The new research ties in with recent thinking among experts about what happens when type 2 diabetes develops, says Domenico Accili, MD, chief of endocrinology at Columbia University Vagelos College of Physicians and Surgeons. "We have been talking for some time, that in diabetes, primarily type 2, the insulin-producing [beta] cell is not dead but simply inactive," he says. "If you put patients with diabetes on a diet, you can do marvels with their beta cells."
Diabetes is the major cause of blindness, kidney failure, heart attack and stroke. The number of people affected by all types of diabetic disorders is now over four times higher than just 40 years ago. This has led the World Health Organization (WHO) to consider diabetes an epidemic, predicting it will soon be the seventh biggest cause of death worldwide.
To drop pounds, Galati emphasizes using portion control, avoiding processed foods, and eating fresh vegetables, fruits, and fresh lean meat, poultry, and fish. Regular exercise should also be part of the program. Typically, he talks to patients about first targeting a weight loss goal of 10 percent. Once that is achieved, they typically strive for increments of 5 percent to 7 percent on a 6- to 12-month basis.
Control and outcomes of both types 1 and 2 diabetes may be improved by patients using home glucose meters to regularly measure their glucose levels. Glucose monitoring is both expensive (largely due to the cost of the consumable test strips) and requires significant commitment on the part of the patient. The effort and expense may be worthwhile for patients when they use the values to sensibly adjust food, exercise, and oral medications or insulin. These adjustments are generally made by the patients themselves following training by a clinician.
There was a clinical trial conducted at Department of Biochemistry, Postgraduate Institute of Basic Medical Sciences Madras, India that studied 22 patients with type 2 diabetes. It reported that supplementing the body with 400 mg of Gymnema Sylvestre extract daily resulted in remarkable reductions in blood glucose levels, hemoglobin A1c and glycosylated plasma protein levels. What’s even more remarkable is that by the end of this 18 month study, participants were able to reduce the dosage of their prescription diabetes medication. Five were even completely off medication and attaining stable blood sugar levels with Gymnema Sylvestre supplementation alone.
Magnesium is a mineral found naturally in foods such as green leafy vegetables, nuts, seeds, and whole grains and in nutritional supplements. Magnesium is needed for more than 300 biochemical reactions. It helps regulate blood sugar levels and is needed for normal muscle and nerve function, heart rhythm, immune function, blood pressure, and for bone health.
Each day in the United States, some 18 million people with diabetes walk a tightrope between too little sugar in the bloodstream and too much. Too little, which may come from a complication of medication, and they may quickly be overcome by dizziness, fatigue, headache, sweating, trembling, and, in severe cases, loss of consciousness and coma. Too much, which can happen after eating too much, especially if the person is older and overweight, and the person may experience weakness, fatigue, excessive thirst, labored breathing, and loss of consciousness.
When a patient is ready to make a big commitment to get their blood sugar under control, Simos works with them to help tease apart what may be causing their blood sugar to spiral. Sometimes it’s what they're eating, sometimes it’s stress at home and at work and sometimes it’s a day full of sitting versus moving. Often, it’s a mix of these things. Other factors may contribute to diabetes risk, including a family history of the disease.
To help patients learn to manage their diabetes successfully, the Diabetes Treatment Center at Desert Springs Hospital offers educational classes, as well as individualized appointments, (in both English and Spanish) on topics such as behavior change, goal setting, healthy eating concepts, carbohydrate counting, dining out, label reading, lipid, medication, stress and sick day management, benefits of exercise, prevention of complications and foot care. Special Gestational Diabetes Education classes are also available for women diagnosed with diabetes during pregnancy. Learn more about the Diabetes Care Education Series >
Eating a balanced diet is vital for people who have diabetes, so work with your doctor or dietitian to set up a menu plan. If you have type 1 diabetes, the timing of your insulin dosage is determined by activity and diet. When you eat and how much you eat are just as important as what you eat. Usually, doctors recommend three small meals and three to four snacks every day to maintain the proper balance between sugar and insulin in the blood.
Some people who have type 2 diabetes can achieve their target blood sugar levels with diet and exercise alone, but many also need diabetes medications or insulin therapy. The decision about which medications are best depends on many factors, including your blood sugar level and any other health problems you have. Your doctor might even combine drugs from different classes to help you control your blood sugar in several different ways.
