Practitioners agree that nutrition is the cornerstone of diabetes management, and that a range of nutrition intervention strategies can be used to meet the metabolic goals and individual preferences of the person with diabetes. However, there are significant differences in the approach and methodologies used by alternative and conventional practitioners to manage the disease. One difference is in terminology. When is remission really remission?
Western or conventional therapies for diabetes have been geared toward regulating blood glucose with a combination of diet modification, insulin and/or oral pharmacological agents, weight loss when appropriate, and exercise. Although Western medicine and Traditional Chinese medicine (TCM) share the diabetes treatment goals of reducing symptoms and preventing complications, their approaches to conceptualizing, diagnosing, and treating the disease are very different. This article will outline the key concepts and therapies of TCM that play a role in the evaluation and treatment of diabetic patients.

Oral diabetes medications may also come in combination tablets such as Metaglip (glipizide/metformin), Prandimet (repaglinide/metformin), Glucovance (glyburide/metformin), Janumet (sitagliptin/metformin), Avandamet (rosiglitazone/metformin), Avandaryl (rosiglitazone/ glimepiride), Duetact (pioglitazone/glimepiride), Actoplus Met (pioglitazone/metformin).


Sometimes people with type 2 diabetes are able to bring their blood glucose levels under control through a combination of weight loss, diet, and exercise, but many people with diabetes take medication to manage their condition. For some, a single diabetes medication is effective, while in other cases a combination of drugs works better. “If diabetes control is suboptimal on the maximum dose of one medication, it’s prudent to add on a second agent,” says Deepashree Gupta, MD, assistant professor of endocrinology at Saint Louis University in Missouri.
Christina Kalberg is the Executive Director of the Diabetes Research Connection (DRC). She comes to DRC with over 10 years of experience as a senior-level executive effectively integrating passion and in-depth skill into well-crafted marketing, public relations, communications, operations and fundraising campaigns to directly fuel multi-million-dollar revenue growth. Christina is a strategist, deftly aligning staff and other stakeholders. She has a Bachelor’s degree in Journalism with an emphasis in Public Relations and a Master’s degree in Business Administration. Christina is also an adjunct professor for the marketing program at Point Loma Nazarene University, where she teaches Digital and Social Media Marketing.

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


In 1991, the National Institutes of Health issued a consensus statement, cautiously recommending surgery as a treatment for people living with morbid obesity, meaning they have a body mass index, or BMI, over 40. For people who have health complications connected to obesity, such as type 2 diabetes, the limit goes down to a BMI of 35. Relying on these guidelines, insurance companies and public payers like Medicaid and Medicare typically only cover surgery for people living with diabetes who fall into that category.
In 1991, the National Institutes of Health issued a consensus statement, cautiously recommending surgery as a treatment for people living with morbid obesity, meaning they have a body mass index, or BMI, over 40. For people who have health complications connected to obesity, such as type 2 diabetes, the limit goes down to a BMI of 35. Relying on these guidelines, insurance companies and public payers like Medicaid and Medicare typically only cover surgery for people living with diabetes who fall into that category.
Because TCM defines diabetes as a disease characterized by Yin deficiency and excess internal heat, an example of a dietary prescription would be to consume spinach, which is cooling, “strengthens all the organs, lubricates the intestines, and promotes urination.”7 A recommendation might be to boil tea from spinach and drink 1 cup three times/day. Other foods considered to be cooling and beneficial for diabetes include vegetables and grains, such as celery, pumpkin, soybeans (i.e., tofu, soymilk), string beans, sweet potato/yam, turnips, tomato, wheat bran, and millet. Fruit remedies, which act in specific therapeutic ways, include crab apple, guava, plum, strawberry, and mulberry.7 It is generally recommended that patients eat a wide variety of seasonal foods and avoid or minimize consumption of sweets and fruits. Meals should be smaller, eaten more frequently, and eaten at regular times each day.
The reason they need it: Their own insulin-producing islet cells, located in the pancreas, aren’t working. Now, scientists across the US are racing to develop effective ways to transplant new islet cells in people with diabetes—an alternative that could make daily life easier and lower risk for insulin side effects like dangerous low blood sugar episodes. 
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).
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.

