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How does acupuncture with diet and change of life styles help in treatment of diabetes mellitus?

BY DR. TUKMACHI CLINICAL DIRECTOR OF UK ACUPUNCTURE


 


Traditional Chinese Acupuncture: 


Is an effective treatment to improve metabolism of blood sugar and lipids and to lower blood viscosity as well as restoring the functions of peripheral nerve cells.  It is an old notion stated that acupuncture is only useful in pain control and most acupuncturists round the world have not been called upon to treat many patients with diabetes, mainly because of the misconception that acupuncture is not suitable for that disorder. However, acupuncturists are now in a position to provide an effective treatment because the points to be needled are also used (in various other combinations) for treating other disorders including diabetes. It is reported that the needling techniques for diabetes treatments are also essentially the same as used world-wide, without requiring special additional training.


The acupuncture treatment in diabetes may involve a needling of to up to a dozen acupuncture points in each single session. Therefore, a course of acupuncture treatment for diabetes is typically long-term, as acupuncture can treat symptoms but not cure diabetes. The treatment course consists of two acupuncture sessions per week, with number of weekly sessions dependent upon improvement in symptoms and decline in blood sugar levels.

In the past years different classes of drug therapies for patients with both Type 1 and Type 2 diabetes have been developed. The theory of genetic re-engineering of insulin to produce insulin analogs (synthetic insulin) with improved properties has enhanced the ability to affect glycaemic control with fewer adverse reactions. For Type 2 patients, the number of orally active anti-diabetic agents has increased from one class of agents (the sulfonylureas - sulfa drugs) to the current total of four classes of agents.

The Western Treatment of Diabetes

The metformin has been used in the treatment of Type 2 diabetes in more than 90 countries for over 30 years. It was approved for use in diabetes patients in the United States in 1995. Metformin reduces the excessive hepatic glucose production that characterizes Type 2 diabetes. With reduced hyperglycaemia, glucose uptake by peripheral tissues is enhanced while insulin levels remain stable or decline. Metformin also lowers elevated cholesterol and lipids, particularly the serum levels of triglycerides. Frequency of adverse effects is low at the doses needed to obtain the desired metabolic effect.

However to prescribe oral anti-diabetic agents alone and in combination for even minimal degrees of hyperglycaemia without an adequate trial of diet and exercise will only serve to accentuate the problem. For the non-insulin dependent diabetic, dietary and life style changes can often provide adequate remediation.  

The diet control
Diabetic patient cannot produce the constantly varying amounts of insulin necessary for obtaining energy from glucose.  One of the first dietary rules for all diabetics is to avoid all sugar and foods containing sugar, such as pastry, candy and soft drinks. While these refined sugars and other simple carbohydrates like white flour must be carefully watched, most diabetics are actually encouraged to eat more complex carbohydrates - the same bulky, fiber-rich unprocessed foods that are now recommended for everyone. Vegetables are ideal. For example, a diabetic can eat a large plate of spinach that contains as much carbohydrate as a tablespoonful of sugar, without suffering any ill effects.

The appropriate easy approach in diabetic patient’s diet is to reduce the amount of fat and to substitute polyunsaturated fats for the saturated type when possible. Fish and poultry are especially recommended instead of fatty cuts of meat. Greasy, fried foods are strongly discouraged.

The overweight diabetics should carefully calculate the proper daily calorie intake for their body weight and activity level, and never exceeding it in order to bring their weight down to an acceptable level.

It has been reported that many diabetics have found it beneficial to eat smaller, more frequent meals, rather than the two or three big meals most people consume daily. Furthermore, most researchers round the world have found that multiple frequent feedings tend to keep blood cholesterol levels lower, for the diabetic and non-diabetic alike.

It is known that European Blueberry (Vaccinium myrtillus)
is a useful fruit in diabetes which acts a natural method of controlling or lowering blood sugar levels when they are slightly elevated. Also Onion and Garlic may have significant blood sugar-lowering action as well as lowering lipids, inhibiting platelet aggregation, and reducing blood pressure.

WHAT ARE THE MEASURES TO PUT DIABETES UNDER CONTROL?

The diabetic patients are at risk for heart disease, kidney disease, atherosclerosis, nerve damage, infection, blindness, and slow healing. Therefore each diabetic patient has to be under a doctor's care and to be constantly monitored.
In addition to acupuncture treatment course, the diabetic regimen should have three cornerstones: nutrition, weight control, and exercise. With regards to diet: each diabetic patient should be tailored to fit the individual needs and lifestyles".

