A Natural Approach To Healthy Blood Sugar
An all-around health strategy, including exercise, diet, maintaining a proper weight and supplementation, will get patients on the right track— and keep them there.
An unhealthy level of blood sugar, or blood glucose, is the opening act to two fatal headliners: diabetes and metabolic syndrome.
Statistics suggest that Americans aren’t monitoring blood sugar levels with much zeal. According to the National Diabetes Information Clearinghouse (NDIC), diabetes affected 25. 8 million people, or more than eight percent of the U.S. population, in 2011. Of that number, seven million were undiagnosed.
Those numbers are not expected to improve. Angela Ginn, RD, LDN, CDE, a spokesperson for the Academy of Nutrition and Dietetics, predicted that by 2020 one in three Americans will have diabetes.
Metabolic syndrome is a harder-totrack, ailment catch-all marked by high fasting blood sugar. “It is considered the gateway to chronic diseases such as type 2 diabetes, hypertension, high triglycerides and atherosclerosis,” said Kristi Hughes, ND, associate director of medical education at the Institute for Functional Medicine and founder of the Center of Natural Healing Arts, Inc.
“Often described as pre-diabetes, metabolic syndrome allows practitioners to identify the physiologic changes that can take place when insulin resistance, inflammation and inner belly fat are spiraling out of control.”
The toll high blood glucose levels extracts on the body is unforgiving, according to NDIC. It damages nerves and blood vessels, leading to complications, such as heart disease, strokes, kidney disease, blindness and amputations. Diabetes, and thus high blood sugar, has a range of causes—including pregnancy, genetics and even viruses. But with type 2 diabetes, the culprit is easy to find.
“We eat so many sugary meals, it [blood sugar] spikes so high, that it’s followed by a spiking of insulin,” said Michael Smith, MD, community liaison at Florida-based supplement manufacturer Life Extension. “When you go through years of these spikes, your body stops responding to insulin.” Or, as Holly Lucille, ND, RN of Healing From Within Healthcare in West Hollywood, CA, described the process: “[It’s] almost like you start to tune out your annoying little sister who is whining all the time.”
Insulin resistance sets the stage for type 2 diabetes. “This creates a build-up of sugar in the bloodstream and worse, a lack of sugar (fuel) in the cells,” explained Dr. Lucille.
Exercise can help keep blood sugar in check. Of course, it should surprise no one that compared to the past “we have much more of a sit-down culture,” said Kyle Cronin, ND, of the Naturopathic Physicians Group in Scottsdale, AZ, “and it’s quite an ordeal to figure out how to get an hour of exercise in.” Daily exercise, she said, helps bring sugars directly into the muscles and increases insulin sensitivity. Dr. Cronin said she has seen the benefits of exercise firsthand, thanks to a borderline diabetic patient. “If he exercised, blood sugar was normal,” she recalled. “When he stopped, blood sugar would go up.”
Diabetes, according to Ginn, is a “self-management disease.” Maintaining healthy blood sugar involves a natural practitioner providing an all-around health strategy that will get their patients on the right track—and keep them there.
Nutrient Acknowledgement
Supplement options supporting optimal blood sugar abound. Dr. Lucille said she likes ginseng. “Most of the promising studies on ginseng and diabetes have used North American ginseng,” she advised. “Those studies have shown that North American ginseng may improve blood sugar control and glycosylated hemoglobin levels,” which is “a form of hemoglobin in the blood used to monitor blood glucose levels over time.”
Dr. Lucille also expressed enthusiasm over chromium. This essential trace mineral “plays an important role in carbohydrate and fat metabolism and helps body cells properly respond to insulin,” she said. “In fact, studies have found low levels of chromium in people with diabetes.” It also earned high marks from Dr. Cronin, who said chromium “helps insulin get sugar into cells.”
The simple mineral’s long presence in the natural products market may have caused people to overlook it, Dr. Cronin added.Meanwhile, Dr. Lucille inadvertently revealed another possibility for its neglect: studies featuring supplementation are far from conclusive.
“For example, a small study published in the journal Diabetes Care compared the diabetes medication sulfonylurea taken with 1,000 mcg of chromium to sulfonylurea taken with a placebo,” said Dr. Lucille. “After six months, people who did not take chromium had a significant increase in body weight, body fat and abdominal fat, whereas people taking the chromium had significant improvements in insulin sensitivity. Another study published in the same journal, however, examined the effect of chromium on glycemic control in insulin-dependent people with type 2 diabetes. People were given either 500 or 1,000 mcg a day of chromium or a placebo for six months. There was no significant difference in glycosylated hemoglobin, body mass index, blood pressure or insulin requirements across the three groups.”
