Diabetes: The Quiet Assailant
 

You walk into a large room filled with people of all races and both genders. Immediately you notice some are single or bilateral amputees. Many carry the white cane indicating blindness; others have thick lenses in their glasses. Less noticeable is the fact that all have some degree of cardiovascular disease. And many have had at least one heart attack. Useless limbs and slurred speech in other inhabitants of this room are the results of stroke.

As you stroll through the room you note those with the puffy faces and sallow skin that frequently accompany kidney failure. Some of these folks undergo renal dialysis three times a week. Several more people are mentally or psychologically impaired; most are obese; a few are thin to the point of emaciation. Yet all the occupants in this room suffer from the same underlying disease: diabetes mellitus. Diabetes mellitus is the number one cause of blindness, the number one cause of kidney failure, and the number one cause of amputation.

What Is It?

Diabetes mellitus is a chronic disorder of the digestive system, involving all nutrients in food. The human body requires glucose (sugar) for energy, both immediately, and stored for future use. Insulin, a hormone produced by specialized cells of the pancreas called Islets of Langerhans, is necessary to move glucose from the bloodstream into the cells for use as energy, A meal is consumed, broken down by the digestive enzymes into basic nutrients for use by the cells. The result of carbohydrate breakdown is a rise in the glucose level of the blood. This triggers the production of insulin and its secretion into the blood-stream, which causes the cells to take in and use the glucose, lowering blood glucose levels to normal limits.

Diabetes mellitus can take two forms. Type I (juvenile onset or insulin-dependent) usually occurs in children or teens, but generally well before age 40. No insulin is being produced at all by the pancreas. Type II, (adult-onset or non-insulin dependent) usually occurs in those over 40, and involves either insufficient insulin production, or decreased efficiency of the hormone itself
 

TYPE 1-lnsulin Dependent Diabetes (IDDM)

This variety of the silent assailant usually strikes young children and adolescents, and is characterized by a complete lack of insulin production. The beta cells of the pancreas which produce insulin are destroyed by a mechanism which is as yet unclear. It is considered to be due to an autoimmune response wherein the body attacks and destroys the beta cell. Exposure to viral and/or chemical agents, response to allergens, and free-radical damage have been proposed as possible causes for beta cell destruction. Hereditary predisposition to injury of these vital cells is probable, since the antibodies against beta cells are present in 75 percent of IDDM patients, but in less than two percent of the nondiabetic population. Insulin dependent diabetics have death versus the rest of the population. IDDM is the leading chronic disease in children. The insulin dependent diabetic will require one or more injections of insulin daily (or a continuous insulin perfusion pump) for the rest of his/her life, and absolute discipline will be required to maintain normal blood sugar levels and prevalent complications.

TYPE ll-Non-Insulin Dependent Diabetes (NIDDM)

If there is such a critter as the"typical" person with NIDDM, he/she will be over 40 years of age, overweight, and consumes the typical American diet of high fat, high sugar, and low fiber. Not an equal opportunity disease, diabetes mellitus, especially NIDDM, afflicts Blacks, Hispanics, Native Americans and Native Hawaiians far more frequently than Caucasians. This disparity appears due both to heredity and such environmental causes as diet and life-style. The NIDDM person's pancreas is functioning, at least halfheartedly, but the body's cells are not responding appropriately to the insulin, and doesn't take in the needed fuel. This leaves the person with very high blood sugar, and therein lies the problem. Poor glycemic control catapults the incidence of complications from possibility to statistical predictability, especially in the areas of amputations, peripheral vascular disease and peripheral neuropathy. The NIDDM patient may be able to control the disease by changing dietary habits, sticking to a diet low in fat, sugar and salt, and by exercising regularly. In those persons for whom the
diet/exercise regimen doesn't bring control of blood sugar, oral anti-glycemic agents are available.

Symptoms
One of the reasons many cases of diabetes are far out of control before being diagnosed is the relative "normalcy" of the symptoms. Acute symptoms are thirst, frequent urination, tiredness and blurred vision, weight loss, and increased irritability. Many of us have one or more of these symptoms occasionally. It isn't until we experience unusually slow healing of bruises or cuts, numbness and tingling of extremities or recurrent infections of skin, gums or urinary tract that. we begin to wonder if something is wrong. That is why for many people, the diagnosis of diabetes is secondary to some other problem; frequently found by blood work for some other condition. This is especially true of non-insulin-dependent diabetics.

Complications
There are not enough adjectives to adequately describe the absolutely devastating consequences of uncontrolled blood sugar. Every system of the body is affected, because every cell of the body uses glucose for energy. In 30 years of clinical nursing practice, I have seen intelligent, capable people who would not control their diet and blood sugar turn into demented beings who suffered several heart attacks and mputations. I have observed patients cram three to four candy bars into their mouths, then express amazement at outrageously elevated blood sugar levels, while stoutly denying noncompliance with their diets. Much of the problem with complications is due to lack of discipline on the part of the patient, since control of blood sugar requires constant attention and personal responsibility. While 90 to 95 percent of all diabetic are non-insulin dependent, or Type II, both forms of the disease lead to massive complication when blood sugars are not controlled.

Tests have shown newly diagnosed Type I diabetics who show no perfusion (blood flow) problems to their heart muscle, but who already show evidence of diminished innervation of the heart muscle by the sympathetic nervous system. Heart disease is the most frequently occurring, life-threatening complication of diabetes. This comes in the form of heart attack, strokes, and peripheral vascular disease. Hypertension, or high blood pressure, secondary to fat plaques in the blood vessels, is frequent. It is not uncommon to have every bed in a coronary care unit filled with patients who are diabetic. Morbidity (illness) and mortality (death) from coronary heart disease can be predicted, since studies have shown high lipid levels and poor glycemic control were associated with a two-fold increase in the risk of (coronary heart disease) morbidity and mortality independent of other cardiovascular risks. Kidney disease is another complication. Sugar in the urine damages kidney tubules, which filter the blood to remove waste products. Damaged tubules spill protein in the form off albumin, which further damages the kidney's filtration system, progressing to renal failure.

