Daily Health Center

Stop Type 2 Diabetes in Its Tracks

There’s an alarming increase in new type 2 diabetes cases. Consider these facts to get a sense of the scope of the problem:

• Diabetes affects more than 6.2 percent of the U.S. population, or 17 million people, but that figure is only the tip of the iceburg. It’s estimated that another 6 million have type 2 diabetes but don’t know it.
• Nearly 20 percent of the population between the ages of 65 and 74 has diabetes, primarily of the type 2 variety. (Type 2 diabetes onset usually occurs after age 30, and its prevalence increases steadily with advancing age.)
• Another 20–25 million Americans are thought to have insulin resistance, a condition in which the body’s tissues are less sensitive to the action of insulin, the hormone that brings blood sugar (glucose) into those tissues to be used as a source of energy. To compensate, the pancreas pumps out more and more insulin, but eventually it can’t keep up, which leads to diabetes.
• Being overweight is the single most important factor in the development of diabetes. I’m sure you’re aware of the steady rise in obesity in the U.S. and other Western countries, so all of these numbers are only going to increase.
• The annual economic cost of diabetes in the U.S. is on the order of $100 billion.

These statistics should alarm you as much as they do me. Although we’re making numerous strides in preventing and treating heart disease, we have more people than ever diagnosed with diabetes, a disease that puts its sufferers at a stepped-up risk for heart disease.

Sadly, I’m fairly accustomed to seeing type 2 diabetes develop in my adult patients, often preceded by years of the insulin resistance. The effects can go undetected, quietly assaulting your body, damaging organs such as your heart, kidneys, brain, and eyes. By the time you have enough symptoms to alert a physician to track your blood sugar, much of the damage has been done.

The Perfect Formula for High-Speed Aging

Add insulin resistance or uncontrolled diabetes (both of which cause wild fluctuations in your blood sugar) to accumulating years, and the diseases of aging will hit at an accelerated rate. Generally, a person who has either chronic insulin resistance or diabetes will look and feel like they’re 75 when they’re only 60 because so many body systems are operating at sub-optimal levels. In short, the higher your blood sugar levels, the faster you age. It’s as simple as that.

So how can you find out if you have stable or unstable blood sugar levels? With my patients, I find out for sure by taking their hemoglobin A1c level (HbA1c).

HbA1c—Your Best Test for Blood Sugar

The HbA1c is a simple blood test that’s typically used for monitoring patients already diagnosed with diabetes or those presumed to have insulin resistance. Clinicians familiar with this test like it because it allows them to see whether a patient’s blood sugar has been out of control for the last two or three months, unlike other tests, which only provide a snapshot of what’s happening at a given moment in time.

Several years ago, I added the HbA1c to the baseline blood panel I order routinely for most patients. Like the blood tests for C-reactive protein and homocysteine, HbA1c is underused by most physicians. However, those physicians practicing preventive medicine will usually run fasting insulin, blood sugar, and HbA1c tests on patients they suspect are at risk.

If any one of these is elevated, chances are good the patient has early insulin resistance. If two or all three are elevated, the patient is certainly headed for type 2 diabetes.

If you have an HbA1c test performed (you can ask to have it included next time your blood is drawn for evaluation), here’s what the results mean:

• 4–6 percent: Blood glucose control is within normal limits
• 6–7 percent: Probable insulin resistance
• Above 7 percent: Elevated blood sugar, indicative of type 2 diabetes

Just as with C-reactive protein and homocysteine, the lower your HbA1c , the better. Anything greater than six percent indicates some degree of insulin resistance.

The Prescription Route

These two recommendations—regular exercise and a healthy diet—are the best “prescription” for high blood sugar and insulin resistance. Together, they work better than any drug on the market.

But what if you can’t exercise because of debilitating arthritis, severe back pain, or advanced obesity? Unfortunately, this scenario is all too common among patients with multiple medical problems.

If you have trouble exercising, or have failed to drop pounds regardless of your caloric cutbacks, then consider discussing the drug metformin (Glucophage) with your doctor.

Metformin performs differently from many of the usual oral agents for diabetes. Rather than stimulating your pancreas to produce more insulin, metformin lowers blood sugar by keeping the liver from making too much sugar, decreasing intestinal absorption of sugars, and helping to lower fatty components in blood—triglycerides and cholesterol—which are often high in people with type 2 diabetes. 

Metformin also has been shown to decrease appetite and help people lose a few pounds, and it does not cause low blood sugar (hypoglycemia), a problematic side effect of most other diabetes medications.

Metformin, however, is not without its dark side. Anyone with kidney impairment shouldn’t take this drug. In addition, a rare but serious side effect is lactic acidosis—the subtle increase of lactic acid in the body, which results in fatigue, low blood pressure, muscle aches, a drop in body temperature, and respiratory problems. So, like all drugs, metformin should be used judiciously and with some caution.

Nutraceuticals to the Rescue

Another way that you can help your body recover from the effects of insulin resistance or full-blown type 2 diabetes is to take nutraceuticals that improve your body’s ability to deal with blood sugar. The following are the same ones that I recommend for my patients with insulin resistance problems or diabetes:

• Coenzyme Q10 (250–300 mg/day standard CoQ10 in divided doses, or 90 mg CoQ10/day in hydrosoluble form): Improves insulin sensitivity, assisting in the lowering and stabilization of blood sugar. CoQ10 levels are usually low in diabetic patients due to the high levels of free radical stress in their bodies, which use up this nutrient.
• Chromium polynicotinate (400 mcg twice daily, 30–60 minutes before meals): Has a favorable impact in the insulin resistance department. Research shows that muscle cells pretreated with chromium are more responsive to insulin, a situation that certainly helps combat insulin resistance.
• Biotin (1,000 mg/day): Promotes more effective glucose storage after meals.
• Alpha lipoic acid (100–300 mg/day): Helps reduce blood sugar, as well as ameliorates some of the complications of diabetes, particularly diabetic polyneuropathy (degeneration of the peripheral nerves).
• Vitamin E (200 IU/day of a broad-spectrum preparation that includes tocotrienols): Reduces free radical oxidative stress in diabetic patients. In an older Scandinavian study, men with the lowest blood levels of vitamin E were more susceptible to developing diabetes than men with normal levels.
• Omega-3 essential fatty acids (1,000 mg purified fish oil/day): Research shows that the highly purified eicosapentaenoic acid (EPA) found in Norwegian fish oil can lower rising blood glucose levels. A bonus is that the omega-3s are known to improve many of the adverse metabolic effects 
of insulin resistance, such as high blood pressure and high triglycerides.

If I were to devise a nutrient combo to help prevent diabetes, I would certainly include all of these nutraceuticals. And, by the way, they can all be safely taken with metformin.

So, to put it all together, weight control, regular exercise, and a healthy diet are the most effective components for regulating fluctuating blood sugars, whether due to insulin resistance or diabetes. In addition, if you suspect you are at risk, check your HbA1c levels on an annual basis if you want to practice smart aging. This is the best way to prepare for what truly can be golden years.

>>back to Daily Health Center