Eating Disorders Common in People With Type 1 Diabetes

From islandernews.com

Key Takeaways

• New research suggests that 1 in 4 people over the age of 16 with type 1 diabetes also has an eating disorder

• Some may intentionally skip insulin doses, thinking it helps them stay slim

• Doing so can upset blood sugar control and raise the odds for complications

THURSDAY, May 9, 2024 (HealthDay News) -- One in every four people age 16 or older with type 1 diabetes may be struggling with an eating disorder, a new review of data on the subject finds.

Type 1 diabetes is an autoimmune disorder in which the body attacks its own insulin-producing cells in the pancreas, making a person reliant on injected insulin. About 5% of diabetes cases are type 1.

The new study was led by doctoral student researcher Pia Niemelä of the University of Eastern Finland. Her team looked at data from 45 studies involving nearly 11,600 people with type 1 diabetes.

They found that over 2,500 patients -- almost 1 in every 4 -- also exhibited symptoms of an eating disorder.

That's not overly surprising, the Finnish team said, since weight gain is a concern for many people with type 1 diabetes. People with the illness can exhibit symptoms like binge eating or cutting back on food intake, but some also practice a form of disordered eating called "insulin omission."

This practice -- skipping insulin doses -- is thought to discourage weight gain, but it can be very unhealthy.

“Intentional skipping or restriction of insulin doses will lead to weight loss, but this also maintains high blood glucose, throwing the management of diabetes off balance,” Niemelä said in a university news release.

The study found that women with type 1 diabetes were more prone to eating disorders than men, but age didn't seem to matter.

“Eating disorder symptoms are often thought to affect adolescents and young adults," Niemelä said. "However, our meta-analysis shows that adults, too, suffer from eating disorder symptoms, which is why it is important to learn to identify patients with eating disorders."

She stressed that developing an eating disorder can encourage complications and worsening illness in people with type 1 diabetes. Certain screening methods can help doctors pick up signs of eating disorders in patients, however.

The study was published in the April issue of Eating Disorders.

https://www.islandernews.com/lifestyle/health/eating-disorders-common-in-people-with-type-1-diabetes/article_df0670d5-ca92-56e1-a2d7-cd9ed9a22379.html 

Benefits of Strength Training for Diabetes

From diatribe.org

Compelling research has shown that resistance exercises like push-ups, squats, and lunges are beneficial for blood sugar management. Here's how to get started.

Aerobic exercise has always held a prominent role in the recommendations of the American Diabetes Association for the prevention and management of type 2 diabetes. This isn’t surprising because aerobic exercises – like swimming, running, walking, and biking – offer a lot to help manage blood glucose. But is it the best choice for diabetes management? 

Strength training, also called resistance training or weight training, may offer a starting point to enhance the effects of aerobic exercise for those living with diabetes. If you’re new to resistance training, it’s a type of physical activity that requires the body’s muscles to move against an opposing force. It usually involves some type of equipment (like elastic resistance bands or free weights) but can be performed through bodyweight exercises like push-ups and squats.  

“Resistance exercise has not been traditionally touted as a therapy, it’s all about aerobic exercise,” said Dr. Stuart Phillips, a research chair in skeletal muscle health at McMaster University. “In my view, resistance exercise is an exercise form that offers many things – strength, mitigating the loss of muscle with aging – and is beneficial for diabetes also.”  

In the last few decades, compelling research has shown that strength training is as good or better than aerobic exercise for keeping blood glucose levels in check. Because of this and other benefits, Phillips said that resistance exercises should be recommended more often as a primary tool for diabetes management. To better understand the benefits of strength training, let’s take a look at what makes it unique. 

Benefits of resistance exercises for diabetes

Improved insulin sensitivity

Studies have shown that strength training improves insulin sensitivity. How exactly? When you lift weights or do other resistance exercises, you increase muscle size, which allows your body to process glucose more efficiently and decreases its need for insulin.

While aerobic exercise has its own benefits, studies have found aerobic exercise alone doesn’t produce the same level of muscle mass and strength as resistance exercises. This makes strength training a great option if you’re looking to reduce insulin needs.

Better blood sugars

Multiple studies show strength training is as effective (and possibly even more so) as aerobic exercise in helping people with diabetes manage their blood glucose. 

