• Healthy Guide To Living With Diabetes

    by Dr. Payal Bhandari
    on Apr 27th, 2017

According to the Center for Disease Control and Prevention (CDC), 1.4 million Americans are diagnosed with diabetes every year. In total, more than 29 million people in the Unites States are affected by diabetes, with type 2 diabetes accounting for between 90 and 95 percent of all cases. There are many things we can do in our lives to be healthier, but proper diet, regular exercise, sufficient sleep, and stress management are essential for living well and effectively manage your diabetes.

What is Diabetes?

Insulin is an extremely important hormone produced by beta cells in the pancreas. Insulin regulates the breakdown of sugars, starches, fats, and proteins from the food and beverages we consume. Insulin controls food is broken down to sugar, and how sugar is then used for energy by your body’s muscles, brain, and major organs to function properly. Insulin also regulates other functions of the body’s cells, including growth.  

Prediabetes is when the body’s cells become resistant to the effects of insulin.  Diabetes is when the pancreas can no longer keep up with the high insulin demand and hence, leads to blood sugar levels reaching toxic levels. When you have diabetes, your body cannot properly use and store food for energy. Our bodies need glucose, the form of sugar most food is broken down to. When our cells become resistant to the effects of insulin, these sugars can no longer be adequately delivered to the body’s cells for energy. In other words, diabetes is when the insulin resistance has become severe enough that the blood sugar remains extremely high. As blood sugar begins to increase to toxic levels, the blood vessels become damaged, causing a high level of inflammation and organ damage. There are two types of diabetes: type 1 and type 2 diabetes.

Type 1 Diabetes

In Type 1 diabetes the pancreas is unable to produce insulin. Type 1 diabetes occurs when your body’s immune system begins to attack the body’s own cells and treats these cells as the enemy. Beta cells within the pancreas begin to be destroyed by the immune system causing decreasing production of insulin.

Type 1 diabetes typically occurs before the age of 40 – primarily in the teen years to early adulthood. 10% of diabetics have type 1 diabetes. These patients must take insulin injections each day for the rest of their lives. They also need to closely monitor their daily blood sugar levels.

Type 2 Diabetes

An estimated 3 out of 4 people with prediabetes will eventually develop Type 2 diabetes. In Type 2 diabetes the body’s cells are no longer able to utilize the insulin produced by the pancreas. In other words, Type 2 diabetes occurs when your body becomes less sensitive to insulin and cannot produce enough insulin to to make up for it. 90% of diabetics have type 2 diabetes.  Type 2 diabetes can be effectively treated with the right diet, regular exercise, and certain medications.

People who are overweight or obese and carry extra weight around the abdomen, those with thyroid or other hormonal problems have a high risk of developing diabetes.

Being overweight, physically inactive, and choosing the wrong foods to eat all play a huge role in developing insulin resistance.  For example, drinking just one can of soda every day will increase a person’s risk of developing Type 2 Diabetes by 22%. Diet sodas increase the risk of developing diabetes by 33%. The risk of developing Type 2 Diabetes also increases with age.  

Up until 1997, type 2 diabetes used to be referred to as adult-onset diabetes. However, the condition was renamed to adjust for the rise in youth being diagnosed with diabetes. From 2001 to 2009, there was a 30.5 % rise in youth with type 2 diabetes and there are on average 5000 new cases per year. Although family history can be a risk factor, obesity is the number one reason for the development of type 2 diabetes in children.

Complications of Insulin Resistance & Diabetes

Diabetes is a serious disease.  It can cause serious health concerns such as: vision loss (including blindness or severe near-sightedness), arthritis, heart disease, nerve damage, compromised immune system with poor healing and high risk of infections, skin rashes and skin tags, hearing loss, gum disease, mental illness such as depression, and stroke.

Eating Healthy With Diabetes

When you have diabetes, it is much more important to eat regularly and space meals no more than 6 hours apart. When eating a meal, green vegetables should take up half the plate, plant-based beans, seeds, or avocados should only take up a quarter of the plate, and whole grains  (not breads, wheat, or refined flour) should take up the last fourth of the plate. According to recent research, minimizing dairy products, meat (i.e., poultry, red meat), eggs, and seafood  consumption to less than 3 times per week, and having a rich plant-based real foods diet will drastically lessen the risk of developing type 2 diabetes. This diet can also effectively treat type 2 diabetes.  