There are a wide range of eye diseases and disorders. They range from blurred vision to cataract, glaucoma, and diabetic retinopathy, which affects the retina itself.

Problems with the lower extremities can occur for several reasons. The vascular system becomes damaged, and atherosclerosis may cause clogging of the smaller arteries and the extremities. The nervous system is impaired. Poor circulation and edema, coupled with diminished feeling in the legs and feet, set up perfect conditions for ulcers and gangrene. The end result of both problems frequently is amputation of the extremity. The effects of neuropathy, however, are not restricted to the extremities. A systemic problem like diabetes affects the entirety of the body, therefore the entire nervous system including the brain, shows symptoms. Depression is not uncommon, nor are mood swings, both being related in part to blood sugar levels. Throughout the body the nerves don't function correctly, from the nerves needed to maintain muscle tone, to those which help digestion, to those controlling blood pressure. Hypertension (from a whole different cause but the same disease) becomes a real threat, aggravating renal problems.

The immune system is disrupted, making the diabetic much more susceptible to infections of all types, and much less capable of fighting them.

Causative Factors
No one doubts the element of heredity, however, studies have shown the incidence of Children with diabetic parents also developing diabetes in the 10 to 15 percent range. Evidence has been presented linking early life stress (under two years of age), exposure to cow's milk, and nitrates as causative of Type I, insulin dependent diabetes.

Obesity is a major factor in development of Type II (NIDDM). According to one author, 90 percent of all diabetics are non-insulin dependent, and 90 percent of NIDDM patients are obese. Obesity is a major factor in the body's decreasing response to insulin. Dietary fat intake must also be considered a risk factor, along with chromium deficiency, and possibly, the nutritional status of the mother during gestation of the diabetic person. According to one source, fewer calories overall during pregnancy is better, significantly reducing the incidence of diabetes in the offspring.

Although one might logically conclude there is some relationship between the development of the disease and one's life-style, one group studied the relationship between maladaptive personality traits and blood sugar control in adult onset (NIDDM) diabetics. The "aggressive-irresponsible" personality type, as assessed by the Personality Diagnostic Questionnaire-Revised, was proven conclusively to be a significant predictor of poor blood sugar control.

Treatment
Type I, insulin-dependent diabetics have no choices. They must take one or more injections of
insulin daily (or use a constant infusion pump) and monitor their blood sugar several times a day,
adjusting the dosage of insulin to the glycemic level. Failure to do so will lead to the body using fats for
energy, causing the development of ketosis, leading to coma and subsequent death.

Education is as vital as insulin, since the diabetic and the family need to understand what the disease is, how it affects the body, what insulin is and does, symptoms of too much insulin and of diabetic coma; different types of insulin and when and why they are used, and dietary and life-style changes which are necessary to help maintain controlled blood sugar levels. Most newly diagnosed IDDM patients receive intensive counseling prior to hospital discharge. However, continuing education and follow-up information sessions are necessary as well.

Sugar is a heavy weight molecule requiring lots of water to excrete. In pulling this water out of the body, sugar spilled into the urine also causes loss of water-soluble nutrients, vitamins, and minerals. So in addition to insulin and dietary changes, vitamin and mineral supplements are in order, since studies have shown Type I diabetics are usually deficient in zinc, calcium plus vitamin D. Persons diagnosed with IDDM must (as their age allows) become self-reliant and self-sufficient. Even children need to understand that consequences of eating a forbidden sweet, of not testing urine or blood for sugar, and taking insulin haphazardly. This disease requires a balancing act involving weight maintenance, adequate exercise, good nutrition, and controlled blood sugar via use of insulin in addition to other factors.

Type II (NIDDM)

Those diagnosed with non-insulin dependent diabetes have more leeway in treatment, however, there is no substitute for dietary control and constant vigilance in maintaining blood sugar control.

In addition to a variety of oral hypoglycemics which your MD may prescribe, several herbs have been employed historically, with varying results, in helping maintain normal blood sugar levels. Animal studies indicating Devil's Club extract could be used to substantially reduce blood sugar without any toxic side effects. Onion and garlic have demonstrated the ability to decrease blood sugar, and in the case of onions, the effect appears dose related. The leaves of bilberry (also known as huckleberry) have long been used for controlling blood sugar, and the flavonoid extracts of the bilberry are proven effective against diabetic retinopathy. Fenugreek used for many digestive problems, is also used to regulate insulin in diabetics found in Sugar-Reg. Ginkgo biloba is predominantly used for circulatory disorders and for improving blood flow to the brain. It can be useful in diabetes in enhancing blood flow to extremities, and in helping protect against diabetic retinopathy. Ginseng is of assistance not only as a general tonic but has been clinically proven to reduce fasting blood sugar levels and body weight.

Vitamin and mineral supplements such as Chromium GTF may be helpful as it assists insulin in the metabolism of sugar. B-vitamins complex support the nervous system and may help prevent or reduce diabetic neuropathy. Vitamin C makes collagen in the body; it therefore strengthens blood vessels, helping to prevent bleeding and speed wound healing.

There are other alternative methods of assisting with control of diabetes. A few suggestions for diabetics include reflexology, relaxation, meditation, and yoga.

Conclusion
Diabetes is a chronic disease. This means you have to learn to live with it, despite many changes in diet and life-style. Maintaining health at maximum levels with diabetes requires careful attention, but it need not become the central focus of one's existence.

Other herbs that will control Blood Sugar are:

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