THURSDAY June 12, 2008 (foodconsumer.org) -- Three recent studies suggest that getting blood sugar to the normal level (6%) with medications did not reduce risk of death from cardiovascular disease in type 2 diabetes patients and some experts say controlling blood pressure and cholesterol might be more important than controlling glucose levels in the blood.

One study known as ACCORD conducted by U.S. researchers actually found that lowering glucose levels, measured as glycated hemoglobin, actually increased mortality rates among diabetes.

Another study called ADVANCE led by researchers from the George Institute for International Health in Australia showed lowering glucose levels did not reduce risk of death from cardiovascular events such as heart attack and stroke.   But it significantly reduced the risk of kidney disease and helped protected the eyes and nerve system.

The third study the VA Diabetes Trial performed by U.S. government researchers showed lowering blood glucose levels did not reduce the risk of death from cardiovascular events either.

These studies did not actually reveal what is really behind the increased risk of cardiovascular death. Some suggested lowering glucose to normal put the diabetics at risk of hypoglycemia and increased their death risk.

But there was no reporting of what role the diabetes drugs might play in the elevated death risk. Early studies showed the diabetes drug Avandia or rosiglitazone may dramatically increase risk of heart attack and heart failure in diabetes patients.   These current studies did not consider the dietary habits of the study subjects either.   Diet is important to diabetics.

High glucose levels in diabetes are associated with a number of serious conditions including heart disease, kidney disease, amputations and blindness.   Although it remain unknown how glucose levels affect the risk of heart risk, management of blood sugar is necessary.

We compiled the following nutrition basics for diabetes patients as well as those who want to prevent or treat diabetes just in case some of them might be interested.  

Nutrition basics for diabetics  

Biotin: Biotin is involved in glucose metabolism and deficiency of it results in ill-utilization of glucose.     Lower levels of biotin were found in insulin dependent diabetics than non-diabetic people. Supplementation of biotin reduced blood glucose levels in insulin-dependent diabetics.     Active yeast, wheat bran, cooked liver, cooked egg, avocado and raw cauliflower are rich in biotin.

Bitter melon:     Bitter melon or otherwise known as bitter gourd is rich in a variety of nutrients including calcium, potassium, vitamin C, B1 to 3, phosphorus and dietary fiber.     In Asia, bitter melon is widely used to treat diabetes.     Studies found the fresh juice of the unripe bitter melon can lower blood sugars.  

Chromium supplements:     Studies showed this supplement improved glucose utilization in people with impaired glucose tolerance, which is associated with elevated risk of heart disease, but not other complications that commonly occur with diabetes.     Broccoli, spices, green beans, ready to eat bran cereals, whole grams and processed meats are relatively rich in this element.  

Coffee:     The majority of early studies suggested that higher intake of coffee may significantly reduce risk of type 2 diabetes mellitus. In one study, men who drank six cups or more of coffee daily had their risk reduced by 54 percent. The risk reduction for women who drank this much of coffee was 29 percent compared to women who did not drink.  

Foods with low glycemic load:     Diabetes people should use low glycemic index foods.     Foods with a high glycemic index generate glucose rapidly, which would demand the system to produce high levels of insulin and cause loss of the insulin-secreting function of the pancreatic beta-cells.     One study showed women with the highest dietary glycemic loads were 37 percent more likely to develop type diabetes 2 during a six-year period.  

Foods with trans fat and saturated fat:     Studies showed that both saturated fat and tarns fat are implicated in diabetes mellitus.     These fats can affect the pancreatic beta-cells.     Diabetics should try hard enough to avoid as much of these fats as possible.     Particularly trans fat, which is known to be implicated in heart disease and possibly kill tens of thousands each year in the United States.  

Dietary fiber:     Using foods that lack fiber has been linked with increased prevalence of diabetes mellitus.     Prospective cohort studies showed diets with lots of fiber from whole grains were linked with reduced risk of developing type 2 diabetes mellitus.     Trials showed increased intake of fiber lowered the risk of developing type diabetes with impaired glucose tolerance.  

Fruits and vegetables:     A diet rich in fruits and vegetables which provide tons of beneficial nutrients was linked with reduced risk of developing diabetes and improved blood glucose control.     One study showed those who consumed at least five servings of fruits and vegetables per day during a period of 20 years had their risk of diabetes reduced by 20 percent.  

Beans:     Beans or also known as legumes including dry beans, peas and lentils are with low glycemic indices, which are friendlier to the pancreas than foods with high glycemic indices. Use of more beans means use of less foods with a high glycemic index, which would otherwise cause excessive blood glucose burden and excessive demand for insulin secretion.     Low glycemic load diets have been linked with reduced risk of developing type 2 diabetes.  

Magnesium:     Many diabetics lose magnesium through urine because of poor control of diabetes and glucose levels.     Magnesium supplements at 400 mg per day were found effective in improving glucose tolerance in the elderly.     Magnesium was found to increase insulin resistance.  

Alcohol:     Moderately drinking alcohol was found associated with lower risk of developing type 2 diabetes compared to those who did not drink while heavy drinking increased the risk.     Moderate drinking of alcohol was also linked with decreased blood insulin levels and improved insulin sensitivity.     But because alcohol is implicated in many adverse conditions or illnesses, those who do not drink should not start drinking.  

Nuts:     Nuts are full of oil and proteins and have relatively lower levels of sugars and starch.     So nuts are generally friendly to diabetics.     One study known as the Nurses' health Study showed an inverse correlation between consumption of peanut butter and the risk of type 2 diabetes in women.     The study found those ate one ounce of nuts five times or more per week during the 16-year study were 27 percent less likely to develop type two diabetes mellitus.     But those who are allergic to nuts should not even try eating any.  

Fish oil:     Fish oil is well known for its beneficial omega 3 fatty acids.     At least one study suggested that eating fatty fish or taking fish oil supplements may reduce risk of death from heart disease, which is the major cause of death for diabetics.     The study found that those who ate high amounts of fish were significantly less likely to suffer from coronary heart disease over the 16-year study period.     Omega fatty acids such as DHA and EPA which are present abundantly in fish oil provide many other health benefits.  

Whole grains:     A few studies showed high intakes of whole grains were associated with reduced risk of type 2 diabetes mellitus.     One study found those who ate 3 daily servings of whole grain foods were 21 to 30 percent less likely to have type 2 diabetes.     The benefit may be due to the fact that the whole grain foods have low glycemic indices.  

Diabetics need to know not only what they can eat, but also need to know what they should avoid.     Foods that have lots of sugars or that can release glucose rapidly should be avoided.    Diabetics should also reduce their dietary fat and meat to preferably around 10 percent.    In the U.S., the average intakes of fat and meat are 30 percent of total calories and 16 percent of total calories, respectively.

At least one study led by Frank B. Hu. M.D. at Harvard School of Public Health in Boston and colleagues found that high dietary fat and meat intake may increase risk of type 2 diabetes in men.    Their results were published in Diabetes Care 25:417-424, 2002.