Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels.[76][77] The goal of treatment is an HbA1C level of 6.5%, but should not be lower than that, and may be set higher.[78] Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.[78] Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal, however.[79]
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.
The major eye complication of diabetes is called diabetic retinopathy. Diabetic retinopathy occurs in patients who have had diabetes for at least five years. Diseased small blood vessels in the back of the eye cause the leakage of protein and blood in the retina. Disease in these blood vessels also causes the formation of small aneurysms (microaneurysms), and new but brittle blood vessels (neovascularization). Spontaneous bleeding from the new and brittle blood vessels can lead to retinal scarring and retinal detachment, thus impairing vision.
In normal persons the hormone insulin, which is made by the beta cells of the pancreas, regulates how much glucose is in the blood. When there is excess glucose in the blood, insulin stimulates cells to absorb enough glucose from the blood for the energy that they need. Insulin also stimulates the liver to absorb and store any glucose that is excess in blood. Insulin release is triggered after a meal when there is rise in blood glucose. When blood glucose levels fall, during exercise for example, insulin levels fall too.

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.[61]
In type 2 diabetes, there also is a steady decline of beta cells that adds to the process of elevated blood sugars. Essentially, if someone is resistant to insulin, the body can, to some degree, increase production of insulin and overcome the level of resistance. After time, if production decreases and insulin cannot be released as vigorously, hyperglycemia develops.
Some studies show that certain plant foods may help your body fight inflammation and use insulin, a hormone that controls blood sugar. Cinnamon extracts can improve sugar metabolism, triggering insulin release, which also boosts cholesterol metabolism. Clove oil extracts (eugenol) have been found to help insulin work and to lower glucose, total cholesterol, LDL, and triglycerides. An unidentified compound in coffee (not caffeine) may enhance insulin sensitivity and lower the chances of developing type 2 diabetes.
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult-onset diabetes mellitus (AODM). In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells).
Wellness is in many ways a counterpoint to the inefficient and inaccessible and alienating elements of the U.S. health-care system. While it may have antiestablishment origins, the industry is now subject to criticism as a new elite establishment, and one that profits off of serious insecurities and medical problems. Marketing for the festival alludes to the opioid epidemic that killed 72,000 Americans last year: “With our world being affected by addiction and mental-health issues, the Wellspring festival couldn’t come at a better time.” At a time when millions of Americans bear medical debt or are doing jobs they would otherwise quit, because they need health insurance, Wanderlust offers monthly payment plans (“rates from 10–30 percent APR”) to afford a ticket.

Pain has been shown to interfere with self-management activities, sleep, physical functioning, work, family relationships, mood, and quality of life. To make matters worse, pain is often invisible to others, so family members, coworkers, and health-care professionals often have no idea what a person in pain is going through. Many people feel that their physicians don’t understand and tell them they “just have to live with it.”
The centerpiece of the weekend was a keynote by Russell Brand. I got in early as a member of the media and grabbed a seat in the front row of the enormous multipurpose convention space. I was sitting watching stagehands and audiovisual technicians bustling around when, about 10 minutes before the crowd was to be let in, Brand came onstage and appeared horrified at the layout of the audience seating. There was a 12-foot aisle in the center, directly in front of where Brand was to stand at his microphone. “This is death,” he scolded, pointing at the space. “I’m supposed to perform into this?”
Learning about the disease and actively participating in the treatment is important, since complications are far less common and less severe in people who have well-managed blood sugar levels.[76][77] The goal of treatment is an HbA1C level of 6.5%, but should not be lower than that, and may be set higher.[78] Attention is also paid to other health problems that may accelerate the negative effects of diabetes. These include smoking, elevated cholesterol levels, obesity, high blood pressure, and lack of regular exercise.[78] Specialized footwear is widely used to reduce the risk of ulceration, or re-ulceration, in at-risk diabetic feet. Evidence for the efficacy of this remains equivocal, however.[79]
Since cardiovascular disease is a serious complication associated with diabetes, some have recommended blood pressure levels below 130/80 mmHg.[89] However, evidence supports less than or equal to somewhere between 140/90 mmHg to 160/100 mmHg; the only additional benefit found for blood pressure targets beneath this range was an isolated decrease in stroke risk, and this was accompanied by an increased risk of other serious adverse events.[90][91] A 2016 review found potential harm to treating lower than 140 mmHg.[92] Among medications that lower blood pressure, angiotensin converting enzyme inhibitors (ACEIs) improve outcomes in those with DM while the similar medications angiotensin receptor blockers (ARBs) do not.[93] Aspirin is also recommended for people with cardiovascular problems, however routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes.[94]
Wellspring is produced by a quickly growing company called Wanderlust, “a global wellness platform” and “a multi-channel company focused around mindful living” by way of “renowned festival events, a full-service media company, and several permanent yoga centers.” Wanderlust was founded in Brooklyn 10 years ago and has since been putting on small, music-and-yoga-based festivals. But Wellspring is a new and much grander undertaking, lasting multiple days and based mostly on workshops and high-profile panels and lectures.

Keep your blood pressure under control. People with diabetes are more likely to have high blood pressure than are people who don't have diabetes. Having both high blood pressure and diabetes greatly increases your risk of complications because both damage your blood vessels and reduce blood flow. Try to keep your blood pressure in the range your doctor recommends, and be sure to have it checked at every office visit.


