Don't underestimate diabetes, expert warns

By Dan Satherley

An Auckland University health researcher is warning the health system is at risk of being overwhelmed by the growing diabetes epidemic.

Dr Rinki Murphy says already 50 percent of hospital admissions involve diabetes, whether as the primary cause or a complicating factor. Diabetes spending in New Zealand is expected to rise to about $1 billion within five years -- 15 percent of all health spending.

It already accounts for 10 percent of health spending in the UK, costing £10 billion a year.

A quarter of that spending takes place in the last year of a patient's life.

"Thanks to the great advances in diabetes management, we're able to live longer with diabetes," says Dr Murphy, bringing the overall cost of treatment up.

She wants more focus on education and prevention. Many people at risk of developing type 2 diabetes don't realise it's a problem until it's too late.

"It creeps up on you, and the complications do take time. In the early phases of the disease many people can ignore it and they don't feel the consequences."

While it's largely the result of "lifestyle choices", Dr Murphy acknowledges it's easier for some to avoid than others.

"We need to be wary of the fact not everyone is on the same level playing field in being able to adopt those choices," she says.

Getting in early is the key.

"We need to engage the public, we need to engage children and have a school curriculum that includes the science behind obesity and diabetes," she explains.

"We need to have more collective actions to make the healthy choices easier ones for all sections of society, and invest in research."

New Zealand is the third-fattest country in the world, behind only the United States and Mexico according to the World Health Organisation.

The Government has refused to take action against sugar-filled food, saying taxes won't work.

http://www.newshub.co.nz/nznews/education/dont-underestimate-diabetes-expert-warns-2016053111#axzz4ADwGvU5K

Could your JOB be putting you at risk of diabetes and heart disease?

From express.co.uk

WORK pressures are putting millions of employees at risk of diabetes and heart disease, a new study has found.
Fears about not being able to clear their desks are to blame for stopping almost three in five workers from leaving the office for a lunchtime stroll.
Despite more than nine in ten workers reporting that being outside makes them feel healthier or more positive, more than half of those who were questioned - 52 per cent - never leave their office for lunch.
Almost one in four, 24 per cent, say they regularly work through their break.
A survey commissioned by the National Charity Partnership, a collaboration between Diabetes UK, the British Heart Foundation (BHF) and Tesco, found that one in three office workers say heavy workloads keep them shackled to their desks at lunchtime while 14 per cent blame the workplace culture and another 13 per cent cite stress as a reason for failing to get a decent midday rest.
The partnership is calling on workers to reclaim their lunch break and get walking to help protect their wellbeing.
Babs Evans, head of prevention for the National Charity Partnership, said: “When you’re under pressure at work it’s easy to forego a lunch break and instead grab a quick bite at your desk, but this isn’t healthy.
“Work-related stress puts a strain on your mental wellbeing and can have a knock-on effect on your physical health.
“People under too much pressure at work are more likely to eat unhealthily and stop being active - behaviours which are linked to a number of health conditions, including Type 2 diabetes and heart and circulatory disease.
“Both conditions are serious and affect millions of people in the UK, with millions more at risk. However, they are largely preventable and being active is an effective way to help reduce your risk.
“Even just a ten minute break away from your desk to go for a walk and clear your head can help to make a big difference with stress relief, which in turn is good for your health.”
More people than ever before are being diagnosed with either Type 2 diabetes or heart disease. Around 3.6million people in the UK currently live with Type 2 diabetes and an estimated 7million have heart and circulatory disease.
Both conditions are potentially life-threatening if left untreated and Type 2 diabetes can double the risk of developing heart and circulatory disease.
Being physically active is known to help reduce the likelihood of developing Type 2 diabetes and heart and circulatory disease.
Only five per cent of workers who were surveyed do something active during their lunch break, such as going to the gym or for a walk. Nearly one in four, 23 per cent, said they simply cannot be bothered.
The new study comes after figures released by the BHF at the start of 2016 which found that one in five Brits openly admit to not exercising.
Meanwhile, 83 per cent do not know what the recommended weekly level of physical activity is.
The National Charity Partnership is running a campaign, Let’s Do This, to support adults to reduce their risk of Type 2 diabetes and heart and circulatory disease by taking small steps towards healthier lifestyles.
Its online Goal Setter allows people to set and monitor their health-related targets and encourages them to stay motivated and achieve their goals.

http://www.express.co.uk/life-style/health/675121/Could-job-risk-diabetes-heart-disease

Diabetes: Children 'not getting recommended checks'

From BBC Health

Almost 75% of older children in England and Wales with diabetes are not getting key health checks, a study suggests.

Data from 27,682 children and young people showed 25.4% of those aged 12 and older had all seven recommended annual checks, such as eye screenings.
However, the Royal College of Paediatrics and Child Health, which carried out the audit, says the overall picture is one of improving care.
Diabetes UK said missed health checks for children was "very worrying".
Health officials recommend all children with diabetes should be assessed to ensure they are managing their condition properly.

Guidelines from NICE (National Institute for Health and Care Excellence) state that all children with diabetes should have their blood sugar levels checked every year and those over the age of 12 should also have six other annual health checks.
These include measures of growth, blood pressure, kidney function, cholesterol, as well as an eye screening and a foot examination.

Future complications

The report looked at data from children and young people with diabetes up to the age of 24 who attended paediatric diabetes units in England and Wales between April 2014 and the end of March 2015.
More than 70% had type 1 diabetes, which requires daily injections of insulin.
Experts say the average blood glucose level (HbA1C) - a marker that measures overall diabetes control - in children with diabetes fell for the fifth consecutive year.
The report found that those achieving "excellent diabetes control" - equivalent to a blood glucose level of less than 7.5% - rose from 15.8% in 2012-13 to 23.5% in 2014-15.
It also found 98.7% of all children and young people had received the blood glucose checks.
The audit showed 23% were now reducing their risk of future complications from the disease.
However, the most commonly missed checks among children aged 12 and older included foot examinations, eye screenings and cholesterol testing.

Despite the improving picture, Dr Justin Warner, consultant in paediatric endocrinology and diabetes at the University Hospital of Wales and clinical lead at the Royal College of Paediatrics and Child Health, said annual health checks for children should not be missed.
"They form part of a lifetime of screening for complications which, if recognised early, are amenable to interventions that reduce progression," he said.
But he said the rate of improvement of those achieving "excellent diabetes control" had exceeded that seen in some other European countries.
The report also noted that worryingly high numbers of children over the age of 12 were already showing signs of early complications.
And children and young people living in the most deprived areas were found to have worse blood glucose test results than those living in more affluent areas.

Bridget Turner, director of policy and care improvement at Diabetes UK, said: "There remains considerable variation in the level of care provided.
"This is very worrying because if children and young people are not supported to manage their diabetes well in early life, they are more likely to be at risk of debilitating and life-threatening complications in adult life such as amputations, blindness and stroke."
She said it was essential that the parents of children and young people with diabetes were supported to help them deal with the illness.

http://www.bbc.co.uk/news/health-36391631

Diabetics must consult doctors for fasting

From emirates247.com

Muslims suffering from diabetes should consult their doctor on whether they can fast during Ramadan, which starts next week, according to a Saudi doctor.
Dr Nassir Al Jahni, a general medicine consultant and head of the diabetes committee in the Western Red Sea port of Jeddah, said at least 140 million people are suffering from diabetes in the Islamic countries.
He said Ramadan this year involves very hot days and long fasting hours, stretching at least 15 hours in the Gulf, adding that this makes it very difficult for sick people.
“People suffering from diabetes should seek medical advice to see if they can fast in Ramadan.
“This depends on the type of diabetes they have and the number of medicine dosage they have every day,” he said, quoted by the Saudi daily ‘Sabq’.
He said iftar, the evening meal in Ramadan, often involves high levels of fat, carbohydrates and sugar in such foods as date, juice, sweets and fries.
“These types of food will increase weight and the sugar level in blood and this will increase the suffering of those who have diabetes,” he said.
“My advice to those who are suffering from advanced level of diabetes is that they should not fast during Ramadan. I mean those who rely heavily on insulin dosages and those who are suffering from diseases that are associated with diabetes.”

http://www.emirates247.com/news/diabetics-must-consult-doctors-for-fasting-2016-05-30-1.631488

Waterford diabetic services at ‘crisis point’

