The physician can also make referrals to a wide variety of professionals for additional health care support. In the UK a patient training course is available for newly diagnosed diabetics (see DESMOND). In big cities, there may be diabetes centers where several specialists, such as diabetes educators and dietitians, work together as a team. In smaller towns, the health care team may come together a little differently depending on the types of practitioners in the area. By working together, doctors and patients can optimize the healthcare team to successfully manage diabetes over the long term.

Because blood sugar levels fluctuate throughout the day and glucose records are imperfect indicators of these changes, the percentage of hemoglobin which is glycosylated is used as a proxy measure of long-term glycemic control in research trials and clinical care of people with diabetes. This test, the hemoglobin A1c or glycosylated hemoglobin reflects average glucoses over the preceding 2–3 months. In nondiabetic persons with normal glucose metabolism the glycosylated hemoglobin is usually 4–6% by the most common methods (normal ranges may vary by method).


For type 2 diabetics, diabetic management consists of a combination of diet, exercise, and weight loss, in any achievable combination depending on the patient. Obesity is very common in type 2 diabetes and contributes greatly to insulin resistance. Weight reduction and exercise improve tissue sensitivity to insulin and allow its proper use by target tissues.[40] Patients who have poor diabetic control after lifestyle modifications are typically placed on oral hypoglycemics. Some Type 2 diabetics eventually fail to respond to these and must proceed to insulin therapy. A study conducted in 2008 found that increasingly complex and costly diabetes treatments are being applied to an increasing population with type 2 diabetes. Data from 1994 to 2007 was analyzed and it was found that the mean number of diabetes medications per treated patient increased from 1.14 in 1994 to 1.63 in 2007.[41]
Recent research shows that the first step in Diabetes management should be for patients to be put on a low carb diet. Patients that are put on a high carb diet find it very difficult to maintain normal blood glucose levels. Patients that are put on a low carb or restricted carbohydrate diet, manage to maintain near normal blood glucose levels and A1cs.[29][30][31][32][33][34][35][36][37]

“In the realm of fatty liver disease, which is highly associated with either prediabetes or fully diagnosed type 2 diabetes, we do know that decreased fat and decreased weight are associated with far better glucose control,” says Galati, who is the author of Eating Yourself Sick: How to Stop Obesity, Fatty Liver, and Diabetes From Killing You and Your Family. “This research reinforces the idea that patients with type 2 diabetes who are obese — which is the vast majority — can improve their blood sugar control as well as their long-term outlook with weight loss.”
There are many promising studies suggesting chromium supplementation may be effective, but they are far from conclusive. For example, a small study published in the journal Diabetes Care compared the diabetes medication sulfonylurea taken with 1,000 mcg of chromium to sulfonylurea taken with a placebo. After 6 months, people who did not take chromium had a significant increase in body weight, body fat, and abdominal fat, whereas people taking the chromium had significant improvements in insulin sensitivity.
Diabetes is a progressive disease however it CAN be reversed. Bariatric surgery results have proven that losing weight in morbidly obese patients with Type 2 Diabetes reverses the disease state. Bariatric surgery outcomes have been studied over 10 years with lower rates of mortality and morbidity. Bypass surgery patients normalize blood sugars within days of the procedure.

