Cell Damage and Repair/Healing Phases

One of the most important elements of being able to reverse your diabetes is to repair the cells and tissues that have been damaged by the diabetes.

Cells and tissues are damaged within a diabetic's body via several harmful  biological and biochemical processes, including inflammation, oxidation and glycation.

These cellular processes not onlyfuel Type 2 diabetes, but, they, also, prevent the reversing of Type 2 diabetes.

Glycation (Advanced Glycated End Products)

Diabetes is specifically characterized by damaged or glycated red blood cells that cause damage to your arteries and capillaries as these glycated red blood cells circulate throughout your body.

As these glycated red blood cells circulate and damage your blood vessels, this leads to chronic cellular inflammation and excess oxidation. This, in turn, causes even more damage.

FYI: Here is an example of a glycated red blood cell:

Glycated Red Blood Cell

As you can see from the diagram, a glycated red blood cell has "jagged" edges, which cause damage to the linings of your blood vessels as these red blood cells circulate throughout your body.

In response to this damage, your immune system triggers various white blood cells and other cells to release various enzymes and repair agents to try to repair the damage caused by these glycated red blood cells.

But, the immune system lacks the resources (e.g. vitamins, minerals, other nutrients) to repair the damage, so it becomes overwhelmed and ill-equipped to deal with the scope of this disease.

Because of the high insulin levels and high blood glucose levels, your kidneys try to get rid of the excess glucose via frequent and excessive urination. But, this excessive urination depletes the body of key vitamins (B-Complex, Vitamin C, Vitamin E) and minerals (calcium, potassium, magnesium, chromium), many of which are needed to fight the diabetes.

The loss of these nutrients prevents proper carbohydrate/protein/fat metabolism, electrolyte balance, nerve protection, insulin regulation, muscle relaxation, and antioxidant protection from free radicals.

In addition, the breakdown of homocysteine is inhibited, causing an increase of cell inflammation leading to a buildup of plaque in the artery walls, which become rigid, thicker and more narrow -- a precursor to developing high blood pressure and heart disease.

The glycated red blood cells have glucose attached to the hemoglobin portion of the red blood cell, as indicated by your hemoglobin A1C.

These glycated red blood cells produce advanced glycation endproducts, or AGEs for short.

As depicted in the following diagram, these AGEs bind to your cells and tissues (such as kidneys, liver, retina, lungs) and contribute to age- and diabetes-related chronic inflammatory diseases such as atherosclerosis, asthma, arthritis, myocardial infarction, nephropathy, retinopathy, and neuropathy.

Cells and Tissues Damaged by Diabetes

In order to help your body repair the cell and tissue damage, what is needed by your body is a potent nutritional program that specifically addresses the insulin resistance, inflammation, oxidation, glycation and depletion of vitamins and minerals.

Then, and only then, can the body begin to repair the damage being caused by the diabetes, and allow the body to heal over a period of time.

Unfortunately, many nutritional programs fail to address all of these areas. This is one of the reasons why many diabetics' bodies remain in a diabetic state.

Note: For more information, refer to the Inflammation and Oxidation web page.

Diabetes  Healing and Repair Phases

When you are young, your body is in a constant and continual state of repair and renewal. A good indicator of this is the smoothness and plumpness of your facial skin because of collagen production. Another indicator is how fast your body heals a cut or a bruise.

But as you get older, your body's cell repair and renewal processes begin to slow down, while harmful processes such as oxidation cause your skin to age due to less collagen production.

When your body is fighting a disease such as Type 2 diabetes, it is under constant attack due to oxidation and various other harmful biological processes such as glycation, chronic inflammation and toxicity.

Your body is in a continual state of attempting repair and renewal of the cell damage caused by the diabetes. But, if nothing is done to help the body with the repair and renewal processes, and interrupt the harmful biological processes, then, these processes eventually take their toll after many years.

So, the key is to provide the body with the necessary key resources via super foods and other nutrients that help to support the body's repair and healing processes while stopping or slowing down the damage caused by the harmful biological processes.

