Diabetes type 2 triggered by pollution, shock new research discovers

From express.co.uk

AIR pollution is a "significant" contributor to type 2 diabetes around the world - triggering more than three million new cases a year, according to new research. Even low pollution levels can pose a health risk, suggests the study.

The research links outdoor air pollution - even at levels deemed safe - to an increased risk of diabetes globally.
The findings raise the possibility that reducing pollution may lead to a drop in diabetes cases in heavily polluted countries such as India and even less polluted ones.
Diabetes is one of the fastest growing diseases, affecting more than 420 million people worldwide.
The main drivers of diabetes include eating an unhealthy diet, a couch potato lifestyle, and obesity.
But the new research, published in The Lancet Planetary Health indicates the extent to which outdoor air pollution plays a role.
Study senior author Dr Ziyad Al-Aly, an Assistant Professor of medicine at Washington University School of Medicine in the United States, said: "Our research shows a significant link between air pollution and diabetes globally.
"We found an increased risk, even at low levels of air pollution currently considered safe by the U.S. Environmental Protection Agency (EPA) and the World Health Organisation (WHO).
"This is important because many industry lobbying groups argue that current levels are too stringent and should be relaxed.
"Evidence shows that current levels are still not sufficiently safe and need to be tightened."
While growing evidence has suggested a link between air pollution and diabetes, researchers have not attempted to quantify that burden until now.
Dr Al-Aly said: "Over the past two decades, there have been bits of research about diabetes and pollution.
"We wanted to thread together the pieces for a broader, more solid understanding."
To evaluate outdoor air pollution, the researchers looked at particulate matter, airborne microscopic pieces of dust, dirt, smoke, soot and liquid droplets.
Previous studies have found that such particles can enter the lungs and invade the bloodstream, contributing to major health conditions such as heart disease, stroke, cancer and kidney disease.
In diabetes, pollution is thought to reduce insulin production and trigger inflammation, preventing the body from converting blood glucose into energy that the body needs to maintain health.

    The overall risk of pollution-related diabetes is tilted more toward lower-income countries

Overall, the researchers estimated that pollution contributed to 3.2 million new diabetes cases globally in 2016, which represents about 14 per cent of all new diabetes cases globally that year.
They also estimated that 8.2 million years of healthy life were lost in 2016 due to pollution-linked diabetes, representing about 14 per cent of all years of healthy life lost due to diabetes from any cause.
The Washington University team, in collaboration with scientists at the Veterans Affairs' Clinical Epidemiology Centre, examined the relationship between particulate matter and the risk of diabetes by first analysing data from 1.7 million U.S. veterans who did not have histories of diabetes.
The researchers linked that patient data with the EPA's land-based air monitoring systems as well as space-borne satellites operated by the National Aeronautics and Space Administration (NASA).
They used several statistical models and tested the validity against controls such as ambient air sodium concentrations, which have no link to diabetes, and lower limb fractures, which have no link to outdoor air pollution, as well as the risk of developing diabetes, which exhibited a strong link to air pollution.
They then sifted through all research related to diabetes and outdoor air pollution and devised a model to evaluate diabetes risk across various pollution levels.
Finally, they analysed data from the Global Burden of Disease study, which is conducted annually with contributions from researchers worldwide.
The data helped to estimate annual cases of diabetes and healthy years of life lost due to pollution.
The researchers also found that the overall risk of pollution-related diabetes is tilted more toward lower-income countries such as India that lack the resources for environmental mitigation systems and clean-air policies.
For instance, poverty-stricken countries facing a higher diabetes-pollution risk include Afghanistan, Papua New Guinea and Guyana, while richer countries such as France, Finland and Iceland experience a lower risk.
In the United States, the EPA's pollution threshold is 12 micrograms per cubic metre of air, the highest level of air pollution considered safe for the public, as set by the Clean Air Act of 1990 and updated in 2012.
However, using mathematical models, Dr Al-Aly's team established an increased diabetes risk at 2.4 micrograms per cubic metre of air.
Based on VA data, among a sample of veterans exposed to pollution at a level of between 5 to 10 micrograms per cubic metre of air, about 21 per cent developed diabetes.
When that exposure increases to 11.9 to 13.6 micrograms per cubic metre of air, about 24 per cent of the group developed diabetes.
A three per cent difference may appear small, but the researchers said that it represents an increase of 5,000 to 6,000 new diabetes cases per 100,000 people in a given year.
Last October, The Lancet Commission on pollution and health published a report outlining knowledge gaps on pollution's harmful health effects.
One of its recommendations was to define and quantify the relationship between pollution and diabetes.

https://www.express.co.uk/life-style/health/981552/diabetes-type-2-pollution-health-risk-new-research

How belly fat increases your risk of diabetes

From health24.com

We know that excess weight increases your risk for many diseases. But it’s a specific kind of fat that makes you more susceptible to diabetes.

It’s a fact that being overweight or obese increases your risk of chronic diseases, including type 2 diabetes.
Unfortunately this doesn’t necessarily mean that slimmer people are safe. If you have slim legs but carry extra weight around your waist, you could be at higher risk for type 2 diabetes, according to a recent study from the University of Oxford.

It's in the genes
The study found a certain gene that causes some people to have an excess of visceral fat was to blame. Visceral fat is fat surrounding the internal organs, which manifests as a flabby belly.

The gene in question is called KLF14, which was shown to modify the way how fat is stored in the human body – meaning that fat is distributed around the belly rather than the hips, especially in men.

Not all fat is equal
Diabetes.co.uk states that not all fat is equal – where the fat is distributed makes a difference in one's risk for diabetes.
According to Harvard Medical School there are several reasons why abdominal fat is more dangerous than any other fat in the body. It is specifically the fat inside the abdomen, located around the internal organs, that is truly bad for your health.
One of the earlier explanations was that this type of fat was linked to the overreaction of the body’s stress response mechanisms, which would lead to a higher blood pressure, higher blood sugar levels and risk of heart diseases.

How is belly fat linked to diabetes?
However, Harvard Medical School's most recent theory is that the fat closest to the organs releases metabolic products directly into the part of the body that carries blood straight to the liver. This means that these fat cells pour fatty acids into the liver, pancreas, heart and other organs – cells that are not engineered to store fat. This leads to organ dysfunction, causing improper control of insulin, blood sugar and cholesterol, which, in turn, can increase your risk of chronic disease.
Visceral fat increases the risk for type 2 diabetes in the following way: The more insulin is produced, the more glucose is taken up by the liver to store for future use. But if the liver is covered in fatty tissue, it can't respond to the insulin quickly enough.
As a result, your blood sugar accumulates in the blood stream instead of being processed by the liver. This causes damage to organs all over your body.

Measure your waist to determine your risk
According to the World Health Organization, studies indicate that the measurement of waist circumference is a better indication of diabetes risk than body mass index – however, it can't be used as the only tool.
Discovery Health recognises the importance of waist circumference as an indication of risk, as they state that accumulated fat can indicate specific health risks. They recommend assessing your risk of diabetes and other diseases by measuring your waist circumference as follows:

• Place the tape measure around your stomach at the level of the belly button. Note that the tape should be snug, but not compressing the skin.
• A man with a waist measurement greater than 102cm and a woman with a waist measurement greater than 88cm are considered more at risk for type 2 diabetes and other diseases.

Slim down your belly
Luckily, even the slightest efforts to lose weight and cut down the circumference of your belly can lower your risk for type 2 diabetes:

• Eat plenty of fibre and fruit and vegetables.
• Avoid or cut down on processed foods high in sodium, fat and sugar. 
• Include lean protein in your diet. 
• Avoid alcohol.
• Spot reduction (targeting belly fat with specific exercises for the abdomen) won't get rid of belly fat, so it's important to incorporate cardiovascular exercise (walking, running, cycling or swimming) into your routine, as this has been shown to get rid of belly fat. 
• Lift weights – resistance training does wonders for the metabolism and can help you get rid of belly fat when done together with cardiovascular exercise. 

https://www.health24.com/Medical/Diabetes/Diabetes-diet-and-obesity/how-belly-fat-increases-your-risk-of-diabetes-20180628

Work stress may be deadly for men with heart disease and diabetes

From reuters.com

(Reuters Health) - Men with heart disease, diabetes or a history of stroke are more likely to die prematurely when they have a stressful job even when they’re relatively healthy, a large European study suggests.
Doctors have long advised patients with heart disease and diabetes to try to reduce major sources of stress in their lives as one way to help minimize their risk of heart attacks and strokes. But studies to date haven’t offered decisive proof that this approach helps people live longer, researchers note in the Lancet Diabetes & Endocrinology.

