How To Cure Diabetes Naturally Without Medication

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Diabetes rates are rising, in fact it is now considered an “epidemic” in the medical community. The American Diabetes Association reports that:

•     23.6 million Americans have diabetes
•     57 million Americans are pre-diabetic
•     1.6 new cases of diabetes are reported each year
•     For those over age 60, almost 1 in 4 have diabetes
•     Diabetes is the 7th leading cause of death
•     Diabetes increases heart attack risk and 68% of diabetes related death certificates report heart related problems

•     75% of adults with diabetes will develop high blood pressure
•     Diabetes is the leading cause of blindness, kidney failure and nervous system disorders

•     Diabetes costs $174 billion annually

Diabetes is a well-established problem and a multi-billion dollar industry. It is medically characterized by Fasting Blood Glucose higher than 126 mg/dL , which ranges between 100-125 mg/dL are considered pre-diabetic and ranges below 99 mg/dL are considered normal.  Studies are finding that a fasting blood glucose below 83 mg/dL is actually a better benchmark, as risk of heart disease begins to increase at anything above that.

Some medical professionals use an Oral Glucose Tolerance Test (OGTT) to test for diabetes. If you’ve ever been pregnant and had to drink the sickeningly sweet sugar cocktail and then have blood drawn, you are familiar with this one. Basically, a patient is given 50-75 grams of glucose in concentrated solution and his blood sugar response is measured. I’m not a fan of this test because no one should be ingesting that much concentrated glucose, and the test is not a completely accurate measure. (Just a side note: if you are a drinker of the “Big Gulp” drinks or large amounts of soda, you are putting your body through a similar test each day! Eventually, your body will respond, probably with something like “Fine, you want diabetes, I’ll show you diabetes!)

A OGTT glucose of less than 140 ml/dl is considered normal, with 141-199 being pre-diabetic and levels above 200 mg/dL considered full-blown diabetes. From my research, I believe that  OGTT blood sugar levels above 140 mg/dL , especially regularly, can increase risk of vision problems, cancer, stroke and cardiovascular disease, even without an official diabetes diagnosis.

It’s obvious that diabetes is a big problem, but what causes it? Some would have you believe it is genetics, other claim a lifestyle or dietary cause…what is it really? Let’s go back to the biology…

Biology 101: Sugar, Carbohydrates, Insulin and Fat

Any food that you ingest is processed and metabolized by the body. Food is broken down into the various building blocks the body needs, and what cannot be metabolized or used is processed and removed by the liver. Protein and fats are used for muscle and tissue regeneration and other processes in the body.
Carbohydrates are typically a fast fuel for the body, but when more are eaten that the body immediately needs, they must be stored.

    Any form of carbohydrate is eventually broken down by the body into glucose, a simple form of sugar. While the body can use glucose for fuel, levels that exceed what  is needed are toxic to the body. In the long run, that whole wheat muffin, cup of millet, or bowl of oatmeal turns into the exact same thing as a cup of soda, a donut or a handful of candy.

    The problem is, glucose is actually toxic if it is just floating around in your bloodstream, so that body has a defense mechanism. Any glucose that is not immediately used is stored as glycogen in the liver and the muscles. This would be all well and good except that your body has a limited number of glycogen receptors. When these are full, as they almost always are in inactive people, the body only has one option left: to store all the excess glucose as saturated fat within the body.

    To make matters worse for the inactive, carb addict, when the body senses glucose in the bloodstream, the pancreas releases a hormone called insulin (perhaps you’ve heard of it?) to signal the body to store the glucose as glycogen. If the glycogen receptors are full and it can’t do this, the body thinks that the cells didn’t get the message and releases even more insulin.

    When this happens for a period of time, the cells start to become resistant to the presence of insulin, causing a vicious cycle. The body then releases even more insulin, trying desperately to get the cells to uptake the toxic glucose. The presence of excess insulin in the bloodstream is also toxic and further damages the receptors on these cells. Eventually, the insulin allows the glucose access to your fat cells to get it out of the bloodstream. In other words- Fat isn’t stored as fat in the body- Sugar (from carbohydrates) is stored as fat!

So, there you have it: excess sugars and carbohydrates increase insulin levels, and when this happens over a period of time, weight gain and insulin resistance occur. Seems pretty simple, right? If only it were… there are other confounding factors involved.

Grains, Sugars and Omega-6 Oils

These three are the axis of evil in the nutrition world. They are all new introductions to the human diet, especially in the forms they are most eaten in (processed flour, table sugar and High Fructose Corn Syrup and vegetable oils).As we already know, grains (especially in a highly processed form) not only raise insulin levels but can damage the lining of the gut, even in those with no official celiac disease. Grains also cause inflammation in the body and can initiate an immune response.

Sugars raise insulin levels, and over extended periods of time, damage the pancreas and cause insulin resistance, a precursor for diabetes. Fructose is the top offender in the sugar world, as it is recognized as a toxin the body and has no proven benefit to the body. Fructose is immediately taken to the liver, where it must be processed, and some doctors now suggest that this may be a large factor in development of fatty liver disease. Excess sugar in the bloodstream also increases the release of cortisol and adrenaline (more on those in a minute), slows the immune response, decreases necessary Leptin levels and promotes fat storage. There are various types of sugar and sweeteners, and while all should be limited, some are worse than others:

    Glucose-Found in almost all carbohydrates and a precursor to glycogen, which the body needs for energy. It should be limited, but is ok in moderation, especially for healthy individuals
    Fructose- A toxic substance that the body does not need in any amount. If consumed, it should be from fruit and not sources like High Fructose Corn Syrup, which greatly increases risk of the above problems from sugar.
    Sucrose- What we know as table sugar. It has a 1:1 ratio of glucose to fructose and creates an insulin response in the body. Should be limited or avoided.
    High Fructose Corn Syrup- Highly concentrated fructose that is dangerous to the body. Should be avoided
    Honey, Maple Syrup, Agave, Molasses, etc- Natural sweeteners that still contain high levels of fructose. Should be consumed only in moderation by healthy individuals with good insulin sensitivity.
    Sugars in fruit- Fruit contains a lot of natural sugar, and while most are ok in moderation, their juices should be avoided as they are concentrated sources of sugar and raise blood glucose and insulin. Best fruit sources are those high in antioxidants and comparatively low in sugars, such as berries.
Omega 6 oils are also a relatively new addition to the diet, making their appearance in the early 1900s. Oils in this category include vegetable, canola, cottonseed, soybean, corn, safflower, sunflower, etc. Consumption of these oils increased in the 1950s when they were promoted as a “healthy” alternative to saturated fats (they weren’t). Research is now showing that consumption of these oils increases risk for obesity and can damage thyroid function. They contribute to insulin resistance and inflammation, further aggravating the poor pancreas.

Omega-6 fats should be consumed in ideally, a 1:1 ratio with Omega-3 fats. Most Americans consumer a ratio closer to 20 or 25:1, greatly increasing risk of diabetes and obesity.

