The World Health Organization has warned of an impending diabetes pandemic in Asia, and Malaysia will not be spared. Already about 10% of adult Malaysians are diabetic, and the prevalence is rising. The situation is not much better in the developed countries. All this despite the billions spent on research, and the availability of many anti-diabetic drugs

Globally, the trend is the same, attributed to the affluent modern lifestyle synonymous with an unhealthy diet, overweight/obesity and lack of physical activity/exercise. In Malaysia, what make the diet unhealthy are the consumption of too much refined carbohydrates devoid of nutrients (“empty calories”) and the glaring lack of vegetables. About 20% of us are overweight and another 10% are obese ( grossly overweight ). We also do not exercise enough.

I have observed people who deliberately push their veggies aside, when these come with their meals. How can these people tell their children to eat veggies? I even know of a lady who has never ever eaten any veggie in her adult life. She is of course severely diabetic, nearly blind, and suffering from frequent boils and foot ulcers. Without any family history, she became diabetic at 30, and although she goes to the hospital regularly for her treatments, the complications set in about 10 years later. She became legally blind at 45, leaving her eldest daughter to take care of the family. She is a single mother, subsisting on aid from the welfare department. I am relating this story to highlight that the complications of diabetes are many and take a heavy toll on the patient, the family, and society. It also illustrates my conviction that nutrients play a crucial role in diabetes.

Diabetes causes a gamut of complications, chief of which are heart disease, stroke, eye problems, kidney disease, foot ulcers, frequent and recalcitrant infections and abscesses, and impotence in men. It is the leading cause of eye disease, kidney failure, leg amputations and erectile dysfunction.

While we know what causes diabetes, unfortunately the prevention and treatment aspects still need to be improved. Type 1 diabetes ( due to lack of insulin production ) is genetic and becomes apparent early, before adulthood. Type 2 diabetes ( due to insulin resistance ), which affects 90% of the patients, also has a familial risk factor ( higher risk if there is a family history ), but all the other risk factors are related to diet and lifestyle, and are therefore modifiable. It usually becomes apparent later in life when the adult has gained weight, becomes more sedentary, and the cumulative effect of many years of the unhealthy diet and lifestyle become significant. In Malaysia, the average age at diagnosis is 45 years. However, the trend worldwide is that diagnosis for diabetes ( heart disease and cancers too ) is occurring at a progressively earlier age due to the increasingly unhealthy diet, obesity, and lack of physical activity, even in children, in the affluent societies.

DIABETES CAN BE CURED

I am terribly disappointed that many articles and scientific reports state that diabetes is an incurable disease. That may be the scientific/medical position, but I strongly disagree, at least with Type 2 diabetes. Even here in Malaysia, we have been able to take diabetic patients off their drugs after extensive modification of their diet, lifestyle, and substituting drugs for specific nutritional supplements. For others, we have managed to drastically reduce their drug dosages, and for a few, we have even been able to save them from leg amputations, including one who was only hours away from the surgery after 3 medical consultants had confirmed that the amputation was necessary.

THE KEY IS PREVENTION

Doctors and scientists have devoted much effort in trying to address the problem of diabetes. Sadly, even in Malaysia, where we pride ourselves with the availability of good, affordable and accessible health services, less than half of known diabetics are adequately and satisfactorily treated. Most diabetics who are undergoing treatment still end up with the various complications that make their lives miserable, affect their work and finances, and shorten their life-spans. Only those who are perfectly controlled, with blood sugar levels normal all the time, can expect reasonably normal lives. Unfortunately, this is rarely achieved. More worrying is that probably 1/3 of diabetics don’t even know of their diabetic condition.

To avoid being a victim of this scourge, the smart solution is prevention. As mentioned above, the only un-modifiable risk factor is the genes you carry. Everything else depends on your commitment to your health.

REDUCE WEIGHT

Obesity is the mother of many diseases. Obesity is strongly linked to diabetes, such that the new term diabesity has been coined to denote those cases whose diabetes are directly linked to their obesity. There have been many cases of morbidly obese diabetic patients who became non-diabetic after losing weight. In such cases, the diabetes was cured! So the first preventive and therapeutic strategy is to lose weight if you are obese, and to maintain a healthy normal weight if you are not. If you are overweight or obese, reducing your weight will also help normalize your lipids, and lower your risk of hypertension, heart disease, stroke, joint problems, and possibly even cancer.

However, only 20% of diabetics are obese. Which means that the other risk factors are also significant.

