Intensive lowering of blood pressure may protect people with type 2 diabetes from heart disease

From health.harvard.edu

Striving to keep systolic blood pressure (the first number in a reading) to 120 millimetres of mercury (mm Hg) or lower offers greater heart health protection for people with type 2 diabetes, high blood pressure, and other risk factors for cardiovascular disease compared to a less aggressive goal, according to a study published online Nov. 16, 2024, by The New England Journal of Medicine.

Half of the nearly 13,000 study subjects were assigned to aggressively reduce their blood pressure to 120 mm Hg or lower, often by taking multiple medications, and the other half were given an easier goal of less than 140 mm Hg. After an average of four years, the incidences of major cardiovascular events (including stroke or heart attack) among people assigned to the goal of no more than 120 mm Hg were significantly lower than among those assigned to less than 140 mm Hg (whose average reading was 135 mm Hg).

Most current guidelines recommend a systolic blood pressure of less than 130 mm Hg for people with diabetes, but these results are consistent with other studies that suggest reducing blood pressure to around 120 mm Hg or lower may offer the most benefit.

https://www.health.harvard.edu/heart-health/intensive-lowering-of-blood-pressure-may-protect-people-with-type-2-diabetes-from-heart-disease 

Recreational exercise, not work activity, linked to lower type 2 diabetes risk

From news-medical.net 

Researchers have found that engaging in moderate to vigorous physical activity during leisure time, regardless of occupational physical activity, is associated with a reduced risk of type 2 diabetes. A combination of sedentary leisure-time activity and demanding occupational activity may increase the risk. Findings from a novel study, appearing in the American Journal of Preventive Medicine, published by Elsevier, add to the body of knowledge that simple lifestyle changes, like recreational physical activity, can make a big difference and can contribute to the global prevention of type 2 diabetes.

The prevalence of type 2 diabetes has more than doubled worldwide over the past decade, making it a major public health burden and a societal challenge.

First author Anna Stage, MSc, Centre for Clinical Research and Prevention, Frederiksberg and Bispebjerg Hospital, Denmark, says, "The World Health Organization (WHO) states that physical activity contributes to preventing and managing noncommunicable diseases such as cardiovascular diseases and type 2 diabetes. The current WHO physical activity guidelines do not distinguish in which domains (e.g., work or leisure time) the recommended physical activity takes place. Our findings revealed that while leisure-time physical activity demonstrated a significant protective effect on type 2 diabetes incidence regardless of occupational physical activity level, no similar benefits were observed for occupational physical activity, suggesting that the 'Physical Activity Health Paradox,' which refers to the contrasting associations of physical activity during leisure time and occupational physical activity with cardiovascular disease, may also apply to type 2 diabetes. Currently the evidence is inconsistent and scarce."

This register-based study utilized data from 5,866 working adults aged 30-60 in the Inter99 cohort in Denmark. Assessment of type 2 diabetes status and date of diagnosis were based on the Danish Diabetes Register covering prevalent and incident diabetes from January 1, 1996 to June 30, 2020. In addition to undergoing a physical examination, participants answered a questionnaire about their levels of occupational physical activity and leisure-time physical activity. Data were analysed in 2024, taking relevant variables into account.

The main findings of the research are:

• Strenuous physical activity at work could be associated with incident type 2 diabetes, however, this was not a statistically significant finding.
• Physical activity during leisure time with moderate to vigorous intensity was associated with a significantly lower risk of type 2 diabetes.
• Sedentary leisure-time activity, such as watching TV or reading, combined with a job that requires any kind of physical activity, was significantly associated with an increased risk of type 2 diabetes.
• Moderate to vigorous intensity physical activity during leisure time combined with any level of occupational physical activity was protective for incident type 2 diabetes.

Stage points out, "It is noteworthy that the WHO recommendations on physical activity do not distinguish between work and leisure time, hence sending a potentially misleading message that daily physical activity accrued during work hours is sufficient to comply with current activity guidelines. However, our findings along with those of others underscore that leisure-time, not occupational, moderate to vigorous physical activity seems to reduce the risk of incident type 2 diabetes, other noncommunicable diseases, and all-cause mortality."

https://www.news-medical.net/news/20250219/Recreational-exercise-not-work-activity-linked-to-lower-type-2-diabetes-risk.aspx

Diabetes and Heart Health

From wvik.org

This month, we have been talking about heart health. Did you know people with diabetes are twice as likely to develop heart disease compared to those without diabetes? In fact, the longer someone has diabetes, the higher their risk of developing heart disease.

High amounts of glucose in your blood damage your blood vessels and nerves, increasing your risk of developing heart disease.

If you have diabetes, here are a few things you can do to protect your heart.

