Defeat Diabetes with Evidence-Based Mind-Body Medicine -- by Samuel Chua and Wong Mei Yin

Diabetes is a common chronic disease in affluent countries, including Singapore. In 1995, an estimated 135 million people worldwide had diabetes. The World Health Organisation (WHO) estimates that by the year 2025, the number of people with diabetes will reach 300 million worldwide. In Singapore, about 9% of the adult population has diabetes and 90% of them are over 40 years old. Nonetheless, it is important to note that diabetes does not happen only to middle aged people ?it can affect people of any age or race.

Diabetes strikes when the body does not produce or use insulin adequately. This then results in too much glucose (sugar) in the blood. Glucose comes from food we consume. The human body needs sugar to produce energy. The amount of this in our blood is closely regulated by insulin.

Insulin is produced by our pancreas. This is a gland found below the stomach. When the pancreas does not produce enough insulin or insulin produced does not work well, sugar gets built up in the blood, which leads to diabetes. Over time, high sugar levels in the blood could give rise to problems including infections, blindness, kidney disorders, fatigue and drowsiness, rapid weight loss, stroke, heart disease, and foot and leg disorders. In severe cases, it could even result in the amputation of limbs.

Diabetes is commonly known as either pancreatic (beta cell) failure (Type 1 Diabetes) or insulin resistance (Type 2 Diabetes). People with Type 1 Diabetes cannot regulate their blood sugar properly because the pancreas produces insufficient amounts of or no insulin. The body’s immune system mistakenly destroys the insulin-producing cells in the pancreas. People with Type 1 Diabetes need insulin injections to help manage blood sugar levels. Type 1 Diabetes is more prevalent among younger people, although this also occurs in older adults.

People with Type 2 Diabetes can still produce insulin, either not enough or adequate amounts. However, the body cannot use the insulin effectively. Type 2 Diabetes is the more common type of diabetes. Through diet management, regular exercise and well-regulated medication, Type 2 Diabetes could be brought under control. If all these fail, people with Type 2 Diabetes could require insulin injections. Research studies have shown that Type 2 Diabetes among high risk adults, can be prevented with changes in lifestyle and health behaviour changes.

There is no cure available for diabetes. Once diagnosed with diabetes, one needs to avoid problems which arises from prolonged hyperglycemia (elevated blood glucose levels) or repeated episodes of hypoglycemia (low blood glucose levels).

People with diabetes can nevertheless still live healthy lives through regular and disciplined monitoring of their blood glucose, diet management, regular exercise and medical treatment adherence. The challenges faced by many people with diabetes rest with the difficulty of motivating themselves to ensure proper self-care behaviours, e.g., the daily routine of blood glucose monitoring, planning balanced diets. As diabetes is often perceived of as a burden, it can contribute to psychological, emotional distresses and interpersonal conflicts. To start with, acceptance of the disease itself could leave one feeling depressed, anxious, angry, frustrated and lost. This is especially so when symptoms could be unpredictable, making the disease management process even more challenging and frustrating.

Research evidence suggests that stress further complicates the management of diabetes. Stress has been found to elevate blood glucose levels. However, there is no ‘magical pill?for eliminating stress. When our body is in distress (‘stress response?, there is an increase in our heartbeat rate, level of stress hormones, breathing rate, blood pressure and blood glucose levels. Excessive stress-induced levels of adrenaline could also damage the blood vessels and compromise the functioning of our immune system.

One could however, learn techniques to prevent and reduce the impact of stress on their mind and body. At Harvard Medical School, University of Massachussetts, Dr Herbert Benson has demonstrated the positive results of reducing blood glucose in people with diabetes when traditional treatment plans are implemented with evidence-based mind-body medicine (MBM) techniques.

Mind-body medicine techniques include relaxation skills such as mindfulness meditation, guided imagery, autogenic training(self-hypnosis), biofeedback, yoga, exercises and even diet management. Essentially, these techniques benefit your body by triggering the ‘relaxation response? This is manifested physiologically by e.g., the slowing down of the heart rate, blood pressure and breathing rate which in turn facilitate an increase of oxygen uptake. Through mindful control of steps we can apply to achieve the deep state of the relaxation response, MBM techniques can help to keep stress hormones in check, thus affecting the glucose levels in our blood. When our mind is in a relaxed state, the body metabolizes carbohydrate more efficiently, thereby influencing the blood glucose levels.

It is important to note that MBM should be used only as an adjunctive form of treatment to enhance the medical treatment plan for diabetes. MBM must not be used to replace conventional medical treatment. Adherence to medication as prescribed by health care professional is critical. Like any other self-care procedure, persistence with regular application is fundamentally necessary to reap optimal benefits. This involves change in one’s perception of their lifestyle habits, their decision about what health benefits they seek, how to manage what is within their control and perseverance in their application of steps for health behaviour changes.

If you are interested to make an appointment to learn how to apply MBM techniques in complement with the medical treatment you are already receiving, you can contact counsellors at Shan You Counselling Centre for an appointment, at Tel: 6741 9293.

References

Payne, C.(2001) Interview with an expert in complementary therapy. James Gordon, MD. Diabetes Spectrum, 14,4, 210-212.

Rice, B, I.(2001) Mind body interventions. Diabetes Spectrum, 14,4, 213-217.