Diabetes and Glucose Control
Diabetes mellitus is characterized by high levels of glucose in the blood. Type 2 diabetes is far more common than type 1 diabetes and is mainly caused by resistance to the effects of the hormone insulin, which facilitates removal of glucose from the blood. Type 1 diabetes is primarily caused by destruction of insulin-producing pancreatic beta cells.
Chronically elevated fasting blood glucose levels—or recurrent, excessive spikes in glucose levels after meals—can lead to devastating long-term consequences such as heart disease, blindness, kidney failure, liver disease, and cancer.
Several natural products, such as white mulberry leaf extract, brown seaweed extract, cinnamon extract, and sorghum bran extract, may promote optimal glucose metabolism and help facilitate healthy glycemic control.
Conventional diagnostic criteria for diabetes include:
Fasting plasma glucose 126 mg/dL or greater,
Non-fasting plasma glucose level 200 mg/dL or greater with diabetes symptoms,
Plasma glucose level 200 mg/dL or greater 2 hours after a 75-g oral glucose tolerance test, or
HbA1C 6.5% or greater
Note: Life Extension believes everyone should strive for optimal glucose control, regardless of whether or not they are diabetic. This means taking action to improve your glycemic control if your fasting glucose is over 85 mg/dL or your HbA1C is higher than 5.0%.
Treatment of Type 2 Diabetes
Dietary and Lifestyle Considerations
Blood sugar control (as assessed by the HbA1C test) is the primary goal of diabetes treatment.
Note: The risk-benefit equation of intensive glycemic control may progressively shift in favor of less-intensive control as diabetes progresses.
Control blood pressure and lipids (see Life Extension’s High Blood Pressure and Atherosclerosis and Cardiovascular Disease protocols).
Eat a low-glycemic-load diet, such as the Mediterranean diet.
In adults with diabetes, 150 minutes per week of moderate-intensity aerobic exercise is generally recommended.
Metformin is considered the first-line drug for type 2 diabetes. Metformin has also been shown to promote weight loss and protect against some cancers, cardiovascular disease, and Alzheimer disease.
Acarbose is a drug that lowers glucose by blocking breakdown of starches and slowing absorption of sugar and carbohydrates.
Other oral glucose-lowering agents or injectable drugs such as insulin may be necessary depending on individual glycemic control and diabetes severity.
Novel and Emerging Strategies
Stem cell therapy is aimed at replacing damaged or destroyed insulin-producing pancreatic beta cells in diabetics with new beta cells derived from human stem cells.
Glucokinase activators have been shown to lower glucose levels and stimulate proliferation of pancreatic beta cells in animal models of type 2 diabetes.
Two anti-obesity agents, lorcaserin and the combination of phentermine and topiramate, have been shown to improve glycemic control in obese individuals with type 2 diabetes.
White mulberry leaf: A component of white mulberry slows carbohydrate absorption and may lessen post-meal blood sugar spikes.
Brown seaweed: In a randomized controlled trial, brown seaweed extract caused a 48.3% decrease in post-meal blood sugar spikes. Significant reductions in post-meal insulin concentrations and improved insulin sensitivity were also observed.
Cinnamon: Studies that supplemented type 2 diabetics and healthy individuals with cinnamon reported lower levels of fasting glucose, HbA1C, and after-meal glucose and insulin concentrations, as well as improvements in insulin sensitivity. These effects have been demonstrated even in those already taking glucose-lowering medication.
Sorghum bran: In a randomized trial in healthy men, muffins made with sorghum were shown to reduce average after-meal glucose and insulin responses.
Benfotiamine: In a clinical trial, type 2 diabetics consumed a high-AGE (advanced glycation end product) meal before and after a 3-day course of benfotiamine. The subjects’ vascular function was assessed after both high-AGE meals. Benfotiamine administration reduced vascular dysfunction.
Note: Under no circumstances should people suddenly stop taking antidiabetic drugs, especially insulin. Individuals with diabetes should work closely with their healthcare provider before initiating a supplement regimen due to the potential risk of hypoglycemia.