Just the Facts Ma’am
First let’s distinguish between the different forms of diabetes. The most common are Type 1 and Type 2 diabetes. Type 1 is classified as an autoimmune disorder that results from a cellular-mediated autoimmune destruction of the β-cells of the pancreas that leads to absolute insulin deficiency[1]. Type 2 diabetes, also known as diabetes mellitus or adult onset diabetes, brings on relative insulin deficiency rather than absolute insulin deficiency as in Type 1. Most patients with this form of diabetes are obese, and obesity itself causes some degree of insulin resistance. Diabetic patients who are not obese by traditional weight criteria may have an increased percentage of body fat distributed predominantly in the abdominal region.

To be classified as a diabetic requires two things, one having a genetic predisposition to the disease and secondly having a fasting blood glucose level greater than 126. Being the daughter of a diabetic, I watched my father deal with the struggle to keep his sugar under control for over 40 years. I’ve also watched as most of my family dealt with the developments of diabetes. With this in mind, I made it a personal mission that I would remain in control of my blood sugar levels. Having been raised to appreciate sweets, and struggling with weight loss issues myself this doesn’t come easy. So how do I do it? Wow, great question. It’s something I’m constantly reviewing and must stay on top of. That’s not to say I don’t indulge and even over indulge at times in a sugar-laden treat. I take a daily combination of supplements, some of which I discuss later in this article, and ordinarily stick to a healthy eating regiment while I also exercise when I can. I’m proud to boast that I passed my recent physical, highlighted by my blood work, with flying colors. My blood sugar levels were perfect, showing a fasting blood sugar (FBS) level at 88 and my HbA1C[2] at a 5.0%. My blood pressure remains steady between a 120/80 to 110/70. More impressively I had made a serious effort in the past year to bring down my cholesterol levels, which I successfully did by 43 points! I hit the trifecta! Even my doctor was impressed.

It’s Only Logical
In a previous line of work I had the good fortune of working in the pharmaceutical industry as I presented and moderated symposiums on various drugs in different markets, one of those being a diabetes drug. I had the benefit of being trained by the American Diabetes Association (ADA) for this line of work. I was privileged to learn from some of the top doctors in the country on the effects of diabetes as well as the medications that were on the market at the time. With this in my arsenal it has helped me to keep this dreaded disease at bay while also understanding the effects of food on the body as well. While everyone doesn’t have access to the information I was afforded, the Internet is a boundless resource and I urge anyone with a family history of diabetes to arm themselves with as much knowledge as they can to avoid the hardships brought on by this disease. As many would agree, it’s prudent to pursue a natural course of action before being left without options that would require medication.

The good news is that there are natural ways to lower your blood sugar levels. The most critical are engaging in regular exercise and maintaining a healthy diet. However, preliminary research indicates using a variety of supplements can help individuals manage and lower blood glucose levels. The most important thing is to best understand how the body responds to food and how your personal choices can affect the outcome of your health.

I Am the Walrus, Coo-coo ca-choo
If your blood glucose levels remain high for an extended amount of time, this can present complications. Recommendations by the ADA indicate that if your FBS remains over 126 for an prolonged period, you are categorized as hyperglycemic. High blood glucose known as hyperglycemia can happen if you go undiagnosed and are not treated. This means you don’t have enough insulin in your body to work with the food you consume. This can also happen if you miss taking your diabetes medicine, eat too much, or don’t get enough exercise. Hyperglycemia can happen when medication or activity levels are not balanced with food intake. It can also happen because of stress or illness. When this happens, a person may have some, or all of the following symptoms: extreme thirst, having to urinate frequently, dry skin, excessive hunger, blurred vision, drowsiness (usually after starchy meals), and wounds that are slow to heal.

Hey Good Lookin’ What’s Cookin’
Any food that you ingest is processed and metabolized by the body. Food is broken down into the various building blocks that the body needs, and what cannot be metabolized or used is processed and removed by the liver. Protein and fats are used for muscle and tissue regeneration and other body processes. Carbohydrates are broken down by the body into glucose, a simple form of sugar, and are typically used as a fast fuel source for the body. When more carbs are eaten than the body immediately needs, they must be stored. While the body can use glucose for fuel, levels that exceed what is needed can be toxic to the body, hence diabetes lies on the horizon. It should be noted that different types of carbohydrates will be used differently by the body. Understanding the differences can help you make smarter choices with regard to choosing a healthy eating lifestyle.

