Winter Maladies: Natural Approaches
June Russell's Health Facts
Alcohol - Diabetes
[Occurrence/Statistics]
[Various Studies/Reports]
[Glucose Regulation]
[Diet]
[Exercise]
[Cholesterol]
[Vision]
[Mental Acuity]
[Depression]
[Neuropathy]
[Treatment Goals]
[Related Links]
Occurrence and Statistics
The number of Americans with diabetes has shot up six-fold since 1958, and there are now 10 million people, the highest level ever, who have diabetes. The main reason for this is that more and more people are overweight.
Nearly 16 million Americans have diabetes, though almost half are unaware of it. The disease contributes to 188,000 deaths a year. Diabetes is characterized by the body’s inability to control the level of glucose in the blood. It is common for diabetes to go unnoticed for years.
More women die of diabetes than breast cancer; over 50,000 amputations each year are a result of diabetes; hundreds of thousands of Americans have gone blind due to diabetes; over 750,000 new cases of diabetes are being diagnosed each year, and people with diabetes are nearly four times more likely to die from heart disease. Diabetes is often called the silent killer! The American Diabetes Association tells us that alcohol is a toxin and that the diabetic’s body reacts to alcohol like a poison. Although one in every 18 Americans has diabetes, half of them are unaware they have it, and all diabetics, 14 million Americans, are at substantial risk when using any alcohol. Alcohol is toxic to the nerves as well and can make some diabetic problems worse. Alcohol affects how the liver clears fat from the blood and even two- to four-ounce glasses of wine a week can raise triglycerides. Alcohol spurs the liver on to make more triglycerides, which is already a problem for many diabetics.
In addition to the risks of hypoglycemia, nerve damage and diabetic eye disease, alcohol is high in calories and low in nutrition, factors that are contrary to dietary recommendations. The benefits of moderate alcohol consumption for diabetics announced (in the year of this report) may have been inflated because lifetime alcohol abstainers were compared with moderate drinkers. Those avoiding alcohol could have done so because of poor health. Various Studies and Reports
Although the American Diabetes Association guidelines say that those with well-controlled diabetes can indulge in a drink or two with meals, not everyone with diabetes can or should, cautions John Buse, PhD, MD, Assistant Professor of Medicine and Director of the Diabetes Clinic at the University of North Carolina at Chapel Hill, and former Director of the Endocrine Clinics at the University of Chicago. As a calorie-laden, nutritionally lacking food, alcohol is a poor choice for any person with diabetes who’s watching his weight, and alcohol consumed without food can cause blood-sugar levels to drop.
In most cases you have no symptoms at all in the early stages of diabetes, yet you have high blood sugar and much damage going on under the surface. Eighty percent of diabetics are obese when they are diagnosed with the disease. Elevated insulin causes the body great difficulty in breaking down fat: weight gain is a symptom. High insulin is a potent stimulator of cancer-cell levels growth. It also raises blood pressure and promotes the activity of free-radicals which are biochemical reactions in the body that accelerate aging and the development of disease.
Breast cancer patients with high levels of insulin in their blood seem to be eight times more likely to die of their disease than other women, and almost four times as likely to have their cancer to recur at a distant site, Canadian researchers have found. Evidence shows that, in the breast, insulin spurs the growth of both normal and cancerous cells.
Alcohol is toxic to the nerves. Some studies show that even light regular drinking (less than two per week) can bring on nerve damage. Many diabetics have high triglycerides, and they should not drink alcohol.
A study in JAMA reported that moderate drinking appears to improve blood-sugar balance by reducing insulin resistance. Alcohol’s heart benefits in previous studies have only been found in people over 40, so only older diabetics were studied. However, in the accompanying editorial, the researchers said that the study “likely provides benefit,” but it is possible that this benefit has been inflated by comparing the death rates of lifetime alcohol abstainers with moderate drinkers. Those who avoid alcohol consumption include an overrepresentation of persons destined for a less favorable risk-benefit ratio were they to drink. They also warned that alcohol can worsen diabetic nerve damage and insulin resistance, as well as induce low blood-glucose levels. Typically when glucose levels drop, the liver converts stored carbohydrate into glucose. But when alcohol is consumed, the liver acts to clear it from the blood instead. The onset of hypoglycemia, or low blood-glucose levels, can occur very quickly and in severe cases can result in coma and brain damage.
