Type 2 diabetes is by far the most common form (around 90% of all cases) and the one which is increasing the most. It primarily affects overweight people in middle age or later. It’s not uncommon for the affected person to also have a high blood pressure and an abnormal lipid profile. Gestational diabetes is a temporary special case of type 2 diabetes.
President Donald Trump’s decision to withdraw U.S. troops from Syria is controversial partly because of the possible consequences for the country’s Kurdish minority. “Among the biggest losers are likely to be the Kurdish troops that the United States has equipped and relied on to fight the Islamic State in Iraq and Syria,” The New York Times editorialized. “Turkey’s president, Recep Tayyip Erdogan, considers many of the Kurds to be terrorists bent on destroying his country. In recent days he has vowed to launch a new offensive against them in the Syrian border region.”
In type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't produce enough, or the insulin does not work properly. Nine out of 10 people with diabetes have type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes be controlled with a combination of diet, weight management and exercise. However, treatment also may include oral glucose-lowering medications (taken by mouth) or insulin injections (shots).
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.
Ariana Shakibinia decided to study public health in large part because she lives with T1D. She had always been interested in public policy, but she says living with this disease has made her more vested in the healthcare conversation. “I am living with what is essentially a pre-existing condition. I’m fortunate enough to have good health insurance, but it makes the potential financial burden of T1D management much more visible and relatable.”
At the opening social event, I made conversation by asking people what had brought them to the festival—which mostly featured things available in most metropolitan areas, and sessions of the sort that can be viewed online. I thought that constituted small talk. By the end, I realized it was not; many people had come for reasons that run deep. I went to the desert wary of the worst side of the wellness movement as an elitist industry that preys on the very human desire to feel like we’re getting ahead of others, but the more I talked to people, the more I realized that the attendees were largely aware of the problems, and wanted to get back to a distilled notion of why people have long come to love wellness trends and fads: the promise of connection.
There are eight dimensions of wellness: occupational, emotional, spiritual, environmental, financial, physical, social, and intellectual. Each dimension of wellness is interrelated with another. Each dimension is equally vital in the pursuit of optimum health. One can reach an optimal level of wellness by understanding how to maintain and optimize each of the dimensions of wellness.
Narcotic medicines, which include opiates such as morphine and synthetics such as oxycodone, are sometimes given for pain. Narcotics dampen all senses, not just pain. Because of side effects including sleepiness, constipation, and addiction, they are less often used for chronic pain than they used to be. But they are still very helpful for some people, and most chronic pain specialists will prescribe them.
^ 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.
People with diabetes can benefit from education about the disease and treatment, good nutrition to achieve a normal body weight, and exercise, with the goal of keeping both short-term and long-term blood glucose levels within acceptable bounds. In addition, given the associated higher risks of cardiovascular disease, lifestyle modifications are recommended to control blood pressure.
Be sure to choose a trusted physical therapist who understands neuropathy, diabetic or otherwise, to help you work through physical therapy methods in order to prevent further nerve damage. Proper attention to physical activity by an expert can prevent any further issues from occurring. Also keep in mind that physical therapy can soothe diabetic nerve pain, but not cure it.
^ Emadian A, Andrews RC, England CY, Wallace V, Thompson JL (November 2015). "The effect of macronutrients on glycaemic control: a systematic review of dietary randomised controlled trials in overweight and obese adults with type 2 diabetes in which there was no difference in weight loss between treatment groups". The British Journal of Nutrition. 114 (10): 1656–66. doi:10.1017/S0007114515003475. PMC 4657029. PMID 26411958.
Though it may be transient, untreated GDM can damage the health of the fetus or mother. Risks to the baby include macrosomia (high birth weight), congenital heart and central nervous system abnormalities, and skeletal muscle malformations. Increased levels of insulin in a fetus's blood may inhibit fetal surfactant production and cause infant respiratory distress syndrome. A high blood bilirubin level may result from red blood cell destruction. In severe cases, perinatal death may occur, most commonly as a result of poor placental perfusion due to vascular impairment. Labor induction may be indicated with decreased placental function. A caesarean section may be performed if there is marked fetal distress or an increased risk of injury associated with macrosomia, such as shoulder dystocia.
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.)
One participant in an online discussion on the Diabetes Self-Management blog wrote, “I noticed that when I was doing something like reading an interesting book, or walking and talking with a friend, I was not consciously feeling pain.” Another wrote, “I keep my mind busy with genealogy [family history] during the day. I play sudoku and crosswords at night until I can fall asleep.”
In another study, albeit including only 30 people, those who were recently diagnosed and went on a very low-calorie diet for eight weeks experienced remission. That remission continued more than six months after their low-calorie diet ended. In people who have had type 2 diabetes for a long time, unfortunately, weight loss has a much more limited impact.
Type 1 diabetes occurs because the insulin-producing cells of the pancreas (beta cells) are damaged. In type 1 diabetes, the pancreas makes little or no insulin, so sugar cannot get into the body's cells for use as energy. People with type 1 diabetes must use insulin injections to control their blood glucose. Type 1 is the most common form of diabetes in people who are under age 30, but it can occur at any age. Ten percent of people with diabetes are diagnosed with type 1.
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.
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.
Many usage guides have disparaged preventative as improper, because it doesn't accord with classical roots: the Latin past participle stem praevent- adds -ion to form prevention and -ive to form preventive. Words ending in -ative ought to have the -at- in the root already: demonstrat- begets demonstration and demonstrative, narrat- begets narration and narrative, and so forth. Since we don't have preventation, then preventative is equally misbegotten, by this way of thinking.
It's unclear how people get the disease — genetics plays a big role, though unknown environmental factors may also trigger the disease. Either way, the disease causes the immune system to mistakenly attack and kill insulin-producing cells, called beta cells, in the pancreas. (This differs from type 2 diabetes, in which the body initially makes sufficient insulin but the cells cannot properly use it.) Without enough insulin working to remove glucose from the blood stream, and allowing glucose to enter the body's cells, blood sugar levels spike. Left untreated, this insulin deficiency leads to a deadly complication called diabetic ketoacidosis. What's more, having high blood sugar over the long term can cause life-threatening complications such as kidney damage or heart disease, according to the Mayo Clinic.
^ Ahlqvist, Emma; Storm, Petter; Käräjämäki, Annemari; Martinell, Mats; Dorkhan, Mozhgan; Carlsson, Annelie; Vikman, Petter; Prasad, Rashmi B; Aly, Dina Mansour (2018). "Novel subgroups of adult-onset diabetes and their association with outcomes: a data-driven cluster analysis of six variables". The Lancet Diabetes & Endocrinology. 0 (5): 361–369. doi:10.1016/S2213-8587(18)30051-2. ISSN 2213-8587. PMID 29503172.
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.
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
Trick (important): Cut down on sweets, and if you can, cut them out entirely for a couple months. I still eat ice cream about once a week, and know people who are losing weight on this diet while eating ice cream almost every day. But this probably won’t be the case for everyone. Better to severely restrict sweets for the first few months, and then gradually reintroduce.
Diabetes is the major cause of blindness, kidney failure, heart attack and stroke. The number of people affected by all types of diabetic disorders is now over four times higher than just 40 years ago. This has led the World Health Organization (WHO) to consider diabetes an epidemic, predicting it will soon be the seventh biggest cause of death worldwide.
Low blood sugar (hypoglycemia) is common in people with type 1 and type 2 DM. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious effects such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases. Moderately low blood sugar may easily be mistaken for drunkenness; rapid breathing and sweating, cold, pale skin are characteristic of low blood sugar but not definitive. Mild to moderate cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon.
Several types of plants are referred to as ginseng, but most studies have used American ginseng. They've shown some sugar-lowering effects in fasting and after-meal blood sugar levels, as well as in A1c results (average blood sugar levels over a 3-month period). But we need larger and more long-term studies. Researchers also found that the amount of sugar-lowering compound in ginseng plants varies widely.
A women gets her blood glucose levels checked at a pop-up clinic in Mexico City’s neighborhood of La Roma by Dr. Eduardo Juarez Oliveros. The clinic was set up by the Association Mexica de Diabetes (AMD) in partnership with Direct Relief. The clinic is aimed at serving populations in the city displaced by the earthquake, especially those with diabetes. (Photo by Meghan Dhaliwal for Direct Relief)
Currently, people with diabetes who receive a transplanted pancreas (typically not possible unless you are also having a kidney transplant) or who receive islet-cell transplants as part of a research study in the US must take these drugs so that their own body won’t attack the new cells. The drugs work, but raise risk for bacterial and viral infections as well as for mouth sores, nausea, diarrhea, high cholesterol, high blood pressure, fatigue and even some cancers.
The old “bring people to the table” metaphor rang especially egregious to the artist and writer Anasa Troutman, who had a similarly revelatory vision for wellness: “Unless we’re willing to make a commitment to community, we will never be well. Even if you wake up every morning and drink your juice and do your yoga, without that commitment to each other we will not be well as a country and as a world,” Troutman said.
The results of his medical tests are still being analyzed, Darkes said, but he hasn't needed insulin injections for a year and a half. "It took a long time to sink in," he noted. But Darkes is confident he no longer has type 1 diabetes. He said that doctors told him that he has a "rare" gene that somehow facilitated his cure. "I'm the only one who carries [the gene], at the moment," and there's no further explanation so far, he said.
A major feature of the disease is a condition known as insulin resistance. Insulin is a hormone that moves glucose (sugar), from the bloodstream into the body’s cells where it is used for energy. For a variety of reasons that are not fully understood, the body’s tissues don’t respond adequately to insulin and glucose then becomes elevated in the bloodstream.
Founded in 2007, San Francisco startup NGM Biopharmaceuticals is a pharmaceutical company that has raised $295.4 million, with pharmaceutical giant Merck & Co., as one of its most recent investors. The company has just filed to sell $75 million of its common stock in an IPO. The company’s primary candidate for treating diabetes is NGM313, an engineered antibody that binds to a novel pathway that reduces insulin resistance. After the successful conclusion of a phase I on the drug, NGM plans to license the antibody to Merck.
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.