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.
Aside from the financial costs of diabetes, the more frightening findings are the complications and co-existing conditions. In 2014, 7.2 million hospital discharges were reported with diabetes as a listed diagnosis. Patients with diabetes were treated for major cardiovascular diseases, ischemic heart disease, stroke, lower-extremity amputation and diabetic ketoacidosis.
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.”
When cells are resistant to insulin, they don’t use the insulin effectively to bring the glucose from the bloodstream into the cell. The pancreas needs to produce more insulin to overcome this resistance in an effort to normalize blood sugar levels. When the pancreas can’t keep up with the insulin demands in a person with insulin resistance, that person develops diabetes.
The drug reduces the amount of glucose made by the liver, and is frequently prescribed because it has been found to help prevent many of the long-term complications of diabetes. Metformin is usually taken without another drug, usually at a dose of 500 milligrams (mg) a day, depending on the brand, to start. Doses are not to exceed 2,000 or 2,500 mg per day.
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.
On day four, my glucose levels had dropped to 4.6 after fasting for 10 hours overnight. It was the first time I'd ever scored a 4. But on day six, I felt really cold. It was mid-July but in the morning my fingertips were white and I had to wear a T-shirt, shirt, jumper and jacket to work. I was hungry, and just walking around the office was tiring. But I was down to 9st 3lb.
8. Amylin Mimetic This type of medication stimulates the release of insulin, and is used along with insulin injections. It may also help suppress hunger and promote weight loss. It’s less commonly used because it’s a shot administered in addition to insulin at each meal. Side effects can include low blood sugar, nausea, vomiting, headache, and redness and irritation at the injection site. Symlin (ramlintide) is what your doctor will prescribe you.
Remember that a healthy diet, regular exercise, and the right medication are all critical to managing type 2 diabetes. Taking the medication your doctor has prescribed for you is key. “Medication adherence can help with glycemic control and A1C reduction, which we know helps with decreasing diabetic complications, like neuropathy, as well as kidney disease,” Gupta says.
The bottom line is that diabetes can be bad news—but this doesn’t have to be the case. Interventions can prevent or delay the disease in people with prediabetes. The Diabetes Prevention Program (DPP), a large study of people at high risk of diabetes, has established a prevention plan that’s both feasible and cost-effective. The DPP showed that weight loss and increased physical activity reduced the development of type 2 diabetes by 58% during a three-year period.