Poor glycemic control refers to persistently elevated blood glucose and glycosylated hemoglobin levels, which may range from 200–500 mg/dl (11–28 mmol/L) and 9–15% or higher over months and years before severe complications occur. Meta-analysis of large studies done on the effects of tight vs. conventional, or more relaxed, glycemic control in type 2 diabetics have failed to demonstrate a difference in all-cause cardiovascular death, non-fatal stroke, or limb amputation, but decreased the risk of nonfatal heart attack by 15%. Additionally, tight glucose control decreased the risk of progression of retinopathy and nephropathy, and decreased the incidence peripheral neuropathy, but increased the risk of hypoglycemia 2.4 times.[21]

Type 2 Diabetes plagues the United States, but is even more rampant in many developing countries, triggered in large part by a shift to less healthy nutritional habits and increasingly sedentary lifestyles, all fueled by the drive of rapid urbanization and economic growth. Asia is one of the largest epicenters of this disease, with an estimated 60 percent of the world’s diabetes patients living in that region.


The vast majority of people with diabetes, on the other hand, have the type 2 form, which is sometimes referred to as adult-onset diabetes, even though more and more children these days are developing this type. Lifestyle changes can play a vital role in controlling type 2; they are generally the initial and preferred method for regulating blood sugar levels, although oral medication and even insulin may eventually need to be added to the treatment regimen.
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.
Glycemic control is a medical term referring to the typical levels of blood sugar (glucose) in a person with diabetes mellitus. Much evidence suggests that many of the long-term complications of diabetes, especially the microvascular complications, result from many years of hyperglycemia (elevated levels of glucose in the blood). Good glycemic control, in the sense of a "target" for treatment, has become an important goal of diabetes care, although recent research suggests that the complications of diabetes may be caused by genetic factors[15] or, in type 1 diabetics, by the continuing effects of the autoimmune disease which first caused the pancreas to lose its insulin-producing ability.[16]
Stem cell research has also been suggested as a potential avenue for a cure since it may permit regrowth of Islet cells which are genetically part of the treated individual, thus perhaps eliminating the need for immuno-suppressants.[48] This new method autologous nonmyeloablative hematopoietic stem cell transplantation was developed by a research team composed by Brazilian and American scientists (Dr. Julio Voltarelli, Dr. Carlos Eduardo Couri, Dr Richard Burt, and colleagues) and it was the first study to use stem cell therapy in human diabetes mellitus This was initially tested in mice and in 2007 there was the first publication of stem cell therapy to treat this form of diabetes.[73] Until 2009, there was 23 patients included and followed for a mean period of 29.8 months (ranging from 7 to 58 months). In the trial, severe immunosuppression with high doses of cyclophosphamide and anti-thymocyte globulin is used with the aim of "turning off" the immunologic system", and then autologous hematopoietic stem cells are reinfused to regenerate a new one. In summary it is a kind of "immunologic reset" that blocks the autoimmune attack against residual pancreatic insulin-producing cells. Until December 2009, 12 patients remained continuously insulin-free for periods ranging from 14 to 52 months and 8 patients became transiently insulin-free for periods ranging from 6 to 47 months. Of these last 8 patients, 2 became insulin-free again after the use of sitagliptin, a DPP-4 inhibitor approved only to treat type 2 diabetic patients and this is also the first study to document the use and complete insulin-independendce in humans with type 1 diabetes with this medication. In parallel with insulin suspension, indirect measures of endogenous insulin secretion revealed that it significantly increased in the whole group of patients, regardless the need of daily exogenous insulin use.[74]
Get Your Fats in Good Balance– Overabundance of Omega-6 fats in the diet is a contributing factor in diabetes. Pay attention to your intake of  Omega-3 and Omega-6 fats and try to get them closer to a 1:1 ratio. For many people, supplementing with a good quality Omega-3 oil can help while dietary adjustments are being made. Avoid Omega-6 seed oils and their sources (these are used at almost every restaurant). Eat fatty fish like salmon and sardines for the Omega-3s.
Diabetes has grown to “epidemic” proportions, and the latest statistics revealed by the U.S. Centers for Disease Control and Prevention state that 30.3 million Americans have diabetes, including the 7.2 million people who weren’t even aware of it. Diabetes is affecting people of all ages, including 132,000 children and adolescents younger than 18 years old. (2)
Lose Excess Weight– Obesity and Diabetes often go hand in hand, and while the debate still rages on if one causes the other, studies show that losing weight can help mitigate diabetes, and also lowers your risk of getting it to begin with. Certain dietary and lifestyle improvements can help you lose weight and are beneficial for diabetes reversal as well.
Mr. Tutty said he jumped at the chance, becoming one of 30 men and women ages 25 to 80 to sign up. Mr. Tutty was one of 13 participants whose fasting plasma glucose dropped, and during the six-month follow-up remained below the seven millimole per liter (or 126 milligrams per deciliter) that defines diabetes. Although Mr. Tutty completed the study nearly three years ago, his fasting blood sugars continue to range from 5.2 to 5.6 mmol/L, he said.
Stem cell research has also been suggested as a potential avenue for a cure since it may permit regrowth of Islet cells which are genetically part of the treated individual, thus perhaps eliminating the need for immuno-suppressants.[48] This new method autologous nonmyeloablative hematopoietic stem cell transplantation was developed by a research team composed by Brazilian and American scientists (Dr. Julio Voltarelli, Dr. Carlos Eduardo Couri, Dr Richard Burt, and colleagues) and it was the first study to use stem cell therapy in human diabetes mellitus This was initially tested in mice and in 2007 there was the first publication of stem cell therapy to treat this form of diabetes.[73] Until 2009, there was 23 patients included and followed for a mean period of 29.8 months (ranging from 7 to 58 months). In the trial, severe immunosuppression with high doses of cyclophosphamide and anti-thymocyte globulin is used with the aim of "turning off" the immunologic system", and then autologous hematopoietic stem cells are reinfused to regenerate a new one. In summary it is a kind of "immunologic reset" that blocks the autoimmune attack against residual pancreatic insulin-producing cells. Until December 2009, 12 patients remained continuously insulin-free for periods ranging from 14 to 52 months and 8 patients became transiently insulin-free for periods ranging from 6 to 47 months. Of these last 8 patients, 2 became insulin-free again after the use of sitagliptin, a DPP-4 inhibitor approved only to treat type 2 diabetic patients and this is also the first study to document the use and complete insulin-independendce in humans with type 1 diabetes with this medication. In parallel with insulin suspension, indirect measures of endogenous insulin secretion revealed that it significantly increased in the whole group of patients, regardless the need of daily exogenous insulin use.[74]
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.

