Endocrinology is the specialty of medicine that deals with hormone disturbances, and both endocrinologists and pediatric endocrinologists manage patients with diabetes. People with diabetes may also be treated by family medicine or internal medicine specialists. When complications arise, people with diabetes may be treated by other specialists, including neurologists, gastroenterologists, ophthalmologists, surgeons, cardiologists, or others.
^ Brunner EJ, Hemingway H, Walker BR, Page M, Clarke P, Juneja M, Shipley MJ, Kumari M, Andrew R, Seckl JR, Papadopoulos A, Checkley S, Rumley A, Lowe GD, Stansfeld SA, Marmot MG (November 2002). "Adrenocortical, autonomic, and inflammatory causes of the metabolic syndrome: nested case-control study". Circulation. 106 (21): 2659–65. doi:10.1161/01.cir.0000038364.26310.bd. PMID 12438290.
Have you ever eaten a salad with low fat dressing, hold the nuts with a swap for lean protein? Did you leave feeling hungry, unsatisfied and searching for something else to fill you up? When this happens and you end up snacking throughout the day you never have the opportunity to burn fat as fuel because your metabolic hormones are increased and you never enter the fasting stage. No Bueno! https://i.ytimg.com/vi/OM263kSxLm4/hqdefault.jpg?sqp
If you're short on time but still want to fit in an effective training session—especially if your goal is fat burn—metabolic resistance training (MRT) is tough to beat. With this training style, the goal is to maximize caloric expenditure while also increasing your metabolic rate. There are many different ways to structure an MRT session, but generally speaking, circuit training lends itself well to this approach.
"Brittle" diabetes, also known as unstable diabetes or labile diabetes, is a term that was traditionally used to describe the dramatic and recurrent swings in glucose levels, often occurring for no apparent reason in insulin-dependent diabetes. This term, however, has no biologic basis and should not be used.[39] Still, type 1 diabetes can be accompanied by irregular and unpredictable high blood sugar levels, frequently with ketosis, and sometimes with serious low blood sugar levels. Other complications include an impaired counterregulatory response to low blood sugar, infection, gastroparesis (which leads to erratic absorption of dietary carbohydrates), and endocrinopathies (e.g., Addison's disease).[39] These phenomena are believed to occur no more frequently than in 1% to 2% of persons with type 1 diabetes.[40]
Dr Jacomien de Villiers qualified as a specialist physician at the University of Pretoria in 1995. She worked at various clinics at the Department of Internal Medicine, Steve Biko Hospital, these include General Internal Medicine, Hypertension, Diabetes and Cardiology. She has run a private practice since 2001, as well as a consultant post at the Endocrine Clinic of Steve Biko Hospital.
Metabolic syndrome is a serious health condition that affects about 23 percent of adults and places them at higher risk of cardiovascular disease, diabetes, stroke and diseases related to fatty buildups in artery walls. The underlying causes of metabolic syndrome include overweight and obesity, physical inactivity, genetic factors and getting older.
MRT, a.k.a. "metabolic resistance training," might as well be called "madman training." It's no-holds-barred, haul-ass, maximum-effort, build-muscle, heave-weight, torch-fat, absolutely insane huff-n-puff training. It'll spike your metabolism, crush calories like beer cans, lift your lactate threshold, boost your ability to make muscle, and maximize your body's capacity for change.
Gary Edward Sander, MD, PhD, FACC, FAHA, FACP, FASH Professor of Medicine, Director of CME Programs, Team Leader, Root Cause Analysis, Tulane University Heart and Vascular Institute; Director of In-Patient Cardiology, Tulane Service, University Hospital; Visiting Physician, Medical Center of Louisiana at New Orleans; Faculty, Pennington Biomedical Research Institute, Louisiana State University; Professor, Tulane University School of Medicine
In a meta-analysis of pooled data from 19 prospective cohort studies involving 762,393 patients, Huang et al reported that, after adjustment for multiple cardiovascular risk factors, prehypertension was associated with a 66% increased risk for stroke, compared with an optimal blood pressure (< 120/80 mm Hg). [41, 42] Patients in the high range of prehypertension (130-139/85-89 mm Hg) had a 95% increased risk of stroke, compared with a 44% increased risk for those in the low range of prehypertension (120-129/80-84 mm Hg). [41, 42]
By the end of the book, you'll be able to create your own safe, effective, and efficient training program best suited to you. Or just choose from one of our 10 general or specialized HIT routines contained in the book. You'll develop the knowledge to change and make it a sustainable effort over time to keep you consistent. You'll be able to adapt to the ever changing dynamic situation that is a progressive training program.

