Physicians at The University of Texas Health Science Center at Houston (UTHealth) have begun enrollment for a pilot study on a promising surgical approach for the management of Type 2 diabetes.

The procedure being tested is designed for adults who have Type 2 diabetes and who are overweight or obese but not morbidly obese. Millions of Americans have Type 2 diabetes and most are overweight.

Involving surgery to the small intestine and stomach, the procedure, which is called an ileal transposition with sleeve gastrectomy, is intended to improve or resolve Type 2 diabetes. It will be performed at Memorial Hermann-Texas Medical Center.

Type 2 diabetes is a serious health problem and can lead to blindness, limb amputation and heart disease. It is characterized by an elevated blood sugar level associated with the body’s inability to produce enough insulin and/or to use it properly.

The researchers’ goal is to enhance the ability of a person with Type 2 diabetes to maintain a normal blood sugar level by moving a section of intestine closer to the stomach and reducing the size of the stomach.

Currently, many with Type 2 diabetes must take medication on a daily basis to keep sugar levels in check.

The surgical procedure has been associated with encouraging results in clinical research conducted abroad. If the procedure proves effective, it could allow some people with Type 2 diabetes to cut back or quit their medications.

The objectives of the study include evaluating the safety of the procedure and determining its effectiveness compared to dietary and medical management of Type 2 diabetes.

“No one has compared this surgery directly to medical therapy in a randomized, prospective study like this,” said Brad Snyder, M.D., the principal investigator of the study and an assistant professor of surgery at the UTHealth Medical School.

The UTHealth doctors plan to treat 10 people with Type 2 diabetes surgically and 10 medically. Participants will be followed over a two-year period and their outcomes compared.

“If we can get patients into remission and off their medications, then we could open the door for people who want to pursue careers as firefighters, police officers and commercial pilots who may at times be limited by this disease,” Snyder said.

An estimated 26 million people in the United States have diabetes, reports the Centers for Disease Control and Prevention. In adults, Type 2 diabetes accounts for about 90 -95 percent of all diagnosed cases of diabetes. Also known as adult onset diabetes and non-insulin dependent diabetes mellitus, Type 2 diabetes is associated with older age, physical inactivity and certain ethnic groups.

“This disease takes a terrible toll on both patients and their families,” said Erik Wilson, M.D., a study investigator and an associate professor of surgery at the UTHealth Medical School.

The ileum is the final section of the small intestine and transposition means to change place. Human studies have shown that when you place the ileum closer to the stomach, food from the stomach enters the ileum quickly and hormones that help regulate diabetes are easily stimulated.

In the procedure, surgeons remove a section of the ileum that is about 5 feet in length and reattach it. In addition, they remove about 80 percent of the stomach. It is a “band-aid” procedure that is performed through tiny incisions on the abdomen. As with surgical procedures, there is a risk of complication and the risk is anticipated to be in the 1 to 2 percent range.

The procedure is similar to a treatment for morbid obesity – metabolic and bariatric surgery, which can involve surgery on the stomach and intestines. Research shows that oftentimes Type 2 diabetes improves or resolves in morbidly obese patient following gastric bypass surgery.

“We’re not completely sure why people with morbid obesity and Type 2 diabetes experience this improvement following surgery,” Snyder said. It could be a combination of the different metabolism of food, the improvement of insulin action or the improvement in insulin secretion, he said.

“This research will help us find some answers and could lead to future treatments,” Snyder said.

Metabolic and bariatric surgery is typically limited to people with a body mass index of 40 kg/m² or more, or a BMI of 35 kg/m² or more with an obesity-related condition in accordance with National Institutes of Health (NIH) parameters for bariatric surgery. BMI is a calculation based on height and weight.

This pilot study for the surgical management of Type 2 diabetes is restricted to people with a body mass index (BMI) of 25 to 34 kg/m², which includes people who are overweight or obese. Participants must be between 21 and 55 years of age and being treated for Type 2 diabetes.

The clinical trial team includes Philip Orlander, M.D., a professor of medicine and director of the Division of Endocrinology, Diabetes and Metabolism at the UTHealth Medical School, who medically treats people with Type 2 diabetes. When treating patients, Orlander often begins by recommending they lose weight through conventional means such as restricting their calories and exercising more, as well as taking commonly used medications for diabetes. If that fails and they are eligible for bariatric surgery, Orlander will recommend bariatric surgery as a way to control their Type 2 diabetes.