Stress, Toxins and the Adrenals
Since the body functions as a whole, it is logical that when one hormone or part of the endocrine system is suffering, the other would be affected as well. This is the reason behind the recent research linking high stress levels to diabetes and other health problems. Most people think of stress only in the mental context (as in, “I’ve got a million things to do, I’m running late and I don’t have time to get anything done… I’m so stressed”) but stress can be physical, psychological, emotional, or mental and can be triggered by many factors including:

•     Lack of sleep
•     Poor diet
•     exposure to toxins
•     infection
•     disease
•     overexercising
•     outside stress

When stress occurs, whatever the source, the hypothalamus signals the adrenals to release cortisol (and adrenaline). These hormones are life-saving in true “fight or flight” situations like running away from a charging animal or hoisting a car off a small child, but they cause big problems when they are regularly produced in excess. Excess cortisol can contribute to hormone imbalance in the body since the body uses hormones like progesterone to manufacture cortisol. Excess cortisol absent of a charging animal can also interfere with the body’s ability to regulate blood sugar, reduce fat burning ability, raise insulin, suppress thyroid function and cause gain in belly fat.

Even stress from lack of quality sleep for just a few nights can elevate cortisol, decrease insulin sensitivity and elevate blood sugar. Most moms have probably felt the hangover-like effects of this during the first weeks of caring for a newborn.
Genetic Factors

Genetic factors do play a role in any disease, but I put this factor last for a reason. Genetic predisposition to a given disease will increase the chances of getting the disease, but not in a vacuum. People with a strong predisposition to liver disease manage to avoid it, and some with a family history of heart disease remain heart-attack free. Even studies among identical twins show that in most cases, twins will get the same diseases, even in different environments, but sometimes they don’t. This means there are other factors involved (see above).

It was once assumed that environmental factors took generations to affect a gene change, but research is now finding that a bad enough toxin or environmental stress can alter genes in a single generation. While genes can pre-dispose us to disease, the disease will only present itself in the presence of factors like toxins, poor diet or stress. A predisposition to diabetes, for instance, might be activated from toxins in foods, pesticides, herbicides, chemicals, or from a poor diet, especially when any of the above factors are also present.

In other words: genetic predisposition can increase your odds of a disease, but genetics alone won’t necessarily give you the disease without other factors. If you know you have genetic predisposition to a given disease, you should certainly be more careful about taking steps to maintain health and prevent it.

Genetic predisposition to liver problems or certain autoimmune diseases often correlate to higher rates of diabetes. This is likely because proper insulin response is handled by the pancreas and liver, so problems here could affect the body’s normal response. Studies have linked certain autoimmune disease and leaky gut syndrome with higher instances of diabetes also, so this correlation is logical as well.

How do we fix it?

All of the above contributing factors don’t usually happen by themselves. Since the body functions as a whole, a problem in one area will usually correlate to problems in others. A combination of the factors above can be the catalyst for a full blown case of diabetes (or a lot of other diseases). While researchers often look at a single variable when trying to discover a cure for a disease, often the best approach is one that addresses the body as a whole. As with all diseases, the best cure is good prevention, but certain measures can help reverse disease once it has occurred.

Unfortunately, most people are not given the benefit of this approach. When diagnosed with diabetes, most people are told to avoid sugar (good step, not the solution). If the problem is bad enough, they are told to take medication to give the body insulin. The problem is, as we saw above, diabetes is a problem with the body’s regulation of insulin, caused by a resistance to insulin and an overproduction to remove toxic amounts of glucose in the bloodstream. Insulin is also dangerous if it is left circulating the the blood. Somehow, treating too much circulating glucose and insulin with more insulin doesn’t seem like the right approach…

It isn’t just keeping blood sugar levels down through insulin control that helps diabetes, but fixing the actual problem causing the diabetes. Addressing just one aspect of the problem (blood sugar or insulin) ignores all the other factors like poor diet, toxins, stress, gut problems, immune issues etc. Instead, this single focuses approach can contribute to the problem, making insulin resistance worse and eventually leading to insulin dependent diabetes when the pancreas shuts down completely. Many doctors and nutrition experts recommend the typical 6-11 servings of complex carbs from whole grain sources daily, suggesting that the fiber helps mitigate insulin response. As I have shown before, 6-11 servings of carbohydrates a day is bad for anyone, but is gasoline on a fire to anyone with an impaired insulin response.

Seven Steps to Help Your Body Reverse Diabetes

The good news (about time!) is that most individuals with Type II diabetes are able to reverse or dramatically mitigate their disease with the proper steps. If you’ve been around my blog much, you might be able to guess what I’m going to suggest:

    Get Insulin Problems Under Control- Diabetes is triggered by insulin resistance and regaining proper insulin sensitivity can help reverse the process. Limit consumption of sugars, grains and processed carbohydrates and focus on healthy proteins, fats and green veggies.

    Get Your Fats in Good Balance- Overabundance of Omega-6 fats in the diet is a contributing factor in diabetes. Pay attention to your intake of  Omega-3 and Omega-6 fats and try to get them closer to a 1:1 ratio. For many people, supplementing with a good quality Omega-3 oil can help while dietary adjustments are being made. Avoid Omega-6 seed oils and their sources (these are used at almost every restaurant). Eat fatty fish like salmon and sardines for the Omega-3s.

    Fix your Gut- Not the beer gut, your intestines. Grains and toxins cause damage to the intestinal lining and facilitate leaky gut syndrome. Depleted beneficial bacteria in the gut caused by poor diet, antibiotic use or being bottle fed as a baby can make the problem worse. Remove the grains, avoid toxins whenever possible and take a high quality probiotic to help the intestines heal. As a note: some people will have continued damage to the gut with exposure to grains, especially gluten, as little as only every 10 days or even every 6 months.

    Exercise- Even the mainstream medical community recognizes the advantage of exercise, as it increases the muscles ability to use insulin and over time can help fix insulin resistance. All exercise isn’t created equal though and fortunately, smaller amounts of high intensity exercise have been shown to have a better effect on insulin levels (and weight loss) than an hour of daily moderate cardio. According to the Healthy Skeptic: “A pair of studies done at McMaster University found that “6-minutes of pure, hard exercise once a week could be just as effective as an hour of daily moderate activity“, according to the June 6, 2005 CNN article reporting on the study.” I recommend high intensity exercise anyway for its various health advantages, and it is great for diabetes control. too.

    Lose Excess Weight- Obesity and Diabetes often go hand in hand, and while the debate still rages on if one causes the other, studies show that losing weight can help mitigate diabetes, and also lowers your risk of getting it to begin with. Certain dietary and lifestyle improvements can help you lose weight and are beneficial for diabetes reversal as well.

    Reduce Stress-  Stress raises cortisol and can lead to hormone imbalance, insulin issues and increases risk for certain types of disease. Work to reduce your sources of stress from lack of sleep, exposure to toxins, mental and emotional sources and poor diet. Getting quality sleep every night can help reduce stress hormone levels and is great for blood sugar.

    Supplement- Supplements can help your body heal from diabetes, especially while your body works to gain proper insulin reactions again. Supplements often associated with helping diabetes symptoms and improving the disease are cinnamon, omega-3 fatty acids, alpha lipoic acid, chromium, coenzyme Q10, garlic, and magnesium

Monitoring the Problem As It Improves

Anyone with diagnosed Diabetes should consult a physician before making any changes to a diabetes regimen, and especially before changing medication dosages. That being said, improving your diet and eating the foods to help your body heal is your prerogative and your right. For the 65% of America that is overweight, including the 37% that are clinically obese, there is a good chance that many are operating in a pre-diabetic state, or may even have undiagnosed diabetes. Even those without any signs of disease can figure out their insulin levels by at home glucose testing.

