells of the pancreas that helps the body use glucose for energy. To understand Diabetes better, it helps to know more about how the body uses food for energy. Your metabolism is responsible for turning food into fuel and delivering it to your hungry cells. Our bodies are made up of millions of cells. To make energy, the cells need food in a very simple form. When we eat or drink, much of what goes into our mouths is broken down into a simple sugar called glucose. The blood and blood vessels transport glucose from the stomach or the liver to our muscles (where it gets converted to energy) or our cells (where it is converted to fat). Man does not live by glucose along. (Woman don’t either!) Glucose cannot go into the cells by itself. This job is assigned to insulin. The pancreas release a substance called insulin into the blood. Insulin serves as the helper, or the "key" that unlocks glucose and releases it into the cells to be used as energy. When glucose leaves the bloodstream and enters the cells, the blood glucose level automatically gets lowered. Low glucose is a benchmark of diabetes. Car Talk In many ways the human body is like a car. For example, to start a car, you must turn the key to move the gas to the engine. Without insulin, or the "key," glucose cannot get into the body's cells for use as energy. This causes the retention of a lot of glucose in the blood, also called "high blood sugar" or diabetes. If you have recently been diagnosed as diabetic, don't fret. With proper treatment and care, you can once again be motoring along the highways and byways of your life. You may need to make a few changes in how you drive (your lifestyle), but chances are it’s about time for a tune-up anyway. Fact is that our bodies, like our car, needs regular care and maintenance. And while your doctor is a good mechanic and an important element in your health care plan, it’s time you took some responsibility yourself and responsibility starts with understanding. So let’s get started right away! The Myths and Truth About Diabetes Myth #1: Type 1 diabetes always starts in childhood, Type 2 starts later. The Truth: Usually, but not always. Type 1 Diabetes can be diagnosed as late as 40 and an increasing number of people are being diagnosed with Type 2 diabetes at a younger age because of rising rate of childhood obesity. Myth#2: You can be diabetic without knowing it. The Truth: This is true only for Type 2 because the symptoms can get overlooked in a majority of cases. People with Type 2 generally have the condition for 5-10 years on average before being diagnosed. However, with Type 1 diabetes the symptoms are much more obvious. Myth#3: Only fat people get diabetes. The Truth: Type 1 Diabetes is not caused by the fat accumulated in the body and even with Type 2 diabetes, which is strongly linked to obesity; around 20% of sufferers are of normal body weight. You can be slim and develop Type 2 diabetes if you have other risk factors. Myth#4: Diabetics cannot – must not – consume sugar. The Truth: Once you find out the degree of your condition, you can then determine how to effectively manage your sugar intake. Myth#5: People with diabetes must cut out all carbs from their diets. The Truth: Carbs are vital for providing energy and should form the basis of any diet. However, diabetics should aim to eat foods that provide a slow, steady energy release. The glycaemic index (GI) is useful because it shows how quickly carbs are converted into blood sugar. Generally it is advisable for diabetes to make small changes in their diet, like swapping white bread and long-grain rice for lower-GI granary bread, and combining a high-GI food like a jacket potato with a low-GI food like beans. Myth#6: Diabetes is not dangerous. The Truth: There is no running away from the fact that diabetes is dangerous and can have serious long-term complications, leading to heart disease, blindness, kidney failure and nerve damage. It can be dangerous if not managed or controlled. Myth#7: Diabetes in pregnancy is just a blip. The Truth: Gestational diabetes goes away once the baby is born, but it means you are at more risk of developing Type 2 diabetes later on in life. It is an indicator that our body is not producing or using insulin as efficiently as it could be. Myth#8: Diabetes is caused by over consumption of sweets. The Truth: Being overweight puts us at higher risk of Type 2 diabetes, but as mentioned before, it makes no difference which food made us fat. Sugar is high in calories so it can contribute to weight gain, but it doesn’t directly cause diabetes. And Type 1 diabetes isn’t caused by diet at all. It’s believed to be an abnormal auto-immune reaction to the body’s own cells. Myth#9: Diabetics just need a daily shot of insulin to survive. The Truth: This may be true in the case of Type 1 diabetes because the body cannot produce any insulin itself, but not in the case of people with Type 2, which has to be treated with a carefully monitored diet and exercise schedule. Myth#10: Alcohol is completely ruled out for diabetics. The Truth: Alcohol is fine in moderation, i.e., 1-2 units a day for women and 2- 3 for men. However, alcohol can also cause low blood sugar so it should not be consumed too quickly, or on an empty stomach. Myth#11: Diabetics cannot --- or rather should not --- exercise The Truth: Exercise in fact does aid the body’s use pf insulin. With Type 1 diabetes, exercise may cause erratic swings in blood sugar levels, but that does not mean we should not exercise, as the benefits outweigh the risks. We may just have to adjust our medication to compensate for the extra glucose being used. The Different Types of Diabetes D Iabetes, as explained in the preceding chapter is a medical term that signifies a problem with the body’s relation to insulin and insulin production. Diabetes implies that the pancreas is not producing enough of the sugar-regulating hormone insulin. There are two major types of diabetes --insulindependent, also known as type I diabetes, and non-insulin-dependent, or type II diabetes. Type 1 Diabetes • When the insulin-producing cells in the pancreas have been destroyed, so the body can no longer produce any insulin. Type I diabetes, (also known as Juvenile Diabetes) is usually found in young children and teenagers, but can also occur later in life. In Type 1 diabetes, the body does not produce adequate quantities of insulin, a hormone needed to convert blood sugar into energy. The general treatment for people with Type 2 diabetes is daily injections of insulin. This keeps keep the blood sugar level within normal ranges. Chin Up! Steve Redgrave, one of the world's greatest Olympic athletes battled Type 1 diabetes to win five Olympic Gold medals in rowing! Type 2 Diabetes • When the body can still produce some insulin but not enough to keep blood sugar levels stable, or the body cannot use it effectively. Type 2 diabetes (also referred to as Mature Onset Diabetes) is the second most common form of diabetes. With Type 2 Diabetes the body can either be producing lesser quantities of insulin than is required or may not be reacting to the insulin correctly. Either way, the result is the unbroken glucose starts accumulating in the bloodstream instead of getting absorbed by cells, which can lead to many serious, long-term health consequences. Type 2 diabetes usually appears later in life, often between the ages of 35-45 years. As it often develops slowly, many people may not recognize the symptoms, so it The toll remains undetected and untreated for a Diabetes kills more than 182,000 Americans each year and is the country's second most-costly disease, behind mental health. High-risk groups include African-Americans over 45 who are overweight, who rarely exercise and who have a family history of the disease. Warning signs of diabetes include excessive thirst, frequent urination, extreme hunger, irritability, unexplained weight loss, tingling in fingers or toes, nausea, fatigue and vomiting. In addition, people with diabetes also run a higher than average risk of developing atherosclerosis. In this condition, the blood vessels to their legs become narrowed, which cause cramps, cold feet, pain upon walking and climbing stairs, and even skin ulcers and gangrene. Peripheral neuropathy, chronic kidney failure and diabetic retinopathy are possible complications that are treatable and preventable with good glucose control. Source: Diabetes Mellitus Manila Bulletin, July very long time. Chin Up! Many people have diabetes without knowing it, and are at a greater risk of long term medical complications. At least, you now know it. So, if knowledge is power, you can now do something to alter your condition. 14, 2005. Ladies Only – Gestational Diabetes The third type of diabetes, Gestational Diabetes is only reported in pregnant women. In this condition, a woman’s blood sugar is always higher than normal because some other hormones produced by the body during pregnancy begin to interfere with the insulin that is being produced naturally. Gestational Diabetes usually becomes apparent during the 24th to 28th week of pregnancy, and, in most cases, disappears of its own accord after the baby is born. Women with gestational diabetes usually do NOT have an increased risk of having a baby with birth defects. However there can be some complications caused by gestational diabetes, although nothing so serious that they cannot be managed with careful attention to nutrition and blood sugar levels. Secondary Diabetes "Secondary" Diabetes refers to elevated blood sugar levels caused by another medical condition. Secondary diabetes for instance may develop when the pancreatic tissue responsible for the production of insulin gets destroyed by disease, such as chronic inflammation of the pancreas or by toxins released by the consumption of excessive alcohol, trauma, or after surgical removal of the pancreas. Diabetes can also result from hormonal disturbances, such as excessive growth hormone production and Cushing's syndrome. It can also be a result of damage to the pancreas caused by chronic over-indulgence in alcohol (Please refer to our special section on Alcohol and Diabetes for more information on this subject). Finally, certain medications may worsen diabetes control, or "unmask" latent Diabetes. This is observed most commonly in patients on steroid-based medications (such as prednisone) or those taking drugs for the treatment of HIV infection (AIDS). With so many factors contributing to the development of diabetes, and considering the chronic, long-term health threat that this disease poses, it’s never too soon to start making healthy adjustments in our lives. And that’s exactly why you purchased this book! Who Gets Diabetes and Why? A nyone, anywhere, at any age can develop diabetes. Often, it takes several years for diabetes to be detected in a person, usually when they have already developed some complication, such as visual impairment, kidney failure, heart disease, stroke or nerve damage. In the underdeveloped part of the world, people with diabetes are not diagnosed at all; consequently, mortality from diabetes-related complications is extremely high in these countries. This is tragic, because diabetes for most part is a manageable disease. The Basics of Diabetes In medical terminology, insufficient WARNING SIGNS production of insulin or the inability of See your doctor if you are suffering from these symptoms which can indicate diabetes, because early treatment is extremely vital for an effective diabetes control and management program: cells to use insulin effectively is called hyperglycemia that eventually leads to diabetes. This latter condition affects mostly the cells of muscle and fat tissues, and results in a condition known • Increased thirst and fatigue • The need to visit the loo all the time, especially at night • Sudden weight loss or gain • Blurred vision as "insulin resistance." This is a primary problem in Type 2 Diabetes. Glucose is a simple sugar found in food. It’s an essential nutrient that provides energy. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. This abundant, unutilized glucose later gets wastefully excreted through urine. Insulin is a hormone that is produced by beta cells of the pancreas. Since it helps in the cell absorption of glucose, it regulates the level of glucose present in the blood. After a meal, the blood glucose level rises naturally. In response to this increased glucose level, the pancreas automatically release more insulin into the bloodstream to help glucose enter the cells and lower the high glucose level in the blood after a meal. After this level falls to normal again, insulin release from the pancreas automatically gets switched off, once again. Risk Factors In case of Type 1 diabetes, the risk factors are mostly out of our control. However in Type 2 diabetes, there are some choices that we can make --- relating to lifestyle and dietary management --- that can reduce the likelihood of developing this disease. ARE YOU AT RISK? Experts recommend regular diabetes screening if you have TWO or more of the following Type 2 risk factors: Risk Factors for Type 1 • Diabetes: These are mainly genetic and • environmental triggers, such as: • Family History – If a member of our immediate family (parent or sibling) has Type 1 diabetes, there is • • • You are white and aged 40+, or Asian/Afro-Caribbean aged 25+ • Your mother, father or sibling had/has diabetes You are overweight (BMI over 25) • You do not exercise You have heart disease, circulation problems or high blood pressure You had diabetes during pregnancy You have polycystic ovary syndrome and are obese • You have been diagnosed with impaired glucose tolerance or impaired fasting glycaemia greater likelihood of us (or our child) having it, too. • Autoimmune Conditions - Type 1 diabetes is generally an autoimmune disease, i.e., it is caused by the body's immune system attacking its own insulin-producing cells in the pancreas. Auto-immune diseases that trigger this condition are Addison's disease, Celiac disease, Grave's disease, Hashimoto's disease, and Pernicious anemia. • Birth and Early Childhood –Being born to an older mother or a mother with pre-eclampsia during pregnancy could be predisposing factors, but more research needs to be done to establish this correlation. There is also some disagreement over whether cow’s milk, fed to infants in the first 6-8 months of their life increases their risk of developing Type I diabetes. • Ethnic Background – It’s been discovered that people of northern European or Mediterranean ancestry are at a higher risk of developing Type 1 Diabetes. Risk Factors for Type 2 Diabetes: • Age - 90-95% of people with diabetes are of Type 2 variety and the risk of developing this disease increase as you age. • Obesity - Over 80 % of people with Type 2 diabetes have been found to be overweight. The greater the obesity, the higher the risk. • Family History – Heredity link has been proved in numerous research papers. Again, the closer our link with the member of the family who has diabetes, the greater our chances of developing it ourselves. Newly-Discovered Scientists have discovered many new genes that appear to increase the risk for developing Type 2 diabetes. Understanding how these genes contribute to the disorder may lead to new strategies for prevention and treatment. These studies have appeared in the April 26, 2007 online editions of Nature Genetics and Science and some of their major conclusions are discussed below: • Physical inactivity - The less exercise we do, the greater our chances of developing diabetes. • Impaired glucose tolerance (IGT) - Impaired glucose tolerance is a level of blood glucose which is higher than normal, but not high enough to be in the range where doctors can classify this condition as diabetes. It does, however, put the body at risk for developing full-blown diabetes, later in life. • Race/ethnicity - Although little research has been done outside of the U.S., American studies show that African-Americans, Hispanic Americans, Native Americans, and Pacific Islanders are at a higher risk of developing diabetes. While the risk for Type 2 Diabetes is higher among Asian-Americans, the risk is lower among Asians (including Japanese, Chinese, and Koreans) and Mexicans. Celebrity