Diabetes is a chronic (long-lasting) health condition that affects how your body turns food into energy. Your body breaks down most of the food you eat into sugar (glucose) and then releases it into your bloodstream. When your blood sugar goes up, it signals your pancreas to release insulin. Insulin in turn lowers your blood sugar but this state of chronically elevated blood sugar is a modern-day epidemic with the Center for Disease Control and Prevention reporting

• 3 million Americans (11.3% of the population) have diabetes.
• 96 million people (38%) have insulin-resistant pre-diabetes.
• 48% of people over the age of 65 are prediabetic. (1).

Despite the fact that these number continue to climb, research has shown that diabetes is an inflammatory disorder and is completely preventable and reversible.

Diabetes and Your Blood Sugar:

Diabetes is classically diagnosed by one of three different mechanisms.

Hemoglobin A1C (HbA1C): The A1C test—also known as the hemoglobin A1C or HbA1c test—is a simple blood test that measures your average blood sugar levels over the past 3 months. It’s one of the commonly used tests to diagnose prediabetes and diabetes and is also the main test to help you and your health care team manage your diabetes. Higher A1C levels are linked to diabetes complications, so reaching and maintaining your individual A1C goal is important if you have diabetes.

Healthy HbA1C levels are considered below 5.7 although most functional medicine doctors like to see them below 5.4.  HbA1C levels above 6.5 are clinically diagnosed as diabetes mellitus.  From 5.7-6.5 it is considered pre-diabetic.

Fasting Plasma Glucose Test (FPG):  The fasting plasma glucose test is the simplest and fastest way to measure blood glucose and diagnose diabetes. While it is not the most accurate, this test is part of comprehensive metabolic profile as seen in standard bloodwork. Fasting means that the individual typically has been instructed to skip breakfast and the test is usually performed in the mid-morning.

Fasting blood sugar under 100 mg/dl is considered normal and healthy although most functional medicine doctors want to see this under 90 mg/dl.  The range from 100-126 mg/dl is considered pre-diabetic and over 126 mg/dl is considered diabetic.

Oral Glucose Tolerance Test (OGTT):  This test measures an individual’s response to a glucose load.  They are instructed fast like the FPG and then they are given a measured dose of glucose (75g for adults) to consume within 5 minutes and the blood is measured both immediately after the drink is finished and 2 hours afterwards.  The 2-hour measurement is major recording.

Normal OGTT levels should be under 140 mg/dl although most functional medicine doctors want to see them under 120 mg/dl.  The pre-diabetic range is from 140-200 mg/dl and over 200 mg/dl is considered diabetic.

Stabilize Your Blood Sugar Naturally:

Most people familiar with diabetes are familiar with one of the hormones made by the pancreas called insulin.  But insulin is not the only hormone involved in regulating blood sugar.

Other hormones that affect blood sugar levels in your body include glucagon, amylin, GIP, GLP-1, epinephrine, cortisol, and growth hormone.

When blood sugar levels get too high, the pancreas releases insulin.  Insulin then opens the door so that glucose can rush into the cells and be turned into energy.

When glucose levels remain chronically elevated for too long, cells stop responding to insulin—they become insulin resistant. In an effort to desperately get the glucose into the cells, the pancreas continues pumping out more and more insulin but to no avail.  Eventually, the pancreas can’t keep up, and blood sugar levels keeps rising and person Is now diagnosed with insulin resistance or diabetes.

Insulin resistance is a characteristic feature of most patients with Type 2 diabetes mellitus (T2DM) and is one of the defining clinical features in Metabolic Syndrome or Syndrome X (2)

What are the signs and symptoms of insulin resistance?

One in three Americans—including half of those 60 and older— have a silent blood sugar problem known as insulin resistance. Insulin resistance increases the risk for prediabetes, type 2 diabetes, and a host of other serious health problems, including heart attacks, strokes, and cancer. (3)

Effects of High Insulin Levels

1. Stimulates Plaque Formation
2. Promotes oxidation of LDLs
3. Contracts blood vessels
4. Kidneys waste nutrients
5. Increases blood pressure
6. Thickens arterial walls
7. Increases triglycerides
8. Promotes extra fat storage
9. Increases blood clotting

High Insulin and Inflammation:

While there can be many causes to insulin resistance, prediabetes, and diabetes the biggest contributors include diet and being overweight.

