Ask The Doctor: Type 2 Diabetes

Answered by Julian Witaker

My 42-year-old brother, Gregg, just found out he has type 2 diabetes, and I’d like to help him get healthy. What can he doto avoid taking prescription drugs?

Your brother is among more than 24 million Americans who have type 2 diabetes. In 1990, less than 5 percent of the nation suffered from diabetes, but now, just 20 years later, 8 percent has the disease. While type 1 (only 5 percent of all diabetes cases) stems from an autoimmune condition affecting the pancreas, type 2 results from unhealthy diets and lifestyles. As our nation eats more fat, sugar, and processed carbs and becomes increasingly sedentary, it’s clear why type 2 has become so widespread.

When people eat high-glycemic, low-nutrient foods that spike blood-glucose levels, their bodies crank out insulin in order to move excess glucose from the bloodstream to the cells, where it can be used for fuel. Gradually, cells become resistant to insulin, glucose lingers in the bloodstream, and the pancreas produces more insulin to try to lower levels.
This high-glucose–high-insulin combo damages cells, particularly in the nervous system, kidneys, retinas, and blood-vessel linings, which is why diabetes is the leading cause of blindness, kidney failure, and amputation in the US. Other complications include heart disease, dementia, erectile dysfunction, and neuropathy (pain and numbness, particularly in the feet and hands). The longer high glucose levels go unchecked, the greater the damage, so your brother is lucky he received this diagnosis now.

Just say no to drugs
Yes, prescription drugs help bring blood-glucose levels down—but at an unacceptable cost. Trials both new (the 2008 ACCORD trial) and old (the University Group Diabetes Program from 1969) show that some blood sugar–lowering drugs, including Avandia and glyburide, increase risk of death from heart disease. Others cause diarrhea, excessive gas, and oily stools. But the real downside of drugs? They don’t address the lifestyle issues that trigger the whole disease process. The good news is your brother can reverse his diabetes with a few lifestyle changes and nutritional tweaks—no drugs required. Here’s a sound plan, based on the treatment program we recommend at the Whitaker Wellness Institute for patients with type 2 diabetes.

Drop weight
Although some slender people have type 2 diabetes, excess weight increases disease risk significantly, so losing weight is the best therapy for practically everyone with type 2. How many pounds patients should shed varies by individual—but any weight loss is a gain. There’s no magic pill for weight loss, so your brother needs to adopt dietary changes and regular exercise.

Doctor your diet
The most therapeutic diet for diabetes is a low-glycemic, Mediterranean-style menu with lots of vegetables and lean proteins, such as fish and poultry; one serving of fruit per day; and healthful fats like olive oil. These foods provide well-rounded nutritional support without the saturated fat of red meat and dairy products or the fast-burning, glucose-spiking carbs found in processed and starchy foods. The Mediterranean diet is also heart healthy, important because diabetes makes you more prone to cardiovascular disease. Finally, while your brother should keep his intake of whole grains to a minimum, these are much better choices than processed grains because our bodies digest them more slowly.

Get a move on
Walking and other forms of aerobic exercise lower blood glucose and burn calories, while resistance exercise builds muscle and improves long-term insulin sensitivity. Exercise actually uses up blood sugar even in the absence of insulin. Gregg should go for a brisk 10-minute walk after each meal and do several sessions of resistance exercise, such as weight lifting, each week. And lifting doesn’t just mean pumping iron at a health club. A home-based regimen of push-ups, sit-ups, squats, and other exercises that use his own body weight gives muscles a solid resistance workout.

Supplement nutrients
Nutritional supplements can also help Gregg lower blood-glucose levels as he implements dietary and activity changes. He can take the following supplements daily: vanadyl sulfate (100 mg), chromium (200 mcg), alpha lipoic acid (400 to 800 mg), cinnamon (500 to 1,000 mg), and Gymnema sylvestre (400 mg). These nutrients are available individually or as combination formulas designed for people with diabetes. To guard against diabetic complications involving blood vessels, nerves, eyes, and kidneys, he can also pop a potent daily multivitamin to replace nutrients lost through the excess urination caused by diabetes.

Look to the future
Because complications from diabetes can be significant, Gregg should be diligent about getting this condition under control—yet he should resist temptation to obsess over his blood sugar. Two studies published in the British Medical Journal in 2008 concluded that self-monitoring blood-sugar levels didn’t improve glucose control and was associated with higher costs, lower quality of life, and more depression.

Rather than a strict regimen of regular self-testing, I suggest Gregg periodically ask his doctor to measure his hemoglobin A1c levels. While a finger stick is a snapshot of blood sugar at a given time, the HbA1c test gives a broader picture of average blood-sugar levels over two or three months. This will allow him to evaluate the efficacy of his overall treatment program and make adjustments if necessary. As he maintains these positive lifestyle changes, Gregg will be well on his way to optimum health.

 

Julian Whitaker, MD, is the director of the Whitaker Wellness Institute in Newport Beach, California, where he’s successfully treated thousands of patients with diabetes. For more information, visit drwhitaker.com.