Diabetes: The Functional Medicine Approach

Type 2 diabetes has reached epidemic proportions in the US and globally. It’s estimated that by 2050 one-third of US adults will have this diet-related chronic disease, which currently afflicts about 10% of the population.

Not only is diabetes now widespread in middle- and low-income countries, which are increasingly adopting a nutrient-poor Western diet, but children and young people are being diagnosed with the illness.

The condition is characterized by a loss of sensitivity to insulin, the hormone that regulates blood sugar levels, resulting in high blood sugar, which can lead to kidney, nerve, retinal, and vascular damage. Increasingly, it’s understood that type 2 diabetes is driven not only by the modern diet of refined carbohydrates, fructose, and industrial seed oils—such as those from corn and grapeseed—but by the lack of exercise, inadequate sleep, stress, gut dysfunction, and environmental toxins.

Medication-based conventional medicine treatment of diabetes has not only failed to stem its rising ride but comes hand-in-hand with serious side effects such as nausea, fatigue, liver and kidney dysfunction, weight gain, rashes, and low blood sugar (hypoglycemia). Dietary guidelines often espoused by conventional medicine practitioners, which promote low-fat, high carbohydrate foods, have proven to be ineffective and may actually worsen the condition.

Functional Medicine (FM), which centers on preventing and treating illness by focusing on patient-centered diet and lifestyle changes, offers new hope for managing the disease. Studies have shown that the low-carbohydrate diet recommended by FM practitioners consistently outperforms a high-carb diet. Further, the type of carbs consumed are critical, say FM doctors, with unprocessed starchy tubers like sweet potatoes, cassava, and plantains being preferable to refined carbs such as bread and pasta.

The low-carb, high-fat ketogenic diet has shown promising results in treating type 2 diabetes by promoting weight loss, reversing kidney damage, and improving cardiovascular health. Studies show that removing gluten from the diet can reduce inflammation and improve insulin resistance. Other dietary changes shown to be effective in managing the disease are increasing protein intake and consuming paleo foods. Nutrients and nutraceuticals that play a role in diabetes prevention include vitamin D, magnesium, B12 and folate, and berberine, which improves insulin resistance.

Other prevention and treatment measures recommended in the FM model include improving gut health. Supplementation with prebiotics and probiotics to promote healthy gut microbiota and improve metabolic function can be useful.  

As a sedentary lifestyle is a known risk factor for type 2 diabetes, exercise is critical. Research shows that walking 30 minutes a day reduces the likelihood of developing the condition by 50%. High-intensity interval training may improve cardiovascular complications and improve blood sugar control.

Data reveals that insufficient sleep—less than seven or eight hours a night—can impair insulin production. Obstructive sleep apnea (OSA), exacerbated by obesity, can promote type 2 diabetes by limiting oxygen supply to the body. Thus, strategies to correct OSA, including weight loss and use of a continuous positive airway pressure machine, are recommended. 

Chronic stress is a significant factor in the type 2 diabetes epidemic, say Functional Medicine practitioners. Hormonal changes from stress are strongly identified with blood sugar imbalances and induce insulin resistance.    

More recently, the role environmental toxins play in type 2 diabetes have come to light, and reducing exposure to harmful chemicals and pollutants is advised. The list of contaminants is long, headed by BPA, found in polycarbonate water bottles; phthalates, found in some personal care products and children’s toys; and POPs (persistent organic pollutants), such as pesticides.   

In the Functional Medicine model, diet and lifestyle modifications can go a long way toward getting to the root cause of type 2 diabetes and managing its progression.