Mechanism of interaction between excess amounts of fatty acids, diacylglycerol, and ceramide and insulin action within the hepatocyte. Diacylglycerol activates PKCε and inhibits activation of IRS-1 by the insulin receptor. Ceramides cause sequestration of Akt2 by PKCζ and inhibit insulin control of gluconeogenesis. These mechanisms have recently been reviewed (99). FFA, free-fatty acid; TG, triacylglycerol.
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.
Regular blood testing, especially in type 1 diabetics, is helpful to keep adequate control of glucose levels and to reduce the chance of long term side effects of the disease. There are many (at least 20+) different types of blood monitoring devices available on the market today; not every meter suits all patients and it is a specific matter of choice for the patient, in consultation with a physician or other experienced professional, to find a meter that they personally find comfortable to use. The principle of the devices is virtually the same: a small blood sample is collected and measured. In one type of meter, the electrochemical, a small blood sample is produced by the patient using a lancet (a sterile pointed needle). The blood droplet is usually collected at the bottom of a test strip, while the other end is inserted in the glucose meter. This test strip contains various chemicals so that when the blood is applied, a small electrical charge is created between two contacts. This charge will vary depending on the glucose levels within the blood. In older glucose meters, the drop of blood is placed on top of a strip. A chemical reaction occurs and the strip changes color. The meter then measures the color of the strip optically.

While Type 1 Diabetes is an autoimmune disorder that seems to affect people with certain gene types, Type 2 Diabetes is triggered by lifestyle choices, such as poor diet and obesity. Eating sugary and processed foods contributes to weight gain, and that extra body fat can be released into the bloodstream, impeding the absorption of insulin and other chemicals related to metabolism. When metabolism is slowed, weight gain is more likely, and the cycle repeats itself. Treatment for Type 2 Diabetes is multifaceted, often including insulin injections, a host of medications, and lifestyle modifications such as diet changes and exercise regimens.

Elevated homocysteine levels in the blood called hyperhomocysteinemia, is a sign that the body isn't producing enough of the amino acid homocysteine. is a rare and serious condition that may be inherited (genetic). People with homocystinuria die at an early age. Symptoms of hyperhomocysteinemia include developmental delays, osteoporosis, blood clots, heart attack, heart disease, stroke, and visual abnormalities.
Insulin pumps are small, computerized devices, about the size of a beeper that you wear on your belt or put in your pocket. They have a small flexible tube with a fine needle on the end. The needle is inserted under the skin of your abdomen and taped in place. The pump releases a carefully measured, steady flow of insulin into the tissue. Insulin pumps can cost $6,000 to $10,000 for the pump, with additional costs for necessary supplies to use the pump.Using a pump means you will have to monitor your blood sugar level at least four times a day. You program doses and make adjustments to your insulin, depending on your food intake and exercise program. Some health care providers prefer the insulin pump over injections because its slow release of insulin imitates a working pancreas.
Type 2 diabetes has long been known to progress despite glucose-lowering treatment, with 50% of individuals requiring insulin therapy within 10 years (1). This seemingly inexorable deterioration in control has been interpreted to mean that the condition is treatable but not curable. Clinical guidelines recognize this deterioration with algorithms of sequential addition of therapies. Insulin resistance and β-cell dysfunction are known to be the major pathophysiologic factors driving type 2 diabetes; however, these factors come into play with very different time courses. Insulin resistance in muscle is the earliest detectable abnormality of type 2 diabetes (2). In contrast, changes in insulin secretion determine both the onset of hyperglycemia and the progression toward insulin therapy (3,4). The etiology of each of these two major factors appears to be distinct. Insulin resistance may be caused by an insulin signaling defect (5), glucose transporter defect (6), or lipotoxicity (7), and β-cell dysfunction is postulated to be caused by amyloid deposition in the islets (8), oxidative stress (9), excess fatty acid (10), or lack of incretin effect (11). The demonstration of reversibility of type 2 diabetes offers the opportunity to evaluate the time sequence of pathophysiologic events during return to normal glucose metabolism and, hence, to unraveling the etiology.
This article is great, it combines all of the info I have found, not only putting it into a well written article but adds info I had not found yet. I have struggled with type 2 and losing weight, starting an aggressive weight cardio plan in 2016 with an A1C level of 9.7%. Even after three months of an hour or more of weight lifting and 30-50 mins of hard hilly terrain bike riding, my bets A1C was 7.7% with lowering my carb count to the recommended range. After an injury caused me to have to stop many of the exercises for a bit my A1C went up to the 9% range. July this year my A1C was 9.9% and my Dr was talking about insulin shots, which I hate needles. One last ditch effort to find a solution and avoid the shots, I found an article about the benefits of intermittent fasting. I did a lot of research on the matter before creating my own version of a Keto diet, and went on a strict diet of 5-8 servings of green leafy vegetables a day, around 45g of carbs a day, 3oz of lean or healthy fat protein a meal and fasting for 18 hours between Dinner till lunch the next day for two and a half months. My A1C was 6.5, I lost 20lbs, and have tons of energy and no cravings. I have altered my diet to fit my new exercise plan, still 5-8 servings of vegetables a day, but have added occasional breakfasts of two eggs and 1/2 cup salsa, no more than 100g of carbs a day except my once a week cheat day that might go slightly higher if my blood sugar is in a good range, 6oz lean healthy fat protein, and a hard boiled egg in between meals.
Exercise– Even the mainstream medical community recognizes the advantage of exercise, as it increases the muscles ability to use insulin and over time can help fix insulin resistance. All exercise isn’t created equal though and fortunately, smaller amounts of high intensity exercise have been shown to have a better effect on insulin levels (and weight loss) than an hour of daily moderate cardio. According to the Healthy Skeptic: “A pair of studies done at McMaster University found that “6-minutes of pure, hard exercise once a week could be just as effective as an hour of daily moderate activity“, according to the June 6, 2005 CNN article reporting on the study.” I recommend high intensity exercise anyway for its various health advantages, and it is great for diabetes control. too.

