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).
For Type 1 diabetics there will always be a need for insulin injections throughout their life. However, both Type 1 and Type 2 diabetics can see dramatic effects on their blood sugars through controlling their diet, and some Type 2 diabetics can fully control the disease by dietary modification. As diabetes can lead to many other complications it is critical to maintain blood sugars as close to normal as possible and diet is the leading factor in this level of control.
When the weight loss lessens the liver and pancreas fat, the insulin-producing beta cells in the pancreas come to life again. "Almost everyone will return to normal if they lose a substantial amount of weight," Taylor says. "This is a simple disease." What's yet to be figured out, he says, is why the weight loss doesn't lead to a reversal in everyone.
For our very insulin resistant patients with type 2 diabetes, after starting out at 30 grams, a few months later most of our patients find that they can increase their daily carb intake to 40 or 50 grams. Fifty grams of total carbohydrate typically allows 4-5 servings of non-starchy vegetables, 2 oz of nuts, and 3 oz of berry fruit (which includes avocado – but obviously you’d need to share it with someone unless it’s a tiny one!)”
Each day in the United States, some 18 million people with diabetes walk a tightrope between too little sugar in the bloodstream and too much. Too little, which may come from a complication of medication, and they may quickly be overcome by dizziness, fatigue, headache, sweating, trembling, and, in severe cases, loss of consciousness and coma. Too much, which can happen after eating too much, especially if the person is older and overweight, and the person may experience weakness, fatigue, excessive thirst, labored breathing, and loss of consciousness.
Acupuncture is a procedure where a practitioner inserts very thin needles into specific points on your skin. Some scientists say that acupuncture triggers the release of the body's natural painkillers. Acupuncture has been shown to offer relief from chronic pain and is sometimes used by people with neuropathy, the painful nerve damage that can happen with diabetes.

Use of a "Diabetes Coach" is becoming an increasingly popular way to manage diabetes. A Diabetes Coach is usually a Certified diabetes educator (CDE) who is trained to help people in all aspects of caring for their diabetes. The CDE can advise the patient on diet, medications, proper use of insulin injections and pumps, exercise, and other ways to manage diabetes while living a healthy and active lifestyle. CDEs can be found locally or by contacting a company which provides personalized diabetes care using CDEs. Diabetes Coaches can speak to a patient on a pay-per-call basis or via a monthly plan.

The National Center for Complementary and Alternative Medicine, part of the National Institutes of Health, defines complementary and alternative medicine as a "group of diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine." Complementary medicine is used with conventional treatments, whereas alternative medicine is used instead of conventional medicine.
Glycated hemoglobin (A1C) test. This blood test indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached. An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes. A result between 5.7 and 6.4 percent is considered prediabetes, which indicates a high risk of developing diabetes. Normal levels are below 5.7 percent.
Studies conducted in the United States[43] and Europe[44] showed that drivers with type 1 diabetes had twice as many collisions as their non-diabetic spouses, demonstrating the increased risk of driving collisions in the type 1 diabetes population. Diabetes can compromise driving safety in several ways. First, long-term complications of diabetes can interfere with the safe operation of a vehicle. For example, diabetic retinopathy (loss of peripheral vision or visual acuity), or peripheral neuropathy (loss of feeling in the feet) can impair a driver’s ability to read street signs, control the speed of the vehicle, apply appropriate pressure to the brakes, etc.
Optimal management of diabetes involves patients measuring and recording their own blood glucose levels. By keeping a diary of their own blood glucose measurements and noting the effect of food and exercise, patients can modify their lifestyle to better control their diabetes. For patients on insulin, patient involvement is important in achieving effective dosing and timing.
Thank you Dr. Hallberg!! I am a Family Nurse Practitioner who did tele-medicine for 5 years before retiring. At 66 years of age my doctor diagnosed me with Type II Diabetes. I refused to take the medication and instead opted for a 6 month trial to lose enough weight to make the difference. After 4 months I’d lost 8 pounds and still had high blood sugars. Then my husband’s PCP recommended watching your TedTalk. That was the beginning and we both jumped into LCHF/Keto with both feet using Diet Doctor and you as our main resources. My husband has lost 38 pounds and I have lost 42 pounds since November 2017. More importantly my lab results today were a HgbA1c of 5.3 with average blood glucose of 105. I have about 50 more pounds to go to be at a healthier weight BUT I owe you a big thank you!! Now I’m working to encourage others of my friends, family and coaching clients to give LCHF/Keto a try! Thanks!!!!
Alternative: “I’m a fat-atarian,” says DeLaney, who tells her patients to avoid low-fat foods. She encourages them to eat whole-fat dairy products, egg yolks, butter, olive oil, and avocado. “Restoring healthful fats to our diets as well as eliminating trans fats and all refined oils that help deplete our fat and vitamin stores will help nourish the body and reduce the need for diabetes medication.”
Until the findings are reproduced consistently, and cinnamon has been show to provide a meaningful improvement in relevant measures, there is no persuasive evidence to suggest that cinnamon has potential as a useful treatment option. Drugs that work, work consistently and provide meaningful improvements in measures of the disease. Why doesn’t cinnamon work?  There may be an active ingredient, but it’s present in low concentrations, and varies in content between the different batches of cinnamon used in the different trials. In that case, the active ingredient needs to be standardized and possibly isolated, which would make it a drug treatment.  Or this could be yet another example of a supplement that looks promising in early studies, only to see the effect disappear as the trials get larger and control for bias more effectively.
It is great to read these columns of Diabetes. I have tried feenugreek but it raises my blood pressure. Since, I am a patient of High Blood pressure, this does not help me. I am 65, control my diet, walk daily for 6-7 km too and take my medication regularly but still blood sugar is out of control. Fasting is usually 150. Any suggestions from friends. Thanks and Cheers for all.
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.
The problem, of course, has not been solved – the sugar bowl is still overflowing. You’ve only moved sugar from the blood (where you could see it) into the body (where you couldn’t see it). So, the very next time you eat, the exact same thing happens. Sugar comes in, spills out into the blood and you take metformin to cram the sugar back into the body. This works for a while, but eventually, the body fills up with sugar, too. Now, that same dose of metformin cannot force any more sugar into the body.
While Type 1 Diabetes is an autoimmune disorder that seems to affect people with certain gene types, Type 2 Diabetes is triggered by lifestyle choices, such as poor diet and obesity. Eating sugary and processed foods contributes to weight gain, and that extra body fat can be released into the bloodstream, impeding the absorption of insulin and other chemicals related to metabolism. When metabolism is slowed, weight gain is more likely, and the cycle repeats itself. Treatment for Type 2 Diabetes is multifaceted, often including insulin injections, a host of medications, and lifestyle modifications such as diet changes and exercise regimens.

