Along with following your diabetes care plan, you may need diabetes medicines, which may include pills or medicines you inject under your skin, such as insulin. Over time, you may need more than one diabetes medicine to manage your blood glucose. Even if you don’t take insulin, you may need it at special times, such as during pregnancy or if you are in the hospital. You also may need medicines for high blood pressure, high cholesterol, or other conditions.
Pregnancy. Gestational diabetes is a kind of diabetes that happens only during pregnancy. Although gestational diabetes goes away after pregnancy, about half of women who had gestational diabetes are diagnosed with type 2 diabetes within 15 years. Even if they don’t have gestational diabetes, women who give birth to babies who weigh 9 pounds or more are more likely to develop type 2 diabetes later in life. The American Academy of Family Physicians (AAFP) recommends screening for gestational diabetes in pregnant women after the 24th week of pregnancy. The AAFP believes there is not enough evidence to determine the benefit and harm of screening for gestational diabetes in pregnant women before the 24th week of pregnancy.
The World Health Organization recommends testing those groups at high risk[55] and in 2014 the USPSTF is considering a similar recommendation.[59] High-risk groups in the United States include: those over 45 years old; those with a first degree relative with diabetes; some ethnic groups, including Hispanics, African-Americans, and Native-Americans; a history of gestational diabetes; polycystic ovary syndrome; excess weight; and conditions associated with metabolic syndrome.[23] The American Diabetes Association recommends screening those who have a BMI over 25 (in people of Asian descent screening is recommended for a BMI over 23).[60]

Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with the disorder, probably due to the rise in childhood obesity. There's no cure for type 2 diabetes, but losing weight, eating well and exercising can help manage the disease. If diet and exercise aren't enough to manage your blood sugar well, you may also need diabetes medications or insulin therapy.
This app allows you to talk with a registered dietitian who can help you with questions you may have or just someone when you need the extra support. This app helps you get a better understanding of the foods you consume and has its own database of over 700,000 different foods to better help you track your weight loss and diabetes. This app is available for $9.99.

That’s a feature that Kelli Rush, 41, a homemaker in Fallon, Nevada, appreciates. She was diagnosed with type 2 diabetes in late 2017, and she’s since made huge strides in improving her A1C. She likes to see the estimated number in the app, and she says it closely matched the lab value when she had the blood test. “It’s nice to know that I’m making progress,” she says.


Most cases of diabetes involve many genes, with each being a small contributor to an increased probability of becoming a type 2 diabetic.[10] If one identical twin has diabetes, the chance of the other developing diabetes within his lifetime is greater than 90%, while the rate for nonidentical siblings is 25–50%.[13] As of 2011, more than 36 genes had been found that contribute to the risk of type 2 diabetes.[38] All of these genes together still only account for 10% of the total heritable component of the disease.[38] The TCF7L2 allele, for example, increases the risk of developing diabetes by 1.5 times and is the greatest risk of the common genetic variants.[13] Most of the genes linked to diabetes are involved in beta cell functions.[13]
Diabetes can occur temporarily during pregnancy, and reports suggest that it occurs in 2% to 10% of all pregnancies. Significant hormonal changes during pregnancy can lead to blood sugar elevation in genetically predisposed individuals. Blood sugar elevation during pregnancy is called gestational diabetes. Gestational diabetes usually resolves once the baby is born. However, 35% to 60% of women with gestational diabetes will eventually develop type 2 diabetes over the next 10 to 20 years, especially in those who require insulin during pregnancy and those who remain overweight after their delivery. Women with gestational diabetes are usually asked to undergo an oral glucose tolerance test about six weeks after giving birth to determine if their diabetes has persisted beyond the pregnancy, or if any evidence (such as impaired glucose tolerance) is present that may be a clue to a risk for developing diabetes.
Carb Manager is the preferred food app for Pamala Moberly, 56, a retired missionary in Tifton, Georgia. “I like that it helps me keep track of total carbs, net carbs, fiber, proteins, and fats. I can even make my own recipes in this app, and it will calculate all of those numbers,” she says. She uses the free version, but adding the subscription service allows you to also enter blood glucose values. (The current subscription price is $8.49 per month or $39.99 per year.)

