Life with diabetes can often feel like you're playing a game where the rules keep changing. Just when you think you've got a hang of it, here comes a new challenge to test your mettle (and your blood sugar levels).
However, nowadays, we have better technology and more knowledge which help with the management of this health condition. In all fairness, you have a lot of things to juggle, like keeping your blood sugar in check and your diet on point, but there are ways to make your life better.
Together we'll explore how to make peace with diabetes-related challenges.
1. Poor blood circulation at the extremities
Imagine the circulatory system as the bustling highway of your body – cars zooming to and fro, delivering essential supplies. For someone with diabetes, it's like there's a constant traffic jam affecting blood flow, particularly in areas far from the heart's pump station, like your feet.
High blood sugar acts like an unruly driver, slamming into the walls of blood vessels over time and creating blockages that slow down circulation to outlying neighbourhoods like your toes and soles.
Additionally, excess sugar can cause static on your communication lines with the nerves. It corrodes these wires until messages about pain or temperature don't get through effectively. So if you step on a tack or develop a blister, you might not get that instant message telling you something’s amiss down below.
That’s why diabetic foot care is crucial. Luckily due to the latest technology advancements, people who suffer from diabetes can now use diabetic neuropathy socks. These are specially designed socks that help increase circulation in your feet and lower legs. Plus, they have padding that helps reduce blisters, moisture and pressure.
2. Diet
Navigating the dietary landscape when you’re suffering from diabetes turns you into a bit of a food detective. You have to scrutinize labels and portions to make sure you don’t accidentally cause a sugar spike.
You have to be extremely careful with the amount of carbs you consume and their sources. Also, too much fat can mess with your body’s insulin efficiency, so you need to pay attention to this as well. On the other hand, foods rich in fibre are the unsung hero of your diet as fibre slows down sugar absorption.
Balancing all these aspects while trying to cook or dine out has you playing constant nutritional chess, which can be exhausting and quite frustrating.
However, once you learn your way through the madness and understand how a healthy diet looks like, things should be easier. It also helps to employ measures designed to keep you healthy for longer, like having a good sleep routine and staying active.
3. Staying active
Staying active with diabetes can feel tricky and sometimes overwhelming. Energy levels in people with diabetes can swing like a jazz solo – one moment you’re riding high on a lively beat, the next you’ve hit a sluggish note thanks to those blood sugar fluctuations.
On top of that, managing the condition itself is pretty time-consuming. Glucose monitoring, meal prepping, and doctor's appointments can fill up your calendar fast.
Your motivation might also flicker now and then. Imagine wanting to hit the gym while feeling side effects from medication or dealing with blood sugar lows. Plus, worries about hypoglycaemia (a sudden drop in blood glucose) during exercise can be daunting.
That doesn’t mean it’s all doom and gloom though. Think of exercise as a trusty companion that can help manage diabetes more effectively than ever. Constant exercise has been shown to steady your sugars and boost your mood.
To make things easier, look for activities that gel with your lifestyle and set achievable goals.
Wrap up
At the end of the day, it's vital to remember that a diagnosis isn't the end of the road. It's more like a detour sign nudging you onto a path less travelled by. Yes, there are obstacles and yes, at times it will be difficult. But once you've got the hang of it, you’ll be able to live a fun and fulfilling life.
As we head into the holiday season, gratitude is top of mind for many. Hear from people with diabetes on what gratitude means to them and other positives they’ve learned along the way.
“When you’re feeling extra thankful for all the positives that diabetes has given you. The community, the strength, the vulnerability, the resilience, the drive to pursue your dreams. I wouldn’t have nearly as much of that if it wasn’t for type 1 diabetes.”
Kate Hall, division 1 NCAA long jump champion and type 1 diabetes advocate, recently posted this on Instagram, sparking a conversation around whether we can, or if we should, try to be grateful for a chronic condition that’s taken so much.
Of course, no one is “grateful” for having diabetes, but expressing gratitude could be useful in managing the mental health challenges many people with diabetes face. More research is needed, butstudies suggestgratitude is linked to improved psychological well-being.
Because people with diabetes are more likely to deal with issues like depression compared to those without diabetes, gratitude could be one part of a self-care toolkit for building resiliency and reducing stress. Studies have found stress to be associated with higher A1C levels and more difficulty with diabetes management, making stress reduction techniques an important part of self-care.
Here are a few ways people living with diabetes and those in the supporting community are practicing gratitude and what it’s done for their health.
