LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

prediabetes

DIABETIC MEDS DON’T CONTROL BLOOD SUGAR

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I think that many diabetics do not fully understand just how dangerous the condition is.  The level of understanding of how damaging the prediabetic state is for our health is even lower.  There are a few important concepts to understand.

First, in the prediabetic state, levels of insulin become elevated.  At normal levels, insulin’s actions are required to keep levels of blood glucose optimal in the bloodstream.  However, when insulin levels go up because of poor quality lifestyle choices, sedentary lifestyles and environmental chemical exposures, the higher levels of insulin become more dangerous than cigarette smoking.

High blood pressure, abdominal obesity, menstrual problems, most types of cancer, blood clotting problems leading to heart attacks and strokes…the list is almost endless.  We live in a society that doesn’t place much concern on being prediabetic unless it means that you can qualify to be put on metformin or some other drug like that.

In the diabetic state, the elevated insulin is still present, but the body can no longer control the levels of glucose so glucose levels elevate in the blood stream.  Now we have more problems on top of the insulin issue.  Glucose, when levels get high enough, will irreversibly damage proteins in a process called glycation (the Maillard reaction).  We check the HbA1c in the bloodstream, which is damage to hemoglobin.  But this damage occurs in EVERY cell of the body.  Every protein in a diabetics’ body has the potential to being damaged by the elevated glucose.  Not good.

 Which then brings us to this article.  Despite being on diabetic medication, the authors found that the diabetics in this study frequently had elevated levels of blood glucose (hyperglycemia) after meals.  This is, for the reason stated above, not good.  While the article did not go into detail, it should be obvious that the contents of the meal will play a large role in the body’s response to the meal.

More processed, more unhealthy = less risk of hyperglycemia.  This article is the perfect example of why “I have diabetes, but it’s under control with medication” is a very dangerous position to live from.  If you are on medication, your condition is NOT, I repeat, NOT, controlled.

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SIMPLE VITAMIN HELPS PANCREAS

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A little background here.  Personally, I think there is nothing more important to the human physiology as managing the relationship between our cells, glucose, insulin and our pancreas.  There is nothing more crucial to our longevity than this.  Period.

Our pancreas is composed of two main types of endocrine cells.  The alpha cells release a hormone called glucagon.  Glucagon helps us to keep a steady level of glucose in the bloodstream so we don’t do bad things like slip into a hypoglycemic coma.  The other cell is the beta cell that produces insulin.

The beta cells, however, have a problem.  They can only do so much work for so long.  Anything that damages them worsens our ability to manage glucose.  Chronic intakes of poor quality diets will do this.  Some diabetic drugs (the sulfonylureas are notorious for burning out the beta cells of the pancreas!) will also contribute to the death of the beta cells.

In a sick twist, high levels of glucose produce oxidative stress within a cell.  The beta cells of the pancreas, the very cells that we need to produce insulin and protect us from high blood sugar, are poorly protected against oxidative stress and vulnerable to dying off when blood sugar is elevated.

Because of this, anything we can do to protect and support the beta cells is a very good thing.  This particular study finds that Vitamin D, among the seemingly hundreds of other benefits, also supports the health of the beta cell. 

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AVOIDING THIS IN FOODS WILL RAISE CHOLESTEROL

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It’s funny.  We think about what foods to add to lower cholesterol such as raw nuts and fish oils.  We think about what foods to avoid to lower cholesterol such as omega-6 containing oils (sunflower, soybean, peanut, cottonseed, etc..), hydrogenated oils and refined carbs.  This article adds yet another dimension–the elevation of lipid levels when a certain mineral is NOT present in the diet.

Sulfur, as a mineral, does all kinds of good things for the body.  It is essential for the maintanence of healthy joints.  It supports the sulfation pathway of detoxification in the liver.  And, looking at this study, diets that are low in sulfur will result in elevations in blood lipids such as cholesterol and triglycerides.

Foods high in sulfur include the cruciferous veggies like broccoli and cauliflower (of course!), onions, garlic and eggs.  And, as expected, these types of foods are good for us in a variety of ways and not just limited to their sulfur content.  So make sure you add these foods into your anti-diabetic lifestyles.

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DO YOU ADD THIS TO YOUR FOOD?

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Variety is the spice of life.  They certainly got the spice part right on this one.  It amazes me how many people miss an opportunity to add culinary delight to meal after meal by adding spices.