By Claire O'Sullivan

Diabetic services in Waterford are at “crisis point” as hospital consultant and community specialist positions are lying unfilled.
Diabetics with type 1 diabetes are being told they need to travel to neighbouring counties to access insulin pumps and there is a two- year waiting list before a diabetic’s file will even be assessed by University Hospital Waterford’s (UHW) lone endocrinologist.
In addition, three badly needed community diabetic positions have not been filled by the HSE in the South East even though more than 75% of diabetics in Waterford are failing to meet target glucose levels.
This failure to appoint new staff comes as the HSE has launches a new Cycle of Care programme at GP level which is aimed at keeping diabetic care in the community and out of hospitals by giving two medical reviews to diabetics each year.
However, GPs in the South East say they can not refer any Cycle of Care patients on to specialised community dieticians or podiatrists as the service is not there.
Diabetics Ireland says the failure to fill these community positions put diabetics at greater risk of attending hospital as in and outpatients — the exact opposite of ‘Cycle of Care’s aims.
There are up to 400 patients with type one diabetes at University Hospital Waterford. However, they have to travel to Kilkenny, Wexford, Clonmel, or Cork, for insulin pumps.
Type one diabetics also have to measure their carbohydrate intake carefully, as this dictates how much insulin they should inject. Week-long carbohydrate counting courses such as Dafne are not available at UHW or in the wider county due to a lack of diabetes dieticians for adults.
Diabetic and local campaigner Liz Murphy said the services are at “crisis point”.
“Type one diabetes if not managed properly can lead to people going blind, to amputations yet we are treated this way,” she said.
“It is a fact that if you provide the help necessary for diabetics to look after their own illness, the care they receive will lead to a decline in diabetics presenting for care in hospitals and GP surgeries. Thus also reducing the huge financial burden on the HSE and the State.”
There are up to 400 Type 1 diabetics attending UHW and more than 1,500 Type 2 diabetics attending UHW.
Responding to a parliamentary question from Fine Gael’s Mary Butler, the Department of Health confirmed that the “outpatient waiting list for endocrinology is running at approximately two years, dependent on the referral and the information supplied, for the consultant to triage the priority of the appointment”.
The HSE’s 2016 Service Plan promised Waterford a community-based diabetes specialist, senior dietician, and senior podiatrist. The posts were sanctioned but the posts have not yet been advertised yet.
A Department of Health spokesman said the permanent post of consultant physician in acute medicine/ endocrinology was offered to a candidate but he decided not to accept the post.
“Recently the hospital has put in place a temporary consultant for a period of six months to provide an opportunity to examine the service and to assess if the second post should be that of consultant physician/endocrinology,” he said.

http://www.irishexaminer.com/ireland/diabetic-services-at-crisis-point-402203.html

Know how diabetes takes a toll on the heart

From dnaindia.com

A team of scientists has uncovered a molecular mechanism involved in a common form of heart damage found in diabetics.
People with diabetes have a two to five time higher risk of developing cardiovascular diseases. For decades physicians have noticed unhealthy changes in the hearts of diabetics called diabetic cardiomyopathy, which is a disorder of the heart muscle that can lead to heart failure.
The molecular mechanisms responsible for this cardiac disorder are poorly understood, although they are key to revealing new targets for the discovery of better treatments and development of more accurate diagnostics. RNA provides the blueprint for making the protein building blocks of cells. The RNA is cut or spliced to generate mRNA used to build proteins. RNA splicing mistakes are associated with many human diseases because they lead to production of the wrong or harmful proteins.
The study of the University of Texas Medical Branch at Galveston in collaboration with Baylor College of Medicine, University of California San Diego and the University of Texas at Dallas sought to further investigate how RBFOX2 regulation contributes to splicing defects seen in diabetic hearts and the consequences of splicing changes on cardiac function.
The UTMB-led study found that RBFOX2 binds to 73% of the RNA that are mis-spliced in diabetic heart tissues. This alternative splicing was found to impair normal gene expression patterns in the heart, especially genes important for molecular metabolism, programmed cell death, protein trafficking and calcium handling in heart muscle tissue. Calcium balance is important in regulating a heartbeat.
"We discovered that RBFOX2 function is disrupted in diabetic hearts before cardiac complications are noticeable and RBFOX2 dysregulation contributes to abnormal calcium signaling in the heart," said lead author N. Muge Kuyumcu-Martinez. "Identifying RBFOX2 as an important contributor to diabetic complications and learning how it is dysregulated may allow us to develop new tools to diagnose, prevent or treat diabetic cardiomyopathy in the future."
The study is published in journal Cell Reports.

http://www.dnaindia.com/health/report-know-how-diabetes-takes-its-toll-on-heart-2217213

Getting 'nagged' slows development of diabetes in men

From dnaindia.com

When it comes to diabetes, "nagging is caring," suggests a new study. The national study led by a Michigan State University sociologist found that an unhappy marriage may actually slow the development of diabetes in men and promote successful treatment once they do get the disease.
Why? It may be because wives are constantly regulating their husband's health behaviours, especially if he is in poor health or diabetic. And while this may improve the husband's health, it also can be seen as annoying and provoke hostility and emotional distress.
"The study challenges the traditional assumption that negative marital quality is always detrimental to health," said lead investigator Hui Liu. "It also encourages family scholars to distinguish different sources and types of marital quality. Sometimes, nagging is caring."
Using data from the National Social Life, Health and Aging Project, Liu and colleagues analysed survey results from 1,228 married respondents over five years. At the onset of the study, the respondents were 57 to 85 years old; 389 had diabetes at the end of the study.
Liu investigated the role of marital quality in diabetes risk and management and found that for men, an increase in negative marital quality lowered the risk of developing diabetes and increased the chances of managing the disease after its onset, while for women, a good marriage was related to a lower risk of being diabetic five years later.
Women may be more sensitive than men to the quality of a relationship and thus more likely to experience a health boost from a good-quality relationship, Liu said. The study noted that since diabetes is the fastest growing chronic condition in the United States, implementation of public policies and programs designed to promote marital quality should also reduce the risk of diabetes and promote health and longevity, especially for women at older ages.

http://www.dnaindia.com/health/report-getting-nagged-slows-development-of-diabetes-in-men-2216804

Lifestyle making young diabetes-prone

From Tribune India

Bathinda, May 26

Owing to unhealthy lifestyle, youngsters are increasingly getting prone to diabetes in the region.

Earlier, the disease would usually be found in adults above 40 years of age, but these days, it is seen in youngsters as well.

The main reasons behind this is said to be overweight and inactive and unhealthy lifestyle of youth.

The common symptoms of diabetes are increased appetite and thirst, unexplained weight loss, fatigability, skin infections, increased urination, blurring vision, sexual dysfunction, slow healing of wounds and itching in perineal area.

There are two types of diabetes — type 1 is called insulin-dependent diabetes mellitus and occurs at a young age or in childhood. There is a complete lack of hormone insulin in the patients.

Around 75 per cent of people have type 2 diabetes mellitus. The reasons for this are poor nutrition, rising stress levels, improper metabolism and lack of fitness.

Dr Sushil Kotru, head of Max Hospital’s endocrine diabetes and obesity care centre, said a large number of youngsters were getting prone to diabetes in the region and the main reason behind this is the unhealthy lifestyle and no physical activity.

He said on an average, he was getting more than 100 patients in the OPD every day.

He said diabetes was called a silent disease because many people don’t know about it even if they are suffering from it and people are also unaware about the problem.

He is treating patients as young as two-year-old, who are suffering from the disease, he added.

Dr Vitull K Gupta, consultant, Kishori Ram Hospital & Diabetes Care Centre and chairman, Association of Physicians of India (Malwa Branch), said people took this disease lightly, which was wrong as it was a deadly disease and the Health Department should create awareness among the masses about it.

He said this disease could lead to many complications relating to eye, foot, skin, heart, hypertension, mental, hearing loss, teeth and gastro.

Bathinda Civil Surgeon Dr Raghubir Singh Randhawa said diabetes was a non-communicable disease and its trend was increasing in the region.

He said, “Seeing the trend, we have started holding screening of patients for diabetes. If anyone is diagnosed with it then we hold counselling sessions for the patient. We are trying to create awareness about the disease through health centres.”

Precautions

Taking normal sleep of about seven hours at night goes a long way in normalising the heart rate (pulse), chemical responses in the body, especially related to clotting and anti-clotting responses and sugar control.

Exercise in moderation for about five days a week helps in normalising sugar levels and cholesterol.

Eating habits

Healthy eating habits and eating the right mix of food plays a significant role in preventing illness.

