These diabetes complications are related to blood vessel diseases and are generally classified into small vessel disease, such as those involving the eyes, kidneys and nerves (microvascular disease), and large vessel disease involving the heart and blood vessels (macrovascular disease). Diabetes accelerates hardening of the arteries (atherosclerosis) of the larger blood vessels, leading to coronary heart disease (angina or heart attack), strokes, and pain in the lower extremities because of lack of blood supply (claudication).
Replacing humans with computers could make patients better control their sugar levels and suffer less complications in the long term. The French company Cellnovo has already shown that just a partially automated system, where blood sugar levels can be monitored wirelessly but patients still select insulin amounts, can reduce the chances of reaching life-threatening low sugar levels up to 39%. The company is now working towards developing a fully automated artificial pancreas in collaboration with Imperial College, the Diabeloop consortium and the Horizon2020 program.
In gastroesophageal reflux disease (GERD), sometimes called heartburn, stomach acid and partially undigested food move backward through the esophagus, escaping from the stomach and through the esophageal sphincter that normally prevents such backsliding. This can occur as a symptom of gastroparesis, says Hiroshi Mashimo, MD, PhD, a gastroenterologist at Harvard Medical School. “If the stomach doesn’t empty, it’s likely to reflux up,” he says. GERD may also result from diabetes-related nerve damage affecting the esophageal sphincter, Mashimo adds. One caution: Some diseases, such as a yeast infection in the esophagus, can masquerade as GERD, so don’t brush off symptoms. We can’t treat the gastroparesis or esophageal sphincter problems that contribute to GERD, but antacids and other medications can help to reduce or neutralize stomach acids (see “PPIs the Right Way,” below).
Though it may be transient, untreated GDM can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital heart and central nervous system abnormalities, and skeletal muscle malformations. Increased levels of insulin in a fetus's blood may inhibit fetal surfactant production and cause infant respiratory distress syndrome. A high blood bilirubin level may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.
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.
Diabetes has grown to “epidemic” proportions, and the latest statistics revealed by the U.S. Centers for Disease Control and Prevention state that 30.3 million Americans have diabetes, including the 7.2 million people who weren’t even aware of it. Diabetes is affecting people of all ages, including 132,000 children and adolescents younger than 18 years old. (2)
Lab studies show that Encellin’s “ultra thin-film implantable cell delivery system” keeps islet cells alive and functioning. In a 2015 study in the journal ACS Nano, Dr. Nyitray and others found that cells in the packaging survived for 90 days in lab animals. New blood vessels grew around the transplants and the cells produced insulin in response to rising glucose levels. In a 2016 study from Dr. Desai’s lab, also published in ACS Nano, human islet cells packaged in the tiny film envelopes survived for six months in mice—and the cells made and released insulin in response to rising blood glucose levels.
According to the Mayo Clinic, doctors may use other tests to diagnose diabetes. For example, they may conduct a fasting blood glucose test, which is a blood glucose test done after a night of fasting. While a fasting blood sugar level of less than 100 milligrams per deciliter (mg/dL) is normal, one that is between 100 to 125 mg/dL signals prediabetes, and a reading that reaches 126 mg/dL on two separate occasions means you have diabetes.
^ Piwernetz K, Home PD, Snorgaard O, Antsiferov M, Staehr-Johansen K, Krans M (May 1993). "Monitoring the targets of the St Vincent Declaration and the implementation of quality management in diabetes care: the DIABCARE initiative. The DIABCARE Monitoring Group of the St Vincent Declaration Steering Committee". Diabetic Medicine. 10 (4): 371–7. doi:10.1111/j.1464-5491.1993.tb00083.x. PMID 8508624.
