| Diabetes is not JUST
diabetes. It is being overweight, having heart
trouble, ageing too quickly - cancer loves sugar -
imbalanced blood sugar is one of the main reasons
for general ill health, and knowing our blood
sugar levels means we can sensibly address the
problem before it becomes serious.
Diabetes is a major problem in
America, affecting an estimated 10 million people,
and is increasing worldwide. There are two types
of diabetes, one in which the pancreas has ceased
production of insulin altogether (and in fact, the
cells that produce it are often found to be
destroyed), and the other in which the cells of
the body have become insulin resistant - as
explained in my article on
Insulin
Resistance, this
means that blood sugar cannot be conveyed into the
cells, with a consequent rise in both blood sugar
and insulin levels.
This latter form of diabetes is
the more common, and is almost always connected
with obesity, more than 80% of those affected
being overweight. Nutritionists now believe that
obesity is the common factor in the increase
of many chronic diseases in the United
States, despite the extraordinary fact that there
are the number of overweight people is increasing
at the same time a Health Club a day opens, and
people are eliminating fat from their diets with
almost religious fervor.
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Blood
sugar problems begin with
carbohydrate-driven "insulin
resistance", a reaction in the body
which prevents insulin from docking with
its receptor sites in our cells. |
Insulin is a hormone, a
messenger in our body, and it is released by the
pancreas to help cope with high levels of sugar in
the blood. Its role is to stimulate the cells to
capture sugar from the blood, and either burn it
for energy as needed then and there, or produce a
storage forms of carbohydrate called glycogen.
When the cells are blocked from accepting insulin,
it is left free in the blood where it cannot
perform its function of lowering blood sugar
levels, and the pancreas is therefore stimulated
to produce more insulin. This leads to a condition
called Hyperinsulemia, which in turn can
lead to diabetes and heart disease.
Where previously alarms were
triggered only when blood sugar levels rose over
125, now new research suggests that patients
with high levels of blood sugar in the
non-diabetic range face a substantial risk of
coronary heart disease and any level over 100
should be addressed.
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The
problem at its most basic is that the
sugar not removed from the blood
has to have an end goal,
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and that is either to be stored
as fat, or to be made into triglycerides: and as
we all know, obesity and high triglycerides
present us with many undesirable bills, which
eventually have to be paid.
A huge 2004 study of
over 39,000 in 40 countries people made an
incontrovertible connection between high blood
sugar and cardiovascular disease. About
half of the subjects were men, averaging 63
years of age, and the researchers determined
that only one man in three had normal glucose
and insulin levels. I in 5 had diabetes
that had gone undetected, and over 1 in 4 had
pre-diabetic readings. This emphasizes the
importance of controlling blood sugar.
As insulin levels rise and
insulin resistance in the body increases. the
situation develops its own momentum: the
activity of the delta desaturase enzymes which
break down essential fatty acids declines,
increased amounts of saturated fats become part of
our cell membranes, and insulin sensitivity
decreases again. The enzyme pathways shut down
through which Arachidonic acid is converted
to the friendly GLA. This in turn means the
messengers (eicosanoids) which promote insulin
sensitivity in the cells are not sent to do their
jobs, more insulin is produced to take care of the
added carbs, and a vicious cycle leading
potentially to diabetes and cardiovascular
problems (Syndrome X, or Insulin Resistance) is
set in motion.
An important ratio for total
health is the amount of lean muscle compared to
the amount of body fat: the higher your ratio of
lean tissue versus fat, the lower your risk for
diabetes. (See RESOURCES)
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Will the
obsessive use of sunscreens lead to
even MORE diabetes??
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The link between
vitamin D3 and diabetes has been known for quite a
while, though the mechanism is not yet explained.
It makes me wonder whether the new phobia about
sun exposure may in the long run have unexpected
consequences, particularly for our children who
would normally be out romping in the vitamin D
rich sunshine all summer..
