According to a new study published in JAMA just three days ago, the increasing prevalence of diabetes may be leveling off. That being said, in 2011 through 2012, the estimated prevalence of diabetes among U.S. adults was 14% and the prevalence of pre-diabetes was 38%, which means about half of the U.S. adult population has either diabetes or pre-diabetes.
Diabetes is a major cause of illness and death and is still a significant problem in the U.S. The healthcare costs associated with diabetes are significant: the American Diabetes Association (ADA) estimates that managing diabetes for just one year costs an average of $6649 per person, which does not include the complications associated with the disease.
Although there was an increase in diabetes between 1988-1994 and 2011-2012, the prevalence estimates saw little change between 2007-2008 and 2011-2012. This leveling off is consistent with the U.S. obesity trends during the same period.
Despite the fact obesity and type 2 diabetes remain major clinical and public health problems in the U.S., the good news is that we can support insulin resistance and correct it through proper lifestyles modifications and nutrient support.
Insulin resistance is preventable and many times reversible through aggressive lifestyle changes, supplements, and exercise and stress management. Weight loss and exercise are considered the best treatments for restoring the body's ability to respond to insulin.
Losing even a few pounds can reduce the risk for health problems and help control glucose levels. Exercise can help prevent diabetes by lowering blood sugar and reducing weight. It also helps the cells become more sensitive to insulin.
Being mindful of carbohydrate intake is important, with a focus on a diet high in fiber and low in sugars and flour with a low glycemic load. Previous research has indicated that insulin resistance has a microbial component that alters the caloric extraction from ingested food. This ties together the importance of dietary fiber and insulin resistance. We also see this with short chain fatty acids (SCFA) on patient stool profiles. Low levels of SCFAs tend to be associated with low levels of beneficial bacteria. When patients introduce prebiotics or increase their dietary fiber intake by consuming fruits and vegetables, the beneficial bacteria and SCFAs both increase.
Healthy, whole foods help prevent and reverse diabetes and insulin resistance. A healthy diet turns on the right gene messages, promotes a healthy metabolism, and prevents insulin resistance and diabetes.
It is beneficial to eat protein daily with each meal and to consume small protein-rich snacks. A high protein breakfast has been shown to improve weight management. I came across a study six weeks ago that demonstrated how skipping breakfast promoted unhealthy blood sugar spikes in diabetics. More and more, people are skipping breakfast, which probably is a combination of busy lifestyles and the intermittent fasting movement. That being said, skipping breakfast is linked to the growing epidemic of obesity and cardiovascular problems as well as being a health risk for diabetes.
Research shows that fasting until noon triggers significant blood sugar spikes and impairs the insulin responses of type 2 diabetics throughout the rest of the day. This was recently published in Diabetes Care and presented at the American Diabetes Association meeting in Boston in June 2015.
There are several nutrients that can play a role in improving insulin signaling such as chromium, zinc, carnosine, benfotiamine, alpha lipoic acid, and inositol.
The relationship between inositol and insulin resistance was examined in an article published this month in the Townsend Letter. Two isomers of inositol, myo-inositol and D-chiro-inositol, are used during insulin signal transduction. The conversion of myo-inositol to D-chiro-inositol is of particular interest because errors here have been strongly implicated in insulin resistance. The body makes D-chiro-inositol from myo-inositol and research suggests that some individuals are less able to make this conversion than others. Since this conversion is impaired in individuals with insulin resistance, it is important to always include D-chiro-inositol with myo-inositol supplementation. In addition, supplementing with D-chiro-inositol alone cannot not fulfill myo-inositol’s roles that are specific and different from D-chiro-inositol, since it does not convert to myo-inositol.
Alpha lipoic acid supplementation has also been found to increase the insulin sensitivity by about 20% to 30%. Finally, essential fatty acids should be consumed for overall health, but most individuals with insulin resistance are deficient. Fish oils help to improve insulin sensitivity and reduce inflammation.
By Michael Jurgelewicz, DC, DACBN, DCBCN
Inositol Modulation of Essential Metabolic Pathways of Insulin Resistance in Metabolic Syndrome, Polycystic Ovarian Syndrome and Type 2 Diabetes. Cristiana Paul, MS, and David M. Brady, ND, DC, CCN, DACBN, Townsend Letter, August/Sept 2015.
Fasting Until Noon Triggers Increased Postprandial Hyperglycemia and Impaired Insulin Response After Lunch and Dinner in Individuals With Type 2 Diabetes: A Randomized Clinical Trial. Jakubowicz D, Wainstein J, Ahren B, Landau Z, Bar-Dayan Y, Froy O. Diabetes Care. 2015 Jul 28. pii: dc150761. [Epub ahead of print]