Low blood sugar (hypoglycemia) is common in people with type 1 and type 2 DM. Most cases are mild and are not considered medical emergencies. Effects can range from feelings of unease, sweating, trembling, and increased appetite in mild cases to more serious effects such as confusion, changes in behavior such as aggressiveness, seizures, unconsciousness, and (rarely) permanent brain damage or death in severe cases.[23][24] Moderately low blood sugar may easily be mistaken for drunkenness;[25] rapid breathing and sweating, cold, pale skin are characteristic of low blood sugar but not definitive.[26] Mild to moderate cases are self-treated by eating or drinking something high in sugar. Severe cases can lead to unconsciousness and must be treated with intravenous glucose or injections with glucagon.[27]
The treatment of low blood sugar consists of administering a quickly absorbed glucose source. These include glucose containing drinks, such as orange juice, soft drinks (not sugar-free), or glucose tablets in doses of 15-20 grams at a time (for example, the equivalent of half a glass of juice). Even cake frosting applied inside the cheeks can work in a pinch if patient cooperation is difficult. If the individual becomes unconscious, glucagon can be given by intramuscular injection.

You can upgrade to a Pro version of this app for 2.99 a month or 27.99 per year and you’ll gain more information on blood sugar reminders, meals. You can create a PDF or Excel file to share your results and progress with you doctor. If you’d like to upgrade even further and get your very own personal certified diabetes educator, you can do so for 19.99 a month or 199.99 for the year.
Still, these choices are just the beginning, and there are lots of other options to explore. We’ve listed our top picks for several types of apps, focusing on those that have numerous and consistent good reviews from users and have been updated recently. Many offer similar features, so you may want to download a few and see which is easiest for you to use.