The food allowed for diabetic patients is lemon water, ‘khatti lassi’, balck tea, sprouted dals, clear soups without fat, salads that include onion, cucumber, radish, cabbage, tomato and boiled green leafy vegetables.

Food that is allowed in moderate quantity is whole wheat flour, whole dals, beans, cooked vegetables and fruits, skimmed milk and its products, egg white, lean meat and fish, almonds, walnuts and sugar free items.
The food items that are totally prohibited for a diabetic patient are all sweets, sugar, gur, honey, sugar syrup, glucose, puddings, chocolate, pastries, cakes, biscuits, banana, mango, grapes, dates, alcoholic drinks, cold drinks, sharbats, dry fruits, and fried items like puri, prantha, samosa, pakoda.

These days even painless glucose continuous monitoring pumps are available in the market at the cost of around Rs two lakh.

This pump is attached with the body of the patient and it automatically controls the content of sugar in the body.

Even insulin pen injections are also available in the market at a reasonable price.

According to the World Health Organisation, the number of diabetics in India doubled in 13 years, from 32 million in 2000 to 63 million in 2013 and the figure is likely to surge to 101.2 million in the next two years.

http://www.tribuneindia.com/news/cities/bathinda/lifestyle-making-young-diabetes-prone/242616.html

New study uncovers mechanisms underlying how diabetes damages the heart

From Science Daily

Cardiac complications are the number one cause of death among diabetics. Now a team of scientists has uncovered a molecular mechanism involved in a common form of heart damage found in people with diabetes.

A research team from The University of Texas Medical Branch at Galveston in collaboration with Baylor College of Medicine, University of California San Diego and the University of Texas at Dallas have published their findings the journal Cell Reports.
People with diabetes have a two to five time higher risk of developing cardiovascular diseases. For decades physicians have noticed unhealthy changes in the hearts of diabetics called diabetic cardiomyopathy, which is a disorder of the heart muscle that can lead to heart failure.
The molecular mechanisms responsible for this cardiac disorder are poorly understood, although they are key to revealing new targets for the discovery of better treatments and development of more accurate diagnostics.
RNA provides the blueprint for making the protein building blocks of cells. The RNA is cut or spliced to generate mRNA used to build proteins. RNA splicing mistakes are associated with many human diseases because they lead to production of the wrong or harmful proteins.
The research team has previously shown that splicing is incorrectly regulated and levels of the splicing regulator RBFOX2 are elevated in diabetic heart tissue. The current study sought to further investigate how RBFOX2 regulation contributes to splicing defects seen in diabetic hearts and the consequences of splicing changes on cardiac function.
The UTMB-led study found that RBFOX2 binds to 73 percent of the RNA that are mis-spliced in diabetic heart tissues. This alternative splicing was found to impair normal gene expression patterns in the heart, especially genes important for molecular metabolism, programmed cell death, protein trafficking and calcium handling in heart muscle tissue. Calcium balance is important in regulating a heartbeat.
"We discovered that RBFOX2 function is disrupted in diabetic hearts before cardiac complications are noticeable and RBFOX2 dysregulation contributes to abnormal calcium signaling in the heart," said N. Muge Kuyumcu-Martinez, lead author and UTMB assistant professor in the department of biochemistry and molecular biology. "Identifying RBFOX2 as an important contributor to diabetic complications and learning how it is dysregulated may allow us to develop new tools to diagnose, prevent or treat diabetic cardiomyopathy in the future."

https://www.sciencedaily.com/releases/2016/05/160526190235.htm

Why Men Should Talk About Diabetes

By Jessica Jarrett

There are several reasons why men often avoid discussing their health, including a fear of receiving bad news. In fact, according to health experts, fear of bad news is the number one reason men avoid talking about their health—among themselves, with their partners, or with their healthcare providers.

This is unfortunate, because a failure to tackle health problems head-on can make them worse in the long run. The good news is that addressing diabetes and related health concerns up front and early on can lessen their impact on your long-term wellbeing.

Diabetes, men, and specific health concerns

Another reason to make managing your diabetes a top priority? Diabetes can add to the particular health concerns many men face as they age. For example, did you know that men with diabetes are more than twice as likely to suffer from low testosterone than men without diabetes? The symptoms of low testosterone can include:

• diminished interest in sex
• erectile dysfunction (ED)
• reduced lean body mass
• depressed mood
• lack of energy

But low testosterone is treatable, and the sooner you talk to your physician about the possibility of low testosterone, the sooner you can be treated. Ideally, once you do, you’ll feel better, you’ll have more energy, and you’ll reduce the risk of other health issues related to this condition—it’s a win-win!
Another concern for men with diabetes is ED. Even if you don’t have low testosterone, you can experience ED as a complication of diabetes. According to the American Diabetes Association (ADA), it's normal to feel embarrassed discussing such an intimate issue, but your healthcare provider is a professional who is there to help you, not judge you. Talking about ED is the only way to learn about treatments and to get the help you need.
Along with medical treatment, adopting a diet and regular physical activity plan may help lessen the chances of developing ED and other issues related to vascular function, such as heart disease. The ADA notes that lifestyle choices that contribute to heart disease and vascular problems also increase the chances of ED. Smoking, being overweight, and being inactive can also contribute to ED.
If you want to keep everything in working order, including your sexual health, your doctor can work with you on a plan that includes smart nutrition choices and regular exercise. Your doctor may also refer you to a diabetes educator or a registered dietitian.
Talk it out
In the end, allowing yourself to be vulnerable enough to discuss—and properly manage—your diabetes-related health concerns is the most “manly” thing you can do. There’s nothing more masculine than taking care of business, including your own!

http://www.albertsons.com/why-men-should-talk-about-diabetes/

Give type 2 diabetics weight-loss surgery to REVERSE their condition, leading experts urge

By Sophie Borland and Anna Hodgekiss

Hundreds of thousands of type 2 diabetics should be offered weight loss surgery to cure diabetes, world experts claimed today.

They say the world is in the grip of a ‘pandemic’ and that drugs and lifestyle interventions alone will not solve the crisis.

Instead, the joint statement by 46 leading international organisations calls for gastric bypass operations to be offered as routinely as hip and knee replacements. 

One reason it is thought to work so well is that patients eat less and the subsequent reduction in weight and calorie consumption causes their blood sugar levels to fall.

In addition, researchers believe the surgery triggers important changes in the bacteria of the gut which also lowers the blood sugar.

The experts said the advice constituted one of the biggest shifts in diabetes treatment guidelines since the advent of insulin - and could have a significant benefit for thousands of patients.

The group said bariatric, or metabolic, surgery could have a significant benefit for patients with the disease.

Francesco Rubin, a professor and chair of metabolic and bariatric surgery at King's College London - and one of the authors of the new guidelines - said many countries across the world are in the midst of 'an epidemic of diabetes'.

While surgery would not be suitable for all, and should not be seen as a silver bullet solution for the global diabetes problem, he said patients should be offered a range of options - including lifestyle changes, medications and surgery.

'For some, surgery may be the best choice,' he said. 

Type 2 diabetes is a long-term condition characterised by insulin resistance. 

Many patients can manage their diabetes with medication and diet, but the disease is often life-long and is a major cause of blindness, kidney failure, heart attacks, stroke and lower limb amputation.

A recent World Health Organisation study found the number of adults with diabetes has quadrupled in the past four decades to 422 million. 

And the international Diabetes Federation (IDF) estimates that by 2040 this will rise to 642 million.

The new guidelines say surgery designed to reduce the stomach and induce weight loss should be recommended to treat all diabetes patients whose body mass index (BMI) is 40 or over.

This is regardless of their blood glucose control, as well as those with a BMI of 30 and over whose blood sugar levels are not being controlled by lifestyle changes or medications.

The guidelines, published in the journal Diabetes Care, were endorsed by 45 international organisations, diabetes specialists and researchers, including the IDF, the American Diabetes Association, the Chinese Diabetes Society and Diabetes India.

Obesity surgery involves the removal of part of the stomach or the re-routing of the small intestine in a bypass operation.

The guidelines are based on a substantial body of evidence, including 11 randomised trials, showing that in most cases surgery can lead to reductions in blood glucose levels below the Type 2 diabetes diagnosis threshold or to a substantial improvement in blood glucose levels.

