Diabetes Mellitus
Diabetes mellitus is a chronic condition that affects how your body turns food into energy. There are three main types of diabetes: Type 1, Type 2, and Type 3. Each type has distinct characteristics, causes, and treatment approaches. As a clinical nutritionist, understanding these differences is crucial in helping manage and mitigate the impact of diabetes through diet and lifestyle changes.
Type 1 Diabetes Mellitus
Etiology: Type 1 diabetes is an autoimmune condition where the body's immune system attacks the insulin-producing beta cells in the pancreas. This leads to little or no insulin production. The exact cause is unknown, but genetic predisposition and environmental factors such as viral infections are believed to play a role.
Symptoms:
Increased thirst and urination
Extreme hunger
Unintended weight loss
Fatigue and weakness
Blurred vision
Diagnosis:
Fasting Blood Sugar Test: A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher on two separate tests indicates diabetes.
Random Blood Sugar Test: A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher at any time of the day, combined with symptoms, suggests diabetes.
Hemoglobin A1c Test: An A1c level of 6.5% or higher on two separate tests indicates diabetes. This test reflects average blood sugar levels over the past 2-3 months.
Autoantibody Tests: These tests can help distinguish Type 1 diabetes from Type 2 diabetes by detecting specific autoantibodies.
Treatment:
Insulin therapy (injections or pump)
Blood sugar monitoring
Healthy eating
Regular physical activity
Nutritional Deficiencies: People with Type 1 diabetes might experience deficiencies in vitamins and minerals such as vitamin D, calcium, magnesium, and zinc due to dietary restrictions or the body's altered nutrient absorption.
Type 2 Diabetes Mellitus
Etiology: Type 2 diabetes is characterised by insulin resistance, where the body's cells do not use insulin properly. Initially, the pancreas makes extra insulin to compensate, but over time it can't keep up, leading to high blood sugar levels. Risk factors include genetics, obesity, physical inactivity, and poor diet.
Symptoms:
Increased thirst and urination
Increased hunger
Fatigue
Blurred vision
Slow-healing sores or frequent infections
Areas of darkened skin, usually in the armpits and neck
Diagnosis:
Fasting Blood Sugar Test: A fasting blood sugar level of 126 mg/dL (7.0 mmol/L) or higher on two separate tests indicates diabetes.
Random Blood Sugar Test: A blood sugar level of 200 mg/dL (11.1 mmol/L) or higher at any time of the day, combined with symptoms, suggests diabetes.
Hemoglobin A1c Test: An A1c level of 6.5% or higher on two separate tests indicates diabetes.
Oral Glucose Tolerance Test (OGTT): After fasting, drinking a sugary solution, and measuring blood sugar levels after 2 hours, a level of 200 mg/dL (11.1 mmol/L) or higher indicates diabetes.
Treatment:
Blood sugar monitoring
Healthy eating
Regular physical activity
Weight loss if needed
Oral medications or insulin therapy in advanced cases
Nutritional Deficiencies: Type 2 diabetes patients might be deficient in magnesium, chromium, and vitamin D. These deficiencies can exacerbate insulin resistance and poor blood sugar control.
Type 3 Diabetes Mellitus (Type 3c or Alzheimer's-related Diabetes)
Etiology: Type 3 diabetes is a term sometimes used to describe Alzheimer's disease as insulin resistance and deficiency in the brain, contributing to cognitive decline. Another usage refers to Type 3c diabetes, which results from pancreatic diseases such as pancreatitis, cystic fibrosis, or pancreatic cancer.
Symptoms:
For Alzheimer's-related diabetes: memory loss, confusion, difficulty in performing familiar tasks
For Type 3c diabetes: symptoms similar to Type 1 and Type 2 diabetes, along with digestive issues
Diagnosis:
For Alzheimer's-related diabetes: Diagnosis involves neuropsychological testing, brain imaging, and considering insulin resistance markers.
For Type 3c diabetes: Diagnosis includes typical diabetes tests (fasting blood sugar, A1c) combined with tests for underlying pancreatic conditions (imaging studies, pancreatic function tests).
Treatment:
For Alzheimer's-related diabetes: management focuses on cognitive symptoms, often using medications for Alzheimer's, lifestyle changes, and blood sugar control.
For Type 3c diabetes: insulin therapy, pancreatic enzyme supplements, and management of underlying pancreatic condition.
Nutritional Deficiencies: People with Type 3 diabetes may experience deficiencies in fat-soluble vitamins (A, D, E, K) due to pancreatic insufficiency affecting nutrient absorption. They may also be deficient in omega-3 fatty acids, which are important for brain health.
Nutritional Recommendations for Diabetes Management
As a clinical nutritionist, guiding my patients towards a balanced diet rich in essential nutrients is key to managing diabetes. Here are some general recommendations:
Carbohydrates: Focus on complex carbohydrates with a low glycemic index, such as whole grains, legumes, and vegetables. Limit refined sugars and processed foods.
Protein: Include lean protein sources like fish, poultry, beans, and nuts. Protein helps in maintaining muscle mass and can aid in blood sugar control.
Fats: Encourage healthy fats from sources like avocados, nuts, seeds, and olive oil. Avoid trans fats and limit saturated fats.
Fiber: A high-fiber diet can help control blood sugar levels and promote digestive health. Aim for fiber-rich foods such as vegetables, fruits, whole grains, and legumes.
Micronutrients: Ensure adequate intake of vitamins and minerals, particularly those that may be deficient in diabetes. Consider supplements if necessary, but always based on individual assessments.
Conclusion
Diabetes mellitus is a complex condition requiring a comprehensive approach to management, including medical treatment, lifestyle changes, and nutritional support. Understanding the nuances of each type of diabetes enables better personalised care for those affected.
If you or someone you know is managing diabetes and needs personalised nutritional guidance, I am here to help. Book a consultation with me today to start your journey towards better health and well-being. I offer telehealth consultations Monday through Friday, and in-person consultations on Wednesdays and Fridays at Professional Chinese Medicine Services.
Address: Suite 5, Level 2/517 St Kilda Rd, Melbourne VIC 3004
I look forward to supporting your health journey!