Another method is to have the individual wear a device that monitors and records the blood pressure at regular intervals during the day to evaluate blood pressure over time. This is especially helpful during the diagnostic process and can help rule out "white coat" hypertension, the high measurements that are sometimes present only when the person is in the doctor's office and not at other times. (See High Blood Pressure: Using an Ambulatory Blood Pressure Monitor on FamilyDoctor.org.)

^ Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC, Spertus JA, Costa F (October 2005). "Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement". Circulation. 112 (17): 2735–52. doi:10.1161/CIRCULATIONAHA.105.169404. PMID 16157765.

MRT should be a total-body routine that works all the major muscles each session. Since the metabolic cost of an exercise relates directly to the amount of muscle worked, incorporate multi-joint exercises whenever possible.[3] Involve more muscle, and you expend more energy. Opt for compound movements: squats, rows and presses will work the muscles of the torso and thighs. Reserve single-joint movements for the arms and calves. Train three, non-consecutive days per week (i.e. Monday, Wednesday, Friday) to allow for adequate recuperation.


Metabolic syndrome is a serious health condition that affects about 23 percent of adults and places them at higher risk of cardiovascular disease, diabetes, stroke and diseases related to fatty buildups in artery walls. The underlying causes of metabolic syndrome include overweight and obesity, physical inactivity, genetic factors and getting older.
When you have type 2 diabetes, your cells don't get enough glucose, which may cause you to lose weight. Also, if you are urinating more frequently because of uncontrolled diabetes, you may lose more calories and water, resulting in weight loss, says Daniel Einhorn, MD, medical director of the Scripps Whittier Diabetes Institute and clinical professor of medicine at the University of California in San Diego. http://www.sandysidhumedia.com/wp-content/uploads/2012/12/angelaquote1.jpg
Pre-eclampsia is a serious condition of the second half of pregnancy and following delivery characterised by increased blood pressure and the presence of protein in the urine.[23] It occurs in about 5% of pregnancies and is responsible for approximately 16% of all maternal deaths globally.[23] Pre-eclampsia also doubles the risk of death of the baby around the time of birth.[23] Usually there are no symptoms in pre-eclampsia and it is detected by routine screening. When symptoms of pre-eclampsia occur the most common are headache, visual disturbance (often "flashing lights"), vomiting, pain over the stomach, and swelling. Pre-eclampsia can occasionally progress to a life-threatening condition called eclampsia, which is a hypertensive emergency and has several serious complications including vision loss, brain swelling, seizures, kidney failure, pulmonary edema, and disseminated intravascular coagulation (a blood clotting disorder).[23][31]
Family or personal history. Your risk increases if you have prediabetes — a precursor to type 2 diabetes — or if a close family member, such as a parent or sibling, has type 2 diabetes. You're also at greater risk if you had gestational diabetes during a previous pregnancy, if you delivered a very large baby or if you had an unexplained stillbirth.
High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure.[5] About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors.[5][6] Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use.[1][5] The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, narrowing of the kidney arteries, an endocrine disorder, or the use of birth control pills.[5]
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Creatinine is produced from creatine, a molecule of major importance for energy production in muscles. Creatinine has been found to be a fairly reliable indicator of kidney function. As the kidneys become impaired the creatinine level in the blood will rise. Normal levels of creatinine in the blood vary from gender and age of the individual. http://www.sandysidhumedia.com/wp-content/uploads/2012/12/cindygallopquote-426x300.jpg
Insulin is vital to patients with type 1 diabetes - they cannot live without a source of exogenous insulin. Without insulin, patients with type 1 diabetes develop severely elevated blood sugar levels. This leads to increased urine glucose, which in turn leads to excessive loss of fluid and electrolytes in the urine. Lack of insulin also causes the inability to store fat and protein along with breakdown of existing fat and protein stores. This dysregulation, results in the process of ketosis and the release of ketones into the blood. Ketones turn the blood acidic, a condition called diabetic ketoacidosis (DKA). Symptoms of diabetic ketoacidosis include nausea, vomiting, and abdominal pain. Without prompt medical treatment, patients with diabetic ketoacidosis can rapidly go into shock, coma, and even death may result.
