.) + Anhang 2 (Matthias Girke)
Was ist Diabetes?
Umgangssprachlich Zuckerkrankheit genannt, bezeichnet der (nicht die) Diabetes mellitus vielfältige Störungen des Stoffwechsels. Alle Betroffenen leiden unter chronischer Hyperglykämie (Überzuckerung).
Die Ursachen: Bestimmte Zellen der Bauchspeicheldrüse produzieren entweder kein oder zu wenig des Hormons Insulin. Oder die Wirkung des Insulins auf wichtige Organe wie Leber,
Muskulatur und Fettgewebe ist gestört.
Insulin: ein lebensnotwendiges Stoffwechselhormon, das den Kohlehydrat-/Eiweiß-/Fettstoffwechsel steuert. Kann es nicht wirken, gerät der Stoffwechsel aus der Balance.
(Quelle: Deutsche Diabetes-Stiftung)
Diabetes vom Typ 1 ist eine Autoimmunerkrankung. Das Immunsystem, das in erster Linie Keime abwehrt, richtet sich dann gegen die Insulin produzierenden Zellen der Bauchspeicheldrüse
und zerstört diese. Die Insulinproduktion kommt zum Erliegen. Die in der Nahrung enthaltenen Bau- und Brennstoffe (z.B. Traubenzucker, also Glukose) können von den Körperzellen nicht
mehr aufgenommen werden.
Der Typ-1-Diabetes zeigt sich oft schon im Kindes- und Jugendalter. Er macht aber nur 5% aller Diabetiker aus!
Diabetes vom Typ 2 ist eine Zivilisationskrankheit. Dabei ist die Wirkung des Insulins in den Körperzellen vermindert, es besteht gleichzeitig ein Insulinmangel. Diese Erkrankung zeigt sich in unterschiedlichen Graden von Insulinresistenz und -mangel. Der Typ-2-Diabetes oder die Vorstufen gehen oft mit anderen Anzeichen des Metabolischen Syndroms einher - 80% der Betroffenen
sind gleichzeitig stark übergewichtig.
(Quelle: Deutsche Diabetes-Stiftung)
Characterisation of diabetes mellitus
Diabetes is one of the most common metabolic disorders worldwide (Wild et al. 2004), characterised by a loss of glucose homeostasis with disturbances in carbohydrate, fat and
protein metabolism resulting from defects in insulin secretion, insulin action, or both (Katzung et al. 2009).
Without adequate insulin, body tissues, in particular the liver, muscular and adipose tissues fail to take up and use glucose from the blood circulation. The resultant elevated blood glucose level is known as hyperglycaemia (Jarald et al. 2008).
Factors contributing to hyperglycaemia:
Digestive System: Decreased incretin effect
Kidneys: Increased glucosen reabsorption
Liver: Increased hepatic glucosenproduction and decreased hepatic glucose uptake
Stomach: Carbohydrates intake
Pancreas: Decreased insulin secretion
Muscles: Decreased peripheral glucose uptake
Islet alpha cell: Increased glucagon secretion
Brain: Neurotransmitter dysfunction
Adipose tissue: Increased lipolysis
Diabetes occurs predominantly in two forms, namely: Type 1 and Type 2.
These two forms differ in terms of pathogenesis but produce essentially similar metabolic derangements (Nowak and Handford 2004).
On the basis of aetiology, the term Type 1 is widely used to describe insulin dependent diabetes mellitus (IDDM) (Nowak and Handford 2004).
This type is the more severe of the two forms, which typically is picked up at a young age, and is less common.
It develops following viral infection, exposure to environmental chemicals, abuse of +/o. exposure to therapeutic drugs or a strong genetic predisposition leading to antigen alteration and subsequent immune attack, causing Beta-cell (β-cell) destruction and leading to zero functioning of the β-cells, therefore resulting in no secretion of insulin (Katzung et al.2009).
Type 2 diabetes mellitus, formerly known as non-insulin dependent diabetes mellitus (NIDDM), is characterised by chronic hyperglycaemia as a consequence of insulin deficiency
caused by insufficient synthesis or secretion of insulin from the β-cells, however many contributing factors remain uncertain .
(Nowak and Handford 2004).
Factors causing hyperglycaemia
Source: Katzung et al. 2009
Diabetes occurs predominantly in two forms, namely: Type 1 and Type 2.
These two forms differ in terms of pathogenesis but produce essentially similar metabolic derangements (Nowak and Handford 2004).
On the basis of aetiology, the term Type 1 is widely used to describe insulin dependent diabetes mellitus (IDDM) (Nowak and Handford 2004).
This type is the more severe of the two forms, which typically is picked up at a young age, and is less common.
It develops following viral infection, exposure to environmental chemicals, abuse of +/o. exposure to therapeutic drugs or a strong genetic predisposition leading to antigen alteration and subsequent
immune attack, causing Beta-cell (β-cell) destruction and leading to zero functioning of the β-cells, therefore resulting in no secretion of insulin (Katzung et al. 2009).
Type 2 diabetes mellitus, formerly known as non-insulin dependent diabetes mellitus (NIDDM), is characterised by chronic hyperglycaemia as a consequence of insulin deficiency caused by insufficient synthesis or secretion of insulin from the β-cells, however many contributing factors remain uncertain (Nowak and Handford 2004).
Pathogenesis of NIDDM or Type 2
Adapted from:Nowak and Handford (2004) Type 2 diabetes is by far the most common form of diabetes (Hannan et al. 2006), accounting for more than 90% of population cases (Nguyen et al.2011).
This form of diabetes has a slow progression or development of symptom; often years will pass without the victim being aware of any change (Nowak and Handford 2004).
Insulin therapy is required less often in this type of diabetes, with the exception being patients that fail to achieve proper glycaemic control, during severe bacterial infections, ketoacidosis,
during pregnancy and in patients with impaired renal or hepatic function (Mizuno et al. 2008).
Complications of diabetes mellitus
Patients with diabetes experience significant morbidity and mortality from micro- +/o. macrovascular complications (Tayyab et al. 2012).
Microvascular disease is defined as damage to the small blood vessels while macrovascular disease is damage to the larger arteries (Nowak and Handford 2004).
The relationship between glycaemic control and diabetic microvascular disease has been established in both Type 1 and Type 2 diabetes.
Acute complications include diabetic ketoacidosis common to Type 1 diabetic patients, and non-ketotic hyperosmolar coma, common in Type 2 diabetic patients (Tayyab et al. 2012).
Regardless of common diabetic treatment regimens, chronic hyperglycaemia has been implicated as the main cause of the adverse effects experienced by patients such as polydipsia,
polyphagia and lingering complications over a significant period (McCueet al. 2005).
