Join Dr. James Odell for Season 2 of the Science of Self-Healing Podcast! He's the Medical and Executive Director for BRMI, as well as a practicing naturopathic doctor for over 35 years, and he's here to share with you his extensive knowledge of medicine from a different perspective.
Ever wonder why your doctor keeps talking about blood sugar? In this episode, we dive into the world of pre-diabetes - a sneaky condition that affects 40% of adults in the US! We'll break down what pre-diabetes really means, how it messes with your body's sugar control, and why it's crucial to catch it early.
You'll learn about the latest research, including how your gut bacteria play a surprising role in managing blood sugar. We'll also share some easy-to-follow tips to keep pre-diabetes at bay, from smart food choices to the best times for exercise.
Whether you're health-conscious or just curious, this episode is your friendly guide to understanding and outsmarting pre-diabetes.
Transcript: Dodging Diabetes: Your Pre-Diabetes Action Plan
In today's episode, we'll be talking about pre-diabetes, a condition that's becoming increasingly common, affecting about 40% of adults in the United States. Many people don't fully understand what it means, how it affects the body, or what steps can be taken to prevent it from progressing to type two diabetes.
So let's dive in today. We'll cover the basics of blood sugar regulation, the different tests used to diagnose pre-diabetes, its potential causes, and practical approaches to reducing your risk.
What Is Blood Sugar Regulation?
Lets begin with a summary of understanding blood sugar regulation. This is a very basic explanation. Your blood needs glucose, a type of sugar for energy. When you eat, carbohydrates in your food are broken down into glucose, which enters into your bloodstream. Normally, your body controls the level of glucose in your blood through the actions of insulin, a hormone produced by the pancreas. Insulin can help absorb glucose and use it for energy to store it for later use. However, when your body has trouble regulating blood sugar, problems can arise. Insulin resistance, or type two diabetes, is a chronic disease that affects the way the body metabolizes sugar. It is characterized by a progressive loss of sensitivity to insulin, the pancreatic hormone that regulates blood sugar levels. In the early stages of type two diabetes, the body produces more insulin to try to overcome reduced insulin sensitivity. However, in the long run, the pancreas can't produce enough insulin to maintain blood sugar levels, resulting in high blood sugar or hyperglycemia. Hyperglycemia induces oxidative stress, which in turn contributes to many of the complications of type two diabetes, such as kidney, nerve, retinal and vascular damage.
Type two diabetes is different from type one diabetes, where there's an impaired insulin production from the pancreas. The problem with that is uncontrolled glucose levels can damage multiple organs, leading to serious health complications.
The Problem With High Blood Sugar
So you might be wondering what kind of damage can happen from high blood sugar. So here we go. High blood sugar harms the heart and blood vessels, increasing the risk of cardiovascular disease, including heart attacks and strokes. It could also damage the kidneys, eyes and the liver, a non alcoholic fatty liver disease. Even the brain can be affected, leading to cognitive decline and a higher risk of dementia. Poor blood sugar control can cause skin issues, including infections and slow wound healing. This is because high blood sugar causes inflammation, oxidative stress and the formation of glycation end products, which can happen when glucose interacts with proteins in the body. As you can see, managing blood glucose levels for overall health is really important.
What Is Pre-Diabetes?
So pre-diabetes is a condition where blood sugar levels are higher than normal, but not yet high enough to be classified as type two diabetes. It's a warning sign that you're at risk for developing type two diabetes, heart disease or stroke. The condition is often asymptomatic, which means that many people do not know they have it. As of recent estimates, approximately 98 million adults in the United States, more than one in three have this condition and don't even know it.
How Is Pre-Diabetes Diagnosed?
So there are several tests used to diagnose pre diabetes. The first one is a fasting blood glucose test. This test measures blood sugar after an eight to twelve hour fast. A fasting blood glucose level of 126 indicates diabetes in the upper limit of normal. A fasting blood glucose is 99. That's a normal one. Any value between 99 and 126 is indicative of pre-diabetes. A drawback of this test is it does not tell us how blood sugar responds to the food we eat.
