How to Prevent and Treat Diabetes with
Natural Medicine
u Challenges, Solutions, & Inspiration
u Diabetes: A 21st Century Epidemic
u Diagnosis, Etiology, Prevention
u Treatment goals
u Nutritional Supplementation
u Botanical Medicines
u Questions and Answers
ØIncreased pressure from the media, drug
companies, and FDA
ØContinued “negative studies” and advances
in conventional medicine
ØContinued marketing of bogus and overly
hyped products
ØLack of tools to help consumers
distinguish what is fact and what is quality in natural products
n Impotent vs. IMPORTANT
information in our stores and on infomercials
n Manufacturer profits often go into
pockets instead of research
n The seduction of a quick buck vs. a
sustainable business
n Credibility. How do YOU
establish credibility?
v Care,
Listen, Educate, Inspire
n Credible
n Passionate
n Educated
n Dedicated
n Positive and adaptable
n Effective communicator
n More responsible marketing by
manufacturers
n Focus on what works instead of what has
more hype
n Effective educational materials and
tools
n Development of successful partnerships
between retailers and quality manufacturers
n
HIGH
VALUES!!
vEthics, integrity, TRUE GMP (Good
Manufacturing Practices)
n Dedicated to our industry
n Committed to the success of the retailer
n Mission and Vision
vWhat does the company really want?
n Opportunity for successful partnership
n Growing need
v Aging population
v Continued rise in diet related diseases
n Truth will prevail
v Women’s Health Initiative, for example
n New and exciting products
vBest from nature is yet to come
n Effective consumer education
vContinued development of information age
Table 1. Major Complications of Diabetes:
¨
Heart disease
and stroke - Adults with diabetes have death rates from cardiovascular disease
about 2 to 4 times higher than normal
¨
High blood
pressure - 75% of adults with diabetes have high blood pressure
¨
Blindness -
Diabetes is the leading cause of blindness among adults
¨
Kidney
disease - Diabetes is the leading reason why people need dialysis
¨
Nervous
system disease - About 60% to 70% of people with diabetes have mild to severe
forms of nervous system damage
¨
Amputations
- More than 60% of lower-limb amputations in the United States occur among
people with diabetes
¨
Periodontal
disease - Almost one third of people with diabetes have severe periodontal
(gum) disease
¨
Pain – Many
diabetics fall victim to chronic pain due to conditions such as arthritis,
neuropathy, circulatory insufficiency or muscle pain
¨
Depression
– Is a common accompaniment of diabetes. Clinical depression can often begin to
occur even years before diabetes is fully evident. As well, depression is
difficult to treat in poorly controlled diabetics
¨
Autoimmune
disorders – thyroid disease, inflammatory arthritis and other diseases of the
immune system commonly add to the suffering of diabetes
l
Type
1 diabetes* (b-cell destruction, usually leading to absolute insulin
deficiency) - immune mediated - affects over 1 million
l Type 2 diabetes* (may range from predominantly insulin resistance with relative insulin deficiency to a predominantly secretory defect with insulin resistance) - affects over 17 million Americans
–
Adult
onset most common, juvenile onset rising
–
Linked
to obesity
l
Impaired glucose tolerance (a.k.a.
“pre-diabetes”) - thought to affect over 16 million Americans
l
Gestational
diabetes
Etiological
factors:
n
Genetics – Concordance rate 23-38%
n
Autoimmunity - 75% have beta-cell antibodies
n
Defect in gut immune system
n
Infectious
trigger – Enteroviruses
n
Bovine albumin peptide - 1.5 greater risk
with early introduction of cow’s milk or breast-feeding less than 3 months
n
Nitrates from water, smoked or cured meats –
Significant oxidative stress on the beta-cells
n
Breastfeeding
and avoidance of allergens
n
Vitamin D supplementation - children who
regularly took cod liver oil had an 80% reduced risk of developing type 1
diabetes while those that had vitamin D deficiency actually had a 300%
increased risk
n
Omega-3
fatty acids – preliminary findings encouraging
Niacinamide
in IDDM (Insulin Dependent Diabetes Mellitus):
A Meta-Analysis of the Evidence
Since 1987,
10 randomized (5 of which were placebo) controlled trials have evaluated
niacinamide therapy in recent-onset IDDM patients for a total of 211
nicotinamide-treated patients. Meta-analysis demonstrates a therapeutic effect
of niacinamide in preserving residual beta-cell function when given at IDDM
diagnosis in addition to insulin. Adverse effects were negligible. The European
Nicotinamide Diabetes Intervention Trial (ENDIT) is currently in progress.