The power of community
Technology has done quite a bit more for people living with diabetes than free them from syringes. Continuous glucose monitors (CGM) have united people through conversations and community building because they are a visual indicator of an otherwise silent condition.
“Seeing others with Omnipod pumps and Dexcom or Libre monitors on their arms feels like connecting to a community of friends,” said Allison Sheridan, who lives in Iowa and has had diabetes for over 16 years.
“Though many insulin-dependent diabetics go about our routines in silence, you still recognize that white contraption adhered to the upper arm as a badge of both struggle and hope – a commonality all people with diabetes face,” she said.
Sheridan recalled feeling grateful on a recent trip to Orlando where a young girl approached her at a theme park.
“She pointed at the Omnipod on my arm and screeched ‘I have one too!’ and showed me her pump. She was elated to find that there were diabetics like her out enjoying one of the happiest places on earth. Her parents, a short distance away, mouthed silent thank you’s as she asked to give me a high-five,” Sheridan said.
Sheridan is also thankful for CGMs as technological advancements, calling the relief from pricking her fingers a “godsend.”
Reclaiming control over your health
Diabetes is a condition that needs to be looked after daily. That is a huge weight to carry, but on the flip side, it also offers the chance to take control of your health.
Danielle Gaffen, a registered dietitian nutritionist in San Diego, described seeing this first-hand with one of her patients who previously had uncontrolled diabetes. He approached her about weight loss after experiencing symptoms like fasting, overeating, and falling asleep during meals.
After a few months of treatment, he showed significant improvement in A1C levels, moving from 11.8 to 5.7, Gaffen said.
“He sent a heartfelt testimonial emphasizing the magnitude of the change, describing it as ‘literally life-changing’ and expressing gratitude for the guidance provided,” she said. “This transformation not only underscores the power of informed dietary decisions but also exemplifies the profound gratitude patients feel when they reclaim control over their health.”
Making better life choices
Dr. Yamuna Gorantla, an endocrinologist at the McFarland Clinic in Iowa, echoed Gaffen’s comments.
“An advantage with a diagnosis of type 2 diabetes is patients learn to do lifestyle modifications, such as healthy eating and exercise, and typically lose weight, which also improves their cholesterol levels and blood pressure,” Gorantla said.
Even though it’s extremely challenging, diabetes forces people to examine their current habits and work with a healthcare team to make necessary improvements.
“Patients with diabetes are often disappointed when they are diagnosed,” said Megan Demeritt, a registered dietitian in Redlands, California. “However, they soon find out that by eating for blood sugar control and general healthfulness, they feel better and have more energy. Balanced blood sugar levels lead to a clearer mind to focus on things that truly matter.”
That’s what Robby Barbaro, health coach and author of “Mastering Diabetes,” described experiencing. Barbaro was diagnosed with type 1 diabetes when he was a teenager.
“This mindset of living healthy, for me, is my greatest joy in life,” he said. “I don’t see it as a sacrifice. I like making healthy food, I like being active, and I like waking up well-rested because I went to bed early. I love being out in the sun because the moment the sun hits my face, it feels good.”
Again, while this might not mean feeling grateful for having diabetes, successfully implementing healthy lifestyle choices could foster a sense of gratitude.
The chance to matter to others
Giving back is one of the most profound ways those with diabetes might see a positive impact from living the condition.
Ryan Hetrick, CEO of Epiphany Wellness in Blackwood, New Jersey, lives with diabetes and has experienced this directly. After going through his own journey uncovering a holistic approach to diabetes care, Hetrick shows gratitude for his health by helping educate others.
“Sharing my experiences and knowledge raises awareness, dispels misconceptions, and promotes empathy and support for those living with diabetes,” Hetrick said.
“As a medical professional working with people with diabetes, I have seen first-hand the impact of gratitude on my patients' outlook and management of their condition. It's my way of giving back to the diabetes community,” he added
While nobody with diabetes would wish the condition on anyone else, this season leads to reflection, and maybe even gratitude, for the wins along the way.
In a recent review published in the International Journal of Obesity, researchers reviewed recent advancements in epidemiological data about type 1 diabetes (T1D) and weight disorders. They explore the challenges scientists and clinicians face in studying and treating these associations. Their findings debunk multiple myths regarding T1D, most notably that the chronic condition only affects lean adolescents. Finally, this review presents recommendations for therapeutic interventions against T1D and guidelines for future research on the topic.