Obesity, especially too much fat in the abdomen and around the organs, called visceral fat, is a main cause of insulin resistance. A waist measurement of 40 inches or more for men and 35 inches or more for women is linked to insulin resistance. (4)

Let’s look at what happens when we eat too many carbohydrates. Carbohydrate rich foods or drinks that contain lots of sugar create a significant demand on the body for insulin production.

Insulin controls the amount of glucose in your bloodstream at any given moment. It also helps store glucose in your liver, fat, and muscles, it regulates your body’s metabolism of carbohydrates, fats, and proteins.

Repeated bouts of high blood sugar cause elevated insulin to initiate fat storage.  Increased fat storage increases a variety of inflammatory chemicals within the body. (5).

Elevated Blood Sugar Accelerates Aging:

AGEs naturally form inside the body when proteins or fats combine with sugars (glycation). This affects the normal function of cells, making them more susceptible to damage and premature aging

When blood sugar stays elevated for too long it interacts with enzymes and other protein molecules creating dangerous substances called Advanced Glycolytic End Products (AGE’s).

AGE’s are highly inflammatory and destructive as they damage tissue throughout the body including nerve fibers and blood vessels (6, 7).  This is one of the reasons we see increased risk for Cardiovascular diseases and Neurodegenerative disease including Alzheimer’s, Parkinson, Strokes, Neuropathy with increased production of AGE’s(8). High blood sugar is not the friend of your brain, your heart or your immune system.

Insulin Resistance, Fertility and Hormonal imbalances

Fluctuating blood sugar levels can disrupt your entire endocrine system, which causes imbalances in the following reproductive hormones:

• Testosterone
• Estrogen
• Progesterone

Increasing testosterone levels in men are associated with less body fat, improved insulin sensitivity, and reduced blood sugar. But when testosterone increases in women, it’s associated with negative effects including:

• More body fat
• Insulin resistance
• Higher blood sugar levels

Estrogen and progesterone are also influenced by blood sugar levels. High estrogen levels increase insulin sensitivity by lowering blood sugar. On the other hand, low estrogen levels and high progesterone levels can lead to insulin resistance by raising blood sugar.

Obesity, inflammation, and hormone imbalances can lead to the development of infertility diseases such as:

• Endometriosis
• Polycystic ovarian syndrome(PCOS)
• Uterine fibroids
• Unexplained infertility

Insulin Resistance and Metabolic Syndrome

Insulin resistance is a characteristic feature of most patients with Type 2 diabetes and is one of the defining clinical features in Metabolic Syndrome or Syndrome X.

Metabolic syndrome is diagnosed as the following.

• Central obesity,
• Atherogenic dyslipidemia (low HDL, elevated LDL and Elevated Triglycerides),
• A Prothrombotic state,
• a Pro-inflammatory state and
• High blood pressure.

The prevalence of Metabolic syndrome among adults 20 years or older is 23.7% in the United States according to the Third National Health and Nutrition Examination Survey (NHANES III). This would indicate that approximately 47 million Americans suffer from Metabolic syndrome

Gut Inflammation and Diabetes

The gut microbiota has been linked to the development of obesity and type 2 diabetes.

In recent decades, chronic low-grade “metabolic” inflammation (local and systemic), also called metainflammation, has been identified to contribute to the development of insulin resistance and progression to type II diabetes. (9)

What researchers have found is that there is a three-way communication between gut microbiota, glucose metabolism and the immune system. When our blood sugar is high as in the cases of Hyperglycemia, this high blood sugar increases gut permeability (creates a leaky gut) which allows bacterial toxins to enter circulation. Once these gut bacteria enter circulation, they fuel a pro inflammatory cytokine response which can result in beta cell dysfunction, insulin resistance and fatty liver disease.

Another way we see the gut health causing diabetes has to do with endotoxemia and intestinal inflammation. Researchers has shown that gut dysbiosis leads to low levels of Butyrate which is a short chain fatty acid.