“The average person with Type 2 diabetes may be on 10 different medications to control their blood sugar, cholesterol and blood pressure,” Orlander said. “When we send people to bariatric surgery, a significant portion may be able to stop all of their diabetes, cholesterol and blood pressure medications.”

Frank Moody, M.D., a professor of surgery at the UTHealth Medical School with a longtime interest in the surgical treatment of digestive system diseases, is assisting the research team and said the study could shed light on hormones involved in the metabolic process. “The team will be looking at the impact of surgery on the processing of sugars by the diabetic subjects with an expectation of fixing the break in their metabolism,” Moody said.

If successful, the next step could involve a large clinical trial, Snyder said. “Our intention is to gather this primary data in a small group to show the safety and likely significance as well.”

Snyder, Wilson and Orlander are collaborating on the study with Kelly Wirfel, M.D., an assistant professor of medicine at the UTHealth Medical School. Snyder and Wilson are members of a UT Specialty Surgery Center called Minimally Invasive Surgeons of Texas (MIST) and are on the medical staff of Memorial Hermann-TMC. Wilson is the director of MIST, chief of Elective General Surgery for the UTHealth Medical School and medical director of Bariatric Surgery for Memorial Hermann-TMC.

The study is titled “A Surgical Approach to the Management of Type 2 Diabetes Mellitus in Patients with a BMI between 25-34 kg/m².” The study was approved by the UTHealth Committee for the Protection of Human Subjects and is anticipated to take about three years to complete.

Source:
University of Texas Health Science Center at Houston
Diabetes From Medical News Today

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“Before our discovery, the mechanism behind how exactly the insulin-producing beta cells in the islet of Langerhans of the pancreas fail in type 2 diabetes was incompletely understood, making it difficult to design new and better therapies, says Mehboob Hussain, M.D., associate professor of pediatrics, medicine and biological chemistry. “Our research cracks open a decades-long mystery.”

After a meal, the pancreas produces insulin to move glucose from the blood into cells for fuel. People with type 2 diabetes either don’t secrete enough insulin or their cells are resistant to its effects.

In a study designed to figure out more precisely how the pancreas releases insulin, Hussain’s group looked at how other cells in the body release chemicals. One particular protein, Snapin, found in nerve cells, caught their eye because it’s used by nerve cells to release chemicals necessary for cell communication. Snapin also is found in the insulin-secreting pancreatic beta cells.

To test the role of Snapin, researchers engineered a change to the Snapin gene in mice to keep Snapin permanently “on” in the pancreas. Researchers removed the pancreas cells and grew them in a dish for a day, then added glucose to the cells and took samples to measure how much insulin was released.

When the scientists compared that measurement to what was released by pancreas cells in normal mice, they found that normal mice released about 2.8 billionths of a gram of insulin per cell, whereas the cells from “Snapin-on” mice released 7.3 billionths of a gram of insulin per cell – about three times the normal amount.

“We were surprised to find that the Snapin-on mice didn’t have more or bigger pancreas cells, they just made more insulin naturally,” says Hussain. “This means all our insulin-secreting cells have this amazing reserve of insulin that we didn’t really know existed and a switch that controls it.”

To see if permanently turning off Snapin would reduce insulin release and further demonstrate that Snapin controls the process, the researchers first grew normal mouse pancreas cells in a dish, and treated them with a chemical that stopped them from making the Snapin protein. They again bathed the cells in glucose and measured how much insulin was released by the cells. Normal cells released 5.8 billionths of a gram of insulin, whereas cells with no Snapin only released 1.1 billionths of a gram of insulin – about 80 percent less.

“These results convinced us that Snapin is indeed the switch that releases insulin from the pancreas,” says Hussain.

Biology / Biochemistry From Medical News Today

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New data released last week from the Centers for Disease Control and Prevention (CDC) paint an urgent picture of the state of diabetes, estimating that nearly 26 million children and adults in the United States are now living with diabetes. With one out of every three Americans at high risk for type 2 diabetes, emphasis must be placed on prevention and lifestyle modifications that can delay or prevent type 2 diabetes, a debilitating disease that can lead to blindness, kidney failure, heart disease and death.

