Are You at Risk for Diabetes?

Dr. Gary Gendron, BS, DC, CCN, CCSP, DACBN, DCBCN
Certified Clinical Nutritionist
Diplomate American Clinical Board of Nutrition

According to obesity statistics from the CDC in 2012, 42% of the U.S. population will be obese by 2030. Health effects will cost the government $550 billion. Total cost of type 2 diabetes related to obesity, $98 billion (2001).

The American Journal of Medicine performed a study in June 2008, on normal glucose and risk of type 2 diabetes. They stated that for every glucose rise of 1 point above 84 represented a 6% increase risk of developing type 2 diabetes.

Stats of an Average “Joe”
Let’s take the average “Joe,” who is 35 years old. He has elevated lipids and triglycerides, is 30 pounds overweight, blood pressure of 135/90, blood glucose is 100, GERD, poor dietary and exercise habits. Where is Joe headed?

• In 1-5 years, he is put on statin drugs, PPI (proton pump inhibitors which block stomach acid production), and ACE/HCTZ to lower blood pressure.
• In 5-10 years, he is on statin drugs, PPI’s, ACE/HCTZ, metformin, NSAIDS.
• In 10-20 years, he is on statin drugs,  ACE/HCTZ, metformin, NSAIDS, and Calcium channel blockers or beta blockers. 6 drugs total.

Metformin is a common drug treatment for type 2 diabetes. It can cause vitamin B12 depletion and homocysteine elevation. This will increase the risk of developing peripheral neuropathy (a deadening of the nerve endings which usually happens in the feet of diabetics.) I strongly recommend screening for B12 deficiency to protect against worsening of peripheral
neuropathy.

Drugs that Can Create Nutrient Depletions:
Some commonly used drugs in obesity and diabetes can create some nutrient depletions. Here are a few:

• Thiazide Diuretics
• K Sparing Diuretics
• Statin Drugs
• Metformin
• Sulfonylureas
• ACE Inhibitors
• Beta Blockers

 

Benefits of Vitamin D and Magnesium
Vitamin D is important as the circulating Vitamin D levels are inversely proportional to insulin resistance. Vitamin D is protective of potential type 2 diabetes risk.

Higher levels of Magnesium show lower risk of developing metabolic syndrome. It also plays a crucial role in insulin regulation. One-third of school age children are deficient in magnesium. Magnesium deficiency in obese children is reported to be strongly associated with insulin resistance, which can eventually lead to type 2 diabetes.

USDA Food Guidelines Not Always Best
The current ADA approach is that people with diabetes can eat the same foods as everyone else. This is not true. They say follow the USDA guidelines and often recommend 40 to 60 grams of carbs per meal for people with diabetes. The result after one year on this program gave modest results, as reported in Diabetes Care 2008. Only 56% of the people achieved a goal of A1C less than 7% and 40% A1C greater thn 7%. Note that an A1C of 7=average blood glucose of 170mg. An A1C of 6=135mg. So it is not that effective. A different approach is needed.

The Importance of the A1C Test
The A1C test is a common blood test used to diagnose type 1 and type 2 diabetes and then to gauge how well you’re managing your diabetes. The A1C test result reflects your average blood sugar level for the past two to three months. Specifically, the A1C test measures what percentage of your hemoglobin — a protein in red blood cells that carries oxygen — is coated with sugar (glycated). The higher your A1C level, the poorer your blood sugar control and the higher your risk of diabetes complications. These people were on medications for blood sugar, hypertension and cholesterol and are obese.

Symptoms and Causes of Type 2 Diabetes:
Symptoms can include: frequent urination/UTI’s, slow healing, yeast infections, numbness/tingling, high blood pressure, high cholesterol, blurred vision, sleepiness, headaches, acting irritable or trouble coping.

Stress is a silent cause. Immune system stress causes inflammation. Common stress leads to increased cortisol and insulin resistance. Low thyroid will cause diabetes. Statin drugs raise glucose levels. According to the Archives of Internal Medicine, statins increase the risk of diabetes by 48%.

Common Risk Factors for Type 2 Diabetes:
Common risk factors include: obesity, diet, sedentary lifestyle, heredity, ethnicity (African and Hispanic Americans), history of gestational diabetes, metabolic syndrome, elevated blood sugar, abnormal lipids, hypertension, advancing age.

Who are the most at risk using current advice? People who are carbohydrate intolerant. Some are more intolerant than others. With Nutrition Response testing, we can detect food allergies and sensitivities. The ideal preventive approach is to lower your carbohydrates to fewer than 70g per day. You can start out as low as 20g and gradually work up as you lose weight.

Success for treating type 2 diabetes is having the best glycemic control using no or the least amount of medications that, over time, leads to weight loss or decreased risk of complications; and having normalized lab values or as close to optimal as possible.

What Should You Do?
Make good decisions at every meal. Keep the carbohydrates down. I recommend lots of greens, fiber and minerals. It is important to know what you are eating to see if you are getting the proper vitamins and minerals. A comprehensive nutritional evaluation performed by a nutrition specialist is recommended. Once deficiences are found, then a custom made, specifically designed nutrition program should begin.

According to the New England Journal of Medicine, Vitamin D improved insulin sensitivity by 60%. It was more potent than metformin (54%) and Rezulin (13%). Getting on a good eating plan with some good strategies is the most important weapon you have for fighting diabetes.

Dr. Gary Gendron
BS, DC, CCN, CCSP, DACBN, DCBCN
239-947-1177
28315 S. Tamiami Trail, Suite 101, Bonita Springs, FL 34134