November is Diabetes Awareness Month in Canada! Did you know that more than 3 million Canadians are currently living with Diabetes? It is estimated that this number will rise to 3.7 million by 2020! As you can see it is important to understand how Diabetes can develop to make the necessary dietary and lifestyle changes as a society, so that we can really work and improve these stats!
Let's start off by discussing what Diabetes is at a physiological level…
What is Insulin Regulation?
Insulin is a hormone that is used to regulate the amount of glucose (sugar) in the blood. When food is ingested it is broken down by the gastrointestinal tract into glucose which then circulates in the bloodstream. The job of insulin is to get this glucose into cells and tissues where it can be used for energy or to store the excess glucose as glycogen in the liver and triglycerides (stored fat) in adipose tissue. Thus, there is a rise in insulin after we eat as a signal for all the cells and tissues in the body to take up the glucose that is circulating in the blood, which helps to lower blood glucose levels.
Eating too often, especially foods that are high in refined carbohydrates can cause insulin to spike consistently throughout the day. This causes cells and tissues to be less sensitive to the continuously high levels of insulin in the body leading to insulin resistance and weight gain. In insulin resistance, blood glucose levels remain elevated as cells and tissues stop listening to the signal of insulin. Chronically high glucose levels in the blood can change the shape of red blood cells and often is a preceding factor in Type 2 Diabetes. When these red blood cells pass through smaller blood vessels they cause inflammation, and ultimately cause damage to the blood vessel. As a result, elevated blood sugars for prolonged periods of time can really affect the whole body and is a risk factor for the development of cardiovascular disease, chronic kidney disease and eye disease.
What Are Signs for Early Blood Sugar Dysregulation?
- Extreme thirst
- Frequent urination
- Frequent infections
- Erectile dysfunction
What is Diabetes?
Diabetes is a disease in which the body cannot produce OR cannot efficiently use the insulin it produces. There are 3 main types of diabetes:
- Gestational Diabetes - Occurs during pregnancy and is usually only temporary
- Type 1 Diabetes - Type 1 diabetes is an autoimmune disease where the body attacks the pancreas (organ that makes insulin). Individuals with type I diabetes are not able to produce their own insulin and thus cannot regulate their own blood sugar. This type of diabetes generally develops in childhood or adolescence but can also develop in adulthood. Treatment for Type 1 diabetes is usually insulin injections or an insulin pump to ensure the body is receiving the required amounts of insulin to regulate blood sugar levels. Roughly, 10% of individuals with diabetes have Type 1.
- Type 2 Diabetes - Type 2 diabetes is when the body cannot efficiently use the insulin that is made and produced by the pancreas OR the body is not able to produce enough insulin and is a result of continuous blood glucose dysregulation explained above. Type 2 diabetes is more common in adulthood and can be managed with healthy eating, regular exercise and supplementation in some cases. However, other cases may require medications or insulin therapy. Individuals with Type 2 Diabetes are 2-4 x more likely to develop Cardiovascular Disease and 3x more likely to be hospitalized for Cardiovascular Disease.
Did you know that reducing blood glucose levels can reduce the risk of cardiovascular disease, heart attacks and strokes?
How To Diagnosis Diabetes?
A Diagnosis of DIABETES is made when:
- Fasting Blood Glucose (FPG) > 7.0 mmol/L (Fasting = no caloric intake for at least 8 hours)
AIC > 6.5%
- Measuring A1C is a better predictor for diabetes, as it measures the average blood glucose levels over a 3 month period which avoids day to day fluctuations.
- Random Blood Glucose (PG) > 11.1 mmol/L
- Fasting insulin can also be tested to see if the body’s needs for insulin are increasing over time
A Diagnosis of PREDIABETES is made when:
Now let’s talk about prevention and treatment…..
How to Control Blood Sugar Levels Naturally?
1. REGULAR EXERCISE- Aerobic exercise which includes running, biking, swimming or walking is THE best way to regulate blood sugar levels. Exercise plays a big role in both the prevention and control of insulin resistance, type 2 diabetes and long-term complications of diabetes.
- Regular physical activity can reduce the chances of developing Cardiovascular disease and overall mortality by 39-70%.
- Regular physical activity also slows the development of peripheral neuropathy, which is experienced as a side effect of long standing diabetes.
- Resistance training improves blood sugar control, decreases insulin resistance, increases lean muscle mass and increases bone mineral density
- Aim to exercise at least 30 mins a day, even if it's just walking and aim to participate in weight lifting (even if it's just your body weight) 2-3x a week.
2. DIET- Regulating the quality of food one chooses to consume on a daily basis can have a big impact on blood sugar regulation and weight control.
Glycemic Index (GI) is a scale that ranks a carbohydrate containing food or drink by how much it raises blood sugar levels after eating or drinking. Foods that have a higher GI raise blood sugar levels higher and faster than low GI foods. Opt to replace high glycemic index carbohydrates with low glycemic index carbohydrates.
- GI >70 = High (ex. potatoes, white rice, corn, turnips and white bread) CHOOSE LESS OFTEN!
- GI: 56-59 = Medium
- GI<55 = Low (Ex. legumes, vegetables, nuts, barley, beans, chickpeas) CHOOSE MOST OFTEN!
- Have several servings of colourful vegetables and low sugar fruits daily (berries, apples, peaches, pears)
- Ensure adequate fiber consumption - Fiber can help to slow the release of glucose into the blood and prevent those insulin spikes!
- Opt for a high protein breakfast and eat a source of protein at each meal to keep blood sugar levels regulated
- Eat at regular intervals every 4-5 hours
If you are going to snack, aim for a well planned snack vs. grazing throughout the day. The basics of a healthy snack include:
- 100-400 calories
- A source of fiber - keeps blood sugar balanced and improves digestion
- A source of protein - helps to keep blood sugar steady and keeps you fuller for longer. Aim for 10-20 g of protein per snack
- A source of fat - eating healthy fats like nuts, seeds, coconut or avocadoes can help you feel satiated. Aim for 1 tbsp per snack
- Aim to reduce calories by about 500 a day. This can help with insulin production and effectiveness utilization
- Check out: This Guide to pick foods that are lower on the GI scale.
3. SUPPLEMENTATION- Natural supplements can be used to lower blood sugar levels and can be a great addition when diet and lifestyle changes are underway!
Cinnamon: Has been shown to decrease A1c levels and fasting blood glucose
Chromium: Allows for cells and tissues to recognize and bind to insulin which can improve insulin sensitivity and lower fasting blood glucose
Gymnema Synvestre: This herb makes sugar no longer enjoyable! It is recommended to eat 1 capsule before eating sugar. This is a great option of helping people fight a sugar addiction! It also helps to reduce fasting glucose and A1c levels
Berberine: Is an analog to Metformin (anti-diabetic drug). It is effective for lowering blood sugar levels in a 3 month time period.
The big take home message from today’s post is PREVENTION! The key to preventing and treating diabetes is rooted in lifestyle and dietary changes. Spend the month of November making conscious decisions of daily eating while incorporating more physical activity into your routine and make notes on energy levels, blood glucose levels, digestion and weight management to keep track. Start slow and work your way up. This means start with changing one meal at a time, always start with breakfast! Once you have perfected this meal move on to the rest. If exercise is something you are not used to, attempt to start with increasing any form of physical activity 2x a week and then work your way up from there.
** Disclaimer: The advice is in this article is for informational purposes only. It does not replace the care of a Naturopathic physician.