Diabetes, do you get “h-angry” or does your stomach growl?

Maybe you’ve been overly thirsty lately, you can’t seem to drink more than you urinate, and thought it was due to the heat outside! Or, does your stomach start growling for lunch WAY before the rest of your colleagues? There may be a reason:

Over 13% of American adults live with diabetes, and 34.5% have pre-diabetes. This means close to 50% of all U.S. adults have diabetes or prediabetes.

For many of us, we write things off like thirst, hunger, slow healing scratches and sores, UTI’s or becoming “h-angry” as a one-off. But maybe we should pay more attention to our body’s subtle, and sometimes not so gentle, warning signs. I find many of my patients have no idea what Diabetes really is, and how it can complicate even the simplest medical procedure, should it become necessary.

$1 out of every $4 in US health care costs is spent on caring for people with diabetes, AND 90% of diabetes cases are preventable! That's an estimated 25 million who could say goodbye to the disease by watching what they eat, drink and getting exercise!

Today in our “Let’s Make America Healthy Again” series, I will map out some helpful steps to avoid Diabetes, what living life with Diabetes can look like, and possible ways FLHC can help you if you already have diabetes. Read on to learn how important it is to reverse America’s shocking Diabetes statistics, and what we as a community can do to help….

So what is Diabetes and why should I care?

Diabetes refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It’s also your brain's main source of fuel.

The underlying cause of diabetes varies by type. But, no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems.

Chronic diabetes conditions include type 1 and type 2 diabetes, and costs Americans Potentially reversible diabetes conditions include pre-diabetes and gestational diabetes.

What is it like to live with Diabetes?

To put it mildly, living with diabetes is no fun! From oftentimes not feeling well, to continuously needing to worry about your blood sugar levels, diabetes takes the carefree out of living.

Diabetes is a progressive disease where the body may require insulin injections to compensate for declining insulin production by the pancreas.

Each week in the US, diabetes causes thousands of complications like stroke, amputation, kidney failure, heart attack and heart failure. Diabetes can lead to serious complications which can affect many different parts of your body. In the worst cases, diabetes can kill you.

All people with type 1 diabetes need to take insulin to help control their blood sugar levels. People with type 2 diabetes may require insulin when altering their nutrition, weight loss, and exercising does not achieve normalized blood glucose (sugar) levels. Read more about what the CDC says about Diabetes HERE.

People with diabetes get hypoglycemia (low blood sugar) when their bodies don't have enough sugar to use as fuel. It can happen for several reasons, including diet, some medications, conditions, and exercise. 

Diabetic shock and insulin reactions are a health risk for anyone with diabetes. It can occur anytime there is an imbalance between the insulin in your system, the amount of food you eat, or your level of activity. Continuous glucose monitors are FDA-approved systems that track your blood sugar levels day and night.

What are the symptoms of Diabetes?

How can you tell if you have diabetes? Most early symptoms are from higher-than-normal levels of glucose in your blood.

The warning signs can be so mild that you don't notice them. That's especially true of type 2 diabetes. Some people don't find out they have it until they experience problems from long-term damage caused by the disease. This is why it’s important to make an appointment for our office to run a blood test for you each year to establish your body’s baseline blood glucose level, and monitor it over time. This way, diabetes won’t sneak up on you and become an urgent health challenge! Preventative annual health monitoring is usually covered by most insurances.

With type 1 diabetes, the symptoms usually happen quickly, in a matter of days or a few weeks. They're much more severe, too.

Early Signs of Diabetes

Both types of diabetes have some of the same telltale warning signs.

Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes, or type 2 diabetes, may sometimes not experience symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the signs and symptoms of type 1 and type 2 diabetes are:

  • Increased thirst

  • Frequent urination

  • Extreme hunger

  • Unexplained weight loss

  • Pain or numbness in your feet or legs 

  • Presence of ketones in the urine (ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin)

  • Fatigue

  • Irritability

  • Blurred vision

  • Slow-healing sores

  • Frequent infections, such as gums or skin infections and yeast infections. Both men and women can get these. Yeast feeds on glucose, so having plenty around makes it thrive. Infections can grow in any warm, moist fold of skin, including: between fingers and toes, under breasts, in or around sex organs (UTI)

  • Impotence or erectile dysfunction (ED)

Type 1 diabetes can develop at any age, though it often appears during childhood or adolescence. Type 2 diabetes, the more common type, can develop at any age, though it's more common in people older than 40.

Pre-diabetes occurs when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes, and is often the “precursor” of type 2 diabetes, unless appropriate measures are taken to prevent its progression.

