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Controlling Your Sugar
By Dr. Winston Craig

            About 24 million Americans have diabetes, including one in four Americans aged 60 and older. Unfortunately, one out of every three people with the disease is unaware that they have it. Altogether, diabetes was the underlying cause of death for almost 70,000 deaths last year. It is now the fifth and sixth leading cause of death among women and men, respectively. Diabetes also increases your risk of hospitalization. Almost one in five people over 45, who are hospitalized, have a diagnosis of diabetes.

            If not well controlled, diabetes can be associated with serious complications and premature death. Complications may include kidney disorders, deterioration of nerve function, and lipid accumulation in blood vessels. As a result, diabetes is a major contributing factor to blindness, dialysis, and lower extremity amputations.

Excessive Weight is the Major Problem

           Over 90% of people with diabetes have type II diabetes. This typically appears in middle-aged and elderly men and women who are overweight. In fact, over 80% of people with diabetes are overweight. It is estimated that 92% of diabetes could be avoided by proper diet and improved lifestyle.

 The growing importance of diabetes today is directly related to the rapid increase in the number of overweight adults and the significant number of overweight children and adolescents. As many as two out of every three adult Americans are overweight, while roughly 15% of children and youth are overweight.

              Why is the carrying of excess body weight so closely associated with the development of diabetes? Fat cells produce compounds that interfere with insulin receptors on cells. Hence, the pancreas has to make more insulin to counter the inefficiency of insulin’s action. With insulin not functioning properly, blood glucose levels remain higher than normal. A fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes, while a person with a fasting blood glucose level of 126 mg/dl or higher is considered to have diabetes.

 Nature and Nuture

            Both genetics and environmental factors play important roles in the development of diabetes. A family history of diabetes certainly increases one’s risk of diabetes. Diabetes is more commonly seen among African-Americans, Latinos, Native Americans, and Asian Americans. It is also more commonly seen in the elderly than in a younger population.

                A healthy lifestyle that includes weight management, regular exercise, and a healthy diet, can reduce both the incidence of diabetes and delay the development of diabetic complications. Losing weight and engaging in a regular exercise program are sure ways to improve the effectiveness of insulin. An hour a day of brisk walking lowers your risk of diabetes by 34%. On the other hand, risk of diabetes in women increased 14% for every two hours a day they spent watching TV.

 Lower Blood Lipids Essential

            Managing your blood lipids is very important since 70% of people with diabetes die of cardiovascular disease. Those persons with diabetes who have elevated cholesterol levels should reduce their intake of saturated and trans fat. In the Nurses’ Health Study, those who ate the most trans fat had a 30% higher risk of diabetes. The major sources of saturated fat in the American diet are meats and dairy products. The main source of trans fat are French fries, chips, cake frostings, popcorn, frozen pizza, and commercial bakery products made with hydrogenated fats.

               People with diabetes having elevated triglycerides who are carbohydrate-sensitive are advised to reduce their carbohydrate intake and replace some of their dietary carbohydrates with mono fats as found in olives, avocados, and nuts. Weight loss will also significantly lower elevated triglyceride levels.

 Meat Worsens the Picture

           The use of meat apparently increases a person’s risk of diabetes. In the Adventist Health Study, the incidence of and mortality from diabetes was observed to be about 1.5 to 2 times higher in non-vegetarians compared with vegetarians. In a study of 70,000 women, those who ate red meat about once a day had  a 22% higher risk of diabetes compared to those who ate meat about once a week. In a study of 42,000 men, those who ate the most processed meats (luncheon meats, hot dogs, and bacon about 5 times a week) had a 46% higher risk of diabetes than those who ate the least (twice a month).

 Plant-based Diet Helpful

            A high-fiber diet, rich in vegetables and legumes (dry beans and lentils) has been shown to help facilitate the management of diabetes by improving glucose tolerance and insulin sensitivity. The regular use of nuts, and whole grain breads and cereals has also been shown to significantly reduce the risk of diabetes by 20 to 30 percent. Oatmeal and barley which are rich in the soluble fiber beta-glucans, can lower blood lipid levels as well as attenuating blood glucose and insulin levels.

                Chromium is an important mineral that facilitates the function of insulin. A diet rich in white bread and white rice will be deficient in chromium, as the trace mineral chromium resides in the bran of grains. In addition to whole grains, brewer’s yeast is also an excellent source of chromium.

 Herbal Adjuncts

             There are a number of herbal products that have proven useful for the treatment of diabetes by various cultures. Asians have valued the use of fenugreek, while Caribbean and Oriental cultures have derived benefit from bitter melon, a cucumber-like fruit. In addition, the Mexicans treasure the properties of prickly pear, a rich source of soluble fiber that proved popular among the  Aztecs. Recently, cinnamon from Sri Lanka, has shown real promise as another therapeutic adjunct in the management of diabetes. The water extract of cinnamon contains compounds that enhance the action of insulin.

 Sweeteners

             While elevated blood sugar is a problem for individuals with diabetes, the use of small amounts of sugar within a meal is usually tolerated.  The use of sugar substitutes such as sucralose (Splenda) and aspartame (Equal, or NutraSweet) has been shown to be safe for persons with diabetes and provide a safe way to control calories. Sugar alcohols, such as sorbitol, are a safe way to provide sweetness without causing any changes in blood sugar levels. On the other hand, the regular use of sweetened soft drinks and beverages, and potatoes is associated with an increased risk of diabetes.

 Change is Needed

             While 24 million Americans have diabetes, another 57 million have pre-diabetes with elevated blood sugar levels. And sadly, many don’t know they have this problem. This means that they will develop diabetes if they do not lose weight, exercise regularly, and eat better. With the stakes so high, lifestyle changes become very important.

Winston  Craig, PhD
Andrews University

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