A growing body of data shows that type 2 diabetes is at least in part rooted in inflammation. The higher a person’s body mass index, the more pro-inflammatory macrophages they have in their adipose tissue, and the higher their chances of developing T2D. In this article, we will highlight the emerging role of inflammation in the pathophysiology of diabetes. We will also analyze the implicated inflammatory pathways and biomarkers of inflammation in diabetes and metabolic diseases.

1. The metabolic syndrome and metabolic Inflammation

Metabolic syndrome often precedes type 2 diabetes and cardiovascular disease. It is characterized by high blood pressure, a large waist circumference, elevated fasting glucose and triglycerides, and low HDL cholesterol.

Metabolic inflammation is currently a hot research topic, wherein peculiarities in metabolic and inflammatory pathways are looked into for their possible contribution to atherosclerosis, Type 2 diabetes and insulin resistance (IR). In MI, insulin signaling is impeded by inflammation caused by obesity. Metabolically activated macrophages are key cells in the process. They are believed to spike both pro- and anti-inflammatory pathways in reaction to lipid spillover from adipocytes.

Diabetes is a complex metabolic disorder affecting the glucose status of the human body. The main clinical diagnostic features are impaired glucose tolerance and hyperglycemia. These occur as the result of an absolute or relative insulin deficiency or resistance to its action. Chronic hyperglycemia associated with diabetes can result in end-organ dysfunction and failure which can involve the retina, kidneys, nerves, heart and blood vessels. There is a  clinical relationship between diabetes and atherosclerotic cardiovascular disease, with the risk for cardiovascular disease (CVD) being significantly elevated in patients with diabetes.

Typically, CVD occurs one to two decades earlier in people with diabetes, with the more aggressive, severe and diffuse distribution. The first WHO Global report on diabetes published in 2016 demonstrates that the number of adults living with diabetes has almost quadrupled since 1980 to 422 million adults and this is expected to rise to 552 million by 2030. There is, therefore, a need for effective novel therapeutic approaches for the treatment and/or prevention of diabetes and atherosclerotic disease.

Various proposals and hypotheses have been developed to describe the mechanisms involved in the propagation of diabetes, mainly focusing on T2D. The increase in the prevalence of the condition has been related to well-recognized risk factors, such as the adoption of a western lifestyle, sedentary lives, lack of physical activity and an energy-dense diet.

Genetic predisposition, ethnicity, and aging are not modifiable risk factors for T2D. Other factors such as being overweight or obese, an unhealthy diet, insufficient physical activity and smoking are modifiable through behavioral and environmental changes. However, increasing evidence has shown that inflammatory pathways are common in both modifiable and non-modifiable factors.

2. When was inflammation first thought to cause diabetes?

Observational studies provided the first evidence for the possible association between inflammation and diabetes. Over a century ago, the administration of high doses of sodium salicylate led to decreased glycosuria in people with a suspected or definite diagnosis of diabetes.  Later studies on the role of inflammation in diabetes revealed that this hypoglycaemic action was related to the inhibition of the serine kinase IkappaB kinase-beta (IKKbeta), which correlates with the post-receptor action of insulin.

A landmark study to correlate inflammation with diabetes was conducted in animal models by Hotamisiligil et al., in 1993 and it revealed that the role of tumor necrosis factor-alpha (TNF-alpha) in obesity and particularly in insulin resistance and diabetes. Epidemiologic associations of inflammation with obesity and T2D were made when circulating concentrations of markers and mediators of inflammation and acute-phase reactants including fibrinogen, C-reactive protein, interleukin (IL)-6, plasminogen activator inhibitor-1, sialic acid, and white cells, have been shown to be elevated in these conditions.

Over the next decades, numerous studies on human and animal models provided further supporting evidence for the role of inflammation in the initiation and progression of diabetes. Accumulative evidence suggests that chronic activation of pro-inflammatory pathways in target cells of insulin action may contribute to obesity, insulin resistance and related metabolic disorders including T2D. The identification of potential pathways connecting inflammation to diabetes has produced growing interest in targeting inflammation to help prevent and control diabetes and related conditions, as well as improving risk stratification for diabetes by using inflammatory biomarkers as potential indexes.

3. What is the relationship between Metabolic Disorders and Inflammation in Type 2 Diabetes?

In several pathophysiological studies carried out, our understanding of insulin resistance and secretion in the course of disease onset and progression has been expanded. Subjects at risk of T2D display an initial state of insulin resistance compensated by hypersecretion of insulin in the beta cells. In the clinical course of the disease this pancreatic functional reserve is eventually unable to cope with the required insulin secretion and by the time diabetes is diagnosed, beta cells are no longer able to secrete enough insulin.

Although the relative contribution of beta-cell dysfunction and insulin resistance can vary in people with T2D, it is generally accepted that abnormal insulin sensitivity precedes the clinical diagnosis of diabetes by up to 15 years. Therefore, along with mechanistic studies investigating mechanisms forming the basis of insulin resistance, more recent research has also focused on the pathways leading to beta-cell failure.

4. Is there evidence of Inflammation in Other Organs in People with Type 2 Diabetes?

There is inconclusive evidence that the inflammatory state in T2D can spread to other organs such as the liver, the neural system and possibly skeletal muscle. More research is needed to support this evidence.

5. What are the Future Perspectives for the Treatment of Diabetes?

Below are some of the approaches currently being investigated.

1. Innovative approaches on T2D to gauge anti-inflammatory diets and moderate an individual’s microbiome are under study.
2. Clinical trials examining the effects of vitamin D supplementation on serum levels of inflammatory markers have provided inconsistent results, with no evidence of effects in most trials, or effects on selected markers in others.
3. There are also studies investigating whether antagonists of leukotriene production enzymes – 5-lipoxygenase (5-LO), 5-LO-activating protein and LTA4 hydrolase – or receptor binding BLT1 have cardiometabolic outcome benefits, however, these results have not yet been reported.
4. The potential for targeting cholinergic pathways, immune modulation or other mediators of inflammation such as JNK and toll-like receptors (TLRs) are also being researched.
    

6. What is the future of understanding metabolic inflammation as a cause of diabetes?

Given the increasing prevalence of diabetes, it is crucial that research focuses on its prevention as well as its treatment. Heart disease, metabolic syndrome and type 2 diabetes (T2D) all have in common the increased concentration of circulatory cytokines as a result of inflammation. Inflammatory cytokines are produced by different cell types and secreted into the circulation, where they regulate different tissues through their local, central and peripheral action.

