According to a review of clinical trials published in December 2014 in JAMA Surgery, people with diabetes who underwent bariatric surgery had greater weight loss than those who received nonsurgical treatment, and the surgery was more effective in helping obese participants get diabetes under control. An article on the notable Surgical Treatment and Medications Potentially Eradicate Diabetes Efficiently trial, which was published in February 2017 in the New England Journal of Medicine, suggests that gastric bypass surgery and sleeve gastrectomy helped people with diabetes attain better glycemic control than medication alone. Compared with the medication-only group, people who underwent the surgeries also saw greater reductions in heart disease risk and medication use, as well as an improved quality of life.
Whether you were diagnosed with type 2 diabetes a week ago or 8 years ago like Jacquie, this life-altering day is almost impossible to forget. Your diagnosis day often marks the beginning of a daily routine of prescription medications or injections, and now there is growing evidence that the burden of diabetes may take a huge toll on your mental health over time as well.
In addition, a strong partnership between the patient and the primary healthcare provider – general practitioner or internist – is an essential tool in the successful management of diabetes. Often the primary care doctor makes the initial diagnosis of diabetes and provides the basic tools to get the patient started on a management program. Regular appointments with the primary care physician and a certified diabetes educator are some of the best things a patient can do in the early weeks after a diagnosis of diabetes. Upon the diagnosis of diabetes, the primary care physician, specialist, or endocrinologist will conduct a full physical and medical examination. A thorough assessment covers topics such as:
Data from the Swedish randomized study of gastric banding showed that a loss of 20% body weight was associated with long-term remission in 73% of a bariatric surgery group, with weight change itself being the principal determinant of glucose control (13). Dietary weight loss of 15 kg allowed for reversal of diabetes in a small group of individuals recently receiving a diagnosis (21). In individuals strongly motivated to regain normal health, substantial weight loss is entirely possible by decreasing food consumption (88). This information should be made available to all people with type 2 diabetes, even though with present methods of changing eating habits, it is unlikely that weight loss can be achieved in those not strongly motivated to escape from diabetes. Some genetic predictors, especially the Ala12 allele at PPARG, of successful long-term weight loss have been identified (89), and use of such markers could guide future therapy. It must be noted that involuntary food shortage, such as a result of war, results in a sharp fall in type 2 diabetes prevalence (90,91).
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]
Dr. Sarah Hallberg is a Medical Director at Virta Health. She also created the Medically Supervised Weight Loss Program at Indiana University Health Arnett and serves as its Medical Director. She is an adjunct Clinical Professor of Medicine at Indiana University School of Medicine. Dr. Hallberg is an expert in diabetes care and is board certified in Internal Medicine, Obesity Medicine, and Clinical Lipidology and also a Registered Clinical Exercise Physiologist from the ACSM.
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
So you go to your doctor. What does he do? Instead of getting rid of the toxic sugar load, he doubles the dose of the medication. If the luggage doesn’t close, the solution is to empty it out, not use more force to . The higher dose of medication helps, but only for a time. Blood sugars go down as you force your body to gag down even more sugar. But eventually, this dose fails as well. So then your doctor gives you a second medication, then a third one and then eventually insulin injections.

Dr. Sivitz emphasizes the importance of being active, eating a healthy diet, and having a good understanding of the role that carbohydrates play. He recommends eating healthy carbs, such as nonstarchy vegetables, fruits, legumes, whole grains, and nonfat dairy products. A certified diabetes educator or a registered dietitian can help personalize your diet and teach you strategies to control your blood sugar. Depending on your desired blood sugar range and weight loss goals, recommendations for foods, carbohydrate intake, and portion sizes may vary. Regardless, if you have diabetes, it will be important to count carbs in your diet because, while not off limits, they can lead to blood sugar spikes when overeaten.
Both type 1 and type 2 diabetes mellitus are chronic conditions that can only be managed using insulin, anti-diabetes medications, lifestyle changes, etc., but cannot be cured. Gestational diabetes generally resolves on itself after the delivery. If not managed properly, diabetes can cause several other complications, like hypoglycemia, diabetic ketoacidosis, nonketotic hyperosmolar coma, etc. Other serious and long-term complications include cardiovascular diseases, chronic renal failure, diabetic retinopathy, etc.