There's also the oral glucose tolerance test. This test measures your blood sugar two hours after you drink a sugary liquid. It shows how well your blood processes glucose. A blood sugar level between 140 and 199, two hours after drinking the liquid indicates pre-diabetes.
Next we have the hemoglobin A1C test. This test measures the percentage of hemoglobin to which sugar has bonded itself to chronically elevated blood sugar. Thus, it reflects an average blood sugar over the past three months. A healthy range for hemoglobin A1C is between 4.6 and 5.3%. Unfortunately, this test can be unreliable in individuals and should be compared with other biomarkers such as fasting insulin, fasting leptin, HOMA-IR, fructocosamine and triglycerides.
Continuous Glucose Monitoring Devices
If your doctor diagnoses you with pre-diabetes, it's a smart idea to ask for a continuous glucose monitoring device. These devices work by using a small sensor inserted just under the skin, usually on your abdomen or arm. This sensor continuously measures your blood glucose levels and sends the data to a receiver on your smartphone about every five minutes. The real time information it provides helps you understand how different foods and activities impact your blood sugar. For instance, you could see how various carbohydrates, like potato chips or specific exercise routines, affect your glucose levels almost immediately after eating or working out. Since everyone's body reacts differently to food and exercise, having this detailed, personalized data can help you make more informed choices about managing your pre diabetes, particularly what to eat.
What Are the Causes of Pre-Diabetes?
So let's move on to some potential causes of pre-diabetes today. We now understand that we cannot blame diabetes on any single factor. Rather, the disease process is driven by a complicated network of diet and lifestyle factors, oxidative stress and genetics. Scientists have identified both genetic and environmental factors that contribute to the development of pre-diabetes. Diet is certainly a co-cause, and the western diet is full of refined carbohydrates, fructose and industrialized seed oils. It is an established risk factor for type two diabetes. Wherever the western diet goes, type two diabetes follows. For example, hunter gatherer populations such as the Australian Aborigines are typically healthier eating their traditional diet when they are displaced and moved to urban environments. However, they replaced their traditional diets with the western type and developed diabetes at record speed. While it might be expected that our diets, particularly those high in sugar, seed oils and processed carbohydrates, play a significant role, recent research has uncovered other surprising additional factors, particularly the gut microbiome.
The Role of the Gut Microbiome in Pre-Diabetes and Diabetes
The gut microbiome is a vast community of microbes living in our digestive system. It plays a crucial role in this process, so let's talk about that for a moment. Recent research has highlighted the importance of the gut microbiome, the trillions of bacteria and other microorganisms living in your digestive tract. These also help regulate your blood sugar. The composition of your gut microbiome can influence how your body processes carbohydrates and regulates your blood sugar. Some studies suggest that having a diverse and balanced microbiome can improve insulin sensitivity, reduce inflammation, and support healthy blood sugar levels. Conversely, an imbalanced microbiome may contribute to insulin resistance and increase risk of pre-diabetes. Maintaining a healthy gut microbiome involves eating a diet rich in fiber, fruits and vegetables and fermented foods like yogurt and sauerkraut, which produce beneficial bacteria. Probiotic cultures also can greatly help to restore and regenerate the intestinal microbiome. Some probiotic strains also demonstrate antidiabetic effects. Supplementation with lactobacilli and bifidobacteria improves biomarkers of inflammation and oxidative stress and type two diabetics and lowers fasting blood sugar by promoting an anti inflammatory gut microbiota. Anti inflammatory gut bacteria in turn help correct underlying inflammation and diabetes and improve metabolic function. Of course, avoiding unnecessary antibiotics is also important as antibiotics destroy the intestinal microbiome.
The Problem With Conventional Medicine
In conventional medicine, the approach to type two diabetes is fought with problems. Under the conventional system, practitioners wait until people have full blown type two diabetes before initiating any therapy. Little is done to alter the course of disease in the pre-diabetic stage when the body is more responsive to diet and lifestyle changes. And most of the drugs to treat type two diabetes have serious side effects. They're associated with liver and kidney dysfunction, nausea, fatigue, dizziness, rashes, weight gain, and hypoglycemia, or low blood sugar. The conventional diet guidelines for diabetics is really outdated. The American Diabetes association dietary guidelines for type two diabetes have long promoted a relatively high intake of carbohydrates by demonizing dietary fats. Yet abundant research indicates this dietary approach not only doesn't work for type two diabetes, but may make the condition worse.
