Type 2 diabetes is a chronic condition that affects the way your body metabolizes sugar (glucose) — an important source of fuel for your body. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or does not produce enough insulin to maintain normal glucose levels.
Today more people are being diagnosed with diabetes than ever due to many factors including the rise in childhood obesity. Diabetes is caused by insulin resistance which along with inflammation is the main driver of most cardiometabolic disease. Three of the top six chronic diseases among Americans are classified as cardiometabolic disease: Cardiovascular disease, Type 2 diabetes, and Stroke.
Functional medicine provides evidence for many of the factors that contribute to why this happens, besides genetics. It also offers a better roadmap to identify these risk factors and clearer solutions to address them once they have been identified. Genetics and environmental factors, such as being overweight and inactive are clear contributors, but there are other risk factors that lead to chronic inflammation and promote insulin resistance. These include:
- Physical inactivity
- Diets high in sugar
- Excessive alcohol
- Poor sleep
- Environmental toxins
- Unhealthy gut flora
- Leaky gut barrier
Conventional medicine teaches us that there is no pharmaceutical cure for type 2 diabetes. However, lifestyle medicine (functional medicine) recognizes that losing weight, eating healthy and exercising can help manage the disease and often reverse it, especially if other factors that may be contributing are addressed. If lifestyle changes are not enough to manage your blood sugar, you may benefit from integrative therapies that have been studied and shown to help control the disease. When these measures fail, diabetic medications or insulin may be needed, but there is evidence that these could be minimized by taking those initial steps first.
In fact, you may have type 2 diabetes for years and not know it because signs and symptoms often develop slowly. Signs and symptoms of type 2 diabetes to look for are:
Unintended weight gain/loss
Areas of darkened skin in armpits and neck
Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Insulin is a hormone that comes from the gland situated behind and below the stomach (pancreas). The pancreas secretes insulin into the bloodstream in response to a meal. The insulin circulates, enabling sugar to enter your cells and lower the amount of sugar in your bloodstream. As your blood sugar level drops, so does the secretion of insulin from your pancreas.
Glucose — a sugar — is a main source of energy for the cells that make up muscles and other tissues. Glucose comes from two major sources: food and your liver. Sugar is absorbed into the bloodstream, where it enters cells with the help of insulin. Your liver stores and makes glucose. When your glucose levels are low, such as when you have not eaten in a while, the liver breaks down stored glycogen into glucose to keep your glucose level within a normal range.
In type 2 diabetes, this process does not work well. Instead of moving into your cells, sugar builds up in your bloodstream. As blood sugar levels increase, the insulin-producing beta cells in the pancreas release more insulin, but eventually these cells become impaired and cannot make enough insulin to meet the body’s demands or more commonly the cells of the body become resistant to the actions of insulin. In the much less common type 1 diabetes, the immune system mistakenly destroys the beta cells of the pancreas, leaving the body with too little insulin.
Factors that may increase your risk of type 2 diabetes in addition to being overweight, is fat distribution. If you store fat mainly in the abdomen, you have a greater risk of type 2 diabetes than if you store fat elsewhere, such as in your hips and thighs. Your risk of type 2 diabetes rises if you are a man with a waist circumference above 40 inches (101.6 centimeters) or a woman with a waist that is greater than 35 inches (88.9 centimeters).
The risk of type 2 diabetes increases as you get older, especially after age 45. That is likely because people tend to exercise less, lose muscle mass and gain weight as they age. But type 2 diabetes is also increasing dramatically among children, adolescents and younger adults. Type 2 diabetes can be difficult to recognize in the early stages when you may have few symptoms.
Diabetes affects many major organs, including your heart, blood vessels, nerves, eyes and kidneys. Controlling your blood sugar levels can help prevent these complications. Diabetes dramatically increases the risk of cardiovascular disease and atherosclerosis. It can also result in nerve damage (neuropathy). Excess blood sugar can cause tingling, numbness, burning or pain that usually begins at the tips of the toes or fingers and gradually spreads upward.
Poor diabetes control can sometimes lead to kidney failure or irreversible kidney disease, which may require dialysis or a kidney transplant. Diabetes increases the risk of serious eye diseases potentially leading to blindness. Left untreated, cuts and blisters can become serious infections, which may heal poorly. Severe damage might require toe, foot or leg amputation. Hearing problems are more common in people with diabetes. Diabetes may leave you more susceptible to skin problems, including bacterial and fungal infections. Type 2 diabetes increases the risk of Alzheimer’s disease, although the mechanism is not well understood. The worse your blood sugar control, the greater the risk appears to be.
Although long-term complications of diabetes develop gradually, they can eventually be disabling or even life-threatening:
- Heart disease or stroke
- Retinopathy – blindness
- Erectile dysfunction
- Nephropathy – kidney disease
- Neuropathy – nerve damage
- Vascular disease – limb amputations
- Alzheimer’s disease
Healthy lifestyle choices can help prevent type 2 diabetes and improve the long-term prognosis, even if you have diabetes in your family. If you have already received a diagnosis of diabetes, you can use healthy lifestyle choices to help control the disease and prevent complications. If you have prediabetes, lifestyle changes can slow or stop the progression to diabetes.
A healthy lifestyle includes
- Eating healthy foods.Choose foods lower in sugar and calories and higher in fiber, so not processed. Focus on fruits, vegetables and whole grains.
- Getting active. Aim for a minimum of 30 to 60 minutes of moderate physical activity — or 15 to 30 minutes of vigorous aerobic activity — on most days. Take a brisk daily walk. Ride a bike. Swim laps. If you cannot fit in a long workout, spread your activity throughout the day.
- Losing weight. If you are overweight, losing 5 to 10 percent of your body weight can reduce the risk of diabetes. To keep your weight in a healthy range, focus on permanent changes to your eating and exercise habits. Motivate yourself by remembering the benefits of losing weight, such as a healthier heart, more energy and improved self-esteem.
- Avoiding being sedentary for long periods. Sitting still for long periods can increase your risk of type 2 diabetes. Try to get up every 30 minutes and move around for at least a few minutes.
Healthy lifestyle choices remain the cornerstone and are essential for preventing or managing diabetes. However, there are several ways utilized in functional medicine to identify patients that are at increased risk of developing diabetes or at greater risk of developing complications of diabetes based on detailed history and screening along with blood testing. The advanced cardiometabolic analysis performed at Willowbend Health & Wellness helps us to understand the key contributors to inflammation and insulin resistance in each patient and identify the best course of action to improve your cardiometabolic health. This is done in a comprehensive systems biology approach to help us identify a starting point and a treatment focus. This offers clear advantages over the conventional model of care that treats symptoms or complications as they unfold. With functional medicine the goal is to arrest or reverse the disease process to assist patients in regaining better quality of life. We are here to assist you.