Resistance exercises also appear to regulate blood sugar for a longer period than aerobic exercise; while aerobic exercise lowers blood glucose during an exercise session, the blood sugar-lowering effects of strength training can last up to 24 hours post-exercise. 

Quick and easy

Resistance exercises may be a good alternative for those who find it difficult to reach the recommended 150 minutes of aerobic exercise a week. Studies have shown that only 24% of adults between 18 and 55 and 2% of adults over 65 meet that quota. 

Strength training is time-efficient and can easily be done at home using your body weight (think push-ups) or minimal equipment (like resistance bands or even milk jugs). An extra benefit is that it will help maintain much-needed muscle mass, which people start losing at a rate of 3-8% per decade after age 30 and accelerates by age 60. 

Loss of muscle mass can be detrimental to overall health and further chronic disease risk. Moreover, as people age, declining muscle strength and loss of mobility are likely to reduce our overall physical activity, which can trigger or worsen challenges around glucose management.

The good news is that this trend can be reversed – it’s never too late to rebuild or build muscle.

How to start 

It may sound intimidating, but making strength training part of your day can be easy. The great thing about resistance exercises is they’re versatile; you can create a workout anywhere, any time, no matter your fitness level. 

As with any exercise routine, consistency is key. Training two to three times a week and targeting all major muscle groups is a good way to start. There is no one “ideal” workout, as everybody is different. 

“I am a fan of time-efficient workouts that are generally whole-body, targeting major muscle groups – chest, back, and legs – and are manageable in a short time,” said Phillips. 

Though there are many different types of resistance exercises, here’s a sample routine Phillips suggests. An extra benefit is that no equipment is required. For all exercises, rest for 90 seconds between sets.

• Squats: Three sets of 10-15 repetitions. 
• Push-ups: Three sets of 10 repetitions (on the floor or against the wall)
• Lunges: Three sets of 10-15 repetitions 
• Bridges: Three sets of 10-15 repetitions
• Planks: Three sets of 10-30 second holds

Aim for at least three sets per muscle group, ideally performed twice weekly for 30-40 minutes max each session.

If you’re new to strength training exercises, the first step is learning the proper form. Some excellent online sources include the National Strength and Conditioning Association (NSCA), which has an extensive exercise video library free online, and the Mayo Clinic Strength Training Guide. 

The bottom line

Strength training can be a safe and useful tool for diabetes management – plus it’s quick and can be easily done at home. 

Building muscle through strength training has a multitude of benefits, including improved insulin sensitivity, glucose control, and metabolism. Maintaining muscle mass is also important for older adults (especially those living with a chronic condition) as it protects bones and reduces the risk of heart disease. 

For people with diabetes and other conditions, it’s always a good idea to talk to a healthcare provider before trying a new exercise routine. 

https://diatribe.org/exercise/benefits-strength-training-diabetes 

Sunlight may help improve Type 2 diabetes, study suggests

From msn.com

BOSTON - Getting more sunlight might help people with Type 2 diabetes.

A mismatch between our internal circadian clocks and modern day living with greater time spent indoors and topsy-turvy schedules has been associated with metabolic disorders, including Type 2 diabetes. But greater exposure to daylight may help.

This was a small study conducted in the Netherlands and Switzerland that exposed 13 participants to two different light treatments over four-and-a-half days: natural light and artificial light. 

They found that those exposed to the natural light had blood sugars that stayed in the normal range for longer periods of time and evidence of improved metabolism compared to those exposed to the artificial light.

The scientists advise people who work in office buildings or live in housing without much natural light to get outdoors in the daylight as often as possible.

https://www.msn.com/en-us/health/medical/sunlight-may-help-improve-type-2-diabetes-study-suggests/ar-AA1hB8UV?apiversion=v2&noservercache=1&domshim=1&renderwebcomponents=1&wcseo=1&batchservertelemetry=1&noservertelemetry=1 

Ancient grains linked to improved type 2 diabetes outcomes

From medicalnewstoday.com

• A new study suggests ancient grain consumption is associated with improved health outcomes for people with type 2 diabetes.
• Ancient grains like oats are rich in dietary fibre and phytochemicals that may help manage blood sugar and cholesterol.
• Experts recommend incorporating minimally refined grains into a healthy, balanced diet to reap the most benefits.

