Peripheral artery disease (PAD), which commonly affects the legs, is the hardening and narrowing of the arteries that can result from a build-up of plaque or fatty deposits in blood vessels outside the heart or brain. Because diabetics sometimes have reduced feeling in their feet and legs, they often do not feel symptoms of PAD and it goes undiagnosed and untreated. The Diabetes Treatment Center at Desert Springs Hospital take a proactive approach to PAD and provides free Ankle Brachial Index screenings for patients.
Momordica Charantia goes under a variety of names and is native to some areas of Asia, India, Africa and South America. Marketed as charantia, it is also known as karela or karolla and bitter melon. The herb may be prepared in a variety of different ways, and may be able to help diabetics with insulin secretion, glucose oxidation and other processes.
In addition to walking and stretching exercises, try interval training cardio, like burst training, or weight training three to five days a week for 20–40 minutes. Burst training can help you burn up to three times more body fat than traditional cardio and can naturally increase insulin sensitivity. You can do this on a spin bike with intervals, or you can try burst training at home.

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.

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.
Type 2 diabetes is a condition that is characterised by chronically elevated blood sugar levels. However, the main cause as well as the driver for this condition is something called Insulin Resistance. When you eat certain foods, particularly refined carbohydrates, that food is converted to sugar inside your body. Your body’s way of dealing with this sugar is to produce a hormone called insulin. Insulin moves the sugar inside your cells so that it can be used for energy. Sounds great, right?

When the insulin levels are unable to keep up with the increasing resistance, blood sugars rise and your doctor diagnoses you with type 2 diabetes and starts you on a pill, such as metformin. But metformin does not get rid of the sugar. Instead, it simply takes the sugar from the blood and rams it back into the liver. The liver doesn’t want it either, so it ships it out to all the other organs — the kidneys, the nerves, the eyes, the heart. Much of this extra sugar will also just get turned into fat.
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.
Sugars raise insulin levels, and over extended periods of time, damage the pancreas and cause insulin resistance, a precursor for diabetes. Fructose is the top offender in the sugar world, as it is recognized as a toxin the body and has no proven benefit to the body. Fructose is immediately taken to the liver, where it must be processed, and some doctors now suggest that this may be a large factor in development of fatty liver disease. Excess sugar in the bloodstream also increases the release of cortisol and adrenaline (more on those in a minute), slows the immune response, decreases necessary Leptin levels and promotes fat storage. There are various types of sugar and sweeteners, and while all should be limited, some are worse than others:
For Type 1 diabetics there will always be a need for insulin injections throughout their life. However, both Type 1 and Type 2 diabetics can see dramatic effects on their blood sugars through controlling their diet, and some Type 2 diabetics can fully control the disease by dietary modification. As diabetes can lead to many other complications it is critical to maintain blood sugars as close to normal as possible and diet is the leading factor in this level of control.
If I could only prescribe one supplement for a diabetes patient, I would prescribe R-alpha-lipoic acid. Alpha-lipoic acid has numerous benefits to the diabetic patient. It is a water- and fat-soluble antioxidant and has been shown to protect patients with fatty liver from liver disease progression. It can help reduce insulin resistance and has been shown to protect people with diabetes from developing complications in their nerves, eyes, and kidneys. R-ALA can prevent glycosylation of proteins, which reduces the A1C level. It is safe, although very rarely it can cause stomach upset. Alpha-lipoic acid is listed either as ALA or R-ALA. When listed as ALA, this means it contains two forms—the S isomer form and the R isomer form, in a 50:50 ratio. The key is to find a product that says it contains “R-ALA” instead of just “ALA.” A good daily working dose of R-ALA is 300 to 1,200 mg a day, which is the equivalent of 600 to 2,400 mg a day of regular ALA, if you buy a regular ALA listed product.
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.
Try to keep carbohydrate amounts stable across the day (some choose lower carbohydrate targets), stand more and sit less and include activities that increase the heart rate and also strength based activities most days across the week. Think about the amount of stress you experience to see how it is increasing your blood glucose levels. If you smoke – stop because it is speeding up the damage to your blood vessels. If you drink alcohol, limit how much you drink.
About 90 percent of people with type 2 diabetes are obese or overweight, according to the Obesity Society. Weight loss is a known treatment for type 2, which affects the majority of the 30.3 million people with diabetes, as it helps people with the disease reduce insulin resistance and absorb blood glucose more effectively. According to the Centers for Disease Control and Prevention (CDC), being overweight makes it harder to control diabetes and is a risk factor for diabetes-related health complications.
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:
Sugars raise insulin levels, and over extended periods of time, damage the pancreas and cause insulin resistance, a precursor for diabetes. Fructose is the top offender in the sugar world, as it is recognized as a toxin the body and has no proven benefit to the body. Fructose is immediately taken to the liver, where it must be processed, and some doctors now suggest that this may be a large factor in development of fatty liver disease. Excess sugar in the bloodstream also increases the release of cortisol and adrenaline (more on those in a minute), slows the immune response, decreases necessary Leptin levels and promotes fat storage. There are various types of sugar and sweeteners, and while all should be limited, some are worse than others:

11. Get regular eye exams: Diabetic retinopathy is caused by elevated levels of blood sugar, which can happen when diabetes goes out of control. The disease can damage the blood vessels around the eye and retina, leading to blurred vision and blindness. Diabetic retinopathy cannot be cured, and often has no early symptoms, which makes it difficult to catch. Diabetics should make sure they get regular eye exams, for early detection and treatment.


He emphasizes lifestyle changes and weight loss as a first step. "We give them a 3-month trial of diet and lifestyle [modification] before starting medications," he says. "A lot of times, for many patients newly diagnosed, we will see the sugars melt back into the normal range" after the weight loss and other changes. He has seen it happen after a weight loss of 7% to 10% of their starting weight.
A spice that is popular for soothing your stomach and aiding digestion, Ginger also has the ability to normalize blood sugar levels. Multiple studies conducted on rats show that ginger extract can have a significant anti-hyperglycemic effect. It lowers serum total cholesterol, triglycerides and increases the HDL-cholesterol levels. Diabetes is a digestive disorder. Diabetics often face issues with acid reflux. Ginger soothes the entire digestive tract, giving diabetics another reason to add ginger to their supplement regimen.
Alternative: “The reason I use food-based supplements is because they most closely help correct what I see as the problem: The food we’re eating is lacking in nutrients,” DeLaney says. “If their vitamin D is low, it tells me all their fat-soluble vitamins are low.” She uses cod liver oil along with high-vitamin butter oil to restore these deficiencies.

Insulin therapy creates risk because of the inability to continuously know a person's blood glucose level and adjust insulin infusion appropriately. New advances in technology have overcome much of this problem. Small, portable insulin infusion pumps are available from several manufacturers. They allow a continuous infusion of small amounts of insulin to be delivered through the skin around the clock, plus the ability to give bolus doses when a person eats or has elevated blood glucose levels. This is very similar to how the pancreas works, but these pumps lack a continuous "feed-back" mechanism. Thus, the user is still at risk of giving too much or too little insulin unless blood glucose measurements are made.