Carbohydrates often get clumped together in two extreme categories, good and bad. Conversely, carbs alone aren’t bad. Everyone needs them because carbs are the body’s primary source of energy. Each of the three types of carbs, sugar, starch and fiber, has a place in your diet. Different types of starches are digested at varying rates. Some are slowly digested, these are often referred to as smart carbs and give you long-term energy while helping you feel full. Other starches digest rapidly and can spike blood sugar. The third type is called resistant starch and isn’t digested; it’s fermented in the large intestine. Many foods with starch contain all three types of carbohydrates and aren’t easily identified on ingredient labels. This makes reading the nutritional info on food labels and deciphering ingredients extremely important in order to choose the right foods to fit your dietary needs. Soluble fiber keeps your blood sugar steady by slowing down the absorption of carbs into your system. Fiber also interferes with the absorption of dietary fat and cholesterol, which can help lower your blood cholesterol level. Insoluble fiber prevents constipation by keeping digestive wastes moving on through the body. Women should consume 25 grams of fiber daily, while men need to get 38 grams each day

Let’s Get Physical… Let me hear your body talk
Whether you have diabetes, are at high risk for developing diabetes or just want to prevent future illness, following a regular exercise regimen is one of the best ways to maintain and improve your health. Regular aerobic exercise reduces visceral fat and body weight without decreasing lean body mass. It has been documented that regular aerobic physical activity must be considered when seeking to remedy and dealing with a diagnosis of diabetes[3]. Just 20 minutes of vigorous physical activity four times a week, or 30 minutes of moderate physical activity 3 times a week, can lower fasting blood sugar levels.

The bottom line is that exercise lowers blood sugar levels. To fuel your exercise, your muscles tap into their glucose reserves for energy. When that supply is exhausted, your body begins to use glucose from your bloodstream, which causes your blood glucose levels to drop. After your workout, your liver replenishes the supply, causing your blood sugar levels to drop even lower. In addition to lowering your blood sugar, regular exercise will increase your insulin sensitivity, lower your blood pressure and cholesterol, burn fat and improve your circulation.

So Build Me Up Buttercup, Don’t Break My Heart
Most experts agree that a low carbohydrate diet that is high in protein is the best choice for those wanting to lower blood sugar levels. However there are a few supplements that have been proven to help control blood sugar levels.

Alpha-lipolic Acid (ALA) – This is an antioxidant that protects your body from cell damage. Incorporating foods high in ALAs like sardines, walnuts, spinach, broccoli and flaxseeds into your diet on a regular basis may help lower your blood sugar levels. ALA is also commercially available in supplement form an has been documented to prevent and treat diabetic neuropathy. ALA supplements can reduce the pain, numbness and burning associated with the most common type of diabetic neuropathy as it may reduce oxidative stress and improve diabetic complications. ALA also reduces cholesterol levels and protects insulin-producing cells in the pancreas adding to the beneficial effects of this supplement.

Gamma-lipoic acid (GLA) is another naturally occurring antioxidant that is present in borage oil, evening primrose oil and blackcurrant seed oil. GLA may also improve the function of nerves damaged by diabetic neuropathy as it plays an important role in modulating inflammation throughout the body, especially when incorporated into the membranes of immune system cells. By converting into beneficial prostaglandins (PGE1s), GLA compensates for this deficiency. The results can be a profound reduction in the impact of inflammation affecting the cardiovascular system, lung function, autoimmune conditions, and metabolic abnormalities including diabetes.

A separate mechanism by which GLA and other beneficial fatty acids reduce inflammation is by activating the powerful peroxisome proliferator-activated receptor (PPAR) system. PPARs are intracellular receptors that modulate cell metabolism and responses to inflammation. GLA works similarly to the class of anti-diabetic drugs known as TZDs (thiazolidinediones such as Actos^® or pioglitazone) by targeting PPARs—but unlike GLA, TZDs come with numerous side effects.

Polyphenols are another antioxidant found in tea and dark chocolate, believed to promote vascular heath and glucose control, as well as lower lipid levels. Green tea contains a polyphenol known as EGCG, which studies have shown have beneficial affects on lowering blood glucose levels.[4]

Cinnamon – There are some early indications that adding cinnamon into your diet can help lower blood sugar levels, as well as cholesterol and triglycerides. Some studies have indicated that cinnamon may mimic the effects of insulin, act as an insulin sensitizer, and improve cellular glucose uptake and glycogen synthesis. Like the majority of supplements, more research is necessary before listing cinnamon as a major natural diabetes treatment. However, you can still enjoy it adding it to foods as its spicy flavor can help substitute the need for added sugars.

Fenugreek is an annual herb native to western Asia and southeastern Europe. Fenugreek has several components, including saponins, alkaloids, and high fiber content that comprise 50% of the seed. This seed is traditionally used to treat constipation, slow gastric emptying, and delay the absorption of glucose from the gastrointestinal tract. Studies indicate that fenugreek increases the rate of insulin release.

