The first hint that type 2 diabetes is a fully reversible syndrome came from bariatric surgery. Almost a quarter century ago, Pories et al. (12) demonstrated that blood glucose levels normalized in obese people with type 2 diabetes undergoing bariatric surgery and that 10 years later, almost 90% remained free of diabetes. The phenomenon was more recently tested in a randomized prospective study comparing gastric banding with intensive medical therapy for type 2 diabetes (13). This least invasive type of surgery was most suitable for the randomized study, although it was associated with lower rates of diabetes reversal than other procedures. Mean fasting plasma glucose fell to normal levels in the surgically treated group but declined only modestly in the intensive medical treatment group despite oral agents and insulin (Fig. 1) (13). Remission of diabetes was related to the degree of weight loss rather than to group allocation and was achieved in 73% of the surgical group and 13% of the intensive medical treatment group because surgery was more effective in achieving weight loss as previously described (14). Type 2 diabetes can be reversed by applying a surgical procedure that diminishes fat mass.
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.
According to the 2017 National Diabetes Statistics Report, over 30 million people living in the United States have diabetes. That’s almost 10 percent of the U.S. population. And diabetes is the seventh leading cause of death in the United States, causing, at least in part, over 250,000 deaths in 2015. That’s why it’s so important to take steps to reverse diabetes and the diabetes epidemic in America.
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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.
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.”
All you need to know about insulin sensitivity factor Insulin sensitivity factor is a measurement that describes how blood sugar levels are affected by taking 1 unit of insulin. It can help a person with type 1 diabetes regulate their blood sugar levels. Learn more about what insulin sensitivity factor is, who should test and when, and what the results mean. Read now
Traditional Chinese medicine (TCM) is a system of healing that is thousands of years old. It has long been utilized in the Chinese culture to treat the complex of symptoms that Western medicine terms diabetes mellitus. This article will outline the key concepts and therapies of TCM that play a role in the evaluation and treatment of diabetic patients.
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Diabetes is a serious disease requiring professional medical attention. The information and recipes on this site, although as accurate and timely as feasibly possible, should not be considered as medical advice, nor as a substitute for the same. All recipes and menus are provided with the implied understanding that directions for exchange sizes will be strictly adhered to, and that blood glucose levels can be affected by not following individualized dietary guidelines as directed by your physician and/or healthcare team.
Anti-diabetic medications are used to control type 2 diabetes mellitus. In this case, body cells are resistant to insulin (injections), therefore medications are given orally to lower the blood glucose levels. In most of the cases, oral hypoglycemic agents are highly effective. One just needs to ascertain which suits him/her the best. There are several classes of anti-diabetic drugs. Largely, their selection depends on the nature of the diabetes, age and situation of the person, as well as other factors.
A couple of studies have found that cinnamon improves blood glucose control in people with type 2 diabetes. In the first study, 60 people with type 2 diabetes were divided into six groups. Three groups took 1, 3 or 6 g of cinnamon a day and the remaining three groups consumed 1, 3 or 6 g of placebo capsules. After 40 days, all three doses of cinnamon significantly reduced fasting blood glucose, triglycerides, LDL cholesterol, and total cholesterol.
After two months under the care of the naturopath, John returned to his primary care doctor to discover that his hemoglobin A1c had dropped from 8.9% to 4.9%—a nondiabetic range. For eight months and counting, he’s been off all his diabetes medication. His last A1c reading was 5.1%. With the help of his naturopath, John seems to have reversed his diabetes.
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.
The thin silicon patch – about the size of a penny – includes more than 100 microneedles, each the size of an eyelash. “The microneedles are loaded with enzymes that are able to sense blood glucose levels and trigger rapid release of insulin into the blood stream in response to high glucose,” according to the American Diabetes Association. “Dr. Gu and his colleagues have tested this technology in a mouse model of type 1 diabetes where it was able to effectively lower blood glucose levels for up to nine hours – a promising result that sets up additional pre-clinical tests (in animals) and, hopefully, eventual clinical trials (in humans).”
During digestion, pancreatic beta cells release not only insulin, but in a much smaller amount, the hormone amylin, which helps mediate sharp rises in blood glucose levels following meals. Pramlintide (Symlin) is a new, synthetic form of amylin that may help improve blood glucose control for some type 1 and type 2 diabetic people who use insulin. Pramlintide has few side effects (nausea is the main one) but it adds another set of injections to a diabetic person's daily pharmaceutical routine, as it cannot be mixed in the same syringe with insulin.
This modality can be contrasted with the emphasis of conventional medicine, which is to cure or mitigate disease, as reported by the American Holistic Health Association. For example, a conventional practitioner will follow an established algorithm for diabetes management that includes a medically established protocol centered on monitoring blood sugar and prescribing medications to balance it. An alternative medicine provider takes a personalized, whole-person approach that may include a prescription for changes in diet and exercise habits, stress reduction, and other lifestyle considerations. (The table below offers a comparison of alternative medicine with conventional medicine.)
In type I diabetes, insufficient levels of insulin result from the immune system itself attacking the pancreatic beta cells. On the other hand, while beta cell dysfunction varies widely between type II diabetes patients, insulin resistance is a major part of the disease. Restoring the beta cells of the pancreas to health is the treatment approach these two diseases share to some degree.
