Anal itching is the irritation of the skin at the exit of the rectum, known as the anus, accompanied by the desire to scratch. Causes include everything from irritating foods we eat, to certain diseases, and infections. Treatment options include medicine including, local anesthetics, for example, lidocaine (Xylocaine), pramoxine (Fleet Pain-Relief), and benzocaine (Lanacane Maximum Strength), vasoconstrictors, for example, phenylephrine 0.25% (Medicone Suppository, Preparation H, Rectocaine), protectants, for example, glycerin, kaolin, lanolin, mineral oil (Balneol), astringents, for example, witch hazel and calamine, antiseptics, for example, boric acid and phenol, aeratolytics, for example, resorcinol, analgesics, for example, camphor and juniper tar, and corticosteroids.
You are more likely to develop type 2 diabetes if you are age 45 or older, have a family history of diabetes, or are overweight. Physical inactivity, race, and certain health problems such as high blood pressure also affect your chance of developing type 2 diabetes. You are also more likely to develop type 2 diabetes if you have prediabetes or had gestational diabetes when you were pregnant. Learn more about risk factors for type 2 diabetes.

Home blood sugar (glucose) testing is an important part of controlling blood sugar. One important goal of diabetes treatment is to keep the blood glucose levels near the normal range of 70 to 120 mg/dl before meals and under 140 mg/dl at two hours after eating. Blood glucose levels are usually tested before and after meals, and at bedtime. The blood sugar level is typically determined by pricking a fingertip with a lancing device and applying the blood to a glucose meter, which reads the value. There are many meters on the market, for example, Accu-Check Advantage, One Touch Ultra, Sure Step and Freestyle. Each meter has its own advantages and disadvantages (some use less blood, some have a larger digital readout, some take a shorter time to give you results, etc.). The test results are then used to help patients make adjustments in medications, diets, and physical activities.


"Advocacy Month was appropriately themed “Midterms Matter: Add your voice,” in light of the Nov. 6 election. ASDA members across the country made sure their fellow students went to the polls to represent the dental profession. It was an especially exciting election season since five dentists were elected to Congress." Read more on ASDA's blog, Mouthing Off
Dr. Fung says he decided to experiment with intermittent fasting because he was frustrated seeing so many diabetic patients with kidney failure. “It occurred to me that fasting was an underutilized therapeutic option for losing weight,” he recalls. “I started doing this five years ago, and a lot of people got incredibly good results – it reversed their diabetes.”

"Brittle" diabetes, also known as unstable diabetes or labile diabetes, is a term that was traditionally used to describe the dramatic and recurrent swings in glucose levels, often occurring for no apparent reason in insulin-dependent diabetes. This term, however, has no biologic basis and should not be used.[39] Still, type 1 diabetes can be accompanied by irregular and unpredictable high blood sugar levels, frequently with ketosis, and sometimes with serious low blood sugar levels. Other complications include an impaired counterregulatory response to low blood sugar, infection, gastroparesis (which leads to erratic absorption of dietary carbohydrates), and endocrinopathies (e.g., Addison's disease).[39] These phenomena are believed to occur no more frequently than in 1% to 2% of persons with type 1 diabetes.[40]
In gastroesophageal reflux disease (GERD), sometimes called heartburn, stomach acid and partially undigested food move backward through the esophagus, escaping from the stomach and through the esophageal sphincter that normally prevents such backsliding. This can occur as a symptom of gastroparesis, says Hiroshi Mashimo, MD, PhD, a gastroenterologist at Harvard Medical School. “If the stomach doesn’t empty, it’s likely to reflux up,” he says. GERD may also result from diabetes-related nerve damage affecting the esophageal sphincter, Mashimo adds. One caution: Some diseases, such as a yeast infection in the esophagus, can masquerade as GERD, so don’t brush off symptoms. We can’t treat the gastroparesis or esophageal sphincter problems that contribute to GERD, but antacids and other medications can help to reduce or neutralize stomach acids (see “PPIs the Right Way,” below).
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
2018 was a year whose realities sometimes seemed to approach the dystopias and dramas of fiction, as stories of family trauma, environmental disaster, and sexual assault played out on the world stage. The books our writers and editors were drawn to this year include many that illuminate these struggles and inequities, whether in the form of visceral sonnets, lyrical history, or dizzyingly surreal detective yarns. But they also reach past political themes to the most intimate and universal of stories: a cross-continental meditation on transitory love, a warm and funny account of aging, a timeless reinvention of an ancient myth, and an absorbing deconstruction of faith, to name a few. Our list isn’t definitive or comprehensive, but guided by individual interests and tastes. Below, you’ll find essays, poetry, three striking fiction debuts, the first graphic novel to be longlisted for the Man Booker Prize, and more.
The culprit in fungal infections of people with diabetes is often Candida albicans. This yeast-like fungus can create itchy rashes of moist, red areas surrounded by tiny blisters and scales. These infections often occur in warm, moist folds of the skin. Problem areas are under the breasts, around the nails, between fingers and toes, in the corners of the mouth, under the foreskin (in uncircumcised men), and in the armpits and groin.
"You only need 10 percent of your beta cells to supply sufficient insulin," Roep said. He said there have been a couple of rare cases where a patient had typical type 1 diabetes but could go through long periods without insulin injections. "Insulin needs can be a moving target, and if you have a lifestyle change it's very plausible that you have a lesser need for insulin, and you can deal with [diabetes] with the beta cells you have," Roep said.