Diabetics D iabetes makes no distinction between rich and poor, and stars such as Halle Berry, Larry King, Patti LeBelle, Sharon Stone, and Elizabeth Taylor are well-known cases of celebrity diabetes. They do not, however, allow it to have a negative impact their professional or personal lives. The implications of not controlling diabetes on the other hand can also be serious as in the premature death of music legend Johnny Cash. Most celebrities however are learning that the best way to fight chronic disease and go on to live long and happy lives by following a healthy lifestyle pattern. Symptoms of Diabetes E arly Diabetes symptoms can be subtle or appear to be harmless…- or we may not experience symptoms at all. So pay close attention to them for early detection: Excessive thirst and increased urination - Excessive thirst and increased urination are classic Diabetes symptoms. When we have Symptoms of Diabetes Mellitus Diabetes, excess sugar (glucose) builds up in our Increased thirst blood. Our kidneys are forced to work overtime to Increased urination filter and absorb the excess sugar. If our kidneys can't keep up, the excess sugar is excreted into our urine along with fluids drawn from our tissues. This triggers frequent urination, which may leave us dehydrated. As we drink more fluids to quench our thirst, we’ll urinate even more. • Weight loss even though the individual is eating more Fatigue, nausea, and vomiting Skin infections, blurred vision, bladder infections Impotence in men and cessation of menses in women Flu-like feeling - Sometimes diabetes symptoms resemble a flu-like illnesses. We may notice fatigue, weakness and loss of appetite. That's because poorlycontrolled Diabetes hampers our body's ability to use sugar for energy. Instead of fueling our cells, the sugar remains in the blood. This leaves us feeling tired and run down. • Weight loss - When we lose sugar through frequent urination, we also lose calories --- creating a feeling of persistent hunger. The combined effect is potentially rapid weight loss, especially with Type 2 diabetes. • Weight gain - Excess weight can make the tissues more resistant to the action of insulin, which increases blood sugar levels. The more fatty tissue present, the more resistant cells become. This is why obesity is a prime risk factor in developing Type 2 diabetes. • Blurred vision - High levels of blood sugar pull fluid from Other problems associated with diabetes affect our ability to focus. Gum Diseases: People with diabetes are at significantly higher risk for severe gum disease. Research indicates that good diabetes management will slow down the progression of gum disease and that blood sugar levels are more easily controlled if periodontal disease is treated1. Left untreated, diabetes can Vision-related problems cause new blood vessels to Many people with diabetes are at risk of unnecessary blindness because they are not receiving regular eye screening, according to a new report by the charity Diabetes UK1 Patients with long-term diabetes are at risk of retinopathy - a disease of the eye which is the leading cause of blindness in working age people across the world. Yet a survey of more than 1,000 diabetes patients in the UK found that 41 per cent were either not receiving regular screening for the condition or were not being screened using a digital camera as recommended by experts. the tissues, including the lenses of the eyes. This can form in the retina as well as damage old vessels. For most people this can cause mild vision problems, such as dark spots, flashing lights or rings around these lights. But for others, these symptoms can be more serious. In rare cases, diabetes can also lead Athletes foot Problems with circulation, open sores or ulcers on your feet or oozing or weeping around your toes, is a good indication of diabetes. Vaginal thrush The presence of untreated diabetes mellitus can help the fungi that cause thrush to flourish. to partial or complete blindness. • Slow-healing sores or frequent infections - High levels of blood sugar impair the body's natural healing process and the ability to fight infections. For women, bladder and vaginal infections are common. • A tingling sensation in hands and feet - Excess sugar in the blood can also lead to nerve damage. Tingling and loss of sensation in the hands and feet, as well as burning pain in the arms, hands, legs and feet. • Red, swollen, tender gums - Diabetes may weaken our ability to fight germs, which increases the risk of gum infection and in bones that hold our teeth in place. The gums may pull away from the teeth, causing them to become loose, or we may develop sores or pockets of pus in the gums - especially if we have a gum infection before diabetes develops. One severe symptom of diabetes is Diabetic Ketoacidosis. This symptom sometimes produces slightly sweet-smelling breath that is caused by acetone, a metabolic byproduct, when the body is forced to burn fatty acids rather than glucose. This process becomes more and more toxic to the body as it continues; the individual may develop diabetic coma and die. Ketoacidosis occurs when individuals are either not getting enough insulin or the insulin is not adequate to allow cells of the body to utilize the glucose. Another severe symptom of unregulated diabetes is Hypoglycemic Coma (insulin shock). This condition is usually brought about by too much insulin. A hypoglycemic reaction causes trembling, weakness or drowsiness, and headache, dizziness, confusion, double vision, and difficulty in coordination. Eventually, convulsions or unconsciousness can follow. Listen to Your Body! If you notice any possible diabetes symptoms, our advice is contact your doctor, immediately. The earlier the condition is diagnosed, the sooner the treatment can start. Diabetes is a serious condition. But with active participation and the support of a health care team and family, we can manage diabetes while continuing to enjoying an active, healthy life. Diagnosing Diabetes The disease can be detected through a routine blood test. New recommendations suggest all adults 45 years of age and older be tested for diabetes every three years. For higherrisk African-Americans, it is suggested that testing begin at a younger age and be given more frequently. The most common test for diabetes is the fasting blood glucose (sugar) test. It is easy to perform and convenient. After the person has fasted overnight (at least 8 hours), a single sample of blood is drawn and sent to the laboratory for analysis. This can also be done accurately in a doctor’s clinic using a glucose meter. A random blood glucose test can also be used to diagnose diabetes. A blood glucose level of 200 mg/dl or higher indicates diabetes. The Oral Glucose Tolerance Test (OGTT) is another gold standard for testing diabetes. For an OGTT also, the person has to fast overnight. After this test, he or she is administered 75 grams of glucose (100 grams for pregnant women). The OGTT measures blood glucose levels five times over a period of three hours. In a person without diabetes, the glucose levels rises and then falls quickly. In someone with diabetes, it rises higher than normal and fails to come down to normal as fast. Another requirement for this test is that the person must be in good health, i.e., without illness or cold. Also, he/she should be active (not lying down, for example, as an inpatient in a hospital) and should not be taking medicines that could interfere with his/her blood glucose level. Again, for three days before the test, the person should have eaten a diet high in carbohydrates (150- 200 grams per day). The morning of the test, it is recommended that he/she not smoke or drink coffee. Test Results and What They Imply Test results may lead to one of the following diagnoses: • Normal response: when the 2-hour glucose level is less than 140 mg/dl, and all values between 0 and 2 hours are less than 200 mg/dl. • Impaired glucose tolerance: when the fasting plasma glucose is less than 126 mg/dl and the 2-hour glucose level is between 140 and 199 mg/dl. • Diabetes: when two diagnostic tests done on different days show that the blood glucose level is high. • Gestational Diabetes: a 100g OGTT, a fasting plasma glucose of more than 95 mg/dl, or a 1-hour glucose level of more than 180 mg/dl, or a 2-hour glucose level of more than 155 mg/dl, or a 3-hour glucose level of more than 140 mg/dl. Treatment and Management No cure has yet been found for diabetes mellitus. There is no question that type I diabetic requires insulin. Insulin preparations have been used in the treatment of diabetes since 1922. Since insulin is not absorbed orally, it must be injected. Your physician will show you how to use a syringe to inject the insulin just under the skin of your thigh, arm or abdomen. As for Type II diabetes, diet alone is enough to cure diabetes mellitus in many cases. The main objective of diet control is to restrict the amount of carbohydrates we eat at one meal. When type II diabetes cannot be controlled satisfactorily with diet therapy, medical doctors recommend drugs known as oral hypoglycemic agents. They appear to stimulate the secretion of insulin by the pancreas as well as enhance the sensitivity of body tissues to insulin. Diabetes Management People who are at-risk can reduce their chances of getting diabetes by eating a low-fat diet, exercising regularly, controlling their weight and taking natural suppliments. The same applies to those who have been diagnosed with the disease and want to control it. In fact, regular exercise is crucial to the management of diabetes and can help keep the disease at bay forever, doctors say. Increased physical activity can help reduce the amount of insulin or oral medication to reduce the risk of cardiovascular disease and control weight gain. In addition, exercise can improve self-esteem and counteract the emotional blues of having a chronic disease. But experts recommend consulting with a doctor before any life style changes. Fact is that people who best adapt to their diabetic condition are the ones who are able to adapt their lifestyle. It starts by regular doctor visits to monitor the body's ability to make insulin, decreasing the amount of glucose the liver makes, slowing down how quickly glucose gets into the bloodstream or working on the cells' ability to use insulin. Doctors stress that while a good relationship between a patient and his or her consisting "diabetes of a team"-- primary-care FOUR WAYS TO TAKE CONTROL OF YOUR DIABETES • • physician, eye doctor, nurse and dietitian--is critical, the most • • Learn about diabetes Know your ABCs, wherein A stands for levels of blood glucose or sugar, B for blood pressure and C for cholesterol Manage your diabetes Get routine check up and care important thing for diabetics to understand is that much of their health is in their hands. It is important that we assume the responsibility for our care, which includes diet and weight control, checking urine for sugar, exercising appropriately, regular comprehensive medical check-ups and living as naturally as possible with the natural gifts that are on our earth. This is something Gladys Knight understands. The Grammy Award-winning entertainer lost her mother a little more than a year ago from complications of the deadly disease, and has a brother and cousin who have also been diagnosed with diabetes. "My mother lived with diabetes for many years. But for her, and our family, education was the key to her living successfully with this disease," Knight says. "And because she had all the available facts about this disease, she was able to live a long and productive life." You, Your Partner and Diabetes “I have had diabetes for many years and have now become impotent as a result of the complications of the disease. I've tried everything, but nothing seems to help. I'm really worried that my marriage is going to fall apart.” ----- Anonymous D Id you know that erectile problems in men and orgasm difficulties in women affect nearly 20% of diabetics. In fact, there is no gender discrimination in diabetes. Researchers recently conducted the largest study ever on the sex lives of women with diabetes and found that 27% women versus 15% men, reported sexual dysfunction. The good news however, is these problems are often caused by psychological rather than pure physiological factors. Often, women with sexual dysfunction tended to be frustrated with their diabetes treatment, which lead them to depression and this eventually begins to reflect on their sexual lives. Here is what experts have to say about maintaining a normal and happy sexual relationship, despite diabetes. To begin with, seek medical assistance the minute you suspect a problem and get a complete checkup. According to Detroit urologist Isaac J. Powell, a thorough examination would include a heart scan and tests for Sexually Transmitted Diseases (STDs), besides diabetes and hypertension. If undetected, the physical ramifications can range from chronic discomfort to sterilization or death. In this context, Dr. Powell says, "Hypertension causes blood vessels that go into the prostate to have decreased blood flow because of a plaque that builds on the vessels. This causes an obstruction that interferes with the man's ability to get an erection." To maintain an erection, three systems have to be working in sync: production of the hormone testosterone, blood vessels that are flexible and open, and nerves that transmit the electrical messages from the penis to the brain, must also be in order. Often with diabetes erections may occur but be less reliable, and then the associated worry about whether the erection will last leads to a cycle of anxiety about performance. What starts off as a physical problem gets compounded by the emotional reactions to it which are often overwhelming. As a preventive measure, young men between the ages of 15-35 should be screened for testicular cancer (the so-called "young man's cancer"), and men who are 40 and older should investigate the condition of their prostate. It has been recorded that prostate cancer strikes more African-American men than any other group, and the irregular urination and painful ejaculation associated with the disease can adversely affect your life. Women likewise, should go through regular breast examinations and pap smears. It is critical to fully disclose all health concerns to the doctor. Here are a few suggestions that he or she may make: Nonsurgical Options • Intrapenile injection is recommended if a physical cause of the problem is found. This gives good erection that lasts for about 30 minutes. Although men often shudder at the thought of getting this shot, they do feel relieved after their performance improves. • Another treatment option is the vacuum device. It’s a plastic cylinder fitted with a pump. This is placed over the penis, which fills with blood "passively," and an elastic band is then slipped off the cylinder onto the penis to create a workable erection. Although somewhat cumbersome, this device can be an effective nonsurgical approach for men who do not want to go under the knife. • Penile Implant: It is another mechanical device that is surgically placed in the shaft of the penis. There are several different types, but the most commonly used has a small pump located in the scrotum that allows the implant to be inflated when needed. When an erection is desired, one has to squeeze on the scrotum. Most users say it is quite effective and not as strange as it sounds. Approximately 90% of men with implants report being satisfied. At this point, 25,000 are inserted each year. And if you have a caring partner, you both will be happy with the renewed sexual contact. But before you go in for this procedure, you should also know its disadvantages: • First, the procedure is not reversible. The implant can be removed, but a natural erection will never again be possible. • If the pump fails, another will have to be put in. • It’s difficult for some men to accept the notion of something "foreign" inside their penis. It would thus be a good idea to speak to a few couples who have gone through the procedure before opting for it. Feel free to ask how it works, how it looks and feels, and whether there are any surprises. A Word of Caution: At times diabetes may make the blood supply so bad that surgery gets completely ruled out. There may interfere with the healing process or infections and tissue damage in the penis after healing may make it necessary to remove the implant. Therefore, it’s extremely important to carefully discuss all the “ifs and buts” with your physician and do a cost-benefit analysis. Fighting it With Drugs Viagra and other medically-approved drugs can be an option. Contrary to popular belief, youth alone won’t protect from impotence. Many younger men are affected by erectile dysfunction due to nicotine and alcohol abuse in addition to health problems such (inflamed prostate as prostatitis gland) and clogged arteries caused by high cholesterol, according to Dr. Powell. Men who have a history of heart problems or who have suffered a recent heart attack are not considered good candidates for Viagra. So consult your physician and don’t go for self-medication. Also, remember, never, ever to use someone else's prescribed medication. Women-friendly If nearing menopause, hormone-replacement therapy can be sought. The symptoms of menopause may range from uncomfortable to unhealthy –– night sweats, hot flashes, painful sex and loss of libido. The hormone estrogen has been proven to protect women from cardiovascular disease and osteoporosis. It may be a good idea to treat menopausal symptoms with hormone-replacement therapy and a proper diet. Physicians can determine the best treatment plan for each of us. Vitamins Help Vitamins are organic substances should be added to our regular diet. Even the healthiest of meals cannot provide all of the 45-plus nutrients that are needed. Marginal deficiencies of one or more nutrients can interfere with good health. The two vitamins that can be effective in this regard are: Vitamin B1 and E. Vitamin B1 converts sugar and starches into energy and Vitamin E is believed to increase fertility in some men. Carefully choose a vitamin regimen that best suits your needs. Zinc stabilizes (or, in some cases, increases) the testosterone level, which fuels the sex drive in both men and women. Ten Commandments for Revving up your sex life 1. Get physical 2. Exercise regularly 3. De-stress and relax 4. Beat the clock 5. Combat impotence 6. Take your vitamins 7. Eat to live and love 8. Avoid nicotine 9. Don't drink in excess 10. Get enough sleep Eat Healthy, Live Hearty It’s a well-acknowledged fact! Experts at the U.S. Department of Agriculture have found that the mineral Boron is vital for hormone production and sexual function. Boron is found in dark green leafy vegetables, fruits (not citrus), nuts and legumes. The Centers for Disease Control and Prevention (CDC) meanwhile suggests that adults eat a healthy breakfast, drink 100 percent fruit juice and load their diets with fruits and vegetables. We can also make meal preparation a romantic twist by doing it together –– it will not only boost energy, but for many, the act of food preparation itself can be a bonding experience. Quit Smoking, Alcohol According to a recent study at the New England Research Institute in Watertown, Mass., importance is more likely to strike men who smoke. Other research has linked nicotine to constricting the arteries and blood vessels –– including those that are responsible for a man's erection. In women, nicotine can interfere with a woman's ability to achieve an orgasm, and may reduce fertility, and trigger early menopause. In addition, our drinking habits can also lead to a range of serious problems, including an enlarged liver, yellow jaundice, cirrhosis, hepatitis, emphysema, arthritis, osteoporosis and stomach ulcers, according to the National Institutes of Health (NIH). NIH data maintains that an occasional glass of wine or liquor can be good for the constitution and may help prevent certain forms of heart disease. Even postmenopausal women have been shown to benefit from an increased level of estrogen stimulated by wine. And, of course, wine has been known to stimulate the mood as well. But remember, too much of a good thing can have the opposite effect. Exercise Regularly The Harvard School of Public Health reports men who are physically inactive are 40 percent more likely to experience erectile dysfunction than men who exercise half an hour a day. According to Terry Mason, chief urologist at Chicago-based Mercy Hospital, working out will not only make us look and feel better, it will also increase our stamina and level of control. "An enhanced body as a result of exercise provides visual stimulation. Everybody wants somebody who visually turns them on," Dr. Mason explains. "Secondly, cardiovascular exercise increases endurance, and that can be a paramount issue in being able to have the level of intensity that the couple would like to have." Learn to Relax Daily stress can erode our health and love life. Learn to de-stress together at the end of the day in more romantic ways, such as enjoying a lathery bubble bath for two, complete with scented candles and a mug of warm milk and honey. Or just watch a movie together. Spend quality time together. If you are adventurous, try sailing, bike riding, walking marathons or roller-blading. Try and catch eight hours of sleep, minimum. Getting adequate sleep is essential to maintaining good health and reducing stress. If you have difficulty in sleeping, then redecorate the bedroom to suit both of you comfortably or stock your nightstand with good reading materials. We can also try some exercise and eat dinner a little earlier in the evening. Insomnia will, however, need medical help. Common Medications Prescribed in Diabetes I f a person is not able to achieve normal blood sugar control through diet and exercise, the doctor may Common Oral Medications recommend oral medications to improve insulin production, lower insulin resistance as well as improve the blood sugar levels in the body. Oral medications complement other lifestyle Sulfonylureas - Amaryl, Chlorpropamide, Diabinese, Tolazamide, Tolinase, Acetohexamide, Glipizide, Glucotrol, Tolbutamide Orinase, Glimepiride, Glyburide (DiaBeta, Micronase), Glibenclamide, Meglitinides - Prandin (Repaglinide), Starlix (Nateglinide), and Mitiglinide habits that support healthy living with diabetes. However, these medications cannot be regarded as a substitute for healthy eating and exercise. There are several oral medications that stimulate insulin secretion. The most common is Biguanides - Other names include Metformin and Glucophage. Thiazolidinedione - Other names inlcude Rosiglitazone, Avandia, Pioglitazone and Actos. Alpha-Glucosidase Inhibitors - Other names include Acarbose, Precose, Glucobay, Miglitol and Glyset sulfonylureas group of medication. What type gets prescribed will depend on age and medical history. Other oral medications work more indirectly, for instance, they help in sensitizing the body to insulin through their effects on other body organs. Biguanides, also known as metformin for instance can inhibit glucose production in the liver. This causes insulin receptors to become more responsive or sensitive to insulin. Insulin sensitizers increase insulin action, without increasing insulin secretion, i.e., it makes it more potent, thereby increasing the risk of high sugar retention in the blood. Another type of medication slows carbohydrate digestion from the stomach. These are called Alpha-glucosidase inhibitors. They block the digestion of carbohydrates, which then delays the release of sugar into the bloodstream. These medications are usually prescribed with a meal to lower blood sugar levels after a meal. Sometimes, this group of medication is prescribed in combination with sulfonylureas or insulin therapy. Remember just because your doctor prescribed it for you DOES not mean it is healthy for you. A drug is a drug for reason… it is an unnatural substance for your body. The Downside of These Chemical Compositions T he biggest drawback with conventional Allopathic medicines --- one that the doctors don’t warn us about --- are the many unintended side effects they cause. Fortunately there are more natural ways to protect us from the cumulative effects of uncontrolled diabetes without experiencing these unpleasant side effects or inviting these health-threatening risks. Among the most common reactions to diabetes medication are skin rashes and muscle aches. People taking certain medications may also experience loss of appetite or a metallic taste in the mouth. Other common effects of oral medication include bloating, gas, diarrhea, nausea or vomiting. Following is a list of side effects of: Sulfonylurea medicine: • Hypoglycemia (low blood glucose) • Upset stomach • Skin rash or itching • Weight gain Biguanide medications: • Upset stomach (nausea, diarrhea) • Metallic taste in mouth Thiazolidinediones • Elevated liver enzymes • Liver failure • Respiratory infection • Fluid retention Alpha-glucosidase inhibitors: • Gas • Cramps and diarrhea • Nausea Meglitinides: • Low blood sugar • Upset stomach Many side effects pass over time. However, low blood sugar is a serious side effect that is more common when taking new medications or when combining oral medications. In addition people who have history of heart, kidney or liver disease need to weigh the risks of oral medication for Diabetes as well as the possibility of interactions with other medications. To better understand the full range of medication side effects talk with your doctor about your family health history. Alternative Medicine Conventional medical system has often been flawed for its limited role in suppressing symptoms and overtaking the role of the body's natural immune responses. It’s charged that the American Medical Association (AMA) has colluded with the multibillion dollar pharmaceutical industry to promote Allopathic medicine, even when it is known and acknowledged the world over that for some debilitating diseases, such as diabetes and cancer, natural care is often the best. Perhaps the only area where modern medicine has proved its utility is in surgery, emergency and trauma management. In all other diseases management areas, Alternative Medicine has proven to be more effective and cost-effective especially for diseases like cancer, heart disease, rheumatoid arthritis, asthma, gastrointestinal disorders, headaches, sinusitis, etc. Alternative methods work by assisting your body to heal itself instead of introducing strong drugs into your system. They emphasize prevention over cure and address the root cause of the disease rather than just provide temporary symptomatic relief. Two Medicines Are Better Than One The Chinese have an old adage according to which "walking on both feet," is better than walking on one. In our present discussion, it would imply that a combination of Eastern and Western medical systems can produce better results than a single procedure. Many practitioners of alternate medicine do just that. Since there may be many underlying factors influencing our health -- poor digestion, nutritional deficiency, toxicity, emotional stress, etc – holistic healthcare along with the use of modern medicine’s hi-tech, scientific diagnostic tools can be very effective in diabetes management. Unfortunately, a conventional doctor who has 20 patients with diabetes will often provide each of them with the same protocol, thus treating the condition and not the patients individually. An alternative practitioner in contrast realizes that diabetes can have many causes. He or she will try to identify each of these causes and treat them individually and differently. This difference between these two approaches is the cornerstone of alternative medicine. Become Your Own Healthcare Provider Doctors today agree that the "cut, burn and poison" approach to disease completely ignores the role of our natural defense mechanism, i.e., our immunological system. In fact, many invasive procedures and chemical protocols weaken the immune system that is already under assault from the disease producing germs and microbes. A doctor can’t cure diabetes! The cure eventually comes from our own immune systems. The doctor's job is merely to provide all the requisite tools and conditions that would make the job of our stressed out immunological system a wee bit easier. So ultimately, it’s our job to preserve our health! Fighting Type 1 Diabetes, Naturally Because of its very nature, Type 1 diabetes does require regular blood sugar tests and medical intervention. But in addition to a traditional medical protocol, we can pursue a number of natural health and wellness steps that can support those efforts: • Try chromium therapy: Under the strict supervision of a doctor, take 200 mcg a day of this essential trace mineral to improve glucose tolerance • Fight back with fiber: Stabilize blood sugar by drawing fiber from whole grains, beans (legumes), vegetables, and fruit. • Protect yourself with alpha lipoic acid: We can protect ourselves against several diabetic complications, such as nerve and kidney damage, by consuming 600 to 1,200 mg of this supplement per day • Discover EPO: Help relieve pain from diabetic neuropathy by taking 4 grams of evening primrose oil supplements per day Please Note: These recommendations are not comprehensive and these are not intended to replace the advice of your doctor or pharmacist. Fighting Type 2 Diabetes, Naturally T he glycemic index system for rating carbs can actually help you beat diabetes, heart attacks, an appetite that's out of control, and more. It can offer dramatic health benefits not just for diabetics, but for almost everyone. Invented in the early 1980s by University of Toronto researchers as a tool to help control diabetes, the glycemic index ranks carbohydrate foods by their effect on your blood sugar levels. From the Research Lab A 1999 Swedish study of Type 2 Diabetes found that 4 weeks on a low-GI diet lowered blood glucose and insulin by 30% compared to a high-GI diet. In a 4-month study led by the University of Toronto's Thomas Wolever, MD, a low-GI diet markedly improved insulin sensitivity in a group of pre-diabetic insulin-resistant people. In a 6-year study of male health professionals, men eating the lowest-GI diets were 25% less likely to get Diabetes. In the Nurses' Health Study, the most powerful diabetes protection--a drop in risk of one-third or more--came from eating a low-GI diet and getting lots of fiber from cereal (7.5 g daily). The Good, Better, and Best of Carbs The type of carbs we eat can make a positive difference on our health and the glycemic index helps us choose the best carbs for us. This index can be used to choose meals and snacks that give us an edge against diabetes, heart attacks, and possibly even cancer. And don't be surprised if you find yourself losing weight to boot! The glycemic index (or GI, for short) assigns carbohydrate-containing foods a number based on how they affect blood sugar, or blood glucose. Low-GI carbs are healthy; highGI carbs are not. • Foods with a GI less than 55 cause only a little blip in blood sugar. • Foods with a GI of 55 to 70 produce a slight rise in blood sugar • Foods with a GI of more than 70 send blood sugar soaring. No matter what form the carb takes initially ---the lactose in a milk, the starch in a bowl of whole-grain cereal, the sucrose in table sugar --- eventually, the body has to break it down to glucose. Glucose winds up in the bloodstream, fueling the cells. What makes a GI number high or low is how quickly the food breaks down during digestion. The longer our bodies have to wrestle with the carb to break it down into glucose, the slower the rise in blood glucose and the lower the GI. The High Risk of a High GI The problem with eating lots of high-GI foods is this: When blood sugar soars, so does the hormone insulin. Insulin's main duty is to scoop up excess blood sugar and store it safely in muscle tissue. In moderation, insulin is a good guy, but it becomes a killer when its levels spike repeatedly, triggering diabetes, heart disease, and possibly cancer. The bad news is that insulin is spiking all the time in people who consume high-GI fare such as bagels, doughnuts, french fries, and other quickly absorbed starchy carbohydrates. Experts point out that our modern diets offer vastly more opportunity to eat starchy high-GI foods than the diets