Diabetes: Everything You Need to Know

The 14th of November marks International Diabetes Day, one of the most common diseases of the 21st century, where the main cause is poor diet.

What is diabetes?

Diabetes mellitus is a group of chronic metabolic disorders characterised by a common element, hyperglycaemia, as a consequence of an alteration in the secretion and/or action of insulin, which also affects the metabolism of other carbohydrates, lipids and proteins.

As we all know, carbohydrates are transformed in the body into glucose, in order to be assimilated by the body and used as energy.

But people with diabetes are characterised by the fact that they are unable to assimilate the glucose that circulates in the blood.

Depending on the cause will indicate the type of diabetes we suffer from.

When there are problems in the assimilation of glucose and this accumulates in the blood, the person is said to suffer from Diabetes Mellitus.

What is the cause of diabetes?

For an autoimmune disease to develop, 3 concepts need to be present:

Think of the coating of our digestive tract as a network of tiny holes, which only allow certain substances to pass through. It is the barrier that keeps out larger particles that can damage our system.

The problem is that due to genetic predisposition, our system can confuse this protein with cells in our body (they have a similar composition), which is why they attack parts of the body itself, in my case the beta cells of the pancreas.

Previous symptoms

There are a number of “warnings” that may indicate diabetes.

These include:

Diabetes symptoms.

Although it’s something I never really take into account.

Everything depends on the intensity with which I train, the rest I get, how much, when and how I eat, and, above all, the work stress I have at that moment. So, that chronic fatigue? I didn’t think much of it, although what I did find a little strange was my continuous need to drink water.

A couple of weeks went by in that state but my need to hydrate seemed to have no end.

I drank around 7-8 litres of water a day, even after padel matches, where I usually drink a litre of water, I could drink another litre and a half at once, which was unusual, and the feeling of thirst was constant too, even after drinking water.

Drinking a lot of water means having to urinate often, which by the end of December was already a nuisance, having to get up every night four or five times to do so.

This didn’t make me suspicious, but everything began to get murkier as I began to see blurry at a distance. My eyesight could only focus properly for a couple of metres, and further away objects started to blur, something that had never happened to me before.

I couldn’t focus well on the number plates of the cars, and the letters of the different signs I came across every day, which I could read at different distances until then, were almost impossible to differentiate.

With all the symptoms together, the disease seemed clear: diabetes.

But I had never heard of LADA diabetes: diabetes 1 was usually diagnosed in young people no older than 30 and type 2 diabetes did not fit me at all.

How is it diagnosed?

A urine test may be sufficient to diagnose diabetes.

It tells us if the glucose excreted in the urine is altered.

However, most of the high blood sugar levels that accompany diabetes are discovered by chance during routine monitoring.

I’m diabetic, what now?

My cells were not insulin resistant, on the contrary, I’m neither obese nor do I abuse a totally unbalanced nutrition; moreover, I’m not sedentary at all.

But even so, in principle, I thought it was type 2 diabetes, so with all this I went to see a doctor at a private clinic in Bilbao, and the results of the analysis showed 289 fasting blood glucose and a CRP of less than 0.05 (this indicates the production of insulin by the pancreas).

With the clear diagnosis (diabetes mellitus type LADA or 1.5, which is the same as type 1), I was referred urgently to the endocrinologist where the doctor would give me a diet, guidelines and explain everything I needed to control and begin to pretend that my pancreas still existed.

He introduced me to the world of the glucometer (finger prick blood glucose measurements) and prescribed slow insulin (16 units) for the night, just to see how I reacted and if I was skilled enough to take the insulin and control my blood glucose.

In addition, she prescribed a diet with a ratio of 65% carbohydrates, 15% protein and 10% fat, a very healthy diet according to her, which I disagreed with but for the moment I chose to follow.

But the worst news was not that I realised that the endocrinologist was anchored in “healthy” diets rich in carbohydrates exclusively, but that she stopped me from doing sport because I had ketoacidosis, and would be dangerous for me.

Types of diabetes

First of all, for those who don’t know, diabetes in general, regardless of the type you have, is a condition in which insulin cannot communicate properly with our cells.

Depending on the type of diabetes, the reasons for its occurrence are very different:

Type 1 diabetes

It’s the immune system itself that’s responsible for destroying the beta cells in the pancreas responsible for synthesising insulin.