An improved understanding of the mechanisms linking inflammation to diabetes and related complications has stimulated interest in targeting inflammatory pathways as part of the strategy to prevent or control diabetes and its complications.

T1D is considered to be more of an immunological response rather than a metabolic disorder and the preliminary results of trials using anti-inflammatory and immunomodulatory medication are promising. These treatments in combination with the possible use of stem cells to regenerate pancreatic beta cells could potentially be the key to the permanent treatment of T1D. Therefore, after a holistic review of the possible mechanisms that lead to T1D and T2D and the numerous already described inflammation pathways that are involved, it becomes more and more clear that future research should focus on simultaneous suppression of various inflammatory response pathways rather than focusing on one pathway at a time.

References

1. NCBI (2017): Nutritional modulation of metabolic inflammation. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28710289

2. EM-Consulte (2012): Inflammation and type 2 diabetes. Retrieved from https://www.em-consulte.com/en/article/735580

3. ECR (2019): The Role Of Inflammation In Diabetes: Current Concepts And Future Perspectives. Retrieved from https://www.ecrjournal.com/articles/role-inflammation-diabetes-concepts-future

The modern diet contains a large number of simple sugars. From bread to donuts, to carbonated drinks to chocolate, cookies, and candy, everywhere you look, temptation abounds. The potential impact on the health of diets rich in free sugars, and particularly fructose, is of major concern. Does the sugar we take have an impact on insulin resistance and obesity? In this article, we look at this risk and the effects of insulin resistance.

1. Sugar and Insulin resistance….

Sugar has a bittersweet reputation when it comes to health. It occurs naturally in all foods that contain carbohydrates, such as fruits and vegetables, grains, and dairy. Consuming whole foods that contain natural sugar is safe. Plant foods also have high amounts of fiber, essential minerals, and antioxidants, and dairy foods contain protein and calcium.

Where does the problem with sugar come about? Added sugar, which is usually extracted or synthesized ……

There is plenty of evidence to suggest that consuming too much sugar can have a negative effect on our metabolic health. Regular sugar consumption produces a constant release of the hormone insulin. Over a period of time, it can lead to serious problems, such as the synthesis of triglycerides, insulin resistance, fatty liver disease, type II diabetes, an increase in very-low-density lipoprotein (the bad kind of cholesterol), and the accumulation of fat on all tissues.

Added sugar intake may contribute to and certainly does exacerbate insulin resistance. For example, added sugar intake is associated with higher blood pressure, inflammation, weight gain, fatty liver disease, health issues that can lead to insulin resistance, and further exacerbation of these issues. Added sugars cater to particularly energy-hungry but metabolically inefficient cells, including senescent cells, cancerous cells, and even quickly proliferating pathogenic bacteria in the gut.

Several genetic and lifestyle factors can contribute to how likely you are to develop insulin resistance. But even if you have a genetic risk, you can help yourself with regular exercise, a balanced diet, avoidance of added dietary sugars, healthy sleep patterns, and stress reduction activities.

Risk factors for insulin resistance and prediabetes include:

• Obesity
• Aging
• physical inactivity
• high cholesterol
• blood pressure
• sleep disorders or circadian rhythm disruption

It is said that one in three Americans—including half of those age 60 and older— have insulin resistance.

2. What exactly is Insulin Resistance?

Insulin resistance is when cells in your muscles, body fat, and liver start resisting or ignoring the signal that the hormone insulin is trying to send out—which is to grab glucose out of the bloodstream and put it into our cells. Glucose, also known as blood sugar, is the body’s main source of fuel. We get glucose from grains, fruit, vegetables, dairy products, and drinks that bring break down into carbohydrates.

3. How does Insulin Resistance develop?

While genetics, aging, and ethnicity play roles in developing insulin sensitivity, the driving forces behind insulin resistance include excess body weight, too much belly fat, a lack of exercise, smoking, and even not getting enough sleep.

As insulin resistance develops, your body fights back by producing more insulin. Over months and years, the beta cells in your pancreas have been working so hard to make insulin get worn out and can no longer keep pace with the demand for more and more insulin. Then – years after insulin resistance silently began – your blood sugar may begin to rise, and you may develop prediabetes or type 2 diabetes. You may also develop non-alcoholic fatty liver disease (NAFLD), a growing problem associated with insulin resistance that boosts your risk for liver damage and heart disease.

4. What are the Signs and Symptoms of Insulin Resistance?

Insulin resistance can be triggered by a combination of factors linked to weight, age, genetics, being sedentary, and smoking.

– Polycystic ovary syndrome (PCOS): Insulin resistance can worsen the symptoms of PCOS, which can include irregular menstrual cycles, infertility, and periods that cause pain.

– A large waist. Experts say the best way to tell whether you’re at risk for insulin resistance involves a tape measure and a moment of truth in front of the bathroom mirror. A waist that measures 35 inches or more for women and 40 or more for men (31.5 inches for women and 35.5 inches for men if you’re of Southeast Asian, Chinese, or Japanese descent) increases the odds of insulin resistance and metabolic syndrome, which is also linked to insulin resistance.

– You have additional signs of metabolic syndrome. According to the National Institutes of Health, in addition to a large waist, if you have three or more of the following, you likely have metabolic syndrome, which creates insulin resistance.

• High triglycerides. Levels of 150 or higher, or taking medication to treat high levels of these blood fats.
• Low HDLs. Low-density lipoprotein levels below 50 for women and 40 for men – or taking medication to raise low high-density lipoprotein (HDL) levels.
• High blood pressure. Readings of 130/85 mmHg or higher or taking medication to control high blood pressure
• High blood sugar. Levels of 100-125 mg/dl (the prediabetes range) or over 125 (diabetes).
• High fasting blood sugar (or you’re on medicine to treat high blood sugar). Mildly high blood sugar may be an early sign of diabetes.

– Acanthosis nigricans: This skin condition can develop in people with insulin resistance. It involves dark patches forming on the groin, armpits, and the back of the neck.

5. What health conditions are related to Insulin Resistance?

The most common health condition related to Insulin Resistance is prediabetes and the resultant Type 2 Diabetes. Insulin resistance also doubles your risk for heart attack and stroke – and triples the odds that your heart attack or ‘brain attack’ will be deadly.
Insulin resistance and metabolic syndrome are also linked with a higher risk for cancers of the bladder, breast, colon, cervix, pancreas, prostate, and uterus. This is because the high insulin levels early in insulin resistance seem to fuel the growth of tumors and suppress the body’s ability to protect itself by killing off malignant cells.