The resultant long-term complications are caused by damage to organs including the eyes, kidneys, nervous system and blood vessels, causing various pathologies such as a therosclerotic vascular disease (Ganet al. 1999/Bastaki 2005),
ketoacidosis, nephropathy, neuropathy, ulceration, eye complications [retinopathy = most common cause of blindness]. ‘diabetic foot’ and limbamputation (Bastaki 2005/Lewis et al.2010).
Oxidative stress induced by chronic hyperglycaemia (Kilet al. 2004) has been shown to be a major underlying mechanism for the formation of harmful byproducts that accumulate and
contribute to development of the long-term complications associated with diabetes (Neriet al. 2005).
Oxidative stress reflects an imbalance between the systemic manifestations of reactive oxygen species (ROS) constantly formed in the human body and the quantities of antioxidant products required to restore balance, causing vasoconstriction (Kuyvenhoven and Meinders 1999). Excess production of ROS leads to the impairment of equilibrium between pro-oxidants and antioxidant systems (Sharma and Kar 2014).
The activation of a number of metabolic pathways induced by chronic hyperglycaemia produce end products that contribute to the development of long-term complications associated with diabetes (Kuyvenhoven and Meinders 1999). For example, the activation of the polyol pathway causes decreased nitric oxide and prostaglandin synthesis, which results in endothelial dysfunction and hypertension.
Increased polyol pathway activity caninduce retinopathy and neuropathy. Similarly, increased protein kinase C (PKC) pathway activity and the formation of non-enzymatic
glycation of proteins can lead to the increased risk of developing nephropathy, neuropathy and retinopathy.
In addition, increased hexosamine pathway activity can potentiate macromolecular damage. Proper glycaemic control, blood pressure management and lipid modification are important to consider as they may independently slow the progression of diabetic related micro- and macrovascular complications, and thus reduce the rates of diabetic retinopathy, neuropathy, nephropathy, diabetic foot infections, atherosclerosis and other associated cardiovascular events, including dyslipidaemia, hypertension, hypercoagulability and obesity (Ratner 2001/Mizuno et al. 2008).
Incidence of diabetes mellitus
Diabetes is a major health problem with its frequency increasing every day from most developed and developing countries (Wild et al. 2004). In South Africa, the prevalence is between 4%
and 6%. The global prevalence was estimated at 2.8% in 2000 (171 million people affected) (Wild et al.2004), 382 million people in 2013 and is estimated to reach 592 million people by the year 2035, with a prevalence of 8.3% (Guariguata et al. 2014).
WHO predicts that diabetes will be the 7th leading cause of death by 2030 (WHO 2011).
The reasons for this global rise have been linked to changes in lifestyle associated with urbanisation, modernisation (Hamdan and Afifi 2004), growth of aged population, increasing trends towards obesity, unhealthy diet, and sedentary lifestyles (Hannan et al. 2006).
Hypertension, coronary heart disease, stroke, genetics and various forms of cancer are amongst the reasons for the global rise in diabetes (Omran 1983/Reddy et al. 1998).
Obesity is a major concern because it indirectly affects or exacerbates the incidence of diabetes, worsening the severity of side effects or accelerating the incidence of diabetic relate
d complications (Mollentze and Levitt 2005/National Department of Health 2006). These data shows that reliable, cost saving therapy is necessary to lower the global rise of diabetes
(Chiha et al. 2012).
Medicinal plants contain enormous potential to provide alternative medicines for treating diabetes, but it is necessary that their effectiveness is researched and substantiated.
The use of medicinal plants are part of traditional practice in many countries and cultures (Soumyanath 2006) including South Africa (van de Venter et al. 2008),
because of their availability, effectiveness, minimal side effects and low cost.
Investigation into antidiabetic agents from traditional medicinal plants is a major driver of research (Palatty et al. 2013).
The use of traditional medicine in the treatment of diabetes
In Africa, many plants are traditionally used for the management and control of various ailments (Baynes 2006) incl. diabetes (Kavishankar et al. 2011).
Globally, approximately 85,000 medicinal plant species (sp.) are reported as medicinally useful (Liu and Wang 2008); however, few have received scientific scrutiny despite
medical and scientific recommendation from the WHO (WHO 2007).
In South Africa, victims of chronic diseases are turning to herbal medicines as alternative sources of treatment as recommended by the National Department of Health (2006).
This renewed interest in plant medicines as alternative therapy to restore health or treat diseases is believed to be motivated by factors such as their effectiveness, that they are more specific
and that they contain diverse secondary metabolites which provide numerous health benefits. The orchestra of chemical compounds within the plants work together synergistically
allowing active compounds to be available to produce maximal therapeutic efficiency that are less toxic than high doses of individual components (van Huyssteen 2007).
Traditional medicine (TM) may provide an effective solution to the threat of diabetes worldwide, thus helping to reduce chronic disease complications and deaths (Fang 2011).
World ethnobotanical information on medicinal plants has reported up to 800 plants used for the treatment of diabetes (Udayakumar et al. 2009).
Numerous medicinal plants offer sustainable management of the sugar levels among diabetic patients and validated for their hypoglycaemic potential using experimental animal models
(Yeh et al. 2003).
Plants such as Momordica charantia and Eugenia jambolana have been shown to ameliorate diabetic complications such as neuropathy, nephropathy, fructose-induced insulin resistance,
and cataracts in experimental animals (Premila and Conboy 2007).
Diabetes is thus a common disease for investigation using natural products.
However, the mechanism of action +/o. components that specifically exert blood glucose lowering effects on tissues or organs remain unknown (Prabhakar and Doble 2011/Palatty et al. 2013).
Diabetic research on the therapeutic effectiveness of natural plant products of South Africa is limited (Afolayan and Sunmonu 2010).
Diabetes mellitus describes a metabolic disorder of multiple aetiology characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism
resulting from defects in insulin secretion, insulin action, or both.
The effects of diabetes mellitus include long-term damage, dysfunction and failure of various organs.
Diabetes mellitus may present with characteristic symptoms such as thirst, polyuria, blurring of vision, and weight loss.
In its most severe forms, ketoacidosis or a non-ketotic hyperosmolar state may develop and lead to stupor, coma and, in the absence of effective treatment, death.
Often symptoms are not severe, or may be absent, and consequently hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before
the diagnosis is made (World Health Organisation, 1999: 2).
The long-term effects of diabetes mellitus include progressive development of the specific complications of retinopathy with potential blindness, nephropathy that may lead to renal failure,
+/o. neuropathy with risk of foot ulcers, amputation, Charcot joints, and features of autonomic dysfunction, including sexual dysfunction.
People with diabetes are at increased risk of cardiovascular, peripheral vascular and cerebrovascular disease.
Several pathogenetic processes are involved in the development of diabetes.
These include processes which destroy the beta cells of the pancreas with consequent insulin deficiency, and others that result in resistance to insulin action.
The abnormalities of carbohydrate, fat and protein metabolism are due to deficient action of insulin on target tissues resulting from insensitivity or lack of insulin (WHO, 1999:2-3).