In many cases this would lead to patients being able to give up or significantly reduce their diabetes medications

http://www.dailymail.co.uk/health/article-3606817/Give-type-2-diabetics-weight-loss-surgery-REVERSE-condition-leading-experts-urge.html

Neighbourhood 'walkability' may influence diabetes risk

By Eleanor McDermid

A Canadian study shows that the walkability of a person's neighbourhood influences their risk of developing diabetes.
The researchers found that people in neighbourhoods that were easier to walk around were less overweight and less likely to develop diabetes over about a decade of follow-up.
In an editorial accompanying the study in JAMA, Andrew Rundle (Columbia University, New York, USA) and Steven Heymsfield (LSU System, Baton Rouge, Louisiana, USA) say that "urban design for neighborhood walkability is an attractive avenue for public health interventions to reduce the risk of developing obesity or diabetes".
However, they note that social features, such as pedestrian safety and levels of crime "may interact with, or perhaps overwhelm, urban design features that support pedestrian activity."
Researcher Gillian Booth (Institute of St Michael's Hospital, Toronto, Ontario, Canada) and colleagues gauged neighbourhood walkability using a validated method based on population and residential density, walkable destinations and street connectivity. They awarded the neighbourhoods, each containing about 400-700 people, a walkability score between 0 and 100. Scores were generally fairly low; when the team split the neighbourhoods into quintiles of walkability, the median score for the top quintile was just 35.2.
Nonetheless, neighbourhoods in the top quintile had the lowest prevalence of overweight and obesity in 2001, at 43.3% versus 53.5% in the bottom quintile (median score 10.1), after accounting for age, gender, income, and ethnicity.
And the prevalence increased only slightly in the top quintile between baseline and 2012, by a nonsignificant 2.1%, whereas it increased significantly in the bottom three quintiles, eg, by 5.4% in the bottom quintile.
There was a similar trend for the incidence of diabetes, with this decreasing in the top two walkability quintiles over time, compared with no significant change in the least walkable neighbourhoods. For example, the incidence declined from 7.7 to 6.2 per 1000 persons in the top quintile - an absolute reduction of 1.5, compared with a nonsignificant 0.65 reduction in the bottom quintile.
People living in more walkable neighbourhoods made more journeys on foot or by bicycle or public transport than people living in less walkable neighbourhoods did, consequently making fewer journeys by private car.
By contrast, other health behaviours, such as fruit and vegetable consumption, leisure time physical activity and smoking were not associated with neighbourhood walkability. Rundle and Heymsfield note that this serves as a "conceptual negative control", strengthening the overall results.
They say that the study "will make a prominent contribution to the research base that informs the urban design and health policy debates for years to come."

http://www.news-medical.net/news/20160525/Neighbourhood-walkability-may-influence-diabetes-risk.aspx

Md.-based meal program designed to prevent, treat Type 2 diabetes

By Rachel Nania

Meal delivery kits have revolutionized the way food-lovers with demanding schedules get a gourmet meal on the table in a matter of minutes. But the latest in the meal-by-mail phenomenon promises benefits beyond saving time.

WASHINGTON — Meal delivery kits have revolutionized the way food-lovers with demanding schedules get a gourmet meal on the table in a matter of minutes.

 

Companies such as Blue Apron and HelloFresh ship boxes of pre-measured ingredients, ready to be thrown in a pan and then on your plate. Others, like Sakara Life and Galley Foods, take care of all the prep work and deliver fully assembled feasts directly to your door.

 

But the latest in the meal-by-mail phenomenon promises benefits beyond saving time: Anemone Lifestyle claims to prevent — and even reverse — Type 2 diabetes.  

 

How does it work? Dr. Pavel Klein, a former professor at Harvard and Georgetown Universities and a Bethesda-based physician and developer of Anemone, said the high-fat, low-carbohydrate program drives rapid weight loss, which helps to reverse insulin insensitivity and return glucose levels to normal. The result, he said, is remission.

 

Klein did not intend to discover this treatment for diabetes. The neurologist, who specializes in epilepsy and sleep disorders, was studying the effect of a ketogenic diet on patients with severe cases of epilepsy when he noticed another trend. After a few weeks, the obese patients in the study lost weight on the diet, and a previously diabetic patient no longer had diabetes.

Klein saw an opportunity to help a large portion of the population — 29.1 million people in the U.S. have diabetes — but first he needed to make a few adjustments. The ketogenic diet he used on his epileptic patients is not the most palatable, he said, and the lifestyle is complicated to maintain.

 

“You would have to shop for foods that have specific carbohydrate-to-fat gram content, you have to calculate the proportions of each component into every meal that you cook, you have to weigh the food … It’s complicated and time-consuming if you do it on your own,” said Klein, who is the director of the Mid-Atlantic Epilepsy and Sleep Center.  

 

He hired a culinary company and gave the team a challenge: Come up with tasty recipes that stay within the diet’s high-fat, low-carbohydrate parameters. The result is Anemone Lifestyle — an eight-month program that includes five daily meals, like pecan and strawberry cream parfait, buttered cauliflower soup and salmon with asparagus.

 

There are no shakes, no bars and there’s no room for deviation. Even beverages consumed during the eight months must be calorie-free.

 

Klein tested his more flavorful meals on a small population and compared the results to other patients who were treated with dietary counseling and the weight loss drug alli.
“We found that the effect on diabetes was quite remarkable. All of the patients who [completed] the program went into diabetic remission,” he said. “Their blood glucose normalized, the other parameters that evaluate glycemic control normalized, like insulin levels … and patients were able to get off their medications.”

 Unlike others out there, ordering Klein’s meal kit requires more than a quick click of the mouse. The program is physician supervised; patients see a doctor every few weeks so they can be monitored and gradually tapered off their medications.

 

The meals, which are prepared in a nearby Maryland kitchen, are delivered weekly in one box.

 

“The meals are very small. When patients see them for the first time they are shocked,” Klein said.

 

However, he explains because of the high-fat content, they are filling. “Fat suppresses hunger, whereas carbohydrates drive it,” he said.  

 

Once the eight months are up, a nutritionist steps in to help participants ease back into a healthy, less rigid routine. After all, entering remission and staying in remission are two very different things.

 

“There’s a natural tendency for many patients to regain weight; it’s about a 50 percent rate of patients who go on to regain weight, so we try to help those patients long-term. And if they manage to keep the weight off … or gain a little bit, then the remission is long-lasting,” said Klein, who adds that he has some patients who have been in remission for four years now.

In addition to the health benefits, Klein said Anemone Lifestyle comes with some economic perks. According to the American Diabetes Association, people with diabetes incur about $13,700 in medical expenses each year. In 2012, the disease cost the country an estimated $245 billion. Getting more patients into remission with a dietary approach can lessen this burden.

 “If you bring a patient into remission, you have got very large cost savings,” Klein said.  

 

However, Anemone Lifestyle is not cheap (it rings up at $29 a day, or $203 a week), but Klein argues the cost is offset by not having to purchase other groceries. He also points out the indirect cost savings of treating Type 2 diabetes, such as decreased risk of heart attack, kidney failure and blindness.

 

Klein said a goal of his is to eventually encourage health care companies to cover some of the costs of the program.

 

“I [aim] to try to make the case to the insurance companies and self-insured companies that it is economically very advantageous for them to subsidize a program like ours because of cost-savings in a way that’s parallel to smoke cessation programs. That is our long-term goal.”
http://wtop.com/health/2016/05/md-based-meal-program-designed-to-prevent-treat-type-2-diabetes/slide/1/

A Healthy Lifestyle Can Fix Diabetes

From: The Times Of India

A diabetic for the last 22 years, the founder of Lifespan began diabetes management clinics across India to help other diabetics lead a healthier and longer life.

Ashok Jain has been a diabetic for the last 22 years. The experience put him a position to be empathetic to others who were dealing with the same situation. This is why, three years ago, he started Lifespan, a chain of diabetes management clinics across the country, to help other diabetics lead a healthier and longer life.

The beginning Diagnosed a diabetic at 37, the chemical engineer and CEO of a chocolate and soft drinks manufacturing company, went through great pains to manage the disease. He jostled a demanding job along with a lifestyle disease that required running around the city to find the right products, the tests, dietician consultations and more.Years of managing diabetes and reading up every book he could find on it, he knew he had to do something for fellow diabetics.

Eight years into the diagnosis, a doctor told Jain that henceforth he doctor told Jain that henceforth he had to be on insulin. "In those days that was like a death knell," he said adding, "When someone says you have to take insulin and then does not even teach you how to take it, you are left shattered."

An all-encompassing facility Jain says, "This disease not only requires 24x7 management, but also needs educators who can explain to patients what it is about. In my 22 years of being a diabetic, I must have lost only two days of productive work because of it."

