Diabetic Care - The Fatty Acid Answer by Jade Beutler Diabetes poses a major health problem, physically and financially, affecting over 16 million Americans at an annual cost of 9 billion dollars. It ranks third among degenerative diseases, only behind heart disease and cancer. This statistic alone may be misleading as the major complications of diabetes in cardiovascular disease, may falsely augment the nation's number one ranked killer, heart disease. Diabetics are classified either Type I (juvenile onset, insulin dependent) comprising 10% of all diabetics, or Type 2 (adult onset, non insulin dependent) comprising 90% of all diabetics. Type 1 patients are afflicted at childhood resulting in the inability of the pancreas to secrete insulin, a key-like hormone responsible for allowing blood sugar to enter the cell (lock) to produce energy for all life functions. In contrast, the pancreas of the Type 2 diabetic typically continues to secrete insulin, although for many reasons the cells become unresponsive (a rusty lock) to the insulin key. Regardless of the classification, diabetes is defined as a malfunction of carbohydrate metabolism. In other words, the body's inability to reliably utilize dietary carbohydrates for energy production. Standard treatment consists of either oral diabetic drugs, daily insulin injections, and dietary and life style management. Drawing much less attention is the careful dietary manipulation of fats and oils in achieving optimal diabetic health. A review of past and present scientific literature underscores the importance of avoiding certain fats while supplementing other fatty acids to meet these ends. It has been discovered that diabetics not only possess a malfunction of carbohydrate metabolism, but a malfunction of fat metabolism as well. Largely ignored, this condition is of paramount importance, because the majority of diabetic complications - neuropathy, retinopathy, impotence, heart disease and stroke - are a result of faulty fatty acid metabolism, coupled with chronic hyperglycemia. The American Diabetic Association's (ADA) only apparent approach in addressing dietary fats is in suggesting a diet in which no more than 30% of daily calories are consumed as fat. According to natural medicine authorities, Dr. Michael Murray, N.D. and Dr. Julian Whitaker, M.D., 30% is too high. They recommend a diet of no more than 20% of calories consumed as fats, not only for diabetics, but all Americans. Their recommendation would equate to 500 calories as fat in a standard 2500 calorie diet, a reduction of 250 fat calories, as compared to the ADA's 30% proposal. This bears significance because the wrong kinds of fats have been proven to cause insulin insensitivity, the cells inability to allow blood sugar to enter the cell. Specifically, the excess consumption of saturated fat and hydrogenated fats and oils contribute to insulin insensitivity. Hydrogenated fat products are particularly dangerous, because they have been chemically altered and are hidden in a plethora of processed foods such as pastries, bread, prepared foods and the list goes on (read the labels carefully!). Margarine, exalted as heart healthy by commercial interests, is the most blatant example of these biologically damaging substances. Both saturated and hydrogenated fats contribute to the development of atherosclerotic plaque and hinder circulation by thickening the blood. In addition, these unhealthful fats increase triglyceride and LDL (bad cholesterol) levels, major detriments to diabetics. Further, hydrogenated fats and oils have been cited scientifically to effect the nervous system of diabetics, while increasing intracellular levels of sorbitol, a substance that induces microvascular fragility and bleeding. As a testament to lowering overall fat consumption with concurrent dietary management, many Type 2 diabetics have rid themselves of all diabetic medications. Type I diabetics have been able to accomplish reduced dosages of injected insulin, bearing significant value as injected insulin has been implicated as contributing to cardiovascular disease. Perhaps of equal or greater importance is the role certain beneficial fatty acids may play in preventing or improving cardiovascular complications attributed to diabetes. Buried in the annals of medicine are extremely optimistic studies attesting to these facts. This information has not been widely publicized in the past because fatty acids