The number of diabetics in the U.S. has steadily increased over the past decade. This is mainly due to the increase in the number of obese and overweight individuals. Several hundred individuals die from this disease or from complications that arise from it yearly. Unfortunately, diabetes has no known cure.

The only defense from this disease is prevention. One way of preventing diabetes is by shedding excess weight. Sadly, most weight loss supplements available today are not meant for individuals who are susceptible to diabetes.

A lot of popular weight loss pills contain high amounts of additives such as fructose, which is liable to raise blood sugar levels. High blood sugar levels are an indication of susceptibility to diabetes. This is one reason why there is an increasing demand for all-natural sugar-free supplements.

A few popular weight loss supplements nowadays contain 100% Acai extract from the Acai berry. Acai is naturally sugar-free. The sweet taste comes naturally from the fruit’s pulp. This way you can get all the health and weight loss benefits of a great supplement, without adding to the risk of diabetes.

Many people are concerned about the effects of food supplements to their health. Acai berry products make for great alternatives since they contain none of the risks most people are avoiding. Acai berry also has an added advantage over other supplements since it contains natural antioxidants that enhance immunity against ailments such as cancer and heart disease.

So if you’re diabetic and need to lose weight, Acai supplements may be worth a try.

To properly control type 2 diabetes you must attack from many different angles. It all begins with proper education, ideally from an org/” rel=”nofollow”>American Diabetes Association (ADA) recognized education center with at least two certified diabetes educators, a nurse and a dietitian. Lifestyle modifications is essential - meaning proper diet, with weight loss and exercise. Studies have shown that a mere 10 pound weight loss can be beneficial to blood pressure, cholesterol, and glucose. I recommend a 10% weight loss over the next year for my overweight and obese patients. Then the key is weight loss maintenance which is best accomplished through exercise. The ADA, American Heart Association, and the Surgeon General all provide exercise guidelines and my analysis of all three is that 150 minutes per week of moderate aerobic activity is best. However, the more the merrier! The national weight control registry showed that people best maintained their weight loss when exercising on average about one hour per day while maintaining a low fat, low calorie diet. Your dietitian can help you to set reasonable, reachable, short-term weight loss goals and guide behavior modification, such as eating breakfast everyday.

After proper education and therapeutic lifestyle changes comes medications. I certainly do not want to provide individual treatment recommendations. These you need to discuss with your provider but this is my general treatment algorithm.

1. Metformin (Glucophage(R)) first-line in nearly all people with diabetes (not to be used with people with kidney failure or heart failure) I prefer the extended-release version for less gastrointestinal side effects.

2. Second-line agent depend upon other factors. For example, with obesity I prefer Exenatide (Byetta(R)) while in patient with less of a weight issue I prefer Pioglitizone (Actos(R)) (not for use in uncontrolled heart failure), and if the patient needs less of a glucose reduction I may use Sitagliptin (Januvia(R)).

3. Third-line I will add Exenatide to Metformin and Pioglitizone or add Pioglitizone to Exenatide and Metformin. I prefer this triple drug combination for a number of reasons.

• Low risk of hypoglycemia
• The possibility of preservation of the beta-cell’s function (insulin-producing cells in the pancreas)
• Good glucose control

4. Insulin is a great product when used in experienced hands by a well educated patient. There are numerous insulins on the market (and that may be another factoid in the future) but suffice it to say that long-acting basal (baseline) insulin is typically the first insulin started and is used to control morning glucoses. Insulin therapy is most often initiated when oral medications and/or Exenatide are no longer able to control glucoses but some providers opt for using insulin earlier in the treatment of diabetes. The ADA’s new treatment algorithm (published in Diabetes Care in December 2008) lists insulin as a possible second-line agent after Metformin. I prefer not to start insulin at this stage unless necessary due to the risk of hypoglycemia not often seen with the other medications listed above.

5. I try to avoid the use of the older sulfonylureas such as Glyburide, Glipizide, and Glimepiride due to their risk of hypoglycemia. That being said, yes I do use them due to their cost effectiveness ($4.00/month at many pharmacies).

The other incredibly important aspect of diabetes treatment is the management and control of blood pressure and cholesterol as these are major risk factors for heart disease. The leading cause of death in people with diabetes.

I often say that the more I treat people with diabetes the more I realized that medicine is truly an art more than a science. Every patient is different and what works well for one will certainly not always work well for another. Individualized treatment goals and individualized treatment are essential to good care. As is the need to be treated by a team of providers to be sure you are receiving all the care and education you need and deserve.

There has been a rising, disturbing trend happening in the world. Conditions characterizing insulin resistance traditionally seen in older adults, are now being seen in our adolescents and young adults. Unless these life threatening health problems are reversed, this predisposes our young people to a range of medical problems that will continue throughout their lives.

We are starting to see a type 2 diabetes epidemic in children and adolescents now because the onset is gradual; the condition takes between eight to ten years to develop. It is following on the the epidemic of obesity which has spread to children in the last ten to twenty years.

There are often no early signs or, are so mild they are missed. What we need to recognize is overweight or obese children are at risk of developing type 2. Type 1 diabetes is still the dominant form of diabetes in children but researchers are indicating than in the next 10 years type 2 will take the lead.

Obese children, particularly older children, are more likely to become obese adults. And it is almost inevitable there will be an epidemic of type 2 diabetes if action is not taken now.

Children most at risk:

• are overweight or obese
• have a strong family history of diabetes
• have an ethnic background
• have signs of insulin resistance such as acanthosis nigricans (a velvety darkening of the skin usually found under the arms, between the fingers and toes, and on the back of the neck), polycystic ovarian syndrome, high blood pressure and blood fat disorders
• over ten years of age (due to hormonal changes which are associated with insulin resistance)

We can’t do anything about genetics or an ethnic background; obesity is a different issue. 85% of children diagnosed with type 2 diabetes are either overweight or obese at the time of diagnosis.

A family affair:

The treatment for diabetes in children is usually a family affair. Parents are responsible for choosing what is available to eat, when to eat, and where. The lifestyle changes are probably going to be major and the whole family is going to have to make them: it will include a healthy diet and increased physical activity. And everyone will benefit, be healthier and live longer!

The aim is to:

• normalize blood sugar levels and the HbA1c level
• reduce blood pressure and blood fats
• decrease the risk of complications associated with diabetes

Family members will also need to be educated:

• on type 2 diabetes
• learn how to give insulin (if prescribed)
• check blood sugar levels
• a health eating plan
• on different types of physical activity

This is where the help of your health care provider and diabetes care team will be invaluable.