You Want To Know!

As a member of the LCDA, you should be proud knowing you are taking a proactive lead in healing the prediabetes or diabetes of yourself or a loved one or a patient. And, you have come to the right organization. By learning about The Eight Essentials, and how to bring positive changes to your diet, lifestyle, supplementation, you will learn information that may help you reverse prediabetes and can help you to reverse or control diabetes.

New Expert Interviews!

The low carb diet is the foundation diet for people who have prediabetes or diabetes. The LCDA promotes a nutritional, fun, tasty way to implement the diet.

 

The LCDA knows that change can be difficult! That is why we are here to help make sense of diabetes and help educate you about how simple life changes can have profound effects on your health and on reversing and controlling your diabetes. We know that you may start only dipping your toes into the water of healing. We are here to lend hope, support and offer answers and confidence in your success.

Quote of the Day:

“Learning Never Exhausts The Mind.”

~ Leonardo da Vinci

Board Member Updates

Remember to order Dr. Morstein’s new outstanding diabetes book at Amazon: Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes

ULTA Labs Coming to the LCDA!

The LCDA will soon have a easy to use link to ULTA LABS on our website where anyone can order very inexpensive labs. If you do not have insurance or if your insurance still leaves you with significant laboratory charges, using Ulta Labs through the LCDA will save you significant money. The LCDA set this up to enhance comprehensive diabetic laboratory testing for patient with prediabetes and diabetes, and established a few panels, but you can order any lab you wish.

Ulta Labs is a company that has arranged with SonoraQuest labs to run very affordable blood work for physicians to order for their patients, or for people to order for themselves. This is a win-win set-up for everyone involved. The LCDA does get a little money from Ulta Labs for promoting lab tests through our website, but it goes straight to the non-profit to help us grow and offer more services for our members.

If you need upcoming labs, and are worried about a large lab bill, it’s easy to check out the prices on the Ulta Labs offered through the LCDA. Keeping on track of helpful lab values means your diabetes and risk factors are reducing, reducing your worry and stress! LCDA and Ulta Labs is a good mix!

Connect to Ulta Labs here: www.UltaLabTests.com/LCDA

Type 2 Diabetes and Sulforaphanes

Essential #7: Supplementation

A recent study showed that taking sulphoraphanes improved fasting glucose levels and decreased Hemoglobine A1C levels in patients with Type 2 diabetes.

Researchers gave 97 patients with T2DM a concentrated broccoli sprout extract (BSE) for three months. In patients who were not well controlled, the BSE improved their glucose and A1Cs, but it did not affect those who were already well controlled. In particular, obese patients who were poorly controlled had significant reductions in their A1Cs, and glucose lowered the most substantially in those who presented first with elevated triglycerides, who shown to be the most insulin resistant, and those with a fatty liver.

The researchers found that the BSE reduced glucose production via several different mechanisms.

So, what exactly is sulforaphanes? Sulforaphanes are phytochemicals–a natural chemical found in plants. It’s precursor glucoaphanin is converted by an enzyme myorosinase found in broccoli and via help from microbes in the gut (requiring a healthy microbiome, as per Essential #5).

They are incredibly well studied, with over 250 studies having occurred so far, even by prestigious institutes such as Harvard. Sulforaphane is a concentrated extract found in cruciferous vegetables: broccoli, brussel sprouts, cauliflower, cabbage, arugula. However, they are highest in broccoli sprouts, which you can grow even in your own kitchen; they can contain 10-100x the amount than in the developed vegetable. You can maximized your sulphorphane intake by heating broccoli for 10 minutes at 140F, or by steaming it lightly for 3-4 minutes so it is tender and tough. Unfortunately, frozen broccoli does not seem to contain any sulphoraphanes, probably from the blanching processing taken to freeze the vegetables. Taking a concentrated, stabilized pill of it is equal to eating about 5.5 pounds of broccoli a day.

Sulforaphane supplements have been shown to have many beneficial effects in our bodies:

  1. It helps with hormonal and chemical detoxification to the extent it lowers the risk of many different types of cancer.
  2. It is considered to be a very strong anti-carcinogen and should be taken by most people who have had cancer, or who wish to prevent it.
  3. It may help block inflammation and reduce pain in joints.
  4. It is an antioxidant throughout the body.

Unfortunately, T2DM is associated with an increase risk of developing many different types of cancer. Highest risk is developing cancers of the liver, pancrease, uterus, and the colon, rectum, breast and bladder.

