Dr. Mona Morstein discusses An Integrative Approach to Diabetes at the March 24, 2022 Functional Medicine Discussion Group Meeting with Dr. Ben Weitz.
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Podcast Highlights
8:28 95% of cases of diabetes are Type II and it is related to obesity, among other things. There are about 8 billion people on earth and about 2 million are overweight. In the US, statistics on obesity are staggering, and even 15% of children are obese. Over 37 million people in the US have diabetes and another 100 million have prediabetes, so one out of every three Americans have diabetes or prediabetes. Close to 50% of those over age 65 have diabetes in the US.
11:02 TYPES OF DIABETES:
1. Type I Diabetes, which is our classic Pediatric Autoimmune disease. It typically does not start below one and half years and fades out around age 25. There is an ongoing trial called the TEDDY trial, which stands for the Environmental Determinants of Diabetes in the Young, and they are looking at figuring out what the triggers are, including diet, nutrient deficiencies, vaccinations, infections, stress, etc..
2. Latent Autoimmune Diabetes of the Adult, LADA. This condition tends to start after age 35 and most are in their 40s and 50s and they are insulin dependent. Many of them get misdiagnosed with type II diabetes, since many physicians are not knowledgeable about LADA. This type I can be very slow onset where they may not need insulin at first, or they may just need a small amount of insulin, sometimes for decades, or they need full blown insulin from the start.
3. Type II Diabetes. This is the most common form of diabetes and it is insulin resistance driven. Most patients with Type II Diabetes are poorly controlled and many of these will go on to eventually need insulin. But insulin dependent Type II Diabetes is still Type II.
4. Mature Onset Diabetes of Youth, MODY. This is related to genetic mutations where people either are unable to secrete insulin or are unable to receive insulin. Athena Diagnostics offers testing to measure 1, 2, 3, 4, 5, and 8 of the MODY genes. For this group, sulfonylureas, which are not really good drugs for most of us, work really well for this group.
18:34 Complications of Type II Diabetes: 1. Hypertension, 2. Chronic Kidney Disease, 3. Impaired vision, 4. Neuropathy, 5. Amputation, 6. Pregnancy complications, and 7. NAFLD. The majority of our cells have an insulin receptor and this allows them to grab glucose and pull it into the cell and turn it to fat and store it or burn it. But there are four cells in the body that don’t have insulin receptors, which are the eyes, the kidneys, the nerves, and the endothelial lining of the blood vessels. When glucose gets into these cells, there is no insulin to process it, so if your blood sugar level is 300, then the sugar in your eyeballs will be 300. The cells in these tissues therefore become damaged if your diabetes is uncontrolled. If your diabetes is uncontrolled, you have a 4-6 times increased risk of dying from cardiovascular disease. Diabetes is the number one reason people wind up with end stage kidney disease. It’s the number one reason adults go blind. It’s the second most common reason for amputations and there are 356 diabetes amputation every day in the US. Diabetes can lead to non-alcoholic fatty liver disease.
22:05 Laboratory Analysis of Diabetes. Labs should include CMP, CBC, lipids, Ferritin, which can help to detect anemia and it is an early indication of fatty liver. If there is indication of fatty liver, you do an ultrasound. GGT, which is another liver detox enzyme. If someone is injecting insulin,