Several types of plants are referred to as ginseng, but most studies have used American ginseng. They've shown some sugar-lowering effects in fasting and after-meal blood sugar levels, as well as in A1c results (average blood sugar levels over a 3-month period). But we need larger and more long-term studies. Researchers also found that the amount of sugar-lowering compound in ginseng plants varies widely.
Diabetes has grown to “epidemic” proportions, and the latest statistics revealed by the U.S. Centers for Disease Control and Prevention state that 30.3 million Americans have diabetes, including the 7.2 million people who weren’t even aware of it. Diabetes is affecting people of all ages, including 132,000 children and adolescents younger than 18 years old. (2)

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. 
Taylor and his colleagues observed that people who were unable to restart normal insulin production had lived with diabetes for a longer time. Individuals who had lived with diabetes for an average of 3.8 years could not correct their condition through weight loss, while those who had it for an average of 2.7 years were able to regain normal blood sugar control.
Type 2 Diabetes plagues the United States, but is even more rampant in many developing countries, triggered in large part by a shift to less healthy nutritional habits and increasingly sedentary lifestyles, all fueled by the drive of rapid urbanization and economic growth. Asia is one of the largest epicenters of this disease, with an estimated 60 percent of the world’s diabetes patients living in that region.
Both type 1 and type 2 diabetes mellitus are chronic conditions that can only be managed using insulin, anti-diabetes medications, lifestyle changes, etc., but cannot be cured. Gestational diabetes generally resolves on itself after the delivery. If not managed properly, diabetes can cause several other complications, like hypoglycemia, diabetic ketoacidosis, nonketotic hyperosmolar coma, etc. Other serious and long-term complications include cardiovascular diseases, chronic renal failure, diabetic retinopathy, etc.

Prolonged and elevated levels of glucose in the blood, which is left unchecked and untreated, will, over time, result in serious diabetic complications in those susceptible and sometimes even death. There is currently no way of testing for susceptibility to complications. Diabetics are therefore recommended to check their blood sugar levels either daily or every few days. There is also diabetes management software available from blood testing manufacturers which can display results and trends over time. Type 1 diabetics normally check more often, due to insulin therapy.

