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.
Anyone with diagnosed Diabetes should consult a physician before making any changes to a diabetes regimen, and especially before changing medication dosages. That being said, improving your diet and eating the foods to help your body heal is your prerogative and your right. For the 65% of America that is overweight, including the 37% that are clinically obese, there is a good chance that many are operating in a pre-diabetic state, or may even have undiagnosed diabetes. Even those without any signs of disease can figure out their insulin levels by at home glucose testing.
Implementing integrative and functional medical nutrition therapy, I helped the patient understand that she could reverse the trajectory she was on by making lifestyle changes—and that’s what she did. We engaged in shared decision making in our ongoing nutrition consultations. Over the course of one year, her physiology and health status changed for the better. Her A1c dropped from 7.2% to 5.6%, and she no longer required medications. She continues to adhere to her new lifestyle program and is confident she’ll remain free of a diabetes diagnosis.
But is John “free of diabetes”? This is where the lines become blurred. Medically speaking, the term “cure” is usually associated with acute disease—a temporary medical condition, such as bacterial pneumonia, that can be cured with antibiotics. For diabetes, which is a chronic disease, it may be more accurate to use the term “remission” rather than cure. Particularly when considering the pathology associated with diabetes and the individual’s genetic predisposition, relapse is always possible. In a consensus statement issued by the ADA, the term remission is defined based on the following definitions:2
If your carb consumption is on the high side (once you add sugar into the mix, you’re most certainly on the high side), it’s stored as fat and you end up with insulin resistance or non-alcoholic fatty liver disease. The reason behind it is that carbs metabolize into glucose, and limiting carbs helps your body control blood sugar more efficiently. It improves overall blood sugar profiles, insulin sensitivity, and hemoglobin A1c, which is a diabetes marker. Going low-carb is especially effective if you’re in the early stages when you do not yet need to administer insulin.
Primary Care Provider: Your primary care provider is the provider you see for general checkups or when you get sick. Your primary care provider may also be the one who refers you to specialists or other team members. Other health care providers who provide primary care include nurse practitioners and physician assistants, who typically work with a physician.
As of now, diabetes is classified as either Type I or Type II. New research suggests there are several more types of diabetes, which all require different treatment approaches, but that’s a developing area of knowledge. On an episode of Bulletproof Radio, Dr. Steven Masley explains why doctors are starting to view Altzheimer’s disease as “type III diabetes” and picks apart the relationship between insulin and brain degeneration. Listen to it on iTunes.
Practitioners agree that nutrition is the cornerstone of diabetes management, and that a range of nutrition intervention strategies can be used to meet the metabolic goals and individual preferences of the person with diabetes. However, there are significant differences in the approach and methodologies used by alternative and conventional practitioners to manage the disease. One difference is in terminology. When is remission really remission?
Self-testing is clearly important in type I diabetes where the use of insulin therapy risks episodes of hypoglycaemia and home-testing allows for adjustment of dosage on each administration. However its benefit in type 2 diabetes is more controversial as there is much more variation in severity of type 2 cases. It has been suggested that some type 2 patients might do as well with home urine-testing alone. The best use of home blood-sugar monitoring is being researched.
Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day. (8) Beer and sweet liquors are especially high in carbohydrates and should be avoided.
Some people with type 2 diabetes can manage their disease by making healthy food choices and being more physically active. Many people with type 2 diabetes need diabetes medicines as well. These medicines may include diabetes pills or medicines you inject under your skin, such as insulin. In time, you may need more than one diabetes medicine to control your blood glucose. Even if you do not take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital.
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)
Random blood sugar test. A blood sample will be taken at a random time. Blood sugar values are expressed in milligrams per deciliter (mg/dL) or millimoles per liter (mmol/L). Regardless of when you last ate, a random blood sugar level of 200 mg/dL (11.1 mmol/L) or higher suggests diabetes, especially when coupled with any of the signs and symptoms of diabetes, such as frequent urination and extreme thirst.
The bottom line is that diabetes can be bad news—but this doesn’t have to be the case. Interventions can prevent or delay the disease in people with prediabetes. The Diabetes Prevention Program (DPP), a large study of people at high risk of diabetes, has established a prevention plan that’s both feasible and cost-effective. The DPP showed that weight loss and increased physical activity reduced the development of type 2 diabetes by 58% during a three-year period.
The good news though is that this can be delayed, and we can do something about preventing and managing the early stages of diabetes through simple lifestyle modifications, and the body will remember these efforts if they can be maintained early in the diagnosis and for as long as possible. This in turn will delay the progression of diabetes and development of diabetes complications.
9. Exercise! Moderate to vigorous exercise that includes both cardio and strength building components are great ways to keep the body fit. Exercise can also contribute to a more positive outlook on life, which can boost the immune system, provide capacity for healthier coping strategies, and decrease stress. Yoga, hiking, and jogging are all good options. To boost your metabolism, make sure your work-outs incorporate strength training. It is also far more effective to incorporate high intensity interval workouts to your regime, such as sprinting and HIIT workouts.
Change in fasting plasma glucose (A), 2 h post-oral glucose tolerance test (B), and homeostasis model assessment (HOMA-B) insulin secretion (C) during the 16-year follow-up in the Whitehall II study. Of the 6,538 people studied, diabetes developed in 505. Time 0 was taken as the diagnosis of diabetes or as the end of follow-up for those remaining normoglycemic. Redrawn with permission from Tabák et al. (80).
Diabetes is a group of diseases characterized by elevated blood glucose levels due to defects in insulin secretion, insulin action, or both. According to the American Diabetes Association (ADA), type 2 diabetes usually begins with insulin resistance. For those people whose bodies resist insulin, the pancreas secretes extra insulin to maintain normal glucose levels. As the condition progresses, insulin production gradually decreases and eventually reaches a level of deficiency that can no longer maintain blood glucose in the normal range. But how type 2 diabetes presents and progresses can vary considerably, as noted by the ADA, and methods of treatment can vary from patient to patient.
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.