2018 was a year whose realities sometimes seemed to approach the dystopias and dramas of fiction, as stories of family trauma, environmental disaster, and sexual assault played out on the world stage. The books our writers and editors were drawn to this year include many that illuminate these struggles and inequities, whether in the form of visceral sonnets, lyrical history, or dizzyingly surreal detective yarns. But they also reach past political themes to the most intimate and universal of stories: a cross-continental meditation on transitory love, a warm and funny account of aging, a timeless reinvention of an ancient myth, and an absorbing deconstruction of faith, to name a few. Our list isn’t definitive or comprehensive, but guided by individual interests and tastes. Below, you’ll find essays, poetry, three striking fiction debuts, the first graphic novel to be longlisted for the Man Booker Prize, and more.
People tend to push themselves until pain or fatigue makes them stop. They then rest for the shortest possible time, then get back to work until pain stops them again. You can prevent this cycle by pacing yourself: Figure out how much you can do without pain, and stop before you reach that point. Rest up, then start again. You’ll get more done with less pain.
Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco. Control of blood pressure and maintaining proper foot care are important for people with the disease. Type 1 DM must be managed with insulin injections. Type 2 DM may be treated with medications with or without insulin. Insulin and some oral medications can cause low blood sugar. Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 DM. Gestational diabetes usually resolves after the birth of the baby.
People with full-blown type 2 diabetes are not able to use the hormone insulin properly, and have what’s called insulin resistance. Insulin is necessary for glucose, or sugar, to get from your blood into your cells to be used for energy. When there is not enough insulin — or when the hormone doesn’t function as it should — glucose accumulates in the blood instead of being used by the cells. This sugar accumulation may lead to the aforementioned complications.
Research shows that cognitive behavioral therapy (CBT) combined with medication works best. CBT works by identifying, understanding, and changing thoughts and behaviors, according to the Anxiety and Depression Association of America. As an active participant in your treatment, in CBT you'll do homework and practice exercises over several weeks or months. “This is a new skill that you’re having to fine-tune and develop over time in order to incorporate it into your day-to-day life,” Bereolos says.
Diabetes was one of the first diseases described, with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine". The Ebers papyrus includes a recommendation for a drink to be taken in such cases. The first described cases are believed to be of type 1 diabetes. Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants.
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.
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)
Engle has since run across the Sahara desert, among other death-defying feats that go well beyond what could be considered good for the joints. This was not a passing hobby or a way of dropping a few pounds. It was, rather, a purposeful blasting of the body. The running community provided for him fellowship and camaraderie, as it does for many people struggling with addiction. It also helped him realize that he didn’t have to give up being intense and passionate and obsessive; he just needed to channel these features in less destructive ways. “Do I run addictively? I’ve been accused of it,” he said. “But I’ve never lost my car after a run.”
Diabetes has grown to “epidemic” proportions, and the latest statistics revealed by the U.S. Centers for Disease Control and Prevention state that 30.3 million Americans have diabetes, including the 7.2 million people who weren’t even aware of it. Diabetes is affecting people of all ages, including 132,000 children and adolescents younger than 18 years old. (2)
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level by promoting the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
In 1991, the National Institutes of Health issued a consensus statement, cautiously recommending surgery as a treatment for people living with morbid obesity, meaning they have a body mass index, or BMI, over 40. For people who have health complications connected to obesity, such as type 2 diabetes, the limit goes down to a BMI of 35. Relying on these guidelines, insurance companies and public payers like Medicaid and Medicare typically only cover surgery for people living with diabetes who fall into that category.
Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses, a lack of insulin may also develop. This form was previously referred to as "non insulin-dependent diabetes mellitus" (NIDDM) or "adult-onset diabetes". The most common cause is a combination of excessive body weight and insufficient exercise.
Efforts to cure or stop type 1 diabetes are still in the early stages, and these approaches will also not be suitable for people that have already lost their insulin-producing cells. A solution could be the creation of an “artificial pancreas” — a fully automated system that can measure glucose levels and inject the right amount of insulin into the bloodstream, just like a healthy pancreas would.
Anti-seizure drugs. Some medications used to treat seizure disorders (epilepsy) are also used to ease nerve pain. The American Diabetes Association recommends starting with pregabalin (Lyrica). Others that have been used to treat neuropathy are gabapentin (Gralise, Neurontin) and carbamazepine (Carbatrol, Tegretol). Side effects may include drowsiness, dizziness and swelling.
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).
Glucose is a simple sugar found in food. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. Carbohydrates are broken down in the small intestine and the glucose in digested food is then absorbed by the intestinal cells into the bloodstream, and is carried by the bloodstream to all the cells in the body where it is utilized. However, glucose cannot enter the cells alone and needs insulin to aid in its transport into the cells. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. In certain types of diabetes, the cells' inability to utilize glucose gives rise to the ironic situation of "starvation in the midst of plenty". The abundant, unutilized glucose is wastefully excreted in the urine.
It could have been confused for a sermon had he not been dressed in black-leather pants and cursed so much. And like many people, he’s not exactly aligned with Alcoholics Anonymous’s religious tone and bent, and so he has rewritten the 12 steps in more colloquial terms for anyone who wants to change, whether the addiction is to “eating badly or to bad jobs or to pornography.” Brand’s own 12 steps, projected on a slide, are:—Are you a bit fucked?
Electrical stimulation can sometimes block pain signals from traveling up the nerves. The most commonly used system is called TENS, which stands for transcutaneous electrical nerve stimulation. TENS works by sending electrical pulses across the surface of the skin into the nerves. The stimulating pulses help prevent pain signals from reaching the brain. They also help stimulate your body to produce higher levels of its own natural painkillers, called endorphins.
People with type 2 diabetes have insulin resistance, which means the body cannot use insulin properly to help glucose get into the cells. In people with type 2 diabetes, insulin doesn’t work well in muscle, fat, and other tissues, so your pancreas (the organ that makes insulin) starts to put out a lot more of it to try and compensate. "This results in high insulin levels in the body,” says Fernando Ovalle, MD, director of the multidisciplinary diabetes clinic at the University of Alabama in Birmingham. This insulin level sends signals to the brain that your body is hungry.