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šŸ”„+ reverses diabetes type 2 06 Jul 2020 American Diabetes AssociationĀ® Welcomes 2019 Principal Officers and New Members to National Board of Directors - read this article along ...

reverses diabetes type 2 āœ“ļø Frequent urination. āœ“ļø Tiredness. āœ“ļø Weight loss may sometimes be present, but is not as marked as in Type 1 diabetes. Most people with ...

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    reverses diabetes type 2 means (šŸ‘ glucose levels chart) | reverses diabetes type 2 home remedieshow to reverses diabetes type 2 for Types for 1 last update 06 Jul 2020 of DiabetesTypes of Diabetes


    Keith, a competitive cyclist from South Africa, developed type 2 diabetes at age 55, despite biking 150 miles (250 km) every week.


    Summary

    Types of Diabetes

    The main types of diabetes are type 2 diabetes, type 1 diabetes, and gestational diabetes. There are other less common types as well, including Maturity Onset Diabetes of the Young (MODY). In general, type 2 is the most common, and associated with insulin resistance and obesity. Type 1 is an autoimmune disease. Gestational diabetes occurs during pregnancy. In practice, however, it is not always easy to distinguish between diabetes types. This page discusses the details of the main types of diabetes and how to distinguish them from each other, including areas of overlap.


    The Details

    About Diabetes

    ""http://en.wikipedia.org/wiki/Diabetes_mellitus""_blank"" of any type develops when the body cannot produce as much insulin as it needs, resulting in high blood glucose levels (Gale 2005). Diabetes used to be considered one disease. Then it was divided into two main types called "" and "" These were later renamed "" and "" Now they are called ""http://en.wikipedia.org/wiki/Type_1_diabetes""_blank"" and ""http://en.wikipedia.org/wiki/Type_2_diabetes""_blank"" Complications from any type of diabetes may include neuropathy (nerve damage), retinopathy (eye damage), nephropathy (kidney damage), and premature death. These may occur even with good glucose control (Narendran et al. 2005). Taking insulin can treat the disease, but is not a cure. The American Diabetes Association (as well as associations in other countries) releases diagnosis and classification guidelines on a regular basis (e.g., American Diabetes Association 2018).Ā 

    What Is Type 2 Diabetes?

    Type 2 is much more common than type 1 diabetes. Type 2 is generally associated with increased insulin resistance and often obesity, and is associated with certain susceptibility genes that tend to be different from the genes associated with type 1 diabetes (Raj et al. 2009). While type 2 diabetes is historically a disease seen in adults, children, even younger than 10 years old, are now developing it (Pettitt et al. 2014). The health risks of type 2 diabetes are higher when diagnosed during childhood than in adulthood (Al-Saeed et al. 2016).

    While obesity increases the risk of developing type 2 diabetes, obesity alone cannot account for all cases of type 2 diabetes. A large U.S. study has found that of adults with diabetes, 80% were overweight, and 49% were obese. It is interesting to note, however, that 20% of the adults with diabetes in this study were not overweight or obese (Nguyen et al. 2011). A subset of the U.S. minority population with diabetes are actually lean and have rapid failure of the insulin-producing beta cells; it is not clear why (Coleman et al. 2014).

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    Type 1 diabetes, formerly called juvenile diabetes, is an autoimmune disease where the body''s not always.

    Sweden is one country where diabetes diagnosis is done right, at least in children. Since 2005, data on all children and adolescents with newly diagnosed diabetes in Sweden are collected and include family history, clinical symptoms, c-peptide levels (a measure of beta cell function), genetic analyses, and detection of numerous autoantibodies. Overall, 95% of the youth with diabetes had type 1, 2% had type 2, 1%Ā Maturity Onset Diabetes of the Young (MODY), and the rest secondary/unspecified type. Of those with type 1, 7% were autoantibody negative (Persson et al. 2018). In the U.S., the government doesn''s a disease that can be diagnosed at any age. The oldest I have seen is 93 years of age! (Oriot et al. 2018). A missed diagnosis can have serious consequences, as was seen in this case study of a 51 year old man (Bao et al. 2019).

    A recent study looked at all new cases of diabetes diagnosed during a three year period in an area of Sweden, and tested people of all ages for GAD and/or islet antibodies (if positive, they were classified as type 1). It found that almost 60% of newly diagnosed type 1 patients were over age 40, with incidence peaks in ages 0-9 and 50-80. Among adults, 6.9% of people with diabetes had type 1, which is similar to or slightly lower than other studies have found (Thunander 2008). In a group of UK adults who developed diabetes after age 30 and were being treated with insulin, 21% met the criteria for type 1 diabetes-- but 47% of them thought they had type 2 (Thomas et al. 2019). In Iceland, population-wide, the number of adults diagnosed with type 1 is about half the number of childrenĀ (Halldora Thordardottir et al. 2019). So while type 1 in adults may be less common than in children, it''t know. Research shows that it may be at the "" of type 1 and type 2 diabetes (Grant et al. 2010; Ramu et al. 2018), perhaps genetically slightly closer to type 1 than type 2 (Carlsson 2019;Ā Mishra et al. 2017; Cousminer et al. 2018), although also distinct from type 1 (Heneberg et al. 2018; Cousminer et al. 2018; Ji et al. 2019). Insulin secretion in LADA is also mid-way between type 1 and type 2 diabetes (Hernandez et al. 2015), as are the immune system changes (Singh et al. 2019). Lifestyle factors generally linked to type 2 diabetes also are linked to LADA (Carlsson 2019). Scientists are trying to find markers that can be used to help diagnosis and help distinguish LADA from type 2 diabetes (e.g., Yu et al. 2019).

