Diabetes

Acupuncture & Traditional Chinese Medicine is effective for those individuals who have had diabetes from a few years to many years; It will relieve major symptoms, such as excessive thirst, over-eating and excessive urination. Traditional Chinese medicine will be chosen based on a review of the diabetic medical history and specific stage of diabetes advancement. Treatment is customized to each individual, minimum 3 month of acupuncture and herbs.

 

Introduction:

If your fasting blood glucose is more than 160 mg/dl or 9 mmol/L, postprandial blood glucose is more than 220 mg/dl or 12 mmol/L, you need to seek medical treatment for drug intervention, must not avoid the treatment just because the drug may have side effects. High fasting blood sugar and abnormal fluctuation of blood sugar may indicate the existence of stress response.

 

Diabetes is not scary. The scary thing is that your wrong life style lead to the high demand for blood sugar, and the drugs you use may further accelerate this trend. If you are willing to stop, listen to your body's voice and reflect on your behavior, you will find that the blood sugar disorder is easy to change.

What are the different types of diabetes?

Diabetes is a group of diseases in which the body doesn’t produce enough or any insulin, doesn’t properly use the insulin that is produced, or exhibits a combination of both. When any of these things happens, the body is unable to get sugar from the blood into the cells. That leads to high blood sugar levels.

 

Glucose, the form of sugar found in your blood, is one of your main energy sources. A lack of insulin or resistance to insulin causes sugar to build up in your blood. This can lead to many health problems.

 

The three main types of diabetes are:

 

1. Type 1 diabetes

Type 1 diabetes is believed to be an autoimmune condition. This means your immune system mistakenly attacks and destroys the beta cells in your pancreas that produce insulin. The damage is permanent. What prompts the attacks isn’t clear. There may be both genetic and environmental reasons. Lifestyle factors aren’t thought to play a role.

2. Type 2 diabetes

Type 2 diabetes starts as insulin resistance. This means your body can’t use insulin efficiently. That stimulates your pancreas to produce more insulin until it can no longer keep up with demand. Insulin production decreases, which leads to high blood sugar.

The exact cause of type 2 diabetes is unknown. Contributing factors may include:

• genetics
• lack of exercise
• being overweight

3. Gestational diabetes

Gestational diabetes is due to insulin-blocking hormones produced during pregnancy. This type of diabetes only occurs during pregnancy.

 

What are the symptoms?

• excessive thirst and hunger
• frequent urination
• drowsiness or fatigue
• dry, itchy skin
• blurry vision
• slow-healing wounds

What are the Diabetes stages: which stage are you at?

1. Primary stage: Control and stabilize blood sugar. It is usually not difficult to control blood sugar smoothly. We can stabilize blood sugar by improving diet structure, changing living habits, low-carbon diet or ketogenic diet when necessary, and increasing drug and insulin intervention.

2. Intermediate stage: Elimination of insulin resistance and stress glucose. Insulin resistance is the root cause of diabetes, and eliminating insulin resistance is the core of improving islet function. Eliminating stress reaction is the reason to avoid blood glucose fluctuation and abnormal increase.

3. Advanced stage: Improve pancreatic function and repair islet cells. In order to cure diabetes and keep away from complications, we should start with avoiding inflammatory reaction and oxidative stress injury, providing more antioxidant protection for the body and promoting the repair of islet function, and really improving islet function.

 

What are the main causes of Pancreatic islet injury

1.Glycotoxicity:

Continuous high blood glucose will lead to a variety of glycosylation reactions. Sugars stick to proteins and lipids, causing denaturation of proteins and lipids. The glycosylation reaction caused by hyperglycemia not only damages our organ function, vascular elasticity and pancreatic islet cells, but also closely related to the aging of our body, which is glycosylation aging: it occurs in many organs of our body, skin, blood vessels, eyeball and lens. Hypoglycemia is a dangerous condition, which can lead to the body's active action of raising glucose: glucagon increases, liver glycogen releases blood glucose, which is used to balance the blood glucose level. If hypoglycemia continues, the secretion of adrenocortical hormone and glucagon increases, and adipoprotein changes into blood glucose through gluconeogenesis. At the same time, it inhibits insulin function and insulin secretion, and a large number of free fatty acids enter the blood Liquid, to further push high blood sugar.

