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.
I bring this up because sleep apnea increases a person’s risk for developing type 2 diabetes. Also, sleep-disordered breathing is also related to proper nutrition throughout life. And perhaps most importantly, the first line of defense in catching sleep-disordered breathing in patients early, are dentists. This is another area where dentists must get involved if we want to tackle the issue of pervasive type 2 diabetes with any success.
While scientific controversy still exists over whether a cure for diabetes even exists, the possibility is still bright with current advances in technology. Cutting-edge technologies like stem cells therapies and regenerative medicine are pushing the envelope, and may hold high promise for a potential cure to diabetes, but there’s also still room for advanced oral-based pharmaceuticals to help in the battle against diabetes. Chronic diseases such as type 2 diabetes can certainly draw big investments, something we see not just from the above companies but from a well-funded startup called Intarcia Therapeutics that we covered a few years ago when it had raised $759 million. It has now taken in $1.6 billion and is STILL in stage 3 clinical trials more than three years later. In other words, you need more than bright ideas to cure diabetes, but a lot of money to bring these therapies to market.
One of the biggest hits in type 2 diabetes treatment is glucagon-like peptide (GLP)-1 receptor agonists, which induce insulin production in beta-pancreatic cells while suppressing the secretion of glucagon. All big pharma have GLP-1 drugs on the market or their pipelines, including Sanofi, Eli Lilly, Roche, AstraZeneca and Boehringer Ingelheim. But Novo Nordisk is going a step further with the first oral version of a GLP-1 drug, which is now close to the market.
Diabetes is a serious disease requiring professional medical attention. The information and recipes on this site, although as accurate and timely as feasibly possible, should not be considered as medical advice, nor as a substitute for the same. All recipes and menus are provided with the implied understanding that directions for exchange sizes will be strictly adhered to, and that blood glucose levels can be affected by not following individualized dietary guidelines as directed by your physician and/or healthcare team.
A women gets her blood glucose levels checked at a pop-up clinic in Mexico City’s neighborhood of La Roma by Dr. Eduardo Juarez Oliveros. The clinic was set up by the Association Mexica de Diabetes (AMD) in partnership with Direct Relief. The clinic is aimed at serving populations in the city displaced by the earthquake, especially those with diabetes. (Photo by Meghan Dhaliwal for Direct Relief)
Certain drugs that affect the brain can help to control chronic pain. Antidepressants in the class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which include duloxetine (Cymbalta), are often prescribed for pain. So are tricyclic antidepressants (TCAs) such as amitriptyline (Elavil). SSRIs often boost energy, while TCAs can make you sleepy. According to the Harvard Medical School website, “Some physicians prescribe an SSRI during the day and amitriptyline at bedtime for pain patients.”
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.
Founded in 2006, Massachusetts-based biotechnology startup Gelesis has raised a total of $118.2 million for developing an oral smart pill. In 2016, the company initially filed an IPO offering of $60 million, but pulled out and instead focused on raising more funding. The technology is based on capsules filled with tiny hydrogel particles that expand between 50 to 100 times their weight in size after absorbing water from the stomach, which results in increased satiety to help obese diabetes patients lose weight and control their sugar metabolism. They are currently undergoing a phase 2 clinical trial on their Gelesis200 product for treating diabetes.
The symptoms may relate to fluid loss and polyuria, but the course may also be insidious. Diabetic animals are more prone to infections. The long-term complications recognized in humans are much rarer in animals. The principles of treatment (weight loss, oral antidiabetics, subcutaneous insulin) and management of emergencies (e.g. ketoacidosis) are similar to those in humans.
The prognosis of diabetes is related to the extent to which the condition is kept under control to prevent the development of the complications described in the preceding sections. Some of the more serious complications of diabetes such as kidney failure and cardiovascular disease, can be life-threatening. Acute complications such as diabetic ketoacidosis can also be life-threatening. As mentioned above, aggressive control of blood sugar levels can prevent or delay the onset of complications, and many people with diabetes lead long and full lives.
In patients with type 2 diabetes, stress, infection, and medications (such as corticosteroids) can also lead to severely elevated blood sugar levels. Accompanied by dehydration, severe blood sugar elevation in patients with type 2 diabetes can lead to an increase in blood osmolality (hyperosmolar state). This condition can worsen and lead to coma (hyperosmolar coma). A hyperosmolar coma usually occurs in elderly patients with type 2 diabetes. Like diabetic ketoacidosis, a hyperosmolar coma is a medical emergency. Immediate treatment with intravenous fluid and insulin is important in reversing the hyperosmolar state. Unlike patients with type 1 diabetes, patients with type 2 diabetes do not generally develop ketoacidosis solely on the basis of their diabetes. Since in general, type 2 diabetes occurs in an older population, concomitant medical conditions are more likely to be present, and these patients may actually be sicker overall. The complication and death rates from hyperosmolar coma is thus higher than in diabetic ketoacidosis.
"Secondary" diabetes refers to elevated blood sugar levels from another medical condition. Secondary diabetes may develop when the pancreatic tissue responsible for the production of insulin is destroyed by disease, such as chronic pancreatitis (inflammation of the pancreas by toxins like excessive alcohol), trauma, or surgical removal of the pancreas.
A representative for the Centers for Medicare and Medicaid Services, however, told Gizmodo the agency “has not received a reconsideration request” to overhaul its coverage of bariatric surgery as of yet. Gizmodo also asked several of the leading insurance companies, such as Anthem, Aetna, and UnitedHealthcare, about any possible revision in their coverage policies. Only Aetna replied, stating it constantly evaluates “new published peer-reviewed studies and medical research when developing our clinical policies.” But the company seemingly has no current plans to roll out any changes.
The first WHO Global report on diabetes demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults. Factors driving this dramatic rise, which is largely on account of type 2 diabetes, include overweight and obesity. The new report calls upon governments to ensure that people are able to make healthy choices and that health systems are able to diagnose, treat and care for people with diabetes.
The combination of diabetes and excess body weight puts individuals at high risk of complications. For people who are overweight or obese, a five percent reduction in body weight has been shown to improve glycemic control, lipids and blood pressure and to reduce the need for medication. Weight loss always sound easy: Just eat less and exercise more. If only it were that simple! There are numerous reasons why people struggle to lose weight including mindset, practical problems (like a busy lifestyle or limited access to healthy food) and stress eating. Many benefit from joining a support group, advice from a dietician or using online tracking applications such as the Body