Nutrition and Diabetes, Part 1

by Dr. Joseph Debé

Diabetes Mellitus affects about 5 percent of Americans, half of whom are not aware of their condition. It is the #5 cause of death from disease in the United States. Diabetes Mellitus is a disorder of fat, protein, and especially carbohydrate metabolism. The hallmark of the condition is elevated blood sugar levels. This can occur either when the pancreas doesn't produce enough insulin or when the body's cells become resistant to the effects of insulin. The two main classes of diabetes are Insulin Dependent Diabetes Mellitus (IDDM), also known as Type I or Juvenile Onset Diabetes, and Non-Insulin Dependent Diabetes Mellitus (NIDDM), also referred to as Type II or Adult Onset Diabetes. 

Type I Diabetes accounts for about 10 percent of cases and results from the destruction of the insulin producing beta cells in the pancreas. Type I Diabetes usually develops in childhood or adolescence. The underlying cause of this may be a viral infection or an autoimmune condition wherein the body's immune system attacks the beta cells. There is a controversial correlation between allergy to cow's milk and development of Type I Diabetes. This allergy is more common in children who are introduced to cow's milk at an early age and consume large amounts of dairy products in childhood. Type I diabetes necessitates life-long use of daily insulin injections. However, diet, nutritional supplements and exercise can lower insulin need and prevent complications. 

Type II Diabetes accounts for about 90 percent of the cases. Unlike Type I Diabetes, insulin levels may be normal or high in this condition. Why is this? The problem is one of insulin resistance. As was alluded to above, insulin resistance is the situation in which insulin fails to perform its job of transporting glucose from the blood into the cells. As many as half of middle aged Americans may have some degree of insulin resistance. Contributing factors to Type II Diabetes are genetic predisposition, obesity (90 percent of those afflicted are obese), certain nutritional excesses (primarily carbohydrates), other nutrient deficiencies, lack of exercise, smoking, food intolerances, and stress. 

The complications of chronically elevated blood glucose and insulin levels are devastating; with coronary heart disease being the most important cause of death and disability in diabetes. Other possible complications of this condition are: stroke, kidney disease, blindness, intermittent claudication, delayed wound healing, weakened immune system, skin ulcers and gangrene, neuropathy or nerve dysfunction, male sexual impotence, leg pain, numbness and weakness. 

Untreated diabetes results in excessive sugar accumulation in the blood. With increasing levels, the sugar spills over into the urine as the body's cells starve. Increased amounts of fluid and nutrients are excreted along with the sugar. Increased urination is the first sign of high blood sugar. If this state persists, it results in increased thirst, hunger, and in Type I Diabetes, weight loss. In some cases though, neuropathy may be the first sign of diabetes. 

Many cases of Type II Diabetes can be controlled by diet alone, without use of medications. A major dietary goal in the treatment of NIDDM is the improvement of body composition; reducing body fat while maintaining lean body tissue. The accomplishment of this alone is often enough to resolve Type II Diabetes because optimizing the ratio between body fat and lean body tissue will improve insulin sensitivity.