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.
Type 2 diabetes, a form of diabetes mellitus, is likely one of the better-known chronic diseases in the world — and that's no surprise. Data from the Centers for Disease Control and Prevention suggest in the United States alone, 30.3 million people, or 9.4 percent of the U.S. population, has diabetes, and the majority of these people have type 2. (1)
American Diabetes Association Joslin Diabetes Center Mayo Clinic International Diabetes Federation Canadian Diabetes Association National Institute of Diabetes and Digestive and Kidney Diseases Diabetes Daily American Heart Association Diabetes Forecast Diabetic Living American Association of Clinical Endocrinologists European Association for the Study of Diabetes
High blood glucose sets up a domino effect of sorts within your body. High blood sugar leads to increased production of urine and the need to urinate more often. Frequent urination causes you to lose a lot of fluid and become dehydrated. Consequently, you develop a dry mouth and feel thirsty more often. If you notice that you are drinking more than usual, or that your mouth often feels dry and you feel thirsty more often, these could be signs of type 2 diabetes.
In diabetes, either the pancreas makes insufficient levels of insulin so cells absorb glucose poorly or cells themselves become insulin resistant and thus unable to absorb glucose despite adequate insulin levels. Both types of change increase blood sugar levels above normal. Parsed this way, type I and type II diabetes overlap some but also differ.
Nerve damage from diabetes is called diabetic neuropathy and is also caused by disease of small blood vessels. In essence, the blood flow to the nerves is limited, leaving the nerves without blood flow, and they get damaged or die as a result (a term known as ischemia). Symptoms of diabetic nerve damage include numbness, burning, and aching of the feet and lower extremities. When the nerve disease causes a complete loss of sensation in the feet, patients may not be aware of injuries to the feet, and fail to properly protect them. Shoes or other protection should be worn as much as possible. Seemingly minor skin injuries should be attended to promptly to avoid serious infections. Because of poor blood circulation, diabetic foot injuries may not heal. Sometimes, minor foot injuries can lead to serious infection, ulcers, and even gangrene, necessitating surgical amputation of toes, feet, and other infected parts.
Preventative soon drew enough attention that The New York Mirror devoted a whole column to it in the newspaper's March 6, 1824, edition. "The conversion of preventive into preventative is an error too common," wrote the anonymous scribe. "Some fall into it from ignorance, and others from inadvertence." The writer attributed its use to "a disposition in people to spell words with more letters than belong to them; or to insert a syllable or syllables, where addition, so far from being advisable or requisite, proves injurious." The column concluded with a call to action: "Let those, then, who from carelessness or any other cause, have been in the habit of using preventative, make it henceforth an invariable rule, whether in writing or in utterance, to prefer the proper and unexceptionable term preventive."
Travis and Ardell found a kindred spirit in Bill Hettler, a staff physician at the University of Wisconsin-Stevens Point. Influenced by their work, Hettler founded the annual National Wellness Conference at Stevens Point, now in its 35th year. The conference lent valuable academic prestige to the wellness movement. It also caught the attention of Tom Dickey, who was working with the New York publisher Rodney Friedman in the early 1980s to set up a monthly newsletter on health, based at the University of California, Berkeley. Friedman wanted the publication to compete with the Harvard Medical School Health Letter, and Dickey suggested using wellness in the title as a contrast. In 1984, the Berkeley Wellness Letter was born.
Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (14)
A substantial proportion of people who experience type 2 diabetes remission after gastric bypass eventually have relapse of the disease down the road. I feel the best study of this was done by my co-author on CROSSROADS, David Arterburn. In a study of nearly 5,000 patients with diabetes who underwent [gastric bypass surgery] and were followed retrospectively for 13 years, about 70% experienced diabetes remission. Among these, about 1/3 eventually relapsed, but it’s important to note that the median disease-free interval was 8.3 years.
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.”
A 2017 article in the journal Diabetes Care explains that the goals for dietary change should be “healthful eating patterns emphasizing a variety of nutrient-dense foods in appropriate portion sizes.” Additional goals include achieving a healthy weight; attaining healthy blood sugar, blood pressure, and lipid levels; and reducing complications. The authors emphasize developing an individualized plan based on “personal and cultural preferences, health literacy and numeracy, access to healthful foods, willingness and ability to make behavioral changes, and barriers to change.”
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. However, after pregnancy approximately 5–10% of women with GDM are found to have DM, most commonly type 2. 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.
Use any combination of the tricks below to accelerate your weight loss and return to good health. If you use all five wisely, you can get to your ideal weight in 6–12 months or less — even if that means losing 100 pounds or more. Yes, think about your weight 10, 20, 30 years ago. Another friend of mine started on this journey last year weighing 270 pounds. He’s in his mid-thirties and about to reach his college wrestling weight class of 197 pounds and just ran his fastest 2 miles ever. He got to this point by following the two rules above and just 3 of the 5 tricks below.
Replacing humans with computers could make patients better control their sugar levels and suffer less complications in the long term. The French company Cellnovo has already shown that just a partially automated system, where blood sugar levels can be monitored wirelessly but patients still select insulin amounts, can reduce the chances of reaching life-threatening low sugar levels up to 39%. The company is now working towards developing a fully automated artificial pancreas in collaboration with Imperial College, the Diabeloop consortium and the Horizon2020 program.
But preventing the disease from progressing if you already have it requires first being able to spot the signs and symptoms of diabetes when they appear. While some type 2 diabetes symptoms may not ever show up, you can watch out for the following common signs of the disease and alert your doctor, especially if you have any of the common risk factors for diabetes. Also keep in mind that while most signs of type 2 diabetes are the same in men and women, there are some distinctions.