As of 2010, an estimated of 285 million people have type 2 diabetes globally, making up about 90% of all the diabetes cases. There is an alarming rise in the prevalence of diabetes in every part of the world, thanks to the eating habits and sedentary lifestyle. And, as opposed to the misconception that eating sweets can result in diabetes, stress and genes can also play a major role in this. As of today, number of diabetics is far more than anytime in the past. Now, even younger generation is not spared by this disease. Generally, diabetes is more common in people who are overweight or obese. Generally, fasting blood sugar levels per 100 ml of blood should be between 80 to 120 mg, which can go up to 160 mg/100 ml of blood after meals. Anything that is constantly above 160 mg/100 ml indicates diabetes. Usually, older and obese people are at increased risk of diabetes because of their inability to produce insulin and lifestyle.
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.
Greek clover is an annual herb with aromatic seeds having medicinal properties. It is also known as fenugreek, and is largely used in curry. Greek clover has properties to lower down the levels of glucose in the body, which, in turn, controls diabetes. Also, when given in changeable doses of 25 gm to 100 gm on a daily basis, it was found to diminish reactive hyperglycemia in diabetic patients. Furthermore, levels of glucose, serum cholesterol, and triglycerides were also appreciably reduced. Alternatively, one can just stir two teaspoons of Greek clover seeds in powder form in warm milk and consume on a regular basis; it will control the levels of blood sugar and keep diabetes at bay. In case one does not want to have the powder in milk, seeds can be eaten wholly, too.
Miscarriage is the medical term for the spontaneous loss of pregnancy from conception to 20 weeks gestation. Risk factors for a woman having a miscarriage include cigarette smoking, older maternal age, radiation exposure, previous miscarriage, maternal weight, illicit drug use, use of NSAIDs, and trauma or anatomical abnormalities to the uterus. There are five classified types of miscarriage: 1) threatened abortion; 2) incomplete abortion; 3) complete abortion; 4) missed abortion; and (5 septic abortion. While there are no specific treatments to stop a miscarriage, a woman's doctor may advise avoiding certain activities, bed rest, etc. If a woman believes she has had a miscarriage, she needs to seek prompt medical attention.

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.
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.
Artificial Intelligence researcher Dr. Cynthia Marling, of the Ohio University Russ College of Engineering and Technology, in collaboration with the Appalachian Rural Health Institute Diabetes Center, is developing a case based reasoning system to aid in diabetes management. The goal of the project is to provide automated intelligent decision support to diabetes patients and their professional care providers by interpreting the ever-increasing quantities of data provided by current diabetes management technology and translating it into better care without time consuming manual effort on the part of an endocrinologist or diabetologist.[56] This type of Artificial Intelligence-based treatment shows some promise with initial testing of a prototype system producing best practice treatment advice which anaylizing physicians deemed to have some degree of benefit over 70% of the time and advice of neutral benefit another nearly 25% of the time.[5]

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.

Known for its immune-boosting and disease-fighting benefits, this Chinese herb has several positive diabetes studies behind it. Re­searchers have found that ginseng slows carbohydrate absorption; increases cells’ ability to use glucose; and increases insulin secretion from the pancreas. A team from the University of Toronto has repeatedly demonstrated that ginseng capsules lower blood glucose 15 to 20 percent compared to placebo pills. These are the best superfoods for people with diabetes.

Because the initial symptoms (fatigue, weakness, frequent urination) are usually mild, about 30 percent of all people with diabetes do not realize that they have the disease. And that can have tragic consequences, because with early diagnosis and treatment, the chances of living a long and productive life are higher than if the disease creeps along until irreversible damage occurs.
However, the observation that normalization of glucose in type 2 diabetes occurred within days after bariatric surgery, before substantial weight loss (15), led to the widespread belief that surgery itself brought about specific changes mediated through incretin hormone secretion (16,17). This reasoning overlooked the major change that follows bariatric surgery: an acute, profound decrease in calorie intake. Typically, those undergoing bariatric surgery have a mean body weight of ∼150 kg (15) and would therefore require a daily calorie intake of ∼13.4 MJ/day (3,200 kcal/day) for weight maintenance (18). This intake decreases precipitously at the time of surgery. The sudden reversal of traffic into fat stores brings about a profound change in intracellular concentration of fat metabolites. It is known that under hypocaloric conditions, fat is mobilized first from the liver and other ectopic sites rather than from visceral or subcutaneous fat stores (19). This process has been studied in detail during more moderate calorie restriction in type 2 diabetes over 8 weeks (20). Fasting plasma glucose was shown to be improved because of an 81% decrease in liver fat content and normalization of hepatic insulin sensitivity with no change in the insulin resistance of muscle.
Whenever this seasonal fruit is available in the market, try to include it in your diet as it can be very effective for the pancreas. Else you can make a powder of dried seeds of Jambul fruit and eat this powder with water twice a day. This fruit is native to India and its neighboring countries but you can find it at Asian markets and herbal shops.
There has been a slew of studies done on the topic of alternative and naturopathic treatments and natural remedies for diabetes, and many of them exhibit long-lasting, beneficial results. While conventional medicine tends to treat only the symptoms of disease, alternative medicine focuses on both the underlying causes of the ailment, as well as the symptoms, evaluating the body as an interconnected whole.

