More than three decades later, wellness is, in fact, a word that Americans might hear every day, or close to it. You can sign up for your company’s employee-wellness program, relax in a wellness spa treatment or even plan some “wellness tourism” for your next vacation. Your cat or dog can get in on the action, too, since the W-word has been pressed into service as a brand of all-natural pet food.
The symptoms may relate to fluid loss and polyuria, but the course may also be insidious. Diabetic animals are more prone to infections. The long-term complications recognized in humans are much rarer in animals. The principles of treatment (weight loss, oral antidiabetics, subcutaneous insulin) and management of emergencies (e.g. ketoacidosis) are similar to those in humans.
Several other signs and symptoms can mark the onset of diabetes although they are not specific to the disease. In addition to the known ones above, they include blurred vision, headache, fatigue, slow healing of cuts, and itchy skin. Prolonged high blood glucose can cause glucose absorption in the lens of the eye, which leads to changes in its shape, resulting in vision changes. Long-term vision loss can also be caused by diabetic retinopathy. A number of skin rashes that can occur in diabetes are collectively known as diabetic dermadromes.
Metformin is generally recommended as a first line treatment for type 2 diabetes, as there is good evidence that it decreases mortality. It works by decreasing the liver's production of glucose. Several other groups of drugs, mostly given by mouth, may also decrease blood sugar in type II DM. These include agents that increase insulin release, agents that decrease absorption of sugar from the intestines, and agents that make the body more sensitive to insulin. When insulin is used in type 2 diabetes, a long-acting formulation is usually added initially, while continuing oral medications. Doses of insulin are then increased to effect.
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Since chronic pain has so many contributing causes — physical, mental, and emotional — there are many ways to break into the pain cycle, reduce pain levels, and gain comfort. There may not be a cure for chronic pain, but a person can gain some control over his pain. Feeling more in control, even a little bit, can help people relax, try new things, and gain even more control. In this way, even severe chronic pain can be managed, and the person with pain can gain better health in the process.
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.
Innovation in technology is not just fuelling advances in diabetes treatments though. I know it will accelerate the path to the cure. And this is what unites people with type-1 diabetes, researchers, our charitable supporters and funders. I am convinced one day we will consign type 1 to the history books and no one will ever receive this life-changing diagnosis again.
We’re growing in ranks. We’re tired of seeing our families suffer from unnecessary illness and tired of having to fight so hard just to eat real food. You’ll know us by the coconut oil on our counters and the chia seeds in our pantries. By the bentonite clay in our bathrooms and the charcoal on our teeth. We often sleep on organic mattresses and have salt lamps in our bedrooms. We can use spirulina with the best of them, cook 5 kinds of bone broth and use castor oil for longer lashes. We might even make homemade deodorant and use essential oil diffusers 24/7.
I went to one interactive session on masculinity, and I was asked to do eye gazing for several minutes with another man while answering prompts like “Something I’m afraid to tell you is” and “Something I love about myself is.” It is meant to teach men to be expressive, and to see that it can feel normal and good. The only strange thing for me was the uninterrupted eye contact at abnormally close range, about a foot. The women in the session watched us do the exercise and shared their reactions afterward, and many seemed genuinely moved because they hadn’t seen men talk to each other like this before.
Efforts to cure or stop type 1 diabetes are still in the early stages, and these approaches will also not be suitable for people that have already lost their insulin-producing cells. A solution could be the creation of an “artificial pancreas” — a fully automated system that can measure glucose levels and inject the right amount of insulin into the bloodstream, just like a healthy pancreas would.
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).
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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These surgeries, even today, come with significant side effects. People have to be vigilant about getting their needed nutrients, since many aren’t as easily absorbed through food anymore. Other substances are too easily absorbed by the body, particularly drugs like alcohol. This vulnerability can then lead to alcohol abuse and may even help explain the slightly higher rates of suicide and self-harm seen in patients soon after surgery. Also distressing is that an estimated one of every 10 patients will fail to lose weight or regain the weight back in the long term, while others will require additional operations to fix complications like stomach leakages.
He asked and then demanded that the 200 or so chairs in the middle of the auditorium be rearranged. This required summoning the fire marshal (as the aisle was a matter of code) who insisted that no changes could be made. Brand held his ground. Event planners gathered around him trying to talk him down. Even if it weren’t for the fire code, moving the chairs at this point would have to be done by union workers and would take time. The audience was waiting outside baking in the sun, Hoess, Wanderlust’s CEO, reminded Brand. But he was insistent. I sensed he was willing to threaten to not go on at all when the organizers finally broke down and agreed to move the chairs.
