15 weeks of high-intensity swimming can help prevent diabetes

By Ida Eriksen


High-intensity swimming can help to keep lifestyle diseases such as type 2 diabetes at bay, shows new research.
“There was a 22 per cent improvement in insulin sensitivity after training at a high-intensity, but no change for those who swim at a low pace. I didn’t expect that,” says co-author Nikolai Nordsborg, Associate Professor in physiology at the University of Copenhagen, Denmark.
The scientists behind the research discovered that short swimming sessions also work, so long as you train at a high-intensity.
The new research is publsihed in the European Journal of Applied Physiology and was funded by the Faroese Research Council.

15 weeks of hard but short training sessions

The new results could help motivate people to embark on a new fitness regime.
“People often say that they don’t have time to train, but you can actually achieve an incredible amount by doing quite little, which is appealing to people who don’t usually workout,” says project leader, Magni Mohr, Associate Professor in physiology at the University of the Faroe Islands.
In the study, 62 middle aged women with high blood pressure took part in a series of high-intensity swimming sessions, three times a week for 15 weeks.
Each session consisted of six to ten reps of front crawl at full throttle for 30 seconds at a time, with a two minute rest in-between.

Training makes women more sensitive to insulin

By the end of the study the women had become more sensitive to insulin--the hormone that regulates blood sugar.
This explains how the short training sessions can help to prevent type 2 diabetes, which develops when we can no longer regulate blood sugar levels.
But Nordsborg and Mohr do not yet know why high-intensity swimming has such a positive effect on insulin sensitivity.
“We have covered a part of the research in swimming, but the underlying understanding of why high-intensity training gives such good results is still missing,” says Nordsborg.

Everyone can benefit from high-intensity training

The new results have implications for the scientific debate surrounding exercise and fitness.
“For a long time people have discussed [recommended] training hard one day so you can take it easy over the next few days. But most new studies suggest less is better, to achieve a long-term effect. So the new study is an important input to previous research,” says Allan Flyvbjerg, Dean at the Department of Health, and professor of diabetes at Aarhus University, Denmark.
And the new results are not only applicable to the middle-aged women who took part in the study, says Flyvbjerg.
“All of us become worse at regulating insulin with age and if we don’t do something about it then a substantial percentage of us will develop type 2 diabetes,” he says.

The World Health Organisation estimates that 422 million people live with diabetes. Around 1.5 million people died due to diabetes in 2012, making it one of the leading causes of death globally.
“In Denmark approximately seven per cent of the population have diabetes and 15 per cent are at risk of developing it,” says Flyvbjerg.

http://sciencenordic.com/15-weeks-high-intensity-swimming-can-help-prevent-diabetes

Lifestyle changes to prevent diabetes can also cut cancer risk: Experts

From India New England News

New Delhi– It may sound exaggerated but the unprecedented growth in Type-2 diabetes over the past 15 years and the deadly rise of cancer have a few common — some even modifiable — risk factors linked to how we lead our daily lives, health experts say.
These include age, sex, obesity, physical activity, diet, alcohol and smoking.

“In 80-90 per cent cases of cancer occurrence, environmental factors, particularly lifestyle disorders, are responsible, which also account for higher number of diabetes cases,” Anil Kumar Dhar, oncologist at Gurgaon’s Columbia Asia Hospital, told IANS.

“Appropriate changes in lifestyle have shown reduction in mortality and morbidity of both the diseases,” Dhar added.
According to the latest World Health Organisation (WHO) estimates, the number of people diagnosed with diabetes in India doubled to 63 million in 2013 from 32 million in 2000 — nearly 100 per cent in 13 years. The number is expected to rise to 101 million by 2030.
“As reported by WHO, more than one million new cases are reported in India while about 680,000 people die due to cancer in India,” Minister of State for Health Anupriya Patel said in a written reply in the Rajya Sabha last month.
According to endocrinologist Purnima Agarwal of Jaypee Hospital, Noida, diabetes and cancer are common diseases with tremendous impact on health worldwide and epidemiologic studies demonstrated that the people with diabetes are more likely to develop cancer.
“However, the exact biological link between cancer and diabetes is still incompletely understood,” she said.
There are two possible links between the two diseases — general mechanism and tissue-specific mechanism.
The general mechanism is linked to insulin resistance which is a hallmark of Type-2 diabetes. “Insulin is a growth factor with predominantly metabolic action but it can have mitogenic effects that can lead to cancer,” Agarwal explained.
“Hyperglycemia or excess of glucose in the bloodstream, chronic inflammation and obesity can also lead to oxidative stress which can increase the risk of cancer,” Agarwal told IANS.
Among the tissue-specific mechanisms linking diabetes with cancer, she mentioned that liver and pancreatic cells exposed to higher insulin concentrations could be the cause of higher incidence of these cancers in diabetic patients.
Various changes secondary to diabetes like fatty liver, increased chances of Hepatitis B and C infections can also contribute to the increased risk.
“Type-2 diabetes is associated with liver, pancreas, kidney, breast and endometrium cancers,” noted Siddharth Kumar Sahai, an oncologist at Gurgaon’s Paras Hospitals.
The common lifestyle factors that can contribute to both diabetes and cancer were recently discussed in a major symposium at the American Association for Cancer Research (AACR) annual meeting where University of Colorado Cancer Center investigator Tim Byers described research showing the link between cancer, diabetes and cardiovascular disease.
“Obesity leads to a chronic inflammatory state and circulating growth factors that have adverse effects on the heart and can also contribute to the development of cancer. But we tend to study these things in isolation, by disease and not by risk factor,” Byers told the gathering.
Overweight/obesity is a well-known risk factor for diabetes mellitus. “There is growing evidence that weight gain is associated with increased risk of some cancer like breast cancer, colon cancer and endometrial cancer,” Agarwal noted.
Similarly, lack of physical activity increases the risk for both Type-2 diabetes and cancer.
“Epidemiological observational studies consistently indicated that higher level of physical activity is associated with lower risk of colon, breast and endometrial cancer,” Agarwal said.
Reducing the risk of diabetes and cancer has to do a lot with what we eat. “Diet rich in red and processed meat, less of fibre is associated with high risk of both Type-2 diabetes and cancer,” she noted.
Another risk factor that diabetes shares with cancer is smoking. It is estimated that worldwide tobacco smoking accounts for 71 per cent of lung cancer death and studies suggested that smoking is also independent risk factor for development of diabetes mellitus.
In addition, it increases the risk of complications of diabetes mellitus like cardiovascular disease and retinopathy, the experts said.
Alcohol consumption in moderate amounts increases the risk of cancers in oral cavity, oesophagus, liver and colon. Excess consumption of alcohol is also a risk factor for Type-2 diabetes.
Understanding the similarities and differences in how these risk factors create cancer and diabetes could aid the ways we prevent these deadly diseases, the experts suggested. (IANS)

http://indianewengland.com/2016/08/lifestyle-changes-prevent-diabetes-can-also-cut-cancer-risk-experts/

Inexpensive drug could slow heart disease for Type 1 diabetic patients

From ncl.ac.uk/press/news

Scientists at Newcastle University believe a drug commonly prescribed for Type 2 diabetes could be routinely taken by Type 1 diabetic patients to slow the development or delay heart disease.
Metformin is an inexpensive treatment that is often used for Type 2 diabetes to lower blood sugar levels by reducing glucose production in the liver.
The drug is not regularly given to patients with Type 1 diabetes. However, for the first time, a clinical trial has revealed metformin can promote a patient's ability to repair their own damaged blood vessels by increasing vascular stem cells.