Hypovitaminosis
D is associated with insulin resistance and ß
cell dysfunction -
http://www.ajcn.org/cgi/content/abstract/79/5/820
Vitamin
D3 and Young Type 1 Diabetes -
http://tinyurl.com/c7zrqu
Don't overlook the
fact that diabetics are at greater risk for
osteoporosis: to quote information provided by Dr.
Steven Schneider in answer to a question in
Medscape, "it is clear that there is an
increased risk for low bone mineral density and
particularly for bone fractures in patients with
type 1 and, to a lesser extent, type 2 diabetes
mellitus. These abnormalities may be related at
least in part to prolonged periods of poor
metabolic control and might be decreased by more
aggressive treatment regimens.......Certainly
women with diabetes need to pay special attention
to the prevention of osteoporosis by maintaining
an adequate calcium and vitamin D intake. This
will often require calcium supplementation, which
may need to be started at an early age while peak
bone mass is still developing."
What he is saying
is that all diabetics are at risk, but children
who have type 1 diabetes are particularly likely
to suffer because of the effects on bone
building during the crucial developmental years.
If your child is a type 1 diabetic,
make sure that adequate calcium and Vitamin D
are provided.
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Onions
and garlic have qualities which make them
extra helpful for diabetics
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Onion and garlic have
significant blood sugar lowering action, because
their double sulfur (Thiole) bonds bind to enzymes
which deactivate insulin, allowing it to be active
longer. The oils have active effects, but
flavonoids such as Quercetin in onions may also
come in to play, and the principal active
ingredients are allyl propyl disulphides (APDS),
and diallyl disulphide oxed
(Allicin) which appear to compete with
insulin for docking sites in the liver, thus
making more free insulin available in the blood
stream and lowering glucose levels
Onion extract has been
found to reduce blood sugar levels during oral and
intravenous glucose tolerance. The effect improved
as the dosage was increased; however, beneficial
effects were observed even for low levels that
used in the diet (eg., 25 to 200 grams). The
effects were similar in both raw and boiled onion
extracts. Onions also affect the hepatic
metabolism of glucose and/or increases the release
of insulin, and/or prevent insulin's destruction.
In supplement form, studies have shown that the
garlic needs to be standardized for its allicin
content, when 800mg per day can significantly
lower fasting blood glucose levels.
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Sufferers
from diabetic neuropathy need to know
about
Alpha
Lipoic Acid
and Acetyl-L-Carnitine
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Alpha Lipoic Acid (also known as
Thioctic Acid, another thiol), has been used for
some years now in Europe for this condition.
Dr. Murray says that ALA "help
diabetics by facilitating better conversion of
sugar into energy...Its ability to improve blood
sugar metabolism is a result of its effects on
glucose metabolism and an ability to increase
insulin sensitivity. Diabetics taking insulin or
blood sugar lowering drugs are cautioned that
lipoic acid supplementation can result in changes
in dosage requirements. Close monitoring of blood
sugar levels is required." Doses are in
the 500 to 600 mg range, and less may not be
effective.
The January 2005 edition of
Diabetes Care, ( vol 28: pp 96-101.) carries
a study by Dr. Sima which evaluated two studies
involving over 1200 patients with diabetic
neuropathy. Analysis indicated significant
improvement, both at the 6 month and 1 year mark
using 1000 mgs of Acetyl-L-Carnitine.
People who had been diagnosed
with diabetes for the shortest length of time not
only experienced the highest level of pain relief,
but also showed improvement in nerve
structure and reactions.
The researchers said the results
suggested that optimal results may be obtained by
starting this therapy as early as possible in the
course of the disease.
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Stress
and inflammation also play a role
in the onset of Diabetes:
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researchers from the National
Institute of Diabetes and Digestive and Kidney
Diseases state that chronic
activation of the immune system, with upregulation
of interleukin-6, may play a role in the
pathogenesis of type 2 diabetes. Cortisol or sex
hormones or both could also be contributing
factors, the investigators add.
Jack Challem, the Nutrition Reporter, traces an
interesting route for a stress/diabetes connection
in his 2007 book, the
Food-Mood Solution (http://www.foodmoodsolution.com/). He points out that
not only does the increased stress of our
lifestyles cause cortisol to be imbalanced, but
also that the changes in our personalities caused
by unrelenting stress lead to less time for, and
less interest in, nutritious cooking and wise
dietary choices.