Clinical Features of Diabetes:
• Dry mouth
• Weight loss
• Pruritus vulvae
• Myopia (Watkins et al., 2003:50).
Of Hippocrates' classic triad of diabetic symptoms -polyuria, polydipsia, polyphagia- polyphagia is the most intriguing, for this symptom most likely reflects the intracellular
(glucose deficiency) as opposed to extracellular (glucose excess) pathophysiology of diabetes.
Hyperglycaemia does not, by itself, entirely define the risk for diabetes or its complications.
Weight gain and insulin resistance, of which excessive calorie intake is the first clinical sign, are the keys to understanding type 2 diabetes (Fournier, 2000:603).
ORTHODOX PHARMACOLOGICAL INTERVENTION
According to Huddle (1999:152), oral hypoglycaemic agents are indicated in those patients with type 2 diabetes mellitus who have not attained adequate glycaemic control despite adhering to
an effective programme of diet and exercise for four to six months, or who in those patients who are symptomatic from the outset.
There are three major groups of oral hypoglycaemic agents:
1. Biguanide (e.g. Metformin)
Metformin is the initial therapy of choice and should be initiated at the time of diagnosis in all patients (both overweight and of normal weight), unless specifically contraindicated (SEMDSA, 2010:509).
Metformin acts by blocking glucose production in the liver (gluconeogenesis) and may also stimulate tissue uptake of glucose. It reduces insulin resistance but does not stimulate insulin secretion
Adverse effects of Metformin include abdominal pain, bloating, diarrhoea, anorexia and very rarely lactic acidosis (Whittaker, 2010:22). In the UK Prospective Diabetes Study
(UKPDS) it was found that Metformin was responsible for a 42% reduction in diabetes related death (Whittaker, 2010:22). Metformin reduces HbA1C by 1 – 2% (SEMDSA, 2010:509).
2. Sulphonylureas (e.g. Glibenclamide) Sulphonylureas are an option for first-line therapy when the HbA1C is above target and the patient is normal weight; or the patient is intolerant of Metformin;
or when rapid control of hyperglycaemic symptoms is needed (SEMDSA, 2010:509). The major mode of action of Sulphonylureas relies on the ability of the pancreas to secrete insulin and they are
therefore known as insulin “secretagogues” (Whittaker, 2010:22-24).
Adverse effects of Sulphonylureas include hypoglycaemia and weight gain (+ 2 kg) (SEMDSA, 2010:509).
According to Whittaker (2010:20-24), Sulphonylureas have proven reduction of microvascular endpoints but unlike Metformin, they have not produced significant reductions in myocardial infarction,
diabetes-related death and overall mortality. Sulphonylureas reduces HbA1C by 1 - 2% (SEMDSA, 2010:509).
3. Thiazolidenediones (e.g. Rosiglitazone) Thiazolidenediones are generic agents and are preferred because of cost-effectiveness (SEMDSA, 2010:509). Thiazolidenediones act by enhancing
insulin action and promoting glucose utilisation in peripheral tissues and suppressing gluconeogenesis in the liver. They reduce insulin resistance but have no effect on insulin secretion (Whittaker, 2010:24).
Adverse effects of Thiazolidenediones include unpredictable weight gain, development of peripheral oedema, mild anaemia and worsening heart failure (Whittaker, 2010:25). Potential beneficial effects of Thiazolidenediones include an improved cholesterol profile (Whittaker, 2010:24). Thiazolidendiones reduces HbA1C by 0.5 - 1.4% (SEMDSA, 2010:510).
[Dr. V. Krishnamurthy]
Most people think that as we have remedies for diabetes in other systems (like insulin in allopathy) there would be corresponding remedies in homeopathy. This is not so.
There is one marked difference between homeopathy and other medical systems (allopathy, ayurveda, siddha)
In allopathy no doctor would give insulin for typhoid; also no one would give antibiotic for diabetes. This is because insulin is for diabetes and no amount of insulin will be of
any use in typhoid.
But in homeopathy one remedy given for eczema patient may be indicated for jaundice in another; the same remedy may be needed in the third patient suffering from cancer.
In such a case the question that would naturally arise in the reader’s mind is, “If so, then what is the basis for prescribing or selecting the remedy in homoeopath?” Answer to this
question will throw light on the uniqueness of homeopathy.
Uran-n.: Laning states that no remedy gives such universally good results; it lessens the sugar and quantity of the urine; he recommended the 3x trituration. It is when the disease is
due to assimilative derangements that Uranium nitricum is the remedy, and symptoms such as defective digestion, languor, debility and much sugar in the urine, enormous appetite
and thirst, yet the patient continues to emaciate.
Syzyg.: Is capable of diminishing the amount of sugar in the urine (used in the tincture and lower triturations).
Vermeulen (2000:1520), A most useful remedy in diabetes mellitus. No other remedy causes in so marked degree the dimunition and disappearance of sugar in the urine.
Ph-ac.: Corresponds to diabetes of nervous origin. It suits cases due to grief and anxiety, those who are indifferent and apathetic, poor in mental and physical force.
It is unquestionably curative of diabetes mellitus in the early stages, where there is great debility and bruised feeling in the muscles.
There will be loss of appetite, sometimes unquenchable thirst and perhaps the patient will be troubled with boils.
Large quantities of pale colorless urine or where there is much phosphatic deposit in the urine it is the remedy.
Vermeulen (2000:1218): should be considered whenever the system has been exposed to the ravages of acute disease, excesses, grief, and loss of vital fluids.
Plb-met.: Hering considered Plumbum one of the most important remedies in diabetes mellitus.
Vermeulen (2000:1269 - 1270), the diabetic symptoms of Plumbum metallicum are great hunger or complete loss of hunger, unquenchable thirst especially for cold water and scanty urine.
Bry.: no remedy has dryness of the lips as a symptom of hepatic disorder more marked than Bryonia, and this is often one of the first symptom of diabetes. There is a persistent bitter taste,
languid, morose and dispirited, thirst may not be extreme nor the appetite voracious, may lose strength through inability to eat.
According to Leung et al. (2009:1702), bitter melon is a popular fruit used for the treatment of diabetes amongst the indigenous populations of Asia, S. America and East Africa.
The rationale for using Momordica charantia in mother tincture and homoeopathic dilution to treat type 2 diabetes mellitus despite it being unproved homoeopathically is that
Momordica charantia is a common food in Indian cuisine and has been used extensively in folk medicine as a remedy for diabetes (Kumar et al., 2010:95). Murray (1995:357
- 358) mentions that Momordica charantia is composed of several compounds with confirmed anti-diabetic properties. Charantin, extracted by alcohol, is a hypoglycaemic agent
composed of mixed steroids that is more potent than the oral hypoglycaemic drug tolbutamide.
Momordica charantia also contains an insulin-like polypeptide, polypeptide P, which lowers blood sugar levels when injected subcutaneously into type 1 diabetics.