For the current study, they examined data on 102,633 men and women living in Finland, France, Sweden and the UK who participated in one of seven studies examining the relationship between work stress and mortality.
“We found that work stress is particularly harmful for those with problems in the cardiovascular and metabolic systems, such as those with diabetes, heart disease or a history of stroke,” said lead study author Mika Kivimaki, a researcher at the University College London and the University of Helsinki.
“We found that this excess risk remained even if the person was free of conventional risk factors, such as smoking, high blood pressure or high cholesterol concentration,” Kivimaki said by email.
Researchers examined two aspects of work stress: having high demands or responsibility but little control or authority, and having a large difference between effort and reward.

At the start of the study, 3,441 participants had health problems such as heart disease, diabetes or a history of stroke. After an average follow-up period of almost 14 years, 3,481 people had died.
Men with health problems like heart disease and diabetes were 68 percent more likely to die when they had work stress than when they did not, the study found.
Even when men diagnosed with these health problems followed a healthy lifestyle, they were twice as likely to die if they had stressful jobs. For those who had achieved normal blood pressure and cholesterol levels, work stress was nonetheless associated with more than a six-fold increase in their risk of a premature death.

None of the women in the study appeared to have an increased risk of premature death when they suffered from work stress. For men without heart disease but with an “effort-reward imbalance” at work, the mortality risk was increased by 22 percent.
The mortality rate for men with work stress and heart disease, diabetes or a history of stroke was about 150 fatalities for every 10,000 people per year; absent a stressful job the annual rate was 98 fatalities for every 10,000 people.
Stress was associated with almost as much increased death risk as current or former smoking, with 78 fatalities a year out of every 10,000 people.
Work stress was also linked to a bigger increase in death rates than high blood pressure, high cholesterol, obesity, physical inactivity and heavy drinking.

https://www.reuters.com/article/us-health-heart-job-stress/work-stress-may-be-deadly-for-men-with-heart-disease-and-diabetes-idUSKBN1JN2Y1

These insulin pills could replace daily injections for diabetics, study says

From ajc.com

Up to 40 million people around the world have Type 1 diabetes, and many of them have to prick themselves with a needle twice a day to ensure their blood sugar levels are in check.
But researchers from the Harvard John A. Paulson School of Engineering and Applied Sciences have now developed an oral delivery method that could replace the painful insulin injections responsible for maintaining appropriate glucose levels.

The research was published in the Proceedings of the National Academy of Sciences on Monday.

While insulin therapy by injection is effective, “many people fail to adhere to that regimen due to pain, phobia of needles, and the interference with normal activities,” senior author Samir Mitragotri said in a news release. “The consequences of the resulting poor glycemic control can lead to serious health complications.”

This new oral delivery features insulin-ionic liquid formation encapsulated in an acid-resistant enteric coating. Because insulin doesn’t fare well inside the stomach’s acidic environment, this enteric coating is critical to avoiding breakdown by gastric acids in the gut.

Researchers have previously tried to re-engineer the insulin molecule to resist acidic breakdown and overcome other gastrointestinal obstacles, but there is no oral insulin delivery product currently available in clinic or hospital settings.

"It has been the holy grail of drug delivery to develop ways to give protein and peptide drugs like insulin by mouth, instead of injection," Georgia Institute of Technology professor Mark Prausnitz, who was not involved in the research, added. “The implications of this work to medicine could be huge, if the findings can be translated into pills that safely and effectively administer insulin and other peptide drugs to humans.”

The researchers plan to continue animal testing and are optimistic about human clinical trials.

https://www.ajc.com/lifestyles/health-med-fit/these-insulin-pills-could-replace-daily-injections-for-diabetics-study-says/z4Q5dtYTrjgAAy0yWCIaOJ/

Insulin pill instead of shot: How close are we for diabetes patients?

From cnn.com

Daily insulin shots for the management of Type 1 and Type 2 diabetes could become a thing of the past, and insulin pills could someday be another option for diabetes patients.

In people with Type 1 diabetes, the pancreas does not make insulin -- a hormone that helps glucose get into your cells to give them energy -- which is why they take insulin. In people with Type 2 diabetes, the body does not make or use insulin well, and so insulin therapy may be needed.

Insulin can be administered using a needle and syringe, a pen injection, a pump through a needle, an inhaler, an injection port or what's called a jet injection, which sends a spray of insulin into the skin at high pressure.

Yet there have been several research efforts around the world to develop pills as another way to take insulin. These efforts are ongoing, but if any are found to be safe and effective, they could change the daily well-being of the more than 400 million people living with diabetes worldwide. About 40% of them rely on insulin injections.

"Insulin is currently given primarily by injections, which is a challenge for Type 1 diabetics and a deterrent for Type 2 diabetic patients to switch to insulin. An oral pill for insulin will make it easier for the patients to take insulin," said Samir Mitragotri, a professor of bioengineering and biologically inspired engineering at the Harvard John A. Paulson School of Engineering and Applied Sciences.

Developing insulin that patients can ingest remains a scientific challenge because insulin can be degraded in the stomach by acids and enzymes before it's used in the body, Mitragotri said.

In other words, insulin has to survive the hostile environment of your digestive system.

"Even if some insulin makes it into the intestine, it cannot cross the intestinal wall, since the wall is designed to prevent the transport of proteins," Mitragotri said.

"The mucus layer present on the wall of the intestine also makes transport of insulin from the intestine into the blood stream very challenging," he said. "Collectively, these hurdles make oral delivery of insulin very difficult."

The science behind insulin you can swallow

Mitragotri was senior author of a study published Monday in the Proceedings of the National Academy of Sciences that described how a new liquid formulation of insulin inside an enterically coated capsule was capable of lowering blood glucose levels in rats.

Enterically coated means the coating can be dissolved only in the body's small intestine.

For the study, researchers gave six nondiabetic male rats an oral insulin capsule and three nondiabetic male rats traditional injections of insulin.

The researchers found that blood glucose levels rapidly dropped 38% in the rats given capsules within two hours and slowly but steadily continued to fall, dropping 45% by 10 hours.

In comparison, blood glucose levels sharply dropped 49% within one hour in the rats given injections. Levels then rose, which is a typical response in nondiabetic rats, before continuing to decrease in a typical pattern.

"Oral delivery of insulin has been challenging. The study demonstrates a new technology to overcome these challenges," Mitragotri said.

"The next step is to perform longer-term safety studies and efficacy testing in larger animals," he said. "These studies will provide the necessary information to support human clinical testing, which we hope will begin in three to five years."

That study was just the latest to experiment with creating an insulin pill; many others do involve testing in humans.

Last month, Oramed Pharmaceuticals launched its largest and most advanced clinical trial of its own oral insulin pill, under the direction of the US Food and Drug Administration. The trial involves 240 patients with Type 2 diabetes.

"A year from now we will better know the potential of our drug to control and maintain blood glucose levels and will have further proof of the longer-term benefits of taking an oral pill versus an injection," Oramed CEO Nadav Kidron said in a news release in May.

Other experimental oral insulin pills are Capsulin by the company Diabetology and HDV-Insulin by the company Diasome, which was the first oral insulin approved for phase three testing by the FDA, according to the company's website.

Insulin you can swallow also has been studied as a possible way to either hold off or prevent the development of Type 1 diabetes, but this approach has been found to be ineffective in human clinical studies.

In a separate study published in the journal JAMA in November, researchers examined whether a type of oral insulin capsule can delay or prevent the development of Type 1 diabetes in the relatives of patients with the disease, who are therefore themselves at a higher risk of developing it, over a 2.7-year period.

That study involved 560 people, some of whom were given an insulin capsule and others who were given a placebo pill.

Though some participants given the insulin capsule had a longer time before being diagnosed with diabetes, overall, "these findings do not support oral insulin as used in this study for diabetes prevention," the researchers wrote.

Many questions remain

The future of insulin therapy is among the research topics on the agenda at the annual scientific conference of the American Diabetes Association this week in Florida.

Research on the oral administration of insulin dates back decades.