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Paleolithic
Diet and Diabetes Control
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I read a fascinating article in
issue 49, 2000 of the Herbalgram (you can
find it at herbalgram.org) which detailed a quest
initially undertaken by 20 Native Americans
of the Seri and O'odham tribes, but eventually
swelling to number 120 "Desert Pilgrims"
These tribes finally tired of
the probing research undertaken by the National
Institute of Health into the high incidence of
Diabetes in Native Americans, and decided to
organize a trek through their ancestral region,
eating nothing but indigenous foods and living off
the land. They were full of trepidation at
the start of the trek, not sure they could make it
through the 12 day, 240 mile journey.
Along the way, they ate
only prickly pear and other cactus, wild
greens, wild game supplied both by villages they
passed through and the efforts of their own
hunters, beans, mescal, chia seeds and chilies.
They drank only water and teas made from creosote
bush, damiana and desert lavender (among other
herbs).
At the end of the walk, there
were reports of dramatically reduced blood glucose
levels as well as improvement in cholesterol
levels. This is living proof of the wisdom
of the Paleolithic diet - which can be simply
summed up as "if it didn't exist 100 years
ago, don't eat it." I would add
"if it doesn't rot with time, don't eat
it"!
Of course, in Paleolithic times there were
going to be days when nothing at all was on the
menu - enforced, fasting, as you might say.
This ties in with interesting
research
(http://www.medicalnewstoday.com/articles/88030.php) which suggests that fasting one day a
month positively affects cardiovascular health,
possibly through reduced exposure to glucose.
Researchers theorize that this one day without
food gives the organs time to rest and work more
efficiently.
There
are two effective dietary approaches that
people who
have this problem can take: |
one is the 40-30-30 diet, where
care is taken every day that the food you eat is
always composed of 40% complex carbohydrates,
30% protein and 30% fat, with between 50 and 100
grams of fiber daily.
The other is to make sure that
you are drinking at least 8 glasses of pure water
every day, and that your sodium intake is
adequate.
The balance of nutrients I
recommend above has a very low glycemic index,
which means that their entry rate into the blood
stream is slow: this in turn means that the body
has time to control the situation, the pancreas is
not over-stimulated to produce insulin, and the
mechanism that stores fat in the body is not put
on high alert. What about the water and salt?
A very interesting book I have
been reading by Dr. Batmanghelidj called Your
Body's Many Cries for Water suggests
persuasively that lack of water and sodium in
the cells of the body activates the brain to
raise its glucose requirements, and by a
complicated process involving Tryptophan,
Histamine and Prostaglandin E, also to inhibit
insulin production.
He states that a low salt diet
is actually counterproductive for diabetics. In
another part of his fascinating book, he
documents many successes with weight loss,
simply by increasing the amount of water his
patients drink daily, and replacing all other
fluids (i.e. pops, especially diet, juices,
coffee & teas) with it.
Supplements can also help: a
British study (Diabetes
Care 2002;25:1709-1714.)
has shown that even
short-term use of dietary phytoestrogens significantly
and positively affects
fasting insulin levels, insulin resistance, HbA1c
levels, total cholesterol levels, LDL cholesterol,
cholesterol/HDL cholesterol ratio, and free
thyroxine (thyroid function) levels. The
investigators concluded that even short term
supplementation with soy phytoestrogens
( though it was not clear whether the soy protein
itself, or its component isoflavones are
responsible for the effect) reduces insulin
resistance and improves glycemic control in type 2
postmenopausal diabetics.
A study in the Journal of the
American Medical Association showed the risk of
diabetes for women whose iron levels are too high
increased significantly. You can access the study
in
RESOURCES.
As long ago as 1982 the American
journal of Clinical Nutrition reported a
correlation between serum chromium and serum
insulin levels, and recent research has
corroborated that, together with vanadium, it is
effective in controlling blood sugar levels.
