Beware: Diabetes can be fatal
Deepak Acharya and Anshu Shrivastava
Diabetes (Sugar disorder) is one of the most insidious disorders of the body metabolism. Factors like improper diet, environmental stress, obesity, viral infection, malnutrition and heredity, each play a role in triggering the disease. Also, people who suffer from high blood pressure (hypertension) often have a tendency toward diabetes. If not properly diagnosed and treated at early stage, it can lead to serious health problems.
The term ‘diabetes’ is derived from the Greek word meaning siphon, or the passing through of water and ‘mellitus’ is Latin for honey sweet, which refers to the excessive flow of urine containing glucose in diabetics. The disease can be traced back to the earliest writings of civilizations in Asia Minor, China, Egypt and India where references were made to boils and infections, excessive thirst, loss of weight and large quantities of honeysweet urine. At these times, those who were affected were middle-class people on diets high in sugar and fat with few wholesome foods such as vegetables and bread. It appears that nothing has changed from that time, as epidemiologically, diabetes mellitus has been linked to the Western lifestyle, full of processed foods high in sugar and fat, and is uncommon in primitive cultures living on natural foods. The research also shows that when these cultures change their diet to the processed foods of Western society they are predisposed to diabetes.
Diabetes takes 2 main forms- The first is Diabetes insipidus (Insipidus = Insipid, tasteless), characterized by choking thrust and large volumes of pale, dilute urine with no abnormal constituents. It occurs due to inadequate secretion of the pituitary hormone, anti-diuretic hormone (ADH) in the body and the other is Diabetes mellitus. The more common of both is Diabetes mellitus (Mellitus = Honey), a constitutional disorder caused by the malfunctioning of the pancreas, a gland that produces insulin. Insulin is an “anaerobic hormone” that helps assimilate glucose in the human body. The chemical imbalance of insulin leads to:
Hyperglycemia (high blood glucose level) occurs when pancreas fail to produce adequate insulin, the hormone needed to convert glucose into energy.
Polyuria: hyperglycemia may exceed renal threshold and result in Polyuria (excessive urination).
Polydypsia: Polyuria results in water loss leading to dehydration of the body leading to polydypsia (excessive drinking).
Polyphagia: Lose of glucose via urine causes a demand of more fuel in the body. As a result, a `diabetic gets a voracious appetite, i.e., Polyphagia (excessive eating).
Wasting: To meet the rising demands of the fuel in the body, endogenous proteins and fats are catabolized. As a result, a diabetic loses weight (i.e., wasting) despite of hearty meals.
Long term complication of diabetes can lead to degenerative changes in the blood vessels, Atherosclerosis (hardening of the arteries); it may also result in Microangiopathy (thickening of the capillary walls).
Paralysis, tiredness, recurrent infections, problems with visions, peripheral neuritis, heart attacks and gangrene are complications that commonly diabetics face.
Skin eruptions may occur due to lack of absorption of sugar in the body.
There is intense itching in the groin; eczema may also appear.
Diabetes is a serious disease that it is placed among the top ten causes of death in the whole world. The two major forms of diabetes mellitus are also known as Type 1 and Type 2. Type 1, or insulin-dependent diabetes mellitus (IDDM), accounts for approximately 10% of all cases and results in the progressive destruction of pancreatic beta cells and the inability to produce insulin. The onset is usually in childhood, but as the Western diet deteriorates many adults are now being affected. This form was fatal until insulin was discovered in the 1920s when injections of insulin were used to control the disease.
Type 2, or non-insulin-dependent diabetes (NIDDM), often named adult onset diabetes, accounts for the remaining 90% of cases. In this form there may be a deficiency of insulin or the action of insulin on the tissues may be impaired (insulin resistance). Diet alone or diet and drugs control this form, although occasionally a type 2 may require insulin. Obesity is present in 80–90% of individuals with type 2 and contributes to insulin resistance. A type 2 who doesn’t control the symptoms can become a type 1 diabetic.
