Diabetes is one of the major health problems affecting Americans. In this condition, cells of the body can’t get energy from the sugar (glucose) circulating in the blood. They may literally starve to death in the midst of plenty. Imagine yourself in a lifeboat in the middle of the ocean. You are desperately thirsty, surrounded by water, but there’s not a drop to drink. A diabetic’s bloodstream has too much glucose, but because insulin is lacking or not effective, it cannot transport this sugar into the cells that need it.
This metabolic disruption creates conditions ripe for heart disease and stroke. Other potential complications include nerve damage (known as neuropathy), sexual dysfunction, kidney disease, and even blindness. But if diabetes is successfully treated so that blood sugar is kept within or close to the normal range, the complication rate can be minimized.
Experts estimate that 20 million Americans have diabetes. That’s nearly 7 percent of the population. Unfortunately, nearly one-third of these diabetics have not been diagnosed and consequently are not being treated. One of the best ways to prevent complications from diabetes is to control blood sugar carefully. The good news is that keeping blood sugar within normal limits can cut the risk of life-threatening consequences such as heart attack and stroke nearly in half.
Doctors classify the disease into two categories. In type 1 diabetes, the immune system attacks the pancreas and destroys the cells that make insulin. Since insulin is crucial for glucose to get into the cells from the bloodstream, the type 1 diabetic must get insulin from somewhere else. Usually, this means injections, often several times a day. (Inhaled insulin may offer another option.) This disease has also been termed insulin-dependent diabetes, which is descriptive, or juvenile diabetes, which is not very helpful. Not all people newly diagnosed with type 1 diabetes are children, and not all children diagnosed with out-of-control blood sugar have type 1 diabetes. Because this disease is so complicated and requires such careful medical supervision, it will not be covered in this chapter.
In type 2 diabetes, by contrast, there is insulin in the bloodstream, sometimes too much of it, but the cells become resistant to its action. Many people with type 2 diabetes are able to control their blood sugar level with diet, exercise, and oral medication. As a result, type 2 diabetes is also referred to as non-insulin-dependent diabetes, or adult-onset diabetes. The latter term is left over from a simpler time. With the increase in childhood obesity, more and more children are being diagnosed with type 2 diabetes all the time. Type 2 diabetes is the most common kind, and it is increasing at an alarming rate. The Centers for Disease Control and Prevention projects that one in three children under the age of 5 will develop this kind of diabetes during their lifetime. If they are Latino, the odds are that one in two will become diabetic.202
Everyone agrees that diabetes has reached epidemic levels. What is unclear is why. Most experts blame the problem on obesity and inactivity. But there are voices in the wilderness suggesting that there may be other factors that are also contributing to this public health nightmare. Some suggest that high-fructose corn syrup, which is widely used as an inexpensive sweetener in juice, soft drinks, and processed foods, might predispose people to diabetes. In animal research this sugar leads to insulin resistance and poor glucose tolerance.203 Until this controversy is sorted out, we discourage the consumption of foods and beverages containing high-fructose corn syrup.
Another even scarier scenario involves the compound bisphenol A (BPA). You’ve probably never heard of this chemical, but the chances are very good that you have it circulating in your body. BPA shows up in the bloodstream of 95 percent of Americans. BPA is a common compound found in plastic. There may be some in your water bottle or jug. It is also in the plastic lining of cans of soft drinks and beer. Canned foods, food storage containers, pacifiers, baby teethers, and dental sealants may contain BPA.
The plastic industry will tell you that small amounts of BPA are nothing to worry about. A study published in the journal Environmental Health Perspectives, however, suggests that when mice are exposed to low levels of BPA for several days, they develop insulin resistance.204 What is so alarming about this discovery is that the levels of BPA used in the experiment would be considered safe for humans by the Environmental Protection Agency (EPA). We don’t know whether BPA is contributing to the ever-increasing incidence of type 2 diabetes, but we sure wish scientists would find out before it’s too late.
Diabetes is common (some diabetologists believe it will soon affect nearly half the population), and its complications are devastating. We have tried to give you a variety of strategies to prevent or control this disease. Remember, though, that whatever tactics you adopt, you must work in close collaboration with your health-care providers.
- Preventing diabetes is possible. Keep your weight under control, emphasize nonstarchy vegetables over pasta or bread, and avoid soft drinks, fruit juice, and processed meats.
- Get plenty of exercise, preferably including some time outdoors so you have 10 to 15 minutes of sunshine on your face and hands several days a week. If you don’t get outside, take 800 to 1,200 IU of vitamin D3 daily.
- If you are diagnosed with diabetes, learn to monitor your blood sugar. Keep track of how exercise and food affect it. Consider cinnamon or vinegar to help smooth out blood sugar in reaction to a carbohydrate meal.
- If you’re considering using herbs or dietary supplements such as chromium, bitter melon, fenugreek, Gymnema sylvestre, or nopal, check with your health-care providers before taking them. Monitor your blood sugar carefully.
- If medication becomes necessary, make sure that you and your physician find the safest and most effective option for you. You shouldn’t have to suffer with dreadful side effects to keep your blood sugar under control.