The word podcast has by now become completely untethered from its namesake—the iPod. Analytics that were once uncapturable have become fairly comprehensive (downloads from Apple Podcasts surpassed 50 billion this year) and specific (Chicago streams more podcasts on Spotify than any other U.S. city does), which has brought new money and possibility to the form. Recipes for how to create a decent series were invented through trial and error, and thousands of producers now understand what makes our ears stand up: cults, cold cases, politics, feminism, and relationships, but most of all: stories.
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.
Every year, 1.4 million Americans receive a life-altering diagnosis of diabetes. The most recent data published by the Centers for Disease Control and Prevention shows that nearly 10 percent of the population has diabetes, and diabetes remains the seventh leading cause of death in the United States. In fact, Type 2 diabetes is looming as the biggest epidemic and public health issue in human history.
At Diabetes Daily, we prefer using the word remission over cure because far too often the state of diabetes returns even with people’s best efforts. Regardless of the definition of a cure, finding a way to live with little to know highs or lows is a worthwhile endeavor. Long-term studies show that even a few years of great blood sugars significantly reduces your long-term risk of complications.
Take good care of your feet. Check your feet every day. If you no longer can feel pain in your feet, you might not notice a foot injury. Instead, use your eyes to look for problems. Use a mirror to see the bottoms of your feet. Use your hands to feel for hot or cold spots, bumps or dry skin. Look for sores, cuts or breaks in the skin. Also check for corns, calluses, blisters, red areas, swelling, ingrown toenails and toenail infections. If it's hard for you to see or reach your feet, get help from a family member or foot doctor.
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.
Rarely, people with diabetes erupt in blisters. Diabetic blisters can occur on the backs of fingers, hands, toes, feet and sometimes on legs or forearms. These sores look like burn blisters and often occur in people who have diabetic neuropathy. They are sometimes large, but they are painless and have no redness around them. They heal by themselves, usually without scars, in about three weeks. The only treatment is to bring blood sugar levels under control.
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.
Normally, blood glucose levels are tightly controlled by insulin, a hormone produced by the pancreas. Insulin lowers the blood glucose level. When the blood glucose elevates (for example, after eating food), insulin is released from the pancreas to normalize the glucose level by promoting the uptake of glucose into body cells. In patients with diabetes, the absence of insufficient production of or lack of response to insulin causes hyperglycemia. Diabetes is a chronic medical condition, meaning that although it can be controlled, it lasts a lifetime.
High blood glucose sets up a domino effect of sorts within your body. High blood sugar leads to increased production of urine and the need to urinate more often. Frequent urination causes you to lose a lot of fluid and become dehydrated. Consequently, you develop a dry mouth and feel thirsty more often. If you notice that you are drinking more than usual, or that your mouth often feels dry and you feel thirsty more often, these could be signs of type 2 diabetes.
While there is a strong genetic component to developing this form of diabetes, there are other risk factors - the most significant of which is obesity. There is a direct relationship between the degree of obesity and the risk of developing type 2 diabetes, and this holds true in children as well as adults. It is estimated that the chance to develop diabetes doubles for every 20% increase over desirable body weight.
Certain drugs that affect the brain can help to control chronic pain. Antidepressants in the class of drugs known as selective serotonin reuptake inhibitors (SSRIs), which include duloxetine (Cymbalta), are often prescribed for pain. So are tricyclic antidepressants (TCAs) such as amitriptyline (Elavil). SSRIs often boost energy, while TCAs can make you sleepy. According to the Harvard Medical School website, “Some physicians prescribe an SSRI during the day and amitriptyline at bedtime for pain patients.”
^ Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, Di Angelantonio E, Ingelsson E, Lawlor DA, Selvin E, Stampfer M, Stehouwer CD, Lewington S, Pennells L, Thompson A, Sattar N, White IR, Ray KK, Danesh J (June 2010). "Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies". Lancet. 375 (9733): 2215–22. doi:10.1016/S0140-6736(10)60484-9. PMC 2904878. PMID 20609967.
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.
In type 2 diabetes, there also is a steady decline of beta cells that adds to the process of elevated blood sugars. Essentially, if someone is resistant to insulin, the body can, to some degree, increase production of insulin and overcome the level of resistance. After time, if production decreases and insulin cannot be released as vigorously, hyperglycemia develops.
