Insulin therapy creates risk because of the inability to continuously know a person's blood glucose level and adjust insulin infusion appropriately. New advances in technology have overcome much of this problem. Small, portable insulin infusion pumps are available from several manufacturers. They allow a continuous infusion of small amounts of insulin to be delivered through the skin around the clock, plus the ability to give bolus doses when a person eats or has elevated blood glucose levels. This is very similar to how the pancreas works, but these pumps lack a continuous "feed-back" mechanism. Thus, the user is still at risk of giving too much or too little insulin unless blood glucose measurements are made.

Your care team may recommend that you use a continuous glucose monitor (CGM). A CGM is a wearable device that can measure blood sugar every few minutes around the clock. It's measured by a thread-like sensor inserted under the skin and secured in place. The more frequent CGM blood sugar readings can help you and the care team do an even better job of troubleshooting and adjusting your insulin doses and diabetes management plan to improve blood sugar control.

Magnesium deficiency is not uncommon in people with diabetes, and it can worsen high blood sugar and insulin resistance. Some studies suggest that supplementing with magnesium may improve insulin function and lower blood sugar levels, but other studies have shown no benefit. Have your doctor check you for deficiency before supplementing with magnesium. These are signs that you’re not getting enough magnesium.

Maintaining normal blood sugar levels is necessary for the body’s overall health. Erratic blood sugar levels can affect the body’s ability to function normally and even lead to complications if left unchecked. Some herbs and spices found in nature do a tremendous job of naturally lowering blood sugar levels, making them a boon for diabetics and pre-diabetics. What’s more, being nature’s multi-taskers, herbs and spices also produce overall health benefits beyond just helping balance blood sugar.

These seeds, used in Indian cooking, have been found to lower blood sugar, increase insulin sensitivity, and reduce high cholesterol, according to several animal and human studies. The effect may be partly due to the seeds’ high fiber content. The seeds also contain an amino acid that appears to boost the release of insulin. In one of the largest studies on fenugreek, 60 people who took 25 grams daily showed significant improvements in blood sugar control and post-meal spikes.
It’s like packing your clothes into a suitcase. At first, the clothes go without any trouble. After a certain point, though, it is just impossible to jam in those last 2 T-shirts. You can’t close the suitcase. The luggage is now ‘resistant’ to the clothes. It’s waaayyy harder to put those last 2 T-shirts than the first 2. It’s the same overflow phenomenon. The cell is filled to bursting with glucose, so trying to force more in is difficult and requires much higher doses of insulin.
Genetic factors do play a role in any disease, but I put this factor last for a reason. Genetic predisposition to a given disease will increase the chances of getting the disease, but not in a vacuum. People with a strong predisposition to liver disease manage to avoid it, and some with a family history of heart disease remain heart-attack free. Even studies among identical twins show that in most cases, twins will get the same diseases, even in different environments, but sometimes they don’t. This means there are other factors involved (see above).
You also might hear about alternative treatments for diabetes, such as herbal remedies and vitamin or mineral supplements. These practices can be risky, especially when people stop following the treatment plan their doctor has given them. So get the facts by talking to your diabetes health care team. They keep track of the latest research developments, and will introduce new products as they become available.
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
Low blood sugar, or hypoglycemia, is a syndrome in which a person's blood sugar is dangerously low. People with type 1 and type 2 diabetes are at risk for this condition. There are other diseases that can cause a person's blood sugar levels to go too low, for example, pancreatitis, Cushing's syndrome, and pancreatic cancer. Symptoms and signs that your blood sugar levels are too low include:
A history of blood sugar level results is especially useful for the diabetic to present to their doctor or physician in the monitoring and control of the disease. Failure to maintain a strict regimen of testing can accelerate symptoms of the condition, and it is therefore imperative that any diabetic patient strictly monitor their glucose levels regularly.
Although a close relationship exists among raised liver fat levels, insulin resistance, and raised liver enzyme levels (52), high levels of liver fat are not inevitably associated with hepatic insulin resistance. This is analogous to the discordance observed in the muscle of trained athletes in whom raised intramyocellular triacylglycerol is associated with high insulin sensitivity (53). This relationship is also seen in muscle of mice overexpressing the enzyme DGAT-1, which rapidly esterifies diacylglycerol to metabolically inert triacylglycerol (54). In both circumstances, raised intracellular triacylglycerol stores coexist with normal insulin sensitivity. When a variant of PNPLA3 was described as determining increased hepatic fat levels, it appeared that a major factor underlying nonalcoholic fatty liver disease and insulin resistance was identified (55). However, this relatively rare genetic variant is not associated with hepatic insulin resistance (56). Because the responsible G allele of PNPLA3 is believed to code for a lipase that is ineffective in triacylglycerol hydrolysis, it appears that diacylglycerol and fatty acids are sequestered as inert triacylglycerol, preventing any inhibitory effect on insulin signaling.
The NIDDK has played an important role in developing “artificial pancreas” technology. An artificial pancreas replaces manual blood glucose testing and the use of insulin shots or a pump. A single system monitors blood glucose levels around the clock and provides insulin or a combination of insulin and a second hormone, glucagon, automatically. The system can also be monitored remotely, for example by parents or medical staff.
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.
They would often say to me, “Doctor. You’ve always said that weight loss is the key to reversing diabetes. Yet you prescribed me a drug that made me gain 25 pounds. How is that good?” I never had a good answer, because none existed. It was not good. The key was weight loss, whereupon the diabetes often goes away or at least gets significantly better. So, logically, insulin does not help reverse the disease, but actually worsens it.

