Diabetes: The differences between types 1 and 2 There are fundamental differences between diabetes type 1 and type 2, including when they might occur, their causes, and how they affect someone's life. Find out here what distinguishes the different forms of the disease, the various symptoms, treatment methods, and how blood tests are interpreted. Read now
Chronic pain creates several vicious cycles. For one, people tend to tense their muscles in response to pain, which often makes the pain worse. Pain also leads people to stop moving, which leads to increasing stiffness and more pain. Pain can interfere with sleep, and restless nights can increase pain. Pain also can contribute to depression and painful emotions such as anger, grief, fear, and frustration, which in turn contribute to pain.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Acupuncture is a procedure where a practitioner inserts very thin needles into specific points on your skin. Some scientists say that acupuncture triggers the release of the body's natural painkillers. Acupuncture has been shown to offer relief from chronic pain and is sometimes used by people with neuropathy, the painful nerve damage that can happen with diabetes.
Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which a T cell-mediated autoimmune attack leads to the loss of beta cells and thus insulin. It causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults, but was traditionally termed "juvenile diabetes" because a majority of these diabetes cases were found in children.
But as I write in my forthcoming book, The Good Neighbor: The Life and Work of Fred Rogers, Rogers’s placidity belied the intense care he took in shaping each episode of his program. He insisted that every word, whether spoken by a person or a puppet, be scrutinized closely, because he knew that children—the preschool-age boys and girls who made up the core of his audience—tend to hear things literally.
Another French company, Valbiotis (FP:ALVAL), has developed the plant-based VALEDIA to reduce the risk of type 2 diabetes by treating patients with pre-diabetic symptoms. The product is based on the active ingredient TOTUM-63, a combination of five plant extracts that work synergistically to address several metabolic factors that play a role in diabetes development.
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.
There are evident parallels between the isolated, secular American lifestyle and the sale of identity, community, and guidance on how to live. The festival’s speakers were called “guide leaders.” Wanderlust’s slogan is “Find your true north.” When I asked Hoess how he thought the festival was going, he said it was great because everyone looked “totally blissed out.” The idea kept coming up that we all worship something, and that God is a necessary construct if only to have something to conceptually subordinate the self.
Though not routinely used any longer, the oral glucose tolerance test (OGTT) is a gold standard for making the diagnosis of type 2 diabetes. It is still commonly used for diagnosing gestational diabetes and in conditions of pre-diabetes, such as polycystic ovary syndrome. With an oral glucose tolerance test, the person fasts overnight (at least eight but not more than 16 hours). Then first, the fasting plasma glucose is tested. After this test, the person receives an oral dose (75 grams) of glucose. There are several methods employed by obstetricians to do this test, but the one described here is standard. Usually, the glucose is in a sweet-tasting liquid that the person drinks. Blood samples are taken at specific intervals to measure the blood glucose.
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).
Some of these problems are skin conditions anyone can have, but people with diabetes get more easily. These include bacterial infections, fungal infections, and itching. Other skin problems happen mostly or only to people with diabetes. These include diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis.
The ketogenic, or keto, diet calls for dramatically increasing your fat intake and consuming a moderate amount of protein and a very low amount of carbs, with the aim of kicking your body into a natural metabolic state called ketosis, in which it relies on burning fat rather than carbs for energy. Ketosis is different from diabetic ketoacidosis, a health emergency that occurs when insulin levels are low in conjunction with high levels of ketones. (37) Ketones are by-products of metabolism that are released in the blood when carb intake is low.
Some risks of the keto diet include low blood sugar, negative medication interactions, and nutrient deficiencies. (People who should avoid the keto diet include those with kidney damage or disease, women who are pregnant or breast-feeding, and those with or at a heightened risk for heart disease due to high blood pressure, high cholesterol, or family history. (40)
Research shows that cognitive behavioral therapy (CBT) combined with medication works best. CBT works by identifying, understanding, and changing thoughts and behaviors, according to the Anxiety and Depression Association of America. As an active participant in your treatment, in CBT you'll do homework and practice exercises over several weeks or months. “This is a new skill that you’re having to fine-tune and develop over time in order to incorporate it into your day-to-day life,” Bereolos says.