Furthermore, research has found a strong association between insulin resistance and memory function decline, increasing the risk of Alzheimer’s disease.

6. Can you prevent or reverse insulin resistance?

The good news is that, yes, insulin resistance can be prevented and also reversed in some cases. Here is what you can do:

• Get recommended amounts of physical activity and structured exercise
• Get adequate sleep
• eat when the sun is up(we are more insulin resistant at night and after a night of poor sleep, due to disrupted circadian rhythms that help regulate our metabolic state)
• Reducing stress and, therefore stress-related inflammation
• Maintaining a healthy weight
• Increasing your plant fiber intake.

All of the above can help improve your insulin sensitivity. It has been shown that combining both diet and exercise have the most impact on insulin sensitivity.

In a fascinating University of New Mexico School of Medicine, study published in the International Journal of Obesity, overweight people who lost 10% of their weight through diet plus exercise saw insulin sensitivity improve by an impressive 80%. Those who lost the same amount of weight through diet alone got a 38% increase. And those who simply got more exercise, but didn’t lose much weight, saw almost no shift in their level of insulin resistance.

Intermittent fasting is also another way in which you can reverse your insulin resistance. This is because it gives your body a break from insulin and glucose signaling pathways that promote cell proliferation and inflammation and may help increase insulin sensitivity.

7. What, therefore, is the relationship between sugar and Insulin Resistance?

There is an association between diets high in sugars (predominantly sucrose) and the risk of disease, and experimental studies have shown that high intakes of fructose (over 100 g/d) can reduce insulin sensitivity. However, somewhat lower intakes may affect serum TG. The mechanisms for such associations or effects have not been convincingly demonstrated.

References:

1. NCBI (2016): A review of recent evidence relating to sugars, insulin resistance, and diabetes. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5174139/

2. Endocrineweb (2019): Insulin resistance causes and symptoms. Retrieved from https://www.endocrineweb.com/conditions/type-2-diabetes/insulin-resistance-causes-symptoms

3. Medical News Today (2019): What to know about insulin resistance. Retrieved from https://www.medicalnewstoday.com/articles/305567.php

4. The Sugar Movement (2016): Sugar vs Fat. Retrieved from https://thatsugarmovement.com/sugar-vs-fat/

5. Harvard Health Publishing (2017): The sweet danger of sugar. Retrieved from https://www.health.harvard.edu/heart-health/the-sweet-danger-of-sugar

6. NCBI (2014): Weight Loss, Exercise, or Both and Cardiometabolic Risk Factors in Obese Older Adults: Results of a Randomized Controlled Trial https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3835728/

Dr. Padda untangles the roots of our current opiate epidemic, obesity epidemic and diabetes epidemic, which are currently in the process of crippling our economy. He discusses hopeful solutions for the future, including how to prevent the eminent devastation of our physical, emotional and financial health as a nation. This is an inspiring and powerful conversation that we should all be thinking about as we visualize a sustainable future for humanity.  

Dr Gurpreet Padda is an interventional pain physician who treats with patients with profound, chronic, severe pain that is unrelenting.  Over time he worked out that there was more to these people’s pain than just the physical source of it and that it was also a systemic or metabolic inflammatory issue and that hyperinsulinemia was at the root of it.  He found that the majority of his patients were obese and either pre-diabetic or diabetic. He found that the majority of them also had leaky gut as well.

This was all caused by the standard American diet (SAD) i.e. vegetable oils, processed carbs and excessive sugar.  He talks about how the junk food companies manipulate the fructose concentration higher than regular fructose corn syrup in order increase the addiction factor.

What he is doing in the community is astounding.  They have over 65,000 active patients in their online program which is totally free and he even contributes more than a million dollars of his own money every year to the program.

You can find out more about this program at:

https://reversingdiabetesmd.com/

We have extremely limited glucose storage as glycogen, or as circulating glucose.

Glycogen:

Glycogen is a large branched polymer of glucose, stored mainly in the liver and the skeletal muscle.  Stored  glycogen can be mobilized to circulating glucose during fasting periods and to the muscle cells during muscle contraction, a process called glycogenolysis.  The total body glycogen storage capacity, in a fasted healthy 70kg human, is  100 g in the liver, and 400 g in the muscle.  The total available calorie output from glycogen reserves is approximately 2,000 calories.

Circulating glucose:

Our blood stream normally carries less than 1 1/2 teaspoons of circulating glucose at any given time (less than 5 g of glucose circulates in the blood of a 70kg human).  The total available calorie output from circulating glucose is 20 calories.

The exact circulating glucose calculation:

Average blood volume for an adult is 70ml/kg.
Assuming a 70kg male=4,900 ml=49 dl or 4.9l
1 liter is 10dl, therefore we have 50dl.
A nondiabetic glucose concentration is <100mg/dL.
Therefor 100mg/dl multiplied by 49dl equals 4900mg of circulating glucose.
4900mg equals 4.9 g of circulating glucose, where each tsp =4.2gm
Total circulating glucose=1.16tsp

As a comparison, 1 gummy bear contains 1.3g of usable sugar.  Consuming 4 gummy bears could double the available circulating glucose, but for the fact insulin rapidly shuttles the glucose out of the circulation and into fat stores.

We have nearly unlimited fat storage capacity, and the primary role of insulin is to remove circulating glucose and convert it to fat storage.  Circulating glucose rapidly oxidizes, undergoing a non-enzymatic Maillard reaction, which results in spontaneous glycation, which we measure as HgBA1C.  The Maillard reaction was initially used to describe the browning and crisping of bread.  This glycation effect changes the cell membranes to a less fluid status, interferes with protein and enzyme function, and often deforms receptor and channels.  The end result of excessive glucose is sticky and nonfunctional cells.

Other advanced glycation end-products are measured as fructosamine.  Excessive circulating glucose is also rapidly excreted through the kidney above levels of 180 mg/dl, creating excessive urination or polyuria.  Glucose metabolism is tightly regulated because it can quickly oxidize and damage cell walls, wreaking havoc on our enzymatic pathways.

What is glycemic index?