Jump up ^ Farmer, A; Wade, A; French, DP; Goyder, E; Kinmonth, AL; Neil, A (2005). "The DiGEM trial protocol – a randomised controlled trial to determine the effect on glycaemic control of different strategies of blood glucose self-monitoring in people with type 2 diabetes ISRCTN47464659". BMC Family Practice. 6 (1): 25. doi:10.1186/1471-2296-6-25. PMC 1185530. PMID 15960852.
Since the body functions as a whole, it is logical that when one hormone or part of the endocrine system is suffering, the other would be affected as well. This is the reason behind the recent research linking high stress levels to diabetes and other health problems. Most people think of stress only in the mental context (as in, “I’ve got a million things to do, I’m running late and I don’t have time to get anything done… I’m so stressed”) but stress can be physical, psychological, emotional, or mental and can be triggered by many factors including:
These dietary recommendations have made high carb, low-fat foods a staple of the American diet. “Healthy” foods like fruit-on-the-bottom yogurt, sugary protein shakes and low-fat processed grains flooded the market. The standard American diet began to include more sugary drinks and sodas, as well as more processed grains. Since all carbohydrates (even complex carbs) are broken down into sugar in the body, these dietary recommendations meant that the average blood sugar of Americans began to rise – and the diabetes epidemic began to grow.
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).
A couple of studies have found that cinnamon improves blood glucose control in people with type 2 diabetes. In the first study, 60 people with type 2 diabetes were divided into six groups. Three groups took 1, 3 or 6 g of cinnamon a day and the remaining three groups consumed 1, 3 or 6 g of placebo capsules. After 40 days, all three doses of cinnamon significantly reduced fasting blood glucose, triglycerides, LDL cholesterol, and total cholesterol.
If however, type 2 diabetes is a result of insulin resistance and being overweight, there is excellent evidence that exercise, decreasing added sugars and saturated fats in the diet, choosing low glycaemic index foods and losing weight – particularly around the abdominal region, can improve blood glucose levels to the extent that it seems like diabetes has been reversed.
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).
Other medications such as metformin or the DPP4 drug class are weight neutral. While this won’t make things worse, they won’t make things better either. Since weight loss is the key to reversing type 2 diabetes, medications won’t make things better. Medications make blood sugars (the symptom) better, but not the diabetes (the actual disease). We’ve been pretending that the symptom is the disease.We can pretend the disease is better, but that doesn’t make it true. That’s the reason most doctors think type 2 diabetes a chronic and progressive disease. We’ve been using the wrong treatment. We’ve been prescribing drugs for a dietary disease. No wonder it doesn’t work.
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.
In medical world, diabetes is known more commonly by the name of diabetes mellitus. In simpler and day-to-day language, it is referred as diabetes. It is a group of metabolic diseases in which a person has high blood sugar, either because cells do not respond to the insulin that is produced, or the body does not produce enough insulin. In both the conditions, the body is not able to get enough amount of insulin to function properly.
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
With that in mind, let’s take a look at some of the best herbs that lower blood sugar, along with a few spices thrown in, to give you a more comprehensive list. Please note that while we normally do not use animal studies to support any dietary supplement, several herbs like garlic and ginger are considered ‘food’ and so, are used traditionally by cultures across the world in their daily diet for their additional medical benefits. So human lab research studies on these are not always available. You can check all available studies under ‘References’ at the end of the article.
Knowing your blood-sugar levels and acting accordingly are among the most important ways to treat T1D. Monitoring lets a person know when insulin may be needed to correct high blood sugar or when carbohydrates may be needed to correct low blood sugar. Monitoring blood sugar can be done using traditional blood-sugar meters or continuous glucose monitors (CGMs).
Insulin is a naturally occurring hormone in your pancreas that helps your body use blood sugar and keeps blood sugar within a healthy range. But in the case of type 2 diabetes, a person’s body doesn’t use insulin properly, leading to insulin resistance. When your pancreas simply can't make enough insulin or use it well enough to control blood sugar, your doctor is likely to prescribe insulin injections.
Magnesium deficiency is common in diabetic patients, as magnesium can be lost in the urine with hyperglycemia. A study in Diabetes Care reported that low magnesium status is common in Type 2 Diabetes Mellitus (T2DM) and showed that when low-magnesium Type 2 Diabetes Mellitus patients were given an oral dose of magnesium daily for sixteen weeks, the mineral reduced insulin resistance, fasting glucose, and A1C levels.
In a person with carbohydrate intolerance, type 2 diabetes or prediabetes, this system breaks down. The body loses its insulin sensitivity and more and more insulin is required to remove the excess blood sugar. As a result, blood sugar levels remain high and insulin levels are high as well, and these high insulin levels can make your body even less sensitive to insulin.
