By M. SCUNZIANO, MD, NMD 03/06/2014 By M. SCUNZIANO, MD, NMD 03/06/2014

1. DIABETES MELLITUS UPDATE:
UNDERSTANDING THE PROBLEM AT LARGE
A DISCUSSION ON WHAT THIS CONDITION
MEANS TO OUR EXISTENCE & HOW TO GET
CONTROL OF IT
By
M. SCUNZIANO, MD, NMD
03/06/2014
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CONTENTS:
 Statistics on diabetes
 Global epidemic
 A simple formula that’s not so simple
 What are types 1 & 2?
 Symptoms
 Other forms of DM
 Complications
 How to diagnose the condition
 Management of DM
 Conventional medical treatments
 Other means of management
 Supplements and more
 Future outlook
 References

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As of 2011, we have startling statistics to report on the state of humans afflicted
with Diabetes Mellitus:
 347 million people worldwide are afflicted with 90% of cases being TYPE 2
and 5-10% TYPE 1 diabetes. (Compare this with a total of 30 million afflicted
in 1985!!)
 Over 3.4 million people died from high fasting blood sugar in 2004
 More than 80% of diabetes deaths occur in low-and-middle income
countries
 Being OVERweight or Obese with slow or sedentary lifestyle is the LARGEST
contributor for the development of DM2
 Estimations are that 20% of people in the US (over 60 million) do not know
that they have diabetes
 The costs of diabetes in 2012 in the US alone:
•$245 billion in total costs
•$176 billion in direct costs
•$69 billion in reduced productivity
DIABETES IS A VERY LARGE PROBLEM…

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These are the top 5 countries with the
GREATEST NUMBER of people afflicted:
DIABETES IS CONSIDERED A
GLOBAL EPIDEMIC BY THE
WORLD HEALTH ORGANIZATION

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India-according to the International Diabetes Foundation, this country has
MORE DIABETICS than any other country. Over 1 million die of the
complications from DM annually in India. The average age of onset is 42.5
years. High incidence is due to combination of: GENETICS + ADOPTION OF
HIGH CALORIE, LOW ACTIVITY LIFESTYLE by a growing middle class.
Estimates for # of cases are on the order of 100 million for 2014.
China- approx. 1 in 10 adults has DM2; over 90 million were estimated to
have DM in 2010. The incidence is almost that of India, according to
research. Causes for such statistics are increasing obesity and more
sedentary lifestyles as incomes rise and the fast food industry flourishes.

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U.S.A.- 30 million (10 % of the population of 320 million)
Indonesia- 10 million ( 4 % of population 238 million)
Japan- 8 million ( over 10 % of population 127 million)

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A RATHER SIMPLE FORMULA IS KEY TO PROGRESS…
>Healthy diet + regular physical activity + maintaining a normal
body weight + avoiding tobacco use can = prevention or delay of
onset of type 2 diabetes.
IT IS SO SIMPLE AND YET MOST ARE UNABLE TO FOLLOW…
REMEMBER: if your genetics are dictating diabetes, IT IS even
more of a reason to be following the formula to the best of your
ability.

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What are TYPE 2 and TYPE 1 DM?

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HISTORICALLY,
DM was one of the first diseases to be described in ancient
times. In Egypt, manuscripts from 1500 BCE note “too great
emptying of urine”. At the same time in India, physicians
described “honey urine” that would attract ants.
The term DIABETES or “to pass through” was coined in
Greece in 230 BCE. The term MELLITUS was added by a
British scholar in 1700 to distinguish the “honey urine”
problem from another form of diabetes called insipidus, in
which there is frequent urination but NO SUGAR involved.

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Types 1 and 2 diabetes were first distinguished by 2 East Indian
doctors: Sushrata & Charaka in 400-500 AD. Type 1 was associated
with YOUTH and type 2 with being OVERWEIGHT.
DIABETES was RARE in ancient times with few cases as we know
recorded then.
Effective TREATMENT was not discovered until 1922 by Canadians
Fred Banting & Charles Best who found insulin.

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TYPE 2 (formerly called adult onset or non-insulin
dependent) DIABETES MELLITUS IS THE MOST
COMMON CHRONIC DISEASE.
This condition results from the body’s
INEFFECTIVE USE OF INSULIN and this is the result of
EXCESS BODY WEIGHT + PHYSICAL INACTIVITY

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WHAT ARE THE SYMPTOMS?
Weakness, excess thirst, excess
hunger, fatigue, weight loss, vision
changes, low or loss of libido, poor
wound healing, tingling or numbness
in hands and feet without trauma or
spinal disease, mood swings and
erectile problems.

