Dr. Podell on Diabetes

The following is excerpted with permission from a book written by Dr. Richard Podell, M.D. This information has been helpful to thousands of people in the past, but is not meant to replace your physician. Be sure to check with your physician before undergoing any change in diet. ©1993 The Podell Medical Center, all rights reserved. May not be reproduced in any form without prior written permission. (see Podell Medical Center) http://www.DrPodell.org

Terry G., 60 years old, had been diabetic for 8 years when she got “nutrition religion”. Six months later and 30 pounds lighter she had a nearly normal blood sugar, had shed all her diabetes medicines and felt better than she had since her teens. Terry’s case is not an exception. Probably half of all diabetics could relinquish their insulin or diabetes pills through meticulous attention to nutrition. And, all diabetics would probably benefit–reducing their risk for diabetes’ long term complications

Diabetics have an increased vulnerability to heart disease, stroke, nerve damage, eye disease, kidney failure, infection and poor wound healing. This is due to several inter-related metabolic abnormalities. Their body’s resist the action of insulin, the hormone that drives sugar (glucose) from the blood into the cells. This is called “insulin resistance.” The diabetic’s blood becomes “thick” or “sticky”. This causes blood clots or thromboses that damage blood vessels. Their metabolism creates excessive levels of biochemical oxidants or free radicals. This injures tissue and stresses the body’s anti-oxidant defenses. Glucose molecules engage in an abnormal coupling with body proteins–a step called glycosylation. This disrupts the proteins’ ability to function biochemically.

Definitely Effective:

• Weight loss
• HCF Diet –high in complex carbohydrates and plant fiber (e.g. whole fruit, green vegetables and beans), low in saturated animal fats, simple sugars.
• Mediterranean Diet–similar to HCF Diet except higher in certain unsaturated vegetable oils; moderate intake of carbohydrates.
• Exercise

Probably Effective:

• Plant fiber concentrates
• Mental Calmness
• Treat High Blood Pressure
• Treat High Cholesterol

Exercise: Exercise rapidly increases the body’s sensitivity to insulin, reducing blood sugar levels.

HCF Diet: Blood sugar usually improves with a diet that is high in complex carbohydrates and plant fiber, and low in saturated animal fat, sugar and refined starch. Strive for at least 5 fruit and vegetable servings daily.

Mediterranean Diet: The most useful alternative to the HCF diet is one that is low in carbohydrates, low in saturated/animal fat, but moderately high in mono-unsaturated oil (olive, canola) and polyunsaturated vegetable oils. (See The Mediterranean Diet). With either diet you are metabolically better off if your carbohydrates come mainly from vegetables, legumes (beans), and whole fruit rather than from sugar, bread or other processed grains.

Mental Calmness: Stress increases the adrenal glands’ output of adrenaline and cortisone, two hormones which act to increase blood sugar. Relaxation training and stress management techniques help improve blood sugar control.

Plant Fiber Concentrates: Plant fiber concentrates such as psyllium (Metamucil, etc.) do more than just help constipation. They also slow the absorption of sugar and starch. The following fibers have modest blood sugar lowering effects: glucomannan, guar gum, legume fiber, oat gum, pea fiber, apple pectin, psyllium. Of course, the most direct way to get fiber is from increasing the fruit, vegetable and legumes in your diet.

Treat Cholesterol: High cholesterol increases the diabetic’s risk for heart disease and stroke. Discuss treatment with your physician.

Treat High Blood Pressure: Even modest blood pressure elevations greatly increase the risk of diabetes complications. Most diabetics should be compulsive about blood pressure control.

Weight loss: It’s easier said than done, but more than half of all adult-onset diabetics could abandon their medicines by slimming down to within 20% of their “ideal” weight. Excess fat cells create chemical messengers that block the body’s ability to respond to insulin. As the fat comes off the diabetic’s own insulin works better and blood sugar improves.

