McInnes, N., Smith, A., Otto, R., Vandermey, J., Punthakee, Z., Sherifali, D., … Gerstein, H. C. (2017, March 15). Piloting a remission strategy in type 2 diabetes: Results of a randomized controlled trial. The Journal of Clinical Endocrinology and Metabolism, 2016-3373. Retrieved from https://academic.oup.com/jcem/article-abstract/doi/10.1210/jc.2016-3373/3070517/Piloting-a-Remission-Strategy-in-Type-2-Diabetes?redirectedFrom=fulltext
The first thing to understand when it comes to treating diabetes is your blood glucose level, which is the amount of glucose in the blood. Glucose is a sugar that comes from the foods we eat and also is formed and stored inside the body. It's the main source of energy for the cells of the body, and is carried to them through the blood. Glucose gets into the cells with the help of the hormone insulin.
Anecdotally, Cummings knows at least one person in the US who got their surgery paid for through their partner’s employer insurance, despite only having a BMI of 31. And he notes that many countries with a robust public health care system have already lowered their BMI limits to mirror the DSS-II guidelines, such as the UK and Saudi Arabia. He also believes that Medicare and Medicaid officials are deliberating whether to adopt the DSS-II guidelines, based on discussions he’s had. “I don’t know how long it’ll take, but we’re crossing our fingers and hoping,” he said.
Lab studies show that Encellin’s “ultra thin-film implantable cell delivery system” keeps islet cells alive and functioning. In a 2015 study in the journal ACS Nano, Dr. Nyitray and others found that cells in the packaging survived for 90 days in lab animals. New blood vessels grew around the transplants and the cells produced insulin in response to rising glucose levels. In a 2016 study from Dr. Desai’s lab, also published in ACS Nano, human islet cells packaged in the tiny film envelopes survived for six months in mice—and the cells made and released insulin in response to rising blood glucose levels.
“Substantial weight loss results in reduced fat inside the liver and pancreas, allowing these organs to return to normal function. What we’re seeing … is that losing weight isn’t just linked to better management of type 2 diabetes: significant weight loss could actually result in lasting remission,” added Taylor, whose team presented the results of the trials at the International Diabetes Federation Congress in Abu Dhabi.
In addition to giving you some ideas about what to eat, the plan also might recommend limiting foods that contain lots of fat or calories and that don't contain vitamins and minerals. Everyone who eats a healthy diet should limit these foods anyway, because eating too much of them can lead to too much weight gain or long-term health problems like heart disease.
How much the blood sugar level goes up after eating depends on the type of nutrients the food has. The three main types of nutrients found in foods are carbohydrates (carbs), proteins, and fats, which provide energy in the form of calories. Foods containing carbs cause blood sugar levels to go up the most. Foods that are mostly protein and/or fat don't affect blood sugar levels nearly as much.
In obese young people, decreased β-cell function has recently been shown to predict deterioration of glucose tolerance (4,78). Additionally, the rate of decline in glucose tolerance in first-degree relatives of type 2 diabetic individuals is strongly related to the loss of β-cell function, whereas insulin sensitivity changes little (79). This observation mirrors those in populations with a high incidence of type 2 diabetes in which transition from hyperinsulinemic normal glucose tolerance to overt diabetes involves a large, rapid rise in glucose levels as a result of a relatively small further loss of acute β-cell competence (3). The Whitehall II study showed in a large population followed prospectively that people with diabetes exhibit a sudden rise in fasting glucose as β-cell function deteriorates (Fig. 5) (80). Hence, the ability of the pancreas to mount a normal, brisk insulin response to an increasing plasma glucose level is lost in the 2 years before the detection of diabetes, although fasting plasma glucose levels may have been at the upper limit of normal for several years. This was very different from the widely assumed linear rise in fasting plasma glucose level and gradual β-cell decompensation but is consistent with the time course of markers of increased liver fat before the onset of type 2 diabetes observed in other studies (81). Data from the West of Scotland Coronary Prevention Study demonstrated that plasma triacylglycerol and ALT levels were modestly elevated 2 years before the diagnosis of type 2 diabetes and that there was a steady rise in the level of this liver enzyme in the run-up to the time of diagnosis (75).
If the patient were to gain weight back or scale back on their physical activity program, high blood glucose would return. If they were to overeat at a meal, their blood glucose probably would continue to go higher than someone without diabetes. Also, the decreased insulin production and/or increased insulin resistance that led to the initial diabetes diagnosis will gradually intensify over the years and during periods of stress. In time, the patient who could maintain normal blood glucose with diet and exercise alone may discover that he or she needs to add oral diabetes medications — or perhaps even insulin injections — to keep blood glucose in a healthy range.
• The vegetable/fruit called bitter melon, bitter gourd, or karela seems to stop insulin resistance. It gets glucose into cells. You can cook with it (many Chinese recipes incorporate this ingredient), eat it raw, or juice it. You can get it at Asian markets or farmers’ markets, or sometimes in supermarkets. It can also be taken as capsules or a tea.
Data from the Swedish randomized study of gastric banding showed that a loss of 20% body weight was associated with long-term remission in 73% of a bariatric surgery group, with weight change itself being the principal determinant of glucose control (13). Dietary weight loss of 15 kg allowed for reversal of diabetes in a small group of individuals recently receiving a diagnosis (21). In individuals strongly motivated to regain normal health, substantial weight loss is entirely possible by decreasing food consumption (88). This information should be made available to all people with type 2 diabetes, even though with present methods of changing eating habits, it is unlikely that weight loss can be achieved in those not strongly motivated to escape from diabetes. Some genetic predictors, especially the Ala12 allele at PPARG, of successful long-term weight loss have been identified (89), and use of such markers could guide future therapy. It must be noted that involuntary food shortage, such as a result of war, results in a sharp fall in type 2 diabetes prevalence (90,91).
Despite these encouraging results, Vulksan cautions that it's too early for diabetic patients to rely on ginseng. Herbs sold in this country are not standardized, he says, so it's difficult to know for certain what you're buying and impossible to ensure consistent dosages. Besides, his study looked only at American ginseng, and he's not certain the results would hold true for the seven other varieties. What's more, researchers haven't conclusively identified ginseng's active ingredients.
A representative for the Centers for Medicare and Medicaid Services, however, told Gizmodo the agency “has not received a reconsideration request” to overhaul its coverage of bariatric surgery as of yet. Gizmodo also asked several of the leading insurance companies, such as Anthem, Aetna, and UnitedHealthcare, about any possible revision in their coverage policies. Only Aetna replied, stating it constantly evaluates “new published peer-reviewed studies and medical research when developing our clinical policies.” But the company seemingly has no current plans to roll out any changes.
A recent study of 46 patients with painful peripheral neuropathy evaluated acupuncture analgesia to determine its short- and long-term efficacy. Using TCM acupuncture points, 34 patients (77%) experienced significant improvement in their symptoms. After a follow-up period of 18–52 weeks, 67% were able to stop or significantly reduce their pain medications. Only 8 (24%) required additional acupuncture treatment; 7 (21%) stated that their symptoms had cleared completely.11
This seems hard to do, but really it’s not if you know one secret: Replace snacking with something far more satisfying — fat. That’s right, the government is wrong to recommend a low fat diet. Fat is what makes you feel full until your next meal. Take away the fat, take away the full. Don’t go to an extreme, but do lean strongly toward a high-fat low-carb diet.