In ancient times, diabetes was diagnosed by licking the urine of the patient. If it tasted sweet, a diagnosis of diabetes mellitus (“honeysweet flow”) was made. As a physician, I am glad we have advanced to better tests...
There are basically four different tests to diagnose diabetes (I am talking here mostly of type II):
• Spot blood sugar. Since sugars rise and fall depending what and when you ate, this is a very unreliable test.
• Fasting blood sugar. Does only take a bit of blood, is cheap and fast – but still can vary with what one ate the day before. However, if your fasting numbers are up consistently, you should pay attention!
• Oral Glucose Tolerance Test: a complicated procedure where one drinks an awfully sweet fluid before blood will be drawn in half-hour intervals to ascertain how fast the sugar load is cleared out. It’s complicated, and very time-consuming for the patient. I object of giving a patient a drink 75 to 100 gm of unpalatably sweet glucose solution – which can’t be healthy if there is a disease caused by sugar. My suspicion is that this test is still be used because doctors can bill the most for this.
• Glycosylated hemoglobin, also called A1c: An easy blood test that gives a rough average of your sugars through the last month. I like this one the best because the usual ups and downs of sugar are not interfering with the test, but going into the overall measuring. With frequent episodes of hypoglycemia (too low blood sugars), the test might come back falsely low or normal. In iron-deficiency, A1c are higher than they really are, suggesting diabetes where there might be none. Every time one eats sugar, it “glycosylates” (adding a sugar to the molecule) a protein on the surface of an erythrocytes (red blood cells), and the chemical process is never reversed as long as the blood cell lives. Red blood cells live about three months; blood we draw is always a mixture of very young cells, newly released into the bloodstream from the bone marrow, and older cells, soon to be discarded. Measuring blood glycosylation therefore represents a fair mirroring of recent sugar intake and over time, those numbers can be compared: A lower A1c means you have done something right lately.
In conventional medicine, A1c is called normal if it is below 6.0. A1c is measured in percent of how much of the blood is “sugared”. Starting at 6.1, you have diabetes. That in it itself is rather absurd: A little step upward from 5.9 to 6.0 does not give you diabetes – you had it coming all along. In Natural Medicine, we think that between 5.0 and 6.0, one has “latent” (developing) diabetes. Why that number of 6.0? Because if one would chose 5.0 as the cut-off point, most Americans would have to be diagnosed with the disease.
The Oral Glucose Tolerance Test is more sensitive to detect cases of diabetes – but only if the cut-off point for diabetes is set at 6.0 A1c.
Arbitrarily putting the number to 6.0 does not make a person healthier. In fact, at the date of diabetes diagnosis, I good proportion of patients have already end-organ failure, namely eye problems, kidney failure, neuropathy – to name a few.
Just looking around tells us that many people are overweight and have some of the telltale signs of diabetes: belly fat, scant hairs on arms and legs, rosy cheeks. One sign alone does not make the diagnosis – but several together gives me an idea. But one can be very overweight and never develop diabetes, because in order to get the disease, you have to have the genes AND an unfortunate lifestyle.
Don’t think that genes are an excuse. Because diabetes type II does not strike, if one lives frugally. For instance, after World War II in Europe, basically nobody had it (but people died in droves of tuberculosis then…). Ten years later, with ballooning economies and waistlines, diabetes was back.
But you don’t have to starve yourself, to heal diabetes. You need a mixture of moderate movement (walking, swimming, biking – or dancing; whatever you like) and a diet without sugars, white starches and bad fats.
In diabetes drug studies, diabetes often is called “controlled” if the blood sugar stays within the limits if 7.0 to 10.0 A1c. We can be sure that at those numbers the damage done by high sugars is continuing in the body. I personally favor an approach that does not “manage” the patient’s diabetes, but gets rid of it. And in many cases it can be done, with exercise, better nutrition – and determination on the patient’s side. Read More
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Salt Water Nose Rinse
July 20, 2010
This water application sounds a bit gross on first encounter. But a salt water nose rinse works well in acute colds, acute and chronic sinusitis, hay fever and sneezing attacks, regardless of their cause, because the rinse flushes out dust, pollen, mites, dander, viruses, bacteria and all kinds of irritating debris from the nasal passages. Therefore, it shortens acute infections and relieves chronic problems.
Take a quarter teaspoon of table or sea salt in a glass of lukewarm water. Stir, lick: Its saltiness should be somewhere between that of the ocean and your tears. Now put a bit of the saltwater into your palm and sniff it up one nostril. It might feel like you are drowning – but you are not. Spit out the phlegm that comes down in the back of your nose. Do the other side. Finish the other side.
This can be done many times a day, especially with an acute cold. For many chronic conditions, it might be enough to do it twice a day. Contraindications: If you tend to have high blood pressure, rinse out your mouth afterward and swallow none of the salty phlegm that will still come down after a few minutes due to the cleansing action of the nose rinse. If the fluid stings or burns in your nose, you might have too little or too much salt; experiment!
A few other tips for chronic sinusitis:
• Avoid all milk and dairy products as they are mucus-producing.
• Avoid ice-cold beverages because they can trigger sneezing attacks and exacerbate asthma. Drink hot beverages – lemon and honey seems to soothe chronic sinusitis. Herbal teas are healing: linden, elderberry flowers, honeysuckle, fennel, thyme, and so on.
• Interestingly, getting chilled might affect some people with chronic conditions. Avoiding cold, draft and having a hot beverage (thermos!) before getting out of bed, might do the trick of warming up.
• Exhaustion depletes immune function; getting enough rest and sleep is especially important in children and adolescents.
• Avoid spicy foods.
• Look for triggering food allergens. Read More
Summer Fare
July 19, 2010
In the summer, we don’t like to eat heavy foods. We have a natural tendency, an innate knowledge, to eat lighter in hot weather. Braised lamb red, cabbage and sweet potatoes is a combination I would not serve now; in the fall, with temperatures down, it will be delicious.
Here is a recipe for a light shrimp salad, easy to make:
• About five to ten cooked shrimps per person. Remove tails and slice the shrimp lengthwise. (Instead of shrimp, cooked lobster, chicken, mussels, crab meat, mushrooms would work).
• Add an onion, finely chopped.
• A can of mandarins or pineapples, or fresh apple or pear (or whatever fruit, you fancy).
• Walnuts or almonds or whatever nuts.
• A bit salt and pepper.
• Fresh or dried dill (or any herb).
• And mayonnaise – as little as possible. I prefer a mayonnaise made with olive oil. You can stretch the mayonnaise with juice from the mandarin can, or with a few drops of olive oil; or both.
• Serve the shrimp salad with corn on the cob, broiled (with sunflower or sesame seeds and olive oil) asparagus, and lentils or a multi-grain bread.
• End the meal with fresh fruit – a watermelon or cherries or strawberries from the field.
This is a good example how I cook: I use what I have at hand and what is fresh and in season and therefore cheap. It never tastes the same twice. And never ever ask me: How much? I am a “feeling” cook, not a measuring one.
This is a Sunday dish. Eating mayonnaise every day is not such a good idea for the waist line – even if it is finger-licking good. By the way, if you have a mixer, you can make your own mayonnaise: Separate eggs into yolks and egg white (use the whites for making meringues later). Beat the yolks until they stiffen a bit. Drop by drop add olive oil – never stop beating, slowly first, then faster. The secret is in never to add too much oil at a time so that the mayonnaise does not curdle. Takes five minutes to make.
Summer fare is about freshness and moderation. Thinking about it: It's the same in the winter. Except that in the summer, the heat helps you with the moderation part - it curbs our appetites. Read More