2.Lipotoxicity

The free fatty acids in the blood can seriously interfere with the binding of insulin and insulin receptor, which preventing insulin deliver blood sugar into the cells. Insulin must be secreted in excess to transfer blood sugar into the cells. Furthermore, it only takes more than 48 hours to cause excessive accumulation of fat in the pancreatic β cells and mitochondrial abnormalities in the environment of high free fatty acids, which will cause insulin release disorder and β cell apoptosis.

3.Oxidative stress

Oxidative stress is a phenomenon caused by an imbalance between production and accumulation of oxygen reactive species (ROS) in cells and tissues and the ability of a biological system to detoxify these reactive products. This is a harmful process that can negatively affect several cellular structures, such as membranes, lipids, proteins, lipoproteins, and deoxyribonucleic acid (DNA). Oxidative stress is the common basis of insulin resistance, diabetes, arteriosclerosis, coronary heart disease and other cardiovascular and cerebrovascular diseases. Oxidative stress occurs when a sudden increase of energy demand requires excessive workload by the organs. For example, after drinking a lot of alcohol, your liver is in a state of oxidative stress when it is working hard to break down alcohol; after eating a couple pieces of cheese cake and a glass of coke, your pancreas will be in a state of oxidative stress in order to produce more insulin; or after getting angry, your adrenaline secretion increases, and your muscles are tense. Peope with diabetes who has persistent hyperglycemia and hyperlipidemia can directly cause the formation of ROS, which can cause lipid peroxidation of cell membrane, damage cell mitochondria and even induce apoptosis of β cells. That's why people with diabetes and poor blood sugar management always feel tired.

4.Pancreatic islet fibrosis

Pancreatic islet fibrosis is usually a consequence of an iinflammation action in type 2 diabetes pathogenesis. During oxidative stress, a large number of mitochondria will be damaged due to the lack of antioxidant protection. More oxidative damage of mitochondria will produce more ROS, and cause B lymphocytes to produce excessive immunoglobulin, and then promote the activation of killer T lymphocytes, leading to pancreatic β cell apoptosis. The increase of oxidation end products, inflammatory factors and dead cells will activate macrophages in our body to participate in the action of immune defense. Macrophages will phagocytize dead cell fragments and peroxidation damaged cells, but they will release tumor necrosis factor - α (TNF - α), which attracts more macrophages, causing more inflammatory signal expression and forming a vicious circle. Fibrosis is common in type 2 diabetic islets, which can lead to structural changes, microcirculation damage, insulin secretion down-regulation and loss of insulin secretion in the first phase.

 

Treament Principles

1.Regulating blood lipids

"Blood Lipids" is the term used for all the fatty substances found in the blood, including cholesterol and triglycerides. Fats in the blood are called lipids. Lipids join with protein in your blood to form lipoproteins. Lipoproteins make energy for your body, so they're important to the cells in your body. Three kinds of lipoproteins, (also called cholesterol), three in your blood: (1) high-density (also called HDL, for short) cholesterol, (2) low-density (also called LDL) cholesterol and (3) very low-density (VLDL) cholesterol. In fact, the 2015–2020 Dietary Guidelines for Americans removed the recommendations of setting a limit to the maximum intake of 300 mg/day cholesterol. The Guidelines still advised eating as little as possible of dietary cholesterol while maintaining a healthy eating pattern. People overwight has higer blood lipids, which greatly reduce the body's efficiency of using blood sugar. We should pay attention not to eat a lot of refined rice and noodles. This kind of food can raise blood sugar too fast, and then excessive sugar will be converted into cholesterol. This is the most easily ignored reason for high blood lipid and its influence on glucose metabolism!

2. Regulating blood sugars

Eat at regular times every day, avoid high glycemic index food. Brown rice, beans, fish, meat and vegetables should be balanced. Only eat low glycemic index food, and no need to worry about limited portions, be sure to eat at least 1 lb vegetables every day, and keep yourself away from hypoglycemia.

3. Eliminating stress factors.

This is crucial! When your body is in stress reaction, it will release a variety of glucocorticoids to increase blood glucose and inhibit insulin. The possible factors leading to stress reaction are: staying up late, high load work, tension, fear, pressure, negative emotions, depression, irregular diet, frequent hypoglycemia, etc., which will lead to increased blood glucose.

Regular diet, avoid triggering stress injury, pay attention to rest and relax! Many people don't know how to relax, and can't get a good rest even when they sleep. They need to learn self relaxation exercise.

