Diabetes

//Western Diagnosis// hyperglycemia resulting from impaired insulin secretion and/or effectiveness

Classification and etiology
b. hyperglycemia c. propensity to DKA d. predominant DM before age 30 e. insulin given f. genetic g. autoimmune - antibodies to pancreatic islet cells h. viral, gluten/dairy sensitivities possible a. hyperglycemia b. over 30 yrs of age c. commonly associated with obesity d. genetic correlation stronger than in IDDM e. impaired insulin secretory response f. insulin resistance
 * IDDM (type I DM)** - 10-15% of DM
 * NIDDM (type II DM)**
 * LADA - Type 1A** - latent autoimmune diabetes adult

Signs & Symptoms
1. often asx initially a. sx from hyperglycemia, glucosuria 2. polyuria, polydipsia, polyphagia 3. weight loss 4. fatigue 5. vaginal itching due to candidiasis 6. poor wound healing 7. late complications a. vascular i. AS CAD aa. angina, MI ii. peripheral AS vascular disease - intermittent claudication iii. diabetic retinopathy - retinal detachment, hemorrhage iv. diabetic nephropathy - albuminuria v. diabetic neuropathy aa. distal, symmetric, sensory polyneuropathy (stocking-glove) bb. nerve infarctions (mononeuropathy) cc. foot ulcers vi. infections, esp on feet 8. DKA (diabetic ketoacidosis) a. usually from lapse in insulin tx or an acute infection - in IDDM b. abnormal ketogenesis c. polyuria, N, V, lethargy, somnolence, coma d. hyperglycemia, hyperketonemia, metabolic acidosis e. glucosuria, ketonuria f. emergency hospitalization 9. NKHHC (nonketotic hyperglycemic hyperosmolar coma) a. complication of NIDDM i. >50% mortality rate b. often from a period of sx hyperglycemia with inadequate fluid intake hence extreme dehydration c. often from acute infection, elderly pt living alone, undx or neglected NIDDM d. extreme dehydration e. impaired consciousness, seizures f. hyperglycemia without hyperketonemia g. emergency hospitalization

Diagnosis
1. serum glucose of >140 mg/dl after an overnight fast on 2 occasions 2. OGTT, OGITT a. 2 different one hour periods greater than 200 mg/dl 3. glycosylated hemoglobin (Hb A1c) a. to monitor long-term glucose control 4. urinary glucose and ketones for monitoring 5. pt. should perform self-glucose monitoring

Treatment
1. insulin, esp for IDDM a. maybe for NIDDM 2. weight loss for NIDDM 3. oral hypoglycemic agents for NIDDM a. sulfonylureas i. Diabinase 4. diet a. inc complex CHO to 70% of calories b. dec all simple sugars c. inc beans d. food allergies i. possible link between cow’s milk and pancreatic beta-cell destruction e. avoid coffee 5. supplementation a. chromium 200 mcg/d b. zinc 30 mg/d - may incraese insulin levels lessening the amount type 1 may need c. vit. E 400 IU/d i. may reduce insulin requirements d. garlic e. bioflavonoids i. quercetin, naringin 6. herbs a. vaccinium myrtillus i. blueberry (leaf tea as well as fruit), bilberry ii. retinopathy, other eye sx b. cinnamon 1/4-1/2 tsp./day may lower glucose levels alpha lioic acid: 600ml. BID esp. w/ neuropathy

LADA - Latin autoimmune disease of the adult between Type 1 & Type 2 -over 30 and not the same antibodies as type 1 but still has some level of insulin resistance Tests: GAD-65: tests to see if it's elevated also ICA - Islet cell antibodies - if positive it indicates type1 and not LADA

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===================================================== //Medical Nutrition:// Blood sugar – greater than 100ug/ml? 120ug/ml? 140ug/ml?

