Gene therapy can be used to manufacture insulin directly: an oral medication, consisting of viral vectors containing the insulin sequence, is digested and delivers its genes to the upper intestines. Those intestinal cells will then behave like any viral infected cell, and will reproduce the insulin protein. The virus can be controlled to infect only the cells which respond to the presence of glucose, such that insulin is produced only in the presence of high glucose levels. Due to the limited numbers of vectors delivered, very few intestinal cells would actually be impacted and would die off naturally in a few days. Therefore, by varying the amount of oral medication used, the amount of insulin created by gene therapy can be increased or decreased as needed. As the insulin-producing intestinal cells die off, they are boosted by additional oral medications.
Thank you so much for providing this expert panel. The varying views helped me understand which areas are somewhat vague and which areas overlap. As a Type2 pre-diabetic of 7 years, I have been informed that I need to take a cholesterol drug, even though my cholesterol has always been low. I was told it’s to help remove calcification in my arteries. I have been considered obese for over 20 years and recently lost 50 lbs (I now weight 197) and am continuing to lose weight. I was told that I would always be a diabetic and would have to take medication. I was so proud of my progress (A1c now 5.6), but this news depressed me. I refused to take the cholesterol drug until I could do some research. This expert panel helped me to realize that it is possible to get off the medication if I continue to eat a healthy diet (low saturated fats) and exercise at least 150 minutes a week. Thank you!
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.
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In obese young people, decreased β-cell function has recently been shown to predict deterioration of glucose tolerance (4,78). Additionally, the rate of decline in glucose tolerance in first-degree relatives of type 2 diabetic individuals is strongly related to the loss of β-cell function, whereas insulin sensitivity changes little (79). This observation mirrors those in populations with a high incidence of type 2 diabetes in which transition from hyperinsulinemic normal glucose tolerance to overt diabetes involves a large, rapid rise in glucose levels as a result of a relatively small further loss of acute β-cell competence (3). The Whitehall II study showed in a large population followed prospectively that people with diabetes exhibit a sudden rise in fasting glucose as β-cell function deteriorates (Fig. 5) (80). Hence, the ability of the pancreas to mount a normal, brisk insulin response to an increasing plasma glucose level is lost in the 2 years before the detection of diabetes, although fasting plasma glucose levels may have been at the upper limit of normal for several years. This was very different from the widely assumed linear rise in fasting plasma glucose level and gradual β-cell decompensation but is consistent with the time course of markers of increased liver fat before the onset of type 2 diabetes observed in other studies (81). Data from the West of Scotland Coronary Prevention Study demonstrated that plasma triacylglycerol and ALT levels were modestly elevated 2 years before the diagnosis of type 2 diabetes and that there was a steady rise in the level of this liver enzyme in the run-up to the time of diagnosis (75).
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High blood sugar (hyperglycemia). Your blood sugar level can rise for many reasons, including eating too much, being sick or not taking enough glucose-lowering medication. Check your blood sugar level often, and watch for signs and symptoms of high blood sugar — frequent urination, increased thirst, dry mouth, blurred vision, fatigue and nausea. If you have hyperglycemia, you'll need to adjust your meal plan, medications or both.
On a personal note, I always encourage full disclosure of a history of diabetes, even if currently diet controlled. Although a glucose level may now be within normal range, certain medical treatments/medications/illnesses may trigger a hyperglycemic (high blood glucose) level. The fully informed medical provider will closely monitor these patients and prevent uncontrolled glucose spikes from occurring.
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.
Yes and no. If you learn to live a healthier lifestyle and stay with it for your remaining years, then yes it can be reversed. This assumes you realized your diagnosis early and you are able to get your A1c below 6%. If you realized your diabetes too late or your A1c is not coming down without insulin then probably not. This is easier to reverse when you are overweight or obese but not so if your BMI is below 25.
Maintaining normal blood sugar levels is necessary for the body’s overall health. Erratic blood sugar levels can affect the body’s ability to function normally and even lead to complications if left unchecked. Some herbs and spices found in nature do a tremendous job of naturally lowering blood sugar levels, making them a boon for diabetics and pre-diabetics. What’s more, being nature’s multi-taskers, herbs and spices also produce overall health benefits beyond just helping balance blood sugar.
The aptly named bitter melon is thought to help cells use glucose more effectively and block sugar absorption in the intestine. When Philippine researchers had men and women take bitter melon in capsule form for three months, they had slight, but consistently, lower blood sugar than those taking a placebo. Gastrointestinal problems are possible side effects. You can reverse diabetes with these science-backed strategies.
Chinese medicine has been using cinnamon for medicinal purposes for hundreds of years. It has been the subject of numerous studies to determine its effect on blood glucose levels. A 2011 study has shown that cinnamon, in whole form or extract, helps lower fasting blood glucose levels. More studies are being done, but cinnamon is showing promise for helping to treat diabetes.
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.