I’ve done this for years and I do it each time I’m pregnant in place of the glucose test. It is a cheap and easy way to keep insulin levels in check and see how your body responds to certain foods. While I can offer general advice on the amount of carbohydrates that should be consumed, at home glucose monitoring allows you to know exactly what your body will and won’t handle.
What you need:

    A glucometer – One of those little finger prick machines that diabetics use to test blood sugar. The machine and the strips can be found at most large stores and drugstores.

    Test strips-Get the strips to go with the machine you buy. Be sure to look at the price of the machine and the strips. It is pretty easy to find an inexpensive machine, but the strips can get pricey.

    Small notebook to keep track of readings and food intake.

What to Do:
Once you have the necessary supplies, take readings of your blood sugar, according to the instructions on your meter, at the following times each day for a week:

•     First thing in the morning before eating or drinking anything
•     Before your normal lunch
•     One hour after lunch
•     Two hours after lunch
•     Three hours after lunch

NOTE: Do not eat or drink anything else during the three hours of testing. You may be able to get an accurate baseline of your insulin response after only a few days, but a week provides more data. If you are already diabetic, you probably have close ideas on these numbers, but take readings at the suggested times anyway to figure out your baseline.

Other Important Steps

    Food Log- Keep an accurate food log of everything you eat and drink and the times during your week of testing your blood sugar. This will help you determine your reaction to specific foods. Don’t make any special effort to diet or eat healthy foods during this time as you want an indication of your normal reactions.

    Carbohydrate Spike Test-On one day of your blood sugar readings (after at least 2-3 days of testing) eat a food high in simple carbs at your test meal (a potato, rice, etc) along with any vegetables, but in the absence of any fats or proteins. This will test your basic glucose reaction to high levels of glucose not mitigated by fat. Record these numbers as usual. Important note: if you usually eat a low-carbohydrate diet, this number might seem higher than it should be. This is because of decreased tolerance to carbohydrates and is not a cause for concern.

    Determine Results-Based on your food log and blood glucose readings, note any specific foods that caused higher readings. I suggest imputing your food log into a website like fitday.com to give accurate analysis of your total carbohydrate, protein, and fat consumption and see which days were the best and worst for your blood glucose.

What Should Your Numbers Look Like?

Ideally, you want your numbers to be as follows:

•     Fasting blood glucose below 83 mg/dL
•     Pre-meal reading-below 90 mg/dL, or at fasting level
•     1 hour reading- under 140 mg/dL
•     2 hour reading-under 120 mg/dL (preferably under 100)
•     3-hour reading-back to pre-meal level
•     No readings above 140 mg/dL

If you have readings higher than this, your body is not processing glucose optimally and you likely have some level of insulin resistance. Reduce the amount of carbs in your diet and remove processed foods entirely. Make sure you are getting good fats and proteins as well. Implement the “Seven Steps” above.

If you have readings on the high end of the pre-diabetic range or in the diabetic range (over 175-180 mg/dL at anytime) consider consulting with a specialist in addition to implementing the “Seven Steps” above.

Even if you don’t have any underlying glucose issues, testing your blood sugar occasionally will help you pin point which carbohydrates you tolerate well and which you don’t. It can help you have a better understanding of your body’s reaction to foods and take control of your health. It is also an accurate alternative to the pregnancy test for gestational diabetes, so talk to your doctor if you’d prefer to test yourself, though you may have to explain your reasons!

Research is constantly giving us more information on diabetes and the various factors that contribute to its steady rise in society over the last few decades. Since most theories on diabetes are just that- theories, research for yourself and figure out your best way or preventing or reversing diabetes. I’ve compiled the best of my own research above, but do your own, too! At the least, please consider making some positive changes to help keep yourself disease free (or become disease free).

Note: I am not a doctor and cannot take the place of your doctor. Before making any changes, especially to medication, consult your doctor or health care professional.

source : http://wellnessmama.com/1440/reverse-diabetes-naturally/

Best Nine Fruits You Should Treat With Extreme Caution

The fundamental problem that causes type 2 diabetes appears to be fat blocking the receptors in muscle cells, which leaves sugar and insulin swirling around aimlessly in your bloodstream.

In my experience, you can beat diabetes by eating foods that are (1) low in sugar, (2) low in fat, (3) low in salt, (4) high in fibre and that (5) are digested slowly. The easiest way to do this is by concentrating on natural, unprocessed foods that are mostly plants and by excluding all diary products (milk, cheese, butter etc) and eggs from the diet.

You also need to drink plenty of water, to aid in the absorption of all the fibre you will be eating with this plant-focused diet. Personally I drink at least two litres of water a day in addition to the water, juices, tea and soy milk in my food and coffee.

You should also take a good multi-vitamin supplement in order to cover any possible dietary deficiencies you might encounter by avoiding dairy products and eggs.

Most fruits contain some natural sugars but usually not to excess. Most are extremely low in fat and salt. They are also high in fibre and are digested slowly. Fruit therefore should be a part of a diabetes beating diet, especially as most fruits are full of micro-nutrients (vitamins and minerals).

However there are some exceptions to this general rule. Here are nine of them-fruits you should treat with extreme caution or avoid altogether.

Dates
Dates provide a wide range of essential nutrients, 2.45g of protein in 100g, along with 8g of dietary fibre. Eat dates regularly and you'll seldom suffer from constipation.

Dates are also particularly rich in the B vitamins. They are also loaded with dietary minerals. But they contain very little vitamin C, virtually none if they have been dried.

The problem with dates is the sugar content... 63% of a ripe date consists of sugars.
However, the glycemic indices for the three different varieties of soft, semi-dry, and dry dates are 35.5, 49.7 and 30.5, which suggests that diabetics can eat a few dates but with caution.

But beware of stuffed dates and glazed dates. The stuffing usually consists of a well-sugared paste while glazing consists almost entirely of sugar.

Figs
Figs are highly nutritious. In fact, dried common figs are the richest plant sources of dietary fibre, copper, manganese, magnesium, potassium, and calcium relative to human needs.

About 10% of a fig, fresh or dried, consists of fibre and figs have a well-founded reputation as a laxative. The fibre in figs is also said to lower insulin and blood glucose levels.

Figs contain almost as much B vitamins as dates. Like dates, they contain little vitamin C. But figs have plenty of antioxidants. Figs are also packed with dietary minerals.

Again, as with dates, the problem is sugar. A 100g of figs contains nearly 64g of carbohydrates, of which sugars make up 48g. This is somewhat less than dates but nevertheless it means that figs have to be treated with caution by diabetics.

If you take a risk and do eat figs, go for the ones with dark skins, as they are the most nutritious.

Plums and prunes
There are hundreds of varieties of plums, each with its own distinctive taste and colour. All can be dried.

Dried plums are called prunes.
 A raw fresh plum (without its stone) has very little fat, protein or sodium. It is a fairly good source of fibre, vitamins A and K, phosphorus and potassium, and a very good source of vitamin C.

Unfortunately, 10% of a plum is sugar and as its glycemic index (GI) can be as high as 53 (depending on the variety,) diabetics should only eat plums in strict moderation.

Drying a plum removes nearly all the water, so the nutritional value of a prune is dramatically different. It also reduces the amount of vitamin C by at least 90%, and more than quadruples the amounts of phosphorus and potassium. Prunes are also rich in copper and boron.

