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.
"You only need 10 percent of your beta cells to supply sufficient insulin," Roep said. He said there have been a couple of rare cases where a patient had typical type 1 diabetes but could go through long periods without insulin injections. "Insulin needs can be a moving target, and if you have a lifestyle change it's very plausible that you have a lesser need for insulin, and you can deal with [diabetes] with the beta cells you have," Roep said.
The culprit in fungal infections of people with diabetes is often Candida albicans. This yeast-like fungus can create itchy rashes of moist, red areas surrounded by tiny blisters and scales. These infections often occur in warm, moist folds of the skin. Problem areas are under the breasts, around the nails, between fingers and toes, in the corners of the mouth, under the foreskin (in uncircumcised men), and in the armpits and groin.
As of 2015, an estimated 415 million people had diabetes worldwide, with type 2 DM making up about 90% of the cases. This represents 8.3% of the adult population, with equal rates in both women and men. As of 2014, trends suggested the rate would continue to rise. Diabetes at least doubles a person's risk of early death. From 2012 to 2015, approximately 1.5 to 5.0 million deaths each year resulted from diabetes. The global economic cost of diabetes in 2014 was estimated to be US$612 billion. In the United States, diabetes cost $245 billion in 2012.
The last time I was in Palm Springs was a year ago for the TEDMED conference (relational platform?), and at the time I was mystified. It was a full house at the price of $4,950 a ticket, even though TED Talks are available for free online. The videos can be sped up if the speaker is boring, segments can be skipped, and tabs can be opened to keep the talk running in the background while getting some email done or shopping for shoes. There would seem, then, very little reason to need to go to the actual conference, to sit through marathon sessions where a fair number of speakers mess up or forget their lines (as I did).
I was diagnosed as a Type I diabetic in October 1993. I was traveling at the time, and I felt lethargic, I was always thirsty, and I was having trouble concentrating. When I returned home, I went for a checkup, and the doctor confirmed my condition. From that day forward, I’ve been injecting myself with insulin every day. Before I switched to an insulin pump in 2011, I calculated that I had given myself about 30,000 needles. That’s a lot of jabbing.
^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.
Studies in type 1 patients have shown that in intensively treated patients, diabetic eye disease decreased by 76%, kidney disease decreased by 54%, and nerve disease decreased by 60%. More recently the EDIC trial has shown that type 1 diabetes is also associated with increased heart disease, similar to type 2 diabetes. However, the price for aggressive blood sugar control is a two to three fold increase in the incidence of abnormally low blood sugar levels (caused by the diabetes medications). For this reason, tight control of diabetes to achieve glucose levels between 70 to120 mg/dl is not recommended for children under 13 years of age, patients with severe recurrent hypoglycemia, patients unaware of their hypoglycemia, and patients with far advanced diabetes complications. To achieve optimal glucose control without an undue risk of abnormally lowering blood sugar levels, patients with type 1 diabetes must monitor their blood glucose at least four times a day and administer insulin at least three times per day. In patients with type 2 diabetes, aggressive blood sugar control has similar beneficial effects on the eyes, kidneys, nerves and blood vessels.
Diabetes mellitus is classified into four broad categories: type 1, type 2, gestational diabetes, and "other specific types". The "other specific types" are a collection of a few dozen individual causes. Diabetes is a more variable disease than once thought and people may have combinations of forms. The term "diabetes", without qualification, usually refers to diabetes mellitus.
The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Apollonius of Memphis. The disease was considered rare during the time of the Roman empire, with Galen commenting he had only seen two cases during his career. This is possibly due to the diet and lifestyle of the ancients, or because the clinical symptoms were observed during the advanced stage of the disease. Galen named the disease "diarrhea of the urine" (diarrhea urinosa).
What this means is the exact opposite of saying that pain is “all in your head.” It means that pain is a summary of all the data that come into your brain from your whole body, your environment, your relationships, feelings, and beliefs. If the summary says, “Things are not well,” you will likely feel pain. Chronic pain is a whole body–mind experience. It always has a physical component, and it always has an emotional component, and there may be other factors as well.
For 15 years, Erez Benari’s struggle with his type 2 diabetes had been a losing one. A software engineer at Microsoft in Seattle, Washington, Benari had stuck to a restrictive diet that kept him off most carbs, along with regular insulin shots. But still, his high blood sugar levels never dropped, while his health continued to decline. In 2013, the then 39-year-old Benari suffered a heart attack.
