Published October 6, 2001 in the North Island Weekender
On a routine blood test John, age 45, had a blood sugar of
6.6 mmol/L (optimal is 4.8-5.1 mmol/L); Triglycerides (TG) 3.5mmol/L (optimal
is less than 2.0); LDL (bad) cholesterol was 4.5 mmol/L (optimal is less than
3.1) and HDL’s (good cholesterol) were .85mmol/L (optimal is greater than
1.42). He did not have any symptoms but he wanted to lose weight and avoid the
heart disease that killed his father at the age of 65 with a heart attack.
To determine if he had insulin resistance I took his ratio
of Triglycerides to HDL’s which was
9.0, greater than 4.3 which is Dr. Reaven’s cut off for normal. Dr. Reaven M.D
is an internationally recognized expert in diabetes and has explained insulin
resistance as the inability of insulin to move sugar into the cell where it is
needed, thus increasing blood sugar, blood fats and body weight
One of the key teaching tools I use for blood sugar
regulation is the glucometer. We make it available to patients after
instructing them how to use it. Blood
sugars are determined one hour before a meal and one hour after the start of
the meal. This is explained by Dr.Schwarzbein, in her book, “The Schwarzbein
Principle” that I mentioned in my article July 28th, 2001. What I
usually find, as does she, is that if folks eat more carbohydrates than protein,
the blood sugar will shoot up more after the carbohydrate meal. Once John could
see this he was able to stick to a higher protein diet. This is of course is
not easy to do as we are so used to craving breads, cereals, potatoes,
crackers, rice and sweets. The cravings for carbohydrates do change over time
and John said to me that when he ate a donut recently it made him sick for 24
hours and we wouldn’t be doing that again! He was allowed one or two
carbohydrates a day, as many vegetables as he wanted, one or two fruits only,
as they are metabolized as sugar, and the rest of his diet was free run,
preservative free, lean meat. He was also a hunter and fisherman, so moose
meat, venison, and wild fish were his meat staples.
The nutritional supplements that helped his blood work to
return to within optimal ranges were chromium, (also for sweet cravings), pure
fish oils, and garlic. Milk thistle and lipotropics factors were added to
assist the liver to improve the metabolism of fats.
Insulin resistance will lead to heart disease more than it will lead to diabetes, so the faster John can bring his blood results back to normal the more he will prevent heart disease. This took 12 months at which time his blood sugar was 5.3, TG 1.58, LDL’s 3.1 and HDL’s 2.0. His insulin ratio had dropped dramatically to 1.80, well within normal limits. At this point I wanted to evaluate his anti-oxidant and inflammation status as these tell me more about cardiovascular risk than cholesterol levels. The comprehensive cardiovascular profile measures anti-oxidants such as Vit E,C, Selenium and Beta-carotene, a few vitamins and minerals, and inflammatory markers such as C-reactive protein, and fibrinogen that indicate increased risk for heart attack if elevated. We did these tests on John, and found he was low in anti-oxidants, magnesium and folic acid but his inflammatory markers were within normal limits. With confidence I was able to re-assure John, that he was at a low risk for heart disease, and would continue to be, if he maintained on a few vitamins, minerals, essential fatty acids and a lower than average carbohydrate diet. He will break the rules, like we all do, but he has since bought his own glucometer, just to keep an eye on his blood sugars, which will be his first sign that he is getting off track again. Once a year he comes in for a repeat chemistry and he continues to do well. Do you know what your blood sugar and cholesterol are?
Dr. Pincott has been practicing naturopathic medicine since 1985 and is currently practicing in Campbell River. She can be reached at (250) 286-3655 or www.DrPincott.com