Diabetes is a disease characterized by a person’s inability to process carbohydrates, a condition that if untreated can lead to often-catastrophic health consequences: lethargy, diminished eyesight, heart attacks, strokes, blindness and a loss of circulation in the feet that could lead to amputation. The Centers for Disease Control and Prevention estimate that in 2014, about 29 million Americans – almost 1 in 10 – had diabetes.
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.
It would be a mistake to assume that the diabetes has gone away, however. Basically, type 1 diabetes occurs when about 90 percent of the body's insulin-producing cells have been destroyed. At the time that type 1 diabetes is diagnosed, most patients still are producing some insulin. If obvious symptoms of type 1 diabetes emerge when the patient has an illness, virus or cold, for example, once the illness subsides the body's insulin needs may decrease. At this point, the number of insulin-producing cells remaining may be enough — for the moment — to meet the person's insulin needs again.
With research funding, people managing this challenging disease have received tools that help them to live better lives. Every advancement or milestone has elevated our understanding of Type 1, achieved improved management and has gotten us one-step closer to an actual cure. That’s why donating to diabetes research is so important — it’s the only way we’ll eliminate this disease.
“These findings are very exciting. They could revolutionize the way type 2 diabetes is treated. This builds on the work into the underlying cause of the condition, so that we can target management effectively,” lead researcher Roy Taylor, from the Newcastle University, told The Guardian. Interesting, indeed, as many of the current treatments for type 2 diabetes involve medication and even surgery to restrict stomach capacity.
It was the same endorsement the first Diabetes Surgery Summit, also organized by Cummings in 2007, had made, but the landscape had changed since then. In addition to more accumulated research, this time, their stance was backed by over 50 international professional organizations, including the American Diabetes Association. And while other medical societies and organizations had long backed surgery as an option for diabetes, the DSS-II guidelines are the first meant to guide clinical practice.
Insulin therapy is taken by diabetics who have type 1 diabetes mellitus, or IDDM, i.e., insulin-dependent diabetes mellitus. In this condition, body is not able to produce any insulin, therefore, it has to be administered externally. Patients with type 2 diabetes mellitus are either resistant to insulin or have relatively low insulin production, or both.
The theory of Five Phases, Wu Xing, is a means of classifying phenomena in terms of five basic processes represented by the elements wood, fire, earth, metal, and water. There exists a dynamic balance and relationship among the elements such that if the balance is interrupted or destroyed, pathological changes may occur. The clockwise movement of one element into the next (wood, fire, earth, and so forth) whereby one element generates, acts on, or promotes the following element, is referred to as the Sheng cycle. The Ke cycle represents an element acting on or controlling another element in a different order (Figure 2).3
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.”
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).
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Because of poor peripheral circulation and slowed healing of skin infections and ulcerations, needling of the lower extremities in diabetic patients should be performed with extreme caution and sterile technique. In general, however, acupuncture appears to be a relatively safe form of treatment. An extensive worldwide literature search identified only 193 adverse events (including relatively minor events, such as bruising and dizziness) over a 15-year period. There have been approximately 86 reported cases of hepatitis B and 1 case of HIV transmission. In all of these cases, nondisposable needles were used.6
The gastric bypass that Benari got, for instance, resculpts the digestive system. Surgeons seal off a large part of the stomach using staples, leaving behind a small upper pouch, while rerouting part of the small intestine to the new pouch, bypassing the rest. The net result is that less food can fit in the stomach, and there’s much less time for that food to be turned into calories before it exits the body. The vertical sleeve gastrectomy, the most popular surgery in recent years, only tinkers with the stomach, using staples to turn it into a small banana-shaped organ. (There are less permanent procedures, such as the lap band, but these have fallen out of favor due to their ineffectiveness).
If you have type 2 diabetes and your body mass index (BMI) is greater than 35, you may be a candidate for weight-loss surgery (bariatric surgery). Blood sugar levels return to normal in 55 to 95 percent of people with diabetes, depending on the procedure performed. Surgeries that bypass a portion of the small intestine have more of an effect on blood sugar levels than do other weight-loss surgeries.
The reason the body stops producing insulin is that it kills off the pancreas’ beta cells, which produce insulin. People with Type 1 diabetes must get their insulin from injections or ingestion, a cumbersome and often imprecise task. Too little insulin and blood sugar levels stay high for extended periods, potentially damaging the body; too much and blood sugar levels crash, possibly causing a person with diabetes to faint or experience an even worse problems, such as a stroke.
In type 2 diabetes the body has an increasingly harder time to handle all the sugar in the blood. Large amounts of the blood sugar-lowering hormone insulin are produced, but it’s still not enough, as insulin sensitivity decreases. At the time of being diagnosed with type 2 diabetes, diabetics usually have ten times more insulin in their bodies than normal. As a side effect, this insulin stores fat and causes weight gain, something that has often been in progress for many years before the disease was diagnosed.
Dr. Steven Lin is a dentist who focusses on the mouth-body connection. Through ancestral nutrition, the oral and gut microbiome, and epigenetics, his programs aim to prevent chronic dental and systemic disease. His book 'The Dental Diet', will be released on January 18'. To receive free updates on functional oral health from Dr. Lin, subscribe to his newsletter below.