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).
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The prevalence of prediabetes is also on the rise, as it’s estimated that almost 34 million U.S. adults were prediabetic in 2015. People with prediabetes have blood glucose levels that are above normal but below the defined threshold of diabetes. Without proper intervention, people with prediabetes are very likely to become type 2 diabetics within a decade.
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According to TCM, the major activity of the blood is to circulate through the body, nourishing and moistening the various organs and tissues. Disharmonies of the blood may manifest as “deficient” blood or “congealed” blood. If deficient blood exists and affects the entire body, the patient may present with dry skin, dizziness, and a dull complexion. Congealed blood may manifest as sharp, stabbing pains accompanied by tumors, cysts, or swelling of the organs (i.e., the liver).4 The key organs associated with blood are the heart, liver, and spleen.
It's unclear how people get the disease — genetics plays a big role, though unknown environmental factors may also trigger the disease. Either way, the disease causes the immune system to mistakenly attack and kill insulin-producing cells, called beta cells, in the pancreas. (This differs from type 2 diabetes, in which the body initially makes sufficient insulin but the cells cannot properly use it.) Without enough insulin working to remove glucose from the blood stream, and allowing glucose to enter the body's cells, blood sugar levels spike. Left untreated, this insulin deficiency leads to a deadly complication called diabetic ketoacidosis. What's more, having high blood sugar over the long term can cause life-threatening complications such as kidney damage or heart disease, according to the Mayo Clinic.
A newer class of diabetes medication, SGLT2 includes three medicines: canagliflozin, dapagliflozin, and empagliflozin. These drugs remove extra sugar from your body by blocking it from the kidneys. It also causes your body to be more sensitive to insulin. The most common side effects caused by SGLT2 are vaginal yeast infections and urinary tract infections.
Not until I actually got this book into my hands could I see that its subtitle read "A medical approach that can slow, stop, even cure Type 2 Diabetes". If I'd known about the subtitle, I wouldn't have been interested in reading the book, since the "medical approach" bit indicated for me that it consisted of traditional precepts penned by a doctor, and also I am not particularly interested in Type 2 diabetes, only Type 1, which I myself have.
Dr Beverley Shields, at the University of Exeter Medical School, who led the research, said: "This finding is really exciting. It suggests that a person with Type 1 diabetes will keep any working beta-cells they still have seven years after diagnosis. We are not sure why this is; it may well be that there is a small group of "resilient" beta-cells resistant to immune attack and these are left after all the "susceptible" beta-cells are destroyed. Understanding what is special about these "resilient" beta-cells may open new pathways to treatment for Type 1 diabetes."
The researchers have cured mice, which are genetically similar to people but different enough that new rounds of animal testing — and millions of dollars more — are needed before human trials can begin. The researchers’ approach is sure to garner skeptics, at least in part because it is a significant departure from the many other attempts at curing diabetes, which typically involve transplanting new cells and/or suppressing the immune system’s attempts to kill off useful ones.
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.
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Efforts to cure or stop type 1 diabetes are still in the early stages, and these approaches will also not be suitable for people that have already lost their insulin-producing cells. A solution could be the creation of an “artificial pancreas” — a fully automated system that can measure glucose levels and inject the right amount of insulin into the bloodstream, just like a healthy pancreas would.
Formal recommendations on how to reverse type 2 diabetes in clinical practice must await further studies. In the meantime, it will be helpful for all individuals with newly diagnosed type 2 diabetes to know that they have a metabolic syndrome that is reversible. They should know that if it is not reversed, the consequences for future health and cost of life insurance are dire, although these serious adverse effects must be balanced against the difficulties and privations associated with a substantial and sustained change in eating patterns. For many people, this may prove to be too high a price to pay, but for those who are strongly motivated to escape from type 2 diabetes, the new understanding gives clear direction. Physicians need to accept that long-term weight loss is achievable for a worthwhile proportion of patients (96). In the United States, diabetes costs $174 billion annually (97), and in the United Kingdom, it accounts for 10% of National Health Service expenditure. Even if only a small proportion of patients with type 2 diabetes return to normal glucose control, the savings in disease burden and economic cost will be enormous.
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.
Within the model of Five Phases, each element is associated with an organ. Wood is associated with the liver, fire with the heart, earth with the spleen-pancreas-stomach, metal with the lungs, and water with the kidneys. In addition, other phenomena, such as seasons, cardinal directions, weather, color, and emotions, are associated with each element. Within the TCM model, diagnostic information is gained by finding out patients’ favorite season, color, and predominant emotion(s).
Swift urges RDs to be informed and stay up-to-date as complementary and alternative medicine data evolves. Use a “whole systems, whole person” approach to health and healing. The Kripalu Center for Yoga and Health is a good place to start. “They have an outstanding program on diabetes care that’s multidisciplinary and integrative,” Swift says. You also can receive continuing education credits for attending.
Qi must flow in the correct quantity and quality through the meridians and organs for health to be maintained. Acupuncture, the insertion of thin, solid metal needles, is performed on 1 or more of the 361 acupuncture points distributed along the meridians in order to regulate and promote the proper flow of Qi.5 Other techniques may be used to stimulate acupuncture points, such as moxibustion, in which the herb “moxa” (Artemesia vulgaris) is used to warm the acupuncture point either above or on the skin. Applied pressure (acupressure), lasers, and magnets also may be used to stimulate acupuncture points.
They also have to balance the food they eat with the amount of insulin they take and their activity level. That's because eating some foods will cause blood sugar levels to go up more than others, whereas insulin and exercise will make blood sugar go down. How much the blood sugar level goes up after eating depends on the type of nutrients the food contains.