Many herbal remedies have been used to reduce inflammation and pain. Writing in the online publication U.S. Pharmacist, Antoine Al-Achi, PhD, a Professor of Pharmaceutics at the Campbell University School of Pharmacy in North Carolina, reported that bromelain (pineapple enzyme), curcumin (an antioxidant found in turmeric), echinacea, chamomile, ginger, and arnica have shown anti-inflammatory effects. Preparations of these plant-based supplements are widely available at health-food stores. If you would like to try one or more of these supplements, speak to your doctor first about possible side effects and drug interactions.
Chronically high blood glucose levels are known to damage nerves, so keeping blood glucose levels close to the normal, nondiabetic range can greatly reduce neuropathic pain. (Sometimes, however, if nerve damage has caused numbness in the feet, legs, hands, or arms, improving blood glucose control can cause pain in these areas as the nerves start to heal and regain function. The pain is usually temporary.)
Diarrhea and constipation may also stem from diabetes-related gut movement issues. And the conditions may be related. “Diarrhea doesn’t mean fast motion; constipation doesn’t mean slow movement,” says Mashimo, happy to clear up a common misconception. “They can be two sides of the same coin.” Constipation, he says, is caused by slow movement of the bowels, which can cause a buildup of harmful bacteria in the colon that, in turn, triggers diarrhea.
A whole range of issues start to crop up when diabetes is left untreated. Excess sugar in the blood can lead to more persistent yeast infections (yeast love sugar). High blood sugar can also affect blood flow, which leads to slower healing for sores and wounds. Over time, the condition can lead to Peripheral Artery Disease (PAD), which causes blood vessels to narrow, lending to a condition called peripheral neuropathy that results in a person not feeling pain. And without a sense of pain after an injury or development of an ulcer, the patient may not realize the wound is progressing – amputation may even be required to save him or her from sepsis.
The reason they need it: Their own insulin-producing islet cells, located in the pancreas, aren’t working. Now, scientists across the US are racing to develop effective ways to transplant new islet cells in people with diabetes—an alternative that could make daily life easier and lower risk for insulin side effects like dangerous low blood sugar episodes.
One easy way to increase your fat content and quit snacking is to begin your meal by eating an avocado. I and others I know have used this trick to easily quit snacking. Avocados protect you from one of the reasons some dietary research wrongly claims that high-fat diets are bad for you: the danger of gorging yourself on delicious, fatty foods. With plain avocados, there is little danger of gorging. Another danger is clogging your arteries and giving yourself heart disease. But it’s been amply shown that the blame for that falls squarely on trans fats, like margarine. If you see any product with the words “partially hydrogenated” or “hydrogenated” in the list of ingredients, put it back, it’s a trans fat. On the other hand, any fat that comes directly from an animal or plant is not a trans fat and can be safely consumed.
It was the same endorsement the first Diabetes Surgery Summit, also organized by Cummings in 2007, had made, but the landscape had changed since then. In addition to more accumulated research, this time, their stance was backed by over 50 international professional organizations, including the American Diabetes Association. And while other medical societies and organizations had long backed surgery as an option for diabetes, the DSS-II guidelines are the first meant to guide clinical practice.
Today Diabetes Relief helps patients actually improve their health and reduce their dependency on medications. Their cutting-edge approach includes individualized infusion therapy using FDA-approved drugs and equipment, enhanced by a proprietary metabolic reconditioning supplement. Along with diabetes education that encourages nutrition and exercise as part of positive lifestyle adjustments, Diabetes Relief’s program is changing lives and achieving amazing outcomes for their patients.
Electrical stimulation can sometimes block pain signals from traveling up the nerves. The most commonly used system is called TENS, which stands for transcutaneous electrical nerve stimulation. TENS works by sending electrical pulses across the surface of the skin into the nerves. The stimulating pulses help prevent pain signals from reaching the brain. They also help stimulate your body to produce higher levels of its own natural painkillers, called endorphins.
First, the health of your gut is critical to your overall health. This is because your gut is home of trillions of microbes called the gut microbiome. These microbes work in symbiotic and antagonistic relationships within your body. A 2017 study using multiple therapies to manipulate the gut microbiome composition, found they could impact the individual’s health more rapidly. This study also found manipulating the gut microbiome as an effective way to avoid insulin resistance and therefore prevent diabetes.