Your diet an important factor
In terms of nutrition, research shows that diet consisting of high carbohydrate and high plant fibre (HCF) has a positive metabolic effect in diabetes mellitus. The diet is high in cereal grains, legumes and root vegetables and restricts simple sugar and fat intake. The caloric intake includes 70–75% complex carbohydrates, 15–20% protein and 10–25% fat. The total fibre content is almost 100g each day. This diet balances blood glucose levels, increases tissue sensitivity to insulin, reduces cholesterol and triglyceride levels and encourages fat loss. In one study when 16 type 1 patients were treated with HCF diets, their average insulin requirements dropped by 38%.
This diet can be modified further by choosing quality wholefoods especially those containing water-soluble fibre, such as beans, oatbran, psyllium husks, pears, apples and vegetables, which slow down the digestion and absorption of carbohydrates preventing rapid rises in blood sugar.
Foods to avoid are processed foods, additives, smoked and cured meats preservatives, milk, fat, cholesterol and sugar, but small amounts of fructose found in fruit do not cause rapid rises in blood sugar levels.
Onions and garlic also have a beneficial effect on blood glucose levels. One study on starch-free bread showed significant improvements in blood glucose and lipid levels in NIDDM. All diabetics should have small regular meals containing both carbohydrate and protein in the ratio 2:1 to regulate and maintain glucose levels.
Eat plenty of fruits and vegetables as these are a natural source of fibers and vitamins. Fruits like rose apple and jamun are recommended for diabetics. Vegetables like bitter gourd’s (karela/ Momordica charantia) anti-diabetic properties have already been practiced in Ayurveda; some other vegetables recommended are drumstick and bimbi. The curry-leaf tree (Murraya koenigii) is one of the traditional Indian plants with reputed benefit in diabetes. We have already mentioned a formulation in this article.
Herbs in the Treatment of Diabetes
Aloe (Aloe vera): Aloe vera is a member of the Lily family even though it resembles a cactus. There are over 240 species of Aloe, but only four species are recognized as having nutritional value with Aloe barbadensis leading the group. Preliminary research suggests aloe gel might lower blood glucose levels. Dose is usually 15–30 ml (50 mg) per day.
Bitter Melon (Momordica charantia): A member of the Cucurbitaceae family, the plant grows in tropical areas of India. The bitter melon grows as a vine bearing green leaves and yellow flowers with oblong green fruit. Bitter melon has a long history of use as a hypoglycemic agent in Asia, Africa, and Latin America, where the plant extract has been referred to as vegetable insulin. Although several constituents of bitter melon have hypoglycemic properties, most interest has focused on a polypeptide isolated from the seeds called polypeptide-p and a mixture of two steroid glycosides referred to as charantin. At least three different compounds in Bitter Melon have been reported to have sugar-regulating properties. Gurmarin, in particular, is a polypeptide considered to be similar to bovine insulin.
Cinnamon Bark (Cinnamon zeylanicum): Cinnamon is getting a lot of attention as a treatment for diabetes. There is preliminary evidence that it can lower blood glucose and cholesterol levels in people with type 2 diabetes. As little as ¼ to ½ teaspoonfuls can have a powerful effect in lowering blood sugar.
Fenugreek (Trigonella foenum-graecum): Dose: 10–15 grams per day in divided doses with meals Fenugreek is effective for lowering postprandial (after meals) blood sugar. The applicable part of fenugreek is the seed. The active constituents include trigonelline, 4-hydroxyisoleucine, and sotolon. About 80% of the total content of free amino acids in the seeds is present as 4- hydroxyisoleucine, which appears to directly stimulate insulin.
This effect is glucose dependent and only occurs in the presence of mode rate to high glucose concentrations. Fenugreek seeds have a distinctive bitter taste and odor.
Ginger (Zingiber officinale): Preliminary research suggests ginger might increase insulin levels. Theoretically, it could have an additive effect with medication used to treat diabetes and cause hypoglycemia.
