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]
Alternative medicine for diabetes is big business, because the public health burden of diabetes is massive, and growing. In 1985, the worldwide prevalence was 30 million people. In 2000, it was 150 million. By 2030, it could be 250 million. Why are more people being diagnosed with diabetes? Obesity, sedentary lifestyles, and an aging population. At its core, diabetes is a disease of sugar (glucose) management. Insulin, secreted by the pancreas, allows cells to use glucose. When the pancreas doesn’t produce insulin,  it’s called Type 1 diabetes. This is an autoimmune disease that strikes early in life, and was a death sentence until insulin was discovered.  When the pancreas can produce insulin, but the amount is insufficient, or when there’s a problem with the uptake of insulin into cells, it’s termed type 2 diabetes.  90% of all diabetes is type 2. Typically a disease of older adults, type 2 diabetes can potentially be treated without drugs of any kind, but success rates are low and medication is eventually advisable. There’s also gestational diabetes, a disease of pregnancy, and prediabetes, where blood sugars are elevated, and diabetes is an expected future diagnosis.

Insulin therapy is taken by diabetics who have type 1 diabetes mellitus, or IDDM, i.e., insulin-dependent diabetes mellitus. In this condition, body is not able to produce any insulin, therefore, it has to be administered externally. Patients with type 2 diabetes mellitus are either resistant to insulin or have relatively low insulin production, or both.

Before making any fiber recommendations, Dean has her patients tested for “pancreatic insufficiency.” She believes people with pancreatic insufficiency should be given digestive enzymes along with fiber, “otherwise the fiber will just bloat them up, and they’ll be quite unhappy,” she says. Dean uses a glucomannan fiber supplement for her patients with type 2 diabetes.
Drugs that increase insulin production by the pancreas or its blood levels and/or reduce sugar production from the liver, including alogliptin (Nesina), dulaglutide (Trulicity), linagliptin (Tradjenta), exenatide (Byetta, Bydureon), liraglutide (Victoza), lixisenatide (Adlyxin), saxagliptin (Onglyza), sitagliptin (Januvia), and semaglutide (Ozempic)
Diabetes can be very complicated, and the physician needs to have as much information as possible to help the patient establish an effective management plan. Physicians may often experience data overload resulting from hundreds of blood-glucose readings, insulin dosages and other health factors occurring between regular office visits which must be deciphered during a relatively brief visit with the patient to determine patterns and establish or modify a treatment plan.[5]
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.

Gestational diabetes develops during pregnancy because hormones interfere with how the body uses insulin. When the pancreas can’t keep up with the insulin demand and blood glucose levels get too high, the result is gestational diabetes. About 2-7 percent of expectant mothers develop gestational diabetes during their pregnancy. Learn more about diabetes and pregnancy.
Alternative: “The reason I use food-based supplements is because they most closely help correct what I see as the problem: The food we’re eating is lacking in nutrients,” DeLaney says. “If their vitamin D is low, it tells me all their fat-soluble vitamins are low.” She uses cod liver oil along with high-vitamin butter oil to restore these deficiencies.
Exenatide (Byetta) was the first drug of the GLP-1 agonist group. It originated from an interesting source, the saliva of the Gila monster. Scientists observed that this small lizard could go a long time without eating. They discovered a substance in its saliva that slowed stomach emptying, thus making the lizard feel fuller for a longer time. This substance resembled the hormone GLP-1.