According to Diabetes Australia's website, diabetes is the epidemic of the 21st century and is the biggest problem confronting our health system. The statistics indicate that there are up to 1.7 million people with diabetes and about 280 Australians develop it daily. No matter what statistic you look at or use it's a big, and growing, problem. While the cause is generally not known, we do know that it's associated with modifiable lifestyle risk factors and these are a critical part to successfully addressing Type 2 diabetes.
There is a concept called the minimum effective dose that is very relevant when addressing these modifiable lifestyle risk factors. The minimum effective dose is defined as the smallest dose that will produce a desired outcome. Now straight up I'll say that I'm not advocating laziness, far from it. What I'm saying is we need to work smarter and recognize what the minimum effort is for the desired outcome. Part of the reason for this is simply human nature. Most diabetics know what they need to do, but their compliance with it is poor. We all know we should eat well and exercise, but all too often those that need to the most don't do it.
So are there "diabetic life hacks" out there that help us to get the outcome we want in the easiest most effective way?
Yes and no. There is ultimately no replacing diet and exercise and it would be foolish to suggest this. However, there are tools available that do help to create the desired outcomes with minimal effort and dose. The most important of these is the daily use of a near infrared sauna.
Some basic sauna background is needed here before I share (with references) how it has been clinically shown to help with Type 2 Diabetes.
There are three types of saunas. The traditional "water on the rocks" sauna, far infrared saunas and near infrared saunas. They all have clinically proven heat, or hyperthermia, benefits. The difference is in how they apply the heat, but they all work from a heat perspective.
The Near Infrared Sauna (also known as a lamp sauna) is different to the others in that in addition to the therapeutic heat benefits, it also provides near infrared light benefits. This cutting edge research is called photobiomodulation and has significant benefits for diabetics. Only the near infrared sauna has the double benefit of heat and light therapy.
Photobiomodulation is quite technical so we'll go with the simplified version which is, that at the end of the day, it creates energy in your cells which can be used for healing. Near infrared light actually penetrates the body deeply and is absorbed by an enzyme called cytochrome c oxidase in our mitochondria. When the cytochrome c oxidase is exposed to the near infrared it increases ATP production. ATP is the molecule that gives us energy so the more ATP we can produce and the quicker we can produce it the better. Again, it's only near infrared does this and not far infrared.
So what does all of this mean for Type 2 Diabetics?
A near infrared sauna will likely be a tremendous help for you.
In 2015 Krause et al. wrote in an article called "heat shock proteins and heat therapy for type 2 diabetes: pros and cons" that "heat therapy is a promising and inexpensive tool to be included in prevention and treatment of sedentary (or unable to perform exercise) obese and diabetic people" . She further goes on to then provide an actual guideline for the use of heat therapy in diabetes.
The research is there, guidelines are laid out, and sauna therapy for type 2 diabetics is supported by practitioners. The problem is that you just hadn't heard of it. Now that's changed as well.
Here are your top clinically proven reasons you should consider using a near infrared sauna to help create the desired outcomes you want with minimal effort and dose.
Right off the bat let's acknowledge that some of the weight loss you will experience in a sauna will be water loss. However there is MUCH more to the process than just this. In a 1981 paper Dean reported that sweating is a complex function and involves millions of glands that produce sweat to cool the body through evaporation. Those glands consume energy while secreting sweat but that is only a fraction of the energy consumed from whole body hyperthermia. The body's thermoregulatory process involves heart rate, cardiac output, and metabolism, all of which consume calories.
Fever is one of the body's natural ways of temperature elevation and a great way to assess energy use. It has been found in studies of patients with fever that the basal metabolic rate increases by 7% for every 0.5 degree Celsius increase in body temperature. The basal metabolic rate is the amount of calories used while at rest so in a sauna session that raises your core temperature by 1 degree we will be increasing calories burned by up to 14% without doing any exercise. This is quite significant especially for those who can't or won't exercise adequately.
Many studies have shown weight loss effects when undergoing regular hyperthermia (sauna) sessions. Here is a summary.
Biro found "the body weight and body fat in obese patients significantly decreased after 2 weeks of sauna therapy". They also reported in a single case study that body weight decreased from 117.5 kg to 100.0 kg and body fat decreased from 46% to 35% over 10 weeks. This was of extra interest as the patient could not exercise because of knee osteoarthritis.
Imamura looked at thermal infrared sauna therapy and its effect on coronary risk factors and found that in addition to tremendous cardiovascular benefits there was a statistically significant decrease in body weight.
Finally, Beever looked at type 2 diabetics who underwent 20-minute, 3x weekly infrared sauna sessions, over a period of 3 months. He found a trend toward decreased waist circumference. He also noted that subject adherence to infrared sauna use is greater than adherence to other lifestyle interventions meaning people were more likely to stick with sauna therapy than other factors such as exercise..
This meets our goal of minimum effort for maximum outcome and is certainly worthy of being on the "diabetic life hack" list.
This is perhaps the most well researched area in sauna therapy and the following is just a small sample.
There are blood pressure benefits. In the study by Beever previously mentioned he also found that there was a significant improvement in systolic blood pressure that decreased by 6.4mm Hg.
Imamura's study previously discussed in weight loss also looked at endothelial dysfunction which is common in diabetics. Endothelial dysfunction is believed to represent an early stage of atherosclerosis, or hardening of the arteries. It has been reported that chronic inhibition of nitric oxide (NO) production is involved and they found that repeated thermal therapy (sauna) improves impaired endothelial function in patients with coronary risk factors. Near infrared has been found to also positively influence NO and cardiovascular health.
Sobajima found that repeated sauna therapy (called Waon therapy) improved exercise tolerance, and cardiac and endothelial function in patient with actual chronic heart failure.
Pilch et al found that after only 7 sauna treatments that were done every other day there was a drop in total cholesterol levels but an increase in high density lipids (HDL) which is considered the "good" cholesterol. Sauna therapy has a healthy effect on the body's metabolism of certain fats and has the same effect as moderate exercise in fat metablolism.
Now to explode some myths about sauna use because I can almost hear you saying I have high blood pressure so I can't use a sauna. Krause writes "people with hypertension are commonly warned to check with a physician before using a hot tub (or sauna ed. Note), but there is little literature on which to base this advice". For most cardiovascular issues the benefits are great and the risks are low. She further goes on to explain "there are some cardiovascular contraindications for the use of heat therapy, such as severe aortic stenosis, unstable angina pectoris, recent myocardial infarction, decompensated heart failure, and cardiac arrhythmia". As you can see saunas are not contraindicated for most problems but if in doubt consulting with an up to date physician is advised.
This is such a small sampling of the significant research out there but there is no doubt that near infrared sauna sessions are good for the heart and are a fantastic addition to any diabetic's self-care.
This is a fascinating area of research but one that comes with a caution. In the long term of course we want to have controlled glucose levels. However, anything that increases our insulin sensitivity will also impact our glucose control and create potential "lows" so you need to be closely monitoring this with your health practitioner. Over time with regular sauna sessions as your insulin sensitivity improves you will likely find that your requirement for insulin or medications may diminish and you need to be aware of this and consult with your health practitioner.
Not convinced? Krause writes " the use of heat therapy in metabolic diseases has brought attention after the observation that sauna, in insulin-dependent diabetic men caused hypoglycaemia symptoms."
Take a look at this study by Kokura. Intermittent hyperthermia (sauna) has been demonstrated to reduce insulin resistance in an obese diabetic mouse model. Insulin resistant diabetic mice were subjected to 30 minutes of hyperthermic treatment, three times a week for twelve weeks. This resulted in a 31% decrease in insulin levels and a significant reduction in blood glucose levels, suggesting re-sensitization to insulin. 31% is a lot in my opinion even if it's in an animal study.
Krause writes "studies have indicated that nitric oxide (NO) and the increase in heat shock protein 70 (HSP) expression is involved in the improvements induced by heat therapy on insulin sensitivity" In other words (because you don't really need to know what NO and HSP are) heat therapy produces nitric oxide and heat shock proteins that in turn result in increased insulin sensitivity. This is good news.
For the more technical details you can read her 2015 paper "Heat shock proteins and heat therapy for type 2 diabetes: pros and cons. She goes on to summarize that "heat therapy has been shown to reduce inflammation, body fat deposition, insulin resistance, body weight and cardiovascular diseases" Pretty good resume for sauna therapy and certainly on my list of diabetic "sauna hacks".
Inflammation is a long known and well accepted factor in type 2 diabetes. Shoelson states in an excellent paper that "obesity, type 2 diabetes, and cardiovascular disease share a metabolic milieu characterized by insulin resistance and chronic subacute inflammation". Hooper goes on to state "in the past several years, research has established a clear causal relationship between chronic inflammation, obesity, and insulin resistance".
Interestingly, we also know that inflammation alone can cause insulin resistance.
Chronic inflammation in obesity and diabetes is a target for heat therapy. The sauna works on inflammation in multiple ways and the two primary ones we know of are nitric oxide and heat shock proteins. Their expression is involved in the improvements induced by heat therapy on inflammation. In other words heat therapy with a near infrared sauna helps with inflammation control and is worthy of being on our list.
The association between diabetes and environmental toxins might not currently be as well known as the factors we've previously discussed but perhaps it should. Did you know that exposure to environmental toxins in the absence of increased caloric intake induces weight gain and insulin resistance. Stated simply, toxins are an invisible, unappreciated cause of obesity and diabetes.
Consider this thought from Hyman "In 2006, scientists at the Harvard School of Public Health found that rates of obesity in infants less than 6 months old have risen 73% since 1980. Mounting evidence points to a unique and unappreciated trigger for obesity—exposure to small traces of environmental chemicals in the environment".
Hyman further explains that "heavy metals such as mercury, lead, and arsenic are also causing diabesity. A recent article in JAMA linked arsenic exposure to increases in the risk of type 2 diabetes. Other data link mercury from fish consumption, dental amalgams, and vaccines through multiple mechanisms including enzymatic disruption, impaired glucose transport, oxidative stress, induction of inflammatory cytokines, and mitochondrial injury. This suggests a new model of potential treatment for diabetes and obesity. A comprehensive detoxification program for petrochemical and heavy metal toxins may be an effective addition to the treatment of diabesity"
This is where saunas excel as sweating is a very important pathway to eliminate toxins. Sears found that toxic metals such as lead, arsenic, mercury and lead are excreted in sweat in relatively high concentrations compared to plasma levels. Since we know that regular sauna users can secrete up to 2 liters per hour this equates to a lot of toxin elimination. 
Many of these toxins have an affinity for fat tissues and this may prove to be critical aspect in diabetic care. The problem is that the toxins remain in the body for a very long time and not only accumulate in the fat, but they also create many health issues and symptoms in the process. Think of this storage fat as being "toxic fat". When a toxin targets and is stored in fat, the fat is now essentially doing a "job" and will be difficult to get rid of in traditional weight loss approaches such as diet. Mobilizing these fat stores is the best way to remove these toxins from the body. The sauna and it's forced sweating has been shown to release these toxins from fat along with exercise.
In 2011 Ross found that repeated sauna sessions improved the health and brain function in police officers that had been exposed to methamphetamine's.
The evidence of environmental toxicity being linked to diabetes is mounting. Using a near infrared sauna can help and in her paper Heat shock proteins and heat therapy for type 2 diabetes: pros and cons concludes "heat therapy is a promising and inexpensive tool to be included in prevention and treatment of sedentary (or unable to perform exercise) obese and diabetic people".
Obviously this meets the criteria required to be on the list of "diabetic life hacks".
One of the unique aspects of the near infrared sauna is of course the near infrared component. Near infrared light therapy is also known as photobiomodulation. It uses invisible, near infrared wavelengths between 700 and 1200 nm to deliver energy to the cells. This energy is then used to stimulate healing. It's worthwhile mentioning that Infrared light therapy has been proven effective by hundreds of studies all over the globe, is 100% natural and has no known adverse side effects.
For example, Byrnes found that photobiomodulation is effective in improving the healing of cutaneous wounds in an animal model of type II diabetes, suggesting that it would be effective in treating chronic cutaneous wounds in diabetic patients.
In Houreld's editorial review called Healing of Diabetic Ulcers Using Photobiomodulation she looks at many studies on the use of near infrared in diabetic issues. This includes a positive impact on foot ulcers which are often a significant issue for diabetics. There is no doubt that near infrared has a very powerful impact on wound healing of all sorts.
Kuffler writes while discussing photobiomodulation that "wound healing is induced by many different near infrared wavelengths and powers with no optimal set of parameters yet being identified. While data suggest that simultaneous multiple wavelength illumination is more efficacious than single wavelengths, the optimal single and multiple wavelengths must be better defined to induce more reliable and extensive healing of different wound types". This may all sound technical but what he is saying is that we know it works, but we still don't know exactly what parameters are best. The real take home point that stands out to me though is that this review study has stated that using multiple wavelengths is better. Bear with me and read on.
In the lab single wavelengths from lasers or LED lights are typically used, but in a near infrared sauna all the wavelengths are present which would suggest that there are some significant benefits to be found in wound healing by using a near infrared sauna. Of course, more research needs to be done but keep in mind you have very little to lose as "to date, there are no reports of major safety issues nor side-effects after near infrared treatment".
There are hundreds of studies being done every year into near infrared light therapy. One of the reasons that there is so much scientific interest in near infrared in the last few years is the lengthy list of conditions it appears to help with. The list includes retinal disease, traumatic brain, optic nerve injury, experimentally induced stroke, familial amyotrophic lateral sclerosis (ALS), multiple sclerosis, Parkinson's and Alzheimer's and far more!
This has brought us to some interesting thoughts and conclusions. One is that these issues involve common pathways, specifically of inflammation and oxidative stress, and mitochondrial dysfunction, indicating that near infrared may be beneficial through the same protective mechanisms. Two, is that it's likely we have evolved needing near infrared and with our current belief about the sun being just damaging we have created, in essence, a "near infrared deficiency" similar to what has occurred with Vit D.
Consider that near infrared therapy is increasingly looking like it could be both neuroprotective AND could slow or stop disease pathology in Alzheimer's and Parkinson's. If that doesn't catch your interest keep in mind that this is something that current mainstream medicine does not do either with Alzheimer's or Parkinson's.
Another study has demonstrated that with near infrared light therapy we can get some people of thyroid medication. In the 2013 study by Höfling the conclusion was that 48% of the hypothyroid patients maintained normal thyroid hormone levels without thyroid medication at the end of the 9-month follow-up. Almost HALF of the people in the study were able to completely come off their medication and remain off the medication even 9 months after the study completed. This is unheard of in modern medicine..
There is clearly a significant benefit to near infrared and the use of a near infrared sauna is sure to benefit you in more ways than you might realize.
The research is clear. Sauna therapy for type 2 diabetics is tremendously beneficial and is recommended in the literature. It may not be well known, but it probably should be. When you find a single therapy that, in 20 minutes every day or other day, can improve weight loss, cardiovascular health, insulin sensitivity, inflammation, wound healing, detoxification and more it's worth exploring. When also consider that near infrared saunas are typically less expensive than the other types of saunas and can be used in existing spaces in your home such as shower cubicles and bathtubs it really truly stands out as an exciting and easy addition to any diabetics lifestyle.
It turns out there are some "diabetic life hacks" out there and the near infrared sauna is certainly one of them. When we consider the concept of minimum effective dose it's clear that with a minimum effort there is a very significant outcome and near infrared saunas should be considered standard therapy for most type 2 diabetics.
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