The relationship between type 2 diabetes and the main modifiable risk factors (excess weight, unhealthy diet, physical inactivity and tobacco use) is similar in all regions of the world. There is growing evidence that the underlying determinants of diabetes are a reflection of the major forces driving social, economic and cultural change: globalization, urbanization, population aging, and the general health policy environment.[74]
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)
Founded in 2006, Massachusetts-based biotechnology startup Gelesis has raised a total of $118.2 million for developing an oral smart pill. In 2016, the company initially filed an IPO offering of $60 million, but pulled out and instead focused on raising more funding. The technology is based on capsules filled with tiny hydrogel particles that expand between 50 to 100 times their weight in size after absorbing water from the stomach, which results in increased satiety to help obese diabetes patients lose weight and control their sugar metabolism. They are currently undergoing a phase 2 clinical trial on their Gelesis200 product for treating diabetes.
When there is excess glucose present in the blood, as with type 2 diabetes, the kidneys react by flushing it out of the blood and into the urine. This results in more urine production and the need to urinate more frequently, as well as an increased risk of urinary tract infections (UTIs) in men and women. People with type 2 diabetes are twice as likely to get a UTI as people without the disease, and the risk is higher in women than in men.
“The cell is the original smart machine,” notes Crystal Nyitray, PhD, on the website of Encellin, the biotech start-up she founded in 2016. “All drugs, devices, and even digital health approaches are trying to restore or copy these functions. At Encellin, we believe in the human cell and creating a safe and reliable solution for patients. We are creating a technology to promote cell function and protection.” 
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.
The WHO estimates that diabetes mellitus resulted in 1.5 million deaths in 2012, making it the 8th leading cause of death.[9][101] However another 2.2 million deaths worldwide were attributable to high blood glucose and the increased risks of cardiovascular disease and other associated complications (e.g. kidney failure), which often lead to premature death and are often listed as the underlying cause on death certificates rather than diabetes.[101][104] For example, in 2014, the International Diabetes Federation (IDF) estimated that diabetes resulted in 4.9 million deaths worldwide,[19] using modeling to estimate the total number of deaths that could be directly or indirectly attributed to diabetes.[20]

Fasting glucose test This test involves giving a blood sample after you have fasted for eight hours. (18) If you have a fasting blood sugar level of less than 100 milligrams per deciliter (mg/dl), your blood sugar levels are normal. But if you have one from 100 to 125 mg/dl, you have prediabetes, and if you have 126 mg/dl on two separate occasions, you have diabetes. (17)
Urinary tract problems. Some medications can interfere with bladder function. Your doctor may recommend stopping or changing medications. A strict urination schedule or urinating every few hours (timed urination) while applying gentle pressure to the bladder area (below your bellybutton) is recommended. Other methods, including self-catheterization, may be needed to remove urine from a nerve-damaged bladder.
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.
Pain affects millions of people with diabetes. For most of these people, the pain is chronic, defined as pain persisting for more than six months, experienced almost every day, and of moderate to severe intensity, or that significantly interferes with daily activities. In some cases, a person’s pain is clearly related to complications of diabetes; in other cases, it is not. Regardless of the cause, however, studies show that chronic pain makes diabetes self-management much more difficult and often leads to higher blood glucose levels.
Wellness was so unfamiliar at the time, Travis recalls, that he constantly had to spell the word when using it over the phone. It soon got national attention when a young doctoral student named Donald B. Ardell profiled Travis’s center in the April 1976 issue of Prevention magazine. In a sidebar, Prevention’s editor, Robert Rodale, welcomed the “exciting field of wellness enhancement,” promising that the magazine would “examine all aspects of wellness promotion.” Even greater exposure came with Rather’s “60 Minutes” piece, which focused on Travis and the Mill Valley center.
In type I diabetes, insufficient levels of insulin result from the immune system itself attacking the pancreatic beta cells. On the other hand, while beta cell dysfunction varies widely between type II diabetes patients, insulin resistance is a major part of the disease. Restoring the beta cells of the pancreas to health is the treatment approach these two diseases share to some degree.

