This is Part One of a series of three Posts. Part Two will cover more questions about Type 2 Diabetes. Part Three will cover Gestational Diabetes.

What causes high blood sugar?
Many things can cause high blood sugar, but what we eat plays the biggest and most direct role in elevating blood sugar. When we eat carbohydrates, our body converts those carbohydrates into glucose, and this can play a role in raising blood sugar. Protein, to a certain degree, in high amounts can also raise blood sugar levels. Fat does not raise blood sugar levels. Stress leading to an increase in the hormone cortisol can also raise blood sugar levels.
What’s the difference between type 1 and type 2 diabetes?
Type 1 diabetes is an autoimmune condition that results in the body’s inability to produce insulin. People who suffer from Type 1 diabetes must be on insulin in order to keep glucose levels within normal limits.
Type 2 diabetes is a disease in which either the body is able to produce insulin but is not able to produce enough or the body does not respond to the insulin that is being produced (known as insulin resistance). People with type 2 diabetes must be on a low carbohydrate diet to keep their diabetes from worsening.
What should your fasting blood glucose be?
A fasting blood sugar should be less than 100 in order to be considered normal. A fasting blood sugar of >100 to 125 is consistent with prediabetes. Fasting blood sugar levels of 126 or greater is diagnostic of diabetes.
If your fasting blood glucose is consistent with prediabetes or type 2 diabetes, we recommend that you speak with your physician.
What is diabetic ketoacidosis?
Diabetic ketoacidosis (or DKA) is a serious medical condition that can result from very high levels of ketones in the blood. If it is not recognized and treated right away, then it can lead to a coma or even death. Because it is such a serious condition, a person who develops diabetic ketoacidosis is usually admitted to the hospital for treatment.
This condition occurs when the body’s cells are unable to use glucose for energy, and the body begins to break down fat for energy instead. Ketones are produced when the body breaks down fat, and very high levels of ketones can make the blood extremely acidic. The acidity can potentially cause coma and death.
People with type 1 diabetes are at risk of developing diabetic ketoacidosis if they do not take their insulin, if they do not eat, or if they become sick for other reasons (such as an infection). It is very unusual for people with type 2 diabetes to develop diabetic ketoacidosis.
Ketosis vs. ketoacidosis: What is the difference?
Ketosis: Endogenous ketones are known to be safe at physiologic levels. It has long been known that ketones are an effective alternate metabolic fuel and recent studies have shown them to be potent epigenetic and hormonal signaling molecules as well. In nutritional ketosis, serum ketones range from 0.5 to 5 mM. This is the body’s normal state of lipolysis (breaking down of fats) that occurs when carbohydrates are avoided.
Ketoacidosis:In stark contrast to this normal physiology of ketosis, pathologic ketoacidosis manifests with serum levels ketone levels of 15-25 mM (i.e., three- to ten-fold higher than in nutritional ketosis). Lipolysis is exquisitely regulated, so it is exceedingly rare for a patient with normal pancreatic beta cell function to enter ketoacidosis.
How does Metformin treat prediabetes and type 2 diabetes?
The mechanism of action of metformin is not fully understood. It appears to reduce glucose production in the liver, although there is now evidence that other factors may also play a role.
What is type 1 diabetes?
Type 1 diabetes is a condition where the body does not produce insulin.
What is insulin? Insulin is a hormone that is needed for the body to move glucose from the blood into the body’s cells. All of the organs in the body, including the brain, the heart, and the lungs, are made of cells. These cells use glucose for energy, which is why it is important for the glucose to move from the bloodstream into the cells.
The lack of insulin production in type 1 diabetes is usually caused by a problem with the pancreas. Type 1 diabetes is considered to be a permanent condition when it is diagnosed.
Prediabetes
What are the signs and symptoms of prediabetes?
Prediabetes is considered to be one of the most insidious precursors to diabetes because it may not have any signs or symptoms. This is why it is so important to do diagnostic blood tests checking a fasting glucose or hemoglobin A1c (Hba1c) test to establish a diagnosis of prediabetes. Many people who have prediabetes do not have any symptoms. By the time symptoms occurs, the diagnosis has usually already progressed to diabetes. There are some rare situations in which an individual can present with diabetes-related complications such as a retinal bleed, neuropathy or even a stroke, while only having a diagnosis of prediabetes.
What is the best diet for prediabetes?
A low carbohydrate diet is the ideal diet for prediabetes. This is because prediabetes occurs when glucose levels start to rise and the body produces insulin to try and lower the glucose levels. If the body cannot produce enough insulin or if the insulin level that the body is producing is not enough to meet the demands of the high glucose load, then glucose levels continue to rise.
How do you reverse prediabetes?
Prediabetes can be reversed by following a low carbohydrate diet.
Once glucose levels are lowered with a low carbohydrate diet, the body’s demand for insulin also goes down. As insulin levels are lowered due to lowered glucose levels, this will then be reflected in lab results such as a normal HbA1c or fasting glucose. Once Hba1c or fasting glucose has been normalized, then one can say that the prediabetes has been put into remission or reversed.
To learn more please read Reversing Diabetes 101 by Dr. Sarah Hallberg. Here is the link https://2healthyhabits.wordpress.com/2018/10/12/reversing-diabetes-101-with-dr-sarah-hallberg-the-truth-about-carbs-blood-sugar-and-reversing-type-2-diabetes/
Dr. Hallberg describes how a low carbohydrate diet can be an effective treatment for insulin resistance in this video.
What is the usual treatment for prediabetes?
Some providers may prescribe Metformin to patients who suffer from prediabetes for some time and are unable to make the dietary changes to reverse their prediabetes, yet are at high risk for developing diabetes.
Many patients who receive a diagnosis of prediabetes will also be told to lose weight with diet and exercise. Weight loss also plays a role in reversing prediabetes; however, the mechanism by which prediabetes is reversed is related to lowering insulin levels, and lowering insulin levels can help reduce weight.
Can prediabetes be reversed permanently?
Prediabetes can be reversed through the dietary changes outlined here. However, it is important to understand that if someone eats a low carbohydrate diet and reverses their prediabetes but then begins eating carbohydrates again in the future, the prediabetes will return.They must eat a low carbohydrate diet lifelong in order to reverse prediabetes and keep it permanently reversed.
The source of this information is the Virta Health website. Here is the link, please copy and paste it into your address bar
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