EXERCISE

A study in USA showed that unfit 40 year old men who did moderate-to-intensive exercise daily for six months ended up being as fit as healthy 20 year old men, with much reduced risk of hypertension, heart disease or diabetes. It certainly takes a lot of commitment and discipline, but is achievable. It should also apply to women. If you are already diabetic, you can certainly expect improvement in your condition if you exercise enough. The benefits of regular exercise go beyond feeling fresh and energetic.

There are very few muscular diabetics. Firstly, if you build muscles, it means you do lots of exercise, and have improved your cardiovascular health, apart from many other benefits. You also reduce your body fat and improve your carbohydrate metabolism. Muscles burn glucose efficiently and therefore help maintain normal glucose levels, and prevent excess fat deposition.

Regular exercise and building muscles are therefore important components of my prevention and treatment for diabetics.

THE ANTI-DIABETIC DIET

There is a lot of debate over the goodness of high protein/low carbohydrate diet versus the traditional “healthy” diet consisting of about 60% of calories coming from carbohydrates. My diet prescription is simple – take lots of fresh, raw veggies ( of many varieties, but minimizing that of the starchy ones like potatoes ); take lots of different fruits ( restrict to 1 or 2 slices or portions only per fruit if you are diabetic ); add healthy fats ( olive oil, avocado, or supplements ), nuts, legumes, and some whole grains and there will be no more room for the unhealthy food to fit in your stomach. If you must have meat, choose fish over chicken, beef or mutton, in that order. You can have enough calories, carbohydrates, fats, and even proteins, plus tons of antioxidants, vitamins, minerals, phytonutrients, enzymes, co-enzymes, fibre, and food for your friendly bacteria if you take lots of fresh fruits and veggies.

Vegetarians are known to be generally healthier than others. They can even be better if they choose their foods properly – favouring nutrient-dense foods like fruits and veggies over empty calories like polished white rice and crystal-clear refined sugar. Even strict vegans do not suffer from protein deficiency or other problems if they plan their diets carefully. Unfortunately many vegetarians still end up with diabetes partly because of their poor choice of foods.

The nutrient-dense fruit & veggie diet is applicable to all who want to be healthy. It will be beneficial in maintaining good health and fighting against health problems like heart disease, cancers and diabetes. There are only minor adjustments for the diabetic patient.

Begin your meal with the fruits and veggies. This will ensure that the food enzymes will assist in the digestion of whatever else you take afterwards. It is sad that some diabetics are advised to avoid fruits by their doctors or dieticians. In my opinion, the nutrients in fruits are essential for diabetics, and the sugar content is permissible, provided you restrict the amount of each fruit, but go for variety, which will provide a wider range of healing nutrients. If you know the glycaemic index of your food choices, then it is better. Go for the lower ones.

There is no restriction for veggies ( except the starchy ones ). Go for a variety of dark-coloured leafy veggies. The more, the better.

LOAD YOURSELF WITH NUTRIENTS

The problem with diabetes is not just the high blood glucose level, but also the lack of sufficient nutrients to protect the cells and organs from damage, and to re-sensitize the cells to insulin. If the cells or organs are already damaged, the nutrients may even reverse the damage. To prevent and treat diabetes, you will need loads of antioxidants, vitamins, minerals, enzymes, co-enzymes, phytonutrients, fibre and probiotics ( friendly bacteria ).

If your diet is nutrient dense, you will already have much of these. If not, you will have to rely on supplements to provide these healing nutrients.

Antioxidants, vitamins and minerals together protect the cells from free-radicals and other factors prevalent in the diabetic patient. Free-radicals are the main culprit in causing diabetic complications, by causing cellular injury, and gradual closure of the micro-circulation ( the smallest blood vessels – arterioles, capillaries and venules ). Most of the diabetic diseases can be traced to free-radical damage and blood flow problem, which in turn cause reduction of nutrients and oxygen reaching the cells which are already starved of glucose ( though the blood may be saturated with glucose, very little gets into the cells for their use, due to the insulin problem ).

As a result, nerves malfunction, healing and immune mechanisms become thwarted, clogging of arteries by cholesterol plaques become rampant, and the whole body suffers.

My prescription includes taking as many of the antioxidant cascade as possible, with other important vitamins and minerals. Fibre helps regulate glucose absorption part from ensuring a healthy bowel. Probiotics is a major component in my fight against infections in diabetics ( and non-diabetics ). The role of probiotics in helping diabetics is only now being slowly realized, as even strong and expensive antibiotics cannot help in many cases. They also improve many other aspects of health.

For insurance, I insist diabetics take these in supplements to ensure they get sufficient amounts, especially if their diet is not perfect ( which is the usual case anyway ).

In the next article, I will share how Qigong and other measures can help prevent and fight diabetes.

 

Dr Amir Farid Isahak
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