“diabetes mellitus overview”

Vegas, A. J., Veiseh, O., Gürtler, M., Millman, J. R., Pagliuca, F. W., Bader, A. R., … Anderson, D. G. (2016, February 18). Long-term glycemic control using polymer-encapsulated human stem cell–derived beta cells in immune-competent mice. Nature Medicine, 22, 306-311. Retrieved from http://www.nature.com/nm/journal/v22/n3/full/nm.4030.html

Carbohydrate counting involves keeping track of the amount of carbohydrates you eat and drink each day. Because carbohydrates turn into glucose in your body, they affect your blood glucose level more than other foods do. Carb counting can help you manage your blood glucose level. If you take insulin, counting carbohydrates can help you know how much insulin to take.

Your doctor will check your blood glucose levels, and if you are diagnosed with diabetes, your doctor will guide you on a plan to keep your blood sugar levels normal. If your diabetes is mild, your doctor will likely recommend a diet plan, exercise, and weight loss. Your doctor may prescribe medications that help reduce blood sugar levels. In some women, insulin may be necessary.

The name of the alpha-glucosidase inhibitor available in the U.S. is acarbose (Precose). Placebo-controlled clinical trials with over 700 patients associated acarbose with reduction of hemoglobin A1c (HbA1c) values. HbA1c is the standard clinical measure of average blood sugars over the preceding three months. However, as a single agent, acarbose has not been as effective as other antidiabetic medications. Since acarbose works in the intestine, its effects are additive to antidiabetic medications that work at other sites (such as sulfonylureas). Clinical studies have demonstrated statistically better control of blood glucose in patients treated with acarbose and a sulfonylurea, compared to the sulfonylurea alone. Acarbose is currently used alone or in combination with a sulfonylurea.

discovering versatile almond flour has changed my low-carb life. check out the many almond flour cookbooks online. also, order some Dreamfields excellent pasta. just these two things, as well as frequent testing to see how you reaact to various foods will make the switch to low-carb easy. i’ve been living like this for 7 years, am on no medication or insulin, and have kept my A1c at around 6. try it!

In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control. (This is a major factor for many patients with type 2 diabetes who ultimately require insulin therapy.) Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.

The main goal of diabetes management is, as far as possible, to restore carbohydrate metabolism to a normal state. To achieve this goal, individuals with an absolute deficiency of insulin require insulin replacement therapy, which is given through injections or an insulin pump. Insulin resistance, in contrast, can be corrected by dietary modifications and exercise. Other goals of diabetes management are to prevent or treat the many complications that can result from the disease itself and from its treatment.

“The most important tool for shopping is the nutrition label,” says Susan Weiner, RD, CDE. “Practice label-reading at home so that you don’t have to spend 10 minutes per food item when you’re in the market.”

The American Diabetes Association (ADA), based on the 2018 guidelines, recommends routine screening for type 2 diabetes beginning at age 45 in those without risk factors. In people with body mass index (BMI) ≥25 kg/m2 and one or more additional risk factor for diabetes, screening should include the A1C, fasting plasma glucose, or two-hour oral glucose tolerance test (OGTT). Patients with prediabetes (A1C ≥5.7%, impaired glucose tolerance or impaired fasting glucose) should be tested yearly. Women who were diagnosed with gestational diabetes should have lifelong testing at least every 3 years. The test should be repeated every three years if the results are normal, dependent upon the risk status of the patient.

The Flexitarian Diet, which emphasizes fruits, veggies, whole grains and plant-based protein, is a smart and healthy choice. One panelist noted that this diet is “a nice approach that could work for the whole family.” more

Endocrinology is the specialty of medicine that deals with hormone disturbances, and both endocrinologists and pediatric endocrinologists manage patients with diabetes. People with diabetes may also be treated by family medicine or internal medicine specialists. When complications arise, people with diabetes may be treated by other specialists, including neurologists, gastroenterologists, ophthalmologists, surgeons, cardiologists, or others.

Miscarriage is the medical term for the spontaneous loss of pregnancy from conception to 20 weeks gestation. Risk factors for a woman having a miscarriage include cigarette smoking, older maternal age, radiation exposure, previous miscarriage, maternal weight, illicit drug use, use of NSAIDs, and trauma or anatomical abnormalities to the uterus. There are five classified types of miscarriage: 1) threatened abortion; 2) incomplete abortion; 3) complete abortion; 4) missed abortion; and (5 septic abortion. While there are no specific treatments to stop a miscarriage, a woman’s doctor may advise avoiding certain activities, bed rest, etc. If a woman believes she has had a miscarriage, she needs to seek prompt medical attention.

These last few years have been exciting times in diabetes care. Many agents for treating type 2 diabetes are under development. Options for insulin therapy and methods for insulin delivery continue to expand and refine. While research continues across multiple areas, one thing remains constant. Achieving the best blood sugar control possible remains the ultimate goal in all people with diabetes. Without doubt, good blood sugar control minimizes the serious long-term of diabetes, including blindness, nerve damage, and kidney damage. Finally, a healthy lifestyle always helps and must remain the cornerstone of diabetes management.

In patients with type 2 diabetes, stress, infection, and medications (such as corticosteroids) can also lead to severely elevated blood sugar levels. Accompanied by dehydration, severe blood sugar elevation in patients with type 2 diabetes can lead to an increase in blood osmolality (hyperosmolar state). This condition can worsen and lead to coma (hyperosmolar coma). A hyperosmolar coma usually occurs in elderly patients with type 2 diabetes. Like diabetic ketoacidosis, a hyperosmolar coma is a medical emergency. Immediate treatment with intravenous fluid and insulin is important in reversing the hyperosmolar state. Unlike patients with type 1 diabetes, patients with type 2 diabetes do not generally develop ketoacidosis solely on the basis of their diabetes. Since in general, type 2 diabetes occurs in an older population, concomitant medical conditions are more likely to be present, and these patients may actually be sicker overall. The complication and death rates from hyperosmolar coma is thus higher than in diabetic ketoacidosis.

After two months under the care of the naturopath, John returned to his primary care doctor to discover that his hemoglobin A1c had dropped from 8.9% to 4.9%—a nondiabetic range. For eight months and counting, he’s been off all his diabetes medication. His last A1c reading was 5.1%. With the help of his naturopath, John seems to have reversed his diabetes.

The plate method. The American Diabetes Association offers a simple seven-step method of meal planning. In essence, it focuses on eating more vegetables. When preparing your plate, fill one-half of it with nonstarchy vegetables, such as spinach, carrots and tomatoes. Fill one-quarter with a protein, such as tuna or lean pork. Fill the last quarter with a whole-grain item or starchy food. Add a serving of fruit or dairy and a drink of water or unsweetened tea or coffee.

Why? Normally your body reabsorbs glucose as it passes through your kidneys. But when diabetes pushes your blood sugar up, your kidneys may not be able to bring it all back in. This causes the body to make more urine, and that takes fluids.

Type 1 diabetes mellitus is characterized by loss of the insulin-producing beta cells of the pancreatic islets, leading to insulin deficiency. This type can be further classified as immune-mediated or idiopathic. The majority of type 1 diabetes is of the immune-mediated nature, in which a T cell-mediated autoimmune attack leads to the loss of beta cells and thus insulin.[34] It causes approximately 10% of diabetes mellitus cases in North America and Europe. Most affected people are otherwise healthy and of a healthy weight when onset occurs. Sensitivity and responsiveness to insulin are usually normal, especially in the early stages. Type 1 diabetes can affect children or adults, but was traditionally termed “juvenile diabetes” because a majority of these diabetes cases were in children.[citation needed]

The dose of insulin will be different for different patients, and patients may react differently to how quickly they respond to a dose. However, various types of insulin are available to help cover the mealtime and day-long needs for blood sugar control.

The exact cause of diabetes is unknown. However, autoimmune disease, genetics, obesity, chronic pancreatitis, certain medications and abnormal protein deposits in the pancreas can play a major role in the development of the disease.

Amazingly, one in four Americans has some form of diabetes or pre-diabetes. If this is not a clear sign that conventional health recommendations are flawed, I don’t know what is. I too have personal experience with this disease. I developed it myself for a short while, when I tried to implement an Eat Right for Your Type program in the late 90s.

Diabetes is manifested through symptoms such as constant thirst, sudden weight loss, blurred vision, numbness of the feet, swollen gums, etc. If you notice any of these symptoms, we suggest you visit your doctor as soon as possible.

mythja/ShutterstockAn apple a day really does keep the doctor away. Eating one apple a day can lower your bad cholesterol by 40%. Eating apples can also lower your risk of developing type 2 diabetes. This power fruit is also high in fiber.