There are four (4) major phases involved in healing and repairing a diabetic’s body to prevent, slow down or reverse the damage and the associated complications:

  1. Blood Glucose Lowering Phase includes a decrease in blood glucose and insulin production and an increase in glucose uptake by the cells, enabling the body to better utilize the excess blood sugar. 
  2. Blood Glucose Stabilization Phase reduces insulin resistance and inflammation, leading to a further decrease in blood glucose and insulin production; and, a strengthening of the immune system to fight off infections. In addition to better utilizing glucose, the body's cells are able to metabolize and burn fat., triggering a gradual loss of weight This eventually leads to a reduction in the need for diabetic medications.
  3. Inflammation Stopped Phase reduces the cell damage, enabling the cells to better absorb the key nutrients needed to improve the diabetic’s overall health. Oxidation (free radical damage) and toxin levels are also reduced.
  4. Cell Repair Phase leads to stronger blood vessels, healthier tissues, etc. enabling lower blood pressure, cholesterol, healthy eyes, healthy kidneys, healthy cardiovascular system, etc. 

Note: Although these phases are associated with a diabetic's body, many of the same  principles and ideas can be applied to a non-diabetic's body as well.

Cell Repair and Healing Phases to Reverse Diabetes

Blood Glucose Lowering Phase

Once a Type 2 diabetic starts to eat properly (e.g. the Death to Diabetes Nutritional Program), the blood glucose levels gradually start to come down, usually within 14 to 21 days, sometimes sooner.

This leads to an increase in insulin sensitivity within the cells and a better utilization of insulin by the cells.

Blood Glucose Stabilization Phase

As blood glucose levels continue to lower, glucose uptake into the cells increase, that is, the amount of glucose absorbed into the cells increase causing an increase in the energy within the cells.

This improves the activity of white blood cells, which in turn, strengthens the immune system so that the diabetic is no longer as easily susceptible to infections.

Eventually this leads to a reduction in the amount of insulin being produced by the pancreas; and, also a reduction in insulin resistance, allowing the liver and muscle cells, to store any extra glucose so that it is not converted to fat (triglycerides) in the blood.

Because of the reduction in insulin, the body is able to metabolize fat, leading to a gradual and consistent loss of fat (weight), if you are overweight.

Inflammation Stopped Phase

Following the reduction in insulin and glucose levels, key nutrients are more readily absorbed by the cells enabling the cells to function much better.

In addition, oxidation (free radical damage) and toxin levels are also reduced. More importantly, the cellular inflammation is reduced, preventing the further spread of damaged cells and tissues.

Cell Repair Phase

This, in turn, sets the stage for the body to initiate the cell repair and healing processes so that the body can recover from the damage caused by the diabetes and high blood glucose/insulin levels.

In addition, this leads to the following health improvements:

  • There is an increase in the utilization of vitamins (B-complex, Vitamin C, Vitamin E) and minerals (calcium, potassium, magnesium, chromium), which are no longer being excreted in the urine due to the kidneys trying to get rid of the excess glucose. 
  • These nutrients prevent proper carbohydrate/protein/fat metabolism, electrolyte balance, nerve protection, insulin regulation, muscle relaxation, and antioxidant protection from free radicals and AGEs.
  • There is a decrease in the production of cholesterol by the liver due to the insulin no longer activating the HMG-CoA reductase enzyme.
  • There is a decrease of blood viscosity (thickness) due to the fact that there is no conversion of any extra glucose to fat, decreasing the triglycerides/LDL cholesterol and the formation of blood clots, preventing heart attacks and strokes.
  • There is no longer a buildup of plaque in the artery walls due to a decrease of cellular inflammation because of less homocysteine.
  • There is a decrease of inflammation markers such as homocysteine, C-reactive protein (CRP), fibrinogen, and lipoprotein(a), leading to less sticky and better moving blood.
  • There is a decrease in advanced glycated end products (AGEs), causing less damage to the protein in the cells, preventing the accelerated aging of the cells.
  • There is a decrease in blood pressure due to the lower insulin/glucose levels, thinner blood and relaxed arteries.
  • There is an increase in cellular function, allowing cells to absorb nutrients, produce energy, remove toxins, and repair the body.
  • Also, the lower insulin/glucose levels prevent the triggering of hormonal hunger – so that diabetics don't feel tired and hungry (hormonal hunger). 

