New findings affirm the power of readily available allies and remedies 08/30/2018
Diabetes is the leading cause of premature deaths in the U.S., where nearly 100 million adults have type-2 diabetes or prediabetes.
So-called “adult onset” or type-2 diabetes is a lifestyle disease, while type-1 diabetes is an uncommon autoimmune disease that typically manifests in childhood or adolescence.
Prediabetes is the condition in which blood sugar levels are unhealthfully high, but not quite high enough to be considered full-blown diabetes. And unless your doctor sees its signs on lab tests, you probably won’t know that you have prediabetes.
In type-2 diabetes, the body does not produce enough insulin and/or respond properly to the hormone, which helps glucose — so-called “blood sugar” — enter cells, to be burned for energy or get stored in muscle and liver cells.
Sadly, American children and adolescents increasingly suffer from prediabetes or full-blown type-2 diabetes — thanks to junky diets laden with sugars and starches, and lack of exercise from sports or physical play.
The signs of type-2 diabetes include excessive thirst, frequent urination, blurred vision, and fatigue, and the risks of untreated diabetes are alarming:
- Heart attack
- Kidney disease
- Sexual problems
- Dizziness and fainting
- Heart/cardiovascular disease
- Trouble sensing bladder fullness
- Blindness and other eye problems
- Digestive problems (gastroparesis)
- High blood pressure (hypertension)
- Nerve pain, especially in the legs and feet
In addition to weight control and daily activity, diet can greatly impact your ability to avoid diabetes.
Let's examine some recent research, whose results suggest five ways to reduce the risk of diabetes, reverse it, or help treat the disease.
#1: Lose Excess Weight, Fast — Post-diagnosis weight loss reverses diabetes
The conventional wisdom about type-2 diabetes is that it’s a lifetime condition that continues to get worse as you age.
But recent research indicates that nearly half of adults with diabetes can reverse the disease if they lose substantial weight within six years of their initial diagnosis.
And the authors of a British study may have found the reason why weight loss works: namely, it improves the function of the pancreatic beta cells that produce insulin.
To examine how weight loss affects pancreatic function, participants with type-2 diabetes were assigned to traditional best-practice care (control group) or an intensive weight loss program (intervention group).
After a year, nearly half of the intervention group had achieved diabetes remission.
Some of those who hadn’t gained normal blood glucose levels simply hadn’t lost enough weight. However, some had lost significant weight but still hadn't achieved remission.
The team then looked at a wide range of metabolic factors among those who had responded to weight loss and those who hadn’t, to identify what might be different.
They discovered that while weight loss could correct deficient fat metabolism — a factor in diabetes — recovery of near-normal beta cell function was the key to achieving remission.
As the study’s senior author, Roy Taylor of Newcastle University, explained, “This observation carries potentially important implications for the initial clinical approach to management. Our data suggest that substantial weight loss at the time of diagnosis is appropriate to rescue the beta cells.”
#2: Stay Active — Two weeks of inactivity may trigger prediabetes
A diabetes diagnosis usually triggers recommendations for exercise and weight loss.
Previous studies found that just a few days of inactivity causes loss of muscle mass and physical strength, and rapidly induce insulin resistance, which is a key characteristic of type-2 diabetes.
And the results of a new study from Canada suggest that interrupting your exercise routine for just a few weeks can trigger big changes with lasting negative effects (McGlory C et al. 2018).
The research team looked at older adults who were overweight and at risk of developing type-2 diabetes.
Study participants lowered their daily activity to no more than 1,000 steps per day to mimic the state of being injured, ill, or housebound.
Pedometers were used to measure activity levels and total number of steps, and blood sugar levels were measured by the research team over the two weeks of the study.
The brief period of inactivity raised blood sugar levels among participants with pre-diabetes and they didn’t always recover fully once they resumed taking more than 1,000 steps daily after the two-week trial period.
Lead author Chris McGlory of Montréal’s McMaster University expressed surprise: “We expected to find that the study participants would become diabetic, but we were surprised to see that they didn't revert back to their healthier state when they returned to normal activity.”
#3: Try this Traditional Herb — A plant chemical shows promise for diabetes
Berberine is an alkaloid-type chemical found in the roots and bark of certain plants.
The most commonly used sources include European barberry, goldenseal, goldthread, Oregon grape, phellodendron, and tree turmeric
Some of those plants have been used in various folk medicine traditions to treat a wide variety of conditions. These include use to reduce inflammation, fight cancer and bacterial infections, and lower blood sugar levels.