An award-winning diabetes logbook app, Diabetes:M allows users to enter glucose readings, insulin injections, and carbohydrates consumed at meals. There is a bolus calculator as well as a food database for looking up and tracking various foods. Detailed graphs, analytical charts, and the ability to generate reports to share with health-care providers are some of the additional features.
I just wanted to let you know about an app that I use and love. The app is called “Diabetes:M”. It is free and has helped me manage my diabetes. I am a Type 1. It lets you log carbs, insulin, etc. and you can send all of the info from it by e-mail to your provider. It has graphs and charts that help out a lot as well. Hope this helps someone else as much as it has helped me. Thanks.
On top of tracking your blood glucose and meals (with a nutrition database and bar-code scanner), the Diabetes:M app will calculate insulin boluses for you. Through the Apple Health app, Diabetes:M will sync with other devices, including glucose meters, Fitbit, Garmin, and many others. You’ll need to pay extra for the subscription to access the full food database, sync multiple devices, and get rid of the ads. (The current subscription cost is $4.99 per month or $49.99 per year.)
Once nerve damage sets in, your risk of infection increases because you may not be able to feel an injury, like a cut on your foot, to help it heal early on. In addition to examining your feet every day, check in with your doctor at the first sign of infection, such as redness or swelling. Protect your feet by keeping your skin moisturized with a coat of petroleum jelly or rich cream, but make sure to keep the areas between your toes dry because extra moisture there can increase the risk of infection, the ADA suggests.
Type 2 diabetes (T2D) is more common than type 1 diabetes with about 90 to 95 percent of people with diabetes having T2D. According to the Centers for Disease Control and Prevention’s report, 30.3 million Americans, or 9.4% of the US population have diabetes.1 More alarming, an estimated 84 million more American adults have prediabetes, which if not treated, will advance to diabetes within five years.1
Coheso is the most prolific developer on Apple's list, with three entries. The second, CarbsControl, is a food logging and carb counting app built for anyone, not just people with diabetes. Its database contains carbohydrate and other nutrition details for over 100,000 foods, including 500 specific food brands and 300 popular fast food and casual dining restaurants.
Glucagon is a hormone that causes the release of glucose from the liver (for example, it promotes gluconeogenesis). Glucagon can be lifesaving and every patient with diabetes who has a history of hypoglycemia (particularly those on insulin) should have a glucagon kit. Families and friends of those with diabetes need to be taught how to administer glucagon, since obviously the patients will not be able to do it themselves in an emergency situation. Another lifesaving device that should be mentioned is very simple; a medic-alert bracelet should be worn by all patients with diabetes.
In type 2 diabetes, the pancreas still makes insulin but the body doesn't respond to it normally. Glucose is less able to enter the cells and do its job of supplying energy (a problem called insulin resistance). This raises the blood sugar level, so the pancreas works hard to make even more insulin. Eventually, this strain can make the pancreas unable to produce enough insulin to keep blood sugar levels normal.
Onset of type 2 diabetes can be delayed or prevented through proper nutrition and regular exercise.[61][62][needs update] Intensive lifestyle measures may reduce the risk by over half.[24][63] The benefit of exercise occurs regardless of the person's initial weight or subsequent weight loss.[64] High levels of physical activity reduce the risk of diabetes by about 28%.[65] Evidence for the benefit of dietary changes alone, however, is limited,[66] with some evidence for a diet high in green leafy vegetables[67] and some for limiting the intake of sugary drinks.[33] There is an association between higher intake of sugar-sweetened fruit juice and diabetes but no evidence of an association with 100% fruit juice.[68] A 2019 review found evidence of benefit from dietary fiber.[69]
Prevention and treatment involve maintaining a healthy diet, regular physical exercise, a normal body weight, and avoiding use of tobacco.[2] Control of blood pressure and maintaining proper foot care are important for people with the disease.[2] Type 1 DM must be managed with insulin injections.[2] Type 2 DM may be treated with medications with or without insulin.[12] Insulin and some oral medications can cause low blood sugar.[13] Weight loss surgery in those with obesity is sometimes an effective measure in those with type 2 DM.[14] Gestational diabetes usually resolves after the birth of the baby.[15]
All information contained on dLife.com is intended for informational and educational purposes only. The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition. All content on dLife.com is created and reviewed in compliance with our Editorial Policy.
Gestational diabetes mellitus (GDM) resembles type 2 DM in several respects, involving a combination of relatively inadequate insulin secretion and responsiveness. It occurs in about 2–10% of all pregnancies and may improve or disappear after delivery.[49] However, after pregnancy approximately 5–10% of women with GDM are found to have DM, most commonly type 2.[49] GDM is fully treatable, but requires careful medical supervision throughout the pregnancy. Management may include dietary changes, blood glucose monitoring, and in some cases, insulin may be required.
Cons: Glucose Buddy does not sync with meters, continuous glucose monitors (CGMs), or pumps. Both Android and Apple users can access glucosebuddy.com, but only Apple users can sync their app with the website; Android users have to manually input their log on the web portal. There is no way to back up your data, so if you lose your phone and you haven’t manually entered logbook data on the website (or if your Apple device didn’t sync), you’ll have to start over. A built-in calorie tracker and food database is planned, but no release date has been set yet.
Diet. Your diet should include lots of complex carbohydrates (such as whole grains), fruits, and vegetables. It’s important to eat at least 3 meals per day and never skip a meal. Eat at about the same time every day. This helps keep your insulin or medicine and sugar levels steady. Avoid empty calories, such as foods high in sugar and fat, or alcohol.