According to the American Diabetes Association, islet transplantation can replace insulin injections and provide more physiological glucose control, but “there are not sufficient donor islets available for all the individuals who need them, and often it takes islets from several donors to transplant one recipient, exacerbating the donor shortage. A major reason for the need for multiple donors is that more than 80% of transplanted islets die within the first week after transplantation. The surviving islets may overwork and gradually die from exhaustion.”
Although a defect in mitochondrial function is associated with extremes of insulin resistance in skeletal muscle (30), this does not appear to be relevant to the etiology of type 2 diabetes. No defect is present in early type 2 diabetes but rather is directly related to ambient plasma glucose concentration (31). Observed rates of mitochondrial ATP production can be modified by increasing or decreasing plasma fatty acid concentration (32,33). Additionally, the onset of insulin stimulation of mitochondrial ATP synthesis is slow, gradually increasing over 2 h, and quite distinct from the acute onset of insulin’s metabolic effects (34). Although it remains possible that secondary mitochondrial effects of hyperglycemia and excess fatty acids exist, there is no evidence for a primary mitochondrial defect underlying type 2 diabetes.
There are numerous studies of botanical medicines and herbs for diabetes that speak to the effectiveness of natural and home remedies for diabetes. I have listed the most useful herbs with the most documented benefits. A patient does not need to take one hundred bottles a day of everything out on the market, but rather it is important to focus on a few botanicals backed by the most impressive studies and the best clinical evidence. The botanicals listed below are safe and effective.
According to the American Diabetes Association, nearly 21 million people in the United States have diabetes, with about 90 percent to 95 percent having type 2 diabetes. Sugar, in the form of glucose, is the main source of fuel for body cells. The hormone insulin allows glucose in the blood to enter cells. In type 2 diabetes, either the body doesn't produce enough insulin or cells are resistant to effects of insulin.
The researchers concluded that the herb might help treat or prevent type 2 diabetes. They noted that S. oblonga appears to act in the same way as today’s oral diabetes drugs (alpha-glucoside inhibitors) in interfering with the absorption of carbohydrates. S. oblonga is not free of side effects, however. It can cause the same gas and cramping as the prescription drugs, particularly in higher doses.
I asked a question at Quora - The first life style change a person is asked to bring in himself is - walk a lot or exercise as much as one can do. Walking or exercising is dehydration. So why dehydration is not a first line of treatment of Diabetes? He replied that walking or exercising is not dehydration. Further he said that while walking a person is suggested to keep high levels of hydration. The people are desperate to mis-lead and mis-inform.
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.
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.
Currently, no fully artificial pancreas system has been approved by the FDA for use in the U.S. The most advanced product on the market in the USA is currently Medtronic’s MiniMed system which can automatically suspend insulin delivery when it detects low blood sugars. The next generation of their system will anticipate low blood sugars and stop insulin delivery in advance.
Indian gooseberry is one of the richest sources of vitamin C. When mixed with bitter gourd juice, its efficacy manifolds, and it can prove to be a highly effective concoction against diabetes. The mixture arouses the islets of Langerhans, that is, the isolated group of cells that secrete the hormone insulin in the pancreas. Just consume one tablespoon of Indian gooseberry juice mixed with one cup of bitter gourd juice daily for 8 to 12 weeks. It is recommended to take it first thing in the morning, if possible. The mixture has also been found to trigger insulin production. All in all, a great herbal remedy for diabetes.
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Type 2 diabetes is by far the most common form (around 90% of all cases) and the one which is increasing the most. It primarily affects overweight people in middle age or later. It’s not uncommon for the affected person to also have a high blood pressure and an abnormal lipid profile. Gestational diabetes is a temporary special case of type 2 diabetes.
The review affirmed how effective surgery is at treating diabetes (possibly even type 1 diabetes). Around two-thirds of patients with diabetes experience a full remission soon after surgery, while the rest are often better able to control their blood sugar through diet, exercise and medication. Other studies have shown that diabetics who have surgery outlive those who haven’t. Some longer-term research has suggested that one-third of these successes slide back into having active diabetes after five years, but to a lesser degree than they might have without surgery. By contrast, a 2014 study found that fewer than 2 percent of diabetes patients given standard care experienced any remission within a seven-year span.
The study included 298 patients, aged 20 to 65, who had been diagnosed with type 2 diabetes within the previous six years. Half of the patients were put on a low-calorie diet and lost an average of 10 to 15 kg (22 to 33 pounds). The other half of patients, who served as a control group, received the best diabetes management available — but that did not include a weight loss program.
In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.
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The findings, reported in the journal Cell Metabolism, show the cells grown in the lab can reduce blood glucose levels to normal. Professor Evans added: “It was a little bit of a surprise to see that beta cells produce a high level of this regulator, but beta cells have to release massive amounts of insulin quickly to control sugar levels. It’s a very energy-intensive process.”
After every hospitalisation she used to come back with blood sugar under reasonable limits. Within 30 days or so, her blood sugar levels will start increasing. With the rising blood sugar level, she used to get severe tooth ache. To manage her tooth ache she used to take pain killers. After few days of use of pain killers her blood sugar will become very high. Almost 450 to 550.
The earliest predictor of the development of type 2 diabetes is low insulin sensitivity in skeletal muscle, but it is important to recognize that this is not a distinct abnormality but rather part of the wide range expressed in the population. Those people in whom diabetes will develop simply have insulin sensitivity, mainly in the lowest population quartile (29). In prediabetic individuals, raised plasma insulin levels compensate and allow normal plasma glucose control. However, because the process of de novo lipogenesis is stimulated by higher insulin levels (38), the scene is set for hepatic fat accumulation. Excess fat deposition in the liver is present before the onset of classical type 2 diabetes (43,74–76), and in established type 2 diabetes, liver fat is supranormal (20). When ultrasound rather than magnetic resonance imaging is used, only more-severe degrees of steatosis are detected, and the prevalence of fatty liver is underestimated, with estimates of 70% of people with type 2 diabetes as having a fatty liver (76). Nonetheless, the prognostic power of merely the presence of a fatty liver is impressive of predicting the onset of type 2 diabetes. A large study of individuals with normal glucose tolerance at baseline showed a very low 8-year incidence of type 2 diabetes if fatty liver had been excluded at baseline, whereas if present, the hazard ratio for diabetes was 5.5 (range 3.6–8.5) (74). In support of this finding, a temporal progression from weight gain to raised liver enzyme levels and onward to hypertriglyceridemia and then glucose intolerance has been demonstrated (77).
While there is no consensus yet on just what type of diet is best for people with type 2 diabetes to follow, there is overwhelming evidence that being active is one of the best things you can do to control your condition. The National Institutes of Health’s landmark Look AHEAD trials, which sought to establish whether intensive lifestyle modifications could affect diabetes outcomes, found that when participants lowered the amount of fat in their diet and increased their physical activity to 150 minutes a week, they reduced their chances of developing type 2 diabetes by 58 percent.
In a study that looked at the anti-hyperglycemic and lipid-lowering properties of Emblica officinalis Gaertn. (Amla) fruit in normal and diabetic human volunteers, the results showed a significant decrease in fasting and 2-h post-prandial blood glucose levels on the 21st day in both normal and diabetic subjects receiving 1, 2 or 3 grams of Amla powder per day as compared with their baseline values.
Q. I have Type 2 diabetes, and I currently take 1,000 milligrams (mg) of metformin twice a day, 5 mg of Onglyza (saxagliptin) once a day, and 5 mg of glipizide once a day. Does it matter when I take the Onglyza and the glipizide? I used to take them both at breakfast, but I thought I might get better blood-glucose-lowering coverage if I took one of them with lunch and one with dinner.