The Diabetes Treatment Center at Desert Springs Hospital was the first inpatient diabetes program in the United States to earn a Certificate of Distinction for Advanced Inpatient Diabetes Care from The Joint Commission. This means that the Hospital meets rigorous standards to control patient blood-sugar levels while they are hospitalized — whether they are experiencing diabetes complications at the time or admitted for an unrelated condition. This is important since controlling blood glucose can be difficult when patients are fighting infections, stressed or on certain medications.
Consider a form of regular fasting (more to come in a later blog), such as intermittent fasting or time-restricted feeding (TRF). TRF means eating your calories during a specific window of the day, and choosing not to eat food for the rest. It’s a great way to reduce insulin levels in your body and help undo the effects of chronically elevated levels.
Second, hypoglycemia can affect a person’s thinking process, coordination, and state of consciousness.[45][46] This disruption in brain functioning is called neuroglycopenia. Studies have demonstrated that the effects of neuroglycopenia impair driving ability.[45][47] A study involving people with type 1 diabetes found that individuals reporting two or more hypoglycemia-related driving mishaps differ physiologically and behaviorally from their counterparts who report no such mishaps.[48] For example, during hypoglycemia, drivers who had two or more mishaps reported fewer warning symptoms, their driving was more impaired, and their body released less epinephrine (a hormone that helps raise BG). Additionally, individuals with a history of hypoglycemia-related driving mishaps appear to use sugar at a faster rate[49] and are relatively slower at processing information.[50] These findings indicate that although anyone with type 1 diabetes may be at some risk of experiencing disruptive hypoglycemia while driving, there is a subgroup of type 1 drivers who are more vulnerable to such events.
Gene therapy can be used to turn duodenum cells and duodenum adult stem cells into beta cells which produce insulin and amylin naturally. By delivering beta cell DNA to the intestine cells in the duodenum, a few intestine cells will turn into beta cells, and subsequently adult stem cells will develop into beta cells. This makes the supply of beta cells in the duodenum self replenishing, and the beta cells will produce insulin in proportional response to carbohydrates consumed.[78]
Many manufacturers offer pen delivery systems. Such systems resemble the ink cartridge in a fountain pen. A small, pen-sized device holds an insulin cartridge (usually containing 300 units). Cartridges are available for the most widely used insulin formulations. The amount of insulin to be injected is dialed in, by turning the bottom of the pen until the required number of units is seen in the dose-viewing window. The tip of the pen consists of a needle that is replaced with each injection. A release mechanism allows the needle to penetrate just under the skin and deliver the required amount of insulin.
Magnesium is high in green leafy vegetables, nuts, beans, and grains, but we remove most beans and all grains from the diet of patients, which is why using magnesium as part of a natural remedy for diabetes can be beneficial. Low intracellular magnesium can cause insulin resistance. Dosing of up to 500 mg a day is fine, but higher than that may result in diarrhea in patients.
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.

Parslane seeds have strong medicinal value and have been used to keep a check on blood sugar since ages. The compounds of parslane seeds help the body to produce insulin in a natural manner. Just consume a teaspoonful of parslane seeds with half a coup of water on a regular basis (everyday) for 4-5 months. It is one of the simpler, but effective home remedies for diabetes.
Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin.
“I have many ways to help patients manage diabetes, but it’s very hard to reverse,” says Dr. Rita Louard, director of the Clinical Diabetes Program at Montefiore Health System in Bronx, New York. Still, some diabetes experts will use the word “reverse” when talking about this topic, Louard says, acknowledging the controversy that exists when discussing diabetes reversal.

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. 
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.
All carbohydrates – to some degree at least – will raise your blood insulin levels. That is why I consider type 2 diabetes a form of “carbohydrate intolerance”. Protein can also raise levels but to a much lesser degree. The only macronutrient that keeps your insulin levels and, therefore, your blood sugar stable is FAT! Therefore, if you are trying to reduce insulin levels, you need to reduce your amount of certain carbohydrates and replace them instead with healthy, natural fats.
8. Get your protein from vegetable sources, fish, and dairy: Plant-based proteins have a balanced nutritional profile (providing fiber, fat, and protein) and are low in saturated fats. Some saturated fats, like those that are heavily processed or from unhealthy animals, can be dangerous, as they raise cholesterol levels and contribute to heart disease. Dairy from pastured animals (such as yogurt) that is low in sugar provides protein, carbohydrates, and beneficial probiotics, and non-mercury contaminated, wild caught fish is a great source of protein that is low in saturated fat and high in amino acids and fatty acids like Omega-3.
9. Exercise! Moderate to vigorous exercise that includes both cardio and strength building components are great ways to keep the body fit. Exercise can also contribute to a more positive outlook on life, which can boost the immune system, provide capacity for healthier coping strategies, and decrease stress. Yoga, hiking, and jogging are all good options. To boost your metabolism, make sure your work-outs incorporate strength training. It is also far more effective to incorporate high intensity interval workouts to your regime, such as sprinting and HIIT workouts.
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.
Most doctors, dietitians and diabetes specialists claim that type 2 diabetes is a chronic and progressive disease. The American Diabetes Association, for example, almost proudly proclaims this on its website. Once you get the diagnosis, it’s a life sentence. But, it’s actually a great big lie. Type 2 diabetes is almost always reversible and this is almost ridiculously easy to prove. This is great news for the more than 50% of American adults who have been diagnosed with pre-diabetes or diabetes. Recognizing this truth is the crucial first step in reversing your diabetes or pre-diabetes. Actually, it something that most people already instinctively recognized to be true.
“Whether it be the patient saying for the fifth time ‘I will start watching my diet and start exercising,’ or a physician saying ‘the A1c is close to goal and I don’t really want to add yet another medication and copay, we will wait and see what happens in another 3 months,’ the end result is lack of intensification and A1c goal attainment,” Pantalone said.
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!