Type
2 diabetes
Etiological
factors linked to insulin insensitivity:
n
Family
history of diabetes (i.e., parent or sibling with type 2 diabetes) - 70 to 90%
concordance rate
n
Interesting
factoid:
–
Arizona
Pima 70% obese; 22% type 2
–
Mexican
Pima 10% obese; <1% type 2
n
Obesity
and low adiponectin levels
n
Increased
waist to hip circumference
n
Age –
increasing age is associated with increased risk beginning at age 45 years
n
Race/ethnicity
(e.g., African American, Hispanic American, Native American, Asian American,
Pacific Islander)
n
Sedentary
lifestyle – the Amish example
n
Hypertension
(blood pressure > 140/90 mm Hg)
n
Triglyceride
level >250 mg/dl
n
Polycystic
ovary syndrome
n
History
of gestational diabetes or delivery of baby over 9 lbs
n
High
glycemic diet – Also associated with increased risk for heart disease and
cancer
n
Dietary
fat - High saturated fat, low omega-3 and monounsaturated fat
n
Chromium
deficiency – Other nutrients may also play a role
n
Prenatal
nutrition - Over consumption of calories during pregnancy linked to NIDDM
(Non-Insulin Dependent Diabetes Mellitus) in offspring
n
Low
antioxidant status - Low vitamin E levels linked to 3.9 times greater risk of
developing NIIDM
Adipocytes:
an endocrine organ?
Examples
of hormonal factors secreted by fat cells:
n Adiponectin – improves insulin
sensitivity
n Resistan – reduces insulin sensitivity
n Leptin – reduces appetite, increases metabolic
rate
n Free fatty acids – reduces insulin and
leptin sensitivity
3,234
subjects with impaired glucose tolerance were randomly assigned to be in a
group receiving a placebo, or metformin (850 mg twice daily), or a
lifestyle-modification program with the goals of at least a 7 percent weight
loss and at least 150 minutes of physical activity per week. The average
follow-up was 2.8 years. The lifestyle intervention reduced the incidence by
58% and metformin by 31%.
TYPE
2 DIABETES
Management
Goals
ØEliminate symptoms and improve well-being
ØPrevent and retard microvascular
complications and macrovascular events
n
Optimize glycemic control
n
Maximize nutritional status
n
Improve rheology
n
Prevent hyperlipidemia
n
Target blood pressure levels
Parameter Target
Value
Fasting blood
glucose 80-120
mg/dL
HbA1C (Hemoglobin A1c
test – see reference [1]) Optimal <6%
Goal <7%
Action
level >8%
LDL-C Optimal <100 mg/dL
Initiate
treatment >130 mg/dL
HDL-C >45
mg/dL
Triglycerides <
200 mg/dL
nFollow a low glycemic diet
nEat a “rainbow” assortment of fruits and vegetables
nReduce exposure to pesticides, and eat to enhance detoxification
reactions and elimination
nReduce the intake of saturated fats and trans fatty acids
nIncrease the intake of the right types of fats (monounsaturated)
nAvoid high-calorie, low nutrient foods
nKeep salt intake low, potassium intake high
nGlycemic index refers to the rise in blood sugar after ingesting
a serving of a food that provides 50g of carbohydrate
nGlycemic load is calculated by multiplying the GI as a decimal
times the amount of carbohydrate in the actual serving of food - Should be less
than 20 for 1 meal (or less than 15 for those with uncontrolled diabetes)
- Decreased GL lessens the chance of heart disease, diabetes, and cancer
Food GI
GL
Carrots,
cooked, ½ cup 49 1.5
Peach, fresh,
1 large 42 3
Watermelon, ½
cup 72 4
Whole wheat bread, 1 slice 69 9.6
Baked potato,
medium 93 14
Brown rice,
cooked, 1 cup 50 16
Banana, 1
medium 55 18
Spaghetti, 1
cup 41 23
White rice, 1
cup 72 26
Grape Nuts™, ½ cup 71 33
Soft drinks,
375 ml 68 35
n
High
Potency Multiple Vitamin and Mineral (e.g. WellBetX™ MultiStart™ [2]
& Complete Multi [3]
n
Additional
Antioxidants
v
Vitamin C:
500 to 1,500 mg daily
v
Vitamin E:
400 to 800 IU daily
n
Greens
Drink Product or Flavonoid-rich Extract
n
Pharmaceutical
grade fish oil product
v
600 mg EPA/DHA daily
nProvides optimal levels of vitamins and minerals along
with key phytochemicals
nComplete formula that reduces the number of pills taken each day
nConvenience and value
nEach formula contains at least one herb
at “therapeutic” levels
nNo window dressing!!!
nNo offending odor, easy to swallow
nManufactured to the highest standards
Enriching Greens™ [4]
n
Key
components:
v
Greens
(barley & wheat grass juice; spirulina, chlorella)
v
Phytosomes
(Milk Thistle, Ginkgo, Grapeseed)
v
Standardized
plant extracts (beet, artichoke, Siberian ginseng, etc.)
v
Soy
lecithin, pectin, bee pollen, etc.
