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the ticking
Prediabetes is a term we use for patients with a chronically elevated blood sugar, which has not yet reached the threshold needed to be
labelled with diabetes, but which is likely to progress unless addressed.
This is an extremely common problem which studies now predict affects approximately a third of adults in the UK. Most of these patients will go on to develop full blown type 2 diabetes unless major steps are taken to reverse the process.
Once diagnosed with diabetes, patients then face a dramatic increased risk of major health complications such as heart attack, stroke, kidney disease, blindness and limb amputation. Almost every part of the body is affected and damaged by the persistently high blood sugar seen in diabetes.
We have almost 5 million diabetics in the UK already, so this devastating surge we now see in prediabetes is a healthcare ‘ticking time-bomb’.
The good news is that if you are diagnosed with prediabetes, it can be fully reversed. The conventional medical approach consists of weight loss through calorie restriction and increased exercise. Certain medication is also now licensed to be used in prediabetics.
The functional medicine approach, however, as always, is to consider the underlying causes for the disease and to address root-causes alongside
conventional treatment to maximise results.
The human body normally regulates blood sugar like a thermostat; keeping levels within a safe and effective range.
Regulation mechanisms are immediately triggered if blood sugar becomes too high or falls too low to correct the level.
Prediabetes tells us there is the start of major dysfunction in this regulatory system and the body is struggling to lower blood sugar when needed.
Insulin is a hormone released by the pancreas in response to food. It lowers blood sugar by acting as a key to body cells, enabling movement from the blood into cells where it is either used for energy or stored for later use.
Overeating food, especially processed carbohydrates such as sugary snacks, bread and pasta, causes ongoing overstimulation of the pancreas. With time, the body becomes less sensitive to insulin. This means that Insulin is no longer effective, and the pancreas has to work harder than ever to produce more insulin to control blood sugar levels.
A vicious cycle thus develops; ever- increasing levels of insulin are mirrored
by increasing resistance to the hormone until eventually the pancreas can no longer secrete enough insulin to control elevated blood sugar.
As humans we have evolved great mechanisms for raising blood sugar. Our prehistoric predecessors would have to cope with long periods without food, and despite this would need to maintain normal blood sugar levels when having to protect themselves or hunt for food.
Through the use of adrenal hormones cortisol and adrenaline, our bodies can mobilise sugar from muscles and liver stores to boost energy for ‘fight-or-flight’ situations.
However, in modern day life, our stresses are not usually so acute; more often, stress factors include work, relationships or finances and are much more chronic and ongoing.
In these situations, ongoing high levels of cortisol and adrenaline have detrimental effects on our health. In addition to stress, gut dysbiosis, hidden infections and inflammation in our bodies can all lead to increased release of stress hormones and the unwelcome consequence of permanently high blood sugar levels contributing to prediabetes.
This demonstrates why not only obesity and diet, but also gut health, adrenal health, stress and whole-body inflammation need to be explored and addressed to effectively tackle prediabetes.
 Dr Vijay Chandraraj
looks at the underlying causes of the disease

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