A 1997 study by Anderson, in Diabetes,
46:1786-91, which was randomized and
placebo-controlled showed that both fasting and
post-prandial sugar and insulin levels were
reduced significantly using chromium. The study
got better results using a dosage of 1000 mcg. per
day, where previously only 200 mcg have been
routinely recommended by nutritionists.
Insulin dependant diabetics
should use chromium with caution, since its very
effectiveness can be dangerous for them.Perhaps
the most widely used form of chromium is Chromium
Picolinate, and in view of some of the rumors that
have been spread about this supplement, almost
always encouraged if not outright started by
companies making rival forms, I want to take this
opportunity of saying that both the USDA and the
manufacturers have undertaken toxicity studies
that meet every standard of such studies, and have
never come up with any adverse results. (HPB June
99;8)
A 2001 study suggests that
treatment with L-Arginine over a long period (1
month in the study) can improves insulin
sensitivity in patients with type 2 diabetes.
The authors of the study point out that L-Arginine,
which increases nitric oxide (NO) levels, is known
to stimulate insulin secretion. In this
study, patients treated with 3 grams of the amino
acid daily showed reductions in systolic blood
pressure compared with placebo-treated patients,
together with significantly increased
forearm blood flow and normal levels of cyclic
guanosine monophosphate, a second messenger of NO.
More to the point, patients who
received L-Arginine had a significant ( 34%)
increase in glucose disposal and significant
improvement in hepatic insulin sensitivity, as
endogenous glucose production decreased
significantly although glucose production in both
the L-Arginine group and the placebo group
remained significantly higher than in 10 normal
subjects.
"Our study has shown for the first time that
an increment in NO availability induced by the
administration of L-arginine is able to increase
insulin sensitivity, even if complete
normalization is not achieved," the authors
conclude.
Diabetes Care
2001;24:875-880.
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An
interesting new compound which may offer
help in fightitng
diabetes is Co-enzyme-A, to which
Pantethine
is a pre-cursor:
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this substance helps maintain
healthy RNA/DNA, deterioration of which can lead
to many age-related disorders, to include
diabetes.
The USDA was considering
applying for a use patent on Cinnamon Extract for
diabetes, based on their studies showing
beneficial effects on blood lipids as well as a
significant 20% improvement in blood sugar levels.
Read the study here
(http://www.ars.usda.gov/is/pr/2004/040419.htm). I hope this doesn't mean that certain fast
food chains will now begin promoting their
cinnamon rolls as nutritional supplements BUT the
substantial evidence for the helpfulness of
cinnamon in blood sugar control can no longer be
ignored.
Another supplement that seems to
help particularly with the problem of insulin
resistance is Garcinia Cambogia. It comes
from India, where it has been traditionally used
as an appetite control, and as an aid in
processing food. It is a source of hydroxy-citric
acid, or HCA, which appears to work by blocking a
key cellular pathway that converts glucose to fat.
Certainly animals fed an HCA supplemented diet
have shown reduced food intake, a decline in body
fat and lowered triglyceride levels.
Traditional Ayurvedic medicine
has successfully applied a herbal approach to
diabetes: a herb called Gymnema
Sylvestre (also recommended by Dr.
Whitaker) which appears to assist the pancreas in
manufacturing insulin, and in studies has been
shown to be successful in helping control both
type 1 and 11 diabetes - in fact, it is
recommended by Natural Health professionals that
you monitor your medication carefully, since this
herb can lower requirements for it.. studies have
been done using a specific Gymnema extract called
GS4, and the results are encouraging. Using
200 mg/day cutspatients' required insulin dose in
half...
Bitter Melon
also helps regulate blood sugar, even for pets,
and research is being done on the herb Fenugreek
for its part in controlling blood sugars. Dr.
