Diabetes

Diabetes Mellitus is a chronic disease where the body does not make or use insulin* properly, resulting in having too much glucose in the blood. The World Health Organization recognizes 3 main forms of diabetes mellitus: type 1, type 2, and gestational diabetes (occurring during pregnancy), which have different causes and population distributions. While all forms are due to the beta cells of the pancreas being unable to produce sufficient insulin to prevent hyperglycemia, the causes are different.

[*Insulin is a hormone that helps the body to control the level of glucose in the blood]

Types of Diabetes Mellitus

Type 1: Insulin-Dependent Diabetes
Persons with Type 1 diabetes cannot control their blood sugar properly because their pancreas produces little or no insulin. Type 1 diabetes is usually due to autoimmune destruction of the pancreatic beta cells. The body’s own immune system mistakenly destroys the insulin producing cells in the pancreas. As a result, glucose builds up in the blood instead of being used for energy. Persons with Type 1 diabetes need insulin injections to control their blood sugars. Although it usually happens to young people before the age of 30 (most often during childhood or their teens), it can also occur in older adults but less commonly. The cause of Type 1 diabetes remains unknown. It is not preventable and it is not caused by eating too much sugar.

Type 2: Non-insulin Dependent Diabetes
About 80% of all persons with diabetes belong to this group. They can produce insulin, but their body does not use it effectively. Type 2 diabetes mellitus is due to insulin resistance or reduced insulin sensitivity, combined with reduced insulin secretion. The defective responsiveness of body tissues to insulin involves the insulin receptor in cell membranes. In the early stage the predominant abnormality is reduced insulin sensitivity, characterized by elevated levels of insulin in the blood. At this stage hyperglycemia can be reversed by a variety of measures and medications that improve insulin sensitivity. As the disease progresses the impairment of insulin secretion worsens, and therapeutic replacement of insulin often becomes necessary.

There are numerous theories as to the exact cause and mechanism in type 2 diabetes. Central obesity (fat concentrated around the waist in relation to abdominal organs, but not subcutaneous fat) is known to predispose individuals for insulin resistance. Abdominal fat is especially active hormonally, secreting a group of hormones called adipokines that may possibly impair glucose tolerance. Obesity is found in approximately 55% of patients diagnosed with type 2 diabetes.

Type 2 diabetes is usually first treated by increasing physical activity, decreasing carbohydrate intake, and losing weight. These can restore insulin sensitivity even when the weight loss is modest, for example around 5 kg, most especially when it is in abdominal fat deposits. It is sometimes possible to achieve long-term, satisfactory glucose control with these measures alone. However, the underlying tendency to insulin resistance is not lost, and so attention to diet, exercise, and weight loss must continue.

Gestational diabetes
Gestational diabetes mellitus (GDM) resembles type 2 diabetes in several respects, involving a combination of inadequate insulin secretion and responsiveness. It occurs in about 2%–5% of all pregnancies and may disappear after delivery. Gestational diabetes is fully treatable but requires careful medical supervision throughout the pregnancy. About 20%–50% of affected women develop type 2 diabetes later in life. Untreated gestational diabetes can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital cardiac and central nervous system anomalies, and skeletal muscle malformations.

Pre-diabetes
Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes.

Who gets diabetes?
About 9% of the adult population in Singapore have diabetes. Diabetes can affect people of any age or race. However, 90% of people with diabetes are over 40 years old.

Some risks of diabetes mellitus include:

References:

 

Herbs for Blood Sugar Support

Trigonella Foenum-Grae-cum Extract (Fenugreek)
Fenugreek has a long history in Ayurvedic and Chinese medicine for numerous indications, including labor induction, aiding digestion and as a general tonic to improve metabolism and health. Preliminary animal and human trials suggest that fenugreek seed powder may support blood sugar as well as blood lipids within normal levels.

Fenugreek has been mentioned in early literature as a blood sugar stabilizing agent and such effects have been evaluated.1It is used as an adjunct in maintaining normal blood sugar levels, and is also supportive in maintaining blood lipids within normal levels.2

 Gymnema Sylvestre Extract (Gurmar)
Gymnema sylvestre is a plant native to the tropical forests of India, and has long been used for blood sugar support. There is some evidence that suggests that gymnema’s positive effects on blood sugar are a result of its regenerative and/or revitalizing effect on the beta cells of the pancreas.