DIAbetes Genetics Replication And Meta-analysis (DIAGRAM) Consortium; Asian Genetic Epidemiology Network Type 2 Diabetes (AGEN-T2D) Consortium; South Asian Type 2 Diabetes (SAT2D) Consortium; Mexican American Type 2 Diabetes (MAT2D) Consortium; Type 2 Diabetes Genetic Exploration by Nex-generation sequencing in muylti-Ethnic Samples (T2D-GENES) Consortium, Mahajan A, Go MJ, Zhang W, Below JE, Gaulton KJ, Ferreira T, Horikoshi M, Johnson AD, Ng MC, Prokopenko I, Saleheen D, Wang X, Zeggini E, Abecasis GR, Adair LS, Almgren P, Atalay M, Aung T, Baldassarre D, Balkau B, Bao Y, Barnett AH, Barroso I, Basit A, Been LF, Beilby J, Bell GI, Benediktsson R, Bergman RN, Boehm BO, Boerwinkle E, Bonnycastle LL, Burtt N, Cai Q, Campbell H, Carey J, Cauchi S, Caulfield M, Chan JC, Chang LC, Chang TJ, Chang YC, Charpentier G, Chen CH, Chen H, Chen YT, Chia KS, Chidambaram M, Chines PS, Cho NH, Cho YM, Chuang LM, Collins FS, Cornelis MC, Couper DJ, Crenshaw AT, van Dam RM, Danesh J, Das D, de Faire U, Dedoussis G, Deloukas P, Dimas AS, Dina C, Doney AS, Donnelly PJ, Dorkhan M, van Duijn C, Dupuis J, Edkins S, Elliott P, Emilsson V, Erbel R, Eriksson JG, Escobedo J, Esko T, Eury E, Florez JC, Fontanillas P, Forouhi NG, Forsen T, Fox C, Fraser RM, Frayling TM, Froguel P, Frossard P, Gao Y, Gertow K, Gieger C, Gigante B, Grallert H, Grant GB, Grrop LC, Groves CJ, Grundberg E, Guiducci C, Hamsten A, Han BG, Hara K, Hassanali N, Hattersley AT, Hayward C, Hedman AK, Herder C, Hofman A, Holmen OL, Hovingh K, Hreidarsson AB, Hu C, Hu FB, Hui J, Humphries SE, Hunt SE, Hunter DJ, Hveem K, Hydrie ZI, Ikegami H, Illig T, Ingelsson E, Islam M, Isomaa B, Jackson AU, Jafar T, James A, Jia W, Jöckel KH, Jonsson A, Jowett JB, Kadowaki T, Kang HM, Kanoni S, Kao WH, Kathiresan S, Kato N, Katulanda P, Keinanen-Kiukaanniemi KM, Kelly AM, Khan H, Khaw KT, Khor CC, Kim HL, Kim S, Kim YJ, Kinnunen L, Klopp N, Kong A, Korpi-Hyövälti E, Kowlessur S, Kraft P, Kravic J, Kristensen MM, Krithika S, Kumar A, Kumate J, Kuusisto J, Kwak SH, Laakso M, Lagou V, Lakka TA, Langenberg C, Langford C, Lawrence R, Leander K, Lee JM, Lee NR, Li M, Li X, Li Y, Liang J, Liju S, Lim WY, Lind L, Lindgren CM, Lindholm E, Liu CT, Liu JJ, Lobbens S, Long J, Loos RJ, Lu W, Luan J, Lyssenko V, Ma RC, Maeda S, Mägi R, Männisto S, Matthews DR, Meigs JB, Melander O, Metspalu A, Meyer J, Mirza G, Mihailov E, Moebus S, Mohan V, Mohlke KL, Morris AD, Mühleisen TW, Müller-Nurasyid M, Musk B, Nakamura J, Nakashima E, Navarro P, Ng PK, Nica AC, Nilsson PM, Njølstad I, Nöthen MM, Ohnaka K, Ong TH, Owen KR, Palmer CN, Pankow JS, Park KS, Parkin M, Pechlivanis S, Pedersen NL, Peltonen L, Perry JR, Peters A, Pinidiyapathirage JM, Platou CG, Potter S, Price JF, Qi L, Radha V, Rallidis L, Rasheed A, Rathman W, Rauramaa R, Raychaudhuri S, Rayner NW, Rees SD, Rehnberg E, Ripatti S, Robertson N, Roden M, Rossin EJ, Rudan I, Rybin D, Saaristo TE, Salomaa V, Saltevo J, Samuel M, Sanghera DK, Saramies J, Scott J, Scott LJ, Scott RA, Segrè AV, Sehmi J, Sennblad B, Shah N, Shah S, Shera AS, Shu XO, Shuldiner AR, Sigurđsson G, Sijbrands E, Silveira A, Sim X, Sivapalaratnam S, Small KS, So WY, Stančáková A, Stefansson K, Steinbach G, Steinthorsdottir V, Stirrups K, Strawbridge RJ, Stringham HM, Sun Q, Suo C, Syvänen AC, Takayanagi R, Takeuchi F, Tay WT, Teslovich TM, Thorand B, Thorleifsson G, Thorsteinsdottir U, Tikkanen E, Trakalo J, Tremoli E, Trip MD, Tsai FJ, Tuomi T, Tuomilehto J, Uitterlinden AG, Valladares-Salgado A, Vedantam S, Veglia F, Voight BF, Wang C, Wareham NJ, Wennauer R, Wickremasinghe AR, Wilsgaard T, Wilson JF, Wiltshire S, Winckler W, Wong TY, Wood AR, Wu JY, Wu Y, Yamamoto K, Yamauchi T, Yang M, Yengo L, Yokota M, Young R, Zabaneh D, Zhang F, Zhang R, Zheng W, Zimmet PZ, Altshuler D, Bowden DW, Cho YS, Cox NJ, Cruz M, Hanis CL, Kooner J, Lee JY, Seielstad M, Teo YY, Boehnke M, Parra EJ, Chambers JC, Tai ES, McCarthy MI, Morris AP. Genome-wide trans-ancestry meta-analysis provides insight into the genetic architecture of type 2 diabetes susceptibility. Nat Genet. 2014 Mar;46(3):234-44. doi: 10.1038/ng.2897. Epub 2014 Feb 9.

