People with type 1 diabetes have to pay a little more attention to their meals and snacks than people who don’t have diabetes. They need to eat a balanced, healthy diet and pay closer attention to what they eat and when they eat it.
On the other hand, in 1983, Richard K. Bernstein began treating people with diabetes and pre-diabetes successfully with a very low-carbohydrate diet, avoiding fruit, added sugar, and starch. Both the Pritikin approach and the Bernstein approach prescribe exercise.
When islet cells have been transplanted via the Edmonton protocol, insulin production (and glycemic control) was restored, but at the expense of continued immunosuppression drugs. Encapsulation of the islet cells in a protective coating has been developed to block the immune response to transplanted cells, which relieves the burden of immunosuppression and benefits the longevity of the transplant.
SI: That was my moment of truth, if you will. I thought, it doesn’t make any sense. What we are telling people to do, the message to pre-diabetics today in America is “Don’t you worry. You’re getting fit but you have to eat a little less, eat a little healthier and exercise a little more everything will be just fine.” Well I had been doing that freaking 20 years.
Pramlintide (Symlin) was the first in a class of injectable, anti-hyperglycemic medications for use in addition to insulin for type 1 diabetes or type 2 diabetes. Pramlintide, the active ingredient in Symlin, is a synthetic analog of human amylin, a naturally occurring neuroendocrine hormone synthesized by pancreatic beta-cells that helps control glucose after meals. Similar to insulin, amylin is absent or deficient in person with diabetes. When used with insulin, amylin can improve glycemic control and has additional benefits that cannot be realized with insulin alone.
The earliest surviving work with a detailed reference to diabetes is that of Aretaeus of Cappadocia (2nd or early 3rd century CE). He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of the “Pneumatic School”. He hypothesized a correlation of diabetes with other diseases, and he discussed differential diagnosis from the snakebite which also provokes excessive thirst. His work remained unknown in the West until 1552, when the first Latin edition was published in Venice.
Have you been going to the bathroom to urinate more often recently? Do you notice that you spend most of the day going to the toilet? When there is too much glucose (sugar) in your blood you will urinate more often.
Type 2 diabetes can be reproduced in any one patient. Of course, the subtle lifestyle changes have to last and that’s why you want to show that once you cure the disease it actually stays in remission.
Type 2 diabetes usually begins with insulin resistance, a condition in which muscle, liver, and fat cells do not use insulin well. As a result, your body needs more insulin to help glucose enter cells. At first, the pancreas makes more insulin to keep up with the added demand. Over the pancreas can’t make enough insulin, and blood glucose levels rise.
To this end, treatment programs such as the Cognitive Behavioural Therapy – Adherence and Depression program (CBT-AD) have been developed to target the psychological mechanisms underpinning adherence. By working on increasing motivation and challenging maladaptive illness perceptions, programs such as CBT-AD aim to enhance self-efficacy and improve diabetes-related distress and one’s overall quality of life.
Weight fluctuations also fall under the umbrella of possible diabetes signs and symptoms. When you lose sugar through frequent urination, you also lose calories. At the same time, diabetes may keep the sugar from your food from reaching your cells — leading to constant hunger. The combined effect is potentially rapid weight loss, especially if you have type 1 diabetes.
Blood sugar is only one part of a healthy lifestyle with diabetes. A person should also have their cholesterol and blood pressure checked regularly to help avoid heart disease. In addition, people with diabetes should check their feet regularly for sores or other problems and should receive regular eye exams.
Type 2 DM begins with insulin resistance, a condition in which cells fail to respond to insulin properly. As the disease progresses a lack of insulin may also develop. This form was previously referred to as “non insulin-dependent diabetes mellitus” (NIDDM) or “adult-onset diabetes”. The most common cause is excessive body weight and insufficient exercise.
A: Diabetes management is a chronic health condition, but can be managed with proper care from doctors. People diagnosed with type 1 and type 2 diabetes must monitor their blood sugar levels several times a day, usually before or after meals. Your doctor will work with you to determine the range of blood sugar levels best for each individual.
• In a small study reported in the Journal of Dietary Supplements in 2011, researchers found that when people with type 2 diabetes supplemented their diets with ground flaxseed, fasting blood glucose levels decreased 19.7 percent, total cholesterol decreased more than 14.3 percent, triglycerides lowered 1.5 percent, and low-density LDL (bad) cholesterol declined 21.8 percent.
If your body doesn’t make enough or any insulin, or if your cells resist the insulin your body makes, the glucose can’t get into them and you have no energy. This can make you more hungry and tired than usual.
Increased ketones in your urine (diabetic ketoacidosis). If your cells are starved for energy, your body may begin to break down fat. This produces toxic acids known as ketones. Watch for loss of appetite, weakness, vomiting, fever, stomach pain and a sweet, fruity breath. You can check your urine for excess ketones with an over-the-counter ketones test kit. If you have excess ketones in your urine, consult your doctor right away or seek emergency care. This condition is more common in people with type 1 diabetes.
Insulin resistance is the diminished ability of cells to respond to the action of insulin in transporting glucose (sugar) from the bloodstream into muscle and other tissues. There are no signs or symptoms of insulin resistance. Causes of insulin can include conditions such as stress, obesity, metabolic syndrome, and steroid use.
SI: Well, they are excited because they can save costs. In America, each state we have who pays your health care. It’s either your employer if you’re at a large company, and most companies will cover it. So we sell both to employers.
There are a few types of diabetes, though the main two types are type 1 and type 2 diabetes. They differ due to the cause. You may have sudden symptoms of diabetes, or a diagnosis may surprise you because the symptoms have been gradual over many months or years.
If the patient is obese and has had difficulty losing weight on their own, talk to a health-care professional. He or she can recommend a dietitian or a weight-modification program to help the patient reach a goal.
Dr. Charles “Pat” Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.