“Basic principles of good health like eating right, exercising regularly, and maintaining a healthy weight can be as effective as medicine in the management of type 2 diabetes for most people,” says Sue McLaughlin, RD, CDE, lead medical nutrition therapist at Nebraska Medicine in Omaha. That's backed up by the Look AHEAD study, a large clinical trial funded by the National Institutes of Health and the Centers for Disease Control and Prevention (CDC). The researchers found that over a four-year period, changes like eating a healthier diet and getting more exercise led to weight loss and improved diabetes control in 5,000 overweight or obese participants with type 2 diabetes.
A spice that is popular for soothing your stomach and aiding digestion, Ginger also has the ability to normalize blood sugar levels. Multiple studies conducted on rats show that ginger extract can have a significant anti-hyperglycemic effect. It lowers serum total cholesterol, triglycerides and increases the HDL-cholesterol levels. Diabetes is a digestive disorder. Diabetics often face issues with acid reflux. Ginger soothes the entire digestive tract, giving diabetics another reason to add ginger to their supplement regimen.
Type 1 diabetes is commonly called “juvenile diabetes” because it tends to develop at a younger age, typically before a person turns 20 years old. Type 1 diabetes is an autoimmune disease where the immune system attacks the insulin-producing beta cells in the pancreas. The damage to the pancreatic cells leads to a reduced ability or complete inability to create insulin. Some of the common causes that trigger this autoimmune response may include a virus, genetically modified organisms, heavy metals, vaccines, or foods like wheat, cow’s milk and soy. (4)

Although the promises are big, these technologies are still far from the market. First, clinical trials will have to show they do work. Then, the price could be steep, as cell therapy precedents for other applications, such as oncology, come with price tags that reach the six figures and are finding difficulties to get reimbursed. Considering that compared to cancer, diabetes is not an immediately life-threatening disease, health insurers in some countries might be reluctant to cover the treatment.
Blood sugar level is measured by means of a glucose meter, with the result either in mg/dL (milligrams per deciliter in the US) or mmol/L (millimoles per litre in Canada and Eastern Europe) of blood. The average normal person has an average fasting glucose level of 4.5 mmol/L (81 mg/dL), with a lows of down to 2.5 and up to 5.4 mmol/L (65 to 98 mg/dL).[7]
Levels which are significantly above or below this range are problematic and can in some cases be dangerous. A level of <3.8 mmol/L (<70 mg/dL) is usually described as a hypoglycemic attack (low blood sugar). Most diabetics know when they are going to "go hypo" and usually are able to eat some food or drink something sweet to raise levels. A patient who is hyperglycemic (high glucose) can also become temporarily hypoglycemic, under certain conditions (e.g. not eating regularly, or after strenuous exercise, followed by fatigue). Intensive efforts to achieve blood sugar levels close to normal have been shown to triple the risk of the most severe form of hypoglycemia, in which the patient requires assistance from by-standers in order to treat the episode.[8] In the United States, there were annually 48,500 hospitalizations for diabetic hypoglycemia and 13,100 for diabetic hypoglycemia resulting in coma in the period 1989 to 1991, before intensive blood sugar control was as widely recommended as today.[9] One study found that hospital admissions for diabetic hypoglycemia increased by 50% from 1990–1993 to 1997–2000, as strict blood sugar control efforts became more common.[10] Among intensively controlled type 1 diabetics, 55% of episodes of severe hypoglycemia occur during sleep, and 6% of all deaths in diabetics under the age of 40 are from nocturnal hypoglycemia in the so-called 'dead-in-bed syndrome,' while National Institute of Health statistics show that 2% to 4% of all deaths in diabetics are from hypoglycemia.[11] In children and adolescents following intensive blood sugar control, 21% of hypoglycemic episodes occurred without explanation.[12] In addition to the deaths caused by diabetic hypoglycemia, periods of severe low blood sugar can also cause permanent brain damage.[13] Although diabetic nerve disease is usually associated with hyperglycemia, hypoglycemia as well can initiate or worsen neuropathy in diabetics intensively struggling to reduce their hyperglycemia.[14]

