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.
Nerves in the legs and feet are often most affected by neuropathy. This can cause you to lose sensation to your feet and legs. Sores and cuts can go unnoticed and lead to infections. In some extreme cases, infections can become severe and lead to ulcers. Over time, this can cause irreparable damage to the soft tissue and lead to the loss of toes or even your foot.
Diabetes experts feel that these blood glucose monitoring devices give patients a significant amount of independence to manage their disease process; and they are a great tool for education as well. It is also important to remember that these devices can be used intermittently with fingerstick measurements. For example, a well-controlled patient with diabetes can rely on fingerstick glucose checks a few times a day and do well. If they become ill, if they decide to embark on a new exercise regimen, if they change their diet and so on, they can use the sensor to supplement their fingerstick regimen, providing more information on how they are responding to new lifestyle changes or stressors. This kind of system takes us one step closer to closing the loop, and to the development of an artificial pancreas that senses insulin requirements based on glucose levels and the body's needs and releases insulin accordingly - the ultimate goal.
Big pharma are in the early stages of developing their own cell therapy approaches for diabetes. Novo Nordisk, one of the largest providers of diabetes treatments, is bidding for stem cells and an encapsulation device, stating that the first clinical trial could take place in the “next few years.” Sanofi, also a big name in diabetes, is working with the German Evotec in a beta cell replacement therapy for diabetics.
Khodneva, Y., Shalev, A., Frank, S. J., Carson, A. P., & Safford, M. M. (2016, May). Calcium channel blocker use is associated with lower fasting serum glucose among adults with diabetes from the REGARDS study. Diabetes Research and Clinical Practice, 115, 115-121. Retrieved from http://www.diabetesresearchclinicalpractice.com/article/S0168-8227(16)00070-X/abstract
What medication is available for diabetes? Diabetes causes blood sugar levels to rise. The body may stop producing insulin, the hormone that regulates blood sugar, and this results in type 1 diabetes. In people with type 2 diabetes, insulin is not working effectively. Learn about the range of treatments for each type and recent medical developments here. Read now
Grains: Grains, especially gluten-containing grains like wheat, contain large amounts of carbohydrates that are broken down into sugar within only a few minutes of consumption. Gluten can cause intestinal inflammation, which affects hormones like cortisol and leptin, and can lead to spikes in blood sugar. I recommend removing all grains from your diet for 90 days as your body adjusts to this healing program. Then you can try bringing sprouted ancient grains back into your diet in small amounts.
The guidelines, if widely accepted, would affect up to a quarter of Americans living with diabetes whose BMI is between 30 and 35. Worldwide, the effects would be even greater, since the majority of the 422 million people with diabetes have a BMI lower than 35. For people of Asian descent, the DSS-II agreed surgery could be considered for people down to 27.5 BMI, since many patients of Asian decent develop diabetes at a lower BMI.
Type 1 and type 2 diabetes were identified as separate conditions for the first time by the Indian physicians Sushruta and Charaka in 400–500 CE with type 1 associated with youth and type 2 with being overweight. The term "mellitus" or "from honey" was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination. Effective treatment was not developed until the early part of the 20th century, when Canadians Frederick Banting and Charles Herbert Best isolated and purified insulin in 1921 and 1922. This was followed by the development of the long-acting insulin NPH in the 1940s.
In 2003, ephedrine -- also known as ma huang -- became the first herbal stimulant ever banned by the FDA. It was a popular component of over-the-counter weight loss drugs. Ephedrine had some benefits, but it could cause far more harm, especially in high doses: insomnia (difficulty falling and staying asleep), high blood pressure, glaucoma, and urinary retention. This herbal supplement has also been associated with numerous cases of stroke.
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.
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.
Type 2 DM is primarily due to lifestyle factors and genetics. A number of lifestyle factors are known to be important to the development of type 2 DM, including obesity (defined by a body mass index of greater than 30), lack of physical activity, poor diet, stress, and urbanization. Excess body fat is associated with 30% of cases in those of Chinese and Japanese descent, 60–80% of cases in those of European and African descent, and 100% of Pima Indians and Pacific Islanders. Even those who are not obese often have a high waist–hip ratio.
Environmental wellness inspires us to live a lifestyle that is respectful of our surroundings. This realm encourages us to live in harmony with the Earth by taking action to protect it. Environmental well-being promotes interaction with nature and your personal environment. Everyone can have a strong environmental conscious simply by raising their awareness.
Acute pain is a lifesaver. Without it, we would have to watch out all the time to keep from injuring or killing ourselves accidentally. This is why people with diabetes are advised to check their feet visually or manually every day: If a person has peripheral neuropathy, particularly if it causes numbness in his feet, the acute pain nerves in his feet may not be working, and if they aren’t, they can’t warn him about injuries or other, normally painful foot problems.
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.
Wellspring is produced by a quickly growing company called Wanderlust, “a global wellness platform” and “a multi-channel company focused around mindful living” by way of “renowned festival events, a full-service media company, and several permanent yoga centers.” Wanderlust was founded in Brooklyn 10 years ago and has since been putting on small, music-and-yoga-based festivals. But Wellspring is a new and much grander undertaking, lasting multiple days and based mostly on workshops and high-profile panels and lectures.
