There are two major types of diabetes, called type 1 and type 2. Type 1 diabetes was also formerly called insulin dependent diabetes mellitus (IDDM), or juvenile-onset diabetes mellitus. In type 1 diabetes, the pancreas undergoes an autoimmune attack by the body itself, and is rendered incapable of making insulin. Abnormal antibodies have been found in the majority of patients with type 1 diabetes. Antibodies are proteins in the blood that are part of the body's immune system. The patient with type 1 diabetes must rely on insulin medication for survival.
Everyone strays; everyone tries to avoid pain instead of learning from it; everyone has ways of escaping anxiety that aren’t productive. At its best, wellness offers habits and practices around which to build a community that will help you feel whole, or at least distract from the sense of inadequacy that drives people to self-injurious behavior—whether it be substance abuse or gambling or mistreating others or spending three hours a day on Instagram despite knowing it makes us feel bad.
Scientists and researchers are skeptical about the possibility of a true cure for type 2 diabetes. Michael German, a professor at the University of California, San Francisco, believes much of the success in a diabetes cure depends on an individual’s genetic makeup. And the Joslin Diabetes Center, the world’s largest diabetes research center and an affiliate institute of Harvard Medical School, claims that there is no cure for diabetes. Regardless, everyone can agree that an effective cure could put an end to the cycle of suffering for diabetes patients.
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.
Insulin — the hormone that allows your body to regulate sugar in the blood — is made in your pancreas. Essentially, insulin resistance is a state in which the body’s cells do not use insulin efficiently. As a result, it takes more insulin than normal to transport blood sugar (glucose) into cells, to be used immediately for fuel or stored for later use. A drop in efficiency in getting glucose to cells creates a problem for cell function; glucose is normally the body’s quickest and most readily available source of energy.
Joyce Lashof, then the dean of Berkeley’s School of Public Health, remembers that wellness was initially a tough sell at the school. Not much was known on campus about the earlier work of Travis and his fellow wellness advocates, but Lashof’s colleagues associated the term wellness with the “flakiness” of Mill Valley and surrounding Marin County. The NBC newsman Edwin Newman had televised an exposé of Marin County’s hedonistic lifestyle, which notoriously opened with a woman getting a peacock-feather massage from two nude men. The Berkeley Wellness Letter, however, managed to avoid such unseemly associations by publishing serious, evidence-based articles on health promotion, while debunking many of the holistic health fads of the day.
What at first seemed petulant, though, was actually a vital objection. The importance of spatial connection with the audience wasn’t a note from just a seasoned comedian, but from a person with experience in 12-step meetings and giving counsel to others going through addiction. Once the audience was finally inside and seated in the newly arranged chairs, Brand put his finger directly onto a nerve. “You’re all here because you’re misfits,” he opened, stifling the residual energy from his introduction. “You wouldn’t be here if there wasn’t something you’re trying to fix, now would you?”
The blood vessels and blood are the highways that transport sugar from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Sugar cannot go into the cells by itself. The pancreas releases insulin into the blood, which serves as the helper, or the "key," that lets sugar into the cells for use as energy.
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.
Insulin serves as a “key” to open your cells, to allow the glucose to enter -- and allow you to use the glucose for energy. Without insulin, there is no “key.” So, the sugar stays -- and builds up-- in the blood. The result: the body’s cells starve from the lack of glucose. And, if left untreated, the high level of “blood sugar” can damage eyes, kidneys, nerves, and the heart, and can also lead to coma and death.
The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves. Damage to the eyes, known as diabetic retinopathy, is caused by damage to the blood vessels in the retina of the eye, and can result in gradual vision loss and eventual blindness. Diabetes also increases the risk of having glaucoma, cataracts, and other eye problems. It is recommended that diabetics visit an eye doctor once a year. Damage to the kidneys, known as diabetic nephropathy, can lead to tissue scarring, urine protein loss, and eventually chronic kidney disease, sometimes requiring dialysis or kidney transplantation. Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes. The symptoms can include numbness, tingling, pain, and altered pain sensation, which can lead to damage to the skin. Diabetes-related foot problems (such as diabetic foot ulcers) may occur, and can be difficult to treat, occasionally requiring amputation. Additionally, proximal diabetic neuropathy causes painful muscle atrophy and weakness.
