Can You Stop T2 Progression?
D.D. Family T2 since 1996 and struggling to be healthy. Maybe progression is more likely in people with strong family histories, even with tight control?? It appears to be a combination of heredity, environmental factors and the degree of BG control maintained. We are all different and family histories play a stronger role in the development and progression of diabetes in some people. The one that is really a wild card to my mind is environmental factors. Science still does not understand that very well. We know that some drugs, some diseases and some environmental toxins can induce diabetes, but this is still poorly understood. So, BG control seems to be about the only factor that we can control. I'm giving it my best shot. I am of the opinion that YES, you can not only STOP insulin resistance (T2) from becoming worse, in many cases, revert to being asymptomatic with proper treatment under the proviso such treatment is prior to doing longterm and permanent damage to the body (In respect to systemic damage, i.e. destruction of beta cells from exhaustion). In the past, I had encountered "Double Diabetes" if you will through improper use of insulin (as in way too much) and had to mitigate this with typical type 2 treatments such as Metformin & Actos, smarter eating, more physical activity and actively counting carbs. Once my weight decreased to optimal boundaries, my insulin resistance was asymptomatic, I was removed from metformin and actos and left to treat my Type 1 diabetes with insulin alone. There are variables! Be prepared for this! There are many in the endocrinological community that are of the opinion that Type 2 diabetes is NEVER curable, but becomes asymptomatic with agressive lifestyle changes mitigating the causes of your type 2 condition. This being said, Continue reading >>
Mesenchymal Stromal Cells To Halt The Progression Of Type 1 Diabetes?
Mesenchymal stromal cells to halt the progression of type 1 diabetes? 1.Department of Medical Cell Biology, Uppsala University, Husargatan 3, Box 571, 75123, Uppsala, Sweden, [email protected] Current Diabetes Reports [01 Jul 2015, 15(7):46] No treatment to halt the progressive loss of insulin-producing beta-cells in type 1 diabetes mellitus has yet been clinically introduced. Strategies tested have at best only transiently preserved beta-cell function and in many cases with obvious side effects of drugs used. Several studies have suggested that mesenchymal stromal cells exert strong immunomodulatory properties with the capability to prevent or halt diabetes development in animal models of type 1 diabetes. A multitude of mechanisms has been forwarded to exert this effect. Recently, we translated this strategy into a first clinical phase I/IIa trial and observed no side effects, and preserved or even increased C-peptide responses to a mixed meal tolerance test during the first year after treatment. Future blinded, larger studies, with extended follow-up, are clearly of interest to investigate this treatment concept. Continue reading >>
Defining And Characterizing The Progression Of Type 2 Diabetes
Go to: Progression from pre-diabetes to overt diabetes Because glucose is a continuous variable, the use of thresholds to make a diagnosis is somewhat arbitrary. The term “pre-diabetes” has become well established and implies a risk of progression to overt diabetes. However, although such progression is well studied in prevention trials, little is known about the rate of progression and the characteristics of such progression in the population at large. Table 1 summarizes some of the factors associated with such progression. Nichols et al. (2) studied the progression of pre-diabetes to overt disease and observed that 8.1% of subjects whose initial abnormal fasting glucose was 100–109 mg/dl and 24.3% of subjects whose initial abnormal fasting glucose was 110–125 mg/dl developed diabetes over an average of 29.0 months (1.34 and 5.56% per year, respectively). A steeper rate of increasing fasting glucose; higher BMI, blood pressure, and triglycerides; and lower HDL cholesterol predicted diabetes development. The Baltimore Longitudinal Study of Aging (3) concluded that although phenotypic differences in rates of progression are partly a function of diagnostic thresholds, fasting and postchallenge hyperglycemia may represent phenotypes with distinct natural histories in the evolution of type 2 diabetes. Does hyperglycemia evolve from normoglycemia gradually over time or as a step increase? Ferrannini et al. (4) measured plasma glucose and insulin levels during oral glucose testing at baseline and after 3 and 7 years of follow-up. In subjects with normal glucose tolerance on all three occasions (nonconverters), FPG increased only slightly over 7 years. In contrast, conversion to both impaired glucose tolerance (IGT) and diabetes among normal glucose tolerance subjects Continue reading >>