One study published in the journal Diabetes in 1988 involved administering nanocapsules of insulin to rats. It found that the capsules preserved the therapeutic effect of insulin when administered.

Still, more research is needed to better understand the possible risks that could come with insulin pills. In general, insulin therapy causes changes in blood sugar, so symptoms of low and high blood sugar could emerge, as seen with insulin injections.

Some studies suggest that use of insulin might be linked with increased risk of cancer, but of course more research is also needed to determine whether such a relationship could emerge with the use of insulin pills.

These pills are far from proven, but they are staking a claim as a possible new avenue for diabetes care.

https://edition.cnn.com/2018/06/25/health/insulin-pill-diabetes-study/index.html

Diabetes and Hot Weather

From chathamhospital.org

This summer, remember that if you are a diabetic, high blood sugar readings require you to drink extra fluid! High blood sugar is like thick syrup in your bloodstream and pulls fluid from your body’s cells to dilute this thickness. When you are in hot weather, fluid loss occurs faster. Everyone needs extra fluids when the weather is hot, but diabetics especially need more to prevent dehydration.
If you have diabetes without control of your blood sugar, you are in more danger of water being lost in your cells. Drink plenty of fluids, preferably non-calorie fluids. Water is best. Keep in mind that over 60% of your body is made up of water, and when you sweat in high temperatures, fluid is lost from your body more rapidly.

How can you keep yourself hydrated?

If you are working indoors, keep a water bottle or large container of water at your desk. If you are working outdoors, put a large thermal drinking container full of ice and water in your vehicle. Sip fluids frequently. If you are thirsty, chances are you are already dehydrated. Tip: children need more fluids than adults, so if you have a diabetic child or teenager, remember that they need extra water.

Signs and symptoms of high blood sugar

1. Increased thirst
2. Increase in going to the bathroom (urination)
3. Tiredness, or feeling sleepy
4. Poor healing skin wounds
5. Blurred vision
6. Numbness or tingling in feet or hands (sometimes a burning sensation)
7. Increase in hunger

If you have not been checked for diabetes, ask your doctor if he or she recommends you be checked. Many people have diabetes and do not know they have it. You are at high risk if someone in your family has diabetes, or if you are overweight and not active.
Remember: keep yourself hydrated by drinking plenty of water. Take care of your body and it will take care of you!

https://www.chathamhospital.org/ch/about-us/news-media/2018/diabetes-and-hot-weather/

Type 2 Diabetes and Weight Loss - The Best Low-Calorie Foods To Add To Your Diet Plan

By Beverleigh H Piepers

For most people who have received a diagnosis of Type 2 diabetes, one of the key things they want to focus on with their nutrition plan is controlling or losing weight. As such, it becomes critically important you are doing all you can to eat a reduced calorie diet and be mindful still about monitoring and controlling your blood sugar levels.
Fortunately, some foods help you achieve both. When you are following a diet plan, you want to look for any food that is...

• low in calories,
• low in sugar, and
• high in fibre or high in protein.

These foods will be your perfect three-punch combination for managing those blood sugar levels while keeping total fat loss humming along.

So which foods fit the bill? Let us look at your top options...

1. Raspberries. Raspberries are the first significant food to have on the agenda as they are rich in fibre, quite low in sugar considering the fact they are a fruit and are also low in calories. They are great for satisfying your cravings for something sweet as well, so perfect for those moments where you feel your willpower weakening.
Eat them on their own, add them to a smoothie, try them on top of some yogurt - there are many tasty ways to eat this berry.

2. Plain Popcorn. Another option to consider is plain popcorn. Popcorn is a high volume food, meaning you can eat a lot of it without the calories adding up to much of anything. It is also ranked very low on the GI scale and is also rich in dietary fibre. This makes it a clear home-run-hit for preventing a spike in blood sugar levels.
Plain popcorn is the perfect snack to serve when you are going to be watching TV for a few hours and need something to munch on.

3. Egg Whites. Egg whites are next up on the list of ideal foods to eat if you want to maximize your nutrition plan while keeping your weight on track. Egg whites do not contain anything in the way of fibre but is loaded with protein - it is 100% pure protein so you will not get much else.

Egg whites are also a high volume food. If you have ever tried to eat one cup of egg whites, you know just how much food this is.
They are also cheap to purchase, so great for those who are looking for a cost-effective option.

4. Butternut Squash. Finally, we come to butternut squash. This vegetable is an excellent alternative to potatoes when you are in the mood as it has a similar consistency. Butternut squash tastes good when baked with just a touch of butter and also contains a moderate dose of fibre while keeping the total carbohydrate count a bit lower.
There you have some healthy options for when you are in need of something new to add to your diet plan and want to keep your nutrition up.

Type 2 diabetes is not a condition you must just live with. By making easy changes to your daily routine, its possible to protect your heart, kidneys, eyes and limbs from the damage often caused by diabetes, and eliminate some of the complications you may already experience.

http://ezinearticles.com/?Type-2-Diabetes-and-Weight-Loss---The-Best-Low-Calorie-Foods-To-Add-To-Your-Diet-Plan&id=9961916

How to spot the first signs of diabetes

From mysouthernhealth.com

Are you really thirsty lately? Really tired?
Symptoms of diabetes can sneak up on a person and seem so minor that they go unnoticed or are attributed to something else.
Common symptoms of type 2 diabetes include:

• Frequent urination;
• Feeling very thirsty;
• Feeling very hungry even though you’ve eaten;
• Extreme fatigue;
• Blurry vision;
• Slow-healing cuts and bruises;
• Tingling, pain or numbness in the hands or feet.

“Some people have symptoms but don’t realize they’re related to diabetes,” said Elaine Boswell King, quality coordinator of the Diabetes Self-Management Education services at Vanderbilt Eskind Diabetes Clinic.

Three blood tests can be used to diagnose diabetes. A common one is the fasting blood glucose test, routinely done during a physical. The A1C test measures blood glucose for the previous two to three months. Another test, the oral glucose tolerance test, shows how your body processes glucose.
A doctor may use a combination of these tests for diagnosis.
Early detection and treatment can prevent complications, such as heart disease, nerve damage, eye problems and kidney disease.
If someone is diagnosed with diabetes, it’s important to get blood glucose level under control with diet, exercise and medication, said Boswell King.
“There are so many options now for medications that are so tailored to the patient,” she said. “We can even factor in other chronic illnesses to help choose the diabetes medication with an added benefit.
“Diabetes is a labour-intensive disease to manage, as patients decide how to eat based on glucose values that day,” she said. “Making choices based on that makes a difference in avoiding developing complications.
“We know that all this hard work to get blood glucose into normal range is worth it.”

http://www.mysouthernhealth.com/symptoms-prediabetes/

Eat this common food to lower type 2 diabetes risk, study says

From ajc.com

Looking for a way to lower your blood glucose levels? One plant may be able to help, according to a new report.

Researchers from the University of Guelph in Canada recently conducted a small study, published in the Journal of Nutrition, to determine the association between lentils, a type of pulse, and reduced blood glucose levels. High blood glucose levels can lead to Type 2 diabetes. 

To do so, they examined 24 healthy adults, who were fed four dishes: white rice only, half white rice and half large green lentils, half white rice and half small green lentils, and half white rice and half split red lentils.

The analysts measured the subjects’ blood glucose levels before they ate and two hours afterward. They then repeated the same experiment this time using white potatoes alone and the same combination of potatoes and lentils.

“We mixed the lentils in with the potatoes and rice because people don’t typically eat pulses on their own, but rather consume them in combination with other starches as part of a larger meal, so we wanted the results to reflect that,” co-author Alison Duncan said in a statement.

After analysing the results, they found that replacing half a serving of rice with lentils caused blood glucose to drop by up to 20 percent. Replacing potatoes with lentils resulted in a 35 percent decrease. 

They explained that pulses, such as lentils, can encourage the production of short-chain fatty acids and slow digestion and the release of sugars into the bloodstream, which can lower blood glucose levels.

“This slower absorption means you don’t experience a spike in glucose,” Duncan said. “Having high levels over a period of time can lead to mismanagement of blood glucose, which is the hallmark of Type 2 diabetes. Essentially, eating lentils can lower that risk.”

The scientists now plan to further their investigations and collaborate with more health experts to explore the benefits of lentils. 