All of this leads to the need for less medications, better diabetes management and a significant improvement is the diabetic's overall health. 

How the Right Diet Helps to Repair Your Cells and Reverse Your Diabetes

Most, if not all, diabetes diets focus on lowering your blood sugar by following a low GI diet and/or a low carb/high fat diet. This may work in the short term, but, since, Type 2 diabetes is more than a blood sugar problem, a low GI/low carb diet will not work in the long run! 

Unfortunately, most people have been told and misled that by eating low glycemic index (GI) foods and more fat/protein that it will lower their blood glucose and reverse their diabetes.

Actually, eating low GI foods and more fat/protein will lower your blood glucose, but, only in the short term. Eventually, over a period of time, your blood glucose will start to go back up.

In addition, low GI, low carb and high protein/fat diets don't address the other harmful biological processes and root causes that fuel Type 2 diabetes. These harmful biological processes and root causes  that fuel your diabetes include cellular inflammation, excess oxidation, RBC glycation, toxicity, and unbalanced hormones (stress).

Consequently, you want a diabetes program that addresses more than blood sugar, including these other biological processes -- otherwise, you may have good blood glucose readings, but, you'll still be diabetic; and, eventually, your blood glucose will start to go back up.

Another key aspect of low GI, low carb and high protein/fat diets is that they fail to address cell repair which is critical to being able to reverse your diabetes. You can't reverse your diabetes by simply lowering your blood sugar!

Now, the Death to Diabetes Nutritional Program does address cell repair, which is critical to optimum health and reversing your diabetes. Other programs fail to mention or address cell repair because they don't know how!

So, if you are diabetic and following aLCHF, ketogenic or other similar diet, make sure that you research how these diets address cell repair.

FYI: The DTD Nutritional Program is flexible enough to include aspects of diets such as LCHF and ketogenic, but, only for a short period of time. Why? Because most of these diets are not sustainable for long periods of time, especially if your health goals include cell repair and reversing your diabetes.

How the Death to Diabetes Wellness Program Address Cell Repair

The Death to Diabetes Wellness Program consists of 10 steps and 6 stages that take a diabetic from being diabetic to being non-diabetic.

As depicted in the following diagram, a diabetic goes from being diabetic with high blood glucose levels (Stage 1) to lowering their blood glucose (Stages 2, 3) using drugs to lowering and stabilizing their blood glucose without the need for drugs (Stage 4) to being non-diabetic (Stages 5, 6).

Blood glucose stabilization and cell repair occur during Stages 4, 5 and 6. In addition, other biological processes are also reduced during this time, including cell inflammation, oxidation, toxicity, and RBC glycation.

The 6 Stages of Death to Diabetes

Note: For more details about transforming your body from a diabetic state (Stage 1) to a non-diabetic state (Stage 6), refer to the Reverse Diabetes from Diabetic State to Non-Diabetic State web page.

Cell Repair and Healing (At the Cell Level): The 3 Phases

The human body has the amazing ability to repair and heal damaged parts of the body -- from infections and diseases such as diabetes and its complications. This is due to the amazing healing and repair capabilities and properties of the cells in our bodies.

Cell repair and healing (at the cellular level) of a wound (injury to the skin) is a complex and dynamic process of replacing devitalized and missing cellular structures and tissue layers. Within these broad phases are a complex and coordinated series of events that includes chemotaxis, phagocytosis, neocollagenesis, collagen degradation, and collagen remodeling.

In addition, angiogenesis, epithelization, and the production of new glycosaminoglycans (GAGs) and proteoglycans are vital to the wound healing processes. The culmination of these biological processes results in the replacement of normal skin structures with fibroblastic mediated scar tissue.