In type 2 diabetes (adult onset diabetes), the pancreas makes insulin, but it either doesn't produce enough, or the insulin does not work properly. Nine out of 10 people with diabetes have type 2. This type occurs most often in people who are over 40 years old but can occur even in childhood if there are risk factors present. Type 2 diabetes may sometimes be controlled with a combination of diet, weight management and exercise. However, treatment also may include oral glucose-lowering medications (taken by mouth) or insulin injections (shots). https://i.ytimg.com/vi/LcWFI9Xawl8/maxresdefault.jpg
^ Qaseem A, Wilt TJ, Rich R, Humphrey LL, Frost J, Forciea MA (17 January 2017). "Pharmacologic Treatment of Hypertension in Adults Aged 60 Years or Older to Higher Versus Lower Blood Pressure Targets: A Clinical Practice Guideline From the American College of Physicians and the American Academy of Family Physicians". Annals of Internal Medicine. 166 (6): 430–437. doi:10.7326/M16-1785. PMID 28135725.
Metabolic syndrome is a cluster of metabolic risk factors that come together in a single individual. These metabolic factors include insulin resistance, hypertension (high blood pressure), cholesterol abnormalities, and an increased risk for blood clotting. Affected individuals are most often overweight or obese. An association between certain metabolic disorders and cardiovascular disease has been known since the 1940s.

Out of this whole article this quote from a participant was the thing that drove my emotions. For anyone who struggles with weight loss resistance this will stab you in the heart. It is so incredibly true. There is nothing quite like feeling like your body is failing you and that even starving yourself, restricting every delicious food and exercising to the max is not enough.


When the glucose concentration in the blood remains high over time, the kidneys will reach a threshold of reabsorption, and glucose will be excreted in the urine (glycosuria).[62] This increases the osmotic pressure of the urine and inhibits reabsorption of water by the kidney, resulting in increased urine production (polyuria) and increased fluid loss. Lost blood volume will be replaced osmotically from water held in body cells and other body compartments, causing dehydration and increased thirst (polydipsia).[60]
In addition, metabolic syndrome has been implicated in the pathophysiology of several other diseases, including obstructive sleep apnea. Breast cancer has also been linked to metabolic syndrome, possibly through dysregulation of the plasminogen activator inhibitor-1 (PAI-1) cycle. [64] Additional studies have linked metabolic syndrome with cancers of the colon, gallbladder, kidney, and, possibly, prostate gland. [65] Evidence is emerging of an association with psoriasis. [66, 67]
When it comes to laboratory values, numbers like blood glucose and A1C levels are commonly checked. Less often, doctors order a test for your fasting insulin level; yet this test can help predict your risk of developing prediabetes and metabolic syndrome. Insulin plays a key role in metabolism, and high insulin levels can promote obesity, stimulate hunger, and increase the storage of fat.
^ Jump up to: a b Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, Clegg AJ (September 2009). "The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation". Health Technology Assessment. 13 (41): 1–190, 215–357, iii–iv. doi:10.3310/hta13410. PMID 19726018.
As a clinician who works with weight loss and obesity, I can tell you with certainty that people can and do become weight loss resistant and can develop some degree of “metabolic damage”. Metabolic damage is a non-diagnostic term many in the weight loss industry use to describe a set of functional disturbances. These disturbances include severe metabolic compensations that result in a depressed metabolic rate, chronic fatigue, immune suppression, and multiple hormonal effects (i.e. suppressed thyroid function, adrenal stress maladaptation, and loss of libido and/or menses).