Drying increases dietary fibre by a factor of five, so it is no surprise that prunes are well-known for their laxative effect.

This fibre includes inulin which, when broken down by intestinal bacteria, makes a more acid environment in the digestive tract which, in turn, makes it easier for calcium to be absorbed.

However, compared to a fresh raw plum, there is nearly four times as much sugar in a prune. So, even though prunes have a GI value of only 29, they need to be treated with caution by diabetics. In fact, my advice would be to ignore them unless you need them for their laxative effects.

Coconut
Coconut meat, the white stuff from inside the coconut, contains less sugar and more protein than bananas, apples and oranges. It is an excellent source of fibre and is relatively high in minerals such as iron, phosphorus and zinc.

The problem with eating coconut is fat-a whopping 33.5g per 100g-of which 30g or about 90% is saturated.
As a diabetic aiming to beat your diabetes, you just need to forget about coconut.

Açaí
Açaí is sold as frozen pulp or juice. It is also an ingredient in drinks, smoothies and foods. Over the last ten years spurious marketing hype has made it very popular as a magical dietary supplement.
Did you know that açaí delivers a variety of amazing health benefits? It can reverse diabetes and other chronic illnesses. Eaten regularly it will also expand the size of your penis and increase your sexual virility if you are a male. It also promotes weight loss (but without gender bias).

Miracle stuff, you might say, except that there are no scientifically controlled independent studies to prove the fabulous health benefits you'll get from consuming açaí. As far as I can tell, açaí has never been evaluated by any reputable laboratory or research institution any where in the world.

Nevertheless, it ain't all bad. The skin and pulp of the açaí fruit contains over 52% carbohydrates though most of this is dietary fibre and little of it is sugar. Açaí also contains many polyphenols, the antioxidants found in plants.

The problem with the açaí fruit is that 32.5g out of 100g consists of fat. So, if the obviously false hype is not enough to put you off, just think of the fat content seemingly custom designed to re-clog the receptors in your muscle cells!

Crystallised fruit (candied or glacé fruit)
Crystallised fruits... aka candied or glacé fruit... are small pieces of fruit or peal that have been preserved using sugar. The fruit is drenched with sugar syrup, and once it has become saturated the sugar prevents the micro-organisms that spoil fruit from growing.

Crystallised fruits can include dates, cherries, pineapple, ginger and chestnuts (marron glacé), as well as orange and lemon peel. Avoid like the plague-for reasons that do not need to be stated.

Dried fruit
Dried fruit is fresh fruit from which most of the water has been removed.
Most of the nutritive value of the fresh fruit is preserved, yet the dried fruit has a sweeter taste and a much longer shelf-life.

Fruit can be dried in two ways. The traditional method is either in the sun or in special heated wind tunnels.
The second way is to infuse the fruit with a sweetener (such as sucrose syrup) before drying, a method used to dry fruits such as cranberries, blueberries, cherries, strawberries and mangoes. Note that some products sold as dried fruit (eg, papaya and pineapples) are in fact candied fruit.

The specific nutrient content of various dried fruits reflect the nutrients in the original fruit. Fruits dried in the traditional manner will have almost the same nutrients as their fresh originals. Fruit infused with sugar before drying will naturally contain a lot more sugar than it had when fresh.

Drying, by definition, removes most of the water which concentrates the fruit's natural sugars. To obtain the same total sugar and energy, the amount of dried fruit you should eat should only be about 1/3 of the quantity of fresh fruit you would eat.

Prunes, dried dates, figs, apricots, peaches, apples and pears deliver energy when you are feeling tired and make great snacks-provided they have been dried in the traditional manner without being infused in a sweetener.

But remember the water (two-thirds of a fruit on average) is gone, so watch how much you eat.

Tinned (canned) fruit
In theory, the nutritional content of canned fruit should be little different than fresh fruit.
However canning usually includes a form of cooking as part of the process which can affect nutritional values. Vitamin C, for example, is destroyed by heat and so fresh fruit will contain more vitamin C than canned fruit.

Some canned fruits have less fibre content than natural foods. This is because the skins are often removed when fruit are being canned.
I
n theory, however, fruit in tin cans should not cause problems for diabetics who are beating their diabetes through diet. The problem is that manufacturers often add sugar during canning.
So you need to read labels carefully.

Grapefruit and other citrus fruits
All citrus fruits have similar properties, and are a rich source of vitamins (especially vitamins B and C), minerals (notably potassium) and dietary fibre (of which 65 to 70% is pectin).

They also contain phytochemicals (biologically active, non-nutrient compounds) that can help to reduce the risk of many chronic diseases which are of crucial importance to diabetics with metabolic syndrome-cardiovascular disease, heart disease, hypertension, stroke, cancer, and anaemia.

Citrus fruits contain no fat, no sodium and no cholesterol. The number of calories is low so they can be useful for reducing weight. Citrus fruits also deliver plenty of fibre.

These fruits contain simple carbohydrates (fructose, glucose and sucrose) and citric acid. However, they all have low GIs (less than 55)-the sharper the taste, the lower the GI-and so diabetics can eat them in moderation.

However not all citrus fruits are wholly beneficial, especially if you are taking certain medications.
For example, grapefruit, according to clinical trials in reputable laboratories, inhibits the enzymes that metabolize several medicines in your intestines. This increases the concentration of these medications in your blood to levels that could be toxic. The effects last for 24 hours or more.

These medicines include drugs for lowering cholesterol, such as atorvastatin (Lipitor), simvastatin (Zocor) and lovastatin (Mevacor) and for controlling blood pressure, such as amlodipine (Norvasc), nifedipine (Adalat, Procardia) and verapamil (Isoptin, Calan).

Grapefruit also blocks the action of antihistamines and some psychiatric medications such as diazepam (Valium).

As I am taking statins to control my cholesterol levels, I never touch grapefruit.
I understand that medical scientists are currently trying to find out whether other citrus fruits, such as oranges, have similar effects but have yet to come up with conclusive answers. Thus I seldom eat oranges or other citrus fruits despite the tonnes of micro-nutrients they contain.

I would recommend you do the same, until such time as the effect of other citrus fruits on the metabolism of vital drugs has been properly assessed.

Summary
Fruit is good for you.
However, you should avoid:

• Stuffed and glazed dates
• Crystallised fruits (candied or glacé fruit)
• Dried fruit that has been infused with sugar before drying
• Prunes (except as laxative)
• Tinned (canned) fruit that contains added sugar
• Grapefruit as it interferes with metabolism of vital drugs

You should treat other citrus fruits with extreme caution until their effects on the metabolism of vital drugs has been scientifically assessed.
In addition, you should eat very little of:

• Dates (sugar 60%)
• Figs (sugar 48%)
• Plums
• Coconut (fat 33.5%)
• Açaí (fat 32.5%)

Paul D Kennedy is a type 2 diabetic. He used his skills as an international consultant and researcher to find a way to control his diabetes using diet alone and, about five years ago, he stopped taking medications to control his blood glucose levels. You can find out more from beating-diabetes.com or by contacting Paul at paul@beating-diabetes.com. His book Beating Diabetes is available for download from Amazon or as a printed edition from Create Space online book store.

Article Source: http://EzineArticles.com/?expert=Paul_D_Kennedy

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Diabetes Cure Natural Way

Diabetes Cure Natural Way

What is Diabetes?

