Category Archives: Diabetes

Prediabetes, Type I, Type II: Prevention and Treatment

Diabetes ~ Part 12/12 Recommendations for Specific Chronic Complications

The more LDL you have, the more cholesterol is in circulation and the greater your risk of heart disease.  Your total cholesterol level should be less than 200 mg/dL.  The LDL should be less than 130 mg/dL and the HDL level should be greater than 35 mg/dL.  Lipoprotein (a), or Lp(a) has an additional molecule of an adhesive protein called apolipoprotein.

Niacin has been shown to lower LDL, cholesterol, Lp(a) lipoprotein, triglyceride, and fibrinogen levels while simultaneously raising HDL cholesterol levels.  Several studies have compared niacin to standard lipid-lowering drugs, including the statin drugs.  The results indicate that while lovastatin produced a greater LDL cholesterol reduction, niacin provided better overall results despite the fact that fewer patients could tolerate a full dosage of niacin because of skin flushing.  The percentage increase in HDL cholesterol, a more significant indicator for coronary heart disease, was dramatically in favor of niacin (33 percent versus 7 percent).

Figure 1.3. Lovastatin vs. Niacin in a 26 Week Study

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The most common blood lipid abnormality in type 2 diabetic patients is elevated triglyceride, decreased HDL cholesterol levels, and a preponderance of smaller, denser LDL particles.

Garlic has a wide range of well-documented effects useful for the diabetic including helping to improve blood sugar control, lower cholesterol and blood pressure, and inhibit some of the factors associated with increased risk for vascular complications of diabetes such as increased fibrinogen levels.

One of the most important nutrients of heart health is coenzyme Q10 (CoQ10).  Supplementing CoQ10 (50 to 100 mg per day) is necessary to prevent the depletion of CoQ10 in body tissues while on these drugs.  Coenzyme Q10 is available primarily in tablets of capsules.

Diabetic retinopathy has two forms: “simple” retinopathy, consisting of bursting of blood vessels, hemorrhages, and swelling; and proliferative retinopathy, with newly formed vessels, scarring, more serious hemorrhage, and retinal detachment.  You should keep an eye on your hemoglobin A1C for maintaining optimal sugar control.  The high the A1C level, the greater the risk for retinopathy.

Gamma-linolenic acid has been shown to improve and prevent diabetic neuropathy.  Diabetes is associated with a substantial disturbance in essential fatty acid metabolism.  One of the key disturbances is the impairment in the process of converting linoleic acid to gamma-linolenic acid (GLA).

Capsaicin is the active component of cayenne pepper (Capisicum frutescens), the ingredient that makes chili peppers hot.  Topically applied capsaicin has been shown to be of considerable benefit in relieving the pain of diabetic neuropathy in numerous double-blind studies.

Alpha-lipoic acid, is an approved drug in Germany for the treatment of diabetic neuropathy.  The beneficial effects of alpha-lipoic in diabetic neuropathy have been confirmed in several double-blind studies at a dosage of 300 to 600 mg daily.

Ginkgo biloba extract (GBE) is probably best known for its ability to improve blood flow to the brain, but it also improves blood flow to the hands and feet.  More than twenty double-blind clinical trials have shown GBE to be very effective in improving peripheral vascular disease and intermittent claudication.

 

Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)

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Diabetes ~ Part 11/12 Diabetic Complications

In diabetes, elevated blood sugar levels and the loss of sensitivity to insulin make it difficult or nearly impossible for cells to maintain homeostasis.  The complications of diabetes are divided into two major categories; acute and chronic.  Acute complications consist of:

  • Hypoglycemia
  • Diabetic Ketoacidosis
  • Nonketotic hyperosmolar hyperglycemia

Hypoglycemia, usually seen in type 1 diabetes, results from taking too much insulin, missing a meal, or over-exercising.  Diabetic ketoacidosis is also more likely to occur in poorly controlled or untreated type 1 diabetes.  Nonketotic hyperosmolar hyperglycemia is a very serious condition that occurs when blood sugar rises to extreme levels, usually in type 2 diabetics with some insulin production or type 1 diabetics who are receiving inadequate levels of insulin for their acute situation.

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Glycosylation refers to the binding of glucose to proteins.  The poorer the glucose control, the greater the binding, which leads to changes in the structure and function of the protein.

Sorbitol is a sugar molecule that is formed from the glucose within cells.  Increased sorbitol levels within cells create an osmotic effect.  Osmosis refers to the movement of water molecules from an area of high concentration to an area of low concentration.  Increased oxidative stress is a major factor in the risk of the chronic complications of diabetes.

