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Diabetes Mellitus
Type 2
View
Related Case Studies Diabetes mellitus has
become one of the most widespread diseases in existence. Over
the past thirty-five years, the industrialized world has seen
the number of diabetes cases multiply fivefold. In the United
States alone, an estimated $150 billion is spent annually on
treating diabetes and related complications. An estimated 16
million people in America are known to have diabetes, but the
most amazing fact is that approximately half of our nation
doesn’t even know they have it yet. More than 24 million
Americans suffer from pre-clinical diabetes and over 80
million have insulin resistance.
Diabetes is now the
leading cause of new cases of blindness in the United States
as a result of diabetic retinopathy. It is also responsible
for over one third of the new cases of end-stage renal disease
in this country. These complications along with diabetic
neuropathy are the result of damage to the microvasculature
(the smallest arteries).
Diabetic treatment is aimed
at decreasing these complications. However, 80% of diabetic
patients will end up dying from a cardiovascular event like a
heart attack, stroke, ruptured aneurysm, or peripheral
vascular disease (loss of a limb). These complications are the
result of accelerated aging of the large arteries in the body.
All the diabetic treatment patients are receiving has not
decreased this risk during the past 40 years. This is partly
due to the fact that by the time a patient is actually
diagnosed with diabetes—60% already have major cardiovascular
disease. They have had insulin resistance and accelerated
damage to their arteries for the past 15 to 20 years before
they became diabetic. Physicians are simply not treating this
insulin resistance and by the time they become diabetic it is
too late.
Why are we seeing such an increase in the
number of people who are becoming diabetic in the United
States? Americans believe a high-carbohydrate, low-fat diet is
the healthiest way to eat. Dietitians believe a carbohydrate
is a carbohydrate, with absolutely no distinction of how fast
we absorb the sugar from that carbohydrate. However,
carbohydrates are simply long chains of sugars that are
released at various rates in the body. This has been
documented in the medical literature as glycemic
index (the rate that sugars are absorbed and increase the
blood sugar). Carbohydrates such as white bread, white flour,
pasta, white rice, and potatoes release their sugars rapidly
(high-glycemic foods) and increase the blood sugars faster
than if you were slapping table sugar on your tongue. Foods
such as green beans, rye bread, whole apples, and cauliflower
release their sugars slowly (low-glycemic foods). This rapid
rise in blood sugar after a high glycemic meal stimulates the
release of insulin from the pancreas, which is needed to
control the blood sugar level. The blood sugar drops and our
body’s crave more calories and more high-glycemic foods. We
simply keep repeating this pattern over and over—day after
day. Medical studies are now showing us that this type of diet
causes us to become less and less sensitive to our own insulin
(insulin resistance). It is a lot like crying "wolf" all of
the time—we are simply stimulating the release of insulin time
after time.
An estimated 24% of the adults in the U.S.
have insulin resistance, also known as Syndrome X or more
recently the Metabolic Syndrome. In my clinical practice, I
have observed a troubling pattern. Many patients beginning in
their late 30s or early 40s begin gaining a significant amount
of weight around their middle (central obesity). They then
begin to develop increased levels of total cholesterol and
triglycerides along with very low levels of HDL or “good”
cholesterol. Shortly thereafter, they develop hypertension,
which needs to be treated. By their late forties, they’ve
become diabetic.
This epidemic pattern of insulin
resistance develops over a 15 to 20 year period. People aren’t
as sensitive to their own insulin as they once were. I see
this over and over in my practice. The sad thing is that once
insulin resistance develops, one’s arteries are aging a third
faster than they should. In other words, for those people in
this category, for every third birthday they can add an
additional year.
Insulin resistance is the beginning
event of a complicated metabolic change that occurs one’s
body. Our bodies still wants and needs to control blood
sugars. Therefore, the beta cells of the pancreas simply put
out more insulin and our blood insulin levels rise. This
elevated insulin in our blood stream is called
hyperinsulinemia and leads to a constellation of metabolic
changes in our body called Syndrome X.
