CSNN Diabetes & Hypoglycemia

Flavanoids?

"Colour" in fruits and vegetables and flowers Antioxidants Anti-inflammatory, anti-allergenic, antiviral and anticarcinogenic properties Flavonoids such as Quercetin promote insulin secretion Studies show herbal flower remedies helpful in treating diabetes they can increase the levels of vitamin C in cells Break down histamines good if you have allergies Eat colourful fruits and vegetables (red cabbage, oranges, berries) 1-2 grams of a variety of flavonoids/ day as supplement

The vicouse sugar cycle?

1. Eat refined sugar that is RAPIDLY absorbed in the bloodstream (because of the lack of fiber) 2. INCREASE of insulin secretion by the pancreas in response to sugar 3. EXCESS INSULIN drives the blood sugar level DOWN and often causes the symptoms of hypoglycemia 4. ADRENAL GLANDS SECRETE EPINEPHRINE (adrenaline), which causes a rapid increase in blood sugar level in response to low blood sugar. 5. ADRENAL EXHAUSTION: from repeated stress, the glands become unresponsive, and do not raise blood sugar back up as well, leading to reactive hypoglycemia and eventually diabetes

What is the glycemic index?

A ranking of foods based on their immediate effect on blood glucose (sugar) levels. The standard value of 100 is based on the rise caused by ingestion of glucose- Table 5.1 pg. 40 Carbohydrate foods that break down quickly during digestion have the highest glycemic index (blood sugar response is fast and high) Carbohydrate that break down slowly (releasing glucose gradually into the bloodstream), have a lower glycemic index Used as a guideline for making dietary recommendations for people with diabetes and hypoglycemia Foods that stimulate insulin surges can cause people to eat 60-70% more calories at the following meal (think sugar cycle) People who eat foods high in glucose (white bread and commercial whole wheat bread) eat an average of 200 calories more at the next meal than those who eat fructose (fruit sugar)

Type 1 diabetes?

Also called Insulin Dependent Diabetes Mellitus (IDDM) Occurs most often in children and adolescents Associated with complete destruction of the beta cells of the pancreas, which manufacture insulin Those with Type I Diabetes require insulin and/or medication to manage diabetes About 10% of diabetics are type I Autoimmune Component : antibodies produced by white blood cells destroy the beta cells of pancreas

Magnesium?

Also involved in glucose metabolism Deficiency common in diabetics and leads to complications such as retinopathy (damage to retina of eye) and heart disease In addition to eating a diet rich in magnesium (swiss chard, spinach, pumpkin seeds, dark chocolate) 300-500 milligrams per day from a highly absorbable form (aspartate or citrate) is recommended Needs B6 to get into cells Avoid magnesium oxide or carbonate as these can get the bowels moving

Type 2 diabetes?

Also known as non-insulin dependent diabetes mellitus (NIDDM) Onset usually occurs after 40 years of age (seeing it earlier now) Up to 90% of all those with diabetes have type II Typically, the insulin level in type II diabetics is elevated, indicating that body cells have lost sensitivity to insulin Obesity is a major contributing factor to this loss of sensitivity. Restoring normal blood sugar levels is key to achieving a healthy body weight Diet is VERY important for managing type II Some doctors will give drugs to manage diabetes when the patient cannot control it with diet Exercise can also help with decreasing the cells resistance to insulin

Complex carbs?

Also knows as starches Composed of many simple sugars joined together by chemical bonds It takes more time for the body to break down the complex carbohydrates into simple sugars thereby leading to more stable blood sugar levels Sources? Vegetables, legumes and whole grains

Biotin

Biotin is a B vitamin manufactured in the intestines by bacteria Without it, metabolism is severely impaired Vegetarian diet has been shown to alter the intestinal flora to promote absorption of biotin Supplementing the diet with high doses of biotin improves the enzyme glucokinase activity and glucose metabolism in diabetics 16mg for Type I (supervision of Dr.) and 9 mg for Type II diabetes were found helpful

Definitin of hypoglycemia including its 2 major categories?

