Since childhood, we’ve been lullabied and serenaded by melodies and rhymes like, “A spoonful of sugar helps the medicine go down” and “Sugar and spice make everything nice”, but are they really true?  While we cannot definitively affirm or deny such claims, emerging evidence does not paint a pretty picture.  For example, a prominent population-based study investigating the relationship between sugar intake and diabetes incidence from over 175 countries found the two to be directly correlated, with a population’s risk for diabetes increasing 1% for every 150 calories consumed from sugar.¹  Within the United States, specifically, it is estimated that the average American consumes approximately 270 calories daily from added sugars, indicating that the majority of us carry at least a minor risk of diabetes.²

Now, we know what you’re probably thinking.  Is a little sugar really a huge deal?  At Family Practice Associates, we believe it is diabolically huge - and not just because it bears written relation to the disease itself.  At present, 30.3 million Americans have diabetes and 84.1 million are on the fast-track to a diagnosis within the next five years.³  Even your neighbor’s fat cat is not immune (yes, animals can also get diabetes).  Fortunately, it doesn’t have to be this way, and we’re here to give dietary solutions that go beyond slashing sugar to help reverse and/or prevent it from happening to you, too.  Read below.   

What is diabetes?

Diabetes is the inability of your body to transport sugar (glucose) out of your blood and into your cells for energy.  A sickeningly sweet condition in the most literal sense, urine from diabetics has been described as tasting “wonderfully sweet as if it were imbued with honey or sugar”,⁴ although the etiology of this phenomenon differs between patients.  Type I diabetes is seen most often in children and is an autoimmune condition, wherein the body’s white blood cells attack its pancreas and prevent it from producing the hormone (insulin) necessary for driving glucose into the body’s cells.  Type II diabetes and its precursor, prediabetes, present most commonly in individuals with overweight or obesity, occurring when their body’s cells become unresponsive to insulin likely due to excessive sugar consumption.  Gestational diabetes only affects pregnant women and happens when a hormone produced by the placenta prevents the body from utilizing insulin properly, leading to elevated blood sugar levels.³

Symptoms of diabetes

Symptoms of diabetes are multitudinous, but most commonly manifest as needing to frequently urinate, as well as having extreme thirst and hunger (even after drinking and eating), fatigue, irritability, blurry vision, delayed wound healing and fruity breath.  Notably, Type I diabetics will also experience unexplained weight loss, whereas Type II diabetics will experience weight gain and pain, tingling, or numbness in their extremities depending on the severity of their condition.³

Complications of diabetes

While diabetes itself is largely reversible (excluding Type I), its associated complications are not and can be life-threatening if not treated early.  These include, but are not limited to:³

• Skin complications, such as bacterial infections, fungal infections, localized itching, foot calluses and ulcers, dermopathy (light brown, scaly patches on the legs), and Acanthosis Nigricans (tan or brown skin patches around bodily creases).
• Eye complications, such as glaucoma (buildup of pressure in the eye), cataracts (clouding of the lens), and retinopathy (damage to blood vessels near the retina).
• Nerve damage resulting in tingling, pain, numbness or weakness in the feet and hands, paralysis of the bladder, urinary tract infections, diarrhea and constipation.
• Compromised blood flow, lessening the body’s ability to fight infections and heal wounds, leading to an increased risk of amputations.
• Reduced renal (kidney) function, hindering removal of waste and bodily fluids, which can result in gout, anemia, skeletal degeneration, cardiovascular disease and stroke.

Treatment for diabetes 

Have you been waiting on this with bated (we also considered adding 'fruity', but figured those who skipped ahead might not catch the pun) breath?  In countering the axioms from the introduction, we want to call your attention to a longstanding proverb – arguably older than sugar itself – that goes, “When diet is wrong, medicine is of no use; when diet is correct, medicine is of no need.”  Though treatment for diabetes does depend on the type, we strongly believe dietary modifications, in accordance with current evidence,^5-7 are always the best medicine.  These dietary recommendations are to:

• Limit carbohydrate intake to <90g per day.
• Eliminate processed foods comprised of flour, sugar, and vegetable oils.
• Choose whole, nutrient-dense foods such as grass-fed meat, wild caught fish, pastured eggs, traditional fats, non-starchy vegetables, and low-sugar fruits (e.g., berries).

(Note: We do not deny the efficacy of conventional treatments relying upon the use of insulin pumps, pre-filled pens, syringes, and/or oral medications for improving insulin sensitivity and glucose excretion; however, they can rarely serve as a permanent solution for diabetes since they do not address its root cause.  With that said, the protocol delineated above cannot be used as a replacement for insulin therapy for individuals with Type I diabetes, but can serve to reduce its requirements postprandially.  Women with gestational diabetes should consult their obstetrician). 

Reducing your risk for diabetes

We’ll keep this short and sweet.  Oops, did we say sweet?  Staying true to the spirit of this article, we better just keep this short. 

First things first, dispose of those glazed donuts in your office’s breakroom that have been tempting you since 9am.  Not only are you looking out for your own health, but your coworkers’ too.  Second, schedule an appointment today with Dr. Pamela Abrams and the providers at Family Practice Associates to further discuss the best dietary options for preventing, treating, or reversing diabetes for good, no matter which condition you’re battling.  And if not for you, then at least for your neighbor’s cat.

by Brenda Burgess, PhD in Nutritional Biochemistry & Physiology (Dr. Pamela Abrams' niece) 

References

1. Basu S. Yoffe P, Hills N, Lustig RH. The Relationship of Sugar to Population-Level Diabetes Prevalence: An Econometric Analysis of Repeated Cross-Sectional Data. PLoS ONE. 2013. 8(2):e57873. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0057873. Accessed 24 Oct 2019.
2. 2015-2020 Dietary Guidelines for Americans Cut Down on Added Sugars. Retrieved from https://health.gov/dietaryguidelines/2015/resources/DGA_Cut-Down-On-Added-Sugars.pdf. Accessed 1 Nov 2019.
3. American Diabetes Association. The path to understanding diabetes starts here. https://www.diabetes.org/diabetes . Accessed 24 Oct 2019.
4. Fried R, Carlton RM. (2018). Type 2 Diabetes: Cardiovascular and Related Complications and Evidence-Based Complementary Treatments. Boca Raton, Florida: CRC Press.
5. Huntriss R, Campbell M, Bedwell C. The interpretation and effect of a low-carbohydrate diet in the management of type 2 diabetes: a systematic review and meta-analysis of randomised controlled trials. Eur J Clin Nutr. 2018. 72(3):311-325. https://www.ncbi.nlm.nih.gov/pubmed/29269890. Accessed 24 Oct 2019.
6. Laurenzi A, Bolla AM, Panigoni G, Doria V, Uccellatore A, Peretti E, Saibene A, Galimberti G, Bosi E, Scavini M. Effects of carbohydrate counting on glucose control and quality of life over 24 weeks in adult patients with type 1 diabetes on continuous subcutaneous insulin infusion: a randomized, prospective clinical trial (GIOCAR). Diabetes Care. 2011. 34(4):823-7. https://www.ncbi.nlm.nih.gov/pubmed/21378215. Accessed 24 Oct 2019.
7. Nielsen JV, Gando C, Joensson E, Paulsson C. Low carbohydrate diet in type 1 diabetes, long-term improvement and adherence: A clinical audit. Diabetol Metab Syndr. 2012. 4(1):23. https://www.ncbi.nlm.nih.gov/pubmed/16454166. Accessed 24 Oct 2019.