Gestational diabetes occurs during pregnancy but may resolve after the baby is delivered.

Why do most Diabetics have a big belly?

When we drink beverages or eat foods sweetened with sucrose, fructose, or high fructose corn syrup, the liver stores this extra sugar as fat, increasing belly fat. The hormones produced by this extra belly fat play a role in insulin resistance, oftentimes leading to type 2 diabetes.

Risk factors for Pre-diabetes and Type 2 Diabetes

Researchers don't fully understand why some people develop prediabetes and type 2 diabetes and others don't. It's clear that certain factors increase the risk, however, including:

  • Weight. The more fatty tissue you have, the more resistant your cells become to insulin.

  • Inactivity. The less active you are, the greater your risk. Physical activity helps you control your weight, uses up glucose as energy and makes your cells more sensitive to insulin.

  • Family history. Your risk increases if a parent or sibling has type 2 diabetes.

  • Race or ethnicity. Although it's unclear why, certain people — including Black, Hispanic, American Indian and Asian American people — are at higher risk.

  • Age. Your risk increases as you get older. This may be because you tend to exercise less, lose muscle mass and gain weight as you age. But type 2 diabetes is also increasing among children, adolescents and younger adults.

  • Gestational diabetes. If you developed gestational diabetes when you were pregnant, your risk of developing prediabetes and type 2 diabetes increases. If you gave birth to a baby weighing more than 9 pounds, you're also at risk of type 2 diabetes.

  • Polycystic ovary syndrome. For women, having polycystic ovary syndrome — a common condition characterized by irregular menstrual periods, excess hair growth and obesity — increases the risk of diabetes.

  • High blood pressure. Having blood pressure over 140/90 is linked to an increased risk of type 2 diabetes.

  • Abnormal cholesterol and triglyceride levels. If you have low levels of high-density lipoprotein (HDL), or "good," cholesterol, your risk of type 2 diabetes is higher. Triglycerides are another type of fat carried in the blood. People with high levels of triglycerides have an increased risk of type 2 diabetes. When we test, we can let you know what your cholesterol and triglyceride levels are.

Complications of Diabetes

Long-term complications of diabetes develop gradually. The longer you have diabetes — and the less controlled your blood sugar — the higher the risk of complications. I don’t mean to scare you; but eventually, diabetes complications may be disabling or even life-threatening. Possible complications include:

  • Cardiovascular disease. Diabetes dramatically increases the risk of various cardiovascular problems, including coronary artery disease with chest pain (angina), heart attack, stroke and narrowing of arteries (atherosclerosis). If you have diabetes, you're more likely to have heart disease or stroke.

  • Nerve damage (neuropathy). Excess sugar can injure the walls of the tiny blood vessels (capillaries) that nourish your nerves, especially in your legs. This can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.

    Left untreated, you could lose all sense of feeling in the affected limbs. Damage to the nerves related to digestion can cause problems with nausea, vomiting, diarrhea or constipation. For men, it may lead to erectile dysfunction (ED).

  • Kidney damage (nephropathy). The kidneys contain millions of tiny blood vessel clusters (glomeruli) that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, which may require dialysis or a kidney transplant.

  • Eye damage (retinopathy). Diabetes can damage the blood vessels of the retina (diabetic retinopathy), potentially leading to blindness. Diabetes also increases the risk of other serious vision conditions, such as cataracts and glaucoma.

  • Foot damage. Nerve damage in the feet or poor blood flow to the feet increases the risk of various foot complications. Left untreated, cuts and blisters can develop serious infections, which often heal poorly. These infections may ultimately require toe, foot or leg amputation.

  • Skin conditions. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections.

  • Hearing impairment. Hearing problems are more common in people with diabetes.

  • Alzheimer's disease. Type 2 diabetes may increase the risk of dementia, such as Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. 

  • Depression. Depression symptoms are common in people with type 1 and type 2 diabetes. Depression can affect diabetes management.

Risk factors and Complications of Gestational Diabetes

Pregnant women can develop gestational diabetes. Some women are at greater risk than are others. Risk factors for gestational diabetes include:

  • Age. Women older than age 25 are at increased risk.

  • Family or personal history. You're at a greater risk if you had gestational diabetes during a previous pregnancy, if you delivered a very large baby or if you had an unexplained stillbirth.

  • Weight. Being overweight before pregnancy increases your risk.

  • Race or ethnicity. For reasons that aren't clear, women who are Black, Hispanic, American Indian or Asian American are more likely to develop gestational diabetes.

