ADVERTORIAL
Nutrition for blood sugar control and diabetes management
The over consumption of refined sugar in manufactured foods and drinks has become a real issue and it is estimated that 30% of the UK population is pre-diabetic. Dr David Mantle FRSC FRCPath, Technical Advisor at Pharma Nord discusses interesting new developments in nutritional intervention.
The importance of blood
glucose control Glucose serves as the primary source of energy generation for most cell types within the body, to which it is transported via the bloodstream following absorption from the intestinal tract. Blood glucose levels are normally tightly regulated, within a normal range of 3.9-5.5 mmol/L (70-110mg/dl).
Actual blood glucose levels fluctuate during the day, particularly after meals; however persistent wide variations from normal range values have both short term and long term health consequences, and are characteristic of insulin resistance and diabetes. In the short term, abnormally low blood glucose (hypoglycaemia) may result in unconsciousness.
In the longer term, abnormally raised blood glucose (hyperglycaemia) results in damage to most organs, for example the heart (diabetic cardiomyopathy), nervous system (diabetic neuropathy), kidneys (diabetic nephrtopathy) and eyes (diabetic retinopathy). Such damage typically results from damage to the blood vessels supplying these organs, which in turn results from binding of glucose to the constituent proteins.
Normal glucose metabolism Dietary carbohydrates such as starch and sucrose are digested via enzymes
(amylase, alpha-glucosidase) in the intestinal tract to form glucose. The glucose is then absorbed from the intestine via an active transport system, the sodium-glucose co- transporter protein, into the bloodstream. Glucose blood levels are controlled via two pancreatic hormones, glucagon and insulin. Glucagon is released by the pancreas in response to lowered blood glucose levels, causing the liver to release glucose from its storage form (glycogen) into the bloodstream. Insulin is secreted by the pancreas in response to raised blood glucose levels. Insulin binds to specific receptors present on most cells, resulting in an influx of glucose into cells, thereby lowering blood glucose levels. Insulin acts in conjunction with the chromium containing peptide chromodulin, which amplifies the receptor binding and blood glucose removing effect of insulin approximately 8-fold. Excess glucose not required for immediate cellular energy generation is converted into fat, which is deposited around the body.
Abnormal blood glucose
metabolism and diabetes Diabetes is a disorder of insulin metabolism, characterised by abnormal blood glucose levels. Symptoms typically include weight loss, increased thirst, increased
urination and
fatigue.There are two main types of diabetes, Type I and Type II. Type I diabetes results from inability of the pancreas to produce sufficient insulin. Insulin producing pancreatic beta cells are destroyed or impaired, either as a result of autoimmune disease or exposure to toxic agents. Type I diabetes typically occurs in younger individuals, and is also known as insulin dependent diabetes, early onset diabetes or juvenile diabetes. Patients with Type I diabetes need to take regular insulin injections to control their blood glucose levels.
In Type II diabetes, the body becomes resistant to the action of its own insulin. As the disease progesses, a lack of insulin may also develop. Type II diabetes typically occurs in middle age onwards, and is also referred to as non-insulin dependent diabetes or adult onset diabetes. Obesity is a major risk factor for Type II diabetes, which can be controlled in many cases by a combination of increased exercise and dietary modification. Most patients who present with Type II diabetes initially develop an insulin resistant, prediabetic stage, in which blood glucose levels are higher than normal, but not sufficiently high to merit a diabetes diagnosis.
At present more than 3 million people in the UK have been diagnosed with diabetes. This figure does not include undiagnosed cases, or those with prediabetes. It is estimated that more than 30% of the UK population may have prediabetes. Approximately 10% of all diabetes cases are of Type I, and 90% of Type II. Control of blood glucose levels is important in both types of diabetes.
General dietary
considerations The World Health Organisation has recommended that daily sugar
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consumption should be limited to no more than 5% of total calorie intake (around 25g/day for an adult), well below the 30% level to which people in Western societies have become accustomed.
Sugar craving can occur for a variety of reasons; it can be viewed as a type of addiction in that the intake of sugar results in the release of mood enhancing substances (serotonin and beta endorphin neurotransmitters) in the brain. Research in experimental rats has reported that sugar can be as addictive as drugs such as cocaine or heroin. Sugar craving can also be a sign of thyroid or adrenal gland malfunction. In people who have a consistently high intake of dietary sugar, insulin gradually loses its ability to interact with cells (insulin signalling), thereby inhibiting the normal mechanism for removing excess glucose from the bloodstream.
This is known as insulin resistance, a condition estimated to affect 25-35% of the population of Western societies. The pancreas responds by trying to produce more insulin, until the pancreatic cells become exhausted. Insulin resistance is a precursor of type II diabetes, a disorder characterised by continually high levels of glucose in the blood, resulting both from insulin resistance and subsequent reduced insulin production by the pancreas.
Nutritional supplements for blood glucose control and
diabetes management Clinical studies have identified a number of nutritional supplements that provide significant benefit in the control of blood glucose levels in patients with insulin resistance or type II diabetes- the following section highlights two such supplements, with novel (Delphinol) and established (chromium) modes of action respectively.
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