Diabetes

Diabetes mellitus – Non Insulin dependent diabetes mellitus (NIDDM) with peripheral vascular disease. By the time a patient becomes insulin dependent, it represents an autoimmune disease and is often too late to prevent the destruction of B cells. (Bone, 2005:160). Type 2 diabetes is a progressive disease, which affects the eyes, nerves, kidneys and blood vessels. (Bone, 2005:6). Iron overload and vitamin E deficiency may be an issue in developing diabetes type 2. People with iron (ferritin) overload had an increased risk of diabetes by a factor of 2.5 and being a blood donor may improve risk of complication. (Bone, 2005:9,10)

Liver function, kidney function, cholesterol, LDL, HDL, full blood count including white blood cell count, ESR, platelet count, iron profile, homocystine and insulin resistance.

The aim would be to reduce or normalise the blood glucose levels, improve the circulation, improve the long-term affects of diabetes, which include vascular disease and iron overload. Improve the fitness and nutritional status of the person. It would be advised to improve and support the functioning of the pancreas in case damage to the insulin-secreting B cells is already underway.

Dose - 5 mL 3 times daily (not to be taken too late in the day as Korean Ginseng is a tonic and adaptogenic herb) best before 5pm

Additional herbals prescribed would be Gymnema as a tablet so the dose could be well regulated, as a tablet it could be introduced slowly and dosed with meals.

St Mary’s Thistle would be prescribed as a tablet to be taken with meals to assist the liver detox pathways and assist in preventing excessive iron uptake.

St Mary’s Thistle was investigated as an alternative to taking Desferrioxamine, which caused severe side effects. These scientists found that silybin binds to the ferric ion (Fe(lll)) (Bone, 200511)

Gymnema is indicated for its action as an antidiabetic and hypoglycaemic agent. Traditionally Gymnema has been used for diabetes (Bone, 2005:133). Clinical studies show a hypoglycaemic effect. Gymnema may take up to 18 months to have a complete effect. (Bone, 2005:133,134). The leaves are thought to increase insulin secretion. A long-term study showed Gymnema extract reduced insulin requirements, fasting blood glucose and possibly pancreatic regeneration. (Bone, 1997:116). A second study on the same group showed similar results and that hypoglycaemic drug doses were reduced. (Bone, 1997:116)

The actions of Goats rue as a hypoglycaemic and antidiabetic is indicated for this patient. Research shows that goat’s rue had a regenerative effect on the insulin-producing cells (B cells) of the pancreas in vivo. (Bone, 2005:157)

Ginkgo is indicated for the Peripheral vascular disease. According to Mills & Bone Ginkgo is a potent Platelet-activating factor (PAF) and useful for restricted peripheral blood flow. (Mills & Bone, 2000:405).

Studies show an increase of 45% in walking distance after taking a dose of 120 mg per day for 24 weeks. (Mills & Bone, 2000:413)

In a double-blind study on 30 patients with diabetes, patients were studied for 8 weeks on 100 mg or 200 mg or placebo. The higher dose gave better results however, both doses showed a small but significant fall in fasting blood glucose. (Mills & Bone, 2000:429) Korean Ginseng would also be appropriate for it adaptogenic and tonic effects, and to improve his general well-being (Bone, 2005:126)

Fenugreek would be useful for its hypoglycaemic properties. (Bone, 2005:138) Mrs Grieve states that it can be used in combination with insulin for diabetes. (Grieve, 1994:299) Clinical studies have show fenugreek alleviated the imbalances associated with lipid metabolism associated with diabetes and that a week and transient hypoglycaemic effect was observed in 50% of patients. (Bone, 2005:140)

Recent studies show fenugreek improves peripheral glucose utilisation and may work via the insulin receptor. (Bone, 2005:8).

