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Taking on the Challenge of Diabetes: Local Practitioners Weigh In

by Martin Miron

Diabetes has become a real, life-threatening epidemic in the U.S., and although most people vaguely associate the disease with consuming too much sugar, it encompasses a vastly more complex landscape of cause and effect, as well as myriad approaches to solving the problem. We surveyed several local doctors to fill in the blanks about this growing issue.

Karissa Scarabino, DO, board-certified in family medicine and osteopathic manipulative medicine, relates, “Type 2 diabetes mellitus affects nearly 26 million U.S. adults aged 20 years or older, with 1.5 million more cases diagnosed in adults each year. By 2050, it is predicted that one in three adults will have diabetes mellitus, including 53 percent of senior citizens. Currently, 79 million adults have pre-diabetes, and many of them, if left untreated, will develop diabetes. diabetes is also linked to considerable morbidity and mortality and is a major cause of heart disease and stroke—it is the seventh-leading cause of death in the United States. It seems inevitable that this disease will eventually affect all families.”

Dr. Joseph S. Gulyas, with more than 30 years as a chiropractor and holistic healer, states, “It is very unfortunate that diabetes has increased
in society, and it will continue to get worse if
the current state of affairs continues in that the food industry continues to sell stuff that they call food and the medical
industry ignores the power of healing within
whole foods.”

Anita Burock Stotts, M.D., certified in functional medicine and board-certified in internal medicine, says, “I believe several lifestyle factors have combined to create more diabetes; poor quality diet, inactivity, stress and exposure to toxins. Many people consume far too many calories in the form of sugar, especially high-fructose corn syrup, and starch, which is quickly converted into sugar (glucose) in the body. In susceptible persons, over time, the fat cells, liver cells and muscle cells which are able to take sugar in to store it develop insulin resistance. Insulin is the hormone that signals cells to accept sugar. In this scenario, the pancreas must secrete more and more insulin in order for the body to store sugar, and eventually cannot keep up with the demand. For most cases of Type 2 diabetes, this is how the disease progresses.”

Certified Nutritionist Susan Brown is of the opinion that “the increased exposure to chemicals, heavy metals, drugs and processed foods’ is a big factor.

Herbalist Erin Ethier says, “I have been around plants and herbs my whole life, and personally, I believe the increase in diabetes is due to poor diet and because our food lacks so many of the nutrients that it once had so you have to go out of your way to eat healthy.

Scarabino says, “Type 2 diabetes mellitus is a chronic disease that is largely preventable and wholly treatable. The largest component of its management is self-care. This type of care includes consuming a well-balanced and whole food diet, participating in regular physical activity, maintaining a healthy weight, and getting proper rest. A healthy lifestyle is even more effective at preventing T2DM. Unfortunately, individuals in the United States continue to gain weight and become more sedentary.

According to Gulyas, “Society needs a better
perspective on the way we see the disease.
It has almost become so commonplace
that people accept it like a stage in getting
older and as something that we have no
control over. As a healthcare practitioner, I reject that
idea and I want to move everyone toward
an idea of prevention. Let’s actually move
everyone towards a better sense of balance 
in their lives with informed decisions on how
and what to eat. The biggest misconception about diabetes
is that people think that they are eating well,
when most times they are not.”

Inactivity speaks for itself,” says Stotts. “Many people have jobs that do not involve physical activity, and leisure time is too often spent in front of screens rather than moving. Additionally, stress not only may cause people to eat compulsively, it may cause the body to secrete hormones such as cortisol, which can cause further elevations in blood glucose. We are also beginning to learn the ways that toxins, including some pharmaceutical agents such as statins, impede our body’s ability to regulate glucose and insulin.”

“The diagnosis of diabetes or pre-diabetes is not
be to seen as a doomed sentence of drugs for
the rest of life,” advises Gulyas.
“The reversibility of Type 2 diabetes is possible
through the holistic approach of eating whole
foods and managing one’s mood, as well as
sleeping and exercise habits.”

