Diabetes mellitus has become one of the most widespread diseases in existence. More than 7 million Malaysians suffer from pre-clinical diabetes and over 16 million have insulin resistance.

Why are we seeing such an increase in the number of people who are becoming diabetic? High sugar intake (which also causes obesity) among Malaysians is one of the contributing factors to the high incidence of diabetes. We consume 26 teaspoons of sugar a day and are the eighth highest sugar users in the world. “Expert” used to believe a high-carbohydrate, low-fat diet is the healthiest way to eat. However, carbohydrates are simply long chains of sugars that are released at various rates in the body. This has been documented in the medical literature as glycemic index (the rate that sugars are absorbed and increase the blood sugar). Carbohydrates such as white bread, white flour, pasta, white reice, and potatoes release their sugars rapidly (high-glycemic foods) and increase the blood sugars faster than if you were slapping table sugar on your tongue.

Foods such as green beans, rye bread, whole apples, and cauliflower release their sugars slowly (low-glycemic foods). This rapid rise in blood sugar after a high glycemic meal stimulates the release of insulin from the pancreas, which is needed to control the blood sugar level. The blood sugar drops and our body’s crave more calories and more high-glycemic foods. Medical studies are now showing us that this type of diet causes us to become less and less sensitive to our own insulin (insulin resistance). Insulin resistance is the beginning event of a complicated metabolic change that occurs in one’s body. Our bodies still wants and needs to control blood sugars. Therefore, the beta cells of the pancreas simply put out more insulin and our blood insulin levels rise. This elevated insulin in our blood stream is called hyperinsulinemia and leads to a constellation of metabolic changes in our body.

Metabolic Syndrome

When a person develops full-blown Metabolic Syndrome, he or she has a 20-fold increased risk of developing cardiovascular disease. After 15 to 20 years in this state, the beta cells of the pancreas finally wear out and your insulin levels begin to fall and your blood sugars begin to rise. First, you develop pre-clinical diabetes. Then a few years later you actually become diabetic. However, it is important to realize that your arteries begin to age at an accelerated rate as soon as you first develop this insulin resistance.

…..high carbohydrates diets increase the risk of developing type-2 diabetes….

In a 6-year Nurses Health study of 65,000 women whose diets were high in carbohydrates from white bread, potatoes, white rice, and pasta (high-glycemic diet), participants had 2.5 times the risk of developing type-2 diabetes (adult onset diabetes) than those who ate a low-glycemic diet.
Watler Willett, a professor of epidemiology and nutrition at the Harvard School of Public Health believes that white flour, white bread, potatoes, white rice, and pasta should actually be moved up the Food Guide Pyramid and considered in the sweets category because metabolically they are the same.

For patients who have type-2 diabetes mellitus, physicians are often treating blood sugars instead of the underlying problem, which is insulin resistance in over 95% of the type-2 diabetic patients. In fact, when insulin resistance is corrected early, it is easily reversible with just basic healthy lifestyle changes. This not only allows the patient to avoid the accelerated aging of their arteries but allows them to avoid becoming diabetic altogether.

An estimated 30% of the adults in Malaysia have insulin resistance, also known as Metabolic Syndrome.

….in my practice as a community pharmacist, I have observed a troubling pattern. Many patients beginning in their late 30s or early 40s begin gaining a significant amount of weight around their middle (central obesity)….

They then begin to develop increased levels of total cholesterol and triglycerides along with very low levels of HDL or “good” cholesterol. Shortly thereafter, they develop hypertension, which needs to be treated. By their late forties, they’ve become diabetic.

Nutrients Essential For Diabetes

Clinical trials have demonstrated patients with pre-clinical diabetes or impaired glucose tolerance have significantly lower levels of antioxidants. There was evidence of significantly increased levels of oxidative stress, which led to a depletion of our antioxidant defense system. In other trials, this oxidative stress was more significant in those who had secondary complications of their diabetes like retinopathy or cardiovascular disease.

….these authors felt that antioxidant supplementation should be added to the traditional insulin treatment as a means to help arrest these complications….

The neurology department at Mayo Clinic reported a study where they experimentally created diabetic peripheral neuropathy. They concluded this complication was indeed caused by oxidative stress. They were able to reverse this nerve damage by giving alpha-lipoic acid, which Is both a fat-soluble and water-soluble antioxidant. They also noted if the subjects had good levels of alpha-lipoic acid because of supplementation before they induces the oxidative stress, there was no nerve damage.

Many micronutrients have been found to be deficient in patients with Metabolic Syndrome, pre-clinical diabetes and actual diabetes. One of the most crucial is chromium. Chromium is critical in the metabolism of glucose and the action of insulin and has been shown to greatly improve insulin sensitivity, especially in those who are deficient.

Vitamin E not only improves the antioxidant defenses but also has been shown to improve insulin resistance. In other studies, a low vitamin E level has been found to be an independent and strong predictor for the development of adult onset diabetes mellitus. There was a five-fold increase in the risk of developing diabetes in those individuals who had low level of vitamin E.

Magnesium deficiency has been associated with both types 1 and 2 diabetes. This low level of magnesium has further been associated with an increased risk of diabetic patients developing diabetic retinopathy as well and when corrected in the elderly a significant improvement in the function of insulin results. Magnesium deficiency may be the most under diagnosed electrolyte abnormality today.

How do I know if I have developed Insulin Resistance? You can know if you have developed insulin resistance when obtaining the results of your last lipid profile from your physician. Simply devide your triglyceride level by your HDL or “good” cholesterol. If this number is greater than 2, you are starting to develop insulin resistance. With Metabolic Syndrome, your triglyceride level begins to increase and your HDL cholesterol will decrease. Therefore, this ratio is an indirect measure of your blood insulin levels.

Hence, check your ratio today and speak to your health professionals for the best recommendations.