Each diabetic patient should read and apply the following:


1. The following are the principles of the right diet:

Load up on carbohydrates:
It is recommended that a type II diabetes diet include up to 50 to 60 percent of calories from carbohydrates. "Generally, the recommendation will be somewhere around 50 percent".  Carbohydrates are either simple (sugars) or complex (starches). Each gram of carbohydrate produces 4 calories.

Go easy on the protein
The protein should amount to about 12 to 20 percent of your calories. Each grain of protein equals 4 calories.

Face the fat.
Cut the fat out of your diet budget. Calories from fat should account for no more than 30 percent of your calories. Each gram of fat produces 9 calories. Every chance you get, replace artery-clogging saturated fat with polyunsaturated or, better yet, monounsaturated fat, or with complex carbohydrates.

Eat food with fiber .
Natural fiber in food has been found to have a host of beneficial effects for everyone. That goes double for people with diabetes. The advises are to gradually head for 40 grams a day. Whole wheat products, barley, oats, legumes, vegetables, and fruit are the best sources of fiber, as well as essential nutrients. One possible benefit fiber provides a diabetic is lower cholesterol levels. The water-soluble fibers found in legumes, oats, barley, and fruit, when eaten in a low-fat diet, have been shown to lower blood fat levels. Fiber also helps keep you from feeling hungry. One of the
main benefits of fiber is that it adds bulk to the diet and for type II people who are trying to control their weight and so are on restricted calories, bulk lets people feel fuller. Besides giving you that pleasantly satiated feeling, fiber foods are good for you. They are often high in important vitamins and minerals.

Cut your cholesterol.
The recommendation is that you should eat no more than 300 milligrams of cholesterol daily. This means cutting way down on organ meat and egg yolks and restraining yourself when it comes to meat and dairy fats. It also means adding fiber to your diet.

2. Looking at the three Dangers for Diabetics:

There are three potentially dangerous acute effects of diabetes needing
medical attention: hypoglycaemia, hyperglycaemia, and wounds. The diabetic needs a doctor's care in certain circumstances when they have the flu. Here's what the experts say.
Hypoglycaemia occurs when blood sugar drops too low. You can treat mild
symptoms yourself. Severe symptoms include headache, confusion, combative behavior, or unconsciousness; get to a hospital emergency room immediately, where a doctor will give you intravenous glucose. lf you're having frequent hypoglycaemic reactions, see your doctor because you may need to change your regimen.
Hyperglycaemia is when blood sugar rises too high. Its mild symptoms are
excess urination, excess appetite or thirst, blurred vision, or dizziness. You can be hyperglycaemic and not have any symptoms, so you will not even know unless you are monitoring your blood glucose. Severe hyperglycaemic symptoms include loss of appetite, stomach cramps, nausea and vomiting, dehydration, fatigue, deep rapid breathing, and coma.
Wounds and sores, especially on the feet and legs, get infected easily in a
person with diabetes. Have them treated by a doctor. When you think you have the flu, call your doctor right away; or get to a hospital emergency room if:
. You are vomiting or having abdominal pain.
. You have large amounts of sugar and acetone in your urine.
· Your blood sugar levels are above 200 milligrams.
. Your temperature is 100 F or more.

3. Substitute for sugar.

Research shows that sucrose and table sugar, when used in equal amounts with starches, doesn't hike blood sugar levels any more than other starches, such as potatoes and wheat. Thus you can have modest amounts of refined sugars if your diabetes is under control and you are not too overweight. But otherwise, check out alternative sweeteners. They are certainly safe to use. It has been approved non-caloric sweeteners, like aspartame and saccharin, and sweeteners with calories, like fructose and sorbitol.

4. Don't Let Your Feet Fail You.

Except for insulin, a diabetic's weakest link is the foot. Nerve damage from diabetes lessens the sensation of pain, so diabetics may not know they have injured their feet. Blood vessel damage means injuries and infections don't heal like they should -a little sore can become gangrenous, leading to amputation. And once you lose one leg as a result of a diabetic amputation, there is a 75 percent chance you will lose the other leg within three to five years. As a diabetic, you have to develop foot consciousness and here is how to keep your feet doing what they should -walking off weight, walking on fitness.

Take a load off the dogs.
Need another reason to lose weight? Consider the pounding your feet take. Obviously, if the feet are your foundation and you have more weight on that foundation, you are going to have more wear and tear on that foundation and it appears that we can notice that in more heavy people than thin people.

