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.
As many doctors watch their diabetic patients slowly decline while implementing traditional methods of care, it’s only natural for them to pursue therapies that actually work to stall and even reverse many of the debilitating comorbidities associated with diabetes. In challenging economic times, it’s difficult for physicians to be able to afford specialized treatment protocols, but they’re constantly on the lookout for ways to provide additional services that have been proven effective.
Even as things stand now, there are a lot of people left out in the cold. A 2016 study, for instance, found that only 41,000 people with diabetes annually get bariatric surgery in the US—fewer than 5 percent of the total new cases diagnosed every year. And the longer someone has diabetes, studies have suggested, the less likely they are to go into remission if they eventually get surgery. Getting those numbers up will not only require changing the minds of insurers, but public opinion, too.
Keep your blood pressure under control. People with diabetes are more likely to have high blood pressure than are people who don't have diabetes. Having both high blood pressure and diabetes greatly increases your risk of complications because both damage your blood vessels and reduce blood flow. Try to keep your blood pressure in the range your doctor recommends, and be sure to have it checked at every office visit.
The progression of nephropathy in patients can be significantly slowed by controlling high blood pressure, and by aggressively treating high blood sugar levels. Angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) used in treating high blood pressure may also benefit kidney disease in patients with diabetes.
One of the most studied programs in the National Institutes of Health’s Diabetes Prevention Program (DPP). This program helps people who have pre-diabetes or a high risk of developing type 2 diabetes lose weight. Studies of the program have found that those who lost about seven percent of their initial weight, kept some of it off, and maintained an exercise program delayed the onset of type 2 diabetes for three years in 58% of cases.
Type II diabetes is by far the more common form: about 95 percent of the population with diabetes have Type II. With Type II, your body still produces insulin, but your cells are unable to process it correctly. Sometimes a change in diet and exercise regimen can solve the problem. Other times, medication is needed to help your cells process insulin. A few years ago, I was told I also had Type II diabetes, which makes my condition quite rare.
What is peripheral neuropathy? Peripheral neuropathy is common among people with diabetes, causing loss of sensitivity in the hands and feet, and in organs such as the kidneys, heart, and eyes. Find out here about other medical conditions and causes that can lead to peripheral neuropathy and result in nerve tingling and muscle wastage or paralysis. Read now
Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.
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.
Interestingly, research suggests anxiety may be tied to type 2 diabetes risk. According to a September 2016 study published in the journal Psychoneuroendocrinology, which measured levels of blood glucose and IL-6, a protein in the body that stimulates immune response and healing, found that people with with low inhibition — or attention control — were more likely to have type 2 diabetes.
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.
This event goes well beyond the initial vision of Wanderlust’s CEO, Sean Hoess, who sat down with me one morning by a hotel pool in running clothes. Hoess is 48, but like many Wellspring attendees looks a decade younger. He just renovated a house in Greenpoint, Brooklyn, and is openly “not a wellness buff”—he prefers tennis. After graduating from Columbia University, he went to law school, but quit practicing to start a record label with a college friend, Jeff Krasno. Krasno’s wife, Schuyler Grant, ran a yoga studio above their office, and the three of them had the idea to start a festival combining the two fields.
Metformin is generally recommended as a first line treatment for type 2 diabetes, as there is good evidence that it decreases mortality. It works by decreasing the liver's production of glucose. Several other groups of drugs, mostly given by mouth, may also decrease blood sugar in type II DM. These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, and agents that make the body more sensitive to insulin. When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications. Doses of insulin are then increased to effect.
A 2017 article in the journal Diabetes Care explains that the goals for dietary change should be “healthful eating patterns emphasizing a variety of nutrient-dense foods in appropriate portion sizes.” Additional goals include achieving a healthy weight; attaining healthy blood sugar, blood pressure, and lipid levels; and reducing complications. The authors emphasize developing an individualized plan based on “personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and barriers to change.”
Sandi takes several medications for diabetes, asthma, and kidney damage, and she says one source of anxiety is the feeling that she can never get her diabetes under control. Recently, when she had to switch her asthma medication, her fasting blood glucose levels skyrocketed from between 85 and 100 milligrams per deciliter (mg/dl) to between 160 and 180 mg/dl. It took two months to bring them back down, but they were still not stabilized.
The combination of diabetes and excess body weight puts individuals at high risk of complications. For people who are overweight or obese, a five percent reduction in body weight has been shown to improve glycemic control, lipids and blood pressure and to reduce the need for medication. Weight loss always sound easy: Just eat less and exercise more. If only it were that simple! There are numerous reasons why people struggle to lose weight including mindset, practical problems (like a busy lifestyle or limited access to healthy food) and stress eating. Many benefit from joining a support group, advice from a dietician or using online tracking applications such as the Body
The old “bring people to the table” metaphor rang especially egregious to the artist and writer Anasa Troutman, who had a similarly revelatory vision for wellness: “Unless we’re willing to make a commitment to community, we will never be well. Even if you wake up every morning and drink your juice and do your yoga, without that commitment to each other we will not be well as a country and as a world,” Troutman said.
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.
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.