The earliest predictor of the development of type 2 diabetes is low insulin sensitivity in skeletal muscle, but it is important to recognize that this is not a distinct abnormality but rather part of the wide range expressed in the population. Those people in whom diabetes will develop simply have insulin sensitivity, mainly in the lowest population quartile (29). In prediabetic individuals, raised plasma insulin levels compensate and allow normal plasma glucose control. However, because the process of de novo lipogenesis is stimulated by higher insulin levels (38), the scene is set for hepatic fat accumulation. Excess fat deposition in the liver is present before the onset of classical type 2 diabetes (43,74–76), and in established type 2 diabetes, liver fat is supranormal (20). When ultrasound rather than magnetic resonance imaging is used, only more-severe degrees of steatosis are detected, and the prevalence of fatty liver is underestimated, with estimates of 70% of people with type 2 diabetes as having a fatty liver (76). Nonetheless, the prognostic power of merely the presence of a fatty liver is impressive of predicting the onset of type 2 diabetes. A large study of individuals with normal glucose tolerance at baseline showed a very low 8-year incidence of type 2 diabetes if fatty liver had been excluded at baseline, whereas if present, the hazard ratio for diabetes was 5.5 (range 3.6–8.5) (74). In support of this finding, a temporal progression from weight gain to raised liver enzyme levels and onward to hypertriglyceridemia and then glucose intolerance has been demonstrated (77).
There have been some small, limited studies as well as anecdotal reports that certain alternative or “natural” treatments can help control blood glucose levels in people with diabetes or otherwise prevent the condition or prevent its complications. These can include herbs or dietary supplements. Examples include garlic, cinnamon, alpha-lipoic acid, aloe vera, chromium, ginseng, and magnesium.
Diabetes education is very important for any diabetic or a person who has a diabetic at home. The education helps an individual to know more about this dreadful disease. Once educated, the individual can control diabetes in a better manner. Administering insulin, medications, and understanding emergency situations like hypoglycemic attacks, etc. are major points of diabetes education. It also includes the diet a diabetic should avoid and have. Diabetes education is very essential for each and every diabetic and individual who has someone close living with diabetes.
If a drug treatment’s efficacy is questionable, the adverse event and safety profile is even more important. As a popular food additive, cinnamon seems safe when consumed at doses of a few grams per day. (1 teaspoon of the powder is about 4.75 grams). While the trials have been small and short in duration, no significant adverse events have been reported. It is Generally Recognised as Safe (GRAS), as a seasoning and flavoring. However, reversible liver damage has been reported with therapeutic use, due to coumarin, a chemical also present in Cassia cinnamon. Those with liver impairment or dysfunction may be at greater risk of harm. There are no published long-term studies with cinnamon that inform us whether chronic consumption of high doses is safe.
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.
The idea of “reversing” is describing the well managed type 2 diabetes that can be maintained without the outcome of complications (eye disease, kidney disease, etc.). And it is totally possible to have type 2 (or type 1 diabetes for that matter) and have no complications – however, this takes careful management and is largely driven by the patient and their access to quality healthcare.
Capsaicin cream, a topical ointment made with cayenne, has been reported by some patients to help lower pain in the hands and feet from diabetic neuropathy. But people with loss of sensation in the hands or feet should use caution when using capsaicin, as they may not be able to fully feel any burning sensation. Check with your doctor if you are thinking of trying this product.
Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars better, but not the diabetes. We can pretend the disease is better, but that doesn’t make it true.
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.
Chronic exposure of β-cells to triacylglycerol or fatty acids either in vitro or in vivo decreases β-cell capacity to respond to an acute increase in glucose levels (57,58). This concept is far from new (59,60), but the observations of what happens during reversal of diabetes provide a new perspective. β-Cells avidly import fatty acids through the CD36 transporter (24,61) and respond to increased fatty acid supply by storing the excess as triacylglycerol (62). The cellular process of insulin secretion in response to an increase in glucose supply depends on ATP generation by glucose oxidation. However, in the context of an oversupply of fatty acids, such chronic nutrient surfeit prevents further increases in ATP production. Increased fatty acid availability inhibits both pyruvate cycling, which is normally increased during an acute increase in glucose availability, and pyruvate dehydrogenase activity, the major rate-limiting enzyme of glucose oxidation (63). Fatty acids have been shown to inhibit β-cell proliferation in vitro by induction of the cell cycle inhibitors p16 and p18, and this effect is magnified by increased glucose concentration (64). This antiproliferative effect is specifically prevented by small interfering RNA knockdown of the inhibitors. In the Zucker diabetic fatty rat, a genetic model of spontaneous type 2 diabetes, the onset of hyperglycemia is preceded by a rapid increase in pancreatic fat (58). It is particularly noteworthy that the onset of diabetes in this genetic model is completely preventable by restriction of food intake (65), illustrating the interaction between genetic susceptibility and environmental factors.
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.
“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.
Pramlintide (Symlin) was the first in a class of injectable, anti-hyperglycemic medications for use in addition to insulin for type 1 diabetes or type 2 diabetes. Pramlintide is a synthetic analog of human amylin, a naturally occurring hormone made by the pancreas to help control glucose after meals. Similar to insulin, amylin is absent or deficient in person with diabetes.