Inhalable insulin has been developed. The original products were withdrawn due to side effects. Afrezza, under development by the pharmaceuticals company MannKind Corporation, was approved by the United States Food and Drug Administration (FDA) for general sale in June 2014. An advantage to inhaled insulin is that it may be more convenient and easy to use.
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.
The consumption of commodified connection doesn’t need to require a small fortune, though. In fact, it can’t, by any of the new, woke definitions of wellness. Hoess would like to get Wellspring up to 4,000 people or so, he tells me, in order to keep the price down. I met two seekers who were there on scholarship, and four who had won a ticket through an Instagram giveaway (people actually do win those things). Hoess contrasted his model with smaller events like the Aspen Ideas Festival (which The Atlantic has long been a partner in producing), which tend to be more expensive at least partly due to scale.
Foods with a low glycemic load: The glycemic index of a food tells you about the blood glucose-raising potential of the food. Foods that have a high glycemic index are converted into sugar after being eaten more quickly than low glycemic foods. If you are fighting diabetes, stick to low glycemic foods like non-starchy vegetables, stone fruits and berries, nuts, seeds, avocados, coconut, organic meat, eggs, wild-caught fish, and raw pastured dairy.
The National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, defines complementary and alternative medicine as a "group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine." Complementary medicine is used with conventional treatments, whereas alternative medicine is used instead of conventional medicine.
^ Cheng J, Zhang W, Zhang X, Han F, Li X, He X, Li Q, Chen J (May 2014). "Effect of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on all-cause mortality, cardiovascular deaths, and cardiovascular events in patients with diabetes mellitus: a meta-analysis". JAMA Internal Medicine. 174 (5): 773–85. doi:10.1001/jamainternmed.2014.348. PMID 24687000.
Diabetes mellitus occurs throughout the world but is more common (especially type 2) in more developed countries. The greatest increase in rates has however been seen in low- and middle-income countries, where more than 80% of diabetic deaths occur. The fastest prevalence increase is expected to occur in Asia and Africa, where most people with diabetes will probably live in 2030. The increase in rates in developing countries follows the trend of urbanization and lifestyle changes, including increasingly sedentary lifestyles, less physically demanding work and the global nutrition transition, marked by increased intake of foods that are high energy-dense but nutrient-poor (often high in sugar and saturated fats, sometimes referred to as the "Western-style" diet). The global prevalence of diabetes might increase by 55% between 2013 and 2035.
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.
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.
To explain what hemoglobin A1c is, think in simple terms. Sugar sticks, and when it's around for a long time, it's harder to get it off. In the body, sugar sticks too, particularly to proteins. The red blood cells that circulate in the body live for about three months before they die off. When sugar sticks to these hemoglobin proteins in these cells, it is known as glycosylated hemoglobin or hemoglobin A1c (HBA1c). Measurement of HBA1c gives us an idea of how much sugar is present in the bloodstream for the preceding three months. In most labs, the normal range is 4%-5.9 %. In poorly controlled diabetes, its 8.0% or above, and in well controlled patients it's less than 7.0% (optimal is <6.5%). The benefits of measuring A1c is that is gives a more reasonable and stable view of what's happening over the course of time (three months), and the value does not vary as much as finger stick blood sugar measurements. There is a direct correlation between A1c levels and average blood sugar levels as follows.
Be active every day. Exercise is one of the best ways to keep your blood sugar under control. It also improves blood flow and keeps your heart healthy. The American Diabetes Association recommends 150 minutes of moderate-intensity exercise a week for most adults with diabetes. Also, it suggests taking a break from sitting every 30 minutes to get a few quick bursts of activity. But talk with your doctor or physical therapist first. If you have decreased feeling in your legs, some types of exercise may be safer than others.
Abnormal cholesterol and triglyceride levels. If you have low levels of high-density lipoprotein (HDL), or "good," cholesterol, your risk of type 2 diabetes is higher. Triglycerides are another type of fat carried in the blood. People with high levels of triglycerides have an increased risk of type 2 diabetes. Your doctor can let you know what your cholesterol and triglyceride levels are.