A new study highlights the potential benefits of including ancient grains in dietary patterns for people with diabetes.

Ancient grains, known for their lack of genetic modification and higher levels of beneficial phytochemicals and fibres, may offer a promising avenue for dietary intervention.

This new analysis of 29 randomized controlled trials suggests ancient grains like oats, brown rice, and millet may produce positive diabetes health outcomes, with particular benefits observed in blood sugar and cholesterol profiles.

However, the study also points to the need for further research, given the variability and limitations of the data reviewed.

The findings, published in Nutrition, Metabolism and Cardiovascular Diseases, underscore the importance of dietary choices in diabetes management alongside traditional medical treatments.

Studying the impact of ancient grains on diabetes

In this systematic review and meta-analysis, researchers assessed the effectiveness of various types of ancient grains in managing diabetes.

The review included 29 randomized controlled trials, of which 13 were meta-analysed.

The studies involved a total of 1,809 participants, with a slightly higher proportion of males (55.2%) and an average age of around 56. The majority of participants had type 2 diabetes, with only one study including individuals with type 1 diabetes.

On average, participants had been living with diabetes for approximately 14 years, with many managing their condition with oral medications or a combination of oral medications and insulin injections.

All included studies looked at cardiovascular risk factors such as body weight, blood sugar, and cholesterol, with varying significant outcomes. However, they didn’t address other vital diabetes management aspects, like patient satisfaction, overall well-being, and the cost-effectiveness of using ancient grains in diabetes treatment.

The studies included in the analysis most commonly examined the effects of oats, brown rice, buckwheat, or chia seeds on diabetes. Notably, only a fraction of the studies (24%) used whole, unrefined grains in their research.

Using specialized software, the researchers combined and analysed the studies’ diverse data to identify consistent trends in the impact of ancient grains on diabetes health outcomes.

Ancient grains improve fasting blood glucose levels

A new study suggests ancient grains like oats and buckwheat may help manage blood sugar and cholesterol in type 2 diabetes. Ulada/Getty Images

In the comprehensive analysis, the vast majority of studies (96.5%) suggested a positive effect of ancient grain consumption on various diabetes markers, including insulin levels, haemoglobin A1c, fasting blood glucose, and cholesterol levels.

Of the studied ancient grains, oats stood out for their potential to significantly improve cholesterol and fasting blood glucose levels in individuals with type 2 diabetes, which is supported by previous researchTrusted Source.

Brown rice also showed beneficial effects, particularly on HbA1c and body mass index (BMI), but not on other blood sugar and cholesterol markers, which is partially aligned with previous research, according to the study authors.

Also of note, millets showed a significant effect on body weight, however, the study authors recommend interpreting this finding with caution due to potentially confounding factors in the included studies.

Conversely, despite their known health benefits, chia seeds did not demonstrate a significant influence on diabetes markers in this meta-analysis, possibly due to the small sample sizes involved.

The study found that ancient grains might benefit those with type 2 diabetes, but the results may not be entirely reliable due to the variability of the studies. The authors call for more standardized, in-depth research on ancient grains for diabetes management.

Ancient grains boost metabolic health

Medical News Today spoke with Avantika Waring, MD, a board-certified physician in endocrinology, diabetes, and metabolism, and chief medical officer at 9amHealth, not involved in the study, about how ancient grains may improve diabetes health outcomes.

Waring explained:

“There are a variety of phytochemicals in whole, ancient grains including flavonoids and phenolic acids (antioxidant, anti-inflammatory properties) and phytosterols (heart healthy and improve the lipid profile) that can improve overall metabolic health and improve blood glucose and cholesterol management in type 2 diabetes.”

She also noted that “the hearty bran layer around the outside of an unprocessed whole grain breaks down slowly therefore preventing spikes in blood sugars which can also help improve diabetes management”.

Eliza Whitaker, a registered dietitian and medical nutrition advisor at Dietitian Insights, who was not involved in the study, also spoke to MNT about potential mechanisms at play in the study’s findings.