Findings from the Diabetes Control and Complications Trial (DCCT) and the United Kingdom Prospective Diabetes Study (UKPDS) have clearly shown that aggressive and intensive control of elevated levels of blood sugar in patients with type 1 and type 2 diabetes decreases the complications of nephropathy, neuropathy, retinopathy, and may reduce the occurrence and severity of large blood vessel diseases. Aggressive control with intensive therapy means achieving fasting glucose levels between 70-120 mg/dl; glucose levels of less than 160 mg/dl after meals; and a near normal hemoglobin A1c levels (see below).
Several vision complications can result from type 2 diabetes, from glaucoma to cataracts to the most common, diabetic retinopathy. Over time, high blood sugar levels can damage the blood vessels in the eyes, Sullivan says. If left untreated, diabetic retinopathy can cause severe vision loss and even blindness. Nearly half of everyone diagnosed with diabetes has some degree of diabetic retinopathy, according to the National Eye Institute.
Type 2 diabetes used to be known as adult-onset diabetes, but today more children are being diagnosed with the disorder, probably due to the rise in childhood obesity. There's no cure for type 2 diabetes, but losing weight, eating well and exercising can help manage the disease. If diet and exercise aren't enough to manage your blood sugar well, you may also need diabetes medications or insulin therapy.
Diabetes Companion is one of two apps on the list by mySugr, an Austrian company that raised money earlier this year. The company adds a little bit of gamification to the traditional diabetes management app. "The Companion is a charming, sometimes outspoken diabetes manager that focuses on making your diabetes data useful in everyday life," the app store description says. "Adding elements of fun, gamification, and immediate feedback (with attitude!) through a diabetes monster to help keep you motivated and involved in your therapy." The app works with Sanofi-Aventis' iPhone-connected IGBStar meter and is a registered class I medical device. 

