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).
^ Piwernetz K, Home PD, Snorgaard O, Antsiferov M, Staehr-Johansen K, Krans M (May 1993). "Monitoring the targets of the St Vincent Declaration and the implementation of quality management in diabetes care: the DIABCARE initiative. The DIABCARE Monitoring Group of the St Vincent Declaration Steering Committee". Diabetic Medicine. 10 (4): 371–7. doi:10.1111/j.1464-5491.1993.tb00083.x. PMID 8508624.
The term "type 1 diabetes" has replaced several former terms, including childhood-onset diabetes, juvenile diabetes, and insulin-dependent diabetes mellitus (IDDM). Likewise, the term "type 2 diabetes" has replaced several former terms, including adult-onset diabetes, obesity-related diabetes, and noninsulin-dependent diabetes mellitus (NIDDM). Beyond these two types, there is no agreed-upon standard nomenclature.
Though the Berkeley newsletter, which at its peak reached a million subscribers, did much to establish the credibility of wellness in the ’80s, language pundits continued to raise their eyebrows. Newman, who also moonlighted as a usage commentator, belittled wellness, calling it an example of “bloating” in the language. In 1988, a survey of the Usage Panel for the American Heritage Dictionary of the English Language found that a whopping 68 percent of panelists disapproved of the word when used to refer to employee-wellness programs and the like, and a critical note was included in the dictionary’s 1992 edition.
The centerpiece of the weekend was a keynote by Russell Brand. I got in early as a member of the media and grabbed a seat in the front row of the enormous multipurpose convention space. I was sitting watching stagehands and audiovisual technicians bustling around when, about 10 minutes before the crowd was to be let in, Brand came onstage and appeared horrified at the layout of the audience seating. There was a 12-foot aisle in the center, directly in front of where Brand was to stand at his microphone. “This is death,” he scolded, pointing at the space. “I’m supposed to perform into this?”
To treat diabetic retinopathy, a laser is used to destroy and prevent the recurrence of the development of these small aneurysms and brittle blood vessels. Approximately 50% of patients with diabetes will develop some degree of diabetic retinopathy after 10 years of diabetes, and 80% retinopathy after 15 years of the disease. Poor control of blood sugar and blood pressure further aggravates eye disease in diabetes.
Insulin is vital to patients with type 1 diabetes - they cannot live without a source of exogenous insulin. Without insulin, patients with type 1 diabetes develop severely elevated blood sugar levels. This leads to increased urine glucose, which in turn leads to excessive loss of fluid and electrolytes in the urine. Lack of insulin also causes the inability to store fat and protein along with breakdown of existing fat and protein stores. This dysregulation, results in the process of ketosis and the release of ketones into the blood. Ketones turn the blood acidic, a condition called diabetic ketoacidosis (DKA). Symptoms of diabetic ketoacidosis include nausea, vomiting, and abdominal pain. Without prompt medical treatment, patients with diabetic ketoacidosis can rapidly go into shock, coma, and even death may result.
Pulmonary insulin delivery is steadily emerging as a promising solution for the treatment of diabetes mellitus. The large as well as thin absorptive area of the lungs has not been explored until now for the treatment of systemic disease like diabetes. With an understanding of the lung anatomy and physiology and the transport mechanism of insulin through lungs, diabetic treatment through the pulmonary route may well become the reality of the 21(st) century. Though the transport of insulin through the lungs itself appears quite encouraging, potential problems concerning the formulation of a peptide like insulin in the form of an aerosol seem to be the most challenging. Stability aspects, stringent control of Mass Median Aerodynamic Diameter, antigenicity, insulin losses due to the device and impaction, sedimentation and diffusion in the nonabsorptive areas of the airway system (especially in the oropharynx) emerge as major concerns. This is in addition to the problems of lack of reproducibility of dose delivery by an inhaler where individual variations due to inspiratory differences and method of use of device come into play. Lung diseases and smoking may alter lung mechanisms and dose alterations are to be studied in such cases. Though almost equally effective, if not more, than the subcutaneous insulin route, even with proved short-term efficacy, insulin delivery through lungs is a potential but not a wholly proven means for blood glucose control.
David Spero is author of Diabetes: Sugar-coated Crisis, (New Society, 2006) and The Art of Getting Well: Maximizing Health When You Have a Chronic Illness (Hunter House, 2002). He writes for Diabetes Self-Management and Arthritis Self-Management magazines regularly and blogs at www.diabetesselfmanagement.com/blog. See more of David’s work at www.davidsperorn.com.
Low blood pressure on standing (orthostatic hypotension). Treatment starts with simple lifestyle changes, such as avoiding alcohol, drinking plenty of water, and sitting or standing slowly. Sleeping with the head of the bed raised 6 to 10 inches helps prevent swings in blood pressure. Your doctor may also recommend compression stockings and similar compression support for your abdomen (abdominal binder). Several medications, either alone or together, may be used to treat orthostatic hypotension.