It’s the patients with type 2 diabetes that lean towards supplements. While lifestyle modifications (exercise, weight loss, and smoking cessation) are the foundation for managing diabetes, drug treatment is usually also required. There are an array of prescription drugs like metformin and glyburide with a long history of use and demonstrated efficacy. Some drugs even decrease mortality – the primary outcome we’re after. But proper treatment has also been shown to the reduce the risk of an array of other consequences: Diabetes is the biggest cause of blindness, kidney failure and non-traumatic amputation. Diabetes is associated with an elevated risk of cardiovascular disease, too. Yet despite the irreversible consequences of diabetes, and the availability of effective medications, type 2 diabetes remains poorly-controlled in many, often because of poor self-management.
An insulin pump is a small machine that gives you small, steady doses of insulin throughout the day. You wear one type of pump outside your body on a belt or in a pocket or pouch. The insulin pump connects to a small plastic tube and a very small needle. You insert the needle under your skin and it stays in place for several days. Insulin then pumps from the machine through the tube into your body 24 hours a day. You also can give yourself doses of insulin through the pump at mealtimes. Another type of pump has no tubes and attaches directly to your skin, such as a self-adhesive pod.
The diabetes looks better, since you can only see the blood sugars. Doctors can congratulate themselves on a illusion of a job well done, even as the patient gets continually sicker. Patients require ever increasing doses of medications and yet still suffer with heart attacks, congestive heart failure, strokes, kidney failure, amputations and blindness. “Oh well” the doctor tells himself, “It’s a chronic, progressive disease”.

Does acupuncture for diabetes work? Acupuncture has many uses, and some research has suggested that it may work for diabetes, although how it would help has not yet been explained. Find out about the types of acupuncture that might help, the risks, and some evidence of its benefits. Anyone considering acupuncture should first check with their doctor. Read now

Type 2 Diabetes plagues the United States, but is even more rampant in many developing countries, triggered in large part by a shift to less healthy nutritional habits and increasingly sedentary lifestyles, all fueled by the drive of rapid urbanization and economic growth. Asia is one of the largest epicenters of this disease, with an estimated 60 percent of the world’s diabetes patients living in that region.
India is said to be the diabetes capital of the world. With nearly 50 million people in India suffering from diabetes, the country has a big challenge to face. First, let’s know what is diabetes. The elevated sugar in the blood is called diabetes. There are two primary reasons behind diabetes - one is when our body stops producing insulin and second is when the body does not respond to insulin that is produced by the body. Insulin is broken down by the body and used as energy, which is transported to the cells. There are two types of diabetes - Type I diabetes and Type II diabetes. Let’s know about them in a little detail:
There are numerous studies of botanical medicines and herbs for diabetes that speak to the effectiveness of natural and home remedies for diabetes. I have listed the most useful herbs with the most documented benefits. A patient does not need to take one hundred bottles a day of everything out on the market, but rather it is important to focus on a few botanicals backed by the most impressive studies and the best clinical evidence. The botanicals listed below are safe and effective.