She highlighted the role of oxidative stress in the progression of diabetes and further explained that the specific “phytochemicalsTrusted Source such as phytosterols, lignans, flavonoids, and carotenoids found in ancient grains have anti-inflammatory properties that can mitigate [this] oxidative stress.”

Compared to modern grain varieties that were mainly cultivated after the 1960s, ancient grains have undergone less genetic modificationTrusted Source and are typically reported to have superior nutritional composition and kernel quality.

Specifically, ancient grains tend to contain higher levels of certain phytochemicals and dietary fibre, which are associated with potential health benefits related to insulin sensitivity, glucose metabolism, and overall blood sugar control.

Still, research directly comparing the impacts of ancient versus modern grains on diabetes health outcomes is limited. Both types can be consumed in minimally processed forms to preserve their nutritional composition and potential benefits.

Should people with diabetes eat more ancient grains?

Waring and Whitaker agreed that ancient grains are safe and likely beneficial for most people with type 2 diabetes to consume in regular portions and as part of a balanced diet.

“People with type 1 diabetes can also eat ancient grains, and they can work with their healthcare provider to adjust their insulin to manage any rise in blood sugars that occurs when consuming carbohydrates,” added Waring.

However, both experts strongly recommend prioritizing minimally refined grains, like oats and chia seeds, over more refined grains, like bread, pasta, or cereal, which likely don’t provide the same benefits.

“Regardless of what type of foods you prefer, covering half the plate with green veggies, quarter with lean protein (can be plant-based like beans or tofu), and a quarter with whole grains is a balanced approach,” said Waring.

When asked whether people with diabetes should opt for a diet rich in ancient grains, which are higher in carbs, versus a diet low in carbs for optimal blood sugar management, Waring concluded:

“While ancient grains and any whole grains can increase the blood sugar levels in a person with diabetes, the higher fibre levels, especially when paired with healthy fats as part of a meal, help minimize blood sugar spikes. Low carb diets are one way to keep blood sugars consistently low, however these are typically not sustainable in the long term, and when you eliminate grains from your diet, you’ll miss out on the fibre, phytochemicals, and plant-based fats that we know promote heart health and longevity.”

https://www.medicalnewstoday.com/articles/ancient-grains-may-help-treat-type-2-diabetes

Adding AI to Artificial Pancreas Enhances Efficiency, Study Finds

From newsroom.uvahealth.com

Adding advanced artificial intelligence to an artificial pancreas regulating type 1 diabetes is safe and improves the system’s efficiency, a first-of-its-kind study from the University of Virginia Centre for Diabetes Technology has found.

In the new study, UVA researchers compared an advanced experimental artificial pancreas system – which automatically monitors and regulates blood sugar for patients with type 1 diabetes – with an artificial pancreas algorithm that incorporated AI, described by the research team as a “Neural-Net Artificial Pancreas.” The AI-supported artificial pancreas kept participants’ blood sugar in the target range for an almost identical amount of time as the advanced system while significantly reducing computational demands, the researchers found. The increased efficiency could allow the developers to implement the system in devices with low computational power, such as an insulin pump, they say.

“So far, this is the first clinical trial of a data-driven artificial pancreas system, which used a extensively trained neural network to deliver insulin automatically," said Boris Kovatchev, PhD, director of the UVA Centre for Diabetes Technology. 

Enhancing the Artificial Pancreas

Fifteen adult participants with type 1 diabetes participated in back-to-back testing sessions at a hotel, using both the advanced artificial pancreas and the AI-supported artificial pancreas for 20 hours and following their daily routines as closely as possible. The AI-supported artificial pancreas system kept participants blood sugar in the target range 86% of the time, compared with 87% for the advanced artificial pancreas system. The AI-supported artificial pancreas showed greatly improved efficiency, reducing computational demands six-fold.

The AI-supported artificial pancreas “is therefore more suitable for implementation in devices with low processing power, such as insulin pumps or pods,” the researchers report in a new scientific paper.

Additional research is needed before the AI-supported artificial pancreas would be ready for use by patients. But the UVA research team hopes that incorporating AI could allow the algorithm to adapt and improve based on data from thousands of users instead of just an individual as well as to automate blood-sugar monitoring and regulation through devices with limited computing power.