How Much Sugar Can My Body Handle? – Reversing Diabetes
The GI assigns a score to how quickly glucose from a specific food enters the bloodstream.  Foods are ranked on a scale of 0 to 100, with glucose having a value of 100. The lower a food’s glycemic index, the slower the blood sugar rises after eating that food. In general, cooking and processing foods makes the GI higher for that food. The higher the GI of a food, the greater the insulin release, and therefore the greater the conversion of circulating glucose to fat storage.

The rate of rise and peak glucose concentration after a meal is often expressed as Glycemic Index (GI).

Glycemic load (GL) measures both how quickly glucose enters the bloodstream (GI) and how much glucose per serving is present. Glycemic Load (GL) is a calculated number and gives a patient a better idea of the effect of a particular food based upon the typical serving size. Watermelon has a high glycemic index of 80,  but a serving of watermelon has so little carbohydrate, that its total glycemic load is only 5.

When glucose levels drop, insulin production also drops, resulting in a conversion of stored fat to circulating ketone bodies and circulating triglycerides.  Circulating ketone bodies are a fuel source, akin to glucose, that do not require insulin to access the cells.

The point of the discussion is that we have extremely limited circulatory capacity for glucose, about 5g glucose or about 20 calories only.  Our constant consumption of processed carbohydrate rich food is inconsistent with our human physiology; which attempts to quickly removes glucose out of circulation to prevent tissue damage.  The constant high exposure eventually overwhelms our clearance capacity, leading to metabolic inflammation, and eventual diabetes.

Wasserman D. H. (2008). Four grams of glucose. American journal of physiology. Endocrinology and metabolism, 296(1), E11-21. 10.1152/ajpendo.90563.2008

Bad habits are easy to pick up but very difficult to do away with. This could be anything such as binge eating, drinking too much booze, over or undersleeping, and too much junking as well. It is now emerging that fast foods will not just make you overweight and obese but also have the potential to damage your immune system.

Study Shows That Fast Foods Plays A Role In Inflammation

A recent study that was carried out by the University of Bonn linked fast food with an on overdrive of the immune system leading to inflammation. The study further connected the inflammatory response to chronic conditions such as cardiovascular diseases and type 2 diabetes. The study concluded that fast food makes the immune system more aggressive in the long term; even after a change to a healthy diet, the body’s defenses remain hyperactive.

Details of the Study

This was a lab study where the investigators placed mice for a month on a fast-food diet which was high in fat, high in sugar, and low in fiber. It was observed that the animals developed a strong inflammatory response throughout the body, similar to what happens following an infection. The mice also developed an increase in the number of certain immune cells called granulocytes and monocytes. This was an indication that progenitor cells in the bone marrow were involved.

When the investigators offered the mice their typical cereal diet for the next month the inflammation subsided. However, they observed that something key did not change: the programming of the progenitor cells. The genes that had been switched on during the fast food phase were still active and capable of triggering inflammation. The innate immune system has a memory which “records” such changes and stores them. This may also explain why overweight children are more likely to become obese in adulthood than their slimmer counterparts.

Long term effects of Wrong Nutrition

Wrong nutrition can cause severe long term consequences. Once you get hooked on fast foods, your body’s immune system is set on overdrive. This is likely to initiate a process of acute, then chronic inflammation. Even after you switch to healthier meals, your immune system may not be able to readjust. This means that you will still be prone to an immune system overdrive and the stand the risk for chronic inflammation. Chronic inflammation has been linked to heart disease and stroke as well as autoimmune diseases. Currently, researchers are also trying to establish the link between chronic inflammation and cancer.

Fast foods are also notoriously linked to obesity and food addiction disorders. The high fat and high salt content may be responsible for the addictive qualities. One review published in NCBI suggested that fast foods cause psychological dependence and obesity over time. The study mentioned that most fast foods are usually accompanied by soda which increases the sugar content 10-fold. Fast foods are high in calories but low in fiber and nutritive value. Extraneous factors such as packaging, pricing, convenience, as well as advertisements also play a role.

10 Tips on How To Dump Fast Foods and Acquire Healthy Eating Habits

1. Make mealtimes fun time for the kids. You can achieve this by involving them in the preparation of the menu and food as well. Teach kids the different nutrients derived from each meal and let them plan out their own meals based on nutritive value. Make sure the food is always presented in an enticing way and the portions are appropriate for age.
2. Choose whole grains as a source of carbs such as whole-wheat bread, rye bread, brown rice, popcorn, oatmeal, and whole-grain cereal. It may take some time before the kids get used to this but in the end, it will be worth every effort.
3. Go for unsaturated fats such as canola, corn, olive, safflower, sesame and sunflower oils in place of butter and saturated fats.
4. When choosing protein sources, go for chicken, fish, and beans that are healthier options. Remove the skin of the chicken before preparing to make it healthier. Limit red meat to once a week.
5. When buying packaged foods make sure to read the labels carefully. Go for the ones that are abundant in fiber, minerals, and vitamins and limit those with sodium, added sugars, saturated fat, and trans fat.
6. Eat at home as often as you can. This will give you more control over the ingredients as well as portion sizes and servings.
7. Make sure that fresh fruits and vegetables are well displayed in the kitchen and living rooms so they are visible and accessible to family members. It is easy for family members to pick up healthy eating habits when they really don’t have to go out of their way to find healthy foods.
8. Incorporate oily fish in your diet. This includes fish such as salmon, mackerel, anchovies, and trout which are high in omega 3 oils.
9. Find healthy ways to cook meals such as steaming, baking, and grilling as opposed to frying. Avoid adding extra oil, salt, or sugars to your recipes to make them more enticing.
10. Consult with a nutritionist or dietitian when and where you need help. Adopting and implementing a healthy eating plan for your family is not easy but with the right support, you are sure to succeed.

References

1. NCBI (2011): Is fast food addictive? Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21999689
2. Cell (2017): Western Diet Triggers NLRP3-Dependent Innate Immune Reprogramming. Retrieved from https://www.cell.com/cell/fulltext/S0092-8674(17)31493-9?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS0092867417314939%3Fshowall%3Dtrue
3. Live Science (2018): What Is Inflammation? Retrieved from https://www.livescience.com/52344-inflammation.html

The carnivore diet for diabetes management presents both promise and controversy. Just like most popular diets, many embark on it expecting radical change without putting in much effort. Unfortunately, the carnivore diet obeys the law of the jungle as aptly put by Rudyard Kipling; “and the wolf that shall keep it may prosper, but the wolf that shall break it must die.”  In short, there’s more than just feasting on meat; this article breaks down the carnivore diet for diabetics and why it may fail in the long run.

