People often want to know about diabetes and diet when they have a diagnosis, but what if we assessed for early signs of imbalance and intervened before diabetes was at its full blown pathological state? This can be the difference between restoring normal function (or at least moving in that direction) versus disease development and progression. Food and nutrition can re-establish functionality and balance in underlying metabolic processes that promote health and vitality. A class example of this is metabolic syndrome or pre diabetes.
Metabolic syndrome or pre diabetes is characterized by high triglycerides, low HDL cholesterol, elevated waist circumference, hypertension, elevated fasting blood glucose (a measure of insulin resistance) and is linked to the further development of type 2 diabetes. For a diagnosis, you need to have at least 3 of the 5 factors, but having even one factor is a sign of imbalance and should be cause for concern.
Let’s take a look at the development of metabolic syndrome (prior to the appearance of any of the 5 factors). It occurs over time. For example, someone might have healthy fasting blood glucose and insulin levels, but when given a challenge test (i.e. give glucose and then check levels 1 and 2 hours post challenge) we may see elevated insulin levels. This indicates that this person has difficulty adjusting to a glucose challenge and is producing high levels of insulin to deal with it. Hyperinsulinemia (high blood insulin levels) is a sign of imbalance and over time is a contributing factor in the development of disease. Hyperinsulinemia can be corrected and managed using a focused nutrition and lifestyle intervention. Detecting the early signs of imbalance related to the development of metabolic syndrome allows for a better opportunity to restore normal function as well as deter the development into type 2 diabetes.
Type 1 diabetes is a different disease than type 2 diabetes, but we can also see a pathway to the diagnosed pathology as well as the importance of diabetes and diet. This is a simplistic example, but relays the point. The “honeymoon period” is a phase of time when type 1 diabetics are still producing insulin and, if recognized early enough, when some may maintain normal or near normal blood glucose with no outside insulin. Eventually, since type 1 diabetes is an autoimmune disorder, the remaining insulin producing cells (beta-cells) are destroyed and she/he becomes insulin dependent. Evidence suggests that autoantibodies can appear even prior to this phase and that beta-cell autoimmunity may be induced very early in life.
What if nutrition intervention was started earlier in the development of type 1 diabetes? Would it make a difference in outcomes? Some say yes. Research suggests that autoimmune diseases are triggered by environmental factors in genetically susceptible people, with dietary elements on the list of possible triggers. Intestinal permeability or “leaky gut” is associated with autoimmune disorders. Gliadin (the main protein in wheat gluten) is one of several known triggers that initiates and promotes leaky gut and this may be especially important in folks with autoimmune disorders that have an already compromised gut. And don’t forget that food is information for your genes. Give your body the “right” nutrition and your genes will promote better biological function or be “expressed” more favorably. Give your body the “wrong” nutrition and your genes will promote poor function and disease (i.e. difference between high versus normal blood sugar levels, high versus normal insulin levels, preservation of beta-cells).
In the conventional medical world, nutrition intervention is often low priority (at best), not considered important (at worst) and often focused on diagnosing disease and treating symptoms. What if, instead of symptom management, we treated the system? (i.e. treat the underlying causes of high blood sugars, not just the high blood sugars)
Multiple factors underlie the root cause of disease development and progression. Nutrition intervention is a key factor regardless if you have pre diabetes, are a newly diagnosed diabetic or if you’ve had type 1 or 2 diabetes for years. Although there is no one-size fits all when it comes to managing a chronic condition, using food and nutrition to address underlying imbalances no matter where you are on the continuum of disease will make a difference in your health. Unfortunately, conventional dietetic practice (i.e. exchange lists, carbohydrate counting) for managing diabetes is focused on treating symptoms and the reason that it often doesn’t make much of an impact. If you are interested in getting to the root of the condition and controlling diabetes with diet check out the links below:
[Sidebar: In no way am I placing blame on anyone with a diagnosed condition in that they should have aggressively managed this condition prior to, when newly diagnosed or even years into it. Conventional medicine focuses on diagnosing disease and treating symptoms, so you often don’t know of the best way to manage a chronic condition and have to do a lot of research and work on your own to accomplish this and find what works for you. I’ve been there too – and I’m a healthcare professional! I think this 15 minute TEDMED talk, “What if we’re wrong about diabetes?”, with Dr. Peter Attia speaks well to this issue, check it out:
The bottom line? Early intervention is important and a nutrition intervention focused on correcting underlying imbalances, whether you have signs of pre diabetes or have had diabetes for years, may help you reach a better state of health and vitality. This a general discussion of diabetes and diet. For more details about specific nutrition intervention strategies for type 1 or type 2 diabetes please check out the links on this page.
IFM, Clinical nutrition: a functional approach, 2004; Lipski, L. Digestive wellness, 2012; Forouton, R. Zonulin: the gateway to leaky gut, DIFM/AND summer newsletter, 2013; http://www.diabetesandenvironment.org/home/other/diet/nutrition; Knip, M. et al. Dietary Intervention in infancy and later signs of beta-cell autoimmunity, NEJM, 2010; 363:1900-1908; Sapone, A. et al. Zonulin upregulation is associated with increased gut permeability in subjects with type 1 diabetes and their relatives. Diabetes, 2006; 55(5):1443-1449.
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