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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    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 , Nutrition & Dietetics, answered
    Some symptoms are self-evident, but others only can be detected through a fasting-glucose test or a glucose-tolerance test. Symptoms include:
    • Weighing more than 15 pounds more than your ideal weight, or having
           a large abdomen;
    • Having blood pressure higher than 145/90, or hypertension;
    • Having a fasting-glucose test result greater or equal to 110 mg/dL, or
           a glucose-tolerance test result greater than or equal to 140
           mg/dL.
    • Having low blood sugar or hypoglycemia, causing you to feel agitated
           and jittery when you are hungry.
    • Having a fasting HDL-cholesterol test result less than 35 and a
           fasting-triglycerides test result greater than 200.
    • Having more active inflammatory compounds, such as C-reactive
           protein.
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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 , 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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    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 on behalf of
    First, let me give a quick explanation of insulin resistance. Insulin resistance means that the body is not responding as well to insulin-the insulin made by the body itself, or insulin injected as a treatment for diabetes-as well as it should. Someone with insulin resistance may require two or three times (maybe even more) the amount of insulin to keep blood sugar normal as someone who has normal responsiveness to insulin.
    Precisely what causes insulin resistance has been a major focus of research in diabetes for several decades. Insulin resistance is clearly the result of abdominal obesity. Fat cells in and around the internal organs of the abdomen make a variety of chemicals that are associated with insulin resistance, so the greater the abdominal obesity-the greater the waist circumference-the more insulin resistant someone is going to be and the greater his or her likelihood of having diabetes. 
    So obesity causes insulin resistance. The question is whether, in turn, insulin resistance also causes obesity, thereby leading to a viscous cycle. To some extent, this is probably the case. One concern here is that insulin is an anabolic hormone, meaning a hormone that promotes energy storage, including fat storage. When you take in calories, some of those calories are going to be stored as fat, and insulin is an important part of this process. Obviously if you don’t take in the calories, you will not store the fat, so those with insulin resistance can still lose weight if they reduce their calorie intake and increase their calorie expenditure through exercise. The weight loss then leads to improved insulin sensitivity, and the problem becomes steadily less severe as someone loses weight. 
    If someone who is insulin resistant has difficulty losing weight despite good dietary and lifestyle habits, metformin may be of help. Metformin is a medication used to treat diabetes, and it works, in part, by enhancing the body’s responsiveness to insulin. The drugs tend to suppress appetite somewhat, and those taking metformin have a fall in blood sugar as well as a decline in insulin levels. This medication sometimes helps people lose weight, and it is generally safe to take as long as you do not have kidney problems. It is available generically and is not very expensive.
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    A Endocrinology Diabetes & Metabolism, answered on behalf of
    Metformin (Glucophage, Glucophage XR, Glumetza, Fortamet, Riomet) and the thiazolidinediones or "TZDs" (pioglitazone [Actos] and rosiglitazone [Avandia]) are drugs that help lower blood sugar not by increasing insulin, but by helping the body react better to the insulin already present. Metformin works primarily by reducing glucose production by the liver, but it doesn't usually shut off the production completely, so you can still meet your fuel needs. Actos and Avandia improve how your muscle cells react to insulin. All these drugs are much less likely to cause hypoglycemia because when your blood sugar starts to go low, your pancreas automatically reduces the amount of insulin that it is making. You're responding better to the insulin, but the amount in your blood is not usually enough to cause hypoglycemia.