Adverse effects of Momordica charantia include:
- Hypoglycaemic coma
- Favism (In individuals with glucose - 6 phosphate defiency)
- Induction of abortions
- Abdominal discomfort
- Diarrhoea (Leung et al., 2009:1706).
The largest study, published in a 1999 issue of the Bangladesh Medical Research Council Bulletin, used an aqueous suspension of bitter melon vegetable pulp in 100 patients
with type 2 diabetes mellitus. The authors evaluated the effect 1 hour after bitter melon was administered and then 2 hours after a 75 gram oral glucose tolerance test.
The average blood glucose was 222mg/dl (12.33mmol/L), which was lower than the previous day’s 2-hour value of 257mg/dl (14.28mmol/L) (Shane-McWhorter, 2005:2).
A study conducted by Khan et al. (2003:3215) demonstrated that the intake of 1 gram, 3 grams, or 6 grams of cinnamon per day reduces serum glucose (18 – 29% after 40 days),
triglyceride, LDL cholesterol, and total cholesterol in people with type 2 diabetes and suggest that the inclusion of cinnamon in the diet of people with type 2 diabetes will reduce
risk factors associated with diabetes and cardiovascular disease.
Two non-randomized controlled clinical trials involving groups of patients with type 1 diabetes and type 2 diabetes showed improved glycaemic control with chronic adjunctive use of Gymnema sylvestre (GS4) extract compared with those who received conventional treatment alone (Yeh et al., 2003:1286).
The effects of Panax (Asian or Korean) ginseng, given in a dosage of 100 or 200 mg per day for eight weeks, were studied in 36 patients with newly diagnosed
type 2 diabetes mellitus.
The study showed improved fasting blood glucose levels.
The 200 - mg dose also resulted in improved HbA1C levels (Kiefer and Pantuso, 2003:1541).
It is concluded by Vuksan and Sievenpiper (2005:149) that the best evidence for clinical efficacy in diabetes remains for ginseng.
Als diabetische Angiopathie werden Gefäßschädigungen bezeichnet, die als Spätkomplikationen bei Diabetes mellitus auftreten.
Durch Veränderungen der Kapillaren (Mikroangiopathie) werden verschiedene Formen der diabetischen Mikroangiopathie verursacht: insbesondere die diabetische Nephropathie, diabetische Retinopathie und diabetische autonome sowie sensorische und motorische Neuropathie.
Die Makroangiopathie ist zwar nicht Diabetes-spezifisch, tritt aber schneller und stärker als bei Nicht-Diabetikern auf, weshalb die Bezeichnung diabetische Makroangiopathie üblich ist. Sie führt zu atherosklerotischen Veränderungen an mittleren und großen Arterien. Sie ist für das hohe Herzinfarkt-, Schlaganfall- und Gangrän-Risiko bei Diabetes verantwortlich.
Die wichtigsten Faktoren, die die Entwicklung von Mikro- und Makroangiopathie bei Diabetikern fördern, sind Hyperglykämie, Hyperlipoproteinämie, Insulinresistenz sowie verschiedene vasoaktive Hormone, Cytokine und Wachstumsfaktoren.
Moschus.: Impotency associated with diabetes.
In Diabetes, 2 or 3 lessened grains of the 3rd trituration of Uran-n. Administered morning and night, will in a short time reduce the quantity of urine passed to nearly a normal standard, and after a continual use, the proportion of sugar is materially.
Oploponax. (= Devil’s club) commonly recommended for the treatment of type II adult onset diabetes, a use of devil’s club that is also extensive in indigenous communities. . . . Since devil’s club is still widely and increasingly, used as a treatment for late onset type II diabetes and is listed in a recent review of anti-diabetic plants, additional research and more rigorous clinical trials are required to validate and characterise or to disprove hypoglycaemic properties in devil’s club.’
[Dr. L.R. Hughes]
Uran-n.: diabetes originating in dyspepsia or assimilative derangement;
Ph-ac.: starting point of the disease was in the nervous system.
Lac-ac.: Great remedy for diabetes mellitus. Especially in addition to the thirst, voracious hunger and profuse urine loaded with sugar, there are rheumatic pains in the joints. High potency is much better and doesn’t not need frequent repetition.
Thyr.: Diabetes mellitus - Gallensteine/mit Adipositas/mit Allergien in der Eigenanamnese, besonders beim Auftreten eines Diabetes nach spontanem Verschwinden
oder nach Unterdrückung allergischer Beschwerden wie z.B. Asthma, das periodisch auftrat.
Diabetes durch geistige Überanstrengung, durch Kummer (Ph-ac. Pic-ac. Sil. Tub.).
Rasche Entwicklung eines Diabetes mellitus mit extremer Schwäche.
Uran-n.: Numerous cases of diabetes are reported cured with this drug. Excessive thirst, emaciation, and, perhaps, also tympanitis. Enormous appetite but the patient emaciates.
www.joslin.org = amerikanische Website für Diabetiker
[Dr. rer. nat. Jan-Christoph Kattenstroth]
L-Arginin-Zufuhr kann Amputation der unteren Extremitäten verhindern
Mangeldurchblutung der Extremitäten im Zusammenspiel mit diabetesbedingten Nervenschädigungen ist die häufigste Ursache für das diabetische Fußsyndrom, eine der häufigsten Amputationsursachen in Deutschland. Eine im Jahr 2004 veröffentlichte Studie von Wissenschaftlern aus den USA konnte zeigen, dass L-Arginin der Mangeldurchblutung entgegenwirkt und so Amputationen verhindert werden können. Die Autoren weisen zusätzlich darauf hin, dass eine Zufuhr von L-Arginin zu einer deutlich schnelleren Abheilung der typischen Geschwüre führte – während Nebenwirkungen ausblieben (Arana et al., 2004).
Derzeit wird weiter viel an L-Arginin und den zugrundeliegenden Mechanismen bei Diabetes mellitus geforscht. Das beweisen drei aktuelle Studien aus den Jahren 2013 und 2014, die ebenfalls übereinstimmend zu dem Schluss kommen, dass eine ausreichende L-Arginin- Versorgung essenziell ist, um genügend von dem wichtigen Botenstoff Stickstoffmonoxid bilden zu können (Hoang et al., 2013; Rajapakse et al., 2013; Claybaugh et al., 2014). Da viele Diabetiker einen L-Arginin-Mangel aufweisen, setzen sie sich unnötig einem weiteren Risikofaktor für die gefürchteten Begleit- und Folgeerkrankungen des Diabetes mellitus aus (Robenek H, Poeggeler B, 2014).
