Patients diagnosed with type 2 diabetes may discover that if they are overweight at diagnosis and then lose weight and begin regular physical activity, their blood glucose returns to normal. Does this mean diabetes has disappeared? No. The development of type 2 diabetes is a gradual process, too, in which the body becomes unable to produce enough insulin for its needs and/or the body's cells become resistant to insulin's effects. Gradually the patient goes from having "impaired glucose tolerance" — a decreased but still adequate ability to convert food into energy — to having "diabetes."
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.
A new class of medications called DPP-4 inhibitors help improve A1C without causing hypoglycemia. They work by by preventing the breakdown of a naturally occurring compound in the body, GLP-1. GLP-1 reduces blood glucose levels in the body, but is broken down very quickly so it does not work well when injected as a drug itself. By interfering in the process that breaks down GLP-1, DPP-4 inhibitors allow it to remain active in the body longer, lowering blood glucose levels only when they are elevated. DPP-4 inhibitors do not tend to cause weight gain and tend to have a neutral or positive effect on cholesterol levels. Alogliptin (Nesina), linagliptin (Tradjenta), saxagliptin (Onglyza), and sitagliptin (Januvia) are the DPP-4 inhibitors currently on the market in the US.
One of the lesser known herbs that lower blood sugar, Marjoram, is high in polyphenols, which aids in stabilizing blood glucose levels. A 2012 study in the Journal of Evidence Based Alternative and Complementary Medicine found that Marjoram reduced formation of Advanced Glycation End (AGE) products. AGE is the smoking gun that researchers today say is responsible for a lot of the complications that diabetics face, like damage to arteries and eyes. Try sprinkling marjoram on your dinner every night to help add variety in flavor. It can often be used as a substitute for oregano in cooking and brings in a distinct flavor to dishes.
These seeds, used in Indian cooking, have been found to lower blood sugar, increase insulin sensitivity, and reduce high cholesterol, according to several animal and human studies. The effect may be partly due to the seeds’ high fiber content. The seeds also contain an amino acid that appears to boost the release of insulin. In one of the largest studies on fenugreek, 60 people who took 25 grams daily showed significant improvements in blood sugar control and post-meal spikes.
You should have no more than three of these “feeding times” per day. The reason limiting the number and duration of your meal times is so important has to do with staying out of the vicious cycle of increasing insulin resistance. To get smart on insulin resistance — the cause of both type 2 diabetes and obesity — read Dr. Jason Fung’s book, The Obesity Code: Unlocking the Secrets of Weight Loss, or watch his free lecture on YouTube.