SUPPLEMENT SUGGESTED COMMENTS

DOSE

Probably Effective:

• Chromium 50-200 mcg
• Coenzyme Q 60-120 mg
• Garlic, onion See below
• Magnesium 300-600 mg
• Vegetable Oil See below
• Vitamin E 400-900 units Close medical supervision
• for >400 units
• Zinc 20-40 mg

Possibly Effective:

• Biotin 3-16 mg Doses over 3 mg require
• close medical supervision
• Vitamin C 500-2000 mg
• Vitamin B 6 50 mg

Probably Effective:

• Capsaicin See below Natural derivative of hot pepper
• Primrose Oil 500 mg of GLA
• Vitamin B 1 50-100 mg
• Vitamin B 12 100 mcg

Possibly Effective:

• Inositol See below Effective in rats but not proved effective in people
• Vitamin B 6 50 mg
• Vitamin C 500-2000 mg

Probably Effective:

• Fish Oil (may increase blood sugar). Do not use without close medical supervision
• Garlic, onion See below
• Taurine 500 mg three times daily (requires close medical supervision)
• Vegetable Oil See below
• Primrose Oil 500 mg GLA

Possibly Effective:

• Magnesium 300-600 mg
• Vitamin E 400 units
• Vitamin B 6 50 mg

Probably Effective:

• Bilberry (herbal) See below
• Bioflavonoids See below
• Coenzyme Q 60-120 mg
• Folic Acid 400-1000 mcg
• Pygnogenols (herbal) See below
• Vitamin B 12 100 mcg
• Vitamin E 400 units
• Possibly Effective
• N-Acetyl Cysteine 500 mg Source for the antioxidant glutathione
• Vitamin C* 500-2000 mg

BILBERRY (Vaccinium myrtillus) is an herb which is high in bioflavonids. It may improve the ability of key proteins to resist abnormal interaction with glucose (glycosylation) and strengthen blood vessels. One study suggests possible benefit for diabetics with retinal disease. Typical dose: 80-160 mg of standardized extract three times daily.

BIOFLAVONOIDS such as quercetin or rutin increases the strength of blood vessels, especially capillaries, and might also increase the pancreas’ production of insulin. See bioflavonoid chapter for discussion of dose.

BIOTIN reduced blood sugar in two double blind studies. However, the dose used were extremely large (9 mg daily). We know little about toxicity at this dose level. One small study found biotin effective for diabetic nerve damage.

CAPSAICIN, a substance found in jalopena pepper reduces diabetic nerve pain if rubbed on the painful area several times daily over a period of weeks. , It is available over-the-counter as Zostrix or as much less expensive generic brands.

CHROMIUM at doses of 50 to 200 micrograms daily reduces blood sugar and insulin requirement in some diabetics, especially among diabetics over age 65.

COENZYME Q: Three Japanese studies indicate that 60 to 120 mg of coenzyme Q daily increases insulin production and improves blood sugar control. Coenzyme Q is an important factor in cellular energy production and also has antioxidant properties.

FOLIC ACID AND VITAMIN B 12 may reduce the risk of heart disease and stroke among the large proportion of diabetics who have an elevated blood level of the amino acid, homocysteine. Vitamin B 12 may also help some patient with diabetic nerve damage. Your doctor can measure the dose needed by response to the blood level of Homocysteine and Methylmalonic Acid. (See section on these nutrients.)

GARLIC AND ONION both have significant blood sugar-lowering action as well as blood-thinning and cholesterol-lowering effects. One study found an increasing ability to reduce blood sugar for increasing amounts of onion over the range of one to seven ounces. Raw and boiled onion had similar effect. Garlic has an effect at one to two cloves a day. Commercial deodorized garlics are also effective at a daily dose that provides about 8 mg of alliin–one of garlic’s main active components.

GLUTATHIONE is often low in diabetics. This may interfere with vitamin C metabolism. Taking N-Acetyl Cysteine (NAC) may increase glutathione.

INOSITOL helps diabetic nerve damage in rats but supplementation studies in humans has so far been disappointing.

MAGNESIUM has potentially beneficial effects at several key steps of glucose and insulin metabolism. Diabetics tend to lose magnesium in their urine and develop magnesium deficiency. Diabetics who are in poor blood sugar control or who develop complications have a higher rate of magnesium deficiency.