Short chain fatty acids improve the gut health through a number of local effects, ranging from maintenance of intestinal barrier integrity, mucus production, and protection against inflammation to reduction of the risk of colorectal cancer (10)

8 Tips To Improve Diabetes

If you have Insulin resistance, Prediabetes, Diabetes, Metabolic Syndrome or Syndrome X, here are some of best action steps you can begin implementing to prevent and reverse Diabetes.  In addition to working with your general practitioner or endocrinologist you should be working with a Certified Functional Medicine Health Practitioner. A Functional Medicine Practitioner will look at the BIG picture of Diabetes, Insulin resistance and Syndrome X and will look at things like hormones, Gut health, inflammation, Oxidative stress, Nutritional imbalances, and diet.

Please keep in mind that these are just a few strategies that we use in our clinic to help individuals with Diabetes.

1)  Follow an Anti-inflammatory Diet:  Follow a low-carb anti-inflammatory diet can drastically reduce your blood sugar levels in only a few weeks. Read this article for some additional suggestion on Reducing Inflammation

2)  Heal Your Microbiome:  We talked about the importance of gut health, leaky gut, short chain fatty acids and the roles these play on toxins and inflammation. An unhealthy gut influences many aspects of blood sugar control.

3) Stress and Adrenal Function- High levels of cortisol in response to chronic stress elevates blood sugar levels. Here’s why, under stressful conditions, cortisol provides the body with glucose by tapping into protein stores via gluconeogenesis in the liver. This energy while critical to stressful event, keeps glucose levels also chronically elevated.

4)  Work on Sleep Hygiene:  According to Sleep Research Foundation, even partial sleep deprivation over one night increases insulin resistance, which can in turn increase blood sugar levels. But what if you have Insomnia and struggle with multiple nights of poor sleep? Follow the tips in this article for some of the common overlooked causes of Insomnia that I wrote a while back. Your body heals when it sleeps- shoot for 8-9 hours of quality sleep every night.

5)  Antioxidants- Antioxidants reduce the damaging effects of free radicals. Free radicals are increased with Insulin resistance, Prediabetes, Metabolic Syndrome. Antioxidants also help with Advanced Glycated End Products (AGEs) that I spoke about earlier. Add Herbs like turmeric, ginger, oregano, garlic, basil, thyme, cinnamon and rosemary as often as you can.  Supplements like Glutathione, Vitamin E, NAC, Alpha Lipoic Acid (ALA), Polyphenols, Flavonoids.

6) Omega 3’s:  Omega 3 fatty acids and in particular the long chain variety EPA and DHA are helpful for the inflammatory damage caused by high glucose levels. Omega3’s also help heart which often suffers when blood sugar levels remain high. Omega 3’s have been shown to lower an inflammatory marker known as CRP. Read this article on some of the blood tests we use in our clinic to identify and monitor inflammation.

7)  Optimize Your Vitamin D3:  Low vitamin D3 is associated with the development of type II diabetes (11).  Not only does low Vitamin D cause Type II diabetes, but Vitamin D deficiency has also been shown to impair insulin synthesis and secretion in humans.  Other studies show a link between vitamin D3 deficiency in early life and the later onset of type 1 diabetes. Supplementing with Vitamin D3 and optimizing your vitamin D is one of the easiest things to do.

Be sure to increase your vitamin D3 through regular sun exposure and taking a high quality Liquid vitamin D3 supplement. If you have atherosclerosis you will want to makes sure you are taking a vitamin D3/K2 supplement.

Vitamin K2 blocks the progression of arterial thickening and stiffening. Studies show higher vitamin K2 intake reduces the risk of dying from heart disease by 57%

8)   Exercise:  Exercise is beneficial for people with diabetes because it can lower your glucose levels not only during, but for up to 24 hours after a workout. The American Diabetes Association (ADA) explains, “As you exercise more, your body becomes better at processing glucose and your insulin sensitivity increases.” Exercise causes your muscles to soak up glucose like a sponge.

If you are struggling with Diabetes, Prediabetes, Syndrome X and you feel like you have hit a brick wall. Contact us today! Our approach is centered around the tenants of Functional Medicine. We will dig deep into the root cause of your health problems and provide a clear strategy to help you gain control of your health.