Lifespan was born out of this aim to help diabetics lead full and productive lives. He says, "At Lifespan, we have all the products a diabetic might need, all the diagnostic tests and tools, along with a large team of diabetologists, dieticians, counsellors and educators -under one roof." 

Pre-diabetes: A serious issue Lifespan was one of the first organisations to create awareness about pre-diabetes. The company announced a prediabetes day, because it believed that if there is a pre-diabetes day then one day there will be no need to have a diabetes day. "Among the 20 per cent pre-diabetics in India, around 60 per cent will turn diabetic. The patients are getting younger, which is disastrous for the country. " 

Reversing pre-diabetes Jain says, "Unless one takes it in their stride, all this can have an emotional affect. Lifespan helps a diabetic to outsource diabetes management.One no longer needs to wait for hours for tests -we send a phlebotomist home at your convenience. There are doctors and counsellors available 24x7 on phone or on the internet. Our team helps you change your lifestyle, weight, and control diabetes. We have helped many young diabetics reverse pre-diabetes."

Increasing your lifespan It is a documented fact that diabetes reduces a man's life by around eight years. Jain says, "If the average lifespan of a person is 70, a diabetic will live up to 62. But if you manage your diabetes well you may live up to 78."  

An opportunity to help others Statistics have revealed that 10 per cent of Indians are diabetic and 20 per cent pre diabetic. Jain says, "This means that around one-third of Indians are either diabetic or prediabetic. The number of patients runs into crores. In the last three yea rs si nce Lifespan began, we have created 33 centres and touched the lives of 65,000 people across the country. So yes, it is satisfying. But with the number of patients in India increasing, even 2,000 clinics will not be enough. The opportunity to do good is huge. We require more doctors and people to help us in this endeavour." 

http://economictimes.indiatimes.com/magazines/panache/lifespans-ashok-jain-a-diabetic-for-22-yrs-says-healthy-lifestyle-can-fix-the-disease/articleshow/52410986.cms
 

Foot problems in diabetes

From Times of India

People with diabetes can develop many different foot problems. Too much glucose, also called sugar, in your blood from diabetes can cause nerve damage and poor blood flow, which can lead to serious foot problems.

Skin Changes

Diabetes can cause changes in the skin of your foot. At times your foot may become very dry. The skin may peel and crack. The problem is that the nerves that control the oil and moisture in your foot no longer work.
Poor Blood Flow

Poor blood flow means not enough blood flows to your legs and feet through your blood vessels. Poor blood flow makes it hard for a sore or an infection to heal. This problem is called peripheral artery disease, also called PAD.

Sometimes, a bad infection never heals. The infection might cause gangrene. If you have gangrene, the skin and tissue around the sore die. The area becomes black and smelly.

Nerve Damage (Neuropathy)

Damaged nerves may stop sending signals, or they may send signals too slowly or at the wrong times. Nerve damage can cause you to lose feeling in your feet.

You may not feel pain, heat, or cold in your legs and feet. You may not feel a pebble inside your sock that is causing a sore. You may not feel a blister caused by poorly fitting shoes.

Calluses

Calluses occur more often and build up faster on the feet of people with diabetes. This is because there are high-pressure areas under the foot. Too many calluses may mean that you will need therapeutic shoes and inserts.

Foot Ulcers

Ulcers occur most often on the ball of the foot or on the bottom of the big toe. Ulcers on the sides of the foot are usually due to poorly fitting shoes.

Remember, even though some ulcers do not hurt, every ulcer should be seen by your health care provider right away. Neglecting ulcers can result in difficult to heal and antibiotic resistant infections, which in turn can lead to loss of a limb.

An important tip:

See your doctor at least once a year for a foot exam, or more often if you have foot problems.
http://timesofindia.indiatimes.com/life-style/listen-to-your-sugar/Foot-problems-in-diabetes/articleshow/52396502.cms

Can 'mindfulness' help people manage their diabetes?

By Euan Wemyss

A study to explore whether a technique similar to meditation can be used to help adults struggling to manage their Type 1 diabetes improve their diabetes control and their emotional wellbeing is under way at the University of Aberdeen.
In partnership with researchers at the Universities of Glasgow and Stirling, and consultant medical staff at NHS Grampian and NHS Greater Glasgow and Clyde, the pilot study will attempt to see whether practising mindfulness leads to lower blood glucose levels and reductions in anxiety and depression.
Some people with diabetes can find it difficult living with the condition and having to carry out complex tasks multiple times per day to regulate their blood glucose levels.
About one third of adults with diabetes experience significant levels of anxiety and depression and this can make it even more difficult for them to manage effectively their condition.
A specially designed mindfulness-based cognitive therapy course has been shown in informal testing by psychologists in NHS Grampian to reduce anxiety and depression symptoms in people with diabetes. This pilot study will explore the effect of this treatment among adults with Type 1 diabetes, whose blood glucose levels are markedly above certain recommended values, and the extent to which researchers are able to recruit to this kind of study. If successful, this will lay the groundwork for a larger-scale study.
Researchers are in the process of inviting volunteers to take part in the study.

Managing Type 1 diabetes
People with Type 1 diabetes have to continually balance three key factors of their life: carbohydrate in food drives blood glucose levels up, whereas injecting insulin and engaging in activity lowers glucose levels. Different foods have dissimilar amounts of glucose and release it at varying rates. Some insulins work in different ways, and some activities burn up glucose at quicker rates than others. It's an endless, complex balancing act.
"As well as trying their best to manage their condition, like everyone else, people with Type 1 diabetes have to deal with the usual ups and downs of life. It's not surprising that some people with diabetes can become anxious and depressed," explains Dr Andy Keen, a health psychologist specialising in diabetes at the University of Aberdeen and NHS Grampian, and chief investigator of the study.
"Both these conditions have characteristics that make managing diabetes even harder. For example, people who are anxious have high levels of stress hormones such as adrenalin and cortisol, and these cause glucose to be released into the bloodstream, driving up blood glucose levels. Also, depression is characterised by fatigue and low motivation, which can make it tricky to devote the time and energy required to manage complex long-term conditions like diabetes.
"Anxiety and depression are characterised by certain styles of thinking, namely worry and rumination. Worry is a style of thinking that focuses on imaginary future catastrophes that rarely, if ever, actually occur and is often accompanied by planning what to do should they happen. Rumination on the other hand is often focused on the past, and concerns continual reflections about our imagined failings and how, because of these, life is unlikely to improve. Psychologists and others believe that these unhelpful ways of thinking maintain anxiety and depression."

What is Mindfulness and how could it help?
"It is best to think of mindfulness as a skill," continues Dr Keen. "It is a way of helping people be better able to focus on the 'here and now' of their lives, and disengage with unhelpful ways of thinking, such as worry and rumination.
"If you change the way people think, then you change the way they feel. We definitely know that anxiety and depression can be significant barriers to effectively managing diabetes, and by alleviating these we can give people the opportunity to invest more time and energy into looking after themselves if they want to do that.
"One of the pioneering things we have done here in Aberdeen at the JJR McLeod Centre for Diabetes, Endocrinology and Metabolism, is include in our mindfulness programmes a focus on promoting self-management because ideally we would like people to improve their quality of life as well as their health, not just the former."
The study will run for two years.
Participants will be expected to attend a mindfulness group one evening a week for eight weeks, and practice mindfulness at home. In addition to observing how well participants manage their blood glucose levels, and their levels of anxiety and depression before, during and after the study, researchers in Aberdeen and Glasgow will be evaluating the extent to which people with Type 1 diabetes are keen to engage in this kind of approach.

http://medicalxpress.com/news/2016-05-mindfulness-people-diabetes.html

Breakthrough could revolutionize diabetes treatment

By Anmar Frangoul

A company has been created to develop "novel technology" to help treat type 1 diabetes and potentially negate the need for insulin injections.
The company, called Islexa, has been launched by the Cell and Gene Therapy Catapult (CGT) and the U.K.'s University of Aberdeen.
According to a release from the University of Aberdeen, the company will look to develop technology which reprograms pancreatic tissue that has been donated, turning it into "fully functional islets."
"Islets are organoids that produce multiple hormones, including insulin, and donated islets are already effectively treating severe cases of type 1 diabetes," Kevin Docherty, a professor at the University of Aberdeen, said.
The university said that the technology could offer thousands more patients with type 1 diabetes the option of an "islet transplant", which provides patients with glucose control that is both effective and long term, negating the need for insulin administration.
"Having a hugely expanded supply of lab grown islets will enable us to significantly extend this established clinical treatment," Docherty added.
Islexa, formed after successful pre-clinical studies, will now concentrate on more pre-clinical development, the hope being that trials can take place "in the next few years."
The U.K.'s National Health Service describes diabetes as being a lifelong condition which causes blood sugar levels, or glucose, to become too high.
Insulin regulates levels of glucose in our blood. Type 1 diabetes occurs when the pancreas produces no insulin, while type 2 diabetes refers to when not enough insulin is produced, or when our body's cells "don't react to insulin."
In the U.S., the American Diabetes Association has estimated that in 2012, 29.1 million Americans had diabetes. The ADA says that diabetes cost the U.S. $245 billion in 2012, with direct medical costs accounting for $176 billion of that total.
The work at the University of Aberdeen has been undertaken as part of "activities led by a consortium" backed by the CGT. Partners include the Scottish Islet Transplant Program, the University of Edinburgh, and the Scottish National Blood Transfusion Service.
"Islet transplantation can transform the lives of patients with type 1 diabetes, and in some cases can result in long term freedom from insulin injections with excellent glucose control," John Casey, lead clinician for the Islet Transplantation Program in Scotland, said in a statement.
Going forward, hopes were high. "This is a really exciting technology that has the potential to bring life-changing benefits to these patients," Keith Thompson, CEO of the CGT and Islexa director, said.
"We are delighted to be forming Islexa with the partners we've worked with so far on this project," Thompson added. "The collaboration has already delivered promising results and the formation of Islexa will accelerate the development of these lab grown islets and ultimately get this potential treatment to thousands of patients," he went on to add.

http://www.cnbc.com/2016/05/19/breakthrough-could-revolutionize-diabetes-treatment.html

Type 1 diabetes treatment could end need for insulin shots

By Julia Kollewe

Insulin shots could become a thing of the past for type 1 diabetes patients thanks to a technology being developed by Cell and Gene Therapy Catapult, a London-based not-for-profit organisation, and Aberdeen University.
The pre-clinical results have encouraged CGT and Aberdeen University to create a spin-out company, called Islexa. It will manufacture lab-grown islets, the organoids responsible for insulin production, by reprogramming donated pancreatic tissue.
Only 30-50 people with type 1 diabetes in the UK currently receive an islet transplant each year, owing to a lack of donors and the difficulty of extracting islets from pancreatic tissue.
Growing islets will “significantly increase the number of patients who can receive the treatment,” Keith Thompson, CGT’s chief executive, told the World Stem Cells and Regenerative Medicine congress in London on Wednesday. He will run Islexa with Michael Bennet from CGT and Anne Lewendon from Aberdeen University.
If clinical trials are successful, the technology means tens of thousands more people could live without the need for frequent insulin injections, although it will take a few years until the treatment is available.
About 320,000 people in Britain have type 1 diabetes, a number set to more than double to 652,000 by 2035. Around the world, 21 million people have type 1 diabetes.
It is a lifelong condition that occurs when the pancreas does not produce any insulin, while type 2 diabetes – far more common, especially as obesity rises around the world – is a condition where the pancreas does not produce enough insulin or the body’s cells do not react to it.

Prof Kevin Docherty, from Aberdeen University, said: “Donated islets are already effectively treating severe cases of type 1 diabetes. Having a hugely expanded supply of lab-grown islets will enable us to significantly extend this established clinical treatment.”
CGT was set up in 2012 and is based on the 12th floor of Guy’s hospital in London. It employs more than 100 people and has government backing through Innovate UK but also gets private funding through partnerships. It is building a £55m cell therapy manufacturing centre in Stevenage. Islexa will use CGT’s labs at Guy’s and facilities at Aberdeen University.
They are looking for investors to take Islexa all the way as a fully fledged external company. The promising early results have given them the confidence to form a wider consortium with the Scottish Islet Transplant Programme, the University of Edinburgh and the Scottish National Blood Transfusion Service.
John Casey, consultant transplant surgeon at the Royal Infirmary of Edinburgh and lead clinician for the islet transplantation programme in Scotland, said: “Islet transplantation can transform the lives of patients with type 1 diabetes, and in some cases can result in long-term freedom from insulin injections with excellent glucose control.”

http://www.theguardian.com/society/2016/may/18/type-1-diabetes-treatment-could-end-need-for-insulin-shots

Type 1 diabetes 'could be caused by germs'

By Gabriel Samuels

Some germs may be responsible for people getting type 1 diabetes, according to a groundbreaking scientific study.
Researchers from Cardiff University’s Institute of Infection & Immunity discovered that certain germs trigger killer T-cells, a form of white blood cell that can cause diabetes.
The killer T-cells destroy insulin-producing ‘beta cells’, leading to an insulin deficiency.
Dr David Cole, a senior research fellow in charge of the study, told The Independent: “These findings could be really helpful for us going forward, now that we are getting a better idea of the environmental risk factors that cause diabetes.
“The behaviour of the T-cells is really like a case of friendly fire, or mistaken identity as they are provoked into attacking the beta cells.
“It could potentially open the door for people to be screened for certain bacteria, lowering the risk of them developing type 1 diabetes through non-genetic causes.”

During their experiments the Cardiff team shone powerful X-rays into infected blood samples, revealing the bacteria which may cause the condition.
Researchers had previously isolated a killer T-cell from a patient with type 1 diabetes to view the interaction, which kills the insulin-producing beta cells in the pancreas.
The Cardiff studies reveal that killer T-cells are highly cross-reactive, and respond to a variety of different pathogen triggers.
Dr Cole continued: “Uncovering the mechanism by which white blood cells detect bacteria is key to us working towards a cure, and these results have been promising.”

The research was published in The Journal of Clinical Investigation and was co-funded by the Biotechnology and Biological Sciences Research Council (BBSRC).
At the start of May scientists from Cardiff’s School of Engineering announced they had created a portable blood glucose monitor which does not pierce the skin.
The new devices can be discreetly attached to the patient’s skin and measure glucose levels using microwaves.
Last March several UK universities announced they are to carry out a series of trials to find a vaccine to type 1 diabetes as part of a £4.4million project.
In January US scientists stated they had halted the condition in mice for a six month period, raising hopes of a cure in humans.

http://www.independent.co.uk/news/science/diabetes-cause-type-1-cause-symptoms-bacteria-latest-study-a7033806.html

Diabetes linked to changes in gene behaviour driven by environment

From Medical Xpress

Why gestational diabetes leads to type 2 diabetes has baffled medical science for decades, but new research led by Deakin University has shown the answer could be in our genes' ability to change their behaviour due to signals from the environment.
Scientists are now beginning to understand how environmental factors can lead to changes to important proteins, called histones, within our cells, and regulate the way genes behave. Changes in gene behaviour caused by the environment, known as epigenetics, mean that factors like poor lifestyle can cause humans to develop diseases.
The new research found that women who develop type 2 diabetes after having gestational diabetes during pregnancy have different modifications of histone proteins from women who don't go on to experience type 2 diabetes.
Lead researcher Professor Leigh Ackland, Director of Deakin University's Centre for Cellular and Molecular Biology, within the School of Life and Environmental Sciences, said the findings had implications for preventing the development of type 2 diabetes in women who had gestational diabetes.
During the two year study, researchers measured changes in histone proteins in four groups of diabetic and non-diabetic women, during pregnancy and in early postpartum.
These groups consisted of women with no diabetes, women who had type 2 diabetes before they became pregnant, women who had gestational diabetes and went on to develop type 2 diabetes and women who had gestational diabetes but didn't develop type 2 diabetes.
The researchers tested the women at three points during and after pregnancy. The results showed that the histones were different between each group of diabetic and non-diabetic women, which is a novel finding.
Professor Ackland said the findings meant that medical professionals may be able, through epigenetic screening measures, to predict which women with gestational diabetes would go on to develop type 2 diabetes.
"By understanding the behaviour of specific genes, caused by epigenetic changes, medical practitioners may be able to target lifestyle prevention measures in women with gestational diabetes, so that they don't go on to experience type 2 diabetes," Professor Ackland said.
"The new findings are exciting and offer us an advanced understanding of how gestational diabetes could lead to type 2 diabetes, even though the study followed women only up until 20 weeks postpartum.
"We now want to complete a longer study, as type 2 diabetes can take many years to develop."
The research team has applied for National Health Medical Research Council funding to continue the study for five years.
Women with a history of gestational diabetes are at increased risk of cardiovascular disease and their offspring have an increased risk of metabolic syndrome, diabetes and cardiovascular disease.
In Australia, the prevalence of gestational diabetes is projected to increase by almost 50 per cent to affect an estimated 13 per cent of pregnancies in the future.
Women who experience gestational diabetes are seven times more likely to contract type 2 diabetes than women with normal blood glucose levels in pregnancy and there is increasing evidence that lifestyle factors including diet and exercise influence the progression of gestational to type 2 diabetes.
"Women with gestational diabetes who have a high risk of developing types 2 diabetes could be identified and put on a lifestyle modification program."
The research, "Epigenetic markers to predict transition from gestational diabetes to type 2 diabetes", has just been published in the latest online edition of high-ranking Journal of Clinical Endocrinology and Metabolism.

http://medicalxpress.com/news/2016-05-diabetes-linked-gene-behaviour-driven.html

Tom Hanks blames unhealthy diet for his diabetes diagnosis

Tom Hanks has admitted he was a "total idiot" for eating an unhealthy diet when he was younger, which he blames for his diabetes diagnosis.
The Oscar-winning actor, 59, revealed in 2013 that he had been diagnosed with Type 2 diabetes.

