In autoimmune diseases, such as type 1 diabetes, the immune system mistakenly manufactures antibodies and inflammatory cells that are directed against and cause damage to patients' own body tissues. In persons with type 1 diabetes, the beta cells of the pancreas, which are responsible for insulin production, are attacked by the misdirected immune system. It is believed that the tendency to develop abnormal antibodies in type 1 diabetes is, in part, genetically inherited, though the details are not fully understood.
Hypoglycemia means abnormally low blood sugar (glucose). In patients with diabetes, the most common cause of low blood sugar is excessive use of insulin or other glucose-lowering medications, to lower the blood sugar level in diabetic patients in the presence of a delayed or absent meal. When low blood sugar levels occur because of too much insulin, it is called an insulin reaction. Sometimes, low blood sugar can be the result of an insufficient caloric intake or sudden excessive physical exertion.
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.
Certain drugs may also help to control pain. These include anti-inflammatory medicines such as ibuprofen, aspirin, naproxen, indomethacin, and many others. While some of these are sold over the counter, they can have side effects, most notably gastrointestinal bleeding. A newer anti-inflammatory, celecoxib (Celebrex), may have fewer gastrointestinal side effects.
In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care in a team approach. Home telehealth support can be an effective management technique.
The review affirmed how effective surgery is at treating diabetes (possibly even type 1 diabetes). Around two-thirds of patients with diabetes experience a full remission soon after surgery, while the rest are often better able to control their blood sugar through diet, exercise and medication. Other studies have shown that diabetics who have surgery outlive those who haven’t. Some longer-term research has suggested that one-third of these successes slide back into having active diabetes after five years, but to a lesser degree than they might have without surgery. By contrast, a 2014 study found that fewer than 2 percent of diabetes patients given standard care experienced any remission within a seven-year span.
^ Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, Stehouwer CD, Lewington S, Pennells L, Thompson A, Sattar N, White IR, Ray KK, Danesh J (June 2010). "Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies". Lancet. 375 (9733): 2215–22. doi:10.1016/S0140-6736(10)60484-9. PMC 2904878. PMID 20609967.
The fact these improvements can happen independently of weight loss should also signify a shift in how we conceptualize both obesity and diabetes, according to Peter Billings, the Seattle bariatric surgeon who operated on Benari. Billings, a nearly 20-year veteran in the field, has started to perform surgery on other lower-BMI patients similar to Benari, though they often pay out of pocket.
In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control. (This is a major factor for many patients with type 2 diabetes who ultimately require insulin therapy.) Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.
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.
Currently, no fully artificial pancreas system has been approved by the FDA for use in the U.S. The most advanced product on the market in the USA is currently Medtronic’s MiniMed system which can automatically suspend insulin delivery when it detects low blood sugars. The next generation of their system will anticipate low blood sugars and stop insulin delivery in advance.
Holiday parties were right around the corner, and I needed a cover story. I didn’t feel like admitting to casual acquaintances, or even to some good friends, that I drive a van for Amazon. I decided to tell them, if asked, that I consult for Amazon, which is loosely true: I spend my days consulting a Rabbit, the handheld Android device loaded with the app that tells me where my next stop is, how many packages are coming off the van, and how hopelessly behind I’ve fallen.
Each month, ASDA issues a Wellness Challenge that asks you to change your behavior in a way that will positively affect your wellness. Each challenge varies in length and activity, but the goal is the same: to get you paying more attention to your well-being and developing good wellness habits. Each challenge will target one (or more) of ASDA’s five dimensions of wellness: emotional, physical, intellectual, occupational and environmental. December's challenge: Brainy expedition. Learn what it takes now.