When a person
develops full-blown Syndrome X, he or she has a 20-fold
increase risk of developing cardiovascular disease. After 15
to 20 years in this state, the beta cells of the pancreas
finally wear out and your insulin levels begin to fall and
your blood sugars begin to rise. First, you develop
pre-clinical diabetes (blood sugars are elevated, but not high
enough for you to be called diabetic). Then a few years later
you actually become diabetic. However, it is important to
realize that your arteries begin to age at an accelerated rate
as soon as you first develop this insulin resistance. This is
why 60% of the patients already have major cardiovascular
disease the day they are first diagnosed with
diabetes.
In a 6-year Nurses Health study of 65,000
women whose diets were high in carbohydrates from white bread,
potatoes, white rice, and pasta (high-glycemic diet),
participants had two and one-half times the risk of developing
type II diabetes (adult onset diabetes) than those who ate a
low-glycemic diet. The researchers excluded other risk factors
such as weight, exercise level, and family history. This
increased risk was related strictly to their
diet.
Walter Willett, a professor of epidemiology and
nutrition at the Harvard School of Public Health and a
co-author of this study, found the results of this study along
with other studies so convincing that he has recommended the
government change the Food Guide Pyramid. The Food Guide
Pyramid recommends 6 to 11 servings of carbohydrates a day but
does not make any distinction whether these are high-glycemic
or low-glycemic carbohydrates. He believes white flour, white
bread, potatoes, white rice, and pasta should actual be moved
up the Food Guide Pyramid and considered in the sweets
category because metabolically they are the same. I couldn't
agree more.
Clinical trials have demonstrated patients
with pre-clinical diabetes or impaired glucose tolerance have
significantly lower levels of antioxidants. There was evidence
of significantly increased levels of oxidative stress, which
led to a depletion of our antioxidant defense system. In other
trials, this oxidative stress was more significant in those
who had secondary complications of their diabetes like
retinopathy or cardiovascular disease. These authors felt that
antioxidant supplementation should be added to the traditional
insulin treatment as a means to help arrest these
complications. The neurology department at Mayo Clinic
reported a study where they experimentally created diabetic
peripheral neuropathy. They concluded this complication was
indeed caused by oxidative stress. They were able to reverse
this nerve damage by giving alpha lipoic acid, which is both a
fat-soluble and water-soluble antioxidant. They also noted if
the subjects had good levels of alpha-lipoic acid because of
supplementation before they induced the oxidative stress,
there was no nerve damage.
Many micronutrients have
been found to be deficient in patients with Syndrome X,
pre-clinical diabetes and actual diabetes. One of the most
crucial is chromium. Chromium is critical in the metabolism of
glucose and the action of insulin and has been shown to
greatly improve insulin sensitivity, especially in those who
are deficient. Studies indicate that almost 90 % of the
American population is deficient in chromium.
Vitamin
E not only improves the antioxidant defenses but also has been
shown to improve insulin resistance. In other studies, a low
vitamin E level has been found to be an independent and strong
predictor for the development of adult onset diabetes
mellitus. There was a five-fold increase in the risk of
developing diabetes in those individuals who had low levels of
vitamin E.
Magnesium deficiency has been associated
with both types 1 and 2 diabetes. This low level of magnesium
has further been associated with an increased risk of diabetic
patients developing diabetic retinopathy as well and when
corrected in the elderly a significant improvement in the
function of insulin results. Diagnosing magnesium deficiency
is quite difficult. Serum magnesium levels must be used where
only 0.3 percent of the body's total magnesium is located.
Cellular levels of magnesium are much more sensitive and
accurate. Magnesium deficiency may be the most under diagnosed
electrolyte abnormality today.
Clinical
Applications
For patients who have type-2 diabetes
mellitus, physicians are often treating blood sugars instead
of the underlying problem, which is insulin resistance in over
95% of the type-2 diabetic patients. In fact, when insulin
resistance is corrected early, it is easily reversible with
just basic healthy lifestyle changes. This not only allows the
patient to avoid the accelerated aging of their arteries but
allows them to avoid becoming diabetic altogether.
With the principles that follow, almost all of my
patients with insulin resistance have reversed their
conditions and 17 documented patients who’ve had full-blown
diabetes have totally reversed their disease.
How do
I know if I have developed Insulin Resistance?