He told the Radio Times: "I'm part of the lazy American generation that has blindly kept dancing through the party and now finds ourselves with a malady.
"I was heavy. You've seen me in movies, you know what I looked like. I was a total idiot.

"I thought I could avoid it by removing the buns from my cheeseburgers.
"Well, it takes a little bit more than that."

However, Hanks is hopeful that he can beat the disease.
"My doctor says if I can hit a target weight, I will not have Type 2 diabetes any more," he said.

The actor became a father at 21 and said that starting a family at such an early age meant that he never became a "s**tfaced artist".
Hanks, now a father-of-four, said: "I'm lucky. I was in charge of offspring at a very early age, so I didn't have the luxury of being able to get stoned a lot.

"And I never drank too much. I was never what I call a s**tfaced artist."
The actor said he doesn't regret that because he didn't think it was more fun to be intoxicated or stoned.

"I thought it was more fun just to be seeing what was going on. I did my share, but it didn't become a habit," he said.

http://www.independent.ie/style/celebrity/celebrity-news/tom-hanks-blames-unhealthy-diet-for-his-diabetes-diagnosis-34721330.html

I ate the wrong things for years. Now I have prediabetes, and that’s a problem.

By Elena Dure

When I was in sixth grade, a friend approached me during recess. “When you’re older, you’re going to be really fat,” she said. “Just look at all the junk you eat.”
I stopped munching on my bag of nachos, thought of all the sugary treats I’d packed for snack that day and knew I was guilty as charged. But given my thin physique and fast metabolism, I didn’t worry.
Ten years later, at the age of 22, those eating habits caught up to me.
After visiting my doctor for a checkup a few months ago, I received an alarming call from him: My blood sugar level was elevated; I needed to watch my glucose intake. In other words, I am prediabetic, and if I don’t significantly decrease my sugar consumption, my body will react in a not-so-pleasant manner.

After a quick Google search, I discovered I am not alone. Approximately 86 million Americans — or 1 in 3 American adults — have prediabetes, according to the Centers for Disease Control and Prevention (CDC). Without weight loss and physical activity, 15 to 30 percent of these folks will develop Type 2 diabetes within five years, the CDC says.

Prediabetes, also known as impaired glucose metabolism, generally has no symptoms. However, people whose blood sugar level is higher than normal but not high enough to be considered diabetic should be tested for diabetes once a year, according to the American Diabetes Association.

People with certain risk factors are likely to develop prediabetes, according to the ADA. These factors include being 45 or older, being overweight and having a family member with diabetes.
As a 22-year-old, 5-foot-7 woman who weighs 110 pounds, I did not expect to find myself on the watch list. But my lack of regular activity and the genetic component of the condition (my grandfather and uncle both had diabetes) set off an alarm, given that full-blown diabetes can cause serious health problems including kidney failure and an increased risk of heart disease or stroke.
Given those risks, I was determined to do what I could to make sure “pre” did not turn into full diabetes. My doctor had already helped me take the first step in that direction.
“We know that a very simple risk test, a series of questions that you can take online or on paper, will give any individual an idea of whether or not they are at risk for developing diabetes. That recognition is critically important because if you don’t suspect you’re at risk, then you’re not going to seek assistance,” said Robert Ratner, the ADA’s chief scientific and medical officer.
An intervention — in the form of dietary changes, extra exercise and sometimes medication — can prevent the development of diabetes, Ratner said.
Nahrain Alzubaidi, an endocrinologist and nutrition specialist at Inova Fairfax Hospital, suggests that people with prediabetes do 30 minutes of activity three to four days a week. She also said they should adopt a diet with whole-grain carbs; good protein such as fish, tofu and skinless poultry; and food rich in “good” polyunsaturated fats such as olive oil and avocado. She advises her patients to avoid red meat if possible and to be cautious about some dairy, such as whole milk, butter and rich cheeses, because these foods are high in saturated fat and may raise cholesterol and the risk of cardiovascular disease.
“We never say zero,” Alzubaidi said. “We all have habits and we all have cultures or ethnic-
background differences. It’s individualized, so we always say in the beginning to at least cut down [on sugar and refined carbs] and find an alternative that is as satisfying as the original but with less amount of damage.”
Ratner said people with pre­diabetes who are overweight should aim for a 10 percent reduction of fat content in their meals and an overall decrease in total calories. Fat consumption should be a maximum of 25 percent of total daily calories. He said a 5 to 7 percent reduction in body weight can lead to a 50 percent reduction of the risk of developing diabetes.
In January, the CDC, the ADA and the American Medical Association, in partnership with the Ad Council, launched a public-awareness campaign about pre­diabetes to get out the message that lifestyle and diet changes can reverse the condition. Critics say the effort is problematic because it focuses on individual behavior instead of on some of the larger societal problems of income inequality and poverty that make diabetes more prevalent in lower-income, minority populations.
Victor Montori, an endocrinologist at the Mayo Clinic in Rochester, Minn., said the campaign targets too many people who may have slightly elevated blood sugar but will never develop diabetes.
“The definition [of prediabetes] that is currently being used is very broad, and that broad definition makes it easy to find the people who are at risk, but unfortunately it classifies too many people as being at risk,” he said.
Ratner and Alzubaidi agree that not everyone with moderately high blood sugar levels like me will develop the disease, but they said it isn’t worth the gamble. Because diabetes remains the leading cause of blindness in working-age people and the leading cause of limb amputations and kidney failure, its prevention is critically important, they said.
“I guess the cynical way that I would look at it is not everyone who smokes cigarettes gets lung cancer, but the chance that you won’t get lung cancer isn’t really a good reason to continue smoking,” Ratner said.
In my case, I amped up my exercise — I now walk about a mile or two every day near where I live in College Park, Md. — and got rid of a lot of junk food, with the aim to eat only whole grains, fruits, vegetables and fish. I also try to stay away from store-bought cakes and cookies as well as candy, chocolate and chips, although I don’t always succeed.
I don’t know if these changes have had any effect on my blood sugar level yet: I go in for a blood test later this spring. But I know these changes often improve one’s blood pressure and cholesterol, among other things. And more important, I feel a lot healthier, a lesson I wish I’d learned way back in middle school.

https://www.washingtonpost.com/national/health-science/i-ate-the-wrong-things-for-years-now-i-have-prediabetes-and-thats-a-problem/2016/05/16/dda002b2-ebb3-11e5-a6f3-21ccdbc5f74e_story.html

Type 2 diabetes risk linked to low thyroid function, new study suggests

By: Bel Marra Health

 A low thyroid function has been found to be a risk factor for type 2 diabetes. Researcher Dr. Layal Chaker said, “Low thyroid function is associated with a higher risk of developing diabetes and also of progression from prediabetes to diabetes. Of course, we’ve always screened for thyroid disorders in patients with type 1 diabetes, because of the autoimmune association…But there’s overlap between the symptoms of hypothyroidism and type 2 diabetes.”
The study included 8,452 individuals over the age of 45 without diabetes, but with low thyroid hormone levels. After an average 7.9-year follow-up, 1,100 developed prediabetes and 798 developed type 2 diabetes. Low hormone levels were found to be a risk factor for diabetes and higher T4 hormone levels were associated with a lower risk of diabetes.
The Centers for Disease Control and Prevention (CDC) estimates that 29.1 million Americans have diabetes of which 8.1 million cases are undiagnosed. With such high numbers, diabetes prevention should really be on the forefront of health.
We currently know and understand many causes of type 2 diabetes. Being overweight, eating a poor diet, not getting enough sleep, and not exercising can all contribute to the onset of type 2 diabetes. But did you know your thyroid could also be a cause of diabetes?