The progression of nephropathy in patients can be significantly slowed by controlling high blood pressure, and by aggressively treating high blood sugar levels. Angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs) used in treating high blood pressure may also benefit kidney disease in patients with diabetes.


As of 2017, an estimated 425 million people had diabetes worldwide,[8] with type 2 DM making up about 90% of the cases.[16][17] This represents 8.8% of the adult population,[8] with equal rates in both women and men.[18] Trend suggests that rates will continue to rise.[8] Diabetes at least doubles a person's risk of early death.[2] In 2017, diabetes resulted in approximately 3.2 to 5.0 million deaths.[8] The global economic cost of diabetes related health expenditure in 2017 was estimated at US$727 billion.[8] In the United States, diabetes cost nearly US$245 billion in 2012.[19]
When you eat, your body changes most of the food you digest into glucose (a form of sugar). A hormone called insulin allows this glucose to enter all the cells of your body. There it is used for energy. Insulin is produced by the pancreas. In someone who has type 2 diabetes, the pancreas doesn’t make enough insulin or the body’s cells can’t use insulin properly (called insulin resistance). This causes glucose to build up in your blood instead of moving into the cells. Too much glucose in the blood can lead to serious health problems that damage the blood vessels, nerves, heart, eyes, and kidneys.

Type 2 diabetes (T2D) is more common than type 1 diabetes with about 90 to 95 percent of people with diabetes having T2D. According to the Centers for Disease Control and Prevention’s report, 30.3 million Americans, or 9.4% of the US population have diabetes.1 More alarming, an estimated 84 million more American adults have prediabetes, which if not treated, will advance to diabetes within five years.1

Meanwhile the ADA, in their most recent update on the Standards of Medical Care in Diabetes, have lifted the restriction on sodium in the diet of those with diabetes. This brings the recommended daily levels of sodium for people with diabetes in line with the general population at 2,300 milligrams (mg) per day. They also acknowledge that there is not a single diet that fits all people with diabetes.
Type 2 diabetes, the most common type of diabetes, is a disease that occurs when your blood glucose, also called blood sugar, is too high. Blood glucose is your main source of energy and comes mainly from the food you eat. Insulin, a hormone made by the pancreas, helps glucose get into your cells to be used for energy. In type 2 diabetes, your body doesn’t make enough insulin or doesn’t use insulin well. Too much glucose then stays in your blood, and not enough reaches your cells.

