Diabetes and Glucose Control
Note: This protocol will focus on type 2, and to a lesser extent type 1 diabetes; readers seeking information about gestational diabetes should consult their physician.
Diabetes mellitus is characterized by high levels of glucose in the blood. Types of diabetes include type 1, type 2, and gestational. Type 2 diabetes is far more common than type 1 and is mainly caused by acquired resistance to the effects of the hormone insulin, which facilitates removal of glucose from the blood. Type 1 diabetes is primarily caused by destruction of insulin-producing pancreatic beta cells by autoimmune disease or rarely other causes such as trauma; type 1 diabetes generally necessitates lifelong insulin therapy (ADA 2015e; Kishore 2014; CDC 2015a; NIDDK 2014a; Mayo Clinic 2014; Norman 2016). Gestational diabetes is a reversible form of diabetes that occurs during pregnancy (NIDDK 2014b).
Chronically elevated fasting blood glucose levels—or recurrent, excessive spikes in glucose levels after meals—can lead to devastating long-term consequences such as heart disease and stroke, blindness, kidney failure, neuropathy, liver disease, and even cancer (Ahmadieh 2014; Kishore 2014; Szablewski 2014; Del Bene 2015; Huang 2014; Kim 2013; Fowler 2008; CDC 2015a). Abnormal glucose and insulin metabolism has been implicated in Alzheimer disease as well. In fact, this link is so compelling that many researchers have referred to Alzheimer disease as type 3 diabetes (Ahmed 2015; Halmos 2016; Mittal 2016).
When diagnosed in middle age, diabetes reduces life expectancy by roughly 10 years, and worldwide one person dies every seven seconds from diabetes-related causes (Shahbazian 2013; Gregg 2012; IDF 2014).
What is alarming, though, is that diabetes is not formally diagnosed until fasting blood glucose reaches 126 mg/dL, and levels up to 100 mg/dL are considered “normal” by mainstream medicine (NIDDK 2014c; Bjornholt 1999; Tirosh 2005).
This is regrettable—as readers of Life Extension publications have long known—because the adverse consequences of impaired glucose metabolism begin to emerge as fasting glucose surpasses about 85 mg/dL (Bjornholt 1999; Kato 2009; Muti 2002; Simons 2000; Meigs 1998).
In contrast to the conventional dogma that fasting glucose levels up to 100 mg/dL are acceptable, an upper limit for fasting glucose of 85 mg/dL is far better for longevity and health (Bjornholt 1999; Gerstein 1999). Also, maintaining a hemoglobin A1C level of less than 5% is likely optimal for enhanced longevity (Cheng 2011).
Type 2 diabetes can usually be significantly improved with diet and lifestyle changes, especially in the early stages (Lagger 2015; Jain 2008; Cho 2014; Lim 2011; Steven 2013). Adopting eating habits modeled after the Mediterranean dietary pattern is a proven strategy to improve cardiometabolic risk and glucose metabolism. The Mediterranean diet is rich in fresh vegetables and fruits, whole grains, nuts and seeds, and olive oil, and contains moderate amounts of fish, dairy, and red wine or other alcoholic beverages. Sweets, highly processed foods, and meat are eaten in small amounts only (Tognon 2014). Regular exercise is also important (Inzucchi 2012b; Fonseca 2013; O'Connor 2015; Whitlatch 2015).
The antidiabetic drugs metformin and acarbose lower fasting glucose with little risk of hypoglycemia, in contrast to drugs like sulfonylureas that directly stimulate insulin secretion. They can often help control glucose levels and improve insulin sensitivity in people who cannot accomplish their blood sugar goals with diet and lifestyle alone (Delgado 2002; Meneilly 2000; Gold Standard 2015c; Gold Standard 2015a). Several natural products, such as sorghum bran extract, white mulberry leaf extract, brown seaweed extract, and cinnamon extract, may also promote optimal glucose metabolism and help users attain healthy glycemic control (Andallu 2001; Hoehn 2012; Poquette 2014; Paradis 2011).
This protocol will explain the difference between type 1 and type 2 diabetes, and how elevated blood sugar, even within the conventional “normal” range, can damage tissues throughout the body. You will read about the dangers of insulin resistance and excess insulin, and how some of the drugs that mainstream medicine uses to treat diabetes increase insulin levels without regard to ambient glucose levels, potentially contributing to problems in the long term. Several novel and emerging glucose control strategies will be described, and evidence for the benefits of many natural agents that support optimal glycemic control will be reviewed.
Since diabetes greatly increases cardiovascular risk, readers of this protocol should also review these other Life Extension protocols: