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.
The other way to make such things accessible is to inundate attendees with advertising—which can undermine the concept by making us feel inadequate without this product or that, rather than by affirming our wholeness. Poolside, Hoess told me that he believes there can still be profit in a less consumerist direction, but that it’s necessary to “redefine capitalism to where it’s not just about pure profit, it’s also about social profit. If we can merge those things, I think business becomes a force for good.”
In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control. (This is a major factor for many patients with type 2 diabetes who ultimately require insulin therapy.) Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.
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.

Pain affects millions of people with diabetes. For most of these people, the pain is chronic, defined as pain persisting for more than six months, experienced almost every day, and of moderate to severe intensity, or that significantly interferes with daily activities. In some cases, a person’s pain is clearly related to complications of diabetes; in other cases, it is not. Regardless of the cause, however, studies show that chronic pain makes diabetes self-management much more difficult and often leads to higher blood glucose levels.
The classic oral glucose tolerance test measures blood glucose levels five times over a period of three hours. Some physicians simply get a baseline blood sample followed by a sample two hours after drinking the glucose solution. In a person without diabetes, the glucose levels rise and then fall quickly. In someone with diabetes, glucose levels rise higher than normal and fail to come back down as fast.

Aside from the financial costs of diabetes, the more frightening findings are the complications and co-existing conditions. In 2014, 7.2 million hospital discharges were reported with diabetes as a listed diagnosis. Patients with diabetes were treated for major cardiovascular diseases, ischemic heart disease, stroke, lower-extremity amputation and diabetic ketoacidosis.
Health ProMed Nursing Director Angel Rodriguez, Ruben Bras of the Puerto Rico Primary Care Association and other ProMed staffers quickly load Humulin R insulin into cold storage at the ProMed San Juan clinic. Humulin R is used to stabilize a patient’s blood sugar. The medicines from Direct Relief were critical after Hurricane Maria, with many patients battling stress and limited access to nutritious food. (Lara Cooper/Direct Relief)
Many herbal remedies have been used to reduce inflammation and pain. Writing in the online publication U.S. Pharmacist, Antoine Al-Achi, PhD, a Professor of Pharmaceutics at the Campbell University School of Pharmacy in North Carolina, reported that bromelain (pineapple enzyme), curcumin (an antioxidant found in turmeric), echinacea, chamomile, ginger, and arnica have shown anti-inflammatory effects. Preparations of these plant-based supplements are widely available at health-food stores. If you would like to try one or more of these supplements, speak to your doctor first about possible side effects and drug interactions.
For now, I manage my diabetes through a combination of technologies. I use a blood test meter to measure my glucose levels at least five times a day. I use a pump that is attached to my abdomen to deliver frequent doses of insulin throughout the day. And now I also use a continuous monitoring device that measures my subcutaneous blood sugar levels to help the insulin pump work more effectively.
If you bring your blood sugar into the healthy range (a hemoglobin A1C reading of 7% or lower), you'll reduce your risk of nerve damage by 60%, according to research from the National Institute of Diabetes and Digestive and Kidney Diseases. "Healthy blood sugar levels can slow the process and ease the pain of diabetic neuropathy," says Aaron I. Vinik, MD, PhD, the director of the research and neuroendocrine unit at Eastern Virginia Medical School.

To treat diabetic retinopathy, a laser is used to destroy and prevent the recurrence of the development of these small aneurysms and brittle blood vessels. Approximately 50% of patients with diabetes will develop some degree of diabetic retinopathy after 10 years of diabetes, and 80% retinopathy after 15 years of the disease. Poor control of blood sugar and blood pressure further aggravates eye disease in diabetes.


For now, I manage my diabetes through a combination of technologies. I use a blood test meter to measure my glucose levels at least five times a day. I use a pump that is attached to my abdomen to deliver frequent doses of insulin throughout the day. And now I also use a continuous monitoring device that measures my subcutaneous blood sugar levels to help the insulin pump work more effectively.

"There have been cases where patients were treated with insulin for years until they discovered it was a rare genetic variant" of MODY, Roep told Live Science. Those people are no longer diagnosed as having type 1 diabetes, and they may be able to manage their blood sugar levels with either oral drugs or diet and exercise changes, "but that would not be the same as being cured," Roep said.  


Pain specialist Karen Burt, MD, director of Integrative Medicine at Contra Costa Regional Health Center in California, says that spiritual approaches help many people with chronic pain. “With chronic pain,” she says, “one needs to connect or return to all positive aspects of one’s being and one’s life. So if puppies and kids and nature and flowers and hot baths and your sister bring you pleasure and comfort, by all means, keep them in your life. By the same token, everyone has internal sources of positivity: one’s faith, one’s awe and appreciation of nature or life itself, and qualities like strength, courage, wisdom, hope, and inspiration.”
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.”
Urinary tract problems. Some medications can interfere with bladder function. Your doctor may recommend stopping or changing medications. A strict urination schedule or urinating every few hours (timed urination) while applying gentle pressure to the bladder area (below your bellybutton) is recommended. Other methods, including self-catheterization, may be needed to remove urine from a nerve-damaged bladder.
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.
But as I write in my forthcoming book, The Good Neighbor: The Life and Work of Fred Rogers, Rogers’s placidity belied the intense care he took in shaping each episode of his program. He insisted that every word, whether spoken by a person or a puppet, be scrutinized closely, because he knew that children—the preschool-age boys and girls who made up the core of his audience—tend to hear things literally.
The last time I was in Palm Springs was a year ago for the TEDMED conference (relational platform?), and at the time I was mystified. It was a full house at the price of $4,950 a ticket, even though TED Talks are available for free online. The videos can be sped up if the speaker is boring, segments can be skipped, and tabs can be opened to keep the talk running in the background while getting some email done or shopping for shoes. There would seem, then, very little reason to need to go to the actual conference, to sit through marathon sessions where a fair number of speakers mess up or forget their lines (as I did).
Glucose is a simple sugar found in food. Glucose is an essential nutrient that provides energy for the proper functioning of the body cells. Carbohydrates are broken down in the small intestine and the glucose in digested food is then absorbed by the intestinal cells into the bloodstream, and is carried by the bloodstream to all the cells in the body where it is utilized. However, glucose cannot enter the cells alone and needs insulin to aid in its transport into the cells. Without insulin, the cells become starved of glucose energy despite the presence of abundant glucose in the bloodstream. In certain types of diabetes, the cells' inability to utilize glucose gives rise to the ironic situation of "starvation in the midst of plenty". The abundant, unutilized glucose is wastefully excreted in the urine.
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.”

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have prediabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having prediabetes puts you at a higher risk of getting type 2 diabetes.
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