What is diabetes mellitus?

Understanding your condition

Type 1 diabetes mellitus is a chronic condition where the pancreas is unable to produce enough of the hormone  insulin to control blood glucose levels. This can be caused by genetic factors or in some cases, by certain viruses, with typical onset occurring during adolescence. Whilst some people may see regression of type 1 diabetes during adulthood, most will require lifelong treatment with insulin injections.

Type 2 diabetes mellitus (T2DM) is the most common form of diabetes, and is associated with cardiometabolic disease. T2DM is a slow progressive disease that will often begin as a result of diet and lifestyle factors that contribute to a consistently elevated blood glucose level, obesity (in particular central abdominal adiposity), and a systemic chronic inflammatory state that leads to endocrine disruption.  

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mature man smiling sitting at outdoor table with take away coffee reading book

Diabetes isn't just about sugar intake

One of the most common misconceptions about the development of Type 2 diabetes mellitus is that it is caused by overconsumption of sugar, yet refined carbohydrate intake, dietary saturated fat intake, lifestyle and environmental factors can all lead to or increase the underlying inflammation that leads to diabetes.

At Melbourne Functional Medicine, our diabetes specialist and natural medicine Practitioner, Mark Payne, uses the most up to date information to treat patients with diabetes. By understanding the complex mechanisms and underlying factors involved in the cause and progression of the condition, they help patients improve insulin sensitivity and their metabolic health so they can reduce the risks associated with diabetes.


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Diabetes symptoms

The most common Type 2 diabetes mellitus symptoms are:

  • Elevated blood glucose levels higher than 6.8mmol/L when fasting
  • Increased thirst that is not satisfied by drinking water
  • Increased urination, particularly at night, and often associated with glucose in the urine when tested
  • Increased hunger as the body is unable to make use of the glucose in the blood for energy

If the condition remains undetected and continues long term the elevated blood glucose levels may result in:

  • Blurred vision (Diabetic retinopathy)
  • Drowsiness and general lethargy
  • Decreased exercise tolerance
  • Damage to the nervous system (Diabetic neuropathy)
  • Damage to the kidneys (Diabetic nephropathy)
  • Damage to the heart and blood vessels leading to what is called cardiometabolic disease

What causes diabetes mellitus?

While it's commonly thought that type 2 diabetes arises from a diet high in sugar, there are often many other factors that lead to the onset of diabetes. The body breaks down not only carbohydrates, but proteins and fats that all contribute to the production of glucose. In particular, intake of refined carbohydrates and saturated fats will contribute to raised blood glucose levels, and are also involved in driving the underlying inflammation that is the main cause of developing diabetes.

A growing body of evidence shows that not only can you prevent diabetes naturally, but that modifiable lifestyle factors including diet, physical activity, stress management, weight management and smoking cessation are the most important factors preventing type 2 diabetes. When these factors are not addressed as part of a healthy lifestyle, the body becomes systemically inflamed, and this inflammatory state becomes the primary driver for the development and progression of type 2 diabetes mellitus.

Diabetes often begins with a pre-diabetic state where the body still has some capacity to control blood glucose levels, although the levels remain consistently mildly elevated. Early intervention and management of the pre-diabetic state through the modifiable lifestyle factors mentioned above can often see reversal of the pre-diabetic states and avoidance of developing diabetes. Yet if the condition continues, a metabolic state called insulin resistance develops, where the normal production of insulin, the hormone that allows glucose to enter cells to be used for energy, becomes ineffective in controlling blood sugar levels. This eventually results in the reduction of insulin production by the pancreas, and diabetes develops.  

Contributing factors

Risk factors for developing diabetes include:

What causes eczema?

Genetics

Research has found people with the ‘atopic triad’ have a defective barrier of the skin and upper and lower respiratory tracts.

These genetic alterations cause a loss of function of filaggrin (filament aggregating protein), which is a protein in the skin that normally breaks down to create natural moisturisation and protect the skin from penetration by pathogens and allergens.

Filaggrin mutations are found in approximately 30 percent of people with atopic dermatitis, and also predispose people to asthma, allergic rhinitis (hayfever), keratosis pilaris (dry rough patches and bumps on the skin), and ichthyosis vulgaris (a chronic condition which causes thick, dry, scaly skin.)If one parent carries this genetic alteration, there is a 50 percent chance their child will develop atopic symptoms. And that risk increases to 80 percent if both parents are affected. 