“We are hoping,” Duncan said, “that building evidence for approval of a health claim for pulses will further encourage people to add pulses to their side dishes.”

https://www.ajc.com/news/world/eat-this-common-food-lower-type-diabetes-risk-study-says/H1SWkLfDH5V85nxIKQJ2MJ/

A World Cup Win for Type 1 Diabetes: Real Madrid’s Nacho Fernandez Scores a Goal

From asweetlife.org

Nacho Fernandez (José Ignacio Fernández Iglesias), who plays for Real Madrid, scored Spain’s third goal of the game against Portugal last night. In the 58th minute, Fernandez’s kick, which has been described as a tremendous strike, put Spain ahead in a game that ended in a 3-3. Nacho has made some people with diabetes pretty darn proud.
In November 2016, Nacho first spoke publicly about his diabetes. He said, “Many people don’t know that I’m diabetic and it wasn’t that I wanted to keep it secret but it is something I usually only discuss when visiting children in hospital.”
Nacho was diagnosed with type 1 diabetes when he was 12 years old. He said, “I’ve had it since I was 12 years old but it is okay because I’m very careful about it. If you have to take care of yourself as a footballer then being a diabetic too means you have do it three times as much.”
ESPN reported  that at the time of his diagnosis, Nacho, who had been playing for the Real Madrid youth team from the age of ten, was told he could no longer play soccer.
“I had been playing for two years at Real Madrid and it was a tough time,” he said. “I remember, when I went into the hospital, the doctor who saw me wasn’t the one who should have seen me.
“That doctor told me that I couldn’t continue playing football and it was a really bad weekend for me.
“But three days later I saw Dr Ramirez, someone I’m very fond of. He told me the opposite — that I had not finished with football at all.”
Asked whether being diabetic meant there were limits on what he could do, Nacho said: “I am lucky to play football, I like to play all kinds of sports, exactly because of that, because it is very important to do physical activity.
“I have no limitations. There are meals that I have to be a little more careful with but I eat everything and I am lucky to have it well controlled.
“It makes you be a more responsible person and take more care of yourself.”

https://asweetlife.org/a-world-cup-win-for-type-1-diabetes-real-madrids-nacho-fernandez-scores-a-goal/?utm_source=ASweetLife.org+List&utm_campaign=092f9e5da9-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-092f9e5da9-413392997

Type 2 Diabetes - Depression Anxiety, and the Risk of Developing Diabetes

By Beverleigh H Piepers

According to the Journal of Affective Disorders, individuals suffering anxiety and depression are twice as likely as happy people to develop Type 2 diabetes. In May of 2018, the journal published an article from the Department of Psychiatry at the McGill University and the department of psychology at Carleton University in Canada.

The researchers looked at 78,025 participants 30 to 75 years of age. They assessed the emotional state of all the participants at the start of the study and compared them with either those with Type 2 diabetes or raised hemoglobin A1c levels three years later. A total of 1096 individuals developed Type 2 diabetes. Those with depression and anxiety were 2.12 times as likely to develop Type 2 diabetes than the participants without either.

According to the World Health Organization, more than 300 million people suffered depression worldwide in 2017. It is the leading cause of disability and has been on the increase since 2005. The most dangerous thing about depression is it can cause people to think they cannot get better. Fortunately, this is not true. Doctors have a wide array of medications used to treat depression, and while it might take time to find the right drug for each individual, there is every reason to hope for a good outcome. Non-pharmaceutical treatments are also helpful.
When we are physically active, our brain makes substances called endorphins, which are natural mood elevators. Getting up off the couch and going to the gym is not comfortable when one has a depressed mood, but it is worth the effort...

• taking a class in something fun like painting or making pottery can be therapeutic.
• growing plants is therapeutic for many people. There is something about keeping a regular schedule of watering, weeding, fertilizing, and seeing good results that can be highly satisfying.
• friends can be a big mood elevator as well, so calling someone or going out for a cup of coffee or a walk through the mall is another way to fight depression.

Anxiety involves feeling a threat when little or none exists and includes stress out of proportion to the impact of a particular event. Anxious individuals find it difficult to set aside their concerns and restlessness...

• parks soothe us by getting us back to our roots. Our species evolved in Africa in the presence of grass and trees, so seeing them again makes us feel at home.
• physical activity can channel all the anxiety into making us healthy. And too tired to feel anxious any more.

Stress raises blood sugar levels. If stress is temporary the blood sugar spike resolves quickly. If stress is ongoing, one needs to get help to deal with stress.

Type 2 diabetes is not a condition you must just live with. By making easy changes to your daily routine, its possible to protect your heart, kidneys, eyes and limbs from the damage often caused by diabetes, and eliminate some of the complications you may already experience.

http://ezinearticles.com/?Type-2-Diabetes---Depression-Anxiety,-and-the-Risk-of-Developing-Diabetes&id=9954304

NHS England issues language and diabetes guidance

From diabetestimes.co.uk

The language used by healthcare professionals can have a profound impact on how people living with diabetes experience their condition"

A guide advising healthcare professionals on the best language to use when communicating with people with diabetes has been published by NHS England.
The publication Language Matters: Language and Diabetes aims to reduce any potential negativity from doctors and nurses in interactions with people living by providing practical guidance.
It includes examples of the most appropriate language to use, with alternatives from unhelpful comments suggested to avoid any negativism and encourage positive interactions. The examples are based on research and supported by a simple set of principles.

The document sets out the principles for good practice for interactions between healthcare professionals and people living with diabetes, drawn up with reference to the experience of people who have diabetes, healthcare professionals and published research.

Dr Partha Kar, associate clinical director for diabetes at NHS England, said: “Diabetes care is changing – and if we as healthcare professionals want to make a difference, it is the building of relationships and relationships and respect which places the patient at the heart of that change which will take it to the next stage. We need to be trusted guides in the journey of those living day in, day out with diabetes.

“As the saying goes… “With great power, comes great responsibility”. Hopefully this piece of work goes some way towards realising the importance of that ethos.”
Writing in the document, Anne Cooper, who lives with type 1 diabetes, and Bob Swindell, who lives with type 2 diabetes, said in a joint introduction: “The language used by healthcare professionals can have a profound impact on how people living with diabetes, and those who care for them, experience their condition and feel about living with it day-to-day. At its best, good use of language; verbal, written and non-verbal (body language) which is more inclusive and values based, can lower anxiety, build confidence, educate and help to improve self-care.

“Conversely, poor communication can be stigmatising, hurtful and undermining of self-care and have a detrimental effect on clinical outcomes. The language used in the care of those with diabetes has the power to reinforce negative stereotypes, but it also has the power to promote positive stereotypes.
“People with diabetes internalise messages from the media, from those around them, but most of all from their healthcare providers. When these messages are perceived negatively, whether it is intended or not, this can lead to feelings of shame, guilt and resentment. People who are ashamed of a condition will find it much harder to engage and manage that condition proactively.”

http://diabetestimes.co.uk/nhs-england-issues-language-and-diabetes-guidance/

How To Talk About Diabetes

From diabetes.org.uk

Being diagnosed with diabetes, or knowing someone who is diagnosed with the condition, may throw up many questions about how it fits into your daily life, from how it makes you feel, to managing diabetes at work, or while you are driving.
Here we've got information to help you manage all of this, starting with how to talk about diabetes and some tips on having those conversations.

Talking about diabetes

Talking about diabetes can be tricky, awkward, difficult, funny, and everything in between. From telling someone you’ve just met about your diabetes, to trying to explain carb counting to relatives, or avoiding that conversation with your doctor – we want to make it easier for you to have those conversations.

Conversation tips

We've written some top tips to help you get started:

• Talking to your friends and family
• Talking to your healthcare professional
• Talking to your colleagues and employer
• Talking to someone with diabetes

Share your own tips on talking about diabetes and join the conversation for this year's Diabetes Week.

https://www.diabetes.org.uk/guide-to-diabetes/life-with-diabetes?utm_source=bronto&utm_medium=email&utm_term=Conversation+tips&utm_content=Conversation+tips&utm_campaign=Enewsletter+June+2018

8 Essential Packing Tips Every Traveller with Diabetes Should Know

By Kerri Sparling

I am a professional packer. Whether I’m away for two days or two weeks, I’ve developed a system that helps me cram a lot of stuff into the confines of a carry on.  That’s no small feat, especially since I’m always traveling with diabetes supplies. And with the summer travel season upon us, it’s a great time to compare traveling with diabetes tips and tricks on how we fit the necessities for our needy pancreases into a carry on bag.