Ginn detailed a variety of supplement possibilities and their assets. Cinnamon increases insulin sensitivity, especially when taken two hours after eating. Fenugreek slows the absorption of sugar in the stomach and stimulates insulin production. Some of her patients have seen an increase in insulin with bitter melon, which stimulates the pancreas to create more insulin.
“It takes a while for the benefits of some supplements to be seen,” Ginn said, who mentioned fenugreek and bitter melon as two examples, “so there’s not a lot of research.” She stressed that practitioners do their homework before recommending supplements to patients.
Supplemental Offerings
Life Extension’s Dr. Smith favors lipoic acid, calling it “a very powerful nutrient” for insulin sensitivity, as well as white kidney bean extract and the simple plant sugar L-arabinose. The latter two block certain digestive enzymes, slowing sugar absorption into the bloodstream. Another favorite is chlorogenic acid, a polyphenol found in the green coffee bean.
Life Extension offers CoffeeGenic, a green coffee bean extract (standardized to 50 percent chlorogenic acid) that inhibits the enzyme glucose-6 phosphatase to slow down the release of and creation of excess glucose in the body.
The effects of green coffee bean extract on blood sugar were presented last fall at the 29th Annual Scientific Meeting of the Obesity Society in Orlando, FL. Scientists conducted a study among 56 healthy volunteers, administering an oral glucose tolerance test before and after a supplemental dose of green coffee extract to measure after-meal blood sugar response.
In subjects not taking green coffee bean extract, the oral glucose tolerance test showed the expected rise of blood sugar to an average of 144 mg/dL after 30 minutes. But in subjects who had taken 200 mg of the green coffee bean extract, that sugar spike was reduced to 124 mg/dL—a 14 percent decrease. The difference existed throughout the twohour study.With a 200 mg dose of green coffee bean extract, subjects had a mean 19 percent reduction of blood sugar at one hour, and a 22 percent reduction (glucose down to 89 mg/dL) at two hours, compared to each patient’s own untreated levels. A 400 mg dose of green coffee bean extract saw reductions of 24 percent at 30 minutes, 28 percent at an hour and 28 percent after two hours, Dr. Smith added.
Some manufacturers take a more inclusive approach. Blood Sugar Balance Formula from America’s Finest, a practitioner line exclusively using ingredients from New Jersey-based Sabinsa Corp., “blends the traditional ayurvedic herbs with the new and more bioavailable form of minerals— organic minerals,” said Dr. Anurag Pande, PhD, Sabinsa’s vice president of scientific affairs.
Dr. Pande outlined the product’s ingredient profile, which includes bitter melon extract and free radical killer alpha lipoic acid. The blend lowers blood sugar while providing antioxidant and mineral support for diabetics.
“The two most prominent herbs used in ayurveda for blood sugar management are gymnema leaves extract and momordica charantia fruit extract,” he said. “Gymnema leaves are often used in India for discouraging people from eating sugar, as chewing the leaves suppresses the sweetness. Vanadium in BGOV [bis-glycinato oxo vanadium] … has potential in management of both type 1 and type 2 diabetes. It has an insulin mimicking effect, which helps to improve glucose management in insulin-dependent diabetics. BGOV also contains glycine, which is one of the amino acids … this formula is supported by the patented bioavailabilityenhancing ingredient called BioPerine, which increases absorption of the actives in the formula for better results.”
Glucose Balance PX from Vermontbased Restorative Formulations features an array of blood sugar-friendly ingredients, including gymnema, chromium and vanadium. Also on the ingredient list is silymarin, or milk thistle. Researchers at Iran’s Department of Pharmacology, Institute of Medicinal Plants, found that type 2 diabetic patients who took 200 mg of silymarin three times daily for four months, along with conventional treatment, saw a beneficial effect on their glycemic profile. Glucose Balance PX also includes opuntia, better known as prickly pear cactus. “Juice and extract from opuntia are used worldwide for supporting healthy metabolism of fats and sugars,” according to the company.
Metagenics, based in California, has expanded its services beyond products, offering FirstLine Therapy Certification (FLTC) programs to natural practitioners. The company describes FirstLine Therapy (FLT) as “a personalized lifestyle medicine program that incorporates therapeutic lifestyle changes (TLC), such as healthy nutrition, nutritional protocols, exercise and stress management.”