Leading cause of illness

Heart disease is the leading cause of illness in diabetic patients, accounting for more than half of all fatalities. Metformin may be used to lower Type 1 diabetic patients’ risk of developing this complication.
Findings of the clinical trial are published today in the journal, Cardiovascular Diabetology. This follows previous laboratory work at Newcastle University which explored the mechanism behind metformin.
Dr Jolanta Weaver, Senior Lecturer in Diabetes Medicine at Newcastle University and Honorary Consultant Diabetologist at Queen Elizabeth Hospital, Gateshead, led both studies.
She believes this new research is a major development in understanding the best ways to further improve treatment in Type 1 diabetes.
Dr Weaver said: “As the outcomes of heart disease is worse in diabetic versus non-diabetic patients, there is a need to identify additional treatment options.
“Metformin could routinely be used by patients with Type 1 diabetes to help lower their chances of developing heart disease, by increasing a repair mechanism created by vascular stem cells released from the bone marrow.
“Our research is an exciting step forward as it may have positive clinical implications for patients with increased risk of cardiovascular disease by improving their treatment options.
“For the first time, this study has shown metformin has additional benefit beyond improving diabetes control when given to patients with relatively well controlled Type 1 diabetes.
“We have established the drug increases patients own vascular stem cells, which will help delay or slowdown heart disease.
“Our findings also show that the cells associated with damaged blood vessels were reduced, confirming that the repair of blood vessels was taking place in our patients.”

How the study was carried out

Researchers studied a treatment group of 23 people aged 19-64 who had Type 1 diabetes for up to 23 years and had no evidence of heart disease.
Patients were given metformin at a dose they could tolerate, between one to three tablets a day, for eight weeks. Participants were advised to adjust their insulin to keep blood glucose levels safe.
Scientists measured patients' stem cells directly in the blood and also grew stem cells in a test tube, observing how they behaved. Another cell type was also counted to assess damaged blood vessels.
The participants were matched with nine patients within the same age bracket who took standard insulin treatment and 23 healthy non-diabetic people aged 20-64.
Experts found that the stem cells of patients who took metformin were able to promote the repair of the blood vessels and there was an improvement in how vascular stem cells worked.

Autoimmune condition

Type 1 diabetes is a lifelong autoimmune condition that develops when the pancreas does not produce any insulin, causing a person's blood sugar level to become too high. It is estimated around 400,000 people in the UK have the condition.
Dr Weaver said: “We have shown that all our patients in the study had their insulin doses reduced after taking metformin and have not suffered any serious adverse effect.
“Patients with Type 1 diabetes may wish to consider discussing with their GP the possibility of adding metformin, even at a very low dose, to the insulin that they are taking. However, care needs to be taken to adjust insulin dose to prevent too low glucose levels.”
A pilot study was funded by Diabetes Research and Wellness Foundation and the extended study was financially supported by the Diabetes Research Fund in Gateshead.
Dr Eleanor Kennedy, Research Manager at Diabetes Research and Wellness Foundation, said: “The Diabetes Research and Wellness Foundation is delighted to have funded the initial pilot study that led Dr Weaver and her colleagues to conduct this small clinical trial.
“The results, which indicate that metformin, a drug commonly used in the treatment of Type 2 diabetes, could also have a powerful effect in people with Type 1 diabetes is unexpected.
“We hope that these results can lead to a much larger clinical trial.”

Case study

Quantity surveyor Alex Laws was part of the Newcastle University clinical trial and is delighted with the results of the study.
The 31-year-old, of Gateshead, was diagnosed with Type 1 diabetes at the age of just seven and has good control of her condition. She was enrolled on the clinical trial in the summer of 2013.
Alex said: “I was keen to be part of the clinical trial as I know how important research is into helping people with the condition - I previously worked in the medical research field.
“People with Type 1 diabetes can suffer from a number of complications, especially in the long-term, so it’s important as much as possible is done to limit serious problems.
“Heart disease is a concern for people with Type 1 diabetes so any treatment that can help with this and give an advantage to the patient is a good thing.”

http://www.ncl.ac.uk/press/news/2016/08/metformintype1diabetes/

For People With Diabetes, There’s Even More Reason Not to Skip Breakfast

By Toby Smithson

Health professionals have long extolled the benefits of eating breakfast and advocated for making the most of this morning meal. Yet, we still find Americans, both young and old, are skipping breakfast. A 2015 survey of 10,000 people from Instantly revealed that less than half of Americans eat breakfast every day. That's a lot of breakfast slackers!

Breakfast is an opportunity to consume more nutrients, such as calcium, magnesium, potassium and protein, to boost energy and thinking power. These added nutrients enhance critical thinking and bolster energy, so you can be at your best. And, breakfast eaters have been shown to be healthier eaters throughout the day – yet another good reason to eat your morning meal.
In addition to these benefits, for people with diabetes, there’s much more at stake when it comes to missing breakfast. A randomized clinical trial published last year in the journal Diabetes Care evaluated the effects of skipping breakfast on blood glucose levels after lunch and dinner in subjects with Type 2 diabetes. The results showed that when the participants fasted until lunch, they had much greater spikes in blood sugar after lunch and dinner, as compared to days when they ate breakfast. The common thinking is if you don’t eat food in the morning, or skip breakfast, you should have better blood glucose readings. But this study showed that the insulin response to eating lunch and dinner was blunted when the subjects skipped breakfast. Most importantly, as the researchers pointed out, these blood glucose spikes and high after-meal blood glucose levels over the long term are strongly linked to cardiovascular complications for people with Type 2 diabetes.

If you’re stumped on what to eat for breakfast, there is research to help us here too. A healthy breakfast includes lean protein, and studies show having protein at breakfast can help prevent spikes in blood sugar levels for people with Type 2 diabetes. So how much protein should you eat? Based on research, you should aim to eat 25 to 30 grams of protein for this meal; this equates to 1 cup of milk plus two eggs or 6 ounces of Greek yogurt plus 2 tablespoons of peanut butter, and is within the recommendations from the 2015-2020 Dietary Guidelines for Americans.

In addition to consuming lean protein, you should eat healthy carbohydrates, such as whole grains, fruit, vegetables or beans, at breakfast. The amount of carbohydrates a person should eat varies by the individual. A study in Diabetes Care found that both high- and low-carbohydrate diets had health benefits. So work with your dietitian and check your blood glucose levels before and two hours after meals to determine how many carbohydrates you should be eating to best manage your diabetes.

Still not sure what to eat? Try these quick, healthy breakfast ideas:

• Plain Greek yogurt (7 ounces) with 3/4 cup of blueberries, cinnamon and 1 ounce of almonds
• Three egg whites plus black beans wrapped in a small whole-grain tortilla
• Top one slice of whole-grain bread with 3/4 cup cottage cheese sprinkled with cinnamon, a sugar substitute and 1 ounce of sliced almonds. Broil in the oven until the cheese starts to melt.
• Four ounces smoked salmon with chopped cucumber and tomato on a whole-grain English muffin

You’ve probably heard the saying “timing is everything.” Though there are other factors to consider here, timing is clearly important when it comes to diabetes and food. So take a moment to enjoy breakfast, and have confidence that your blood sugar will actually improve.

http://health.usnews.com/health-news/blogs/eat-run/articles/2016-08-25/for-people-with-diabetes-theres-even-more-reason-not-to-skip-breakfast

Getting enough omega-3 may cut risk of diabetic retinopathy

From Fox News Health

For adults with type 2 diabetes, following a Mediterranean diet including at least two servings of fatty fish per week may lower the risk of diabetic retinopathy, according to an observational study from Spain.
The researchers analyzed data on people participating in a larger randomized trial known as PREDIMED, which ran from 2003 to 2009 in Spain and tested a Mediterranean diet with added extra virgin olive oil or nuts against a usual comparison diet for preventing heart problems over time.
About 3,600 adults aged 55 to 80 who took part in PREDIMED had type 2 diabetes and the analysis focused on them.
Based on food frequency questionnaires, the researchers determined that three quarters of these participants had met target omega-3 fatty acid intake levels of 500 mg per day, which can be achieved by meeting American Heart Association guidelines of two weekly servings of fish, preferably oily fish like salmon.