On The Road To Diabetes: How To Halt Disease Progression And Turn Back To Health
Stanford University School of Medicine blog On the road to diabetes: How to halt disease progression and turn back to health This is the second in a series of blog posts by Randall Stafford, MD, PhD, discussing prediabetes and Type 2 diabetes. While diabetes is a serious chronic disease with devastating complications, it usually develops after years of insulin resistance, or prediabetes. Prediabetes can progress to diabetes when liver and muscle cells become more and more insulin resistant (they don't respond properly to this internal insulin signal) and have increasing problems removing sugar from the bloodstream. The good news is that if prediabetes is recognized early, it can be reversed. Lets check in on Gary, who we met earlier . Gary, a 45-year-old computer engineer, had many signs of prediabetes, including excess weight, a big belt size (40 inches), blood pressure of 138/83 and blood tests showing: High blood sugar (glucose) level (113 mg/dL); Optimal less than 90 Low HDL, the good cholesterol (27 mg/dL); Optimal greater than 50 Increased triglycerides (210 mg/dL); Optimal less than 100 He came to the doctor seeking advice about how to avoid developing diabetes. Based on his doctors recommendations, he focused on daily exercise using his home rowing machine for 30 minutes per day. He also cut down on his craft beer intake (each 12 oz. bottle has 200-plus calories) from 12 to 4 per week and started walking daily with his wife for 30 minutes. Three months later, his body weight was down by 8 pounds, his blood pressure was 132/78 and his fasting blood sugar was below 100. How to you know that you have prediabetes? There are two main approaches to determine if you have prediabetes or insulin resistance. The simplest is to look for a fasting blood sugar of 100-125 mg Continue reading >>
Researchers Make Progress On A Pill To Stop Type 2 Diabetes
Pharmaceutical researchers are one step closer to making a pill that can reverse the symptoms of type 2 diabetes. They published their research in the journal Nature Chemical Biology. Diabetes and its complications are a major issue within the United States and abroad. In 2012, the American Diabetes Association reported that 29.1 million Americans, or 9.3 percent of the population, lived with diabetes. Various factors, including age and obesity, can cause a person’s body to stop responding to the blood-sugar regulating hormone called insulin. Current drugs for type 2 diabetes work by eliminating glucose from a person’s bloodstream. These prescriptions can help a great deal, but they’re not a cure, and the side effects can be nasty. The authors of the new study wondered if they could address the problem farther up in the pipeline by convincing the body to respond to insulin again. They created a compound that blocks the release of a chemical called low molecular weight protein tyrosine phosphatase (LMPTP), an enzyme that’s previously been implicated in insulin resistance. They gave the drugs to a group of obese, diabetic mice by mouth, once a day for four weeks, all the time monitoring the rodents’ blood sugar and insulin resistance. In that short time, the animals’ bodies began responding to insulin and their blood sugar began to stabilize. The mice experienced no side effects. The next step will be testing the drug in other animals, and then in people. Lead researcher Stephanie Stanford of the University of California, San Diego, is hopeful the pill’s success will translate into the human body and reduce the need for insulin injections and other drugs. “This could lead to a new therapeutic strategy for treating type 2 diabetes,” she told New Scientist Continue reading >>
Understanding And Identifying Pre-diabetes Can We Halt The Diabetes Epidemic?
Understanding and Identifying Pre-diabetes Can We Halt the Diabetes Epidemic? European Endocrinology, 2008; 4(2):16-8; DOI: Citation European Endocrinology, 2008; 4(2):16-8; DOI: Approximately 1.5 million people in the US develop diabetes each year, and are at risk of diabetic complications. Virtually all of these people had normal glucose metabolism at birth, and the vast majority (~95%) with type 2 diabetes experienced gradual progression towards the diabetic state over the ensuing decades of life. The term pre-diabetes refers to impaired glucose tolerance (IGT) and impaired fasting glucose (IFG), two intermediate metabolic states between normal glucose tolerance (NGT) and diabetes. IGT is defined by a plasma glucose level of 140199mg/dl two hours following ingestion of a 75g oral solution; IFG is defined by a fasting plasma glucose value that lies between 100 and 125mg/dl.1 Estimates from the Centers for Disease Control and Prevention (CDC)2 indicate that in 19881994, among US adults 4074 years of age 33.8% had IFG, 15.4% had IGT and 40.1% had pre-diabetes (IGT or IFG or both). More recent data are available for IFG, but not IGT: in 20032006, 25.9% of US adults 20 years of age or over and 35.4% of adults 60 years of age or over had IFG.2 Applying this percentage to the entire US population in 2007, the CDC has estimated that there are approximately 57 million American adults 20 years of age or older with IFG, which means that at least 57 million American adults have pre-diabetes.2 The risk factors identified for pre-diabetes overlap considerably with those for type 2 diabetes and include obesity, family history of diabetes, low high-density lipoprotein (HDL) cholesterol, high triglycerides, high blood pressure, history of gestational diabetes and ethnicity. The pres Continue reading >>
How To Stop The Progression Of Prediabetes To Diabetes
ROCHESTER, Minn. — August 24, 2012. The progression from insulin resistance and prediabetes to diabetes likely can be stopped with changes in diet and lifestyle, according to the August issue of Mayo Clinic Health Letter. In people with insulin resistance, cells do not respond normally to insulin, and the body's fuel, glucose. As a result, the body produces more insulin to overcome the resistance. Over time, cells become more resistant, and the body can't keep up with insulin production. Blood glucose levels rise and eventually, type 2 diabetes develops. But the progression from prediabetes to type 2 diabetes often can be stopped. One large study, the Diabetes Prevention Program, found that modest lifestyle changes reduced the risk of progression by 71 percent in adults age 60 and older. Participants who reduced their risk the most: Consumed fewer calories and cut back on fat. Exercised the equivalent of brisk walking 30 minutes a day, five days a week. Lost a little weight. The goal was 7 percent of body weight; for example, 14 pounds for a person weighing 200 pounds. Insulin resistance appears to be caused by a combination of genetic and lifestyle factors. A sedentary lifestyle and a family history of diabetes are risk factors. So is being black, Native American, Asian-American, Hispanic or a Pacific Islander. Being overweight, especially with excess fat around the abdomen, is the greatest modifiable risk factor for progressing to type 2 diabetes among those who already have insulin resistance. Several medications have been shown to reduce the risk of type 2 diabetes. The best appears to be metformin (Glucophage), but studies show many limitations. This medication is least effective in adults over 45 and not recommended for those over 60. Even for younger adults, me Continue reading >>
Clinical Trials To Stop The Progression Of Type 2 Diabetes
Home Diabetes Overview Articles Type 2 diabetes Clinical trials to stop the progression of type 2 diabetes Clinical trials to stop the progression of type 2 diabetes Type 2 diabetes is a chronic, progressive disease. Blood glucose levels may initially return to normal in people who are fairly recently diagnosed with diabetes who are taking a first-line medication (for example, metformin). Unfortunately, blood glucose generally rise again over the course of time, leading people to require a second medication. Again, while blood glucose levels improve with extra medication, they typically creep up again over time, leading to the addition of more medications. Why does type 2 diabetes progress over time? Type 2 diabetes is caused when the beta-cells in the pancreas cannot make enough insulin to keep blood glucose levels in the normal range. This is known as beta-cell dysfunction, and this dysfunction gets worse with the passage of time, resulting in rising blood glucose levels. Most importantly, none of the currently available diabetes medications can stop this progressive deterioration of the beta-cells. This is why more and more medications need to be added over time, to try to keep a persons blood glucose levels at target. Can the worsening of beta-cells be stopped or reversed? In the first few years after the diagnosis of type 2 diabetes, there is a reversible component to beta-cell dysfunction. In fact, in early type 2 diabetes, intensive insulin therapy for as little as two to four weeks can improve the function of the beta-cells and cause diabetes to go into remission, which means that people can maintain blood glucose levels in the target range for up to a year without needing any medication. While this is encouraging news, this remission is not permanent. Eventual Continue reading >>
Halt The Progression Of Type 2 Diabetes
A few years ago, a patient told me how he was first diagnosed with type 2 diabetes during a routine physical. He asked his doctor Is there a cure for diabetes? His doctor replied, No, there is not. My patient then asked, Will I die from it? The doctor replied, No, you will not die from it if you look after yourself. Mark (not his real name) and his doctor then went on to discuss how to manage his diabetes and prevent its complications: attend diabetes education sessions, incorporate healthy lifestyle practices and start on diabetes medication. Marks outlook was very proactive and he decided he wanted to take control of his diabetes instead of letting it take control of him. One way to be proactive is to enroll in a clinical trial, investigating better ways to treat and lessen the long-term severity of type 2 diabetes. The REmission Studies Evaluating T2DM: Intermittent Insulin Therapy (RESET IT) trial is testing to see if beta-cells (which produce insulin) can continue functioning over long periods of time. As diabetes progresses, our beta-cells make less insulin. The resulting beta-cell dysfunction leads to loss of blood glucose control, despite medication. This eventually means insulin therapy. One of the factors contributing to beta-cell dysfunction is glucotoxicity (elevated glucose levels). So the theory is that in the early stages of type 2 diabetes, eliminating glucotoxicity would reverse some of the beta-cell dysfunction that leads to the worsening of diabetes. In short, the sooner you control your glucose, the better. There have been many studies supporting the short-term use of intensive insulin therapy early in the course of type 2 diabetes to improve beta-cell function. After shortterm insulin therapy for two to five weeks, the rates of drug-free remission Continue reading >>
Type 2 Diabetes: Stopping The Epidemic
Diabetes occurs when the pancreas can't secrete insulin (type 1) or when the body's cells can't recognize insulin (type 2). Statistical spikes in type 2 diabetes incidence are directly linked to increased levels of obesity associated with unbalanced dietary patterns and decreased levels of physical activity. Inhalation of industrial air pollution and tobacco smoke has also been implicated as a cause of insulin resistance. In this article, I'll review the consequences of untreated and poorly-treated type 2 diabetes, lab values, medications and treatments, and critical patient teaching points. Type 1 diabetes affects 5% of patients with diabetes. In this type, a genetic defect in the immune system causes the body to produce antibodies against its own insulin-producing pancreatic beta cells. Beta cell mass diminishes to the point where the patient must be supplied with exogenous insulin. The onset of this disease is usually between ages 10 and 12 in girls and between ages 12 and 14 in boys. In one-third of patients, type 1 diabetes appears before age 20, and most cases develop before age 30. There's also a delayed form in which pancreatic antibodies appear in adulthood. Environmental factors associated with the onset of type 1 diabetes are rubella, coxsackie, and other viral infections. Type 1 diabetes may be accompanied by another autoimmune disorder, such as hypothyroidism, pernicious anemia, or alopecia. The type 1 patient is subject to rapid increases in blood glucose, with development of ketoacidosis. Type 2 diabetes affects 95% of patients with diabetes and exists when insulin resistance causes extracellular glucose levels to rise above 126 mg/dL (after 8 hours of fasting). Patients at particular risk are those who exceed the recommended weight-for-height tables, ea Continue reading >>
Can Early Use Of Insulin, Glp-1 Halt Diabetes Progression?
