In this February 2015 edition of the ACP Internist, I came across an article announcing to physicians that numerous major organizations had come to agree on 10 principles of caring for people at risk for diabetes. Principle one is identifying diabetes and “prediabetes”. The organization endorsement list is extensive and reputable.
The reason diabetes and prediabetes is a focus of health concern is the associated acute and chronic illnesses that go hand in hand with this disease. Type II diabetes has a strong correlation with arteriosclerosis and the presentations of acute myocardial infarction and other vascular diseases. Heart disease remains the single most common cause of death in America.
Amongst the cholesterol experts it is widely recognized that diabetes can actually be predicted using advanced lipid testing, specifically lipoprotein analysis. Cholesterol is carried in our blood stream in combination with triglycerides and complex fat molecules. Since fat and water (which is the largest component of our blood in our arteries and veins) don’t mix, these fatty molecules have to be packaged in “soap bubbles” called lipoproteins.
The diagnosis of diabetes follows a continuum. The guidelines focus on blood sugar levels as persistently abnormal blood sugar levels defines diabetes. It turns out that when lipoprotein analysis is carried out, persons who are developing insulin resistance can be identified. In insulin resistance, the cholesterol delivery system becomes dysfunctional. This is manefested by smaller than normal/optimal cholesterol carrying particles-the lipoproteins. Since the particles are smaller in size there has to be a much higher number of particles circulating in the bloodstream for the same amount of measured cholesterol. It turns out that the number of circulating lipoproteins correlates the strongest for facilitating cholesterol build up in our arteries. These smaller particles are also more oxidized. Oxidation is a high energy state which injures our cells and tissues. As a cholelesterol specialist (lipidologist) who relies on advanced lipoprotein analysis to optimize cardivascular risk, I can predict the risk for developing diabetes even before blood sugar levels become significantly abnormal.
Principle two in the principles document advised managing prediabetes. Using the “Wellness” approach to assessing peoples health, this practice actively identifies prediabetes as well as other nutritional problems. The subsequent recommendations of the principles document follow logically from identifying risk. Self-education and support, individualized nutrition therapy, exercise encouragement and subsequently improved blood lipids and sugar become a major focus of staying well. Internal Medicine Lipid & Wellness of Fort Myers offers a registered dietitian to provide the education, tailored dietary counseling and if necessary education on actual diabetes and blood sugar monitoring. Blood sugar monitoring is helpful as part of the educational process of learning how meal choices affect blood sugar responses to eating.
Internal Medicine Lipid & Wellness also offers high quality nutritional supplements to optimize nutrition and hence cellular function. At health physicals it is routine to measure body fat%, important nutrients like vitamin B12 and vitamin D levels, tissue antioxidant level, cholesterol profiles and if desired advanced lipid testing.