Diabetes Mellitus Type 1
Diabetes mellitus is a condition defining the body’s inability to utilize glucose (sugar) for energy. Persons suffering from this condition do not produce, or do not use, insulin effectively. There are two major categories of diabetes mellitus:
- Type 1 diabetes: Also referenced as insulin dependent diabetes mellitus (IDDM), or juvenile onset diabetes. In type 1 diabetes the pancreas does not produce enough insulin. This type of diabetes usually occurs in people younger than age 30, and most often in children and adolescents. Type 1 diabetics are dependent upon insulin injections for the control of their blood sugar levels.
- Type 2 diabetes: Also known as non-insulin dependent diabetes (NIDDM), or adult onset diabetes. Type 2 diabetes results in the cells of the body becoming resistant to insulin.
Although the exact cause of type 1 diabetes is unknown, it is thought to be due to an autoimmune reaction, in which the immune system destroys the insulin-producing beta cells in the pancreas. This abnormal immune response may be triggered by a viral infection, a vaccination, a toxic chemical, or after inflammation of the pancreas during acute pancreatitis. Genetic factors may also play a role in susceptibility.
Type 1 diabetes increases the risk of chronic conditions including; heart disease, stroke, kidney disease, loss of nerve function (peripheral neuropathies ), retinopathy (a disease of the retina), blindness, immune system problems with increased susceptibility to infections, and circulation problems that can lead to skin ulcers, poor wound healing, and amputation.
The main symptoms of type 1 diabetes are:
- Excessive urination
- Thirst and a dry mouth
- Lack of energy
- Blurry vision and dizziness
In type 1 diabetes, untreated high blood sugar can lead to ketoacidosis, a condition where toxic chemicals called ketones are produced. Ketoacidosis occurs when body tissues are unable to take up glucose due to inadequate insulin, and have to burn fats for energy. Ketoacidosis is a medical emergency because it can lead to severe dehydration and coma if not treated immediately. The symptoms of ketoacidosis include:
- Nausea and vomiting
- Abdominal pain
- Shortness of breath (Kussmaul breathing)
- Acetone (fruity) smell to the breath
According to the National Center for Health Statistics (1):
- Approximately 13.4 million Americans have diabetes
- About 6.6 percent of Americans have diabetes
- In 2001, diabetes accounted for 71,372 deaths in the US
- Diabetes is the 6th leading cause of death in the US
- Type 1 diabetes accounts for 5 to 10 percent of diagnosed diabetes in the US
Diabetes is diagnosed by lab tests that determine blood glucose level, such as the fasting plasma glucose (FPG) or the two-hour plasma glucose (OGTT â€“ oral glucose tolerance test).
Diabetes treatment includes dietary and lifestyle modifications, nutritional supplements, and prescription drug therapy. Type 1 diabetes is usually treated with insulin injections in order to maintain a blood glucose level within the normal, or tolerable, range without marked fluctuations. Insulin is available in various forms, including rapid-acting, short-acting, intermediate-acting, long-acting, and Human Insulin (rDNA) Mixtures.
To reduce the risk of developing diabetic complications, patients have to monitor their glucose levels with a blood glucose meter. Insulin may also be administered by using an insulin pump, which automatically dispenses insulin through a catheter inserted into the skin.
The trace mineral, chromium, is often low in patients with diabetes, hypoglycemia, and obesity. Chromium can be depleted by eating a diet high in both refined sugar and white flour products, and also by the lack of exercise. Chromium assists in the regulation of blood glucose levels, aids in decreasing insulin resistance, aids in weight loss, and helps to stabilize the body’s metabolism (2, 3).
Studies have shown that chromium supplementation can decrease fasting blood glucose levels, improve glucose tolerance, lower insulin levels, and decrease total cholesterol and triglyceride levels in patients with diabetes (4, 5). Diabetic patients can supplement their diets with different forms of chromium, including chromium polynicotinate, chromium picolinate, GTF (glucose tolerance factor) chromium, or chromium-enriched yeasts (6). Changes in insulin requirements may occur with chromium therapy, therefore, physician monitoring is advisable.
Vitamin C is often low in patients with diabetes, because the transport of Vitamin C into cells is facilitated by insulin (7, 8). Vitamin C lowers blood glucose levels, strengthens capillaries, aids wound healing, protects against free radicals, and strengthens the immune system. Studies have shown that the supplementation with Vitamin C can also reduce sorbitol accumulation and glycosylation of proteins (9-11). This is especially significant, since sorbitol accumulation and glycosylation of proteins are linked to diabetic complications including eye and nerve diseases (12).
