~ Strategies for Controlling Blood Sugar, Part 2 - An Integrated Approach

Controlling Blood Sugar: An Integrated Approach

Eric Braverman, MD, is an integrative medicine specialist and director of the Place for Achieving Total Health (PATH Medical) in New York City. Dr. Braverman reports tremendous success in working with patients with high blood sugar. By integrating supplements, diet, medication, and lifestyle changes, his patients have achieved better health and relief from the ravages of diabetes and high blood sugar.

Dietary modification is a crucial part of Dr. Braverman's approach. "Sugar, white flour, and soft drinks today are what tobacco was 50 years ago," he says. "We're seeing the result of long-term consumption of junk food, despite warnings about its consequences. This simple rule of thumb for general health is especially important for diabetics: eliminate processed foods such as white sugar, white rice, and white flour from your diet."

Dr. Braverman is also a strong advocate of diabetes screening. "Considering the looming diabetes epidemic, everyone should insist on a glucose test," he adds. "Those with risk factors should monitor their blood sugar every three months, and those who enjoy good health should request a hemoglobin A1C (HbA1c) test at their annual physical. It's as important as a Pap smear, cardiogram, PSA, or breast exam."

Using his integrative approach, Dr. Braverman has seen significant improvement in the laboratory parameters of his patients. "Diabetics often have HbA1c levels over 12%," he explains. "Standard therapies typically lower that by one or two points. The Life Extension protocol can cut it in half. I have used Life Extension techniques to lower HbA1c levels of 14% down to 8%, and a level of 13% was returned to normal (below 6%). Diabetics who have triglyceride levels of 1500 mg/dL are frequently reversed to normal, cholesterol levels of 373 mg/dL are reversed to normal, and even signs of kidney failure with a blood creatinine level of 2.1-2.2 mg/dL have been reversed. Diabetics are at a high risk of developing Alzheimer's and early memory loss 30 years before developing dementia. We've been able to reverse this memory problem as well."

Dr. Braverman's advice is simple and direct: "Maintain a healthy weight, eat properly, balance your hormones, and take the right supplements."

Hormone Balance and Diabetes

Hormone balancing is a critical yet often overlooked element in a program of diabetes management, according to Dr. Braverman. He believes that declining hormone levels result in diminished blood sugar control, since hormone deficiencies can decrease the effectiveness of insulin. One theory of aging suggests that we are only as young as our oldest part. If we do not address the diminished hormone levels that accompany normal aging, then therapies will be only marginally effective. High blood sugar may represent only the tip of the iceberg, or the visible manifestation of a greater problem, which is an underlying hormone imbalance.

In order to balance hormone levels, it is first necessary to assess the levels of several hormones in the body. Blood testing provides an accurate way to assess hormone status. Typically, hormone testing for men will assess levels of DHEA, testosterone, and estrogen. Hormone testing for women assesses DHEA, estrogen, progesterone, and testosterone.

Testosterone supplementation for men reduces insulin resistance, raises beneficial HDL, lowers blood pressure and triglycerides, and helps to reduce excess weight while building muscle.50,51 "I've had patients reduce their insulin from 100 units to 50 by balancing their testosterone," says Dr. Braverman.

Women tend to gain weight easily from age 35 on due to decreasing levels of estrogen, progesterone, and testosterone. Data suggest that correcting these hormone imbalances in women improves glucose control and may alleviate the tendency to gain weight.52 Additionally, many women anecdotally report improved mood, energy, and libido following hormone balancing.

A proper level of DHEA (dehydroepiandrosterone) should be maintained in both men and women to support insulin's action on glucose.53 Women typically need up to 100 mg of DHEA daily, while men typically require up to 200 mg.

Dr. Braverman recommends bioidentical hormones rather than synthetic hormones such as Premarin®. He notes that men and women must be screened thoroughly for cancer before taking any sex hormones. Nutritional and herbal supplements, such as Life Extension's Super MiraForte and Natural Estrogen, help balance hormone levels in men and women, respectively.