“We’ve seen that diabetes has been on the rise for quite a while, but the new data from the CDC is a real wake-up call. One in four Americans living with diabetes is still undiagnosed, highlighting how essential it is for Americans to know if they are at risk and take action, if needed,” said Robert R. Henry, MD, President, Medicine & Science, American Diabetes Association. “Let’s use these devastating new numbers as inspiration to work harder and stop diabetes in its tracks.”

Early diagnosis of type 2 diabetes is critical to successful treatment and delaying and preventing some of its complications. For many, diagnosis may come seven to ten years after the actual onset of diabetes, often only after patients have already started to show signs of one or more of its complications. Studies have shown that exercising 150 minutes a week and losing 7% of your body weight (about 15 pounds if you weigh 200 pounds), can prevent or delay type 2 diabetes by 57%.

The American Diabetes Association offers tips to help prevent or delay the development of type 2 diabetes and its complications:

• Know Your Risk. There are certain risk factors you can’t change, including being over 45 years of age, a family history of diabetes, or coming from a certain family background (African American, American Indian, Asian American or Pacific Islander, or Hispanic/Latino). Other risk factors you can control include being overweight or inactive, eating an unhealthy diet, smoking, or having higher than normal blood glucose, blood pressure or cholesterol levels.
• Get a Check Up. Don’t wait until you get sick to see your health care provider. Schedule a complete evaluation to learn your numbers, including:
• Blood glucose – There are three different tests that measure blood glucose levels: A1C, Fasting Plasma Glucose (FPG) and Oral Glucose Tolerance Test (OGGT). These tests will determine if prediabetes or diabetes is present.
• Blood pressure level – A healthy blood pressure level is below 120/80. Early high blood pressure is between 120/80 and 140/90. High blood pressure is 140/90 and higher.
• Blood lipid levels – A blood lipid test measures HDL (good) cholesterol, LDL (bad) cholesterol) and triglycerides. To maintain optimal health, it is important to be aware of your lipid levels and to maintain low LDL cholesterol levels.
• Move Those Feet. Experts suggest exercising 30 minutes a day most days of the week. If exercising that long is intimidating at first, try walking 10 minutes most days of the week. Find other ways to be more active, such as taking the stairs and parking farther away.
• Sneak in Healthy Foods. Instead of making a complete lifestyle change, try incorporating one small change into your diet at a time. Choose lower-calorie snacks, eat a salad and a vegetable with dinner, or take home half of your main course when you eat out.

The American Diabetes Association offers free resources for those at risk for type 2 diabetes:

• My Health Advisor – Calculate your risk for type 2 diabetes and heart disease by entering some basic health information. After your risk is calculated, you can quickly and easily see the difference simple lifestyle changes — like losing 10 pounds or quitting smoking — can make in your overall risk.
• CheckUp America – Get in-depth information about the different risk factors associated with type 2 diabetes and what you can do to lower that risk.
• Center for Information and Community Support – By calling 800-DIABETES or chatting with a representative online, you can request free information in English and Spanish, including the new booklet Top 5 Ways to Stop Diabetes and Get Healthy Right Now!

Source:
American Diabetes Association
Diabetes From Medical News Today

http://www.medicalnewstoday.com

Diabetes Forecast, the consumer magazine of the American Diabetes Association, has published its annual Consumer Guide in its January issue. The number of products on the market can be overwhelming, so Diabetes Forecast seeks to help people with diabetes select the ones that best meet their needs. Highlights from this comprehensive guide to diabetes management products include:

• On the Horizon — Smaller insulin pumps; a tool to turn an iPhone into a glucose meter; a new inhaled insulin; and the most notable cutting-edge technologies coming down the pike.
• Blood Glucose Meters — A complete guide to virtually every meter on the market today, plus everything you need to know about coding, data storage, blood sample sizes, temperature limitations, lancing devices, and more.
• Continuous Glucose Monitors — In-depth, side-by-side comparisons of all four CGMs on the market, plus a list of key functions to consider.
• Insulin Pumps and Infusion Sets — In-depth, side-by-side comparisons of all three pumps currently available, plus what to consider when choosing a pump and infusion set.
• Insulin Pens — An at-a-glance guide to every pen available, with listings of crucial features.
• Online-only listings of diabetes medications and insulins.