You
can know if you have developed insulin resistance when
obtaining the results of your last lipid profile from your
physician. Simply divide your triglyceride level by your HDL
or “good” cholesterol. If this number is greater than 2, you
are starting to develop insulin resistance. With Syndrome X
your triglyceride level begins to increase and your HDL
cholesterol will decrease. Therefore, this ratio is an
indirect measure of your blood insulin levels. The greater
this number—the higher your insulin levels and the more
serious your problem has become. For example, if your
triglyceride level is 350 and your HDL level is 35—you have a
ratio of 10 and are well into this serious metabolic
disorder.
Why Don’t Physicians Treat Insulin
Resistance?
Physicians have been content treating
the complications or the results of insulin resistance such as
high blood pressure, elevated cholesterol and triglycerides,
and even diabetes itself without treating the underlying
cause—insulin resistance. In my personal opinion, the main
reason physicians don’t treat insulin resistance is there’s no
drug for it. Physicians are drug- and disease-oriented.
Insulin resistance is treated—as you will see—by making some
basic lifestyle changes.
Nutritional Supplement Recommendations
I recommend that all my patients take the basic nutritional
support I refer to as cellular
nutrition. This foundational regime provides all the
necessary micronutrients to the cell at ideal levels (not RDA
levels) for significant health benefits as documented in the
medical literature. When the cell is given maximum support, it
can then determine what it does and does not need. Over a
six-month period each cell is able to not only overcome
nutritional deficiencies but also to optimize
ALL the nutrients, which are needed to combat oxidative
stress.
The synergistic affect of providing all the nutrients
needed by one’s body at the most advantageous levels results
in optimizing and rebuilding the body’s natural immune system,
antioxidant, and repair systems back to their fullest fighting
potential against disease.
Minimal support for Cellular
Nutrition:
My minimal recommendation for creating cellular
nutrition is to simply take Usana’s Mega Antioxidant and
Chelated Minerals, called "The Essentials" at their
recommended doses (3 of each daily). The Essentials offers the
cell ALL of the antioxidants, B-cofactors, and antioxidant
minerals needed by the cell at ideal levels. In order to
achieve the best results, I recommend taking 1 Mega
Antioxidant and 1 Chelated Mineral with each meal.
Nutritionals should always be taken with food because of
better absorption and better tolerance. However, as a
physician, I realize that compliance with taking supplements
three times a day is a major issue. Therefore, if you tend to
frequently forget the lunchtime dose, I suggest taking the
supplements twice daily: taking 2 Mega Antioxidants and 1
Chelated Mineral in the morning with breakfast and 1 Mega
Antioxidant and 2 Chelated Minerals in the evening with the
evening meal.
Optimal support for Cellular
Nutrition:
For the most favorable results for basic cellular
nutrition, I also recommend adding to the Usana Essentials
either OptOmega (2 tsps daily) or BiOmega-3 (4 capsules
daily), which provides the essential fats and Fibergy, which
assures the individual is receiving the additional fiber his
or her body needs. I also recommend adding Active Calcium (4
tablets daily) to provide additional calcium, magnesium, and
vitamin D that our bodies need. These recommendations provide
all the nutrients at their ideal levels creating the cellular
nutrition I recommend in my book, What Your Doctor Doesn’t
Know About Nutritional Medicine May Be Killing You.
Optimizers
It is critical that you know the necessity of adding
optimizers to your foundational cellular nutrition for optimal
results. Patients who are suffering from a chronic
degenerative disease or illness are under more oxidative
stress than the average healthy individual. Therefore, adding
potent Optimizers to the basic cellular nutrition offers you
the best chance to bring this oxidative stress back under
control. The synergy and increased potency created by this
approach to nutritional medicine is why I’m able to get such
consistent results in my patients.
However, to suit each individual’s unique needs, I always
offer both an optimal and a minimal plan for cellular
nutrition and for adding Optimizers. Obviously, one’s
improvement will be quicker and more consistent with the
optimal recommendations; however, a minimal regime can still
produce significant clinical results.
Recommended Optimizers: Optimal:
- Proflavanol 90*--2 tablets daily
Optimal Recommendations
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
| Active
Calcium |
1 |
1 |
2 |
| Proflavanol
90 |
1 |
|
1 |
| Optomega |
2
tsps |
|
|
| Biomega-3 (an
option instead of Optomega) |
1 |
1 |
2 |
*Adding at least one serving of
Fibergy daily will enhance these
recommendations.