Obesity and diabetes – a brief history
Weight-related disorders, the most common of which are overweight and obesity, present substantial clinical and socioeconomic burdens globally. More than 1 billion individuals worldwide suffer from obesity, with the condition estimated to have claimed more than 5 million lives in 2019 alone. Alarmingly, changing trends in diet and physical activity are driving significant increases in obesity rates, with current obesity prevalence almost triple that of 1975. Western countries are worst affected by this negative trend, with reports highlighting that United States (US) obesity rates have seen a fourfold increase since 1980.
Compared to the far more prevalent type 2 diabetes (T2D), type 1 diabetes (T1D) is a rare, usually genetic condition affecting between 3-10% of people with diabetes. It is thought to be an autoimmune disorder and is characterized by the reduced or complete inability of the pancreas to produce insulin, resulting in a toxic build-up of sugar in a patient's bloodstream. Because its onset was historically noted in adolescents, the condition has been called 'juvenile' diabetes, but recent research has discovered that T1D can develop in individuals of any age group.
In the US, T1D is reported to affect 5.6% of all diabetic patients. A popular clinical notion was that T1D affects only lean individuals, with overweight and obese individuals immune to the condition. Given this notion and the post-coronavirus-2019 (COVID-19) trend of increasing overweight prevalence, T1D prevalence was expected to reduce. However, recent research has debunked this view and found a positive cyclic feedback association between excess weight disorders and T1D. This leads to predictions that T1D prevalence will increase from its current 3.7 million to more than 17 million by 2040.
T1D remains the less-studied diabetes version, with research into the disease a fraction of that into T2D. Improving professional and public knowledge about the disease, its causative agents, and optimal management strategies will allow clinicians to better prepare for the upcoming surge in T1D patients and improve the quality of life for all patients of this chronic condition.
About the study
The present review aims to elucidate current knowledge on the relationship between T1D and obesity, summarise the drivers of both conditions and discuss the best evidence-backed management strategies for treating T1D. The PubMed (MEDLINE) online scientific repository was searched for all publications researching obesity, T1D, their known contributors and risk determinants, and interventions against both conditions from database initiation till June 2023. More than 120 papers were identified for descriptive summarization and discussion following title, abstract, and full-text screening.
The reviewed literature was summarized under four main subheadings – 1. Multinational patterns of obesity with type 1 diabetes, 2. The distinctive biopsychosocial factors contributing to increased obesity in type 1 diabetes, 3. Treatments for obesity in patients with type 1 diabetes, and 4. Future directions for obesity management in type 1 diabetes.
Study findings
Unlike previously thought, overweight and obesity are significantly positively associated with T1D. Research has revealed that in adolescents between the ages of 16 and 19, every incremental standard deviation (SD) from mean body mass index (BMI) was associated with a 25% increased risk of developing T1D. These findings have been validated by Mendelian randomization studies and genome-wide association studies (GWAS).
Encouragingly, these GWAS also elucidated an unexpected finding – children with severe obesity (and, therefore, high T1D risk) could drastically reduce their T1D risk by up to 22% for every 10% weight loss. This suggests the existence of a critical window of opportunity wherein weight management interventions before the onset of T1D could potentially prevent the development of the condition, directly improving the futures of thousands or even millions of would-be diabetic patients.
This review highlights significant confound between metrics and methodologies used to measure overweight/obesity and T1D globally, as noted from the SEARCH (US-based), Diabetes Patienten Verlaufsdokumentation (Europe-based), Type 1 Diabetes Exchange (US-based), all of which found positive associations between obesity and T1D, but with prevalence ranging for just 15.3% to 36% or more. Similarly, the SWEET cohort (Europe, India, and Canada) documented a 10-trend of reduced childhood and adolescent obesity, whereas the Diabetes Control and Complications Trial (DCCT) found no such reductions. Finally, UK-based studies have found no association between obesity and T1D, contradicting the previously mentioned cohorts.
The last few decades have seen unprecedented increases in poor health behaviours, most notably in the consumption of energy-dense foods (e.g., the Western diet) and shifts to highly sedentary lifestyles, especially following the COVID-19 pandemic and its associated 'work-from-home.' These trends have defined the obesogenic (obesity-inducing) landscape, which is now known to arise from a combination of genetic, political, socioeconomic, and cultural factors. Unfortunately, despite new risk contributors being discovered almost every day, most have not received adequate attention, both from clinicians and policymakers.
