Have you been diagnosed with prediabetes, elevated fasting blood glucose, insulin resistance, metabolic syndrome, or type 2 diabetes mellitus? If so, you are not alone! Currently, more than 37 million Americans have type 2 diabetes and 96 million have prediabetes. This represents more than a doubling of the case toll over the past 20 years. Given the fact that diabetes leads to life-threatening complications while severely diminishing the sufferer’s quality of life, we should be very concerned about these statistics!
Many people do not initially know that they have diabetes, but the trajectory is predictable and insidious. In fact, a diagnosis of prediabetes signals the beginning of widespread hormonal dysregulation in the body. This means that we should be educating ourselves so that we can see it coming and do something about it. This blog will focus on the precursors to diabetes, the signs and symptoms that should sound the alarm, and what we can do to reverse this at a root cause level using functional medicine.
Insulin Resistance: Are You at Risk?
The modern American lifestyle including poor diet, lack of exercise, high stress levels, and exposures to toxins is a strong risk factor for glandular dysfunction. Hormones are produced by a gland (for example insulin from the pancreas) in order to tell a cell to perform a task. Insulin lets the body’s cells know that they should pick up glucose from the bloodstream and use it as fuel. In cases of insulin resistance, the target cells are not responsive, instead they are “resistant” to insulin. Two issues can then arise: 1. Insulin’s effects are diminished and 2. The body pumps out more insulin to try and compensate. Therefore, in early cases of insulin resistance, the pancreas produces plenty of insulin, but the cells are not able to use it to move glucose out of the bloodstream for fuel. Your cells are starved, and you are left craving sugar. The pancreas then produces even more insulin, high levels of which can lead to weight gain among other deleterious effects that perpetuate the cycle. Even more concerning, are the effects of chronically high blood glucose levels. If the cells are unable to utilize the circulating sugars due to resistance to insulin, this sugar wreaks havoc on every organ system. Chronically high blood glucose levels damage blood vessels, tissues, and nerves and can lead to heart disease, kidney disease, blindness, infection, and much more. Scary stuff!
Metabolic Syndrome
Metabolic syndrome is the physical condition that occurs when an individual has insulin resistance. The medical community diagnoses metabolic syndrome when an individual has three of the following symptoms: Large waist, high triglycerides, low HDL (good) cholesterol, high blood pressure, and elevated fasting blood glucose. These are all signs that your body is sounding an alarm and you absolutely should pay attention. If insulin resistance is left unchecked, the pancreas will in essence “wear out” as it is overtaxed by the task of producing more and more insulin to get a response from the cells. When this occurs blood sugar levels can get very high and an individual qualifies for a diagnosis of type 2 diabetes. Longer term, the result is the need for lifelong insulin by injection as the pancreas stops working entirely. It is extremely important to recognize the danger signals and intervene early!
What Can You Do?
In functional medicine the ultimate goal is always to find the root cause of the issue and reverse it. In this case, the goal is to revive the cells’ responsiveness to insulin, reverse any damage to the pancreas, and protect the integrity of the endocrine system in general. This takes detective work! First and foremost, functional labwork is needed including a comprehensive panel with fasting insulin levels (not routinely checked with your typical labwork), hemoglobin A1c, and fasting blood glucose. I also check for signs of stress related conditions, cardiovascular complications, nutritional deficiencies, toxic exposures, other glandular issues (those involving the thyroid and adrenals in particular), and much more. A very in-depth study of the results combined with a thorough health history (obtained at visits and in questionnaire form), usually leads me to the starting line. The underlying issues are addressed in layers over time using herbal therapies, nutritional supplements, and lifestyle interventions. Prescription drugs are reserved for full blown type 2 diabetes to mitigate long term damage as we work on the underlying issues. Five key considerations are:
1. Weight loss: This is harder than it sounds when there are high levels of circulating insulin contributing to abdominal fat deposition. Thyroid hormone resistance and high cortisol from long term stress often coexists with insulin resistance and can make weight loss even more difficult. Functional medicine takes these issues into consideration! I work with my patients to address the underlying causes of weight gain and difficult loss. When an individual loses weight, their insulin sensitivity always improves, making this an important piece of the puzzle.
2. Exercise: Physical activity rewires the endocrine system! Hormonal changes are made as the body adapts to increasing levels of movement. I work with my clients to capitalize on what they enjoy doing and safely increase their participation in an active lifestyle.
3. Diet: You can eat in a way that decreases the call for and surge of insulin. This is essential for blood sugar regulation, weight loss, pancreatic health, control of cravings, and insulin sensitivity. I advise my patients to be mindful of the glycemic index of foods and am a strong believer in targeted food combining to mitigate insulin and blood sugar instability. The basics are: Always eat a protein, healthy fat, and carbohydrate when you have a meal or snack; Never eat a carbohydrate alone; Choose whole, organic, complex carbohydrates; Strive to keep your blood sugar stable without excessive highs and lows.
4. Stress management: I cannot always reduce your actual life stress levels, but I can help you to perceive and respond to stress differently. This can be done through lifestyle practices and herbal therapies which really shine in this department. Your adrenal glands may need support in order to heal from the damage of constant stress: If they have been pumping out lots of cortisol (stress hormone) due to long term stress, they may be hurting! The next layer is to mitigate the negative effects of chronically high cortisol levels which coincidentally lead to insulin resistance, elevated blood glucose levels, and thyroid issues. Finally, I will work on your overall stress handling. In other words, I would like to instill a feeling of calm in the face of stress, thereby demanding less cortisol production from the adrenal glands. Adaptogenic herbs such as Ashwagandha, Rhodiola, and Eleuthro are incredible at this, each with their individualized effects and recommendations.
5. Detoxification: Certain chemicals are endocrine disruptors. This is well-known and studied extensively. I work with my patients to not only rid their daily life of possible toxic exposures, but also to improve their innate detoxification pathways. This will promote overall hormonal health as well as weight loss and overall well-being.
Final Take Away
The final take away here is that elevated blood sugar is a serious and widespread issue that should not be taken lightly. If caught and treated early, complete recovery of wellness can be expected. An individualized approach that targets the root cause is ESSENTIAL! If you are interested in learning more, please reach out today!