Specifically, the beta islets of the pancreas (islets of langerhans), which are responsible for insulin generation, are treated as “intruders”, which ultimately kills the islets and stops generating insulin.

Between 5 and 10% of cases are of this type, and it is an autoimmune disease.

It occurs in young people (under 40 years of age) and its onset is usually abrupt.

Type 2 diabetes

The receptors on the cells become resistant to the effects of insulin itself.

It manifests in adulthood and is closely associated with obesity and being overweight.

It accounts for 85% of diabetes cases.

In people with Type II, there is insulin production, but it doesn’t work properly, in most cases because the places where it has to act (receptors) are not sensitive to it.

Gestational Diabetes Mellitus (GDM)

This type of diabetes, called gestational diabetes mellitus (GDM), is usually first diagnosed in women when they become pregnant.

Normally gestational diabetes develops late in pregnancy, so the baby is already well formed, even though it is still developing.

It usually disappears after giving birth.

However, women with gestational diabetes mellitus should regulate their blood glucose levels to avoid possible risks to the baby.

How should you treat your diabetes?

Pills

Type 2 diabetes can be treated in an initial phase with pills that help to capture the insulin generated by the pancreas.

Insulin injection

In type 1 diabetes, a pill can’t be used because the problem is not in the cells but in the fact that not enough (or any) insulin is produced, because the insulin producer is practically destroyed.

Insulin injection

Therefore, from the beginning, external insulin will need to be used, administered in injections before each carbohydrate meal (rapid insulin) and another administration of insulin to control basal glucose (slow insulin).

Glycometers

To find out how much glucose we have in our blood, we have to prick our fingers and put a drop of blood on a test strip that’s connected to a glucometer.

It tells us the amount of glucose we have in our blood at that moment (with a small % error) to be able to control it much better.

Continuous glucose meters are already available and are currently subsidised for children.

These are on-demand and automatic and there are more and more models coming out with different characteristics.

Pumps and patches

There are insulin pumps that can be configured by the user for activity, day to day, that learn with you and that administer insulin automatically, but they are still an aid in the administration of insulin and you can’t forget about this disease for a single day.

Advances in treatment

Little by little, medical guidelines are taking away the fear of fats, so demonised for years, and welcoming low-carbohydrate diets.

They are prescribing diets with less than 30-40% carbohydrates.

Something unthinkable in the last decade. But there are still many professionals who are reluctant to change, as was the case with my endocrinologist.

Can diabetes be cured?

Depending on the type, our body acts in a different way, which may or may not cause it to go into remission:

Type I diabetes is not reversible

The immune system creates antibodies to an “intruder”, which, in turn, destroy the insulin-generating islets.

These antibodies are generated for life, so there is no possibility of regenerating the islets.

From the beginning, the person suffering from this type of disease must use external insulin injected into the skin (it cannot be administered orally because digestion would destroy it), calculating at each meal the exact amount needed for the carbohydrates to be ingested.

Can Type 2 diabetes be reversed?

In fact, there are countless examples and cases of people with type 2 diabetes who have gone into remission thanks to low-carbohydrate diets and increased daily activity.

When it’s said that you’re in remission, it means you still have the disease but you do not need medication to control it, i.e. you’re a healthy person as long as you follow the low-carbohydrate diet.

Incretins

Incretins (gut-derived insulinotropic hormones) play an important role in the regulation of glucose balance in healthy subjects and are responsible for 50-70% of the insulin response to a meal.

There are two main mediators of its function:

1. Glucose-dependent insulinotropic polypeptide (GIP)
2. Glucagon-like peptide-1 (GLP-1)

As such, the replacement of GLP-1 and GIP by exogenous administration is one of the goals of science.

Diet for diabetics

The most suitable diet will be a carbohydrate-restricted diet (either moderate, low or ketogenic).

Benefits of reducing carbohydrates

The exchange of carbohydrates for protein and fat, even when we are talking about isocaloric exchanges:

Increase Protein and Fat

But you can’t live by carbohydrates alone.

A window of opportunity opens up for other hormonal satiety signals derived from PROTEIN and FAT, such as Colecistokinin, GLP1 and peptide YY.