Over about a six-year follow-up period, there were 69 new cases of sight-threatening diabetic retinopathy. People who were meeting omega-3 fatty acid guidelines when the study began were 48 percent less likely to have this diagnosis during the study than others, according to the findings published in JAMA Ophthalmology, August 18.
It's hard to say whether the results would have been the same with omega-3 supplements, said lead author Aleix Sala-Vila, a researcher with CIBERObn (Spanish Biomedical Research Center in Physiopathology of Obesity and Nutrition) in Madrid and IDIBAPS at Hospital Clinic in Barcelona.
But there have been encouraging results from several research teams studying dietary intake of omega-3 fatty acids and vision for all people, not just those with diabetes, he said.
"The incidence of diabetes mellitus type 2 is increasing, and therefore more individuals will suffer from diabetic complications which, if not properly managed, may lead to permanent eye damage," Sala-Vila said by email.
"People should be aware that regarding diet, even small changes in the right direction can lead to substantial benefit for themselves," he said. "Incorporating fish into their diet can be a way to live longer and better," and is beneficial for the heart and brain, he said.
Salmon, shrimp and light canned tuna are good, low-mercury options, he said.
"Diet modification is a cornerstone of diabetes care," writes Dr. Michael Larsen of Rigshospitalet-Glostrup and University of Copenhagen in Denmark in a commentary accompanying the study.
"It seems a safe bet now to spread one's food intake to include the gifts of our oceans and forests, while we consider how they can be protected for future generations and wait for large and ambitious studies of the effects of diet on diabetic retinopathy," Larsen writes.

http://www.foxnews.com/health/2016/08/25/getting-enough-omega-3-may-cut-risk-diabetic-retinopathy.html

Eat citrus fruits to ward off heart disease, diabetes risk

From indianexpress.com

Higher intake of citrus fruits like oranges and lemons can help keep you healthy as well as prevent harmful effects of obesity-related heart disease, liver disease and diabetes, a study has found.
Citrus fruits contain large amounts of antioxidants, a class of which are called flavanones.
When humans consume a high-fat diet, they accumulate fat in their bodies. Fat cells produce excessive reactive oxygen species, which can damage cells in a process called oxidative stress.
These oxidative stress coupled with inflammation in obese individuals increases the risk of developing heart disease, liver disease and diabetes, the researchers said.
“Our results indicate that in the future we can use citrus flavanones to prevent or delay chronic diseases caused by obesity in humans,” said Paula S. Ferreira, a graduate student at Universidade Estadual Paulista (UNESP) in Brazil.

However, “the study did not show any weight loss due to the citrus flavanones,” added lead researcher Thais B. Cesar from UNESP.
Even without losing weight, citrus fruits can help become healthier with lower oxidative stress, less liver damage and reduce risks of other obesity-related diseases, the researchers noted.
“The study also suggests that consuming citrus fruits probably could have beneficial effects for people who are not obese, but have diets rich in fats, putting them at risk of developing cardiovascular disease, insulin resistance and abdominal obesity,” Ferreira explained.
For the study, the team conducted an experiment with 50 mice, treating them with flavanones found in oranges, limes and lemons, or a high-fat diet.
They focused on flavanones such as hesperidin, eriocitrin and eriodictyol. For a month, researchers gave groups either a standard diet, a high-fat diet, a high-fat diet plus hesperidin, a high-fat diet plus eriocitrin or a high-fat diet plus eriodictyol.

The group who consumed high-fat diet without the flavanones showed increase in the levels of cell-damage markers called thiobarbituric acid reactive substances (TBARS) by 80 per cent in the blood and 57 per cent in the liver compared to mice on a standard diet.
But hesperidin, eriocitrin and eriodictyol were found to decrease the TBARS levels in the liver by 50 per cent, 57 per cent and 64 per cent, respectively, compared with mice fed on a high-fat diet but not given flavanones.
Eriocitrin and eriodictyol also reduced TBARS levels in the blood by 48 per cent and 47 per cent, respectively, in these mice.
In addition, mice treated with hesperidin and eriodictyol had reduced fat accumulation and damage in the liver.
The findings were presented at the 252nd National Meeting and Exposition of the American Chemical Society (ACS), held in Philadelphia, recently.

 http://indianexpress.com/article/lifestyle/health/eat-citrus-fruits-to-ward-off-heart-disease-diabetes-risk-2991024/

Fit teens and young adults have reduced diabetes risk

From auburnpub.com

DEAR DOCTOR K: My teenage son doesn't like sports or exercise. Diabetes runs in our family. You say exercise protects against diabetes and is valuable even in young adults. Can you give me some ammunition to convince my teenager to exercise?

DEAR READER: Perfect timing: A new study has been published that provides an answer. Most studies of exercise have been in adults, often older adults. Until this recent study, there wasn't a lot of information about teenagers.

The new study looked at 1.5 million teenage men enlisted in the military in Sweden between the years 1969 and 1997. None had diabetes at the time they entered the military. Because military service is required in Sweden, these young men included over 97 percent of all Swedish men aged 18. Health records were available for all the men, for up to the next 40 years.

At the time they entered military service, their aerobic capacity, a reflection of the amount of aerobic exercise, was measured. So was their muscle strength, a reflection of the amount of strength or resistance training. Medical records over the next several decades also identified which of the young men developed diabetes (the common type, called Type 2 or "adult-onset" diabetes).

The research team then could compare the young men who were the least fit to those who were the most fit, with regard to the rate with which they developed Type 2 diabetes many decades later. Those who were the least fit (both in terms of aerobic capacity and muscle strength) were more than three times more likely to later develop diabetes.

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This connection between fitness and reduced risk of diabetes was true regardless of how much the teens weighed when they began military service. That's important because exercise helps to reduce weight, and lower weight helps to protect against diabetes. This study shows that exercise in teenagers — both aerobic exercise and strength training — reduces the risk of diabetes in later life, even if the exercise hasn't led them to achieve a healthy weight.

Aerobic exercise and strength training cause several different chemical changes in muscle. These changes cause muscle to extract sugar from the blood more efficiently. That, in turn, lowers blood sugar levels. Regular exercise also shrinks the size and number of fat cells. This leads to hormonal changes that reduce the risk of developing diabetes.

A weakness of this study is that it did not measure again, later in life, the aerobic capacity and muscle strength of these young men. It is theoretically possible that the ones who exercised the most as teens continued to exercise the most as older adults. In other words, maybe the exercise when they were teens didn't protect them, only the exercise later in life. That's possible, but I think it's more likely that regular exercise in teenage and young adult years protects against diabetes many years later.

I hope that's the ammunition you need. It should be — if your son is a rational teenager. But I know that rational teens can sometimes be hard to find!

http://auburnpub.com/onlyinprint/dr-k/fit-teens-and-young-adults-have-reduced-diabetes-risk/article_c41daae5-274f-598c-aa9a-ff313baf96b3.html

Sleep doctor: Less than 7 hours can worsen diabetes

By Randy Dotinga

SAN DIEGO – A sleep specialist told an audience of diabetes educators that quality sleep is “profoundly important” to the health of their patients, and regularly sleeping fewer than 7 hours a night can wreak havoc on glucose levels and insulin resistance.

There’s even evidence of a link between lack of sleep, diabetes, and heart disease, according to Terese C. Hammond, MD, medical director of the Keck Hospital of the University of Southern California Sleep Disorders Centre in Los Angeles. “We don’t know which way the cause goes, but we know there’s a connection,” she said.

Dr. Hammond, who spoke at the annual meeting of the American Association of Diabetes Educators, noted that the vast majority of adults need 7-9 hours of sleep a night.

If you repeatedly don’t reach 7 hours, “there is ample evidence that some metabolic and biologic things happen to your body. Glucose goes up and insulin is secreted. Leptin decreases – the protein that tells us when we’re sated, when our hunger is satisfied. It’s a pretty potent combination, and this is associated with increases in weight and carbohydrate intake,” Dr. Hammond said.

Indeed, findings from one small study suggest a link between chronic insufficient sleep to consumption of more calories, mostly carbohydrates. The study authors speculated this may be because people eat extra food to account for being awake more but take in more than they need.

It is possible for people to pay off a “sleep debt” by catching up on sleep, Dr. Hammond said, but only if the sleep is lost temporarily, as during a heavy medical rotation or after a personal tragedy. When sleep loss is chronic, she said, “it’s becoming apparent that the end-organ consequences are not fully recoverable.”