Fenugreek seeds are high in soluble fiber, which helps lower blood sugar by slowing down carbohydrate digestion and absorption. Studies show that fenugreek cane help reduce the rate at which sugar is absorbed from the stomach during the process of digestion. It also appears to be capable of stimulating the pancreatic cells to increase insulin production. Both these actions are believed to be a result of the action by an amino acid present in fenugreek called 4-hydroxyisoleucine.

In a controlled trial, incorporating 15 grams of powdered fenugreek seed into a meal eaten by people with type 2 diabetes reduced the rise in blood glucose following the meal. Another controlled trial found that taking 2.5 grams of fenugreek twice a day for three months reduced blood sugar levels in people with mild type 2 diabetes. Even a more moderate dose of 1 gram per day of an extract of fenugreek seeds for two months improved some measures of blood sugar control and insulin function in people with type 2 diabetes. However the main use of fenugreek points to how it benefits post-prandial blood sugar numbers when taken with meals. It assists by controlling glucose absorption when eating and reflected positively in overall blood sugar test results.

Other studies[5] suggested that fenugreek may also contain a substance that stimulates insulin production helping to improve blood sugar control. Another appealing tid-bit about fenugreek is that it has been shown to lower LDL cholesterol and triglyceride levels in people with high lipid levels adding to its list of appealing features.

IMPORTANT: It should be noted that there is theoretical risk of interaction between fenugreek and warfarin, so be sure to consult with your doctor before adding this to your daily diet.

Gymnema or Gurmar  – As the name indicates, Gurmar is a climbing shrub and the leaves have been traditionally believed to be capable of destroying sugar. Gymnema leaves contain saponins and gymnemic acids that have anti-diabetic action[6]. Studies have found that gymnemic acids show the ability to reduce the amount of sugar absorbed by the intestine during the process of digestion.

Gymnema is commercially available in tablet or capsule form, although chewing on a few leaves has been recommended as it can reduce your ability to sense the sweetness of foods. This observation has led researchers to conclude that this remedy may play a role in suppressing appetite, and can be useful to diabetics who seek to control their dietary intake while also promoting weight loss. Gymnema also appears to increase the amount of insulin secreted by the pancreas helping with insulin resistance.

Gymnema can also be consumed as a hot beverage when steeped as a tea by boiling a handful of dry leaves in water. To help mask the bitter taste, it has been suggested to add cardamom for those who find the taste unappealing. Others suggestions were to add a teaspoon of gymnema leaf powder when preparing green tea to drink once or twice per day.

Vitamin E – Research supports the conclusion that people whose diets have a healthy dose of antioxidants, including vitamin E, are at lower risk to develop diabetes then those with lower antioxidant intake. It has also shown that vitamin E helps diabetics to gain better control of their blood sugar. According to preliminary research, a daily dose of vitamin E may help delay the onset of type 2 diabetes in overweight adults who are at high risk for the disease.

Self-awareness: Know Your Body
Another key element to keeping blood sugar levels under control is keeping track of your body. If you have already been diagnosed with elevated blood sugar levels, high or even moderately high, you should test your levels daily. Although the standard is to test before eating, many agree you should test your levels after meals as well. These post-prandial levels can give you insight into how your body is responding to foods and if your body’s response is improving. If you’re on medication it will most certainly depict how your body is handling your food intake accounting for the treatments you partake in.

If you are currently taking any medication to treat diabetes, its extremely important to vigorously test your blood sugar levels especially if you begin taking any of the supplements discussed here. They may help lower your blood sugar and you’ll need your doctors guidance to insure you don’t lower your levels too much as you balance your prescription medications with your new healthy efforts. When levels drop too low this is known as hypoglycemia, and can be risky as well.  Hypoglycemia can happen when a person eats too little food, takes too much insulin, diabetes medicine, or anti-diabetic supplemental treatment or even if one is more physically active than usual. Often hypoglycemia happens suddenly and sometimes there is no explanation for why it occurs. When this happens, a person may have some, all or a combination of the following symptoms: Shaking, fast heartbeat, sweating, dizziness, feeling anxious, hunger, vision problems, weakness, fatigue, headache and irritability.

If you’re ever in a situation where your blood sugar suddenly drops too low, try drinking some orange or apple juice to bring your levels up quickly and prevent any detrimental effects from a hypoglycemic attack. My dad used to keep a small supply of juice boxes with him, even some at his bedside in case his sugar levels dropped at night. This could be a way to insure levels not to fall to low as they will fluctuate when adjusting your medications or adding any new treatments. Again, it’s important to review any new strategies with your doctor including my suggestion to drink juice if your levels drop.

Striking a balance between supplementation and moderating food intake may seem like a delicate dance. But the more you practice, the easier it gets. You’ll surely be the benefactor, as when sugar levels normalize you’ll find you have more energy and feel better.  As they say, “Life is short, and it is up to you to make it sweet.” – Sarah Louise Delany