There’s more in the January issue. What’s new in healthy living: type 2 diabetes in children, new guidelines for diagnosing gestational diabetes, the latest on calcium and vitamin D, and more. Plus: How to Perfect Your Pasta, a step-by-step illustrated guide to nutritious pasta dishes, with recipes for healthy takes on favorite sauces.

Source:
American Diabetes Association

Diabetes From Medical News Today

http://www.medicalnewstoday.com/articles/212700.php

Your risk for developing type 2 diabetes can be influenced by a variety of factors. Some you can control… others you can’t. Here’s what you need to watch out for:

• being overweight
• being inactive
• having a family history of diabetes, a parent or sibling with the disease
• getting older
• being a member of certain races, blacks, Hispanics, American Indians and Asian Americans
• having prediabetes, gestational diabetes or babies over 9 pounds.

Currently the medical community is not sure why some people get diabetes and others don’t, but if you have one risk factor (or more) there’s plenty you can do to help reduce the risk.

The Glasgow researchers studied the effects of regular aerobic exercise in 34 females who had at least one type 2 diabetic parent, and 36 women who had no family history of the condition. At the beginning of the study, the group with the family history connection to diabetes had higher insulin resistance than the subjects who didn’t have a diabetic parent or sibling did.

Bu just what type of exercise did they do? The study involved a program of three 30 minute sessions the first week, working up to five 1 hour sessions by the end of the study. The exercises the women were given were cardiovascular in nature – running, aerobics, cycling or using a rowing machine. A good, solid workout. And while the family history group showed such a marked improvement in their insulin resistance, the control group showed no significant change by the end of the study.

Though more research is surely needed, this result is a good argument for getting up, and getting moving, especially if you carry a family risk of type 2 diabetes.

Type 2 diabetes is a nasty enough condition on it’s own, but it has been shown to also increase the risk of heart disease in patients, with a rather worryingly two thirds of diabetics actually dying from heart disease. The good news though according to Dr. Nick Barwell who participated in the study is that, “”People at high risk have it within their power to substantially reduce their risk by increasing their activity levels.”

So, if you have a parent, sibling or grandparent with diabetes type 2, it does not necessarily mean that the condition has to become a part of your life too. You can take steps today to do something about it. It may require a bit of effort… and a bit of change… but starting a regular exercise regime now, which involves aerobic exercise, can absolutely have a positive impact on your chances of avoiding this life altering disease.

To begin lets discuss the types of exercise available to you. Exercise generally falls under two main categories; ‘Cardiovascular Training’ and ‘Resistance Training’. Cardiovascular training focuses on improving the amount of oxygen that is delivered to your muscles which in turn improves your endurance and stamina. There are many choices when it comes to cardiovascular exercise which include cycling, jogging and swimming. Resistance training focuses on improving your strength using short, explosive movements. When it comes to resistance training the choices are a little more limited and involve the use of free weights, machine weights or your own body weight.

So which type is best for your diabetes and your overall health? Well, both types have their advantages. Cardiovascular training is more effective at stimulating the body to use blood sugar for energy but weight training has been linked with significant improvements in blood sugar control. My advice is to do a mixture of both cardiovascular training and resistance training as part of your regular exercise routine. This will allow you to gain the maximum benefit from each type of exercise which include:

1) IMPROVED BLOOD SUGAR CONTROL:- As mentioned above both types of exercise can help you control your blood sugar levels by prompting your body to burn more blood sugar. In fact in some cases of type 2 diabetes exercise has been so effective that it has removed the need for insulin injections.

2) IMPROVED RECEPTIVENESS TO INSULIN:- One of the key problems facing diabetics is a lack of insulin in the body. However, research suggests that regular exercise can improve the body’s sensitivity to insulin. Therefore, by exercising regularly diabetics can use the limited insulin they have available more effectively.

3) REDUCED BODY FAT LEVELS:- Both types of exercise can help you burn fat in different ways. Cardiovascular training stimulates fat burning directly (both during and after exercise) whereas building muscle mass through resistance training can slightly increase the number of calories you burn each day. Fat cells are more resistant to insulin than muscle cells and so by burning them off through exercise you can make your body more receptive to insulin.