In regard to diabetes specifically, she said, research has linked insufficient sleep to higher rates of central obesity, higher rates of diabetes in blacks and whites, impaired glucose tolerance, decreased insulin, metabolic syndrome, and high lipids. Too much sleep has also been linked to poor health outcomes.

How can medical professionals help patients improve sleep? “The most important thing to remember about sleep is that it’s a very primitive process,” according to Dr. Hammond. “You can’t think yourself into better sleep. You have to act yourself into better sleep through light, temperature, sound, and repetitive behaviours.”

Controversial research has linked sleeping pills to higher mortality rates, she says. “I try to avoid them long term for insomnia, and not only because there’s probably an increased risk. They stop working eventually.”

Another approach, cognitive behavioural therapy (CBT), is “the most potent way to change behaviour,” she said.

“CBT improves sleep efficiency in a vast majority of chronic medical diseases,” she said. “It does just as well as drugs and better than most sleeping pills.”

According to Dr. Hammond, CBT focuses on several strategies:

• Education about sleep hygiene, such as limiting the bedroom to nighttime sleep and intimacy, going to bed at the same time every night, and focusing on a dark, cool, quiet environment.

• Increasing the “sleep drive” through temporary sleep deprivation.

• Relaxation training through techniques like guided imagery, biofeedback, progressive muscle relaxation, and self-hypnosis.

Dr. Hammond reported having no relevant financial disclosures.

http://www.clinicalendocrinologynews.com/specialty-focus/diabetes/single-article-page/sleep-doctor-less-than-7-hours-can-worsen-diabetes/42872814ea050255a4ff19d50ab3bc9c.html

Two common fruits can help prevent heart disease and diabetes

From startat60.com

While they are a great remedy to keep a cold away, a bonus for weight loss battles and work wonders in adding that extra ‘zing’ to your day, a new study has revealed that these common fruits could actually help stop diseases caused by obesity too.
Oranges and lemons are not only fully loaded with Vitamin C, they are shown to have antioxidants that prevent obesity-related heart disease, liver disease, and diabetes.
While they do not prevent obesity, people who enjoy a high fat diet but are not yet obese could also benefit by preventing diseases linked to the food they eat.

The study by Universidade Estadual Paulista (UNESP) in Brazil suggested obesity increases the risk of developing heart disease, liver disease and diabetes because of oxidative stress and inflammation.

Eating a high-fat diet causes the fat to accumulate fat in their bodies and these fat cells produce excessive reactive oxygen species, which can damage cells in a process called oxidative stress.

Graduate student Paula Ferreira said: “Our results indicate that in the future we can use citrus flavanones, a class of antioxidants, to prevent or delay chronic diseases caused by obesity in humans. This study also suggests that consuming citrus fruits probably could have beneficial effects for people who are not obese, but have diets rich in fats, putting them at risk of developing cardiovascular disease, insulin resistance and abdominal obesity.”

Further research will look at how best to administer these flavanones, whether in citrus juice, by consuming the fruit or developing a pill with these antioxidants.

https://startsat60.com/health/two-common-fruits-can-help-prevent-heart-disease-and-diabetes

Eating oily fish may lower risk of diabetic vision-loss

From indianexpress.com

The retina is rich in long-chain omega-3 polyunsaturated fatty acids found in oily fish. (Source: Wikimedia Commons)Eating oily fish twice in a week — equivalent to 500 mg per day of dietary omega-3 polyunsaturated fatty acids — can decrease the risk of sight-threatening diabetic retinopathy in middle-aged and older individuals with Type 2 diabetes, finds a study.
Diabetic retinopathy is a diabetes complication that affects eyes and has become a leading global cause of vision loss. It is caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).
The increasing prevalence of Type 2 diabetes mellitus, coupled with an increased lifespan, has resulted in a steady rise of disability in older individuals with diabetes.

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The retina is rich in long-chain omega-3 polyunsaturated fatty acids.
Many experimental models have supported dietary long-chain omega-3 polyunsaturated fatty acids’ protection against diabetic retinopathy, however, clinical data is lacking, the researchers said, in the paper published online by JAMA Ophthalmology.
The team conducted a prospective study within the randomised clinical trial Prevencion con Dieta Mediterranea (PREDIMED).
From 2003 to 2009, 3,614 individuals aged 55 to 80 years with a previous diagnosis of Type 2 diabetes were recruited in Spain.
Participants meeting the long-chain omega-3 polyunsaturated fatty acids recommendation at baseline (500 mg/d or greater) showed a 48 per cent reduced risk of sight-threatening diabetic retinopathy, than those with lower levels of the fatty acids.
“Our findings, which are consistent with the current model of the pathogenesis of diabetic retinopathy and data from experimental models, add to the notion of fish-derived long-chain omega-3 polyunsaturated fatty acids as a healthy fat,” said Aleix Sala-Vila from the Lipid Clinic in Barcelona.

http://indianexpress.com/article/lifestyle/health/eating-oily-fish-may-lower-risk-of-diabetic-vision-loss-2986858/

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A Dietary Approach to Managing Type 2 Diabetes

From diabetesincontrol.com

Adopting a Mediterranean diet in patients with diabetes helps improve glucose levels.     
Managing diabetes can be a challenge when taking into account numerous patient-specific factors like, complexity of the medication regimen, side effect profile of these medications, cost, and lifestyle modifications, which make it harder to successfully control a patient’s diabetes. These factors are usually tied in with the socioeconomic background of the patient, religious beliefs, and cultural awareness. In the United States, diets consist mostly of low fruit and vegetable content, as well as low content of nuts and seeds, with increased content of meats, trans fats, and sodium. The nutritional content of this diet is responsible for the majority of the cases of T2DM. Initially, when managing a patient’s diabetes, diet and exercise is the initial recommendation based on patient’s current clinical presentation; keeping in mind that more uncontrolled cases warrant medication therapy. Therefore, talking to a patient about changes in their diet can be challenging. How do we handle these situations? What is the best diet for a patient? Is it a one-size fits all model? Understanding a patient’s dietary habits, their motivation to get better and what they seek to accomplish can help you obtain a better understanding of what is the best option for managing a patient’s diabetes.
Various studies suggest the use of a Mediterranean diet in patients with diabetes. However, not every patient knows what goes into this diet and what are the benefits behind it. A meta-analysis done by Koloverou and colleagues found that there is a 23% reduction in the risk of developing diabetes, regardless of world region and patient’s health status. In the PRE-DIMED trial, patients on a Mediterranean diet had a 40% reduction in the risk of developing diabetes. Additionally, when obtaining glycemic control in patients with diabetes, it was found that a Mediterranean diet with low carbohydrate content had a higher rate of remission in patients with diabetes, when compared to low-fat content.
Recently, Letois and colleagues studied the effects of a Mediterranean diet on mortality in the elderly population. In this cohort study, baseline characteristics and dietary patterns were obtained for 8,937 patients. Baseline characteristics included: education, income, occupation, smoking status, alcohol intake, history of CVD, BMI, depression, diabetes, hypertension, hypercholesterolemia, dependence, physical activity, self-rated health, number of drugs, and number of chronic diseases. When assessing dietary patterns, researchers focused on fruits and/or vegetables, fish, meat, and olive oil as their four main food consumption groups. These covariates were accounted for and a Cox proportional hazards regression was utilized to explain the association between dietary habits and mortality risk. Participants were followed for 10 years (mean= 8.9 years) and during the study period, 2,016 participants died.
It was found that those who died had history of CVD, vascular risk factors, poor health (self-reported), and smoked or consumed alcohol. The association between the 10-year mortality risk and dietary patterns showed better survival in those individuals who consumed at least 1 fruit and 1 vegetable per day (P=0.03) or at least 4 servings per week (P=0.0005), consumed fish at least 2 servings per week (P=0.01). It was also found that meat consumption in servings greater than 1 per day had a negative effect on survival (P=0.03). Finally, the use of olive oil was found to be inversely correlated with mortality risk only in women (moderate olive oil use: HR 0·80; 95 % CI 0·68, 0·94, P = 0·007; intensive use: HR 0·72; 95 % CI 0·60, 0·85, P = 0·0002.
These findings highlight the potential benefits of a Mediterranean diet in the elderly (>65 y/o). It is important to note that even though there are benefits to this diet, it does not highlight the exact benefits in patients with diabetes. From the study sample, only 855 patients had diabetes and the effects on their disease state are not explained. However, data from previous studies show the potential benefits of this diet with diabetes remission, glycemic control, and incidence of developing diabetes. With this data and on-going efforts, the authors suggest developing nutritional programs with the efforts of increasing public health awareness. More studies should be done to focus on the association between survival, diet, and healthy behaviors in patients with diabetes to get more evidence for the use of this diet.
Practice Pearls:

• Examine your patient population in order to implement new diet programs and improve health outcomes in diabetic patients.
• Implementing a Mediterranean diet plan that focuses mostly on fruits, vegetables, fish, and olive oil can help improve mortality rates in the elderly population.
• Utilizing a Mediterranean diet in patients with diabetes can help improve glycemic levels and potentially decrease the need for medications.

http://www.diabetesincontrol.com/a-dietary-approach-to-managing-type-2-diabetes/

Diabetes treatment could be revolutionised by making people cold

By John Speakman

For people in northern countries enjoying summer sun, I hate to put a dampener on things but winter’s coming. The cold months can seem to go on forever, yet scientists are uncovering a new reason to be grateful for them.
It turns out that cold climates may help keep type 2 diabetes at bay because of surprising findings about how temperatures affect certain “good” fats in the body. This insight potentially opens up exciting new means of treating people with diabetes – which afflicts 415m people worldwide and is predicted to increase to 641m by 2040.

Strangely enough, this possibility arose from scientists trying to develop something else, namely a new major way of treating obesity. The two endeavours are linked in ways we don’t yet fully understand. To get a sense of how, you need to understand a bit about fat.
Our bodies have three types of fat: white, brown and brite. White fat cells are the body’s energy stores, comprising about a fifth of the weight of the average man and about a quarter of the average woman. Obesity is an excessive storage of this fat, and this increases the risks of type 2 diabetes. Almost 90% of people with type 2 diabetes are overweight or obese.
Brown fat cells operate very differently. They are packed with mitochondria, which are rod-shaped organelles that are present in all cells. Mitochondria are often called the power houses of the cell for the way they convert nutrients in our food into a fuel source known as ATP that powers all cellular functions. Unusually, however, brown fat cells contain a special protein that when activated, restricts this conversion so that the energy is released as heat instead.
You find a lot of brown fat in small mammals like mice and rats that need lots of heat to regulate their body temperature. Human babies have it, too, but for a long time it was thought to disappear in adults, who can usually keep sufficiently warm through metabolic processes. In 2007, however, it was shown that adult humans do have functional deposits of these cells. This discovery is part of the reason for the recent excitement among obesity scientists.

Great brite hope

Brite (BRown in whITE) fat cells only came on the radar 25 to 30 years ago. Several groups observed that when small mammals are placed in the cold, their white fat deposits take on a browner appearance – a process we now call “browning”. Much more recently we realised that these cells – also known as beige – come from a separate lineage to white fat even though they are related.
When brite cells mature they can act like either white or brown cells as the body’s needs change between energy storage and heat production. Scientists have been trying to understand this process, believing that if we can switch these cells into their brown phase, we may be able to activate them along with the body’s brown fat to burn off the energy stored in true white fat cells. Exposure to cold could be the key, since research has previously shown that this activates brown and brite fat in both small mammals and humans.
But will it work? A paper I recently co-authored sought to investigate this by analysing public health data. Our rationale was that if you can burn off excess white fat by increasing the sum of brown/brite fat in the body; and activate this through exposure to cold, people will on average be thinner in colder climates.

America under the microscope

Ours was not a completely new idea, but previous attempts were confounded by trying to compare different countries. Instead we focused on just one country – the US, which has one of the highest obesity rates in the world.
We recovered data on levels of obesity, type 2 diabetes, poverty, race and temperature from 2,654 of America’s 3,146 mainland counties, covering around 170m people. We found a weak correlation between the ambient temperature and obesity prevalence.
The average level of obesity in a typical northerly county with an average temperature of 5℃ was 29.6% compared to 33.6% in counties further south with an average temperature of 25℃ – in other words that big difference in temperature was only linked with about 1.1 times as much obesity.
Unexpectedly, though, the effect of climate on type 2 diabetes was much stronger. In the same two types of cooler and warmer counties, the prevalence of the illness was 1.6 times higher in the warmer ones (12.1% prevalence compared to 7.6% in the cooler counties).

It is not quite that simple, however. Warmer counties have higher populations of African Americans and are poorer, both of which are also linked to higher prevalence of obesity and type 2 diabetes. When we factored this into the data analysis, it completely accounted for the disparity in relation to obesity. With type 2 diabetes, the temperature effect was reduced but still remained very strong.
The message seems clear: switching on your brown and brite fat may not do very much for your obesity levels, but it may have a strong impact on type 2 diabetes.

The way ahead

Despite our best efforts to control for confounding factors, it is always possible the data is being affected by something we overlooked. We were delighted therefore that while our paper was in review a small clinical trial was published in the Nature Medicine journal which showed enormous beneficial effects on insulin action from exposing type 2 diabetic patients to cold temperatures (15℃) for six hours per day.
The interesting thing was these benefits occurred despite only small changes in the patients' brown and brite tissues. This suggests there is something special about being exposed to cold that may affect type 2 diabetes risk that we don’t yet fully understand.
So while this analysis suggests that the hopes of being able to treat obesity by switching on brown and brite fat tissue may turn out to be disappointing, something else exciting appears to be emerging instead. Patients with type 2 diabetes may see a major new additional avenue in treatment in the years ahead.

http://theconversation.com/diabetes-treatment-could-be-revolutionised-by-making-people-cold-64062

Fighting diabetes begins with awarness

By Abha Saxena

Diabetes is a worldwide epidemic and particularly prevalent here in the United States. According to the American Diabetes Association, approximately 29 million Americans suffer from diabetes. That equates to one in 10 Americans who are living with diabetes. It is estimated that by 2020, one in three will be affected by this disease. Diabetes is the leading cause of kidney failure in the U.S. While alarming, the statistics cannot begin to capture the impact diabetes and kidney disease have in the lives of individual patients and their families. The average cost of health care for a person with diabetes is often more than twice the cost of those without diabetes. The physical, emotional, and financial struggles they face can be overwhelming and occur not just nationally, but right here in our own community!
As a physician I serve patients with diabetes and kidney disease in Cedar Rapids. Through this experience, I have seen many patients struggle to afford their medication expenses, medical supplies and even transportation costs to receive lifesaving treatments. I have a strong feeling that these diseases have to be attacked not just on an individual basis but also by raising awareness in the community. If our entire community comes together and helps in changing lifestyles along with helping people with diabetes and kidney disease manage their disease appropriately, it will help future generations. To address some of these problems the UnityPoint Health Diabetes and Kidney Fund was established. The fund provides financial assistance to patients with diabetes and kidney disease who live in our community.
To raise awareness about diabetes and kidney disease, UnityPoint Health is proudly hosting a “LiveWell 5K Walk/Run,” which will take place August 27, 2016. This year’s theme is “Dancing through the Decades” and will feature music along the route, as well as educational and family friendly activities at NewBo Market. Money raised from this event will go to the fund.
I extend an invitation to the community to join me on August 27 to support those struggling with diabetes and to become aware of its prevention. More information and registration can be found at unitypoint.org/livewell5k. Every dollar raised will go directly to patient assistance. It is with my upmost gratitude, I thank those sponsors and individuals who have already seen the power of Diabetes and Kidney fund by supporting those most needy within our community. I hope you will be among them as well.

http://www.thegazette.com/subject/opinion/guest-columnists/fighting-diabetes-begins-with-awarness-20160816

Type 2 diabetes increasingly affects the young and slim; here’s what we should do about it

From the conversation.com

It is well recognised that increasing rates of type 2 diabetes are mainly driven by obesity and lifestyle factors. But that’s not the whole story. Genetics and epigenetics – changes in gene expression – also play an important role.
We are starting to see an increase in type 2 diabetes in leaner people at a much younger age than usually associated with the disease. This means in addition to focusing on good diet and exercise, we need better awareness of groups most at risk of type 2 diabetes.
These include many ethnic groups, women with a history of gestational diabetes and people with a family history of diabetes. In my clinical practice, I have seen teenagers and even children as young as seven, as well as younger patients of Asian, African and Middle Eastern origin with type 2 diabetes.
Among Indigenous people in Central Australia, rates of diabetes are some of the worst in the world, at around three times that of non-Indigenous people. Studies in some remote communities suggest a prevalence of type 2 diabetes of up to 30%, compared to a rate of around 5% in the non-Indigenous population.
All this indicates lifestyle decisions alone can’t be responsible. We need to stop the blame and shame for a condition that has an association with lifestyle, but for many is a consequence of the toxic mix of genetics and modern life.