Diet is considered an important aspect of treatment for diabetes. In order to reduce weight a deficit of 500 to 1000 kcal metabolises fat. Saturated fats particularly should be restricted. (Bone, 2005:160-161)

A review of literature searches was done to determine the role of ordinary culinary herbs on diabetes type 2. The herbs looked at where Cinnamon, Ginger, Garlic, Basil, oregano, sage, nutmeg, cloves, tea, cumin seed and turmeric. This paper states that diabetes type 2 affects hundreds of millions of people globally and that 90% of these are non-insulin dependent. (Kelble, 2005:81). Type 2 diabetes is characterised by hyperglycaemia, or an excessive mean blood glucose level, altered metabolism of lipids, carbohydrates, proteins and increased vascular disease.The paper suggests that an increased intake of processed carbohydrates and saturated fats may be a cause of diabetes type 2. In addition, a reduced antioxidant activity may be a primary issue in diabetes type 2 leading to vascular disease. Plant based foods can improve glucose metabolism and improve the general health of the diabetic. The effects of improved lipid metabolism, increased antioxidant status, improved capillary function, lowered blood pressure and cholesterol where observed. “In addition to the increasingly well studied benefits of fruits and vegetable intake, many common household spices can make an important contribution to avoiding and perhaps, reversing insulin resistance.” (Kelble, 2005:81)

Cinnamon has a chemical, methyl hydroxy chalcone polymer (MHCP) which significantly improves the status of the diabetic due to increased glucose metabolism. “To a cell, MHCP behaves in a similar way to insulin, “most likely triggering the same cascade as the insulin signalling pathway,” MHCP both activates an enzyme that helps insulin get into cells, and prevents other enzymes that block this process.” In a two month study on human’s cinnamon was given as a capsule and not only did it reduce blood glucose but also reduced total cholesterol, LDL and triglycerides. It was noted that cinnamon had a sustained affect in the body and was not necessary to ingest it daily. The improvement in cholesterol significantly reduced the risk of heart disease common in diabetics. (Kelble, 2005:82-83)

Ginger – in a study on ginger it was found that when fat cells where doused with ginger extract, cells significantly take in more insulin and that by adding ginger to sugary foods the glycemic index goes down stabilising blood sugar levels. Ginger was also found to lower total cholesterol and triglycerides, reducing atherosclerosis and vascular disease. Ginger is also useful for its effects on platelets reducing platelet aggregation reducing the risk of stroke. (Kelble, 2005:83)

Garlic was found to improve the way the body handles glucose. It is a hypoglycaemic and can reduce blood glucose levels, garlic is to be uncooked as cooking inhibits allicin formation. (Kelble, 2005:83)

Basil, oregano and sage all increase cellular glucose metabolism giving better control of blood sugar levels. (Kelble, 2005:83). Nutmeg and cloves increased insulin activity and overall cellular glucose metabolism. Both have a positive effect on cholesterol and heart conditions. (Kelble, 2005:83). Drinking black, green or oolong tea without milk or cream enhanced insulin activity. (Kelble, 2005:85). Also the paper noted that cumin seed and turmeric common in curry powder, both played a significant role in lowering blood glucose and that cumin seed took a longer time to lower glucose than other spices. (Kelble, 2005:86)

This paper concluded that many other unexpected natural products with insulin improving properties included allspice, bay leaf, rosemary, ginseng, fenugreek, black berry, banana, mango, peanut butter, witch hazel (the dried bark), some mushrooms (shiitake), onion, soybean, and vanilla bean all had an effect. A normal dose (those used in cooking) was sufficient and larger doses negated or inhibited these effects. In general, it would be recommended for the patient to use a good variety of these spices daily to ensure stability for his blood glucose levels. Drinking green tea with a meal may prevent the uptake of iron (Bone, 2005:12)

If the patient is not good at cooking it could be recommended that he do cooking classes. Do regular exercise. (Bone, 2005:161)

these are

• Type 1 - insulin dependent
• Type 2 - insulin independent

• Irritability
• Fatigue
• Slow healing cuts and bruises
• A change in vision
• Occasional fainting
• There may be weight loss despite
• intense hunger and overeating

They may display the same symptoms as type 1, but quite often type 2 diabetics show no symptoms at all. Many of these people are unaware that they have the disease of only learn that their blood sugar is high after a routine exam for another medical problem. A diagnosis of diabetes is made after testing the blood and urine for high sugar content. The blood may also be tested for insulin levels, and urine tested for ketones. Ketones are the end products of breaking down of fat for energy. Because the diabetic’s body cannot use sugar, it burns fat for fuel and the end products of this energy production are eliminated in the urine. Proper diet: is crucial in the treatment of diabetes. Persons with type 2 diabetes can frequently control their diabetes with diet alone. Overweight individuals will probably be required to lose weight. After weight loss is achieved, balanced meals that maintain the proper weight will be stressed. It is recommended that the diet be low in fats (to reduce the chance of developing arteriosclerosis) and limited in simple sugars.