“Neural-net implementation allows the algorithm to learn from the data of the person wearing the system,” Kovatchev said. “This opens the door to real-time, AI-driven personalized insulin delivery.”

Efforts to develop an AI-supported artificial pancreas builds on the earlier ground-breaking work of the UVA Centre for Diabetes Technology to create a separate artificial pancreas system that has already been approved for use by patients. Manufactured by Tandem Diabetes Care and sold as the Control-IQ system, the U.S. Food and Drug Administration has approved the system for people ages 2 and older with type 1 diabetes. 

Developing innovations to improve treatment options and better patients’ lives is a key mission for UVA Health – as outlined in its first-ever 10-year strategic plan – and for UVA’s forthcoming Paul and Diane Manning Institute of Biotechnology, now under construction at Fontaine Research Park. 

Findings Published

The AI study results have been published in the journal Diabetes Technology & Therapeutics. The article’s authors are Alberto Castillo, Elliott Pryor, Laura L. Kollar, Charlotte L. Barnett, Mark D. DeBoer, Sue A. Brown and Kovatchev. Funding for the study came from the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases, grant R01 DK 133148, and the National Center for Advancing Translational Sciences, grant UL1TR003015. Tandem Diabetes Care provided the insulin pumps used in the trial, while Dexcom Inc. provided the continuous glucose monitors. Disclosures from the researchers can be found in the paper.

https://newsroom.uvahealth.com/2024/05/02/adding-ai-artificial-pancreas-enhances-efficiency-study-finds/ 

Regularly eating avocado is linked to lower diabetes risk in women

From medicalnewstoday.com

• Avocados are rich in fibre, antioxidants, and healthy fats that can support metabolic health and insulin sensitivity.
• A new study suggests avocado consumption may significantly reduce diabetes risk, particularly among women.
• Experts recommend a balanced and diverse diet rather than overemphasizing specific foods for diabetes prevention. However, including avocados can be a healthy choice.

New research published in the Journal of the Academy of Nutrition and Dietetics suggests a potential association between avocado consumption and diabetes risk among Mexican adults.

Diabetes is the second leading cause of death in Mexico, affecting around 15.2% of adultsTrusted Source (12.8 million).

To investigate the relationship between avocado consumption and diabetes risk, researchers studied mostly self-reported dietary habits and diabetes diagnosis information from survey responses of a portion of the Mexican population. The majority of these respondents were classified as having overweight or obesity.

The results showed that women who consumed avocados were less likely to develop diabetes than those who did not eat them. This connection, however, was not observed in men.

A recent study from Mexico links avocado consumption with a lower diabetes risk. Image credit: Tatiana Maksimova/Getty Images

Studying avocado consumption and diabetes risk  

This study analysed data on Mexican adults aged 20 and older from the Mexican National Survey of Health and Nutrition (ENSANUT) years 2012, 2016, and 2018.

After excluding specific individuals, such as those who were pregnant or breastfeeding, and those with missing or unreliable data regarding diabetes and avocado intake, the final sample included 25,640 participants.

Approximately 59% were female, and more than 60% had abdominal obesity.

In the surveys, dietary information was assessed using a 7-day food-frequency questionnaire to determine avocado consumption habits, and participants were strictly classified as avocado consumers (consuming any amount of avocado) or non-consumers.

The presence of diabetes was primarily identified through self-reported diagnoses, with a portion of the participants using clinical measures of blood sugar levels to confirm diabetes cases.

The participants also self-reported demographic and cardiometabolic risk factors such as age, sex, socioeconomic level, education, body mass index (BMI), abdominal obesity, healthy eating index (HEI-2015) score, calorie intake, lifestyle habits, and pre-existing conditions.

However, trained personnel measured the participants’ weight, height, and waist circumference.

Upon gathering the survey data, the researchers analysed it using descriptive statistics and logistic regression models to investigate the link between avocado consumption and diabetes risk among the adult population in Mexico.

Eating avocado tied to lower diabetes risk in women

Among the participants, about 45% reported consuming avocados, with average daily intakes of 34.7 grams (g) for men and 29.8 g for women.

Those who ate avocados generally had higher levels of education and belonged to a higher socioeconomic class than those who did not consume avocados.

