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  • The Complexities of Diabetes (and Sugar Dysregulation)

    When you hear the word, “diabetes,” sugary and processed foods probably come to mind. Yet, food is only one component of this issue. There’s a lot more going on in the body than we think with sugar dysregulation, and it doesn’t take a full diagnosis of diabetes to wreak havoc on many different body systems. Case in point, I just had a patient whose blood sugar levels were normal, yet she has signs of diabetic neuropathy, or a type of nerve damage due to diabetes.

    Because diabetes is such a multi-faceted disease, it really is the perfect example to explain how everything is connected in the body through the lens of functional medicine. So, let’s dive in and look at the many factors that affect diabetes: 

    • Adrenal Glands – The adrenal glands are small glands that sit on top of the kidneys and manage our stress response, blood sugar control, and blood pressure, among other things. One of their responsibilities is to secrete a hormone called cortisol, which is a master hormone that directs sugar wherever it needs to go, especially during times of stress when blood sugar is needed to fuel the body. This release of cortisol has a profound effect on insulin, how sensitive (or not) our cells are to receiving insulin, our ability (or not) to absorb sugar properly from the gut, and our liver’s function. When the adrenals are stressed from an infection, a food sensitivity and/or reaction, poor sleep, emotional stress, etc. it has the ability to cause sugar dysregulation in even healthy individuals (Knutson & Van Cauter, 2008). If stress becomes chronic, these mechanisms can profoundly negatively affect blood sugar and insulin levels.
    • Liver – Among its 500+ different functions in the body, the liver stores sugar for later use as glycogen. That’s one of the reasons it’s the largest gland in the body; it is a back-up battery when sudden surges of sugar are needed (think “fight or flight” situations). In between meals or during times of stress, the liver breaks down glycogen and releases sugar into the blood. Unfortunately, the livers of today are much more impacted by our environment and lifestyle due to pollutants, medicines, chemicals from our food, etc. This, in turn, negatively affects our liver’s ability to regulate sugar function.
    • Gut – It’s likely that you’ve heard of “leaky gut,” or increased intestinal permeability, which is a condition that abnormally allows undigested food particles and foreign invaders to pass through the lining of the small intestine and into the bloodstream. Having a leaky gut causes inflammation, possible food sensitivities, as well as altered sugar transport in terms of speed and quantity from the intestines to the blood. This, in turn, negatively affects signaling, processing, and receptivity of blood sugar in the body.
    • Pancreas – The pancreas contains beta cells, which store and release insulin. When inflammation is present in the body, the pancreas is very sensitive to it, as it impairs insulin production. When insulin production becomes impaired, beta cells may burnout, leading to a possible dependency on insulin medicine to restore proper pancreatic function. 
    • Insulin Receptor Sites – Every cell in the human body contains insulin receptors. In healthy individuals, insulin binds to the insulin receptors, opening up a gateway for sugar to enter the cell to be utilized for cell function. If this “lock and key” does not open the door, though, it can create a resistance to insulin. Insulin resistance causes insulin (a hormone) to rise, which causes a profound inflammatory effect on other hormones.
    • Health Status – Whatever state your body is in – be it inflamed, stressed, toxic, hormonally imbalanced, etc. – affects how sugar is needed, utilized, and distributed throughout your body.
    • Vascular Health – Damage to blood vessels causes inflammation, which increases blood sugar levels. Blood vessels are also the distribution centers for sugar, so if function is impaired, so is blood sugar distribution.
    • Food – The average American consumes the equivalent of 19.5 teaspoons of sugar per day. The American Heart Association and World Health Organization advise no more than 9 teaspoons a day for men and no more than 6 teaspoons a day for women (Aliferis, 2012). Thus, the average American consumes sugar in a quantity WAY beyond our body’s capacity to utilize sugar in a healthy way.

    Hopefully, this helps paint the bigger picture of diabetes and the many underlying factors involved in the etiology of the disease. Our next blog will focus on this latter component – food – in greater detail, as food is a major component of diabetes (and sugar isn’t the only factor!).

     

    References

    Aliferis, L. (2014). How Much Sugar Is Too Much? A New Tool To Shed Some Light. NPR.org. http://www.npr.org/blogs/thesalt/2014/11/10/363058314/how-much-sugar-is-too-much-a-new-tool-sheds-some-light.

    Knutson, K.L., Van Cauter, E. (2008). Associations between sleep loss and increased risk of obesity and diabetes. Ann N Y Acad Sci. 1129:287-304. http://www.ncbi.nlm.nih.gov/pubmed/18591489

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