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>>>>Heart attacks are much more common in DM and can be a
first indicator in many cases of the existence of DM.
>>>>Women with waist sizes 35 inches or greater have a higher
risk for diabetes.
>>>>Men with waist sizes 40 inches or greater are at higher risk.
NOTE: the above is true even if a body mass index or BMI is
normal. BMI is a calculation based on height, weight and a
multiplication factor of 703. BMI of 18.5-24.9 is normal; 25-29.9
is overweight; 30-39.9 is obese and 40 or greater is morbidly
obese.
BMI= weight in pounds x703
height in square inches

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In TYPE 2 DM, the pancreas is not
producing insulin normally and the
body cells do not respond adequately
to insulin (this is called insulin
resistance). The liver cells, muscle
cells and fat cells are predominantly
those involved. Normally the liver
responds to insulin by SUPRESSing
glucose release. However, if the cells are resistant, the liver will secrete
STORED glucose and the level goes up in the blood but the cells are not
using it properly. This leads to a state of IMPAIRED or MALNOURISHMENT
of the body. This happens with excess body fat and a person will start
losing weight as he/she is more impaired without measures to improve
the condition.

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>>>TYPE 1 DM (PREVIOUSLY KNOWN AS JUVENILE OR CHILDHOOD ONSET OR
INSULIN-DEPENDENT) IS LESS COMMON.
This is a genetically influenced disease. Many genes contribute to its
development.
In TYPE1 DM, the body’s PANCREAS cannot form insulin or has a markedly
reduced ability to produce it. A major theory as to the cause of type 1 DM is a
viral-triggered autoimmune response such that the immune system attacks the
viral-infected cells along with the insulin-secreting cells of the pancreas. Drugs
and chemicals may also be implicated in destruction of pancreatic cells that may
lead to type 1 DM.
Another proposed theory: autoimmune antibodies against COW’S milk proteins.
NOTE: The symptoms mentioned above with TYPE2 are usually MORE EXTREME
with TYPE 1 DM.

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OTHER DIABETIC CONDITIONS…

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Gestational DM: high blood sugar (hyperglycemia) detected during
pregnancy; this usually resolves when the pregnancy is over; it is a risk for
later development of TYPE 2 DM; if a woman gains extreme excess of weight
and remains physically inactive during and following pregnancy, DM is very
likely to develop.
MODY or maturity-onset diabetes of youth: occurs in 1-2% of people; occurs
in ages 25 and less; it often goes unrecognized.
Situations that can accelerate or predispose one to DM: certain viruses,
drugs, pancreatitis, thyroid disease, excess cortisol, cystic fibrosis, cancers,
testosterone deficiency.

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IMPAIRED FASTING GLUCOSE (IFG)or Pre-Diabetes: this is a transitional
condition that indicate a person at higher risk for developing a
complete diagnosis of diabetes. Testing for fasting glucose will indicate
if a person is in this category. Sugars measured after an overnight fast
from 100 to 124 mg/dl are in this category. Once a level of 125mg/dl is
detected and is repeatable with same or higher results, DM is a
diagnosis.
CAUTION! People with IFG or Pre-diabetes are likely to develop DM in 3
years if no measures are taken for prevention.
The GOOD NEWS is that pre-diabetes is REVERSIBLE.
The BAD NEWS is that Diabetes is IRREVERSIBLE according to
conventional sources and research.

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Loss of sensation, vision, heart conditions, stroke, erectile and other
sexual dysfunction, skin diseases, memory losses, kidney problems,
chronic urinary tract infections, infections in general, need for limb
amputations, chronic fatigue, depression and other mental
dysfunction.
KEEP IN MIND: THESE COMPLICATIONS WILL OCCUR IF ONE DOES
NOT TAKE CARE OF THE BODY. IF BLOOD SUGAR REMAINS
UNCONTROLLED, THESE CATASTROPHES ARE ALL WAITING TO
HAPPEN.
>>>>>>WE SHOULD ABSOLUTELY STRIVE TOWARD REVERSIBILITY
OF DIABETES!!>>>>>>>>
COMPLICATIONS OF DM…

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HOW DO WE DIAGNOSE DIABETES?