When we talk “spice” it does not necessarily mean “spicy,” although it certainly could.  Spices like rosemary, thyme and basil do not make a dish spicy, but they absolutely liven up the flavor.  The list of spices and spice combinations are limited only by your imagination, palate, and occasionally, your sense of adventure.

The beautiful thing about spices is that they pack a massive wallop of phytonutrients for almost zero calories.  AND they taste great!  What more could you ask for?

This particular study looked at how a spiced up meal affected both markers of glucose metabolism and antioxidant status in the bloodstream.  Those eating the high spice meal had lower levels of insulin and triglycerides after the meal and twice the antioxidant level in the bloodstream.  This would unquestionably be part of an anti-diabetic lifestyle.

So load up on the spices on everything you eat.  You organic, grass few meats.  Your veggies.  Maybe just stick your tongue out and drop it directly on there..

A few notes, however.  Avoid MSG containing spice mixes at all costs.  And don’t waste the spices by taking them in a supplement (such as cinnamon).  Why miss out on what the spice can do to your meal?  And if you’re planning on grilling the veggies, lightly spray them with some olive oil so the spices with stick better..

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THIS COMMON CONTAMINANT CAN AFFECT FERTILITY

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I realize that my office is a single isolated system and by no means does it reflect the entire picture of what happens outside of my office.  With this in mind, I can honestly say that I have never had a patient who went through “fertility treatment” and fertility was actually addressed.

We need to understand that, when boiled down to an organism level, our body’s only goal is to reproduce and propagate the species (forget arguments about Maslow’s Hierarchy of Needs here).  So if a couple cannot get pregnant and do the ONE thing it is supposed to do, this is a massive red warning light that something is not right. 

So, one would think that a fertility “expert” would then dig into the more common reasons why infertility can occur.  Sadly, the couples that I have come across over the years have not had this experience.  Instead, some bloodwork is taken and they are usually given a course of Clomid or Metformin or IVF, spending thousands of dollars.  Sometimes it’s successful, sometimes not.

But, if the physiology of the couple is screaming that something is wrong, shouldn’t we pay attention to that FIRST?  Society is paying the price for forced fertility in preterm births, multiple births, obese infants and children and, in the years to come, increased rates of obesity, heart disease and diabetes.

Instead, a full evaluation should include looking at prediabetes (a major cause of infertility in women and almost completely lifestyle-mediated via polycystic ovarian syndrome), prenatal vitamins (almost all of the prescription ones are of very low quality and really, really expensive!) and toxic exposure.

The last one can be a toughie.  A detailed look at what a couple may be exposed to should be undertaken, from pesticides to fertilizers to flame retardants to BPA from plastic water bottles.  The couple should be counseled to avoid as many chemical exposures as is feasibly possible as well as recommendations on detoxification programs to help the body clear out the toxins we are exposed to that we cannot reasonably avoid.

THIS is infertility treatment.

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STATINS PRODUCE MORE HARM THAN GOOD

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It should come as no big shock that I am certainly not an advocate of the statin class of drugs to lower cholesterol.  There are many reasons why I am so vehemently opposed to the use of this drugs.  How could this be, when it cuts the risk of a cardiac event by 50%??

For primary prevention (meaning we are trying to prevent a first heart attack), in almost all studies I’ve read, regardless of what value you look at (cholesterol, hsCRP, LDL), a statin will cut the RELATIVE RISK down by 50%.  If you are a physician that does not understand research and take the drug company’s headline as gospel, this seems like a godsend.  Every patient walking through the door is going to get their blood pressure checked and get a prescription for a statin, thinking that you are doing wonders for your patients.

However, before we jump up and down in excitement, we need to understand relative vs absolute risk.  In most of the studies, the numbers are pretty consistent.  Treat 100 people for 3 years and, instead of 2 people having a heart attack, only 1 does.  The RELATIVE drop from 2 to 1 is a 50% reduction and sounds great.  But since the overall risk is pretty low in this population (typically referred to as a 10 yr risk), the absolute risk reduction is a paltry 1%.  This flat out sucks.

There are some lifestyle interventions or supplements that fall into the same category.  The relative risk reductions may appear more powerful than if you put it into absolute risk reductions.  Here’s the difference.  Statins are very expensive (although with the loss of the patent on Lipitor the prices will drop substantially) and have a long list of side effects.  Muscle damage (the damage is present even if someone taking statins does not have muscle pain).  Depletion of CoQ10.  Probably the greatest scare is the increased risk of diabetes.