The earliest surviving work with a detailed reference to diabetes is that of Aretaeus of Cappadocia (2nd or early 3rd century CE). He described the symptoms and the course of the disease, which he attributed to the moisture and coldness, reflecting the beliefs of the "Pneumatic School". He hypothesized a correlation of diabetes with other diseases, and he discussed differential diagnosis from the snakebite which also provokes excessive thirst. His work remained unknown in the West until 1552, when the first Latin edition was published in Venice.[110]
Research has shown this is NOT an imaginary issue. As far back as 1975, researchers published a study in the journal Lancet that looked at the issue of weight loss resistance. 29 women who claimed they could not lose weight were studied. The researchers, like many of us, assumed these women simply were not compliant and wanted to test their metabolism by sequestering them in a house and controlling all food and exercise they did. Each woman was put on a strict 1500 calorie a day diet.
14 November 2018. On World Diabetes Day 2018, WHO joins partners around the world to highlight the impact diabetes has on families and the role of family members in supporting prevention, early diagnosis and good management of diabetes. More than 400 million people live with diabetes worldwide, and the prevalence is predicted to continue rising if current trends prevail. Diabetes is a major cause of premature dying, blindness, kidney failure, heart attack, stroke and lower limb amputation. It was the seventh leading cause of death in 2016.
No magic here—MRT is just a term covering various combinations of intense, efficient cardiovascular and muscular training. MRT can involve supersets, circuits, speed, low rest and compound movements; it almost always packs a double-punch of aerobic and anaerobic work, breaking down barriers between traditional weight training and cardio. If you're sick of long rest periods and the sleepy treadmill slump, MRT might be for you.
Studies in type 1 patients have shown that in intensively treated patients, diabetic eye disease decreased by 76%, kidney disease decreased by 54%, and nerve disease decreased by 60%. More recently the EDIC trial has shown that type 1 diabetes is also associated with increased heart disease, similar to type 2 diabetes. However, the price for aggressive blood sugar control is a two to three fold increase in the incidence of abnormally low blood sugar levels (caused by the diabetes medications). For this reason, tight control of diabetes to achieve glucose levels between 70 to120 mg/dl is not recommended for children under 13 years of age, patients with severe recurrent hypoglycemia, patients unaware of their hypoglycemia, and patients with far advanced diabetes complications. To achieve optimal glucose control without an undue risk of abnormally lowering blood sugar levels, patients with type 1 diabetes must monitor their blood glucose at least four times a day and administer insulin at least three times per day. In patients with type 2 diabetes, aggressive blood sugar control has similar beneficial effects on the eyes, kidneys, nerves and blood vessels.
Historically the treatment for what was called the "hard pulse disease" consisted in reducing the quantity of blood by bloodletting or the application of leeches.[152] This was advocated by The Yellow Emperor of China, Cornelius Celsus, Galen, and Hippocrates.[152] The therapeutic approach for the treatment of hard pulse disease included changes in lifestyle (staying away from anger and sexual intercourse) and dietary program for patients (avoiding the consumption of wine, meat, and pastries, reducing the volume of food in a meal, maintaining a low-energy diet and the dietary usage of spinach and vinegar).
The second hormone that becomes involved when you begin to lose weight is a hormone known as leptin. Leptin is a hormone that is released from the fat cells to signal to the brain about how much fat we have in storage. To our body this is kind of like the indicator on a car telling us how much fuel we have in the tank. Leptin is also a messenger that is involved with controlling your metabolic rate AND your appetite.
Arachidonic acid (with its precursor – linoleic acid) serve as a substrate to the production of inflammatory mediators known as eicosanoids, whereas the arachidonic acid-containing compound diacylglycerol (DAG) is a precursor to the endocannabinoid 2-arachidonoylglycerol (2-AG) while fatty acid amide hydrolase (FAAH) mediates the metabolism of anandamide into arachidonic acid.[37][35] Anandamide can also be produced from N-acylphosphatidylethanolamine via several pathways.[35] Anandamide and 2-AG can also be hydrolized into arachidonic acid, potentially leading to increased eicosanoid synthesis.[35] Metabolic syndrome is a risk factor for neurological disorders.[38] Metabolomic studies suggest an excess of organic acids, impaired lipid oxidation byproducts, essential fatty acids and essential amino acids in the blood serum of affected patients.