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1) Pediatricians will check blood levels for children and overweight children must be
counseled with parents on weight loss & physical fitness.
2) Type 1 and type 2 DM can be distinguished based on the presenting
circumstances. In type 1, a person is usually a young child, adolescent or young
adult. Classic symptoms: frequent urination, severe thirst, severe hunger, fatigue
and weight loss.
3) Any doubts on the difference between 1 and 2 can be resolved with
measurements of ANTIBODIES in type 1 (high) and C-peptide levels in type
2(normal or high). C-peptide is an indicator of insulin presence and it is low in
type 1. C-peptide does not measure exogenous or outside source of insulin.
4) Adults who are 45 and older are STRONGLY advised to have blood sugar levels
measured.
5) If you are overweight or obese, it is for your own protection that you should have
your blood sugar level checked by a professional.

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6) The following is a table of indicators for normal, pre-diabetes and diabetes:
NOTE: HBA1C measurement is used to diagnose pre-diabetes, type 2 DM. It is not used to
diagnose type 1 DM or gestational DM. It is a gold standard for diagnosis in current times.
In 2009 an International Expert Committee comprised of the ADA, IDF, EASD
recommended that an HBA1C of > 6.5% should be the point of diagnosis.
Pregnancy: a check for diabetes is done with an oral glucose tolerance test between 24-
28 weeks.
HBA1C (%)
FASTING
GLUCOSE
(mg/dl)
ORAL
GTT(mg/d)
DM 6.5% >/= 126 200 or >
Pre-DM 5.7-6.4% 100-125 140-199
NL Close to 5% 99 or < 139 or <

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IF YOU HAVE A FAMILY HISTORY OF
DIABETES, PLEASE TAKE ALL
PRECAUTIONS. CHECK YOUR BLOOD
SUGAR WITH PROFESSIONAL GUIDANCE.
HIGH RISK!!

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MANAGEMENT OF DIABETES…

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>>A proper diet and lifestyle are the fundamentals for
diabetic management.
>>EXERCISE must be done in order to see the best
outcome.
>>Weight loss in overweight and obese people is essential.
Aerobic exercise leads to DECREASED HBA1C with better
insulin sensitivity. It is most beneficial to use both
resistance (weights, pullies, bands, etc.) and aerobics
excellent results.
>>Low glycemic diet is recommended

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>>Conventional medicine has the following pharmaceuticals used for
diabetes:
TYPE 1: insulin must be administered exogenously via injection or
pump. This can be facilitated by a diabetic educator or nurse. Pumps
are recommended for children especially.
TYPE 2: metformin, sulfonylureas like glipizide, alpha-glucosidase
inhibitors like precarbose, GLP-1 (glucagon-like peptide 1) analogues
like Byetta, DPP4-inhibitors like Januvia and Onglyza and others all
work to enhance the insulin function by one mechanism or another.
Many type 2 diabetics will go on to use insulin as well due to poor
control with oral or other injectable-type meds.

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>>ACEI meds like lisinopril, captopril and ramipril have been shown to
improve outcomes in diabetes. Another class called ARB agents like
losartan, Benicar and Avapro are alternatives used. A major side effect is
COUGH.
>>Weight loss surgery in the morbidly obese patients has been shown to
be an effective measure to help treat diabetes. Complications of surgery
are to be considered and many may not qualify because of poor heart or
lung diseases.
>>Other treatment developments include stem cell therapy, pancreas
transplants, antibody inhibitors. More studies and information to come in
the future.

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MORE ON MANAGEMENT, PREVENTION
AND MEANS TO AVOID
COMPLICATIONS…

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1) If you are born with type 1 DM, insulin is a
necessity. Keeping best habits as mentioned
above will lead to long and productive lives.
2) Learn best sources on nutrition. Fad diets and
solicitors for easy ways to get to goal are not
recommended. Talk to a health provider who
can guide you.
3) Foods to eat: organic is best! Use WHOLE
FOODS which means…the whole bean, veggie,
fruit, nut or seed.
4) Foods to avoid: highly processed, fast foods,
soda, ice cream, honey and other simple sugars

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5) If you have been diagnosed with type 2 DM, you need to
change your life habits. That is a must.
6) A combination of: eating without bias, preparing food at
home with love, avoiding the dessert must-haves, shopping
wisely with emphasis on fresh produce, dried beans, nuts,
seeds and fish, growing your own food or using fresh
markets with local grown food, daily 30 minutes of exercise,
good sleep, relaxation, contacts with loved ones and friends,
social involvements and working for a greater cause, all make
the difference.
7) Eat light and balanced. Eat slow and chew very well.
8) Stop smoking now.
9) Alcohol is not helpful so leave it aside.