The more intense the exercise, the better. According to the British diabetes association diabetes.co.uk, high-intensity interval training (HIIT) may be better for weight loss and glucose control than continuous aerobic activity like jogging. HIIT involves alternating between short bursts of increased intensity exercise and rest — for instance, running and then walking on and off throughout the workout.
Conventional: A dietary pattern that includes carbohydrates from fruits, vegetables, whole grains, legumes, and low-fat milk is encouraged for good health. Carbohydrate intake should be monitored using carbohydrate counting or experienced-based estimation. The Recommended Dietary Allowance for digestible carbohydrates is 130 g/day, which will provide a sufficient amount of glucose needed to fuel the central nervous system without reliance on glucose production from protein or fat. Using foods with a low glycemic index that are rich in fiber and other important nutrients is encouraged.
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.
Grains: Grains, especially gluten-containing grains like wheat, contain large amounts of carbohydrates that are broken down into sugar within only a few minutes of consumption. Gluten can cause intestinal inflammation, which affects hormones like cortisol and leptin, and can lead to spikes in blood sugar. I recommend removing all grains from your diet for 90 days as your body adjusts to this healing program. Then you can try bringing sprouted ancient grains back into your diet in small amounts.
Although a close relationship exists among raised liver fat levels, insulin resistance, and raised liver enzyme levels (52), high levels of liver fat are not inevitably associated with hepatic insulin resistance. This is analogous to the discordance observed in the muscle of trained athletes in whom raised intramyocellular triacylglycerol is associated with high insulin sensitivity (53). This relationship is also seen in muscle of mice overexpressing the enzyme DGAT-1, which rapidly esterifies diacylglycerol to metabolically inert triacylglycerol (54). In both circumstances, raised intracellular triacylglycerol stores coexist with normal insulin sensitivity. When a variant of PNPLA3 was described as determining increased hepatic fat levels, it appeared that a major factor underlying nonalcoholic fatty liver disease and insulin resistance was identified (55). However, this relatively rare genetic variant is not associated with hepatic insulin resistance (56). Because the responsible G allele of PNPLA3 is believed to code for a lipase that is ineffective in triacylglycerol hydrolysis, it appears that diacylglycerol and fatty acids are sequestered as inert triacylglycerol, preventing any inhibitory effect on insulin signaling.
Everybody and their brother is jumping on the Diabetes bandwagon. I remember when Dr. Neal Barnard and Dr. Gabriel Cousens were the only two advocating a vegan diet to reverse Type 2 Diabetes and nobody was listening. Now, it seems there is some Doctor who pops out of the woodwork who claims to have the “Real” cure. Bottom line a ketogenic diet is dangerous for diabetics. It has been proven through studies that high fat diets are detrimental for glucose control. Fasting is also hit and miss for glucose control. As each person’s body is different and responds differently, a keto diet may work at first, but over time blood sugar numbers will rise. I tried a keto diet for 8 weeks. First three weeks it worked great then my glucose numbers slowly started to rise and it started to get hard to control my numbers. Same with fasting. My body responds to eating smaller meals every two hours, 90% vegan and raw. I eat chicken and fish sparingly. It works for me. But, I have known many diabetics who ended up in a bad place on a keto diet. In the long run it is a big fail. There are no studies that support it, whereas there are numerous studies (even government funded studies) that support a vegan diet to reverse diabetes.
Gestational diabetes develops during pregnancy because hormones interfere with how the body uses insulin. When the pancreas can’t keep up with the insulin demand and blood glucose levels get too high, the result is gestational diabetes. About 2-7 percent of expectant mothers develop gestational diabetes during their pregnancy. Learn more about diabetes and pregnancy.
Before making any fiber recommendations, Dean has her patients tested for “pancreatic insufficiency.” She believes people with pancreatic insufficiency should be given digestive enzymes along with fiber, “otherwise the fiber will just bloat them up, and they’ll be quite unhappy,” she says. Dean uses a glucomannan fiber supplement for her patients with type 2 diabetes.

The way you take insulin may depend on your lifestyle, insurance plan, and preferences. You may decide that needles are not for you and prefer a different method. Talk with your doctor about the options and which is best for you. Most people with diabetes use a needle and syringe, pen, or insulin pump. Inhalers, injection ports, and jet injectors are less common.

In discussing self management with the person with diabetes I focus on how healthy lifestyle behaviors can change the treatment plan. Introducing healthy lifestyle behaviors by providing consistent and predictable meals, daily activity, healthy coping and consistent medication management can improve overall glucose control and may change the overall treatment plan for managing diabetes.
Relying on their own perceptions of symptoms of hyperglycemia or hypoglycemia is usually unsatisfactory as mild to moderate hyperglycemia causes no obvious symptoms in nearly all patients. Other considerations include the fact that, while food takes several hours to be digested and absorbed, insulin administration can have glucose lowering effects for as little as 2 hours or 24 hours or more (depending on the nature of the insulin preparation used and individual patient reaction). In addition, the onset and duration of the effects of oral hypoglycemic agents vary from type to type and from patient to patient.
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.
Some people with diabetes use a computerized pump -- called an insulin pump -- that gives insulin on a set basis. You and your doctor program the pump to deliver a certain amount of insulin throughout the day (the basal dose). Plus, you program the pump to deliver a certain amount of insulin based on your blood sugar level before you eat (bolus dose).
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