Diabetics struggle primarily with one issue which is blood sugar control. Consequently, the best diet for them should be one with low-carb but high energy. The carnivore diet appears to fit this tab pretty well, especially when you don’t spare your fatty meat. It would be better if you could spruce this up with some healthy veges, but the carnivore diet does not allow this. So what does the carnivore diet have to offer diabetics?

What Is A Carnivore Diet?

The carnivore diet is a meat based diet that excludes all plant products. It typically consists of red meat, poultry, organ meats, processed meats like bacon, sausage, hot dogs, fish, and eggs.  Some people also allow dairy such as cheese and spices.

It excludes plant based foods such as fruits, vegetables, legumes, grains, nuts, and seeds. Unlike other popular low carb diets such as keto diet and paleo diet, the carnivore diet aims for zero carbs.

Starting on a carnivore diet involves eliminating carbohydrates gradually as you observe how your body reacts. The idea is to adapt to the change, without triggering a crash due to the absence of carbs. Once the body has settled in, patients can then push 30 days or even make this a lifestyle based on the improvements achieved.

What Are The Benefits Of A Carnivore Diet For Type 2 Diabetes?

In short the benefits of a carnivore diet are attached to the elimination of carbohydrates which are the enemies of your glucose levels. Diabetes management is actually an intricate carb-counting and sugar monitoring affair. With carbohydrates off the list, you have more control over your blood sugar levels among other benefits.

1.   Weight Loss

The Carnivore Diet is more filling and may cause weight loss because you consume less food and fewer calories. In one study 132 adults with excess weight were put on 4 different energy-restricted diets. Results revealed that those who ate high-protein diets lost significantly more weight and fat mass than those who ate fewer proteins. Another 2009 study also showed that a protein diet produced sustained weight loss.

Weight loss has been strongly linked to diabetes reversal. A recent study showed that losing about 15 kgs of weight can help to revive beta cell function. Beta cells are the cells in the pancreas that produce insulin. Reviving dead or dormant beta cells can help in reversing diabetes. However, this approach works best for newly diagnosed cases of diabetes type 2.

Apart from this, sustained weight loss may reduce chances for diabetes related complications. However, weight loss can also be achieved through reducing calorie intake and through physical exercise as well.

2.   Reduces Inflammation

The carnivore diet excludes processed foods such as cookies, cakes, candy, and pastries which are likely to trigger inflammation. These foods are loaded with empty calories and they easily spike glucose levels. This is why refined carbs and sugary foods are usually reduced or eliminated from a diabetic diet.

Inflammation increases insulin resistance as well as decrease insulin secretion. Reducing inflammation can help in reversing these symptoms of diabetes type 2.

Other benefits of a carnivore diet include:

• Less brain fog and fatigue
• Improved breathing
• Improved circulation
• Stabilization of glucose levels

Should you try the carnivore diet?

As much as there are many obvious benefits to the carnivore diet, you need to consult with your healthcare expert before trying it out. There are a few concerns that may dissuade one from recommending the carnivore diet for diabetes which include:

1. The risk for hypoglycemia

Hypoglycemia generally means low blood sugar levels. A person with diabetes type 2 usually has overproduction of insulin in the initial stages, even if they have reduced sensitivity to insulin. By taking a diet that completely eliminates carbohydrates; the patient is at risk of having hypoglycemia. Should this happen, the person may need to consume a fast-acting carbohydrate to get their blood sugar levels up again.

2. Carnivore diet does not offer fiber

Fiber adds bulk to stool and this helps in preventing constipation. The carnivore diet can easily cause chronic constipation as it does not contain fiber.

Fiber is also important for the proper balance of healthy microbiota in the gut. An imbalance in gut microbiota can trigger chronic inflammation and insulin resistance as well.

In summary, there are lots of benefits that one can achieve from the carnivore diet. However, one needs to seek expert opinion before they adopt this diet for long term. Up to date there are no clinical studies that have investigated the long term benefits of a carnivore diet.

References

1.    NCBI (2009): A moderate-protein diet produces sustained weight loss and long-term changes in body composition and blood lipids in obese adults. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/19158228

2.    Science Alert (2019): Type 2 Diabetes Can Be Reversed Even Without Intensive Weight Loss, Study Shows. Retrieved from https://www.sciencealert.com/type-2-diabetes-can-be-reversed-even-without-intensive-weight-loss-research-shows

3.    NCBI (2014): Targeting inflammation in diabetes: Newer therapeutic options. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4138593/

4.    NCBI (2016): Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation. Retrieved from Randomised clinical trial: mixed soluble/insoluble fibre vs. psyllium for chronic constipation.

Sugar has been vilified over the years with claims of its disastrous effects on our health. Are these claims true? Does taken a soda a day guarantee one ill health? What of the effects of excess sugar on obesity? In this article, we will explore these claims and determine whether indeed excessive sugar intake leads to obesity.

1. What is obesity?

Obesity rates have skyrocketed over the past century. In 1962, 46 percent of adults in the U.S. were considered overweight or obese. By 2010,that figure had jumped to 75 percent.

So, what exactly is obesity……

Obesity is a complex disease involving an excessive amount of body fat. Obesity isn’t just a cosmetic concern. It is a medical problem that increases your risk of other diseases and health problems, such as heart disease, diabetes, high blood pressure and certain cancers.

Obesity is diagnosed when your body mass index (BMI) is 30 or higher. To determine your body mass index, divide your weight in pounds by your height in inches squared and multiply by 703. Or divide your weight in kilograms by your height in meters squared.

BMI	Weight status
Below 18.5	Underweight
18.5-24.9	Normal
25.0-29.9	Overweight
30.0 and higher	Obesity

For most people, BMI provides a reasonable estimate of body fat. However, BMI doesn’t directly measure body fat, so some people, such as muscular athletes, may have a BMI in the obesity category even though they don’t have excess body fat.

2. Sugar and obesity

Obesity is a complex problem with multiple causes. But among the likely suspects, sugar is a top favorite. As sugar consumption has increased, so too has the size of our waistlines.

Added sugars are a controversial and hotly debated topic. Consumption of added sugars has been implicated in increased risk of a variety of chronic diseases including obesity, cardiovascular disease, diabetes and non-alcoholic fatty liver disease (NAFLD) as well as cognitive decline and even some cancers. Support for these putative associations has been challenged, however, on a variety of fronts.