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.
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.
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.
Beware of claims that seem too good to be true. Look for scientific-based sources of information. The National Diabetes Information Clearinghouse collects resource information for the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Reference Collection, a service of the National Institutes of Health. To learn more about alternative therapies for diabetes treatment, contact the National Center for Complementary and Alternative Medicine Clearinghouse.
Another study published in the same journal, however, examined the effect of chromium on glycemic control in insulin-dependent people with type 2 diabetes. People were given either 500 or 1,000 mcg a day of chromium or a placebo for six months. There was no significant difference in glycosylated hemoglobin, body mass index, blood pressure, or insulin requirements across the three groups.
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
Insulin pumps are small, computerized devices, about the size of a beeper that you wear on your belt or put in your pocket. They have a small flexible tube with a fine needle on the end. The needle is inserted under the skin of your abdomen and taped in place. The pump releases a carefully measured, steady flow of insulin into the tissue. Insulin pumps can cost $6,000 to $10,000 for the pump, with additional costs for necessary supplies to use the pump.Using a pump means you will have to monitor your blood sugar level at least four times a day. You program doses and make adjustments to your insulin, depending on your food intake and exercise program. Some health care providers prefer the insulin pump over injections because its slow release of insulin imitates a working pancreas.

“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.
These dietary recommendations have made high carb, low-fat foods a staple of the American diet. “Healthy” foods like fruit-on-the-bottom yogurt, sugary protein shakes and low-fat processed grains flooded the market. The standard American diet began to include more sugary drinks and sodas, as well as more processed grains. Since all carbohydrates (even complex carbs) are broken down into sugar in the body, these dietary recommendations meant that the average blood sugar of Americans began to rise – and the diabetes epidemic began to grow.
Artificial Intelligence researcher Dr. Cynthia Marling, of the Ohio University Russ College of Engineering and Technology, in collaboration with the Appalachian Rural Health Institute Diabetes Center, is developing a case based reasoning system to aid in diabetes management. The goal of the project is to provide automated intelligent decision support to diabetes patients and their professional care providers by interpreting the ever-increasing quantities of data provided by current diabetes management technology and translating it into better care without time consuming manual effort on the part of an endocrinologist or diabetologist.[56] This type of Artificial Intelligence-based treatment shows some promise with initial testing of a prototype system producing best practice treatment advice which anaylizing physicians deemed to have some degree of benefit over 70% of the time and advice of neutral benefit another nearly 25% of the time.[5]
Baseline Endothelial Reactivity was 1.88+/-0.7 (range 1.0-3.3), with 145/200 pts (72%)having endothelial dysfunction (less than 1.60). At 6 months, ER increased to 2.25+/-0.5 (range 1.2-3.6) (p<0.01). Only 40/200 (20%) remained with ED, but all had increased ER numbers. Ten pts stopped the polyphenols after a normal PAT; all developed ED on repeat PAT "
Foods high in fiber: Research shows that 90 percent of the U.S. population doesn’t consume enough fiber on a daily basis. High-fiber foods help slow down glucose absorption, regulate your blood sugar levels and support detoxification. Aim to eat at least 30 grams of fiber per day, which can come from vegetables (like Brussels sprouts, peas and artichokes), avocados, berries, nuts and seeds, especially chia seeds and flaxseeds. (9)
Together with evidence of normalization of insulin secretion after bariatric surgery (84), insights into the behavior of the liver and pancreas during hypocaloric dieting lead to a hypothesis of the etiology and pathogenesis of type 2 diabetes (Fig. 6): The accumulation of fat in liver and secondarily in the pancreas will lead to self-reinforcing cycles that interact to bring about type 2 diabetes. Fatty liver leads to impaired fasting glucose metabolism and increases export of VLDL triacylglycerol (85), which increases fat delivery to all tissues, including the islets. The liver and pancreas cycles drive onward after diagnosis with steadily decreasing β-cell function. However, of note, observations of the reversal of type 2 diabetes confirm that if the primary influence of positive calorie balance is removed, then the processes are reversible (21).

An insulin pump is composed of a reservoir similar to that of an insulin cartridge, a battery-operated pump, and a computer chip that allows the user to control the exact amount of insulin being delivered. The pump is attached to a thin plastic tube (an infusion set) that has a cannula (like a needle but soft) at the end through which insulin passes. This cannula is inserted under the skin, usually on the abdomen.. The pump continuously delivers insulin, 24 hours a day. The amount of insulin is programmed and is administered at a constant rate (basal rate). Often, the amount of insulin needed over the course of 24 hours varies, depending on factors like exercise, activity level, and sleep. The insulin pump allows the user to program many different basal rates to allow for variations in lifestyle. The user can also program the pump to deliver additional insulin during meals, covering the excess demands for insulin caused by eating carbohydrates.

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