Diabetes is two different diseases, both involving the hormone insulin. In type 1, which typically strikes before age 25 and only accounts for about 5 percent of the disease, the pancreas stops producing insulin, which is required to usher blood sugar (glucose) into the body’s cells. Type 1 diabetics must inject insulin. Type 2 diabetes typically develops after age 40, either because the pancreas does not produce enough insulin, or because the cells become “resistant” and can’t use it.

In both types of diabetes, sugar builds up in the blood and causes the blood to become sticky. Eventually, this sticky blood gums up the blood vessels and causes the condition’s complications: cardiovascular disease (heart disease and stroke); poor wound healing; and problems with the eyes, kidneys, legs, nervous system and sexual organs.

read : How to Treat Type 1 Diabetes Naturally

Type 1 diabetes is caused by bad luck. Type 2 is strongly associated with obesity and the lifestyle that causes it: lack of exercise and a diet low in fruits and vegetables, and high in sugar, fat and animal products. As weight increases, the body’s cells become insulin-resistant.

Unlike type 1 diabetes, which has a fairly sudden onset, type 2 develops slowly, over years, as weight rises. Because of its slow development, type 2 diabetes rarely produces dramatic symptoms, and many people with the disease have no idea they have it.

There are other risk factors for type 2 diabetes beyond obesity, but these risk factors are by no means destiny. Even in people with a family history, lifestyle adjustments can prevent the disease or eliminate it. Researchers at the University of Texas Health Sciences Center in San Antonio followed 3,682 people with type 2 diabetes for seven years. During that time, diet modifications, weight loss and exercise allowed 12 percent of them to become nondiabetic, according to a 1998 article in Diabetes Care.

Lifestyle Modifications for Diabetes

Diabetes Cure Natural Way
Regular exercise and weight loss can prevent and treat type 2 diabetes:

• UCLA researchers persuaded 652 type 2 diabetics to enroll in a medically supervised diet and exercise program. The participants took daily walks and ate a diet very low in fat and cholesterol and high in fruits, vegetables and beans. After just 26 days, their average blood sugar levels dropped 15 percent. Of those taking diabetes medications, 71 percent were able to discontinue them. Of those injecting insulin, 39 percent were able to stop.

• Finnish researchers recruited 522 middle-aged overweight adults who were not diabetic but showed signs of insulin resistance. Half of the participants, the controls, received general health advice. The other half exercised for 30 minutes a day and ate a lowfat diet with lots of fruits and vegetables. Four years later, the diet-exercise group had lost an average of nine pounds versus two pounds in the control group. Diabetes developed in 23 percent of the controls but in just 11 percent of the diet-exercise group.

“The evidence is overwhelming,” says Joe Pizzorno, former president of Bastyr University near Seattle, a leading naturopathic medical school. “Our Western diet and lifestyle cause type 2 diabetes. To prevent it, get regular exercise. Eat less saturated fat and cholesterol by reducing or eliminating animal products. And eat more fruits, vegetables, beans and whole grains.”

A plant-based diet helps prevent diabetes in three ways: First, compared with the typical American diet, it’s much lower in fat, so it helps control weight. Second, it’s high in fiber, which helps control blood sugar. And third, plant foods are rich in antioxidant nutrients, which improve the body’s ability to use insulin. As blood levels of antioxidants rise, diabetes risk drops. According to a new study, herbs and spices are among the top 50 dietary sources of antioxidants. For more about the study and the benefits of herbs and spices

Source: http://www.motherearthliving.com/health-and-wellness/natural-ways-to-treat-diabetes.aspx#ixzz394D9evjM

Type 2 Diabetes Cure Research

Type 2 Diabetes Cure Research

Can Type 2 diabetes be cured with just a simple injection?

Researchers at the Salk Institute for Biological Studies found a single injection of the protein FGF1 can restore blood sugar levels to a healthy range for two days, the Science Daily reported.

Also, the researchers learned sustained treatment can also reverse insulin insensitivity, the cause of diabetes—and without the side effects of present treatments.

"Controlling glucose is a dominant problem in our society. And FGF1 offers a new method to control glucose in a powerful and unexpected way," said Ronald Evans, director of Salk's Gene Expression Laboratory and author of the paper.

"With FGF1, we really haven't seen hypoglycemia or other common side effects. It may be that FGF1 leads to a more 'normal' type of response compared to other drugs because it metabolizes quickly in the body and targets certain cell types," added Salk postdoctoral research fellow Jae Myoung Suh, a member of Evans' lab and first author of the new paper.

Scientists believe this could lead to a new generation of safer, more effective diabetes drugs.

The treatment could also potentially help patients of Type 2 diabetes, which can stem from excess weight and inactivity and which has increased dramatically in the past few decades.

While diabetes has no specific cure, it is managed with diet, exercise and pharmaceuticals.

Other researchers on the study included Maryam Ahmadian, Eiji Yoshihara, Weiwei Fan, Yun-Qiang Yin, Ruth Yu, and Annette R. Atkins of the Salk Institute for Biological Studies; Weilin Liu, Johan Jonker, Theo van Dijk, and Rick Havinga of the University of Groningen; Christopher Liddle of the University of Sydney; Denise Lackey, Olivia Osborn, and Jerrold Olefsky of the University of California at San Diego; and Regina Goetz, Zhifeng Huang, and Moosa Mohammadi of the New York University School of Medicine.

Injecting protein

In their study, Evans' team injected FGF1 into obese mice with diabetes - and found a single dose managed to drop blood sugar levels to normal levels in all the diabetic mice.

"Many previous studies that injected FGF1 showed no effect on healthy mice. However, when we injected it into a diabetic mouse, we saw a dramatic improvement in glucose," said Michael Downes, a senior staff scientist and co-corresponding author.

Also, the researchers found the FGF1 treatment had advantages over the diabetes drug Actos, which allegedly has side effects ranging from unwanted weight gain to dangerous heart and liver problems.

The team also found FGF1 did not trigger these side effects or cause glucose levels to drop to dangerously low levels, even at high doses.

"Instead, the injections restored the body's own ability to naturally regulate insulin and blood sugar levels, keeping glucose amounts within a safe range — effectively reversing the core symptoms of diabetes," Science Daily said.

Questions

Despite the findings, researchers have yet to fully understand the mechanism of FGF1, though their findings may bring the protein a step closer to therapeutic use.

"We want to move this to people by developing a new generation of FGF1 variants that solely affect glucose and not cell growth. If we can find the perfect variation, I think we will have on our hands a very new, very effective tool for glucose control," Evans said. — Joel Locsin/TJD, GMA News

source : http://www.gmanetwork.com/news/story/371303/scitech/science/can-one-simple-injection-cure-diabetes

Diabetes Cure Diet Plan

Ever see the top 10 lists for foods everyone should eat to superpower your diet? Ever wonder which will mesh with your diabetes meal plan? Wonder no more. Your list of the top 10 diabetes superfoods has arrived.

As with all foods, you need to work the diabetes superfoods into your individualized meal plan in appropriate portions.

All of the foods in our list have a low glycemic index or GI and provide key nutrients that are lacking in the typical western diet such as:

-calcium
-potassium
-fiber
-magnesium
-vitamins A (as carotenoids), C, and E.

There isn’t research that clearly points to supplementation, so always think first about getting your nutrients from foods. Below is our list of superfoods to include in your diet.