Sometimes alcohol can cause blood sugar levels to go up, instead of down. The glucose-lowering effects of an alcoholic beverage can last for as long as 8 to 12 hours after drinking says the American Diabetes Association.
While the liver is busy processing alcohol, it stops releasing glucose (blood sugar). This glucose-lowering effect can last for as long as 8 to 12 hours after drinking. Sometimes alcohol can cause blood sugar levels to go up instead of down, and this is a particular concern for people with diabetes. Low blood sugar, as well as alcohol, can affect your coordination, perceptions, and reflexes.
Diabetes Care, Jan. 2002, states that the American Diabetes Association's new nutritional guidelines for diabetes control, relaxes dietary restrictions on high sugar foods. They add that moderate daily alcohol intake poses no threat and may be healthy. {Dr. Mercola's comment} Telling diabetics that they can have sugar occasionally is like telling an alcoholic that a glass of wine occasionally is okay, or a smoker that it's all right to smoke once in a while. Sugar needs to be avoided at all times by a diabetic since it has such a devastating effect on their health, and sugar is also highly addictive.
Death rates for diabetes, along with the number of cases, are climbing, largely the result of a sharp increase in obesity.
See Alcohol - Weight in this Web site for more information.
Alcohol may be the hardest "food" for diabetics to manage because social drinking is so pervasive in our society. If you are diabetic, moderate drinking is acceptable provided proper precautions are taken. When you drink, your liver stops making glucose so it can remove the alcohol from your blood. Because glucose production is shut down, hypoglycemia (low blood sugar) becomes a risk for diabetics, particularly if drinking on an empty stomach, or if drinking shortly after taking insulin or glucose-lowering oral medications. Also because it takes two hours for just one ounce of alcohol to metabolize and leave your system, the risk continues long after the glass is empty. For individuals with well-controlled diabetes, alcohol intake should follow guidelines the USDA has established for the general population, one drink for women and two for men daily. Added precautions: always eat something before you drink alcohol; you need the glucose from food since your liver will stop producing it once you drink alcohol. Carefully check the level of what you're drinking, and be sure to account for added calories and carbohydrates in fruit juices, sodas and other mixers. Check the proof of distilled spirits, and the alcohol level of beer and wines. Don't exercise before drinking; exercise lowers blood glucose levels, and drinking alcohol will reduce them further.
Dancing counts as exercise, so think about skipping the drinks if you are hitting the dance floor. Be prepared for hypoglycemia, in case your blood glucose levels dip below 65 to 70 mg/dl; and, Glucagon will not help treat alcohol-induced hypoglycemia. Bring along your blood glucose monitor and check your levels frequently. Also warn a friend or companion that you are diabetic and what to do in case of a hypoglycemic attack. This is important because hypoglycemia can resemble intoxication, and you may need immediate medical attention if you lose consciousness or start vomiting. The American Diabetes Association (ADA) warns that other conditions prohibit alcohol use, such as pregnancy or trying to get pregnant, certain diabetic complications, liver disease, peptic ulcer, gastritis, pancreatitis, or planning to drive any type of motorized vehicle.
Dehydration can cause dry skin which may crack and peel, making it easier for harmful organisms to enter. People with diabetes are more susceptible to the common bacterial and fungal skin infections, and without proper care, skin problems can turn serious, and might cause permanent damage.
In type 1 diabetes, moderate consumption of alcohol in the evening may predispose patients to hypoglycemia after breakfast the next morning. This is associated with reduced nocturnal growth, and reduced hormone secretion. Patients should be informed of this risk and advised regarding appropriate preventive measures.