More than just lifestyle changes

Type 2 diabetes accounts for more than 90% of all diabetes cases and affects mainly middle-aged and older people who are overweight or obese.
Type 2 diabetes is thought to occur from a combination of factors: when the pancreas can’t produce enough insulin; and when the insulin is unable to do its job, to regulate blood sugar.
Why these two factors happen is not completely understood. The physiology may vary between different populations but broadly relates to excessive storage of fat, reduced muscle activity with poor uptake of glucose and genetic predisposition.
In contrast, type 1 diabetes is unrelated to lifestyle factors, has onset in children or young adults and relates to a complete destruction of the insulin-producing (beta) cells in the pancreas.
The cause is not known but may relate to genetic predisposition and an environmental trigger, such as a virus or toxin.
Both types of diabetes may cause a range of serious complications, including loss of limbs, if not aggressively treated.

Genetics and epigenetics

So why are the young and slim getting type 2 diabetes? One theory is epigenetics.
Epigenetics describes the biological process in which environmental factors may affect the expression of genes (where the gene codes for a particular biological function) rather than the alteration of genes themselves.
This process can occur as early as in the womb – before the child is born – with consequences that affect genetic expression for much of their lives.
Conditions such as obesity and gestational diabetes, where women with no pre-existing diabetes develop it during pregnancy, have the potential to alter gene expression in a developing foetus.
This may lead to a predisposition for a range of chronic illnesses, including diabetes. Some ethnic groups are at much greater risk of gestational diabetes; Indigenous women have rates nearly double that of non-Indigenous women.
The exact mechanisms that create such predispositions aren’t known and are the subject of intense ongoing research.

Aggressive treatment

Many studies have shown early aggressive treatment before any sign of diabetes damage can better prevent complications, such as heart disease, kidney failure or blindness.
Aggressive treatment means we should aim for blood sugar levels to be as close to normal – between 4 and 5.5 mmol per litre and non-fasting glucose of 4 to 7.8 mmol per litre – as possible. This often requires medication in addition to intensive lifestyle changes.
Not only is it more expensive to treat complications once they are symptomatic but the outcomes of doing so are poorer. Comparing some of the key diabetes studies over the past 20 years, we found a strategy targeting near-normal blood glucose levels resulted in fewer kidney, eye and heart complications compared with those that had a more relaxed target.
The main factor limiting perfect control of blood glucose is hypoglycaemia. Characterised by low blood glucose levels, it can cause discomfort, confusion or even coma in extreme cases.
For this reason, we need newer medications which can better control blood sugar without the risk of hypoglycemia. Until we get these, the risk makes it acceptable to have less-than-perfect control in some instances.
Modern drug treatment has improved overall, however, and we have access to a range of therapeutics that can be used effectively from early in the disease. Lifestyle measures are an important part of treatment but their benefit may diminish as type 2 diabetes progresses or gets worse over time.

Removing the stigma

Governments must recognise the importance of access to effective new therapies for diabetes as well as adequately fund clinical services to properly manage this complex chronic illness – especially in highly endemic areas such as remote Indigenous communities.
Premature death rates for people with type 2 diabetes are around three times greater than in the general population, largely due to heart disease and stroke. Adjusted years of life lost are greater for those with type 2 diabetes than for those with breast, lung or bowel cancer.
There is a significant stigma and shame attached to the diagnosis of type 2 diabetes, particularly in younger patients. This adds an unfortunate barrier to successful treatment. Until this is improved, we will continue to under-treat our patients and misinform our health providers.

http://theconversation.com/type-2-diabetes-increasingly-affects-the-young-and-slim-heres-what-we-should-do-about-it-61283

 

Diabetes Prevention Strategies

By Dr James Rouse

DENVER, CO - Many of us tend to generalize when it comes to talking about diabetes. Truth is, there’s a difference. Type 1 diabetes is an autoimmune disease that affects the pancreas, preventing it from producing insulin, a hormone that allows glucose (sugar) to be converted into energy. The causes of Type 1 diabetes are believed to be genetic and/or environmental, and unlike type 2 diabetes, T1D has nothing to do with diet and lifestyle. Type 2 diabetes (T2D) has everything to do with diet and lifestyle.

There are several factors that can affect blood sugar: food (carbohydrates, fiber, protein, fat), physical activity levels, alcohol, stress, daily routine, medications, illness, and menstruation and menopause. How we approach each of these areas will have either a positive or not so positive impact on how we feel and how well we maintain balanced blood sugar levels. Stable blood sugar levels help us live long, healthy lives.
Carbohydrates, especially simple starchy carbohydrates and fruit, raise blood sugar faster and have the greatest effect on blood glucose compared to foods that contain proteins or fats. Fiber, protein, and fat can blunt the rise in blood sugar after a meal.
Aiming for a healthy balance of carbohydrates, protein, and fat in your meals can help you manage your blood sugars. But it's important to choose quality carbohydrates and smart fats, like: Vegetables, beans, whole grains, fruit, fish, nuts and seeds, avocado, olives, and extra virgin olive oil.
If you are wondering why any of this information is even important or what the big deal is with T2D, here are some things you need to know.  Adults with T2D die of heart disease twice to four times as often than adults without diabetes. Adults with diabetes have twice to four times the risk of having a stroke and nearly 70% of adults over age 20 with T2D have high blood pressure and need to take medication to manage it.  Having diabetes increases your risk for early blindness, kidney disease and failure, and damage to your nervous system. Management of T2D places a tremendous burden on our healthcare system and yet it is a disease of poor choices.
Here are some proactive measures you can take to help prevent T2D.
1) Start moving. Two recent randomized clinical trials concluded that around 150 minutes (that’s just 30 minutes five times a week) of physical activity and diet-induced weight loss of 5–7% decreased the risk of progression of T2d by over 50%. Vigorous physical activity helps improve mood and has a positive lowering effect on blood fat (cholesterol) and blood pressure. Regular exercise can decrease risk of heart attack and stroke and improve quality of life.
2) Consider adding whey protein to your daily diet. Whey protein powder  mixes easily in to your morning oatmeal, yogurt and even your creamy soups...added to orange juice it helps to bring balance and mixed with milk can help to bring a protein hit when poured over your favourite cereal. Whey protein helps to improve insulin sensitivity and balance blood sugar.

3) Eat a "rainbow" of life giving and health affirming antioxidants from a colourful variety of fruits and vegetables. These superfoods can help you to thrive and fight accelerated ageing!
5) Take a TV time out or take a weekly media fast. Your body, mind and spirit will thrive without TV, the news or other energy and time stealers. Use that time to exercise, cook healthy foods for friends or do something that stretches your comfort zone and grow! Turn off the TV and turn on your creativity!

6) Looking for a nutty way to healthfully manage your blood pressure? Enjoy nuts daily-they are a healthy source of heart healthy fats, blood sugar balancing fiber and those who snack regularly on nuts tend to be more successful with weight loss and weight management-go nuts!

7) If you are time crunched for exercise, give intervals a try. To get more metabolism out of each breath simply change speeds. Interval walking, running, swimming, etc., is simply changing speeds while you move. Changing speeds will increase your metabolism, endurance in less time.

8) Diabetics tend to have lower levels of the very important and powerful antioxidant glutathione. A healthy level of glutathione is associated with greater overall vitality, health and longevity. You can build glutathione by enjoying avocados, grapefruit, spinach and other dark green leafies.