One of the critical goals in diabetes prevention and treatment is to flood the body with high level of antioxidant compounds to counteract the negative effects of free radicals and pro-oxidants.

Homocysteine is a potentially harmful compound formed in the conversion of the amino acid methionine to cysteine.  Homocysteine is thought to promote atherosclerosis by directly damaging the artery and by reducing the integrity of the vessel wall, as well as by interfering with the formation of collagen.

Blood pressure control is essential in preventing the complications of diabetes, especially kidney disease, retinopathy, and stroke.  The health of the artery is critical to maintaining normal blood pressure.  Endothelial cell dysfunction can lead to stiffening of arteries because normally endothelial cells produce nitric oxide, which relaxes the blood vessel wall.  Some important lifestyle factors that may cause high blood pressure include:

  • Stress
  • Lack of exercise
  • Smoking

The dietary factors include:

  • Obesity
  • High sodium-to-potassium ratio
  • Low fiber
  • High sugar diet
  • High saturated fat and low omega-3 fatty acid intake
  • Diet low in calcium, magnesium, and vitamin C
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Special foods for those with high blood pressure may consist of the following:

  1. Celery is a particularly interesting recommendation for high blood pressure because of the noted compound 3-n-butylphthalide (3nB).
  2. Garlic and onions are also important foods for lowering blood pressure.

 

Some of the long-term (chronic) complications consists of:

  • Atherosclerosis and other vascular lesions are the underlying factors in the development of many of the chronic complications of diabetes.
  • Retinopathy and cataracts of diabetes is a serious eye disease involving the retina.
  • Neuropathy usually refers to the loss of peripheral nerve function and is characterized by tingling sensations, numbness, loss of function, and a characteristic burning pain known as neuropathic pain.
  • Poor wound healing is common in diabetes such as microvascular changes leading to poor circulation and functional deficiency of vitamin C.
  • Foot ulcers are common in individuals with diabetes due to the microvascular changes leading to a lack of blood supply, peripheral neuropathy, poor wound healing, and immune system dysfunction leading to chronic infections in the feet.
  • Immune system dysfunction often begins to occur long before a diagnosis of diabetes is made. A recurrent vaginal or skin yeast infection is the clue that leads to the detection of diabetes in many cases.
  • Depression and cognitive difficulties are very common in diabetics. Depression may begin to occur decades before the onset of type 2 diabetes when the individual first develops insulin resistance.

Part 12: Recommendations for Specific Chronic Complications

Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)

Diabetes ~ Part 10/12 Lifestyle and Attitude in Managing Diabetes

Diabetes was a rarity in cultures with people that ate diets composed entirely of wholesome, natural foods; who exercised vigorously; who lived and worked outdoors under natural sunlight; and who were exposed to a minimum of environmental pollutants.  A physician’s primary goal is to help diabetic, pre-diabetic, or insulin-resistant patients take the first safe exit off the freeway and head in a completely new direction.

In dealing with diabetes it is important to realize that relying on conventional medicine alone sets in play a relentless worsening of the condition with little chance of successfully modifying the outcome.  Diabetics or those with a pre-diabetic condition such as impaired glucose tolerance or syndrome X need to make serious changes in their whole way of life

If you have diabetes or a pre-diabetic condition, you will need to accept the need for change.  Denial is a big barrier to change.  People who have addictive conditions, the first step in recovery is a willingness to see one’s situation exactly as it is.  Depression is another common barrier to change which is a common occurrence in diabetes.  Five critical changes must occur and must be consistently maintained if you want to win good health and avoid catastrophic outcomes from diabetes.

  1. Change your attitude
  2. Learn to deal with stress
  3. Don’t smoke
  4. Achieve ideal body weight
  5. Exercise regularly

The first step in dealing with diabetes is developing a positive attitude.  The most important coping mechanism to learn is how to calm the mind and body.  The goal of relaxation techniques is to produce a physiological response known as relaxation response which requires breathing with the diaphragm, which changes a person’s physiology by activating the relaxation centers in the brain.  There are three key habits to help you develop a positive mental attitude.

  1. Improve the way you talk to yourself
  2. Ask better questions
  3. Set positive goals

The damaging effects of diabetes are multiplied over and over again if you smoke.  To be able to quit smoking is not easy.  Once you have come to grips with the fact that you must quit, the next step is to set a quit date.  You should have a physician to assist you with this.  Smoking is both and addiction and a collection of habits that have been integrated into your lifestyle.