At the start of the study, all of the patients had been taking two oral diabetes drugs for at least six months. But they still had poorly controlled diabetes based on blood tests showing so-called hemoglobin A1c levels, which reflect average blood sugar levels over about three months. Readings above 6.5 signal diabetes, and everyone in the study had readings of at least 7.
A: Fasting plasma glucose and weight change 2 years after randomization either to gastric banding or to intensive medical therapy for weight loss and glucose control. Data plotted with permission from Dixon et al. (13). B: Early changes in fasting plasma glucose level following pancreatoduodenal bypass surgery. A decrease into the normal range was seen within 7 days. Reproduced with permission from Taylor (98).
The men took a six-hour educational course on diabetes and intermittent fasting prior to fasting. For the experiment, one man fasted for 24 hours three days per week, and the other two alternated their fasting days throughout the week. On fast days, they ate one low-calorie meal in the evening, and drank low-cal beverages, such as water, coffee, tea, and broth. The authors encouraged participants to opt for low-carb on the eating days.
Cinnamon’s effectiveness as a treatment for diabetes has not been established. A prescription drug as ineffective as cinnamon likely wouldn’t pass FDA muster. Existing drug treatments for diabetes, on the other hand, are cheap, effective, and generally well tolerated. Compared to drug therapy, we don’t know if cinnamon can reduce the risk of mortality due to diabetes, or the progression to any of the other serious outcomes of diabetes. For my patients that insist on trying cinnamon, I’d caution them of the risks, and reinforce that cinnamon is no alternative for lifestyle changes and medication if necessary. It may be natural, sure, but that doesn’t mean it’s either safe or effective.
It’s like packing your clothes into a suitcase. At first, the clothes go without any trouble. After a certain point, though, it is just impossible to jam in those last 2 T-shirts. You can’t close the suitcase. The luggage is now ‘resistant’ to the clothes. It’s waaayyy harder to put those last 2 T-shirts than the first 2. It’s the same overflow phenomenon. The cell is filled to bursting with glucose, so trying to force more in is difficult and requires much higher doses of insulin.
During this 8-week study, β-cell function was tested by a gold standard method that used a stepped glucose infusion with subsequent arginine bolus (21). In type 2 diabetes, the glucose-induced initial rapid peak of insulin secretion (the first phase insulin response) typically is absent. This was confirmed at baseline in the study, but the first phase response increased gradually over 8 weeks of a very-low-calorie diet to become indistinguishable from that of age- and weight-matched nondiabetic control subjects. The maximum insulin response, as elicited by arginine bolus during hyperglycemia, also normalized. Pancreas fat content decreased gradually during the study period to become the same as that in the control group, a time course matching that of the increase in both first phase and total insulin secretion (Fig. 3). Fat content in the islets was not directly measured, although it is known that islets take up fat avidly (24) and that islet fat content closely reflects total pancreatic fat content in animal models (25). Although a cause-and-effect relationship between raised intraorgan fat levels and metabolic effect has not yet been proven, the time course data following the dietary intervention study are highly suggestive of a causal link (21).
Cinnamonium cassia and its relative C. burmanii are the types of cinnamon that have the best effect on diabetes symptoms. There have been numerous studies on cinnamon and, overall, they have shown cinnamon can slow stomach emptying and lower postprandial glucose levels. It also reduces glucose levels in Type 2 Diabetes Mellitus patients who have had poor diabetic control. It may also be helpful in lowering insulin levels, blood pressure, and A1C, and reduce AGE formation. This is a safe herb for diabetics. A good dose is 1 to 2 g a day or 200 mg or more of a concentrated extract.
If you have type 2 diabetes, sometimes eating healthy and engaging in physical activity is not enough. Your doctor may give you oral medication to help control your blood glucose levels. For people with type 1 diabetes (and some people with type 2 diabetes) this means taking insulin. People with type 1 diabetes must take insulin to control diabetes--and this can only be done through multiple injections or by an insulin pump, a small device that delivers insulin continuously throughout the day. For more on medications and diabetes, click here.
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.
Treatment for diabetes requires keeping close watch over your blood sugar levels (and keeping them at a goal set by your doctor) with a combination of medications, exercise, and diet. By paying close attention to what and when you eat, you can minimize or avoid the "seesaw effect" of rapidly changing blood sugar levels, which can require quick changes in medication dosages, especially insulin.