Recently, a small clinical trial in England studied the effects of a strict liquid diet on 30 people who had lived with Type 2 diabetes for up to 23 years. Nearly half of those studied had a remission that lasted six months after the diet was over. While the study was small, the finding offers hope to millions who have been told they must live with the intractable disease.
The first step is to eliminate all sugar and refined starches from your diet. Sugar has no nutritional value and can therefore be eliminated. Starches are simply long chains of sugars. Highly refined starches such as flour or white rice are quickly broken down by digestion into glucose. This is quickly absorbed into the blood and raises blood sugar. For example, eating white bread increases blood sugars very quickly. Doesn’t it seem self-evident that we should avoid foods that raise blood sugars because they will eventually be absorbed into the body? The optimum strategy is to eat little or no refined carbohydrates.
Poor oral hygiene is a great factor to take under consideration when it comes to oral problems and even more in people with diabetes. Diabetic people are advised to brush their teeth at least twice a day, and if possible, after all meals and snacks. However, brushing in the morning and at night is mandatory as well as flossing and using an anti-bacterial mouthwash. Individuals who suffer from diabetes are recommended to use toothpaste that contains fluoride as this has proved to be the most efficient in fighting oral infections and tooth decay. Flossing must be done at least once a day, as well because it is helpful in preventing oral problems by removing the plaque between the teeth, which is not removed when brushing.
For our very insulin resistant patients with type 2 diabetes, after starting out at 30 grams, a few months later most of our patients find that they can increase their daily carb intake to 40 or 50 grams. Fifty grams of total carbohydrate typically allows 4-5 servings of non-starchy vegetables, 2 oz of nuts, and 3 oz of berry fruit (which includes avocado – but obviously you’d need to share it with someone unless it’s a tiny one!)”
An injection port has a short tube that you insert into the tissue beneath your skin. On the skin’s surface, an adhesive patch or dressing holds the port in place. You inject insulin through the port with a needle and syringe or an insulin pen. The port stays in place for a few days, and then you replace the port. With an injection port, you no longer puncture your skin for each shot—only when you apply a new port.
However, the observation that normalization of glucose in type 2 diabetes occurred within days after bariatric surgery, before substantial weight loss (15), led to the widespread belief that surgery itself brought about specific changes mediated through incretin hormone secretion (16,17). This reasoning overlooked the major change that follows bariatric surgery: an acute, profound decrease in calorie intake. Typically, those undergoing bariatric surgery have a mean body weight of ∼150 kg (15) and would therefore require a daily calorie intake of ∼13.4 MJ/day (3,200 kcal/day) for weight maintenance (18). This intake decreases precipitously at the time of surgery. The sudden reversal of traffic into fat stores brings about a profound change in intracellular concentration of fat metabolites. It is known that under hypocaloric conditions, fat is mobilized first from the liver and other ectopic sites rather than from visceral or subcutaneous fat stores (19). This process has been studied in detail during more moderate calorie restriction in type 2 diabetes over 8 weeks (20). Fasting plasma glucose was shown to be improved because of an 81% decrease in liver fat content and normalization of hepatic insulin sensitivity with no change in the insulin resistance of muscle.
Normally, the process goes like this: The carbohydrates from your food are converted into a form of sugar called glucose. Glucose is the preferred fuel for your body's cells, and it's the only food your brain can use. The glucose floats along in the bloodstream until the pancreas, a large gland located behind the stomach, goes into action. The pancreas produces insulin, a hormone that signals body cells to take in the glucose. Once inside the cell, the glucose is either used as fuel to produce heat or energy or is stored as fat.
To prevent further diabetic complications as well as serious oral problems, diabetic persons must keep their blood sugar levels under control and have a proper oral hygiene. A study in the Journal of Periodontology found that poorly controlled type 2 diabetic patients are more likely to develop periodontal disease than well-controlled diabetics are.[58] At the same time, diabetic patients are recommended to have regular checkups with a dental care provider at least once in three to four months. Diabetics who receive good dental care and have good insulin control typically have a better chance at avoiding gum disease to help prevent tooth loss.[61]
Cyrus Khambatta earned a PhD in Nutritional Biochemistry from UC Berkeley after being diagnosed with type 1 diabetes in his senior year of college at Stanford University in 2002. He is an internationally recognized nutrition and fitness coach for people living with type 1, type 1.5, prediabetes and type 2 diabetes, and has helped hundreds of people around the world achieve exceptional insulin sensitivity by adopting low-fat, plant-based whole foods nutrition.
I made a mistake in an earlier comment that I need to correct. I thought the VLDL represented the very small particles, and that is totally wrong. Here are the actual test results of the very small particles from a Quest Diagnostics after about 18 months on a ketogenic diet, with abundant use of MCT oil as caprylic acid. If the administrator deletes that comment, to avoid confusion, that would be fine with me. I can also provide much more data, as that test is pretty comprehensive.
Pramlintide is administered by injection just prior to meals (three times each day) for type 1 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control despite optimal insulin therapy and type 2 diabetes as an additional treatment to mealtime insulin therapy for those failing to achieve desired glucose control with optimal insulin therapy.
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