9) Join the optimists club today! Optimists have lower inflammation, healthier hearts and tend to live longer. Look at the bright side and thrive!

10) If you exercise in the morning you will sleep better at night. Morning movers tend towards deeper sleep. Deep sleep is the stage where we truly repair, rejuvenate and recover-you will also help yourself with healthier weight management, better coping with stress and higher self esteem and confidence.
11) Minimize consumption of starches and sugar. Processed foods, white flour and most flour-based products, cakes, cookies, chips, crackers, etc – these all turn to sugar rapidly in the body and are best kept to a minimum.
12) Consider supplements:
- Resveratrol, an antioxidant (anti-inflammatory) compound found in red grapes, is shown to improve glucose tolerance and insulin sensitivity. In supplement form, studies have shown dose ranges between 50 milligrams (mg) – 400 mg day.
- Magnesium – helps promote healthy insulin production. Found in spinach, tofu, sunflower seeds, pumpkin seeds, almonds, halibut, sesame seeds, black beans, Swiss chard, broccoli and lentils. In supplement form, consider up to 400 mg/day. In a study performed at Harvard University, 85,060 women and 42,872 men who had no history of diabetes, cardiovascular disease, or cancer were studied. Their magnesium intake was evaluated using a validated food frequency questionnaire every 2 to 4 years. Their findings propose "a significant inverse association between magnesium intake and diabetes risk." Diabetes Care 2004;27(1):134-140. A similar study found a protective role with higher intake of magnesium in reducing the risk of developing type 2 diabetes, especially in overweight women Diabetes Care  2004;27(1):59-65.
Several more studies support the preventive role of magnesium with regards to diabetes prevention. In a large population based study in Taiwan, magnesium was actually added to the drinking water and a significant protective effect was seen with magnesium being linked to a lower risk of dying from diabetes mellitus. Magnes Res 1999;12(2):131-137.  
Magnesium is just one of those minerals that is essential for optimal health.  One of the best ways to obtain magnesium is through the diet.  The best sources of magnesium are: amaranth, sunflower seeds, quinoa, spinach, wild rice, tofu, almonds, halibut, brown rice, white beans, and avocado.  If these foods are not regularly a part of your diet then you may want to consider supplementing magnesium.
- Chromium (GTF) – 1000 micrograms (mcg) daily – helps regulate blood sugar and improve insulin sensitivity.
13) Eat fish a few times a week – the omega-3 fatty acids found in deep sea cold water fish may benefit heart health and blood sugar levels.
14) Eat small, frequent healthy meals throughout the day rather than skipping meals and eating one large meal at night. Frequent healthy snacking will help keep blood sugar levels stable and energy levels high. Nuts, seeds, cottage cheese, protein smoothies, Greek yogurt, soup, veggies, hummus – all great snack ideas.
15) Yoga/meditation – find ways to help distress. We love yoga and meditation because it helps bring focus back to the breath and deep belly breathing. Find at least five minutes a day to give yourself a time out and just slow down the breathing, close your eyes or get yourself to the nearest yoga class. If you relish doing yoga in the privacy of your own home, check out the many options available online.

http://www.9news.com/life/wellness/optimum-wellness/diabetes-prevention-strategies/298595941

NZers discover potential diabetes breakthrough

By Jesse Mulligan

New Zealand researchers believe they've made a potentially significant breakthrough in the management and treatment of Type 2 diabetes.
More than 240,000 people in New Zealand have been diagnosed with diabetes - mostly Type 2, which is linked with obesity.
While exercise has been shown to improve the health of people with Type 2 diabetes, its effect can vary greatly between different people.
Now, researchers from Massey University believe a new non-drug therapy could make a big difference to those with the disease.
Martin Gram of Massey's School of Sport and Exercise told RNZ's Jesse Mulligan they had developed a natural protein, made up of a unique amino acid and mineral composition, which was having positive results for the study's participants.
It related to a damaging interaction happening in the blood of those with the disease, he said.
"The elevated glucose levels in the blood is increasing the ... 'reactive oxygen species'."
That could stop insulin working properly, but the protein might help break the circle and act as an antioxidant, he said.
Dr Gram said so far all the participants in the study had noted a decrease in the clinical measure of Type 2 diabetes, HbA1c.
There were currently limited options available for people with Type 2 diabetes, and a natural protein would be a significant development for those with the disease, he said.
If the protein turned out to be efficient, Dr Gram said it could take several years before it became available.
Anyone interested in taking part in the study is asked to contact Massey University in Wellington.

http://www.radionz.co.nz/national/programmes/afternoons/audio/201812183/nzers-discover-potential-diabetes-breakthrough

Peer support, connectivity empowers college students with diabetes

From healio.com

SAN DIEGO — Young adults with type 1 diabetes often struggle with the new and added burden of managing a complicated disease on their own as they head off to college, yet many clinical providers and diabetes educators fail to discuss the topics that students have questions about, according to a speaker here.
“We realized that the right information wasn’t available,” said Christina Roth, chief executive officer and founder of the nonprofit advocacy group College Diabetes Network, said during the presentation at the American Association of Diabetes Educators annual meeting. “It wasn’t necessarily available in all the right topics, written in the right way, and in a way that was accessible when [young adults] actually needed it. So, our website has become a hub of information specific to young adults with diabetes.”

Christina Roth

College Diabetes Network, or CDN, founded in 2009, has evolved to become a network of more than 85 chapters with another 30 in development, Roth said. The organization serves as a platform for collaboration with other partner efforts to identify gaps in the system related to young adults with diabetes and address them to better manage transition risk with resources like the “Off to College” program.
“We want to make this time in life, this transitional period, safer, we want to make it easier and just a little more endurable,” Roth said. “Our job is to create the platform that brings [young adults] together. With their local communities that they work to create so passionately, we’re then able to connect all of them and create this larger community of adults with diabetes that hadn’t existed before.”
To help foster a safer transition, the CDN Off to College Program provides printed booklets for students and their families and informational toolkits for health clinics and diabetes organizations to host local Off to College events.
The tools stress that topics including drinking, managing relationships and mental health need to be discussed in an open and honest way, Roth said.
“It is also important to recognize that the source of the information, and the way in which it is delivered plays a critical role,” Roth told Endocrine Today before the presentation. “Often at this time in life, getting information from a peer will be far more impactful and effective and is more likely to lead to behavior changes.”
Peer support can be critical during this time and foster important connections between young adults with diabetes, Roth said; however, forcing such relationships on a young adult, either by the parent or provider, can have the opposite effect of driving a person away from resources.
“One of the key reasons CDN offers our free student membership is to incentivize students and young adults with diabetes to stay in contact, even passively,” Roth said. “This then creates a continuous line of communication, which, when they are ready, they can use to connect further.”
Parents and providers can start the conversation with college-age young adults by introducing the idea of connecting with peers not as a "support group," but simply as a way to trade tips and tricks and to talk to someone else who “gets it when they are high in class” Roth said.
Currently, there are no clinical care recommendations related to young adults that mention the role of peer support, Roth said, and she would like to see that change.
“There should be more encouragement for providers to be more proactive in embracing support systems and tools outside of the clinic,” Roth said. “Focusing more on helping their patient put systems in place to support them for all the time in between visits, instead of simply relying on that individual's motivation being enough, but looking at it as failure when it is not.” – by Regina Schaffer

http://www.healio.com/endocrinology/diabetes-education/news/online/%7B654a0719-e076-47e3-bfba-ca71d79b3a4c%7D/peer-support-connectivity-empowers-college-students-with-diabetes