Beneficial Effects of Fiber

In addition to recommending abundant dietary fiber to his patients, Dr. Braverman advocates the use of fiber supplements. Supplemental sources of fiber include psyllium husk, guar gum, and a dietary fiber blend called PGX™. Psyllium husk can be used in capsule or powder form, and has been reported to decrease glucose absorption and reduce total cholesterol and LDL in type II diabetics.54 Guar gum is another beneficial fiber for controlling blood sugar because it slows gastric emptying and thus the absorption of glucose.55 PGX™ is a fiber supplement that binds to many times its weight in water, helping to slow carbohydrate absorption and promote a feeling of fullness. Clinical trials support its application in improving glycemic control in diabetes and in enhancing lipid profiles.56,57 (See Novel Fiber Limits Sugar Absorption, Life Extension, September 2004.)

The Importance of Supplements

Nutritional supplements are powerful tools in supporting healthy metabolism and normalizing blood sugar. High blood sugar is marked by many complications, including increased risk for heart disease, kidney and nerve damage, visual deterioration, and vascular problems.

Chromium is a trace mineral with numerous beneficial actions for supporting healthy blood sugar. Chromium appears to promote insulin sensitivity and improve glycemic control in many individuals.58 Additionally, chromium has been found to lower blood glucose levels, both at fasting and at two hours following a glucose challenge.59 Chromium also has been demonstrated to lower triglyceride levels and boost levels of HDL in patients with type II diabetes.59 Chromium thus helps to optimize both blood sugar levels and blood lipid profiles.

Essential fatty acids such as EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) are crucial nutrients for people with high blood sugar. In mammal studies, EPA supplementation helps to prevent insulin resistance and improve glucose tolerance test parameters.60 Human studies have demonstrated that EPA and DHA together help lower serum triglycerides and raise HDL in non-insulin-dependent diabetic patients.61 Additionally, EPA and DHA supplements decreased rates of lipid peroxidation and raised levels of glutathione peroxidase, an antioxidant enzyme.61 Omega-3 fatty acids therefore may help to improve the dyslipidemia that often occurs with hyperglycemia and may decrease the rate of vascular complications.

Lipoic acid, a potent antioxidant and coenzyme, is one of the most critical nutrients for people with high blood sugar. Clinical and animal studies have shown that lipoic acid stimulates insulin-mediated glucose uptake.62 In rats fed a high-sugar diet, lipoic acid improved insulin sensitivity and glucose tolerance.62 In a study of type II diabetics, three months of supplementation with lipoic acid helped to improve painful neuropathy symptoms in 77% and eliminated symptoms in 19% of participants.63 Lipoic acid also improved nerve-conduction velocity, which is often compromised in diabetic patients suffering from neuropathy.63 Lipoic acid therefore acts by several mechanisms to improve insulin sensitivity as well as help support healthy nerve function.

Bilberry, a close relative of the blueberry, has been eaten and used medicinally for centuries because of its high nutritive value. Bilberry leaf decoctions administered orally have been shown to lower blood glucose levels.64 Bilberry exhibits an affinity for the tissues of the eye, improving the delivery of oxygen and blood to the eye tissues and scavenging free radicals that can contribute to conditions such as cataracts and macular degeneration.64 Anthocyanosides present in bilberry have been found to retard the development of cataracts in animals and humans.64 European studies have shown that bilberry anthocyanosides are highly effective in preventing diabetic retinopathy.64 Additionally, bilberry extracts improve microcirculation, enhance collagen integrity, and exert anti-inflammatory properties.64 Bilberry is thus a powerful tool in protecting the eyes against the secondary effects of high blood sugar.

A multi-vitamin/mineral helps form the foundation of a healthy lifestyle for all adults, and is especially important for those with hyperglycemia. Diabetic patients are susceptible to infections and delayed wound healing. An important study showed that diabetics who supplemented with a multi-vitamin/mineral formula for one year experienced a decreased rate of illness, infection, and missed time from work compared to study subjects who took a placebo.65 Thus, a multi-vitamin/mineral supplement may help patients with high blood sugar to optimize health and prevent illness.

References . . .

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