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The study included 298 patients, aged 20 to 65, who had been diagnosed with type 2 diabetes within the previous six years. Half of the patients were put on a low-calorie diet and lost an average of 10 to 15 kg (22 to 33 pounds). The other half of patients, who served as a control group, received the best diabetes management available — but that did not include a weight loss program.

Effect of an 8-week very-low-calorie diet in type 2 diabetes on arginine-induced maximal insulin secretion (A), first phase insulin response to a 2.8 mmol/L increase in plasma glucose (B), and pancreas triacylglycerol (TG) content (C). For comparison, data for a matched nondiabetic control group are shown as ○. Replotted with permission from Lim et al. (21).


The immune system of a person with diabetes kills off useful “beta” cells, but the UT researchers say they have found a way to make other cells in the pancreas perform the necessary work. Their approach, announced earlier this month in the academic journal Current Pharmaceutical Biotechnology, not only would have implications for Type 1, formerly called juvenile diabetes, but also could help treat the far more common Type 2 variety, also known as adult-onset diabetes.


It's unclear whether this rare side effect poses a risk for otherwise healthy kids with diabetes taking the drug, but until this is known, the precautions recommended for adults should be followed. Because in adults lactic acidosis is more likely to happen when a person is ill, diabetes pills should be stopped when your child is sick or has the flu.

Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent.


Several prediabetes interventions exist based on evidence from the landmark Diabetes Prevention Program (DPP) study. The DPP study reported that moderate weight loss (5-7% of body weight, or ~10-15 lbs. for someone weighing 200 lbs.), counseling, and education on healthy eating and behavior reduced the risk of developing type 2 diabetes by 58%. Data presented at the ADA 2014 conference showed that after 15 years of follow-up of the DPP study groups, the results were still encouraging: 27% of those in the original lifestyle group had a significant reduction in type 2 diabetes progression compared to the control group.

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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.
7. SGLT2 Inhibitors These drugs work by increasing the amount of glucose excreted in the urine. They've been associated with weight loss and improvement in blood pressure. Side effects may include urinary tract infections and diabetic ketoacidosis, a serious condition in which acid blood levels rise. They are Invokana (canagliflozin) and Farxiga (dapagliflozin).
The immune system of a person with diabetes kills off useful “beta” cells, but the UT researchers say they have found a way to make other cells in the pancreas perform the necessary work. Their approach, announced earlier this month in the academic journal Current Pharmaceutical Biotechnology, not only would have implications for Type 1, formerly called juvenile diabetes, but also could help treat the far more common Type 2 variety, also known as adult-onset diabetes.
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You can talk to your diabetes health care team about planning your exercise along with your meals and insulin. They'll offer specific suggestions to help you get ready for exercise or join a sport and give you written instructions to help you respond to any diabetes problems that may occur during exercise, like hypoglycemia (low blood sugar), or hyperglycemia (high blood sugar).
In type 1 diabetes, the body produces none of the insulin that regulates our blood sugar levels. Very high glucose levels can damage the body's organs. Patients with type 2 diabetes, however, do produce insulin - just not enough to keep their glucose levels normal. Because I was fit and not overweight (obesity is a major risk factor in type 2 diabetes; however, a number of non-obese people, particularly members of south Asian communities, are also prone to it), my doctor told me I could control my condition with diet alone.

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.”
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