Although regular exercise is a fantastic way to moderate your diabetes it is very important that you take the following precautions.

• Always monitor your blood sugar levels before, during and after exercise using a portable glucose meter. Although exercise can help control your blood sugar levels you need to be aware if any fluctuations occur.
• Always keep insulin and glucose nearby so that you can quickly address any potential blood sugar fluctuations.
• Make sure that you stay properly hydrated whilst working out as dehydration can can cause further blood sugar fluctuations.
• Talk to your doctor before beginning an exercise plan. They will know about your health better than most people and therefore will be able to advise you of any further precautions you need to take when exercising.

Regular exercise can do wonders for your health, your appearance and your diabetes. If you want to command greater control over your diabetes then you should start getting physical today. Begin with just a daily brisk walk and then progressively work your way towards more intense forms of exercise. Before you know it you will have made huge steps in your health, your fitness and your diabetes management.

Every intention has been made to make this article accurate and informative but it is intended for general information only. Diabetes is a medical condition and this article is not intended as a substitute for the advice of your doctor or a qualified medical practitioner. If you have any concerns regarding any form of diabetes you should seek the advice of your doctor immediately.

There are two types of diabetes. Type 1 usually manifests itself at an early age. It is sometimes referred to as adolescent diabetes. In Type 1 the body cannot produce enough of its own insulin. Type 2 diabetes manifests itself later in life. In Type 2 diabetes the body fails to produce adequate levels of insulin or it becomes resistant to its own insulin.

In both types of diabetes the body is unable to process sugar properly. Blood sugar levels increase because the body cannot transport sugar to the cells where it is needed. It becomes essential to reduce blood sugar levels. This can be done by medication, by diet and by exercise.

Exercise can, therefore, be a valuable tool in diabetes management. This is true for both types of diabetes. Whether an individual has Type 1 or Type 2 diabetes they can benefit from exercise.

Type 1 diabetics will benefit from exercise because it can assist in the maintenance of insulin sensitivity and increases the use of glucose by the muscles. Exercise will also help to avoid excessive weight gain. Type 1 diabetes cannot be cured, but some of the health problems associated with it can be reduced by means of exercise.

Type 2 diabetics will also benefit from exercise. Type 2 diabetes is preventable and exercise will help in its prevention. Even such a simple activity as a 30 minute walk every day can reduce the risk of developing Type 2 diabetes.

To sum up: exercise will reduce blood sugar levels and help maintain insulin sensitivity. It will also improve circulation. This is important for diabetics because they are known to have circulatory problems. Diabetics often suffer from poor circulation in the legs and feet. Exercise helps to promote blood circulation. Regular exercise will also help to lower blood pressure and so reduce the risk of stroke.

There are, however, certain risks associated with exercise for diabetics. Since exercise lowers blood sugar diabetics must measure their blood sugar levels before and after exercise. The body will use more sugar during exercise and become more sensitive to insulin. Exercise can potentially result in hypoglycemia. Checking blood sugar levels will avoid this danger. With this precaution the benefits of exercise will outweigh the possible risks.

A diabetic should also take care to carry candy or fruit juice with them during exercise in case their blood sugar falls too low. They should make sure to inform the staff at the gym or their exercise partners that they are diabetic. An exercise buddy is a good idea for anyone but doubly so for a diabetic. Exercising with a friend can help maintain your motivation and for a diabetic it can help avoid the dangers of your blood sugar falling too low.

Watch out for the tell tale signs of low blood sugar level. Check your heart rate after exercise. Are you sweating abnormally, shaking, or feeling very hungry? These can all be signs of low blood sugar.

The general rule for everyone beginning exercise is to take things slowly. For diabetics this should be emphasised. Build up your routine as your level of fitness improves. Set yourself realistic goals. Begin with short sessions of gentle exercise. Gradually move on to more ambitious targets are you feel confident to do so. There is not need to push yourself to the point of exhaustion. Little and often is the best plan.

Successful incorporation of exercise into your daily routine will significantly improve your quality of life as a diabetic. It will help you manage your condition and avoid many of the health problems associated with diabetes.