Carbs and fats provide energy for the body. When carbs are limited in the diet, fat becomes the preferred and efficient fuel source. When you reduce your intake of one macronutrient, you have to increase your intake of at least one other macronutrient—otherwise you’ll feel hungry and not have enough energy. The low-fat craze started with flawed science that incorrectly stated that fat was dangerous. In a low carb, high-fat diet, fat provides you with the energy your body needs, and also helps knock out hunger and cravings.
Other research conducted at the same institute studied possible regeneration of the islets of langerhans in rats that were made diabetic for the study and then given gymnema sylvestre leaf extracts. The diabetic rats were able to double the number of their islets and beta cell numbers. Researchers felt that the herbal therapy was able to bring blood sugar stability by repairing the pancreas and increasing insulin secretion.
This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Triglycerides are a common form of fat that we digest. Triglycerides are the main ingredient in animal fats and vegetable oils. Elevated levels of triglycerides are a risk factor for heart disease, heart attack, stroke, fatty liver disease, and pancreatitis. Elevated levels of triglycerides are also associated with diseases like diabetes, kidney disease, and medications (for example, diuretics, birth control pills, and beta blockers). Dietary changes, and medication if necessary can help lower triglyceride blood levels.
Until the findings are reproduced consistently, and cinnamon has been show to provide a meaningful improvement in relevant measures, there is no persuasive evidence to suggest that cinnamon has potential as a useful treatment option. Drugs that work, work consistently and provide meaningful improvements in measures of the disease. Why doesn’t cinnamon work?  There may be an active ingredient, but it’s present in low concentrations, and varies in content between the different batches of cinnamon used in the different trials. In that case, the active ingredient needs to be standardized and possibly isolated, which would make it a drug treatment.  Or this could be yet another example of a supplement that looks promising in early studies, only to see the effect disappear as the trials get larger and control for bias more effectively.
I made a mistake in an earlier comment that I need to correct. I thought the VLDL represented the very small particles, and that is totally wrong. Here are the actual test results of the very small particles from a Quest Diagnostics after about 18 months on a ketogenic diet, with abundant use of MCT oil as caprylic acid. If the administrator deletes that comment, to avoid confusion, that would be fine with me. I can also provide much more data, as that test is pretty comprehensive.
To drop pounds, Galati emphasizes using portion control, avoiding processed foods, and eating fresh vegetables, fruits, and fresh lean meat, poultry, and fish. Regular exercise should also be part of the program. Typically, he talks to patients about first targeting a weight loss goal of 10 percent. Once that is achieved, they typically strive for increments of 5 percent to 7 percent on a 6- to 12-month basis.
O-3 oils, with both EPA and DHA, can help patients by lowering lipid panels (reduce triglycerides and cholesterol); reducing insulin resistance; reducing pain and inflammation so exercise and sleep are easier; reducing the risk of cardiovascular disease by lowering blood pressure; reducing the risk of dementia and Alzheimer’s disease; preventing and treating anxiety and depression; and promoting antioxidant actions in the body and brain to help reduce developing diabetic complications.
Greek clover is an annual herb with aromatic seeds having medicinal properties. It is also known as fenugreek, and is largely used in curry. Greek clover has properties to lower down the levels of glucose in the body, which, in turn, controls diabetes. Also, when given in changeable doses of 25 gm to 100 gm on a daily basis, it was found to diminish reactive hyperglycemia in diabetic patients. Furthermore, levels of glucose, serum cholesterol, and triglycerides were also appreciably reduced. Alternatively, one can just stir two teaspoons of Greek clover seeds in powder form in warm milk and consume on a regular basis; it will control the levels of blood sugar and keep diabetes at bay. In case one does not want to have the powder in milk, seeds can be eaten wholly, too.
High doses of magnesium may cause diarrhea, nausea, loss of appetite, muscle weakness, difficulty breathing, low blood pressure, irregular heart rate, and confusion. It can interact with certain medications, such as those for osteoporosis, high blood pressure (calcium channel blockers), as well as some antibiotics, muscle relaxants, and diuretics.​
A further danger of insulin treatment is that while diabetic microangiopathy is usually explained as the result of hyperglycemia, studies in rats indicate that the higher than normal level of insulin diabetics inject to control their hyperglycemia may itself promote small blood vessel disease.[14] While there is no clear evidence that controlling hyperglycemia reduces diabetic macrovascular and cardiovascular disease, there are indications that intensive efforts to normalize blood glucose levels may worsen cardiovascular and cause diabetic mortality.[42]