The Benefits of a Ketogenic Diet for Pre-Diabetes
Scientific research indicates that low carbohydrate diets are superior to high carbohydrate diets for the treatment of type two diabetes. In addition to adjusting carbohydrate quantity, you also need to change the quality of the carbs you consume. Instead of refined carbohydrates such as pasta and bread, eat moderate amounts of starchy tubers like sweet potatoes, cassava, beets and rutabagas, plantains, whole fruit and moderate amounts of full fat types of foods if tolerated. Increasing numbers of people are experimenting with the ketogenic diet for the treatment of type two diabetes with strong positive results. The ketogenic diet is a very low carb, moderate protein, high fat diet that causes the body to rely on fatty acids and ketones for fuel rather than glucose. Studies indicate that the ketogenic diet has significant benefits for type two diabetics. A ketogenic diet has been found to improve the hemoglobin A1C levels, promote weight loss, reverse kidney damage and improve blood lipids. In cardiovascular health and type two diabetics. It has also proven more successful than a conventional low carb diet for diabetes. In recent years, multiple studies have examined the effects of gluten on type two diabetes. We know that celiac disease is more common in individuals with poorly controlled diabetes than in the general population. This finding suggests that gluten may contribute to the development and progression of diabetes. Furthermore, animal models of type two diabetes indicate that a gluten free diet increases the functional capacity of the beta cells of the pancreas. Those are the ones responsible for making insulin and improving glucose tolerance. So how does gluten contribute to diabetes? The answer lies in the damaging effects of gluten on the intestinal barrier. Gluten increases intestinal permeability, causing leaky gut and systemic inflammation. These two factors have been found to precede type two diabetes. Removing gluten from the diet restores the intestinal barrier integrity and reduces inflammation, thereby improving insulin resistance and potentially reversing the course of diabetes. Also, protein is a powerful tool for managing type two diabetes. Increasing quality protein intake improves blood sugar control and satiety, a feeling of fullness and preserves lean body mass in diabetics. According to the research, a protein intake of 20% to 30% of the total calories is best for optimizing type two diabetes management.
Tips for Preventing Pre-Diabetes
Okay, so here's some very helpful hints to prevent pre diabetes, especially since these are almost all lifestyle changes you could take.
The first is to maintain a healthy diet. You want to focus on whole, unprocessed foods, particularly organic in nature. Choose complex carbohydrates like whole grains, fruits and vegetables, which are digested more slowly and cause a gradual rise in blood sugar. Avoid sugary drinks, refined carbohydrates and processed snacks that cause spikes in blood sugar.
You should exercise regularly. Physical activity helps your body use insulin more efficiently. Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity each week. Combined with strength training exercises, this can include walking, cycling, swimming, racquet sports or lifting weights. Also consider when you exercise, a brisk walk after a carbohydrate rich meal can be very beneficial.
Lose excess weight. Even a modest weight loss of five to 7% of your body weight can significantly reduce your risk of developing type two diabetes. Focus on gradual, sustainable weight loss through a combination of diet and exercise.
Get enough sleep. Poor sleep can affect insulin sensitivity and blood sugar levels. Aim for at least seven to 9 hours of quality sleep per night and try to maintain a regular sleep schedule.
Eat more fiber. Aim for 25 to 30 grams of fiber a day. Chia seeds that's chia chia seeds are an excellent fiber source. The reason for this is that fiber feeds the good bacteria in your gut, which helps to control how glucose is metabolized, so it actually helps the microbiome.
Don't eat within three hours of going to bed because this will cause your glucose levels to stay elevated through the night. That could cause sleep disturbances.
Purchase and use a monitoring device to see how your body reacts to certain food and exercise. We all react differently, so you must see how your body responds to different types of carbohydrates and exercise.
Consider intermittent fasting to restore the pancreas ability to make insulin properly. Again, there are many websites on intermittent fasting and many ways to do that, so I encourage you to look into this. Number nine, food supplements can help.
Supplements for Pre-Diabetes
So I'm going to talk about a few food supplements.
