Diabetes Type 2

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    A answered
    Diabetes is typically diagnosed by measuring the blood sugar level. This is typically done in a medical laboratory or doctor's office on a small sample of blood, or at home or other location with a glucometer or automatic measuring device. Since blood sugar can fluctuate moment to moment, there are several methods used by the medical laboratory to standardize the measurement. These include testing the blood sugar after fasting for 10 hours or more (FBS), testing the blood sugar 2 hours after a meal (2-hour postprandial sugar), and, finally, the glucose tolerance test (GTT).

    In addition, the hemoglobin A1c is typically checked, as it shows what the average blood sugar has been over a longer interval of time. Sometimes, diabetes specialists will also use additional tests to better characterize a person's diabetes. These include serum C-peptide, C-reactive protein (CRP), and insulin levels. These are used only in special cases and usually require special expertise to interpret.
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    A , Integrative Medicine, answered
    A simple blood test, called a fasting insulin level, will detect insulin resistance. Although the normal range (i.e., you’re not in the highest or lowest 2 percent of the population) is considered 5 to 25 units/ml, if your morning fasting insulin blood level is greater than 10 to 15, this could be excess insulin production suggestive of insulin resistance.
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    Signs or symptoms of insulin resistance include increased thirst and increased need to urinate, resulting in having to get up multiple times during the night to use the bathroom. Others may experience weight loss or fatigue.

    These signs and symptoms of insulin resistance are related to elevated glucose, or sugar, in your bloodstream. Your body typically keeps tight control of the level of glucose in your system. It is important to see your primary care doctor if you think you may have elevated blood sugar or have risk factors including family history or obesity.
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    A , Internal Medicine, answered
    One early sign of insulin resistance is the appearance of a brown, thick, velvety patch of skin behind your neck. The condition—called acanthosis nigricans—is an early sign of metabolic syndrome, which is associated with high blood pressure, high blood lipids, and high blood sugar.
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    A , Cardiology (Cardiovascular Disease), answered
    Insulin resistance—in which the body isn't able to use the hormone insulin properly in order to get energy from glucose—can develop as a result of weight gain. That's because putting on pounds means an increase in body fat (adipose tissue). Fat cells are highly active. They produce many different chemicals, including inflammatory compounds, fatty acids and various hormones. These and other chemicals released by fat cells create changes that can result in insulin resistance. Not surprisingly, obese people have a high risk for insulin resistance and type 2 diabetes.
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    A Health Education, answered on behalf of
    Weight gain causes an increased demand on the pancreas to make more insulin, which it can't do. Since it cannot produce enough insulin, the blood sugar gets higher. Plus, your metabolic needs are higher, your heart rate increases -- everything is increased.
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    Obesity contributes to insulin resistance and negatively affects the body’s ability to use insulin properly. 

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    A , Psychiatry, answered
    Caught and treated early, insulin resistance is reversible in more than 90% of patients, and there is a clear improvement in well-being associated with this reversal. To get to the foundation of the problem, you must do a diagnostic work-up, to identify and deal with the layered factors which promote insulin resistance and diabetes. Factors to be assessed include:

    1. Cortisol -- levels which are too high, (as might be the case in anxiety disorders, mood disorders, and psychotic disorders) cause insulin to be elevated, and increase appetite. Cortisol can be reduced easily enough by either supplements or medications, as well as psychotherapeutic methods (e.g., biofeedback, certain therapies, body work etc).

    2. Female and male hormones -- low levels of testosterone result in lowered lean body mass (therefore lower metabolic rate), lower energy and vitality. High levels of estrogens (e.g. with potent birth control pills) can also cause weigh gain, albeit in a different pattern of distribution.

    3. Stress -- many people over eat when tired, angry, frustrated, bored, lonely; Becoming mindful of your sense of hunger before eating, can, over time, reduce unconscious habitual stress eating. Identifying the situations which make you stressed and problem solving them when possible can help reduce stress eating. Keeping a daily log (what you ate, when you ate it, and situations in which you over-ate) will definitely raise consciousness.

    4. Lifestyle -- getting adequate sleep (7-9 hours for most people), moderate exercise 4-5 times per week will reduce the tendency to eat highly processed foods in an out of control manner when you are tired.

    5. Inflammation and toxins -- inflammation due to infection, or toxins in your environment can cause weight gain, as a hormone called Leptin can rise to unusual levels. Irvingia Gabonensis has been shown to help reverse leptin elevation and therefore help with appetite reduction and weight loss.

    6. Nutritional deficiencies (e.g., chromium, vanadium, thiamine) can lead to trouble handling carbohydrates in the body.

    7. Calorie restriction -- the hardest part of the program is to reduce calories, but with the above measures, perhaps a support group (e.g. weight watchers, over-eaters anonymous, food addicts anonymous), you can do it.
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    A , Endocrinology Diabetes & Metabolism, answered

    First and foremost blood sugar can be controlled in anyone, it’s the degree of effort and number of medications it takes to do it that varies. At its most basic level, the most common type of diabetes, Type-2, is a disease of insulin resistance. It’s insulin resistance that’s the root cause of all the trouble, so as such, all diabetes medications could be said to treat insulin resistance.

    The only drugs that are engineered specifically as anti-insulin resistance medications, however, are the TZD class which include Actos and the recently controversial Avandia. The common, safe, cheep, and effective diabetes starter-drug metformin has a small insulin sensitizing effect as well.

    Although it seems counter-intuitive at first glance, insulin is a great way to fight insulin resistance. You might think that this is just throwing gasoline on a bonfire, but in fact it gives your body a break. By adding insulin from the outside, you can reach a steady blood sugar without so much work from the inside. This serves to preserve some of the body’s insulin producing capabilities, which would otherwise burn out form over use.

    For people who are very, very, very insulin resistant we have a special insulin called U-500 that is five times stronger than “normal” insulin. This helps to reduce the volume of liquid needed while maintaining the effect. More bang for the buck, as it were.

    And of course, sometimes the best medication is no medication at all. Insulin resistance itself can be reduced without medication by losing weight. The exact numbers escape me, but I think you buy a 7% drop in insulin resistance for every 10% of your weight you lose. The bottom line is that Even a few pounds can lower your insulin resistance and improve your blood sugar with no additional medication.

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    Medications for insulin resistance are a class of medications to help people with type 2 diabetes. These medications work in different ways but ultimately reduce the amount of glucose circulating in the blood or increase the body's natural production of insulin. Two common medications that people have probably heard of are metformin and glipizide.
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