Am besten in Kombination mit Folsäure, Vitamin B6 und B12
L-Arginin lässt sich eingeschränkt über die normale Nahrung aufnehmen. Natürliche Quellen sind vor allem Hülsenfrüchte und Nüsse. Bei Vorerkrankungen, wie Gefäßerkrankungen und Diabetes mellitus, ist ein höherer Arginin-Bedarf zu decken. Hierfür haben sich diätetische Lebensmittel in Form von Tabletten oder Pulvern mit L-Arginin bewährt. Damit L-Arginin und NO ihre Wirkung voll entfalten können, sollte auf die Kombination mit Folsäure, Vitamin B6 und Vitamin B12 geachtet werden (z.B. in „Telcor Arginin plus“, rezeptfrei, Apotheke). B-Vitamine unterstützen als
Co-Faktoren der NO-Synthese nicht nur die Freisetzung von NO aus L-Arginin (Bendall et al., 2014), sie spielen auch eine maßgebliche Rolle bei der Regulation und Senkung des Homocysteinspiegels im Blut. Homocystein ist eine schwefelhaltige Aminosäure, die über verschiedene Mechanismen die Verfügbarkeit von NO und L-Arginin im Körper verringert. Damit Homocystein im Körper abgebaut werden kann, müssen B-Vitamine in ausreichender Menge vorhanden sein (Martí-Carvajal et al., 2013).
Fungi grow more actively in sugar solutions. Vaginal mycosis developes quite often during pregnancy with its tendency towards pre-diabetes.
Krankheit: Juckreiz/schlecht heilende Hautbeschwerden, Starke Hypoglykämie: Schwindel/unsichere Gang/Ohnmacht/Schwitzen/Blässe/Zittern/Herz-klopfen/nervös/
Unterleibschmerz/ANfällig vor Erkältung + Halsschmerz + Grippe + Bronchitis + Lungenentzündung (Polio);
Patient riecht wie Zucker
Die Erkrankungen des peripheren Nervensystems bei Diabetes mellitus = verschieden. Am häufigsten ist die längenabhängige distal-symmetrische sensomotorische Polyneuropathie manifestiert sich zunächst an längsten
Nervenfasern (Ischiasnerv), Früh: sockenförmig verteilte Parästhesien/Störung in Empfindungen auf Reizen. Später: Schmerz/Muskelkrämpfe/teilweise Lähmung der kleinen Fußmuskeln und Fuß- und Zehenheber
(oft nicht beachtet) sind neben Sensibilitätsstörung und autonomer Denervierung wegbereitend für das diabetischen Fußsyndrom. Differenzialdiagnosen: immunbedingte entzündliche Polyneuropathien mit und ohne
Paraproteinämie (falsche und zu viele Proteine im Blut), eine Radikuloneuritis (Wurzelentzündung der Nerv(en)) bei Borreliose und toxisch bedingte Neuropathien zu bedenken. Seltener Karpaltunnelsyndrom/örtliche
Gemeinsames Merkmal dieser diabetischen Neuropathieformen = akutes neuropathisches Schmerzsyndrom, rasch gefolgt von umschriebener Muskellähmung.
Ursache: Pertussis vaccine has been connected with juvenile onset diabetes as the vaccine acts directly on the islets of Langerhans, the insulin-secreting parts of the pancreas (Gaublomme, 1997).
1. hypoglycæmia 2. diabetes.
This emphasises the link between candidiasis and diabetes, as does the fact that the organism is identified by the physiological character of its assimilation and fermentation of sugar. The use of Foll. successfully in candidiasis (Assilem, 1990) similarly underlines the connection with female sex hormones;
Blutzucker nüchtern vor Frühstück 80 - 90 Mg Blutzucker in 100 Ml im Blut/ (nicht > 130)
Nach 2 h. nach Zuckerhaltiges 120 - 140 Mg/> als 180 Mg = Hyperglycämie (Diabetes).
Nach 3e - 4e h. nach Zuckerhaltiges 80 - 90 Mg.. < 80 Mg. = Hypoglykämie (Kopfschmerz/schwach/Muskelmüdigkeit/Hunger/reizbar/nervöse Unruhe
Erhöhte Blutzuckerspiegel fördert Krebs.
Erniedrigte Blutzuckerspiegel kann Viren hemmen o. fördern
Karotte senkt Zuckergehalt wenn verursacht durch Mangel an Kali-salzen.
Vitamin B Komplex
Helon.: 1st stage, urine profuse, clear, saccharin, lips dry stick together, THIRST, restless, emaciation.
Kali-acet. in diabetes
Ign.. diabetes following emotional shock.
Vanad-s. = Katalysator zu Insulin/zu niedrigem Blutzuckergehalt,
Cyclopia intermedia Diabetes/Menopause
Galega officinalis. Blutzucker senkend
Grifolia frondosa Bluthochdruck/Krebstherapie/Blutzucker senkend/Osteoporose/Leber
Lentinus edodes Diabetes Bindegewebe stärkend, = appetithemmend/Ausdauer erhöhend/Fördert Umwandlung LDL-Chol. in HDL-Chol.
Aktiviert Immunsystem, hemmt Tumoren, steigert Ins.
Quelle: MykoVital GmbH 06047/7073
Remedies: Syzyg. Uran-n. Ph-ac. Nat-m. Ceph. Gymne. Abroma-a. Aven. With-s. (= Ashwagandha). Helon.
Calc-ars. C 6. Pancreatinum 3x. Cean. 3x. These 3 taken 3x daily will give good result. Covers all types of diabetic.
1/4 teaspoonful Cinnamon powder takes as a tea or in food also helps to reduce BS level.
Arn. C 6 as Wet. Dose.
--------- + Furunkel/+ Karbunkel: Cephd-i. Crot-h.
--------- + Gallensteinen But-ac
--------- + Gangrän: Colos. Sec. + Ars. + Kreos.
--------- + durst: Chion
--------- + rheumatic pain: Lac-ac.
--------- + schlaflos: Carc.
--------- + Schleimabsonderung Brust: Squil.
--------- + Nierenentzündung: Canthin
--------- Benz-ac + Ph-ac + Sal-ac.
Sil. + Silikaten?
Sulph. In the beginning of diabetes.
Diabetes mellitus: Abrom-a-rx. Ars-br. Syzyg. Uran-n.
[Dr. Herbert A. Roberts]
Probably the type of glandular imbalance we meet most frequently is diabetes mellitus. The accepted therapy is insulin, and it has a definite influence on the sugar output; yet few physicians pause to consider whether this treatment is curative or merely palliative - a substitution therapy. Recent experiments indicate that continued massive doses of insulin may result in an increase of sugar following an initial decrease; and that it may remain at a fairly high level so long as the insulin therapy is pushed.
A case recently observed provided the interesting phenomenon of a marked decrease of sugar output when the patient was forced to do without her insulin for a
few days; and that when she returned to a decreased insulin dosage the amount of sugar remained at a much lower level than while she was receiving massive doses.
A series of observations on patients under homoeopathic care would be valuable.