She says that the problem with diabetes is that it’s a silent disease. “Apart from needing to go to the loo a few times in the middle of the night, I experienced zero symptoms. Diabetes had no impact on my life – 99% of the time I forgot I even had it. Perhaps if it had been a disease with more symptoms, I would have been more motivated to do something about it.”

There are some interesting developments in blood glucose monitoring including continuous glucose sensors. The new continuous glucose sensor systems involve an implantable cannula placed just under the skin in the abdomen or in the arm. This cannula allows for frequent sampling of blood glucose levels. Attached to this is a transmitter that sends the data to a pager-like device. This device has a visual screen that allows the wearer to see, not only the current glucose reading, but also the graphic trends. In some devices, the rate of change of blood sugar is also shown. There are alarms for low and high sugar levels. Certain models will alarm if the rate of change indicates the wearer is at risk for dropping or rising blood glucose too rapidly. One version is specifically designed to interface with their insulin pumps. In most cases the patient still must manually approve any insulin dose (the pump cannot blindly respond to the glucose information it receives, it can only give a calculated suggestion as to whether the wearer should give insulin, and if so, how much). However, in 2013 the US FDA approved the first artificial pancreas type device, meaning an implanted sensor and pump combination that stops insulin delivery when glucose levels reach a certain low point. All of these devices need to be correlated to fingersticks measurements for a few hours before they can function independently. The devices can then provide readings for 3 to 5 days.


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.
The primary complications of diabetes due to damage in small blood vessels include damage to the eyes, kidneys, and nerves.[32] 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.[32] 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.[33] 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.[32] Damage to the nerves of the body, known as diabetic neuropathy, is the most common complication of diabetes.[32] 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.

Type 2 diabetes is the most common form of diabetes, and unlike type 1 diabetes, it usually occurs in people over the age of 40, especially those who are overweight. Type 2 diabetes is caused by insulin resistance, which means that the hormone insulin is being released, but a person doesn’t respond to it appropriately. Type 2 diabetes is a metabolic disorder that’s caused by high blood sugar. The body can keep up for a period of time by producing more insulin, but over time the insulin receptor sites burn out. Eventually, diabetes can affect nearly every system in the body, impacting your energy, digestion, weight, sleep, vision and more. (5)
While there is currently no cure for diabetes, researchers are hopeful for advancements. A 2017 pilot study may provide hope for a diabetes cure in the future. Researchers found that an intensive metabolic intervention, combining personalized exercise routines, strict diet, and glucose-controlling drugs could achieve partial or complete remission in 40 percent of patients, who were then able to stop their medication. More comprehensive studies are in the pipeline.
The pain of diabetic nerve damage may respond to traditional treatments with certain medications such as gabapentin (Neurontin), phenytoin (Dilantin), and carbamazepine (Tegretol) that are traditionally used in the treatment of seizure disorders. Amitriptyline (Elavil, Endep) and desipramine (Norpraminine) are medications that are traditionally used for depression. While many of these medications are not indicated specifically for the treatment of diabetes related nerve pain, they are used by physicians commonly.

Acetaminophen, aspirin, ibuprofen, or naproxen can ease mild to moderate pain caused by diabetic nerve damage, says Kimberly Sackheim, DO, a clinical assistant professor of rehabilitation medicine at NYU Langone Medical Center's Rusk Rehabilitation. "But speak with your physician if you take them regularly," she says. Some of these drugs may raise your risk of heart attack, stroke, or kidney damage.
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.
Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day. (8) Beer and sweet liquors are especially high in carbohydrates and should be avoided.

Founded in 1999, San Diego-based ViaCyte has raised a total of $201.5 million in funding, with major investments from Johnson & Johnson and Bain Capital. ViaCyte is addressing diabetes by developing a technology based on converting stem cells into pancreatic tissue that can produce insulin, and implanting the new tissue into patients inside an immunoprotective device for continuous insulin production.