Gulyas notes, “As we look at the crisis of diabetes in
our country, I do see hope for the future.
Many more people are improving their
lifestyle and beginning to understand that
diabetes is not just something that you treat
with a pill. Time is a major factor in healing,
and it is foolish to think that someone’s
habits will change overnight. Everyone, including healthcare practitioners, need to
tell patients
know that they do have control of their
situation, and that success will come.”

Stotts  advises, “As a functional medicine practitioner, I try to educate my patients that long before an official diagnosis of diabetes is made, many people have insulin resistance, which is detrimental to health; sometimes decades before. I look at not only blood sugar levels, but also hemoglobin A1C and glucose and insulin tolerance tests in order to diagnose my patients early and give them the best chance to avoid complications of diabetes.”

“There is strong evidence that the pathophysiologic processes that lead to Type 2 diabetes start decades before a diagnosis,” states Scarabino.The genetic predisposition is also affected by environmental factors and comorbid illnesses such as neuropathic pain and non–diabetes-related pain from osteoarthritis. Pain is decreased or eliminated with osteopathic manipulative treatment. Defining diabetes narrowly as a disease of glucose regulation underestimates the role that stress, pain, sleep patterns and illness play on glucose control.”

Stotts says, “I think there are two important misconceptions: people don’t understand that we should look for insulin resistance and treat it; and they don’t understand that many cases of diabetes Type 2 can be prevented or reversed. I will also add a word about diabetes Type 1, which is an autoimmune disease.  So many people don’t realize that about 10 percent of patients who have this condition also have celiac disease. All patients with Type 1 diabetes should be screened for celiac disease, as should their first-degree relatives.”

“The biggest misconception about diabetes is that it can only be managed with drugs. Detoxification is critical to opening up organ pathways to allow essential nutrition to be absorbed by the body, says Brown. “By taking herbal and whole food supplements specific for your body type and detoxifying organ systems, especially the liver and pancreas, the body can repair itself. The body will correct itself when supplied with nutrient dense foods and the natural detoxification processes are supported.”

Physical activity leads to an increase of blood glucose uptake,” advises Scarabino. “In those with Type 2 diabetes, moderate exercise will cause blood glucose levels to decline. The amount of reduction in the glucose is related to the duration and intensity of exercise, as well as the pre-exercise glucose control and overall state of fitness. A combination of aerobic and resistance training may be more effective for glucose management than either one alone. Even as little as one week of aerobic training can improve whole body insulin sensitivity.

“I would just say that while the idea of diabetes can feel very scary, there are many beneficial choices that people can make. The missing link is to feel empowered,” says Stotts.

As Ethier recommends, “Beneficial herbs include cinnamon, which helps to reduce fasting blood glucose; garlic, which can help reduce insulin resistance; and ginger, which can improve lipid metabolism that can help decrease diabetes. Garlic is also being looked at to lower and stabilize blood sugar levels.”

“The hope is that people come to the realization that by changing their foods and lifestyle and detoxifying the organ systems, especially the pancreas and liver, they can regain their health,” says Brown.

The largest component of Type 2 diabetes management is self-care, which includes regulating dietary intake, physical activity, sleep and stress reduction, in addition to checking glucose measurements, taking medication and problem-solving when glucose is out of range,” says Scarabino. Further, self-care involves the prevention and treatment of complications, which include daily skin and foot checks, routine medical care, screening examinations and early intervention if a problem arises.”

Dr. Karissa Scarabino, Osteopathic Health of Saratoga, 28 Clinton St., Ste. 3, Saratoga Springs. 518-250-3221, OsteopathicHealthOfSaratoga.com.

 Dr. Joseph S. Gulyas, Northeast Spine & Wellness, 306b Grooms Rd., Clifton Park, and 1873 Western Ave., Ste. 101, in Albany. 518-371-4800, DrGulyas.com.

 Dr. Anita Burock Stotts, Healthy Endeavors Medicine, 2592 Western Ave., Ste. 102, Guilderland/Altamont. 518-355-2060 HealthyEndeavorsMed.com.

Susan Brown, Vitality Health Center, 3441 Amsterdam Rd. (Rte. 5), Scotia. 518-372-4706, GetVitalHealth.com.

Erin Ethier, Earthly Remedies by Erin, 264 Main St., Richmondville, 518-534-3003, EarthlyRemediesByErin.com.