Questions for Dr. Shawn - Diabetes, Supplements
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"Dear Dr. Shawn:
”My dog has developed diabetes. Her doctor has said that she needs insulin injections twice daily. Do you have any other advice that might help her?"
Diabetes mellitus is a common pancreatic disorder of cats and dogs. Diabetes is classified at type 1 or type 2. Type 1 diabetes is also called insulin dependent diabetes. In this disorder, there is destruction of the beta cells (insulin-producing cells) of the pancreas. Treatment involves replacing insulin through insulin injections given 1-2 times per day.
Type 2 diabetes is also called non-insulin dependent diabetes, as insulin is usually not required for treating pets with this disorder. Insulin resistance and dysfunctional beta cells, rather than permanent destruction of beta cells, are seen in pets with type 2 diabetes.
Type 1 diabetes is the most common type. Most (if not all) dogs have type 1 diabetes; approximately 50-70% of cats have type1 diabetes, with the remainder having type 2 diabetes.
Causes of type 1 diabetes include immune mediated destruction of the beta cells of the pancreas in dogs and amyloidosis (deposition of amyloid protein in the pancreas) in cats. Other causes of diabetes in dogs and cats include obesity (probably the most common cause of type 2 diabetes in cats,) genetics, infection, pancreatitis, and administration of certain medications (corticosteroids, progesterone compounds.)
Treating diabetes involves conventional and complementary therapies. Conventional therapy for pets with type 1 diabetes is with the injectable drug insulin, which works to lower blood sugar. Oral hypoglycemic agents (which lower blood sugar) can be used but are not routinely prescribed for most diabetic pets. In cats with type 1 or type 2 diabetes, dietary therapy (usually a high protein, high fat, low carbohydrate diet designed to minimize fluctuations in blood glucose) and exercise (when possible) may be effective in lowering blood sugar and controlling clinical signs. Dogs with type 1 or type 2 diabetes also benefit from diet (usually a higher fiber diet containing increased amounts of soluble and insoluble fiber designed to reduce obesity and minimize fluctuations in blood glucose) and exercise (when possible.)
Several supplements may be beneficial in dogs and cats with diabetes. They include gymnema, chromium, vanadium, and glandular extracts.
The herb gymnema may help improve blood sugar control. It can increase insulin secretion and also enhance insulin’s effectiveness. As is true with many complementary therapies, gymnema is most likely to be helpful in cases of non-insulin dependent diabetes (type 2) or in very mild cases of insulin-dependent diabetes when insulin injections are not yet required (type 1.) However, it is also used as a supportive treatment in those cases requiring insulin.
Chromium is a trace mineral in the body and is necessary for pancreatic beta cell sensitivity (beta cells make insulin,) insulin binding, insulin receptor enzymes and insulin receptor sites. Supplemental chromium tended to balance glucose metabolism, by improving C-peptide levels, leading to enhanced pancreatic beta cell function.
Vanadium is also a mineral. It has insulin-like properties and may inhibit protein tyrosine phosphatase (PTP.) With insulin-resistant type II diabetics vanadium may help balance glucose levels by increasing glycogen synthesis (glycogen is a storage form of glucose.)
Glandular therapy is also used in the treatment of diabetes. This therapy uses whole animal tissues or extracts of the pancreas. Glandular supplements contain active substances that can exert physiologic effects. Glandular supplements, when taken into the pet’s body, accumulate in their target tissues. The accumulation is more rapid by traumatized body organs or glands than healthy tissues, which may indicate an increased requirement for those ingredients contained in the glandular supplements.
In addition to targeting specific damaged organs and glands, supplementation with glandular supplements may also provide specific nutrients to the pet. For example, glands contain hormones in addition to a number of other chemical constituents. These low doses of crude hormones are suitable for any pet needing hormone replacement, but especially for those pets with mild disease or those that simply need gentle organ support.
Glandular supplements also function as a source of enzymes that may encourage the pet to produce hormones or help the pet maintain health or fight disease.
Finally, glandular supplements are sources of active lipids and steroids that may be of benefit to pets.
As you can see, diabetes can be a complicated disease requiring a variety of therapies. For some pets with diabetes, a combination of insulin or an oral medication to control diabetes may need to be combined with complementary therapies, diet, and exercise. For other pets, it may be possible to reduce or eliminate the need for conventional medications.
"Dear Dr. Shawn:
"My cat is diabetic and very dependent on his two insulin shots a day. Is there any way I could get him down to one shot a day using diet, exercise or natural remedies?"
"Diabetes in cats can be insulin-dependent (insulin is needed) or non-insulin-dependent (insulin is not needed.) About half of all cats with diabetes will need insulin (or oral hypoglycemic medications) and the other half have the milder form that can be controlled with diet and exercise. Since your cat requires insulin at this time, your cat may need insulin his entire life.
Having said that, there are some things you can try to decrease the need for insulin therapy. Supplements including chromium and vanadium show promise. Various herbal remedies have been shown to lower blood glucose levels. I would not start these on your own without veterinary supervision as we don't want to excessively lower his blood sugar quickly as this can be fatal. Exercise is important as it promotes insulin being moved from the bloodstream into muscle tissue. While getting cats to exercise is not easy, it can be done. Some of my clients can put a harness on the cat and take the cat for walks. You can also throw cat toys for the cat to chase, or get a fishing pole with a toy attached and get your cat to chase this. My cat loves to chase things and I love to chase her around the house, so she gets a lot of exercise.
Finally, proper diet is important for all pets, not just those with diabetes. For dogs, increased fiber in the diet binds glucose in the intestines which can decrease the need for insulin. While this can be useful for cats, especially those that are overweight, the current recommendation is to feed cats a diet for normal adult cats high in protein. Homemade diets are best as you can control the quality and quantity of ingredients; you can find a good one in The Natural Health Bible for Dogs & Cats. There is speculation among holistic veterinarians that many commercial cat foods, which are high in carbohydrates, might predispose cats to develop diabetes later in life. Work with your doctor to find the best diet for your cat."
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