Bring glucose tabs.  Traveling with glucose tabs is easiest because they are light weight, can get through airport security screenings without any trouble, and won’t melt or spoil in the heat or cold.  (Also, if they spill in your bag, they are easier to clean up than … say, juice.) You can keep a tube of tabs in your backpack or purse and a jar in your carry on.
Learn to military roll your clothes.  I know this doesn’t sound like diabetes-related advice, but the more you pack with precision, the more stuff you can fit into your carry on.  (Lifehacker has a great video to show you how to roll your clothes.)  If rolling them seems confusing, try employing packing cubes for keeping your things organized.

Bring – and WEAR – a medical ID.  Especially if you’re traveling alone, definitely wear medical ID jewelry while on the road.  (I wear mine every day because I’m both used to it and also pretty damn paranoid.)  Today’s medical IDs are fashionable and nice looking, so adding it to your wardrobe on the regular is easier than in the past.  But fashion preferences aside, a medical ID can speak for you when you might not be able to speak for yourself, so err on the side of caution and wear one.
Have a bag dedicated to diabetes supplies.  Grab a spare packing cube, or camping bag, and .  I like to keep my medical supplies in a bright orange bag so that I can find it quickly in my suitcase.  Keeping my diabetes supplies separate from my toiletries also helps prevent shampoo or moisturizer from getting into my pump supplies.  Also, it makes it easier for me to spot-check and make sure I have everything I need, without having to pick through a bigger bag of toiletries.
Make an actual list.  I keep an index card with my diabetes supplies written on it and I use it to confirm that I have everything I need when I’m packing.  I always bring the same things:  insulin bottle, insulin pen, insulin pump infusion sets, cartridges, needle to fill cartridges, medical tape, backup test strips, insulin pen needle caps, spare lancets, spare CGM sensor (if I’m on the road for several days), and my non-diabetes related medical supplies.  A quick glance at this list helps me grab what I need and prevents me from bringing stuff I don’t need.
Have necessary info at the ready.  In keeping with that index card list, I also keep a photo on my phone of my most current pump settings.  You never know when you may need to have that information handy, and if you’re like me and you don’t know your basal rates off-hand, photographic evidence is a good idea.  Same goes for having contact information for your medical team in your phone, as well as an emergency contact (In Case of Emergency, or ICE) number.
Bring back ups.  This is good advice for both diabetes-related stuff and run-of-the-mill stuff.  Always bring extras of things you may need.  If you wear an insulin pump, get a prescription for a long acting insulin pen and keep it in your supply bag while traveling, just in case your pump gets the hiccups and you need to go back to shots for a few days.  (And bring extra socks and underwear because it’s always nice to have a spare pair. So says everyone’s grandmother.)
Look into a loaner pump.  This goes along with having a back up.  If you’re taking a longer trip and the idea of bouncing back to MDI makes you feel uncomfortable, connect with your insulin pump manufacturer to see if they can hook you up with a loaner pump.  Most pump companies will send you a loaner for travel (you send it back when you’ve returned from your trip).

But most importantly? HAVE FUN.  (“And be safe,” she whispers in her mom voice.)  With a little planning, packing with diabetes can be streamlined to minimize trouble and maximize fun.

https://asweetlife.org/8-essential-packing-tips-every-traveler-with-diabetes-should-know/?utm_source=ASweetLife.org+List&utm_campaign=dc2ea8283a-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-dc2ea8283a-413392997

Diabetes type 2: Avoid these alcoholic drinks to maintain healthy blood sugar levels

From express.co.uk

DIABETES type 2 occurs later in life due to problems with the hormone insulin, meaning your body struggles to control blood sugar levels. Sufferers need to change their diet and monitor blood sugar levels regularly to avoid a spike, which if it lasts for a while could cause heart problems or kidney damage.

Diabetes type 2 can be treated through eating a balanced diet and exercising regularly.
In some cases, this approach has even helped to reverse the condition.
Diabetics use blood tests to monitor their blood sugar levels and change their diets to help them maintain this.
A high blood sugar level that is maintained increases their risk of heart disease, blindness and kidney problems, among others.
You should scrap low-alcohol wines if you already have diabetes, according to Diabetes UK, one of the UK charities representing sufferers.

“Avoid low-alcohol wines as these often have more sugar than normal ones,” said the charity on its website.
“If you do choose these, just stick to a glass or two.
“Try to limit drinks with a lot of sugar, such as sweet sherries, sweet wines and liqueurs.”
Wines with the least sugar include dry red and white wines.
Sweet wines, on the other hand, could contain as much as 200 grams of sugar per litre.

Diabetes UK also advises you should not have low-sugar beers and ciders as they contain more alcohol.
“Just one pint of a low-sugar beer can bring you above the alcohol limit,” they say.
They also recommend avoiding sugary mixers with spirits and high carb drinks.
“Have diet or sugar-free mixers with any spirits - if a friend gets one for you, make it clear what you need.
“Some drinks like beer, ales and ciders contain carbs and will increase your blood sugar levels.”

Diabetes.co.uk adds that people with the condition need to be “extra careful” about what they drink.
“Alcohol intake significantly increases the risk of low blood sugar levels,” they say on their website.
“If your diabetes is already under control, a moderate amount of alcohol may be fine either before, during or soon after a meal.
“Even if you have a drink, this may not influence short-term blood glucose levels. However, there are some precautions to be taken care of.”
UK government guidelines say that you are not supposed to drink more than 14 units of alcohol a week, that’s around six pints of beer or just over five glasses of wine.

https://www.express.co.uk/life-style/health/971827/diabetes-type-2-diet-alcohol-blood-sugar-avoid-what-drinks-can-i-have

Are dates good for diabetes?

From hindustantimes.com

Dietitians say dates are one of the superfoods you must have in your diet. Loaded with good nutrients and rich in natural sugar, they are good for diabetes patients as well. Here’s what experts have to say.

Dates are nothing short of a superfood. They are rich in soluble and insoluble fibres which boost gut health, and are loaded with selenium, copper, potassium, magnesium and moderate concentrations of manganese, iron, phosphorus, and calcium.
While selenium protects the body from oxidative stress which leads to diabetic complications, atherosclerosis, cancer and neurodegenerative diseases like Alzheimer’s; the potassium and low sodium content makes it good for people suffering from hypertension. It also contains phytochemicals or naturally occurring plant chemicals that can lower cholesterol, reducing risk of heart disease and cancer. They are also rich in iron, making it a perfect option for anaemic people.

People with regular blood sugar levels can eat up to 3-5 dates in a day. The natural sugars in it make it an ideal food to break your fast, and the ideal time to eat it is early in the morning or with breakfast to stay active through the day.
But is this nutritious food good for diabetics as well? Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. “GI or Glycemic Index is the relative ranking of carbohydrate in foods, according to how they affect blood glucose levels. Eating various types of dates or mixing it in meals with plain yoghurt may be of benefit in glycaemic control in diabetic patients. Another study says that diabetic patients can consume six to eight Tamer and 8 to 10 Rutab dates in a day. The equivalent of 7-10 dates was used in another study, which is similar to what is maximally eaten at a single sitting by UAE subjects,” says Gargi Sharma, Nutritionist, Bhatia Hospital, Mumbai on Dates for Diabetics.

Since dates are dried, their calorie content tends to be higher than other fresh fruits. They are also high in natural sugar making it a perfect snack for an immediate burst of energy. “Dates can be consumed by diabetics if their sugar levels are in control. It is advisable to consult your dietician/doctor the amount of dates can be consumed individually,” says Dr Roshani Gadge, diabetologist consultant, Gadge Diabetes Centre. She adds that it is fine for diabetics to eat 1-2 dates a week so long as they have diabetes under control, exercise regularly and maintain healthy eating habits.
What happens if you OD in it? “Dates are high in calories, and a small serving i.e. 1/4 cup has more than 100 calories, which is high given the small serving size. So, regularly consuming dates in high amounts can lead to a caloric build-up, which, in turn, can cause weight gain,” says Sharma. Eating too many dates can also lead to hyperkalemia (high potassium levels), and the sugar content can trigger tooth decay and lead to cavities as well.

https://www.hindustantimes.com/fitness/are-dates-good-for-diabetes-here-s-all-about-its-nutrition-value-when-to-eat-and-more/story-peABsAOpRgXN61hksKMu5L.html

How Do You Know Which Diabetes Drug Is Best for You?

