A rapid-acting inhaled insulin (Afrezza) is also FDA-approved for use before meals. It must be used in combination with long-acting insulin in patients with type 1 diabetes and should not be used by those who smoke or have chronic lung disease. It comes as a single dose cartridge.Premixed insulin is also available for people who need to use more than one type of insulin.
One of the biggest hits in type 2 diabetes treatment is glucagon-like peptide (GLP)-1 receptor agonists, which induce insulin production in beta-pancreatic cells while suppressing the secretion of glucagon. All big pharma have GLP-1 drugs on the market or their pipelines, including Sanofi, Eli Lilly, Roche, AstraZeneca and Boehringer Ingelheim. But Novo Nordisk is going a step further with the first oral version of a GLP-1 drug, which is now close to the market.
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.
They would often say to me, “Doctor. You’ve always said that weight loss is the key to reversing diabetes. Yet you prescribed me a drug that made me gain 25 pounds. How is that good?” I never had a good answer, because none existed. The truth was that insulin was not good for type 2 diabetes — it was only good for reducing blood glucose. The key was weight loss, whereupon the diabetes often goes away or at least gets significantly better. So, logically, insulin does not help reverse the disease, but actually worsens it.
Jump up ^ Brown AF, Mangione CM, Saliba D, Sarkisian CA; Mangione; Saliba; Sarkisian; California Healthcare Foundation/American Geriatrics Society Panel on Improving Care for Elders with Diabetes (May 2003). "Guidelines for improving the care of the older person with diabetes mellitus". J Am Geriatr Soc. 51 (5 Suppl Guidelines): S265–80. doi:10.1046/j.1532-5415.51.5s.1.x. PMID 12694461.
Thank you for explaining just how things work. I have just (2months ago)gone off Diabetes Type 2 medication. BGLs around 7-10 now. It looks like I replace the rolled oats for cauliflower for breakfast and the three slices of wholegrain sourdough bread for veggies. Those two items were the continued delaying function. I’ll be on my way to decreasing the BGLs to normal, now. I have lots of fat from cold pressed virgin olive oil in my home-made hummus and over the veggies. I can look forward to the soya coffee with no guilt.
Type 2 diabetes develops when the body cannot use insulin properly or make enough insulin, so the body cannot properly use or store glucose (a form of sugar) and sugar backs up into the bloodstream, raising blood sugar levels. In the United States, some 8.9 percent of adults 20 and older have been found to have diabetes, and health officials estimate that another 3.5 percent have undiagnosed diabetes.
Although a defect in mitochondrial function is associated with extremes of insulin resistance in skeletal muscle (30), this does not appear to be relevant to the etiology of type 2 diabetes. No defect is present in early type 2 diabetes but rather is directly related to ambient plasma glucose concentration (31). Observed rates of mitochondrial ATP production can be modified by increasing or decreasing plasma fatty acid concentration (32,33). Additionally, the onset of insulin stimulation of mitochondrial ATP synthesis is slow, gradually increasing over 2 h, and quite distinct from the acute onset of insulin’s metabolic effects (34). Although it remains possible that secondary mitochondrial effects of hyperglycemia and excess fatty acids exist, there is no evidence for a primary mitochondrial defect underlying type 2 diabetes.
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).
Type 2 diabetes is a chronic disease (meaning there isn’t a “cure”) and tends to be progressive. The longer that someone has been living with Type 2 diabetes the less insulin their beta cells may be producing. This doesn’t mean that lifestyle modification is irrelevant–but does mean that individuals should work on accepting their Type 2 diabetes diagnosis so they can focus on managing their diabetes in the best way possible.
As the fats decreased inside the liver and the pancreas, some individuals also experienced improved functioning of their pancreatic beta cells, which store and release insulin, a hormone that helps control blood sugar levels. The likelihood of regaining normal glucose control depends on the ability of the beta cells to recover, the study authors say.
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.
Foods with a low glycemic load: The glycemic index of a food tells you about the blood glucose-raising potential of the food. Foods that have a high glycemic index are converted into sugar after being eaten more quickly than low glycemic foods. If you are fighting diabetes, stick to low glycemic foods like non-starchy vegetables, stone fruits and berries, nuts, seeds, avocados, coconut, organic meat, eggs, wild-caught fish, and raw pastured dairy.
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.
“Patients should empower themselves by checking their blood sugars daily, knowing what their target blood sugar levels should be, and having regular appointments with their doctor,” Arguello added. “If patients are having blood sugars above their target blood sugar levels then this may be a warning sign that they need to talk with their physician on how to take a different approach in managing their diabetes.”
The accepted view has been that the β-cell dysfunction of established diabetes progresses inexorably (79,82,83), whereas insulin resistance can be modified at least to some extent. However, it is now clear that the β-cell defect, not solely hepatic insulin resistance, may be reversible by weight loss at least early in the course of type 2 diabetes (21,84). The low insulin sensitivity of muscle tissue does not change materially either during the onset of diabetes or during subsequent reversal. Overall, the information on the inhibitory effects of excess fat on β-cell function and apoptosis permits a new understanding of the etiology and time course of type 2 diabetes.
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.
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.
As a result of his research and his success stories, Taylor encourages other doctors to stop turning to diabetes medicines right away and more strongly encourage weight loss as the first step for their patients newly diagnosed with type 2 diabetes. And the sooner, the better, he says. While Maher reversed his diabetes decades later, that's not typical, Taylor says. The ideal management, he says, is to start serious weight loss efforts right away.
Besides going raw and eliminating sugar out of your life, you must switch to raw milk or its alternatives. In the book, The Devil in the Milk, Dr. Kevin Woodford explains how the type of milk we drink, directly reflects of the high incidence of many diseases, including diabetes and cancers. There are many substitutes available from almond milk to oat milk. They are extremely healthy and easy to make.