“I am extremely pleased to see that technology developed in Tejal Desai’s group is getting to the point that we can explore this for therapeutic purposes,” Matthias Hebrok, PhD, the director of the Diabetes Center at UCSF and a member of Encellin’s scientific advisory board, noted on the UCSF website. “Encapsulation and protection of islet cells remain a critical hurdle that needs to be overcome before cell therapy becomes a reality in type 1 diabetes.”
One of the most advanced alternatives comes from the Diabetes Research Institute (DRI) in the US, which is developing a bioengineered mini-organ where insulin-producing cells are encapsulated within a protective barrier. Two years ago, the DRI announced that the first patient treated in an ongoing Phase I/II trial no longer requires insulin therapy.
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.
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.
If the amount of insulin available is insufficient, or if cells respond poorly to the effects of insulin (insulin insensitivity or insulin resistance), or if the insulin itself is defective, then glucose will not be absorbed properly by the body cells that require it, and it will not be stored appropriately in the liver and muscles. The net effect is persistently high levels of blood glucose, poor protein synthesis, and other metabolic derangements, such as acidosis.[60]
Keeping your blood sugar under control to prevent nerve damage is the best way to avoid nerve pain. Follow your doctor’s advice for diet, exercise, and treatments if you already experience diabetic nerve pain. Diabetic neuropathy doesn’t have any known cures. However, many treatments can help lessen the discomfort and pain caused by diabetic nerve pain, and your doctor can assist you in selecting one that works best for you.
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).
Medications include a long (and boring) list of chemical names such as metformin, sulfonylureas, meglitinides, thiazolidinediones … you get the point. Each of these drugs works by either helping the body secrete more insulin, making tissues more sensitive to the hormone, or preventing the secretion of more sugar into the bloodstream. But, ultimately, the first line of defense against diabetes is direct insulin injection because of its high efficacy. And there are at least six main types of insulin, accompanied by another long list of difficult-to-pronounce suffixes, each with a slightly different effect. Along with treatment, diabetes requires constant monitoring for blood sugar levels, which include at-home blood tests, and routine medical check-ups. An insulin pump that monitors and injects insulin when needed is another option.
Maryland company Orgenesis (ORGS) is developing a proprietary therapeutic platform that transforms adult liver cells into insulin-generating cells to provide patients with independent insulin production. Earlier this year, Orgenesis entered into a partnership with HekaBio K.K. to conduct clinical trials in Japan. The company appears to be moving into licensing the technology to other companies for further development.
“I am extremely pleased to see that technology developed in Tejal Desai’s group is getting to the point that we can explore this for therapeutic purposes,” Matthias Hebrok, PhD, the director of the Diabetes Center at UCSF and a member of Encellin’s scientific advisory board, noted on the UCSF website. “Encapsulation and protection of islet cells remain a critical hurdle that needs to be overcome before cell therapy becomes a reality in type 1 diabetes.”
More than three decades later, wellness is, in fact, a word that Americans might hear every day, or close to it. You can sign up for your company’s employee-wellness program, relax in a wellness spa treatment or even plan some “wellness tourism” for your next vacation. Your cat or dog can get in on the action, too, since the W-word has been pressed into service as a brand of all-natural pet food.
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.
After completing a thorough consult and obtaining current lab results, the patient is administered an individualized IV exogenous insulin-based therapy designed to mimic a normal secretion profile with physiological concentrations in the portal vein simultaneously with an induced hyperglycemic state. This provides an improved glucose disposition and utilization as well as ATP (adenosine triphosphate) production and mitochondria function. These effects result in decreased progression of diabetic complications.
The term "diabetes" or "to pass through" was first used in 230 BCE by the Greek Apollonius of Memphis.[108] The disease was considered rare during the time of the Roman empire, with Galen commenting he had only seen two cases during his career.[108] 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).[110]
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.
Over time, a prolonged exposure to high blood sugar can damage the nerves throughout the body — a condition called diabetic neuropathy. Some people may not have any symptoms of the damage, while others may notice numbness, tingling, or pain in the extremities. “At the beginning, [diabetic neuropathy] usually starts in the feet and then it progresses upward,” says Dr. Ovalle. Although most common in people who have had type 2 diabetes for 25 years or more, it can occur in people who have prediabetes as well. In some studies, almost 50 percent of unexplained peripheral neuropathy [in the extremities], whether painful or otherwise, turns out to be caused by prediabetes or diabetes, says Dr. Einhorn.
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