Sf. Nutrition and phytotherapy
for type 2 diabetes
‘Ann Walker
Senior Lecturer in Homan Norton
Hugh Sinclair Unit of Human Nutrition
The University of Reading, UK
Monier ofthe College of Prationers of Pytathespy
‘Menber ofthe Nasional lata of Mail Herbals
Diabetes in UK
+ 1-2. %of the populations and
increasing
4% of people > 65 years
+ 16% of Asian adults
+ Diabetes increases risk of heart
disease (2 fold in men and 3 fold in
women)
+ Increasing burden on health services
Diagnosis of diabetes
+ Type I: acute onset, Usually <35 years.
Fatigue, blurred vision, skin infections,
‘hunger, weight loss, tingling and numbuess
of hands and feet, coma
+ Type 2: chronic onset. Usuelly > 40 years
and overweight. Often only discovered
during routine medical examination,
‘Skin/urinary tract infections, fatigue
Aetiology of type 2 diabetes
i ae
aie one
cicero
Inala sistant
1
[Compensioy
‘sel plasms
‘nail f — Batscol stress
na pty
ee (ety poe) —<
[Based] iutin resistance
ayahaion spent
Lv: plas neta P— Bete stress
(testes)
Insulin Resistance Syndrome
(IRS)
+ Associated with central obesity (apple-
shape)
+ HIGH CIRCULATING INSULIN
+ Insulin resistence
+ Raised blood glucose
+ Increased blood triglyceride levels
+ Reduced HDL cholesterol
+ Increased blood pressure
Complications of poor glucose control
+ Cataract, retinal damage
+ Nerve damage
+ Kidney damage
+ Cardiovascular disease
CAUSED BY:-
= (@)cell oedema
= @alyestion of tsue proteins, including
capillary
membranes
= (atherosclerosisManagement objectives in type 2 diabetes
Integrative approach to management
of type 2 diabetes
+ To contol blood glucose levels within the normal
range throughout he day
~ to avoid glycosuria and big swings in blood ghacose eae
= tw rode risk of protein plysation + Conventional drugs
+ Slow ghicose absorption and spare insulin + Weightloss
= seh ear fire + Diet motifeation: masro-and mie | Nutrition
feds tow ghee dex auton end
+ Dietentancement micronutients [" Photo-
+ Herbal medicine ne
~ entane moet inthe
Elements of a ‘healthy’ diet Glycaemic index of foods
eas + Olscote 100
+ Five portions of fruit & vegetables a day J -yrpsnaseathecad = 0
+ Abalance of essentil fatty acids (omega + Whitebread °
‘G:omege-3 ratio): 2-3 portions of eily fish a 4 sececid 9
week and es polyunsaturated margerine cecal a
+ Wholegrain cereals, nuts, seeds, beans | potigwon < cer.
+ Adequate calcium + Baked beans: 40,
+ Plenty of water + Leatils 2»
+ Fructore 20
Is there mineral deficiency in diabetes?
Low intake of minerals
= poor food choice
ssedentary lifestyle
Changes in kidney and gastrointestinal
physiology due hyperglycaemia
~ increased urinary excretion
+ reduced intestinal absorption
Cr Zn and Mg and glucose control
+ Gr Partof Glucose Tolerance Factor, elps
release of asulin from beta ells, increases insutin
‘eeepc numbers and insulin binding to receptors
+ Zn: participates inthe production, storage
and release of insulin from beta cells
+ Mg: Cofactor for glucose uptake by cells,
cofactor for enzymes of glucose oxidation,
involved in insulin seoretion and actionStudies on Mg, Cr and Zn status in diabetes since 1989
‘Mg Cr and Za supplementation studies in type 2
diabetes over the last 10 years
Vitamins and type 2 diabetes
+ Urinary loss of water-soluble vitamins
enhanced
+ Supplements of vitamin BS may reduce
slyceted haemoglobin (HBA le) levels
+ Supplements of vitamins B6, B12 and folic acid
reduce risk of raised plasma homorysteine -
Fisk factor for CHD
+ High-dose vitamin E and C may reduce protein
lyestion and atherosclerosis by reducing fee-
sical damage
Possible supplementation of a healthy diet
for people with type 2 diabetes
+ A high poteney multi-vitamin & mineral
‘supplement containing all vitamins & essential
rinerals, including Cr, Se, Ma and Zn
+ Vitamin C: 05-108
+ Vitamin E: $00 iv
+ Magnesium 500 mg (+Caleium $00 mg?)
+ 2g omega fatty acids (preferably
EPA*DHA)
‘Type 2 diabetes: case history - Yvonne
+ It vsitul 99: 67 yeu ol woman wit ype 2 diabetes,
Inyperesion, oste-arthits king Metformin, Gli, Zt.
Low vty sor thot painfl soll jolt (Re, tanh,
big tow), waking Sic ad pit Iog12
= Diamar nse a fst
Z Darccmeement Mbt ASME SOIC 0 CLO
S Hebalmatne Gale Case FE, tg, paren FE
pedo pun Fe Gasooc mlb
Sep 99: fog 11-4 Gyre ext 400 mg bid
Jan 0 iT ile wal! Miguard wo ropes A-ZvEC 100g
‘May 00: fog <10 + Willow eomplec26id
‘Aug 00: fhg7 + rutin 350 mg
‘ep 0: fg sleeping ae feting beter: on-going teat!
MIDI Study: The effect of « daily vitamin +
mineral supplement (Diabetone) for 3 months on
glycaemic and lipaemic control and well-being of
26 non-insulin dependent type 2 diabetics:
a randomised, double-blind, crossover study