Nancy Gahles, DC, CCH, RSHom(NA), discusses the interconnected epidemics of diabetes and obesity.

by Nancy Gahles, DC, CCH, RSHom(NA)

Political rhetoric has been the language of the day since the presidential campaign became the dominant force in the news about two years ago. Catch phrases like “diabesity” and the spouting of statistics has become common jargon used for folks to interpret where we stand as a society and where and how change needs to be made.

At the risk of sounding like a politician, the reality is that 21 million Americans have Type 2 diabetes and 6.2 million are currently undiagnosed. The complications from Type 2 diabetes include: heart disease, stroke, high blood pressure, blindness, sensory loss, kidney disease and amputations. The management of these chronic conditions account for the largest share of our insurance and economic burden.

The Diabetes Care journal reported a study conducted by Kaiser Permanente, that found that the rate of pre-existing diabetes among pregnant women in the United States had doubled in the time period from 1999-2005. Among teenagers, the increase was even larger. Jean Lawrence, author of the study, notes that the complications from having diabetes during pregnancy (gestational diabetes), increases the risk of miscarriage early in the pregnancy, increases the risk of stillbirth later in the pregnancy and increases risk of birth defects, larger babies and more difficult deliveries.

Why the term “diabesity”?  Because, according to Lawrence, “It is important to recognize with the increase in obesity, more women than ever will be entering their reproductive years with diabetes.” (NaturalNews by David Gutierrez).  Diabesity is an epidemic that is not limited to women and teens, but includes children as well. According to the Center for Disease Control, 14% of children five years and younger are obese. Not chubby-cheeked cherubim – obese children.

The author of that study is certainly not the only one to sound the clarion call of weight loss as a mechanism with which to manage diabetes. The gold standard of current conventional treatment of Type 2 diabetes is weight loss, exercise and oral medications/insulin.

So why is the rate of diabesity increasing so dramatically? Where have we, as healthcare practitioners, dropped the ball? Or, maybe we never picked it up at all.

A condition as preventable and manageable as this one lends itself beautifully to an integrative approach.  Not every practitioner has the time or the inclination to delve into the dietary practices and lifestyle choices of each person who is overweight or whose blood work suggests a predisposition to or an overt diabetic condition. That is why we are fortunate to have a community of practitioners replete with those who do have the time and the passion for consulting and correcting one or more of the lifestyle choices that need to be changed.

In this day and age, when there are so many conditions on the spectrum of unknown etiology and with less than dramatic treatment outcomes, I am thrilled to be presented with a case of Type 2 diabetes. A typical case history will reveal the presence or predisposition to diabetes. Either the patient has diabetes, is obese and at risk for it, or has a family history of diabetes. As always, education remains a key ingredient here. In my experience, most patients who have diabetes or have a family history, think that there is nothing that they can do if it is hereditary. They do not make the connection between hereditary and lifestyle choices. They think that hereditary means that you get diabetes no matter what because your parent(s) had it. This is the stuff that may be “over your pay grade”, to borrow the words of a political candidate. That means that it takes too long to educate your patient in this way. It may be that all you do is tear off a fact sheet with nutritional do’s and dont’s for them to follow. Now, we all know that is a prescription doomed to fail. Thankfully, there are holistic health counselors, registered dieticians, nutritionists, life/health coaches and the like in our community, whose job it is to spend the time with each patient assessing them on an individual basis and helping them to find eating habits that meet their needs and decrease their health risks.

Exercise is a major factor in both preventing and managing Type 2 diabetes. Again, assessment of the patient and referral to the appropriate partner in healthcare is as easy as developing a relationship with your local health club. The staff usually consists of personal trainers, yoga and Pilates instructors, and may, in addition to the usual workout equipment, have a pool for swimming. Again, if it is not your “thing” to take the time to discuss each of these options with your patient, refer them to someone who will. In my experience, my patients are always grateful that I cared about them enough to send them to the best specialist for their condition.

Eating whole, organic nutritious foods is key to good health in general. Adding certain supplements can decrease some risk factors as well. The September edition of the Journal of Medicinal Foods reported on a study done in Kyoto, Japan, which found that administration of chlorella resulted in “noticeable reductions in body fat percentages, total serum cholesterol and fasting blood glucose levels.” ( by Barbara L. Minton). This is simply an example of how we can inform ourselves and educate others about options that are within our control, in order to manage a potentially debilitating chronic disease. This is an area of specialty where practitioners of functional medicine may be of great value to you. The literature is replete with food supplements and nutraceuticals that benefit diabetes, but that is an area of study in and of itself. There are also contraindications to the use of some vitamins and herbs in combination with allopathic medication, therefore, it is best to refer to a professional who is well versed in this field.

The more pessimistic news (and Lord knows I am the least pessimistic person!) is that some factors that increase our risk for Type 2 diabetes are out of our control and out of control in general. Environmental pollutants and the byproducts that are leached into our groundwater and soil account for some of these risk factors.  Diabetes Care (31:1574-1579, 2008) reported on a study entitled Increased Risk of Diabetes and Polychlorinated Biphenyls and Dioxins. The title says it all. Environmental pollutants are a contributory factor to the breakdown of our endocrine systems. The conclusion of the study, a 24-year follow-up of the Yuncheng cohort, was that Yuncheng women who had endured exposure to PCDF’s and Dioxin, suffered from increased incidences of diabetes. 

We do have professionals who specialize in the relief of toxic burden to the body through various detoxification methods.  It behooves us to investigate those treatments that yield the best outcomes and to find practitioners that we trust to refer our patients to who fall into this category.

Indeed, all of us who eat supermarket fruits and vegetables and drink our water from plastic containers are exposed to these contaminants and may be susceptible to developing diabetes as a result. It is, in fact, a matter of individual susceptibility. A careful case history may elicit this information. A patient may tell of significant environmental exposure or of chemical sensitivities or food allergies in general. This could be an indication that the patient is a candidate for constitutional homeopathic treatment. In one study where a hundred cases of diabetes were treated with homeopathy, 84% of the cases showed normalized blood sugar levels. Another group that supplemented treatment with homeopathy, showed 97% improvement as compared to 47% without homeopathy. Diabetes-related complications respond equally well to homeopathy.  Of 60 patients with diabetic retinitis given Arnica 5c, 47% experienced dramatic improvement. A very positive note for working with homeopathy and allopathic medicines is the fact that there is no contraindication to using both simultaneously. In fact, as noted in the study above, better outcomes are seen in conditions where both homeopathy and allopathy are used together.

Acupuncture and Chinese herbs have been shown to have marked improvements in the prevention and treatment of diabetes as well. We have many acupuncturists in our community to call upon for their expertise.

As with the treatment of all conditions, it is the person whom you are ultimately treating. The person who has a condition that is diagnosable or a tendency to one, needs to be informed and educated about how to best exercise their options in order to maximize their health and well-being. People with Type 2 diabetes need to be informed that responsible lifestyle choices are part of their care plan. It is not enough to prescribe a medication without education. That is a strategy that teaches the patient to rely on a pill to control their symptoms.  If we are to reign in the spiraling cost of healthcare and increase the quality of life of our patients, it is our responsibility to offer them choices, options and practitioners to support them in an integrative model of self reliance and team management.

We are fortunate to have all manner of professions, practitioners and information in our midst. The beauty of an online community such as ours is that it is convenient and efficient to use. Simply log in, search and ye shall find!

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