You’ve probably heard some of these phrases used to describe the shortcomings of the modern medicine paradigm: “A pill for every ill;” “name it, blame it, treat it, street it;” and “it treats the disease, not the patient with the disease.” Clearly, the conventional approach is missing something both patients and providers desire.
Many of us in the integrative or functional health care fields enjoy unique benefits related to an expanded way of interacting with patients, primarily through a systems biology approach. We have the privilege and skills to simultaneously promote overall health while treating the suffering related to a disease. If there is a disease process that best demonstrates the differences between the conventional and integrative approach, it must be type 2 diabetes and its various comorbidities and complications.
Blood Sugar, Insulin and Cardiometabolic Disease
The typical health trajectory for the standard Western patient usually looks like this: poor diet and lifestyle signals from an early age, including prenatally, plus an increasing environmental toxin body burden that goes unchecked for at least the first few decades. This ominous disease-promoting past bathes the patient’s unique genetic code in an unhealthy epigenome, ultimately resulting in the diagnosis of one or more names in a massive extended family of cardiometabolic disease.
Whether it’s type 2 diabetes, obesity, prediabetes, metabolic syndrome, insulin resistance, polycystic ovary syndrome, non-alcoholic fatty liver disease, hypertriglyceridemia, low HDL, hyperlipoproteinemia, metabolic dyslipidemia, sarcopenia, Alzheimer’s disease, dementia, osteoporosis… You get the point. Unhealthy blood sugar and insulin levels are intermediate conditions between poor lifestyle, toxic burden and the resultant diseases.
The Integrative Approach to Cardiometabolic Disease
Using Supplements to Support Lifestyle Medicine
Luckily, these conditions can be addressed and possibly reversed once they’re identified, but a solid lifestyle medicine approach is first and foremost. Address diet, movement, sleep and stress management signals slowly but surely. Without these healthy epigenetic signals from daily life choices, we would simply be creating another incomplete approach that might be labeled “a green pill for every ill.”
Admittedly, most patients don’t flip their lifestyles from tragic to transformative overnight. That’s why it makes great sense to use nutraceuticals that can help change signals in the interim. They can support disease treatment in the short term while promoting long-term healthy physiology.
Metabolic Dysfunction and Cardiovascular Disease
The functional, integrative approach to “cardiovascular disease” necessarily incorporates metabolic dysfunction. It recognizes the need to expand beyond lipids, blood pressure and smoking to include the following:
- Visceral adiposity
Further, we utilize strategies that address cortisol and stress, the gut microbiome, detoxification, and elimination for a well-rounded systems biology approach to cardiometabolic disease.
This all sounds lovely and good, but let’s be honest: A therapeutic care plan that involves optimizing behavior related to multiple unhealthy lifestyle patterns plus all the items just listed starts to feel overwhelming for both provider and patient. Fortunately, the body’s systems overlap, and the therapies we have found to be effective overlap as well.
Regarding blood sugar and insulin, there are some reliable and well-studied nutrients to keep in mind. When used in complementary combinations, patients benefit from a powerful therapeutic tool: synergy.
Interestingly, conventional medicine has only recently begun promoting a multi-faceted approach to treating cardiovascular risk factors. For example, it’s now advised to use several anti-hypertensive medications at low or moderate doses versus the age-old practice of maximizing one prescription before moving on to the second and third.
This is a major shift in the modern paradigm. Whole systems-based medical providers have been employing this strategy for centuries, and it inherently avoids the mistake of dividing the body into separate parts or isolated diseases.
Cardiometabolic Supplement Blends
In practice, I’ve always found that cardiometabolic nutrient blends are beneficial from a biochemical, digestive and mental health perspective. You can leverage synergy through nutrients that complement each other physiologically, reduce capsule fatigue on both the gut and mind, and improve compliance to achieve the best outcomes for your patients.
Here’s a table featuring some of my favorite evidence-based cardiometabolic nutrients you can use to support your patients’ unique risk factors or biomarkers:
|Alpha lipoic acid||Antioxidant, insulin sensitivity, neuropathy, high blood pressure|
|Berberine||Antimicrobial, insulin sensitivity, lowers A1c in diabetics|
|Chromium||Insulin sensitivity, lowers glucose|
|EPA/DHA||Anti-inflammatory, supports stabilizing rupture-prone plaque|
|N-acetyl cysteine||Antioxidant, detoxification, performed better than metformin in study|
|Niacin||Hypertriglyceridemia, low HDL|
|Vanadyl sulfate||Insulin sensitivity, lowers glucose|
*Insulin resistance increases small, dense LDL
The Bottom Line
I always say that being a functional medicine provider is much like being a chef versus a recipe follower. As we all navigate the wonderful therapeutic partnerships we have with our patients, please remember blood sugar and insulin as part of your total care menu plan. Not only are you addressing the risks against the number one killer of both men and women in Western countries, but you’re also supporting the prevention of many common, interconnected cardiometabolic risks and conditions.
Why treat these diseases individually when a comprehensive blood sugar and insulin support regimen can protect against them foundationally?
Shilpa P. Saxena, MD, IFMCP is a board-certified family physician with an uncompromising commitment to make functional medicine the new healthcare.
Dr. Saxena serves as Chief Medical Officer at Forum Health while maintaining her patient care skills at their Tampa location. As a practicing physician for over 20 years, she loved to share her clinical, financial, operational, and technological
expertise as faculty with the Institute for Functional Medicine, the Andrew Weil Center for Integrative Medicine, George Washington University’s Metabolic Medicine Institute, University of Miami Miller School of Medicine’s Department of
Family Medicine and Community Health, and Universidad San Ignacio de Loyola (Lima, Perú).
Dr. Saxena is a long-standing team member at the Lifestyle Matrix Resource Center team serving as a Practice Growth and Cardiometabolic Medicine Expert. Her classic keep-it-simple and heartwarming style of teaching continues to make her one of the most effective and loved educators in the field.