It seems sensible to consider discussing with your integrative physician adding a sulforphane supplement to your daily intake. The daily dose is 30 mg a day, one simple pill. If you are obese, or have high triglycerides, elevated fasting glucose or A1C, are very insulin resistant, and especially if you have a family history of cancer, a sulforaphane supplement seems like it could be a good addition. You can order sulforphanes through FullScript Supplements, associated with the LCDA website.

If you have a sulfur sensitivity or gene mutation along sulfur lines, this supplement may be contraindicated. Please discuss taking it with your integrative physician before doing so.

Diabetes and Cancer: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2890380/

Random Microalbuminuria

General Diabetes Information: Laboratory Tests

At least once per year, a patient with diabetes should have their urine tested for a random microalbuminuria. You simply urinate into a little plastic container at your doctor’s office, at home and bring it to the lab, or at the lab itself. There doesn’t have to be any cleansing of the genital area before urinating as when testing for a urinary tract infection.

Random microalbuminuria is a valuable test that indicates, as early as possible, if you are developing any diabetic related kidney disease. Microalbuminuria uncovers an abnormally elevated leve of urine albumin, beyond what can be found on a typical urine dipstick. The presence of microalbuminuria (MA) is a warning–and a motivational sign to work harder on their comprehensive integrative protocol–that the person might be heading towards developing full-blown diabetic kidney disease, and an increased risk of heart disease. Unfortunately, diabetic patients who have been uncontrolled for years, due to the typical failure of conventional care, are the #1 population of patients who develop end-stage renal disease and require dialysis. No patient compliant with comprehensive integrative care should ever develop renal damage.

Up to 30% of newly diagnosed T2DM will already have elevated MA: about 75% will just have the MA and up to 25% might already have overt kidney damage developing.

MA is diagnosed when urinary albumin level is 30 mg/d or higher.

When should a person with diabetes be tested for microalbuminuria:

  • T1DM patient–five years after diagnosis and then annually
  • LADA patient–do yearly
  • T2DM Patient–at diagnosis and then annually

Random MA is scored in this way:

  • Normal: < 30 mg/g creat
  • Microalbuminuria positive: 30-299 mg/g creat
  • Macroalbuminuria: ≥300 mg/g creat

Other situations can increase the MA: short term hypoglycemia, intense exercise, urinary tract infection, significant hypertension, congestive heart failure and an acute fever. Statin drugs can also increase the MA result. If the MA is high and none of those are occurring, your physician can repeat the test to ensure it was accurate. If it was, and the same elevation occurs, over 300, a referal to a nephrologist may be indicated. However, if you instead decide to be copmliant with your comprehenisve integrative program established by your physician, you will see that the MA can handily return to normal within three months, oftentimes. So, this is when a lab test can be used in a positive motivational way, to encourage a patient to see their own kidneys heal up from early kidney damage.

In conventional care, two different types of hypertensives medications are used to protect the kidneys: T1DM patients Ace-Inhibitors (Lisinopril, for example), and T2DM patient Angiotensin Receptor Blockers (Valsartan, for example). It is highly imperative to never take those drugs together as they can damage the kidneys.

Random microalbuminuria is a very important lab value that should be tested in patients with diabetes. In the next section, we’ll learn how to treat injured kidneys with integrative medicine.

Elevated Microalbuminuriaria and Integrative Care

General Diabetes Information: Laboratory Tests

If you get an elevated random microalbuminuria (MA) result, it can be scary–no one wishes to develop kidney failure and need regular dialysis. However, like any other area of the body, the kidneys can heal, especially when the damage to them is caught early. Using comprehensive integrative care is your best bet for reversing the damage and once again having healthy kidneys.

If you have an elevated MA, you can still eat the low carb diet your integrative medical practitioner recommends, In fact, it is almost always the getting off that diet and cheating on carbs that causes an elevated MA, as hyperglycemic oxidative damage is the key to kidney damage as it is to eye, nerve, and blood vessel damage.

So, first thing is to recommit to the low carb diet! That is the foundation for getting glucose numbers under control. Stopping smoking, exercising and working on all the other Essentials is important, too. For example, many environmental chemicals need to be cleared by the liver and kidneys, and protecting those organs means reducing exposure to pesticides and all the other persistent organic pollutent chemicals “out there”.

As for diet, studies have shown that a low carb, high fat, ketogenic diet may reverse impaired kidney function in both T1DM and T2DM patients. A low carb, iron restricted (that is low red meat and pork diet) was also effective at reversing kidney damage. Iron can cause oxidative damage in the adult body when too much is ingested.

Also, losing weight is important. Central obesity has been shown to promote kidney failure through several physiological mechanisms. Weight loss significantly reduces MA to even normal levels.