"First, there remains an inadequate comprehension of obesity in the pathogenesis of T1D, which may impede effective prevention and treatment strategies. Second, treating obesity is complicated by intensive insulin therapy, the standard of care for T1D, which paradoxically causes weight gain, creating a challenging dilemma for achieving weight management goals. Third, health disparities in T1D lead to a wide variation in disability-adjusted life years (DALY), with unaddressed gaps."
Notably, T1D is characterized by the induction of β-cell inflammation. This condition is exacerbated by obesity due to the latter's comorbidities, including lipotoxicity, mitochondrial dysfunction, glucotoxicity, adipose tissue damage, endocrine alterations, and the recently described imbalances in gut microbial communities. The interplay between these factors induces synergistic effects much more pronounced than any taken in isolation. Current research fails to incorporate these effects in its predictions and intervention recommendations, often resulting in suboptimal outcomes. Future clinical research should account for the holistic effects of T1D and diabetes and aim to treat body conditions rather than focus on one at the cost of the other.
An ideal example of this is exercise, the primary non-clinical intervention in obesity treatment. While high-intensity exercise significantly promotes weight loss, subjecting a T1D patient to vigorous physical activity can sometimes cause more harm than good because it increases hyperglycaemia (high blood sugar), the main T1D complication. If used as an intervention, exercise must be tailored to account for both obesity and T1D (e.g., low-intensity walking as opposed to high-intensity running).
"Breakthroughs in insulin pumps, continuous glucose monitoring, and sensor-automated insulin devices help control glycaemic levels around most forms of exercise and hold the most optimistic hope in exercise safety."
Similarly, dietary and nutritional interventions tailored toward treating obesity may sometimes aggravate T1D, resulting in increases in pharmacotherapeutic interventions (insulin injections). Dietary interventions must be fine-tuned on a per-patient basis rather than a 'one-size-fits-all' medical nutrition therapy (MNT) approach.
The use of pharmacological interventions should similarly be extensively tested before use. Incretin mimetics (receptor agonists that increase insulin release from the pancreas) should be used with care lest they cause unexpected weight loss outcomes. The importance of patient education and adaptable care as a growing body of evidence suggests that patient-reported symptoms can closely resemble clinically diagnosed medical profiles and might be used as preliminary proxies for the latter.
"Finally, attention to healthcare inequality should intensify. The evolving technological innovations and limited availability of off-label medications are progressively tilting towards a first-world-centric resolution."
A growing body of research highlights that socioeconomically backward communities and racial minorities are the worst affected by T1D and obesity, a phenomenon aggravated by their being at increased risk of both conditions. Policymakers and pharmaceutical companies should ensure fair and cost-effective healthcare administration to all patients, irrespective of the size of their wallets.
Conclusions
T1D has historically received far less clinical and scientific interest than its much more prevalent T2D counterpart, resulting in numerous myths and misinformation about its prevalence, associated risk factors, and optimal treatment. Recent research has begun debunking these myths, revealing that the prevalence of T1D is higher than previously thought, and its incidence is expected to surge in the coming years. Unlike previously assumed, T1D is not restricted to lean individuals. Instead, its associations with weight abnormalities are synergistic and profound. Future research, policy, and interventions must be patient-specific and tailored to address T1D, obesity, and their comorbidities simultaneously.
"On a systemic level, an aligned multi-stakeholder initiative is needed to ensure the true value of the global action plan on this T1D-obesity burden."
High blood sugar management tips: Control diabetes with these 10 low glycaemic index foods
Embarking on a journey to decode the mysteries of the Glycaemic Index (GI) is like stepping into the world of carbohydrates and blood sugar regulation. The Glycaemic Index (GI) is a numeric scale that measures how quickly carbohydrates in food raise blood sugar levels. Low GI foods are digested and absorbed slowly, causing a gradual rise in blood sugar. High GI foods, on the other hand, cause a sudden spike. Understanding how different foods affect our body's glucose response requires an understanding of this classification.
In an exclusive interaction with TheHealthSite.com, Abhishek Gaggneja, Founder & Health Coach, Goodveda, highlighted the importance of managing diabetes with low GI foods. Scroll down to know more.
Low, Moderate, and High GI Categories
There are three categories of GI. Due to their prolonged energy release and gradual digestion, low GI foods include things like leafy greens and legumes. Good foods that balance the fast and slow release of energy are known as moderate GI foods, like Greek yogurt or quinoa. Sugary snacks and certain cereals are examples of high-GI foods that can cause a sharp spike in blood sugar.