Become a foot inspector. 
Inspect your feet two or three times a day Have someone else do this for you if you don't have good eyesight. Make sure there is no redness, bruises, cuts, blisters, cracks, heat, swelling, or infection.

Keep them clean.
Wash your feet well with mild soap and pat them dry every day.

Keep them dry.
Use a good foot powder between the toes, and change your socks frequently.

Keep them well-maintained
Cut your toenails short and straight across. Treat athlete's foot and other minor problems promptly. Never go barefoot.
your calluses with a pumice stone. Don't soak your feet for prolonged periods.

Keep them warm on cold days.
But don't use a hot-water bottle or heating pad because they can burn you without your knowing it.

Make sure your shoes fit well.
Research has indicated that the running shoe may be better for protecting the feet of people with diabetes than expensive custom-made shoes costing hundreds of pounds. The research and development put into both running and walking shoes has far exceeded that of the dress shoe industry. The running or walking shoe of today is part of whole "foot-support system”. As a result of the research put into them, you are buying a very biomechanically sound piece of equipment for your feet.

Don't forget the socks.
Before you slip on one of those biomechanic sound shoes, however, make sure your socks are up to the task. Socks are also part of the foot-support system. For athletic or casual wear with either walking or running shoes, it is recommended that Thor-Lo socks, which come in 11 sports-specific varieties. Most boast thick, cushioned heel and toe pads that help protect the feet of those with diabetes.

5. Proceed with caution
People with well-controlled diabetes can use fructose and sorbitol with little problem.  Fructose raises blood sugar the least of the caloric sweeteners. But, in people with low insulin reserves, fructose will raise triglyceride levels. The consumption of large amounts, both fructose and sorbitol can cause diarrhoea.

6. Beware: calories ahead.
Calorie-rich fructose and sorbitol, both found in fruit (sorbitol breaks down in the body to form fructose), are not exchanges for the non-caloric sweeteners. So if you have added fructose and taken out saccharin, you have still added calories to your diet.

7. Eat smaller meals more often
The diabetic body can handle smaller meals more easily because the smaller the meal, the less insulin is needed to handle the glucose influx from each meal. Less glucose equals less insulin equals more constant blood sugar levels. Some diabetes meal plans call for three meals a day or three small meals plus one or two small snacks between meals. It more appropriate that more actual meals because often if people go too long between meals they get so hungry they can't control what they eat at the next meal.  It is also recommended the snacks, like a piece of fruit or a couple of crackers between meals.

8. Use care with alcohol.
It is recommended that you drink no more than 2 ounces of liquor twice weekly. That is 3 ounces of distilled beverage, 8 ounces of wine, or 24 ounces of beer. Take your drink with food. Light beer and dry wine may be the way to go because they have fewer carbohydrates.

9. Treat booze like fat.
Exchange alcohol calories for fat calories, because alcohol is high in calories per gram and because it is metabolized like fat.

 10. Don't take fish oil.
Omega-3 capsules may help prevent atherosclerosis, another diabetes complication. But it has been shown to increase blood glucose levels if you take too much it, simply because it is high calorie. One study showed what the researchers called a "rapid metabolic deterioration" when 5.5 grams of omega-3 were taken daily for a month. But eating fatty fish is encouraged.

11. Lose weight.
Weight loss is the number one priority. Eighty percent of type II diabetics are overweight. They tend to live a sedentary life and eat a lot. Obesity may obliterate insulin receptors so sugar can't enter the cells and remains in your blood. If you are overweight, diet and exercise will almost certainly help you lose some weight and get your blood sugar back to normal, and that may be all you need. Sometimes, all you have to lose is 5 or 10 pounds and you are fine.

12. Don’t go to extremes.
May be you have tried every fad diet, even tried fasting, and still haven't lost weight. There's some evidence that it might be harder for a person with diabetes to shed pounds than for a person without diabetes. It is preferred that the weight control can be achieved by improving eating habits and exercise and that will help controlling the blood sugar and blood fat levels. Don't let frustration drive you to a fad diet. If all the fad diets worked, we wouldn't need new ones all the time. They may not be nutritionally sound, and they may be so restrictive people can't stick with them.

13. Self-treatment of mild hypoglycaemia.
Hypoglycaemia occurs when blood sugar drops too low. Because keeping their blood sugar at normal levels requires quite a balancing act, diabetics are  particularly prone to hypoglycaemia. People with adult-onset diabetes usually get hypoglycaemia from skipping or delaying meal, or from unplanned-for strenuous  exercise.
Symptoms of mild hypoglycaemia include numbness in the mouth, cool wet skin, a fluttering feeling in the chest, and hunger. To treat it yourself, you need to take some form of sugar that is readily available. Drink something sweet like orange juice or soda, or eat a candy bar and be ready for it by carrying candy or mints with you.