The sugars in your diet can be eithernaturally occurring or added. Naturally occurring sugars are found naturally in foods such as fruit (fructose) and milk (lactose). Added sugars are sugars and syrups put in foods during preparation or processing, or added at the table.

Numerous dietary and lifestyle habits can lead to weight gain and cause you to put on excess body fat.Consuming a diet high in added sugars, such as those found in sweetened beverages, candy, baked goods, and sugary cereals, is a contributing factor in weight gain and chronic health conditions, including obesity, heart disease, and diabetes.

Many people consume more sugar than they realize. It’s important to be aware of how much sugar you consume because our bodies don’t need sugar to function properly. Added sugars contribute zero nutrients but many added calories, which can lead to extra pounds or even obesity, thereby reducing impacting our health.

The ways in which added sugar intake leads to weight gain and increased body fat are complex and involve many factors.

3. Some ways why added sugar is fattening….

1. It is high in empty calories
   Added sugars are sweeteners added to foods and beverages to improve taste. Common types of added sugar include fructose, corn syrup, cane sugar, and agave.Excess sugar may cause you to pack on weight because it’s high in calories while offering few other nutrients.Though using small amounts of added sugar is unlikely to cause weight gain, regularly indulging in foods high in added sugars may cause you to gain excess body fat quicker and more drastically.
   2. Impacts blood sugar and hormone levels

   It’s well known that eating sugary foods significantly raises your blood sugar levels.Though enjoying a sweet food infrequently isn’t likely to harm health, daily consumption of large amounts of added sugar can lead to chronically elevated blood sugar levels.

   Prolonged elevated blood sugar — known as hyperglycemia — can cause serious harm to your body, by causing insulin resistance and resulting including weight gain.

   3. May lead to overeating

   Foods high in added sugars tend to be less filling. Eating foods rich in carbs — particularly refined carbs high in added sugars — yet low in protein can negatively impact fullness and may lead to weight gain by causing you to eat more at subsequent meals throughout the day or overeat at any one particular seating.

   Animal studies indicate that fructose impacts signaling systems in your hypothalamus, increasing levels of hunger-stimulating neuropeptides — molecules that communicate with one another, influencing brain activity — while decreasing fullness signals. Additionally, your body is predisposed to crave sweetness. In fact, research shows that sugar consumption is driven by the pleasure derived from the sweet taste of sugary drinks and foods.

   4. Linked to obesity and chronic disease

   Numerous studies have linked high intake of added sugars to weight gain and chronic conditions, such as obesity, heart disease, and diabetes.This effect has been observed both in adults and in children. Recently, a review of 30 studies in more than 242,000 adults and children found a significant link between sugar-sweetened beverages and obesity.

   4. What are some of the health problems associated with obesity?

   People with obesity are more likely to develop a number of potentially serious health problems, including:

   • Heart disease and strokes. Obesity makes you more likely to have high blood pressure and abnormal cholesterol levels, which are risk factors for heart disease and strokes.
   • Type 2 diabetes. Obesity can affect the way your body uses insulin to control blood sugar levels. This raises your risk of insulin resistance and diabetes.
   • Certain cancers. Obesity may increase your risk of cancer of the uterus, cervix, endometrium, ovary, breast, colon, rectum, esophagus, liver, gallbladder, pancreas, kidney and prostate.
   • Digestive problems. Obesity increases the likelihood that you’ll develop heartburn, gallbladder disease and liver problems.
   • Gynecological and sexual problems. Obesity may cause infertility and irregular periods in women. Obesity also can cause erectile dysfunction in men.
   • Sleep apnea. People with obesity are more likely to have sleep apnea, a potentially serious disorder in which breathing repeatedly stops and starts during sleep.
   • Osteoarthritis. Obesity increases the stress placed on weight-bearing joints, in addition to promoting inflammation within the body. These factors may lead to complications such as osteoarthritis.

   5. How can obesity affect your quality of life?

   People who are obese often find themselves struggling with some issues that might diminish their overall quality of life. Some of these issues might include:

   • Depression
   • Disability
   • Sexual problems
   • Shame and guilt
   • Social isolation
   • Lower work achievement

   6. How can you keep yourself from getting obese?
   

   Whether you’re at risk of obesity, currently overweight or at a healthy weight, you can take steps to prevent unhealthy weight gain and related health problems.

   • Exercise regularly. You need to get 150 to 300 minutes of moderate-intensity activity a week to prevent weight gain. Moderately intense physical activities include fast walking and swimming.
   • Follow a healthy-eating plan. Focus on low-calorie, nutrient-dense foods, such as fruits, vegetables and whole grains. Avoid saturated fat and limit sweets and alcohol. Eat three regular meals a day with limited snacking. You can still enjoy small amounts of high-fat, high-calorie foods as an infrequent treat.
   • Know and avoid the food traps that cause you to eat. Identify situations that trigger out-of-control eating. Try keeping a journal and write down what you eat, how much you eat, when you eat, how you’re feeling and how hungry you are, stay in control of your eating behaviors.
   • Monitor your weight regularly. People who weigh themselves at least once a week are more successful in keeping off excess pounds.
   • Be consistent. Sticking to your healthy-weight plan all the time
     

     7. So, is sugar friend or foe?

     Interfering with your hormones, increasing hunger, and displacing healthy foods are just a few of the ways that added sugars can lead to weight gain.Aside from causing you to put on excess body fat, eating too much added sugar can significantly increase your risk of chronic conditions, such as obesity, heart disease, and diabetes. It is thus wise to consume added sugars with caution because a stitch in time save nine.

     References

     1. Endocrineweb(2018):Insulin Resistance Causes and Symptoms, Retrieved from

     https://www.endocrineweb.com/conditions/type-2-diabetes/insulin-resistance-causes-symptoms

     2. Healthline (2019):6 Ways Added Sugar Is Fattening. Retrieved from

     https://www.healthline.com/nutrition/does-sugar-make-you-fat#section1

     3. American Heart Association (2018): Added Sugars. Retrieved from

     https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/added-sugars

     4. NCBI (2016): Relationship between Added Sugars Consumption and Chronic Disease Risk Factors: Current Understanding. Retrieved from

     https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5133084/

     5. John Hopkins Medicine (2019): Obesity, Sugar and Heart Health. Retrieved from

     https://www.hopkinsmedicine.org/health/wellness-and-prevention/obesity-sugar-and-heart-health

     6. Mayo Clinic: Retrieved from

     https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742

Given that obesity and associated disorder type II diabetes mellitus have reached epidemic proportions worldwide, the development of efficient prevention and therapeutic interventions is a global public health interest. There is now a large body of evidence suggesting that the micro-organisms colonizing the human gut, known as gut microbiota, play a central role in human physiology and metabolism. Understanding how gut microbiota affects and regulates key metabolic functions such as glucose regulation and insulin resistance is an important health issue. We will highlight how prebiotic/probiotic interventions affect these bacterial processes and are now considered as promising approaches to treat obese and diabetic patients.