Many people may not want to divulge their bathroom dramas to a doctor, or anyone, or may think that heartburn is common and no big deal. Everyone gets a tummy ache now and again, but if you have diabetes, GI symptoms may indicate that something is chronically wrong. “If it bothers you, it’s worth getting checked out,” says Bragg. With a proper diagnosis, you and your health care provider can come up with a plan to make your whole body feel a whole lot better.
The water was in boxes because Wellspring purposely forwent wasteful plastic bottles—a half measure, after inviting thousands of people to exercise in the desert. The water was alkaline because that’s a trendy new way to sell people water, and its maker was a sponsor of the festival. The class, too, was sponsored, an Adidas logo projected onto the wall. Outside was a food truck selling Bulletproof concoctions with “brain octane oil.” In a capacious central cavern was “one of the world’s largest wellness exhibitions,” where vendors pitched cosmetics and supplements and bars and tonics. On offer were complimentary CBD-oil massages (sponsored by the seller of said oils) and a balancing of people’s sacral chakras with something called a BioCharger (trademark), “a natural cellular revitalization platform that uses a full spectrum of light and harmonic frequencies to deliver restorative energy” and that promises to help with “creativity, sexuality, and acceptance of new experiences.”
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.
Dr. Nyitray established Encellin soon after she received her PhD in chemistry and chemical biology from the University of California San Francisco in 2015. Her work at UCSF, with advisor Tejal Desai, PhD, chair of the Department of Bioengineering and Therapeutic Sciences in UCSF’s schools of Pharmacy and Medicine, focused on developing a packaging system for islet cells.
The problem, according to gastroenterologist Hiroshi Mashimo, MD, PhD, is that 70 percent of PPI users take the medications incorrectly. “They aren’t getting proper instruction,” says Mashimo. “Most people equate PPIs as a stronger form of an antacid.” Antacids neutralize acid and are meant to be taken to quell symptoms as they occur. PPIs are part of a more long-term strategy. The right way to take them is in the morning, just before or with breakfast. Food “turns on” the body’s acid-making cells; the medication can then work to stop stomach acid production.
Acute pain is a lifesaver. Without it, we would have to watch out all the time to keep from injuring or killing ourselves accidentally. This is why people with diabetes are advised to check their feet visually or manually every day: If a person has peripheral neuropathy, particularly if it causes numbness in his feet, the acute pain nerves in his feet may not be working, and if they aren’t, they can’t warn him about injuries or other, normally painful foot problems.
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.
The Diabetes Control and Complications Trial (DCCT) was a clinical study conducted by the United States National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) that was published in the New England Journal of Medicine in 1993. Test subjects all had diabetes mellitus type 1 and were randomized to a tight glycemic arm and a control arm with the standard of care at the time; people were followed for an average of seven years, and people in the treatment had dramatically lower rates of diabetic complications. It was as a landmark study at the time, and significantly changed the management of all forms of diabetes.
The emphatic takeaway is that the opposite of addiction is connection. Beating the disease is fundamentally about preempting the point where you lose the freedom to choose: Don’t hold the drink in your hand; don’t go to the party where you know exactly what will go down. In the moment before the bad decision, Brand urged, “you have to make the commitment to call someone who can be your North Star. Someone who is not spellbound in that moment. Someone who can tell you the problem you’re trying to escape is still going to be there, and it’s not going to work, and you’re gonna feel like shit afterward. This is why we need people further down the path, so they can hold our shit as we grow.”
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.
Nerves in the legs and feet are often most affected by neuropathy. This can cause you to lose sensation to your feet and legs. Sores and cuts can go unnoticed and lead to infections. In some extreme cases, infections can become severe and lead to ulcers. Over time, this can cause irreparable damage to the soft tissue and lead to the loss of toes or even your foot.
The major eye complication of diabetes is called diabetic retinopathy. Diabetic retinopathy occurs in patients who have had diabetes for at least five years. Diseased small blood vessels in the back of the eye cause the leakage of protein and blood in the retina. Disease in these blood vessels also causes the formation of small aneurysms (microaneurysms), and new but brittle blood vessels (neovascularization). Spontaneous bleeding from the new and brittle blood vessels can lead to retinal scarring and retinal detachment, thus impairing vision.
“The cell is the original smart machine,” notes Crystal Nyitray, PhD, on the website of Encellin, the biotech start-up she founded in 2016. “All drugs, devices, and even digital health approaches are trying to restore or copy these functions. At Encellin, we believe in the human cell and creating a safe and reliable solution for patients. We are creating a technology to promote cell function and protection.”
By the late 2000s the concept had become widely used in employee assistance programs in workplaces, and funding for development of such programs in small business was included in the Affordable Care Act. The use of corporate wellness programs has been criticised as being discriminatory to people with disabilities. At the same time, while there were magazines devoted to wellness, it was noted that mainstream news sources had begun to devote more page space to "health and wellness themes".
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.”
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.