Diabetic ketoacidosis can be caused by infections, stress, or trauma, all of which may increase insulin requirements. In addition, missing doses of insulin is also an obvious risk factor for developing diabetic ketoacidosis. Urgent treatment of diabetic ketoacidosis involves the intravenous administration of fluid, electrolytes, and insulin, usually in a hospital intensive care unit. Dehydration can be very severe, and it is not unusual to need to replace 6-7 liters of fluid when a person presents in diabetic ketoacidosis. Antibiotics are given for infections. With treatment, abnormal blood sugar levels, ketone production, acidosis, and dehydration can be reversed rapidly, and patients can recover remarkably well.
Use any combination of the tricks below to accelerate your weight loss and return to good health. If you use all five wisely, you can get to your ideal weight in 6–12 months or less — even if that means losing 100 pounds or more. Yes, think about your weight 10, 20, 30 years ago. Another friend of mine started on this journey last year weighing 270 pounds. He’s in his mid-thirties and about to reach his college wrestling weight class of 197 pounds and just ran his fastest 2 miles ever. He got to this point by following the two rules above and just 3 of the 5 tricks below.
It could have been confused for a sermon had he not been dressed in black-leather pants and cursed so much. And like many people, he’s not exactly aligned with Alcoholics Anonymous’s religious tone and bent, and so he has rewritten the 12 steps in more colloquial terms for anyone who wants to change, whether the addiction is to “eating badly or to bad jobs or to pornography.” Brand’s own 12 steps, projected on a slide, are:—Are you a bit fucked?
Type II diabetes is more common than Type I diabetes in India. Type II diabetes usually happens to people who are above the age of 40. This type of diabetes is caused due to insulin resistance. In this case, the pancreas produces insulin but the body is not able to respond to it properly. There can be many reasons behind type II diabetes. Some of the reasons can be being overweight, high blood pressure, having a poor diet, taking too much stress, hormone imbalance, certain medications and leading a sedentary lifestyle. Though type II diabetes can be reversed.
For now, I manage my diabetes through a combination of technologies. I use a blood test meter to measure my glucose levels at least five times a day. I use a pump that is attached to my abdomen to deliver frequent doses of insulin throughout the day. And now I also use a continuous monitoring device that measures my subcutaneous blood sugar levels to help the insulin pump work more effectively.
Exercise is often one of the best treatments for pain. Responding to an entry on pain in the Diabetes Self-Management blog, a Canadian man with Type 2 diabetes reported, “I have cured my back pain completely since starting weight-lifting exercises 18 months ago. I do horizontal and inclined bench presses. I started with 50 lbs and built to 150 lbs. The benches provide complete back support.”
Insulin is released into the blood by beta cells (β-cells), found in the islets of Langerhans in the pancreas, in response to rising levels of blood glucose, typically after eating. Insulin is used by about two-thirds of the body's cells to absorb glucose from the blood for use as fuel, for conversion to other needed molecules, or for storage. Lower glucose levels result in decreased insulin release from the beta cells and in the breakdown of glycogen to glucose. This process is mainly controlled by the hormone glucagon, which acts in the opposite manner to insulin.
Tyler played college basketball at Utah State from 2007-2011, and had the opportunity to play in three NCAA tournaments. His coaches and trainers always had Gatorade or candy on hand in case his blood glucose dropped during a game. Tyler tested his blood glucose right before training, and during halftime breaks. He says working out and playing basketball has helped him to better control his T1D.
When pain is a source of fear, anger, or grief, it usually hurts more. Cancer patients may experience worse pain, because they fear it means their disease is worsening or that they may be dying. Because your thoughts about your pain have a major effect on how bad it feels, it can help to change your thoughts. For example, you might try changing a negative thought such as, “This pain keeps me from doing everything I like,” to a more realistic, positive one such as, “This pain makes it harder to do things, but I can sometimes find different ways to do them.” Doing this can actually turn down your pain level.