"Diabetes Care," reported showing that body mass index may change the positive effect, of light-to- moderate alcohol consumption. Ronny A. Bell, PhD, MS, et al., of the Department of Public Health Sciences at Wake Forest University School of Medicine, in Winston-Salem, N.C., stated that: "This study contradicts previous research showing a positive effect of light-to-moderate chronic alcohol consumption {on insulin sensitivity}, in that the relationship was shown in this analysis to be attenuated by body composition, a known CVD risk factor." Ronald Watson, PhD, Professor in the College of Public Health and School of Medicine at the University of Arizona in Tucson (and former head of the National Institute on Alcohol Abuse and Alcoholism for 6 years), commented that "I and the NIH conclude that increasing alcohol use will benefit a few by lowering heart disease a little, while increasing the chance of damage to many by addiction." Dr. Bell finishes by saying, "Alcohol is by no means a safe drug, nor something that can in anyway be recommended for health promotion. Suggesting that alcohol is somehow beneficial is so outweighed by its toxicity, as to be criminal."
There are significant risks involved with alcohol and diabetes. Even small amounts of alcohol can result in dramatic swings in the blood sugar levels. Peripheral neuropathy, an unpleasant inflammation of the nerve endings common in diabetics, can be exacerbated by alcohol. Even worse, alcohol may increase “insulin resistance,” meaning it takes larger and larger doses to be effective. Since insulin itself is atherogenic (i.e., causes hardening of the arteries) alcohol could be setting off on a vicious cycle that just isn’t worth the short-lived satisfaction of alcohol consumption. Alcohol may be the hardest “food” for diabetics to manage because social drinking is so pervasive in our society. If you are diabetic, moderate drinking is acceptable provided proper precautions are taken. When you drink, your liver stops making glucose so it can clean the alcohol from your blood. Because the glucose production is shut down, hypoglycemia (low blood sugar) becomes a risk for diabetics, particularly if drinking on an empty stomach, or shortly after taking insulin or glucose-lowering oral medications. Also because it takes two hours for just one ounce of alcohol to metabolize and leave your system, the risk continues long after the glass is empty. For individuals with well-controlled diabetes, alcohol intake should follow guidelines the USDA has established for the general population; one for women and 2 for men daily. Added precautions: Always eat something before you drink alcohol - you need the glucose from food since your liver will stop producing it once you drink alcohol. Carefully check the level of what you’re drinking, and be sure to account for added calories and carbohydrates in fruit juices, sodas and other mixers. Check the proof of distilled spirits, and the alcohol level of beer and wines. Don’t exercise before drinking, exercise lowers blood glucose levels, and drinking alcohol will reduce glucose further. Dancing counts as exercise, so think about skipping the drinks if you are hitting the dance floor. Be prepared for hypoglycemia, in case your blood glucose levels dip below 65 to 70 mg/dl, and Glucagon will not help treat alcohol-induced hypoglycemia. Bring along your blood glucose monitor and check your levels frequently, also warn a friend or companion that you are diabetic and what to do in case of a hypoglycemic attack. This is important because hypoglycemia can resemble intoxication, and you may need immediate medical attention if you lose consciousness or start vomiting. The American Diabetes Association (ADA) warns that other conditions would prohibit alcohol use; pregnancy or trying to get pregnant, certain diabetic complications, liver disease, peptic ulcer, gastritis, pancreatitis, or planning to drive any type of motorized vehicle.
If you suffer from neuropathy, drinking can make it worse. If you have high triglycerides (over 200 mg/dl) you should abstain. If you have chronic hypertension limit or eliminate your alcohol intake. (Diabetics are already at risk for high blood pressure, and alcohol has been shown to raise blood pressure even further.) Chronic high blood pressure can contribute to a host of diabetic complications, including kidney failure, heart disease and retinopathy. A number of diabetes medications, other prescriptions, and over-the-counter drugs should not be taken when using alcohol. If you are practicing ‘tight control,’ you may do better to not drink alcohol at all because of the resulting impaired judgment when consuming alcohol.