Exercise is a vital part of the management of diabetes. All diabetics should aim to make exercise a part of their daily routine. Exercise can help to improve the quality of life for diabetics. But there are some safeguards to consider before you start an exercise regime. It is wise to consult your health professional before you begin. This would be true for anyone, but it is especially so for someone who suffers from diabetes.

That means that intense exercise can help to both prevent and treat diabetes. The most tissue damage occurs immediately after eating when blood sugar levels rise the highest. After you eat, sugar goes from the intestines into the bloodstream. The only places that sugar can be stored are in your muscles and liver. When your muscles are not exercised, they are full of sugar and sugar has no place to go after it enters your bloodstream.

Aerobic exercise, commonly referred to as cardio, raises the heart rate and the breathing rate while working major muscle groups. Cardio burns blood sugar and stored fat, and is recommended by most doctors for their diabetic patients. Dancing, swimming, aerobics, tennis, basketball, and bicycling are all forms of aerobic exercise. Cardio offers all of the benefits mentioned above, and is especially important for diabetics.

Exercises like jogging, swimming, fast walking and cycling are good for diabetics. These exercises help to keep cardiovascular system in good condition. These exercises should couple with stretching exercises as warming and cooling down exercises. A typical exercise session should consist of: 10 minutes of warming up exercise of stretching type; about 20-30 minutes of aerobic exercise and finally 5 minutes of cool down and stretching exercise.

A regular exercise program can help the body respond to insulin and is known to be effective in managing blood glucose. Diabetes types exercise can lower blood glucose and possibly reduce the amount of medication one needs to treat diabetes. Some are even able to eliminate the need for any medication. With exercise, one can also improve the circulation in many areas of the body such as arms, legs, fingers and the major joints.

Diabetes Exercise, along with good nutrition, helps decrease body fat, which helps control glucose metabolism. Exercise and good nutrition provide real physical payoffs–they are essential to controlling diabetes. Exercise can help prolong your life and get better the quality of your added months and years.

Insulin circulates throughout your network of blood vessels along with sugar, and acts as a key, opening channels that line your cells, which allows sugar to exit your bloodstream and enter your cells where it is used for energy. When insulin is not able to do its job, the cells can’t get the sugar they need, and too much sugar builds up in the blood. Insulin resistance, which is very common, doesn’t cause type 2 diabetes by itself. The pancreas usually rallies to compensate for the resistance by pumping out more insulin.

The overworked pancreas may eventually stop producing enough insulin and the person with type 2 diabetes may need to take daily injections of insulin. Blood samples are taken at intervals for 2 to 3 hours. Test results are compared with a standard and show how the body uses glucose over time.

Insulin levels drop as a result of decreased production, and blood glucose levels are allowed to rise to very high, toxic levels. Although diet and exercise, along with supplementation, are still strongly recommended, a number of prescription drugs might also be necessary. Insulin is a hormone made by the body to regulate the amount of sugar in the blood. High levels of sugar in the blood can seriously affect other body systems, particularly over long periods of time. Insulin is a hormone produced by the beta cells of the pancreas, an organ behind the stomach.

Regular exercise 3-5 times a week will not only keep your heart rate and blood levels in the right places but also ensure you are maintaining your body and reducing the risk of diabetes. Regular exercise tackles several risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. Regular exercise helps control the amount of glucose in the blood. It also helps burn excess calories and fat so you can manage your weight. Regular exercise also may help lower blood lipids and reduce some effects of stress, both important factors in treating diabetes and preventing complications.

Exercise and weight loss are very important to prevent Type 2 Diabetes from worsening. Exercise increases the body’s energy level, lowers tension, and improves your ability to handle stress. Living with type 2 diabetes is a life changing experience.

Medical management of type 2 diabetes is essential, along with nutrition counseling, medication use, behavior change therapy, and physical activity as the focuses of therapeutic intervention. There are identifiable limitations (e.g., presence of complications leading to impairment or disability) and precautions (e.g., degree of metabolic control) to be addressed when developing a physical activity program. Medically speaking, endocrinology involves the diagnosis and management of these illnesses. Endocrinology is often associated with the study of diabetes and metabolism, or with reproductive medicine. Medicines for diabetes and other health conditions may need to be adjusted if a person is also using a dietary supplement.