• Excess carbs  low blood sugar (BS), stimulating cortisol release, then eventually high BS (IRS closure) • Panic attacks, insomnia • Migraines, generalized pain (fibromyalgia) • Hostility • Decreased brain function • Depression and fatigue • Sleep disorder • Decreases TH1 immunity • Releases insulin insulin receptor site become resistant increased insulin and sugar make fat • Increased LDLs and triglycerides lowers HDLs and increases inflammatory cytokines IL6 clots • ALT increases with fats stuck in the liver

• With High BS -Tissue gets glycosylated and it becomes dysfunctional – Arthritis – Neuropathy – Brain neuron degeneration – Slow healing – Poor circulation infections – Kidney dysfunction – Vision loss – Weight gain, obesity – Heart disease

NASH
• Non- Alcoholic Steatic Hepatitis – Metabolic syndrome • Elevated Liver enzyme- ALT • AST increased with ETOH • Reduced with normalizing BS (Low simple sugar diet) + weight loss - slowly • Liver herbs- Milk thistle, tumeric, burdock, • Green tea, Betaine 20 gm/d, VitE, Pantethine – 600mg/d, Taurine – 2-6gm/d, Mg – 300mg/d, choline, carnitine, ... • Fiber, • Exercise • Relaxation • Acupuncture – things that reduce cholesterol but increase HDLs

Causes of Diabetes
• Infections • - gut • - systemic • - teeth • Overeating/obesity • Nutrient deficiency • -chromium • -zinc • - magnesium • Sugar • Toxins • Genes • Hormone imbalance • - Iron overload • Vit D def. • Stress

Tx syndrome x: ~ Glucometer
• Bernstein’s or Mercola or Fuhrman’s • Exercise, weight loss, stress reduction – hugs, normalize BP (Detox?) • Organic foods, Low simple carbs (Glycemic ind.) • Fresh fruits and veggies, Fiber • Nuts and seeds • Grass fed red meat – healthy animals • Eggs free range organic – not fried, fish • Olive oil organic/ grass fed dairy butter • Folate/ B12/ VitC, olive leaf, treat infections Dr. Chongs formulas: []

2005 • The cafeteria is a lifesaver. You have a huge variety of food to choose from. Look for grilled lean meat and fish, fresh fruits and veggies, whole grains, and low-fat cheese and milk. Avoid fried foods, cheesy or creamy sauces, sugary cereals, high sugar fruit juices and sodas, full-fat cheese and milk. And remember, half portions of bad-for-you foods are better than full portions. BMI / 5’8” 26.5- 175lb 22 145lb

//Medical Nutrition From Marz//

Treatment:
-increase complex carbs to 60-70% of caloric intake; decrease fat to 20% -Decrease sucrose and other simple carbohydrates -Increase consumption of foods with low glycemic indexes, esp. legumes -Treat food sensitivities -Increase omega-3 fatty acids -Chromium (GTF) - 200mcg/day -Brewer's Yeast - 1 tablespoon TID - Fiber - up to 80g./day - guar gum, oat bran -Avoid Coffee -Vitamin B6 - 100mg can block platelet functions for up to 52 hours, preventing thromboxane release -Zinc picolinate - 30mg./day -Vitamin E 400IU Garlic -Magnesium - 500mg./day Vitamin C - 2g./day increasing to 2-4g./day -Vitamin D -Fenugreek Seeds - -Bioflavonoids - quercetin 500mg./day -Gymnema sylvestre -Niacin and/or niacinamide - 250mg-1500mg - esp. at early onset -Thyroid -Vanadium (Vanadyl sulfate - 15-50mg./day - insulin-like activity & improves glucose tolerance -Biotin - may be up to 16mg./day - cofactor for glucokinase -Vaccinium myrtillus (Bilberry) - increases capillary integrity and improves venous tone, esp. effective in macular degeneration and cataracts

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=============================================================== = = = = =Treatment= -Epsom Salts Bath -Salt Rub

Dietary Recommendations
Drink fresh uncooked vegetable juice. Chicory, endives, fennel, radishes, spinach, cabbage, watercress, cucumbers. Good vegetables to eat: onions, eggplant, cabbage, cucumbers, potatoes, watercress, parsley, endives and radishes.

Recommended Minerals (Type 2)
-Magnesium -Potassium -Lithium -Vanadium -Zinc

Prescription (Maturity Onset)
2 month treatment. Check glycemia: if the result is satisfactory, maintain prescription for 15 or 20 days/month Morning: Acer Campestre D1, 50 drops Noon: Olea Europaea D1, 50 drops Supper: Morus Nigra, 50 drops Bedtime: Juglans Regia D1, 50 drops