Nitric Oxide and Diabetes!

DiabetesDiabetes has become a national health problem.  Fortunately, there are clinical studies to show that nitric oxide can positively affect the complications of diabetes.  This blog will help you understand the hard facts, complications, and the potential of a proper nitric oxide / l-arginine protocol to help with this devastating disease. 

Now before we start you might be wondering why an endocrine disease is showing up on a web site focused on cardiovascular health.  The answer is that diabetes directly affects the vascular system giving rise to most of the complications.  One noted clinical expert in this area, Dr. J. Joseph Prendergast says,

“Many people still think diabetes is a disease about sugar.  It’s not the sugar!  It’s the complications!”

Dr. Prendergast is not discounting the need to control your blood sugar.  That’s extremely important.  What he’s trying to get people to understand is that unregulated glucose (blood sugar) causes high levels of oxidative stress which damages the endothelial cells and their ability to properly produce nitric oxide – the master signaling molecule for your cardiovascular system.  To prevent the complications you also need to repair the damage to the endothelium.         

The Hard Facts!

Diabetes is a disease in which the body does not produce insulin (Type 1) or does not properly respond to insulin (Type 2).  According to the most recent statistics from the Diabetes Association of Greater Cleveland (updated in February of 2009)17.9 million American have been diagnosed with diabetes.

What makes this “America’s largest healthcare epidemic” is that 57 million Americans are in a pre-diabetic condition where their blood glucose levels are higher than normal but not high enough to be diagnosed with type 2 diabetes. 

Almost 25% of the American population is either in a pre-diabetic or diabetic condition and this is creating an enormous health challenge. 

Type 2 diabetes in adolescents has increased 10 times over the last decade and now represents 33% of new pediatric diabetes cases where as 20 years ago it was only 2%.  This diabetic problem is even worse for African Americans since they are 1.8 times as likely to develop diabetes as whites.  And, the death rates for African Americans with diabetes are 27 percent higher than for whites.  It is estimated that the annual health care costs of a type 2 diabetic is 2.3 times greater than a person without this disease.

Complications of Diabetes!

If you have diabetes or if you have a family member or friend who has diabetes than you already know how challenging this disease can be.  According to the Diabetes Association of Greater Cleveland:

  • Diabetes is a leading cause of adult blindness, lower-limb amputation, kidney disease and nerve damage.
  • 40% of diabetics suffer some degree of hearing impairment.
  • 66% of diabetics die from a heart attack or stroke.
  • 28% of diabetics develop kidney disease
  • 23% of diabetics have foot problems including numbness and amputations.

To put these numbers in perspective, every 24 hours 4,100 new cases of diabetes are diagnosed, 810 people will die, 230 will have a diabetes-related amputation, 120 new patients will require kidney dialysis or transplant, 55 will go blind, and nearly 65% of diabetics will die from cardiovascular disease.

How Nitric Oxide Helps!

Although there is no evidence to date that shows that Nitric Oxide (NO) improves insulin availability, there is plenty of evidence that NO can intervene to help prevent diabetic complications.  A family of enzymes called Nitric Oxide Synthase (NOS) generates NO from the essential amino acid L-arginine.  NO is the master signaling molecule for the cardiovascular system, is an important neurotransmitter, helps to mediate pain, and is necessary in wound healing and tissue repair.

Unfortunately, NO production is often impaired in both Type I and Type II diabetics.  Current research seems to indicate three limiting factors:

Limiting Factor 1 is an accumulation of asymmetrical dimethly arginine or ADMA in the blood.  Under normal metabolism of L-arginine a small amount of a natural inhibitor to the NOS enzymes is formed called ADMA.  Normally, ADMA doesn’t accumulate because it is eliminated in the urine through normal kidney functions.  However, reduced kidney function is part of aging and both Type I and Type II diabetes accelerates this kidney dysfunction.  This allows ADMA to accumulate in the blood stream and inhibit the NOS enzymes to reduce NO production.

Limiting Factor 2 is a change in pH from alkaline to acidic.  The NOS enzymes are pH dependent and work best in slightly alkaline (basic) conditions.  In diabetes, glycolysis and ketoacidosis are negative factors that force tissue pH towards acidic conditions.  To compensate the body will use calcium to restore its proper alkaline pH.  Calcium is needed to activate the NOS enzymes.  Thus, this acidic change causes the NOS enzymes to become less active and efficient resulting in a decrease in NO production.

Limiting Factor 3 is adequate supplies of oxygen necessary for the NOS enzymes and NO production.  Since diabetics typically have impaired circulation this reduces blood flow and the body’s ability to supply oxygen to the endothelial cells particularly in the extremities.  Additionally, diabetics often experience elevated blood glucose levels.  This extra glucose becomes attached to the hemoglobin to change its structure and to bind NO instead of oxygen.  Once NO is bound to the hemoglobin it is not easily released which compounds the problem.

Diabetes creates a compounding effect which leads to a multitude of complications.  As this disease causes biochemical changes in the blood stream, kidneys and surrounding tissues thru low oxygen, acidosis, and the accumulation of ADMA it reduces the production of NO.  The reduction in NO reduces wound healing and tissue repair (especially affecting the endothelial cells).  This reduction also limits normal vasodilation which affects the cardiovascular system.  This continues to impair the production of NO which negatively affects neurotransmission and pain.  Thus, many of the complications of diabetes such as heart disease and high blood pressure, retinopathy (eye problems), neuropathy (nerve damage), kidney disease, bruises to the hands, feet and legs, and poor circulation to the extremities (which often lead to amputation) are all aggravated by low NO production.

Two Fold Approach to Improved Diabetic Health!

Most people who deal with diabetes only deal with blood sugar levels.  There is no question that this approach is absolutely necessary.  Unfortunately, the oxidative damage done to the endothelial cells is not addressed.  Yet addressing this problem is critical to reducing the risk for diabetic complications.  Again, I refer back to Dr. J. Joseph Prendergast and his comment at the beginning of this post:

“Many people still think diabetes is a disease about sugar.  It’s not the sugar!  It’s the complications!”    

Dr. Prendergast has 35+ years of experience as a prominent Endocrinologist in Palo Alto California with an extremely large patient base of diabetics.  His clinical studies have shown that if you implement a proper Nitric Oxide / L-arginine protocol you can effectively reduce and/or eliminate much of the oxidative stress to the endothelial cells.  This results in good NO production to eliminate or reduce many diabetic complications.  For example, of the 7,000 patients who have followed his Nitric Oxide / L-arginine protocol none have had serious hospitalizations, no amputations, and less than 1% has had cardiovascular issues.

Monitoring blood sugar levels will always be important for proper diabetic care.  Equally important is properly nourishing your endothelial cells through diet (please read my article about the Acid – Alkaline Balance), exercise, and taking sufficient amounts of L-arginine.  Each of these three lifestyle factors will go a long way to helping your endothelial cells stay healthy and produce the necessary Nitric Oxide to prevent the complications of diabetes.     

Together we can work to save a million lives!

Dan Hammer

The information contained in this blog is for general information purposes only and never as a substitute for professional medical advice or medical exam.  The information contain in this blogging website has not been evaluated by the Food and Drug Administration and should not be used to diagnose, treat, cure or prevent any disease without the supervision of a qualified medical doctor.