4. Improving mitochondria function

Lots of patients with diabetes do not have typical symptoms, but generally have fatigue, which indicates the problems of blood glucose metabolism and energy utilization. Hypoxia is also a stress stimulating factor, it will also cause the body to increase blood sugar. Many diabetic patients have decreased lung function and sedentary lifestyle. Routine aerobic exercise and abdominal breathing will improve the body to achieve normal metabolic reaction, make energy sufficient, and reduce the harmful metabolic waste to the body.

 

How are different types of diabetes treated by Westering Medicine:

The main goal is to keep blood glucose levels within the target range. Targets vary with the type of diabetes, age, and presence of complications.

Treating type 1

All people with type 1 diabetes must take insulin to live because damage to the pancreas is permanent. There are different types of insulin available with different times of onset, peak, and duration. You can also use an insulin pump, which is a device worn outside your body that can be programmed to release a specific dose. You’ll need to monitor your blood sugar levels throughout the day. If necessary, you may also need to take medication to control cholesterol, high blood pressure, or other complications.

Treating type 2

Type 2 diabetes is managed with diet and exercise, and can also be treated with a variety of medications to help control blood sugar. The first-line medication is usually metformin (Glumetza, Glucophage, Fortamet, Riomet). This drug helps your body use insulin more effectively. If metformin doesn’t work, your doctor can add other medications or try something different.

 

A Complete List of Diabetes Medications and side-facts

 

1. Alpha-glucosidase inhibitors

Alpha-glucosidase inhibitors medications are taken before meals.  The mechanism is to form a competitive, reversible inhibition of pancreatic alpha-amylase and membrane-bound intestinal alpha-glucoside hydrolase enzymes. In diabetic patients, this enzyme

inhibition results in a delayed glucose absorption and a lowering of postprandial hyperglycemia.

These drugs include:

• acarbose (Precose)
• miglitol (Glyset)

2.Biguanides

Biguanides decrease how much sugar your liver makes. They decrease how much sugar your intestines absorb, make your body more sensitive to insulin, and help your muscles absorb glucose. It's mechanism is to decreases hepatic glucose production, decreases intestinal absorption of glucose, and improves insulin sensitivity by increasing peripheral glucose uptake and utilization. Metformin is substantially excreted by the kidney, and the risk of metformin accumulation and lactic acidosis increases with the degree of impairment of renal function. FDA recommended this drug to be promptly discontinued if the following events occurs: cardiovascular collapse (shock) from whatever cause, acute congestive heart failure, acute myocardial infarction and other conditions characterized by hypoxemia.

The most common biguanide is metformin (Glucophage, Metformin Hydrochloride ER, Glumetza, Riomet, Fortamet).

Metformin can also be combined with other drugs for type 2 diabetes. It’s an ingredient in the following medications:

• metformin-alogliptin (Kazano)
• metformin-canagliflozin (Invokamet)
• metformin-dapagliflozin (Xigduo XR)
• metformin-empagliflozin (Synjardy)
• metformin-glipizide
• metformin-glyburide (Glucovance)
• metformin-linagliptin (Jentadueto)
• metformin-pioglitazone (Actoplus)
• metformin-repaglinide (PrandiMet)
• metformin-rosiglitazone (Avandamet)
• metformin-saxagliptin (Kombiglyze XR)
• metformin-sitagliptin (Janumet)

3.Dopamine agonist

Bromocriptine (Cycloset) is a dopamine agonist. Bromocriptine’s dopaminergic effect can cause paradoxical blocking of GH release through tuberoinfundibular pathways, decreasing circulating blood concentrations of GH, altering monoamine neurotransmitter concentrations in the suprachiasmatic and ventromedial nuclei of the hypothalamus, causing a sympatholytic effect that decreases metabolic processes which can lead to glucose intolerance and insulin resistance. More serious side effects include: Psychosis,  Fibrosis (retroperitoneal, pleural, cardiac valve), and Cardiovascular incidents (valvular damage, stroke, myocardial infarction).

4.Dipeptidyl peptidase-4 (DPP-4) inhibitors

DPP-4 inhibitors help the body continue to make insulin. They work by reducing blood sugar without causing hypoglycemia (low blood sugar). These drugs can also help the pancreas make more insulin. DPP-4 is an abundant enzyme that is present on the surface of most cells. It rapidly deactivates some incretin hormones, such as a glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1). These hormones are both released by intestinal cells in response to a meal. By antagonizing DPP-4, active postprandial incretin levels can be prolonged, which can result in increased insulin synthesis and release and decreased glucagon secretion, all of which can help regulate glucose homeostasis. (FDA) safety review has found alogliptin may increase the risk of heart failure, particularly in patients who already have heart or kidney disease.

