The drug reduces the amount of glucose made by the liver, and is frequently prescribed because it has been found to help prevent many of the long-term complications of diabetes. Metformin is usually taken without another drug, usually at a dose of 500 milligrams (mg) a day, depending on the brand, to start. Doses are not to exceed 2,000 or 2,500 mg per day.


“The field has suffered from a checkered history 20, 30 years ago, when there were operations that were dangerous. But modern metabolic surgery is very safe,” Cummings said. “The risk of dying from a laparoscopic gastric bypass is a little bit less than the risk of dying from having your gallbladder or appendix removed. But we never consider those risky surgeries; they’re totally bread-and-butter procedures.”
Diabetes is one of the most prevalent chronic diseases in the United States. The morbidity and mortality associated with the disease is significant and derives primarily from complications of persistent hyperglycemia. Longstanding hyperglycemia has been shown to lead to vascular complications involving large and small blood vessels, such as arteriosclerosis, glomerulosclerosis, and retinopathy. Diabetic neuropathy, characterized by pain and paresthesias, is among the most frequent complications of longstanding, poorly controlled diabetes and is often associated with a reduction in physical activity and with sleep disturbances.1,2

8. Amylin Mimetic This type of medication stimulates the release of insulin, and is used along with insulin injections. It may also help suppress hunger and promote weight loss. It’s less commonly used because it’s a shot administered in addition to insulin at each meal. Side effects can include low blood sugar, nausea, vomiting, headache, and redness and irritation at the injection site. Symlin (ramlintide) is what your doctor will prescribe you.


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
What’s critical is not necessarily the cutoff itself, but where someone falls within the ranges listed above. The level of risk of developing type 2 diabetes is closely related to A1c or FPG at diagnosis. Those in the higher ranges (A1c closer to 6.4%, FPG closer to 125 mg/dl) are much more likely to progress to type 2 diabetes, whereas those at lower ranges (A1c closer to 5.7%, FPG closer to 100 mg/dl) are relatively more likely to revert back to normal glucose levels or stay within the prediabetes range. Age of diagnosis and the level of insulin production still occurring at diagnosis also impact the chances of reverting to normoglycemia (normal blood sugar levels).
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

With all of the nutrition information available today about improving blood sugar, it can be a bit daunting to know which information is correct and which is not. It is so important to look to what science-based evidence and research says about the subject. But even more, we need this science to be translated into easy to understand advice so that we can actually incorporate it into our lives and benefit from it. This is the most important factor.


Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways.
“Three years after receiving two administrations of the bacillus Calmette-Guérin (BCG) vaccine four weeks apart, all members of a group of adults with longstanding type 1 diabetes showed an improvement in HbA1c to near normal levels – improvement that persisted for the following five years. The study from a Massachusetts General Hospital (MGH) research team – published in npj Vaccines – also reports that the effects of BCG vaccine on blood sugar control appear to depend on a totally novel metabolic mechanism that increases cellular consumption of glucose.

Curcumin is a bright yellow chemical produced by the spice turmeric, among other plants. Curcumin seems to have multiple benefits for diabetes symptoms. It has been shown to be a marked inhibitor of reactive oxygen species that promote oxidation damage in cells. Curcumin lowers inflammatory chemicals like tumor necrosis factor-alpha, and that’s good because TNF-a causes insulin resistance and irritates fatty livers. Curcumin can reduce another pro-inflammatory chemical called NF-KB. The above-mentioned actions provide a benefit in diabetes protection and reduce the risk of developing diabetes symptoms and complications. Curcumin has also been shown to enhance pancreatic beta cell functioning and reduce fatty liver deposition. It reduces high blood sugar, A1C, and insulin resistance. It was also shown to reduce the onset of Alzheimer’s disease, and that is a higher risk in diabetic patients than in nondiabetic patients. A good dose is 200 to 3,000 mg a day.
"You only need 10 percent of your beta cells to supply sufficient insulin," Roep said. He said there have been a couple of rare cases where a patient had typical type 1 diabetes but could go through long periods without insulin injections. "Insulin needs can be a moving target, and if you have a lifestyle change it's very plausible that you have a lesser need for insulin, and you can deal with [diabetes] with the beta cells you have," Roep said.