Participants, according to Dr. Hughes, who is an FLTC instructor, “learn how to use the lifestyle medicine materials and tools” to treat what she calls “cardiometabolic syndrome,” which ranges “from metabolic syndrome to altered lipids profiles (i.e. cholesterol, triglycerides, etc.), and high blood pressure, cardiovascular disease, altered body composition to obesity and type 2 diabetes.” After the three and a half day program, a FLT certified practitioner can partner with an “FLT practice specialist” who will assist the practice in creating and implementing its own FLT action plan.
“FLT is the solutions-based program that provides a portfolio of flexible tools and training to streamline the integration of lifestyle therapy into clinical practice regardless of the specialty or practice focus,” Dr. Hughes said. “It provides the patient education and guidance in a format that patients can understand and follow for life. This is why patients get superior results.Many are able to experience risk reduction goals in as little as 12 weeks.”
An integrative approach is exactly what natural practitioners should share with their patients, according to Sabinsa’s Dr. Pande. “Supplements provide support for healthy blood sugar levels,” he said. “However, the importance of a healthy lifestyle cannot be overstated.”
Ginn agreed, adding that exercise, diet and a healthy weight can increase insulin sensitivity.
Food & the Physical
Exercise doesn’t have to even be intense, just a 45-minute walk, said Dr. Cronin, adding that exercise also relieves stress, which is a destructive force on the body.
“No. 1 for everyone with a sugar issue: do resistant muscle exercises, not heavy weights or muscle building,” concurred Life Extension’s Dr. Smith. “Resistant exercises are about muscle tonicity. Your skeletal muscles, they are the most metabolically active system in the body.” When toned, he explained, they “love to soak up sugar from the blood.”
Staying active means little, however, if the right diet isn’t followed. “I get people on the right diet,” said Dr. Smith. “They’re exercising, taking the right nutrients, but when I question them I find out they’re going to Dunkin’ Donuts and getting their doughnut every day.”
A dietary game plan is easy to recommend. “One of the best things one can do is to eat a whole foods diet full of fruits and vegetables with clean protein, including legumes and whole grains, and decrease the consumption of refined food products and sugar,” said Dr. Lucille. “It is also imperative to keep your blood sugar stable by eating small meals frequently throughout the day.”Other dietary lapses that lead to increased blood glucose levels, according to Dr. Hughes: excess carbohydrates, a lack of phytonutrients and skipping meals.
Buying the right foods and preparing them properly cannot be overlooked, according to Dr. Cronin. Patients should gravitate to foods that aren’t processed and stick to raw fruits and vegetables. “Say you have an apple,” she said. “If you’re apple is fresh and raw, that has the fibers and the enzymes, but, basically, it has a much lower glycemic index than if you cooked it.” The glycemic index ranks carbohy drates on a scale from 0-100 according to the extent to which they raise blood sugar levels after eating.
Dr. Cronin said patients might stay on the good side of the glycemic index by incorporating inadvisable sources of protein. An example offered is a patient asking: A baked potato is OK if I load it with sour cream and bacon bits? No, it’s not, she shared, but having carrots and celery with hummus is.White potatoes can be replaced with other potatoes. Small replacements go a long way. “Take the person where they are and bring them a little closer to what they can do,” Dr. Cronin advised. “You don’t want it so people are frustrated.”
When it comes to diabetes prevention, Ginn believes scare tactics and going too far into the future don’t work. A patient’s game plan “must be personal and immediate,” she said.
“Once they understand what diabetes is—understand the real definition of it— then we look to see what their personal care is,” Ginn added. “If it’s to lose weight and live a long healthy life, I want to walk, focus on those goals and make sure they’re associated with a larger goal.”
Finally, natural practitioners must take initiative. Ginn advised testing patients of all ages, and not waiting until blood sugar levels skyrocket past the recommended numbers—a fasting blood glucose level of between 80-90; HgbA1C levels below 5.5, according to Dr. Hughes. Any number on the borderline of high “needs to be addressed right then and there,” said Ginn, adding that that approach can reduce health care costs and give patients a better quality of life.
It’s a little step that might reverse what is quickly becoming a national health nightmare.
Healthy Take Aways
Diabetes, which results from high blood sugar levels, affects over 25 million Americans. Seven million don’t know they have the disease.
The keys to increasing insulin sensitivity are exercise, diet and maintaining a proper weight. There are no shortcuts; all three must be followed.
Popular supplement options for healthy blood sugar include chromium, cinnamon and ayurvedic herbs.
Natural practitioners must stress to patients that maintaining healthy blood sugar can be accomplished in small, gradual steps.