Without insulin, that extra sugar starts to hang out in your blood with nowhere to go. Just like with honey or sweet syrup, high concentrations of sugar causes the blood to thicken. Physiologically, this pulls fluids and water from other parts of the body into the bloodstream, causing swelling and dryness. Early symptoms of diabetes are relatively mild, including excessive peeing, dry mouth, itchy skin, hunger, fatigue, and blurred vision.
For her part, St Clair thought she was inquiring about a technical glitch. Her brother—the brother who along with three other siblings had gifted her the DNA test for her birthday—wasn’t showing up right in her family tree. It was not a glitch, the woman on the line had to explain gently, if this news can ever land gently: The man St Clair thought of as her brother only shared enough DNA with her to be a half-sibling. In fact, she didn’t match any family members on her father’s side. Her biological father must be someone else.
“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.”
So how does the wellness movement keep perspective and stay focused on what matters? It’s not about just finding one’s true north but following it, day after day, year after year. Straying happens as more of a gradual slide than as any single decision to go down a bad road. You start off doing what you think is right or helpful or normal, and then it feels good to make some money, and then it feels necessary, and you have an obligation to grow and to be seen as flourishing and successful. Then before you know it, you’re running a huge company that’s preying on seekers and begging them off course.
Many people may not want to divulge their bathroom dramas to a doctor, or anyone, or may think that heartburn is common and no big deal. Everyone gets a tummy ache now and again, but if you have diabetes, GI symptoms may indicate that something is chronically wrong. “If it bothers you, it’s worth getting checked out,” says Bragg. With a proper diagnosis, you and your health care provider can come up with a plan to make your whole body feel a whole lot better.
Health ProMed Nursing Director Angel Rodriguez, Ruben Bras of the Puerto Rico Primary Care Association and other ProMed staffers quickly load Humulin R insulin into cold storage at the ProMed San Juan clinic. Humulin R is used to stabilize a patient’s blood sugar. The medicines from Direct Relief were critical after Hurricane Maria, with many patients battling stress and limited access to nutritious food. (Lara Cooper/Direct Relief)
Today, 425 million adults live with diabetes, and that number is expected to grow to 629 million by 2045, with the greatest number between the ages of 40 to 59 years old. The global prevalence of diabetes has risen from 4.7 percent in 1980 to 8.5 percent in 2014, with the proportion of type 2 diabetes increasing around the world. On top of those numbers, another whopping 352 million people are at risk of developing type 2 diabetes. According to the 2017 Economic Cost of Diabetes survey sponsored by the American Diabetes Association, the total cost of diabetes was estimated to be $327 billion, a 26 percent increase since 2012. About three-quarters of those costs are associated with direct medical expenditures. Patients with diabetes are expected to pay an average of $9,600 in additional medical costs annually. A diabetes cure could cut out a nice chunk of fat out of those costs, potentially worth $245 billion from the 30 million diabetic Americans alone.
Anecdotally, Cummings knows at least one person in the US who got their surgery paid for through their partner’s employer insurance, despite only having a BMI of 31. And he notes that many countries with a robust public health care system have already lowered their BMI limits to mirror the DSS-II guidelines, such as the UK and Saudi Arabia. He also believes that Medicare and Medicaid officials are deliberating whether to adopt the DSS-II guidelines, based on discussions he’s had. “I don’t know how long it’ll take, but we’re crossing our fingers and hoping,” he said.
But preventing the disease from progressing if you already have it requires first being able to spot the signs and symptoms of diabetes when they appear. While some type 2 diabetes symptoms may not ever show up, you can watch out for the following common signs of the disease and alert your doctor, especially if you have any of the common risk factors for diabetes. Also keep in mind that while most signs of type 2 diabetes are the same in men and women, there are some distinctions.