The most important determining factor as to whether the diabetic needs to be managed by drugs or insulin is the adequacy of blood sugar control. It is critical that blood glucose levels be monitored carefully, particularly if blood sugar levels have been relatively uncontrolled. An elevation in post-prandial (after-meal) blood sugar levels is perhaps the major contributor to the development of diabetic complications, especially heart disease and diseases of the microvasculature (small blood vessels within the eyes, kidneys, and nerves).
The best fiber sources for reducing postprandial blood sugar levels, lowering cholesterol levels, and promoting weight loss are those that are rich in water-soluble fibers such as glucomannan (from knojac root), psyllium, guar gum, defatted fenugreek seed powder or fiber, seaweed fibers (alginate and carrageenan), and pectin.
PolyGlycoPlex (PGX) is a unique blend of selected, highly viscous soluble polysaccharide fibers that act synergistically to develop a higher level of viscosity and expansion with water than with the same quantity of any fiber alone. PGX exerts an affect equal to three to five times that of other fibers alone. It possesses the greatest viscosity of any single dietary fiber. It is three times as viscous as guar and approximately seven times as viscous as psyllium. By combining glucomannan with other soluble fibers, the viscosity of PGXTM is amplified further and has a viscosity three to five times that of any glucomannan alone. PGXTM is based at the intense scientific research of the University of Toronto led by Vladimir Vuksan, Ph.D. The viscosity of soluble fiber is directly related to its physiological effects and ultimately its overall health benefits in humans.
One of the most important enzymes is the alpha-glucosidases that line the intestines. Because the enzymes are essential for the breakdown of starches, complex carbohydrates, maltose, and sucrose into absorbable glucose molecules, inhibiting them can diminish after-meal rises in both glucose and insulin.
Touchi is a fermented soybean product that has been used in China and Japan for more than 3,000 years. Touchi extract is concentrated to possess high levels of naturally occurring alpha-glucosidase inhibitors.
The mulberry plant has been shown to possess significant hypoglycemic effects in animal studies and it contains a very effective alpha-glucosidase inhibitor along with other compounds that appear to improve blood sugar control. Mulberry extract has been studied in type 2 diabetes and the results are excellent. Mulberry therapy was shown to reduce the amount of damage to the cell membranes of red blood cells, indicating a significant antioxidant effect.
Gymnema extract appears to work in type 2 diabetes by enhancing the action of insulin. The dosage for Gymnema sylvestre extract is 200mg twice daily.
Fenugreek seeds have demonstrated significant antidiabetic effects in experimental and clinical studies. The active ingredient is the special soluble fiber of fenugreek along with the alkaloid trigonelline. Fenugreek appears to be helpful in both type 1 and type 2 diabetes.
The sulfonylureas appear to stimulate the pancreas to secrete additional insulin by making beta cells more sensitive to glucose. The major side effect of sulfonylureas is hypoglycemia. Other possible side effects include allergic skin reactions, headache, fatigue, indigestion, nausea and vomiting, and liver damage.
Biguanide-type oral antihyperglycemics currently consist of only one approved medication which is metformin (commercially known as Glucophage). The medication reduces triglycerides and LDL cholesterol and increases HDL cholesterol. Metformin works by decreasing glucose production by the liver, increasing glucose uptake by muscles, and perhaps by mildly reducing appetite. Minor side effects include diarrhea, nausea, vomiting, abdominal bloating, and flatulence. These side effects usually lessen with time.
The newest class of oral antihyperglycemic drugs are the thiazolidinediones, such as pioglitazone (Actose) and rosiglitazone (Avandia).
Part 10: Lifestyle and Attitude in Managing Diabetes
Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)