Among these traditional uses, reliance on berberine to lower blood sugar levels appears to enjoy the best scientific support.
In fact, preliminary research suggests that taking 500 mg of berberine 2-3 times daily for up to three months might control blood sugar as effectively as commonly prescribed diabetes drugs such as metformin and rosiglitazone.
Back in 2006, an Australia-based research team tested berberine’s potential to lower blood sugar (glucose) levels in rodents — and found that it did just that, in part by activating an enzyme that helps improve insulin sensitivity. Better yet, berberine also tended to reduce the rodents’ body weight.
And, as study co-author David James, said, “Berberine has been used for decades, if not centuries, with few reported side effects.”
More recently — and relevantly — the authors of a recent evidence review found substantial evidence that berberine also helps people with type-2 diabetes (Lan J et al. 2015).
Its authors reviewed 27 randomized, controlled clinical trials involving over 2,500 patients, which either tested berberine versus a placebo, or when berberine was given with or without the diabetes drugs metformin and rosiglitazone.
Specifically, as they wrote, "BBR [berberine] significantly lowered fasting blood glucose (FBG), hemoglobin A(1c), triglyceride, and insulin levels in patients with type 2 diabetes … [and the] FBG- and hemoglobin A(1c)-lowering efficacies of BBR were similar to those of metformin and rosiglitazone."
Encouragingly, they also found good evidence that berberine, plus healthy lifestyle interventions, improved several key markers of diabetes — more than lifestyle changes alone or a placebo.
Similarly, patients enjoyed better results from the combination of berberine plus anti-hypoglycemia (low blood-sugar) drugs, versus the drugs alone.
In summary, the results of their review indicate that berberine produces benefits comparable to those of standard type 2-diabetes drugs — without side effects.
#4: Get Your Whole Grains — Diet high in wheat or rye fiber may cut diabetes risk
Last year, Finnish scientists published their analysis of data from the Finnish Diabetes Prevention Study — a 15-year study — and data from two similar studies.
Their study was designed to determine whether (and how) specific “metabolites” (metabolic break-down products) released by intestinal bacteria might help deflect type-2 diabetes (de Mello VD at Al 2015).
All 200 participants in the Finnish Diabetes Prevention Study were overweight with impaired glucose tolerance. About half developed type-2 diabetes within the first five years and the remainder didn’t develop type-2 diabetes within 15 years.
The team studied the differences in the metabolic profiles of both groups, using a new technique called “metabolomics”, which allows scientists to compare levels of various bacterial metabolites to various health outcomes in people.
Critically, their analysis linked higher blood levels of indolepropionic acid — a bacteria-produced metabolite — to significantly lower risk for developing diabetes. And they found the same link in two other studies.
What are the practical implications of these findings? The answer, in a word, is “eat whole grains”.
The Finnish team linked diets high in whole wheat and rye to the highest levels of indolepropionic acid — a bacterial metabolite that also exerts anti-inflammatory effects.
Higher blood levels of indolepropionic acid also boosted secretion of insulin by the pancreas, which may explain how it helps to protect against the development of diabetes.
As study co-author Kati Hanhineva said, “Earlier studies, too, have linked intestinal bacteria with the risk of disease in overweight people. Our findings suggest that indolepropionic acid may be one factor that mediates the protective effect of diet and intestinal bacteria.”
#5: Go Fish — Omega-3s lower key inflammation marker in diabetic patients
Two years ago, a British-Chinese team the impact of supplemental omega-3 fish oil on key inflammation markers in adults with type-2 diabetes.
Type-2 diabetes is associated with higher levels of several “biomarkers” for systemic inflammation — including C-reactive protein or CRP, high levels of which also signal higher risk for cardiovascular disease.
The constant low-grade inflammation caused when a diabetes patient’s body struggles to regulate blood sugar is linked to hardening of the arteries, heart disease, and obesity — all of which can result from uncontrolled type-2 diabetes.
Previous research indicates that omega-3 fatty acids can help reduce low-grade inflammation — and may help to fight the inflammation caused by adult-onset diabetes.
This review encompassed eight relatively short clinical studies, ranging in length from six to 12 weeks (Lin N et al. 2016).
Diabetes patients were given fish oil supplements, delivering either pure EPA, pure DHA, or a blend of the two seafood-source omega-3 fatty acids, in doses ranging from 1 gram to 6 grams daily.