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.
Healthy fats: Medium-chained fatty acids found in coconut and red palm oil can help balance blood sugar levels, and they serve as the preferred fuel source for your body rather than sugar. Using coconut milk, ghee and grass-fed butter can also help balance out your blood sugar levels, so include these foods into your meals and smoothies. Some research actually suggests that a high-fat, low carb diet known as the keto diet may be a novel approach to reverse diabetes naturally, although you don’t technically have to go into ketosis to achieve the benefits of healthy fats in treating diabetes. (12)
If I could only prescribe one supplement for a diabetes patient, I would prescribe R-alpha-lipoic acid. Alpha-lipoic acid has numerous benefits to the diabetic patient. It is a water- and fat-soluble antioxidant and has been shown to protect patients with fatty liver from liver disease progression. It can help reduce insulin resistance and has been shown to protect people with diabetes from developing complications in their nerves, eyes, and kidneys. R-ALA can prevent glycosylation of proteins, which reduces the A1C level. It is safe, although very rarely it can cause stomach upset. Alpha-lipoic acid is listed either as ALA or R-ALA. When listed as ALA, this means it contains two forms—the S isomer form and the R isomer form, in a 50:50 ratio. The key is to find a product that says it contains “R-ALA” instead of just “ALA.” A good daily working dose of R-ALA is 300 to 1,200 mg a day, which is the equivalent of 600 to 2,400 mg a day of regular ALA, if you buy a regular ALA listed product.
Try to keep carbohydrate amounts stable across the day (some choose lower carbohydrate targets), stand more and sit less and include activities that increase the heart rate and also strength based activities most days across the week. Think about the amount of stress you experience to see how it is increasing your blood glucose levels. If you smoke – stop because it is speeding up the damage to your blood vessels. If you drink alcohol, limit how much you drink.
Diabetic persons must increase their awareness about oral infections as they have a double impact on health. Firstly, people with diabetes are more likely to develop periodontal disease, which causes increased blood sugar levels, often leading to diabetes complications. Severe periodontal disease can increase blood sugar, contributing to increased periods of time when the body functions with a high blood sugar. This puts diabetics at increased risk for diabetic complications.
Taking 200 micrograms of chromium picolinate three times daily with meals can help improve insulin sensitivity. A review published in Diabetes Technology and Therapeutics evaluated 13 studies that reported significant improvement in glycemic control and substantial reductions in hyperglycemia and hyperinsulinemia after patients used chromium picolinate supplementation. Other positive outcomes from supplementing with chromium picolinate included reduced cholesterol and triglyceride levels and reduced requirements for hypoglycemic medication. (14)
The prevalence of prediabetes is also on the rise, as it’s estimated that almost 34 million U.S. adults were prediabetic in 2015. People with prediabetes have blood glucose levels that are above normal but below the defined threshold of diabetes. Without proper intervention, people with prediabetes are very likely to become type 2 diabetics within a decade.
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.
Genetic factors do play a role in any disease, but I put this factor last for a reason. Genetic predisposition to a given disease will increase the chances of getting the disease, but not in a vacuum. People with a strong predisposition to liver disease manage to avoid it, and some with a family history of heart disease remain heart-attack free. Even studies among identical twins show that in most cases, twins will get the same diseases, even in different environments, but sometimes they don’t. This means there are other factors involved (see above).
Relying on their own perceptions of symptoms of hyperglycemia or hypoglycemia is usually unsatisfactory as mild to moderate hyperglycemia causes no obvious symptoms in nearly all patients. Other considerations include the fact that, while food takes several hours to be digested and absorbed, insulin administration can have glucose lowering effects for as little as 2 hours or 24 hours or more (depending on the nature of the insulin preparation used and individual patient reaction). In addition, the onset and duration of the effects of oral hypoglycemic agents vary from type to type and from patient to patient.
Many studies show that lifestyle changes, such as losing weight, eating healthy and increasing physical activity, can dramatically reduce the progression of Type 2 diabetes and may control Type 1 diabetes. These lifestyle changes can also help minimize other risk factors such as high blood pressure and blood cholesterol, which can have a negative impact on people with diabetes.
Levels greater than 13–15 mmol/L (230–270 mg/dL) are considered high, and should be monitored closely to ensure that they reduce rather than continue to remain high. The patient is advised to seek urgent medical attention as soon as possible if blood sugar levels continue to rise after 2–3 tests. High blood sugar levels are known as hyperglycemia, which is not as easy to detect as hypoglycemia and usually happens over a period of days rather than hours or minutes. If left untreated, this can result in diabetic coma and death.
I do not believe it can be an actual reversal, more of a remission. If no longer needing medication to control blood sugar looks like reversal it is only possible if the person maintains regular exercise and a healthy weight. The length of time one has diabetes plays a role as does one’s genes. There are some thin people who have type 2 diabetes due to heredity.
Over a period of years, you went from pre-diabetes, to diabetes, to taking one medication, then two then three and then finally large doses of insulin. Here’s the thing. If you are taking more and more medications to keep your blood sugars at the same level, your diabetes is getting worse! Even if your blood sugars get better, your diabetes is getting worse. This is unfortunately what happens to virtually every patient. The body is already overflowing with sugar. The medications only hide the blood sugar by cramming it into the engorged body.
Drugs of this class decrease the absorption of carbohydrates from the intestine. Before being absorbed into the bloodstream, enzymes in the small intestine must break down carbohydrates into smaller sugar particles, such as glucose. One of the enzymes involved in breaking down carbohydrates is called alpha-glucosidase. By inhibiting this enzyme, carbohydrates are not broken down as efficiently, and glucose absorption is delayed.