PRIMROSE OIL, a source of the essential fatty acid GLA reduced nerve damage in a one year double-blind study of 111 diabetics. Patients taking a placebo were not helped. The treatment dose was 480 mg of GLA (gamma linolenic acid). This required 12 capsules daily. Lower doses might work if dietary fat were restricted. Borage and black currant seed oil are alternative and somewhat less expensive sources of GLA. Two large borage capsules could provide 480 mg of GLA.

PYCNOGENOLS (also known as OCPs or Pine Bark Extract) are bioflavonoids extracted from grape seed skin or certain tree barks. They are similar to the active ingredients in Bilberry. Pycnogenols may improve the integrity of blood capillaries in diabetics. Typical dose: 150 to 300 mg daily.

TAURINE is an amino acid which tends to be low in diabetics. During a 90 day “double-blind” study Taurine supplements reduced the “stickiness” of the blood of diabetics. The dose used was a modest 500 mg three times daily.

VEGETABLE OILS containing large amounts of polyunsaturated fatty acids (PUFA) may reduce blood sugar, blood vessel and nerve complications. Warning: The best way to get vegetable oil us to eat green and yellow vegetables, legumes, nuts and seeds. Salad oils and margarine are okay in moderation, but high doses increase the body’s oxidative stress. Take extra vitamin E if you eat much oil.

Vitamin B6 (pyridoxine) is often low in diabetics, especially among those who have nerve damage. Vitamin B 6 is important for magnesium metabolism. Some studies show benefit for diabetics taking vitamin B 6, but others do not.

VITAMIN C is often low in diabetics. Most studies show an improvement in blood sugar control with taking vitamin C supplements. However, others do not, and the matter is not yet settled. Caution: Extra vitamin C can affect the results of urine tests for glucose. It does not alter the blood tests.

VITAMIN E: At 400 I.U. daily Vitamin E reduces oxidation stress and decreases the stickiness of blood. At 900 I.U., vitamin E has been shown to improve the body’s ability to use glucose and might reduce insulin requirements. Many people use vitamin E at 400 I.U. Toxic reactions, if they occur, seem to be rare. However, there is not much experience with the 900 I.U. dose.

VITAMIN B1 (thiamine), if low, can contribute to nerve damage. Your doctor can check your thiamine level with a functional test called a erythrocyte transketolase.

ZINC: At 20 mg daily zinc may improve glucose utilization, strengthen wound healing and increase resistance to infection.

SUMMARY:

Dietary Advice:

• Seek ideal weight.
• Prescribe yourself 5 servings per day of vegetables and fruit. Encourage Legumes.

• Adopt a low fat, high plant fiber/complex carbohydrate diet (See HCF Diet). However, a low carbohydrate, Mediterranean- type diet is preferred for those who do not do well with high carbohydrates.

Therapeutic Supplements:

Most diabetics should take a high-dose Therapeutic-Style Vitamin/Mineral supplement such as Diabetiks®. This supplement provides large, but reasonable doses of the nutrients noted with *. The following daily supplements make sense for most diabetics:

• Bioflavonoids* 100 mg
• Chromium* 50-200 mcg
• Folic Acid* 400-1000 mcg
• Magnesium* 300-600 mg
• N-Acetyl Cysteine 500 mg (glutathione source)
• Vitamin B 1* 50-100 mg
• Vitamin B 12* 100 mcg
• Vitamin B 6* 50 mg
• Vitamin C* 500-2000
• Vitamin E* 400 I.U.
• Zinc* 20-40 mg.

In consultation with your physician consider also:

• Biotin (only with intense medical supervision)
• Bilberry or Pycnogenols as a source of bioflavonoid
• Capsaicin (for pain due to nerve damage)
• Coenzyme Q 60-120 mg.
• Fiber supplements.
• Garlic, onion–definitely as a food, and, with the advice of your physician as a supplement.
• Primrose Oil (GLA)–especially for nerve damage
• Taurine-especially for blood thinning.

A parent’s letter of daughter’s progress from vaccine induced juvenile diabetes.
More information on DIABETES.

This information has been helpful to thousands of people in the past, but is not meant to replace your physician. Be sure to check with your physician before undergoing any change in diet.We recommend taking the anti-oxidants PowerVites, Diabetiks and either Primrose Oile or Signal369for GLA.