Classes of Diabetes

Classes of Diabetes
by Dr. Janet McKenzie, ND, MBA, BSn

The most prevalent forms of diabetes are commonly referred to as Type 1, Type 2 and gestational diabetes. In Type 1, the cells of the pancreas that secrete insulin die. Insulin is the hormone that regulates blood sugar, or glucose, by influencing the capacity of cells to use it as fuel for their activities.

Sometimes the insulin-secreting pancreatic cells die because of actions of the immune system (“immune-mediated Type 1 diabetes”). At other times, there is no apparent cause of cell death (“idiopathic Type 1 diabetes”)1. Type 1 diabetes can occur in people of any age but is the most common form affecting children, which is why in the past it was referred to as juvenile or early onset diabetes. Insulin-dependent diabetes is another term that has been used to refer to Type 1 diabetes.

In Type 2 diabetes, the body tissues become increasingly resistant to the effects of insulin. Insulin secretion may be impacted in a variety of ways: it may initially increase, it may decrease or it may remain relatively unchanged. Type 2 diabetes tends to develop in people who are middle-aged or older, and may be caused or worsened by poor dietary and lifestyle habits. This form of diabetes has also been referred to as non-insulin-dependent or late onset diabetes.

Gestational diabetes occurs in as many as 7% of pregnancies and resembles Type 2 diabetes in that it involves some combination of reduced insulin production and altered insulin sensitivity2. Gestational diabetes is sometimes referred to as Type 3 diabetes, as is another condition, latent autoimmune diabetes of adults (LADA). LADA is a condition in which Type 1 diabetes develops in an adult. It may be misdiagnosed as Type 2 diabetes if the diagnosis is based on the person’s age rather than on the nature of the metabolic failure (loss of insulin-secreting cells versus loss of tissue receptors for insulin)3.

Prediabetes is a condition in which sensitivity to insulin is declining. It is characterized by blood sugar levels that are at or just above the high end of the normal range and is thought to precede the development of Type 2 diabetes.

Natural Treatments for Diabetes
The objectives of treatment for all forms of diabetes are the same: to improve the uptake of glucose at a cellular level and to maintain blood glucose levels within a tight spectrum. Vitamin, mineral and botanical supplementation can be effective in achieving these objectives.

Vitamin D
Our bodies make Vitamin D when they are exposed to sufficient quantities of sunlight. Because we live in a northern climate, Canadians are at risk for Vitamin D deficiency, especially during the winter. Recent studies have shown a link between decreased levels of Vitamin D and susceptibility to both Type 1 and Type 2 diabetes.4, 5, 6, 7

Food sources of Vitamin D include cod, salmon, sardines, milk and eggs. Consult your MD or naturopathic doctor if you are concerned about being deficient.

Chromium
Chromium is a component of a molecule known as glucose tolerance factor (GTF) which helps cell receptors respond to insulin to stabilize blood glucose levels. Studies show that chromium can enhance impaired glucose metabolism.8,9

Good food sources of chromium include romaine lettuce, tomatoes and onions. While chromium is found in many foods, it tends to be there in very small amounts. As a result, it is often necessary to take chromium as a supplement if a therapeutic level of the nutrient is needed.

Vanadium
Vanadium is another mineral that has been shown to help normalize blood glucose levels, possibly through an insulin-like effect on cells.10, 11 Food sources of vanadium include seafood, mushrooms and culinary herbs such as black pepper, dill and parsley.

Bitter Melon
Bitter melon, also known as Momordica charantia, is a gourd-like fruit that grows in South America, Asia and Africa. It has been used by practitioners of folk medicine in those areas to control the symptoms of diabetes for centuries, and has been shown in research to have a sugar-lowering impact.12

Gymnema
Gymnema sylvestre is an herb commonly used in India to reduce the desire to eat sugary foods. It has been shown in research to reduce the symptoms of diabetes and improve blood markers of the condition, such as glycated hemoglobin. 13, 14

Type 2 diabetes is considered to be preventable because an appropriate diet and exercise regimen can forestall the development of the disease. But irrespective of the “face” diabetes is presenting; diet, lifestyle factors and targeted supplementation can make significant improvements in the signs and symptoms of the condition. If you think you might be at risk for diabetes, consider discussing your situation with a naturopathic doctor – a natural treatment just might make all the difference.

References:
1 Rother KI. Diabetes treatment–bridging the divide. N Engl J Med. 2007 Apr 12;356(15):1499-501.
2 Ferrara A et al. An increase in the incidence of gestational diabetes mellitus: Northern California, 1991-2000. Obstet Gynecol. 2004 Mar;103(3):526-33.
3 Landin-Olsson, Mona Latent Autoimmune Diabetes in Adults. Annals of the New York Academy of Sciences 958:112-116 (2002)
4 Bailey, R et al. Association of the Vitamin D Metabolism Gene CYP27B1 With Type 1 Diabetes. Diabetes October 2007 vol. 56 no. 10 2616-2621
5 Mohr, S. B. et al. The association between ultraviolet B irradiance, vitamin D status and incidence rates of type 1 diabetes in 51 regions worldwide. Diabetologia 2008 Volume 51, Number 8, 1391-1398
6 Palomer, X. Role of vitamin D in the pathogenesis of type 2 diabetes mellitus. Diabetes, Obesity and Metabolism. March 2008; 10(3):185–197
7 Chiu KC, Chu A, Go VL, Saad MF: Hypovitaminosis D is associated with insulin resistance and beta cell dysfunction. Am J Clin Nutr 79:820–825, 2004
8 Albarracin, C.A. et al. Chromium picolinate and biotin combination improves glucose metabolism in treated, uncontrolled overweight to obese patients with type 2 diabetes. Diabetes/Metabolism Research and Reviews Jan 2008; 24(1): 41–51
9 Balk, E. M. et al. Effect of Chromium Supplementation on Glucose Metabolism and Lipids: A systematic review of randomized controlled trials. Diabetes Care August 2007; 30(8): 2154-2163
10 Karmaker S A novel drug delivery system for type 1 diabetes: insulin-mimetic vanadyl-poly(gamma- glutamic acid) complex. J Inorg Biochem. 2006 Sep;100(9):1535-46.
11 Sakurai H et al. Metallo allixinate complexes with anti-diabetic and anti-metabolic syndrome activities. Metallomics. 2010 Oct 1;2(10):670-82.
12 Nahas R and Moher M Complementary and alternative medicine for the treatment of type 2 diabetes. Can Fam Physician June 2009; 55 (6): 591 – 596
13 Kumar S.N. et al. An Open Label Study on the Supplementation of Gymnema sylvestre in Type 2 Diabetics. Journal Of Dietary Supplements. September 2010; 7(3): 273-282
14 Liu, Bo et al. Characterisation of the Insulinotropic Activity of an Aqueous Extract of Gymnema Sylvestre in Mouse β-Cells and Human Islets of Langerhans. Cell Physiol Biochem 2009;23:125-132

Janet McKenzie is a graduate of the University of British Columbia School of Nursing, Queen’s School of Business and the Canadian School of Naturopathic Medicine. She has practices in Hamilton and Toronto, and teaches at the Canadian School of Natural Nutrition.