This type of discussion occurs all the time. A patient has been assessed by their physician, and informed that they have a medical problem of some sort. The patient, reluctant to accept the physician’s evaluation, heads to the pharmacy for a second opinion. In some cases, the patient may question the physician’s advice: “All my physician wants to do is prescribe drugs.” Yet there’s a disconnect when it comes to strategies for management. More often than not, non-drug approaches are rejected out-of-hand (probably because the sample I speak with have already made the decision to buy something). And in those that are leery of medical management, there’s often a willingness to consider anything that’s available without a prescription – particularly if it’s perceived as “natural.” Natural products are gentle, safe, and effective, while medicine is thought of as unnatural, harsh, and potentially dangerous. This is the appeal to nature fallacy, nothing more. Purveyors of supplements leverage the appeal to nature fallacy into the marketing strategy of choice for almost all supplements and “alternative” medicines.  And it leads to bad health care decisions.
The first hint that type 2 diabetes is a fully reversible syndrome came from bariatric surgery. Almost a quarter century ago, Pories et al. (12) demonstrated that blood glucose levels normalized in obese people with type 2 diabetes undergoing bariatric surgery and that 10 years later, almost 90% remained free of diabetes. The phenomenon was more recently tested in a randomized prospective study comparing gastric banding with intensive medical therapy for type 2 diabetes (13). This least invasive type of surgery was most suitable for the randomized study, although it was associated with lower rates of diabetes reversal than other procedures. Mean fasting plasma glucose fell to normal levels in the surgically treated group but declined only modestly in the intensive medical treatment group despite oral agents and insulin (Fig. 1) (13). Remission of diabetes was related to the degree of weight loss rather than to group allocation and was achieved in 73% of the surgical group and 13% of the intensive medical treatment group because surgery was more effective in achieving weight loss as previously described (14). Type 2 diabetes can be reversed by applying a surgical procedure that diminishes fat mass.
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 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.
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.
Dental care is therefore even more important for diabetic patients than for healthy individuals. Maintaining the teeth and gum healthy is done by taking some preventing measures such as regular appointments at a dentist and a very good oral hygiene. Also, oral health problems can be avoided by closely monitoring the blood sugar levels. Patients who keep better under control their blood sugar levels and diabetes are less likely to develop oral health problems when compared to diabetic patients who control their disease moderately or poorly.
Type 2 diabetes is almost always reversible and this is almost ridiculously easy to prove. This is great news for the more than 50% of American adults who have been diagnosed with pre-diabetes or diabetes. Recognizing this truth is the crucial first step in reversing your diabetes or pre-diabetes. Actually, it something that most people already instinctively recognized to be true.
Jump up ^ Qaseem A, Vijan S, Snow V, Cross JT, Weiss KB, Owens DK; Vijan; Snow; Cross; Weiss; Owens; Clinical Efficacy Assessment Subcommittee of the American College of Physicians (September 2007). "Glycemic control and type 2 diabetes mellitus: the optimal hemoglobin A1c targets. A guidance statement from the American College of Physicians". Annals of Internal Medicine. 147 (6): 417–22. doi:10.7326/0003-4819-147-6-200709180-00012. PMID 17876024. Retrieved 19 July 2008.
Evidence linking hepatic insulin sensitivity to intraorgan triglyceride content has been steadily accumulating. In insulin-treated type 2 diabetes, insulin dose correlates with the extent of fatty liver (35), and in turn, this is associated with insulin sensitivity to suppression of hepatic glucose production (36). Decreasing the fat content of liver is associated with improvement in insulin suppression of glucose production and, thereby, with improvement in fasting plasma glucose (20,23).
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.
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.

McInnes, N., Smith, A., Otto, R., Vandermey, J., Punthakee, Z., Sherifali, D., … Gerstein, H. C. (2017, March 15). Piloting a remission strategy in type 2 diabetes: Results of a randomized controlled trial. The Journal of Clinical Endocrinology and Metabolism, 2016-3373. Retrieved from
As diabetes is a prime risk factor for cardiovascular disease, controlling other risk factors which may give rise to secondary conditions, as well as the diabetes itself, is one of the facets of diabetes management. Checking cholesterol, LDL, HDL and triglyceride levels may indicate hyperlipoproteinemia, which may warrant treatment with hypolipidemic drugs. Checking the blood pressure and keeping it within strict limits (using diet and antihypertensive treatment) protects against the retinal, renal and cardiovascular complications of diabetes. Regular follow-up by a podiatrist or other foot health specialists is encouraged to prevent the development of diabetic foot. Annual eye exams are suggested to monitor for progression of diabetic retinopathy.
The essential feature of type 2 diabetes and pre-diabetes is that our bodies are completely filled with sugar. It’s not just too much sugar in the blood. That’s only part of the problem. There’s too much sugar in our entire body. Imagine our bodies to be a sugar bowl. A bowl of sugar. When we are young, our sugar bowl is empty. Over decades, we eat too much of the wrong things — sugary cereals, desserts and white bread. The sugar bowl gradually fills up with sugar until completely full. The next time you eat, sugar comes into the body, but the bowl is full, so it spills out into the blood.
Recent advances and research in management of Diabetes with traditionally used natural therapies have resulted in development of products from that facilitate production and proper utilization of insulin in the body. These preparations (Biogetica) are natural and work in conjugation with conventional therapies as supportive treatment protocols, they are absolutely safe and the patients are never at risk of developing hypoglycemic attacks due to the therapies.
Robert Ferry Jr., MD, is a U.S. board-certified Pediatric Endocrinologist. After taking his baccalaureate degree from Yale College, receiving his doctoral degree and residency training in pediatrics at University of Texas Health Science Center at San Antonio (UTHSCSA), he completed fellowship training in pediatric endocrinology at The Children's Hospital of Philadelphia.