Characterized by low blood glucose levels Hypoglycemia results from the faulty metabolism of carbohydrates This occurs when blood sugar levels fall causing irritability, anxiety & nervousness. When blood sugar levels are too high, the hormone insulin is released, When blood sugar is low, hunger signals are given and stores of sugar & fat are released into the bloodstream. If this natural balance is sluggish, hypoglycemia can result. 2 Categories: Reactive Hypoglycemia Fasting Hypoglycemia- very rare, only appears in severe disease states such as those involving pancreatic tumors, liver damage, starvation, and various cancers 1> Reactive Hypoglycemia: is the most common. Characterized by the development of symptoms of hypoglycemia from 2-4 hours after a meal. May also result from the use of certain drugs. 2> Symptoms of Hypoglycemia: Headache, depression, anxiety, irritability, blurred vision, excessive sweating, confusion, bizarre behavior, mood swings, and even convulsions

Secondary diabetes?

Diabetes developing as a result of other conditions: Pancreatic disease hormone disturbances drugs malnutrition Gestational Diabetes Impaired glucose tolerance (a condition that includes pre-diabetic, chemical, latent, borderline, subclinical, and asymptomatic diabetes

Describe how diabetes can be related to inadequate dietary fiber intake?

Dietary carbohydrates play a central role in the cause, prevention and treatment of both diabetes and hypoglycemia Carbohydrates and Fiber can affect our blood sugar levels Let's look at the relationship between diabetes and fiber intake Studies have shown that diabetes is clearly linked to a lack of dietary fiber Dietary fiber refers to the components of the plant cell wall as well as indigestible residues from plant foods The type of fiber with the most beneficial effect on blood sugar control are the water-soluble forms, which are capable of slowing down the digestion and absorption of carbohydrates This slowing down of the digestion prevents the rapid rise in blood sugar, prevents excessive secretion of insulin and improves the uptake of glucose by the liver and other tissues. Good water soluble fiber sources: most vegetables, apples, pears, legumes, oat bran, nuts, seeds, psyllium and flax (aim for 50 or more grams a day) Most people consume no where near this amount!

High glycemic foods?

Elevate insulin and blood glucose Stimulate fat-storage Increase hyperactivity

classic symptoms of Diabetes?

Frequent urination Excessive thirst Excessive appetite

Simple carbs fructose?

Fructose: found in fruits, maple syrup and honey. VERY sweet and is roughly 1 ½ times sweeter than sucrose (white sugar). To be utilized by the body the liver must convert fructose to glucose

Vitamin E

Functions mostly as an antioxidant Can improve insulin action and exerts a number of beneficial effects that may aid in preventing the long term complications of diabetes (cell protection) Food Sources: Wheat germ, nuts, nut butters, seeds Selenium works synergistically with Vit E Food sources: brazil nuts (selenium)

Describe how the glucose-insulin tolerance test (G-ITT) is more sensitive in diagnosing both diabetes and hypoglycemia?

GITT - Glucose - Insulin Tolerance Test: is a standard 6 hour GTT coupled with the measurement of insulin levels as well as measuring the blood sugar levels. This can be more accurate as insulin levels can be compared with blood sugar levels to test if any type of insulin resistance has developed. The GITT can give a better diagnosis in both diabetes & hypoglycemia. Measuring insulin at the same time as blood sugar is recommended since symptoms often correlate better with evaluations of these hormones than with glucose levels, alone. Disadvantage: this test can be more costly

Simple carbs Glucose?

Glucose: primary repeating sugar unit of most carbohydrates Not as sweet as fructose and sucrose. Found in fruits, honey, sweet corn, and most root vegetables

Low glycemic Foods?

Help balance blood glucose and insulin levels Help reduce excess body fat levels Beneficial for those with diabetes and hypoglycemia

Diet and lifestyle for diabetes?

High Complex Carb and High Fiber diet with fresh, natural, whole foods Low glycemic foods: especially legumes, garlic and onions Avoid simple, processed, refined and concentrated carbohydrates and alcohol Keep "bad" fats to a minimum (link to heart disease for those with diabetes) Pg 144 for more Plant based medicines Develop an exercise program to elevate heart rate to at least 60% of maximum - ½ hr at least 3x per week Supplement with good multivitamin/mineral formula and other supplements as indicated previously

Maganese?

Important cofactor in the key enzymes of glucose metabolism Functions in many enzyme systems, including those for blood sugar control, energy metabolism and thyroid function Diabetics have been shown to have only one-half the manganese of normal individuals ~30mg/day

Potassium?

