Studies have demonstrated the noninferiority of basal insulin plus a single injection of rapid-acting insulin at the largest meal relative to basal insulin plus a GLP-1 receptor agonist relative to two daily injections of premixed insulins (Fig. 8.2). Basal insulin plus GLP-1 receptor agonists are associated with less hypoglycemia and with weight loss instead of weight gain but may be less tolerable and have a greater cost (58,59). In November 2016, the FDA approved two different once-daily fixed-dual combination products containing basal insulin plus a GLP-1 receptor agonist: insulin glargine plus lixisenatide and insulin degludec plus Other options for treatment intensification include adding a single injection of rapid-acting insulin analog (lispro, aspart, or glulisine) before the largest meal or stopping the basal insulin and initiating a premixed (or biphasic) insulin (NPH/Regular 70/30, 70/30 aspart mix, 75/25 or 50/50 lispro mix) twice daily, usually before breakfast and before dinner. Each approach has its advantages and disadvantages. For example, providers may wish to consider regimen flexibility when devising a plan for the initiation and adjustment of insulin therapy in people with type 2 diabetes, with rapid-acting insulin offering greater flexibility in terms of meal planning than premixed insulin. If one regimen is not effective (i.e., basal insulin plus GLP-1 receptor agonist), consider switching to another regimen to achieve A1C targets (i.e., basal insulin plus single injection of rapid-acting insulin or premixed insulin twice daily) (60,61). Regular human insulin and human NPH/Regular premixed formulations (70/30) are less costly alternatives to rapid-acting insulin analogs and premixed insulin analogs, respectively, but their pharmacodynamic profiles may make them less optimal.
To take things one step further, there is one particular sensor that is new to the market that is designed to communicate directly with the insulin pump. While the pump does not yet respond directly to information from the sensor, it “requests” a response from the patient if there is a need for adjustments according to the patterns it has been programmed to detect. The ultimate goal of this technology is to “close the loop” by continuously sensing what the body needs, then responding with the appropriate insulin dose.
Jump up ^ Makam, AN; Nguyen, OK (10 January 2017). “An Evidence-Based Medicine Approach to Antihyperglycemic Therapy in Diabetes Mellitus to Overcome Overtreatment”. Circulation. 135 (2): 180–95. doi:10.1161/CIRCULATIONAHA.116.022622. PMID 28069712.
Men who have type 2 diabetes are twice as likely to have low testosterone (low-T) than men who do not have diabetes. Because of the low levels of the hormone testosterone, men with diabetes can have unhealthy symptoms that are not seen in women with diabetes.
Some people with diabetes need to eat at about the same time each day. Others can be more flexible with the timing of their meals. Depending on your diabetes medicines or type of insulin, you may need to eat the same amount of carbohydrates at the same time each day. If you take “mealtime” insulin, your eating schedule can be more flexible.
Therefore, diabetes treatment is aimed at keeping blood glucose levels as close to the normal range as safely possible. Studies have shown that doing this reduces the risk of developing major complications associated with type 1 and type 2 diabetes.
Jump up ^ Cox D, Gonder-Frederick LA, Kovatchev BP, Julian DM, Clarke WL (2000). “Progressive hypoglycemia’s impact on driving simulation performance”. Diabetes Care. 23 (2): 163–70. doi:10.2337/diacare.23.2.163. PMID 10868825.
If you have type 2 diabetes, the answer to this question is much less clear. Many people can keep their blood glucose in a healthy range without medications (either oral diabetes medications or insulin injections) if they lose weight and keep their weight down, are regularly physically active, and follow a meal plan that helps them keep portion sizes under control and helps them spread the amount of carbohydrate they eat at each meal throughout the day.
Jump up ^ Roberts, Christian; Barnard, R. James (2005). “Effects of exercise and diet on chronic disease”. Journal of Applied Physiology. 98 (1): 3–30. doi:10.1152/japplphysiol.00852.2004. PMID 15591300.
