“We’ve seen strong and sustained increases in the incidence of diabetes since 1990, and they show no sign of slowing down,” says Linda S. Geiss, MA, chief of diabetes surveillance at the Centers for Disease Control. “It’s like a runaway train.”
Approximately 90 to 95 percent of the 24 million people with diabetes have Type 2, also known as diabetes mellitus. Another 57 million—40 percent of Americans aged 40 to 70—are prediabetic, which means they have higher than normal blood sugar levels (though lower than diabetic levels).
Those figures aren’t promising for long-term health, since diabetes is a disease that has the ability to eat you alive, according to John B. Buse, MD, PhD, professor at the UNC School of Medicine.
The leading cause of amputation, blindness, heart attack, kidney failure, and stroke, this deadly disease also impacts gastrointestinal health, hearing, mental outlook, sexual function, and sleep.
The good news is that, unlike Type 1 that’s triggered by autoimmune disorders, genes, or viruses, Type 2 diabetes “is an almost totally avoidable disease,” says Walter Willett, MD, MPH, at Harvard School of Public Health. “We estimate that more than 92 percent of the cases could be avoided by diet and lifestyle.”
Watch Your Waist
“Weight is the strongest risk factor by far for diabetes,” adds Dr. Willett. But until recently researchers didn’t understand why.
“We didn’t know how local deposits of fat cells could cause insulin resistance at distant sites like the liver, muscle, and elsewhere in the body,” explains JoAnn E. Manson, MD, at Harvard Medical School.
Now research suggests that these cells, particularly deeper visceral fat cells around the belly, busily signal other cells throughout the body. Furthermore, “some of them produce a state of inflammation, and that interferes with the insulin receptors on cells,” she adds.
You don’t need to lose all your extra fat cells to defend against Type 2. Investigators with the Diabetes Prevention Program randomly assigned more than 3,000 people with blood sugar levels at or just below prediabetic levels to a placebo, blood-sugar-lowering drug (metformin), or lifestyle changes (losing weight by increasing exercise to two-and-a-half hours weekly while consuming a healthy diet).
After three years, “the lifestyle intervention cut the risk of diabetes in these high-risk individuals by more than half,” reports researcher Rena Wing, PhD, at Brown University Medical School.
And study participants didn’t even lose that much, “only a 7 percent weight loss initially and a 4.5 percent weight loss after three years.”
Although the drug was only half as effective as weight loss, “I often hear that the results get translated by physicians as ‘let’s put all these people on metformin.’ I find that upsetting,” Dr. Wing adds.
Begin each day with a low-glycemic (high-fiber/low-calorie) breakfast. Then choose one low-glycemic carbohydrate (beans and lentils, most fruits and veggies, plus bulgur, oats, or quinoa) at each meal.
“The evidence is moderately strong that refined carbohydrates and a high-glycemic load increase the risk of diabetes,” says Dr. Manson, while whole grains and fiber in a low-glycemic diet have been associated with lower risk.
In a meta-analysis of eight studies, people who consumed the most fiber from grains had approximately 30 percent lower risk of diabetes.
“It’s not just fiber,” adds Dr. Willett. Important nutrients, including chromium and magnesium, are stripped away when grains are refined.
Eating whole fruits and leafy green vegetables lowers Type 2 diabetes risk in healthy nurses, long-term research shows.
A recent Canadian study suggests that antioxidants (available in brightly colored fruits and veggies) help lower C-reactive protein—an inflammatory marker that’s a strong predictor of cardiovascular events—in people with Type 2 diabetes. Moderately obese adults had better glycemic control on a Mediterranean diet, rich in seafood, than did those on a low-fat diet. This diet’s wealth of antioxidants, high-fiber content, and omega-3 fats may account for its beneficial effects among people with metabolic syndrome.
A recent double-blind, placebo-controlled trial finds that 2 grams a day of omega-3 fatty acids significantly lowers triglyceride levels in people with Type 2 diabetes without adversely impacting glucose control.
It’s important to limit cholesterol and saturated fats, sodium, and simple sugars. In addition to saturated fat, red meat contains heme iron, which has been linked to diabetes in women. Even riskier is sodium nitrite that’s added to processed meats (e.g., bacon, hot dogs, and lunch meats). Beans, poultry, seafood, and soy are much safer sources of protein.
Older Type 2 diabetics who supplemented their diets with amino acid snacks significantly lowered their blood sugar and insulin levels, one small study finds.
Also avoid trans fats, which increase inflammation, adds Dr. Willett. And use lower-fat cooking techniques: baking, broiling, grilling, poaching, or roasting without added fat.
Women who report eating nuts or peanut butter at least five times a week have a 20 to 30 percent lower risk of diabetes than those who almost never consume these foods. Fiber, magnesium, and other nutrients in nuts probably play a role here, too.
In another study, women who ate potatoes about four times a week had a higher risk of diabetes than those who ate them only a couple of times a month.
Sweets, particularly in liquid form, have a high glycemic load and increase the body’s need for insulin. Even “fruit juice and fruit punch, but not fruit, are associated with an increased risk [for diabetes],” adds Dr. Manson. Drink water instead of sugary drinks or fruit juice. But test your tap water periodically, as high chronic exposure to inorganic arsenic in water supplies can lead to Type 2 diabetes. Filter it if necessary.
Consider Supportive Supplements
Research suggests that people with higher levels of vitamin D are less likely to develop diabetes. “Vitamin D is stored in adipose tissue, so if you have more fat, more vitamin D is stored and less is available to circulate,” explains Anastassios G. Pittas, MD, at Tufts Medical Center. “And vitamin D ameliorates systemic inflammation, which is a cause of insulin resistance.”
Since a growing number of Americans (particularly those who live north of Hartford, CT, and Boulder, CO) are low in this vitamin, consider supplementation if you’re at risk for Type 2 diabetes.
Fiber supplements can also help control Type 2 diabetes. In one recent study, a highly viscous, fermentable fiber from barley and oats increased satiety, helping subjects to lose weight. In another, a blend of umbrella arum (Amorphophallus konjac) and xanthum gum proved as effective as oat bran (Avena sativa) and pysllium (Plantago ovata)—in even smaller amounts.
For other supplements that help fight this form of diabetes, see Natural Solutions chart below:
Natural Solutions Supplements Benefits Notes Alpha lipoic acid Improves glucose uptake; approved for treating diabetic nerve disorders in Germany. Helps regenerate the body’s own antioxidants (vitamins C and E). B complex B6, B12, and folic acid help lower homocysteine, linked to diabetes. B6 and biotin help lessen neuropathy (nerve damage). Bitter melon (Momordica charantia) Can significantly lower blood sugar. Take as tea or in a capsule after meals. Chromium picolinate Helps insulin transport glucose to the cells. Niacin-bound chromium may be most effective. Cinnamon (Cinnamomum verum) Helps lower blood sugar. As little as 1 tsp a day lowers blood glucose. CoQ10 Helps lessen insulin resistance. Also effective against hardening of the arteries, a complication of diabetes. Fenugreek (Trigonella foenum-graecum) Seed powder reduces blood sugar, improves glucose tolerance, and lowers LDL, total cholesterol, and triglycerides. May help reduce medication dosage, but always discuss with your healthcare provider first. Ginseng (Panax ginseng) Helps lower blood sugar and weight. 100 mg standardized extract with 4 percent ginsenosides, twice daily. Magnesium Improves glycemic control in Type 2 diabetes. Low levels may be strong predictor of Type 2 in some individuals. Maitake (Grifola frondosa) SX-fraction decreased glucose levels up to 16 hours in animal studies. Case studies are also promising. Mulberry (Morus alba L.) Lowers postmeal blood sugar spikes, improves insulin sensitivity, and helps with healthy weight management. Used in Asia to treat Type 2 diabetes. Taurine Amino acid that helps stabilize blood sugar in both types of diabetes. Low levels increase susceptibility to heart damage and retinopathy. Tulasi (Ocimum sanctum L.) Contains eugenol, believed to protect beta cells in the pancreas from free-radical damage. Increases insulin secretion and lowers blood sugar, total and LDL cholesterol, and triglycerides. Turmeric (Curcuma longa) Contains curcumin that reduces inflammation and lowers the risk for Type 2 diabetes in animal studies. Also helps lower high cholesterol and triglycerides. Vanadium Trace mineral that improves insulin sensitivity in small studies. Useful for diabetics who have low insulin levels. Vitamin C Significantly improves blood-sugar balance. Also helps protect against the oxidative damage of LDL cholesterol. Vitamin D Needed by the islet cells in the pancreas for normal insulin secretion. Vitamin D status inversely related to insulin sensitivity. Vitamin E Improves insulin activity in Type 2 diabetes and reduces oxidative stress. When levels of E are low, the risk for Type 2 diabetes increased by nearly 4 to 1.