The focus of this blog post will be specifically on T2DM, there are several different forms of diabetes, but they will not be discussed in this blog post. According to the CDC, 2021 data show that 38.4 million people of all ages, or 11.6%, or 1 in 10 people of the population, have diabetes. Approximately 8.7 million adults age 18 years of age and older who met laboratory criteria for diabetes are not even aware they have diabetes.
About 98 million American adults – more than one in 3 people- have prediabetes. More than eight out of ten adults with prediabetes do not even know they have it. Prediabetes increases the risk of T2DM, heart disease and stroke.
The total direct and indirect cost of those diagnosed with T2DM is estimated to be 413 billion dollars a year. Diabetes was listed as the 8th leading cause of death in the United States (US) in 2021. It is the leading cause of blindness for US adults ages 18 to 64. Diabetes increases the risk of Cardiovascular complications (heart attack and stroke), chronic kidney disease – CKD (including ESRD [end-stage renal disease], requiring dialysis), blindness, and death.
In the US, we have seen a dramatic increase not only in T2DM but also in obesity and abnormal cholesterol. This cluster of symptoms is referred to as metabolic syndrome, insulin resistance, or syndrome X. To be diagnosed with metabolic syndrome, three or more of the following must be present: a waist circumference greater than 35 inches for women or 40 inches for men, fasting blood sugar higher than 100 mg/dl, fasting triglyceride levels higher than 150 mg/dl, fasting high-density lipoprotein (HDL) cholesterol <50 mg/dl for women or <40 mg/dl for men, and blood pressure higher than 130/85 mmHg.
Metabolic syndrome, like T2DM, is predominant in the Western lifestyle. Being overweight or obese, prediabetes, physical inactivity, abnormal cholesterol, a family history of diabetes, having gestational diabetes, and certain ethnic groups have increased risk for developing diabetes.
However, most risk factors are modifiable, meaning we can change them. In America, we are digging our graves because of what we eat and how much we eat, and we do not exercise. Genetics is not much of an issue in regards to T2DM in comparison to type one diabetes. Unfortunately, many times, we learn poor eating habits from our family members, but we can change these eating habits, and when we do this, it can have a positive impact on our health.
T2DM is caused by an abnormal increase in blood glucose. This is caused by insulin resistance, where our cells are not responding appropriately to insulin. Insulin is secreted by the pancreas, and it allows glucose or sugar to enter our cells to give us energy. However, in T2DM, this process no longer works efficiently, so over time, the amount of glucose in our blood increases, which can lead to diabetes.
Common symptoms of diabetes can include frequent hunger, thirst, urination, poor wound healing, fatigue, numbness or tingling in the hands or feet, etc. However, some people are unaware of these symptoms and are only diagnosed once blood work is done.
T2DM can be diagnosed with fasting blood glucose; 126 mg/dL or higher on two separate occasions is considered diabetes, or an A1c of 6.5% or above. A prediabetic’s fasting glucose ranges between 100 and 125 mg/dL, and their A1c ranges between 5.7 and 6.4%.
In all my patients, I also like to measure fasting insulin for a more well-rounded picture of diabetes risk or those with diabetes, diabetes management, and progression. I prefer my patients to have a fasting insulin of less than seven because research has shown that those with fasting insulin greater than 7 have an increased risk for type 2 diabetes and metabolic syndrome.
Now, there are several different classes of medications utilized to manage diabetes, ranging from Metformin (a biguanide), Januiva (DPP4 inhibitors), Ozempic [Glucagon-like peptide 1 (GLP-1)], Jardiance (Sodium-glucose cotransporter 2 [SGL2] inhibitors), Amaryl (sulfonylureas), Avandia or Actos [Thiazolidinediones (TZDs)], and various forms insulin. However, as I mentioned earlier, many, if not most, of the factors that contribute to diabetes are modifiable, meaning you do not have to develop diabetes or live the rest of your life with diabetes. Still, it is up to you to make that change. Do you want to live with this disease for the rest of your life?
Dietary changes are essential; in the West, we eat too many processed sugars, carbohydrates, and inflammatory foods and too much food at once. A whole-food diet is best, meaning real food, not processed. Increasing non-starchy vegetables, fruits (in season), quality proteins, and fats is a great start.
Time-restricted eating means we purposefully put ourselves on fast throughout the day. For example, some people eat only during an 8-hour window. This will vary for each person. Women, especially premenopausal women, must be careful with prolonged fasts because they can affect our hormones, primarily cortisol. However, various types of intermittent fasting exist; if you have diabetes, especially if you are on insulin, you must work with a health professional if you attempt some form of time-restricted eating to prevent harmful effects, such as hypoglycemia. But time-restricted eating promotes autophagy. Autophagy is a process where the body clears damaged or dysfunctional cellular debris from our body, which is good. Autophagy occurs during periods of fasting.
Even though exercise has become a dirty word, it is important in decreasing her glucose levels. Research has demonstrated that exercise can decrease the risk of T2DM by almost 50%. Find an exercise you like and be consistent.
Supplements such as B vitamins, zinc, magnesium, chromium, and berberine have all been shown to help with glucose regulation. Soluble fiber in the diet also helps.
Reducing stress, getting a good night’s rest (7 to 8 hours) of uninterrupted sleep, monitoring glucose, correcting hormonal issues, and even improving the gut microbiome can all have a positive overall effect on glucose regulation.
Again, diabetes is not a death sentence, but what will you do with the information I have shared with you today? If you are looking for a clinician who utilizes an integrative approach to decreasing the risk of T2DM or managing it, call or text us at 813-669-3084.
