This presentation is dedicated to a woman I shall call Diane.  Diane was a shining light in her community who succumbed to death after complications from Diabetes Miletus II.

In my herbalist capacity, I direct the Philo School of Herbal Energetics and am a practitioner.  I also work three days a week as a social worker with the elderly and disabled in Fort Bragg.  At other times my attention turns to my family, my garden, and rebuilding my home and outbuildings.  Helen and Scott Nearing spoke about balancing family, community and work in Living the Good Life.  My life is a good life.

My work as a social worker in Fort Bragg brings me into contact with many who are challenged both physically and financially.  Over time, and particularly with Diane, I have learned about the effects of Diabetes Miletus II, or Adult Onset Diabetes.  Diabetes Miletus II, or DMII, is a rapidly growing illness, particularly among children and adolescents.  About 1/3 of the population currently has the precursor to DMII, which is called Metabolic Syndrome. Metabolic Syndrome can be detected up to 15 years before the diagnosis of DMII.  DMII can be prevented and even reversed in its early stages by changes in lifestyle and diet.  Many believe that Metabolic Syndrome and DMII are, in part, results of a food industry intent on selling highly refined and processed foods.  

Before we get into the herbal part of this presentation, it will really help to understand some of our own physiology and the chemistry of Metabolic Syndrome and Diabetes Miletus II.

Lets talk about some physiological terms involved with understanding Metabolic Syndrome and DMII.  First is the pancreas, which is a gland located near the stomach.  The pancreas does double duty in supplying the duodenum with digestive fluid and secreting the hormone insulin into the blood.  Insulin regulates the level of sugar in the blood by allowing the cells to open and utilize the sugar for energy.  Insulin resistance is the term used when the insulin is unable to transport the blood sugar into the cells.  Blood sugar levels are in danger when too much sugar from a diet of simple sugars and carbohydrates are released into the blood over a long period of time, causing overuse and depletion of the insulin. 

Blood sugar levels are also in danger because of insulin resistance which causes the sugar and insulin to remain in the blood stream rather than being taken up by the cells.  The glycemic index is a measure of how long it takes for a food to break down into glucose which is then broken down by enzymes to produce energy.  The higher the glycemic index the more the body experiences shock in processing the transformation into energy.    

Please visualize your bloodstream with its platelets, insulin, white cells, red blood cells, oxygen and other healthy components moving through your body to oxygenate and clean it.  Then visualize your bloodstream getting clogged with sugar and insulin.  Add a high component of trans fat and triglycerides, high LDLs or bad cholesterol, and a lack of magnesium in the diet and you have clogged arteries.  When you have clogged arteries, you are in a prothrombotic state where blood circulation can simply stop. 

Metabolic Syndrome, the precursor of DMII, is defined by six distinguishing characteristics: 

1.                  Insulin Resistance with or without glucose intolerance

2.                  Weight gain around the waist (the “apple”, not the “pear” shape)

3.                  High Triglycerides from saturated fats & Omega 6 EFAs (Essential Fatty Acids) with HDL or “good cholesterol”.  Good cholesterol may take LDL, or “bad cholesterol” to the liver through the arteries, then out.

4.                  Elevated blood pressure.

5.                  Prothrombotic State (a predisposition to heart attacks and strokes).

6.                  Hypomagnesium (too little magnesium)

The advantage of defining Metabolic Syndrome and being on the watch for it is that DMII can often be prevented.  Up to 80% of DMII candidates are obese, particularly with weight gain around the middle.  As we shall see, this is a part of a condition that can be reversed.

Diabetes Miletus II or DMII.

DMII is a truly frightening disease.  It contributes to chronic heart failure (CHF), strokes, end stage renal disease and other illnesses that directly cause death.  Over time arteries shut down as they become clogged, the body accumulates water because the kidneys can no longer function well, the heart and arteries are clogged and blood pressure soars, and slowly the body ceases to function. The body bloats, circulation ceases and feet and even legs bleed and ultimately must be amputated. At the end, the heart fills with fluid and there is death.   Watching this happen to someone, as I did with Diane, is horribly painful.  It is a slow death, a degenerative death, filled with pain, filled with distortion of the body,   

Currently in the United States 16.2 million people have DMII.  That number is increasing.  You who are here at the Northern California Women’s Herbal Symposium are less likely than most to wind up with Diabetes.  However, some of you could, predisposed by genetics, diet and lifestyle.  My hope is to warn those of you in danger and to inspire all of you to spread the word about preventing this terrible danger to our communities.

Diabetes Miletus II from a Tissue State View

Matthew Wood, in The Practice of Traditional Western Herbalism, writes that chronic diabetes creates a relaxed condition with loss of fluids via the kidney and skin.  The body loses fluid and potassium but there is an increase of sodium.  If the fluid loss is a primary issue, we would then know to address the issue of relaxation of tissues.  Here we would look at DMII and Metabolic Syndrome to respond to astringents.  In this view we would consider raspberry, blackberry, sumac, witch hazel, wild geranium, salvia, horse chestnut, bayberry, blackberry, and bilberry or blueberry.  It is important to note that one of the symptoms for diagnosing diabetes is great thirst.  This is also true in animals.

