Joyce Lashof, then the dean of Berkeley’s School of Public Health, remembers that wellness was initially a tough sell at the school. Not much was known on campus about the earlier work of Travis and his fellow wellness advocates, but Lashof’s colleagues associated the term wellness with the “flakiness” of Mill Valley and surrounding Marin County. The NBC newsman Edwin Newman had televised an exposé of Marin County’s hedonistic lifestyle, which notoriously opened with a woman getting a peacock-feather massage from two nude men. The Berkeley Wellness Letter, however, managed to avoid such unseemly associations by publishing serious, evidence-based articles on health promotion, while debunking many of the holistic health fads of the day.
There is no cure for diabetes. It’s a chronic condition that must be managed for life. This seems odd, given all the modern medical technology we have at our disposal. We can insert heart pacemakers, perform liver transplants, even adapt to bionic limbs, but coming up with a replacement for the islets that produce insulin in the pancreas appears to be out of reach for now. There is something about the pancreas that makes it difficult to fix, which is part of the reason pancreatic cancer remains so deadly.
Diabetes experts feel that these blood glucose monitoring devices give patients a significant amount of independence to manage their disease process; and they are a great tool for education as well. It is also important to remember that these devices can be used intermittently with fingerstick measurements. For example, a well-controlled patient with diabetes can rely on fingerstick glucose checks a few times a day and do well. If they become ill, if they decide to embark on a new exercise regimen, if they change their diet and so on, they can use the sensor to supplement their fingerstick regimen, providing more information on how they are responding to new lifestyle changes or stressors. This kind of system takes us one step closer to closing the loop, and to the development of an artificial pancreas that senses insulin requirements based on glucose levels and the body's needs and releases insulin accordingly - the ultimate goal.
In type 2 diabetes the body has an increasingly harder time to handle all the sugar in the blood. Large amounts of the blood sugar-lowering hormone insulin are produced, but it’s still not enough, as insulin sensitivity decreases. At the time of being diagnosed with type 2 diabetes, diabetics usually have ten times more insulin in their bodies than normal. As a side effect, this insulin stores fat and causes weight gain, something that has often been in progress for many years before the disease was diagnosed.
Low blood pressure on standing (orthostatic hypotension). Treatment starts with simple lifestyle changes, such as avoiding alcohol, drinking plenty of water, and sitting or standing slowly. Sleeping with the head of the bed raised 6 to 10 inches helps prevent swings in blood pressure. Your doctor may also recommend compression stockings and similar compression support for your abdomen (abdominal binder). Several medications, either alone or together, may be used to treat orthostatic hypotension.
Regarding age, data shows that for each decade after 40 years of age regardless of weight there is an increase in incidence of diabetes. The prevalence of diabetes in persons 65 years of age and older is around 25%. Type 2 diabetes is also more common in certain ethnic groups. Compared with a 7% prevalence in non-Hispanic Caucasians, the prevalence in Asian Americans is estimated to be 8.0%, in Hispanics 13%, in blacks around 12.3%, and in certain Native American communities 20% to 50%. Finally, diabetes occurs much more frequently in women with a prior history of diabetes that develops during pregnancy (gestational diabetes).
Diabetes is a whole-body problem. The disease is marked by too high blood glucose, which affects the many cells fed by the circulatory system. The cells of the gastrointestinal (GI) tract and the nerves that control its movement are no exception. People with diabetes have an elevated risk for a spectrum of GI disorders that can make life uncomfortable. Identifying the cause of GI discomfort is the first step toward getting the right treatment and finding relief.
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.