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Central obesity is a key feature of the syndrome, being both a sign and a cause, in that the increasing adiposity often reflected in high waist circumference may both result from and contribute to insulin resistance. However, despite the importance of obesity, patients who are of normal weight may also be insulin-resistant and have the syndrome.[27]
This could be considered the "corollary" to #2.  Doing a set of 100 barbell snatches is absurd, as technique breaks down, and the amount of weight an athlete can use is almost too trivial to even call it metabolic RESISTANCE training.  Plus, it would likely take about 2-3 minutes to complete, which means that you're getting much more aerobic, even if an athlete is "working hard."  My feeling is that you use your work bouts to challenge anaerobic systems, and your recovery period to condition the aerobic energy system.  Let's be honest: most strength training enthusiasts care more about the aerobic system for recovery than actual aerobic exercise performance, anyway.
Diabetic ketoacidosis can be caused by infections, stress, or trauma, all of which may increase insulin requirements. In addition, missing doses of insulin is also an obvious risk factor for developing diabetic ketoacidosis. Urgent treatment of diabetic ketoacidosis involves the intravenous administration of fluid, electrolytes, and insulin, usually in a hospital intensive care unit. Dehydration can be very severe, and it is not unusual to need to replace 6-7 liters of fluid when a person presents in diabetic ketoacidosis. Antibiotics are given for infections. With treatment, abnormal blood sugar levels, ketone production, acidosis, and dehydration can be reversed rapidly, and patients can recover remarkably well.
Target organ damage occurs through multiple mechanisms in metabolic syndrome. The individual diseases leading to metabolic syndrome produce adverse clinical consequences. For example, hypertension in metabolic syndrome causes left ventricular hypertrophy, progressive peripheral arterial disease, and renal dysfunction. [12] However, the cumulative risk for metabolic syndrome appears to cause microvascular dysfunction, which further amplifies insulin resistance and promotes hypertension. [13]
Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.
Over time, a prolonged exposure to high blood sugar can damage the nerves throughout the body — a condition called diabetic neuropathy. Some people may not have any symptoms of the damage, while others may notice numbness, tingling, or pain in the extremities. “At the beginning, [diabetic neuropathy] usually starts in the feet and then it progresses upward,” says Dr. Ovalle. Although most common in people who have had type 2 diabetes for 25 years or more, it can occur in people who have prediabetes as well. In some studies, almost 50 percent of unexplained peripheral neuropathy [in the extremities], whether painful or otherwise, turns out to be caused by prediabetes or diabetes, says Dr. Einhorn.
Researchers assigned overweight subjects to three groups: diet-only, diet plus aerobics, diet plus aerobics plus weights. The diet group lost 14.6 pounds of fat in 12 weeks. The aerobic group lost only one more pound than the diet group. Their training was three times a week starting at 30 minutes and progressing to 50 minutes over the 12 weeks. Nothing special. But the weight training group lost over 21 pounds of fat. That's 44% and 35% more than diet and cardio-only groups respectively. The addition of aerobic training didn't result in significant fat loss over dieting alone. Thirty-six sessions of up to 50 minutes is a lot of work for one additional pound of fat loss. But the addition of resistance training greatly accelerated fat loss results.

Sat Sharma, MD, FRCPC is a member of the following medical societies: American Academy of Sleep Medicine, American College of Chest Physicians, American College of Physicians-American Society of Internal Medicine, American Thoracic Society, Canadian Medical Association, Royal College of Physicians and Surgeons of Canada, Royal Society of Medicine, Society of Critical Care Medicine, and World Medical Association
Diabetes: The differences between types 1 and 2 There are fundamental differences between diabetes type 1 and type 2, including when they might occur, their causes, and how they affect someone's life. Find out here what distinguishes the different forms of the disease, the various symptoms, treatment methods, and how blood tests are interpreted. Read now
Whelton, P. K., Carey, R. M., Aronow, W. S., Casey, D. E., Collins, K. J., Dennison Himmelfarb, C., ...Wright, J. T. (2017, November 13). ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults. A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Hypertension. Retrieved from http://hyper.ahajournals.org/content/early/2017/11/10/HYP.0000000000000065

The blood vessels and blood are the highways that transport sugar from where it is either taken in (the stomach) or manufactured (in the liver) to the cells where it is used (muscles) or where it is stored (fat). Sugar cannot go into the cells by itself. The pancreas releases insulin into the blood, which serves as the helper, or the "key," that lets sugar into the cells for use as energy. http://www.sandysidhumedia.com/wp-content/uploads/2012/12/quotecaroline.jpg
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