1. The gut microbiota of an obese person…

Obesity is a chronic, complex, and multifactorial disease representing the fifth leading cause of death in the world and accounting for almost 3.4 million deaths each year. Low-grade inflammation is the hallmark of metabolic disorders such as obesity, type 2 diabetes and nonalcoholic fatty liver disease.

Microbiota is now recognized as a real functional “organ” due to its immense impact on human health and has become the subject of intensive research over recent years. The vast majority of microbes reside in the intestinal tract, where they influence host physiology by playing fundamentally important roles in digestion, nutrition, immune regulation, and metabolism.

Gut microbiota composition and activity can fluctuate over time and depend on different factors including genetics, sex, age, health status, and drug/antibiotic consumption. Over the last decade, a large number of publications have reported a prominent role of microbiota in metabolic diseases.

Notably, accumulated evidence suggests an association between a dysregulated gut microbiome and obesity, glycemic control impairment, and therefore T2DM pathophysiology.

2. Obesity, Diabetes, and Dysbiosis

The preservation a normal and healthy gut microbiota plays a critical role in maintaining good health. Alterations of both composition and function of the microbiota, termed dysbiosis, are common features of several pathologies including metabolic diseases such as obesity and T2DM.

A number of preclinical and clinical studies have attempted to describe the differences between gut microbiota in obese, compared to lean individuals and have reported that obesity is related to lower microbial diversity and greater depletion. In early obesity, microbiota studies report that an increase of body weight is associated with a microbiota shift.

Although T2DM is generally considered as an attribute to obesity, some studies have correlated glycemic control impairment and insulin resistance to specific gut microbiota composition. Furthermore, antidiabetic drugs liraglutide and metformin have been recently shown to significantly lower body weight and improve glucose metabolism while considerably modifying the composition of gut microbiota.

Liraglutide decreased obesity-related microbial phenotypes and increased lean-related phenotypes while metformin modifies the intestinal microbiota composition by inducing the growth of several bacteria.

There is proof that gut microbiota is involved in the beneficial glucose-lowering effects of antidiabetic agents and that it is a promising therapeutic target in T2DM and the glycemic control impairment context.

3. How can Gut Microbiota be moderated?

Through several mechanisms, gut bacteria influence the chronic low grade inflammation that culminates in insulin resistance and the increase in fat deposits and body weight gain, characteristic of obese individuals.

With the acknowledgement of these obesity and inflammation induction mechanisms, several strategies to block or attenuate them are being developed and tested, in order to benefit obese and type 2 diabetic patients. We will look at these mechanisms and the effect they have:

3.1. Antibiotic Therapy

The use of broad spectrum antibiotic therapy greatly modifies the gut microbiota profile although the prevalence of surviving bacteria and the benefits for the host have not been determined, as the concept of a “healthy” gut microbiota is still under investigation.

The main mechanism suggested by antibiotic administration is a reduction in circulating LPS levels, which lessens inflammation and improves the insulin resistance induced by obesity in the liver, muscle, and adipose tissue. Improved intestinal function has also been noted as a benefit of the administration of antibiotics.

However, even with this striking metabolic improvement in antibiotic therapy experiments, it seems that translating this strategy to humans is not the best option, as there are complex issues such as antibiotic resistance in chronic administration panels and evidence that indicates a relationship between chronic low-dose antibiotic therapy and body weight gain.

3.2. Probiotics

Probiotics are live microorganisms that can be consumed through fermented foods or supplements. More and more studies show that the balance or imbalance of bacteria in your digestive system is linked to overall health and disease. Probiotics promote a healthy balance of gut bacteria and have been linked to a wide range of health benefits.

As obesity is a key cause of diabetes, probiotics can help with weight loss through a number of different mechanisms. An example is that some probiotics prevent the absorption of dietary fat in the intestine.The fat is then excreted through feces rather than stored in the body. Probiotics may also help you feel fuller for longer, burn more calories and store less fat. This is partly caused by increasing levels of certain hormones, such as GLP-1.

Probiotics may also help with weight loss directly. In one study, dieting women who took Lactobacillus rhamnosus for 3 months lost 50% more weight than women who didn’t take a probiotic. Another study of 210 people found that taking even low doses of Lactobacillus gasseri for 12 weeks resulted in an 8.5%.

It is however important to note that not all probiotics aid in weight loss. Some studies have found certain probiotics, such as Lactobacillus acidophilus, can even lead to weight gain.

3.3. Prebiotics

Prebiotics are classified as the non-digestible food ingredients that probiotics can feed off. They are used in the gut to increase populations of healthy bacteria, aid digestion and enhance the production of valuable vitamins. Galactooligosaccharides (GOS) are the most advanced form of prebiotics which belong to a group of particular nutrient fibers that feed and encourage the growth of good bacteria in the gut.

The major source of prebiotics is dietary fibre. They occur naturally in fruits and vegetables, but you can also take them in the form of nutritional supplements.

3.4. Bariatric Surgery

Bariatric surgery is an important method in the treatment of obesity. It is quite effective in achieving and protecting weight loss. This effectiveness of obesity treatment after bariatric surgery is not only related to food consumption. The altered microbiota after bariatric surgery has an impact on its effectiveness. Malabsorption status after bariatric surgery, changes in the metabolism of bile acids, changes in gastric pH, and changes in the metabolism of hormones lead to gut microbiota changes. Changes in microbiota also affect energy homeostasis. Because of these reasons, body weight loss is achieved after bariatric surgery.

4. What role will gut microbiota play in the treatment of T2DM in the future?

It is becoming increasingly clear that gut microbiota has profound impact on general health and well-being. Notably, it is now well-established that imbalanced gut microbiota is linked to host glycemic control impairment and T2DM development. Although the precise role of gut microbiota remains incompletely understood, further investigation is likely to be very helpful in the treatment and control of obesity, and resultant Type 2 Diabetes.

