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Diabetes mellitus is an inability to metabolize carbohydrates resulting from inadequate insulin production, absence of insulin production, or impaired utilization of insulin. Other forms of diabetes (such as diabetes insipidus and gestational diabetes) are not included in this discussion.
There are several types of diabetes mellitus, type 1, type 2, and gestational diabetes, as well as diabetes insipidus, and a more recently recognized form of adult-onset disease called latent autoimmune diabetes in adults (LADA).1 This article concerns type 1 diabetes, which also has been called childhood-onset diabetes or insulin-dependent diabetes. In type 1 diabetes, the pancreas cannot make any insulin, and therefore, the body cannot process glucose. Natural therapies cannot cure type 1 diabetes, but they may help by making the body more receptive to insulin supplied by injection or an insulin pump. It is particularly critical for people with type 1 diabetes to work carefully with the doctor prescribing insulin before contemplating the use of any herbs, supplements, or dietary changes mentioned in this article. Any change that makes the body more receptive to insulin could require critical changes in insulin dosage, and this must be determined by the treating physician.
People with diabetes cannot properly process glucose, the main sugar the body uses for energy. As a result, glucose stays in the blood, causing blood glucose to rise. At the same time, the cells of the body are starved for glucose, because without insulin, glucose cannot enter cells. People with diabetes are at increased risk for heart disease, atherosclerosis, cataracts, retinopathy, stroke, poor wound healing, infections, and damage to the kidneys and nerves. The risk of diabetes-related health complications can be decreased with proper blood sugar management and a healthy lifestyle.
Everyone with diabetes aged 6 months and older should get a seasonal flu shot. Close household contacts and out-of-home caregivers of people with diabetes also should be vaccinated against the flu each year.
People with type 1 diabetes who engage in regular exercise require less insulin.2 However, in the short term, exercise can induce low blood sugar or even occasionally increase blood sugar.3 Therefore, people with type 1 diabetes should never begin an intensive exercise program without consulting a healthcare professional.
The American Diabetes Association (ADA) recommends that people with diabetes limit their daily alcohol consumption to one drink for women and two drinks for men.4 The Centers for Disease Control defines one drink as equivalent to a 12 ounce can of beer, 8 ounces of malt liquor, 5 ounces of wine, and 1.5 ounces of hard liquor. Similar to research on healthy people, preliminary studies in adults with diabetes find reduced risk of heart disease with light to moderate drinking.5 Beyond moderate drinking, alcohol will be more harmful than beneficial. Drinking alcohol with type 1 diabetes can result in hypoglycemia or hyperglycemia, depending on the circumstances, but moderate amounts of alcohol ingested with food are less likely to affect blood glucose levels.6 People with diabetes who drink two or more drinks per day were reported to have a high risk for eye damage in one preliminary study,7 but another, larger study found no association between alcohol use and eye damage.8 However, alcohol consumption does have numerous downsides, including risk of addiction and increased risk of several types of cancer. For this reason, it is not advised that people who do not drink begin doing so simply for its possible heart-protective benefits. Ask your doctor what is best for you, taking into account your personal medical history.
People with diabetes who smoke are at higher risk for kidney damage,9heart disease,10 and other diabetes-related health problems. Smokers also are more likely to develop diabetes,11 so it's important for people with diabetes who smoke to quit.
Most healthcare providers agree on the necessity of self-monitoring of blood glucose (SMBG) by people with type 1 diabetes. Advocates of SMBG, such as the American Diabetes Association (ADA), have observed that SMBG by people with diabetes has revolutionized management of the disease, enabling them to achieve and maintain specific blood glucose and laboratory value goals.12 These observations are well-supported in the medical literature.13 Children should be taught proper techniques for SMBG as well. A study of children and adolescents with type 1 diabetes showed that, after adjusting for several factors, increased SMBG frequency was associated with lower A1C—the more intensive the SMBG, the better the child’s A1C, suggesting SMBG significantly improves glucose control. In the range of 0–5 tests per day, A1C decreased by 0.46% per additional test per day.14
Detractors point out that indiscriminate use of self-monitoring is of questionable value and adds enormously to healthcare costs.15 The ADA acknowledges that accuracy of SMBG is instrument- and technique-dependent. Errors in technique and inadequate use of control procedures have been shown to lead to inaccurate test results.16 Nevertheless, it is likely that self-monitoring of blood glucose, if used properly, can have a positive effect by increasing patient involvement in overall diabetes care.17 Pharmacists and healthcare practitioners can teach people with diabetes important skills that will enhance their ability to properly self-manage blood glucose. Regular follow-up visits with a diabetes healthcare practitioner, including downloading and reviewing SMBG results, is important.18
Acupuncture may be helpful in the management of diabetes, or complications associated with the disease. In a preliminary trial, 77% of people suffering from diabetic nerve damage (neuropathy) experienced significant reduction in pain following up to six acupuncture treatments over a ten-week period. Many also were able to reduce pain medications, but no long-term change in blood-sugar control was observed.19 Bladder control problems, a complication of long-term diabetes, responded to acupuncture treatment, with a significant reduction in symptoms in both controlled and uncontrolled trials.20, 21
Copyright © 2017 Healthnotes, Inc. All rights reserved. www.healthnotes.com
The information presented by Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2017.