In gastroesophageal reflux disease (GERD), sometimes called heartburn, stomach acid and partially undigested food move backward through the esophagus, escaping from the stomach and through the esophageal sphincter that normally prevents such backsliding. This can occur as a symptom of gastroparesis, says Hiroshi Mashimo, MD, PhD, a gastroenterologist at Harvard Medical School. “If the stomach doesn’t empty, it’s likely to reflux up,” he says. GERD may also result from diabetes-related nerve damage affecting the esophageal sphincter, Mashimo adds. One caution: Some diseases, such as a yeast infection in the esophagus, can masquerade as GERD, so don’t brush off symptoms. We can’t treat the gastroparesis or esophageal sphincter problems that contribute to GERD, but antacids and other medications can help to reduce or neutralize stomach acids (see “PPIs the Right Way,” below).
Medications used to treat diabetes do so by lowering blood sugar levels. There is broad consensus that when people with diabetes maintain tight glucose control (also called "tight glycemic control") -- keeping the glucose levels in their blood within normal ranges - that they experience fewer complications like kidney problems and eye problems.[84][85] There is however debate as to whether this is cost effective for people later in life.[86]
By the late 2000s the concept had become widely used in employee assistance programs in workplaces, and funding for development of such programs in small business was included in the Affordable Care Act.[2] The use of corporate wellness programs has been criticised as being discriminatory to people with disabilities.[4] At the same time, while there were magazines devoted to wellness, it was noted that mainstream news sources had begun to devote more page space to "health and wellness themes".[5]
Diabetes was one of the first diseases described,[107] with an Egyptian manuscript from c. 1500 BCE mentioning "too great emptying of the urine".[108] The Ebers papyrus includes a recommendation for a drink to be taken in such cases.[109] The first described cases are believed to be of type 1 diabetes.[108] Indian physicians around the same time identified the disease and classified it as madhumeha or "honey urine", noting the urine would attract ants.[108][109]

Benari, an Ashkenazi Jew, doesn’t fall into that category. But Cummings and other bariatric experts I spoke to said that surgery should be a possible option for any person whose diabetes isn’t improving. Cummings himself is currently working on a clinical trial in India of bariatric patients with BMIs as low as 25. And he expects similar trials will come down the pipeline.


When pain is a source of fear, anger, or grief, it usually hurts more. Cancer patients may experience worse pain, because they fear it means their disease is worsening or that they may be dying. Because your thoughts about your pain have a major effect on how bad it feels, it can help to change your thoughts. For example, you might try changing a negative thought such as, “This pain keeps me from doing everything I like,” to a more realistic, positive one such as, “This pain makes it harder to do things, but I can sometimes find different ways to do them.” Doing this can actually turn down your pain level.
Home blood sugar (glucose) testing is an important part of controlling blood sugar. One important goal of diabetes treatment is to keep the blood glucose levels near the normal range of 70 to 120 mg/dl before meals and under 140 mg/dl at two hours after eating. Blood glucose levels are usually tested before and after meals, and at bedtime. The blood sugar level is typically determined by pricking a fingertip with a lancing device and applying the blood to a glucose meter, which reads the value. There are many meters on the market, for example, Accu-Check Advantage, One Touch Ultra, Sure Step and Freestyle. Each meter has its own advantages and disadvantages (some use less blood, some have a larger digital readout, some take a shorter time to give you results, etc.). The test results are then used to help patients make adjustments in medications, diets, and physical activities.

For over a decade, Cummings and others have tried to reframe the very concept of bariatric surgery (they prefer “metabolic surgery”). Their work has shown these procedures just don’t change how much food the stomach can fit; they trigger a cascade of metabolic and bodily changes, many of which help people with type 2 diabetes naturally get their blood sugar under control. Some changes even start happening before a patient loses weight, such as higher levels of peptide production in the gut that seem to restore a patient’s sensitivity to insulin.
Maintaining an optimal level of wellness is absolutely crucial to live a higher quality life. Wellness matters. Wellness matters because everything we do and every emotion we feel relates to our well-being. In turn, our well-being directly affects our actions and emotions. It’s an ongoing circle. Therefore, it is important for everyone to achieve optimal wellness in order to subdue stress, reduce the risk of illness and ensure positive interactions.
Foods with a low glycemic load: The glycemic index of a food tells you about the blood glucose-raising potential of the food. Foods that have a high glycemic index are converted into sugar after being eaten more quickly than low glycemic foods. If you are fighting diabetes, stick to low glycemic foods like non-starchy vegetables, stone fruits and berries, nuts, seeds, avocados, coconut, organic meat, eggs, wild-caught fish, and raw pastured dairy.
Around 75% of people with diabetes have type 2 diabetes mellitus. This was earlier termed non-insulin dependent diabetes mellitus (NIDDM) or maturity-onset diabetes mellitus. The number of people with type 2 diabetes is rapidly increasing. In type 2 diabetes, not enough insulin is produced or the insulin that is made by the body is insufficient to meet the needs of the body. Obesity or being overweight predisposes to type 2 diabetes.
In the picture to the right you can see the lunch that I was unbelievably served at the 11th International Congress on Obesity in Stockholm 2010. This is a major international conference for obesity doctors and scientists. The food contains almost exclusively energy from sugar and starches, things that are broken down to simple sugars in the stomach.

Insulin is a type of hormone made up of 45 amino acids, and it is important for signaling to the body’s cells to pick up excess sugar from the bloodstream. Normally, whenever you decide to drown yourself in a Big Gulp from 7-Eleven, the sugars in the soda will be absorbed through your stomach directly into your bloodstream. Insulin is pumped out by the pancreas, which acts as a signal that gives the thumbs up to your muscles and fat cells to throw a sweet rager with the soda you just dumped into your body. Everyone has a good time – until the party ends.


When Dan Hamilton was diagnosed with T1D in 1972, the doctor told him he wouldn’t live past 50. Fast forward 45 years, and Dan is strong and healthy at 59. He credits his health to the advancements in treatment and care over the years. He has been an early adopter of every technology that has come along, and exercises regularly as part of a healthy lifestyle.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
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