An Essential Part of Blood Sugar Regulation
For people managing diabetes in particular, understanding the GI is essential to maintaining blood sugar balance. People can maintain stable glucose levels by choosing low-GI foods, which help prevent abrupt blood sugar spikes and crashes. Since consistent energy levels are a prerequisite for optimal performance, athletes are also beginning to understand the value of making informed decisions during training and competition.
Developing a Well-Balanced Diet Using Low-GI Foods
Including low-GI foods in your daily meals makes it easier to build a balanced plate. Consuming these foods is a great way to maintain a healthy lifestyle because they not only help regulate blood sugar but also give you sustained energy. Fibre and important vitamins are among the nutrients in low-GI foods that support general health.
The Relationship Between GI and Weight Loss
It is noteworthy that GI and weight control are related. Choosing foods with a low GI can help you lose weight and keep it off. These foods slow digestion and increase feelings of fullness, which lowers overall food intake and reduces cravings. This makes the environment favourable for successful weight management, especially when combined with stable blood sugar levels.
Integrating Knowledge
When choosing low-GI foods for meals and snacks, helpful advice is priceless. People are better equipped to make informed decisions in their kitchens and at the grocery store when they know how to read food labels to find GI information. In the pursuit of a well-rounded and health-conscious diet, this knack becomes useful.
Examining the Larger Picture: Boundaries and Beyond
Although the Glycaemic Index is a useful tool, it's important to be aware of its limitations. An all-encompassing approach to healthy eating must take into account variables like portion sizes, general nutrition, and specific dietary requirements. A thorough plan for preserving general health and well-being is ensured when GI awareness is combined with knowledge of these factors.
Bonus: The Top 10 Diabetes-Friendly Low-GI Foods
Here is a list of the top 10 low-GI foods that are perfect for people with diabetes. These foods support a healthy, balanced diet in addition to assisting with blood sugar regulation. These foods offer a distinct combination of nutrients, displaying the variety of choices available for sustaining a stable blood sugar level.
Dalia: A substantial serving of Dalia, a popular low-GI breakfast food, releases energy gradually throughout the morning.
Legumes: Rich in protein and fibre and low in GI, beans, lentils, and chickpeas help you feel fuller for longer.
Leafy Greens: Packed with nutrients, spinach, kale, and collard greens offer a low-GI choice for improved general health.
Non-Starchy Vegetables: Asparagus, cauliflower, and broccoli are diabetes-friendly options that add variety to a diet.
Quinoa: A low-GI, high-protein grain that enhances the nutritional content of meals when added to salads or as a side dish.
Berries: Strawberries, raspberries, and blueberries are high in antioxidants and low in sugar and GI.
Nuts: Pistachios, walnuts, and almonds have a low GI and healthy fats that promote heart health.
Greek yogurt: A high-protein food that has a lower GI than some other dairy products, which makes it a wise choice for controlling blood sugar levels.
Sweet potatoes: A nutrient-dense, high-fibre substitute for regular potatoes that provide long-lasting energy along with essential nutrients.
These foods improve blood sugar regulation and enhance general health when included in your diet.
Final Thoughts: Taking Charge of Your Health
Knowing the Glycaemic Index gives you the ability to choose what should go on your plate with knowledge. A big step toward reaching your wellness objectives is incorporating low-GI foods and taking a broad view of nutrition, regardless of whether you're managing diabetes or just trying to be as healthy as possible. Thus, use the Glycaemic Index as a roadmap to a happier, healthier life.
People with diabetes are at a higher risk of developing eating disorders. Things get even more complicated when obesity is involved. Here’s why compassionate care and specialised treatment are so important.
Sugar, cigarettes, weed, alcohol, cocaine, and then food. Monica Romano, a 55-year-old living in Bellingham, Washington, lists her “drugs” in order of addiction.
Romano quit drugs like cocaine at the age of 30 but then developed another addiction.
“Food became my new drug,” she said. She described her first time binge eating feeling as natural as breathing. Now she identifies as a food addict, with obesity as one of the symptoms.
Looking back, she realises she had binge eating disorder – a chronic condition marked bycompulsive overeating– but never discussed it with doctors.
Due to her weight, family history, and diagnosis of metabolic syndrome, Romano worries about the ever-present threat of diabetes. Metabolic syndrome increases the risk for health conditions like diabetes, heart disease, and stroke. Many people with metabolic syndrome also have insulin resistance, which over time may lead to type 2 diabetes.