We must remember that once insulin therapy is established, it tends to become necessary to the patient and there is little hope of establishing normal balance. Therefore it is more practical to begin treatment by the use of the homoeopathic remedy, for we can always go to insulin later if this is necessary. We find suitable remedies for Sugar in Urine in the repertories, and most of the remedies listed are deep in action or are closely related to emotional states. The diabetic patient usually presents subjective symptoms that clearly indicate the simillimum, or he may be able to give a history of emotional shock preceding his present affliction that will point the way to the remedy. It is possible that his symptoms are so clearly marked that the indications for a constitutional remedy cannot be overlooked, even though his remedy has not been proven to produce the sugar imbalance.
In such case, if the patient improves on the indicated remedy, we are justified in adding it to those already listed, giving it a tentative clinical rating. If the general level of health is raised, even though the low sugar threshold remains the same, we may safely rely on the remedy which maintains general improvement, and not be too anxious over the sugar output. Recent research work has indicated the influence of the pancreas in peptic ulcer.
Nahrungsergänzungsmittel: Ca/Cu/Ch/K/Se/Va/Mn/Zn/Mg/Vit B1/B6/Biotin/C/E//B12/Folic acid/ Ser-ang während Dialyse gebraucht verkürzt de Zeit der Dialyse.
[Alan Tillotson] From a blog.
I am a juvenile diabetic, insulin dependant, and have been so since age 10. I'm now 46. I have managed to avoid all complications so far, with perfect retinas, normal heart, liver and kidney function etc. I got involved with healing to try to find a way out of the bleak future I read about when I was 11 in a book I got from the library, which told me that I would most probably develop any number of serious problems. So far zilch. I'm keeping my fingers crossed. It is very interesting that before I had any formal training in natural medicine, my body figured out several things (because it made me feel good), such as the addition of lots of blueberries and raspberries
and carrots to my diet was good, as well as onion and garlic.
Juvenile diabetics can learn to sense their own sugar levels by developing body awareness. This makes it much less likely to eat when sugar levels exceed 200, thus driving them up to the 300's and creating lots of ketones, or to allow low blood sugars, with the negative effect of eating too much too fast and having an upswing.
Juvenile diabetics which are called "brittle" are just nutrient deficient or very nervous/tight. I have maintained a high nutrient diet (easily assimilable minerals), for decades, and blood sugar swings have been minimal. This includes multi-minerals supplements +/o. herbs like dandelion, turmeric, nettles, parsley, seaweeds.
Juvenile diabetics need to constantly move their bodies. Hard work is excellent medicine.
Juvenile diabetics tend to be vata natured (Ayurvedic term for nervous personality), and so their diet needs more good quality oils and fats than adult onset diabetics, to maintain healthy membranes.
The Ayurvedic combination of triphala (three fruits, famous ayurvedic formula) plus shilajatu (ayurvedic mineral substance), taken long term, prevents deterioration.
Some sort of Yoga or T'ai chi or meditation practice is essential to develop the ability to get really relaxed (I mean like super, super relaxed), which really helps maintain solid health, stable blood sugars. Advanced pranayama or qi kung exercises, in which qi is made to move or flow with strong diaphramatic control, improves the general circulation a lot.
Aspartame sometimes raises blood sugar in diabetics worse than pure cane sugar.
San qi (Chinese herb) can arrrest hemorrhage in diabetic retinopathy better than anything. 1-2 grams of concentrated powder TID, even useful long term.
Blood thinning therapy (moving blood in Chinese terms) is essential (Salv./Paeon./carthamus, cnidium, bilberry, turmeric, bromelain. Keeps the tiny vessels happy, especially when combined with the minerals.
I advocate not worrying about money for those damn expensive test strips, and just investing in other commodities. Juvenile diabetics tend to have periods where their blood sugars become unstable, often for days or weeks.
During these times it is essential to check the sugar every few hours, and take extra regular insulin if necessary, drink more water, and change to a lower volume high protein and fat, low carbohydrate and sugar-free diet for a short while, to even out sugar delivery to the system. When sugars are stable, change to a more high vegetable carbohydrate and raw vegetable diet to even things out. This alternation needs to be clearly understood.
Juvenile diabetics need more vitamin E. They do not seem to benefit from chromium as much as adult onset types.
Lucillia sericata. = Made Schmeißfliege/scheidet in äußerliche Schleimhaut Allant. aus in Wunde (heilt Wunde), verzehrt nur krankes Gewebe/werden gebraucht um nicht schließende Wunden zu heilen. Quelle: Apotheke
Tupelohonig (gewonnen aus Nyssa sylvatica Cornales./= antibiotisch/= geeignet für Diabetiker).
Suis-pan. = Pankreas vom Schweineembryo
Allerlei: Hypoglycemia = zu niedrige Blutzuckerspiegel/= Vorstufe Diabetes
Beschwerden: Nervös/Herzrasen/zittern/Schweiß/Denken erschwert/leichtes Empfinden im Kopf/Wirkung von Exzitotoxine
Syndrom X: = Beschwerden durch Insulinreistenz (Vorstufe Diabetes Type II).
1. Insulinreistenz + 2. ZU wenig Prog + 3. VIEL Eikosanoiden-2 verursachen in Wechseljahren. GEFÄHRLICHE Wechselwirkung
Vorbeugung: 3 große Mahlzeiten + 3 kleine Zwischenmahlzeiten aus HOCHwertige Nahrungsmittel (wenig Eiweiß aus Eier/Milchprodukten/Soja)
Verzichten auf raffinierten Kohlenhydraten/Süßes/Alkohol (steigert Östrog.-wirkung).
Defekte in der Insulin Sekretion zeigen sich in einer Hyperglykämie, welche besser unter Diabetes mellitus bekannt ist.
Type I: Insulinmangel durch verminderte Insulinausschüttung des Pankreas/= insulinabhängige Diabetes/fast nur Kinder und Jugendliche/wird den Autoimmunerkrankungen zugerechnet. Hier führt die Zerstörung der pankreatischen Inselzellen zu einem absoluten Insulinmangel. 5 - 10 % aller Erkrankten/Symptome wie Polyurie, Polydipsie und starker Gewichtsverlust sind charakteristisch.
Type II: Körper vermindert Insulinrezeptoren an Zellen, nimmt dadurch verfügbare Stärke nicht auf/= Altersdiabetes/Patienten ab einem Alter von 40 Jahren auf o. bei übergewichtigen Patienten. 90 - 95% aller Erkrankten. Die auftretenden Symptome sind minimal. Ein relativer Insulinmangel entsteht durch jahrelange Glucose-Überernährung, wodurch es zu einer Erschöpfung. der B-Zellen der Pankreas kommt.
Bei einem funktionierenden Zuckerstoffwechsel liegen die Blutglucosespiegel immer relativ konstant bei 70 bis 150 mg/dl. Chronisch erhöhte Glucosekonzentrationen im Plasma führen zu mikrovaskulären Krankheiten, wie die Retinopathie, verursachen Nierenfunktionsstörungen oder schädigen Nerven.