Determining the need for weight loss is one of the most important first steps in determining the treatment priorities in the diabetic by the use of the body mass index (BMI).  To calculate your BMI use the following calculation:

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Most people will successfully lose 10 percent of their body weight by consistently learning to make wise food choices, avoiding overeating at all costs, and consistently finishing each day with a modest calorie deficit by eating slightly less that than they need to maintain their weight in addition to burning some extra calories with moderate exercise.

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Successful and long-lasting weight loss results from losing ½ to 2 pounds per week, depending on the amount of total weight to be lost.

Exercising is essential in the prevention and management of diabetes as well as in pre-diabetic conditions such as glucose intolerance and syndrome X.  It has been shown to sustain weight loss more effectively than any other treatment available.  Exercise directly improves insulin sensitivity and blood sugar, probably from a combination of increased lean muscle mass and an improvement in muscle cell metabolism.  Exercise also decreases symptoms of anxiety and depression and improves sexual functioning, confidence, and self-esteem.  Aerobic exercise, strength training, and stretching exercises are the three types of exercises recommended for people with diabetes.

Aerobic exercises produce a rise in heart and respiratory rates.  Strength training should be done two or three times per week with light to moderate weights.  Stretching exercises should be done daily.  You should make a commitment to achieve optimal health by choosing to be positive, choosing to eat for optimum health; choosing to lead a health-promoting lifestyle, and choosing to support your body chemistry through proper nutritional supplementation.  By doing this, you are building a strong foundation for achieving ideal health and a long life, and possibly setting the stage for a possible cure.

 

Part 11: Diabetic Complications

Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)

Diabetes ~ Part 9/12 ~ Natural Products for Type 2 Diabetes

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.

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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.

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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.)

Diabetes ~ Part 8/12 ~ Natural Products for Type 1 Diabetes

The biggest recent change in insulin came with the development of recombinant DNA technology that allowed synthesis of a “human” type of insulin from bacteria and yeast rather than relying on animal pancreatic tissue for extraction.  Currently insulin must be injected via syringe, pump, or insulin pen.   Insulin types are classified not by their source; but rather by how fast they start to work and how long their effects last.

Intensive insulin therapy has been made possible largely through the development of breakthrough immediate-acting insulins (insulin lispro [Humalog] and insulin aspart [Novolog]) as well as a novel very-long-acting insulin (insulin glargine [Lantus}).  Lantus provides a near-constant (basal) release of insulin for one full day.  Intensive insulin therapy requires much more frequent testing of blood glucose and frequent injections, the timing and the dose of insulin can be easily adjusted to accommodate daily variations in the diabetic’s eating and exercise schedule and food intake.  The decision to use multiple injections of insulin versus an insulin pump depends on the preference of the patient and the ability of the health care provider and diabetes teaching unit to provide the necessary resources and support.

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The insulin pump approximates the natural levels of insulin in the best of currently available techniques, but it is not without drawbacks.  The device must be worn constantly and can be in irritation.  Also, the risk of hypoglycemia is greater.   The wearer must be highly motivated, able to operate the pump, willing to test blood glucose frequently, and astute enough to know when a problem is developing

One of the key advantages of the insulin pen is convenience and is usually a strong motivator to make the switch from the syringe-and-needle approach.  It is inconspicuous, quick, and easy.  It is also less painful because smaller-gauge needles are used.  Use of an insulin pen or pump requires the user to recognize factors that may cause a change in their blood sugar levels.

The therapy goals for individuals with type 1 diabetes with supportive natural products involves:

  1. Preserving beta cell function and possibly reversing the autoimmune process
  2. Enhancing the effectiveness of insulin therapy to allow for lower dosages
  3. Reducing after-meal elevations in blood sugar levels

The key to stopping type 1 diabetes is to start therapy as soon as possible after the diagnosis or within the first year at the latest.  The two key supplements are the niacinamide form of vitamin B3 and green tea extract or the herb Pterocarpus marsupium.  Niacinamide has been shown to prevent some of the immune-mediated destruction of the pancreatic beta cells and may actually help reverse the process.  The plant pterocarpus has a long history of use in India as a treatment for diabetes.

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Individuals with poorly controlled type 1 diabetes should consider taking biotin, Gymnema sylvestre, or Korean ginseng extract to try to improve insulin utilization.  Biotin is a B vitamin that functions in the manufacture and use of carbohydrates, fats, and amino acids.  Biotin supplementation has been shown to enhance insulin sensitivity and increase the activity of the enzyme glucokinase, the enzyme responsible for the first step in the use of glucose by the liver.