By Steven Findlay

The incidence of type 2 diabetes is rapidly rising, as has been well publicized in recent years. An estimated 30 million people in the US, or about 9.4% of the population, have it. That’s up from 2.5% in 1980. Some 1.5 million adults are newly diagnosed every year. An increasing number are younger than 40.
But, shockingly, despite widespread attention to the increase in diabetes, 1 in 3 people who have it have not been diagnosed. And many who have been diagnosed don’t get adequate treatment, according to numerous studies over the past decade.
That includes not being prescribed the right drug at the right dose. It also includes people who experience adverse effects from a diabetes drug and, as a result, stop taking it. On average, 10 to 20% of people with diabetes stop taking their pills due to side effects.
This article focuses on the pros and cons of the oral diabetes drugs. Almost all people with diabetes are candidates for one or more of these medicines — but with so many kinds of diabetes drugs on the market, the choice can be difficult and confusing (even for doctors).
This article is based on a Consumer Reports Best Buy Drugs report, written by me and other CR staffers, with input and advice from CR’s medical consultants and 3 external physician reviewers. The full report has background and other information and advice on diabetes and its treatment.

The Best Buy Drug diabetes report was, in turn, based on a review of the scientific evidence on the effectiveness, safety and adverse effects of diabetes drugs conducted by the Johns Hopkins Evidence-Based Practice Centre. That review — involving some 200 studies — was sponsored by the federal Agency for Healthcare Research and Quality (AHRQ). The advice herein, however, is solely attributable to Consumer Reports Best Buy Drugs and not to Johns Hopkins, AHRQ or the US Department of Health and Human Services.
This article doesn’t evaluate insulin since it’s rarely used as an initial or ongoing treatment for people with type 2 diabetes.

Why Diabetes Is So Bad

• Diabetes more than doubles the risk of developing and dying prematurely of heart disease and other problems.
• Diabetes significantly raises the risk of stroke; nerve, kidney and eye damage; blindness; impotence; decreased circulation in the legs and feet; and susceptibility to infections that can lead to amputations of toes, feet or part of a leg.
• Diabetes is the seventh leading cause of death in the United States and a leading cause of disability.
• In the early stages of diabetes, most people don’t experience symptoms. Yet, the damage to organs occurs even in the absence of symptoms. That’s why it’s critical for people to get their blood sugar checked periodically. Also, symptoms can be mild and intermittent for years, also delaying diagnosis. These include fatigue, blurred vision, frequent urination, numbness or tingling in hands or feet, weight loss and increased thirst and hunger.

The Good News

Proper treatment can keep people with diabetes healthy. People with diabetes who receive good and consistent care can live a normal life.
The aim of treatment, with both lifestyle changes and medications, is to lower your blood sugar (as represented by your hemoglobin A1c level) and keep it low, reduce symptoms, and reduce the risk of diabetes complications.
Managing diabetes is complex, but studies are now quite clear: Lifestyle changes matter and even small changes — such as losing 10 to 15 pounds or exercising just 20 to 30 minutes several days a week — can help. Both yield solid benefits, and enable some people with diabetes to stop taking their medicines.

The 8 Types of Diabetes Meds

The 8 types of diabetes medicines work in quite different ways. But all lower blood sugar, help improve the body’s use of glucose, and decrease symptoms.
None of the 8 kinds of drugs are problem-free; all can fail to control blood sugar adequately over time in some people who take them. As a result, the different types of drugs are often used in combination, and your doctor may switch you from one type of drug to another.
About half of people with diabetes who start taking one type of medicine will need another type (or insulin) within 3 years.
Side Effects and Safety
Side effects are a serious problem with diabetes medicines. They vary from drug class to drug class and medicine to medicine.
Since many people with diabetes are trying to lose weight, the weight gain that can occur with some drugs can be especially frustrating. Here’s an overall assessment:

Common Side Effects

• Weight gain
• Gastrointestinal side effects (abdominal pain, nausea, vomiting, diarrhea, gassiness and bloating)
• Edema (fluid in legs and ankles)

Uncommon

• Hypoglycemia or low blood sugar (usually minor if caught in time, but can be serious or fatal if not treated; symptoms include profuse sweating, tremor, shakiness, dizziness, hunger.
• When serious, includes mental confusion, coma, and risk of stroke or death)
• Congestive heart failure
• Anemia (low red blood cell count)
• Allergic reactions
• Urine infections
• Yeast infections
• Hip and non-hip fractures

Very Rare

• Lactic acidosis (buildup of acid in the blood)
• Macular edema (eye problems)
• Liver disease/liver failure
• Pancreatitis (inflamed pancreas)
• Cancer

Overall Pros and Cons

With the very important caveat that studies do not reveal how a specific person will respond to any particular diabetes drug, our evaluation leads to the following overall conclusions:
Metformin is a good initial choice for most people.
Taking 2 diabetes drugs can have a positive additive effect on reducing HbA1c. This is a net plus for people whose blood glucose is not well controlled by taking just one drug. The downside is that taking 2 drugs poses a higher risk of side effects. Taking lower doses of each drug can reduce that risk.
Blood sugar (HbA1c) reduction is similar across all the classes of diabetes drugs, except dipeptidyl peptidase-4 inhibitors and alpha-glucosidase inhibitors, which have a somewhat smaller effect.
Diabetes drugs have differing effects on weight. It’s important to discuss this effect with your doctor. In short-term studies, the largest weight loss occurred among people taking a glucagon-like peptide 1 receptor agonist or a sodium-glucose co-transporter-2 inhibitor. Weight increased with sulfonylureas, thiazolidinediones and meglitinides.
The diabetes drugs have distinctly different “safety profiles.” Less is known about the safety of newer medications. This factor may be one of the primary drivers of your and your doctor’s decision for initial and ongoing treatment.
Minor but annoying side effects may also play a role in your and your doctor’s choice of a diabetes medicine or medicines. For example, gastrointestinal side effects — including bloating, gas, nausea, vomiting and diarrhea — are very frequent with acarbose and glucagon-like peptide-1 receptor agonists. They occur less with metformin.

What is Pre-Diabetes?

Many Americans have blood sugar levels above normal, but less than the level that warrants a diagnosis of type 2 diabetes. The most recent estimate from the CDC (Centres for Disease Control and Prevention) indicates that 34% of adults 20 and older — 84 million people — have blood glucose levels in this “pre-diabetes” or “borderline diabetes” range.
A growing body of research shows that people with pre-diabetes have both a high risk of developing diabetes, and an elevated risk of heart disease and stroke even if their blood sugar levels never rise into the full diabetes range. In one study involving 10,428 people in Australia, for example, those with pre-diabetes were found to have 2.5 times the risk of dying prematurely from heart disease over a 5-year period compared to people whose blood sugar was normal.
This has led doctors to intensify efforts to identify and treat people with pre-diabetes. But most doctors agree, and research backs them up, that dietary and lifestyle changes — with the main goal being losing weight — can be very effective at keeping pre-diabetes under control, and before any medication needs to be prescribed.

https://medshadow.org/your-meds/diabetes-drug-best/

Are there actually multiple types of diabetes?

From health24.com

Recognising that there are more than three types of diabetes could lead to more effective treatment options for diabetes patients.

Diabetes has long been thought to consist of two main groups: type 1, which mostly affects younger people who are unable to produce insulin, and type 2, resulting in resistance to insulin, with glucose unable to enter cells even when there is sufficient insulin.
According to a study published in The Lancet: Diabetes & Endocrinology, type 2 diabetes is divided into four distinct subtypes.
Although not discussed in the study, mention should also be made of gestational diabetes. Less common than types 1 and 2, it is a condition that may occur during pregnancy. Changing hormones and weight gain make it hard for the bodies of mothers-to-be body to keep up with their need for insulin.