Additionally, over three-quarters of avocado consumers resided in urban areas.

Across both genders, avocado eaters also tended to have slightly higher scores on the healthy eating index, indicating a somewhat more nutritious diet overall.

These findings suggest that individuals who consumed avocados likely had greater access to and resources for healthier food options. It is important to note, however, that the study’s adjusted models considered and accounted for these factors.

In women, avocado consumers showed a 22% and 29% lower risk of developing diabetes in unadjusted and adjusted models, respectively. However, this protective effect of avocado consumption was not observed in men.

This relationship remained consistent when laboratory-confirmed diabetes diagnoses were used instead of self-reported diagnoses.

How might avocados contribute to lower diabetes risk?

Medical News Today spoke with Avantika Waring, MD, a board-certified physician in endocrinology, diabetes, and metabolism, and chief medical officer at 9amHealth, not involved in the study, about how avocados may reduce diabetes risk among women.

Waring explained:

“There are a few potential ways that avocado consumption could lower risk of diabetes in women, including the presence of antioxidants which can reduce inflammation and cellular damage that would otherwise increase the risk of conditions like diabetes. Avocados, being high in fat and fibre, also have a low glycaemic index, and therefore don’t promote spikes in glucose and the resulting rise in insulin levels that are metabolically unfavourable.”

She pointed out, though, that these mechanisms are speculative, and suggested that the high fibre and healthy fats in avocados could also promote fullness, subsequently decreasing the intake of less nutritious foods.

Thomas M. Holland, MD, MS, physician-scientist at the RUSH Institute for Healthy Aging, Rush University System for Health, not involved in the study, similarly highlighted that avocados, rich in “insulin-sensitizing nutrients,” could potentially stabilize the diabetic disease process.

“However, it remains a challenge to precisely determine why the association was observed only in women and not in men,” he said.

He proposed that various factors might influence the disease course in women, including sex differences in diabetesTrusted Source that are related to hormonal changes across the lifespan, genetic and environmental factors, and psychosocial stressors that uniquely impact women’s diabetes risk.

Waring concurred, emphasizing the significant hormonal shifts women experience during key life stages. “During pregnancy, women become more insulin resistant for example, and during menopause as oestrogen levels drop, body fat patterns change in women that can result in a higher risk of diabetes,” she said.

Ultimately, it is unclear what caused the sex differences in avocado consumption’s impact on diabetes risk in this study, highlighting the need for further research on sex-specific dietary interventions and personalized nutrition recommendations.

Should we eat more avocados to lower risk of diabetes? 

Eliza Whitaker, MS, RDN, a registered dietitian and medical nutrition advisor at Dietitian Insights, who was not involved in the study, noted the study’s major limitation in broadly categorizing avocado consumers, making it hard to determine the beneficial amount of avocado intake.

She mentioned that lumping occasional and frequent avocado consumers together complicates understanding the precise impact on diabetes risk.

As far as we can tell, based on current science, she said: “Avocados may be associated with a lower risk of diabetes, but avocados alone aren’t enough to reduce that risk. We have to look at the diet as a whole when it comes to reducing the risk of developing diabetes.”

Waring echoed this sentiment, suggesting the study supports the consumption of unprocessed, heart-healthy foods, including fruits and vegetables, for better metabolic health but doesn’t result in specific dietary guidance regarding avocado consumption.

Overall, “maintaining a healthy lifestyle, with diet being one component, enhances an individual’s ability to take control of their disease process,” Holland added, emphasizing a holistic approach to disease prevention.

Although the study cannot be used to draw definitive conclusions about avocado consumption and diabetes risk, Holland suggested the associations it reveals still carry significant weight.

Regarding whether individuals should incorporate avocados to reduce diabetes risk, Holland concluded:

“Considering the abundance and diversity of nutrients found in avocados, there is compelling evidence that incorporating them into a healthier diet, such as the DASH diet, Mediterranean diet, or MIND diet, is strongly recommended for diabetes management.”

https://www.medicalnewstoday.com/articles/regularly-eating-avocado-linked-to-lower-diabetes-risk-in-women#Studying-avocado-consumption-and-diabetes-risk