Reversal of type 2 diabetes to normal metabolic control by either bariatric surgery or hypocaloric diet allows for the time sequence of underlying pathophysiologic mechanisms to be observed. In reverse order, the same mechanisms are likely to determine the events leading to the onset of hyperglycemia and permit insight into the etiology of type 2 diabetes. Within 7 days of instituting a substantial negative calorie balance by either dietary intervention or bariatric surgery, fasting plasma glucose levels can normalize. This rapid change relates to a substantial fall in liver fat content and return of normal hepatic insulin sensitivity. Over 8 weeks, first phase and maximal rates of insulin secretion steadily return to normal, and this change is in step with steadily decreasing pancreatic fat content. The difference in time course of these two processes is striking. Recent information on the intracellular effects of excess lipid intermediaries explains the likely biochemical basis, which simplifies both the basic understanding of the condition and the concepts used to determine appropriate management. Recent large, long-duration population studies on time course of plasma glucose and insulin secretion before the diagnosis of diabetes are consistent with this new understanding. Type 2 diabetes has long been regarded as inevitably progressive, requiring increasing numbers of oral hypoglycemic agents and eventually insulin, but it is now certain that the disease process can be halted with restoration of normal carbohydrate and fat metabolism. Type 2 diabetes can be understood as a potentially reversible metabolic state precipitated by the single cause of chronic excess intraorgan fat.


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You can talk to your diabetes health care team about planning your exercise along with your meals and insulin. They'll offer specific suggestions to help you get ready for exercise or join a sport and give you written instructions to help you respond to any diabetes problems that may occur during exercise, like hypoglycemia (low blood sugar), or hyperglycemia (high blood sugar).
Researcher Qizhi Tang, PhD, at the University of California, San Francisco, is studying the changes induced in beta cells by the shortage of oxygen and nutrients. Stem cell-derived islets have a low survival rate in the first few days after transplant due to the lack of adequate oxygen and nutrient supplies. However, the American Diabetes Association states, “Evidence suggests that beta cells can be trained to survive oxygen and nutrient shortages that they are exposed to before and after transplantation.”
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Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst.

Beware of claims that seem too good to be true. Look for scientific-based sources of information. The National Diabetes Information Clearinghouse collects resource information for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Reference Collection, a service of the National Institutes of Health. To learn more about alternative therapies for diabetes treatment, contact the National Center for Complementary and Alternative Medicine Clearinghouse.
The extent of weight loss required to reverse type 2 diabetes is much greater than conventionally advised. A clear distinction must be made between weight loss that improves glucose control but leaves blood glucose levels abnormal and weight loss of sufficient degree to normalize pancreatic function. The Belfast diet study provides an example of moderate weight loss leading to reasonably controlled, yet persistent diabetes. This study showed that a mean weight loss of 11 kg decreased fasting blood glucose levels from 10.4 to 7.0 mmol/L but that this abnormal level presaged the all-too-familiar deterioration of control (87).
Sage can have metformin-like effects, according to a study published in the British Journal of Nutrition. So you may want to consider cooking with this herb often. It has been used on traditional medicine for centuries, as one of the important herbs to reduce blood sugar. A word of warning – taking high doses of sage along with diabetes medications might cause your blood sugar to go too low, a condition called hypoglycemia. Monitor your blood sugar closely.
Qigong (pronounced “chi gong”) is literally translated as “function of Qi.” It emphasizes the connection between the mind and body. It is a meditative method that consists of breathing techniques that can be combined with body movements in order to regulate, harness, and enhance Qi. Qigong is used as a means of promoting health, healing, spiritual growth, and overall well-being. While Qigong is not typically used as a major treatment modality for diabetes, it has been found to be a valuable adjunctive therapy for this condition. There are specific Qigong exercises for diabetes.15

