Diabetes: The differences between types 1 and 2 There are fundamental differences between diabetes type 1 and type 2, including when they might occur, their causes, and how they affect someone's life. Find out here what distinguishes the different forms of the disease, the various symptoms, treatment methods, and how blood tests are interpreted. Read now
“The field has suffered from a checkered history 20, 30 years ago, when there were operations that were dangerous. But modern metabolic surgery is very safe,” Cummings said. “The risk of dying from a laparoscopic gastric bypass is a little bit less than the risk of dying from having your gallbladder or appendix removed. But we never consider those risky surgeries; they’re totally bread-and-butter procedures.”
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.”
During this 8-week study, β-cell function was tested by a gold standard method that used a stepped glucose infusion with subsequent arginine bolus (21). In type 2 diabetes, the glucose-induced initial rapid peak of insulin secretion (the first phase insulin response) typically is absent. This was confirmed at baseline in the study, but the first phase response increased gradually over 8 weeks of a very-low-calorie diet to become indistinguishable from that of age- and weight-matched nondiabetic control subjects. The maximum insulin response, as elicited by arginine bolus during hyperglycemia, also normalized. Pancreas fat content decreased gradually during the study period to become the same as that in the control group, a time course matching that of the increase in both first phase and total insulin secretion (Fig. 3). Fat content in the islets was not directly measured, although it is known that islets take up fat avidly (24) and that islet fat content closely reflects total pancreatic fat content in animal models (25). Although a cause-and-effect relationship between raised intraorgan fat levels and metabolic effect has not yet been proven, the time course data following the dietary intervention study are highly suggestive of a causal link (21).
Want to learn more about diabetes drugs? Read the “Diabetes Medicines” series from certified diabetes educator Amy Campbell, covering metformin, sulfonylureas, meglitinides, thiazolidinediones, DPP-4 inhibitors, SGLT2 inhibitors, alpha-glucosidase inhibitors, bile acid sequestrants and dopamine receptor agonists, and non-insulin injectable diabetes medications.
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.
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.
Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased oran donor are purified, processed, and transferred into another person. Immunosuppressive medications are needed to prevent rejection which is a typical challenge with any transplant. These medications carry a number of serious side effects such as decreased kidney function, high blood pressure, anemia and lowered white blood cells counts.
The three main types of nutrients found in foods are carbohydrates (or carbs), proteins, and fats, which all provide energy in the form of calories. Foods containing carbs cause blood sugar levels to go up the most. Foods that contain mostly protein and/or fat don't affect blood sugar levels as much. Our bodies need all of these nutrients — in different amounts — to function normally.
There are two medicines in this group: repaglinide and nateglinide. Both of these lower your blood glucose by prompting the pancreas to release more insulin. These drugs work quickly and do not stay in your system long. So they are a good option if your meal schedule varies or is unpredictable. They also cause less weight gain that other oral diabetes medicines.
Now the question is, "what is the medicine that cures Diabetes?" The answer is, "Food is the medicine." Sounds interesting? Here in India, in the last 10 years we have seen a few thousands of them completely cured of Diabetes. All they have done is, they reversed the situation. To understand this, we first have to understand the bio-chemistry of Type-2 Diabetes. Type-2 Diabetes is caused either because our Pancreas not producing enough Insulin and/or our cells are not able to take the Insulin. Without the insulin accepted by the insulin receptors, the Glucose channel is not activated to take the Glucose. In most patients, even if Pancreas does not work well, Insulin units are given and then the insulin is slowly accepted by the Insulin receptors. But any food rich in Sugars, releases lot of Glucose instantly into the blood stream which cannot be absorbed by the cell at the same pace as the Insulin receptors are not capable/ready to accept the Insulin.
What can people with prediabetes do to avoid the progression from prediabetes to type 2 diabetes? The most important action people diagnosed with prediabetes can take is to focus on living a healthy lifestyle. This includes making healthy food choices, controlling portions, and increasing physical activity. Regarding weight control, research shows losing 5-7% (often about 10–20 lbs.) from your initial body weight and keeping off as much of that weight over time as possible is critical to lowering the risk of type 2 diabetes. This task is of course easier said than done, but sustained weight loss over time can be key to improving health and delaying or preventing the onset of type 2 diabetes.
Thiazolidenediones can increase risk of heart failure and should not be used in patients with symptoms of heart failure. Liver enzymes should be checked regularly with use. Other side effects include weight gain, fatigue, swelling of the legs or ankles, increased risk for fractures in female patients. Avandia may have a potential increased risk for heart attack.
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.
A representative for the Centers for Medicare and Medicaid Services, however, told Gizmodo the agency “has not received a reconsideration request” to overhaul its coverage of bariatric surgery as of yet. Gizmodo also asked several of the leading insurance companies, such as Anthem, Aetna, and UnitedHealthcare, about any possible revision in their coverage policies. Only Aetna replied, stating it constantly evaluates “new published peer-reviewed studies and medical research when developing our clinical policies.” But the company seemingly has no current plans to roll out any changes.
It is important to note that these herbs and spices are intended to support blood sugar maintenance and are not meant to replace diabetes/hyperglycemic medications. Research does show benefits to incorporating these herbs and spices, so enjoy incorporating them daily into your favorite recipes for a boost of flavor and blood sugar-lowering benefit.
