As self-management of diabetes typically involves lifestyle modifications, adherence may pose a significant self-management burden on many individuals.[65] For example, individuals with diabetes may find themselves faced with the need to self-monitor their blood glucose levels, adhere to healthier diets and maintain exercise regimens regularly in order to maintain metabolic control and reduce the risk of developing cardiovascular problems. Barriers to adherence have been associated with key psychological mechanisms: knowledge of self-management, beliefs about the efficacy of treatment and self-efficacy/perceived control.[65] Such mechanisms are inter-related, as one's thoughts (e.g. one's perception of diabetes, or one's appraisal of how helpful self-management is) is likely to relate to one's emotions (e.g. motivation to change), which in turn, affects one's self-efficacy (one's confidence in their ability to engage in a behaviour to achieve a desired outcome).[66]
In Type 2 diabetes, the insulin that is produced does not work effectively. This is referred to as “insulin resistance.” Previously referred to as “adult-onset diabetes,” Type 2 diabetes is the most common form and occurs most frequently in inactive, overweight adults. With rising rates of childhood obesity, we are now seeing Type 2 diabetes diagnosed in more children and teens. Type 2 diabetes is usually treated with a diet that promotes weight loss, exercise and oral medications. Over time, most with Type 2 diabetes produce less insulin. Because of this,insulin may also be required to treat Type 2 diabetes. 
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.
If I could only prescribe one supplement for a diabetes patient, I would prescribe R-alpha-lipoic acid. Alpha-lipoic acid has numerous benefits to the diabetic patient. It is a water- and fat-soluble antioxidant and has been shown to protect patients with fatty liver from liver disease progression. It can help reduce insulin resistance and has been shown to protect people with diabetes from developing complications in their nerves, eyes, and kidneys. R-ALA can prevent glycosylation of proteins, which reduces the A1C level. It is safe, although very rarely it can cause stomach upset. Alpha-lipoic acid is listed either as ALA or R-ALA. When listed as ALA, this means it contains two forms—the S isomer form and the R isomer form, in a 50:50 ratio. The key is to find a product that says it contains “R-ALA” instead of just “ALA.” A good daily working dose of R-ALA is 300 to 1,200 mg a day, which is the equivalent of 600 to 2,400 mg a day of regular ALA, if you buy a regular ALA listed product.

Dr. Mona Morstein is a naturopathic physician with a medical practice focused in integrative diabetes treatment. Her clinic, Arizona Integrative Medical Solutions, is located in Tempe, Arizona, where she sees patients of all ages and genders for acute and chronic conditions. An expert on prediabetes and diabetes, she is a frequent lecturer at conferences and webinars, and is the founder and executive director of The Low Carb Diabetes Association. Dr. Morstein is also a member of the Arizona Diabetes Coalition. Visit her website lowcarbdiabetes.org
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Does acupuncture for diabetes work? Acupuncture has many uses, and some research has suggested that it may work for diabetes, although how it would help has not yet been explained. Find out about the types of acupuncture that might help, the risks, and some evidence of its benefits. Anyone considering acupuncture should first check with their doctor. Read now
Drugs that increase insulin production by the pancreas or its blood levels and/or reduce sugar production from the liver, including alogliptin (Nesina), dulaglutide (Trulicity), linagliptin (Tradjenta), exenatide (Byetta, Bydureon), liraglutide (Victoza), lixisenatide (Adlyxin), saxagliptin (Onglyza), sitagliptin (Januvia), and semaglutide (Ozempic)
The first approach to managing diabetes usually means practicing healthier lifestyle habits. This is often centered on eating a better diet, getting exercise, and losing weight if necessary. If your doctor says that you need to make these changes, it’s smart to tailor them to your personal preferences so that you'll be more likely to stick with them.

With diabetes, however, either the pancreas doesn’t produce the correct amount of insulin (Type 1) or the body’s cells are unable to process and utilize the insulin (Type 2). In both cases, this causes a buildup of glucose in the blood, which results in inadequate energy supply for the body and can cause dehydration, kidney and nerve damage, blindness, an increased risk for heart attack and stroke, and more.
Fasting is the simplest and fastest method to force your body to burn sugar for energy. Glucose in the blood is the most easily accessible source of energy for the body. Fasting is merely the flip side of eating – if you are not eating you are fasting. When you eat, your body stores food energy. When you fast, your body burns food energy. If you simply lengthen out your periods of fasting, you can burn off the stored sugar.

The benefits of T1D medications far outweigh their associated side effects. The most common side effects of insulin are injection site reactions, which includes redness, soreness or irritation around the area. People can also experience lowered potassium levels and a risk of hypoglycemia. While these side effects can sound daunting, keep in mind that many people using these medications don’t experience serious side effects at all.