Can Early Use of Insulin, GLP-1 Halt Diabetes Progression? Conferences > ADA 2014 Published on: June 14, 2014 Can Early Use of Insulin, GLP-1 Halt Diabetes Progression? For years, the standard for treating type 2 diabetes mellitus (T2DM) has been step therapy. Patients are told to make changes in their diets and to exercise more. Then, most start metformin; if T2DM progresses, doctors add drugs from among the dozen other classes, either alone but typically in combination. For years, the standard for treating type 2 diabetes mellitus (T2DM) has been step therapy. Patients are told to make changes in their diets and to exercise more. Then, most start metformin; if T2DM progresses, doctors add drugs from among the dozen other classes, either alone but typically in combination. Insulin is added last, after a slow march of deteriorating beta cell function and, possibly complications such as retinopathy or kidney disease. But what if treatment for newly diagnosed diabetes looked more like care in cancer? What if insulin came first, for just a few weeks, and the decline in beta cell function could be arrested or even reversed? What if the maintenance therapy, after this intervention, was not metformin but 1 of the newer, more powerful drugs approved in recent years? On Friday, a panel at the 74th Scientific Sessions of the American Diabetes Association (ADA) said this concept holds promise, even as they had to hold back some of the best news that will be unveiled before the meeting ends. The session, Initial Treatment of Type 2 DiabetesNew and Not-So-New Ideas, held at the Moscone Center in San Francisco, California, began with Sunder Mudaliar, MD, of the Center for Metabolic Research at the University of California at San Diego, who gave an overview of the concept of glucoli Continue reading >>
- Encapsulated stem cells halt type 1 diabetes in mice for six months
- Effects of Insulin Plus Glucagon-Like Peptide-1 Receptor Agonists (GLP-1RAs) in Treating Type 1 Diabetes Mellitus: A Systematic Review and Meta-Analysis
- New measure of insulin-making cells could gauge diabetes progression, treatment
Medications Dont Slow Progression Of Type 2 Diabetes - Uchicago Medicine
In youth with impaired glucose tolerance or recent-onset type 2 diabetes , neither initial treatment with long-acting insulin followed by the drug metformin, nor metformin alone preserved the bodys ability to make insulin, according to results published online June 25 inDiabetes Care. The publication is concurrent to a presentation of the results at the American Diabetes Association Scientific Sessions in Orlando, Florida. The results come from a study of 91 youth ages 10-19, part of the larger Restoring Insulin Secretion (RISE) study. To determine if early, aggressive treatment would improve outcomes, participants at four study sites were randomly assigned to one of two treatment groups. The first received three months of glarginea long-acting insulinfollowed by nine months of metformin. The second received only metformin for 12 months. Participants were then monitored for three more months after treatment ended. The RISE Pediatric Medication Study found that beta cell functionkey to the bodys ability to make and release insulindeclined in both groups during treatment and worsened after treatment ended. An earlier NIH-funded study also found that type 2 diabetes progresses more rapidly in youth than previously reported in adults despite comparable treatment. Only two drugs are currently approved for youth with type 2 diabetes, and we were disheartened to find that neither effectively slows disease progression, said Dr. Ellen Leschek, project scientist for the RISE Consortium and program director in NIDDKs Division of Diabetes, Endocrinology, and Metabolic Diseases. Type 2 diabetes in youth has grown with the obesity epidemic, and we need treatments that work for kids. Its clear from this study and others that type 2 diabetes in youth is more aggressive than in adults. Continue reading >>
Type 2 Diabetes Guide
When your doctor tells you that you have prediabetes, you might think there's no reason to take action just yet. Or you might assume that you're definitely going to get diabetes. Not so! You do need to take prediabetes seriously, but there's still time to turn things around -- if you start now. The goal is to get your blood sugar level out of the prediabetes range, and keep it that way. What you do every day makes a big difference. Making lifestyle changes may be even more powerful than just taking medication. That's what happened in a large study called the Diabetes Prevention Program: People with prediabetes who lost a small amount of weight through diet and exercise cut their odds of getting type 2 diabetes by 