MAJOR RISK FACTORS FOR TYPE 2 DIABETES
Here are some of the major risk factors for type 2 diabetes:

1. Age – As people age, the chances of getting diabetes type 2 is considerably higher. So for those who are older than 45 years, they are at a higher risk of getting the disease.
2. Overweight – Being overweight is another strong risk factor especially the person is heavier in the center.
3. Genetic factors – Having someone with diabetes in the family puts you at a higher risk.
4. Certain ethnic groups such as such as native americans, african americans, latino americans, pacific islanders and asian individuals who are at higher risk for developing type 2 diabetes.
5. People with high blood pressure and high cholestorol levels are at higher risk for type 2 diabetes.
6. Women at risk – women who have had a big baby of more than 9lbs are at higher risk of having type 2 diabetes. Other risk factors include women who had gestational diabetes, polycystic overian syndrom, irregular menstrual cycles and developing facial hair.

Of all these common risk factors, the most common are those who have family history as well as those who are gaining weight in the middle.

HOW TO CONTROL TYPE 2 DIABETES
Diabetes can be one of the hardest diseases to treat as it does not go away. It is always there with you, day in and day out. It will affect your daily life in what you do and what you eat. You have to be always conscious of your blood sugar as you can’t let it go too high to avoid complications. The next best thing you can do to help yourself is to control the disease.

The main cause of type 2 diabetes is insulin resistance and insulin deficiency. So the first thing you want to do is to help reduce the resistance of insulin. Exercising and losing weight can help reducing resistance to insulin and thus control type 2 diabetes. The other way is using pills which your doctor will recommend to you. However,due to the advance technology as well as rising awareness of using alternative way to treat type 2 diabetes, herbal and natural supplements are increasingly popular.

Here are a few of the natural/alternative herbs which have worked for many diabetics:

1. Bitter melon has long been regarded as the natural cure for diabetes. This fruit is known for its abilities to regulate blood glucose level. In fact, bitter melon is recommended by the Dept of Philippines as one of the best herbal medicines for managing diabetes.
2. Gymnema sylvestre is a herb native to the tropical forests of southern and central India where it has been used as a naturopathic treatment for diabetes for nearly two millennia. This herb has been shown to reduce blood sugar levels when used for an extended period of time. The active ingredient is thought to be gurmenic acid which has structure similar to saccharose. Extracts of Gymnema is not only claimed to curb sweet tooths but also for treatment of as varied problems as hyperglycemia, obesity, high cholesterol levels, anemia and digestion.
3. Cassia (Cinnamomum aromaticum or Chinese cinnamon) is a close relative to cinnamon. In fact, when cinnamon is said to be beneficial for diabetes, it is actually cassia, a less delicate version of the true cinnamon. A 2003 study published in the DiabetesCare journal followed Type 2 diabetics ingesting 1, 3 or 6 grams of cassia daily. Those taking 6 grams shows changes after 20 days, and those taking lesser doses showed changes after 40 days. Regardless of the amount of cassia taken, they reduced their mean fasting serum glucose levels 18–29%, their triglyceride levels 23–30%, their LDL cholesterol 7–27%, and their total cholesterol 12–26%, over others taking placebos. The effects, which may even be produced by brewing a tea from cassia bark, may also be beneficial for non-diabetics to prevent and control elevated glucose and blood lipid levels.
4. Chromium – Starting in the 1960s reports have shown that Chromium helps cells respond properly to naturally produced insulin. Current estimates show that 90% of Americans are lacking in this essential mineral nutrient.
5. Helps to improve circulation in the little capillaries in the hands and feet. Also valuable in balancing the digestion and strengthening the immune system.
6. Mulberry leaves is know to effectively help regulate blood sugar levels. Drink as tea can help to reduce absorption of sugar and carbohydrates. It is also a good source of antioxidants, vitamin C and carotene.

Beside these, there are others less known herbs for controlling diabetes. These herbs when combine together in the right balance can be very powerful in helping you manage diabetes. However, it is important to research on these supplements to ensure they indeed do what they claim. ProvenHealthCare.com provides informative reviews and articles on alternative methods of controlling diabetes.