Findings
in a clinical study at the University of Alberta:
nIncreased blood antioxidant capacity by
11%
nTotal cholesterol and LDL cholesterol
were reduced by 6%
nHDL cholesterol was increased by 8%
nReports of better bowel function and
higher energy levels
nMixes well and tastes great!!
RxOmega-3
Factors™ [5]
Pharmaceutical Grade EPA/DHA
n
High
concentration (600 mg) of long-chain fatty acids per 1000 mg capsule
n Ideal ratio of EPA to DHA – 400 mg EPA
and 200 mg DHA per capsule!!!!!!
n
Strict
quality control standards insures no:
v
Heavy
metals
v
Dioxan,
PCBs, and other pesticides/herbicides
v Lipid peroxides and damaged fats
Proposed
criteria:
nManufactured in a certified GMP facility approved for
pharmaceutical products
nManufactured according to pharmaceutical standards that include
quality control steps to insure purity and potency
nMust provide at least a 60% concentration of the most active
long-chain omega-3 fatty acids (EPA and DHA)
nRatio of omega-3 fatty acids to arachidonic acid must be greater
than 50:1
n
Chromium
- Low levels may lead to insulin insensitivity
n
Vitamins
C and E - Increased requirements
n
Magnesium
- Increased requirements, improves all aspects
n
Biotin
- Activates glucokinase, promotes glucose utilization
n
Vitamin
B6 - Prevents and improves neuropathy
n
Folic
acid and B12 - Prevents/improves neuropathy
n
Zinc,
manganese, vanadyl - Improve insulin action
n
Alpha-lipoic
acid - Prevents/improves neuropathy
n
Omega-3
Fatty acids - Improves cell membrane and blood lipid levels
Magnesium
Supplementation
Reasons to supplement in diabetics:
Ø
Magnesium
deficiency common in diabetics (RBC vs. serum)
Ø
Improves
insulin response and actions
Ø
Improves
glucose tolerance
Ø
Improves
cell membrane fluidity
Ø
Magnesium
levels are inversely correlated with diabetic retinopathy and vascular disease
n
Natural “vitamin-like” compound involved in
energy production
n
Used in Germany for over 30 years
n
Unique antioxidant effects
n
Improves insulin sensitivity and blood sugar
control
n
Prevents or improves neuropathy
n
Dosage: 300 to 600 mg
Bitter
Melon (Momardica
charantia): Clinical Study in Type II Diabetes
Type II diabetic
patients were given either 5g of dried bitter melon powder 3 times daily or 100
ml of an aqueous extract of bitter melon as a single dose in the morning. After
3 weeks, patients receiving the dried powder (n=5) experienced a drop of 25% in
blood sugar levels. The patient (n=7) receiving the aqueous extract experienced
a statistically significant drop of 54% after 3 weeks and a drop in glycosylated
hemoglobin from 8.37 to 6.95 after 7 weeks.
60 patients with
NIIDM followed a prescribed diet with or without 25 grams of fenugreek seed
powder divided into two equal portions taken during lunch and dinner. Fasting
blood sugar measurements decreased by 25% in the fenugreek supplemented group
after 24 weeks and glycosylated hemoglobin levels dropped 12.2% from 9.6 to
8.4%. Also, TC declined 14%, LDL 16% and Trigs 15%; HDL increased by 10%.
Flavonoid-rich
Extracts:
Beneficial Effects in Diabetes
n
Antioxidant
n
Increase intracellular vitamin C concentrations
n
Inhibit
aldose reductase
n
Improve rheology
n
Improve
microvascular integrity
Flavonoid-rich Extracts:
Tissue Specific Antioxidants
Examples:
vQuercetin – Mast cells; best for
allergies and eczema.
vBilberry extract (anthocyanosides) – Retina; best for
eyes.
vGrapeseed extract (procyanidolic oligomers) – LDL
cholesterol, retina, vascular lining, lungs; best overall antioxidant
vMilk thistle extract (silymarin) - Liver
vHawthorn (procyanidins) – Heart, aorta, arteries;
best for heart disease
v Green tea (polyphenols) – LDL
cholesterol, gastrointestinal tract; best for cancer prevention
v Ginkgo biloba (ginkgo flavonglycosides) – brain,
vascular lining; best for people over 50 years of age
Garlic
TAP™ > 4,000 mcg per
day of allicin
Clinical
Applications:
n
Atherosclerosis treatment and prevention
n
Elevated blood lipids
n High blood pressure
Dosage:
Dosage is
based on allicin potential: daily dose should provide at least 8 mg alliin or a
total allicin potential of 4,000 mcg.
Key
Advantages: