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Functional medicine and chiropractic: A case series in Type 2 Diabetes Mellitus reversal

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most chiropractors today. Such a definition carries the risk of loss of scope. There is no evidence that any
other profession has improved public and professional acceptance, growth and cultural authority by
contracting their scope or definition of practice. Rather there is evidence to the contrary.
Conservative care of the extremities, specifically manual therapy, continues to be an unmet need and
demand by patients and yet is an integral service primarily provided by chiropractors. Though research and
study of manual therapy for peripheral disorders has exploded, chiropractors still remain the primary
providers of this service. Furthermore, the historical record finds no evidence of (previous) non-medical and
limited licensed professionals increasing their acceptance, scope and utilization by reducing their scope or
definition of their scope.
Conclusions: This commentary offers arguments and evidence that there is an increasing and unmet demand
by patients for extremity care with a concurrent intensified interest in diagnosis, treatment and research by
chiropractors and other professionals. There are better definitions that protect the interests of patients who
demand this care, such as ‘‘chiropractors are doctors who specialize in nonsurgical spine and extremity care’
and/or ‘‘chiropractors are doctors who specialize in the care of nonsurgical spine and joint disorders’’.
doi: 10.1016/j.clch.2011.09.006
Functional medicine and chiropractic: A case series in Type 2 Diabetes Mellitus reversal
§
Stephanie Chaney, Tom Chaney, Paul A. Oakley *
*Corresponding author.
E-mail address: docoakley.icc@gmail.com
Introduction: Diabetes Mellitus (DM) is a syndrome characterized by hyperglycemia resulting from absolute/
relative impairment in insulin secretion and/or insulin action. Type II DM (T2DM) usually affects adults >30
years and affects 23.6 million Americans; another 57 million are pre-diabetic. The current standard of care
for T2DM includes oral medications, insulin injections, and general lifestyle and nutritional advice. Con-
ditions associated with T2DM include obesity, hypertension, hyperlipidemia, pancreatitis and hypothyroid-
ism. Complications include neuropathy, heart disease, stroke, kidney failure, blindness, and death.
Typically, recommendations given to a T2DM patient are only general. Considering that dietary choices are
a statistically proven factor in the incidence of developing T2DM and that perhaps as low as one-quarter of
patients follow dietary measures, we hypothesized that with a comprehensive, individualized functional
medicine (FM) and chiropractic treatment plan, T2DM patients could reduce and/or eliminate use of
medication and reverse their disease. This case series involves the treatment of four, previously MD-
diagnosed, T2DM patients taking diabetes-specific medication.
Methods: Initial exam included blood work, health/neurological questionnaires, hormone testing, adrenal
gland testing and an expanded gastrointestinal panel. During treatment, blood markers including a full lipid
panel, glycosylated hemoglobin (HbA1c), liver enzymes, vitamin D, and others were monitored every 6—8
weeks.
Treatment plans of FM (specific nutritional and lifestyle consulting, nutritional supplementation, detox-
ification) and chiropractic manipulation were recommended to correct biomechanical and biochemical
imbalances, nutritional deficiencies, presence of parasites and infections as possible causes/contributors to
elevated blood sugar levels. The patients were referred back to their prescribing physician for follow-up as
necessary to have their medications adjusted/eliminated.
Results: Four T2DM patients (2 female, 2 male) having an average age of 65 yrs (range 57—73 yrs), average
weight of 209.4 lbs (172—280 lbs), average pre-treatment and pharmacologically maintained glycosylated
hemoglobin of 6.25% (5.3—8.0% HbA1c) consented to a functional medicine and chiropractic program (5—9
months duration). All were overweight/obese, and all were on multiple medications for diabetes and other
diabetes-related diseases.
All 4 patients achieved a reversal of their diabetic conditions and were able to maintain normal
glycosylated hemoglobin levels (HbA1c) without use of any oral medication or insulin. On average, the
group lowered their HbA1c 0.5%, one patient dropped from 8.0% with 90 units of insulin to 5.9% without
insulin in 6 months. All patients lost weight, on average 39 lbs, one patient lost 56 lbs in 5 months.
FM consultations started semiweekly, tapering to semimonthly, chiropractic was on a semimonthly basis.
One patient received chiropractic 3!/week during their program. No specific exercise regimens were
recommended other than walking; one patient did vibration plate exercises for 15 min, 3!/week.
Abstracts from the WFC’s 11th Biennial Congress 147
Discussion: Diet and lifestyle factors are a vital factor in the establishment and therefore the reversal of
T2DM. The Merck Manual suggests diet to achieve weight reduction is most important in overweight patients
with Type II DM. Since all four patients were overweight and all lost significant weight on their programs, this
undoubtedly played an important part in the reestablishment in normal physiological blood markers
especially HbA1c.
Conclusion: This study demonstrates the efficacy of natural means with which to reverse T2DM.
doi: 10.1016/j.clch.2011.09.007
Difficulties in entering clinical practice
§
Fa
´bio Dal Bello *, Luis Costa Cantera
*Corresponding author.
E-mail address: fabaoquiro@hotmail.com
Introduction: When starting clinical practice, students in the health arena face many difficulties within the
scope of patient therapy. Unlike theoretical learning, which is proving increasingly effective in introducing
the student to problem-based learning and performing tests in groups, to learn clinical practice requires
venturing beyond theoretical knowledge to develop practical skills associated with the psychological factors
that influence the student’s conduct when attending a patient. This study aimed to verify the causes and the
prevalence of difficulties presented by chiropractic students when starting their clinical practice; verify the
most used chiropractic technique as well as identify those that are more difficult to implement in the
beginning of clinical performance.
Methods: This study was performed with 39 chiropractic students enrolled in the chiropractic course from
a college in southern Brazil, who were beginning clinical practice within the chiropractic curriculum of the
institution. A questionnaire was given to the students with questions related to their difficulties in starting to
attend a patient with the aim of verifying the causes and prevalence of these difficulties when starting the
practical learning process.
Results: The first questions given to the students referred to their difficulties when starting to attend
patients, and clinical information submitted by those who are seeking chiropractic care. The question
presented by the students which gave them most difficulty was uncertainty in making the correct decision,
with 69.2% of the answers. The students reported that they considered insufficient knowledge (12.8%) was
the second most prevalent cause regarding their difficulties. For decision-making in clinical care, the
students considered that their main difficulties related to the inability to conduct safe pathological diagnosis
(53.8%) and insufficient knowledge to conduct the laboratory analysis of the patient’s condition (23.1%). The
students also answered questions related to their ability and difficulties in performing different chiropractic
techniques, and the Gonstead Cervical Chair (56.4%) and Gonstead SHC lumbar (53.8%) have shown greater
difficulty.
Discussion: Many learning techniques are searching to promote education productivity increasingly
significant to the students needs, especially regarding to clinical uncertainties and decision making;
however, the reality has shown that when starting clinical practice, the students will always have some
difficulty in carrying out their activities.
Conclusion: It is concluded that by providing didactic teaching in addition to theoretical and practical
knowledge, thus stimulating the students, knowledge and understanding of the patient in physical and
psychological range, the difficulties regarding the first clinical attendance could be minimized. It is also
concluded that the creation of methods that provide practice of all techniques taught in chiropractic
curriculum and their knowledge and interdisciplinary clinical relationship may promote the formation of
students who are more confident and able to act professionally.
doi: 10.1016/j.clch.2011.09.008
148 Abstracts from the WFC’s 11th Biennial Congress
... Therefore, the rationale for supplementation of vitamin D for t2DM patients is substantiated. Vitamin D supplementation has been proven to reduce the risk of developing the disease [14], as well as to reverse the disease state altogether [15][16][17]. ...
... As this study demonstrates that the majority of people with t2DM suffer from inadequate amounts of vitamin D, vitamin D testing should be routine for all people at risk for t2DM, pre-diabetics and those currently suffering with t2DM in order to elevate levels sufficiently to improve insulin sensitivity and improve long-term outcomes [15][16][17][18]26]. ...
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This study explores the relationship of 25-hydroxylvitamin D blood levels in 106 randomly selected patient files with diagnosed type 2 Diabetes Mellitus (t2DM) who enrolled in a functional medicine diabetes reversal program from a chiropractic clinic located in Annapolis, Maryland, USA. Using a conservative recommendation for normal serum 25-hydroxyvitamin D concentration of 32 ng/ml, insufficiency level of 20 - 30 ng/ml, and deficiency level < 20 ng/ml, 21% (22/106) of our population were normal, 39% (41/106) were insufficient, and alarmingly, 35% (37/106) were outright deficient. Clinically, 74% (78/ 106) of our entire sample had significantly low vitamin D levels. Ou et al. (2011) determined the optimal concentration of serum 25OHD to be 40 ng/ml in order to optimize insulin sensitivity. In our sample 100/ 106 (94%) had vitamin D levels at or below this optimal cut-off level. BMI was negatively correlated with vitamin D; that is, the greater the BMI of the patient the less their vitamin D level. Both obesity and hypovitaminosis D are each mutually exclusive predictors for t2DM. Obesity and vitamin D deficiency may work synergistically to propel an individual into the diseased state of t2DM. As this study demonstrates that the majority of people with t2DM suffer from inadequate amounts of vitamin D, vitamin D testing should be routine for all people at risk for t2DM, prediabetics and those currently suffering with t2DM in order to elevate levels sufficiently to improve insulin sensitivity and improve long-term outcomes.
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