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.
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.
Over the last century, advancements in new treatments aided by the remarkable developments in computer technology have helped many people better manage the disease, but achieving optimal glucose control remains an unattainable goal for the vast majority of those with diabetes, and particularly among young people. Despite patients' best attempts, managing diabetes remains a challenging, daily balancing act that requires constant vigilance. That's because insulin therapy cannot ideally mimic the exquisite biological function of a healthy pancreas. And that's why the Diabetes Research Institute and Foundation remain passionately committed to achieving this singular goal. Learn more about our progress toward a cure and the steps we are taking to turn our vision into reality.
Magnesium is a mineral found naturally in foods such as green leafy vegetables, nuts, seeds, and whole grains and in nutritional supplements. Magnesium is needed for more than 300 biochemical reactions. It helps regulate blood sugar levels and is needed for normal muscle and nerve function, heart rhythm, immune function, blood pressure, and for bone health.
How long will diabetes stay away after weight loss? Long-term normal blood glucose control in previously diabetic individuals after bariatric surgery demonstrates that diabetes does not recur for up to 10 years, unless substantial weight gain occurs (86). These observations are consistent with the twin cycle hypothesis and the existence of a trigger level for adverse metabolic effects of fat in the pancreas. Hence, for a given individual with type 2 diabetes, reducing the liver and pancreas fat content below his or her personal trigger levels would be expected to result in a release from the fatty acid–mediated dysfunction. Individual tolerance of different degrees of fat exposure vary, and understanding this liposusceptibility will underpin the future understanding of genetically determined risk in any given environment. However, this should not obscure the central point: If a person has type 2 diabetes, there is more fat in the liver and pancreas than he or she can cope with.
The care team may recommend that your child use a continuous glucose monitor (CGM). A CGM is a wearable device that can measure blood sugar every few minutes around the clock. It's measured by a thread-like sensor that is inserted under the skin and secured in place. Sensors can stay in place for about a week before they have to be replaced and are accurate enough to replace frequent finger-stick testing. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your child's diabetes management plan to improve blood sugar control.
Metformin: The DPP study found that metformin, the safest first-line therapy for type 2 diabetes, may help delay the onset of type 2 diabetes in people with prediabetes. Participants who took the low-cost generic drug had a 31% reduced risk of developing type 2 diabetes compared to the control group (those not on metformin or intensive lifestyle intervention). Again, 15-year follow up data showed that 17% of those on metformin continued to have a significant reduction in type 2 progression. At this time, metformin (or any other medication, for that matter) is not currently FDA approved for prediabetes, and it is sometimes prescribed “off-label” by a healthcare provider. Your healthcare provider can give you more information and determine whether metformin is a good option for you.
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.”
It is great to read these columns of Diabetes. I have tried feenugreek but it raises my blood pressure. Since, I am a patient of High Blood pressure, this does not help me. I am 65, control my diet, walk daily for 6-7 km too and take my medication regularly but still blood sugar is out of control. Fasting is usually 150. Any suggestions from friends. Thanks and Cheers for all.
Together with evidence of normalization of insulin secretion after bariatric surgery (84), insights into the behavior of the liver and pancreas during hypocaloric dieting lead to a hypothesis of the etiology and pathogenesis of type 2 diabetes (Fig. 6): The accumulation of fat in liver and secondarily in the pancreas will lead to self-reinforcing cycles that interact to bring about type 2 diabetes. Fatty liver leads to impaired fasting glucose metabolism and increases export of VLDL triacylglycerol (85), which increases fat delivery to all tissues, including the islets. The liver and pancreas cycles drive onward after diagnosis with steadily decreasing β-cell function. However, of note, observations of the reversal of type 2 diabetes confirm that if the primary influence of positive calorie balance is removed, then the processes are reversible (21).
Despite the encouraging findings, more research will be necessary to confirm that S. oblonga is an effective treatment for type 2 diabetes and to determine whether it offers any long-term health benefits. The researchers also want to look into the question of whether or not S. oblonga can prevent type 2 diabetes. They suggested that an extract could be added to a food or beverage for easy use.
Alpha-glucosidase inhibitors help control blood sugar levels by preventing the digestion of carbohydrates. Carbohydrates include starchy foods like potatoes and corn. They also include most grains (bread, rice, crackers, cereal) and sugary sweets. The two medicines in this group are acarbose and miglitol. These medicines may cause bloating, nausea, diarrhea, and flatulence (gas).
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways.
Curcumin. The compound curcumin, which is found in the spice tumeric, has been shown to both boost blood sugar control and help prevent the disease. In a nine-month study of 240 adults with pre-diabetes, those who took curcumin capsules (which are available over-the-counter) completely avoided developing diabetes while a sixth of patients in the placebo group did.
There is a risk that those who attempt it and fail could end up worse off, speculates Annie Hoang, a registered dietitian at Sunnybrook. An individual’s metabolism might switch into “starvation mode,” reducing the amount of energy needed at rest, she explains. That means some patients could regain all the weight they lost – and more – if they stop doing intermittent fasting.
The American Diabetes Association contends the promise of an unlimited source of beta cells from stem cell technology is likely to become a reality in the next several years, in an article on its site. “However, how to use this new source of cells, how these cells live and function after transplantation, and how to best control immune responses against the transplanted tissue present additional barriers to the widespread use of islet transplant. Research in these areas will be essential for the realization of the potential of stem cell derived islets for the cure of diabetes.”