Lab studies show that Encellin’s “ultra thin-film implantable cell delivery system” keeps islet cells alive and functioning. In a 2015 study in the journal ACS Nano, Dr. Nyitray and others found that cells in the packaging survived for 90 days in lab animals. New blood vessels grew around the transplants and the cells produced insulin in response to rising glucose levels. In a 2016 study from Dr. Desai’s lab, also published in ACS Nano, human islet cells packaged in the tiny film envelopes survived for six months in mice—and the cells made and released insulin in response to rising blood glucose levels.
Several other signs and symptoms can mark the onset of diabetes although they are not specific to the disease. In addition to the known ones above, they include blurred vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. Long-term vision loss can also be caused by diabetic retinopathy. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.
Cataracts and glaucoma are also more common among diabetics. It is also important to note that since the lens of the eye lets water through, if blood sugar concentrations vary a lot, the lens of the eye will shrink and swell with fluid accordingly. As a result, blurry vision is very common in poorly controlled diabetes. Patients are usually discouraged from getting a new eyeglass prescription until their blood sugar is controlled. This allows for a more accurate assessment of what kind of glasses prescription is required.
At present, the American Diabetes Association does not recommend general screening of the population for type 1 diabetes, though screening of high risk individuals, such as those with a first degree relative (sibling or parent) with type 1 diabetes should be encouraged. Type 1 diabetes tends to occur in young, lean individuals, usually before 30 years of age; however, older patients do present with this form of diabetes on occasion. This subgroup is referred to as latent autoimmune diabetes in adults (LADA). LADA is a slow, progressive form of type 1 diabetes. Of all the people with diabetes, only approximately 10% have type 1 diabetes and the remaining 90% have type 2 diabetes.
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult-onset diabetes mellitus (AODM). In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells).
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?”
The same thing applies to the chronic back and leg pain so many people have. There may be a few pain signals coming up from tired muscles or joints toward the brain. Those signals go through nerve centers called “pain gates.” Those “gates” are where the signals are mixed with other sense data, feelings, and body states such as tension. In people with chronic pain, the gates amplify the signals over and over until the pain is severe. They do this because the brain thinks the person needs to be warned away from a real threat, such as taking a hand out of the fire so it doesn’t burn.
Powerful drugs like oxycodone (Oxycontin) and the opioid-like medicine tramadol (Conzip, Ultram) can treat much stronger pain. But these tend to be a last resort for pain relief. You might use these medications if other treatments aren’t working. However, these drugs aren’t meant for long-term relief because of side effects and the potential for addiction. Work closely with your doctor and use caution when taking opioid medicines.
The 1989 "St. Vincent Declaration" was the result of international efforts to improve the care accorded to those with diabetes. Doing so is important not only in terms of quality of life and life expectancy but also economically – expenses due to diabetes have been shown to be a major drain on health – and productivity-related resources for healthcare systems and governments.
In diabetes, either the pancreas makes insufficient levels of insulin so cells absorb glucose poorly or cells themselves become insulin resistant and thus unable to absorb glucose despite adequate insulin levels. Both types of change increase blood sugar levels above normal. Parsed this way, type I and type II diabetes overlap some but also differ.
There is no known preventive measure for type 1 diabetes. Type 2 diabetes – which accounts for 85–90% of all cases – can often be prevented or delayed by maintaining a normal body weight, engaging in physical activity, and consuming a healthy diet. Higher levels of physical activity (more than 90 minutes per day) reduce the risk of diabetes by 28%. Dietary changes known to be effective in helping to prevent diabetes include maintaining a diet rich in whole grains and fiber, and choosing good fats, such as the polyunsaturated fats found in nuts, vegetable oils, and fish. Limiting sugary beverages and eating less red meat and other sources of saturated fat can also help prevent diabetes. Tobacco smoking is also associated with an increased risk of diabetes and its complications, so smoking cessation can be an important preventive measure as well.
Diabetes doesn’t cause nearly as much of a stir in the media compared to HIV or cancer, but a few well-known names are associated with the disease – Halle Berry, Tom Hanks, and Paula Deen. And who doesn’t love that Food Network maven and American celebrity chef? Scandals aside, diabetes comes in two versions – Type I or Type II. In Type I, the pancreas decides to drop out of the physiological rat race and go on to discover its own metabolic purpose in life. As a result, the body generates little or no insulin, a hormone important in sugar metabolism. In Type II, unfortunate dietary choices, such as eating tons of sugar and carbohydrates, jam up the sugar absorption process, causing the body to become resistant to the insulin hormone. Type 2 makes up 90 percent of all cases of diabetes, which is going to be our focus here as we talk about when there will be a cure for diabetes. (Spoiler alert: Probably only after we ban the Big Gulp and the Big Mac.)
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.
Most universities and colleges have health centers that offer counseling services to enrolled students. You can take advantage of counseling services and/or medical services for stress and other areas of mental wellness. It’s in your best interest – and that of your patients – if you are the healthiest version of yourself. Find information on the health center at your dental school.
Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (14)
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.