There is, in fact, no difference in meaning between preventive and preventative. Some, including William Safire in a 1993 On Language column, have suggested using preventive as an adjective and preventative as a noun, but both forms of the word have alternated freely as adjective and noun since they entered the language in the 17th century. Despite their introduction into English at roughly the same time (the Oxford English Dictionary dates preventive back to 1626 and preventative to 1655), preventive has won out as the preferred version.
Founded in 2014, San Francisco-based startup Virta has raised $82 million after a recent Series B round led by Venrock, a venture capital firm with ties to the Rockefeller fortune. The company is an online medical clinic that applies nutritional biochemistry to reverse type 2 diabetes. The company provides a starter kit, coaching, and physician check-ups online through a subscription fee-model to give patients access to the tools to treat and monitor their diabetes.
Some research, however, suggests a more drastic dietary change. A 2017 literature review concluded that “whole-foods, plant-based diet—legumes, whole grains, fruits, vegetables, and nuts, with limited or no intake of refined foods and animal products—are highly beneficial for preventing and treating type 2 diabetes.” A 2018 study found that overweight people who switched to a vegan diet for 16 weeks showed improvements in insulin sensitivity compared to a control group.
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.
Connection itself can be monetized, of course—in ways that create factions and cliques, or in inclusive ways that bring together people of various socioeconomic strata. That actually may look something like Wanderlust. The market is flooded with things we can consume alone on our couches or at the gym with headphones in. But we are hungry for connection—to hear the same things said but to have a person speaking directly to us (and to a few hundred other people).
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.
The pain of diabetic nerve damage may respond to traditional treatments with certain medications such as gabapentin (Neurontin), phenytoin (Dilantin), and carbamazepine (Tegretol) that are traditionally used in the treatment of seizure disorders. Amitriptyline (Elavil, Endep) and desipramine (Norpraminine) are medications that are traditionally used for depression. While many of these medications are not indicated specifically for the treatment of diabetes related nerve pain, they are used by physicians commonly.
The bionic pancreas is another project from Boston University and Massachusetts General Hospital in a joint effort to create a bionic pancreas, a type of artificial pancreas which not only includes insulin but also glucagon to raise blood sugar. The system is intended to use an algorithm that checks every 5 minutes to calculate the amount of insulin or glucagon needed. The project has recently formed into a public benefit corporation called Beta Bionics. This newer structure allows it to serve not just shareholders, but also the public good. Beta Bionics also became the first American company to raise over a $1 million from small investors under new public investing rules!
People with diabetes are unable to control the level of sugar in their blood, usually due to a breakdown in how their bodies use the hormone insulin. It’s not completely clear how obesity can contribute to diabetes, but it is known that excess weight is associated with chronic inflammation and a dysfunctional metabolism. And these factors in turn make it easier for someone to stop responding to the presence of insulin as easily as they once did. So by using surgery to help very obese people with diabetes lose weight, the logic goes, you can indirectly treat or prevent the condition. But doctors such as David Cummings, a senior investigator at the University of Washington’s Diabetes & Obesity Center of Excellence, are pushing back against this way of thinking.
India is said to be the diabetes capital of the world. With nearly 50 million people in India suffering from diabetes, the country has a big challenge to face. First, let’s know what is diabetes. The elevated sugar in the blood is called diabetes. There are two primary reasons behind diabetes - one is when our body stops producing insulin and second is when the body does not respond to insulin that is produced by the body. Insulin is broken down by the body and used as energy, which is transported to the cells. There are two types of diabetes - Type I diabetes and Type II diabetes. Let’s know about them in a little detail:
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.
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.
The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves. Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness. Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that diabetics visit an eye doctor once a year. Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation. Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes. The symptoms can include numbness, tingling, pain, and altered pain sensation, which can lead to damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathy causes painful muscle atrophy and weakness.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
This is at odds with the consumerist bent to wellness. If the movement indeed rejects the quick-fix products, which seems infeasible, it’s unclear what wellness is to become. If wellness is actually essentially the inverse of consumerism, and nearly synonymous with connectedness and wholeness and feeling complete, then the industry will need a new way to monetize.
Type 2 diabetes, a form of diabetes mellitus, is likely one of the better-known chronic diseases in the world — and that's no surprise. Data from the Centers for Disease Control and Prevention suggest in the United States alone, 30.3 million people, or 9.4 percent of the U.S. population, has diabetes, and the majority of these people have type 2. (1)