Although similar to troglitazone, extensive studies have failed to associate pioglitazone and rosiglitazone with any liver problems. Both pioglitazone and rosiglitazone act by increasing the sensitivity (responsiveness) of cells to insulin. They improve the sensitivity of muscle and fat cells to insulin. These drugs effectively lower blood sugars in patients with type 2 diabetes.

In addition to daily blood sugar monitoring, your doctor will likely recommend regular A1C testing to measure your average blood sugar level for the past two to three months. Compared with repeated daily blood sugar tests, A1C testing better indicates how well your diabetes treatment plan is working overall. An elevated A1C level may signal the need for a change in your insulin regimen or meal plan. Your target A1C goal may vary depending on your age and various other factors. However, for most people with diabetes, the American Diabetes Association recommends an A1C of below 7 percent. Ask your doctor what your A1C target is.

The health-care professional should check the feet and lower legs of the patient at every visit for cuts, scrapes, blisters, or other lesions that could become infected. Adults with diabetes should check the soles of their feet and their legs daily with a hand-held mirror, either by themselves or with the assistance of a relative or caretaker.

Type 2 diabetes is a serious disease, and following your diabetes treatment plan takes round-the-clock commitment. But your efforts are worthwhile because following your treatment plan can reduce your risk of complications.

If you have type 1 diabetes you’ll need to manage your glucose levels by matching your insulin to your diet and activity. If you have type 2 diabetes, you may manage your blood sugars with diet and activity alone, or add medications as needed.

Blood sugar level is measured by means of a glucose meter, with the result either in mg/dL (milligrams per deciliter in the US) or mmol/L (millimoles per litre in Canada and Eastern Europe) of blood. The average normal person has an average fasting glucose level of 4.5 mmol/L (81 mg/dL), with a lows of down to 2.5 and up to 5.4 mmol/L (65 to 98 mg/dL).[8]

If you have diabetes or prediabetes, your doctor will likely recommend that you see a dietitian to help you develop a healthy eating plan. The plan helps you control your blood sugar (glucose), manage your weight and control risk factors for heart disease, such as high blood pressure and high blood fats.

Before you have a slice of cake, ask yourself the following questions: Will that small piece of cake be satisfying or will I still be hungry? How will it fit into my meal plan? Do I have 300 calories to “spend” on this? Are there other choices I could make which would contribute less fat?

One downside of eating fish is some kinds may contain high levels of mercury, notably shark, swordfish, king mackerel, and tilefish. While children and pregnant women are advised by the U.S. Food and Drug Administration (FDA) to avoid eating these varieties, the benefits of eating fish outweigh the potential risks for middle-aged and older men and women, as long as the amount of fish is eaten within FDA and Environmental Protection Agency guidelines. Eating a variety of seafood helps minimize the amount of mercury in your diet.

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  1. The City of Hope’s Diabetes and Metabolism Research Institute also recently announced a project called the Wanek Family Project for Type 1 Diabetes. This is a 6-year project that aims to cure type 1 diabetes. While more research needs to be done in this field, the current outlook for people diagnosed with type 1 diabetes is promising.
    Diabetes treatment is based on how severe the symptoms and lab work are and whether there are any other health issues that could complicate therapy. Each dog will respond a little bit differently to treatment, and therapy must be tailored to the individual dog throughout his life.
    Alcohol use: Moderate or eliminate consumption of alcohol. Try to have no more than seven alcoholic drinks in a week, and never more than two drinks in an evening. One drink is considered 1.5 ounces of liquor, 6 ounces of wine, or 12 ounces of beer. Excessive alcohol use is a known risk factor for type 2 diabetes. Alcohol consumption can cause low or high blood sugar levels, nerve pain (neuritis), and an increase in triglycerides.
    The glucagon-like peptide 1 (GLP-1) agonists, or incretin mimetics, are injectable agents that help the pancreas to produce insulin more efficiently. They bind to GLP-1 receptors and stimulate glucose dependent insulin release. These drugs inhibit glucagon secretion and slow gastric emptying. In turn, this prevents a steep rise in blood glucose levels after eating.

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