"What is interesting is that some patients retain beta cell function for over 50 years," he said. "And, it seems if you retain some, that's a lot better." So, for Darkes to still have some functioning beta cells would not be impossible, but it wouldn't eliminate the disease, Von Herrath said. "Depending on how many beta cells he has, maybe his form of type 1 diabetes was not very severe."
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.
The bottom line is that diabetes can be bad news—but this doesn’t have to be the case. Interventions can prevent or delay the disease in people with prediabetes. The Diabetes Prevention Program (DPP), a large study of people at high risk of diabetes, has established a prevention plan that’s both feasible and cost-effective. The DPP showed that weight loss and increased physical activity reduced the development of type 2 diabetes by 58% during a three-year period.
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.
Formal recommendations on how to reverse type 2 diabetes in clinical practice must await further studies. In the meantime, it will be helpful for all individuals with newly diagnosed type 2 diabetes to know that they have a metabolic syndrome that is reversible. They should know that if it is not reversed, the consequences for future health and cost of life insurance are dire, although these serious adverse effects must be balanced against the difficulties and privations associated with a substantial and sustained change in eating patterns. For many people, this may prove to be too high a price to pay, but for those who are strongly motivated to escape from type 2 diabetes, the new understanding gives clear direction. Physicians need to accept that long-term weight loss is achievable for a worthwhile proportion of patients (96). In the United States, diabetes costs $174 billion annually (97), and in the United Kingdom, it accounts for 10% of National Health Service expenditure. Even if only a small proportion of patients with type 2 diabetes return to normal glucose control, the savings in disease burden and economic cost will be enormous.
Panax ginseng (Korean ginseng), which has a long history of use as a hypoglycemic agent. At least five constituents of this herb have been shown to exert hypoglycemic effects. In one study, treatment with ginseng lowered blood glucose levels and improved mood and psychological performance as compared with placebo. Recommended dosage is 100–200 mg/day.14
There are many drugs available to treat type 2 diabetes. Your diabetes care team can help you understand the differences among the types of medication on this long list, and will explain how you take them, what they do, and what side effects they may cause. Your doctor will discuss your specific situation and your options for adding one or more types of medication to your treatment.
Glucose in the bloodstream passes through the kidneys, where it can either be excreted or reabsorbed. Sodium-glucose transporter 2 (SGLT2) works in the kidney to reabsorb glucose, and a new class of medication, SGLT2 inhibitors, block this action, causing excess glucose to be eliminated in the urine. Canagliflozin (Invokana), dapagliflozin (Farxiga), and empagliflozin (Jardiance) are SGLT2 inhibitors that have been approved by the FDA to treat type 2 diabetes. Because they increase glucose levels in the urine, side effects can include urinary tract and yeast infections.
According to TCM, the major activity of the blood is to circulate through the body, nourishing and moistening the various organs and tissues. Disharmonies of the blood may manifest as “deficient” blood or “congealed” blood. If deficient blood exists and affects the entire body, the patient may present with dry skin, dizziness, and a dull complexion. Congealed blood may manifest as sharp, stabbing pains accompanied by tumors, cysts, or swelling of the organs (i.e., the liver).4 The key organs associated with blood are the heart, liver, and spleen.
Evidence linking hepatic insulin sensitivity to intraorgan triglyceride content has been steadily accumulating. In insulin-treated type 2 diabetes, insulin dose correlates with the extent of fatty liver (35), and in turn, this is associated with insulin sensitivity to suppression of hepatic glucose production (36). Decreasing the fat content of liver is associated with improvement in insulin suppression of glucose production and, thereby, with improvement in fasting plasma glucose (20,23).
The Chinese language includes two terms for diabetes. The traditional name, Xiao-ke, correlates closely with diabetes in most instances. Xiao-ke syndrome means “wasting and thirsting.” The more modern term, Tang-niao-bing, means “sugar urine illness.” Reference to diabetes by the traditional term appears in the earliest texts, including the first medical text in Chinese history, Huang Di Nei Jing, or The Yellow Emperor’s Inner Classic.
