If your cells aren’t responding to insulin, your pancreas produces more to turn up the volume on the signal that glucose is available and the cells should absorb it. When your pancreas can keep up, blood glucose stays within healthy ranges, and all is well. When your pancreas starts to poop out, you end up with insulin deficiency, which leads to blood sugar fluctuations and weight gain.
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.
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.
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.
If you are interested in trying a natural treatment in addition to standard treatment, be sure do so only under the close supervision of your physician. If diabetes is not properly controlled, the consequences can be life-threatening. Also, inform your physician about any herbs, supplements, or natural treatments you are using, because some may interact with the medications you are taking and result in hypoglycemia unless properly coordinated. 
These are a relatively new class of drugs used to treat type 2 diabetes. They are oral medications that work by blocking the kidneys' reabsorption of glucose, leading to increased glucose excretion and reduction of blood sugar levels. The US FDA approved the SGLT2 inhibitors canagliflozin (Invokana) in March 2013 and dapagliflozin (Farxiga) in January 2014.
Neem tree leaves have ingredients and compounds that lower blood glucose considerably. This property of neem makes it an excellent home remedy for diabetes. A glassful of neem leaves' juice when consumed first thing in the morning can benefit considerably. Regular and prolonged consumption can even trigger production of insulin and subside diabetes completely.
Second, all minerals and vitamins should be taken in the most absorbable, bioactive forms. This makes the product a little more expensive, but there is a huge difference in the body’s ability to absorb and metabolize different forms of nutrients. I recommend Pure Encapsulations’ Polyphenol Nutrients to my patients, as part of a natural home remedies protocol for diabetes.
Sometimes pills for diabetes — even when combined with diet and exercise — aren't enough to keep blood sugar levels under control. Some people with type 2 diabetes also have to take insulin. The only way to get insulin into the body now is by injection with a needle or with an insulin pump. If someone tried to take insulin as a pill, the acids and digestive juices in the stomach and intestines would break down the medicine, and it wouldn't work.
Effect of an 8-week very-low-calorie diet in type 2 diabetes on arginine-induced maximal insulin secretion (A), first phase insulin response to a 2.8 mmol/L increase in plasma glucose (B), and pancreas triacylglycerol (TG) content (C). For comparison, data for a matched nondiabetic control group are shown as ○. Replotted with permission from Lim et al. (21).
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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.


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).
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.
Chong points to previous research in Circulation that describes the underlying mechanisms of sleep apnea. In people with sleep apnea, activation of the sympathetic nervous system — including increased heart rate, increased blood pressure, and constriction of blood vessels — all led to a higher risk of heart attack and stroke, which can be compounded in people who have type 2 diabetes (and thus already have a higher risk of heart disease).
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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