Insulin und C-Peptid
Ein erhöhter Blutzuckerspiegel stimuliert die B-Zellen der Bauchspeicheldrüse zur Produktion und Freisetzung von Insulin. Insulin erzeugt einen hypoglykämischen Effekt, indem es die zelluläre Aufnahme von Glukose in Muskel- und Fettgewebe fördert und die Glukoneogenese stoppt. Extrazelluläre Glukose wird durch Insulin zu den intrazellulären Speicherplätzen befördert, wo es in Form von Glykogen gespeichert wird. Glukagon, Epinephrin, GH und Cortisol wirken als Gegenspieler von Insulin. Sie erhöhen die Blutzuckerkonzentration indem sie die Glykoneogenese stimulieren.
Die Bestimmung von Insulin hat aber einen großen Nachteil. Die Insulintests können zwischen endogenem und exogenem Insulin nicht unterscheiden. Viele Patienten entwickeln Antikörper gegen Insulin, welche die Tests stören. Diese Problematik kann durch die Bestimmung von C-Peptid ausgeschaltet werden.
Indications for hypoglycemia/disturbed sugar metabolism: ravenous appetite soon after eating/constant appetite/never satisfied/sleepless/> eating/tendency to eat frequently between meals/irresistible desire to take sweets/strong impulse to eat on waking often because of a fainting feeling or weakness/trembling when hungry/irritable when hungry (on waking), etc.
Cause of hypoglycemia is USE of 'rapid' carbohydrates (refined sugar/refined flour) in modern nourishment. Other causes are: caffeine (in coffee/cola/tea/chocolate/cocoa)/
alcohol/cigarettes. Kaffein stimulates the adrenal glands to set adrenaline free that stimulates in turn the release of sugar from the liver into the bloodstream. Emotional causes
underneath such as lack of affection and inability to handle affection. Hypoglycemia influences our social behavior/emotional well being. mental and social erratic/violent/antisocial
behavior (child: violent fits of anger with striking, kicking, vandalism, aggressive/discontent).
Behavior of juvenile delinquents > wenn put on a sugar free diet. (Spiritual nutrition and the rainbow diet, Dr. Gabriel Cousens)
Compensation of lack of love/affection: getting it by any means or refusal of any form (Lac-h.).
insatiable appetite (boulimia) versus no appetite at all and sometimes a refusal to eat resulting in anorexia.
Thirst for large quantities versus no thirst at all.
Great need to cuddle versus refusing every contact.
Exaggerated sucking of fingers versus no sucking of fingers at all,
putting everything in the mouth versus never putting anything in the mouth.
Sensitive to pain versus almost insensitive to pain.
No appetite in the morning versus ravenous appetite on waking so that he has to eat first.
gentleness # very aggressive behavior.
Cold feet, but sometimes so hot at night sticking them out of bed.
The most frequent way to compensate a lack of affection seems to be by far the use of sweets of any kind. A link between love and sweets ("sweet boy or girl" "honey", "sweetheart", "sugar", etc).
Many symptoms related to food desires and aversions, appetite and eating. DESIRES any kind of sweets (chocolate/licorice/pastries/biscuits/“junk sweets“).
Increased appetite before menses/desires sweets after dinner.
No appetite at all in the morning after rising and increased appetite in the afternoon (evening/candies) and no need during the day.
Hypoglycemia with NEED to eat first on waking and tendency to eat frequently between the meals, not feeling well if the meal is postponed a little.
Feel weak/trembling/empty in the stomach/dizzy or get a headache if they cannot eat at regular hours. Feel weak and irritable in the morning/difficult to activate themselves/generally > after breakfast.
Helo-s.x Gilatide (= peptide in saliva has shown effect in the treatment of Alzheimer/Diabetes/ADD)/improves memory and learning: Novel Nootropic (= smart drugs/memory enhancers/cognitive enhancers) Peptide (= Exenatide®).
Verwandt sind Alzheimer und ALS.
Folgen bei Kinder von Mütter mit Diabetes: Puls = schwach + schnelles, vergrößertes Herz
Phytologie: Phlor. senkt Blutzuckerspiegel/‡ Rosm ‡
Datisca cannabina = Scheinhanf/Cucurbitales. C 6 Diabetes
craving and associated aggravation of behavior; R.S.: Tannenharz der Signatur entsprechend bei Zuckerkrankheit (Diabetes), die zu den typischen Altersleiden gehört und stets mit schlechter Wundheilung einhergeht. ‡
R.S. explained in the 1920s: “Imagine that you are stressing the memory capacity of the child excessively around the 9th or 10th year of life, that memory is used too much as in education. The consequences of this will show themselves only when the human being is in his thirties or forties or even later. Then the person will become either a sufferer of rheuma or diabetes. Precisely when memory is used inappropriately around the 9th or 10nth year of life, then this overwhelming of memory in childhood will show itself later in excessive deposits of metabolic products ... On the other hand, when the child is required to use too little memory (appealing too little to the child’s ability to remember) then we will call forth in later life a tendency for inflammatory processes of all sorts. To understand how the bodily conditions of one epoch of life are the consequences of the spiritual-soul conditions of another life-stage is one of the most important things that we must realize”.
We are practicing plenty of that in the rearing of our children. Over-intellectualization, unreasonable expectations of mental performance, now often beginning with kindergarten, leads to the metabolic syndrome on the one hand. And on the other hand, lack of a rhythmic lifestyle, starting with irregular meals/irregular sleep times/stresses and anxieties for children living between multiple families, can lead to the later life inflammations. Not surprisingly, underlying obesity, as a fat deposit, and diabetes, as a sugar deposit, scientists are finding a pervasive inflammatory process.
Ultimately the excesses of childhood reveal themselves as leading to a generalized state of exhaustion of the Ego (the personal individuality) where, sadly enough, this results in a culture where a majority of adults begin their mature years in a chronically overwhelmed state [literally not taking hold of our bodies (let alone of the social requirements around us)] and these untended physiological processes fall apart and result in disease. It is a scenario like this that points out the true incalculable importance of preventive hygiene and holistic lifestyle changes.
Treatment of diabetes referring to medications or nutritional changes, needs to focus on strengthening the Ego in addition to attempting to affect the physical body in a more narrow sense by lowering sugar or burning fat. Inspired by R.S.’s work there are several creative modalities that we can use along with conventional therapies. The common denominator for all these ideas is a reawakening of the personal individuality.