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

Others have also changed their lives through the diet. Carlos Cervantes, 53 and from the US, was at death's door when he tried it. He weighed 120kg, suffered a heart attack in spring 2011, his eyesight and kidneys were failing and he faced having an infected toe amputated. He even had fungus growing out of his ears, feeding on his ultra-high blood sugar levels. But after seeing a TV report on the Newcastle research, he started eating only 600 calories a day, replacing the supplements with not just vegetables but fruit, lean chicken, turkey, occasional bread and a daily milkshake. Two months later he had lost 40kg and 18 months later he is still free of his type  2 diabetes.


Rosiglitazone (Avandia) and pioglitazone (ACTOS) are in a group of drugs called thiazolidinediones. These drugs help insulin work better in the muscle and fat and also reduce glucose production in the liver. The first drug in this group, troglitazone (Rezulin), was removed from the market because it caused serious liver problems in a small number of people. So far rosiglitazone and pioglitazone have not shown the same problems, but users are still monitored closely for liver problems as a precaution. Both drugs appear to increase the risk for heart failure in some individuals, and there is debate about whether rosiglitazone may contribute to an increased risk for heart attacks. Both drugs are effective at reducing A1C and generally have few side effects. 

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.
For 15 years, Erez Benari’s struggle with his type 2 diabetes had been a losing one. A software engineer at Microsoft in Seattle, Washington, Benari had stuck to a restrictive diet that kept him off most carbs, along with regular insulin shots. But still, his high blood sugar levels never dropped, while his health continued to decline. In 2013, the then 39-year-old Benari suffered a heart attack.
Mango tree leaves have been found to possess medicinal values to lower down the levels of blood glucose. Soak around 30 grams of fresh and clean mango tree leaves in around half a liter of water overnight. Squeeze the leaves in water to make a concoction.Consume this mixture empty stomach in the morning. It is an effective remedy to control beginning diabetes. One can also dry some mango leaves in shade and prepare its powder to be taken twice a day with water.
"There have been cases where patients were treated with insulin for years until they discovered it was a rare genetic variant" of MODY, Roep told Live Science. Those people are no longer diagnosed as having type 1 diabetes, and they may be able to manage their blood sugar levels with either oral drugs or diet and exercise changes, "but that would not be the same as being cured," Roep said.  
According to the World Health Organization (WHO), global diabetes cases have increased from 108 million in 1980 to 422 million in 2014. Those numbers are expected to reach 642 million by 2040. According to data from the U.S. Centers for Disease Control and Prevention (CDC) reports, type 2 diabetes accounts for around 90 to 95 percent of cases in adults.
Qi must flow in the correct quantity and quality through the meridians and organs for health to be maintained. Acupuncture, the insertion of thin, solid metal needles, is performed on 1 or more of the 361 acupuncture points distributed along the meridians in order to regulate and promote the proper flow of Qi.5 Other techniques may be used to stimulate acupuncture points, such as moxibustion, in which the herb “moxa” (Artemesia vulgaris) is used to warm the acupuncture point either above or on the skin. Applied pressure (acupressure), lasers, and magnets also may be used to stimulate acupuncture points.
Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased oran donor are purified, processed, and transferred into another person. Immunosuppressive medications are needed to prevent rejection which is a typical challenge with any transplant. These medications carry a number of serious side effects such as decreased kidney function, high blood pressure, anemia and lowered white blood cells counts.
Momordica Charantia goes under a variety of names and is native to some areas of Asia, India, Africa and South America. Marketed as charantia, it is also known as karela or karolla and bitter melon. The herb may be prepared in a variety of different ways, and may be able to help diabetics with insulin secretion, glucose oxidation and other processes.