If you'd like some proof that diabetes is a disease you can live well with, consider the accomplishments of these prolific people with diabetes: jazz musician Dizzy Gillespie, singer Ella Fitzgerald, actress Mary Tyler Moore, and baseball Hall-of-Famer Jim "Catfish" Hunter. Even before treatment was as sophisticated as it is today, author Ernest Hemingway and inventor Thomas Edison, both of whom had diabetes, managed to leave their marks on the world.

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.
In 2003, ephedrine -- also known as ma huang -- became the first herbal stimulant ever banned by the FDA. It was a popular component of over-the-counter weight loss drugs. Ephedrine had some benefits, but it could cause far more harm, especially in high doses: insomnia (difficulty falling and staying asleep), high blood pressure, glaucoma, and urinary retention. This herbal supplement has also been associated with numerous cases of stroke.
Cinnamonium cassia and its relative C. burmanii are the types of cinnamon that have the best effect on diabetes symptoms. There have been numerous studies on cinnamon and, overall, they have shown cinnamon can slow stomach emptying and lower postprandial glucose levels. It also reduces glucose levels in Type 2 Diabetes Mellitus patients who have had poor diabetic control. It may also be helpful in lowering insulin levels, blood pressure, and A1C, and reduce AGE formation. This is a safe herb for diabetics. A good dose is 1 to 2 g a day or 200 mg or more of a concentrated extract.
Cyrus Khambatta earned a PhD in Nutritional Biochemistry from UC Berkeley after being diagnosed with type 1 diabetes in his senior year of college at Stanford University in 2002. He is an internationally recognized nutrition and fitness coach for people living with type 1, type 1.5, prediabetes and type 2 diabetes, and has helped hundreds of people around the world achieve exceptional insulin sensitivity by adopting low-fat, plant-based whole foods nutrition.
Benefits of control and reduced hospital admission have been reported.[26] However, patients on oral medication who do not self-adjust their drug dosage will miss many of the benefits of self-testing, and so it is questionable in this group. This is particularly so for patients taking monotherapy with metformin who are not at risk of hypoglycaemia. Regular 6 monthly laboratory testing of HbA1c (glycated haemoglobin) provides some assurance of long-term effective control and allows the adjustment of the patient's routine medication dosages in such cases. High frequency of self-testing in type 2 diabetes has not been shown to be associated with improved control.[27] The argument is made, though, that type 2 patients with poor long term control despite home blood glucose monitoring, either have not had this integrated into their overall management, or are long overdue for tighter control by a switch from oral medication to injected insulin.[28]

Desert Springs Hospital has developed specific protocols, computerized technology and systems to provide diabetes patients highest level of care. For example, the staff use special tools to maintain tight blood-sugar control during patient hospitalizations, such as the Glucommander, a computer that works with an insulin drip to monitor patients’ blood-sugar levels. 
Chong points to previous research in Circulation that describes the underlying mechanisms of sleep apnea. In people with sleep apnea, activation of the sympathetic nervous system — including increased heart rate, increased blood pressure, and constriction of blood vessels — all led to a higher risk of heart attack and stroke, which can be compounded in people who have type 2 diabetes (and thus already have a higher risk of heart disease).
One of the lesser known herbs that lower blood sugar, Marjoram, is high in polyphenols, which aids in stabilizing blood glucose levels. A 2012 study in the Journal of Evidence Based Alternative and Complementary Medicine found that Marjoram reduced formation of Advanced Glycation End (AGE) products. AGE is the smoking gun that researchers today say is responsible for a lot of the complications that diabetics face, like damage to arteries and eyes. Try sprinkling marjoram on your dinner every night to help add variety in flavor. It can often be used as a substitute for oregano in cooking and brings in a distinct flavor to dishes.
This section deals only with approaches for curing the underlying condition of diabetes type 1, by enabling the body to endogenously, in vivo, produce insulin in response to the level of blood glucose. It does not cover other approaches, such as, for instance, closed-loop integrated glucometer/insulin pump products, which could potentially increase the quality-of-life for some who have diabetes type 1, and may by some be termed "artificial pancreas".

These are a relatively new class of drugs used to treat type 2 diabetes. They are oral medications that work by blocking the kidneys' reabsorption of glucose, leading to increased glucose excretion and reduction of blood sugar levels. The US FDA approved the SGLT2 inhibitors canagliflozin (Invokana) in March 2013 and dapagliflozin (Farxiga) in January 2014.
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