The relation between thyroid disease and diabetes

Thyroid disorders affect nearly as many Americans as diabetes – about 27 million. Both diabetes and thyroid disorders affect the endocrine system – glands that secrete hormones useful for bodily functions. So it is not surprising that those with diabetes may also have a thyroid disorder, and vice versa.
In diabetes, the body has a difficult time using insulin, and since the thyroid is responsible for the metabolism, it then greatly affects the manageability of diabetes. The two are so closely related that among those with diabetes the occurrence of thyroid disorders increases by 10 percent.
Although it appears that thyroid disorders and diabetes occur simultaneously, researchers have yet to uncover the exact cause-and-effect relationship between the two.

How does thyroid disease affect blood sugar level and diabetes?

There is an apparent relationship between thyroid disease and diabetes, albeit not fully understood, so it’s important to know how exactly thyroid diseases affect diabetes.
Controlling sugar metabolism is one of the thyroid’s functions. A thyroid disorder then negatively impacts blood sugar, making diabetes more difficult to manage.
In hyperthyroidism, the thyroid is working too quickly, resulting in an increase in blood sugar produced by the liver and quicker absorption.
With hyperthyroidism the thyroid is working slower, so insulin may get cleared more slowly. Along with hypothyroidism comes higher cholesterol as well, which is again a dangerous enemy for diabetics.
Thyroid dysfunction can:

• Slow down the cell’s ability to absorb glucose
• Decrease the amount of glucose in the gut
• Slow down the response of insulin when blood sugar levels spike.

Clearly then, thyroid disorders weigh heavily on diabetes.

Effect of diabetes on thyroid disease

On the other hand, if diabetes isn’t controlled, high blood sugar can negatively impact the thyroid health by destroying the thyroid gland, especially in individuals with an autoimmune thyroid disease.
But when blood sugar is low, cortisol – the stress hormone – is released, creating a hormone imbalance as well as prompting the liver to pump out more insulin. Once again, this leads to further damage to the thyroid gland.
Thyroid disease and diabetes share many common symptoms including fatigue, weight loss or weight gain, and trouble sleeping. These symptoms may become worse if the thyroid disease or diabetes is not managed properly.

Tips to manage thyroid disorders

A common theme between thyroid diseases and diabetes is management. Without proper management both illnesses can become more severe, making the health of the individual worse. Here are a few tips to help you manage your thyroid disorder more successfully.

• Use hormone replacement medications
• Eat an iodine- and selenium-rich diet
• Exercise
• Reduce stress
• Eliminate soy and gluten from your diet.

These are just some tips that can help you better manage your thyroid disorder.

Tips to managing diabetes

On the other hand, it is just as important to manage your diabetes. Although many of the tips are similar, they are still important to note.

• Eat a balanced diet
• Avoid processed and fried foods
• Exercise
• Control your weight
• Monitor your blood sugar numbers
• Pay attention to the carbohydrate content in food items – they, too, contain sugar
• Monitor your sugar intake

By following these tips, you can also have proper control of your diabetes. Pair them together with the tips to manage your thyroid disease, and you can continue to live a healthy life.
If you’re concerned about your thyroid or your diabetes, speak with your doctor. Also keep in mind that diabetes is preventable, so lowering your risk of developing diabetes can also lower your chances of developing a thyroid disorder. So if your doctor is already concerned that you may be prediabetic, start taking the appropriate measures to prevent the onset of diabetes.

http://www.belmarrahealth.com/type-2-diabetes-risk-linked-to-low-thyroid-function-new-study-suggests/

Grape-orange combo can beat obesity, diabetes, heart disease

From Times Of India

You can keep obesity , diabetes and heart disease at bay by consuming a mixture of red grapes and oranges , suggests a new study.

The University of Warwick researchers found that a combination of two compounds found in red grapes and oranges could be used to improve the health of people with diabetes, and reduce cases of obesity and heart disease.

Paul Thornalley, who led the research, said that this is an incredibly exciting development and could have a massive impact on their ability to treat these diseases. As well as helping to treat diabetes and heart disease it could defuse the obesity time bomb.

The team studied two compounds found in fruits but not usually found together. The compounds are trans-resveratrol (tRES), found in red grapes, and hesperetin (HESP), found in oranges. When given jointly at pharmaceutical doses the compounds acted in tandem to decrease blood glucose, improve the action of insulin and improve the health of arteries.  
The compounds act by increasing a protein called glyoxalase 1 (Glo1) in the body which neutralises a damaging sugar-derived compound called methylglyoxal (MG).

  Thirty-two overweight and obese people within the 18-80 age range, who had a BMI between 25 - 40, took part in the trial.  

He noted, "As exciting as our breakthrough is it is important to stress that physical activity, diet, other lifestyle factors and current treatments should be adhered to."  

Thornalley and his team are now hoping manufacturers will want to explore the use of the compound as pharmaceutical products.  

The study appears in the journal Diabetes.

 

 

http://timesofindia.indiatimes.com/life-style/health-fitness/diet/Grape-orange-combo-can-beat-obesity-diabetes-heart-disease/articleshow/52254370.cms

Researchers find link between melatonin, diabetes risk

By Stephen Feller

LUND, Sweden, May 13 (UPI) -- Researchers may have found why having a sleep disorder or working overnight is thought to increase risk for developing type 2 diabetes.
A genetic variation causes insulin-producing beta cells to be more sensitive to melatonin, affecting their ability to secrete insulin and throwing off the control of blood sugar, according to a study published in the journal Cell Metabolism.
Melatonin regulates the circadian rhythm, reacting to light and dark throughout the course of the day. The hormone increases, peaking at night, during sleep -- part of the reason it has been used as a drug for sleeping.
Previous research conducted by the same researchers at Lund University in 2009 showed a gene variant to melatonin receptor 1B increases risk for type 2 diabetes. The variant causes the level of the melatonin receptors in beta cells to increase, making them more sensitive to melatonin and stopping them from secreting insulin.
"A third of all people carry this specific gene variant," Hindrik Mulder, a professor at Lund University, said in a press release. "Our results show that the effect of melatonin is stronger in them. We believe that this explains their increased risk of developing type 2 diabetes."
For the study, researchers recruited 23 healthy carriers of the gene variant and 22 people without the variant, treating them with four milligrams of melatonin before bed for three months.
The researchers found insulin secretion was lower among participants with the genetic variation, and that blood glucose levels were higher among all participants after melatonin treatment -- but most significantly in those with the variation.
"There is still no scientific support for this theory, but it ought to be studied in the future, on the basis of our new findings," Mulder said.

http://www.upi.com/Health_News/2016/05/13/Researchers-find-link-between-melatonin-diabetes-risk/7081463162949/

Fruit compounds may yield new treatment for obesity, diabetes and heart disease

From South China Morning Post

Combining substances found in red grapes and oranges could yield a treatment beneficial to some patients, study finds; genetic finds about brain tumours in dogs may help humans.
A combination of two compounds found in red grapes and oranges could be used to improve the health of people with diabetes, and reduce cases of obesity and heart disease. When given jointly at pharmaceutical doses once a day for eight weeks to 32 overweight and obese study participants, the compounds acted in tandem to decrease blood glucose, improve the action of insulin and improve the health of arteries.
Researchers at the University of Warwick in Britain who conducted the study, published in the journal Diabetes, hope their discovery will be developed to provide a treatment for patients. The two compounds – trans-resveratrol found in red grapes and hesperetin in oranges – act by increasing a protein called glyoxalase 1 (Glo1) in the body which neutralises a sugar-derived compound called methylglyoxal, a major contributor to the damaging effects of sugar.
The study participants, aged between 18 and 80 years old, were given the supplement in capsule form once a day for eight weeks and were asked to maintain their usual diet and physical activity levels. The researchers found that highly overweight subjects, who had body mass indexes of over 27.5, displayed increased Glo1 activity, decreased glucose levels, improved working of insulin, improved artery function and decreased blood vessel inflammation. There was no placebo effect.
Lead researcher Professor Paul Thornalley says: “As exciting as our breakthrough is it is important to stress that physical activity, diet, other lifestyle factors and current treatments should be adhered to.”

http://www.scmp.com/lifestyle/health-beauty/article/1944404/fruit-compounds-may-yield-new-treatment-obesity-diabetes-and