Who is at risk of developing prediabetes? A well-known paper published in the Lancet in 2010 recommends screening for type 2 diabetes (which would also screen for prediabetes) every 3-5 years in all adults over the age of 45, regardless of other risk factors. Overweight and obese adults (a BMI >25 kg/m2) are also at significantly greater risk for developing prediabetes, as well as people with a family history of type 2 diabetes.
If I could only prescribe one supplement for a diabetes patient, I would prescribe R-alpha-lipoic acid. Alpha-lipoic acid has numerous benefits to the diabetic patient. It is a water- and fat-soluble antioxidant and has been shown to protect patients with fatty liver from liver disease progression. It can help reduce insulin resistance and has been shown to protect people with diabetes from developing complications in their nerves, eyes, and kidneys. R-ALA can prevent glycosylation of proteins, which reduces the A1C level. It is safe, although very rarely it can cause stomach upset. Alpha-lipoic acid is listed either as ALA or R-ALA. When listed as ALA, this means it contains two forms—the S isomer form and the R isomer form, in a 50:50 ratio. The key is to find a product that says it contains “R-ALA” instead of just “ALA.” A good daily working dose of R-ALA is 300 to 1,200 mg a day, which is the equivalent of 600 to 2,400 mg a day of regular ALA, if you buy a regular ALA listed product.
A substantial proportion of people who experience type 2 diabetes remission after gastric bypass eventually have relapse of the disease down the road. I feel the best study of this was done by my co-author on CROSSROADS, David Arterburn. In a study of nearly 5,000 patients with diabetes who underwent [gastric bypass surgery] and were followed retrospectively for 13 years, about 70% experienced diabetes remission. Among these, about 1/3 eventually relapsed, but it’s important to note that the median disease-free interval was 8.3 years.
I think I may have the link to the original article and will post back here. I am actually going to meet Denise Faustman on 8/13 at 3:00 to learn more about the study It’s a clinical trial that is being held at mass general. I am surprised by the rather negative comments on here. I have lupus and type 1for 32years. I have no complications but lupus puts the same organs at risk as diabetes does. If I can barely take any insulin and have normal ranges without doing barely any work I will try it. I don’t see… Read more »

Vanadium is a compound found in tiny amounts in plants and animals. Early studies showed that vanadium normalized blood sugar levels in animals with type 1 and type 2 diabetes. When people with diabetes were given vanadium, they had a modest increase in insulin sensitivity and were able to lower their need for insulin. Researchers want to understand how vanadium works in the body, find potential side effects, and set safe dosages.


A. A couple of factors determine the optimal timing of medicine doses. Some drugs, such as rapid-acting insulin, are usually taken just before meals, and others must be taken on an empty stomach or with food. The way a drug works in the body, as well as the time it takes to start working and the duration of its action, may also determine the best time to take a medicine. Glipizide begins working in approximately 30 minutes to an hour. Since this drug increases insulin secretion, it is recommended that you take it before meals to reduce the risk of hypoglycemic episodes. If you take it only once a day, it’s best to do so prior to the largest meal of the day, or with breakfast. Saxagliptin starts working within hours and only achieves peak concentrations in the body after several hours. Saxagliptin, and other agents in the dipeptidyl peptidase-4 (DPP-4) inhibitor class, prevent the breakdown of a hormone called glucagon-like peptide (GLP) in response to the extra glucose in your blood after you eat, which increases the body’s insulin production. Although concentrations of GLP and other similar hormones are higher after eating, they are also released throughout the day under normal circumstances. So saxagliptin and other DPP-4 inhibitors can be taken without regard to meals.
But is John “free of diabetes”? This is where the lines become blurred. Medically speaking, the term “cure” is usually associated with acute disease—a temporary medical condition, such as bacterial pneumonia, that can be cured with antibiotics. For diabetes, which is a chronic disease, it may be more accurate to use the term “remission” rather than cure. Particularly when considering the pathology associated with diabetes and the individual’s genetic predisposition, relapse is always possible. In a consensus statement issued by the ADA, the term remission is defined based on the following definitions:2

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While there is no consensus yet on just what type of diet is best for people with type 2 diabetes to follow, there is overwhelming evidence that being active is one of the best things you can do to control your condition. The National Institutes of Health’s landmark Look AHEAD trials, which sought to establish whether intensive lifestyle modifications could affect diabetes outcomes, found that when participants lowered the amount of fat in their diet and increased their physical activity to 150 minutes a week, they reduced their chances of developing type 2 diabetes by 58 percent.
Cloves protect the heart, liver and lens of the eye of diabetic rats, according to studies. This spice contains 30% of the antioxidant phenol in dry weight, along with antioxidants anthocyanins and quercetin. As a result, cloves have antiseptic as well as germicidal properties. It also offers anti-inflammatory, analgesic and digestive health benefits for diabetics.
The overall goal of treatment with insulin (and other diabetes medicines) is to achieve the best match possible between the amounts of insulin given and the person's individual needs for insulin throughout the day and night. In this way, blood sugar levels can be kept as close to normal as possible to help avoid both short- and long-term problems from diabetes.
If the patient were to gain weight back or scale back on their physical activity program, high blood glucose would return. If they were to overeat at a meal, their blood glucose probably would continue to go higher than someone without diabetes. Also, the decreased insulin production and/or increased insulin resistance that led to the initial diabetes diagnosis will gradually intensify over the years and during periods of stress. In time, the patient who could maintain normal blood glucose with diet and exercise alone may discover that he or she needs to add oral diabetes medications — or perhaps even insulin injections — to keep blood glucose in a healthy range.
At his first visit, the naturopathic doctor told John he’d be “off medication and free of diabetes in three months.” John left the doctor’s office with instructions to eat a low-carb diet. He’d been on a low-fat diet for years because of heart problems, but while he’d cut the fat, his meals included many highly processed foods. His new diet included “a lot of salads and healthful, organic foods.” He was given several whole food supplements that he says were “simple to mix and tasted good.”
A: Fasting plasma glucose and weight change 2 years after randomization either to gastric banding or to intensive medical therapy for weight loss and glucose control. Data plotted with permission from Dixon et al. (13). B: Early changes in fasting plasma glucose level following pancreatoduodenal bypass surgery. A decrease into the normal range was seen within 7 days. Reproduced with permission from Taylor (98).
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This seems hard to do, but really it’s not if you know one secret: Replace snacking with something far more satisfying — fat. That’s right, the government is wrong to recommend a low fat diet. Fat is what makes you feel full until your next meal. Take away the fat, take away the full. Don’t go to an extreme, but do lean strongly toward a high-fat low-carb diet.
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