Minimal Recommendation
| Nutritional Supplement |
Breakfast |
Lunch |
Dinner |
| Mega
Antioxidant (Mega AO) |
1 |
1 |
1 |
| Chelated
Mineral (Multi Mineral) |
1 |
1 |
1 |
If you are frequently going to miss taking your lunchtime
dose, it is better to simply take your nutritionals twice
daily. I recommend taking 2 Mega Antioxidants, 1 Chelated
Mineral in the morning with breakfast and then taking 1 Mega
Antioxidant, 2 Chelated Minerals in the evening. You should
try to divide up your Active Calcium, essential fats, and
Optimizers equally as possible between the AM and PM
dose.
Consider a Power Shake
USANA has a fantastic line of nutritionally balanced drinks
that many of my patients consume as a meal substitute. In
fact, I personally start every morning with 2 scoops of
Fibergy, 2 scoops of Soyomax, and 2 teaspoonfuls of OptOmega.
This provides me with a perfect, balanced, unpolluted meal to
start my day. It allows me the opportunity to supplement my
diet with soy protein; extra needed fiber, and essential fat.
This meal is also a low-glycemic meal, which will not spike my
blood sugar. Likewise, many USANA associates are using their
imaginations to create exceptionally tasting meals with
Fibergy and OptOmega. By blending in frozen, whole fruit for
added flavor they are creating a variety of great tasting
drinks.
Isn’t it remarkable that by simply taking USANA Essentials,
Active Calcium and a power drink (remember, to consider this
part of your food budget, since it is replacing an entire
meal), the body is supplied with complete, and balanced cellular
nutrition for every cell in the body? The synergy that is
created, especially when adding needed Optimizers is
phenomenal. Remember, the underlying problem is oxidative
stress NOT a nutritional deficiency.
Why I recommend USANA Products
USANA strictly follows pharmaceutical-grade Good
Manufacturing Practices (GMP). This means they not only
purchase pharmaceutical-grade raw products, but also
manufacture the products according to tough
pharmaceutical-quality guidelines. In addition, USANA Health
Sciences follows USP guidelines for potency, uniformity, and
dissolution of the tablet. In a nutshell, USANA manufactures
their products to the strict standards of over-the-counter
drugs even though not required to do so—assuring all of their
customers and associates that what is on the label is actually
in the tablet.
Usana's essentials are complete and balanced and provides
the cellular nutrition that I strongly recommend in my book,
What Your Doctor Doesn't Know About Nutritional Medicine May
Be Killing You. This improves compliance and makes taking
these advanced levels of nutritional supplements
easier.
Starting Your USANA Nutritional Program
Over eighty percent of my patients are able to start the
USANA Nutritional Program with absolutely no set backs while
beginning to experience the health benefits of high-quality
nutritional supplements immediately. Please keep in mind these
supplements are extremely potent and optimal levels of
nutrients are being provided that the body has never had
before. The body is therefore able to finally rid itself of
toxins, which have been accumulating for years (called
detoxification). This is especially true in those who are
suffering from a serious illness and are taking a significant
amount of medication. It is important to understand the
possible signs and symptoms of detoxification so that you can
deal with them confidently and properly.
Detoxification:
The most common detoxification reaction is muscle aches
and/or mild headache. These symptoms will usually pass within
a few weeks. If the discomfort is not unbearable, I simply
have my patients continue their program as I have prescribed.
However, occasionally there is a more severe reaction. The
patient is not in danger, rather, the amounts of nutrients are
just too much too fast. In this case, I have my patients quit
their supplements for a few days until the reaction subsides.
I will then have them start back on their program but
initially at lower doses (approximately one third of the
recommended dose). Once they are tolerating this amount of
supplementation, I suggest slowly building up to the
recommended doses.
Some of my patients actually develop a "detox" skin rash
somewhere on their body. As you know, the skin is an important
route for ridding the body’s toxins. This rash is a dry, red
rash that looks almost like a mild sunburn. Some people
confuse this with an allergic reaction to the supplements.