Why Sugar is Poison

Dr. Abram Hoffer said, “Refined sugar and all refined foods such as polished rice, white flour, and the like are nothing else than legalized poisons”, and that “sugar is the basic addictive substance from which all other addictions flow”.  We certainly know that this is true with alcohol.  Many foods have a high glycemic index, which is to say that they break down rapidly into sugar in the blood.                                                                                                                                                                                                                                                                                                    The pancreas is then stimulated to produce insulin and gets worn out by too much demand.  The body also goes into hyperactivity to store the sugar as fat, to produce cholesterol, and to conserve water.  This is happening with all sugar, fruit, or carbohydrate you take in.  Simple sugars (to include fruit) and carbohydrates have higher glycemic indices. 

You can use several visualizations here.  One is to conjure up a two year old into whom you have just inserted a large piece of chocolate cake with frosting and ice cream all made with white sugar and flour.  You are surely all familiar with the hyperactivity of such a child.  The body of that child has just experienced blood sugar shock and is trying desperately to process the sweets.  It involves the entire body but impacts the blood vessels, which lose their oxygen carrying capacity, the pancreas which struggles desperately to produce enough insulin to deal with the sugar, the insulin which is trying mightily to bring the sugar into the cells to be used as energy.  

Another helpful image is the sugar-in-the-gas-tank vision.  When, in the old days, before the sophistication of police detection, opponents to clear cutting of redwoods would sneak up in the night and pour sugar into the gas tank of the logging trucks.  It was remarkably effective in stopping the engines of the trucks by causing them to seize up, which is the same effect it has on the two year old or you. 

Lower sugar (glucose) levels allow insulin to promote amino acid uptake in almost all cells and tissues, promotes more efficient degradation of glucose by oxidation (fewer free radicals for one), promotes healthier liver function, and helps your body in many other ways. 

FOODS TO CONSUME

1.         Restrict your intake of high glycemic index foods which include simple sugars and carbohydrates, fruit, alcohol, trans fats and saturated fats. 

2.         When you do have sugar or simple carbs, make sure you ingest protein too.  This decreases the chances of insulin resistance.

3.         Dr. Carolyn Dean, in Natural Prescriptions for Common Ailments, writes, “The best diet for diabetes includes daily portions of dried peas and beans in soups or stews; whole grains (avoiding wheat); brn, especially oat bran; lots of vegetables, preferably raw or lightly steamed; deep-sea fish; chicken, turkey, and lamb; and one or two pieces of fruit a day.  Fruit juice is too concentrated.”

THE ROLE OF EXERCISE

Nutrition Action Magazine of December, 2005 reports that the one thing that seems to deteriorate quickest with inactivity is insulin sensitivity.  Regular activity reverses the damage.  Insulin sensitivity is enhanced and the cells can uptake and process glucose more easily.  People with high but pre-diabetic blood sugar levels who did aerobic exercise for 2 ½ hours or more and lost 7% of their body weight were 58% lower for risk of diabetes than a control group.  Diabetes, and Metabolic Syndrome are both highly correlated to sedentary lifestyles.

FOOD SUPPLEMENTS AND VITAMINS

• Antioxidents to counteract the deoxygenation of the blood
• Alpha Lipoic Acid
• Magnesium – remember that hypomagnesium is a factor
• Chromium which has a glucose tolerance factor
• DHA
• CLA
• Vitamin E
• B complex and B12 injections to heal nerve damage caused by excess sugar
• Vitamin C with bioflavonoids to fight infection and for wound healing 

There are, fortunately, herbal medicines or neutraceuticals that are very beneficial for Metabolic Syndrome and DMII.

1.                  Fenugreek Seed (Trigonella foenum-graecum) has traditionally been used by herbalists to lower glucose levels, increase insulin sensitivity, lower LDL and triglycerides, and raise HDL. 

2.                  Garlic (Allium sativum) has also been traditionally used to help with all components of insulin resistance syndrome.  It lowers cholesterol and blood pressure.

3.                  Ginseng Root (Panax quinquefolium, Panax ginseng) as an adaptogen lowers blood glucose possibly by stimulating the pancreas and lowering blood pressure. 

4.                  Cinnamon (Cinnamomum species) improves the utilization of glucose by fat cells, enhances insulin receptor functions, acts as an antioxident, anti-inflammatory, lowers blood sugar, LDL and triglycerides, and reverses detrimental

effects of high fructose diet on insulin resistance.  There is potential toxicity in long term use of the oil.

5.                  Black Tea(Camellia sinensis) increases the metabolic rate, improves blood sugar metabolism, lowers blood pressure, LDL, and  is hepatoprotective (protects the liver),

6.                  Green Tea (Camellia sinensis) is anti-inflammatory, lowers blood sugar and enhances insulin sensitivity,

7.                  Bitter Melon (Lagerstroemia speciosa) lowers blood sugar, decreases appetite and food craving & promotes weight loss

THE UNSUNG ROLE OF STEVIA

As I researched DMII and Metabolic Syndrome, I kept looking for some mention of Stevia (Stevia rebaudeiana).  Stevia is a plant with a very sweet leaf.  The leaf can be used simply dried.  It is also found in health food stores as a powdered or liquid product. I didn’t find a single mention of Stevia in any writing about DMII.  Rosemary Gladstar does recommend it for many of her formulations in her Family Herbal.   

Stevia is safe for is safe for everyone to use, to include those with Metabolic Syndrome and DMII.  It is also very easy to grow.  I have been growing and using Stevia for about three years now.  It doesn’t make it through the winter but it grows rapidly and happily and produces an abundant annual harvest.  The leaves are used, dried and powdered.  It is also readily available in health food stores.         

With many thanks to Dr. Robert Rountree whose inspiring presentation at the 2005 AHG Conference prompted this paper.