There are major barriers for widespread use of islet also-transplantation that can help people with type 1 diabetes. The shortage of islets from donors is a huge obstacle. The other obstacle is that this is still considered an experimental procedure and until the procedure is considered successful enough to be labeled therapeutic by the FDA instead of experimental, the costs of these transplants come from limited research funds.
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).
Yin and Yang are complementary opposites used to describe how things function in relation to each other and to the universe. They are interdependent—one cannot exist without the other, and they have the ability to transform into each other.3 The traditional Yin-Yang symbol (Figure 1) depicts the Yin (the dark side) flowing into the Yang (the light side) and vice versa. The dots within each side symbolize that there is always a bit of Yin within Yang and a bit of Yang within Yin; there are no absolutes. All physiological functions of the body, as well as the signs and symptoms of disease, can be differentiated on the basis of Yin and Yang characteristics.
Regular monitoring of clinical trial participants found that HbA1c levels of those receiving BCG had dropped by more than 10 percent at three years after treatment and by more than 18 percent at four years. That reduction was maintained over the next four years, with treated participants having an average HbA1c of 6.65, close to the 6.5 considered the threshold for diabetes diagnosis, and with no reports of severe hypoglycemia. Participants in the placebo group and in a comparison group of patients receiving no treatment experienced consistent HbA1c elevations over the same eight-year time period.
Known as gurmar, or “sugar destroyer,” in Aryuvedic medicine, Gymnema has consistently shown benefits in patients with diabetes. The most active part of Gymnema seems to be gymnemic acids, and many products list the percentage each capsule contains. Analyses of the herb for diabetes have shown it may be helpful in lowering high blood sugar levels. It can delay glucose absorption from the intestine. It was shown to regenerate pancreatic tissues, allowing more insulin to be produced, and help regulate insulin secretion. It also increases the utilization of glucose by the cell, reducing insulin resistance and decreasing appetite, especially for sweets. I usually use it in capsules, or in liquid form in some patients. Due to Gymnema having a very similar shape to glucose, it can fit into the taste bud receptors for sugar; it thus has unbelievable power to actually prevent the taste of sweets in the mouth for up to 1.5 hours. When I have a patient who is still struggling to not eat cake and cookies and so forth at parties or celebrations (or just in general), I will give her a tincture of Gymnema sylvestre. This is one of my favorite herbs for diabetes. In capsule form doses of 400 to 2,400 mg a day are recommended.
Kelly Prinkey-Krupinski, 48 and an avid dog lover, has been struggling with adult onset Type 1 diabetes for 12 years. She said the disease runs her life. “It is a constant struggle,” she said. “My mind is always aware that every bite of food that I eat, every medicine I take, every illness and emotion I experience will affect my blood sugar. There is never a vacation from the constant balancing act to stay alive. It scares me to think of a time when I can't obtain the insulin that I must take 24-7. I would pray that there will be a cure in my lifetime. I just hate to think of the kids that struggle with Type 1 diabetes. This research with dogs sounds promising. As a dog lover myself, I would love to see if our canine friends can be cured. I'm excited to see the results.”
One easy way to increase your fat content and quit snacking is to begin your meal by eating an avocado. I and others I know have used this trick to easily quit snacking. Avocados protect you from one of the reasons some dietary research wrongly claims that high-fat diets are bad for you: the danger of gorging yourself on delicious, fatty foods. With plain avocados, there is little danger of gorging. Another danger is clogging your arteries and giving yourself heart disease. But it’s been amply shown that the blame for that falls squarely on trans fats, like margarine. If you see any product with the words “partially hydrogenated” or “hydrogenated” in the list of ingredients, put it back, it’s a trans fat. On the other hand, any fat that comes directly from an animal or plant is not a trans fat and can be safely consumed.