A substantial proportion of people who experience type 2 diabetes remission after gastric bypass eventually have relapse of the disease down the road. I feel the best study of this was done by my co-author on CROSSROADS, David Arterburn. In a study of nearly 5,000 patients with diabetes who underwent [gastric bypass surgery] and were followed retrospectively for 13 years, about 70% experienced diabetes remission. Among these, about 1/3 eventually relapsed, but it’s important to note that the median disease-free interval was 8.3 years.
TCM does not offer a cure for diabetes, but instead aims to optimize the body’s ability to function normally. There is still a great need for more and better research on the efficacy and safety of both Chinese herbals, which are being used along with or in lieu of Western pharmaceuticals, and acupuncture in the care of diabetic patients. Patients, TCM practitioners, and physicians who choose to integrate the two forms of care must all recognize the importance of careful monitoring of blood glucose levels, as well as monitoring for potential side effects such as drug-herb interactions.
Sulfonylureas stimulate the beta cells of the pancreas to release more insulin. Sulfonylurea drugs have been in use since the 1950s. Chlorpropamide (Diabinese) is the only first-generation sulfonylurea still in use today. The second generation sulfonylureas are used in smaller doses than the first-generation drugs. There are three second-generation drugs: glimepiride (Amaryl), glipizide (Glucotrol and Glucotrol XL), and glyburide (Micronase, Glynase, and Diabeta). These drugs are generally taken one to two times a day, before meals. All sulfonylurea drugs have similar effects on blood glucose levels, but they differ in side effects, how often they are taken, and interactions with other drugs.
Taking a fish oil supplement can help improve markers of diabetes by reducing triglyceride levels and raising HDL cholesterol levels. Research published in the Journal of Research in Medical Sciences shows that omega-3 fatty acids found in fish oil are necessary for proper insulin function, preventing insulin intolerance and reducing inflammation. (16) To use fish oil as a natural remedy for diabetes, take 1,000 milligrams daily.
Alternative: “The reason I use food-based supplements is because they most closely help correct what I see as the problem: The food we’re eating is lacking in nutrients,” DeLaney says. “If their vitamin D is low, it tells me all their fat-soluble vitamins are low.” She uses cod liver oil along with high-vitamin butter oil to restore these deficiencies.
According to TCM, Xiao-ke is attributed to three main factors: improper diet (consuming large quantities of sweets, fatty or greasy foods, alcohol, and hot drinks such as hot coffee or tea), emotional disturbances (stress, anxiety, depression,) and a constitutional Yin deficiency (fatigue, weakness, lethargy, pale complexion).7 To the Western ear, TCM diagnoses sound esoteric, even poetic. In the case of a person with diabetes presenting with symptoms of excessive thirst, the diagnosis can be described as kidney Yin deficiency along with lung Yin deficiency and “internal heat that consumes fluids, thus bringing on wasting and thirsting.”7
A. A couple of factors determine the optimal timing of medicine doses. Some drugs, such as rapid-acting insulin, are usually taken just before meals, and others must be taken on an empty stomach or with food. The way a drug works in the body, as well as the time it takes to start working and the duration of its action, may also determine the best time to take a medicine. Glipizide begins working in approximately 30 minutes to an hour. Since this drug increases insulin secretion, it is recommended that you take it before meals to reduce the risk of hypoglycemic episodes. If you take it only once a day, it’s best to do so prior to the largest meal of the day, or with breakfast. Saxagliptin starts working within hours and only achieves peak concentrations in the body after several hours. Saxagliptin, and other agents in the dipeptidyl peptidase-4 (DPP-4) inhibitor class, prevent the breakdown of a hormone called glucagon-like peptide (GLP) in response to the extra glucose in your blood after you eat, which increases the body’s insulin production. Although concentrations of GLP and other similar hormones are higher after eating, they are also released throughout the day under normal circumstances. So saxagliptin and other DPP-4 inhibitors can be taken without regard to meals.
Within the hepatocyte, fatty acids can only be derived from de novo lipogenesis, uptake of nonesterified fatty acid and LDL, or lipolysis of intracellular triacylglycerol. The fatty acid pool may be oxidized for energy or may be combined with glycerol to form mono-, di-, and then triacylglycerols. It is possible that a lower ability to oxidize fat within the hepatocyte could be one of several susceptibility factors for the accumulation of liver fat (45). Excess diacylglycerol has a profound effect on activating protein kinase C epsilon type (PKCε), which inhibits the signaling pathway from the insulin receptor to insulin receptor substrate 1 (IRS-1), the first postreceptor step in intracellular insulin action (46). Thus, under circumstances of chronic energy excess, a raised level of intracellular diacylglycerol specifically prevents normal insulin action, and hepatic glucose production fails to be controlled (Fig. 4). High-fat feeding of rodents brings about raised levels of diacylglycerol, PKCε activation, and insulin resistance. However, if fatty acids are preferentially oxidized rather than esterified to diacylglycerol, then PKCε activation is prevented, and hepatic insulin sensitivity is maintained. The molecular specificity of this mechanism has been confirmed by use of antisense oligonucleotide to PKCε, which prevents hepatic insulin resistance despite raised diacylglycerol levels during high-fat feeding (47). In obese humans, intrahepatic diacylglycerol concentration has been shown to correlate with hepatic insulin sensitivity (48,49). Additionally, the presence of excess fatty acids promotes ceramide synthesis by esterification with sphingosine. Ceramides cause sequestration of Akt2 and activation of gluconeogenic enzymes (Fig. 4), although no relationship with in vivo insulin resistance could be demonstrated in humans (49). However, the described intracellular regulatory roles of diacylglycerol and ceramide are consistent with the in vivo observations of hepatic steatosis and control of hepatic glucose production (20,21).