Food allergy and sensitivity

Food hypersensitivity has been found to cause or exacerbate atopic dermatitis in 10-30% of cases, and 90% of these are caused by eggs, milk, peanuts, soy and wheat.

Compromised gut health

The connection between the gut microbiome and skin health is complex, however, research has found the microbiota contributes to the development, persistence, and severity of atopic dermatitis through immunologic, metabolic and neuroendocrine pathways.

Nutritional deficiencies

Deficiency of Omega-6 essential fatty acids (EFA) has been linked with the increased incidence of atopic dermatitis, along with the inability for the body to efficiently metabolise EFA’s to gamma linoleic acids (GLA) and arachidonic acids (AA).

Weather and environment

Changing weather conditions can certainly aggravate eczema symptoms, but the triggers are subject to change among individuals.

Hormones

Hormones also play a role in the course of atopic dermatitis, including the stress hormone cortisol which triggers an inflammatory immune response affecting all organs of the body, including the skin.

Mould exposure

Mould exposure and susceptibility to mould can cause Chronic Inflammatory Response Syndrome (CIRS), of which dermatitis is a manifestation.

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The conventional approach to diabetes treatment

The conventional approach to management of Type 2 diabetes mellitus involves:

  • Dietary modification to reduce simple sugar intake and increase complex carbohydrates, quality proteins and fibre
  • Increase physical activity to assist with glucose utilisation and achieve and maintain a healthy weight
  • Reduce overweight and obesity through diet and exercise

If these non-pharmacological approaches are not effective in managing blood glucose levels, the next stage of treatment will usually involve prescribing oral hypoglycaemics. These are prescription medications that act to reduce blood glucose levels. In some cases when blood glucose levels are already elevated, these medications may be used while the diet and lifestyle strategies are implemented.

In situations where diet and lifestyle modification and oral hypoglycaemics aren't effective in reducing blood sugar levels, a person may be prescribed insulin injections. 

Whilst in some people these strategies may be effective in managing blood glucose levels, this approach to the management of diabetes does not address the primary underlying cause for the development of insulin resistance and dysregulated blood glucose, inflammation. If the systemic inflammatory state of the body which is causing the metabolic disruption continues, it is unlikely that these conventional approaches to treatment of type 2 diabetes will be effective long term.


Natural medicine for diabetes - the Melbourne Functional Medicine approach

The functional medicine approach that diabetes specialist, Mark Payne, takes is to thoroughly assess each patient to determine the factors contributing to their diabetic state. While considering the common dietary and lifestyle factors contributing to the disease, Mark will look closely for other potential drivers of inflammation in the body, and address them, such as:

Functional testing considerations

There are a range of tests that are helpful in identifying the factors that may be contributing to dysregulation of blood glucose, insulin, and inflammation in the body. Some of these tests include:

  • A comprehensive cardiovascular profile screens for the most important markers for cardiovascular disease and cardiometabolic disease
  • In some cases it can be helpful to have certain general pathology tests done for things like fasting blood glucose, glucose tolerance, serum insulin levels and HbA1c (a measure of blood glucose levels over the previous 3 months)
  • Organic Acids test helps to identify if other metabolic pathways have been affected by or are contributing to the development of Type 2 diabetes mellitus
  • Insulin Resistance Index helps to identify if the blood glucose dysregulation is affected by or contributing to the development of insulin resistance

Formulating a personalised metabolic health plan

Once insights have been collated, your natural medicine practitioner will discuss the natural ways to treat type 2 diabetes and work with you to develop a personalised healthcare plan to improve your metabolic fitness, to bring your body in the best position to heal. Your alternative treatment plan for diabetes may include:

  • A low glycaemic, anti-inflammatory diet high in fibre and rich in antioxidants
  • A focus on protein intake to help balance blood sugar levels
  • Reducing saturated fat intake, replacing with monounsaturated and polyunsaturated fats like olives, avocado and oily fish
  • Targeted nutritional supplementation to improve metabolism of glucose and insulin production, like chromium, magnesium, B vitamins and taurine
  • Herbal medicines like cinnamon and bitter melon to regular blood sugar levels, or herbs like boswellia or turmeric to reduce inflammation
  • Lifestyle modification, including exercise and stress reduction techniques
  • A detoxification protocol to reduce toxin load

Alongside your practitioner, your health coach will help you implement all the steps in your treatment plan, and give you all the support you need so you can start feeling well again.