Reversal of type 2 diabetes to normal metabolic control by either bariatric surgery or hypocaloric diet allows for the time sequence of underlying pathophysiologic mechanisms to be observed. In reverse order, the same mechanisms are likely to determine the events leading to the onset of hyperglycemia and permit insight into the etiology of type 2 diabetes. Within 7 days of instituting a substantial negative calorie balance by either dietary intervention or bariatric surgery, fasting plasma glucose levels can normalize. This rapid change relates to a substantial fall in liver fat content and return of normal hepatic insulin sensitivity. Over 8 weeks, first phase and maximal rates of insulin secretion steadily return to normal, and this change is in step with steadily decreasing pancreatic fat content. The difference in time course of these two processes is striking. Recent information on the intracellular effects of excess lipid intermediaries explains the likely biochemical basis, which simplifies both the basic understanding of the condition and the concepts used to determine appropriate management. Recent large, long-duration population studies on time course of plasma glucose and insulin secretion before the diagnosis of diabetes are consistent with this new understanding. Type 2 diabetes has long been regarded as inevitably progressive, requiring increasing numbers of oral hypoglycemic agents and eventually insulin, but it is now certain that the disease process can be halted with restoration of normal carbohydrate and fat metabolism. Type 2 diabetes can be understood as a potentially reversible metabolic state precipitated by the single cause of chronic excess intraorgan fat.
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“The problem is we don’t treat diabetes as a dietary problem; we treat it with a lot of drugs, and that never addresses the root problem of the diabetes,” says principal investigator Jason Fung, MD, a kidney specialist at Scarborough and Rouge Hospital in Toronto, Canada, and author of The Complete Guide to Fasting,and The Obesity Code, a 2016 book thought to help popularize intermittent fasting.
Studies funded by the National Institutes of Health (NIH) have demonstrated that face-to-face training programs designed to help individuals with type 1 diabetes better anticipate, detect, and prevent extreme BG can reduce the occurrence of future hypoglycemia-related driving mishaps.[51][52][53] An internet-version of this training has also been shown to have significant beneficial results.[54] Additional NIH funded research to develop internet interventions specifically to help improve driving safety in drivers with type 1 diabetes is currently underway.[55]
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.
Diabetics often find their bodies swinging wildly out of equilibrium. In Type 1 Diabetes, the body attacks insulin-producing cells in the pancreas, causing a rise in blood sugar levels. In Type 2 Diabetes there is insufficient insulin produced in the pancreas, which slows the metabolism and elevates blood sugar levels. Both conditions, if not treated correctly, can cause a host of unpleasant side effects including high blood pressure, neuropathy, kidney damage, and in extreme cases amputation and even death.
If diagnosed at an early stage, diabetes can be controlled with some minor lifestyle changes. A person can straightaway keep a check on his/her diet and start exercising on a regular basis. At any stage of diabetes, however, lifestyle changes are required. Therefore, it is better to imbibe these changes in one's life as soon as one comes to know about this disease.

There has been a good amount of attention and time spent on discussing the “reversal” of diabetes, but there’s not been a lot of good facts to explain what this means. First, type 1 diabetes (an autoimmune disease) cannot be reversed, cured or avoided – period. It can be managed with insulin and made easier with good lifestyle choices like staying active and eating a healthy diet.
Pramlintide is administered by injection just prior to meals (three times each day) for type 1 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control despite optimal insulin therapy and type 2 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control with optimal insulin therapy.
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