Beans

Whether you prefer kidney, pinto, navy, or black beans, you can’t find better nutrition than that provided by beans. They are very high in fiber, giving you about 1/3 of your daily requirement in just a ½ cup, and are also good sources of magnesium and potassium.

They are considered starchy vegetables, but ½ cup provides as much protein as an ounce of meat without the saturated fat. To save time you can use canned beans, but be sure to drain and rinse them to get rid of as much sodium as possible.

Dark Green Leafy Vegetables

Spinach, collards, kale – these powerhouse foods are so low in calories and carbohydrate. You can’t eat too much.

Citrus Fruit

Grapefruit, oranges, lemons and limes. Pick your favorites and get part of your daily dose of soluble fiber and vitamin C.

Sweet Potatoes

A starchy vegetable packed full of vitamin A and fiber. Try in place of regular potatoes for a lower GI alternative.

Berries

Which are your favorites: blueberries, strawberries or another variety? Regardless, they are all packed with antioxidants, vitamins and fiber. Make a parfait alternating the fruit with light, non-fat yogurt for a new favorite dessert.

Tomatoes

An old standby where everyone can find a favorite. The good news is that no matter how you like your tomatoes, pureed, raw, or in a sauce, you’re eating vital nutrients like vitamin C, iron, vitamin E.
Fish High in Omega-3 Fatty Acids

Salmon is a favorite in this category. Stay away from the breaded and deep fat fried variety... they don’t count in your goal of 6-9 ounces of fish per week.

Whole Grains

It’s the germ and bran of the whole grain you’re after.  It contains all the nutrients a grain product has to offer. When you purchase processed grains like bread made from enriched wheat flour, you don’t get these. A few more of the nutrients these foods offer are magnesium, chromium, omega 3 fatty acids and folate.

Pearled barley and oatmeal are a source of fiber and potassium.

Nuts

An ounce of nuts can go a long way in providing key healthy fats along with hunger management. Other benefits are a dose of magnesium and fiber.

Some nuts and seeds, such as walnuts and flax seeds, also contain omega-3 fatty acids.

Fat-free Milk and Yogurt

Everyone knows dairy can help build strong bones and teeth. In addition to calcium, many fortified dairy products are a good source of vitamin D. More research is emerging on the connection between vitamin D and good health.

Some of the above list can be tough on the budget depending on the season and where you live. Look for lower cost options such as fruit and vegetables in season or frozen or canned fish.

Foods that every budget can live with year round are beans and rolled oats or barley that you cook from scratch.

Of course, you probably don't want to limit yourself to just these items for every meal. The American Diabetes Association's book What Do I Eat Now? provides a step-by-step guide to eating right.

See more at: http://www.diabetes.org/food-and-fitness/food/what-can-i-eat/making-healthy-food-choices/diabetes-superfoods.html#sthash.XyclvUTv.dpuf

Treating Diabetes Mellitus Type 2

Here are the great articles from patient.co.uk about treating diabetes mellitus type 2

The first-line treatment for type 2 diabetes is diet, weight control and physical activity. If your blood sugar (glucose) level remains high despite a trial of these lifestyle measures then tablets to reduce the blood glucose level are usually advised. Insulin injections are needed in some cases if the blood glucose level remains too high despite taking tablets. Treatments for other related problems may also be advised. This leaflet mainly discusses treatments that can lower the blood glucose level. It briefly mentions other treatments that may also be advised if you have type 2 diabetes.

How is the blood glucose level monitored?

The blood test that is mainly used to keep a check on your blood sugar (glucose) level is called the HbA1c test. This test is commonly done every 2-6 months by your doctor or nurse. The HbA1c test measures a part of the red blood cells. Glucose in the blood attaches to part of the red blood cells. This part can be measured and gives a good indication of your average blood glucose level over the previous 1-3 months.

Treatment aims to lower your HbA1c to below a target level which is usually agreed between you and your doctor. Ideally, the aim is to maintain your HbA1c to less than 48 mmol/mol (6.5%) but this may not always be possible to achieve and the target level of HbA1c should be agreed on an individual basis between you and your doctor (for example, by increasing the dose of your medication, etc).

In general, the nearer your HbA1c level is to normal:

The better you are likely to feel, and

The less likely you are to develop complications from diabetes, such as heart disease, eye problems, kidney problems, feet problems, etc.

Lifestyle - diet, weight control and physical activity

You can usually improve your sugar (glucose) control if you:

Eat a healthy balanced diet. Your practice nurse and/or a dietician will give details on how to eat a healthy diet. The diet is the same as recommended for everyone. The idea that you need special foods if you have diabetes is a myth. Basically, you should aim to eat a diet low in fat, high in fibre and with plenty of starchy foods, fruit and vegetables.

Lose weight if you are overweight. Getting to a perfect weight is unrealistic for many people. However, if you are obese or overweight then losing some weight will help to reduce your blood glucose level (and have other health benefits too).

Do some physical activity regularly. If you are able, a minimum of 30 minutes' brisk walking at least five times a week is advised. Anything more vigorous and more often is even better. For example, swimming, cycling, jogging, dancing. Ideally you should do an activity that gets you at least mildly out of breath and mildly sweaty. You can spread the activity over the day - for example, two 15-minute spells per day of brisk walking, cycling, dancing, etc. Regular physical activity also reduces your risk of having a heart attack or stroke.

Many people with type 2 diabetes can reduce their blood glucose (and HbA1c) to a target level by the above measures. However, if the level remains too high after a trial of these measures for a few months then medication is usually advised. Medication is used in addition to, and not instead of, the above lifestyle measures.

Medication to reduce the blood glucose level

Metformin

Metformin is a biguanide medicine. It lowers blood glucose mainly by decreasing the amount of sugar (glucose) that your liver releases into the bloodstream. It also increases the sensitivity of your body's cells to insulin (so more glucose is taken into cells with the same amount of insulin in the bloodstream.) Metformin has also been shown in studies to lower your risk of other complications of diabetes (such as heart attack and stroke).

Metformin is commonly the first tablet advised if your blood glucose level is not controlled by lifestyle measures alone. It is particularly useful if you are overweight, as it is less likely than some other glucose-lowering tablets to cause weight gain. Another advantage of metformin is that it generally does not cause a low blood glucose level (hypoglycaemia - sometimes called a 'hypo') which is a possible problem with some other glucose-lowering tablets. You can also take metformin in addition to other glucose-lowering tablets if one tablet does not control blood glucose well enough on its own.

Possible problems with metformin

When metformin is first started, some people feel sick or have mild diarrhoea. These are less likely to occur if you start with a low dose and gradually build up to the usual dose over a few weeks. If these side-effects do occur, they tend to ease off in time. Other side-effects are uncommon. (See the leaflet that comes in the drug packet for full details of cautions and possible side-effects.)

Sulfonylurea medicines

There are several types of sulfonylurea medicines. These include gliclazide, glimepiride, and glipizide. They work by increasing the amount of insulin that your pancreas makes. (If you have type 2 diabetes, you still make insulin in your pancreas. However, you do not make enough to keep your blood glucose level normal.)

A sulfonylurea tends to be used if you cannot take metformin (perhaps because of side-effects or other reasons), or if you are not overweight. Usually a low dose is started. The dose can be increased if necessary every few weeks until there is good control of the blood glucose level. You can take a sulfonylurea in addition to other glucose-lowering tablets if one tablet does not control blood glucose well enough on its own.

