Even as things stand now, there are a lot of people left out in the cold. A 2016 study, for instance, found that only 41,000 people with diabetes annually get bariatric surgery in the US—fewer than 5 percent of the total new cases diagnosed every year. And the longer someone has diabetes, studies have suggested, the less likely they are to go into remission if they eventually get surgery. Getting those numbers up will not only require changing the minds of insurers, but public opinion, too.
In some kids with diabetes, repeated insulin injections can cause a thickening or lumpiness of the fatty tissue beneath the skin, called lipodystrophy (or lipohypertrophy). This is more likely if injections are given in the same area again and again rather than in different injection sites as recommended. Usually, this is only a cosmetic problem. But in some cases, insulin injected in areas of skin with lipodystrophy may not be absorbed into the bloodstream as it should. This can make the insulin dose take longer than usual to work.
The overall goal of treatment with insulin (and other diabetes medicines) is to achieve the best match possible between the amounts of insulin given and the person's individual needs for insulin throughout the day and night. In this way, blood sugar levels can be kept as close to normal as possible to help avoid both short- and long-term problems from diabetes.
However, the observation that normalization of glucose in type 2 diabetes occurred within days after bariatric surgery, before substantial weight loss (15), led to the widespread belief that surgery itself brought about specific changes mediated through incretin hormone secretion (16,17). This reasoning overlooked the major change that follows bariatric surgery: an acute, profound decrease in calorie intake. Typically, those undergoing bariatric surgery have a mean body weight of ∼150 kg (15) and would therefore require a daily calorie intake of ∼13.4 MJ/day (3,200 kcal/day) for weight maintenance (18). This intake decreases precipitously at the time of surgery. The sudden reversal of traffic into fat stores brings about a profound change in intracellular concentration of fat metabolites. It is known that under hypocaloric conditions, fat is mobilized first from the liver and other ectopic sites rather than from visceral or subcutaneous fat stores (19). This process has been studied in detail during more moderate calorie restriction in type 2 diabetes over 8 weeks (20). Fasting plasma glucose was shown to be improved because of an 81% decrease in liver fat content and normalization of hepatic insulin sensitivity with no change in the insulin resistance of muscle.
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You’re probably referring to Salacia oblonga (or S. oblonga) an herb traditionally used in Indian medicine to help control the increase in blood sugar that follows a meal. A study published in the January 2005 issue of the Journal of the American Dietetic Association found that a drink made with the herb blunts this effect and also reduces insulin levels. S. oblonga grows in India and Sri Lanka, but is not well known in the United States, and has not been widely researched.
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.”
A randomized, sham-controlled, crossover study of 50 adults with type 2 diabetes evaluated the effectiveness of Percutaneous Nerve Stimulation (PENS) therapy in the treatment of neuropathic pain. PENS is a modern adaptation of acupuncture that uses percutaneously placed acupuncture needles to stimulate peripheral sensory and motor nerves innervating the region of neuropathic pain. The results showed that active PENS treatment improved neuropathic pain symptoms in all patients. In addition to reducing pain, the treatment improved physical activity levels, sense of well-being, and quality of sleep and reduced oral non-opioid analgesic medication requirements.2