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 = (atherosclerosisManagement 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 actionStudies 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