A 2005 study on the anti-diabetic effect of garlic in normal and lab-induced diabetic rats, published in the journal Phytomedicine, found that oral administration significantly decreased serum glucose, total cholesterol, triglycerides, urea, uric acid, creatinine, AST and ALT levels. While it increased serum insulin in diabetic rats, this was not so in the case of normal rats. It concluded that garlic must be considered as an excellent candidate for future human studies on diabetes mellitus. What’s better, garlic also helps reduce high cholesterol levels, a complication that diabetics often face. This makes it an excellent spice to use for in all recipes!
Insulin therapy is taken by diabetics who have type 1 diabetes mellitus, or IDDM, i.e., insulin-dependent diabetes mellitus. In this condition, body is not able to produce any insulin, therefore, it has to be administered externally. Patients with type 2 diabetes mellitus are either resistant to insulin or have relatively low insulin production, or both.
Yes. The combination of insulin and an oral medication, when taken as directed by your doctor, is very safe and effective in controlling blood sugar. A typical combination therapy consists of taking an oral medication during the day and insulin at night. Once you begin taking insulin, you will need to monitor your blood sugar more often to reduce the risk of low blood sugar reactions.Combination therapies are often helpful for people who have Type 2 diabetes (adult onset diabetes). If you have been taking an oral medication, your doctor may change your treatment plan to include insulin injections. This change is often made to help people with Type 2 diabetes gain better control of their blood sugar.
The most detrimental thing sugar does is cause inflammation, and inflammation is the root of almost everything that misfires in your body. There is a direct link between inflammation and diabetes,[6] and a lower carb diet reduces C-reactive protein, a marker of inflammation.[7] In addition to sugar, it’s a good idea to keep an eye on your toxic load and keep your omega-3 to omega-6 ratio low to keep inflammation down.
Gene therapy can be used to manufacture insulin directly: an oral medication, consisting of viral vectors containing the insulin sequence, is digested and delivers its genes to the upper intestines. Those intestinal cells will then behave like any viral infected cell, and will reproduce the insulin protein. The virus can be controlled to infect only the cells which respond to the presence of glucose, such that insulin is produced only in the presence of high glucose levels. Due to the limited numbers of vectors delivered, very few intestinal cells would actually be impacted and would die off naturally in a few days. Therefore, by varying the amount of oral medication used, the amount of insulin created by gene therapy can be increased or decreased as needed. As the insulin-producing intestinal cells die off, they are boosted by additional oral medications.[76]

“The degree of carbohydrate restriction that we recommend to establish and then maintain nutritional ketosis depends upon individual factors such degree of insulin resistance (metabolic syndrome or type 2 diabetes?) and physical activity. These starting levels of carb restriction typically vary between 30 and 60 grams per day of total carbs. The best way to determine one’s carbohydrate tolerance is to directly measure blood ketones with a finger-stick glucometer that also accommodates ketone testing.

Type I diabetes usually occurs in people who are below the age 20 and that is why it is also called as juvenile diabetes. In this type, the body becomes partially or completely unable to produce insulin. Type I diabetes is an autoimmune disease. In this, your immune system attacks the pancreas from where the insulin is produced, thereby making the pancreas inefficient or unable to produce insulin. Type I diabetes cannot be prevented, it can only be controlled with healthy lifestyle changes.
Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.