Current treatments of this complex chronic disease are far from being ideal since in a majority of patients, T2DM remains poorly controlled in the long run. Using pre/probiotics to control blood glucose has been considered for a long time, and the discovery of the key roles of gut bacteria in T2DM has boosted research efforts in this field.

A better understanding of how gut microbiota impacts general health will help in outlining new treatment strategies. These strategies will help in identifying probiotic strains with antidiabetic activities, or nutritional interventions that can increase helpful microbiota in the gut.

References:

1. Hindawi (2013): Influence of Gut Microbiota on Subclinical Inflammation and Insulin Resistance. Retrieved from https://www.hindawi.com/journals/mi/2013/986734/2. Frontiers in Endrocrinology (2019): Impact of Gut Microbiota on Host Glycemic Control. Retrieved from https://www.frontiersin.org/articles/10.3389/fendo.2019.00029/full

3. NCBI (2019): The effects of bariatric surgery on gut microbiota in patients with obesity: a review of the literature. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343052/

4. Bimuno(2018) : Prebiotics. Retrieved from https://www.bimuno.com/prebiotics

5. Healthline (2016): 8 Health Benefits of Probiotics. Retrieved from https://www.healthline.com/nutrition/8-health-benefits-of-probiotics

Many people living with diabetes often wonder if diabetes remission is a possibility for them.  Well, for most people, this is an achievable goal. If you are lucky enough you can go for years without taking any diabetes medication but still maintain normal sugar levels if you are willing to put in the hard work. This article will show you how.

Type 2 diabetes is a serious chronic condition that can cause debilitating effects. It can be lifelong and get worse over time for many, but only the flip side, it can also present no problems when it goes into long-term remission.

Most people embrace a triad approach to treating Type 2 diabetes; medication, diet, and exercise. Some lucky few are able to drop off their medication and still maintain normal blood sugar.  But research shows that many people can be able to achieve a similar level of success in the management of diabetes.

Is diabetes reversal the same as diabetes remission?

Remission is often confused with diabetes reversal. However, the two mean totally different things. Whereas reversal implies that one is completely cured of diabetes, remission means that a person is living symptom-free for a long duration of time without being on medication. With remission, there is always the awareness that the disease might recur. Our article on the difference between diabetes reversal and remission explains it better. You can read it here.

What is diabetes remission?

Diabetes remission occurs in people suffering from Type 2 diabetes; it means that you can maintain normal blood sugar levels without needing to take any diabetes medication. Diabetes remission is not a cure for diabetes. The term remission means that Type 2 diabetes might come back, or it might not. Also, if one resumes normal diet and lifestyle (unhealthy) then their blood sugar is likely to spike.

In 2009, the American Diabetes Association defined Type 2 Diabetes as follows:

3 Categories

Partial remission, complete remission and prolonged remission as

• Partial remission: blood sugar which does not meet the classification for Type 2 Diabetes; fasting blood glucose 5.5 – 6.9 mmol/l for at least 1 year.
• Complete remission: normal glucose values i.e. fasting blood glucose < 5.6 mmol/L for at least 1 year.
• Prolonged remission: normal glucose values i.e.
  fasting blood glucose < 5.6 mmol/L for at least 5.

For all the three categories listed above, the patient must have been off all diabetic medication for the given duration of time. According to the American Diabetes Association, when a person combines diet and exercise with blood sugar lowering medication such as Metformin they do not qualify for remission.

Remission can be achieved after bariatric surgery or by making drastic dietary and lifestyle changes.

How To Achieve Diabetes Remission

1.    Weight Loss

Losing weight around the waist can significantly increase your chances of remission.

Before embarking on a weight loss journey, it is important to first consult with your healthcare provider. This is to make sure it’s safe for you, especially if you have other health conditions. You might also need help in determining which weight loss approach works best for you.

To understand how losing weight can cause remission, we need to draw the link between being overweight and Type 2 diabetes. The fat that builds up around the midsection is dangerous because it surrounds important organs like the liver and pancreas. This makes it more difficult for those organs to work properly, leading to Type 2 diabetes.

Research has shown that almost 50% of individuals with type 2 diabetes can achieve remission to a non-diabetic state through weight loss. This has been associated with early and sustained improvement in the functioning of pancreatic beta cells.

However, not everyone who develops Type 2 diabetes is overweight. Other factors such as age, ethnicity and family history come into play as well. These factors influence how well the liver and pancreas work, and also where we store our fat. As much as we cannot change these factors, we can influence diabetes type 2 by altering the factors within our control.

Also, not everyone who loses extra weight will go into remission. However, weight loss on its own has significant health merits for a diabetic person. This may mean having to take fewer meds and having less risk for complications.

2.    Making Drastic Diet and lifestyle changes

Research has shown that a low-calorie diet could help people lose weight and go into remission. Other than promoting weight loss, switching to a non-inflammatory diet can also reduce insulin resistance. Metabolic inflammation is a key driver for insulin resistance and type 2 diabetes. Improving insulin sensitivity can trigger remission. For more on non-inflammatory diets, you can read out the article here.

Lifestyle changes such as taking up regular exercise will also help to achieve weight loss.

3.    Weight loss surgery for diabetes remission

Bariatric surgery can also help one to achieve remission. What bariatric surgery does is to actually help one to eat less and achieve healthy and sustainable weight loss. Bariatric surgery is not a quick fix for obesity and diabetes. However, in a few circumstances, your doctor may recommend this approach. Note that before approval you have to show dedication and discipline that you will be able to stick through the weight loss program.

What To Do When You Are In Remission

Diabetes remission may mean different things for different people. For others, it may last for a year before it recurs again while for others it may disappear for extended periods of time. However, it comes with reduced blood sugar, better cholesterol levels and reduced blood pressure for most people. These signs are an indication of better health outcomes in the long run.

Once you are in remission, you should strive to maintain the positive health habits that triggered the remission in the first place. Keep going to your regular check-ups and speak to your healthcare team if you’re worried about anything or have any questions. Maintain a positive and hopeful spirit as you work towards achieving prolonged remission.

References

1. Diabetes UK: What is diabetes? Retrieved from https://www.diabetes.org.uk/diabetes-the-basics/what-is-type-2-diabetes
2. Diabetes UK: Diabetes Remission. Retrieved from https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/treating-your-diabetes/type2-diabetes-remission#remission%20research
3. Science Daily (2018): Why weight loss produces remission of type 2 diabetes in some patients. Retrieved from https://www.sciencedaily.com/releases/2018/08/180802141722.htm