Most women who have gestational diabetes deliver healthy babies. However, untreated or uncontrolled blood sugar levels can cause problems for you and your baby, including:

  • Excess growth. Extra glucose can cross the placenta, which triggers your baby's pancreas to make extra insulin. This can cause your baby to grow too large (macrosomia). Very large babies are more likely to require a C-section birth.

  • Type 2 diabetes later in life. Babies and mothers who have gestational diabetes have a higher risk of developing obesity and type 2 diabetes later in life.

  • Preeclampsia. This condition is characterized by high blood pressure, excess protein in the urine, and swelling in the legs and feet. Preeclampsia can lead to serious or even life-threatening complications for both mother and baby.

My PRESCRIPTION to keep your Blood Sugars in check NATURALLY

1. Exercise regularly

Regular exercise can help you achieve and maintain a moderate weight and increase your insulin sensitivity. Increased insulin sensitivity means your cells are better able to use the available sugar in your bloodstream. 

Exercise also helps your muscles use blood sugar for energy and muscle contraction.  If you have problems with blood sugar management, you should routinely check your levels. This will help you learn how you respond to different activities and keep your blood sugar levels from getting either too high or too low.

Useful forms of exercise include brisk walking, running, biking, dancing, hiking, swimming, weightlifting, and more.

2. Manage your carbohydrate intake

Your body breaks carbohydrates down into sugars (mostly glucose), and then insulin helps your body use and store sugar for energy.

When you eat too many carbohydrates or have insulin-function problems, this process fails, and blood glucose levels can rise.

Many studies also show that a low carbohydrate diet helps reduce blood sugar levels and prevent blood sugar spikes. What’s more, a low carb diet can help manage blood sugar levels in the long run.

3. Increase your fiber intake

Fiber slows carbohydrate digestion and sugar absorption. For these reasons, it promotes a more gradual rise in blood sugar levels. 

Furthermore, the type of fiber you eat may play a role. There are two kinds of fiber: insoluble and soluble.

While both are important, soluble fiber has explicitly been shown to improve blood sugar management.

Additionally, high fiber foods can help better manage type 1 diabetes by improving the body’s ability to regulate blood sugar and reducing blood sugar lows. Foods that are high in fiber include: vegetables, fruits and legumes.

The recommended daily intake of fiber is about 25 grams for women and 38 grams for men. That’s about 14 grams for every 1,000 calories.

4. Drink water and stay hydrated

Drinking enough water may help you keep your blood sugar levels within healthy limits. In addition to preventing dehydration, it helps your kidneys flush out the excess sugar through urine.

Drinking water regularly helps rehydrate the blood, and lowers blood sugar levels. Keep in mind that water and other non-caloric beverages are best. Sugar-sweetened drinks raise blood glucose, drive weight gain, and increase diabetes risk.

5. Implement portion control

Portion control helps regulate calorie intake and can help maintain a moderate weight. Monitoring your serving sizes also helps reduce calorie intake and subsequent blood sugar spikes.

Here are some helpful tips for managing portion sizes:

  • Measure and weigh portions.

  • Use smaller plates.

  • Avoid all-you-can-eat restaurants.

  • Read food labels and check the serving sizes.

  • Keep a food journal.

  • Eat slowly.

6. Choose foods with a low glycemic index

The glycemic index measures how we absorb or digest foods, which affects the rate at which blood sugar levels rise. Both the amount and type of carbohydrates determine how a food affects blood sugar levels.

Eating low-glycemic-index foods has been shown to reduce blood sugar levels in those with diabetes. Although the glycemic index of foods is important, the amount of carbohydrates consumed also matters. 

Foods with a low to moderate glycemic index include:

  • non-starchy vegetables

  • meat

  • berries

  • eggs

  • nuts

  • legumes

  • oils

7. Manage stress levels

Stress can affect your blood sugar levels. Hormones such as glucagon and cortisol are secreted during stress. These hormones cause blood sugar levels to go up.

Exercise, relaxation, and meditation can significantly reduced stress and lower blood sugar levels. Exercises and relaxation methods like yoga and mindfulness-based stress reduction may also help correct insulin secretion problems in chronic diabetes.

8. Monitor your blood sugar levels

Measuring and monitoring blood glucose levels can also help you better manage your levels. “What gets measured gets managed.”

For example, keeping track of your blood sugar levels helps you determine whether you need to make adjustments in meals or exercise. It will also help you find out how your body reacts to certain foods. Try measuring your levels every day and keeping track of the numbers in a log.