If you have type 2 diabetes, your body becomes resistant to insulin. Your body is no longer using the hormone efficiently. This forces your pancreas to work harder to make more insulin. Over time, this can damage cells in your pancreas. Eventually, your pancreas may not be able to produce any insulin.
What you eat: Schmidt suggests gradually cutting foods that aren’t allowed while focusing on eating whole fruits, vegetables, nuts, seeds, healthful oils (such as olive and coconut), and high-quality proteins including lean grass-fed meats, poultry, eggs, and low-mercury fish rich in omega-3 fats, such as salmon.
Learn how to lose weight and keep it off. If your last diet attempt wasn’t a success, or life events have caused you to gain weight, don’t be discouraged. The key is to find a plan that works with your body’s individual needs so that you can avoid common diet pitfalls and find long-term, weight loss success. Read: How to Lose Weight and Keep It Off
Although there isn’t a single diabetic diet that fits every person’s needs, there are general guidelines people with prediabetes or diabetes should follow to live well and thrive. Eating healthfully with diabetes is essential to helping control blood glucose (blood sugar), blood lipids (cholesterol), and blood pressure — whether you take blood glucose-lowering medications or not. Today, following a diabetic diet means integrating smart food choices into your eating plan, which can help you manage your weight and ABCs (A1C; blood pressure; cholesterol) levels for life.
Prediabetes is a condition in which a person has early symptoms of diabetes, but have not yet fully developed the condition. If prediabetes is not treated with lifestyle changes, the person will develop type 2 diabetes.
The major long-term complications relate to damage to blood vessels. Diabetes doubles the risk of cardiovascular disease and about 75% of deaths in diabetics are due to coronary artery disease. Other “macrovascular” diseases are stroke, and peripheral artery disease.
People with type 1 diabetes (T1D) can live long, happy lives with proper care and disease management. Advancements in medication types and delivery methods give people the freedom to choose which treatment options work best with their particular circumstance. T1D prognoses can be greatly improved with a combination of treatments and lifestyle choices.
Carrots are noted for their high vitamin A, made from the antioxidant beta-carotene in carrots. This vitamin is necessary for good vision and immune function, and it may help prevent the development of some cancers, according to the Mayo Clinic.
Jump up ^ Kiehm TG, Anderson JW, Ward K (1976). “Beneficial effects of a high carbohydrate, high fiber diet on hyperglycemic diabetic men”. The American Journal of Clinical Nutrition. 29 (8): 895–99. doi:10.1093/ajcn/29.8.895. PMID 941870.
On the other hand, grains in the form of popular foods such as white bread, as well as sugary, processed, or packaged grains, should be avoided or limited to avoid unwanted blood sugar spikes. Also, refined white flour doesn’t contain the same vitamins, minerals, fiber, and health benefits as whole grains.
Diabetes limits your body’s ability to properly move sugar out of your blood stream and into your cells, where the sugar is stored and used for energy. Because your body isn’t getting enough of that energy, diabetes patients can experience “polyphagia,” which is a kind of all-the-time hunger, shows research in the journal Diabetes Care.
Especially avoid gluten-containing grains and white wheat flour products such as bread, bagels, pretzels, cereals and crackers. All grains break down into sugars and have the potential to severely spike blood glucose. The gluten in these foods causes the gut to become inflamed and can have an effect on hormones that regulate blood glucose.
People who have type 1 diabetes must take insulin as part of their treatment. Because their bodies can’t make insulin anymore, they need to get the right amount to keep their blood sugar levels in a healthy range.
Diabetes is a chronic, long-term disease marked by high levels of sugar in the blood. It can be caused by too little or no insulin (a hormone produced by the pancreas to regulate blood sugar), resistance to insulin (when cells in the body cannot effectively use insulin), or both. Diabetes can lead to serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations, such as a foot or lower leg.