Know your A1C results. Your haemoglobin A1C differs from your daily blood sugar checks because it shows the average blood glucose level over the past three months. Your healthcare provider will set your A1C goal, which will generally be below 7%.

Know your blood pressure. When you have high blood pressure, excess stress is placed on your blood vessels, damaging your heart, brain, and kidneys, putting you at risk for a heart attack or stroke. For most people who have diabetes, your blood pressure goal will be below 140/90 mm Hg. But speak with your healthcare provider to see what is best for you.

Knowing your numbers and keeping them within the desired range will help decrease your risk of heart disease. This week, speak to your healthcare provider to get tested and then take steps to make the lifestyle changes needed to protect your heart.

Thank you for listening! I hope you have a happy and healthy day ahead. Content for this episode was provided by Diane Reinhold, nutrition and wellness educator for University of Illinois Extension. 

https://www.wvik.org/podcast/wellness-wake-up-call/2025-02-16/diabetes-and-heart-health

Doctor shares five symptoms of type 2 diabetes – one isn't usually 'associated' with disease

From getsurrey.co.uk

Dr Amir Khan has shared five symptoms of type 2 diabetes to watch out for, including one that people might not ordinarily attribute to this common health condition

Diabetes is a very common health condition that causes a person's blood sugar to become too high, which can lead to an array of health issues. Diabetes UK estimates a staggering 5.8million people nationwide have the condition, the vast majority of whom will have type 2.

While 4.6million people are diagnosed with the disease, the charity believes as many as 1.3million people may be living with type 2 diabetes without realising. Now, Dr Amir Khan – a GP who regularly promotes healthy living both online and on TV – has shared five warning signs that may appear in those who have the disease.

"Type 2 diabetes is a complex condition where your insulin doesn't work as well as it should do to keep your blood sugars in check," he explained in a TikTok video. He added that those who develop the condition may do so for a number of reasons linked to genetics and lifestyle.

Here are the five possible symptoms of type 2 diabetes Dr Khan believes people should be aware of.

Feeling tired all the time

"This is the most common symptom I see," the celebrity GP began. "Because your body's insulin isn't working as it should to release energy from your sugars, your body will look for other energy sources such as your protein and fat stores.

"These are harder to break down and you don't have as much energy in them, so you end up feeling tired."

Frequent infections

"If you're not using those sugars, something else will," Dr Khan warned. He stressed pathogens and bugs could use the sugars in diabetes sufferers' bodies to thrive, making them more prone to coughs and sneezes or even more serious conditions.

"Whether it's urinary tract infections, thrush or skin infections, these bugs love sugars to feed off and they thrive." The doctor also explained that high blood sugar can make your immune system less effective.

Needing to pee frequently

"If your blood sugars are persistently high, your body will try to lower this by making you go to the loo to pee out those excess sugars," Dr Khan explained.

However, he warned, this also leads to a loss of fluid, which can cause diabetes sufferers to notice another symptom – dehydration.

Unintentional weight loss

Dr Khan stressed that many people do not associate weight loss with diabetes – in fact, the opposite may be true. "Lots of people associate type 2 diabetes with being overweight," he said.

"Although that is a risk factor, when your sugars are high and your insulin isn't working to break them down and bring [sugar levels] down, your body starts breaking down those fats and proteins, as I talked about earlier, and you can end up with unexplained weight loss."

Nerve pain

"We call this peripheral neuropathy," Dr Khan said. "It usually causes tingling, burning or painful sensations in your toes and feet."

Dr Khan explained high levels of sugar can damage "those tiny little nerves" in the toes, as well as the blood vessels in those areas. "That makes it harder for them to carry proper nerve impulses," he added.

The NHS lists the symptoms of diabetes as: feeling very thirsty; peeing more frequently than usual, particularly at night; feeling very tired; weight loss and loss of muscle bulk; itching around the penis or vagina, or frequent episodes of thrush; and blurred vision.

Noticing any of these symptoms does not necessarily mean you have diabetes. If you're worried, it's important to see a doctor.

https://www.getsurrey.co.uk/news/health/amir-khan-shares-five-symptoms-31012586 

Diabetes UK experts share two-ingredient breakfast that avoids glucose spikes

From msn.com

After being diagnosed with diabetes, people will need to make major diet changes. But, swapping out your usual meals doesn't have to result in boring ones - with Diabetes UK experts sharing that you can still enjoy treats like pancakes for breakfast - just a little differently.

You'll need two mashed bananas and a lightly beaten egg to start. Afterwards, you can personally pick your favourite toppings with good choices including fruit and yoghurt.

The method to produce these protein-packed pancakes (20g per serving) is simple. Just mix the two ingredients together to form a batter, then add a ladleful of mixture to a frying pan that has been spritzed with cooking spray.

