Diabetes and Nutrition: Take Charge!

By Jeanne Drisko, M.D.

The foundation for diabetic care is a whole foods diet, followed by lifestyle and environmental changes. To this add a lot of water. Water rinses your body constantly.

A high supply of carotenoids in the bloodstream is associated with very good insulin and glucose control

When you eat and what you eat is very important because the food actually talks to every cell of your body. If you eat a lot of processed food that comes out of a package, it will raise insulin levels very high. When your insulin level rises rapidly, it actually down-regulates the insulin sensitivity on the cell surface. Diet is not just counting calories. The food is actually giving a message to your cell.

A high carbohydrate diet really slams the cells. It’s really very hard on the insulin levels. Insulin seems to shoot up and it makes the receptors again insensitive. The high carbohydrate diet also increases those bad fats and the bad cholesterol in our bloodstream. For a long time, you were told to eat a low fat diet and thought you were going to lower the bad fats in your bloodstream. When you ate that high sugar, high carbohydrate diet, you raised your triglycerides and bad cholesterol as well. It’s now been recognized in various mainstream journals that high carbohydrate diets are not helpful.

This gets us back to our whole, fresh foods. There was an article in the 1999 issue of the American Journal of Epidemiology, showing the importance of diets high in carotenoids that we find in the colorful vegetable group. A high supply of carotenoids in the bloodstream is associated with very good insulin and glucose control. So the more fresh fruits and vegetables you can eat, the better control you have on the insulin levels in your bloodstream.

Flavonoids, a key component of fruits and many other fresh foods, are associated with better diabetic control. You may be able to buy a supplement with flavonoids in it, but you are going to be better off starting with a good, whole foods diet.

Good fats make up the lining of every cell in the body as well as the lining of the components inside of the cell. When the lining of the cell is normally formed with these good fats, they influence how the cells use insulin. There are two families of fatty acids, the omega-6 and the omega-3. The omega-3 is in short supply in our diets currently. Omega-3 fatty acids come from cold water fish and flax oil predominantly.

Omega-6 fatty acids come from vegetable oils and grains. Unfortunately, we tend to get too much omega-6 fatty acids in our diets. If you stick with a whole foods diet and try to get some of the good omega-3 polyunsaturated fatty acids in your diet, the receptors of your cells are going to be much more responsive to insulin.

These fats make up the walls of all our cells and the lining of our nuclear envelope inside of the cell. This is what protects our energy making machinery in the cell. If you eat processed corn oil and other fats of that type, the cells are going to take up the wrong type of fat. These bad fats make the insulin receptor sites less functional because these fats are stiff and they don’t fit right into the cell wall. Also, cut out the trans fatty acids such as margarine, the kind of processed fat that is man-made or handled. (It is also necessary to cut back on saturated fats which come from animal fat.) The trans fatty acids decrease the membrane fluidity. Cell membranes would feel velvet-like if you could touch them-soft and easily deformed. But, when you put in the wrong kind of fat, these cell membranes become very stiff. This is important because the insulin comes to the cell wall and binds to the cell wall. Fatty acids carry glucose across the cell wall with it into the cell. If the cell can’t get that glucose into the energy factory of the cell, it can’t use it for energy.

When you are not as sensitive to insulin, you tend to make too much insulin. Therefore, we have a lot of insulin floating around, but it is not being used effectively because it is not binding to the cell wall properly and it is not getting glucose across to make energy.

So what does all the diet information mean? Moderation is the key word. You should have a moderate intake of carbohydrates, obtained from a complex whole foods source. You should consume a moderate amount of fat, but emphasize the essential fatty acids the polyunsaturated fatty acids and the mono-unsaturated fatty acids like olive oil. Again, you need a moderate high quality source of protein. All of these things should decrease your fasting  glucose, decrease your insulin level and decrease your triglyceride levels and your low density cholesterol.

An article in a recent issue of The New England Journal of Medicine suggests that exercise is one of the most important things you could do to improve the responsiveness of the cell to insulin. Another part of this is smoking cessation. There is no doubt that if you smoke, the load of oxidative (free radical) damage is tremendous. It is very hard for the body, when it is already under this metabolic burden of having diabetes, to fight the extra damage from smoking.  Stress reduction is also important.

Weight-loss is another important factor. Type 2 diabetics have too much insulin, but the cell is not sensitive to it. When you lose weight, your cells become more sensitive to the insulin so your body stops making so much insulin.

Micronutrients are important to diabetics.
• Vitamin E- It is important for diabetics because it increases insulin sensitivity, particularly in type 2 diabetics. When you look at that fat layer of the cell, vitamin E is probably protecting that nice fat layer from oxidant damage.
• Vitamin C-When you are a diabetic, you need extra amounts of vitamin C. Vitamin C protects that nice fatty layer of the cells. It also helps bolster your immune system to help fight off those common infections.
• Vitamin B6-Recent research shows diabetics seem to have lower blood levels of B6. People predisposed to heart disease have high homocysteine in the bloodstream. Vitamin B6 helps eliminate excess homocysteine. If vitamin B6 is already in short supply, then diabetics may be at a greater risk for heart disease.
• Vitamin B 12-helps improve the neurologic function. Diabetics often have neuropathy that causes numbness and tingling in the lower legs. Vitamin B 12 is helpful with this problem. There is no reported toxicity in the literature ever reported to vitamin B 12.
• Vitamin B 3-comes in two forms, niacin or niacinamide. They are really not interchangeable. If your physician prescribes niacin, you can’t substitute niacinamide. Niacin may impair glucose tolerance and blood sugar control. Niacinamide is used in early stages of type I diabetes. If you take it long term it seems to impair blood sugar control.
• Biotin-improves glucose control. It may also help in the pain of neuropathy and discomfort in the legs and in the hands.
• Coenzyme Q 10-is in every cell of the body. It works in the power supply, in the mitochondria (the little energy factory in the cell). It also works to mop up free radicals.
• Alpha Lipoic Acid-is found in the cells making energy. It is probably one of the powerful antioxidants. It also seems to be very powerful in helping the insulin move glucose into the cells so it can be used.
• Chromium-in adequate supplies, improves glucose tolerance and lowers triglycerides.
• Vanadium-helps with diabetes. Vanadate and vanadium sulfate forms have demonstrated insulin-like characteristics and improve insulin sensitivity in non-insulin dependent diabetics. Be very careful with this trace mineral.
• Magnesium-is typically low in diabetics even though it improves cellular uptake of glucose by insulin.
• Zinc-Diabetics appear to lose zinc easily in the urine. At the same time, zinc binds to and stabilizes insulin.

As you can see, nutrients, fatty acids, and trace minerals, along with exercise and weight and stress reduction, are important in the control of diabetes. The best way to get these nutrients is to eat a whole foods diet that is naturally rich in them. If you plan to add any of these in the way of supplements, it is wise to test first to see what your status is before adding them. And most importantly, tell your doctor what you are taking in the way of vitamins, trace minerals, and fatty acids.