Important electrolyte and essential for conversion of blood sugar into glycogen Affects insulin sensitivity, responsiveness and secretion Get sources from foods! Fresh fruits and vegetables, spinach, swiss chard, celery, cucumbers, tomatoes, cantaloupe.. Supplement on advise of physician only especially if the person has diabetes (pg. 103)

B6 Pyridoxine

Important in the formation of body proteins and structural compounds, chemical transmitters in the nervous system, red blood cells, and hormone like compounds known as prostaglandins. Critical in maintaining hormone balance and proper immune function There are antagonists to B6's function in the food supply: Yellow dye #5, drugs, oral contraceptives, alcohol, and excessive protein inhibit Vitamin B6 absorption. Supplementing can protect against diabetic neuropathy (nerve pain, nerve damage) Vitamin B12 also protects against diabetic neuropathy

The role of Insulin hormone?

Insulin helps control blood glucose levels by signaling the liver and muscle and fat cells to take in glucose from the blood. Insulin therefore helps cells to take in glucose to be used for energy. If the body has sufficient energy, insulin signals the liver to take up glucose and store it as glycogen.

Zinc

Involved in virtually all aspects of insulin metabolism Diabetics typically excrete too much zinc in their urine and require supplementation In addition to foods high in zinc (whole grains, nuts, seeds, legumes) take ~ 30 milligrams per day

Niacin B3

Niacin, like chromium, faciliates the uptake of glucose into cells Supplementing in the form of niacinamide (nicotinamide) has been shown to prevent the development of diabetes in experimental animals Results of these studies suggests that niacinamide can prevent Type 1 form happening or if given soon enough on the onset of diabetes, it can help restore beta cells or a least slow down their destruction Supplement is base on body weight- roughly 25 milligrams per 2 pounds

Simple Carbohydrates?

Quickly absorbed Provide ready source of energy Types of Simple Sugar: Monosaccharides (one sugar molecule) Disaccharides (two sugar molecules) Sucrose (white sugar- 1 glucose + 1 fructose), maltose (2 glucose), lactose (glucose + galactose)

Vitamin C

Since insulin facilitates the transport of Vitamin C into the cells, many diabetics do not have enough Vitamin C inside the cells of their bodies, therefore diabetics need more vitamin C than healthy non-diabetics Recommended supplement up to 2 g a day Eat vitamin C rich foods (peppers, broccoli, brussel sprouts, oranges, strawberries etc)

Advice for those with Diabetes?

Substantially alter diet and lifestyle (HUGE) Re-establish normal blood sugar control and prevent the development of diabetes or decrease/prevent complications A patient under a Physician's care must monitor themselves carefully: Careful attention to symptoms Results of home glucose monitoring and other blood tests are essential Work closely with prescribing physician to monitor drug dosages

Describe the wide range of therapies recommended for addressing (1) diabetes and (2) hypoglycemia?

Supplying those with Diabetes and Hypoglycemia with dietary supplementation has been shown to improve blood sugar control as well as help prevent or improve many complications of these conditions A good place to start is with a good quality multi vitamin and mineral formula specific to support diabetes or hypoglycemia Nutrients= Chromium, Vit C, Niacin (B3), Biotin, Vit B6 pyrodoxine, Vit B12, Vit E, Maganese, magnesium, Potassium, Zinc, Flavanoids. ( A good place to start is with a good quality multi vitamin and mineral formula specific to support diabetes or hypoglycemia)

Explain why the hypoglycemia questionnaire is considered the most useful tool in the diagnosis of hypoglycemia?

This is one of the most useful tools in the diagnosis of hypoglycemia because it assesses the symptoms, and it is free ...no medical costs like the other tests Score of 15 or more indicates that hypoglycemia is extremely likely

Diabetes-hypoglycemic link?