Gulvel (Tinospora cordifolia): Grows wild along roadsides throughout the tropical and sub-tropical plains of India and Sri Lanka. Plant extracts causes reduction in fasting blood sugar in rabbits and rats.
Gurmar (Gymnema sylvestre): A tropical plant of the milkweed family with an ancient Sanskrit name meaning “destroyer of sugar.” Preliminary clinicalresearch indicates that certain Gymnema extracts can reduce blood glucose and glycosated hemoglobin (Hb A1c) in Type I and Type II diabetics.
Holy Basil (Ocimum sanctum): Preliminary evidence suggests that holy leaf extract may decrease fasting (17.6%) and postprandial blood glucose in patients with Type II diabetes.
Jambolan (Syzygium cumini): A close relative of the clove tree Syzygium aromaticum, Jambolan is native to east India and the Malay Peninsula, but has spread as far as China and Australia and is grown in the Caribbean. Only the bark of the Jambolan has proven medicinal value, although the seeds are often used as well. In Asian medicine, it is used for diabetes, diarrhea, sore throat, and diseases of the spleen.
Neem (Azadirachta indica): Neem is a member of the Mahogany family (Meliaceae) which includes a large array of tropical trees and shrubs native to both the Old and New World. Evidence indicates that Neem might possess some hypoglycemic activity.
Red Sandalwood (Pterocarpus marsupium): Like Gymnema sylvestre, this is a traditional herb used in India to help rejuvenate the insulin-producing pancreatic beta cells. One group of researchers investigating diabetic rats compared Pterocarpus’ observed effects on blood glucose levels to those of metformin, a drug familiar to many diabetics.
Stevia (Stevia rebaudiana): Stevia is a non-caloric herb, native to Paraguay, which has been used as a sweetener and flavor enhancer for centuries. Clinical research suggests that stevioside, a constituent of Stevia, might reduce postprandial glucose levels by 18% in people with Type II diabetes.
Tumeric (Curcuma longa): Turmeric has been used for thousands of years in Asian Indian cookery and is an ingredient in curry powder. Ground from dried curcumin, a rhizome of the ginger family, turmeric is not peppery and rather mild tasting.
Exercise can be beneficial for diabetics. It helps to lower body fat and reduces total serum cholesterol and triglycerides. It improves circulation, self-esteem and self-image and reduces emotional stress. Following exercise, additional decreases in blood glucose occur as it is stored in the muscles as glycogen. However, the power to reduce the blood sugar is destroyed when glucose levels are high at the beginning of exercise, especially if ketones (by-products of fat break down) are present. For each 30–45 minutes of exercise, 10–15 grams of extra carbohydrate are needed. Regular, consistent, steady exercise for twenty minutes four times each week gives the greatest benefit.
Care should be taken with lifestyle issues. Drinking alcohol inhibits gluconeogenesis (liver’s production of glucose from amino acids). It increases the risk of hypoglycaemia in people taking insulin and causes eye and nerve damage. People with diabetes should, therefore, not drink on an empty stomach. Smokers also need to be careful as they have a high risk of kidney damage and heart disease. Prescription drugs should be checked as they can have adverse effects on blood glucose levels. All areas of stress, emotional imbalances and self-esteem should be targeted. The biggest hurdle for most diabetics is to accept the disease and live with it rather than fighting against it, which can cause inner turmoil.
Dr Deepak Acharya: A microbiologist turned ethnobotanist, a herbal hunter and Director of Abhumka Herbal Pvt Ltd (www.abhumka.com), Ahmedabad, India. He has been involved in scouting, documentation and validation of indigenous herbal practices of indigenous healers in Patalkot (www.patalkot.com) and Dangs. He can be contacted at email@example.com.
Dr Anshu Shrivastava: He is working as Scientist (Product Development) with Abhumka Herbal Pvt. Ltd. He has written several popular articles on herbs and health for many online portals. (firstname.lastname@example.org).
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