Nutrition and Diabetes, Part 2

by Dr. Joseph Debé

There is no one "Diabetes Diet" that is best for everyone. However, good general dietary guidelines for management of Type II Diabetes are: 

1. Eat whole foods; 

2. Avoid or at least minimize simple carbohydrates such as sugar, candy, pastries, soda, and fruit juices, as these cause a rapid rise in blood sugar and resultant sudden demand for insulin, thereby stressing the pancreas; 

3. Increase dietary fiber intake as it slows sugar absorption; 

4. Avoid fried food; 

5. Avoid artificial sweeteners, as these may interfere with energy production, weight loss and glucose control; 

6. Reduce intake of saturated fat and hydrogenated vegetable oils as these increase risk to atherosclerosis and may increase insulin resistance. 

Each individual should use home blood glucose testing to monitor response to different foods, diets, meal size and meal frequency. Some diabetics do well on a high complex carbohydrate, high-fiber diet rich in fruits, vegetables, whole grains, nuts, seeds, and legumes. Based on my review of the literature, however, it is my opinion that most diabetics need quite the opposite: a diet restricted in carbohydrates with higher levels of protein and sometimes more fat as well. 

There have been several studies that have compared a high carbohydrate diet with a high monounsaturated fat diet for diabetics. The higher fat diets have produced more favorable biochemical changes. 

A dietary study published in "Diabetes Care" in January, 1995, compared the effects of an American Diabetes Association diet of 55% carbohydrate, 30% fat, 15% protein to one consisting of 40% carbohydrate, 45% fat and 15% protein. The high carbohydrate diet was found to produce higher levels of blood glucose, insulin and triglycerides. The authors of this study concluded that in patients with Non-Insulin Dependent Diabetes Mellitus "...multiple risk factors for coronary heart disease are accentuated when these individuals consume diets recommended to reduce this risk." Thus, the typically recommended American Diabetes Association diet seemed to increase heart disease risk factors, while the higher fat diet did just the opposite. 

A dietary study published in 1994 by Milton Crane, M.D. revealed some very impressive symptomatic and biochemical changes in Type II Diabetic patients with peripheral neuropathy (nerve pain in the legs). The diet given was strictly vegetarian, high in complex carbohydrate and fiber, low in simple sugars, contained 10-15% fat, and was devoid of cholesterol and refined foods. The results were as follows: 

1. Blood glucose normalized; 

2. Cholesterol, triglycerides and bodyweight decreased; 

3. Within 2-1/2 weeks, 17 of the 21 subjects had resolution of their leg pain. 

In addition to diet, there are a wide variety of vitamin, mineral, plant and other natural supplements that can improve the body's metabolism of glucose and reduce the complications of diabetes. The following are helpful in normalizing glucose and insulin metabolism: 

1. Soluble fiber such as pea, oat, guar gum, pectin, glucommonan; 

2. Vitamins A, B6, C, E, biotin; 

3. Minerals such as chromium, magnesium, copper, potassium, manganese, zinc and vanadium; 

4. Fatty acids such as gamma linolenic acid and omega 3 fatty acids; 

5. Food concentrates from Jerusalem artichoke, brewer's yeast, onion, and garlic;

6. Metabolic Intermediate compounds such as carnitine, alpha lipoic acid, and coenzyme Q10; 

7. Herbs such as Aloe Vera, Bitter Melon, Gymnema Sylvestre, Fenugreek Seeds, and Siberian Ginseng; 

8. Aerobic and strength training exercise; 

9. Stress reduction techniques. 

Diabetic complications result from two main processes that damage tissues and organs: 

1. Intracellular sorbitol accumulation, and 

2. Glycosylation of proteins. 

Sorbitol is a crystalline alcohol formed from glucose in the body. Diabetics have increased intracellular sorbitol accumulation, which leads to cataracts, retinopathy and neuropathy. Vitamin C and bioflavanoids like quercetin reduce sorbitol formation by inhibiting aldose reductase, the enzyme that converts glucose to sorbitol. 

Glycosylation is the irreversible binding of glucose to proteins. The crust that forms on a cooked piece of bread is the result of the glycosylation reaction. This process occurs in all of us to some degree. However, excessive glycosylation in the body disturbs the functioning of the involved protein and leads to tissue damage and premature aging. The higher the blood sugar, the more glycosylation that results. Glycosylation leads to thickening of blood vessels, which diminishes blood flow, ultimately leading to cellular damage and death. This process is involved in diabetic kidney disease, neuropathy, and eye problems. Benfotiamine, carnosine, vitamins B6, C, and E, and the herb Gymnema Sylvestre, all inhibit glycosylation. 

To further reduce the incidence of diabetic retinopathy and cataracts, the following are important: vitamins B12 and C, magnesium, Bilberry, Grape Seed Extract, Gingko Biloba, and shark cartilage. 

In addition to a vegan diet, the following have been shown to be helpful in the management of diabetic neuropathy: vitamins B1, B6, B12, inositol, biotin, evening primrose oil, omega 3 fatty acids, alpha lipoic acid, and topical Capsaicin. 

To further reduce the severity of atherosclerosis, the diabetic can use: vitamins B6, B12, C, E, and folic acid, chromium, pantethine, magnesium, garlic, onions, Fenugreek Seed, Gymnema Sylvestre, Gingko Biloba, chondroitin sulfate, aortic glycosaminoglcans, and fish oil. 

Animal studies have shown that Gymnema Sylvestre and Pterocarpus can both regenerate the pancreatic insulin secreting beta cells. Vitamins B6, C, and niacinamide are also important for the health of the beta cells. 

There are several laboratory tests that can be used to determine if you have or are prone to diabetes: 

1. Fasting blood glucose levels, which give a "snapshot" of your blood sugar status; 

2. Fasting blood insulin levels which, when elevated, signal insulin resistance; 

3. Plasma glycosylated proteins which give a measure of longer term blood sugar control; and 

4. A carbohydrate challenge test, which is like an endocrine system stress test that determines your body's response to eating a high carbohydrate meal. It will show if blood sugar levels become abnormal, if insulin levels go too high or too low, if insulin resistance is present, and if the adrenal or stress glands produce excessive levels of cortisol. The carbohydrate challenge test can predict the development of sugar metabolism problems years in advance and can reveal risk factors for other diseases as well. 

For best results, consult with a licensed nutritionist to have your condition assessed and a diet and supplement program tailor-made. Keep in mind, though, the primary subject of this article: that diet and supplements can have a powerful effect on optimizing glucose and insulin levels. Therefore, if you are taking diabetic medication, consult your medical doctor to have your dosage adjusted as your condition improves.