Possible problems with sulfonylureas

As sulfonylureas boost your level of insulin, low blood sugar (hypoglycaemia, or hypo) is a possible complication. However, this is an uncommon problem and unlikely to happen if you: have regular meals, don't miss meals, and don't drink too much alcohol. Symptoms of hypoglycaemia include trembling, sweating, anxiety, blurred vision, tingling lips, paleness, mood change, vagueness or confusion. To treat hypoglycaemia: take a sugary drink or some sweets. Then, eat a starchy snack such as a sandwich.

Some weight gain is a common side-effect. Other side-effects are uncommon and are usually mild. They include: feeling sick (nausea), mild diarrhoea and constipation. (See the leaflet that comes in the medicine packet for full details of cautions and possible side-effects.)

Nateglinide and repaglinide

Nateglinide and repaglinide have a similar action to sulfonylureas. However, they are not commonly used. After taking a dose they quickly boost the insulin level, but the effect of each dose does not last very long. Each dose is taken shortly before main meals (and a dose omitted if you miss a meal). One of these drugs may be an option if you have meals at irregular times. However, a sulfonylurea is generally preferred as a first choice to boost the level of insulin throughout the day. As with sulfonylureas, possible side-effects include weight gain and hypoglycaemia. (See the leaflet that comes in the medicine packet for full details of cautions and possible side-effects.)

Dipeptidyl peptidase 4 inhibitors (also known as incretin enhancers)

This group includes linagliptin, saxagliptin, sitagliptin and vildagliptin. Dipeptidyl peptidase-4 (DPP4) is a chemical (an enzyme) which breaks down hormones called incretins. Incretins are chemicals (hormones) which are produced by the gut (intestine) in response to food. These medicines work by reducing your blood glucose level by enhancing the effects of incretins as they prevent DPP4 from working. One of these may be advised in addition to metformin or a sulfonylurea, or even to both of these if your HbA1c level is still high.

Side-effects are uncommon and are usually mild. They may include feeling sick or having wind (flatulence). If you take vildagliptin then there is a slight risk of liver damage. Therefore, you should have a blood test to check on your liver function before starting it and then at regular intervals. (See the leaflet that comes in the medicine packet for full details of cautions and possible side-effects.)

Thiazolidinediones

Commonly called glitazones (eg, pioglitazone), thiazolidinediones lower blood glucose by increasing the sensitivity of your body's cells to insulin (so more glucose is taken into cells for the same amount of insulin in the bloodstream). They are not usually used alone, but are an option to take in addition to metformin or a sulfonylurea.

Possible problems with thiazolidinediones

You should not take these medicines if you have heart failure, as this can worsen. There is also a slight risk of liver damage. Therefore, you should have a blood test to check on your liver function before starting these medicines. The blood test is then repeated at regular intervals. Some weight gain is a common side-effect, probably due to fluid retention. Hypoglycaemia is an uncommon side-effect. Other possible side-effects are uncommon. (See the leaflet that comes in the medicine packet for full details of cautions and possible side-effects.)

Acarbose

Acarbose works by delaying the absorption of carbohydrates (which are broken down into glucose) from the gut. Therefore, it can reduce the peaks of blood glucose which may occur after meals. It is an option if you are unable to use other tablets to keep your blood glucose level down. It can also be used in addition to other glucose-lowering tablets. However, many people develop gut-related side-effects when taking acarbose, such as bloating, wind, and diarrhoea. Therefore, it is not used very often.

Insulin

Insulin injections lower blood glucose. Only some people with type 2 diabetes need insulin. It may be advised if your blood glucose level is not well controlled by tablets. The dose and type of insulin used varies from person to person. Sometimes insulin is used alone. However, sometimes it is used in addition to your tablets (such as metformin or a sulfonylurea). If you are advised to use insulin your doctor or practice nurse will give detailed advice on how and when to use it.

Possible problems with insulin

Some weight gain is a common side-effect. Weight gain may be less of a problem if you use insulin in combination with a glucose-lowering tablet such as metformin. Hypoglycaemia is a possible complication.

Exenatide and liraglutide - glucagon-like peptide-1 mimetics

Exenatide and liraglutide are treatments given as an injection. They work in a similar way to the action of the naturally occurring hormone glucagon-like peptide-1 (GLP-1). These actions include stimulating insulin secretion in response to glucose and preventing glucagon (a hormone which raises blood sugar) release after meals.

Exenatide and liraglutide are usually used as an add-on treatment to improve glucose control when insulin treatment is not acceptable. There is a once weekly treatment available. Side-effects may include hypoglycaemia, feeling sick and headaches. People receiving this treatment usually lose weight.

Other treatments

To help prevent heart disease, stroke and poor circulation:

If you have high blood pressure then it should be treated. See separate leaflet called Diabetes and High Blood Pressure.

You should not smoke.

You will usually be advised to take tablets to lower your blood cholesterol level.

To help prevent some serious infections, you are usually advised to be immunised against flu each year, and also given an immunisation against pneumococcal infection.

Other treatments may be advised if you develop complications from diabetes.

Monitoring treatment

Your treatment should be monitored regularly in a diabetes clinic. You may need to step up treatment from time to time. For example, your blood sugar (glucose) may be well controlled by lifestyle measures alone for a number of years. However, in time, you may need to add in one tablet. And then at a later time you may need to add in another tablet to keep your blood glucose level down.

source : http://www.patient.co.uk/health/treatments-for-type-2-diabetes

How to Treat Type 1 Diabetes Naturally

Long-Term Discontinuation of Insulin Treatment in a Type 1 Diabetic Patient
A case for late autoimmune diabetes of the adult?

Jan Ruxer, MD, PHD, Michal Mozdzan, MD, Leszek Czupryniak, MD, PHD and Jerzy Loba, MD, PHD

Type 1 diabetes is a well-defined condition requiring life-saving insulin replacement therapy immediately after diagnosis (1). It is also a well-known fact from the natural course of the disease that soon after the insulin therapy has been initiated, insulin requirements decrease, sometimes rapidly, and patients who stopped taking insulin shortly after diabetes diagnosis have been reported (2). However, this so-called “honeymoon period” usually starts several weeks after the diagnosis and rarely exceeds several months’ duration. It is believed, however, and has been unfortunately shown in the past, e.g., during wartime, that insulin discontinuation in a long-standing type 1 diabetic patient poses a serious threat to health and life (3,4). We describe a case of a patient with a definite diagnosis of autoimmune diabetes who, 2 years after having been diagnosed with diabetes, stopped insulin treatment for a period of 17 months and did not develop ketoacidosis.

In April 2000, a 19-year-old woman was admitted to the Metabolic Diseases Department due to profound weakness, dizziness, and increased thirst, as well as a 10-kg weight loss in 6 months. The symptoms occurred several months earlier but became more severe within the previous 8 weeks.

The patient was diagnosed with type 1 diabetes in November 1998. Her symptoms at the time gradually developed for 4 months and included increased thirst, polyuria, weight loss, and mild ketoacidosis. At the time of diagnosis, her blood glucose was 17.8 mmol/l. She was positive for islet cell autoantibodies (ICAs), with a titer of 90 JDF units, as well as positive for antibodies against GAD (anti-GAD, 80 units/ml). The treatment on discharge consisted of an intensive insulin regimen: short-acting insulin before meals and long-acting insulin twice daily; the daily requirement of insulin was 46 units.