2. Biguanides Metformin is the only form of biguanide currently available. While it may promote modest weight loss and a slight decline in LDL, or "bad," cholesterol, side effects may include nausea, diarrhea, and (when other risk factors are present) the harmful buildup of lactic acid. Glucophage, Glumteza, and Riomet are some brand-name types of metformin available for use.
Clearly separate from the characteristic lack of acute insulin secretion in response to increase in glucose supply is the matter of total mass of β-cells. The former determines the immediate metabolic response to eating, whereas the latter places a long-term limitation on total possible insulin response. Histological studies of the pancreas in type 2 diabetes consistently show an ∼50% reduction in number of β-cells compared with normal subjects (66). β-Cell loss appears to increase as duration of diabetes increases (67). The process is likely to be regulated by apoptosis, a mechanism known to be increased by chronic exposure to increased fatty acid metabolites (68). Ceramides, which are synthesized directly from fatty acids, are likely mediators of the lipid effects on apoptosis (10,69). In light of new knowledge about β-cell apoptosis and rates of turnover during adult life, it is conceivable that removal of adverse factors could result in restoration of normal β-cell number, even late in the disease (66,70). Plasticity of lineage and transdifferentiation of human adult β-cells could also be relevant, and the evidence for this has recently been reviewed (71). β-Cell number following reversal of type 2 diabetes remains to be examined, but overall, it is clear that at least a critical mass of β-cells is not permanently damaged but merely metabolically inhibited.
Garlic: Potent, but effective. Garlic is known as one of the oldest medicines in the world…and with good reason. An animal study that administered high doses of raw garlic to rats for 4 weeks found that it had a profound effect of reducing blood glucose levels, as well as cholesterol and triglycerides compared to rats who did not receive raw garlic (2). They also tested rats with boiled garlic, and saw no changes in blood glucose, so the benefit comes from raw garlic.
Whole-body insulin resistance is the earliest predictor of type 2 diabetes onset, and this mainly reflects muscle insulin resistance (26). However, careful separation of the contributions of muscle and liver have shown that early improvement in control of fasting plasma glucose level is associated only with improvement in liver insulin sensitivity (20,21). It is clear that the resumption of normal or near-normal diurnal blood glucose control does not require improvement in muscle insulin sensitivity. Although this finding may at first appear surprising, it is supported by a wide range of earlier observations. Mice totally lacking in skeletal muscle insulin receptors do not develop diabetes (27). Humans who have the PPP1R3A genetic variant of muscle glycogen synthase cannot store glycogen in muscle after meals but are not necessarily hyperglycemic (28). Many normoglycemic individuals maintain normal blood glucose levels with a degree of muscle insulin resistance identical to those with type 2 diabetes (29).
“I am extremely pleased to see that technology developed in Tejal Desai’s group is getting to the point that we can explore this for therapeutic purposes,” Matthias Hebrok, PhD, the director of the Diabetes Center at UCSF and a member of Encellin’s scientific advisory board, noted on the UCSF website. “Encapsulation and protection of islet cells remain a critical hurdle that needs to be overcome before cell therapy becomes a reality in type 1 diabetes.”
Researchers from Newcastle and Glasgow Universities believe they have found a way to effectively reverse type 2 diabetes, without requiring a new kind of drug or invasive surgery. Type 2 diabetes is a chronic condition that affects how a person’s body metabolizes sugar, either because they’ve developed resistance to the hormone insulin, or their pancreas fails to produce enough insulin.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
Kelly Prinkey-Krupinski, 48 and an avid dog lover, has been struggling with adult onset Type 1 diabetes for 12 years. She said the disease runs her life. “It is a constant struggle,” she said. “My mind is always aware that every bite of food that I eat, every medicine I take, every illness and emotion I experience will affect my blood sugar. There is never a vacation from the constant balancing act to stay alive. It scares me to think of a time when I can't obtain the insulin that I must take 24-7. I would pray that there will be a cure in my lifetime. I just hate to think of the kids that struggle with Type 1 diabetes. This research with dogs sounds promising. As a dog lover myself, I would love to see if our canine friends can be cured. I'm excited to see the results.”
Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin.
Acarbose (Precose) and miglitol (Glyset) are alpha-glucosidase inhibitors. These drugs help the body to lower blood glucose levels by blocking the breakdown of starches, such as bread, potatoes, and pasta in the intestine. They also slow the breakdown of some sugars, such as table sugar. Their action slows the rise in blood glucose levels after a meal. They should be taken with the first bite of a meal. These drugs may have side effects, including gas and diarrhea.
Initial clinical trial results, published in a 2012 PLOS One paper, reported that two doses of BCG spaced four weeks apart led to reductions in autoreactive T cells, an increase in Tregs and what turned out to be a transient increase in insulin production. But by the end of that short, 20-week trial, there was no reduction in HbA1c, the established measure of blood sugar levels over time. An extension and expansion of that trial with long term follow-up, the current results are based on data from 282 human study participants – 52 with type 1 diabetes who participated in the BCG clinical trials and 230 who contributed blood samples for mechanistic studies.
If you google “diabetes cure” you are directed to websites like WebMD and the Mayo Clinic where you find information on diet, exercise, medication, and insulin therapy, but nothing about the cure. This lack of information may have to do with the fact that Americans spend $322 billion a year to treat diabetes, $60 billion a year on weight-loss programs, and $124 billion a year on snack foods. This is about 3% of the US economy! Because so many peoples’ livelihoods are supported by diabetes and its main cause, obesity, the viral effect of people getting cured and telling others is greatly diminished.