These drugs include:

• alogliptin (Nesina)
• alogliptin-metformin (Kazano)
• alogliptin-pioglitazone (Oseni)
• linagliptin (Tradjenta)
• linagliptin-empagliflozin (Glyxambi)
• linagliptin-metformin (Jentadueto)
• saxagliptin (Onglyza)
• saxagliptin-metformin (Kombiglyze XR)
• sitagliptin (Januvia)
• sitagliptin-metformin (Janumet and Janumet XR)
• sitagliptin and simvastatin (Juvisync)

5. Glucagon-like peptide-1 receptor agonists (GLP-1 receptor agonists)

These drugs act as an agonist at the GLP-1 receptor, which makes it a type of incretin mimetic. This causes an increase of insulin secretion, predominantly in the presence of high blood glucose. They increase B-cell growth and how much insulin your body uses. They decrease your appetite and how much glucagon your body uses. They also slow stomach emptying. For some people, atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease may predominate over their diabetes. In these cases, the American Diabetes Association (ADA) recommends certain GLP-1 receptor agonists as part of an antihyperglycemic treatment regimen. FDA review has found this types drugs may increase risk of Thyroid C-Cell Tumors, acute Pancreatitis, hypoglycemia, and renal Impairment.

These drugs include:

• albiglutide (Tanzeum)
• dulaglutide (Trulicity)
• exenatide (Byetta)
• exenatide extended-release (Bydureon)
• liraglutide (Victoza)
• semaglutide (Ozempic)

 

6. Meglitinides

These medications help your body release insulin. However, in some cases, they may lower your blood sugar too much.

These drugs aren’t for everyone. They include:

• nateglinide (Starlix)
• repaglinide (Prandin)
• repaglinide-metformin (Prandimet)
• Sodium-glucose transporter (SGLT) 2 inhibitors

 

Sodium-glucose transporter (SGLT) 2 inhibitors work by preventing the kidneys from holding on to glucose. Instead, your body gets rid of the glucose through your urine. In cases where atherosclerotic cardiovascular disease, heart failure, or chronic kidney disease predominate, the ADA recommends SGLT2 inhibitors as a possible treatment option.

• dapagliflozin (Farxiga)
• dapagliflozin-metformin (Xigduo XR)
• canagliflozin (Invokana)
• canagliflozin-metformin (Invokamet)
• empagliflozin (Jardiance)
• empagliflozin-linagliptin (Glyxambi)
• empagliflozin-metformin (Synjardy)
• ertugliflozin (Steglatro)

 

7. Sulfonylureas

Sulfonylureas are widely used to treat non-insulin dependent diabetes mellitus. They work by stimulating insulin secretion from the pancreatic beta-cell. Their primary mechanism of action is to close ATP-sensitive K-channels in the beta-cell plasma membrane, and so initiate a chain of events which results in insulin release. The most common adverse effects of sulfonylureas are hypoglycemia, weight gain, and risk for cardiovascular events. Clinicians initially prescribe lower doses of sulfonylureas to prevent the risks of hypoglycemia. Unfortunately, in some patients taking sulfonylureas, the adverse effects may outweigh the benefits.

These drugs include:

• glimepiride (Amaryl)
• glimepiride-pioglitazone (Duetact)
• glimepiride-rosiglitazone (Avandaryl)
• gliclazide
• glipizide (Glucotrol)
• glipizide-metformin (Metaglip)
• glyburide (DiaBeta, Glynase, Micronase)
• glyburide-metformin (Glucovance)
• chlorpropamide (Diabinese)
• tolazamide (Tolinase)
• tolbutamide (Orinase, Tol-Tab)

 

8. Thiazolidinediones

Thiazolidinediones work by decreasing glucose in your liver. They also help your fat cells use insulin better.

These drugs come with an increased risk of heart disease. If your doctor gives you one of these drugs, they’ll watch your heart function during treatment.

Options include:

• rosiglitazone (Avandia)
• rosiglitazone-glimepiride (Avandaryl)
• rosiglitazone-metformin (Amaryl M)
• pioglitazone (Actos)
• pioglitazone-alogliptin (Oseni)
• pioglitazone-glimepiride (Duetact)
• pioglitazone-metformin (Actoplus Met, Actoplus Met XR)

 

9. Other drugs

People with type 1 and type 2 diabetes often need to take other medications to treat conditions that are common with diabetes.