Cook each pancake for about two minutes on each side until golden and repeat the process using up the batter. Once ready, eat straight away with your chosen toppings.

                                           This easy recipe replaces milk and flour for alternatives that won't cause a blood sugar spike © Getty

People with diabetes can eat bananas as part of a balanced diet - but this should still be in moderation. It might be better to eat less ripe (green) bananas instead of classic yellow ones as less-ripe fruits lead to a slower, more manageable increase in blood sugar.

Eggs are low in carbohydrates and have a low glycaemic index, which means they don't significantly affect blood sugar levels. Again, they should still be eaten in moderation as overeating eggs has also been linked to an increase in type 2 diabetes. 

https://www.msn.com/en-gb/health/nutrition/diabetes-uk-experts-share-two-ingredient-breakfast-that-avoids-glucose-spikes/ar-AA1z2utB?ocid=msedgntp&pc=HCTS&cvid=12e2173aaa924d42aed1026fc3d277cf&ei=10

Can Type 2 Diabetes Be Reversed?

From medicine.yale.edu

More than 36 million Americans have type 2 diabetes, a condition primarily attributed to the body’s cells not responding to insulin properly, leading to high blood sugar levels. Due to the concomitant increase in the prevalence of obesity, type 2 diabetes is rising across the U.S. and around the world.

Research shows that most cases of type 2 diabetes can be prevented through lifestyle interventions. But if you already have the condition, can it be reversed? 

The answer is a resounding yes, according to Gerald I. Shulman, MD, PhD, George R. Cowgill Professor of Medicine (Endocrinology) and Cellular & Molecular Physiology at Yale School of Medicine (YSM), Investigator Emeritus of the Howard Hughes Medical Institute, and co-director of the Yale Diabetes Research Centre.

Insulin resistance drives type 2 diabetes, Shulman explains. “If you reverse insulin resistance, you reverse type 2 diabetes,” he said. In a landmark study, Shulman and Kitt Petersen, MD, professor of medicine (endocrinology), showed that modest weight reduction—even as little as 10%—does just that. The study, Shulman said, has been replicated multiple times in large groups of individuals.

However, Shulman notes, many people who are initially successful at losing weight regain it. The novel anti-obesity GLP-1 medications can play an important role in helping people maintain this weight loss over the long term to treat diabetes and other diseases, he said.

Patricia Peter, MD, assistant professor of medicine (endocrinology) at YSM, echoes the importance of addressing insulin resistance. “The best way to reverse type 2 diabetes is to decrease your body's resistance to the actions of the insulin made by the pancreas,” she said. “For most people, this means trying to attain a healthy weight, exercising regularly, and minimizing sugars and excessive carbohydrates in your diet.”

Both Peter and Shulman stress that addressing the disease has significant implications for overall health.

“Over time, high levels of sugar in the blood can damage your vision, nerves, heart and kidney function,” Peter said. “Thus, the sooner you can get your blood sugars back into the normal range by addressing or reversing diabetes, the less damage that high blood sugar can do.”

Shulman pointed to studies that show a decrease in well-established complications of diabetes, such as blindness, end-stage kidney disease, and non-traumatic loss of limbs, when diabetes is treated.

Even better than treating type 2 diabetes is focusing on what drives it, Shulman added. “In reversing insulin resistance, we not only reverse type 2 diabetes but also prevent heart disease, fatty liver disease, obesity-associated cancers, and Alzheimer’s disease, among many other problems that insulin resistance leads to,” he said.

https://medicine.yale.edu/news-article/can-type-2-diabetes-be-reversed/

Thriving with Diabetes in Your Older Years: Tips for Healthy Living

From bannerhealth.com

Managing diabetes as you age can be challenging. Knowing how your diabetes may change as you age can help you better handle those changes. Focusing on key habits and making small, manageable changes can make a big difference in your overall health and well-being. 

How diabetes management changes with age

As you grow older, changes in your body may affect how you manage diabetes. Your metabolism may slow down, you may lose muscle mass and you might not get as much exercise and physical activity as you used to.

“You’re also more likely to be dealing with other medical conditions at the same time,” said April Ehrlich, MD, a geriatric medicine specialist with Banner - University Medicine.

Medications may work differently as well. That’s because your kidney or liver function may change and these organs process medications. Medicine might stay in your system longer and have more of an effect.

Tell your health care provider about any symptoms or side effects and review your medications regularly.

“Your provider will consider your medical conditions, physical abilities, memory and social situation. Over time, they may focus more on preventing low blood sugars, minimizing medication and side effects and maximizing what matters most to you,” Dr. Ehrlich said.

Blood sugar control for seniors

Talk to your provider about your management plan and blood sugar goal. “Measuring and managing blood sugar levels may change depending on how you and your provider decide to best manage your diabetes. Your provider may ask you to check your sugars at a specific interval or this may not be necessary. Your goal blood sugar level may increase, especially if you have multiple medical conditions,” Dr. Ehrlich said.

You can use tools like blood sugar logs or apps to track trends. Talk to your provider about adjusting your medication if you notice any changes in your blood sugar levels based on meals, activity, medication or any other reason.

Be aware of the symptoms you might notice if your blood sugar gets too high or too low:

• High blood sugar (hyperglycaemia): Blurred vision, fatigue and frequent urination. Talk to your provider if your blood sugar is high.
• Low blood sugar (hypoglycaemia): Shakiness, confusion and sweating. “Have juice, hard candy or glucose tablets with you to take to avoid dangerously low levels and call your provider immediately,” Dr. Ehrlich said.

Eating well with diabetes as you age

Good nutrition is key to blood sugar control and your overall health and small changes in what you eat can make a big difference. “Your provider may recommend a tailored nutrition plan based on your goals,” Dr. Ehrlich said. 

Focus on these healthy eating tips for older adults with diabetes:

• Eat high-fibre options like whole grains, fruits and vegetables. They help your body absorb sugar more slowly so your blood sugar levels don’t spike.
• Choose low-sodium foods, since reducing salt intake may help manage blood pressure. Flavour foods with herbs and spices instead.
• Be sure to get enough protein. “Older adults with diabetes are at higher risk for losing muscle mass, so maintaining adequate protein intake is important,” Dr. Ehrlich said.
• Plan smart meals. Balance your plate with half vegetables, a quarter lean protein and a quarter whole grains. Eat smaller, more frequent meals to prevent blood sugar swings.

Staying active and staying safe

Physical activity is an important part of managing your diabetes. It helps control your blood sugar and lower your risk of complications. “Staying active can help you maintain your muscle mass, support your bone health, preserve your physical independence and help prevent falls. Older adults should exercise regularly and include both cardio and weight-bearing exercise,” Dr. Ehrlich said.

Good exercises for seniors with diabetes are:

• Walking, which is a simple way to boost your circulation and manage blood sugar.
• Swimming or water aerobics, which can give you a full-body workout while being gentle on your joints.
• Resistance exercises, which can build strength. Be sure to use light weights or resistance bands.
• Chair yoga, which can help you stay strong and flexible even if you can’t get up and down from the floor.

To stay safe, keep these tips in mind:

• Talk to your health care provider before you start any new activities.
• Warm up before and cool down after exercise to help prevent injuries.
• Monitor blood sugar levels before and after activity, especially if you take insulin.

Preventing complications

These steps can help reduce your risk of diabetes-related complications, such as heart disease, neuropathy or vision problems:

• See your health care provider regularly to check your overall health and make sure you’re controlling your blood sugar well.
• Don’t skip meals, especially if you take insulin.
• Have your eyes examined routinely to look for signs of retinopathy, a vision problem that can stem from diabetes.
• Check your feet for wounds when you put on your shoes and have your provider or a podiatrist treat any small cuts or sores before they get worse.
• Manage other chronic health conditions like high blood pressure or high cholesterol.
• Moisturize your skin every day to keep it from getting dry and cracking.
• Stay hydrated, especially in warm weather. As you get older it may be harder for you to recognize when you are thirsty.

“Avoiding complications is very important in older adults. Let your provider know immediately if you are having low blood sugars, side effects from your medications, trouble remembering to take your medications, difficulty affording your medications or unintended weight loss,” Dr. Ehrich said.

Managing emotional health

“Managing diabetes can be a very difficult and emotional process. If you are struggling, let your provider know. There may be ways to simplify your management plan,” Dr. Ehrlich said. It’s just as important to take care of your emotional well-being as it is to manage physical symptoms. 

These tips can help:

• Stay active.
• Get plenty of sleep.
• Participate in activities you enjoy.
• Reduce stress with meditation, mindfulness, deep breathing or journaling. Stress can raise your blood sugar levels. 
• Connect with friends or join an online or in-person diabetes support group to share your experiences and learn from others.
• Talk openly with your loved ones about your care needs.
• Focus on small, achievable goals and celebrate wins like maintaining stable blood sugar for a week or trying a new recipe.

The bottom line on managing diabetes in older adults

Managing diabetes as you age may bring new challenges, but you can thrive with planning and support. Whether it’s monitoring blood sugar, eating well, staying active or caring for your mental health, small, consistent steps can bring big improvements.

For care designed just for you, speak with your health care provider or connect with an expert at Banner Health. Taking charge of your diabetes today can help keep you healthier in the future.

https://www.bannerhealth.com/healthcareblog/better-me/healthy-living-with-diabetes-as-you-get-older