It is great to read these columns of Diabetes. I have tried feenugreek but it raises my blood pressure. Since, I am a patient of High Blood pressure, this does not help me. I am 65, control my diet, walk daily for 6-7 km too and take my medication regularly but still blood sugar is out of control. Fasting is usually 150. Any suggestions from friends. Thanks and Cheers for all.
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).
One of the biggest hits in type 2 diabetes treatment is glucagon-like peptide (GLP)-1 receptor agonists, which induce insulin production in beta-pancreatic cells while suppressing the secretion of glucagon. All big pharma have GLP-1 drugs on the market or their pipelines, including Sanofi, Eli Lilly, Roche, AstraZeneca and Boehringer Ingelheim. But Novo Nordisk is going a step further with the first oral version of a GLP-1 drug, which is now close to the market.
Steve Vincent, 58, from Southampton, England, was diagnosed with type 2 in December 2010. He was told there was no known cure and he had an increased risk of heart attack, stroke, blindness and limb loss. He had a BMI of 29, weighed 93kg and showed an HbA1c of 10.7%. In summer 2011 he read the reversal story and went on a daily 600 calories green vegetable diet and three litres of water, for two months. At the end he was and remains diabetes-free. In December 2012 he told me: "All my blood test levels are within the normal range, and my cholesterol and blood pressure levels are now normal." When he came off the diet he weighed just 72kg, although he has put on weight since then as he admits he has not been eating as healthily as he might, but his BMI remains at a healthy 24, and his HbA1c level is 5.5%.
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).
The BAS colesevelam (Welchol) is a cholesterol-lowering medication that also reduces blood glucose levels in patients with diabetes. BASs help remove cholesterol from the body, particularly LDL cholesterol, which is often elevated in people with diabetes. The medications reduce LDL cholesterol by binding with bile acids in the digestive system; the body in turn uses cholesterol to replace the bile acids, which lowers cholesterol levels. The mechanism by which colesevelam lowers glucose levels is not well understood. Because BASs are not absorbed into the bloodstream, they are usually safe for use by patients who may not be able to use other medications because of liver problems. Because of the way they work, side effects of BASs can include flatulence and constipation.
Diabetes pills are not a form of insulin. They help the body make more insulin or use insulin more effectively. This helps reduce the amount of glucose in the bloodstream between meals and at night, which helps keep blood sugar levels under control. Diabetes pills can also help with weight loss and help improve cholesterol and triglyceride levels, which tend to be abnormal in people with type 2 diabetes.
A new study from the Faustman Lab at Massachusetts General Hospital suggests that a nearly 100 year old tuberculosis vaccine called BCG may hold cure-like promise for people with Type 1 diabetes. The bacillus Calmette-Guérin (BCG) vaccine, one of the oldest vaccines in the world, was developed for tuberculosis protection and for early stage bladder cancer therapy.
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Type 2 diabetes, the most common type, can start when the body doesn't use insulin as it should. If your body can't keep up with the need for insulin, you may need to take pills. Along with meal planning and physical activity, diabetes pills help people with type 2 diabetes or gestational diabetes keep their blood glucose levels on target. Several kinds of pills are available. Each works in a different way. Many people take two or three kinds of pills. Some people take combination pills. Combination pills contain two kinds of diabetes medicine in one tablet. Some people take pills and insulin.