A computer-controlled algorithm connects the CGM and insulin pump so they communicate. As the CGM detects high blood sugar, the pump knows to provide a specific amount of insulin. The goal is to provide the patient with more normalized and ideal blood sugar management without the constant hassle of decisions by the patient who is presumably allowed to live a more normal life.
“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.
When cells are resistant to insulin, they don’t use the insulin effectively to bring the glucose from the bloodstream into the cell. The pancreas needs to produce more insulin to overcome this resistance in an effort to normalize blood sugar levels. When the pancreas can’t keep up with the insulin demands in a person with insulin resistance, that person develops diabetes.
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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Online diabetes prevention programs: The CDC has now given pending recognition status to three digital prevention programs: DPS Health, Noom Health, and Omada Health. These offer the same one year long educational curriculum as the DPP study, but in an online format. Some insurance companies and employers cover these programs, and you can find more information at the links above. These digital versions are excellent options for those who live far away from NDPP locations or who prefer the anonymity and convenience of doing the program online.
One can't, in spite of the initial reported success of following a 600 kcal vegetarian diet for 8 weeks cured all 11 participants of their diabetes, resulting in an enormous very beneficial weight loss of 15 kg and reversal of pancreatic fat infiltration that many think is the underlying defect causing type 2 diabetes, see this 2011 paper Reversal of type 2 diabetes: normalisation of beta cell function in association with decreased pancreas and liver triacylglycerol only just 3 months afterwards diabetes had recurred in 5 out of the 11 see Diet reverses Type 2 Diabetes
Chronic exposure of β-cells to triacylglycerol or fatty acids either in vitro or in vivo decreases β-cell capacity to respond to an acute increase in glucose levels (57,58). This concept is far from new (59,60), but the observations of what happens during reversal of diabetes provide a new perspective. β-Cells avidly import fatty acids through the CD36 transporter (24,61) and respond to increased fatty acid supply by storing the excess as triacylglycerol (62). The cellular process of insulin secretion in response to an increase in glucose supply depends on ATP generation by glucose oxidation. However, in the context of an oversupply of fatty acids, such chronic nutrient surfeit prevents further increases in ATP production. Increased fatty acid availability inhibits both pyruvate cycling, which is normally increased during an acute increase in glucose availability, and pyruvate dehydrogenase activity, the major rate-limiting enzyme of glucose oxidation (63). Fatty acids have been shown to inhibit β-cell proliferation in vitro by induction of the cell cycle inhibitors p16 and p18, and this effect is magnified by increased glucose concentration (64). This antiproliferative effect is specifically prevented by small interfering RNA knockdown of the inhibitors. In the Zucker diabetic fatty rat, a genetic model of spontaneous type 2 diabetes, the onset of hyperglycemia is preceded by a rapid increase in pancreatic fat (58). It is particularly noteworthy that the onset of diabetes in this genetic model is completely preventable by restriction of food intake (65), illustrating the interaction between genetic susceptibility and environmental factors.
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.
Before making any fiber recommendations, Dean has her patients tested for “pancreatic insufficiency.” She believes people with pancreatic insufficiency should be given digestive enzymes along with fiber, “otherwise the fiber will just bloat them up, and they’ll be quite unhappy,” she says. Dean uses a glucomannan fiber supplement for her patients with type 2 diabetes.
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.
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.