on which our race evolved. Food and Diabetes Fortunately, diabetes experts no longer recommend a single diet for all people with diabetes. Instead, they advocate dietary regimes that are flexible and take into account a person's lifestyle and particular health needs. Would you believe that ancient Egyptians consumed nothing stronger than cabbage to combat 87 deadly diseases while onion was good enough for curbing another 28! They didn’t have an aspirin or tylenol to depend on. Nor, did they have an agency like ADA in those days. Today, because, there are so many authorities on health, each working at a cross-purpose, there seems to be no agreement on what constitutes good health. The result… that there are more myths than truths about treatment for various diseases. Take for instance ADA’s latest diet recommendation for diabetics. The new guidelines relax restrictions on sugar rich foods. This is not surprising considering that the ADA, which relies mainly on donations to fund its efforts, accepted more than $23 million dollars from food manufacturers and drug companies in 2005. The charity even licenses its logo to various food companies for use on diet or low-sugar products in exchange for sponsorship money, according to Jessica Fraser’s report on News Target (http://www.newstarget.com/021183.html) The ADA's advice to diabetics is that they can keep eating all the ice cream, sweets and soft drinks they want, as long as they control their blood sugar with pharmaceuticals, which is not just absurd, but potentially dangerous. Meanwhile, national surveys continue to demonstrate that the lack of Recommended Daily Amounts (RDA) of nutrients in our diets and increased intake of sugar-rich food is the leading cause of degenerative diseases, including diabetes. My research shows that the prevalence of degenerative diseases ---- or what are more commonly known as lifestyle diseases ---- are almost absent in aboriginal societies. The diseases include coronary heart diseases, high blood pressure, degenerated disc, osteoarthritis, appendicitis, gallstone, diabetes, obesity, strokes, hemorrhoids, hiatal hernia, dental caries, rectal polyps, varicose veins, cancer of colon, ovarian or breast cancer. The interesting fact here is that lifestyle (especially eating habits) has been attested to being the biggest factor contributing to this wide scale difference. The aboriginal studies found that the Greenland Eskimos have a diet that was much higher in good fat (i.e. fish) and low in refined sugary carbohydrates, compared to that of the modern societies, primarily sugar rich and low nutrient fast food. This is the reason I have dubbed ADA’s new guidelines as the biggest diet deception in the medical world! It promotes sugar as safe whereas, anyone with the slightest bit of medical knowledge of the disease would tell you that exactly the reverse is true for diabetics. Fungus and Mushrooms The Japanese maitake mushroom (Grifola frondisa) contains beta-glucan that some believe can fight cancer and improve the health of people suffering from HW, diabetes, high blood pressure and high cholesterol and obesity. However because so little is actually known about the medicinal properties of fungi, it’s best not to try anything that has not been scientifically tested. One of the leading experts implicating fungi is Dr. A. V. Costantini, M.D., the former head of the World Health Organization’s (WHO) Collaborating Center for Mycotoxins in Food. He was also a former pulmonologist and clinical professor at the University of California at San Francisco’s School of Medicine. Dr. Costantini and his colleagues spent 20 years studying how fungi may cause some of the world’s most horrific diseases. According to these experts: • Corn harbors a number of fungi that produce mycotoxins that specifically harm the pancreas. The harmful substances in corn that can destroy pancreas are fumonisin, T-2 mycotoxin and diacetoxyscirpenol. In Latin America where corn is a staple, these mycotoxins are in fact suspected to be causing the current burst of a diabetes epidemic. • The commercial antibiotic streptozotocin is a mycotoxin produced by the soil fungus Streptomyces achromogenes. The U.S. Dept. of Health and Human Services in its “Ninth Report on Carcinogens” has found evidence that this antibiotic promotes kidney and pancreatic islet cell tumors in laboratory rats. Many, many antibiotics such as penicillin are also mycotoxins. • Uric acid is a normal constituent of urine, but when fungi excrete uric acid they produce alloxan as well — which is known to initiate diabetes in laboratory animals. • A fungus called Aspergilus niger often contaminates peanuts and corn. At times it produces oxalic acid in large quantities that may cause death by blocking our body cells ability to convert carbohydrates into usable energy. At a lower concentration, oxalic acid escalates blood sugars, leading to diabetes. The Deadly Link Between Grains, Sugar and Mycotoxins Did you know that sugar is the primary food of fungi? This makes the carbohydrates in all grains such as corn, wheat, and rice among their most cherished foods. Incidentally, we ingest mycotoxins in meats and dairy products when mold-infested grains are feed to cattle. While cooking kills them, their mycotoxins are virtually heat-resistant. In addition, these poisons are highly fat-soluble so they may abound in foods such as the fat in grainfed meats. Wait there is more…. The most dangerous carcinogenic substance on earth is alfatoxin, excreted by the fungus Aspergilus. It’s so harmful that it’s the only mycotoxin screened by the USDA. It’s considered to be 100 times more able to cause cancer than the industrial pollutant PCB. Alfatoxin was brought to the attention of the public in 1988. That summer, the US corn crop grown on mineral poor soil and further weakened by a severe drought could not withstand a heavy infestation of Aspergilus. A Matter of Fat D id you know that eating out at fast-food restaurants more than twice a week dramatically increases the risk of diabetes? These are the disconcerting findings of a team of U.S.-based researchers who have a strong link between not just fast food and obesity; but also fast food and diabetes. What’s worse, they also found that fast food increases Insulin resistance in your body. According to study done by Dr. David Ludwig of the Children's Hospital. An epidemic of obesity has coincided with the rapid expansion of fast-food outlets. It helps to explain why more than half of adults in England are officially overweight. Around 23% women and 22% men are obese compared with 8% women and 6% men in the 1980s. What’s even worse, obesity has been found to cut life expectancy by an average nine years while increasing the risk of heart disease, strokes and some cancers. And an alarming figure of 30,000 deaths a year is blamed on obesity! Fat and Diabetes For several years scientists have known that fatty diets, obesity and Type 2 diabetes are linked, but they were not able to explain why until researchers at the University of California at San Diego came up with the answer. The reason is that a particular enzyme, Gnt-4a glycosyltransferase (Gnt-4a), which is vital to the production of Insulin is suppressed by fatty foods. The enzyme plays a key role in enabling pancreatic cells to sense blood glucose levels and produce appropriate levels of Insulin. Professor Jamey Marth, who led the research, said, “We have discovered a mechanistic explanation for beta cell failure in response to a high-fat diet and obesity, a molecular trigger which begins the chain of events lead from hyperglycaemia (high blood sugar) to Insulin resistance and the mergence of Type 2 diabetes.” The Institute of Medicine's 2005 guidelines state that 20 to 35 percent of the total daily calorie allotment for adults comes from fat. And, all fats contain the same number of calories (100 per tablespoon), regardless of saturation. So those who suffer from Type 2 diabetes, have a two to fivefold excess risk of developing coronary heart disease compared with non-diabetics. Junk That Junk Food! A research led by David Ludwig, published in medical journal Pediatrics has also found that fast food industry is taking a heavy toll of the health of the children. After examining data from surveys of 6,212 children and adolescents, Dr Ludwig and his team concluded “children who ate fast food consumed more total and saturated fat, more total carbohydrates and added sugars, less dietary fiber, and more calories per gram of solid food than children who did not eat fast food. Not surprisingly, they also consumed less milk, fiber, fruit and non-starchy vegetables.” “Thirty percent of the children in the survey ate fast food on any given day during the survey, and they ate an average of 187 calories a day more than those who did not eat fast food. These additional calories could account for an extra six pounds of weight gain per year,” according to Ludwig. Regardless of these findings, experts estimate that children’s consumption of fast foods has increased fivefold, from two percent in the late 1970s, to 10 percent by the mid-1990s, during which time the number of fast food joints has more than doubled to an estimated 250,000 nationwide. Worse, experts at the Medical Research Council have found that most fast food is very dense in calories, which means that even a relatively small amount can shoot up a person’s total calorific intake. The researchers found that these "energy dense" foods can fool people into consuming more calories than the body needs.” We knew that controlling blood glucose in diabetics is important for preventing eye and kidney complications, but we were uncertain of the true value of controlling blood glucose in relation to cardiovascular complications. The increased cardiovascular risk in diabetes is related as much to hypertension and dyslipidaemia as to glucose control. Therefore, we need to aggressively control blood pressure (aiming for 140/80mmHg) and lipids if our likelihood of developing a coronary heart disease that’s related to diabetes. Risk Reversal The main principle in dietary treatment of Hyperlipidaemia is to restrict fat to less than 30 per cent of your total caloric intake, with less than 10 per cent obtained from saturated fat. There is scientific evidence that if you have diabetes, by reversing this atherogenic lipid profile you can successfully prevent cardiovascular problems. Fat File But before we conclude that fat –– an essential cause for obesity –– should be cut out completely from our diet, we MUST know that all fats don’t act the same. Some are definitely harmful, but a few others are helpful –– even necessary –– for proper functioning of your bodies. Both animal and plant-derived foods contain fat, which is a prime source of calories (or energy) for our bodies. Fat provides essential Fatty Acids not produced by our bodies, which regulate cholesterol metabolism and other processes, and promote proper growth and development. Fats also transport fat-soluble vitamins A, D, E, and K--important for vision, healthy skin, and proper immune function –– to cells and aid their absorption in the intestines. The Various Forms of Fat In addition to saturated, monounsaturated and polyunsaturated fats, there are triglycerides, Trans Fatty Acids, and Omega 3 and Omega 6 Fatty Acids. Saturated fatty acid has the maximum possible number of hydrogen atoms attached to every carbon atom. It is therefore said to be “saturated” with hydrogen atoms. However some Fatty Acids have one pair of Hydrogen atom missing in the middle of the molecule. This gap is called “unsaturation” and the Fatty Acid is then referred to as “monounsaturated.” Finally, Fatty Acids that have more than one pair of Hydrogen atoms missing are called “polyunsaturated.” Saturated fats (which contain saturated fatty acids) are mostly found in foods of animal origin. Monounsaturated and polyunsaturated fats (which contain monounsaturated and polyunsaturated Fatty Acids) are generally concentrated in plants and some sea food. Polyunsaturated Fatty Acids are of two kinds: Omega-3 or Omega-6. Scientists tell them apart by the point at which the Hydrogen atom goes missing or the points of “nonsaturation." Recently a new term has been added to the fat lexicon: Trans Fatty Acids. These are byproducts of partial hydrogenation, a process in which some of the missing Hydrogen atoms are put back into polyunsaturated fats. “Partially hydrogenated vegetable oils,” such as vegetable shortening and margarine become solid at room temperature. Fat Components Unsaturated oils appear to increase cell fluidity and flexibility, thus contributing to overall health. Chemically, these may be monounsaturated or polyunsaturated, both of which can bring down blood cholesterol substantially when substituted for saturated fats. Heart-healthy monounsaturated fats –– oils like olive and canola –– stay liquid at room temperature but become cloudy or solidify if put in the refrigerator. Avocados and most nuts (including spreads like peanut butter) contain monounsaturated fats, as well as many other essential nutrients, therefore making them healthy additions to your diet. Polyunsaturated fats are liquid at room temperature as well as when refrigerated. It is found in vegetable oils such as corn, soy, sunflower and safflower. Peanut oil is on the lower end of the unsaturated spectrum, but it is easily utilized by the body and can be totally hydrogenated, leaving no unhealthy Trans Fats. Labeled as �bad’, saturated fats and Trans Fats are sometimes lumped together and can clog arteries and raise levels of LDL ("bad" cholesterol). Health authorities recommend that these fats should not exceed 10 percent of your calories (22 grams for a 2,000 calorie diet) if your LDL is less than 130. Animal products like butter, lard, whole milk and meat are high in saturated fats, which are solid and waxy at room temperature. So diabetics should immediately cut short their intake in daily meals. Meanwhile, Trans Fats have similar effects as saturated fats, with an added negative at high levels because they not only raise LDL levels, but they also reduce HDL (the good cholesterol). Trans fats began showing up in high amounts about 20 years ago in many foods after commercial processors began using polyunsaturated fats (considered healthy) in a wide range of baked goods and snacks. (See the restaurant guide at the end of this chapter) Eating Smart Eating vegetable fats or polyunsaturated fats instead of saturated fats can significantly lower the risk for diabetes in postmenopausal women, according to a study to be published in the issue of Diabetes Care. This study may bring good cheer to people who are also trying to lose weight as a means of warding off Type 2 diabetes that has long been associated with obesity. The Iowa Women's Health Study, led by researchers at the Harvard and University of Minnesota Schools of Public Health, found that substituting vegetable fat for saturated fats in the diets of women ages 55-69 lowered their risk for Type 2 diabetes by 22%. Substituting polyunsaturated fats for saturated fats lowered the risk by 16%. Diet And finally, a few diet suggestions from The Basic Basics Diabetes Handbook by nutritional therapist Jane Frank to help you ward off both obesity and diabetes: • Those with Type 2 diabetes can achieve lower blood glucose and blood fats following a diet made up of 30% protein, 40% carbohydrate and 30% fat. This eating pattern must be characterized by high intake of vegetables, pulses, fruit, whole grains and a low intake of red meat, processed meat, high-fat dairy products and refined grains. • Broccoli is often recommended by doctors as a nutraceutical. • Onions and garlic appear to increase Insulin in the blood by preventing it being inactivated by the liver. • Buckwheat may help increase Insulin sensitivity, helping the body to use Insulin more effectively. • Cinnamon, just one gram a day, could reduce blood glucose levels by 20 per cent. • Oily fish lowers serum triglycerides and contribute to glycaemic control. The Restaurant Menu Warning List Don’t Order Because Soup (unless made from scratch) Contains MSG ~ Anything with gravy (unless made Contains MSG from scratch) Salad dressings Contains MSC and unhealthy oils (use olive oil and