About Diabetes, Type 2: Type 2 diabetes is characterized by "insulin resistance" as body cells do not respond appropriately when insulin is present. This is a more complex problem than type 1, but is sometimes easier to treat, since insulin is still produced, especially in the initial years. Type 2 may go unnoticed for years in a patient before diagnosis, since the symptoms are typically milder (no ketoacidosis) and can be sporadic. However, severe complications can result from unnoticed type 2 diabetes, including renal failure, and coronary artery disease. Type 2 diabetes was formerly known by a variety of partially misleading names, including "adult-onset diabetes", "obesity-related diabetes", "insulin-resistant diabetes", or "non-insulin-dependent diabetes" (NIDDM). It may be caused by a number of diseases, such as hemochromatosis and polycystic ovary syndrome, and can also be caused by certain types of medications (e.g. long-term steroid use). About 90-95% of all North American cases of diabetes are type 2, and about 20% of the population over the age of 65 is a type 2 diabetic. The fraction of type 2 diabetics in other parts of the world varies substantially, almost certainly for environmental and lifestyle reasons. There is also a strong inheritable genetic connection in type 2 diabetes: having relatives (especially first degree) with type 2 is a considerable risk factor for developing type 2 diabetes. The majority of patients with type 2 diabetes mellitus are obese - chronic obesity leads to increased insulin resistance that can develop into diabetes, most likely because adipose tissue is a (recently identified) source of chemical signals (hormones and cytokines).
Scientists are trying to figure out how to transplant islet cells and then protect them from the patient’s immune system so that long-term immunosuppressive medications aren’t required. Micro encapsulation is an approach scientists are testing to find out if a special coating to the transplanted islets can help the patient avoid rejection of those islets. These coatings let in nutrients to nourish the cells but prevent your body’s immune system from attacking them.
In type I diabetes, insufficient levels of insulin result from the immune system itself attacking the pancreatic beta cells. On the other hand, while beta cell dysfunction varies widely between type II diabetes patients, insulin resistance is a major part of the disease. Restoring the beta cells of the pancreas to health is the treatment approach these two diseases share to some degree.
Who is at risk of developing prediabetes? A well-known paper published in the Lancet in 2010 recommends screening for type 2 diabetes (which would also screen for prediabetes) every 3-5 years in all adults over the age of 45, regardless of other risk factors. Overweight and obese adults (a BMI >25 kg/m2) are also at significantly greater risk for developing prediabetes, as well as people with a family history of type 2 diabetes.
An aromatic herb that is used commonly to add flavor and aroma to meats and soups, Rosemary also helps normalize blood sugar levels naturally. It promotes weight loss as well, which is a double boon for many diabetics who struggle with weight issues. A research conducted in Jordan to study the effects of rosemary on lipid profile in diabetic rats proved that rosemary has no significant influence on serum glucose level and lipid profile of normal rats. But when rosemary extract was administered to diabetic rats for 4 weeks, their blood sugar levels reduced by 20%, cholesterol levels by 22%, triglyceride levels by 24%, and LDL by 27% while HDL increased by 18% respectively. The study was published in African Journal of Plant Science Vol. 6 in 2012.
Sometimes people with type 2 diabetes are able to bring their blood glucose levels under control through a combination of weight loss, diet, and exercise, but many people with diabetes take medication to manage their condition. For some, a single diabetes medication is effective, while in other cases a combination of drugs works better. “If diabetes control is suboptimal on the maximum dose of one medication, it’s prudent to add on a second agent,” says Deepashree Gupta, MD, assistant professor of endocrinology at Saint Louis University in Missouri.
Gupta says that with her patients, “we typically emphasize cutting out processed food and sugary drinks to begin with, and exercise recommendations include 150 minutes of moderate-intensity cardiovascular exercise per week, and two to three days per week of strength training, which is consistent with exercise guidelines from the Centers for Disease Control and Prevention.” The American Diabetes Association recommends replacing high-fat, high-sugar, high-salt foods with a mix of fiber, protein, fruits, and vegetables to keep blood sugar levels steady.