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
The accepted view has been that the β-cell dysfunction of established diabetes progresses inexorably (79,82,83), whereas insulin resistance can be modified at least to some extent. However, it is now clear that the β-cell defect, not solely hepatic insulin resistance, may be reversible by weight loss at least early in the course of type 2 diabetes (21,84). The low insulin sensitivity of muscle tissue does not change materially either during the onset of diabetes or during subsequent reversal. Overall, the information on the inhibitory effects of excess fat on β-cell function and apoptosis permits a new understanding of the etiology and time course of type 2 diabetes.
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
Another study published in the same journal, however, examined the effect of chromium on glycemic control in insulin-dependent people with type 2 diabetes. People were given either 500 or 1,000 mcg a day of chromium or a placebo for six months. There was no significant difference in glycosylated hemoglobin, body mass index, blood pressure, or insulin requirements across the three groups.
Currently, there is no cure for Type 1 diabetes, but it can be treated successfully by administering insulin, either by an injection or pump, and by following a healthy, balanced diet and getting regular physical activity. Looking after diabetes requires planning and attention, which may feel overwhelming at times, especially when your child is first diagnosed. However, there’s no reason for it to stop your child living the healthy, happy and successful life you had hoped for them.
Schedule a yearly physical exam and regular eye exams. Your regular diabetes checkups aren't meant to replace regular physicals or routine eye exams. During the physical, your doctor will look for any diabetes-related complications, as well as screen for other medical problems. Your eye care specialist will check for signs of retinal damage, cataracts and glaucoma.
“Type 1 diabetes affects about one in every 100 companion animals in the U.S., including dogs and cats, and approximately 1.25 million American children and adults,” Purdue University reports. “Because diabetes in dogs happens similarly in humans, treatment has so far been largely the same: Both need their glucose to be monitored throughout the day and insulin to be administered after meals.”
First, speak with your doctor — you should not start relying on plants or stop your medicines on your own. You’ll need to work closely with your diabetes health-care provider, and you’ll need to do some research and monitor yourself. Still, millions of people are using plant medicines, and a number of them have written to Diabetes Self-Management to tell us that they’re working.
She says that the problem with diabetes is that it’s a silent disease. “Apart from needing to go to the loo a few times in the middle of the night, I experienced zero symptoms. Diabetes had no impact on my life – 99% of the time I forgot I even had it. Perhaps if it had been a disease with more symptoms, I would have been more motivated to do something about it.”
A kid who has really low blood sugar might need a glucagon shot. Glucagon (say: GLOO-kuh-gon) is a hormone that helps raise blood sugar levels very quickly. Your doctor will tell your parents about these shots and explain how and when to give you one. It also might be a good idea for older brothers and sisters, babysitters, teachers, and other adults who take care of you to know about these shots. Everyone also should know when to call 911 because of a diabetes emergency.
Oskar Minkowski and Joseph Von Mering met accidently in a library in 1889. Striking up a conversation, they began to debate whether the pancreas helped digest and absorb fats. Performing a pancreatectomy on a dog that same night, they found the dog developed glycosuria, a condition associated with diabetes that causes the production of a lot of urine. Minkowski found the urine was 12% sugar. They then depancreatized another dog and found that prevented hyperglycemia.
But a prescription doesn’t have to be a life sentence. It may be that, through weight loss and physical activity, you can reduce your risk of diabetes, or prevent it from occurring. "The only evidence-based treatment that can 'cure' diabetes is weight-loss surgery,” says Gupta, “but weight loss in overweight or obese type 2 diabetes patients certainly helps with decreasing drugs.”
The earliest oral diabetes drugs were the sulfonylureas. These work by stimulating the pancreas to produce more insulin. The oldest of these drugs still on the market is chlorpropamide (Diabinese), which has been used for more than 50 years. The second-generation sulfonylureas are taken once or twice a day. They include glipizide (Glucotrol, Glucotrol XL), glyburide (Micronase, DiaBeta, Glynase), and glimepiride (Amaryl).
You can't "turn off" insulin once it's been injected — it's going to work no matter what — so it's important to time and match the amounts of insulin given with the body's needs throughout the day and night. Following a meal plan from day to day and getting regular physical activity will help make it easier for your child to achieve good diabetes control.
The Food and Drug Administration (FDA) does not regulate herbs, minerals, animal products, and patent formulas that come into the United States from China. Herbal products are considered dietary supplements according to the Dietary Supplement and Health Education Act (DSHEA) of 1994; therefore, the manufacturers do not need FDA approval or evaluation for safety, purity, and efficacy before bringing their products to market. There have been reports of some formulas imported from China containing heavy metals such as lead and mercury and of others being deliberately adulterated with conventional Western pharmaceuticals, such as corticosteroids, anti-inflammatory agents, and benzodiazepines.16
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.
Oregano and Sage: One group of researchers tested a variety of herbs and spices for a specific antioxidant activity that help to prevent an increase in hemoglobin A1C, a protein maker in the blood that is affected by blood sugar levels. They found that two of the herbs with the highest antioxidant levels were oregano and sage (1)…can you say Italian food?
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."
Dr. Mona Morstein is a naturopathic physician with a medical practice focused in integrative diabetes treatment. Her clinic, Arizona Integrative Medical Solutions, is located in Tempe, Arizona, where she sees patients of all ages and genders for acute and chronic conditions. An expert on prediabetes and diabetes, she is a frequent lecturer at conferences and webinars, and is the founder and executive director of The Low Carb Diabetes Association. Dr. Morstein is also a member of the Arizona Diabetes Coalition. Visit her website lowcarbdiabetes.org
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.