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Type II diabetes is by far the more common form: about 95 percent of the population with diabetes have Type II. With Type II, your body still produces insulin, but your cells are unable to process it correctly. Sometimes a change in diet and exercise regimen can solve the problem. Other times, medication is needed to help your cells process insulin. A few years ago, I was told I also had Type II diabetes, which makes my condition quite rare.
Weight loss surgery in those with obesity and type two diabetes is often an effective measure. Many are able to maintain normal blood sugar levels with little or no medications following surgery and long-term mortality is decreased. There is, however, a short-term mortality risk of less than 1% from the surgery. The body mass index cutoffs for when surgery is appropriate are not yet clear. It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.
Surveys of people with diabetes report rates of chronic pain anywhere from 20% to over 60% — much higher than rates in the general population. The types of pain most often reported by people with diabetes include back pain and neuropathy pain in the feet or hands. (Peripheral neuropathy, or nerve damage in the feet and hands, is a common complication of diabetes.) Headaches and other pain sites are also frequently reported. Many people with diabetes also have arthritis, fibromyalgia (an arthritis-related illness that causes widespread muscle and joint pain and fatigue), or other painful conditions.
“The cell is the original smart machine,” notes Crystal Nyitray, PhD, on the website of Encellin, the biotech start-up she founded in 2016. “All drugs, devices, and even digital health approaches are trying to restore or copy these functions. At Encellin, we believe in the human cell and creating a safe and reliable solution for patients. We are creating a technology to promote cell function and protection.”
^ Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH (August 2016). "Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013". BMJ. 354: i3857. doi:10.1136/bmj.i3857. PMC 4979358. PMID 27510511.
This makes Darkes' story seem less plausible, said Dr. Matthias von Herrath, a professor of developmental immunology at La Jolla Institute in California, and an expert in type 1 diabetes. This type of claim is "earth-shattering," he said. "If it's not well corroborated, it's like your grandmother's rumor kitchen" — there's nothing backing the story. If there is a clinical record and the data are clear, the doctors should publish a case report, Von Herrath told Live Science.
Grains: Grains, especially gluten-containing grains like wheat, contain large amounts of carbohydrates that are broken down into sugar within only a few minutes of consumption. Gluten can cause intestinal inflammation, which affects hormones like cortisol and leptin, and can lead to spikes in blood sugar. I recommend removing all grains from your diet for 90 days as your body adjusts to this healing program. Then you can try bringing sprouted ancient grains back into your diet in small amounts.
Engle has since run across the Sahara desert, among other death-defying feats that go well beyond what could be considered good for the joints. This was not a passing hobby or a way of dropping a few pounds. It was, rather, a purposeful blasting of the body. The running community provided for him fellowship and camaraderie, as it does for many people struggling with addiction. It also helped him realize that he didn’t have to give up being intense and passionate and obsessive; he just needed to channel these features in less destructive ways. “Do I run addictively? I’ve been accused of it,” he said. “But I’ve never lost my car after a run.”
Trick (important): Cut down on sweets, and if you can, cut them out entirely for a couple months. I still eat ice cream about once a week, and know people who are losing weight on this diet while eating ice cream almost every day. But this probably won’t be the case for everyone. Better to severely restrict sweets for the first few months, and then gradually reintroduce.
Currently, people with diabetes who receive a transplanted pancreas (typically not possible unless you are also having a kidney transplant) or who receive islet-cell transplants as part of a research study in the US must take these drugs so that their own body won’t attack the new cells. The drugs work, but raise risk for bacterial and viral infections as well as for mouth sores, nausea, diarrhea, high cholesterol, high blood pressure, fatigue and even some cancers.
Several studies show laughter is among the best medicines for pain. In Japanese studies of arthritis, people who watched a humorous show reduced their pain by more than 50% for as long as 12 hours. You can watch funny videos or read humorous writing, watch kids or puppies play, or do whatever it takes to make you laugh. You can also laugh for no reason at all. The effect seems to be the same.
Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (14)
One of the most common ways people with type 2 diabetes attempt to lower their blood sugar is by drastically reducing their intake of carbs. The ADA agrees that carbohydrate counting is essential if you have diabetes, but extreme diets like the ketogenic diet, which reduces carb intake to as little as 5 percent of your daily calories, can be risky for some people with diabetes. (36)