(Health authorities worldwide say that healthy people should try to take 250mg to 500mg of omega-3s — combined DHA and EPA — daily.)
The authors concluded that omega-3 fatty acid dietary supplements tend to lower CRP levels in patients with type-2 diabetes.
As they wrote in their conclusion, “this meta-analysis indicates that persons with T2DM [type-2 diabetes] who received n-3 PUFA [omega-3] supplements had significantly lower CRP levels compared with subjects in control groups.”
- Chang W, Chen L, Hatch GM. Berberine as a therapy for type 2 diabetes and its complications: From mechanism of action to clinical studies. Biochem Cell Biol. 2015 Oct;93(5):479-86. doi: 10.1139/bcb-2014-0107. Epub 2014 Dec 1. Review.
- de Mello VD et al. Indolepropionic acid and novel lipid metabolites are associated with a lower risk of type 2 diabetes in the Finnish Diabetes Prevention Study. Sci Rep. 2017 Apr 11;7:46337. doi: 10.1038/srep46337. PubMed PMID: 28397877.
- Lan J, Zhao Y, Dong F, Yan Z, Zheng W, Fan J, Sun G. Meta-analysis of the effect and safety of berberine in the treatment of type 2 diabetes mellitus, hyperlipemia and hypertension. J Ethnopharmacol. 2015 Feb 23;161:69-81. doi: 10.1016/j.jep.2014.09.049. Epub 2014 Dec 10. Review. PubMed PMID: 25498346.
- Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB. Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006 Aug;55(8):2256-64. PubMed PMID: 16873688.
- Lin N, Shi J, Li Y-M, et al. What is the impact of n-3 PUFAs on inflammation markers in Type 2 diabetic mellitus populations?: a systematic review and meta-analysis of randomized controlled trials. Lipids in Health and Disease. 2016;15:133. doi:10.1186/s12944-016-0303-7.
- McGlory C, von Allmen MT, Stokes T, Morton RW, Hector AJ, Lago BA, Raphenya AR, Smith BK, McArthur AG, Steinberg GR, Baker SK, Phillips SM. Failed Recovery of Glycemic Control and Myofibrillar Protein Synthesis With 2 wk of Physical Inactivity in Overweight, Prediabetic Older Adults. J Gerontol A Biol Sci Med Sci. 2018 Jul 9;73(8):1070-1077. doi: 10.1093/gerona/glx203. PubMed PMID: 29095970; PubMed Central PMCID: PMC6037059.
- Pang B, Zhao LH, Zhou Q, Zhao TY, Wang H, Gu CJ, Tong XL. Application of berberine on treating type 2 diabetes mellitus. Int J Endocrinol. 2015;2015:905749. doi: 10.1155/2015/905749. Epub 2015 Mar 11. Review.
- Taylor R, Al-Mrabeh A, Zhyzhneuskaya S, Peters C, Barnes AC, Aribisala BS, Hollingsworth KG, Mathers JC, Sattar N, Lean MEJ. Remission of Human Type 2 Diabetes Requires Decrease in Liver and Pancreas Fat Content but Is Dependent upon Capacity for β Cell Recovery. Cell Metab. 2018 Jul 24. pii: S1550-4131(18)30446-7. doi: 10.1016/j.cmet.2018.07.003. [Epub ahead of print] PubMed PMID: 30078554.
- Tuomainen M, Lindström J, Lehtonen M, Auriola S, Pihlajamäki J, Peltonen M, Tuomilehto J, Uusitupa M, de Mello VD, Hanhineva K. Associations of serum indolepropionic acid, a gut microbiota metabolite, with type 2 diabetes and low-grade inflammation in high-risk individuals. Nutr Diabetes. 2018 May 25;8(1):35. doi: 10.1038/s41387-018-0046-9.
- Web MD. Berberine. Accessed at https://www.webmd.com/vitamins/ai/ingredientmono-1126/berberine
- Zhang H, Wei J, Xue R, Wu JD, Zhao W, Wang ZZ, Wang SK, Zhou ZX, Song DQ, Wang YM, Pan HN, Kong WJ, Jiang JD. Berberine lowers blood glucose in type 2 diabetes mellitus patients through increasing insulin receptor expression. Metabolism. 2010 Feb;59(2):285-92. doi: 10.1016/j.metabol.2009.07.029. Epub 2009 Oct 1.