As depicted in the diagram below, there are 3 phases to the cell repair and healing process.
1. Inflammation Phase
2. Proliferation Phase
3. Remodeling Phase

For most common wounds, the inflammation phase occurs immediately following the injury and lasts approximately 6 days. The proliferation or fibroblastic phase occurs at the termination of the inflammatory phase and can last up to 4 weeks. The remodeling or scar maturation phase begins at the fourth week and can last for years.

Note: These phases overlap and, in some cases, the first two phases may repeat themselves before the wound is completely healed.

Inflammation Phase

The Inflammation Phase constricts blood vessels and activates coagulation factors, preventing additional blood loss. The coagulation cascade causes the release of neutrophils, which engulf debris and microorganisms, providing the first line of defense against infection.

Also, it causes the release of leukocytes, which attack the bacteria in the wound, and monocytes, which remove dead tissue, blood clots, and bacteria from the site. Protein and clotting factors also permeate the wound.

Note: The inflammation phase can persist due to infection, nutritional deficiencies, or medication use. Also, the inflammation and proliferation phases cycle can repeat if the scab falls off and the wound is not fully healed; or, the healing may stall during either stage and not reach the third stage. This may require an intervention to re-initiate the healing phases.

In the late inflammation phase, monocytes converted in the tissue to macrophages, which digest and kill bacterial pathogens, scavenge tissue debris and destroy remaining neutrophils. Macrophages begin the transition from inflammation to repair by secreting a variety of chemotactic and growth factors that stimulate cell migration, proliferation, and formation of the tissue matrix.

Please Note: If the injury is not healing, the inflammation continues and may become chronic. Over time, if the immune system becomes overtaxed, this can lead to an autoimmune disease or a serious infection.

Proliferation Phase

The Proliferation Phase develops new blood vessels, which promote the growth of granulation tissue and the formation of new epithelial cells (skin cells). Collagen is the major connective tissue protein produced and released by fibroblasts. The connective tissue physically supports the new blood vessels that form and endothelial cells promote growth of new vessels. These new blood vessels are necessary to meet the nutritional needs of the wound healing process.

Chemotactic and growth factors released from platelets and macrophages stimulate the migration and activation of fibroblasts that produce a variety of substances essential to repair, including glycosaminoglycans (mainly hyaluronic acid, chondroitin-4-sulfate, dermatan sulfate, and heparan sulfate) and collagen.

These form an amorphous, gel-like connective tissue matrix necessary for cell migration. During this phase,. new tissue forms a protective covering over the wound; and, the collagen and the granulation tissue grow and cross-link to form a scar.

New capillary growth must accompany the advancing fibroblasts into the damaged area to provide metabolic needs.

Collagen synthesis and cross-linkage is responsible for vascular integrity and strength of new capillary beds. Early in the proliferation phase fibroblast activity is limited to cellular replication and migration.

Later, the growing mass of fibroblast cells begin to synthesize and secrete measurable amounts of collagen. Collagen levels rise continually for approximately three weeks. The amount of collagen secreted during this period determines the tensile strength of the repair area.

Remodeling Phase

The Remodeling Phase overlaps with the Proliferation Phase towards the end of healing. It is the process of remodeling of the collagen fibers laid down in the proliferation phase.

This phase is characterized by the buildup of new collagen and the breakdown of old collagen (remodeling of collagen from Type III to Type I) and, includes a reorganization of new collagen fibers, forming a more organized lattice structure that progressively continues to increase tensile strength. The wound edges are pulled inward by myofibroblasts, and scar tissue becomes softer and flattens out. The remodeling process continues up to two years.

Contraction of the wound is ongoing, resulting in part from the proliferation of the specialized fibroblasts (myofibroblasts), which resemble contractile smooth muscle cells.

Nerve endings are re-growing and tissue is rearranging itself. In short, there is a lot of activity still happening long after your wound has healed on the surface.

Scar tissue continues to strengthen throughout this phase, which can last for up to two years. Over time, the scar will change from red to white and reach its full tensile strength of 60% – 70% of the original tissue.

Note: Essential to all phases of wound healing are adequate blood flow, tissue perfusion, and oxygenation. Adequate blood flow and tissue perfusion help ensure that oxygen and nutrients are delivered to the wound.

The production of collagen, for example, depends upon the availability of oxygen and protein at the wound site.

As collagen develops, other components of the healing process—including white blood cell mobility, granulation tissue formation, and blood vessel development—improve as well.

Cellular activity reduces and the number of blood vessels in the wounded area decrease to complete the final phase.

3 Phases of Cell Repair and Healing for a Wound - Death-to-Diabetes

How Superior Nutrition Helps to Repair and Heal Diabetic's Body

Nutritional support for wound healing can greatly affect the three major phases of the repair and healing process: the inflammatory, proliferative, and remodeling phases.

Poor nutrition can prolong every stage of the wound healing process and cause the development of non-healing wounds. Significant wounds can increase the nutritional demands of the body, which means that a patient will need more nutrients than usual to allow for optimum wound healing.

Proper nutrition is essential for wound healing. This means eating a well-balanced diet including fruits, vegetables, organic whole grains, raw nuts, quality proteins, and healthy fats like monounsaturated and polyunsaturated fats and omega-3 fatty acids.

However, the body has specific nutritional needs for optimal wound healing. These include increased protein, vitamin A, vitamin C and zinc consumption. Incorporating foods high in these nutrients gives your body the tools it needs to repair injuries.

To heal a wound, the body needs to produce new proteins from amino acids. When nutrition is inadequate, the body tries to get these amino acids from the lean body mass (LBM), which is the sum of the body's protein and water content.

Approximately 50 to 60 percent of the LBM is composed of the skeletal muscles. In the presence of significant wounds, such as non-healing wounds, this response can lead to severe muscle wasting. When the loss from the LBM reaches 20 percent, the body will try to conserve the LBM by limiting the amino acids used for wound healing.

At this stage, the process of wound healing slows. Further loss of proteins can also cause the development of new wounds due to skin thinning brought about by the loss of collagen proteins.

Collagen Production and Oxygen Levels

Two of the key biological processes associated with cell repair and healing is Collagen Production and Increased Oxygen Levels.

Collagen Production: Vitamin C helps wounds heal quicker by assisting with production of collagen, a protein that your body uses to make connective tissues, such as skin, tendons and ligaments.

A laboratory study on diabetic mice, published in the August 2012 issue of the "International Journal of Molecular Medicine," found that applying vitamin C directly to an incision decreased healing time and boosted skin strength with higher content of collagen in the healing tissue compared to control mice that did not receive vitamin C.

As you get older, your body produces less collagen, which slows down your cell repair. And, if you're diabetic, your body produces even less collagen and there is less cell repair and healing.

This is why it's so important to eat healthy foods that can help with the collagen production as well as the cell repair and healing.

Oxygen Levels: Antioxidant vitamins, including C, E, A, zinc and selenium, appear to speed wound healing, according to a study published in the January 2012 issue of the journal "Clinical Nutrition."

In the study, trauma patients with wound healing disorders took oral supplements of the vitamins for 14 days. Results showed that oxygen levels in the healing tissue, which has high energy requirements and requires high levels of oxygen to provide the necessary energy, were maintained in the supplemented group but decreased in the control group.

Additionally, wound closure happened faster in the supplemented group. Researchers concluded that eating foods (such as vegetables)that contain antioxidants might help wounds heal faster.

General Nutritional Requirements for Healing

Carbohydrates should supply 50 to 60 percent of the total caloric intake to ensure adequate energy stores. Carbohydrates are also important components of glycoproteins, which play roles in the wound healing process. Cell migration and proliferation are processes mediated by cell surface molecules composed of carbohydrates.

High quality carbohydrates that help with cell repair and healing include green, leafy vegetables, bright-colored vegetables, beans, and some whole fruits.