• These drugs can include:
• aspirin for heart health
• drugs for high cholesterol
• high blood pressure medications

Copping strategies:

 

1.Life style changes: avoid staying up late. eating slowly with extra time to chew. Daily 30 minutes walk. ( focus on heel, sole, toes). Abdominal breathing 10 minutes daily. At the begining, abdominal breathing is not easy to adhere to, you can get up every half an hour, do a few deep breathing, and walk around for 5 minutes. (by the way, in the new 2020 to 2025 Dietary Guidelines for Americans: by USDA & HHS, it is also recommended to carry out activities every half an hour.)

2.Low carb diet: a low carb diet will consist of 130g or less of carbohydrate a day. This means focusing on eating fats, proteins like meat, poultry, fish and eggs, and some non-starchy vegetables.

• a.Avoid high glycemic index food, the sudden rise of blood sugar will transform into more fat. A good glycemic index for diabetics is less than 55. learn to pull down the sugar index! For example, add a tea spoon of coconut oil or some mung beans when making rice. Banana is high in sugar, but when mixed with avocado and yogurt, the sugar index will drop. Soybean and brown rice are rich in cellulose or can be directly supplemented with cellulose, which can make sugar and lipid absorbed slowly, without the roller coaster changes of blood glucose and blood lipid.
• b. Avoid trans fats. Trans fat has a long metabolic cycle in the body, which seriously affects liver function.
• c. Avoid alcohol, energy drink. No cold drinks. a glass of water should be drunk at room temperature, 30 min prior meals.
• d. All vegetables needed to be steamed, boiled, or stir fried. Minimum 1 lb vegetables per day. No cold characteristic food, such as salad, beer, ice-cream.

3. More antioxidant protection: including vitamin C, B3, B6 and vitamin E to improve lipid metabolism and protect liver, Alpha-lipoic acid to prevent the glycosylation reaction. High concentration of antioxidant can inhibit the release of tumor necrosis factor from macrophages. The role of drugs and insulin is only to control glucose. This simple blood glucose control can not prevent the continuous degradation of islet function, nor can it solve the problem of islet self repair from the root. We need more nutritional support for the pancreas and even the whole body. It has been proved that islet cells can regenerate continuously under the action of growth hormone, Hepatocyte Growth Factor and Gastric inhibitory polypeptide (GIP). By replenishing the body with enough arginine and stimulating the secretion of growth hormone in a certain way, it will provide more help to the pancreas.

4.Monitoring your blood sugar:

• a. A glucose tolerance test (GTT) may be used to help diagnose prediabetes and diabetes. but most commonly, a fasting blood glucose (FBG) or hemoglobin A1c test is used for diabetes screening.
• b. You need check at least 6 times a day for blood sugar: before and 2 hours after each meal, and keep the record.

5. Avoid hypoglycemia

Hypoglycemia does more harm to our body than hyperglycemia. Some people follow diet, exercise and strict control of blood sugar with drugs or insulin, but they don't focus the risk of hypoglycemia. When you feel hypoglycemia, the damage has happened. Diabetic patients must be alert to the possibility of hypoglycemia, each hypoglycemia will trigger stress response, will make the next hypoglycemia more likely to occur, will also make the blood glucose reserves become higher. This is why normal people has hypoglycemia symptoms when blood sugar goes below 60 mg/dl, compare to 90 mg/dl for some diabetic patients.

 

6. Acupuncture and Traditional Chinese Herbs

In traditional Chinese medicine, diabetes is believed to be caused by an imbalance in the body's energy flow or qi. Acupuncture aims to correct this imbalance by stimulating certain points on the body that are believed to affect the flow of energy. There are multiple types and stages based on each individual's conditions. I will construct individual treatment plan to help you manage your blood sugar, via strengthening your liver, spleen and kidney function.

 

Research has shown that acupuncture can help to regulate blood sugar levels by stimulating the release of insulin, the hormone that regulates glucose (sugar) in the bloodstream. Acupuncture can also help to reduce inflammation, improve circulation, and relieve pain, which are all important factors in managing diabetes.

 

Acupuncture can be used in conjunction with other diabetes treatments, such as medication, diet, and exercise, to improve overall health and reduce the risk of complications associated with diabetes.

 

 

 

 

 

 

 

 

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