Niacin or niacinamide (Vitamin B3)
Niacin, or niacinamide (Vitamin B3) supplementation, may be beneficial in diabetic patients. Studies suggest that dietary supplementation with niacinamide can prevent *type 1 diabetes from developing or, if given soon enough at the onset of the condition, helps to slow the destruction of insulin-producing cells in the pancreas (13). Due to niacin’s side effects at high doses (skin flushing, gastric irritation, nausea, and liver damage), the safest form of niacin is flush-free niacin (inositol hexanicotinate).
Vitamin E may be beneficial in diabetic patients. Studies show that vitamin E supplementation helps to enhance insulin sensitivity and glucose transport, reduces the risk of heart failure, and prevents other diabetic complications (14-17).
Magnesium levels are often low in diabetic patients. Magnesium is involved in glucose metabolism. Studies report that its supplementation may prevent diabetic complications, such as retinopathy and heart disease (18-21).
Zinc levels are often deficient in diabetic patients. Zinc helps to regulate insulin metabolism, and clinical study has found that zinc supplementation improves insulin levels and poor wound healing (22-24).
Alpha-lipoic acid (ALA)
Alpha-lipoic acid (ALA) is an antioxidant that may be beneficial in diabetic patients. Studies have determined that ALA supplementation improves insulin levels and may prevent diabetic complications such as retinopathy (25-29).
Carnitine is a vitamin-like nutrient that boosts energy production through the breakdown of fats by the mitochondria. Carnitine also helps to regulate insulin metabolism and may prevent diabetic complications such as neuropathy (30, 31).
Vanadium, a trace mineral, may be beneficial in diabetic patients. Studies have found that vanadium supplementation improves blood glucose levels, and may help slow the destruction of insulin-producing beta cells in the pancreas (32-35).
Essential Fatty Acids (Evening primrose oil, Borage Oil, Black Currant Oil)
Evening primrose oil, a gamma-linolenic acid (GLA), may be beneficial in diabetic patients. Diabetes is associated with a disturbance in GLA metabolism, and GLA supplementation, in the form of evening primrose, borage, or black currant oils, may be beneficial for proper nerve function. It may also prevent diabetic complications, like neuropathy (36-42).
Gymnema sylvestre, a native plant found in India, has been traditionally used for the natural treatment of diabetes. Studies have found that gymnema supplementation may improve insulin levels, decrease blood glucose, and may help to regenerate the insulin-producing beta cells in the pancreas (43-46).
Bitter melon (Momordica Charantia)
Bitter melon, also known as balsam pear or karela fruit, is a tropical fruit found in Asia and South America. It has a long-standing tradition for the treatment of diabetes. Studies have found that bitter melon contains an insulin-like polypeptide that may decrease blood glucose levels and improve insulin levels (47-55).
Bilberry (Vaccinium Myrtillus)
Bilberry has a long tradition in the treatment of diabetes. Bilberry flavonoids (anthocyanosides) have potent antioxant effects. Anthocyanosides may provide for a decrease in blood glucose levels, strengthening of capillaries, and assist in the prevention of diabetic complications such as retinopathy (56, 57).
Biotin, a vitamin B-complex nutrient, aids in glucose metabolism, improves insulin sensitivity, and increases glucokinase activity; the enzyme responsible for the first step of glucose utilization (58). Studies show that biotin supplementation may decrease blood glucose levels and prevent diabetic complications such as neuropathy (59-61). Since changes in insulin requirements may occur with high doses of biotin, physician monitoring is advisable.
N-acetyl cysteine (NAC)
N-acetyl cysteine (NAC), is a potent antioxidant and precursor for the synthesis of glutathione (a detoxifying agent). Supplementation with NAC may have beneficial effects for diabetics, such as preserving beta cell function in the pancreas (62).
Coenzyme Q10 (CoQ10)
Coenzyme Q10 (CoQ10) is an antioxidant that boosts cellular energy production in the mitochondria, the cell’s energy powerhouse. Supplementation with CoQ10 may have beneficial effects for diabetics, such as preserving beta cell function in the pancreas and controlling blood glucose levels (63, 64). For enhanced results, it is often recommended that CoQ10 be taken with other antioxidants.
Carnosine, an amino acid peptide, can reduce the toxic glycosylation of proteins. This is especially significant, since glycosylation of proteins is linked to diabetic complications of the eye and nervous system (65).
Silymarin, an antioxidant flavonoid derived from the milk thistle herb, may have beneficial effects for diabetics. Supplementation with sylmarin has been found to lower blood glucose levels, improve liver function, and reduce free-radical activity (66).
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