When we eat starchy or sweet foods they are broken down in the digestive system to a sugar called glucose. This is then absorbed into the bloodstream. Too much or too little sugar in the bloodstream can be dangerous and damaging to the body. A hormone called insulin helps to keep blood sugar levels under control. Insulin is released by the pancreas, to match the amount of glucose in the blood. It enables glucose to enter cells via a lock and key system so glucose can be used for energy or stored for later use.

Diabetes mellitus is the term used for metabolic disorders associated with a deficiency, or the impaired action, of insulin. If there’s not enough insulin produced or the body cells have stopped responding to insulin sugar remains in the bloodstream. A high blood sugar levels is also known as hyperglycemia. Long-term, hyperglycaemia can lead to damage to the cardiovascular system, kidneys, nerves and eyes.

The symptoms of diabetes include:

• Sweet smelling urine
• Excessive urination
• Extreme thirst
• Weight change – either sudden weight loss (type 1) or weight gain around the middle (type 2)
• Weakness and fatigue
• Difficulty concentrating and remembering things
• Blurred vision
• Slow healing of cuts and infections.
• Numbness and tingling sensations
• Fruity smelling breath

There are a number of different types of diabetes:

Type 1 diabetes

This type of diabetes occurs when the cells in the pancreas that make insulin are destroyed by the immune system. This is called an autoimmune reaction. It’s not clear what triggers this to happen but genetic factors, viruses and immune reactions to foods are all thought to be possible culprits.

Type 1 diabetes typically occurs in childhood (though it can happen in adults too). Since the pancreas is damaged and no insulin is produced it requires lifelong insulin injections to manage blood sugar levels.

Type 2 diabetes

Type 2 diabetes develops when the body’s cells have become resistant to insulin. Eating lots of refined, starchy, sweet foods which release their glucose into the bloodstream quickly can increase the amount of insulin released. If this happens too frequently, the body starts to ignore the insulin message. This can lead to permanently high blood sugar levels.

Being apple-shaped or having an inflammatory health condition can also make you more prone to developing type 2 diabetes.

Type 2 diabetes is managed with medications that increase insulin sensitivity and release such as metformin and glipizide. In the later stages, insulin may be needed if the pancreas has become exhausted and can’t produce enough.

Secondary Diabetes

The term secondary diabetes is used to describe diabetes that develops as a result of using certain medications, or from having a particular related health condition. Things know to contribute to secondary diabetes include:

• Long-term use of steroid medications
• Pancreatitis
• Pancreas removal
• Pancreatic cancer
• Adrenal tumours that secrete stress hormones
• Pituitary tumours that secrete excess growth hormone
• Cystic fibrosis
• Hemochromatosis
• Polycystic ovary syndrome (PCOS)

Treatment depends on whether a lack of insulin or insulin resistance is the problem.

Gestational diabetes.

Gestational diabetes is a type of diabetes that only occurs during pregnancy. It is thought to be caused by pregnancy hormones interfering with insulin receptors. It usually disappears after the baby is born. However, mums that have had gestational diabetes are at an increased risk of developing type 2 diabetes later in life and so are their children.

Standard treatment for gestational diabetes is insulin injections. In some cases, insulin sensitising medications like metformin will also be used.

How functional medicine can help

No matter what the type of diabetes, a diet specifically planned to balance blood sugar levels is key. A functional medicine practitioner can design a personalised diet plan that meets all your nutritional requirements and includes foods, herbs and spices that have a positive action on insulin sensitivity. This is vital to reduce the risk of long term complications.

A structured exercise plan is also very important. Exercise helps to improve insulin sensitivity and keep blood sugar levels under control. The type of exercise will depend on the individual situation, current health status and whether there are any other health conditions that need to be accommodated.

There are also certain nutrients, herbal remedies and supplements that can assist with keeping blood sugar levels balanced. Once a full case history has been taken, your functional medicine practitioner will be able to make personalised recommendations for you.

Any underlying health problems or imbalances can also be addressed at the same time. Functional medicine aims to address all aspects of health. Tackling underlying inflammation or hormonal imbalances that are contributing to your blood sugar imbalances also forms part of a comprehensive treatment strategy.