58%, compared to 31% for people who only took the prescription drug metformin. Start by making these three changes. If you're overweight, slimming down is the key to turning the odds in your favor. Research shows that shedding just 5% to 10% of your body weight is often enough to get blood sugar levels back into the normal range and avoid diabetes or at least delay its onset. To reach your goal, limit portion sizes; cut calories; and eat fewer foods that are high in fat (especially saturated fat), sugar, and carbohydrates. You should also eat a wide variety of fruits, vegetables, lean protein, and whole grains. Leading an active life is a must. Aim for 30 minutes of aerobic activity (something that raises your heart rate, like walking, biking, or swimming) 5 days a week (150 minutes per week). Plus, do some strength-training exercise, like lifting weights or using resistance bands, at least twice a week. Strength work builds muscle, which helps lower your blood sugar level, helps your body respond better to insulin (which controls blood sugar), and burns calori Continue reading >>
Reversing Type 2 Diabetes
Tweet Reversing diabetes is a term that usually refers to a significant long-term improvement in insulin sensitivity in people with type 2 diabetes. People with type 2 diabetes that are able to get their HbA1c below 42 mmol/mol (6%) without taking diabetes medication are said to have reversed or resolved their diabetes. This also known as putting diabetes into remission. Loss of body weight can be particularly beneficial in helping to reverse the progression of diabetes. With time and dedication, type 2 diabetes can be reversed and the results can be very rewarding, with less tiredness and better all-round health. If you think you need to come off your diabetes medication, ensure you speak to your healthcare team before doing so. Understanding how diabetes progresses The most common cause of type 2 diabetes is obesity-related, which generally follows a vicious cycle pattern: Diet high in calories -particularly if high in refined carbohydrates. Insulin levels in the bloodstream rise to cope with the high- and quick-acting carb intake. Weight is gained around the belly (central or truncal obesity). Consistently high insulin levels lead to the body’s cells becoming resistant to insulin and commonly lead to weight gain. High insulin levels also increase weight gain. Insulin resistance leads to an increase in blood sugar levels, particularly after meals. The pancreas produces more insulin to cope with rising blood sugar levels. High sugar levels lead to feelings of lethargy and high insulin levels lead to increased hunger. Hunger often leads to overeating and lethargy, with less physical activity being taken. Overeating, less activity and high insulin levels all lead to further weight gain and more insulin resistance. Consistently high demand on the pancreas to produce ext Continue reading >>
Type 2 Diabetes
Print Overview Type 2 diabetes, once known as adult-onset or noninsulin-dependent diabetes, is a chronic condition that affects the way your body metabolizes sugar (glucose), your body's important source of fuel. With type 2 diabetes, your body either resists the effects of insulin — a hormone that regulates the movement of sugar into your cells — or doesn't produce enough insulin to maintain a normal glucose level. More common in adults, type 2 diabetes increasingly affects children as childhood obesity increases. There's no cure for type 2 diabetes, but you may be able to manage the condition by eating well, exercising and maintaining a healthy weight. If diet and exercise aren't enough to manage your blood sugar well, you also may need diabetes medications or insulin therapy. Symptoms Signs and symptoms of type 2 diabetes often develop slowly. In fact, you can have type 2 diabetes for years and not know it. Look for: Increased thirst and frequent urination. Excess sugar building up in your bloodstream causes fluid to be pulled from the tissues. This may leave you thirsty. As a result, you may drink — and urinate — more than usual. Increased hunger. Without enough insulin to move sugar into your cells, your muscles and organs become depleted of energy. This triggers intense hunger. Weight loss. Despite eating more than usual to relieve hunger, you may lose weight. Without the ability to metabolize glucose, the body uses alternative fuels stored in muscle and fat. Calories are lost as excess glucose is released in the urine. Fatigue. If your cells are deprived of sugar, you may become tired and irritable. Blurred vision. If your blood sugar is too high, fluid may be pulled from the lenses of your eyes. This may affect your ability to focus. Slow-healing sores o Continue reading >>