The first one on the list is cinnamon. As a whole cinnamon powder or as an extract. Cinnamon is a very helpful addition to the pre diabetic diet. Many studies suggest that it helps to lower blood sugar and improves diabetic control. Cinnamon may also help your blood cells better respond to insulin.
Next is berberine. Berberine is a bitter compound with potent anti diabetic properties. It can be found in Oregon grape, barberry and goldenseal plants. It improves insulin resistance and insulin secretion. It inhibits the generation of glucose in the liver, reduces the intestinal absorption of glucose and promotes an anti-inflammatory activity in the gut. Microbiota. Interestingly, berberine works in the same way as the anti diabetic medication metformin without the side effects. Berberine may improve insulin sensitivity, enhance blood sugar intake from your body, basically through your muscles, which helps to lower the blood sugar.
The next is alpha lipoic acid. Alpha lipoic acid is a sulfur containing compound that acts as a powerful antioxidant in the body by boosting the body's endogenous antioxidant systems. Alpha lipoic acid alleviates oxidative stress, an underlying cause of type two diabetes. This helps reduce diabetic complications such as diabetic neuropathy. Alpha lipoic acid also activates AMPK. This is a protein with blood sugar lowering effects.
Next on the list is vitamin D. It isn't only crucial for healthy bones, it also regulates immunity. Very important for the immune system as so many people with cancer end up showing that they have low vitamin D levels. It also regulates inflammation and insulin sensitivity. Low vitamin D is a risk factor for developing type two diabetes, whereas vitamin D supplementation reduces inflammation and oxidative stress in diabetics and magnesium can also greatly help control better insulin utilization.
Magnesium is an essential cofactor for over 300 enzyme systems in the body, including several that regulate blood sugar. Magnesium insufficiency is associated with an increased risk of type two diabetes, whereas magnesium supplementation improves insulin sensitivity and blood sugar control. While magnesium is available in a variety of foods such as nuts, avocados, and dark chocolate, it can be difficult to obtain enough of this mineral from food to support optimal health. So most nutritionists recommend supplementing with anywhere from about 400 to 600 milligrams of magnesium daily, preferably chelated to glycinate or malate for optimal absorption. Orotates are also very good for individuals.
With pre-diabetes who are trying to prevent pre-diabetes. There are two very good supplements to consider. These are methylators. They help your body methylate, which is a very important process for the liver and for detoxification. Two of them are 5-methyltetrahydrofolate (5-MTHF). That's 5-methyltetrahydrofolate as well as a methylated B12.
Another really important B vitamin is thiamine. Thiamine is a carrier of glucose into the central nervous system that's actually into the brain, and so taking thiamin on a regular basis can also help with pre-diabetes or in prevention of pre-diabetes.
Lastly, the trace mineral chromium also plays a critical role in insulin utilization.
Next, you should reduce your stress levels. Chronic stress is often an overlooked but significant risk factor for type two diabetes. The hormonal changes that go hand in hand with chronic stress cause blood sugar imbalances. Stress is associated with insulin resistance and is significantly increased risk of type two diabetes in adults. The profound effect on stress on blood sugar is mediated by the HPA axis. That's the hypothalamus pituitary adrenal axis, the body's stress response system. Essentially, the chronic HPA axis activation causes beta cell dysfunction in the pancreas, inhibiting the effects of insulin and inducing insulin resistance. Research indicates that reducing psychological stress can improve blood sugar management and type two diabetes. So meditation, yoga, breathing exercises and such have been found to decrease fasting blood sugar, glucose and post meal glucose in diabetics. If you're new to the concept of mindfulness, I recommend starting with an app such as calm or headspace, which offers guided meditation and breathing exercises that are simple and effective for alleviating stress.
Conclusions
Pre-diabetes is a serious condition affecting millions of people, but is also a preventable one. By understanding the basics of blood sugar regulation, taking advantage of all the available diagnostic tests, maintaining a healthy intestinal microbiome, and making proactive lifestyle changes, you can significantly reduce your risk of developing type two diabetes. Remember, the sooner you act, the better your chances of preventing more serious health issues down the line. Thank you for tuning in today to our episode. Stay healthy and until next time, be well.
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