An aid: Intermittent Fasting

By improving insulin resistance, IF also improves this situation and reduces hunger in the long term.

You get your fill with less food.

This results in greater ease in maintaining the weight lost and the initial metabolic improvements achieved.

Prevention

Although there is no cure for diabetes, we can reduce its incidence by keeping the following in mind:

Importance of physical exercise

The beneficial effect of physical exercise is due to increased cellular glucose uptake and improved insulin sensitivity.

This beneficial action occurs primarily in muscle cells.
Exercise involving large muscle groups is most appropriate for increasing glucose uptake.

In this case, training with weights is highly recommended.

Natural products for diabetes

Within traditional medicine, we can find natural remedies to treat certain pathologies.

Burdock Root

Burdock burdock has been used for centuries to treat a range of ailments.

Traditionally it has been used as a “blood purifier” to cleanse the blood of toxins, as a diuretic, and as a topical remedy for skin problems such as eczema, acne, and psoriasis.

Burdock may also play a useful role as a diabetic herb, in helping to control blood sugar levels due to the root’s inulin content, a natural fibre.

Stevia

Stevia comes from a family of plants native to South American countries such as Paraguay and Brazil. It has also been cultivated in Israel, Japan, Korea and China.

Stevia contains no sugar or calories, making it a great substitute for sugar, and can be used as a natural sweetener for people with diabetes.

Due to its properties, stevia has been studied as a diabetes herb and possible treatment for this pathology.

In a review of research, Georgetown University Medical Center reported that stevia significantly reduces blood sugar response to meals. The center also reported that stevia shows an improvement in blood pressure.

Aloe Vera

Aloe vera has been used for centuries for its healing properties.

Most notably, aloe vera has been used for skin care, but its benefits do not end there.

It has also been used successfully to treat constipation and to control blood sugar levels

Gymnema Silvestre

Gymnema is a shrub native to India and Africa. The leaves are used for medicinal purposes. Gymnema has a long history of use in Indian Ayurvedic medicine to treat diabetes, metabolic syndrome, weight loss and coughs.

The Hindu name, gurmar, means “destroyer of sugar”.

Today, research confirms that wild gymnema leaf contains gymnemic acid to help control blood sugar levels.

Green tea

There have been studies on the potential efficacy of compounds from green tea(EGCG) on improving glucose metabolism by increasing insulin sensitivity and thus improving glucose metabolism, as well as improving kidney function and reducing the deterioration of insulin-producing cells in the pancreas.

Green Tea Powder from EssentialSeries

Bitter melon (Momordica charantia)

These are the specific components that help control blood sugar.

Polypeptide-P appears to produce insulin-like effects, and together with charantin and vicin result in lower blood sugar level due to improved insulin sensitivity. That’s to say, glucose uptake by tissues, liver and muscle glycogen synthesis, together with inhibition of enzymes involved in glucose production.

Konjac

A plant of the genus Amorphophallus, native to Southeast Asia, from Japan and China to southern Indonesia. Contains glucomannan and mucilage.

Glucomannan is sold as a supplement and is a soluble fibre that has a sequestering effect (it forms a viscous gel that delays the absorption of lipids and carbohydrates), a bulking effect (it increases stomach fullness and prolongs the feeling of satiety).

Glucomannan Powder from RawSeries.

Tips for diabetics

Fat Loss

Through energy deficit, in one of the following ways:

Strength training will be essential.

Controlling glucose

Blood glucose levels are a reflection of how sugar is metabolised by the body.

For this reason, it is necessary to keep these levels in balance:

Low carb diet.

More information for patients suffering from diabetes

Learn what things are good for preventing diabetes and which things can trigger an imbalance, making diabetes worse and harmful to your health.

Watch out for medicines

Sometimes, when suffering from diabetes, taking too high a dose of medication or following an excessively radical diet can cause hypoglycaemia in people with diabetes.

The future of diabetes

We are in a time of constant change and evolution in the management, treatment and prevention of diabetes.

The new information technologies facilitate learning for people with diabetes, thus helping to facilitate adherence to treatment and increasing their quality of life.

There are numerous mobile apps to improve diabetes management, healthy eating and physical activity monitoring,

As well as specialised social networks for patients and professionals to share experiences, information and research.

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