Research suggests that the topical and selective anesthetic effect of the plant might result from the competition between these active glycosides and sweet substances for the receptor sites.1In a study of 22 patients who were given 400mg gymnema extract daily along with their usual medications, all patients demonstrated healthier blood sugar levels. Of 22 patients, 21 reported considerable improvement. 2 It was postulated that gymnema may enhance the production of insulin. 3

Gymnema also supports the heart and circulatory system, as well as the uterus and urinary tract. 4 It is interesting to note that gymnema extract is without side effects and supports blood sugar in a balanced way. When given to healthy volunteers, gymnema demonstrated adaptogenic effects.

Guggul Extract
Guggul has undergone investigation for its ability to support healthy blood lipid levels, which has been recognized since the vedic ages. Oral administration of guggul supports healthy cholesterol levels, which has been demonstrated in animal studies. 1,2It may also be helpful for weight loss.3

Green Tea Extract
Green tea extract contains polyphenols and an essential oil. 1 The polyphenols strengthen the walls of blood vessels, which are responsible for regulating blood vessel permeability. Green tea’s ability to support healthy blood sugar levels has also been confirmed in animal studies. The fact that aged rats responded so dramatically to these polyphenols implies that they potentially can inhibit age-related changes in blood sugar levels, which may contribute to several degenerative conditions. Tea polyphenols support healthy blood sugar levels by inhibiting the activity of both salivary and intestinal amylase (the enzyme that breaks down starch), which causes starch to be broken down more slowly, minimizing spikes in blood sugar. In addition, according to a recent study, tea may also reduce the intestinal absorption of glucose.

A relatively little known compound found in onions and in tea, especially green tea, called diphenylamine, appears to support healthy blood sugar levels. In addition, the blood sugar supporting effects of tea offers significant anti-aging benefits through calorie restriction, reduced glycation, and lower insulin secretion. Consuming a carbohydrate-rich meal with tea will slow down the release of glucose and reduce its absorption (it also reduces the absorption of iron, another anti-aging benefit). By preventing the harmful spike in insulin, tea offers other benefits that go with calorie restriction and insulin support.1

Azadirachta Indica Extract (Neem)
Neem contains bitters as well as quercetin and b-sitosterol glucoside. 1 Aqueous extract of neem leaves has been shown to support healthy blood sugar levels.2 Neem was also shown to support blood pressure within normal levels.3 Neem has been commonly used to maintain a healthy microbial environment in the digestive tract.

Eugenia Jambolana Extract (Jambu)
Jambolana or Jambolan, is a species of cloves used in Ayurvedic medicine. It is used to support blood sugar within normal levels and the health of the pancreas. Jambolan is preferred for blood sugar support because it is without side effects.

Momordica Charantia Extract (Bitter Melon)
Momordica charantia has been referred to as both a vegetable and a fruit, and is widely cultivated in Asia, Africa and South America. It has been used extensively in folk medicine as a remedy for blood sugar conditions. The blood sugar supporting action of the fresh juice or unripe fruit has been established in experimental animal models, as well as human clinical trials. 1

Bitter melon contains several compounds with confirmed blood sugar supporting properties. Bitter melon also contains an insulin-like polypeptide called polypeptide-P, which is similar in structure to bovine insulin.

Bitter melon’s mechanism for supporting healthy blood sugar levels is unknown, but in animal studies it has been proposed that it has a direct action similar to insulin. 2

The recommended dose of bitter melon depends on the form being consumed. Dosage for tincture ranges from 5ml 2 to 3 times daily to as high as 50ml per day. 3 However, bitter melon juice is very difficult to make palatable since, as the name implies, it is quite bitter. To avoid the bitter taste, the Indians and Chinese crush the herb and form tablets. In Central America, it is prepared as an extract or decoction. Dosages of capsulized dried powder range from 3-15g daily. However, to avoid the necessity of taking so many capsules, a standardized extract may be used at dosages of 100-200mg three times daily.

Lipoic Acid
Lipoic acid is a vitamin-like substance produced in small amounts by the body, and is important to almost all cells. Lipoic acid is found in just a few food sources, such as brewer’s yeast, liver and spinach. Lipoic acid assists the body’s energy production and acts as a powerful antioxidant, making it especially supportive for people with blood sugar conditions.