are naturally occurring nutrients and can not be patented by pharmaceutical companies and sold at exorbitant prices. One such fatty acid, gamma linolenic acid (GLA), is found in nature's most concentrated form as Borage seed oil (24% GLA). The results of GLA supplementation in diabetics are truly astounding, as outlined below. Diabetic neuropathy (a painful nerve disorder resulting from reduced blood flow and subsequent oxygen depravation of the limbs or organs) was reversed in studies conducted by seven medical centers. In a separate, but similar study, 12 patients afflicted with diabetic neuropathy were given 360 mg. of GLA daily (the equivalent of two, 1000 mg. Borage oil capsules), while 10 others were given a placebo (inactive substance). After 6 months the GLA group showed statistically significant improvement as compared to the placebo group. In addition, GLA supplementation has been reported to normalize the faulty fatty acid metabolism attributed to diabetes by bypassing the enzyme system responsible for this disorder. By doing so, the body's response to inflammation, pain and swelling is stabilized. Arterial muscle tone, responsible for blood pressure and optimal circulation, is also regulated by this system. Animal studies conducted with GLA have revealed the normalization of intercellular sorbitol levels. Another study of Type I diabetics cited favorable changes in HDL (good cholesterol) and blood platelet adhesiveness (³stickiness²). Also of interest is the family classification of Omega 3 fatty acids. This specialized class of fatty acids have been extensively studied for their potential protective effects on cardiovascular disease. Fish oils have been widely touted for their content of Omega 3's. Recent reports have discounted the safety of fish oils due to the possibility of chemical contamination, vitamin A or D toxicity and high levels of lipid peroxides (rancid fats). In contrast, organic flaxseed oil contains twice the amount of Omega 3 fatty acids (57%) without the risks associated with fish oils. Studies confined to diabetics and Omega 3 fatty acids reveal the following:
Given the compelling research cited here, a reasonable approach should include the following:
 In summary, diabetics have been found to possess
faulty fatty acid metabolism which may contribute
to the cardiovascular complications associated with
the disease. Scientific research has established the
reduction of certain harmful fats, with the addition
of beneficial fatty acids, may offer a significant
breakthrough in combating diabetic cardiovascular
complications with the potential of significantly
lowering health care costs.
To obtain high quality essential fatty acid products, visit your local independently owned health food store. Diabetes is a serious health problem and any dietary manipulation of foods or nutrients should only be considered with the advice of a qualified health professional. To locate a naturopathic physician near you phone (206) 323-7610. This article is for informational purposes only and should not be considered medical advice. This article is dedicated to my dear friend and diabetic, Scott Satren. 
References:1) Fatty Acid and Prostaglandin Metabolism in Children with Diabetes Mellitus. Arisaka, M. (Prostaglandin's, leukotrens and essential fatty acid, July 1991.) 2) The Effect of Gamma Linolenic Acid on Human Diabetic Peripheral Neuropathy. Jamal, G.A. (Diabetic Medicine, May 1990) 3) Pathogenesis of Diabetic Neuropathy: The Role of the N-6 Essential Fatty Acids and Their Eicosanoid Derivatives. Jamal, G.A. (Diabetic Medicine, Aug. 1990) 4) Essential Fatty Acid Treatment, Effects on Nerve Conduction in Streptozotocin Diabetic Rats. Tomlinson DR. (Diabetologia, Sept. 1 989) 5) Action of Evening Primrose Oil on Cardiovascular Risk Factors in Insulin Dependent Diabetics. Uccella, R. (Clinica Terapeutica, June 1989) 6) The Use of Gamma Linolenic Acid in Diabetic Neuropathy, Agents and Actions. Horrobin, D.F. (Supplements, 1992) 7) Pilot Study on Omega 3 Fatty Acids in Type 1 Diabetes Mellitus. Langraf-Leurs, M. M. (Diabetes, March 1990) 8) Effects of Omega 3 Fatty Acids in Type 1 Diabetic Subjects on Lipid Values and Hemorhelogical Parameters. 9) Essential Fatty Acids and Complications of Diabetes Mellitus. Horrobin, D.F (Wiener Klinishe Wochenschrift, April 1989) 10) Glucose Turnover in BHE Rats Fed EFA Deficient Hydrogenated Coconut Oil. (Diabetes Research, Jan. 1990) |