Different clusters

The groupings are referred to as clusters in the study:
Cluster 1 (Type 1 diabetes): These individuals are usually diagnosed before the age of 40. Peak age of diagnosis is around 14. Some type 1 diabetics are unable to make insulin because of an autoimmune disease.
Cluster 2 (Type 2 diabetes): This group is similar to cluster 1 as both include individuals with extreme insulin-deficient diabetes; however in their case their immune system is not involved. The condition is a result of poor metabolic control, indicated by high A1C levels, which is the two to three month average of blood sugar levels. Vision loss due to diabetes was more common in this group than any of the others.
Cluster 3 (Type 2 diabetes): These people are overweight, and while they do make insulin, their bodies do not respond to it. These individuals are considered highly resistant to insulin. This group also has a much higher risk of diabetic nephropathy.
Cluster 4 (Type 2 diabetes): The individuals in this cluster have mild obesity-related diabetes, but metabolically they are healthier than cluster three.
Cluster 5 (Type 2 diabetes): This cluster contains people who were older when they were diagnosed. Their diabetes was also the mildest and progressed the slowest.

Effective treatment
These distinctions and groupings could help create more individualised and subsequently more effective care for diabetes patients. Senior study author, Dr Leif Groop, director of Lund University Diabetes Center in Sweden, explained in a press release by the journal, “Today, we intensify treatment after things have happened. With this new classification, it makes it possible to do it before things happen.”
Three-and-a-half million South Africans (about 6% of the population) suffer from diabetes and there are many more who are undiagnosed. According to a previous Health24 article, it is estimated that another five million South Africans have prediabetes, a condition where insulin resistance causes blood glucose levels to be higher than normal, but not high enough to be diagnosed as type 2 diabetes.
Treatment would also be more effective if diagnoses were based on the specific characteristics of each patient’s age of diagnosis as well as their risks for kidney disease and loss of vision, both complications of diabetes.             

Changing the way we think about diabetes
The researchers say that their grouping system could be helpful for both newly diagnosed diabetes patients as well as those who have had type 2 for many years. However, it has not been made clear whether patients can move between clusters as their condition changes. They go on to state that a larger study needs to be done that will include a larger variable and more diverse populations.
The study argues that it is more useful combining several different components to create more specific diabetes diagnoses than just using one based on glucose levels to diagnose either type 1 or type 2.
"This new sub-stratification could change the way we think about type 2 diabetes and help to tailor and target early treatment to patients who would benefit most, thereby representing a first step towards precision medicine in diabetes," they maintain.

The potential impact of these clusters 
There have been criticisms of this study by doctors from all over the world. On of these critics is Dr Rob Sladek, a professor at McGill University and Genome Quebec Innovation Centre in Canada.
Dr Sladek told Medscape Medical News that he "was not completely surprised" that there were as many as five clusters of diabetes.
"We already know that there is a group of adult-onset patients that are severely insulin deficient. In addition, we think of diabetes as being a balance between insulin needs or insulin resistance, say from obesity, and insulin production," he said.
Dr Groop admits that this might be an implementation problem, "The risk of missing important outcomes is clearly less than with the traditional classification." This is because lumping a very diverse group together makes it difficult to pinpoint differentiating risks.
Despite the potential benefits of these groupings, diabetes experts have expressed their concerns and doubts and whether in reality, doctors would be able to apply them to their patients' care.

https://www.health24.com/Medical/Diabetes/News/are-there-actually-multiple-types-of-diabetes-20180607-2

 

Diabetic and skipping meals? Here's how you can end up in an emergency room

From indiatimes.com

Have you recently been diagnosed with diabetes? Don't take it lightly. Skipping meals and delaying snack time can lead to medical emergencies in diabetes patients.

Here are the three big complications that patients with diabetes can experience due to their irregular food habits:

Hypoglycemia: Common signs and symptoms include headaches, lightheadedness, fainting spells, fatigue, tremors, blurred vision and unsteadiness. In the absence of immediate medical attention, hypoglycemia could even result in seizures, loss of consciousness, coma and death.

Hyperglycemia: Also known as elevated blood sugar levels can occur especially in patients of diabetes who don't follow dietary regulations. Main symptoms include increased thirst and a frequent need to urinate. If left unattended, these patients are at a high risk of medical emergencies.

Dehydration: Most people experience varying degrees of dehydration when they follow irregular eating habits. Prolonged fasting periods can be dangerous for people with diabetes. This is often exacerbated by India's hot and humid climate. Common signs of dehydration to watch out for include fatigue, nausea, trouble concentrating and disorientation in severe cases.

Some simple ways to avoid these complications are:
- Consult your doctor for a well-monitored dietary plan, and follow it diligently.
- Monitor your blood sugar levels at least 4-6 times a day, or as recommended by your doctor.
- Sometimes, and in the initial stages, the symptoms can be very subtle. Consult your doctor immediately.
- Take the daily diabetes medication as advised by your doctor.
- Do not overeat.
- Avoid or limit your intake of sweet and fatty food.

https://economictimes.indiatimes.com/magazines/panache/diabetic-and-skipping-meals-heres-how-you-can-end-up-in-an-emergency-room/articleshow/64452049.cms

Study proves dieting CAN reverse diabetes – as chronic calorie excess causes the disease, says Dr Miriam Stoppard

From mirror.co.uk

Following new advice from a GP could see patients go into remission or even come off drugs, according to the results of a major study

You could cure your Type 2 ­diabetes if you follow new ­advice from your GP.
Around four million UK ­patients with the condition might be helped – they could go into remission and even come off drugs.
A wonderful study, The Diabetes Remission Clinical Trial (DiRECT), has shown that weight management supervised by GPs might normalise blood sugar levels without the use of drugs.
This is a complete change in the treatment of diabetes.
“It’s a crashingly simple disease,” says one of the trial’s researchers, Roy Taylor, professor of medicine and metabolism at Newcastle University.
The DiRECT study “shows ­conclusively that Type 2 diabetes is caused by chronic calorie excess,” he says.
This triggers “a twin cycle of ­deterioration” – first, fat accumulates in the liver and eventually spills over into the pancreas.
This results in failure of insulin secretion after eating, and precipitates the onset of ­hyperglycaemia (high blood sugar).
Prof Taylor adds: “Losing less than 1g of fat from the pancreas can restart the normal production of insulin, reversing Type 2 diabetes. That can only be done through substantial weight loss rather than by any drug.”
If a new drug showed similar results we’d be over the moon.
Stephen Lawrence, clinical lead for diabetes at the Royal College of General Practitioners and fellow at Warwick University, heralded the DiRECT paper as a “landmark study”.
DiRECT, the biggest ever study funded by the charity Diabetes UK, tracked 298 patients who’d had diabetes diagnosed during the previous six years.
Half were assigned to take diabetes drugs and receive conventional weight-loss advice.

The other half were told to stop taking all drugs for diabetes and to eat a low-calorie diet balanced in nutrients – shakes or soups containing no more than 853 calories a day – for up to five months.
They were then given intensive ­guidance by their GPs to gradually reintroduce a normal diet, individually tailored, over two to eight weeks.
Michael Lean, co-lead of DiRECT, points out: “In DiRECT, 40% of the patients were from the two most deprived socioeconomic groups, and 40% were being treated with six or more drugs for a variety of diseases.”
There’s no doubt this made it a stiff test of the treatment.
At 12 months, nearly half (46%) of participants were cured of their diabetes and were off drugs.
Furthermore, the chances of ­remission from diabetes increased the more weight a person lost, and study participants who lost 15kg or more typically achieved complete remission within a one year.
It’s a cure that’s simple and effective.

https://www.mirror.co.uk/lifestyle/health/study-proves-dieting-can-reverse-12641497

Debunking 10 diabetes myths

From thejakartapost.com

Diabetes can cause serious complications and is one of the leading causes of death in adults.
Diabetes could even double the risk of a heart attack, said Iman Asikin, acting director of prevention and control of non-communicable diseases at the Health Ministry.
"The disease is also the main cause of blindness, kidney failure, lower limb amputation and other long-term effects that lower the quality of life," Iman said on Monday as quoted by tempo.co.
Iman straightens out some of the common myths surrounding diabetes in the tempo.co report and lays out the facts for better public awareness about the disease and managing it.