(Susan is a real patient but we’ve changed her name and image to protect her privacy.)

Case study

See how functional medicine is helping our patients achieve better health and richer lives.

Susan is a 60 year old female who presented to the clinic with Type 2 Diabetes Mellitus, overweight and with chronic sleep problems. Her fasting blood glucose fluctuated between 7-8mmol/L and would rise to 17mmol/L after eating. A measure of her HbA1c levels at 9.2% indicates that her blood glucose regulation had been poorly managed over the proceeding 3 months.


A review of Susan’s diet showed regular meal skipping, high intake of coffee, and low in fruits vegetables and fibre. She was undertaking a moderate amount of exercise each week including walking and 3-4 gym sessions, however there was no effect on reducing weight.

Read Susan's story by hitting the button below

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FAQs

What are the causes and effects of diabetes mellitus?

Diabetes mellitus is caused by dietary and lifestyle factors such as high refined carbohydrate and saturated fat intake, stress, and a sedentary lifestyle, that contribute to a consistently elevated blood glucose level, obesity, and a systemic chronic inflammatory state that leads to disruption of insulin receptor sensitivity and insulin production.

Symptoms of diabetes include increased thirst not satisfied by drinking water, frequent urination, especially at night, increased hunger, weight loss, fatigue, drowsiness and decreased exercise tolerance.

If this disrupted metabolic state continues long term, the elevated blood glucose levels may result in damage to the heart and blood vessels leading to cardiometabolic disease, and diabetic neuropathy that results in blurred vision, kidney damage, and nervous system damage.


How to manage diabetes mellitus naturally?

The most effective natural treatment for diabetes starts with managing dietary and lifestyle measures such as reducing saturated fat and refined carbohydrate intake, eating a low glycaemic diet rich in fibre and antioxidants, along with addressing the underlying inflammation, often through targeted nutritional and herbal interventions alongside lifestyle factors such as increasing exercise, reducing alcohol and cigarette consumption and stress, as well as treating other contributing factors like gut dysbiosis, autoimmunity, or toxin overload.

How to know if you have diabetes

Fasting blood glucose levels higher than 6.8mmol/L indicates diabetes, along with symptoms such as increased thirst not quenched by drinking water, urination, and hunger.

Other tests such as the glucose tolerance test, serum insulin levels, HbA1c (a measure of blood glucose levels over the previous 3 months) and c-peptide (a marker used to measure insulin secretion) can also be used to get a better picture of metabolic health.

The Insulin Resistance Index helps identify if the dysregulation in blood glucose levels is affected by or contributing to the development of insulin resistance.

What’s the difference between type 1 and 2 diabetes?

Type 1 diabetes mellitus is an autoimmune condition where the pancreas is being attacked by the body, resulting in being unable to make the hormone insulin. Most people diagnosed with type 1 diabetes will require treatment with insulin injections for the rest of their life.

A type 2 diabetes diagnosis is often a result of diet and lifestyle factors that cause a consistently high blood glucose level, obesity and systemic chronic inflammatory state that can lead to endocrine disruption.


Is diabetes an autoimmune disease?

Diabetes mellitus type 1 is an autoimmune condition that attacks the pancreas, making it unable to produce insulin.

Diabetes mellitus type 2 is not an autoimmune condition but a metabolic condition that often arises as a result of dietary and lifestyle factors. 


Where can I find a functional medicine diabetes specialist?

Our functional medicine practitioner and diabetes specialist, Mark Payne, consults from our Melbourne Functional Medicine clinic in South Melbourne. Mark uses a cutting edge approach that combines the latest functional medicine tools and insights with results-focused health coaching in our revolutionary six-month healthcare program. 

We offer telehealth throughout Australia, so you can access our world-class diabetes healthcare wherever you are. 

Can’t find what you’re looking for? Reach out to the team directly – we’ll be happy to assist.