Chinese medicine has been using cinnamon for medicinal purposes for hundreds of years. It has been the subject of numerous studies to determine its effect on blood glucose levels. A 2011 study has shown that cinnamon, in whole form or extract, helps lower fasting blood glucose levels. More studies are being done, but cinnamon is showing promise for helping to treat diabetes.
Insulin is a hormone produced by cells in the pancreas called beta cells. Insulin helps the body use blood glucose (a type of sugar) for energy. People with type 2 diabetes do not make enough insulin and/or their bodies do not respond well to it, leading to elevated blood sugar levels. Oral diabetes medications bring blood sugar levels into the normal range through a variety of ways.
One benefit of these foods is that they generally promote weight loss, which is a major factor in reversing diabetes. A study following 306 diabetic individuals found that losing weight under a structured program (with the supervision of a primary care physician) resulted in almost half of the participants going into total diabetes remission. This means they were able to stay off their medications permanently (assuming they stayed on a healthy diet). Quality of life also improved by over seven points on average for the patients on the dietary regimen, while it decreased by about three points for the control group. (13)
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As of this writing, new and exciting research is being done to prevent and cure Diabetes. JDRF Australia is working on a cure that aims to allow the body to produce insulin and for the body to stop attacking its own B-cells. Another cure that is being worked on is enhancing the survival of B-cells so that they can be transplanted to diagnosed patients. In terms of prevention, since testing can now be done for an individual’s genetic risk, diet modifications have been found to delay the onset of diabetes to at least five years.
The number of treatments for chronic conditions such as diabetes ranges from 6 to 14 sessions. This may be followed by “tune up” sessions every 2–6 months.6 The cost for the initial session is about $75 –$150, with the follow-up visits costing $65–100 each. Third-party payment for complementary and alternative therapies varies from state to state. Some insurers, such as Blue Cross Blue Shield, cover certain therapies for specific diagnoses only, i.e., acupuncture for pain-related diagnoses. For an additional cost, a few insurance companies offer a separate complementary medicine package that allows the insured to see complementary medicine practitioners at a discounted rate.
If the rapid changes in metabolism following bariatric surgery are a consequence of the sudden change in calorie balance, the defects in both insulin secretion and hepatic insulin sensitivity of type 2 diabetes should be correctable by change in diet alone. To test this hypothesis, a group of people with type 2 diabetes were studied before and during a 600 kcal/day diet (21). Within 7 days, liver fat decreased by 30%, becoming similar to that of the control group, and hepatic insulin sensitivity normalized (Fig. 2). The close association between liver fat content and hepatic glucose production had previously been established (20,22,23). Plasma glucose normalized by day 7 of the diet.
Also called weight-loss surgery or metabolic surgery, bariatric surgery may help some people with obesity and type 2 diabetes lose a large amount of weight and regain normal blood glucose levels. Some people with diabetes may no longer need their diabetes medicine after bariatric surgery. Whether and for how long blood glucose levels improve seems to vary by the patient, type of weight-loss surgery, and amount of weight the person loses. Other factors include how long someone has had diabetes and whether or not the person uses insulin.1
Encellin’s ultra thin-film device won a $10,000 research prize in The American Diabetes Association's 22nd Annual Leaders Forum HealthTech Showcase in Northern California in late 2017. The company also won a 2016 Innovation Award from the San Francisco-based Rosenman Institute, an organization that aims to support the development of innovative medical-device technologies.
But is John “free of diabetes”? This is where the lines become blurred. Medically speaking, the term “cure” is usually associated with acute disease—a temporary medical condition, such as bacterial pneumonia, that can be cured with antibiotics. For diabetes, which is a chronic disease, it may be more accurate to use the term “remission” rather than cure. Particularly when considering the pathology associated with diabetes and the individual’s genetic predisposition, relapse is always possible. In a consensus statement issued by the ADA, the term remission is defined based on the following definitions:2
Trick (important): Cut down on sweets, and if you can, cut them out entirely for a couple months. I still eat ice cream about once a week, and know people who are losing weight on this diet while eating ice cream almost every day. But this probably won’t be the case for everyone. Better to severely restrict sweets for the first few months, and then gradually reintroduce.