This vicious cycle puts extra stress on the adrenal glands and the pancreas. Chronic high levels of insulin causes sugar to be stored as fat. This prevents the burning of fat as energy & causes the liver to overproduce cholesterol. This excessive glucose starts to gum up all proteins in the body (glycosylation) described a few slides earlier. Muscle atrophy, brain function declines, arteries harden, heart attack & stroke become high risk to develop. Glycosylation also causes connective tissue to stiffen, skin loses tone & elasticity, sugar can encrust the lens of the eyes creating retinopathy. This can also happen in the nerves creating neuropathy. The most critical component of diabetes and hypoglycemia treatment or prevention is the avoidance of refined sugar Eating low glycemic foods, and combining protein and fat with carbohydrates to slow the absorption of sugar into the blood stream

Diet and lifestyle for hypoglycemia?

Use of dietary therapy to stabilize blood sugar levels Avoid simple, refined, processed sugars & alcohol High complex carb and high fiber diet Consume legumes often Frequent small meals to stabilize blood sugar levels Same as diabetes with exercise, plant based remedies and supplements

Explain how to use the glucose tolerance test (GTT) to diagnose both diabetes and hypoglycemia?

Used to diagnose both diabetes & reactive hypoglycemia. After a subject fasts for a least 12 hours, a baseline glucose measurement is made. Then a very sweet drink containing glucose is given to the subject. The blood sugar levels are checked at 30 min, one hour and then hourly for up to 6 hours. If the blood sugar levels rise to more than 200 ml/dl - diabetes is indicated. If the blood sugar falls below 50 ml/dl hypoglycemia is indicated

Explain how the hypoglycemic index can be especially effective in diagnosing borderline cases of hypoglycemia and for gauging the effect of specific carbohydrates on blood sugar?

Used to test hypoglycemia, usually in borderline cases Determined by dividing the decrease in the blood glucose level (during the 90-min period before it reaches the lowest point) by the value of the lowest point. A hypoglycemic index greater than 0.8 usually indicates reactive hypoglycemia. Not commonly used

Chromium

Vital to blood sugar control (enhances the action of insulin) Can be depleted by eating refined sugars, white flour products, and lack of exercise 200-400mcg per day Food Sources: romaine lettuce, tomatoes, onions, brewer's yeast, oysters, liver, whole grains, bran cereals Better taken on its own, not with multivitamin, before or after meals Chromium polynicotinate, chromium picolinate, and chromium-enriched yeast are suitable forms of dietary supplements

Definition of diabetes?

What is Diabetes? Chronic disorder of carbohydrate metabolism but..... The effects of diabetes is not limited to CHO metabolism Lipid & protein metabolism play an important role in the progression of the disease. Abnormal glucose metabolism accounts for poorly regulated biochemical processes that glycosylate hemoglobin and other proteins and lipids throughout the body. Glycosylation is when glucose accumulates in the blood. This excessive glucose gums up all proteins and the body rendering them non-functional and structurally distorted (eg. when hemoglobin is caked with glucose, the brain, heart & muscles receive less oxygen-this creates some of the secondary diseases associated with diabetes). What is Diabetes? Greatly increase the risk of loss of nerve function, heart disease, stroke and kidney disease Can occur when the pancreas does not secrete enough insulin or if the cells of the body become resistant to insulin. To understand diabetes it is important to understand the role of the insulin hormone......

B 12

Works with folic acid in many body processes, including synthesis of DNA. Since vitamin B12 works to reactivate folic acid, a deficiency of B12often results in a folic acid deficiency if folic acid levels are marginal Found in foods derived from animals Supplement if strict vegetarian or vegan 1000-3000 micrograms of B12 /day

Complex carbohydrates?

they are different from simple because they are natural, like fruit and vegetables. They have many nutrients and enzymes and fiber accompanying the sugar that aid in the utilization of the sugar. - Also knows as starches Composed of many simple sugars joined together by chemical bonds It takes more time for the body to break down the complex carbohydrates into simple sugars thereby leading to more stable blood sugar levels Sources? Vegetables, legumes and whole grains

simple sugars, Problems with Carbohydrates begin when they are refined?

they are quickly absorbed by the body and are a source of quick energy. All the vitamins have been removed, from breakfast cereal, wite sugar and bread and pasteries. Avoid = sucrose, glucose, maltose, lactose, fructose, corn syurup, white grape juice concentrate they all mean that sugar has been added. -eating foods high in simple sugars can be harmful to blood sugar control. when sugar foods are eaten alone, the blood sugar level rises quickly, producing a strain on blood sugar controll