14. Make it a family affair.
If the whole family doesn't make these nutritional changes to improve eating habits and control weight, it will be hard, if not impossible, for the person with diabetes to do it alone.

15. Exercise.
The benefits of regular exercise for everybody, diabetic or not, are well recognised. But diabetics have even more reason to get their arms and legs moving and their hearts pumping. Exercise strengthens the heartbeat, helps control blood sugar levels, and increases circulation to the body's extremities. Exercise can cut the level of cholesterol and triglycerides while raising the level of high-density lipoproteins (the “good" cholesterol that protects against heart disease). It helps you control your weight, increases your stamina, and lets you sleep more soundly. And it really helps shore up your emotional fortitude. Regular exercise has been shown to have beneficial effects on mood, especially for depression.  There's also some evidence that exercise increases the number of insulin receptors on cell surfaces, which means insulin can find a place to put glucose where it's needed - inside the cells. In fact, to a person with diabetes, exercise is like a dose of insulin.  Repetitive, rhythmic movements involving your large muscles -arms and legs- are best for diabetics. That means walking, jogging & swimming, rowing & or bicycling. You have to exercise regularly and at least three times a week for 20 to 30 minutes, the experts say. Your doctor may even prescribe exercise five to seven times a week. Studies showed that even a two- or three-day layoff from exercise reverse its beneficial effects in diabetes.

16. Take care of your teeth.
A diabetic has to maintain an absolutely immaculate mouth, because diabetics are much more susceptible to infection, they are also more susceptible to gum disease, which is a bacterial infection. Everything a non-diabetic person should do for dental health, a diabetic person should do even more conscientiously. This means more frequent visits to your dentist and especially conscientious brushing and flossing to control plaque and tartar.

17. Reduce stress.
Stress and anxiety can destabilize diabetic control in two ways. Some people's blood sugar can skyrocket, others' goes way down. When diabetic are depressed or anxious, frequently they do not adhere to their regimen very well, relapsing into a fat and sugar pig-out and couch potato-hood. Diabetes, with its constant emotional and physical demands, is a stressful disease. If a person is having some very stressful life events they are having trouble coping with, they should seek the help of a mental health professional. Here are some ways you can help yourself relieve stress.
Relax:
relaxation therapy and cognitive therapy for diabetes control and have been found very helpful. Relaxation techniques focus on controlled breathing and visualization, and can be learned from professionals or books.
Learn how to think:
Cognitive therapy teaches you to recognise the kinds of thinking you engage in that might be affecting your mood. You might have thoughts like “my legs are really ugly because of the marks from injecting insulin” or “I feel like a freak every time I have to test my urine”.  You can turn those negative thoughts about the regimen into a more rational way of looking at it. You can instead think “Nobody's noticing those little marks in my skin but me”.
Improve your perspective:
Some people do focus on their illness too much. They label themselves as having this chronic illness, and it colours everything. Well, it does not colour everything. You do have to be more disciplined about your daily life in terms of your eating schedule, but it does not have to hamper you. You need to add uplifts to your daily life for a better perspective. So do something you enjoy doing- buy yourself something new., call a friend you have not talked to in a long time, any little treat that is not expensive and you do not have to plan weeks for, but that you can do on a daily or weekly basis.

18. Use care with “over the counter”:
some over-the-counter drugs contain sugar and other ingredients that can disturb blood sugar levels. Watch out for over-the-counter stuff. Always check the label for any warning directed to people with diabetes, but don't stop there. Ask the pharmacist if you are not sure, and be sure to monitor your reactions after taking any over-the-counter medication and of course, check with your doctor. Here are a few ingredients to be wary of:

Aspirin:
large quantities of aspirin taken for chronic pain can lower blood sugar levels. Occasional small amounts, such as two tablets for a headache, are not enough to worry about.
Caffeine:
The main ingredient in over-the-counter appetite suppressants is caffeine, which can raise blood sugar levels when taken in large amounts.
Many headache and cold medications also are loaded with caffeine.
Ephedrine or epinephrine.
These are used in preparations that treat respiratory diseases, but they can increase blood sugar in people with Type II diabetes. So can phenylephrine, a drug found in nasal sprays and cold preparations.

If you suffer from Diabetes, acupuncture may be what you’ve been looking for to ease your problems and to restore your health and vitality. Please call us today
 

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