Leigh Broadmoor (News from the Herbal Village,
Vol. 1V, Issue 1: 11) points out that fenugreek is
about 50% fiber, with 20% being mucilage and
mucilage makes a significant difference to blood
sugar levels. She cites a study done by the Indian
National Institute of Nutrition where 10 IDDM
patients were given 100 grams of debittered
fenugreek seed powder per day, which led to a 30%
decrease in fasting glucose and an improvement in
glucose tolerance. The amount of sugar excreted in
the urine dropped by 54% without a concomitant
increase in blood sugar levels. She says this
result cannot be explained entirely by the
mucilage, and fenugreek also contains many plant
phytochemicals which may be part of the effect. Be
careful of Fenugreek if you have allergies to
other foods n the same family, such as soy or
peanuts!
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A
new entry is an extract of a herb called
Lagerstroemia Speciosa,
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which helps transport glucose
and therefore balance blood sugar, evening out the
highs and the lows. Companies are now coming out
with combinations of the herbs and nutrients
helpful for insulin control, and three I recommend
are Glucoreg by Solaray, Glucocare by Ayurvedic
Concepts, and Glucotrim by Nature's Plus. My own
formulation, Glucose Support, contains many of
these helpful nutrients.
Jarrow Formulas makes a protein
mix called Glycemic Balance, which has been used
very successfully by many of my clients attempting
to control sugar variations, and a formula called
Glucose Optimizer, which in effect contains nearly
everything I have mentioned to regulate blood
sugar. Another herb which helps balance blood
sugar is American Ginseng, which has been shown to
lower blood sugar levels even in non-diabetics. (Arch.Intern.Med.,
Apr. 10 2000; 160(7):1009-13)
An interesting and little known fact is that the
end products of sugar metabolism in the body are
actually used as markers for aging.
They are called AGEs, appropriately enough, which
stands for Advanced Glycation End Products. The
more of them you have, the older your biological
age. Controlling your blood sugar,
therefore, can actually address your life span.
Some studies suggest American Ginseng can lower
the AGE levels. So, if you want to live longer,
limit your carbohydrate intake, choose any
carbohydrates you eat from those containing sugars
which enter the blood slowly, usually because they
are accompanied by protein, fiber or fatty acids,
and select supplements which will help you balance
your sugars. See RESOURCES
for more about Glycemic Index and Glycemic Load.
Consider
the financial costs of Diabetes, as
estimated by the American
Diabetes Association: http://care.diabetesjournals.org/cgi/content/full/26/3/917
Direct medical and indirect expenditures
attributable to diabetes in
2002 were estimated at $132 billion.
Direct medical expenditures
alone totaled $91.8 billion and
comprised $23.2 billion for
diabetes care, $24.6 billion for chronic
complications attributable to
diabetes, and $44.1 billion for excess
prevalence of general medical
conditions. Inpatient days (43.9%),
nursing home care (15.1%),
and office visits (10.9%) constituted
the major expenditure groups
by service settings. In addition, 51.8%
of direct medical expenditures
were incurred by people >65 years
old. Attributable indirect expenditures
resulting from lost workdays,
restricted activity days, mortality, and
permanent disability due to
diabetes totaled $39.8 billion. U.S.
health expenditures for the
health care components included in the
study totaled $865 billion, of
which $160 billion was incurred by
people with diabetes. Per capita medical
expenditures totaled $13,243
for people with diabetes and $2,560 for
people without diabetes. When
adjusting for differences in age, sex,
and race/ethnicity between
the population with and without
diabetes, people with diabetes
had medical expenditures that were 2.4
times higher than
expenditures that would be incurred by
the same group in the absence
of diabetes. |
Cigarette smoking
is now further implicated as a culprit of
impaired glucose tolerance. According to
findings published recently in the Annals of
Internal Medicine , risk of impaired fasting
glucose and type 2 diabetes increases in a
dose-dependent manner with the number of
cigarettes smoked per day and the number of
pack-years of exposure. Nakanishi et al (Ann
Intern Med. 2000;133:183-191.)perceive the
findings as evidence that smoking is a
"modifiable risk factor that can be
targeted" for diabetes prevention.