Proteins, which are made up of amino acids, should constitute 20 to 25 percent of the required caloric intake. Amino acids such as leucine, arginine and glutamine have been shown to possess anabolic activity. Protein production is a vital process in wound healing. This process is mediated by fibroblasts, which produce collagen, the skin's major structural protein.

To promote optimal wound healing, increase your intake of protein, which is essential for immune system functions, skin health and the production of enzymes. In fact, it is a necessary fuel for most bodily functions.

High quality proteins include "clean" meat, poultry and fish. Meats like venison and organic beef are good for providing your body with the protein it needs to heal wounds, as are free range poultry like chicken and turkey; and, seafood like shrimp, tuna, cod and halibut.

Fats comprise 20 to 30 percent of the total dietary requirement. They also provide additional energy during wound healing and are the raw materials used for the production of new cell membranes.

High quality fats include plant oils such as extra virgin olive oil that contain monounsaturated fats; and, fish oils that contain Omega-3 EFAs .

Vitamin A, which is stored in the liver for several months, can be found in butter, egg yolk, carrots, squash, pumpkin and other orange foods. The vitamin works to stimulate the inflammatory response and, in effect, jumpstart collagen synthesis. This function is necessary for the development of new skin and veins. According to the National Institutes of Health, low levels of this element can lead to increased risk of wound infection and delayed healing.

Along with vision and immune system support, vitamin A promotes skin health and cell growth. Food sources include calf liver, organic eggs and raw milk for their vitamin A content; and, all provide protein as well, making them effective choices for wound healing.

Additionally, vitamin A can be obtained from orange and yellow fruits and vegetables like carrots, sweet potatoes, turnips, winter squash, cantaloupe and apricots. Dark green leafy vegetables like spinach, kale, mustard greens and swiss chard are other options for high vitamin A content and wound healing.

Vitamin B consists of several different types, including B1 (thiamine), B2 (riboflavin), B3 (niacin) and so forth. The main purpose of this vitamin complex is to metabolize carbohydrates and proteins to produce energy, which is essential for cell growth and movement. Vitamin B can be found in a range of foods, most commonly poultry, eggs, dairy and fish.

Vitamin C is important to the synthesis of collagen and the growth of new blood vessels to replace damaged tissue. This element also has a strong antioxidant effect that enhances the immune system and, in effect, protects against wound infection. Another benefit is that vitamin C helps the body better absorb iron, which works to supply the wound bed with oxygen and energy for more efficient cellular development.

Vitamin C has a wide variety of functions and benefits, especially from its antioxidant properties. One such benefit is the ability to accelerate wound healing. Berries and citrus fruits are excellent sources of vitamin C, as are broccoli and cauliflower, bell peppers, asparagus, peas, tomatoes and kiwi. Additionally, dark leafy greens are not only high in vitamin A, they are also high in vitamin C, making them optimal foods to promote wound healing.

Zinc is a mineral that has many benefits for the body, including helping balance blood sugar levels and metabolism, promoting immune system functions and strengthening sensory perceptions.

Conveniently, many of the foods high in zinc are also high in the other nutrients necessary to optimal wound healing. These include calves liver and other meats, shrimp, peas, asparagus, broccoli and dark green leafy vegetables.

Consuming foods that contain zinc are recommended for people with wounds and injuries. Such foods include meat products (oysters and other sea foods, beef, chicken, etc), dairy products, wheat germ, and various nuts, beans, and lentils.

Superior Nutrition Stops Diabetic Complications

A superior nutritional program (such as the DTD Nutritional Program) is powerful enough to stop the progression of your diabetes and the development of one or more diabetic complications, e.g. retinopathy, nephropathy, neuropathy, or heart disease.

Next Steps

If you want to do more than just control your blood sugar, here is a list of the author's key books for repairing and healing your body:

For more information about the specific foods and nutrients that help to repair and heal a diabetic's body, refer to the Healing Foods for Reversing Diabetes web page.

Note: The defining of these 4 phases by the author led to the development of his 6-stage Diabetes Wellness Program.

The 5 Healing Foods

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