“I have luckily managed to escape it so far. But the threat is always at the back of my mind,” she said.
Identifying and treating each of her conditions, while working to avoid a diabetes diagnosis, has been a long and difficult journey, fraught with stigma and challenges.
Three complex, intertwined conditions
Dealing with the ups and downs of one medical journey can be daunting. Dealing with three simultaneously can seem downright impossible.
But that’s exactly where some people are, as they navigate complications and conflicting advice on living with and treating obesity, eating disorders, and diabetes. This is becoming a more prevalent issue as clinical obesity rates continue to rise – almost 41% of Americans live with obesity, according to the Centers for Disease Control and Prevention (CDC).
Clinical obesity is a disease defined by the CDC as someone who has a body mass index (BMI) of 30 or higher. It’s important to note that BMI doesn’t accurately measure body fat content; while it can be used as a screening tool, BMI is not a reliable measure for diagnosing obesity.
Along with the rising obesity rates, diabetes cases have doubled in the last 20 years, with overweight and obesity being a major risk factor for type 2 diabetes. Even though not everyone with diabetes has excess weight, 80-90% of the type 2 diabetes population has overweight or obesity.
People with diabetes also have higher rates of eating disorders than the general public, with 20% experiencing an eating disorder at some point. Bulimia nervosa is a more common eating disorder in type 1 diabetes and binge eating without purging is more common with type 2 diabetes.
The need for awareness and understanding around treatment
People with obesity, diabetes, and eating disorders can experience dilemmas in treatment that contradict each other – what helps with one condition might fuel another.
Dr. Ann Goebel-Fabbri is a clinical psychologist who works with people managing these conditions (sometimes all three at once). She recalled an instance of one patient with overweight and type 2 diabetes who sought treatment to stabilize her binge eating disorder.
However, the recommended weight management meal plan they recommended to help with her eating disorder conflicted with the recommended treatment for diabetes and obesity.
“The problem was her meal plan at the treatment center completely ignored that to improve health in diabetes, a modest amount of weight loss is actually indicated,” Goebel-Fabbri said.
“So the question is, how do we approach those concepts in ways that allow enough complexity, variation in foods, enjoyable foods, and prevent concepts and feelings like deprivation, shame, and failure?” she said.
Goebel-Fabbri added that treatment must involve an understanding that deprivation doesn’t work. Eliminating a whole food group, as is the case with very low-carb diets, intermittent fasting, and other trendy fad diets, is actually more likely to increase the likelihood of binging. She said that it also only focuses on short-term success, rather than a long-term plan.
“We need to help people develop modest and realistic goals for weight loss,” she said. Pursuing multi-faceted, meaningful treatment, Romano is getting treatment at a clinic specialising in obesity and is also in counselling to help her better understand the link between trauma, post-traumatic stress disorder, and eating disorders.
“That was eye-opening because it explained why I felt compelled to binge as a response to others noticing my weight loss,” she said. “In some strange way losing weight became synonymous with losing control. I’m still grappling with that one – this hasn’t been an easy fix.”
“Sure, weight loss drugs and even bariatric surgery, which I considered for a while, can help but they are tools. Eating disorders are multifaceted and without mindset work, we miss the complete picture,” Romano said.
Alle C. Hall lives with prediabetes and has had binge eating disorder her whole life. At times, she’s also dealt with bulimia and exercise compulsion.
Along the way, Hall said that some primary care doctors and OB-GYNs have impeded progress in getting treatment. Their weigh-ins and lectures about diet and exercise have led to sometimes days-long binging episodes, she said.
Instead, she hopes digging into past trauma will get to the root cause and help with healing. For her, writing a book was a part of healing. She encourages others to pursue a project or creative endeavor as it could be a valuable part of the healing process.
“There is no need to spend your time feeling like you have no willpower,” Hall said. “I know this to be true: get the help you need.”
Many people use dietary supplements like cinnamon, magnesium, or vitamin D to help prevent or manage diabetes, a disease marked by high blood sugar levels.
Research has primarily focused on the effects of dietary supplements in people with type 2 diabetes. This type of diabetes occurs over time as the body becomes resistant to insulin, which, simply put, is a hormone that helps convert food into energy.
There is less data about the benefits of supplements for those with type 1 diabetes, an autoimmune disorder that happens when the pancreas doesn't make enough insulin.
