Functional Medicine Diabetes
Functional Medicine Diabetes
Functional Medicine Diabetes
DM
Dr. dr. Amarullah H. Siregar, FAARM, FAAM, FABC, DIHom, DNMed, MSc, MA, PhD
CCPG
BPPT, 20 September 2014
Double diabetes
Drug induced diabetes
Glucagonoma
a rare form of pancreatic cancer.
Hemochromatosis
iron-storage disease
Secondary diabetes
effect of diabetes
Diabetes Mellitus
impaired insulin secretion
peripheral insulin resistance
hyperglycemia.
- polydipsia,
- polyphagia,
- polyuria.
DM type 1 Juvenile & IDDM
DM type 2 Adult & NIDDM
LADA marker
Glutamic acid decarbox
(GAD-65)
PTP-1B
IA-2 (IA-2)
Islet Cell Autoantibody
(ICAs)
Insulin Autoantibody,
(IAA)
C-peptide
PHENOTYPE MECHANISM
PHYSIOGENESIS PROCESS
Cross-talk
Insulin is secreted from
the -cells of the
pancreas in response
to elevations in plasma
glucose. The hormone
decreases glucose
production from the
liver, and increases
glucose uptake,
utilization and storage
in fat and muscle. The
fat cell is important in
metabolic regulation,
releasing FFAs that
reduce glucose uptake
in muscle, insulin
secretion from the cell, and increase
glucose production
from the liver. The fat
cell can also secrete
'adipokines' such as
leptin, adiponectin and
TNF, which regulate
food intake, energy
expenditure and insulin
sensitivity.
mIRNA
PTP1B
BIOMOLECULAR MECHANISM
microRNAs (miRNAs)
key regulators
of
mRNA
Translational control
mechanisms in
cellular metabolism.
GENOTYPE MECHANISM
Circulation. 2011;123:236-238
Normal condition
- following feeding: insulin produced in -cells
after release : reach target tissues (muscle, liver & adipose)
cause uptake of glucose,
reduce the production of glucose
activate fat production and storage.
MicroRNAs (miRNAs) affect insulin signalling
- miR-124a and miR-34a involved in pancreatic development
effects on: - FOXO2 (forkhead box protein O2),
[Transcriptional activator which triggers apoptosis]
NATUROCEUTICAL
Molecular
Sites of action
TARGET
TARGET
DPP-4 rapidly
degrades incretin
NATUROCEUTICAL
inhibit DPP-4 to
increase active
incretin
NATUROCEUTICAL
DPP-4 (Gliptin): enzyme which destroys the hormone incretin
Incretins help the body produce more insulin
Low blood
Glucose
High blood
Glucose
ALGORYTHM
OF DIABETIC CARE
Glucose
from intestine
Glucagon release
Liver release
Glucose to blood
Insulin release
Hepatic glucose
output
Appetite control
Energy used
Lipotoxicity
Glucose
reabsorption
Uptake
&
Utilization
Glucosidase
Nutrients for Blood Glucose Control: A Review and Clinical Guide. October, 2013
Research discoveries
References
Methode
Result
Cinnamon
DB RCT
T2DM
miRNA
HbA1c
Metabolic
S+
Charantin
in-vitro
Induced
ADMc-1
AMPK
PTP-1B
S+
Journal of Diab
Res (2014),
Article ID 862473
Chromium
in-vitro
Induced
miRNA
HOMA-IR
PTP-1B
S+
J Ethnopharmacol.
2009 Nov 12;126(2):
339-44.
Gymnema
DB RCT
T2DM
C peptide
Cytosolic
HbA1c
S+
J Endocrinol. 1990
Sep;126(3):451-9
Vanadium
RCT
T2DM
Insulin
miRNA
HbA1c
S+
References
Methode
Result
Green coffee
RCT
T2DM
HbA1c
Insulin
S+
J Biosci. 2011
Jun;36(2):383-96
Fenugreek
RCT
T2DM
HbA1c
Insulin
GLUT
S+
J Clin Invest.
Oct 15, 2001;
108(8): 11051107
Galega
in vitro
Induced
AMPK
Glucagon
HMGCoA
S+
T2DM
Insulin
HbA1c
ANA
S+
Eur J Biochem.
2002 Feb;269(4):
1050-9.
T2DM
HOMA-IR
PTP-1B
LAR
S+
Banaba
RCT