Wellness isn’t just gendered. Most of the products and services that define the industry are clearly marketed toward young, thin, toned, ambulatory women who are white. Some speakers were blunt about the fact that wellness is often synonymous with—and sometimes a proxy for—whiteness. One panel was literally called “Wellness Beyond Whiteness,” in which it was decided that wellness needed to be totally reconciled into something for everyone—not to simply be “inclusive” or “bring people to the table,” but to demolish the table and, as with any growing movement, keep building new tables.
Diabetic ketoacidosis can be caused by infections, stress, or trauma, all of which may increase insulin requirements. In addition, missing doses of insulin is also an obvious risk factor for developing diabetic ketoacidosis. Urgent treatment of diabetic ketoacidosis involves the intravenous administration of fluid, electrolytes, and insulin, usually in a hospital intensive care unit. Dehydration can be very severe, and it is not unusual to need to replace 6-7 liters of fluid when a person presents in diabetic ketoacidosis. Antibiotics are given for infections. With treatment, abnormal blood sugar levels, ketone production, acidosis, and dehydration can be reversed rapidly, and patients can recover remarkably well.
Maddy Arnstein has lived with T1D for over 50 years. She became involved with JDRF when she saw the dramatic difference technologies like the insulin pump could have on her life. Maddy was quickly drawn to advocacy—initially to help secure continued renewal of funding for the Special Diabetes Program (SDP). But once she started using a continuous glucose monitor, she dedicated herself to fighting for Medicare coverage.
Diabetes is a whole-body problem. The disease is marked by too high blood glucose, which affects the many cells fed by the circulatory system. The cells of the gastrointestinal (GI) tract and the nerves that control its movement are no exception. People with diabetes have an elevated risk for a spectrum of GI disorders that can make life uncomfortable. Identifying the cause of GI discomfort is the first step toward getting the right treatment and finding relief.
^ O'Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Ou N, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX, Anderson JL, Jacobs AK, Halperin JL, Albert NM, Brindis RG, Creager MA, DeMets D, Guyton RA, Hochman JS, Kovacs RJ, Kushner FG, Ohman EM, Stevenson WG, Yancy CW (January 2013). "2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines". Circulation. 127 (4): e362–425. doi:10.1161/CIR.0b013e3182742cf6. PMID 23247304.

Since cardiovascular disease is a serious complication associated with diabetes, some have recommended blood pressure levels below 130/80 mmHg.[89] However, evidence supports less than or equal to somewhere between 140/90 mmHg to 160/100 mmHg; the only additional benefit found for blood pressure targets beneath this range was an isolated decrease in stroke risk, and this was accompanied by an increased risk of other serious adverse events.[90][91] A 2016 review found potential harm to treating lower than 140 mmHg.[92] Among medications that lower blood pressure, angiotensin converting enzyme inhibitors (ACEIs) improve outcomes in those with DM while the similar medications angiotensin receptor blockers (ARBs) do not.[93] Aspirin is also recommended for people with cardiovascular problems, however routine use of aspirin has not been found to improve outcomes in uncomplicated diabetes.[94]
Gestational diabetes mellitus (GDM) resembles type 2 DM in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2–10% of all pregnancies and may improve or disappear after delivery.[50] However, after pregnancy approximately 5–10% of women with GDM are found to have DM, most commonly type 2.[50] GDM is fully treatable, but requires careful medical supervision throughout the pregnancy. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required.

Dr. Fung says he decided to experiment with intermittent fasting because he was frustrated seeing so many diabetic patients with kidney failure. “It occurred to me that fasting was an underutilized therapeutic option for losing weight,” he recalls. “I started doing this five years ago, and a lot of people got incredibly good results – it reversed their diabetes.”

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.
As a global network of medical research charities, the Juvenile Diabetes Research Foundation (JDRF) is driving research into new treatments that present tremendous opportunities to deliver enhanced health and wellbeing for people with type-1 diabetes. The technology I am currently most enthused about is glucose responsive insulin, which I think is going to transform how people treat and live with type 1 in the future.
Off-label drug use means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that it has not been approved for. However, a doctor can still use the drug for that purpose. The FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. Therefore, your doctor can prescribe a drug however they think is best for your care.
The first media reports of Darkes' supposed cure, along with a similar description of the "rare" gene that partially explained it, began surfacing in February 2017. At the time, Darkes made it clear that his doctors in Northampton were still reviewing the test results, and that they would report on their findings soon. A story published in March 2017 in the Northampton Chronicle and Echo reported that Darkes' test results "are expected to be published next week."

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]


But does Darkes' story really mean type 1 diabetes can be cured? Darkes declined to provide his medical records, and the experts Live Science spoke to said there were several missing or confusing pieces of information in his story. Usually, incredible medical stories like this one are reported as case reports in the medical literature, the experts said. And even if the details of his story can ultimately be confirmed, the experts emphasized that it's extremely unlikely that Darkes' case would lead to a widespread cure for type 1 diabetes, as reports in the media have wrongly suggested.
Antidepressants most commonly treat depression. However, they can be prescribed for diabetic nerve pain because they interfere with chemicals in your brain that cause you to feel pain. Your doctor may recommend tricyclic antidepressants, such as amitriptyline, imipramine (Tofranil), and desipramine (Norpramin). These can cause unpleasant side effects like dry mouth, fatigue, and sweating.
People with type 2 diabetes have insulin resistance, which means the body cannot use insulin properly to help glucose get into the cells. In people with type 2 diabetes, insulin doesn’t work well in muscle, fat, and other tissues, so your pancreas (the organ that makes insulin) starts to put out a lot more of it to try and compensate. "This results in high insulin levels in the body,” says Fernando Ovalle, MD, director of the multidisciplinary diabetes clinic at the University of Alabama in Birmingham. This insulin level sends signals to the brain that your body is hungry.
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