vinegar as an alternative) Diet sodas Contain Nutrasweet Iced tea (herbal tea OK) High levels of oxalic acid (causes kidney stones) Fruit juice (except for fresh- Highly acidic squeezed) Decaffeinated coffee or teas (natural Contain solvents and chemicals used herbal teas OK) in the decaffeinating process French fries or fried foods Fried in cheap, unhealthy vegetable oils Understanding Carbohydrates T he Atkins and South Beach diets have caused us to look at carbohydrates in a new way. The first and most important point to understand is that all carbohydrates are sugars. Your mind may differentiate between carbs that taste sweet ('sugar') and those that don't ('starch) --- but your body doesn’t. The simple sugars in foods that are most important to human nutrition are called sucrose, fructose, lactose, and maltose. However, the only sugar our bodies care about is glucose because that’s the only sugar that’s can be absorbed by the body and converted into energy. All other simple sugars are broken down during digestion process to the primary food type, i.e., glucose. Here is a description of various sugar types; • Sucrose is the white granulated substance that most of us think of as 'sugar' and put into our cereal every morning. Sucrose is derived from sugar cane, sugar beets, and the syrup from sugar maple trees. Sucrose is also naturally present in most fruits and vegetables, along with higher amounts of other sugars. Sucrose is a disaccharide (meaning 'two sugars') which coverts to glucose and fructose. • Fructose is the form of sugar found in fruits, honey, and corn syrup. It is nearly twice as sweet as sucrose. When fructose is added to processed foods, manufacturers can say that their product has no added sugar. This is a �legal technicality’ since fructose really is a sugar…just not sucrose. Fructose is a monosaccharide (meaning 'one sugar') which is absorbed intact and changed into glucose by the liver. • Lactose is the sugar found in milk and milk products. It is also a disaccharide that converts into glucose and galactose. (Galactose is changed into glucose in the liver) • Maltose is a sugar found in grains. It is a disaccharide, but rather than getting converted into glucose and fructose or galactose, it breaks down into glucose…and MORE glucose. Thus, for diabetics this is the worst form of 'sugar.' No “Ose” For You! So you can be sure than when you see on the label of a product ending with these three letters, it is almost certain to be a sugar. Dextrose, for example, is merely another name for glucose. The only exception is cellulose. Although cellulose is, indeed, a complex sugar molecule is the material that plant cell walls are made of. The human digestive system has no enzyme to digest cellulose. It has no nutritional value and passes straight through you. Cellulose once used to be called roughage. Now we refer to it as fiber. Four Easy Diet Changes for Diabetes Tweaking our lifestyle is the first step in diabetes prevention - and it's never too late to start. Consider these latest diabetes prevention tips from the American Diabetes Association: Tip 1: Lighten Up If overweight, diabetes prevention may simply hinge on weight loss. Every pound lost can improve health. And you may be surprised by how much. In one study, overweight adults who lost a modest amount of weight - 5 percent to 10 percent of initial body weight - and exercised regularly reduced the risk of developing Diabetes by 58 percent over three years. To keep our weight in a healthy range, we should focus on permanent changes to our eating and exercise habits. Involve other family members as well. Motivation can come from remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem. Tip 2: Be A Trend Setter, Not A Fad Follower Low-carb, high-protein or other fad diets may help us lose weight at first, but they're not likely to help us maintain a healthy weight in the long run. And by excluding or strictly limiting a particular food group, we may in fact be giving up essential nutrients. Instead, think variety and portion control as part of an overall healthy-eating plan. Choose healthy foods low in fat and calories, including fruits, vegetables and various lean foods from groups. the other major food Tip 3: Follow the Fiber It's rough, it's tough - and it can reduce the risk of Diabetes by improving blood sugar control. And that's not all. Fiber also reduces the risk of heart disease. It can even promote weight loss by helping us feel full longer. Aim for 25 to 50 grams of fiber a day. Foods high in fiber include fruits, vegetables, beans, whole grains, nuts and seeds. Tip 4: Great Grains Whole grains are another important piece in the Diabetes-prevention puzzle. Try to make at least half of the grains whole grains. Even if we’ve been eating white bread and baking with refined flour for years, switching to whole grains is easier than we think. Many foods made from whole grains come ready to eat, including various breads, pasta products and ready-to-eat cereals. Look for the word "whole" on the package and among the first few items in the ingredient list. Try to choose items with at least 3 grams of fiber per serving. Foods to Enjoy and Avoid F ighting Diabetes with food can be a pleasure! How? Just focus on these friendly foods…and the recipes found in the bonus sections at the end of this book. Fowl Up We can feast on poultry whenever we like. Chicken, goose, duck, and turkey may be enjoyed often. Note: turkey is very low in fat, so fat needs to be added in order to slow down digestion. Fatten Up Perhaps surprisingly, animal and meat fats do not affect blood sugar. They may, however, affect cholesterol, so enjoy them, but in moderation. Go Fishing Fish and seafood of all types are good for many aspects of total body health. Egg-cellent Choice Enjoy eggs often. But do avoid "omega-3 eggs" as these have been artificially fed which upsets the natural fatty acid profile. Be A Dairy Queen (or King) Dairy products such as cheeses and yogurt, and can be enjoyed with moderation and are a great way to add flavor to sauces and drinks. Foods Too Avoid Any healthy eating plan requires we simply learn to say “no” to some foods that we may be eating regularly. Some of these names are obvious – others less so. • Sugar and artificial sweeteners, including honey. The only exception is stevia • Sweets and chocolates, including so-called sugar-free types • "Diet" and "sugar-free" foods in general (except sugar-free jelly) • Processed grains and foods made from them: white flour, rye, barley, corn, white rice, white bread, pasta, pastry, cakes, biscuits, pies, tarts, breakfast cereals, etc. • Starchy vegetables: potatoes and parsnips in particular; and go easy with beet, carrots, peas, beans, et cetera and packets of mixed vegetables which might contain them • Milk, except in small quantities • Cottage cheese, again except in small amounts Learn to Say NO to Packaged Foods Beware of commercially packaged foods such as TV dinners, "lean" or "light" in particular, and fast foods, snack foods and "health foods". They all contain chemical substances which we can easily do without. Mind and Body I It’s all in the mind, even the control of this disease… Who would know better than you, how stressful it is to be diabetic? But did you also know that we can actually cope with the disease as we deal with stress? Researchers maintain people who believe they can control their diabetes are better off than those who do not see their diabetes as under their control. This self control can be achieved either through psychological techniques such as developing a positive attitude, meditation, self-hypnosis; by causal attribution; or by behavioral techniques such as diet regulation, medication, accessing information or controlling side-effects. But first, let’s examine stress… That awful feeing… Though stress can have different impact on different people, we all experience it in some form or the other, everyday –– noise, crowd, a bad relationship, job interview, meeting deadlines or while commuting to work. The signs are also common –– sweaty palms, heart palpitations, fatigue, headaches or even worse, depression, anger, frustration or the vague feeling of uneasiness. But what you may not know is that stress is not an isolated problem. Instead, it is a part of a complex response that not only affects our emotions but our body’s metabolism as well. Stress and Your Body Stress is a natural survival response which occurs when we feel threatened by thoughts or external stressors. When we are in a stressful situation, our circulatory system shoots up and blood is pushed rapidly towards different parts of the body. To the organs and systems that protect us against these threats and as a consequence, this increases our blood pressure. However, because the blood supply has been diverted, the supply to the digestive system is reduced as well, making the process of digestion slower and less effective. Stress also constricts the blood vessels, increases heart rate, and produces other physiological manifestations, all instantaneously! We may also tremble or perspire. The face may flush and we may feel a surge of adrenaline flow through our body. Our mouth may become dry and we may feel nauseated, and breathing may become more rapid and shallow. The heart begin to pound and muscles may become tight, leading to headaches or cramps. Though stress prepares us to counter any threat, it may also lead to an inability to respond in a way that eliminates it. An unabated stress may cause even more stress -- creating a vicious cycle and taking a heavy toll on our body. In fact, many researchers believe prolonged stress puts such a strain on the body in a manner that the immune system eventually breaks down and in the process makes the body vulnerable to numerous other diseases. Stress and Diabetes Stress is particularly dangerous for people with diabetes. The hormones the body releases as part of the fight response are actually meant to prepare the body for quick action. These hormones break down stored glycogen into blood glucose, which the body should be able to use for energy. But people with diabetes cannot effectively use this extra glucose for energy, so the result is a rapid rise in blood sugar. During times of stress, our self-care skills may also slip a bit. When we’re under pressure, if we have to meet a tight deadline for example, we may not take time to eat. Even if we do eat, chances are we won't spend too much time choosing foods that fit into our diet plan. Alternatively, maybe we’ll decide to forgo exercise, because there are just too many other important things on our 'to do' list. We may decide, like a number of people, to have a few 'drinks' or smoke a bit more to help us relax when feeling stressed. Any of these behaviors can seriously impair blood sugar levels. Therefore, Know Your Metabolism From the discussion above, it’s clear that there is a close relationship between stress and glucose metabolism. Some scientists have suggested that autonomic nervous system is involved in Type 2 diabetes. Stressful stimuli produce a prolonged sympathetic nervous system discharge that increases the production of epinephrine, a chemical substance produced in adrenal gland medulla. All this interferes with the function of pancreas and carbohydrate metabolism. In addition, cortisol, increased by chronic stress, causes increased glucose production by the liver and increased cellular resistance to insulin. Both effects promote higher blood glucose levels, which may lead to obesity and a predisposition to diabetes. This is supported by a variety of scientific studies. Sources of Stress in Diabetics There are two ways of looking at the issue. Stress may affect the diabetic condition. On the other hand, the realization that we are suffering from a chronic ailment can cause us stress. We may feel under a great deal of pressure to maintain 'perfect' control of our diabetes because the side-effects of diabetes are interfering with our life and relationships. We all have a unique way of responding to stress or what we perceive as “stressful situations.” Our upbringing, self-esteem, beliefs about ourselves and the world, the way in which we guide ourselves in our thoughts and actions–all of these factors determine the quality and strength of our stress response. The degree to which we feel in control of our life also plays an important role in this response, as does the way we feel, both physically and emotionally, and the way we get along with other people. In summary, everyone's method of dealing with stress is unique and individual. It’s a product of our thoughts, emotions and behaviors. So How Should You Cope With Stress? You’ll be happy to learn that by merely maintaining a positive and happy disposition; we can control our diabetes and avoid many of its long-term complications. Because diabetes is so difficult to control effectively over the long run, it is important to pay close attention to both our psychological well-being, as well as our metabolic control. Ideal diabetic management occurs when we are satisfied with the treatment regime and are also maintaining effective blood glucose control. Simply following one or the other measure won’t do --- both have to move in tandem. Useful Stress Busters Experts contend that certain relaxation techniques and regular exercise can be extremely useful in stress management. There are many different types of clinical relaxation techniques, including meditation and deep breathing, hypnosis and bio-feedback. Discuss the technique that would be most appropriate for you with your diabetes team. Pinpoint the source of your stress. Try to objectively identify your stressors and pinpoint what specifically is causing you to feel stress. Maybe you are having a hard time with the symptoms of diabetes. Maybe you are tired of sticking to your treatment program, or maybe you are just tired of thinking about Diabetes. Once identified, eliminate as many stressors from your life as possible. Certain physical activities can be a great means of stress control. Exercise is not only a good way to release stress but can also be a very beneficial part of the diabetes treatment. (Please refer to our next section on exercise for more details). Finally, regardless of how diabetes is affecting us, there is still some kind of exercise which could suit our stress-busting needs. Brisk walking, swimming and dancing, for instance, all allow release of tension. However before we embark on any program, we should seek our doctor's approval. Meanwhile, be positive and fight back with confidence! All That You Must Know About Food Labels I n a major move, according to the new policy guidelines issued by the FDA that went into effect May 1994, the nutrition information on the new label must be in bigger type and appear on a white or other neutral contrasting background, when practical. Other Label Benefits • New regulations require labels on most packaged foods to provide nutrition information. Earlier this was voluntary and appeared on only about 60 percent of such foods. • The nutrition information for fresh fruits and vegetables and raw meat and fish may appear at the point of purchase. • In addition, besides continuing to provide information about calories, fat, carbohydrate, sodium, protein, iron, calcium, and vitamins A and C, labels must also inform about saturated fat and cholesterol. These two nutrients are important to people with diabetes because diabetes increases the risk of heart disease, and heart disease is also linked to high intakes of saturated fat and cholesterol. How to Follow the New Labeling Guidelines? We can begin by examining the Nutrition Facts panel, usually carried on the side or the back of the food package. The important parameters on which we make healthy food choices could be: • % Daily Values: A column headed %Daily Values shows whether a food is high or low in many of the nutrients listed. As a rule of thumb, if the number is 5 or less, the food may be considered low in that nutrient. The goal for most people with diabetes must be to pick foods that have low % Daily Values for fat, saturated fat, and cholesterol and high % Daily Values for fiber. • Serving Sizes: The serving size information gives the amount of food to which all other numbers on the