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Lentils, beans, nuts, seeds, berries,
millet, quinoa, lemons, limes,
mushrooms, radishes, celery, onions,
garlic.
All green leafy veggies, herbs and spices
are perfectly fine for daily consumption.
Cinnamon, ginger, turmeric, fenugreek,
bitter melon are some of the finest
ingredients to add to a diabetic
management diet.
LOW GLYCEMIC FOODS TO INCLUDE REGULARLY:

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SUPPLEMENTS FOR DIABETICS TO USE
IN ADDITION TO GOOD DIET AND
LIFESTYLE…

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If you are using medications, check with your health provider on the combinations
of meds and supplements possible.
These are some of the most commonly used products:
GYMNEMA- an old plant that can be
obtained from health outlets to help
reduce the sweet cravings and
therefore lower sugar intake. Doses of
400mg a day are good. Make sure that
the product indicates 75% gymnemic
acid for best quality.
ALPHA LIPOIC ACID- a compound found in
broccoli, yeast, spinach that may be helpful in
peripheral neuropathy of DM. Doses of 250mg
twice daily are safe.

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CHROMIUM PICOLINATE- a combination of a trace mineral
chromium with a natural substance picolinic acid that helps
with carbohydrate processing. Small doses of 200mcg-
400mcg a day are safe. May help with weight control as
well.
BITTER MELON- a fruit that can be taken straight as a
juice of 2 ounces twice daily or 1 tsp of the extract 3
times a day; may use capsules of extract 300-900mg 3
times a day.

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FENUGREEK- an ancient plant that is used for its
flavor in foods and health benefits to the body; used
widely in India in food and called ‘‘methi”; helps
reduce carb cravings. May use as the seed in food or
in tea for a beverage. Take 1 gram 2-3 times a day as
a supplement.
MULTIVITAMIN AND MINERAL COMPLEXES-
choose a reputable brand such as New Chapter,
Source Naturals, Solaray, Kal , Youngevity, Gaia, or
Nature’s Plus.

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FUTURE OUTLOOK FOR DIABETES:
Unless we have a change in our lifestyle habits in our
cultures here and abroad with proper education starting
early in childhood, the future looks grim.
Now is the time to change your own patterns and help
those in your family.
No matter how many drugs or procedures, supplements
or gadgets that are made to work on diabetes treatment,
the only way to stamp out diabetes is to PREVENT IT.

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Good nutritional advice is found at these sources:
1) The KUSHI INSTITUTE IN BECKETT MASS. ADRESS IS 198 LELENAD ROAD,
BECKETT, MASS, 01223; CALL 1800-975-8744; WEBSITE
WWW.KUSHIINSTITUTE.ORG
2) THE WHITAKER WELLNESS CENTER IN NAPLES, FL. AT 300 GOODLETTE
RAOD, NAPLES, FL.; CALL 239-436-6770
3) THE DHANVANTARIC AYUERVEDIC CENTER IN FLORIDA ON 1308 LASALIDA
WAY IN LEESBURG, FL 34748
4) DIABETIC EDUCATORS WHO ARE WELL-TRAINED IN THE HOLISTIC
APPROACH. CONTACT 352-597-7249 FOR MORE INFORMATION ON OUR
OWN DIABETIC EDUCATOR AT ACCESS HEALTH CARE
REFERENCES

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BOOKS:
1) Cherewatenko, v. M.D. The Diabetic Cure: A Natural Plan that
Can Slow, Stop even Cure Type 2 Diabetes; William-Morrow
Paperbacks, 2000, USA
2) Ellison, S. Over the Counter Cures; Sourcebooks, Inc., 2009, USA
3) Owens, W. Type 2 Diabetes Cure (Natural Books); a Kindle book;
Amazon Digital Books, 20001113, Australia/USA
4) Reader’s Digest Healthy Living Guides: Reverse Diabetes Series;
Reader’s Digest Association, Inc., 2011, 2012, 2013
Additional website:
www.diabetes.niddk.nih.gov