    Some researchers propose that the term LADA be retired altogether (while acknowledging that the term helped "") (Rolandsson and Palmer 2010). They also point out that considering LADA as a form of type 1 diabetes means that more adults than children are affected by autoimmune diabetes. Other researchers are trying to figure out how to distinguish LADA from "" (Castelblanco et al. 2018) and honestly I''s pancreas, parts may have functional beta cells while other parts don''s basically applying a precision medicine approach to type 1 diabetes.Ā 

    Before Diabetes Develops: The Stages of Disease DevelopmentĀ 

    In 2015, new stages of type 1 diabetes development were proposed, to encourage risk screening and prevention studies (Insel et al. 2015). The three stages are:Ā 
    • Stage 1: pancreatic beta cell autoimmunity (2 or more autoantibodies) with normal blood sugar levels (presymptomatic)
    • Stage 2: pancreatic beta cell autoimmunity with higher blood sugar levels or glucose intolerance (presymptomatic)
    • Stage 3: clinical onset of type 1 diabetes with high blood sugar levels and symptoms
    In 2017, a new name for Stage 1 type 1 diabetes was proposed, Autoimmune Beta Cell Disorder (ABCD) (Bonifacio et al. 2017). There are various controversies surrounding this proposed name (e.g., ABCD is already used as a term to describe obesity, Adiposity-Based Chronic Disease) but it seems like general support of the use of stages to better characterize the early development of type 1 diabetes (Becker and Insel, 2018).

    Insulin Resistance and Obesity in Type 1 Diabetes

    People with type 1 diabetes have higher insulin resistance than those without diabetes, even in lean patients (e.g., Donga et al. 2013). A Colorado study found that insulin resistance was a significant feature in adults with type 1. This insulin resistance was not explained by body mass index, percentage fat, visceral fat, lipids/cholesterol, exercise, or high blood glucose (Bergman et al. 2012).Ā 

    Curiously, in a study of Malaysian people, those with LADA had higher insulin resistance levels than antibody-negative adults with diabetes, despite a lower body mass index (Salem et al. 2014).

    There are obese people with type 1 diabetes, and that can also cause misdiagnosis. Misdiagnosis can have serious consequences, even in adults. For example, a person who underwent bariatric surgery for obesity ended up with ketoacidosis, because they had type 1, not type 2 diabetes (Pilla et al. 2018).

    It seems pretty clear that non-immune processes like insulin resistance or obesity can stress beta cells, as well as amplify autoimmunity and contribute to the development of type 1 diabetes, especially at older ages (Redondo et al. 2019). See the Insulin ResistanceĀ and Height and Weight pages for more on this topic.

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    Fulminant type 1 diabetes is a subtype of type 1 diabetes characterized by extremely rapid onset and complete deficiency of insulin due to the destruction of pancreatic beta cells, more common in Asians. Autoimmunity may (or may not) play a role in fulminant type 1 diabetes, although this is under investigation (Wang et al. 2016).Ā One study defines it as, ""https://en.wikipedia.org/wiki/Glycated_hemoglobin""_blank""https://en.wikipedia.org/wiki/C-peptide""_blank"" This study, however, describes a case where the patient recovered some beta cell function over time, taking a small amount of insulin. The authors point out that fulminant type 1 diabetes is heterogeneous (Kaneko et al. 2017), as is type 1 diabetes throughout Asia (Park et al. 2017). Glucagon levels are also lower in those with fulminant type 1 diabetes as compared to people with type 1 diabetes (Komada et al. 2018).Ā Liu et al. (2018) present the diagnostic criteria for fulminant type 1 diabetes as agreed on by the Japanese Diabetes Association. One study notes that the process is so rapid that it may take only a few days, seldom longer than a week-- which could explain why some people have a relatively normal HbA1c but very high blood sugar levels (Keskin et al. 2018). Since it is so fast-acting, there is a high risk of death and proper diagnosis is important (You et al. 2019).

    Interestingly, fulminant type 1 diabetes often appears in pregnant women (Yang et al. 2020). So I am wondering if there is a link between this and ""? (See below under Gestational Diabetes). Does pregnancy somehow trigger autoimmunity and a fast-onset type 1? (I personally developed type 1 during pregnancy and know a lot of other women who have as well).