But, the biggest, staring you right in the face, answer is that I have NEVER not had a patient bring their cholesterol levels in line with the right lifestyle choices.  This is and will always be the only appropriate way to handle lipid issues.  The vast majority of patients with lipid (total cholesterol, triglycerides, HDL, VLDL) problems are pre-diabetic.  So giving these patients a drug that will worsen the physiological state that is making the number off kilter is just plain bad medicine.

http://jama.ama-assn.org/content/305/24/2556.abstract

THIS AMINO ACID AS POWERFUL AS NEW DIABETIC DRUGS?

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Ok..if you don’t remember what GLP-1 and DPP-4 refers to, refer back to some earlier posts.  In general, the hormone GLP-1 has some very potent actions on helping our bodies deal with the sugars that we eat and keeping us away from diabetes.

All of the new diabetes drug research is along these two lines–mimicking our own GLP-1 or inhibiting our enzyme that breaks down our own GLP-1 (this enzyme is called DPP-4).  The push of money in this direction is amazing.  For the rest of us, however, we don’t need to take fancy new (i.e. untested) drugs to get our bodies to work better.

We already know that merely chewing our food longer will provide a strong GLP-1 response by our bodies.  No more or less calories.  No need to change our diets (providing that it doesn’t need changing).  Just chew more.

This article provides us information on additional tools that can help our bodies function properly and avoid diabetes.  The amino acid glutamine is considered a conditionally essential amino acid, meaning that our bodies can manufacturer it on its own, but under certain conditions of increased need our body cannot make as much as it needs.  Glutamine is found in many animal proteins, seafoods, spinach, parsley, beets and cabbage, among others.

I have generally thought of supplemental glutamine for healing the gut, for which it has a good track record.  This particular study finds that glutamine also has the ability to increase our GLP-1 levels in addition to helping with some other anti-diabetic properties. 

While I don’t typically use glutamine in prediabetics and diabetics, it will be interesting to keep supplementation with this amino acid in the toolbox.

http://jn.nutrition.org/content/141/7/1233.abstract

WHY YOU SHOULD AVOID CHEERIOS, OATMEAL FOR BREAKFAST…

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I hope we can skip the discussion about needing breakfast here.  It does still amaze me how many people skip breakfast.  Not enough time.  Not hungry.  Trying to cut calories.  However, with new patients coming into my office, I can say that few actually were eating an appropriate breakfast if they were even eating it.  Most are under the mistaken impression that something like Cheerios, Special K or oatmeal constitutes a good breakfast.

First, before we cover what a good breakfast consists of, let’s again stress just how darn important it is.  This particular study takes an interesting look at what happens to our physiology when we skip breakfast.  Researchers had participants divided into a breakfast (B) and no-breakfast (NB) group, then, 2.5 hours later, gave them a liquid drink.  Those in the NB group had all around worse response in their blood to the drink than those who did eat breakfast (higher sugar, higher insulin, higher fats, lower GLP, more calories at lunch).

Basically, skipping breakfast sent the participants physiology into a tailspin towards diabetes.  Pretty darn impressive for a single meal, huh?  Imagine when it is a pattern of lifestyle.

Now, on to the “what” portion of breakfast.  It should come as no surprise that dairy, refined carbs and artificial colors/flavors are off the list.  So this rules out the Special K cereals and pretty much 98% of what the big confectionery companies (Kellogg’s, Quaker, Nabisco, Kraft) produce.

I always steer patients towards a very high fiber (8+ grams) or protein based breakfast.  That means real peanut butter on true whole grain bread.  Omega 3 eggs cooked in olive oil.  A handful of nuts.  There are some very high quality cereals made by Kashi, Amy’s, Nature’s Path, etc, that meet the high fiber qualification.  Just add one of the many nut milks available (soy, hazelnut, almond, rice, hemp, etc…) instead of dairy.

You should note that this rules out all but the highest quality oatmeals.  Your typical “instant” oatmeals are not going to provide this high of a level of fiber and likely contain lots of added sugars.  You could, however, do a plain oatmeal and add in your own cinnamon, nuts and / or granola to improve the value.

Either way, careful attention to breakfast is absolutely critical towards a lifetime of diabetes avoidance and maintaining ideal body composition.