Extra sleep can help cut women's risk of diabetes - but unfortunately not for men

By Miriam Stoppard

Ever wanted to get a cup of tea in bed in the morning? Well, here’s your excuse: extra sleep may cut a woman’s risk of diabetes.
But the same isn’t true of men, who risk a higher chance of diabetes if they lie in. So don’t let him snooze on through the morning if you want to keep your man healthy.
A Dutch-led team of researchers has studied almost 800 healthy middle-aged men and women to learn more about the link between sleep and diabetes.
This could be important in ­overcoming the curse of the diabetes epidemic.
Volunteers were told to wear a device that tracked their sleep and underwent tests to show how well their body was able to use insulin, the hormone that controls blood sugar and prevents the ­development of diabetes.
With Type 2 diabetes the body doesn’t make enough insulin – or struggles to use the insulin that is made, so blood sugar levels soar.
The volunteers slept for an average of seven hours and 18 minutes. But when the women slept longer than this, their bodies became better at using insulin.
And the longer they slept, the more responsive they were to the hormone, eliminating their risk of diabetes.
Women win both ways because lack of sleep is also linked to their better use of insulin. It’s a completely different story for men, in fact, the very opposite.
Sleeping for more than an average time ­significantly cut their ability to use insulin, making them more susceptible to diabetes.

Researcher Dr Femke Rutters, of the VU Medical Centre in Amsterdam, said: “In a group of nearly 800 healthy people, we observed sex-specific relationships between sleep duration and glucose metabolism.
In men, sleeping too much or too little was related to less ­responsiveness of the cells in the body to insulin, reducing glucose uptake and thus increasing the risk of developing diabetes in the future.
“In women, however, no such ­association was observed.”
The research shows yet again how important sleep is as a key aspect of health. We know men get less deep, restorative sleep than women, and so their health is more likely to suffer from sleep deprivation.
It’s less clear why extra sleep is bad for men but good for women. However, it’s possible that men who regularly ­oversleep are already ill in some way.
Previous research has shown that while women spend longer in bed than men they usually get less sleep. Not so in this new research.

http://www.mirror.co.uk/lifestyle/health/extra-sleep-can-help-cut-8945267

Type 2 Diabetes - Are Whole Grain Oats Helpful in Controlling Blood Sugar and Cholesterol Levels?

By Beverleigh H Piepers

According to a September 2016 report published in the journal Nutrients, dietary whole grain oats are helpful for lowering blood sugar, blood lipids, and weight in people who have been diagnosed with Type 2 diabetes. Investigators at Peking University in Beijing, China, divided the number of Type 2 diabetics into four groups...

• sixty participants received the usual care only,
• seventy-nine diabetics received a healthy low-fat, high-fiber diet,
• eighty of the diabetics received a healthy eating plan with 50-grams of oats instead of their usual cereal,
• seventy-nine received a healthy diet with 100-grams of oats instead of their usual cereal

After thirty days the following significant changes were seen in the different groups...
1. The "50-grams of oats group" compared to the healthy diet group...

• lower after-meal blood sugar readings,
• lower total blood cholesterol levels,
• lower low-density cholesterol (LDL or "bad" cholesterol), and
• lower blood fats.

2. The "100-grams of oats" group compared to the 50 grams group...

• a greater reduction in after-meal blood sugar levels than the 50-gram group,
• a more significant decrease in total cholesterol,
• a more significant reduction in insulin resistance,
• a more significant decrease in low-density cholesterol.

Among 298 overweight Type 2 diabetics, the 100-gram individuals had the highest weight loss after one year.
From these results, the researchers concluded there is a reason to recommend whole grain oats to people diagnosed with Type 2 diabetes.
Whole grains are the ones least processed. Rolled oats are somewhat processed but still whole. A half cup of uncooked whole grain oats, with about 300 calories, supplies the following percentage of the recommended daily requirements (RDAs) for...

• fiber: slows down carbohydrate absorption by 33%
• iron: necessary for building red blood cells - 20%
• calcium: builds bones - 4%
• thiamin: B vitamin, helps turn carbohydrates to energy - 40%
• riboflavin: B vitamin, red blood cell production - 6%
• niacin: B vitamin, helps digestive and nervous systems - 3%
• vitamin B6: builds red blood cells - 4%
• folate: B vitamin, builds red blood cells - 11%
• pantothenic acid: B vitamin, helps some enzymes - 10%

One cup of dried rolled oats becomes two cups when cooked in water. Boil a half cup of rolled oats in water and add some cinnamon for an even more anti-diabetic benefit. Add a little stevia, some blueberries or almonds, and you are all set for a good morning.

A quarter cup of soymilk fortified with vitamins A and D and calcium will provide the following percentage of the RDAs of...

• vitamin A: vision - 2%
• calcium: 2%
• iron: 1%
• vitamin D: builds bones - 6%
• thiamin: 1%
• riboflavin: 6%
• niacin: 1%
• vitamin B6: 1%
• folate: 1%
• vitamin B12: especially important for vegans, builds red blood cells - 8%
• pantothenic acid: 3%

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

http://ezinearticles.com/?Type-2-Diabetes---Are-Whole-Grain-Oats-Helpful-in-Controlling-Blood-Sugar-and-Cholesterol-Levels?&id=9528393

Diabetes in children is a chronic, but treatable, disease

From sciencedaily.com

For those people living with diabetes, every day requires around-the-clock monitoring and management.