Culture gap can make diabetes diet harder

From deccanchronicle.com

Patients with diabetes must work hard every day to count the carbs they consume, to avoid dangerous spikes or dips in blood sugar.
Learning how to do it can be close to impossible, though, when language and cultural barriers make it difficult for doctors to understand what patients typically eat, a case report in Lancet Diabetes and Endocrinology suggests.
“Carbohydrate counting is critical for accurate management of diabetes,” said co-author Dr. Sumana Narasimhan, a pediatric endocrinologist at Cleveland Clinic Children’s in Ohio.
“If we don’t fix this problem, families of children with diabetes from non-western cultures may continue to guess the carbohydrate count of their ethnic foods, resulting in inaccurate insulin dosing and poorly controlled diabetes,” Narasimhan added by email. “The risk of diabetes complications is higher when diabetes is not managed properly.”
The case report involved a child recently diagnosed with type 1 diabetes, a chronic condition usually diagnosed in children or young adults. With this condition, the pancreas produces little or no insulin, a hormone needed to allow blood sugar, or glucose, to enter cells and produce energy.
People with type 1 diabetes typically have to test their own blood sugar levels throughout the day and inject insulin to manage them. Getting the insulin dose right requires patients to count carbs correctly.
In this case, the child’s mother asked doctors how to count carbs for the traditional Middle Eastern foods she prepared at home.
Doctors found some pamphlets and online resources for following a diabetes diet that were translated into Arabic. But the information was still mostly based on a typical Western or European diet, not on traditional foods like tabbouleh, hareeseh and chicken shawarma that are more common in a typical Middle Eastern diet.
While doctors did eventually find some resources in Arabic based on nutrients common in Middle Eastern diets, it was still difficult to calculate the carbohydrates in an entire meal.
While this is just one case, the patient's experience suggests a need for culturally appropriate food lists and nutrition information in multiple languages, Narasimhan and co-author Dr. Hamza Nasir of Dow University of Health Sciences in Karachi, Pakistan, conclude.
Because type 1 diabetes so often affects kids, the burden of managing their disease falls to parents, often the mothers who prepare their meals, Nasir said by email.
“When this mother asked us about carb content in traditional Arab foods, we were a bit puzzled as the usual patient information pamphlets do not carry this information,” Nasir said.

What this mother experienced speaks to a larger problem people from other cultures may encounter when they seek treatment in the U.S., said Dr. Brigid Gregg, a researcher at C.S. Mott Children’s Hospital at the University of Michigan in Ann Arbor.
“I do think there is a broader problem understanding the nutrient content of certain home cooked ethnic foods as well as home cooked foods in general,” Gregg, who wasn’t involved in the case report, said by email.
“This makes accurate carbohydrate counting difficult and may have the unfortunate effect of encouraging the use of prepackaged foods for better dosing accuracy,” Gregg added. “Families generally feel more peace of mind when they know the exact carbohydrate count of the foods they are giving their family member with diabetes, and there is a great deal of certainty with food that comes with a label.”

http://www.deccanchronicle.com/lifestyle/health-and-wellbeing/130816/culture-gap-can-make-diabetes-diet-harder.html

'Mobile text messages can reduce diabetes risk factors'

By Kalyan Ray

The ubiquitous mobile phone can double up as a dispenser of useful medical advice for millions of Indians suffering from diabetes.
Sending text messages twice in a week to one million Indians advising them to exercise, have less fat, and eat more fruits and vegetables actually helped reduce the risk factors for diabetes among Indians, found a team of researchers, who experimented with mobile phones to spread public health advices.

This is the first scientific study to demonstrate the power and reach of the mobile phones to effect a change in the diabetes risk behaviour in India.

India tops the world with an estimated 66 million diabetic patients. Close to a million die each year and several millions are prone to it. India's diabetes prevalence is four times higher than among Caucasians in the United States.
When a team of researchers from the US and India set out to check if mobile phone can be used as a health promotion intervention delivery channel, India with its billion plus connections was picked up as the test case.

The study has now found that almost 40% more people improved their health behaviours as a result of the text messages they received twice in a week, compared to those who did not receive those messages.

“This shows the potential for even the most basic of mobile phones to be used as a viable tool to deliver public health messages on a large scale across a diverse population. Just a basic mobile phone can make an impact,” said lead scientist Angela Fidler Pfammatter, research assistant professor in preventive medicine at Northwestern University Feinberg School of Medicine.

“It would make sense to undertake a controlled study measuring exact cost and detailing the health outcomes as the next step prior to scaling up this strategy,” Pfammatter told DH.

The researchers analysed the responses from 982 people who were randomly selected from the recipients of a health promotion campaign launched by a mobile company in 2012-13.
Though a set of 56 messages in 12 Indian languages were sent to a million Indians, 982 adult individuals were picked as representative sample up for the analysis.

The recipients were compared against a control population of 943 Indians who did not get those messages. Every person was followed for six months to find out the behavioural changes, if any.

The study found while people in both the experimental and control group improved their health behaviours over six months, the experimental group improved significantly more.

http://www.deccanherald.com/content/563601/mobile-text-messages-can-reduce.html

Texting a million people in India improves diabetes prevention

From sciencedaily.com

A study that sent twice-weekly text messages to a million people in India advising them to exercise, eat less fat, and eat more fruits and vegetables increased these health behaviors known to prevent diabetes, reports new research from Northwestern Medicine and Arogya World, a global health non-profit organization.

This effort is the first to use the power and reach of mobile phones to change diabetes risk behaviors in a large number of people from different parts of a vast country like India. It has implications for diabetes prevention in low and middle-income countries.
In India, the diabetes burden is very high. An estimated 66 million people live with the disease, and 1 million die from it each year. Indian Americans also are hard hit with diabetes. The diabetes prevalence in this population is four times higher than among Caucasians in the United States.
Researchers compared composite scores of the experimental group's fruit, vegetable and fat intake and exercise with the control group. While people in both the experimental and control group improved their health behaviors over six months, the experimental group improved significantly more.
Almost 40 percent more people improved their health behaviors as a result of the texting (299 showing improvement in the experimental group versus 185 in the control group), based on data in the paper.
The study will be published August 8 in the Journal of Medical and Internet Research.
"Noncommunicable diseases, one of the leading health and development challenges of the century, demand simple, proven, cost-effective prevention solutions that can be easily deployed at the population level," said Nalini Saligram, founder and CEO of Arogya World. "Our mDiabetes study suggests mobile health technology is a smart solution and has broad implications for diabetes prevention at the population level in low and middle-income countries."
"This shows the potential for even the most basic of mobile phones to be used as a viable tool to deliver public health messages on a large scale across a diverse population," said lead study author Angela Fidler Pfammatter, research assistant professor in preventive medicine at Northwestern University Feinberg School of Medicine. "And you just need a basic mobile phone. This can make an impact."
Bonnie Spring, director of the Center for Behavior and Health at Feinberg, collaborated on the research. Sandhya Ramlingam of Arogya World implemented the behavior change study.
The study gathered responses from nearly 1,000 people who received text messages as part of Arogya World's mDiabetes initiative and compared them to responses from a similar number of people who didn't receive the text messages. The randomly chosen 1,000 individuals, who were surveyed by phone in the language of their choice, were considered a representative sample of the one million participants.
The study scored for fruit, vegetable and fat consumption as well as exercise in participants at baseline and six months. There were 943 people in the control group, 982 in the experimental one.
Arogya World partnered with Nokia during 2012-2013 on mDiabetes to send text messages on diabetes and its prevention in 12 languages, twice a week for six months, to 1 million of its subscribers from all over India who opted in.
The 56 text messages were developed with Emory University and culturally adapted for India with extensive consumer feedback.
Northwestern University researchers contributed to the study design and data analysis. Using rigorous statistical analysis to correct for baseline differences, and by scoring each study participant on positive and negative behaviors, the authors showed clear health behavior differences between those who received the text messages and those who did not.
Noncommunicable diseases include heart disease, diabetes, cancer and chronic lung diseases. According to the World Health Organization, 80 percent of heart disease, 80 percent of type 2 diabetes and 40 percent of cancers are preventable with three lifestyle changes -- avoiding tobacco, eating healthy foods and increasing physical activity.
Indians get diabetes in their 30s and 40s, 10 years earlier than most Americans. Two-thirds of the population of India is under age 35. Mobile phone use is widespread throughout India, making this an ideal way to deliver health messages.
In addition to the text message program, Arogya World has developed a mobile app, myArogya, to help working Indians prevent chronic disease.

https://www.sciencedaily.com/releases/2016/08/160808115607.htm