Although a close relationship exists among raised liver fat levels, insulin resistance, and raised liver enzyme levels (52), high levels of liver fat are not inevitably associated with hepatic insulin resistance. This is analogous to the discordance observed in the muscle of trained athletes in whom raised intramyocellular triacylglycerol is associated with high insulin sensitivity (53). This relationship is also seen in muscle of mice overexpressing the enzyme DGAT-1, which rapidly esterifies diacylglycerol to metabolically inert triacylglycerol (54). In both circumstances, raised intracellular triacylglycerol stores coexist with normal insulin sensitivity. When a variant of PNPLA3 was described as determining increased hepatic fat levels, it appeared that a major factor underlying nonalcoholic fatty liver disease and insulin resistance was identified (55). However, this relatively rare genetic variant is not associated with hepatic insulin resistance (56). Because the responsible G allele of PNPLA3 is believed to code for a lipase that is ineffective in triacylglycerol hydrolysis, it appears that diacylglycerol and fatty acids are sequestered as inert triacylglycerol, preventing any inhibitory effect on insulin signaling.
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.
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.
One of my patients, aged 58, had an initial hemoglobin A1c of 7.2%. She was taking oral hypoglycemic agents, statins, and proton pump inhibitors—the basic treatment for every diabetes diagnosis. The patient was 28 lbs overweight and worked long hours. She didn’t exercise, mostly ate a processed food diet, and was sleep deprived. The patient had a family history of diabetes, and ultimately her lifestyle expressed her genetic tendencies.
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.
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).
Research is constantly giving us more information on diabetes and the various factors that contribute to its steady rise in society over the last few decades. Since most theories on diabetes are just that- theories, research for yourself and figure out your best way or preventing or reversing diabetes. I’ve compiled the best of my own research above, but do your own, too! At the least, please consider making some positive changes to help keep yourself disease free (or become disease free).
Second, hypoglycemia can affect a person’s thinking process, coordination, and state of consciousness. This disruption in brain functioning is called neuroglycopenia. Studies have demonstrated that the effects of neuroglycopenia impair driving ability. A study involving people with type 1 diabetes found that individuals reporting two or more hypoglycemia-related driving mishaps differ physiologically and behaviorally from their counterparts who report no such mishaps. For example, during hypoglycemia, drivers who had two or more mishaps reported fewer warning symptoms, their driving was more impaired, and their body released less epinephrine (a hormone that helps raise BG). Additionally, individuals with a history of hypoglycemia-related driving mishaps appear to use sugar at a faster rate and are relatively slower at processing information. These findings indicate that although anyone with type 1 diabetes may be at some risk of experiencing disruptive hypoglycemia while driving, there is a subgroup of type 1 drivers who are more vulnerable to such events.
Swift urges RDs to be informed and stay up-to-date as complementary and alternative medicine data evolves. Use a “whole systems, whole person” approach to health and healing. The Kripalu Center for Yoga and Health is a good place to start. “They have an outstanding program on diabetes care that’s multidisciplinary and integrative,” Swift says. You also can receive continuing education credits for attending.
A 2012 review of ginseng in animals and human beings found that not only does ginseng reduce insulin resistance, it also lowers HbA1C levels. It’s been used in traditional Chinese medicine for centuries as one of the most potent herbs for blood sugar control. Indian ginseng, also called Ashwagandha, offers fantastic all round benefits. Scientists are also researching the connection between diabetes and Alzhiemer’s. Panax Ginseng is a type of ginseng that is able to help with both diabetes and Alzheimer’s.
Desert Springs Hospital has developed specific protocols, computerized technology and systems to provide diabetes patients highest level of care. For example, the staff use special tools to maintain tight blood-sugar control during patient hospitalizations, such as the Glucommander, a computer that works with an insulin drip to monitor patients’ blood-sugar levels.
11. Get regular eye exams: Diabetic retinopathy is caused by elevated levels of blood sugar, which can happen when diabetes goes out of control. The disease can damage the blood vessels around the eye and retina, leading to blurred vision and blindness. Diabetic retinopathy cannot be cured, and often has no early symptoms, which makes it difficult to catch. Diabetics should make sure they get regular eye exams, for early detection and treatment.
A study published in 2014 by the Second University of Naples showed that a low-carbohydrate Mediterranean diet was able to achieve significant rates of remission in people with type 2 diabetes. After one year of following the diet, 15% of participants achieved remission and, after six years, 5% had achieved remission on the diet – a stunning achievement.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.