Fibrous roughage is also recommended because it is not only filling and low-calorie, but also reduces or slows the absorption of sugar in the digestive tract.

• Clams
• Crabs
• All starches
• All sugars except natural sugars eg ripe fruit
• Peanuts

A book, which should be read by all those with illness.

As the protein requirement is higher than normal, thus the load on the kidneys is also higher which may be a problem. Increase the raw green salad (at least 1 per day eg raw spinach, celery including leaf, beetroot tops, lettuce, raw green beans, and silver beet. Avocado is excellent for diabetes. Ripe olive is highly recommended. Sun ripened fruit - mid morning and lunch as these are foods, which stimulate (activate) the system use: pineapple, strawberries, oranges, apricot, currants, peaches, apples, coconut, raspberries, cherries, lemon, lime, and grapefruit. Fruit should never be sweetened with sugar. Never eat fruit & vegetables at the same meal. Vegetables cooked should be steamed or baked in olive oil (virgin) never overcooked as this washes away nutrients. Young tender beet tops & beets are highly recommended; full-grown beetroot contains too much sugar. Main eating factors to consider

• High carbohydrate & fibre combination is found in the grains
• Barley, high nutrient
• Wheat bran, high protein amino acids arginine & histidine
• Rice bran, high iron, niacin, and vitamin b1
• Millet, high nutrient
• Brown rice, high nutrient
• Wild rice & tapioca, are high carbohydrates only containing pantothenic acid & manganese
• High amino acids for growth (arginine & histidine)
  • Wheat germ
  • Cottage cheese
  • Avocado
  • Almonds
  • Pumpkin seeds
  • Sesame seeds
  • Sunflower seeds
  • Walnuts
  • Cashews
  • Pecans
  • Hazelnuts
  • Pine nuts
  • Pistachios
  • Fish
  • Include bran, oatmeal (freshly ground), slippery elm water are all-beneficial.
  • Soybean sprouts, boil until tender, place in baking dish add vegetable extract, onion, garlic, tomatoes, herb salt to taste.
  • Complex carbohydrates and dietary fibre especially the soluble form eg oats and legumes improve glycemic control also lowers serum cholesterol & triglycerides and promotes weight loss reducing the risk of heart disease. High carbohydrate diets are low in fat reducing the risk of cardiovascular disease.
  • Recommended carbohydrates 60% of diet 50g or more dietary fibre daily
  • Fibre has been shown to lower blood glucose levels due to increased digestion and absorption time also believed to improve receptor sensitivity to insulin making utilization of available insulin more efficient i.e. A fresh orange is more beneficial than an orange juice, whole wheat bread better than white bread. Diabetic vegetarians are better off.
  • Natural treatment (diabetes)

• Jambul-seeds - reduces sugar in the urine "acts quickly"
• Blackberry leaves - enhances the oxygen levels, improves circulation - always poor in diabetics
• Goats rue - anti-diabetic action, lowers
• Dried flowering - blood sugar levels best in plant & seed combination
• Prickly pear - contains large amounts of nopal pads natural organic insulin which strengthens pancreas and helps overcome diabetes
• Dandelion root - balances natural sugars remove excess water.
• Gentian root - strengthens spleen and pancreas and contains naturals sugars.

Diet
small frequent meals Natural sugars only e.g fruit Plenty of small drinks throughout day Watch salt intake Reduce the intake of meats especially and never combine with starches E.g meat & potatoes

are oysters, clams, crabs, chicken, all starches, all sugars except natural fruit sugars, fruit sugars need to be kept low

• Breathing - deep breathing exercises to help circulation and nutrition
• Massage - gentle massage facilitates peripheral circulation
• Herbs - herbal formula will need to be adjusted according to the amount of insulin the patient is taking.

Bone K.2005, Foundations of Herbal Medicine, HS 429 Study Guide, Armidale, N.S.W

Mills S & Bone K, 2000, Principles and Practice of Phytotherapy, London.

Grieve M, 1931 revised 1994, A Modern Herbal, Kent

Kelble A, 2005, Spices and type 2 diabetes, Nutrition & Food Science, volume 35, p 81-87, online.

Bone K, 1996, Clinical Applications of Ayurvedic and Chines Herbs, Qld Australia

Bone K, 2005, HS429 Residential school handout, Armidale NSW