^ 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.
Poxel (PP:POXEL) is a French pharmaceutical company that recently received $30.1 million in post-IPO equity in 2016. The company has developed an orally active medication called Imeglimin, which targets all three organs and body systems that are affected by diabetes simultaneously: the pancreas, liver, and muscles. The drug is currently undergoing phase 3 clinical work in Japan, and will commence phase 3 trials in the European Union and the United States that will be completed by 2019. The company is also concurrently working on several other pharmaceutical agents in various stages of the development pipeline.
Diabetes mellitus is a chronic disease, for which there is no known cure except in very specific situations. Management concentrates on keeping blood sugar levels as close to normal, without causing low blood sugar. This can usually be accomplished with a healthy diet, exercise, weight loss, and use of appropriate medications (insulin in the case of type 1 diabetes; oral medications, as well as possibly insulin, in type 2 diabetes).
Physical treatments for chronic pain can include applying heat or cold to the part that hurts, massage, exercise, and rest. Sensations of heat, cold, and touch travel on the same nerves as pain sensations, but they travel faster. A sensation of gentle touch, heat, or cold will therefore beat a pain signal to the next pain gate and block the pain from getting through. Certain substances including capsaicin (chili pepper extract) provide a sensation of heat when rubbed on the skin that may keep a pain gate blocked for hours.
Engle has since run across the Sahara desert, among other death-defying feats that go well beyond what could be considered good for the joints. This was not a passing hobby or a way of dropping a few pounds. It was, rather, a purposeful blasting of the body. The running community provided for him fellowship and camaraderie, as it does for many people struggling with addiction. It also helped him realize that he didn’t have to give up being intense and passionate and obsessive; he just needed to channel these features in less destructive ways. “Do I run addictively? I’ve been accused of it,” he said. “But I’ve never lost my car after a run.”
Glucagon is a hormone that causes the release of glucose from the liver (for example, it promotes gluconeogenesis). Glucagon can be lifesaving and every patient with diabetes who has a history of hypoglycemia (particularly those on insulin) should have a glucagon kit. Families and friends of those with diabetes need to be taught how to administer glucagon, since obviously the patients will not be able to do it themselves in an emergency situation. Another lifesaving device that should be mentioned is very simple; a medic-alert bracelet should be worn by all patients with diabetes.
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Brand’s talk veered only more earnest, about his own trials with addiction to crack and heroin and how 12-step programs helped him “get the keys to his life back.” Drugs are a symbol, he implored. “The craving isn’t for drugs. All yearning and desire are inappropriate substitutes for what you want, which is to be at one with God, which is connection.”
Let’s face it, when you’re a college-educated 57-year-old slinging parcels for a living, something in your life has not gone according to plan. That said, my moments of chagrin are far outnumbered by the upsides of the job, which include windfall connections with grateful strangers. There’s a certain novelty, after decades at a legacy media company—Time Inc.—in playing for the team that’s winning big, that’s not considered a dinosaur, even if that team is paying me $17 an hour (plus OT!). It’s been healthy for me, a fair-haired Anglo-Saxon with a Roman numeral in my name (John Austin Murphy III), to be a minority in my workplace, and in some of the neighborhoods where I deliver. As Amazon reaches maximum ubiquity in our lives (“Alexa, play Led Zeppelin”), as online shopping turns malls into mausoleums, it’s been illuminating to see exactly how a package makes the final leg of its journey.
In countries using a general practitioner system, such as the United Kingdom, care may take place mainly outside hospitals, with hospital-based specialist care used only in case of complications, difficult blood sugar control, or research projects. In other circumstances, general practitioners and specialists share care in a team approach. Home telehealth support can be an effective management technique.
Type 1 diabetes is partly inherited, with multiple genes, including certain HLA genotypes, known to influence the risk of diabetes. In genetically susceptible people, the onset of diabetes can be triggered by one or more environmental factors, such as a viral infection or diet. Several viruses have been implicated, but to date there is no stringent evidence to support this hypothesis in humans. Among dietary factors, data suggest that gliadin (a protein present in gluten) may play a role in the development of type 1 diabetes, but the mechanism is not fully understood.