Benari, an Ashkenazi Jew, doesn’t fall into that category. But Cummings and other bariatric experts I spoke to said that surgery should be a possible option for any person whose diabetes isn’t improving. Cummings himself is currently working on a clinical trial in India of bariatric patients with BMIs as low as 25. And he expects similar trials will come down the pipeline.
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.
People with diabetes are unable to control the level of sugar in their blood, usually due to a breakdown in how their bodies use the hormone insulin. It’s not completely clear how obesity can contribute to diabetes, but it is known that excess weight is associated with chronic inflammation and a dysfunctional metabolism. And these factors in turn make it easier for someone to stop responding to the presence of insulin as easily as they once did. So by using surgery to help very obese people with diabetes lose weight, the logic goes, you can indirectly treat or prevent the condition. But doctors such as David Cummings, a senior investigator at the University of Washington’s Diabetes & Obesity Center of Excellence, are pushing back against this way of thinking.
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
Why do people develop prediabetes? Prediabetes develops through a combination of factors that are still being investigated. For sure, lifestyle factors (food, exercise, stress, sleep) play a role, but family history and genetics certainly do as well. It is easy to assume that prediabetes is the result of being overweight, but the relationship is not that simple. While obesity is one underlying cause of insulin resistance, many overweight individuals may never develop prediabetes or type 2 diabetes, and a minority of people with prediabetes have never been overweight. To make matters worse, it can be increasingly difficult to make healthy choices in today’s toxic food environment that steers all of us to make the wrong food choices, and there are many factors that can contribute to weight gain in addition to diet.
Eight categories of diabetes medicine are available in pill form: metformin (a biguanide), sulfonylureas, thiazolidinediones, meglitinides, alpha-glucosidase inhibitors, sodium-glucose transporter 2 (SGLT2), dipeptidyl peptidase-4 (DPP-4) inhibitors, and bile acid sequestrants. Each medicine has good points and bad points. Your doctor will decide which medicine is right for you.
The American Diabetes Association contends the promise of an unlimited source of beta cells from stem cell technology is likely to become a reality in the next several years, in an article on its site. “However, how to use this new source of cells, how these cells live and function after transplantation, and how to best control immune responses against the transplanted tissue present additional barriers to the widespread use of islet transplant. Research in these areas will be essential for the realization of the potential of stem cell derived islets for the cure of diabetes.”
2. Biguanides Metformin is the only form of biguanide currently available. While it may promote modest weight loss and a slight decline in LDL, or "bad," cholesterol, side effects may include nausea, diarrhea, and (when other risk factors are present) the harmful buildup of lactic acid. Glucophage, Glumteza, and Riomet are some brand-name types of metformin available for use.
Recent global increase in diabetes, especially type II diabetes, is a product of the global obesity epidemic and attendant increase in Metabolic syndrome. In turn this has fueled an increase in surgical intervention in the form of Bariatric surgery. Diabetes reversal often follows sustained weight loss and indeed a 2014 Cochrane review of such surgeries found diabetes improvement in 5 randomized clinical trials (4). However, depending on the country and insurance plans, such weight loss surgery can be costly. They're also not risk-free with risks varying greatly depending on the person's overall health profile and age as well as skill and experience of the surgeon.
Trick (most important): Go for longer periods of time without eating (yes, yes, fasting). Consume water only for days or weeks at a time. Your fat will literally dissolve away, and with it your type 2 diabetes and other ailments. The definitive book here is Dr. Joel Fuhrman’s book, Fasting and Eating for Health: A Medical Doctor’s Program for Conquering Disease. I highly recommend it; if you’re skeptical, read the 200+ testimonial comments on Amazon. I and at least 20 of my friends have tried fasts lasting days to weeks. It works, and it is amazing.