Other key nutritional benefits to reduce MA scores and reverse kidney damage:

  1. Avoid refined sugar–this is associated directly with causing high blood pressure, and that damages the kidneys.
  2. Omega-3 oils can reduce kidney damage: grass fed/finished meat, leafy greens, walnuts, omega-3 eggs, oily fishes, flax and chia seeds, and supplementation of fish oils and flax seed oil.
  3. Eating organic soy instead of red meat can help heal kidneys.

Many botanical and nutritional supplements can also be used to normalize MA and heal the kidneys, especially when added to a low carb diet and a protocol containing the other Essentials.

Beneficial kidney botanicals include:

  1. Codonopsis root
  2. Pellitory of the Wall/Parietaria
  3. Astragalus root
  4. Lespedeza aerial parts
  5. Chinese rhubarb root
  6. Licorice root
  7. Cinnamon bark
  8. Stinging nettle seed
  9. Rheum palmatum
  10. Gingko biloba
  11. Salvia Miltorrhiza/Dan Shen
  12. Panax Ginseng

Those herbs listed above are the key herbs for your integrative practitioner to use to help regenerate and heal your kidney cells. Various herbal tinctures (liquid based alcohol extraction) contain mixtures of those, and some can also be taken in capsule form. There are indeed medical studies showing their benefits as both protective and healing to kidney tissue.

Some of our old favorite antioxidants recommended for all diabetic patients to take have been shown to protect and heal the kidneys, too.

Here is a list of beneficial supplements:

  1. Benfotiamine has been shown to be very helpful with diabetic kidney disease
  2. Alpha lipoic acid by itself but also in combination with benfotiamine
  3. Curcumin extract and Quercitin (bioflavinoid)–both of these have studies showing benefits to the kidneys
  4. Omega-3 fish oils–as in the diet, taking supplementation is very effective as well.
  5. Even simple antioxidants like Vitamin C and Vitamin E are helpful.

The LCDA strongly believes that a compliant patient following The Eight Essentials has a low risk of developing diabetic kidney disease and can easily and effectively heal up elevated levels of microalbuminuria. The first step is ensuring your MA is tested, and then, if elevated, and only medications are being offered to you, search for a physician doing comprehensive integrative care, who can set up a regimen including the above botanicals and supplements to get your kidney healthy and have it stay healthy.

DPP-4 Drugs and Heart Failure

Essentials #8: Medications

The drug class of Dipeptidyl peptidase (DPP)-4 inhibitor is unfortunately, to the LCDA, a failed class of oral hypoglycemic drugs. Designed to prevent the breakdown of Glucagon Like Peptide-1, a hormone in our body that helps lower glucose levels, it is not very effective. Studies show that the DPP-4 is mostly insignificant at lowering glucose levels–perhaps a drop of 0.4-0.5% of A1C can be obtained at the highest doses of a DPP-4 medication. Of course, changing to a low carb diet can lower an A1C 5% in three months! Even patients on a DPP-4 inhibitor oftentimes note they haven’t really seen much change in their glucose levels.

There are several drugs in this category: Januvia (sitagliptin), Onglyza (Saxagliptin) and Tradjenta (Linagliptin), and Nesina (Alogliptin).

Earlier this month Januvia, Nesina and Tradjenta were given a new warning label by the FDA. A study showed that patients on Saxagliptin where hospitalized more for congestive heart failure. The FDA decided to conservatively have all the drugs in that class list that warning

However, a 7 year study done in the UK, however, studying 14,735 patients showed the Sitagliptin actually did not cause any congestive heart failure in patients with established cardiovascular disease. This was a randomized double-blind, placeo-controlled trial, the best type of trial in medicine. The mean follow-up time for patients in the study was three years. There was no difference in negative side effects between the Sitagliptin group and the placebo ground.

So, even though the FDA made an all-inclusive warning for the entire class of this drug, Sitagliptin has a study that seems to clearly remove it from that particular possible side-effect. If you have to be put on a DPP-4 inhibitor, you should ask your physician to choose Januvia.

The LCDA includes medications in their Essentials because diabetic patients may, at times, need to be on medications (T2DM), or will absolutely need to be on insulin (T1DM). Although the DPP-4 inhibitors do not cause weight gain or serious hypoglycemic events (in general), they also are not very effective at lowering glucose levels. Adding in that three of the four drugs may cause congestive heart failure in patients already with cardiovascular disease means that it’s best to seek comprehensive integrative care for one’s diabetes and try to avoid or being able to get off oral hypoglycemic agents entirely.