Here's what you need to know about dietary supplements' effectiveness and side effects that may help lower blood sugar.
Keep in mind that the American Diabetes Association does not recommend the use of dietary supplements to manage or prevent diabetes. Supplements have not been proven to consistently lower blood sugar.
With that in mind, here's the latest evidence about the uses and side effects of supplements that are often touted for diabetes.
PixelsEffect / Getty Images
Alpha-Lipoic Acid
Alpha-lipoic acid is a fatty acid that acts as an antioxidant. It has been studied for diabetes and its complications, such as:
Macular edema (blood vessels leak into the eye's retina)
But so far, there's little evidence it helps.
An extensive review of 10 studies concluded that alpha-lipoic acid did not lower the following in people with type 2 diabetes any more than a placebo (sugar pill):
A clinical trial of people with type 1 diabetes found no difference in hemoglobin A1c (a measurement of blood sugar control over the past few months) from alpha-lipoic acid vs. a placebo.
The evidence of alpha-lipoic acid's effects on neuropathy is mixed.
A systematic review reported that three of eight trials studied showed symptom improvement for those taking the supplement, while the other five trials didn't show improvement.
There is no evidence that alpha-lipoic acid helps with nephropathy or macular edema.
Safety and Precautions
At normal doses, alpha-lipoic acid is considered safe, even for people with heart disease, diabetes, and neurological conditions.
Side effects that may occur with this supplement include the following:
Chromium is a trace element found in foods like meat, grains, and produce.
It may enhance the effects of insulin and help break down sugars, but more research is needed to know for sure.
The evidence for chromium's effects on diabetes is mixed.
One review of 10 studies concluded that chromium supplementation modestly improved haemoglobin A1c levels in people with type 2 diabetes.
Chromium did not improve fasting blood sugar or cholesterol levels.
Safety and Precautions
AIs for chromium in adults are 25 micrograms (mcg) per day in females and 35 mcg in females. AIs drop to 30 mcg during pregnancy but increase to 45 mcg during breastfeeding.
Taking chromium with insulin or Glucophage (metformin) together may cause hypoglycaemia (low blood sugar).
Watch for signs of hypoglycaemia, such as the following:
Shakiness
Headache
Fast heart rate
Chromium may also cause the following side effects, according to case reports:
The popular spice cinnamon has been studied in people with prediabetes and type 2 diabetes for its effects on:
Blood sugar
Cholesterol
Blood pressure
According to an analysis of 16 clinical trials, cinnamon supplements lowered fasting blood sugar and insulin resistance in people with type 2 diabetes and prediabetes (high blood sugar levels not high enough to be considered type 2 diabetes).
However, researchers noted that more robust trials are needed because the existing ones have a lot of variability.
Other extensive reviews have shown that cinnamon significantly reduced blood pressure and cholesterol levels in people with type 2 diabetes, including:
More research is needed to determine the effects of cinnamon in people with type 1 diabetes.
Safety and Precautions
Cinnamon is safe for most people at doses below 6 grams (g) daily.
However, there have been reports of high coumarin levels in species like cassia cinnamon (Cinnamomum cassia). Adverse effects of too much coumarin over time can include the following:
Liver toxicity
Cancer
True cinnamon (Cinnamomum verum), also known as Ceylon or Sri Lankan Cinnamon, tends to have lower levels of coumarin.
Magnesium supplements are available in lots of different formulations, but magnesium oxide has been studied the most in clinical trials for diabetes.
Safety and Precautions
The RDA for magnesium in adults is 310 mg for females and 400 mg for males. This amount increases slightly as you age. Limit magnesium doses to 350 milligrams (mg) daily.
You may be getting magnesium from your food, including fortified products like cereals.
At higher doses, magnesium supplements are associated with the following common side effects:
One review of 30 studies determined that omega-3 fatty acids helped decrease blood sugar and insulin resistance (when cells don't respond well to insulin, can't easily take up glucose from the blood, and require more insulin).
Results from another, smaller review suggest that eating more omega-3 fatty acids helped protect against type 2 diabetes.
On the other hand, an analysis of 46 clinical trials showed that omega-3 fatty acids had no significant effects on blood sugar or insulin resistance.
In people with type 2 diabetes, omega-3 fatty acids did improve levels of the following:
Adequate Intakes (AIs) for omega-3s in adults are 1.6 g for males and 1.1 g for females, slightly increasing during pregnancy. If you regularly eat fish or nuts, you may get adequate omega-3s. Omega-3s can also be found in fortified foods like eggs, yogurt and milk, juices, cereals, and more.