Nutrition Facts panel apply. Serving sizes now are more uniform among similar products and reflect the amounts people actually eat. For example, the reference amount for a serving of snack crackers is 30 g. Thus, the serving size for soda crackers is 10 crackers and for Goldfish Tiny Crackers, 55, because these are the amounts that come closest to 30 g. The similarity makes it easier to compare the nutritional qualities of related foods. However, Please Note: People who use the Exchange Lists should be aware that the serving size on the label may not be the same as that in the Exchange Lists. For example, the label serving size for orange juice is 8 fluid ounces (240 milliliters). In the exchange lists, the serving size is 4 ounces (one-half cup) or 120 mL. So, a person who drinks one cup of orange juice has used two fruit exchanges. • Calorie and Other Information: The Nutrition Facts panel also gives total calories and calories from fat per serving of food. This is helpful for people who count calories and monitor their daily percentage of calories from fat. Here's how to use calories from fat information: At the end of the day, add up total calories and then calories from fat eaten. Divide calories from fat by total calories. The answer gives the percentage of calories from fat eaten that day. For example, 450 calories from fat divided by 1,800 total calories = 0.25 (25 percent), an amount within the recommended level of not more than 30 percent calories from fat. • Count the Carbs: The label also gives grams of total carbohydrate, protein and fat, which can be used for carbohydrate counting. The values listed for total carbohydrate include all carbohydrate, including dietary fiber and sugars. Not singled out is complex carbohydrates, such as starches. The sugars include naturally present sugars, such as lactose in milk and fructose in fruits, and those added to the food, such as table sugar, corn syrup, and dextrose. • Count Proteins as Well: The listing of grams of protein also is helpful for those restricting their protein intake, either to reduce their risk of kidney disease or to manage the developed kidney disease. • Front Label Info: Elsewhere on the label, consumers may find claims about the food’s nutritional benefits. Some claims, such as "low-fat," "no saturated fat," and "high-fiber," describe nutrient levels and could be particularly interesting to people with diabetes because they high-light foods containing nutrients at beneficial levels. Other claims, called health claims, show a relationship between a nutrient or food and a disease or health condition. FDA has authorized eight such claims; they are the only ones about which there is significant scientific agreement. Two that relate to heart disease are of particular interest to people with diabetes: * A diet low in saturated fat and cholesterol may help reduce the risk of coronary heart disease. * A diet rich in fruits, vegetables and grain products that contain fiber, particularly soluble fiber, and are low in saturated fat and cholesterol may help reduce the risk of coronary heart disease. Both claims however must also state that heart disease depends on many other factors. Nonetheless, this kind of labeling does enable the consumer to use it to choose healthier foods. For people with diabetes, that's especially important because of the increased risk of other chronic diseases. Nutrient Claims Guide for Individual Foods Fat • Fat-free: less than 0.5 grams (g) fat per serving • Low-fat: 3 g or less per serving and, if the serving size is 30 g or less or 2 tablespoons or less, per 50 g of the food • Reduced or less fat: at least 25 percent less per serving than reference food Saturated Fat • Saturated fat free: less than 0.5 g and less than 0.5 g of trans fatty acids per serving • Low saturated fat: 1 g or less per serving and not more than 15 percent of calories from saturated fatty acids • Reduced or less saturated fat: at least 25 percent less per serving than reference food Cholesterol • Cholesterol-free: less than 2 milligrams (mg) and 2 g or less of saturated fat per serving • Low-cholesterol: 20 mg or less and 2 g or less of saturated fat per serving and, if the serving is 30 g or less or 2 tablespoons or less, per 50 g of the food • Reduced or less cholesterol: at least 25 percent less than reference food and 2 g or less of saturated fat per serving The following claims can be used to describe meat, poultry, seafood, and game meats: • Lean: less than 10 g fat, 4.5 g or less saturated fat, and less than 95 mg cholesterol per serving and per 100 g • Extra lean: less than 5 g fat, less than 2 g saturated fat, and less than 95 mg cholesterol per serving and per 100 g • Healthy: This claim would apply, if the food has a) "Low fat," "low saturated fat," with 60 mg or less cholesterol per serving (or, if raw meat, poultry and fish, "extra lean") b) At least 10 percent of Daily Value for one or more of vitamins A and C, iron, calcium, protein, and fiber per serving c). After Jan. 1, 1998, maximum prescribed sodium levels drop to 360 mg. Calories • Calorie-free: fewer than 5 calories per serving • Low-calorie: 40 or fewer calories per serving and, if the serving size is 30 g or less or 2 tablespoons or less, per 50 g of the food • Reduced or fewer calories: at least 25 percent fewer calories per serving than the reference food • Light: This claim can carry two meanings a) One-third fewer calories or half the fat of the reference food--if the food derives 50% or more of its calories from fat, the reduction must be 50% of the fat b) A "low-calorie," "low-fat" food whose sodium content has been reduced by 50 percent from the reference food ("Light in sodium" means the food has 50 percent or less sodium than the reference food and may be used on foods that are not "low-calorie" and "lowfat.") Fiber • High-fiber: 5 g or more per serving • Good source of fiber: 2.5 g to 4.9 g per serving • More or added fiber: at least 2.5 g more per serving than the reference food. (Label will say 10 percent more of the Daily Value for fiber.) Please Note: Foods making claims about increased fiber content also must meet the definition for "low-fat" or the amount of total fat per serving must appear next to the claim. Sugar • Sugar-free: less than 0.5 g per serving • No added sugar, without added sugar, no sugar added: This can also imply two things: a) No sugar or ingredients that functionally substitute for sugar (for example, fruit juices) added during processing or packing b) No ingredients made with added sugars, such as jams, jellies, or concentrated fruit juice ("Sugar-free" and "No added sugar" signal a reduction in calories from sugars only, not from fat, protein and other carbohydrates. If the total calories are not reduced or the food is not "low-calorie," a statement will appear next to the "sugar-free" claim explaining that the food is "not low-calorie," "not reduced calorie," or "not for weight control." If the total calories are reduced, the claim must be accompanied by a "lowcalorie" or "reduced-calorie" claim.) Reduced sugar: at least 25 percent less sugar than the reference food. Alcohol, Smoking and Diabetes I f you thought alcohol and diabetes can have no connect, think again. A community health study conducted in 2001 reveals a strong co-relation between alcohol use and the risk for developing Type 2 diabetes in middle-age men but not women. More than 12,000 middle-age males and females participated in the multi-center Atherosclerosis Risk in Communities study, where researchers tracked participants' alcohol consumption and other health risk factors over a period of several years. W.H. Linda Kao, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA, and study colleagues reported in the October 2001 edition of American Journal of Epidemiology that excess -- not moderate levels -- of alcohol consumption could increase a subject’s chances for developing Type 2 diabetes. The results can be more alarming for those who drink liquor compared to those who drink just beer or wine! Not just alcohol, but smoking can also play havoc with our sugar level. A five-year Japanese study for instance has linked cigarette smoking to the risk of developing Type 2 diabetes. Researchers there found that the longer their 1,266 middleaged male subjects smoked, the worse the health impact. They calculated that smoking over 31 cigarettes a day, increased the risk of developing diabetes four fold compared to non-smokers. The Root Link Diabetics and alcoholics can blame their genes! Both diabetes and alcohol-drinking habits are influenced by heredity. The C57BL mice strain, which originally was developed for diabetes research, is inherently diabetic and several sublines of this strain have a genetically determined high alcohol intake, a group of researchers have found. It has also been found that alcohol can induce insulin resistance, glucose intolerance and even overt diabetes. This could explain the high representation of diabetes in alcoholics and also the aphorism that there are more alcoholics who are diabetic than there are diabetics who are alcoholic! However, there have been countless studies that do prove a link between alcohol and Type 2 diabetes. A large study in three different populations reported no link but it is important to note that a number of cross-sectional and prospective epidemiological studies have found out an association between alcohol consumption and hypertension. Unfortunately, the mechanisms controlling alcohol drinking remain largely unknown. For instance, when water is not available, the drinking of alcohol solutions is controlled largely by the mechanisms regulating fluid balance. But voluntary alcohol drinking, even when water is available, seems likely to be controlled by mechanisms that are derived from the control of some macronutrients -- the closest match being carbohydrates. This explains why factors which alter carbohydrate intake, such as diabetes and thiamine deficiency, often, alter alcohol selection In fact, dietary factors might also be beneficial to help control drinking habits. Would you believe that a vegetarian diet could actually suppress alcohol abuse to a large extent? A famous chemist Justus von Liebig, who lived at the beginning of the nineteenth century (and who was not himself a vegetarian), said plant food abolishes the urge for wine and other alcoholic drinks. Other forms of nutritional therapy have also been recommended for the treatment of alcoholics. Vitamins, especially thiamine, are frequently recommended for overcoming the deficiencies that develop during drinking. But all said and done, it may be days or even weeks before the diabetogenic symptoms begin to disappear. Even then, we would need to continuously stick to a diet low in carbohydrates and high in fats or protein. This recommendation appears consistent with the results of the laboratory studies on the interaction between food and alcohol. Exercise ---a Must D uring exercise, muscles can burn glucose at almost 20 times the normal non-exercising rate. The liver makes sugar available either by depleting its own storage or by changing fatty acids from adipose (fat) tissue into glucose and releasing them to the muscles for utilization. In normal human physiology, the liver and muscles "talk" so appropriately the liver produces the exact amount of glucose the muscles need, so the blood sugar level tends not to change very much. The level of insulin in the blood regulates the glucose coming from the liver and going into the muscle. For people with diabetes however, this level of insulin might vary, especially if the diabetes is poorly controlled. In a patient whose diabetes is well-controlled, the glucose level might stay stable or drop because the ability to control the level of insulin is lost. This might occur either because pills make the body produce insulin without food or exercise, or because the insulin was given by injection. In a patient whose diabetes is poorly controlled, the glucose level is generally high because the insulin level is low, and the muscles and liver don't "talk," causing glucose levels to fall, stay stable, or even rise dangerously with exercise. Muscle Power Think of your muscles as itty bitty fuel tanks. They store glucose (sugar) and they burn it to make energy. If our tank is full (of glucose), it doesn’t matter how much or how little we eat, our muscle �tanks’ can’t store it. So, we have to empty out the muscle tanks (through exercise) every day in order to �make room’ for the calories we take in when we eat. Increasing physical activity can help to lose weight. But even if it doesn't, it's still important to get off the couch. Whether we lose weight or not, physical activity lowers blood sugar and boosts our sensitivity to insulin - which helps keep blood sugar within a normal range. When we exercise, our muscles use sugar (glucose) for energy. This reduces the blood sugar. The more strenuous the workout, the longer the effect lasts - there's more. With Type 2 Diabetes, exercise can increase insulin sensitivity. This means the body requires less insulin to escort sugar into our cells. Along with a healthy-eating plan, exercise may even reduce - or eliminate - our need for glucose-lowering medication. In addition, exercise boosts mood and energy levels! What’s not to like about that? Even Mini Efforts Can Yield Maxi Results Diabetes increases the risk of high blood pressure, heart attack, stroke and other cardiovascular diseases. Exercise counteracts the risk by improving blood flow, increasing the heart's pumping power and improving cholesterol levels. And, of course, exercise can help us lose weight - and keep it off. Regular exercise can greatly reduce the risk of cardiovascular disease (a major risk for those with diabetes), help us lose weight and manage stress. If you can’t work with a personal trainer, get regular exercise by joining a gym or social club that’s centered around physical activities (mall walking, for example), or get family members to join you for walks or bike rides. Start with strength and cardiovascular exercises —as 10 minutes a day is a great start. It is easy to get frustrated, but even better to persist and get positive results. The goal is to eventually build a low ratio of fat to muscle and increase insulin sensitivity. Exercises that lead to a total body workout are preferable, even for beginners. Try a regiment of traditional push-ups. (If you can't do them, try the modified version with knees on the floor for support). Just do as many as you can, and build up to completing 3 sets of 10 reps. Eating to Win Try to eat 1 to 2 hours before exercise (to optimize energy for a workout), and check blood sugar before and after exercising. Consult Your Doctor Before jumping into a fitness program, get your doctor's OK to exercise - especially if you've been inactive for a long period of time. Discuss with your doctor which activities you're contemplating and whether you should impose certain restrictions pertaining to one or more exercises. For example, if you have diabetic retinopathy - abnormal growth of blood vessels on your retina - strenuous activity could lead to bleeding or retinal detachment. You may need to avoid certain activities, such as weightlifting or jogging. If you have reduced sensation in your feet, your doctor may recommend non-weight-bearing activities, such as swimming or biking. With your doctor's OK, aim for at least 30 minutes of moderate physical activity a day. Take a brisk daily walk. Ride your bike. Swim laps. If you can't fit in a long workout, break it up into smaller sessions spread throughout the day. Even trading the elevator for the stairs and parking farther from your destination are steps in the right direction. Also discuss with your doctor the best time to exercise. If have to take insulin, you might need to adjust your insulin dose before exercising or wait a few hours to exercise after injecting insulin. Exercise good judgment When we’re ready to exercise, we should start slowly and gradually build stamina. We should work our way up to 30 minutes of moderate-intensity exercise most days of the week. While working out, we need to remember to take good care of ourselves. • Check blood sugar before, during and after exercise - especially if you take insulin or medications that can cause low blood sugar (hypoglycemia). It is recommended you carry glucose tablets or hard candy in case ones blood sugar drops too low or we feel shaky, nervous or confused. • Pay attention to our feet. Wear smooth-fitting socks and comfortable athletic shoes. Examine the feet before and after exercise for any signs of potential damage, such as cuts or blisters. • Drink plenty of fluids while exercising, especially when it's hot. Dehydration can increase blood sugar. If exercising for more than an hour, we should drink carbohydrate-containing beverages rather than plain water. • Experiencing warning signs - severe shortness of breath, dizziness, faintness, nausea, chest pain, heart palpitations, or pain in an arm or in your jaw - stop exercising. If you don't feel better within 15 minutes, seek immediate medical help. Once we understand how our body responds to exercise, we’ll be even closer to a healthier us. The Right Exercise for YOU Exercise is like a drug. It has to be prescribed and tailored for each situation. For people with Diabetes, the prescription might be different than for people with Action Plan heart disease or back pain. • Since the muscles that use glucose • • appropriately are the long, thin muscles, we need to develop these muscles. With a daily low-resistance, high-frequency exercise/activity • Exercise daily or at least five times a week. Exercise for 45 to 55 minutes at a time. Exercise has no long-term effect on glucose. 