Although pop, fruit juice, alcohol, or milk products seem like they would keep you hydrated, they actually do the opposite. If you are thirsty, drink warm water with a pinch of salt. The more sugar you eat or drink, the more excess glucose you will have in your blood. Drinking sweet drinks and dairy products will raise your blood sugar levels and increase your risk for obesity.

Try to avoid food with artificial and processed sugars. Eating fresh fruit is another story. Although a cup of fruit juice may be equivalent to a cup of fresh fruit according to USDA guidelines, fruit juice is toxic to your body primarily in its inability to digest the juice and instead cause major spikes in your sugar level. It is best to stick with having only one piece of fruit once a day that is eaten alone and slowly. There are many essential nutrients in fruit which do not exist in fruit juice.

Plant-based high fiber foods help to effectively optimize the digestion of food and the absorption of essential nutrients. They also help us feel full while preventing sudden spikes in blood sugar levels. When blood sugar levels are well controlled, cholesterol production within the liver also remains well balanced.  

You can increase your fiber intake by eating the skins of fruits and green vegetables, having whole grains (not wheat, white rice, or flour-based foods) and beans (i.e., lentils, dals, moong) added to your stews, soups, stir-frys, and salads. Replace meat, dairy products, seafood, and eggs with plant-based proteins. Add ground flax seeds and sunflowers or avocados to your salads. If you are not used to eating this much fiber, make sure you start slow and drink plenty of water to avoid gas or constipation.

Soluble fiber is especially helpful for diabetics and can be found in buckwheat, millet, fareo, barley, black beans, split peas, lentils, etc. Beans also contain a high amount of iron, potassium, protein, and complex carbohydrates. Fruits and vegetables have a high water and fiber content with multiple vitamins and minerals. Veggies that are particularly high in soluble fiber are: dark green leafy vegetables (i.e., kale, swiss chard, bok choy, spinach), brussel sprouts, turnips, and okra.

Staying Active With Diabetes

Regular physical activity is essential to living well and managing your diabetes effectively. Exercise helps manage blood sugar levels and improve your body’s reaction to insulin. One of the most difficult parts about integrating exercise into our daily routine is that modern living has removed most forms of regular physical activity from our lives. There are many barriers that prevent us from physical activity, including ourselves. Changing your attitude towards active living one step at a time can get you started on forming positive habits. For example, if you think you are too tired or simply lack in motivation, consider this: exercise gives you more energy and helps you sleep better!

If you think you have no time, start slow. Any bit of physical activity you get matters. Every 30 minutes, get up and move for two minutes. Once you start doing exercises, start with 5 to 10 minutes at a time throughout the day. Shorter exercise sessions are just as useful as long ones. You’ll be amazed at how much time you can scrounge up!

Aerobic and resistance exercise are both important for people living with diabetes. Not sure what the difference is? Aerobics exercise includes continuous activity that raises your heart rate and breathing, such as walking, jogging, biking, and swimming. On the other hand, resistance exercise includes repetitive activity to build muscle strength, including using weights, weight machines, or your own body weight.

Make physical activity a part of your daily habits. Walk or ride a bike whenever you can. Instead of going out for movie night, try to make social or family activities more active. Trying new activities can really open up the door to having fun and staying physically active. Think of a dance you’d like to learn and join a class. Being a part of a casual sports team is a good way to also stay active and comes with social motivation. The good news is that there are many ways to get exercise and manage your diabetes.

Mind-Body Practices For Diabetes

Chronic stress increases your blood sugar levels and makes insulin work less effectively. In addition to healthy eating and exercise, stress management is important for managing diabetes. Mindfulness meditation has been proven to help manage stress and live well with diabetes.

Treatment of Diabetes

As with any chronic illness, prediabetes requires personalized treatment to best understand its underlying culprit(s).  Diabetes can be remarkably improved and even reversed through aggressive lifestyle counseling focused on nutrition, physical activity, sleep and stress management.  If you would like to learn more about how to reverse your pre-diabetes or optimize your diabetes, contact Dr. Payal Bhandari, M.D. Dr. Bhandari is an integrative functional medicine physician who specializes in chronic illness. She  will define a personalized treatment which targets how to effectively lessen your insulin resistance and many of its associated health complications.

Author Dr. Payal Bhandari Dr. Payal Bhandari M.D. is a leading practitioner of integrative and functional medicine in San Francisco.

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