Type 2 DM is primarily due to lifestyle factors and genetics.[45] A number of lifestyle factors are known to be important to the development of type 2 DM, including obesity (defined by a body mass index of greater than 30), lack of physical activity, poor diet, stress, and urbanization.[16] Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders.[11] Even those who are not obese often have a high waist–hip ratio.[11]

^ Emadian A, Andrews RC, England CY, Wallace V, Thompson JL (November 2015). "The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups". The British Journal of Nutrition. 114 (10): 1656–66. doi:10.1017/S0007114515003475. PMC 4657029. PMID 26411958.
Although the promises are big, these technologies are still far from the market. First, clinical trials will have to show they do work. Then, the price could be steep, as cell therapy precedents for other applications, such as oncology, come with price tags that reach the six figures and are finding difficulties to get reimbursed. Considering that compared to cancer, diabetes is not an immediately life-threatening disease, health insurers in some countries might be reluctant to cover the treatment.
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.
There are some interesting developments in blood glucose monitoring including continuous glucose sensors. The new continuous glucose sensor systems involve an implantable cannula placed just under the skin in the abdomen or in the arm. This cannula allows for frequent sampling of blood glucose levels. Attached to this is a transmitter that sends the data to a pager-like device. This device has a visual screen that allows the wearer to see, not only the current glucose reading, but also the graphic trends. In some devices, the rate of change of blood sugar is also shown. There are alarms for low and high sugar levels. Certain models will alarm if the rate of change indicates the wearer is at risk for dropping or rising blood glucose too rapidly. One version is specifically designed to interface with their insulin pumps. In most cases the patient still must manually approve any insulin dose (the pump cannot blindly respond to the glucose information it receives, it can only give a calculated suggestion as to whether the wearer should give insulin, and if so, how much). However, in 2013 the US FDA approved the first artificial pancreas type device, meaning an implanted sensor and pump combination that stops insulin delivery when glucose levels reach a certain low point. All of these devices need to be correlated to fingersticks measurements for a few hours before they can function independently. The devices can then provide readings for 3 to 5 days.
A Wall Street Journal op-ed by Tommy Meyerson, a veteran of the Syria campaign, argues that “the Kurdish-led civil administration does the heavy lifting of guarding hundreds of ISIS’ most dangerous foreign fighters,” asserts that the West “owes them a debt,” and warns that a Turkish invasion into territory they hold “would force Kurdish forces to pull back from the front lines against the remnant of ISIS, allowing the jihadists to regroup and proliferate.”
The U.S. Department of Health and Human Services recommends that adults “engage in 150 minutes per week of moderate-intensity or 75 minutes per week of vigorous-intensity aerobic physical activity, or an equivalent combination of the two. Additional recommendation: muscle-strengthening activities that involve all major muscle groups two or more days per week.

According to Jack D. Bragg, DO, associate professor of clinical medicine at the University of Missouri, most diabetes-related GI issues stem from a problem with one thing: motion. The digestive tract is a finely tuned muscular machine. It pulls and pushes, expands and contracts, relaxes and squeezes to carry food from your mouth, down the esophagus, into the stomach, and, finally, through 25 feet of nutrient- and water-extracting intestine that ends in, well, your exit.
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.

Strengthening muscles eases pressure on the joints and tendons. It also gives you a greater sense of control, which really helps people deal with pain. Stretching to increase your flexibility can also be helpful for pain relief, when done as part of a regular exercise routine. Walking, sitting, and moving with good posture and balance can take pressure off tender muscles and nerves. You may want to consult a physical therapist to find exercises that are right for you.
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.
Physical treatments for chronic pain can include applying heat or cold to the part that hurts, massage, exercise, and rest. Sensations of heat, cold, and touch travel on the same nerves as pain sensations, but they travel faster. A sensation of gentle touch, heat, or cold will therefore beat a pain signal to the next pain gate and block the pain from getting through. Certain substances including capsaicin (chili pepper extract) provide a sensation of heat when rubbed on the skin that may keep a pain gate blocked for hours.
A 2018 study suggested that three types should be abandoned as too simplistic.[57] It classified diabetes into five subgroups, with what is typically described as type 1 and autoimmune late-onset diabetes categorized as one group, whereas type 2 encompasses four categories. This is hoped to improve diabetes treatment by tailoring it more specifically to the subgroups.[58]

Treatment for gastroparesis can include dietary changes such as eating less fiber and eating smaller, more frequent meals. Medications are available as well that can spur muscle contractions in the stomach or help control nausea. Another option for some people is to have a gastric pacing device, similar to a heart pacemaker, surgically implanted to stimulate stomach movements.


Access the ADA’s health and wellness programs as part of your ADA student membership. Each state association has a health and wellness director who can help you with anything from stress, mental well-being and addiction. You can contact your state association directly or call ADA Manager of Dentist Health and Wellness Alison Bramhall at 312-440-2622.
When there is excess glucose present in the blood, as with type 2 diabetes, the kidneys react by flushing it out of the blood and into the urine. This results in more urine production and the need to urinate more frequently, as well as an increased risk of urinary tract infections (UTIs) in men and women. People with type 2 diabetes are twice as likely to get a UTI as people without the disease, and the risk is higher in women than in men.
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