Following these five principles can significantly influence blood glucose levels. However, not everyone responds the same. Some people with have immediate low blood glucose levels. Others may experience a slow and steady improvement of glucose control. Some may have temporary high glucose levels. Our experience is that this is transient and most people will improve.
Is this okay to use against gestational diabetes? I have PCOS and am pre-diabetic. I actually followed this way of eating (before seeing the Ted talk) with my first GD pregnancy and was scolded by the nutritionist. Yet my blood sugar was kept below 98 and I lost 15 lbs and our son’s blood sugar was perfect with an apgar of 10. So I’m thinking of just going this way again despite the ADA’s recommendations.
Since type 2 diabetes is merely excessive glucose in the body, burning it off will reverse the disease. While it may sound severe, fasting has been practiced for at least 2000 years. It is the oldest dietary therapy known. Literally millions of people throughout human history have fasted without problems. If you are taking prescription medications, you should seek the advice of a physician. But the bottom line comes to this.
Yet Gabbay says preliminary human studies with positive results, like this week’s in BMJ Case Reports, suggest the diet is worthy of further study in a larger population over a longer period of time. For now, he cautions people with diabetes, especially those on insulin and sulfonylureas to lower their blood sugar, against trying intermittent fasting before speaking with their healthcare provider.
Most lifestyle interventions focus on eating less and exercising more. But many patients have tried this and have seen minimal results, while also fighting unsustainable hunger and cravings. The problem with these programs is that they tend to be high in carbs, even if they are cutting back on calories. When you eat a high-carb diet, the resulting increase in your blood sugar triggers an insulin response in your body, and insulin blocks your body’s ability to burn fat. Insulin actively blocks the breakdown of stored body fat, meaning that as long as insulin is high, it will be very difficult to lose weight—even if you are eating very little.
Known as gurmar, or “sugar destroyer,” in Aryuvedic medicine, Gymnema has consistently shown benefits in patients with diabetes. The most active part of Gymnema seems to be gymnemic acids, and many products list the percentage each capsule contains. Analyses of the herb for diabetes have shown it may be helpful in lowering high blood sugar levels. It can delay glucose absorption from the intestine. It was shown to regenerate pancreatic tissues, allowing more insulin to be produced, and help regulate insulin secretion. It also increases the utilization of glucose by the cell, reducing insulin resistance and decreasing appetite, especially for sweets. I usually use it in capsules, or in liquid form in some patients. Due to Gymnema having a very similar shape to glucose, it can fit into the taste bud receptors for sugar; it thus has unbelievable power to actually prevent the taste of sweets in the mouth for up to 1.5 hours. When I have a patient who is still struggling to not eat cake and cookies and so forth at parties or celebrations (or just in general), I will give her a tincture of Gymnema sylvestre. This is one of my favorite herbs for diabetes. In capsule form doses of 400 to 2,400 mg a day are recommended.
The term diabetes includes several different metabolic disorders that all, if left untreated, result in abnormally high concentration of a sugar called glucose in the blood. Diabetes mellitus type 1 results when the pancreas no longer produces significant amounts of the hormone insulin, usually owing to the autoimmune destruction of the insulin-producing beta cells of the pancreas. Diabetes mellitus type 2, in contrast, is now thought to result from autoimmune attacks on the pancreas and/or insulin resistance. The pancreas of a person with type 2 diabetes may be producing normal or even abnormally large amounts of insulin. Other forms of diabetes mellitus, such as the various forms of maturity onset diabetes of the young, may represent some combination of insufficient insulin production and insulin resistance. Some degree of insulin resistance may also be present in a person with type 1 diabetes.
Low blood sugar (hypoglycemia). If your blood sugar level drops below your target range, it's known as low blood sugar (hypoglycemia). Your blood sugar level can drop for many reasons, including skipping a meal, inadvertently taking more medication than usual or getting more physical activity than normal. Low blood sugar is most likely if you take glucose-lowering medications that promote the secretion of insulin or if you're taking insulin.
“Diabetes type 1 is very different from your standard disease. Insulin requirements vary greatly from one day to another and there is no way patients can know what they need,” Roman Hovorka, Professor at the University of Cambridge, explained to me during an interview. His research group is working on the development of an algorithm that can accurately predict insulin requirements for a specific patient at any moment.
Diabetes is a growing global epidemic that affects millions of people worldwide, but recent studies on various natural remedies for diabetes provide hope for reversing this disease. From adopting a fasting-mimicking diet to incorporating superfoods like spirulina and ginseng, there are lots of natural options that provide long-lasting results. Committing to healthy choices and positive lifestyle changes has helped many people overcome the disease, proving that Diabetes does not have to be a life sentence.
Most of those foods are refined, processed starches and sugars. Lots of diets place people on a restricted plan that doesn’t allow the refined, processed starches and sugars, and people lose weight, regain good BG control and feel better. However, in most cases, the weight comes back and weight creeps up and BG begins rising again due to the inability to sustain many of these diets.

Yet Gabbay says preliminary human studies with positive results, like this week’s in BMJ Case Reports, suggest the diet is worthy of further study in a larger population over a longer period of time. For now, he cautions people with diabetes, especially those on insulin and sulfonylureas to lower their blood sugar, against trying intermittent fasting before speaking with their healthcare provider.


Recent research shows that the first step in Diabetes management should be for patients to be put on a low carb diet. Patients that are put on a high carb diet find it very difficult to maintain normal blood glucose levels. Patients that are put on a low carb or restricted carbohydrate diet, manage to maintain near normal blood glucose levels and A1cs.[29][30][31][32][33][34][35][36][37]

If however, type 2 diabetes is a result of insulin resistance and being overweight, there is excellent evidence that exercise, decreasing added sugars and saturated fats in the diet, choosing low glycaemic index foods and losing weight – particularly around the abdominal region, can improve blood glucose levels to the extent that it seems like diabetes has been reversed.
“People need to understand the continuum of diabetes,” she says. “If they’re on an upward trajectory of insulin resistance and a downward trajectory of insulin production weight loss, healthful eating and physical activity will slow down the insulin-loss trajectory and improve insulin sensitivity.” But, she says, “If they gain weight back, the diabetes comes back.”
I agree with the group consensus. Type 2 diabetes can be reversed, or controlled, as long as the prescription sticks. Many people don’t know this and the word needs to be spread! I’ve worked with patients who have been able to reach a healthy BMI and eliminate the need for medications to treat type 2 diabetes after adopting a plant-based diet. A prescription to focus on increasing fiber intake (http://www.pcrm.org/sites/default/files/pdfs/health/dietary-fiber-checklist.pdf) instead of counting carbohydrates makes it easy to add, instead of subtract, from each meal. It’s a win-win for both patients and providers.
The good news though is that this can be delayed, and we can do something about preventing and managing the early stages of diabetes through simple lifestyle modifications, and the body will remember these efforts if they can be maintained early in the diagnosis and for as long as possible. This in turn will delay the progression of diabetes and development of diabetes complications.

The twin cycle hypothesis of the etiology of type 2 diabetes. During long-term intake of more calories than are expended each day, any excess carbohydrate must undergo de novo lipogenesis, which particularly promotes fat accumulation in the liver. Because insulin stimulates de novo lipogenesis, individuals with a degree of insulin resistance (determined by family or lifestyle factors) will accumulate liver fat more readily than others because of higher plasma insulin levels. In turn, the increased liver fat will cause relative resistance to insulin suppression of hepatic glucose production. Over many years, a modest increase in fasting plasma glucose level will stimulate increased basal insulin secretion rates to maintain euglycemia. The consequent hyperinsulinemia will further increase the conversion of excess calories to liver fat. A cycle of hyperinsulinemia and blunted suppression of hepatic glucose production becomes established. Fatty liver leads to increased export of VLDL triacylglycerol (85), which will increase fat delivery to all tissues, including the islets. This process is further stimulated by elevated plasma glucose levels (85). Excess fatty acid availability in the pancreatic islet would be expected to impair the acute insulin secretion in response to ingested food, and at a certain level of fatty acid exposure, postprandial hyperglycemia will supervene. The hyperglycemia will further increase insulin secretion rates, with consequent enhancement of hepatic lipogenesis, spinning the liver cycle faster and driving the pancreas cycle. Eventually, the fatty acid and glucose inhibitory effects on the islets reach a trigger level that leads to a relatively sudden onset of clinical diabetes. Figure adapted with permission from Taylor (98).
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These substances are not considered to be medications by the US FDA and are therefore not regulated as such. This means that there are no standards in place to ensure that a given product contains the substance or dose as described on the label. There are also no requirements to perform studies showing that the products are safe or effective. Side effects of supplements are typically not well understood, and some supplements can interfere with the action of medications.
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