A classical indication given by R.S. is the use of Rosm. Initially he recommended baths with a strong amount of rosemary oil with the admonition that it should be clearly smelled by the patient so that one would be aware of the herb through one’s sense organs during the bath. Various modalities have been developed over the years to make this application more effective (oil dispersion bath). The rosemary plant exhibits the principles that we are considering above in an exemplary fashion. It takes the forces of fragrance and warmth contained in its etheric oils back into the plant instead of dispersing them generally into the surrounding environment the way lavender does, for example. The plant does not allow its life-forces to be used in developing large leaves or flowers. But rather, it concentrates all its strength towards the inside and results in the typical woody, small, shrubby appearance that is so characteristic of this plant. Interestingly Rosm. has been found to be a powerful anti-inflammatory and anti-oxidant. Research has shown, however, that it is ineffective if it doesn’t have an appropriate quality control shown in the standardization of its most active ingredients of Rosmarinic and Carnosinic acids. These new insight make it reasonable to use Rosm. as an oral nutritional supplement also.
To overcome the chronic exhaustion of life forces stemming form the above-mentioned educational “headyness,” remedies made from roots are very helpful. While it is beyond the scope of this brief article to fully explain the connection, it can be intuitively seen that there is a correspondence between the herbal root system that connects the plant with the surrounding earth and the human nerve-sense organization that connects us in turn with our surrounding world. Root extracts have been known since antiquity as valued tonics or as specific healers for various conditions. A gentian or curcumin tincture help through their spiciness and bitterness to overcome stagnant intestinal processes, particularly such common conditions accompanying diabetes as an overly slow emptying of the stomach. More recently, other root formulations from plants such as Withania or Rhodiola have been shown to be particularly energizing and restorative.
Anthroposophical medicine has emphasis on with various forms of quartz = silica. Silicates help not only in restoring the normal function of sense organs that can be damaged by abnormal glucose levels but also help in normalizing the metabolism of the sugar overload.
Several substances are involved in helping the Ego either connect itself more strongly with the body or helping it to relax and go to sleep. If Calcium in general can be seen as having more calming effects. It can be used against allergies and sleeplessness. Phos. has an invigorating, awakening effect. In the proper formulation, in a very dilute form, Phos. can help the spiritual self to better take hold of metabolic processes.
Visc-a.: in phytology used to lower blood pressure/enhances fertility/also occasionally used in the treatment of epilepsy. R.S.: prepared properly and given in injectable form it had cancer fighting abilities. The mistletoe demonstrates through its peculiar growth rhythms that it emphasizes at all times its own “individuality.” Contrary to most other plants, it has a dormant state in the summer and develops its berries around New Year’s time in the winter. It would make sense to use the mistletoe, but this time in tincture form, as an extract, in order to reengage the Ego in the body by forcing it to overcome the “contrariness” of this herb. There is an African tradition mentioning mistletoe therapy in diabetes. In experimental animal studies mistletoe treatment could not show a direct sugar level lowering effect but it had a positive influence on diabetes associated symptoms, such as hyperphagia (overeating) and polydipsia (overdrinking).
Any form of change in lifestyle results in an increased “mastery” of the Ego over the physical body aligns itself with the anthroposophical understanding of treating diabetes. Ultimately, the age-old observation that aerobic exertion lowers blood sugar is nothing more, nor less, than the reality of the Will taking hold of the metabolic forces. Leading a rhythmical life, with structured meals at the same time every day, is not only in harmony with the well-known biorhythms of insulin secretion (a high and low every 15 minutes and every 90 minutes) but demonstrates the benefits when the “I” dictates when and how much is to be ingested.
Diabetes is increasing. In the last decade diabetes rose by 3,3% nationwide to 6,5% of the population. This immense increase of a chronic illness, with its personal, social and economic consequences, poses many questions.
We know that the biochemical problem underlying the clinical features is an absolute or functional deficiency of insulin. This insulin deficiency leads to impairment in the handling of body glucose (sugar), and problems in fat and protein metabolism. Modern medical research has made, and continues to make, ever more refined discoveries about the cause and manifestation of this disorder which involves essentially every aspect of the human body. The fact that we can treat diabetes with insulin, saving the lives of millions, is gratifying to the patient and physician. But we might also ask: what is going on beyond the biochemical problem? Could the rising incidence be a consequences of actions on the part of society or the individual?
Anthroposophical medicine does provide insights which might be helpful in engaging the whole person as an important participant in the potential healing or therapy of this complex disorder. In the book by Rudolf Steiner and Ita Wegman "Fundamentals of Therapy," in the chapter on diabetes mellitus we read that: "Where there is sugar, there is ego organization; where sugar is generated, the ego organization appears and orients the subhuman (vegetative, animal) corporeality towards the human." The most dramatic demonstration verifying such a statement is the hypoglycemic (low sugar) state, in which very low blood sugar leads to unconsciousness and ultimately, if not replaced, to death.
In diabetes mellitus the ego organization becomes so weakened that it can no longer effectively act on the substance of sugar. What should have happened to sugar through the ego organization then happens to it through the astral and etheric domains. The structure, substance, and function of all components of our body are not at our own service but act out their own "extra human" impulses. Our blood sugar level is not maintained within a stable range, it acts like sugar in a sugar jar, the more you pour in the more you have, only in the body it's not really yours - you can't use it! Blood vessels lose their normal structure, the finer tissue components of blood vessels overgrow, and become too `alive' to permit the ego to live properly in the body. The body can become estranged to the extent that limbs need to be amputated because of inadequate blood supply.
We can cite innumerable other examples showing how the body progressively loses its function as intended for the ego because the organization that needs to be active in the body is too weak. Hence the question: what can be done to strengthen the ego organization?
If health experts blame the wired couch potato culture of our times and realize that obesity is closely tied to diabetes, certainly we can realize that we, as ego beings, are not very involved in penetrating our body as our instrument, permitting vegetative and animal functions to predominate.
In fact, diabetes is aggravated by everything that diverts the ego organization from an engaged function in body activity, i.e. most of our passive-receptive activities today. It has been realized in the past, and still is today, that good hard physical activity, work in short, has a very helpful effect on those with diabetes or pre-diabetes.
As the body tissue used for movement becomes ever less penetrated by the ego, as the blood, vehicle for the ego, becomes less able to individualize the sugar, so also the nervous system substance becomes estranged from the weakened ego organization resulting in diabetic neuropathy.
In considering these problems it is helpful again to quote Fundamentals of Therapy: "Processes taking place in the head organization should be parallel processes to soul and spirit activity. However, because the latter activities take their course too fast or too slowly, they fall out of the parallelism. It is as if the nervous system were thinking independently alongside the thinking human being; but this is an activity which should only be carried out during sleep. In the diabetic, a form of sleep in the depths of the organism runs parallel to the waking state".
Of course much more should be said for a deeper insight into diabetes, but perhaps what has been shared here, out of a spiritual scientific view (never contradicting but always complementing and enhancing the natural scientific view), shows that this complicated chronic illness is a mandate to the human being—to be wake and be active in thinking, feeling, and willing, and to engage in enthusiastic home and work activities.