It is important to note that these herbs and spices are intended to support blood sugar maintenance and are not meant to replace diabetes/hyperglycemic medications. Research does show benefits to incorporating these herbs and spices, so enjoy incorporating them daily into your favorite recipes for a boost of flavor and blood sugar-lowering benefit.


It’s long been believed that the condition is manageable, but not curable. According to findings published in the journal The Lancet, however, type 2 diabetes can be reversed through weight loss. More specifically, by reducing the amount of fat being carried in and around the abdomen, as accumulated fat in this region impedes the function of the pancreas.


In diabetes, either the pancreas makes insufficient levels of insulin so cells absorb glucose poorly or cells themselves become insulin resistant and thus unable to absorb glucose despite adequate insulin levels. Both types of change increase blood sugar levels above normal. Parsed this way, type I and type II diabetes overlap some but also differ.
Dr Beverley Shields, at the University of Exeter Medical School, who led the research, said: "This finding is really exciting. It suggests that a person with Type 1 diabetes will keep any working beta-cells they still have seven years after diagnosis. We are not sure why this is; it may well be that there is a small group of "resilient" beta-cells resistant to immune attack and these are left after all the "susceptible" beta-cells are destroyed. Understanding what is special about these "resilient" beta-cells may open new pathways to treatment for Type 1 diabetes."
Called ALA for short, this vitamin-like substance neutralizes many types of free radicals. A build-up of free radicals, caused in part by high blood sugar, can lead to nerve damage and other problems. ALA may also help muscle cells take up blood sugar. In a German study, a team of scientists had 40 adults take either an ALA supplement or a placebo. At the end of the four-week study, the ALA group had improved their insulin sensitivity 27 percent. The placebo group showed no improvement. Other studies have shown a decrease in nerve pain, numbness, and burning.
Researchers are discovering more about the causes of type 2 diabetes but as yet there are no clear avenues for a cure. With this said, there has been success in reversing the development of type 2 diabetes. Methods which result in a significant loss of weight have been successful in helping people to control blood glucose levels and have allowed some people to come off their diabetic medication. Methods such as bariatric surgery and very low calorie diets have been successful in allowing patients to reduce dependency on medication.
Q. I have Type 2 diabetes, and I currently take 1,000 milligrams (mg) of metformin twice a day, 5 mg of Onglyza (saxagliptin) once a day, and 5 mg of glipizide once a day. Does it matter when I take the Onglyza and the glipizide? I used to take them both at breakfast, but I thought I might get better blood-glucose-lowering coverage if I took one of them with lunch and one with dinner.
Fluids are bodily liquids other than blood and include saliva, sweat, urine, tears, and semen. Fluids act to moisten both the exterior (skin and hair) and the internal organs. Disharmonies of fluids may result in dryness and excess heat. The key organs involved in the formation, distribution, and excretion of fluids are the lungs, spleen, and kidneys.3

There was a clinical trial conducted at Department of Biochemistry, Postgraduate Institute of Basic Medical Sciences Madras, India that studied 22 patients with type 2 diabetes. It reported that supplementing the body with 400 mg of Gymnema Sylvestre extract daily resulted in remarkable reductions in blood glucose levels, hemoglobin A1c and glycosylated plasma protein levels. What’s even more remarkable is that by the end of this 18 month study, participants were able to reduce the dosage of their prescription diabetes medication. Five were even completely off medication and attaining stable blood sugar levels with Gymnema Sylvestre supplementation alone.
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.
In 1991, the National Institutes of Health issued a consensus statement, cautiously recommending surgery as a treatment for people living with morbid obesity, meaning they have a body mass index, or BMI, over 40. For people who have health complications connected to obesity, such as type 2 diabetes, the limit goes down to a BMI of 35. Relying on these guidelines, insurance companies and public payers like Medicaid and Medicare typically only cover surgery for people living with diabetes who fall into that category.
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