The patient continued with her treatment for the next 2 years. She was compliant with physician recommendations, adhered to a prescribed diet, and performed self-monitoring of blood glucose four to six times daily. Her mean daily blood glucose ranged from 5.6 to 11.1 mmol/l. However, in November 2000, the patient stopped taking insulin and went on a free diet. The immediate cause of the sudden change of her behavior was a deep conflict with her parents, which eventually led to her leaving home for 13 months. During this time, she, using her words, “was well and completely forgot about her diabetes.” In December 2001, she returned to her parents, although she refused to restart insulin therapy or to have a therapeutic session with a psychologist.

When she was admitted to our department in April 2002, her blood glucose was 29.8 mmol/l. It was established that she had not been taking insulin for the previous 17 months, nor had she been measuring her glucose or following any diet. Her body mass was 53 kg, height 165 cm, BMI 19.5 kg/m2, and blood pressure 120/80 mmHg. No abnormalities in physical examination were found. Her acid-base balance was pH 7.44, serum bicarbonate 20 mmol/l, and base excess −2.8 mmol/l; she also had a trace of ketones in her urine. Her HbA1c was 10.6% and C-peptide 0.21 nmol/l (reference range 0.17–1.2). As at diabetes diagnosis, she was positive for ICAs and anti-GAD, although the titers of these autoantibodies were distinctly lower: 10 JDF units and 5.8 units/ml, respectively. In the beginning, she was treated with intravenous insulin infusion with a mean daily insulin requirement of ∼90 units and, after 3 days, transferred to a basal-bolus insulin regimen. At discharge, she was taking 70 units of insulin daily; she was well and accepted reinitiated insulin therapy.

We present a case of a patient diagnosed with type 1 diabetes in whom long-term insulin discontinuation did not result in acute hyperglycemic crises. The diagnosis of type 1 diabetes seems to be valid, because the immunologic tests confirmed that autoimmunologic processes developed in the patient (1). However, lack of severe (or, for that matter, any clinically significant) ketoacidosis during discontinuation of insulin is somewhat surprising. The clinical course of the diabetes was typical of type 2 rather than type 1 diabetes (5). Seventeen months free of insulin therapy suggested that the patient still had residual insulin secretion sufficient to maintain effective glucose metabolism. It is particularly worth noting that autoantibody assays failed to identify that she required insulin to maintain her life. The period of not taking insulin cannot be, however, labeled a “honeymoon period” since the patient was treated with stable doses of insulin for the previous 2 years. The clinical course of the disease is probably most typical of late autoimmune diabetes of the adult (LADA), which probably should have been diagnosed in the patient (6). LADA has recently gained considerable interest among both researchers and clinicians, probably due to increasing availability of immunological assays (7,8). However, its clinical identification is still unclear, as even the issue of insulin requirement at diagnosis is still a matter of dispute (9,10). The results of several studies indicate that LADA patients might constitute up to one-third of the alleged type 2 diabetic population (6,7,9), and the aberrant course of diabetes should always make one consider LADA as a possible diagnostic option, particularly in younger subjects (7–9).

Discontinuation of insulin treatment is not an uncommon event in diabetes therapy (11,12). HsinYu et al. (11) recently identified three predictors of ceasing insulin therapy: age >40 years at diabetes diagnosis, severe diabetic ketoacidosis as a first symptom, and excessive body weight. We have raised the issue of infection at the moment of diabetes diagnosis as another possible predictor of nonrequirement for insulin in further therapy (12). However, none of the above factors were present in our patient.

In our opinion, two conclusions can be drawn from the case. First, despite years of intensive research, pathophysiology of diabetes is still far from being clear, as even type 1 diabetes seems to be a heterogenous disease. Our patient was developing diabetic symptoms relatively slowly, and had it not been for her age and slim build, she could well have been regarded as a type 2 diabetic subject. Second, the presence of autoantibodies typical of autoimmune diabetes may not definitely lead to the diagnosis of type 1 diabetes because many patients with type 2 diabetes may also present with some features of autoimmunity. Therefore, finding clear, unequivocal criteria for differentiation between type 1 and type 2 diabetes seems to be the urgent issue of utmost importance.

Footnotes

Address correspondence to Dr. Leszek Czupryniak, Department of Diabetology, University Hospital no. 1, Kopcinskiego 22, 90-153 Lodz, Poland. E-mail: bigosik@poczta.onet.pl.

References

↵ Atkinson MA, Eisenbarth GS: Type 1 diabetes: new perspectives on disease pathogenesis and treatment. Lancet 358: 221–229, 2001 CrossRefMedline
↵ Agner T, Damm P, Binder C: Remission in IDDM: prospective study of basal C-peptide and insulin dose in 268 consecutive patients. Diabetes Care 10: 164–169, 1987 Abstract/FREE Full Text
↵ Semetkowska-Jurkiewicz E, Jaromczyk-Slisz J, Horoszek-Maziarz S: Analysis of the cause of death in diabetic ketoacidosis based on 5 years of personal observation [article in Polish]. Pol Tyg Lek 44: 484–487, 1989 Medline
↵ Irwin J, Cohle SD: Sudden death due to diabetic ketoacidosis. Am J Forensic Med Pathol 9: 119–121, 1988 Medline
↵ Bell D: Pathophysiology of type 2 diabetes and its relationship to new therapeutic approaches. Diabetes Educ 26 (Suppl.): 4–7, 2000
↵ Zimmet PZ, Tuomi T, Mackay IR, Rowley MJ, Knowles W, Cohen M, Lang DA: Latent autoimmune diabetes mellitus in adults (LADA): the role of antibodies to glutamic acid decarboxylase in diagnosis and prediction of insulin dependency. Diabet Med 11: 299–303, 1994 Medline
↵ Schernthaner G, Hink S, Kopp HP, Muzyka B, Streit G, Kroiss A: Progress in the characterization of slowly progressive autoimmune diabetes in adult patients (LADA or type 1.5 diabetes). Exp Clin Endocrinol Diabetes 109: S94–S108, 2001
↵ Tan HH, Lim SC: Latent autoimmune diabetes in adults (LADA): a case series. Singapore Med J 42: 513–516, 2001 Medline
↵ Pozzilli P, Di Mario U: Autoimmune diabetes not requiring insulin at diagnosis (latent autoimmune diabetes of the adult): definition, characterization, and potential prevention (Review). Diabetes Care 24: 1460–1467, 2001 Abstract/FREE Full Text
↵ Szepietowska B, Szelachowska M, Kinalska I: Do latent autoimmune diabetes diabetes of the adult (LADA) patients require insulin at diagnosis? Response to Pozzilli and Di Mario (Letter). Diabetes Care 25: 1662, 2002 FREE Full Text
↵ Hsin Yu E, Guo HR, Wu TJ: Factors associated with discontinuing insulin therapy after diabetic ketoacidosis in adult diabetic patients. Diabet Med 18: 895–899, 2001 CrossRefMedline
↵ Czupryniak L, Ruxer J, Saryusz-Wolska M, Loba J: Discontinuing insulin therapy after diabetic ketoacidosis: is its cause worth considering? Diabet Med. In press

source : http://care.diabetesjournals.org/content/26/4/1314.full