    Double Diabetes in Children

    More and more children, meanwhile, have characteristics of both type 1 and 2 diabetes, including autoantibodies to beta cells, as well as signs of increased insulin resistance or obesity. Some call this "" or "" diabetes (Khawandanah 2019; Pozzilli et al. 2007; Pozzilli et al. 2011). In fact, a large number of people with diabetes may have both type 1 and type 2 associated processes contributing to their diabetes (Tuomi 2005). Interestingly, one research group took another look at the diagnosis of children with diabetes (mostly type 1), after an average of 7 years. Fully 20% of the patients had a different diagnosis that what was originally given, after reevaluation. And, 10% of the children were determined to have both type 1 and type 2, a "" Lipton et al. 2011).

    A German study of children diagnosed with type 2 diabetes found that 15% tested positive for islet autoantibodies (Awa et al. 2013). A similar UK study found that 30% of children with type 2 tested positive for autoantibodies, while 26% of those with type 1 tested negative (Perchard et al. 2015). A U.S. study found that of 145 obese youth diagnosed with type 2 diabetes, 70 tested positive for autoantibodies-- that's 48% (Rivera-Vega et al. 2015). A study of children from India found that 7% had "" 51% had type 1, 13% had type 2, and fully 29% had an "" type of diabetes (Mishra et al. 2018).

    Other authors have described a "" in diabetes. They analyzed US children diagnosed with diabetes, and tested their autoantibody levels and levels of insulin resistance. They found that 55% of the children could be classified as autoimmune and insulin sensitive (traditional type 1), and 16% as non-autoimmune and insulin resistant (traditional type 2). Almost 20% had autoimmunity and insulin resistance, signs of both type 1 and type 2, perhaps including those who are overweight with type 1. Then 10% were non-autoimmune but insulin sensitive, showing signs of neither type 1 or type 2, perhaps indicating a different type altogether (such asĀ MODY) (Dabelea et al. 2011).

    Immune Dysfunction in Type 2 Diabetes

    There is growing evidence that immune system abnormalities may play a role in type 2 diabetes. While type 2 diabetes is not considered an autoimmune disease, 15-35% of type 2 patients diagnosed before age 45 test positive for antibodies to GAD, as do 7-9% of patients diagnosed at an older age (Tuomi 2005). (These antibodies are also a marker of type 1 diabetes; see the Autoimmunity page for more information on the antibodies associated with type 1 diabetes). Here are examples of studies where people diagnosed with "" were tested for autoimmunity:
    • In the U.K., about 10% of adults who had been diagnosed with type 2 diabetes tested positive for islet or GAD autoantibodies (Fourlanos et al. 2005).Ā 
    • In the U.S., 6.4% of a group of overweight or obese adults diagnosed with type 2 diabetes tested positive for islet autoantibodies, including 12.8% of those with severe obesity (Pilla et al. 2018).Ā 
    • In the Czech Republic, 13% of people diagnosed with type 2 tested positive for GAD autoantibodies (Martinka et al. 2016).
    • In Bulgaria, 10% of adults diagnosed with type 2 tested positive for autoantibodies (Zaharieva et al. 2017).Ā 
    • In China, about 6% of adults with diabetes tested positive for autoantibodies (Xiang et al. 2018).Ā 
    • Another Chinese study found much higher rates, 28.5% (Gao et al. 2019).
    • And another from China found 5.5% in males and 6% in females (Tang et al. 2019).
    • In Italy, 25% of people diagnosed with type 2 tested positive for autoantibodies (Tiberti et al. 2018).Ā 
    • In India, about 1.5% ofĀ adults diagnosed with type 2 diabetesĀ tested positive for autoantibodies (Sachan et al. 2015).Ā 
    Including elderly adults:
    • In China, over 35% of elderly adults diagnosed with type 2 diabetes tested positive for islet autoimmunity (Li et al. 2018).
    • In Argentina, 16% of non-obese adults diagnosed with diabetes after age 65 tested positive for autoantibodies (Yohena et al. 2019).
    And children as well:
    In both adults and children, then, a percentage of people with type 2 diabetes show signs of autoimmunity. It may be that they were simply misdiagnosed, and really have type 1 diabetes.

    However, chronic inflammation (a sign of immune dysfunction), is also involved in type 2 diabetes, insulin resistance, and obesity. Some authors are questioning whether or not type 2 diabetes may also involve some sort of autoimmune response (Itariu and Stulnig, 2014;Velloso et al. 2013). Immune cells have been found in the islets of people with type 2 diabetes, showing islet inflammation likely plays a role in the beta cell failure found in type 2 diabetes (Westwell-Roper and Ehses, 2014). Obesity can also play a role. The levels of antibodies can vary by body mass index (BMI); certain antibodies are higher in those more obese, while others are lower (Buzzetti et al. 2015).

    There is evidence that islet autoimmunity plays a role in the development of type 2 diabetes. Some type 2 patients may even test negative for islet autoantibodies, but positive for islet reactive T-cells-- these authors refer to this characteristic as "" (Brooks-Worrell et al. 2011). For example, certain inflammatory autoreactive T-cells are found in people with type 1 and type 2 diabetes (CD-4+ T-cells), while other autoreactive cells are only found in people with type 1 (CD-8+ T-cells) (Sarikonda et al. 2014).

    Other authors have found that additional autoantibodies are found in people with type 1 diabetes, and a small percentage (5%) of people with type 2. 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