This is not typically so. I have never seen an allergic
reaction to the USANA Essentials and can only recall a couple
of patients who reacted to Proflavanol because they were
actually allergic to grapes.
Patients may also experience some aspect of loose stools or
even diarrhea. This again is a common "detox" reaction because
the GI tract is another prime route for eliminating toxins
from the body. This symptom will usually diminish within a
couple of weeks. It is an important part of the detoxification
and healing process. Therefore, I usually encourage my
patients to continue the supplements as recommended unless
their bottom gets too sore. I will then again recommend lower
doses of the supplements until they feel better and then begin
adding the supplements back more slowly until the recommended
doses are reached. Diarrhea can be the result of the magnesium
in the Active Calcium or by the Proflavanol. Again, this is
usually a mild reaction and will improve over the first week
or two. However, some of my patients need to discontinue the
Active Calcium and/or the Proflavanol until this settles down.
I then have them slowly add back the Proflavanol and
eventually the Active Calcium.
Increasing dietary fiber may also increase the amount of
intestinal gas and the frequency of bowel movements. This will
improve with time as the body adjusts to the higher intake of
fiber, but is an important aspect of getting rid of the
toxins, which have accumulated in the body.
Natural Relaxation Response:
A small percentage of patients develop a natural relaxation
response when minerals are absorbed into their body. This is
of great concern to those patients who have just been told
that nutritional supplementation will help improve their
energy level. They take the supplements as recommended only to
find themselves more fatigued and dragging themselves through
their day. If you experience this response, I recommend that
you take all of your minerals (including the Active Calcium)
with a light bedtime snack. This allows you to take advantage
of your body’s response while getting a good night’s
sleep.
Stomach Upset:
A small percentage of patients have difficulty tolerating
vitamin C. It can cause an upset stomach that will usually
become evident a couple days after starting their nutritional
program. With USANA’s specially combined vitamin C into Poly
C, I have seen many of people who could not previously
tolerate any nutritional supplements do very well with USANA’s
Mega Antioxidant. However, if nausea is experienced, I suggest
taking one Mega Antioxidant with the largest meal. Once this
level of supplementation is better tolerated, I suggest slowly
adding another Mega Antioxidant to the next largest meal. I
anticipate building them up to the recommended level of
supplementation, but sometimes this is just not possible. For
those extremely sensitive, I advise using Body Rox (the
teenage dose of Antioxidants and Minerals) as the best
alternative option.
Taking Your Supplements with Your Medication
I am often asked, "Can I take my nutritionals with my
medication?" To this I respond with this question, "Can you
eat?" I hope my point is made gently but clearly—nutritional
supplements simply contain nutrients we should be getting from
our foods, but at levels we can no longer obtain from our
foods. If you can eat anything, you can also take nutritional
supplements. The only exception to this is for those taking
the medication, Coumadin (Warfarin), which blocks vitamin K in
the body as a way of thinning the blood. If a patient is on
Coumadin, I recommend he or she take the Canadian Essentials
and Canadian Active Calcium because they contain no vitamin K.
Also, patients who are on thyroid medication should take their
medication on an empty stomach at least 1 hour prior to meals
or prior to taking supplements. Thyroid medication should not
be taken with food or with supplements because calcium can
block the absorption of the medication.
Disclaimer
Every effort has been made to make this web site as
accurate as possible. The purpose of this site is to educate
and inform. As such it is based on scientific evidence and my
clinical training and experience. No individual should at any
time use the information found on this web site for
self-diagnosis, treatment, or justification in accepting or
declining any medical therapy for any health problems or
diseases. Any application of the advice herein is at the
reader’s own discretion and risk. Therefore, any individual
who has a specific health problem or is taking medications
must first seek advice from his or her personal physician or
healthcare provider before starting a nutritional supplement
program. Dr. Strand shall have neither liability nor
responsibility to any person or entity with respect to loss,
damage, or injury caused or alleged to be caused directly or
indirectly by the information contained in this web site. We
assume no responsibility for errors, inaccuracies, omissions,
or any inconsistency herein. Any slights of people, places, or
organizations are unintentional.
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© 1999, 2000, 2001,
2002, 2003, 2004 Ray D Strand, M.D. P.C.
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