Many chiropractors are searching for ways to ethically increase their patient loads and make clinical practice more rewarding professionally and financially. Have you ever considered specializing in health care—preventing chronic degenerative conditions like diabetes before they can be recognized and measured quantitatively by medicine?
“Sick care” is practiced by recognizing and characterizing disease conditions (diagnosis). Once the diagnosis is pronounced, treatment is dictated by prevailing therapeutic procedures. However, until the disease process can be measured through lab work, there can be no acceptable procedures; hence, the guesswork of prescribing drugs for symptoms, with haphazard results.
Health care, on the other hand, is practiced by maintaining normal body functions. Deviations from normal are caused by only one factor: stress. Hans Selye, MD, was nominated for the Pulitzer Prize for Medicine in 1964 for his research on the effect of stress on the human body. His research found that the accumulative effects of stress are predictable. Selye said in his book, The Stress of Life, that as a medical student he was struck by the fact that most disease conditions presented similar symptoms before the disease process could actually be identified. Fatigue, elevated temperature, swelling, redness, and pain were the most common. This led him on a lifelong study to determine why.
Selye found that there are essentially only three kinds of stress: mechanical, emotional, and chemical (or nutritional). Identify the stress and remove it, and your patients who are not yet diseased will get well. You may also have to provide proper nourishment for affected tissues to heal. As a chiropractor, you are already an expert at identifying mechanical stress. Emotional stress is beyond my expertise. That leaves nutritional stress and the subject of this article—diabetes.
The term “diabesity” (diabetes + obesity) is increasingly being used to label the patients with Type II diabetes who are overweight. Here are the current statistics according to the Centers for Disease Control and Prevention:
- 17 million Americans have diabetes.
- 90% of diabetics have Type II (diet-related) diabetes.
- 60% of adults with Type II diabetes are overweight.
- 97% of youths diagnosed with Type II diabetes are overweight.
Diabetes is the leading cause of adult blindness, kidney failure, non-traumatic amputations, heart disease, and stroke. The goal, of course, is to prevent the onset of diabetes. The way to do that is to recognize the possibility that your patient has an Impaired Glucose Tolerance (IGT). Medical practitioners have long referred to these patients as “borderline diabetics” meaning the patient has a blood glucose level that is higher than normal, but not high enough to be classified as diabetes. These are the patients with whom you can best practice health care, thus preventing disease. It is estimated that 20 million people in the United States have IGT, and that the number is rising rapidly. It is further estimated that 50% of these people will develop Type II diabetes. That means there are more than a few patients in your practice and in your neighborhood who could use your help.
Health and Human Services Secretary Tommy Thompson and American Diabetes Association President Christopher Saudek, MD, are asking doctors to begin screening overweight patients age 45 and older for pre-diabetes. They state that patients with the following risk factors may develop IGT:
- Family history of diabetes
- Being overweight
- Women who have gestational diabetes or have given birth to a baby weighing more than nine pounds
- People with steroid-induced hyperglycemia
- Those with high blood pressure
- Those with an abnormal lipid blood profile (low HDL cholesterol and high triglyceride levels)
- Those with any of the above and a genetic predilection are particularly at risk. This includes African Americans, American Indians, Hispanic/Latino Americans, Asian Americans, and Pacific Islanders.
Medical experts are recommending that IGT screening should include glucose monitoring and fasting lipid profiles for those at high risk, as indicated by their past health histories. It is interesting to note they are not recommending prescription drugs for the condition. That puts you, as a chiropractor, in the picture for specializing in health care to increase professional and financial success.
Recognizing those patients at risk for specific future problems allows you to both teach the patient how to maintain their health and monitor their progress. The experience is thus rewarding for you and the patient. Preventing chronic degenerative conditions before they can be measured quantitatively does wonders for building referrals.
The Surgeon General of the United States has pointed out that many chronic degenerative diseases have their beginning with poor diet and digestion. Yet, it is difficult to find agreement among so-called experts as to what constitutes a healthy diet. Many doctors do not take the time to inquire into their patients’ dietary habits, primarily because of the lack of objective clinical findings that suggest a problem exists.
The easiest and most definitive screening procedure for problems in this area is identifying persistent or recurring loss of a normal thoracic kyphosis. Generally, it is a transitory condition related to muscle contraction and not osseous abnormality. It is most commonly caused by muscle contractions associated with viscero-somatic reflexes from those organs that receive their spinal innervations from T4 to T9. The list includes the heart, lungs, bronchi, stomach, pancreas, spleen, liver, gallbladder, and adrenal glands.
When loss of the normal thoracic kyphosis (so-called “anterior dorsals”) is found, palpate for postprandial muscle contractions under the right and left anterior costal arches and in the epigastric area. Palpatory muscle contraction (trigger points) and soreness will always help delineate the stressed digestive organ. Inquiry into the patient’s last meal will be quite instructive. These findings are often, but not necessarily, associated with chronic headache patterns.
When no digestive stress is present (the presence of symptoms is irrelevant) and blood glucose levels are normal, muscle contractions under the costal arches and in the mid-thoracic spine will not be found. Henri Gillet, DC, found that 3-to-10 cups of coffee will produce them!1 Consider the correlation between this and the following two studies.
A study released by the Harvard School of Public Health in 2002 found that men who eat processed meats (such as bacon and sausage) are 46% more likely to develop Type II diabetes than men who eat less of these foods. Over 40,000 healthy men between the ages of 40 and 75 were studied. The results were dose-related; that is, the highest incidence was among those men who ate processed meat five or more times per week.2
Also, a study of the effects of caffeine on blood sugar levels was completed in 2002.3 It is known that caffeine can enter the brain and directly increase blood pressure and stimulate the release of stress hormones (cortisol). These hormones are known to affect insulin and, therefore, blood sugar levels. Insulin sensitivity was measured in selected healthy individuals after administration of caffeine or placebo. The caffeine administered was the equivalent of three cups of coffee. The study showed that caffeine increased both blood pressure and stress hormone levels. It decreased the effectiveness of insulin by 15%.
Poor diet, inadequate digestion, stress, and caffeine all play a role in the development of Type II diabetes, which is now reaching epidemic proportions. Pharmaceutical companies will continue to develop drugs for its treatment, but the best approach is drug-free prevention, according to Daniel Einhorn, MD, director of the Scripps Whittier Diabetes Institute. He states that loss of 5-to-7% of body weight within one year coupled with walking or bicycling 150 minutes a week (thirty minutes per day) is the best therapy known. But, he says that most people will need the guidance of a health care professional to achieve those results.4 Why shouldn’t that health professional be you? TAC
Howard F. Loomis, Jr., DC, president of Enzyme Formulations, Inc., has an extensive background in enzymes and enzyme formulations. As president of 21st Century Nutrition, Inc., for fifteen years, he has forged a remarkable career as an educator, having conducted over 400 seminars to date in the United States, Canada, Germany, and Australia, on the diagnosis and treatment of enzyme deficiency syndromes. Call 21st Century Nutrition at 1-800-662-2630 for more information.