The earliest predictor of the development of type 2 diabetes is low insulin sensitivity in skeletal muscle, but it is important to recognize that this is not a distinct abnormality but rather part of the wide range expressed in the population. Those people in whom diabetes will develop simply have insulin sensitivity, mainly in the lowest population quartile (29). In prediabetic individuals, raised plasma insulin levels compensate and allow normal plasma glucose control. However, because the process of de novo lipogenesis is stimulated by higher insulin levels (38), the scene is set for hepatic fat accumulation. Excess fat deposition in the liver is present before the onset of classical type 2 diabetes (43,74–76), and in established type 2 diabetes, liver fat is supranormal (20). When ultrasound rather than magnetic resonance imaging is used, only more-severe degrees of steatosis are detected, and the prevalence of fatty liver is underestimated, with estimates of 70% of people with type 2 diabetes as having a fatty liver (76). Nonetheless, the prognostic power of merely the presence of a fatty liver is impressive of predicting the onset of type 2 diabetes. A large study of individuals with normal glucose tolerance at baseline showed a very low 8-year incidence of type 2 diabetes if fatty liver had been excluded at baseline, whereas if present, the hazard ratio for diabetes was 5.5 (range 3.6–8.5) (74). In support of this finding, a temporal progression from weight gain to raised liver enzyme levels and onward to hypertriglyceridemia and then glucose intolerance has been demonstrated (77).
In type 1 diabetes, the pancreas loses its ability to make insulin because the body's immune system attacks and destroys the cells that produce insulin. No one knows exactly why this happens, but scientists think it has something to do with genes. But just getting the genes for diabetes isn't usually enough. A person probably would then have to be exposed to something else — like a virus — to get type 1 diabetes.
^ McBrien K, Rabi DM, Campbell N, Barnieh L, Clement F, Hemmelgarn BR, Tonelli M, Leiter LA, Klarenbach SW, Manns BJ (September 2012). "Intensive and Standard Blood Pressure Targets in Patients With Type 2 Diabetes Mellitus: Systematic Review and Meta-analysis". Archives of Internal Medicine. 172 (17): 1296–303. doi:10.1001/archinternmed.2012.3147. PMID 22868819.
Per the WHO, people with fasting glucose levels from 6.1 to 6.9 mmol/l (110 to 125 mg/dl) are considered to have impaired fasting glucose.[67] people with plasma glucose at or above 7.8 mmol/l (140 mg/dl), but not over 11.1 mmol/l (200 mg/dl), two hours after a 75 gram oral glucose load are considered to have impaired glucose tolerance. Of these two prediabetic states, the latter in particular is a major risk factor for progression to full-blown diabetes mellitus, as well as cardiovascular disease.[68] The American Diabetes Association (ADA) since 2003 uses a slightly different range for impaired fasting glucose of 5.6 to 6.9 mmol/l (100 to 125 mg/dl).[69]
Type 2 DM is characterized by insulin resistance, which may be combined with relatively reduced insulin secretion.[10] The defective responsiveness of body tissues to insulin is believed to involve the insulin receptor. However, the specific defects are not known. Diabetes mellitus cases due to a known defect are classified separately. Type 2 DM is the most common type of diabetes mellitus.[2]
Reversal of type 2 diabetes to normal metabolic control by either bariatric surgery or hypocaloric diet allows for the time sequence of underlying pathophysiologic mechanisms to be observed. In reverse order, the same mechanisms are likely to determine the events leading to the onset of hyperglycemia and permit insight into the etiology of type 2 diabetes. Within 7 days of instituting a substantial negative calorie balance by either dietary intervention or bariatric surgery, fasting plasma glucose levels can normalize. This rapid change relates to a substantial fall in liver fat content and return of normal hepatic insulin sensitivity. Over 8 weeks, first phase and maximal rates of insulin secretion steadily return to normal, and this change is in step with steadily decreasing pancreatic fat content. The difference in time course of these two processes is striking. Recent information on the intracellular effects of excess lipid intermediaries explains the likely biochemical basis, which simplifies both the basic understanding of the condition and the concepts used to determine appropriate management. Recent large, long-duration population studies on time course of plasma glucose and insulin secretion before the diagnosis of diabetes are consistent with this new understanding. Type 2 diabetes has long been regarded as inevitably progressive, requiring increasing numbers of oral hypoglycemic agents and eventually insulin, but it is now certain that the disease process can be halted with restoration of normal carbohydrate and fat metabolism. Type 2 diabetes can be understood as a potentially reversible metabolic state precipitated by the single cause of chronic excess intraorgan fat.
Anything that makes life with type 1 diabetes or type 2 diabetes easier is a win, and research shows that using a diabetes app can improve your health. For example, a review published online in March 2018 in the journal Diabetes, Obesity and Metabolism combined the results of 16 trials of type 2 diabetes apps and found that, on average, using a diabetes app led to a drop in hemoglobin A1C of 0.57 percent.

In addition to the problems with an increase in insulin resistance, the release of insulin by the pancreas may also be defective and suboptimal. In fact, there is a known steady decline in beta cell production of insulin in type 2 diabetes that contributes to worsening glucose control. (This is a major factor for many patients with type 2 diabetes who ultimately require insulin therapy.) Finally, the liver in these patients continues to produce glucose through a process called gluconeogenesis despite elevated glucose levels. The control of gluconeogenesis becomes compromised.

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