RESOURCE GUIDE

Books: (All are found on Amazon.com)

  1. Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes. Dr. Mona Morstein

Ulta Labs:www.UltaLabTests.com/LCDA

Supplements:

Diamend by Priority One Supplements (created by Dr. Mona Morstein of the LCDA)–contains benfotiamine, alpha lipoic acid, at therapeutic doses and many other ingredients. Ask your comprehensive integrative practitioner to consider prescribing you Diamend.

LOW CARB RECIPES

Recipe #1 | Spinach and Feta Cheese Pie

Pork Chops with Dijon Herb Sauce

Ingredients:

Grain Free Pie Crust:
* 1 1/2 cups almond meal/flour
* 1 egg
* 1 tbsp coconut flour
* salt and pepper to taste

Spinach and Feta Pie Filling:
* 1.1 lb spinach fresh or frozen (see notes below)
* 6 eggs beaten
* 1/2 onion finely diced
* 1 cup cream cheese full fat
* 1 cup feta crumbled
* huge handful fresh mint chopped
* salt and pepper to taste

Directions:

Grain Free Pie Crust:

1. Mix all the ingredients together with a fork.

2. Grease and line a 24cm/ 9.5 inch pie/flan dish. I used a loose bottom tin, but not essential. If you do use a loose bottom dish, place it in the oven on a baking tray, just in case any liquid spills out.

3. Place the pie crust mixture onto the lined dish. Place a piece of baking paper on top and smooth out the pie crust with the back of your hand or a glass tumbler to fill the pie dish. Remove the top baking paper. By doing it this way, it saves you from rolling it out the pastry and cutting any excess off.

4. Make holes all over the base with a fork. This will help the pie crust bake evenly and crispen.

5. Bake at 180C/350F for 15 minutes. Remove from oven.

Spinach and Feta Pie Filling:

1. Defrost the spinach and squeeze as much of the water out as you can. This is an important step, otherwise you will end up with a soggy pie.

2. Place the spinach and all other ingredients in a large mixing bowl.

3. Mix gently, but do leave some cream cheese and feta lumps.

4. Pour onto the cooked pie crust.

5. bake at 180C/350F for 40 minutes or until the centre is cooked.

Recipe Notes:

Fresh Spinach – if using fresh spinach, remember to chop and wilt the spinach first before adding to the pie filling. You can either wilt the spinach in a frying pan for a few minutes whilst stirring, or in a microwaveable dish. Drain off any excess liquid.

Nutrition Information:

Amount per serving: 1 slice
* Calories: 209
* Total Fat: 16 g
* Protein: 10.6 g
* Total Carbohydrates 4.2g
* Dietary Fiber 2.2g
* Carbs: 2.0 g

Recipe #2 | Keto Egg Fast Fettucini

Roasted Broccoli Parmesan

Dr. Morstein really was excited to find this recipe! She can’t wait to try it herself!

Ingredients:

For the pasta:
* 2 eggs
* 1 oz cream cheese
* pinch of salt
* pinch of garlic powder
* 1/8 tsp black pepper

For the sauce:

* 1 oz Mascarpone cheese (This is an Italian cream cheese).
* 1 Tbsp grated parmesan cheese
* 1 Tbsp butter

Directions:

For the pasta:

1. Blend the eggs, cream cheese, salt, garlic powder, and pepper in a magic bullet or blender. Pour into a butter-greased 8 x 8 pan. Bake at 325 for 8 minutes or until just set. Remove and let cool for about 5 minutes. Using a spatula, gently release the sheet of “pasta” from the pan. Roll it up and slice with a sharp knife into 1/8 inch thick slices. Gently unroll and set aside.

For the sauce:

1. Combine the mascarpone, parmesan cheese, and butter in a small bowl. Microwave on high for 30 seconds. Whisk. Microwave on high another 30 seconds. Whisk again until smooth (this may take a minute because the sauce will have separated – keep whisking and it will come back together!) Add the pasta to the hot sauce and toss gently. Serve immediately with more freshly ground black pepper if desired.

Alternative Sauce Recipe:

1. As an alternative to the mascarpone, you can make this sauce in the same method with 2 oz cream cheese, 2 Tbsp heavy whipping cream, 1 Tbsp parmesan, 1 Tbsp butter – it will taste amazing. I doubt it will make a big difference in your results though, so if it’s what you have on hand, go for it!

Approx nutrition info per serving:
* Calories: 491,
* Fat: 47g
* Protein: 19 g
* Carbs: 2g net carbs