The risks for developing type 2 diabetes were
imposing. In comparison with never-smokers, the
relative risk was 1.08 for ever-smokers, 1.88
for the one-to-20-cigarette group, 3.02 for the
21-to-30-cigarette group, and 4.09 for heavier
smokers -- constituting a statistically
significant trend across current-smoker
categories. The longer the habit has
existed, the greater the increase of risk.
"The mechanism of how cigarette smoking
increases the risk for impaired fasting glucose
and type 2 diabetes remains to be
elucidated," write Nakanishi and
colleagues. They cite recent study findings
suggesting that smoking causes insulin
resistance in peripheral tissues, increased
serum insulin and C-peptide levels, and the
release of counterregulatory hormones.
Of course,
they might also consider the fact that most
cigarettes contain sugar.
Then, consider also the health
costs:
People with a fasting blood sugar level of
100-125 mg/dl had an adjusted nearly 300%
increase in their risk for coronary heart
disease than people with a level below 79 mg/dl.
This information was compiled from a
cross-sectional study of nearly 2500 people.
In fact, the Cleveland Clinic Foundation now
uses a fasting blood sugar of 90 mg/dl or higher
as a biomarker of coronary heart disease risk.
The Cleveland Clinic gets very concerned when
they encounter someone with a fasting blood
sugar above 90 mg/dl. They try to intervene with
exercise, diet and weight control.
(American
Journal Cardiology March 2002(1);89(5):596-9)
Additionally, in the June 22nd
2002 edition of Lancet, a Swedish study at the
Karolinska Institute was published which
researched patients admitted for acute
myocardial infarctions: these patients had not
previously had any reason to suspect that they
suffered from any blood sugar imbalances:
the researchers recorded blood sugar levels at
admission, during the stay in the hospital,
at the time of discharge, and 3 months
later. At hospital discharge, 58 of 164
patients (35%) had impaired glucose tolerance,
and 51 patients (31%) had undiagnosed diabetes,
the researchers found. At 3 months, 58 of 144
(40%) patients had impaired glucose and 36
patients (25%) were diabetic.
Diabetes is a very serious
health condition, and I do not to suggest that you
make changes without your Doctor's consent; for
many people, however, nutrition makes the
difference between medication & control.
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Find
the recommended supplements here
QUICK LINKS
The
Mood-Food Solution - http://www.foodmoodsolution.com/
Chromium
and Diabetes - http://diabetes.diabetesjournals.org/cgi/content/abstract/46/11/1786
Low
Vitamin D and Blood Sugar - http://www.ajcn.org/cgi/content/abstract/79/5/820
Treatment
of symptomatic diabetic polyneuropathy
with the antioxidant alpha-lipoic acid -
http://care.diabetesjournals.org/cgi/content/abstract/22/8/1296?maxtoshow=&HITS=&hits=&RESULTFORMAT=&fulltext=lipoic+acid&searchid=1034863029414_1326&stored_search=&FIRSTINDEX=0&journalcode=diacare
Diabetes
#1 Shame of Orthodox Doctors - http://www.newmediaexplorer.org/chris/2007/10/29/diabetes_1_shame_of_the_orthodox_doctors_chromium_more.htm
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Link
between Obesity, Syndrome X/Insulin
Resistance and Alzheimer's/Dementia?
- http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=9366728&dopt=Abstract
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Click
here for more information about the
Glycemic Index, and a list of food
values - http://www.mendosa.com/common_foods.htm
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To
find out how many Carbohydrates are
right for you, click here -
http://www.global-fitness.com/at.cgi?a=204562&e=carbcalc_intro.html
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Alpha
Lipoic Acid and Diabetic Neuropathy -
http://www.berkeley.edu/news/media/releases/96legacy/releases.96/14316.html
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Connection
between Iron Levels and Diabetes in
Women -
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=14871914&dopt=Abstract
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Omega
3 and Depression in Diabetics -
http://www.onderzoekinformatie.nl/en/oi/nod/onderzoek/OND1284172/
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Your
Body's Many Cries for Water -
F.
Batmanghelidj - http://www.fetchbook.info/search_Batmanghelidj_/searchBy_Author.html
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Related
articles you may find interesting:
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