They will always have the pre-diabetes diagnosis and have the potential to develop type 2 diabetes if aggressive dietary, exercise and or medication is not followed. It is possible to achieve a normal non-diabetic HbA1c after this – virtually not having any clinical evidence of the pre-diabetes, however the disease process is still there and being held at bay.
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Suppose your friend is diagnosed with type 2 diabetes, then works hard to lose 50 pounds. He takes himself off all his medications and his blood sugars are now normal. What would you say to him? Probably something like “Great job. You’re really taking care of yourself. Keep it up!” What you wouldn’t say is something like “You’re such a dirty, filthy liar. My doctor says this is a chronic and progressive disease so you must be lying ”. It seems perfectly obvious that diabetes reversed because your friend lost all that weight. And that’s the point. The disease is reversible.
The more intense the exercise, the better. According to the British diabetes association diabetes.co.uk, high-intensity interval training (HIIT) may be better for weight loss and glucose control than continuous aerobic activity like jogging. HIIT involves alternating between short bursts of increased intensity exercise and rest — for instance, running and then walking on and off throughout the workout.
Refined sugar: Refined sugar rapidly spikes blood glucose, and soda, fruit juice and other sugary beverages are the worst culprits. These forms of sugar enter the bloodstream rapidly and can cause extreme elevations in blood glucose. (7) Even though natural sweeteners like raw honey and maple syrup are better options, they can still affect blood sugar levels, so only use these foods on occasion. Your best option is to switch to stevia, a natural sweetener that won’t have as much of an impact.
So, can you “reverse” diabetes? No – but you can manage it very well with the help of a Certified Diabetes Educator (CDE) and a knowledgeable primary care physician or endocrinologist. There are even prescription apps available to bridge the care that your clinicians can give you between visits and apps that offer virtual CDE’s for greater assistance.
As diabetes is a prime risk factor for cardiovascular disease, controlling other risk factors which may give rise to secondary conditions, as well as the diabetes itself, is one of the facets of diabetes management. Checking cholesterol, LDL, HDL and triglyceride levels may indicate hyperlipoproteinemia, which may warrant treatment with hypolipidemic drugs. Checking the blood pressure and keeping it within strict limits (using diet and antihypertensive treatment) protects against the retinal, renal and cardiovascular complications of diabetes. Regular follow-up by a podiatrist or other foot health specialists is encouraged to prevent the development of diabetic foot. Annual eye exams are suggested to monitor for progression of diabetic retinopathy.
Some studies suggest that low magnesium levels may worsen blood glucose control in type 2 diabetes. There is also some evidence that magnesium supplementation may help with insulin resistance. For example, a study examined the effect of magnesium or placebo in 63 people with type 2 diabetes and low magnesium levels who were taking the medication glibenclamide. After 16 weeks, people who took magnesium had improved insulin sensitivity and lower fasting glucose levels.
Given the consequences of diabetes, self-management is something I want to encourage, not discourage. Without a commitment from the patient to take an active role in managing their diabetes, any treatment plan is doomed to fail. So is self-treatment with supplements a wise idea? There’s an array available, and patients regularly ask about the latest treatment “Big Pharma doesn’t want you to know about”. That treatment used to be chromium. Ginseng was popular for a time, too. Fenugreek and bitter melon are used as well. The treatment that seems most popular now is cinnamon. Like any other herbal remedy, most sources will tell you that it’s been used for “thousands of years” as a medicinal herb. As a treatment for diabetes, I have my doubts. While reports of diabetes go back to 1552 BCE, the ability to effectively measure any diabetes treatment only goes back a few decades. Interest in cinnamon as a treatment seems to have started with in vitro tests but gained some plausibility in 2003, when a study from Alam Khan suggested several grams of cassia cinnamon per day could lower fasting blood glucose. Khan randomized Type 2 diabetes to 1g, 3g, or 6g of cinnamon for 40 days. All three groups improved their fasting blood glucose, and blood lipid levels, but there was no effect on A1C.
Currently, one goal for diabetics is to avoid or minimize chronic diabetic complications, as well as to avoid acute problems of hyperglycemia or hypoglycemia. Adequate control of diabetes leads to lower risk of complications associated with unmonitored diabetes including kidney failure (requiring dialysis or transplant), blindness, heart disease and limb amputation. The most prevalent form of medication is hypoglycemic treatment through either oral hypoglycemics and/or insulin therapy. There is emerging evidence that full-blown diabetes mellitus type 2 can be evaded in those with only mildly impaired glucose tolerance.
Like the sulfonylureas, meglitinides is a class of drugs that work by promoting insulin secretion from the pancreas. Unlike the sulfonylureas, which last longer in the body, repaglinide (Prandin) and nateglinide (Starlix) are very short acting, with peak effects within one hour. For this reason, they are given up to three times a day just before meals.