Omega-3 fatty acids don't typically cause severe side effects. However, high levels (over four grams per day) of omega-3s have modestly increased the risk of atrial fibrillation in people with, or at risk for, cardiovascular disease.
Omega-3s may cause mild gastrointestinal effects like the following:
Bad breath
Heartburn
Nausea
Diarrhoea
Berberine
Berberine is an herb used in traditional Chinese medicine and Ayurvedic medicine (the ancient medicine system of India) to help lower blood sugar and cholesterol in people with type 2 diabetes.
A review of 46 clinical trials demonstrated that berberine, with or without standard diabetes medicines, improved the following measurements related to diabetes control:
Effects were greater for berberine plus standard diabetes medicine, but even berberine alone showed modest benefits on haemoglobin A1c and fasting blood sugar levels.
Safety and Precautions
Berberine should be avoided during pregnancy and breastfeeding as it may cause jaundice or brain damage in infants who are exposed to it.
Side effects of berberine include constipation and diarrhoea.
Vitamin D
Vitamin D is made in the body from sunlight's ultraviolet rays.
Research shows that getting enough vitamin D may help prevent both type 1 and type 2 diabetes.
Supplementing with vitamin D3 (cholecalciferol) 2,000 international units (IU) daily can be helpful in managing or preventing type 1 diabetes.
Taking at least 1,000 IU daily for a year or more significantly lowered the odds of developing type 2 diabetes, according to a review of nine clinical trials.
Interestingly, lower doses of vitamin D had no effect on diabetes risk.
Safety and Precautions
The normal Recommended Dietary Allowance (RDA) of vitamin D for adults is 600 IU or 15 mcg.
You may be getting additional vitamin D from your food, including special fortified products like:
Orange juice
Cereals
Milk
You can also get adequate vitamin D from sun exposure. However, the following factors can make getting enough vitamin D from sunlight challenging:
Living at higher latitudes
Fall and winter months in cold climates
Living in cloudy climates
Having darker skin
Supplementation is a viable option in these cases.
However, note that high doses of vitamin D from supplements can cause the following side effects:
Typically, management involves both lifestyle modifications (like exercise and a healthy diet) and medications (like insulin or other prescription medications).
Some dietary supplements may cause kidney damage, which people with diabetes are particularly susceptible to. If you have kidney disease, be especially careful about using supplements to help manage your blood sugar.
Ultimately, a supplement is not a good substitute for diabetes medications that are proven to be safe and effective.
If you have diabetes or are trying to prevent it, it's important to discuss the use of any supplement with your healthcare provider in order to optimize your health goals.
In the United States, the Food and Drug Administration (FDA) does not regulate supplements the way it regulates prescription drugs. That means some supplement products may not contain what the label says.
When choosing a supplement, look for third-party tested products and consult a healthcare provider, an RD or RDN, or a pharmacist.
Summary
So far, there's some evidence that dietary supplements like cinnamon, berberine, and vitamin D may improve blood sugar control in people with diabetes. These are not substitutes for FDA-approved diabetes medications, though.
A healthy diet is essential in preventing and managing diabetes and its complications. A low-fat, high-fibre diet like the Mediterranean diet can help prevent type 2 diabetes.
Low-carbohydrate and vegan diets have also modestly improved blood sugar levels.
FREQUENTLY ASKED QUESTIONS
What supplements are good for diabetes?
If you have low magnesium or vitamin D levels, taking those supplements may help cut your risk of developing diabetes.
There's some evidence that berberine, cinnamon, and omega-3 fatty acids can benefit people with type 2 diabetes or prediabetes (high blood sugar levels not high enough to be considered type 2 diabetes).
Are cinnamon supplements good for diabetes?
Though more research is needed, cinnamon has been shown to lower blood sugar and insulin resistance in people with prediabetes and type 2 diabetes.
Can supplements for diabetes interact with prescription medications?
Yes. For example, chromium can interact with insulin and other diabetes medicines to cause hypoglycaemia (low blood sugar). And omega-3 fatty acids may increase the effects of blood thinners like Jantoven (warfarin) and cause excess bleeding.
To optimize safety and minimize side effects, discuss the use of any supplements you plan to take with your healthcare provider or pharmacist, who can screen for drug interactions with your current list of medications.
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