Digging Deeper into Diabetes
By Andrea Colon, ND and Lauren Young, ND
hormone produced by pancreatic beta cells which controls sugar levels in the body. Historically, there were two classifications of Diabetes mellitus: Type 1, an autoim- mune disorder which attacks pancreatic beta cells and thereby prevents the nor- mal production of insulin, and Type 2, a progressive disease that reduces the ability of the body to utilize insulin properly. More recently, a third type has emerged in the literature: Type 3c, insulin dysfunction resulting from pancreatic disease states. Because the therapeutic approaches for each of these distinct types varies greatly, this discussion will focus solely on Diabe- tes mellitus, Type 2.
D Because 90% of all diabetes patients
over the age of 40 are diagnosed with Type 2, this subtype has become increasingly visible within the world of public health and for good reason. While elevated blood sugar may seem relatively inconsequential, in reality, diabetes affects every system of the body. Rampant sugar molecules damage the endothelial lining of blood vessels and prevent the formation of new, healthy blood vessels (angiogenesis), setting up ideal con- ditions for diffuse vascular disease. Without ample blood supply, each organ system de- teriorates, leading to cardiac disease, renal disorders, compromised immune function, liver dysfunction, stroke, psychiatric disor- ders, visual impairments, and neuropathy.
Not only are the ramifications of uncontrolled diabetes greatly underesti- mated, the number of diagnosed cases of the disorder is staggering, and continues to grow. According to the World Health Organization (WHO), the number of people with diabetes has risen from 108 million in
iabetes mellitus, more commonly known as simply “diabetes,” in- volves the dysfunction of insulin, a
1980 to 422 million in 2014. In the United States alone, 29 million people have been diagnosed with the disease, and the epi- demic continues to grow. Indeed, diabetes has become a global health crisis.
Unfortunately, the care provided by
conventional medical practitioners typically emphasizes prescriptive medications to reduce blood glucose levels, and while this is a necessary aspect of disease manage- ment, it does not truly address the root of the pathology. Diet and lifestyle changes play a tremendous part in reducing risk factors in pre-diabetics and in gaining sugar control in diagnosed patients, but even with following the strictest of protocols, there are a significant number of patients who do not find improvement. It is clear that a more creative approach to studying the etiology of diabetes is necessary to developing more effective treatment options.
The Endocrine System
Cellular endocrinology “deals with all the related aspects of biochemical mechanisms, synthesis and production of extracellular signal transductions, and other mechanisms in hormonal control,” including hormonal gene expression and regulation. In other words, it investigates how the endocrine system both affects and is affected by intracellular activity. Through this lens, researchers can investigate diabe- tes as the result of dysfunction within the organelles of individual cells, addressing dysfunction within these organelles at every step of the metabolic process. This very targeted approach allows investigators and clinicians to develop individually-tailored treatment options that may address very nuanced causes of sugar dysregulation, thereby bringing about more successful out- comes in the management of this disease.
30 Natural Nutmeg - November/December 2018 Metabolic Inflammation
In a study designed to investigate the effects of diabetes on the human brain, researchers found that diabetes-related intracellular stress to the mitochondria and endoplasmic reticulum created what they termed “metabolic inflammation,” which in turn, caused cell death within the brain. This manifested as cerebral dysfunction, or “diabetes-associated cognitive decline”.
This concept of diabetes-associated
cellular trauma is not limited to the brain, it can happen all over the body. A study performed in 2014 by a team in France found that hyperglycemia is a huge culprit in the creation of reactive oxygen spe- cies or damaging free radicals within the diabetic body, and when combined with a reduced antioxidant ability creates a state of chronic inflammation. Despite aggres- sive antioxidant vitamin administration, no real evidence to the reduction of harmful inflammation was shown. While the find- ings of this particular study may be disheart- ening to some, the researchers’ proposal for further investigation provides even greater insight into the importance of antioxidant support in diabetic therapies.
For instance, it is unclear how far the pathology of the participants had pro- gressed before they had enrolled in this study. Is there a threshold at which oxida- tive damage is irreversible in relation to diabetic neuropathy, insulin sensitivity, and cognitive decline? Perhaps the methods of administration, the forms of, or the dosages of the vitamins used in this study could be altered, with more favorable results. Would bolstering antioxidant precursors (as opposed to poorly-absorbed whole anti- oxidant formulations) within the body elicit the proper utilization of the antioxidant vitamins? This study leaves many opportuni- ties for further investigation.
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