How to treat diabetes from a functional medicine approach

While type 2 diabetes was once considered a “disease of affluence,” the global expansion of numbers in lower-income countries, can be seen due to low nutrient-dense diets with higher intakes of processed foods.
Type 2 diabetes is a condition that has traditionally seen this occur in people over 40, however, we are seeing the age at which people are diagnosed with it become younger and younger, even children diagnosed are at risk. Similar to the global expansion, Type 2 diabetes in the UK has seen a huge growth with an estimated 4 million people (6%) in the UK living with this condition. To put it into perspective in1996, the number of people diagnosed with diabetes in the UK has risen from 1.4 million to its current 4 million figure, and that number is expected to rise to 5 million by 2025. Type 2 diabetes is a lot more common than Type1 in the UK with 90% of diabetes having type 2 versus 10% with type. From a nutrition perspective, type 2 can be managed through a healthy diet and lifestyle.
What is Type 2 diabetes?
Type 2 diabetes is a chronic disease in how sugar is metabolized. Initially, there is a loss of sensitivity to insulin, the hormone which regulates the body’s sugar levels. What we can see happening in the early stages of this disease is the pancreas produces more insulin to overcome insulin sensitivity. However, as the disease gets worse, the body isn’t able to produce enough insulin to maintain blood sugar homeostasis (balanced blood sugar levels) which results in high blood sugar. How quickly this develops will depend on a number of factors and very much a case of wait and see in traditional medicine, whereas in functional medicine, we look at strategies to prevent the disease worsening and be proactive with our treatment and support strategies to stem the tide and try and reverse the disease. There are well-known risk factors for developing type 2 diabetes that includes.
  • Sedentary lifestyle
  • Genetics
  • Being overweight
  • Having diabetes during pregnancy (gestational diabetes)
  • Having pre-diabetes (impaired glucose tolerance)
  • High-fat diet
  • Oxidative Stress
The biggest risk factor of them all is what is on the end of your fork if you are following a western diet which includes refined carbohydrates, high fat, refined sugar, low vegetable intake, and inflammatory industrial seed oils (soy, canola, sunflower). If type 2 diabetes is not dealt with it can lead to long term complications due to high blood sugar levels including.
  • Eye disease
  • Hardening of the arteries
  • Nerve damage
  • Foot complications
  • Neurological issues
Prevention is always better than cure, but if you do develop diabetes there are many things you can do to effectively manage the disease and lead an active, healthy lifestyle. We recommend setting up an appointment with us at the clinic for a thorough consultation where we will be able to make specific recommendations and design a bespoke protocol for both prevention or management. Changing one’s lifestyle and diet is one of the most important forms of treatment in the prevention and management of type 2 diabetes which includes the consumption of alcohol consumption, which is essentially liquid sugar. Losing weight will help improve your body’s ability to reduce insulin resistance. Added to that it can also help lower cholesterol and blood pressure which reduces the risk of diabetes.
Exercise coupled with diet is the best way to lose weight. Starting slow and building up your activity if you have been sedentary is recommended so your body can get used to the changes. Even starting off with walking 20 minutes per day has been shown to reduce the risk of developing diabetes by 50%. There is good data to suggest that strengthening exercises at least twice per week can help with regulating metabolism and reducing insulin resistance. Ideally, you want to develop an exercise regimen that you can maintain long term, and which doesn’t have to be done at a gym, such as home zoom video workouts or YouTube classes which are ubiquitous.
Why doesn’t the conventional system work? What we see in the UK, for the most part, is patients having to wait until their fully diabetic before full treatment begins. As we know, GP’s get very little nutrition training with their medical degrees and recommending a well-balanced diet that can include a lot of carbohydrates which, of course, won’t be beneficial for diabetics. More needs to be done to alter the course of the disease in the prediabetic stage when the body is more responsive to change. In addition, the drugs used to manage and treat type 2 diabetes have serious side effects. Biguanides, Glinides, Sulphonylureas and Thiazolidinedione are some of the medications used to treat type 2 diabetes. However, these medications can be associated with liver and kidney dysfunction, weight gain, neurological symptoms, rashes, and low blood sugar.
Treating Diabetes with nutrition and functional medicine.
Eating whole unprocessed foods as much as possible and getting nutrition from a range of different food sources is key to maintaining a healthy, diverse and balanced diet. We understand that making changes can be difficult, which is why our practitioners can help you identify specific nutritional and lifestyle changes to assist you in stages to clients with weight control, prevention and management of diabetes.
Carb Quality
We can see a growing body of research, and in addition to clinical findings, supporting a very low refined carbohydrate diet for type 2 diabetes to achieve optimal results. A recent meta-analysis and systematic review of 18 randomized controlled trials saw results confirm that a low carbohydrate diet produces significant improvements in the key diabetic markets including HbA1c, triglycerides, and cholesterol, while also lowering patients’ requirements to take medicine. There is good information on the type of foods given out by the British Diabetic Association to reduce blood glucose levels including eating complex carbohydrates such as brown rice, whole grains, root vegetables such as sweet potato and whole fruits, However consuming more fiber, thereby increasing the quality of your carbohydrates which can come from vegetables and fruits which is also considered carbohydrates has shown to help diabetics. 
In terms of fats and protein, I would look to minimise these as true insulin resistance comes from fat getting into the way of glucose trying to get into the cells. If we just think of this as the most simple mechanism of insulin resistance,  then fats should be substantially lowered while you are getting blood glucose back into homeostasis. I am not saying no fat, I am just saying lower them and look at how much (good and bad) fat you are consuming on da daily basis. Although, fats do lower the insulin spike on paper, internally this is detrimental to the management of the condition, as we need to look at why glucose isn’t getting into the cells. One of the main problems in diabetics is the role of glucose which is maligned. Of course, I am not talking about refined sugar which is candy, sweet and cakes etc which are inflammatory and have a completely different metabolic effect than clean glucose that you get from fruits, vegetables and whole grains. If you think of the consumption of glucose,  it nearly always gets accompanied by fats. For example, a beef burger might with fries would seem like the worse combination for a diabetic, but if we really look at the issue in this example, is that there is too much accompanying fat from the deep-fried fries and the hamburger. Of course, context is everything. as eating just potatoes would with no accompanying vegetables would also be problematic as there would be too much of an insulin spike. 
In the functional medicine and nutrition world, we look at every person individually and there are other factors that come into play such as the severity of the disease, how long they have had the disease and looking at other organs such as liver health to see what is driving the disease. At our London functional medicine clinic on Harley Street, we look to take a holistic approach with each and every individual to see what is the root cause of the disease.

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