Women 65 or over with type 2 diabetes (the most common kind) are twice as likely to break a hip or shoulder. Women with diabetes had denser bones than the others in the study, but speculation is that diabetes may weaken the architecture of the bones without actually thinning them, or other complications of the disease could increase the chance of bone-shattering falls. Regulation of GlucoseThe sugar glucose is the main energy source for all tissues. It is derived from three sources; from food, being manufactured in the body, and from the breakdown of glycogen (a form of glucose that the body stores in the liver). Hormones help to maintain a constant concentration of glucose in the blood. This is especially important for the brain because it cannot make or store glucose supplied by the blood. Even brief periods of low glucose (hypoglycemia) can cause brain damage.
Alcohol promotes extra insulin release from the pancreas in response to glucose, causing hypoglycemia. At the same time, alcohol depletes the liver’s glycogen stores and impairs its capacity for formation of new glucose.
Two hormones that are secreted by the pancreas and that regulate blood glucose levels are insulin and glucagon. Insulin lowers the glucose concentration in the blood; glucagon raises it. Because prevention of hypoglycemia is vital for the body, several hormones from the adrenal glands and pituitary back up glucagon function. Alcohol consumption interferes with all three glucose sources and with the actions of the regulatory hormones. The body’s glucose production is inhibited while the alcohol is being metabolized, and even in well nourished people, alcohol can disturb blood sugar levels. Alcohol consumption can be especially harmful in diabetics. Diet
There are a number of things that are going on in the bodies of those with diabetes that make the vitamin requirement higher, particularly vitamin C (500 mg/day) and E (400 to 800/day). Chromium is a mineral that helps insulin do its job.
Jane E. Freedman, MD, lead author in a study in 'Circulation,' and assistant professor of medicine and pharmacology at Georgetown University, cautioned that people who have diabetes should avoid grape juice because of its high sugar content.
You can lower your risk of diabetes as much as 40 percent by eliminating at least 3 to 5 gm of trans fats per day from your diet Exercise
Exercise is important for diabetics because it helps to prevent blood sugar from rising too high. The higher blood sugar levels rise after eating, the more sugar sticks to the surface of cell membranes, which, when converted to sorbitol, destroys the cells and causes all the harmful side effects of diabetes. Every diabetic should participate in a vigorous exercise program.
Your brain gets almost all of its fuel from sugar in your bloodstream, and when this sugar level drops, your brain can’t get enough fuel to function properly, you feel tired and confused and can pass out. There is only enough sugar in your bloodstream to last three minutes. To keep your blood sugar level from dropping, your liver must constantly release sugar from its cells into your bloodstream, but there is only enough sugar in your liver to last 12 hours at rest. When you exercise intensely, your muscles draw sugar from your bloodstream at a rapid rate. Your liver can run out of its stored sugar and your blood sugar level can drop and you pass out from low blood sugar.
A trial sponsored by the National Institutes of health (NIH) found that at-risk people who exercised at least 30 minutes a day reduced their risk of type 2 diabetes by 58%, even without medication. In contrast, those who used the diabetes drug Glucophage (metformin) without diet and exercise reduced the risk by only 31%. Type 2 diabetes is strongly associated with obesity. So many of our problems can be avoided through diet and exercise, says Tommy Thompson, Secretary of the Department of Health and Human Services (HHS). Cholesterol and Triglycerides
Patients with diabetes have more than double the risk of heart disease and stroke than healthy people, but the majority are unaware of their increased risk. Two-thirds report that they experience at least one heart disease symptom such as high blood pressure and high cholesterol.
It is estimated that 25 percent of Americans are insulin-resistant; that is, their cells have become less resistant to insulin, so the body pumps out more of it. This can progress to diabetes and is associated with a common cluster of disorders; obesity, high blood pressure, and low HDL (“good”) cholesterol, high triglycerides, that has been dubbed Syndrome X.