24-48 hours after your workout, the beneficial effects on Diabetes and its control are lost. Therefore exercise is a life-long commitment. Get committed to your exercise plan! program lasting 45 to55 minutes, the control of blood glucose for those with Diabetes improves and stabilizes even before weight loss is achieved. Herbs – Do’s and Don’ts Most experts agree that the treatment of diabetes and hypoglycemia requires nutritional supplementation. Supplying these people with additional key nutrients has been shown to improve blood sugar control as well as help prevent or improve many of the major complications of their conditions. Following supplements are generally recommended for diabetics: Chromium For the body to function, each cell must "open its door" and allow sugar to enter. Chromium has been called the key that unlocks that door. Without it, sugar builds up in the blood, and eventually diabetes develops. It would seem to make perfect sense, then, to take chromium supplements to ward off diabetes. And some studies have suggested that supplementing with chromium helps keep blood sugar under control. Why Is Chromium Important? Chromium is available in a variety of forms: as a single supplement, as an ingredient in multivitamins, or combined with any number of vitamins and/or minerals. Chromium picolinate Do you know that 90% of all Americans don t even get the recommended daily dosage of chromium? Yet this mineral may be very beneficial for diabetics. In a study taking chromium per day reduces glucose levels of diabetics by 18% and glycoslated hemoglobin by 10%. and chromium histidine are believed to be better absorbed than other forms of the mineral. Natural foods that contain chromium include: black pepper, broccoli, dried beans, and whole grains. As the name implies, chromium picolinate it is a combination of two different substances: chromium and picolinate. The Chromium component helps to increase efficiency of insulin, the hormone that controls blood glucose (blood sugar) levels; while picolinate is an amino acid derivative that allows the body to use chromium much readily. Why is Fiber So Good For Diabetes? Vitamin C Diet with high soluble fibers are especially important for diabetics because soluble fiber increases the time it takes for food to digest and for glucose to get into the blood. Flax seed meal is one of the best sources of soluble fiber. In a 1991 University of Toronto study, consumption of flax seed meal was shown to improve glucose tolerance by over 25%. The primary function of vitamin C is in the manufacture of collagen, the main protein substance of the human body. Since collagen is such an important protein in the structure that holds the body together (connective tissue, cartilage, tendons and so on), vitamin C is vital for wound repair, (Source: Some New Facts You Need to Know about Diabetes, International Journal of Humanities and Peace, Vol. 17, 2001) healthy gums, and the prevention of easy bruising. The fact is that a diabetic person needs more vitamin C than healthy non-diabetics. A chronic, latent vitamin C deficiency can lead to a number of problems for the diabetic. This includes an increased tendency to bleed, poor wound healing, an elevated cholesterol level and a depressed immune system. Vitamin B12 (Cobalamin) A vitamin B12 deficiency is characterized by numbness of the feet, "pins and needles" sensations, or a burning feeling. It has been used with some success in treating diabetic neuropathy. Oral supplementation with 1,000 to 3,000 micrograms (100 mg 300 mg) of B12 per day may be sufficient for diabetic and hypoglycemies, but intramuscular vitamin B12 may be necessary. Other nutritional supplement that helps control the blood sugar level are the following vitamin E, manganese, potassium, zinc and flavonoids. Vitamin E Vitamin E has proven to be effective for a variety of disease states and has been shown to be useful in safely lowering blood sugar levels. Known for its antioxidant powers, Vitamin E appears to reduce the free radical damage that causes the complications of diabetes, such as heart disease and nerve damage, which can lead to blindness and amputation. Research shows that daily supplements of vitamin E can significantly reduce the damage in diabetics that ultimately leads to cardiovascular disease. (70% of deaths from diabetes are related to damaged and clogged arteries.) Ishwarlal Jialal, MD, PhD, professor of internal medicine and pathology at the University of Texas Health Science Center at Dallas found that giving 1,200 IU of E a day to people with diabetes greatly reduced the tendency of LDL cholesterol to begin creating a buildup of fat and other debris on artery walls. Diabetes experts recommend 600 IU of E a day. There are two types of Vitamin E, natural (d-alpha tocopherol) and synthetic (dl-alpha tocopherol). Milligram for milligram, natural is more potent, so it takes less to get the same benefit. Vitamin E can be found in single ingredient supplements, multivitamins, and herbal preparations. But large doses are generally found as single-ingredient supplements. Good natural sources of Vitamin E include: Avocados, nuts, and vegetable oils. Magnesium Diabetes is the most common disorder associated with low magnesium. One out of 3 people suffering from Type 2 diabetes tests low on this mineral. Additional intake of Magnesium reduces many complications associated with diabetes, such as heart disease, kidney problems, diabetic retinopathy, impotence and nerve damages. Magnesium is essential for the transport of glucose and is also important for the release of the hormone insulin, which helps to control blood sugar levels. Some studies show that as magnesium intake goes up, the risk of developing Type 2 Diabetes goes down. Other findings suggest that magnesium supplementation of about 350 mg a day improves insulin resistance and blood sugar control. Although it’s not clear whether low magnesium levels are the cause or the result of diabetes, experts contend that it's a good practice to make sure that you're getting enough magnesium. Most people, especially seniors, don't get enough! Supplements come in a variety of forms, including magnesium acetate, aspartate, carbonate, chloride, citrate, glycinate, hydroxide, lactate, oxide, or pidolate. And they come in a variety of combinations, from multis to special-formula supplements for diabetes. Green leafy vegetables, legumes, nuts, wheat germ, and whole grains are natural sources of magnesium . Alpha-Lipoic Acid Researchers have discovered that this potent antioxidant (experts say it’s more potent than vitamins E or C) may be an effective treatment for a common complication of diabetes, known as diabetic neuropathy. It can develop when high blood sugar levels damage delicate nerve endings. The result is a stabbing, tingling, and burning pain in the legs, feet, and hands, especially at night. In Germany, alpha-lipoic acid is a prescription drug used to treat diabetic neuropathy. It may also help control blood sugar in diabetics, possibly by lowering insulin levels and increasing the transport of sugar into cells. Alpha-lipoic acid is found in small amounts in some foods—spinach and meat, for example—but not enough to make a real difference. For that, studies show you need 600 to 1,200 mg a day, amounts that can come only from supplements. Plant or Herbal Supplements Used for Blood Sugar Control Here is a short description of plant-based supplements that are also beneficial for diabetics: Gymnema Sylvestre (Gumar) This is a woody climbing plant that grows in the tropical forests of Central and Southern India. The leaves are used in herbal medicine preparations. The active ingredient in gymnema silvestre is "gymnemic acid," which affects the taste buds in the oral cavity. It interferes with the taste of sweetness, which explains the Hindi (Indian language) name gumar "Destroyed of sugar." It also reduces the metabolic effects of sugar by altering its digestion by the intestine, thus reducing the absorption of sugar in the blood. Eugenia Jambolana (Jambul) These seeds found in Central and Scientific Evidence You Cannot Refute South India and Western America have been found most effective for diabetic people as they quickly reduce the sugar in the urine, which is known as glucosuria. It also has the power of regulating the diabetesinducing conversion of starch into sugar in cases of an increase in In a 1991 study, six type II diabetics were given 100 mg of bitter melon, momordica charantia (also known as balsam pear, bitter gourd, bitter cucumber or la-kwa) solution each day. In 3 weeks, their blood glucose levels dropped an average of 54%. In seven weeks, blood glucose levels of all six diabetics were close to normal and sugar was no longer detectable in their urine. (Source: Some New Facts You Need to Know about Diabetes, International Journal of Humanities and Peace, Vol. 17, 2001) production of glucose. Momordica Charantia (Bitter Melon) This has been used extensively in folk medicine as a remedy for diabetes. It contains an insulin-like property known as polypeptide-P, which helps lower blood sugar levels. Trigonella foenum graeceum Try Melabic (Fenugreek Seeds) Fenugreek is a well-known leafy vegetable that is prized by Diabetics because of its high soluble fiber content. Fiber helps in lowering blood sugar levels by slowing the digestion It’s one of the most comprehensive and reliable blood sugar stablizer available in the market today. Endorsed by nature healers, Melabic can use insulin more efficiently, help reverse diabetes, regulate glucose metabolism, increase insulin sensitivity, rebuild damaged pancreatic tissues, promote healthy weight loss and give you more energy that you ever felt in your life. To find out more visit http://www.melabic.com and absorption of carbohydrates. Fenugreek also contains a substance that helps to control blood sugar levels and increased insulin production. Fenugreek seeds have been shown to diminish reactive hyperglycaemia in diabetic patients. Levels of glucose, serum cholesterol and tryglycerides are significantly reduced when the seeds were consumed. Always remember: The best assurance for maximum health and an active life comes from our own responsible attitude and from following the advice we receive from our physician. Plant-based therapy should not be used by itself. Proper and effective natural treatment of daibetes and hypoglycemia requires careful integration of diet, proper exercises, lifestyle modification, nutritional supplements and prescribed medications. Cayenne Many herbalists believe that cayenne is the most useful and valuable herb in the herb kingdom, not only for our digestive system, but also for our heart and circulatory system. It acts as a catalyst and increases the effectiveness of other herbs when used with them. Originally grown only in South America, the cayenne plant has now spread across the globe both as a food and as a medicine. Certain medicinal herbs are known for their These strong hypoglycemic include garlic and effect. onion, goldenseal and cayenne pepper. The �hypoglycemic effect” means that the cayenne lowers blood sugar the same way insulin does. Cayenne also contains a resinous and pungent substance known as capsaicin. This chemical relieves pain by acting on sensory nerves. Cayenne is especially effective when used as a topical ointment to treat the discomfort of neuropathy The recommended dose of cayenne is two to four capsules daily. But for those already suffering from low blood sugar, cayenne is best avoided. Psyllium Like Fenugreek, psyllium is a good nutritional supplement for Diabetics because of its soluble fiber content. In some studies, taking unsweetened or artificially-sweetened psyllium appeared to delay the absorption of carbohydrates from foods. As a result, blood sugar levels did not increase as much or as rise as fast as they would have normally. And in clinical trials, patients who took psyllium supplements were able to lower their blood sugar by up to 19%. It’s recommended that you should take 5 grams of psyllium supplements three times per day for eight weeks. This should not only lower your blood glucose level but also your cholesterol level. Two-for-one! Please Note: when taking psyllium supplements, make sure you drink plenty of water. The Jury Is Still Out The following herbs are still being studied for their therapeutic value in diabetes: • Aloe vera • American ginseng • Asian ginseng • Bilberry • Hairy basil (seed) • Holy basil (leaf) • Onion Thumbs Down There is no scientific evidence for the following herbs, despite their prescription in certain alternative health regimens • Eleuthero • Mistletoe • Olive leaf • Reishi • Fructo-oligosaccharides (FOS) • Inositol • Medium chain triglycerides • Quercetin • Starch blockers • Taurine • Vanadium (for type 2 diabetes) • Vitamin B3 (Niacinamide) Complementary Care M anaging stress is key to managing blood sugar levels. In addition to a medically recommended treatment plan, many people find it helpful to seek out extra activities that optimize their physical and emotional health. These are called complementary therapies, because they fit alongside, rather than in place of, the doctor's advice. One example of a complementary therapy is taking vitamins and other supplements, such as a daily multivitamin. Another example of a complementary therapy is joining a weight-loss, stop smoking, or other group, in order to fight a habit that compounds the health risks brought on by diabetes. A third example is engaging in a stress reduction activity. This is important because, for many people, dealing with Diabetes is very stressful and can trigger depression or other emotional problems. Examples of stress reduction activities include signing up for a yoga class, learning deep breathing and other meditation exercises. Complementary care doesn’t have to be expensive. To relieve stress and promote wellness, something as simple as a scented bath or a massage from a partner can provide tremendous benefits. End Notes D iabetes is a disease that affects millions of people and their families around the world. However by taking good care of ourselves, we can control diabetes and prevent major complications which can come from it. Afterall, an ounce of prevention is worth a pound of cure! Checklist for Health Lifestyle-related →Create a balanced meal plan and stick to it. →Try supplements that have been shown to have an impact on fighting diabetes. (Discuss your choices with an alternative healthcare provider) →Exercise at least 3-4 times weekly for 20 to 40 minutes each session. →Practice good foot and skin care. →No smoking! →Try to manage stress as best as you can. Attend a stress management workshop to help you learn better coping methods. See Your Doctor →See your doctor regularly… • Every 3-4 months for regular check-ups if you are treated with insulin. • Every 4-6 months if you are treated with other diabetes medications • Every 4-6 months if you are managing diabetes with diet and exercise alone. →Follow your medication schedule as prescribed by your doctor. You should know the names of your medications (brand and generic names) and how they work. Always keep a list of your medications with you. →Keep your blood glucose level at the recommended range and CALL YOUR DOCTOR if… • If your blood glucose is less than 70 mg/dl and you have more than one unexplained low blood glucose reaction a week. • If your blood glucose is greater that 180 mg/dl for more than a week or if you have two consecutive readings greater than 300 mg/dl. →Record your blood glucose and urine ketone test results. Bring your log book with you to all of your doctor’s visits. Regular Testing →Test your blood glucose regularly, as recommended by your health care provider and more often when you’re sick. →Test your urine for ketones when your blood glucose is over 300 mg/dl. (Tip: Test your urine more often when you’re sick.) →Have a glycosylated hemoglobin test (HbA1c) four times a year or as recommended. →Have your eyes examined and have a urinalysis test once a year…or as often as recommended by your doctor. →Have your cholesterol and triglyceride levels checked (lipid profile test) once a year. →Have a dental examination every six months. A DUMMIES GUIDE FOR DIABETICS Eat In Measured Quantity 1 slice white or brown bread, 1/2 hamburger bun, 1 biscuit, (1" diameter), 1/2 cup rice, grits, macaroni or noodles group, 1 cup ready-to-eat cereal (flake-non sugar-coated), 1/2 cup cooked cereal (oatmeal or cream of wheat), 1/2 bagel Eat Generously (3-5 servings daily) • 1 cup raw green leafy vegetables, 1/2 cup cooked vegetable (collards, okra, snap beans, pole beans, turnips, kale mustard greens, green cabbage, potatoes, squash, carrots and onions), 3/4 cup low-sodium vegetable juice • A variety of fruits, such as medium apple, banana, peach, mango, orange, pear, 1/2 grapefruit or 1/4 cantaloupe, 1/2 cup of grapes, 1 cup of strawberries or blackberries, 3/4 cup 100% fruit juice, 1/2 cup canned fruit packed in light syrup or natural fruit juice Eat Moderately • 3 oz. poultry, lean beef, fish lean pork and eggs (3 per week), 3 oz. lean lamb and lean ground meats, Dry Beans, Eggs 1/2 cup cooked dried peas or beans, 1 tablespoon of peanut butter (limit servings) 1/4 cup nuts Note: Bake, broil, grill, stew or boil meats whenever possible. Limit use of shellfish due to high cholesterol content. • 1 cup milk (lactose-free) or buttermilk 1% or skim milk recommended, milk, cheese, 1/2 cup ice cream, ice milk or low-fat frozen yogurt 1-1/2 oz. natural cheese (cheddar, colby, provolone, mozzorella) 1/2 cup cottage cheese, 1 cup low-fat yogurt Eat Sparingly • Snacks, sweets, cakes, pies, cookies and other desserts • Go easy on rich desserts, candies, soft drinks and alcoholic beverages, snack foods items, such as chips, cheese puffs, corn chips and pork skins (These are all high in sugar, fat and salt) • Foods such as chitterlings, sausage, fats & oils group. Bacon, pork neckbones, fat back, hog jowls and pig feet should be avoided because these are high in fat content, and provide calories that are low in nutrients. Please Note: These foods do not have enough nutrients to fit in any of the basic food groups and should not be used to replace foods from other food groups. Tim and I both completely understand how hard this life change can be, change is hard for some. With the right mind frame and relaxed attitude you can do this! Everyday will not be perfect and your body will let you know it! However every day you focus on natural ways to take care of the one body you have in this life time you will be one step closer to being free of this diabetes epidemic to spend more time with your loved ones! I hope you have absorbed all the great information and realize how important it is to take your health into your own hands. My husband Tim would be long gone if we did not take the responsibility of his disease into our own hands. All the best to you and your loved ones on your journey and remember we are here to support you and to let you know you can do it. You can beat this disease! Take care, Recipes for Diabetes The best way to ensure we eat right is to eat well. That means investing a little bit of time and effort to prepare homemade food items that are nutritious, health-promoting…and really, really tasty. We don’t have to spend the rest of our life in a state of deprivation. Instead of saying “No” to bad foods, think about saying “Yes” to good foods. As we establish new habits, we’ll find that cravings for unhealthy food will gradually begin to vanish. And, although you may not believe it yet, the foods that were once irresistible to us will start to look less and less appealing. Eventually, knowing how unhealthy a food can be for you will be enough to deter us, forever. Now I am so excited to share with you a project that I poured my heart and soul into. I have worked endless hours testing and trying numerous meals for our Diabetes Cookbook, which are not only good for you but yummy tasting! No recipe is made with Splenda – (which is full of harmful chemicals) that most diabetic cookbooks recommend for a white sugar substitute. My family, friends and experts in the health industry have been very gracious to be my guinea pig taste testers. I have to say after so many hours to even count and too many dishes ruined we have some real winners in our cookbook. I have included some recipes below that I encourage you to try, don’t even tell anyone that the meal is good for them. Food is something that we need, depend on, socialize with, take comfort in so why not make the best of it in the most flavor-able healthy way. You can find out more about The Diabetes Cookbook by visiting http://www.thediabetescookbook. If you have any questions please let me know at [email protected] , I am more than willing to help in anyway that I can. I have provided a few recipes that you might want to give a try, and remember if you have a favorite recipe that you would love to share with everyone, PLEASE email it and I will make sure to pass it on. I want to thank you for taking the time to read my book and I want to wish you all the best in your journey and fight against diabetes. I know that if you take action you will change your life. Remember I am there for you every step of the way and would love to hear your story. So please send me an update from time to time to let me know how you are doing To Your Health Julia Hanf Curry in A Hurry Soup Ingredients 1 10 ounce package frozen lima beans 1 tablespoon margarine 1 bunch scallions, white and 1 inch green, sliced (about 1/2 cup, 45 g) 1 teaspoon curry powder 1/2 teaspoon salt 1/8 teaspoon pepper 1/2 teaspoon crushed dried tarragon 4 sprigs flat-leaf parsley 2 cups fat-free low-sodium chicken broth 1/2 cup skim milk Procedure • Thaw the lima beans and place in the bowl of a food processor or blender. • Add the margarine, scallions, curry powder, salt and pepper, tarragon, and parsley. • Process until smooth. • Place the lima bean mixture into a pot. • Add the broth and milk. Bring to a simmer, cover and simmer for 10 minutes. • If the soup is too thick add water to bring it the consistency you like • Ladle 1/4 cup soup into espresso cups and serve as an aperitif. Roasted Eggplant Spread It Around Ingredients 1 large eggplant (approximately 2 lbs.) Cooking spray 1 head of garlic Juice of 1 lemon 2 tablespoons olive oil 1 tablespoon red wine vinegar 2 tablespoons chopped flat-leaf parsley 1/4 teaspoon cayenne pepper 1/4 teaspoon ground cumin 1/8 teaspoon kosher salt (optional) Freshly ground pepper Procedure • Preheat oven to 425°F • Cut eggplant in half lengthwise and lightly coat with cooking spray. • Place, cut side down, on a large baking sheet. • Separate garlic into cloves, but do not peel. • Wrap garlic cloves in aluminum foil and bake alongside the eggplant for 30 minutes, until tender. • Unwrap garlic and peel. Place in a medium bowl. • Scoop out eggplant flesh & place in bowl, Discard skin. Mix in lemon juice, olive oil, vinegar, parsley, cayenne pepper, cumin, salt (if using), and pepper. BLEND! Stew beef with vegetables Ingredients • 2 lbs. lean stew beef, diced • 1 10-oz can low-fat cream of mushroom soup • 2 cups chopped onions • 2 cups sliced carrots • 1 cup chopped green bell pepper • 23 reduced-sodium beef boufillon cubes • 1/2 cup red wine • 2 cups water Method • Combine all ingredients except the rice in a large soup pot. • Bring to a boil and reduce the heat. • Simmer until the beef becomes tender, about 1 to 1 1/2 hours Add more water if necessary • Serve over 1/2 cup of hot rice Delightful Desserts for Diabetics Here are some desert recipes that diabetics can tuck in without any guilt pangs Cherry Pie Ingredients • Pastry for double crust 9-inch pie • 2 16-ounce packages frozen, no-sugar-added pitted cherries • 2 packets sugar substitute - Stevia • 4 teaspoons all-purpose flour • 4 teaspoons cornstarch • 1/4 teaspoon ground nutmeg • 1/4 teaspoon ground cinnamon • 5 to 7 drops red food color Method • Thaw cherries completely in strainer set in bowl; reserve 3/4 cup cherty juice. Mix sugar substitute, flour, cornstarch, nutmeg and cinnamon in small saucepan; stir in cherry juice and heat to boiling. • Boil, stirring constantly, 1 minute. • Remove from heat and stir in cherries;stir in food color. • Roll half of the pastry on floured surface into circle 1 inch larger than inverted 9inch pie pan; ease pastry into pan. Pour cherry mixture into pastry. Roll remaining, pastry on floured surface to 1/8-inch thickness; cut into 10 to 12 strips, 1/2 inch wide • Arrange pastry strips over filling and weave into lattice design. Trim ends of lattice strips; fold edge of lower crust over ends of lattice shills. Seal and flute edge. • Bake in preheated 425-degree oven until pastry is browned, 35 to 40 minutes. • Cool on wire rack. Tangy Lemon Squares Ingredients • 3 cups all-purpose flour • 8 packets sugar substitute - Stevia • 1/8 teaspoon salt • 6 tablespoons butter or margarine, cut into pieces • 1 teaspoon grated lemon peel • 1 teaspoon vanilla • 2 eggs • 18 packets sugar substitute • 1/4 cup lemon juice • 4 tablespoons butter or margarine, melted • 1 tablespoon grated lemon peel Method • Combine flora, salt and 2 1/2 teaspoons sweetened in medium bowl. • Cut in butter with pastry blender until mixture resembles coarse crumbs. • Sprinkle with 1 teaspoon lemon peel and vanilla; mix with hands to form dough. • Press dough evenly on bottom and 1/4-inch up sides of 8-inch square baking pan. • Bake in preheated 350 degree oven 8 to 10 minutes. • Cool on wire rack. • Beat eggs and with remaining sugar substitute; mix in lemon juice, butter and 1 tablespoon lemon peel. • Pour mixture into bake pastry. Bake until lemon filling is set, about 15 minutes. • Cool completely on wire rack. Pineapple Upside Down Cake Ingredients • 8 1/4-ounce can light pineapple slices in fruit juice, drained • 1/2 cup unsweetened applesauce • 18 packets sugar substitute - Stevia • 1 egg • 1/2 teaspoon vanilla • 1 cup cake flour • 1 teaspoon baking powder • 1/4 teaspoon baking soda • 1/2 teaspoon ground cinnamon • 1/4 teaspoon salt • 1/2 cup buttermilk Method • Arrange drained pineapple slices in bottom of lightly greased 8-inch cake pan • Mix applesauce, sugar substitute, egg and vanilla until smooth in medium bowl • Mix in combined cake flour, baking powder, baking soda, cinnamon, nutmeg and salt alternately with buttermilk, beginning and ending with dry ingredients. • Pour batter over pineapple slices in pan. • Bake in preheated 350-degree oven until cake is browned and toothpick inserted in center comes out clean, about 20 minutes. • Invert cake immediately onto serving plate. Spread Fruit Topping over warm cake. Serve warm. For the Fruit Topping 3 tablespoons light apricot pre serve with sugar substitute or apricot spreadable fruit 1 teaspoon lemon juice 1 teaspoon cornstarch 6 packets sugar substitute or 1/4 teaspoon maple extract Method • Mix reserve, lemon juice and cornstarch in small saucepan; heat to boiling, stirring constantly. • Remove from heat. • Stir in sugar substitute and maple extract Glossary Agoraphobia: fear of open spaces, often preventing individuals from leaving home Aneurysm: swelling and weakening of a blood vessel wall, making it more susceptible to rupture. Diabetic ketoacidosis: a symptom produced by acetone produced by the metabolism of fatty acids rather than glucose Diabetic neuropathy: diabetes-induced deterioration of the neurons in the peripheral areas of the body with consequent tingling, pain, and numbness. Diabetic retinopathy: diabetic-induced deterioration of the blood vessels supplying the optic retina. Glucagon: a pancreatic hormone that retrieves stored energy for use by the body Hyperglycemia: excess glucose in the blood. Hypoglycemic coma: loss of consciousness from drastic reduction in the amount of glucose in the blood often brought on by too much available insulin. Insulin: a pancreatic hormone that provides energy to cells and stores this as fat. Self-efficacy: individuals' perceptions of whether certain situations can be handled and whether they can do it. Type 1 diabetes: diabetes that often begins early in life (childhood or adolescence) and originates from the failure of the pancreas to produce insulin Type 2 diabetes: diabetes that often begins later in life (40s or 50s) and is more likely brought on by a sedentary lifestyle, lack of exercise, a high-fat diet, and excess body fat. BONUS SECTIONS Online Resources Web Sites: • American Diabetes Association (Web Site: http://www.diabetes.org/home.jsp). This could be your one-stop shop for all information on diabetes culled from reliable, authoritative sources and experts in the field. • The Diabetes Mall: (Web Site: http://www.diabetesnet.com:80/). Information about many facets of daibetes, treatment and prevention. • Alternative Medicine Digest: (Web Site: http://www.alternativemedicine.com) Site devoted to many illnesses, including diabetes. • Diabetes Herbal Treatment Home Page: (Web Site: http://www.diabetea.com:80/) Best nutrition, Inc. advertises and sells Gymnema Herbal Tea, which it says can play a role in treating conditions caused by excessive sugar intakes. • Information About the Gerson Therapy: (Web Site: http://home.unicomp.net/lschiele/gersn.htm) The Gerson Therapy is an intensive, nutrition-based and detoxifying medical treatment for daibetes. It works closely with nature to help the sick body fid itself of disease through the supportive effects of simple foods, juices and non-toxic medication. • The Diabetes Home Page: (Web Site: http://www.nd.edu/hhowisen/diabetes.html) Offers a variety of information about treatments. • CDC Diabetes Home Page: (Web Site: http://www.cdc.gov/nccdphp/ddi/whatsnew.htm) A look at government programs, statistics and facts about diabetes. • ChiLel Qigong Home Page - Miracles of Natural Healing: (Web Site: http://www.chilel-qigong.com/) ChiLel consists of visualizations combined with a series of gentle movements which can be easily learned by anyone who wants to improve and sustain their health and wellness. • RxHealth.com: (Web Site: http://www.rxhealth.com/diabetes.htm) Site has lots of information and links to information about the disease. • USA Today: (Web Site: http://www.usatoday.com:80/life/health/general/ingen000.htm). This site has many inspiring stories about diabetics and how they overcame their disease and strengthened their disease resistance. Disclaimers • The material in this book is for information purposes only. We strongly recommend that you consult a healthcare professional before attempting any of the strategies recommended in this e-book. • Finally, while medicinal herbs are generally extremely safe, they may at times contain substances that can are drug-like in function. Mixing supplements, herbs, and OTC or prescription medication may thus lead to unintended, dangerous consequences due to drug interaction, so follow your doctor’s counsel before subscribing to any of these treatment schedules and protocols.
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