Chromium polynicotinate
Since as early as 1854, a substance was identified that improved healthy blood sugar levels. It was a complex of chromium and several amino acids that is now known as Glucose Tolerance Factor (GTF). GTF chromium does not act like insulin, but rather, appears to enhance insulin sensitivity. It has been noted that tissue concentrations of chromium in the U.S. decline with age. Nearly 20 controlled studies have demonstrated the positive effect of chromium for the management of blood sugar. In clinical studies, supplementing the diet with chromium has been shown to decrease fasting glucose levels, improve glucose tolerance, lower insulin levels and support healthy cholesterol and triglyceride levels. 1

Vanadyl Sulfate
Prior to the discovery of insulin in 1922, the trace mineral vanadium was used because of its ability to mimic the activity of insulin. 2 small studies have confirmed the effectiveness of vanadyl sulfate at a dose of 100mg/day in improving insulin sensitivity. 1, 2

Vanadyl sulfate is a biologically active form of vanadium. Because of its insulin-like properties, vanadyl is being used to manage blood sugar. Studies show that vanadyl is very effective in normalizing blood sugar levels and controlling related conditions. 3

Bilberry Extract
Bilberry is widely used for conditions related to or resulting from blood sugar imbalances.  Bilberry also improves night vision, supports capillary strength, supports healthy blood flow, and has antioxidant activity. Research done mostly in Italy has also uncovered bilberry’s potential for supporting the retina and other eye conditions associated with poor blood circulation. 1

Tumeric (Curcumin 95%)
Curcuminoids, found in high concentrations in tumeric extract, have been primarily recognized for their “super” antioxidant properties. Curcuminoids are capable of both the prevention of free radical formation and intervention to neutralize existing free radicals.

Curcuminoids are natural plant compounds that guard the cells, tissues and organs of the body from numerous “inside” and “outside” detrimental influences. Unlike other antioxidants, which have more of a “policing effect” on such errant molecules, the turmeric cucuminoids merge with potential free radicals before they form.

Cayenne Pepper Extract
Cayenne contains capsaicin, the compound that produces the “hot” in hot peppers. Cayenne is known to increase the metabolic rate, which is one reason why people get so hot and sweaty after eating spicy foods. 1 One of the additional benefits of cayenne is its function as a digestive aid. Cayenne increases the secretion of acids in the stomach, which increases the absorption and effectiveness of other herbs consumed with it. In a double-blind trial, reductions in appetite were found in healthy Japanese women and Caucasian men when they consumed cayenne pepper along with meals. 2 A similar trial showed that cayenne raised metabolic rate in Japanese women. 3 These trials suggest that cayenne may be beneficial for weight loss.

Piper Nigrum & Vinca Rosea (Banaba Leaf Extract)
Banaba is a botanical extract that come from the leaves of the banaba tree. In Southeast Asia and the Philippines, the leaves are traditionally used as an herbal remedy to support healthy blood sugar levels. Banaba balances blood sugar, regulates insulin levels and supports healthy weight loss. 1

Corosolic acid, a triterpenoid found in the leaves, helps balance blood sugar by stimulating glucose uptake. This effect is similar to that of insulin, which induces glucose transport from the blood into body cells. 2, 3 Animal studies have shown it to be supportive for managing both blood sugar conditions and obesity. 3-5

Researchers have found that banaba contains at least 3 other active ingredients including lagerstroemin, flosin B and reginin A. These natural phytochemicals regulate glucose uptake, and may play a role in banaba’s ability to support healthy blood sugar levels. 6,7

The blood sugar regulating properties of banaba have been demonstrated in cell culture and animal and human studies. In an animal study, banaba normalizes blood sugar, and also had a normalizing effect on blood pressure. 3-5, 7 In a human study, banaba extract showed significant blood sugar stabilizing effects. 8

Cinnamon Extract
Cinnamon has been in the news lately because it is proving to be effective in supporting healthy blood sugar and cholesterol within normal levels. Dr. Richard Anderson and his research team at the U.S. Department of Agriculture have been studying the effects of cinnamon on improving insulin, blood sugar and blood lipid metabolism for the past 20 years. In 2004, they identified cinnamon’s bioactive compound polyphenol type-A polymer. 1 Before that, Anderson worked with a team of researchers in Pakistan to test cinnamon extract’s ability to lower glucose and lipid levels in 60 patients. One group received a placebo, while the other received cinnamon in daily amounts of 1, 3, or 6 grams. The treatment lasted 40 days. 2 The results were dramatic. All three cinnamon doses had a strong impact on blood sugar levels, reducing them by 18-29% following 40 days of treatment. Positive effects on blood lipid levels were also observed. By contrast, the placebo group had no significant effect on either measure. The highest dose (6g/day) produced the most rapid response, while the lowest dose (1g/day) produced the most sustained response, i.e., a continued reduction in glucose levels even at the 60-day mark; the reduction observed was 16%. The two higher doses produced slightly lower sustained response, which were not statistically significant. Researchers also noted blood sugar problems returned when subjects stopped taking cinnamon.

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