Diabetics not only have high blood levels of sugar, they also often have high blood levels of the bad LDL, triglycerides and Lp(a), and low levels of the good HDL cholesterol. A study in the medical journal Diabetes, Obesity and Metabolism shows that niacin (one of the B vitamins) can treat most cholesterol problems associated with diabetes (an 80% lowering of LDL and a rise in HDL2 that prevents heart attacks). Niacin also lowered triglycerides and the bad clotting factor, Lp(a). (Also HBA1C, the most important test to measure diabetic control, improved significantly with niacin.) Vision
Reducing blood sugars to near normal can help reduce the risk of eye problems by up to 76%, nerve damage by 60%, and severe kidney problems by 54%.
Alcohol worsens glucose tolerance in the elderly and diabetics. Diabetics who drink alcohol have a high risk for eye and nerve damage. Until more is known, diabetics should avoid alcohol.
Because of the relationship between vascular and retinal health, it is not surprising that high blood pressure might threaten vision. Increased blood pressure can cause small blood vessels to burst and bleed into the retina. Studies have shown that high blood pressure in people with diabetes increases the risk of diabetic retinopathy, diseased retinas in people with diabetes. Mental Acuity
Elevated blood sugar may contribute to Alzheimer’s. The effect of sugar on the change of certain proteins in the body and brain make them more inflammatory. Alzheimer’s is a brain inflammation and some of the treatments that have been used to treat other inflammations, such as arthritis, has been shown to reduce the progression of Alzheimer’s.
People with diabetes and high blood pressure are more likely to suffer a decline in mental ability as they age, says a study. It is the first study to show changes in younger diabetics, says Dr. David Knopman, a Mayo clinic neurologist who led the study.
Want to keep your memory sharp as you get older? Control you blood sugar. A new study by doctors at the Nathan Kline Institute in New York found that when blood sugar goes up, even a little higher than normal, memory and cognitive performance go down. Depression
Having diabetes doubles your odds of depression, furthermore, either condition can make the other worse, notes researcher Patrick Lustman, PhD, Professor of Medical Psychology at Washington University in St. Louis. This conclusion was from a review of 25 years' worth of research. Depression can contribute to overeating, which can lead to being overweight, a factor for diabetes, or to elevated blood sugar if you have diabetes. Depression can also lead to physical inactivity, another diabetes risk factor. Insulin resistance, one of the hallmarks of diabetes, raises levels of the stress hormone cortisol, a marker for depression. Nerve Damage and Neuropathy
If you suffer from neuropathy, drinking can make it worse. If you have high triglycerides (over 200 mg/dl) you should abstain. If you have chronic hypertension, limit or eliminate your alcohol intake. (Diabetics are already at risk for high blood pressure, and alcohol has been shown to raise it even further, and chronic high blood pressure can contribute to a host of diabetic complications, including kidney failure, heart disease and retinopathy.) A number of diabetes medications, other prescriptions and over-the-counter drugs should not be taken when using alcohol. If you are practicing "tight control," you may do better to not drink alcohol at all because of the resulting impaired judgment when consuming alcohol. Approximately half of all diabetics are older than 55 years of age. Drinking alcohol can increase the pain, burning, tingling and numbness and other symptoms found with nerve damage. Some studies show that even light regular drinking (less than two per week) can bring on nerve damage. Every year 190,000 will die from diabetes and its related symptoms. When you mix alcohol and exercise, you increase the risk of blood sugar going low, because drinking a beer (or wine) will stop your liver from sending out any glucose, and the glucose-lowering effect can last for as long as 8 to 12 hours. People with diabetes should set goals for better control of blood glucose levels as close to the normal range as is possible for them. Diabetes Organization - Feb 2000} Treatment Goals for Diabetes
Treatment goals for people with diabetes: keep the blood sugar in a normal range, keep cholesterol and other blood fats in the normal range, keep blood pressure normal, lose weight if necessary, maintain target range weight, exercise regularly, and eat a balanced diet with appropriate vitamins, minerals and fiber.
Better, safer ways to reduce cardiovascular disease:
Multivitamin use is associated with a reduced risk of cardiovascular disease and diabetes. Related Links on this Site |