9. Get enough quality sleep

Getting enough sleep feels excellent and is necessary for good health. Poor sleeping habits and a lack of rest can also affect blood sugar levels and insulin sensitivity. Poor sleep can increase appetite and promote weight gain.

Sleep deprivation decreases the release of growth hormones and increases cortisol levels. Both of these play an essential role in blood sugar management.

Adequate sleep is about both quantity and quality. It’s best to get a sufficient amount of high quality sleep every night.

10. Eat foods rich in chromium and magnesium

High blood sugar levels and diabetes have also been linked to micronutrient deficiencies. Examples include deficiencies in the minerals chromium and magnesium.

Chromium is involved in carbohydrate and fat metabolism. It also helps regulate blood sugar levels. A lack of chromium may predispose you to carbohydrate intolerance. Chromium-rich foods include: meats, fruit, vegetables and nuts.

Magnesium has also been shown to benefit blood sugar levels, while magnesium deficiency has been linked to a higher risk of developing diabetes.

Studies have linked individuals with the highest magnesium intake with up to a 47% lower risk for developing type 2 diabetes. However, if you already eat plenty of magnesium-rich foods, you probably will not benefit from supplements.

Magnesium-rich foods include: dark leafy greens, squash and pumpkin seeds, tuna, dark chocolate, bananas, avocados and beans.

11. Try apple cider vinegar

Apple cider vinegar promotes lower fasting blood sugar levels, possibly decreasing its production by the liver or increasing its use by cells. It may be mixed in a few ounces of water that you can drink before a high carbohydrate meal or be mixed in salad dressing.

NOTE: It is essential to talk with your doctor before taking apple cider vinegar if you’re already taking medications that lower blood sugar.

12. Experiment with cinnamon extract

Cinnamon has been shown to improve insulin sensitivity by decreasing insulin resistance at the cellular level. Studies show cinnamon can also lower blood sugar levels by up to 29%. It slows the breakdown of carbohydrates in the digestive tract, which moderates the rise in blood sugar after a meal.

However, there are some risks involved if you take too much cinnamon. For more info, read article HERE.

13. Try berberine

Berberine is the active component of an herb used in traditional Chinese medicine, including treating diabetes. Berberine has been shown to help lower blood sugar and enhance carbohydrate breakdown for energy.

What’s more, berberine may be as effective as some blood-sugar-lowering drugs. This makes it one of the most effective supplements for those with diabetes or pre-diabetes.

Berberine may have some side effects, such as: diarrhea, constipation, flatulence and abdominal pain. Speak with your healthcare provider first if you’re considering using berberine.

14. Eat fenugreek seeds

Fenugreek seeds are a great source of soluble fiber, which can help manage blood sugar levels. Many studies have shown that fenugreek can effectively lower blood sugar in people with diabetes. It also helps reduce fasting glucose and improve glucose tolerance.

Although not that popular, fenugreek can be added to baked goods to help treat diabetes. The recommended dose of fenugreek seeds is 2–5 grams per day, although this varies from study to study.

15. Maintain a Moderate Weight

It’s a no-brainer that maintaining a moderate weight will help improve your health and may help prevent future health problems. Weight management also promotes healthy blood sugar levels and has been shown to help reduce your risk for developing diabetes.

Even a 7% reduction in body weight can decrease your risk for developing diabetes by up to 58%, and it seems to work even better than a common diabetes medication. What’s more, these decreased risks can be sustained long term .

It’s important to monitor your waistline (not your weight), as it’s perhaps the most crucial weight-related factor for estimating your diabetes risk.

Having a healthy waist measurement may even be more important than your overall weight! A measurement of more than 35 inches for women and more than 40 inches for men is associated with an increased risk of developing insulin resistance, high blood sugar levels, and type 2 diabetes.

THE BOTTOM LINE

The good news is that 90 percent of diabetes is preventable, that's an estimated 25 million who could say goodbye to the disease by watching what they eat, drink and getting exercise!

Be sure to talk with your healthcare provider before making lifestyle changes or trying new supplements. This is particularly important if you have problems with blood sugar management or if you’re taking medications to lower blood glucose levels.

If you have diabetes, think you may have diabetes, or have blood sugar management problems, please reach out to us! It’s important to work with a healthcare provider to create and start a treatment plan as soon as possible.

I hope today’s newsletter has given you a greater insight into what happens when you get your blood sugar levels out of balance. It’s dangerous, and your body truly depends on you to treat it with respect and love.

Remember, sugar levels are important, and are essential for our bodies and brains! It’s a lifestyle choice, the sooner you get it right, the healthier you’ll be!

Dr Derek Ferguson