Gymnema is another plant from India that has long been used as a treatment for diabetes.  It has been shown to enhance glucose control in diabetic dogs and rabbits.  There is evidence in animal studies that gymnema promotes regeneration of the insulin-producing beta cells in the pancreas.  No side effects have been reported from gymnema extract; however, diabetics on insulin should be careful to monitor blood sugar when beginning this product because insulin dosages may have to be decreased to avoid hypoglycemia.

 

 

Part 9: Natural Products for Type 2 Diabetes

Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)

Diabetes: Part 7 of 12 ~ Diet Therapy in Managing Diabetes

One of the most successful treatments in combating type 1 and type 2 diabetes is diet.  Restricting carbohydrates of all sorts in favor of high-protein and fatty foods is one of the first dietary strategies; but with disastrous results to the long-term health of diabetics because it carried severe consequences to cardiovascular and kidney health.  Eating the right type of oils promotes proper insulin action.  Any diet that severely restricts beneficial oils would ultimately fail.

energybalance_calories_chartIf you need to increase your caloric intake, try to get the extra calories you need by increasing the number of servings of vegetables, nuts, and legumes, as these are the best foods for improving blood sugar control.

It is very important not to overcook vegetables.  Overcooking not only will result in loss of important nutrients; it will also alter the flavor of the vegetable.  Whole grains provide substantially more nutrients and health-promoting properties.  Whole grains are a major source of complex carbohydrates, dietary fiber, magnesium and other minerals, and B vitamins.  Diets rich in whole grains have been shown to be helpful in both prevention and treatment of diabetes, but they must have a low glycemic load below 20.  It is not recommended to use canned vegetables or fruits, but canned beans retain their fiber content and anticancer flavoids.

Fruits are a rich source of many beneficial nutrients, and regular fruit consumption has been shown to offer significant protection against diabetes and other chronic degenerative conditions, including cancer, heart disease, cataracts, and strokes.  Macadamia nut oil is the best cooking oil, but olive oil is great for sauteed vegetables while canola oil is usually best for baked goods because it has the least “nutty” flavor.  Coconut oil is also ver stable in cooking and is fine to use in small quantities.

There a lot of people allergic to dairy or lack the necessary enzymes to digest dairy products.  For those that do not consume dairy products, they should take a high-potency multiple vitamin and mineral formula that provides sufficient levels of calcium.

Achieving optimal daily blood glucose measurements and hemoglobin A1C levels ensures a longer, healthier life for people with type 1 diabetes.  Diet and intensified insulin therapy is crucial.  Clinical studies have shown impressive results in improving blood sugar control for people on diets high in fiber and low in glycemic load.  Diet is a key therapeutic area in type 2 diabetes.  Dieting alone can often be effective as the sole factor in treating and reversing type 2 diabetes.  High intake of dietary fiber of the soluble type, above the level recommended by ADA, improves glycemic control, decreases hyperinsulineHEPApr2013mia, and lowers plasma lipid concentrations in patients with type 2 diabetes.

One of the best things that a person with diabetes can do is to take a high-potency multiple vitamin and mineral formula.  Taking a multiple vitamin and mineral supplement has shown to boost immune function and reduce infections in diabetics.  Chromium is vital to proper blood sugar control, as it functions in the body as a key constituent in the glucose tolerance factor.  Chromium works closely with insulin in facilitating the uptake of glucose into cells.  Without chromium, insulin’s action is blocked and glucose levels are elevated.  By substituting  the diet with chromium in type 2 diabetes, it has been shown to decrease fasting glucose levels, improve glucose tolerance, lower insulin levels, and decrease total cholesterol and triglyceride levels, while increasing HDL cholesterol levels.

Vitamin C is vital for wound repair, healthy gums, and the prevention of easy bruising.  Vitamin E in a natural form  (d-) functions primarily as an antioxidant in protecting against damage to the cell membranes.  Niacin is an essential component of the glucose tolerance factor, making it a key nutrient for hypoglycemia and diabetes.  Vitamin B6 is critical in maintaining hormonal balance and proper immune function and offers significant protection against the development of neuropathy.

Part 8: Natural Products for Type 1 Diabetes

Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)

Diabetes: Part 6 of 12 ~ Monitoring Diabetes

Diabetes is one condition where medical doctors, naturopathic physicians, and certified diabetes educators should play a significant role in education, coaching,

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and prescribing of care.  Unless it is properly managed and supervised, diabetes can be viewed as a state of biochemical anarchy that will lead to organ injury and accelerated aging.  Diabetes damages many of the complex control systems that faithfully govern and protect the body.  Diabetics who develop a keen awareness of the risk factors through regular testing and properly supervised self-monitoring program are much more likely to benefit from changes in lifestyle,
diet, supplements, and medications.  If the blood sugar gets too high, the kidneys are unable to conserve all of the sugar in the blood that it is filtering and glucose will then begin appearing in the urine.  Most diabetics can do away with urine glucose measurements as long as they are willing and able to follow a proper program of blood glucose monitoring.