Myth 1: People with diabetes need to follow a special diet.
Iman disagrees with the idea that people with diabetes require a special diet, saying instead that a healthy diet is beneficial for everyone, including those with diabetes. A healthy diet comprises nuts and pulses, vegetables and fruits, and incorporates limiting or avoiding fats and processed carbohydrates, especially processed sugar.
Myth 2: Diabetes-friendly and sugar-free food is good for you.
The health official says that no foods are completely free of sugar, as all foods contain a certain amount of sugar, such as in the form of carbohydrates. Thus, there is no such thing as a 100% sugar-free food.
Myth 3: People with diabetes cannot donate blood.
People with diabetes can still donate blood, as long as they keep their sugar levels under control.
Myth 4: Women with diabetes should not get pregnant.
The fact is that by keeping blood sugar levels under control, women with diabetes can still get pregnant and give birth to a healthy baby.
Myth 5: Diabetes in pregnant women will disappear after giving birth.
About 50 to 70 percent of women with gestational diabetes, a form of high blood sugar that affects pregnant women, stand the risk of developing diabetes type 2 within five to 10 years after giving birth. Without treatment, their child will also have a risk of developing diabetes type 2 in adulthood.
Myth 6: Use of insulin during pregnancy has a negative impact on the fetus.
Insulin does not have a negative impact on the fetus. In fact, it is high blood sugar levels that could have a negative impact on fetal development. Only a slight amount of injected insulin can penetrate the placenta, unlike an oral tablet, so it is safe to use insulin injections to control blood sugar levels during pregnancy.
Myth 7: Diabetic people can eat wheat, but cannot eat rice.
Wheat and rice both contain carbohydrates and have a similar glycemic index, which means they both increase blood sugar levels in a similar way. People with diabetes should therefore consume wheat and rice in limited amounts.
Myth 8: People with diabetes cannot eat candy or chocolate. 
With a healthy diet and regular exercise, people with diabetes can eat candy, ice cream, cake and other confectionaries, but only in limited amounts and frequencies, such as during special occasions.
Myth 9: Diabetic people cannot eat pasta, breads, potatoes or noodles.
Starch is a kind of flour that, among other things, functions as a natural preservative. Breads, noodles and pasta usually contain starch, as do potatoes. People with diabetes can consume them, but only in small amounts.
Myth 10: People with diabetes cannot exercise too much, because it can reduce blood sugar levels excessively.
This is incorrect. People who take insulin must exercise in a balanced and regular way. People with type 2 diabetes who are not dependent on insulin but still take regular medication, will not experience a sudden drop in sugar levels from exercising. In fact, regular exercise is important in controlling diabetes, as is maintaining normal bodyweight.

http://www.thejakartapost.com/life/2018/06/02/debunking-10-diabetes-myths.html

Type 2 Diabetes and Healthy Living - Exercising Is Not a Fix for Poor Food Choices

By Beverleigh H Piepers

When it comes to exercise, many people do just fine. Not everyone has an inactive lifestyle. Some people have a job where they are on their feet for most or all of the day. Others play a sport every week because it is a hobby and they enjoy it: so they are regularly active. Some people are gym rats and are in and out of the gym on several days of the week. Not surprisingly, exercise can be addictive. It brings on a positive mood and a surge in energy levels while doing well for the body.
With that said, exercise should never be used to rationalize or attempt to fix poor nutrition. Here is what is meant by this: food is still number one. You are encouraged to exercise as much as possible within reason. It will only help you. But if you think this allows you to have greater freedom with your eating plan, you would be mistaken. Or worse - if you are using the activity as a way of attempting to fix your poor food choices.

Admittedly, much of this has to do with body weight. You will find many people do not struggle with exercising but have a hard time maintaining a healthy body weight. They might even joke about their exercise routine making them fat when they realize their body weight is not changing, or they are gaining weight. For weight loss - nutrition is number one. For health, the same often applies.

Remember, food is fuel for your body, and if you are not providing your body with high-quality nutrients, you are depriving your body of what it needs...

1. You cannot outrun the fork. Exercise as much as you like - but if you are eating more than your body needs, you will put on weight. Even if you are at the gym for two hours and having the best workouts of your life.
2. You must be careful with how you eat. Frequent meals will keep your blood sugar levels high. Insulin responses stimulate your appetite. So this means frequent meals are more likely to make you eat more, rather than less, even if your portion sizes are smaller.

3. You must also mind what you eat. Fats carry a lot of calories, so even if the whipped cream you are eating is sugar-free, it might be calorie dense. And sugars! Be very careful with them, always.
At the end of the day, you need to exercise and eat well. It is not one or the other. And never use exercise as a fix for poor nutrition.

Although managing your disease can be very challenging, Type 2 diabetes is not a condition you must just live with. You can make simple changes to your daily routine and lower both your weight and your blood sugar levels. Hang in there, the longer you do it, the easier it gets.

http://ezinearticles.com/?Type-2-Diabetes-and-Healthy-Living---Exercising-Is-Not-a-Fix-for-Poor-Food-Choices&id=9950737

4 Ways Diabetes Can Affect Your Eyes

By Samer Hamada

Diabetes is a condition that is caused when blood sugar levels within the body becomes too high and can affect people of all ages. There are various side-effects of having diabetes and it is a condition that should be taken seriously and monitored closely. Looking after your eyes when you have diabetes is vital as having the condition can cause eye problems, which if not looked after correctly, can lead to deterioration and potential irreversible eye damage. In this article I will look at 4 ways diabetes can affect the eyes.

1. Diabetic Retinopathy

Diabetic retinopathy is probably the most commonly known complication of having diabetes and must be taken seriously as it can lead to blindness. Diabetic retinopathy affects the retina, which is the back of eye. The retina is the part of the eye that converts the light we see into signals which are sent to the brain via the optic nerve, this is then processed by the brain into the images that we see. Diabetic retinopathy is caused when the small blood vessels on your retina become blocked, leak or grow abnormality due to the high blood sugar levels. There are 3 types of diabetic retinopathy;

1. Background diabetic retinopathy - this type is the very early changes to the retina, it doesn't normally affect sight but must be monitored carefully to ensure it doesn't become worse.
2. Diabetic maculopathy - this type is when the background diabetic retinopathy has developed on or around the macular. The macular is crucial when giving good vision as it provides central vision. Having diabetic maculopathy can affect sight.
3. Proliferative diabetic retinopathy - this type is caused when background diabetic retinopathy become worse. When the blood vessels become damaged or blocked in a large area by the above two types it causes a reduced supply of blood to the retina. The body tries to compensate this by growing new vessels on the retina's surface, but these vessels tend to be very weak and bleed, which in turn can affect the vision. The bleeding also can cause scarring which pulls on the retina, this can cause a retinal detachment. While retinal detachments can be fixed, sometimes this may not be possible, leading to impaired vision or blindness.

2. Cataracts

While developing cataracts is extremely common and a part of the eyes natural aging process, people with diabetes can develop cataracts earlier and faster. Cataracts are caused by the eyes ageing, becoming cloudy and more rigid. Symptoms of cataracts tend to be blurred vision and glare or halos, especially at night time. Cataracts are usually easily removed by undergoing cataract surgery and in its place an artificial intraocular lens is implanted to restore vision.

3. Glaucoma

Glaucoma is caused by an increase in the eye's pressure. Pressure develops when the eye's fluid cannot be drained as normal. This can then cause damage to the blood vessels and nerves within the eye leading to impaired vision, and if not monitored and treated correctly, can cause blindness. If you have diabetes, you are more likely to develop a rare glaucoma called neovascular glaucoma. This type of rare glaucoma is caused when new blood vessels develop and grow on the iris, which is the coloured part of the eye, and this blocks the normal flow of eye fluid and in turn increases the eye's internal pressure. While regular types of glaucoma can be treated with eye drops and possible surgery if needed, neovascular glaucoma is difficult to treat and laser surgery or implants may have to be used to control the glaucoma.

4. Blurred Vision

Blurred vision may be caused by something else, such as cataracts, but when you have diabetes it can sometimes be caused by an imbalance of your blood sugar levels that can easily be rectified. The high blood sugar levels can cause the lens within your eye to swell, which gives a blurry vision effect. To treat this, you may just need to get your blood sugar levels back under control and within limit. It may take a few months for the blurred vision to disappear. If you do develop blurred vision, make an appointment with your GP and optician or eye clinic, so they can make sure it is nothing more serious.
Remember if you have diabetes to get your eyes checked regularly. Everyone over the age of 12 with diabetes should be invited to a yearly diabetic eye screening and it is important not to miss this. Early detection of diabetic eye diseases could save your vision.

http://ezinearticles.com/?4-Ways-Diabetes-Can-Affect-Your-Eyes&id=9949720