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.
That is the goal of Imcyse, a French company running a clinical trial with an immunotherapy designed to stop type 1 diabetes. Patients that have been diagnosed within the last 6 months, who still retain some insulin-producing cells, are given a treatment designed to make the immune system destroy the specific immune cells that are attacking insulin-producing cells. Results are expected later this year and will reveal whether the treatment has the potential to become a cure.
In 2016, the 2nd Diabetes Surgery Summit released its own guidelines, arguing that surgery should be widely recommended for moderately obese people with diabetes who haven’t responded well to other treatments. They also agreed it should be considered for mildly obese people. And because of how cost-effective surgery is, especially compared to standard treatment, insurance companies should be willing to foot the bill, it said.
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.
Chronic pain creates several vicious cycles. For one, people tend to tense their muscles in response to pain, which often makes the pain worse. Pain also leads people to stop moving, which leads to increasing stiffness and more pain. Pain can interfere with sleep, and restless nights can increase pain. Pain also can contribute to depression and painful emotions such as anger, grief, fear, and frustration, which in turn contribute to pain.
Dietary factors also influence the risk of developing type 2 DM. Consumption of sugar-sweetened drinks in excess is associated with an increased risk. The type of fats in the diet is also important, with saturated fat and trans fats increasing the risk and polyunsaturated and monounsaturated fat decreasing the risk. Eating lots of white rice, and other starches, also may increase the risk of diabetes. A lack of physical activity is believed to cause 7% of cases.
Dr. Nyitray established Encellin soon after she received her PhD in chemistry and chemical biology from the University of California San Francisco in 2015. Her work at UCSF, with advisor Tejal Desai, PhD, chair of the Department of Bioengineering and Therapeutic Sciences in UCSF’s schools of Pharmacy and Medicine, focused on developing a packaging system for islet cells.
Check out the NWI Podcast to hear from wellness experts in all Six Dimensions of Wellness. Hear from wellness coaches, worksite wellness experts, psychologists, medical doctors, spiritual teachers, and more with evidence-based information and practical tips on how to improve your holistic wellness today. Go to NWIpodcast.org to listen and download show notes and bonus materials (NWI members get access to exclusive bonus materials). You can also listen on Soundcloud or subscribe on iTunes.
Exercise naturally supports your metabolism by burning fat and building lean muscle. To prevent and reverse diabetes, make exercise a part of your daily routine. This doesn’t necessary mean that you have to spend time at the gym. Simple forms of physical activity, like getting outside and walking for 20 to 30 minute every day, can be extremely beneficial, especially after meals. Practicing yoga or stretching at home or in a studio is another great option.
Recent global increase in diabetes, especially type II diabetes, is a product of the global obesity epidemic and attendant increase in Metabolic syndrome. In turn this has fueled an increase in surgical intervention in the form of Bariatric surgery. Diabetes reversal often follows sustained weight loss and indeed a 2014 Cochrane review of such surgeries found diabetes improvement in 5 randomized clinical trials (4). However, depending on the country and insurance plans, such weight loss surgery can be costly. They're also not risk-free with risks varying greatly depending on the person's overall health profile and age as well as skill and experience of the surgeon.
Replacing humans with computers could make patients better control their sugar levels and suffer less complications in the long term. The French company Cellnovo has already shown that just a partially automated system, where blood sugar levels can be monitored wirelessly but patients still select insulin amounts, can reduce the chances of reaching life-threatening low sugar levels up to 39%. The company is now working towards developing a fully automated artificial pancreas in collaboration with Imperial College, the Diabeloop consortium and the Horizon2020 program.
To determine your best treatment course, the Diabetes Relief team requires a metabolic test during your consultation. This simple, pain-free, highly accurate breathing test takes only about 10 minutes. From there, the medical team can first determine if the treatment will help. Then they will design an individualized blend of traditional diabetic care coupled with a revolutionary infusion therapy and a supplement protocol as the patient’s care plan to “help you get your life back.” All patient care is overseen by Medical Director Lindsey Jackson, MD, PhD, a multidisciplinary physician with expertise in cell biology, wound healing, and hyperbarics, who has significant scientific publications in books and journals.
Bruce C., from Katy, has been a type 2 diabetic for 20 years and has experienced neuropathy and retinopathy for four years. Within weeks of receiving care at Diabetes Relief, Bruce said, “I began to feel my feet again!” Michael W., from Crosby, a type 1 diabetic who also has neuropathy and thyroid disease, said Diabetes Relief “has given me my life back.”
Be sure to choose a trusted physical therapist who understands neuropathy, diabetic or otherwise, to help you work through physical therapy methods in order to prevent further nerve damage. Proper attention to physical activity by an expert can prevent any further issues from occurring. Also keep in mind that physical therapy can soothe diabetic nerve pain, but not cure it.
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)
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.