In a diabetic, ketones will appear in the urine when there is a severe deficiency in the availability or the activity of insulin. This can occur if an insulin-dependent diabetic accidentally or purposefully forgets to take his or her insulin.  It can also occur when a diabetic becomes ill, is injured, or is given high doses of cortisone-related drugs.

Severe dehydration also rapidly occurs because the kidneys are unable to conserve water in the presence of such extraordinary levels of blood sugar.  This dangerous state, called diabetic ketoacidosis, must be treated as a medical emergency, usually necessitating intravenous insulin, high amounts of IV fluids, and careful monitoring, usually in an intensive-care unit.  Ignoring ketoacidosis can rapidly lead to death.  The presence of urine ketones may indicate impending or even established ketoacidosis, thus requiring immediate medical attention.

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Diabetics who do not maintain vigilant awareness of their blood sugar and who do not make every effort to keep their blood sugar under tight control can expect a significant increase in their risk of serious health problems such as eye, kidney, and heart disease as well as a host of other problems such as depression, fatigue, impotence, and chronic infections.  In order to achieve blood sugar levels that are consistently as close to normal as possible, type 1 diabetics must replicate this natural situation as closely as possible.  They need to monitor their blood sugar frequently, and they must learn to use this information to make ongoing adjustments to their insulin injections, diet, and exercise.

Intensive insulin therapy allows a diabetic to achieve near-normal levels of blood glucose along with enjoying improved lifestyle flexibility.  With conventional, infrequent insulin injections, diabetics must structure their meals and other lifestyle aspects around their injections or face serious abnormalities of blood sugar.

Every type 2 diabetic should own a blood glucose monitor and should become intimately familiar with its use.  Type 2 diabetics who are not on insulin and whose blood sugar is well controlled according to regularly scheduled laboratory testing would still be wise to designate an intensive blood sugar measuring day every 1 to 3 weeks.  Numerous dietary factors, supplements, exercise, stress, and illness can all have a significant impact on blood sugar control.

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Diabetics who have more advanced diabetes and who have diminished pancreatic insulin production may also benefit from efforts to establish consistently near-normal blood sugar control using intensive insulin therapy similar to that of type 1 diabetics.  A blood test of C-peptide levels can provide an estimate of how much insulin the type 2 diabetic is producing and is one way to help determine the appropriateness of using insulin.

The greatest breakthrough in blood glucose monitoring is found in the device known as the GlucoWatch.  The GlucoWatch is worn much like a wristwatch.  A small electrical current from the device works to extract a tiny amount of fluid through the skin.  Clinical studies conducted by the manufacturer indicated that GlucoWatch measurements generally were consistent with results from traditional finger-prick blood tests.

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The GlucoWatch was less effective at detecting very low glucose levels than it was at detecting very high levels.

More than half of diabetics (both type 1 and type 2) have high blood pressure (hypertension).  Effective blood pressure control has also been shown to help maintain insulin sensitivity in the diabetic.  Ideal treatment will maintain a diabetic’s blood pressure consistently at less than 130/85.  Diabetics with a history of hypertension periodically undergo ambulatory blood pressure

I use this style/brand as well.  Really works good. ~ d.a.i Google Images

I use this style/brand as well.  ~ d.a.i
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monitoring.  Ambulatory blood pressure monitoring enables the physician to determine whether blood pressure is under ideal control around the clock and in a variety of circumstances.

Diabetes is the primary cause of kidney failure, dialysis, and kidney transplant.  All diabetics should undergo regular monitoring for early kidney disease through measuring the level of small amounts of the protein albumin in the urine every 3 months when visiting the doctor for A1C determination.  Diabetics should also be carefully followed by an eye specialist who should perform a dilated retinal eye exam at least once per year.  It is also important for all diabetics to have a foot exam every 3 months to look for breaks or ulcers in the skin, damage to or abnormalities of the nails, and quality of circulation, and also sensory tests to rule out nerve damage.  Treadmill testing is useful as a screen for coronary artery blockages as well as a general measure of aerobic fitness.

Part 7: Diet Therapy in Managing Diabetes

Recommended reading: How to Prevent and Treat Diabetes with Natural Medicine (Michael Murray, N.D., Michael Lyon, M.D.)