So says Jason A. Klein, MD, a pediatric endocrinologist who heads the Pediatric Diabetes Program at NYU Lutheran and who also works collaboratively with colleagues at the Hassenfeld Children's Hospital of New York at NYU Langone Medical Centre and its Pediatric Diabetes Centre.
"In order to successfully manage blood sugar levels, those living with diabetes must perform fingerstick checks, keep records, monitor food intake, keep up their physical activity, and calculate medication doses based on past trends. Needless to say, day to day monitoring can become tedious and at times exhausting for patients, and so it is important that they stay motivated," the diabetes specialist adds.
This daily monitoring can be a particular challenge for young people who also have to be attentive to when and what they eat and drink, as well as their activities at home, in school or while hanging out with friends. Even a minor ailment like a cold may require changes in the medical regimen because of the effect inflammation has on the blood sugar.
But diabetes is not the "death sentence" that Klein says many of his patients and their families seem to believe.

Jason Klein, MD, director, Pediatric Diabetes Centre, NYU Lutheran, with Paola Munoz, 12, as they reviewed her glucose log.
"Although there is no cure at this time, treatment options have significantly improved over the years," assures Klein. "With insulin pens, pumps, and modern devices that allow more precise and continuous day and night monitoring of blood sugar levels, we can make small adjustments in the dosage of insulin to prevent sugar levels from rising or dropping too fast. Excellent glucose control gives patients and their families peace of mind."
The routine followed by people with diabetes is all too familiar to Klein. At age 14, he was diagnosed with monogenic diabetes, a rare form of the disease caused by a faulty gene.
The care he received as a teenager, coupled with his desire to help young people with a similar condition, inspired him to study medicine at SUNY Downstate and to follow in the footsteps of his own doctor, Pavel Fort, who became his mentor through seven years of training including a fellowship in endocrinology at the Cohen Children's Medical Centre/North Shore-LIJ Health System.
To help allay fears, Klein does not hesitate to share his story with patients and their families. A mother once told him "but you look normal," as if a person with diabetes should look a particular way.
"There are many misperceptions of diabetes. One of the most common misunderstandings is that people get diabetes solely from eating too much and gaining excessive weight. While type 2 diabetes -- most common in adults but certainly present in children and adolescents -- does develop due to weight gain, it is also genetically based. And though we always promote healthy lifestyles, the much more common diabetes in the pediatric age range -- type 1 diabetes -- does not develop secondary to poor eating habits; it is an autoimmune disease that prevents the body's normal production of insulin, a hormone produced by the pancreas that is responsible for regulating the blood sugar levels of the body," explains Klein.
"Regardless of the type of diabetes a patient may have, education of the patient and the family is extremely important. We treat the whole family not just the person who has the diagnosis of diabetes because it affects everyone in the family."
Kidney problems, blindness, amputations and cardiovascular disease are among the most serious and most widely known long-term complications of diabetes. And given the prevalence of the condition, Klein says that when patients are given a diagnosis of diabetes, many families can only picture unfortunate outcomes for their kids. "We begin with listening to what the families and patients know about diabetes, since many of their fears are based in old or incorrect information," Klein says. "With good blood sugar control and use of modern treatments and technologies, patients today do not have to have overly rigid lifestyles in order to life long, healthy lives free of complications."
At his office in the NYU Lutheran Family Health Centre at 5610 Second Avenue, Klein makes clear to patients and their families about the need for a healthy diet, avoidance of sugary drinks, and a good amount of physical activity or exercise. "Moderation is key," he says. Some signs that a child may have high blood sugar include increased thirst and frequent urination.
For patients who already have diabetes, Klein directs kids to get involved in their treatment and continues to motivate them when they become adolescents. He focuses on engaging patients in their own diabetes management, developing good habits and awareness in order to prevent complications.

https://www.sciencedaily.com/releases/2016/09/160928083405.htm

On the front lines of the fight against Type 2 diabetes

By Elizabeth Aguilera

Dr. Steve Mittelman inspects the fresh fruits and vegetables at a farmers market on the grounds of Children's Hospital Los Angeles. He established the weekly market two years ago in his role as director of the hospital's Diabetes and Obesity Program.
"You really want the good healthy foods to be convenient and you’re not always going to think about going to the store to pick up these things," he says. "But if it’s right here at your work or where your child is, then you can pick it up very conveniently."
The market is also designed to help patient families living in areas "that don’t have access to fresh produce," Mittelman says. "Showing them what there is and what to do with it is an educational thing and an opportunity they may not have."

The farmers market is just one of a number of efforts by the medical and public health communities to combat the rise of Type 2 diabetes, especially among kids and young adults. Experts believe they won't get the upper hand on the disease until they persuade enough people that a healthy diet and regular exercise can prevent it or minimize its damage if it has already struck.
Type 2 diabetes occurs when the body’s insulin stops working or does not properly direct blood sugar where it needs to go. If left uncontrolled, the disease can lead to kidney failure, nerve damage, blindness, stroke and heart attack.
Type 2 disproportionately affects Latinos, African-Americans and Native Americans, and it has spread along with obesity. Latinos and Native Americans, or any group with indigenous heritage, have an slightly higher risk because of a genetic predisposition for diabetes, experts say.
In California, about 9 percent of adults have been diagnosed with Type 2 diabetes, and an estimated 46 percent are prediabetic or undiagnosed, according to a recent study by the UCLA Center for Health Policy Research. In Los Angeles County, the figures are 10 and 44 percent, respectively.
The farmers market is just one of a number of efforts by the medical and public health communities to combat the rise of Type 2 diabetes, especially among kids and young adults. Experts believe they won't get the upper hand on the disease until they persuade enough people that a healthy diet and regular exercise can prevent it or minimize its damage if it has already struck.
Type 2 diabetes occurs when the body’s insulin stops working or does not properly direct blood sugar where it needs to go. If left uncontrolled, the disease can lead to kidney failure, nerve damage, blindness, stroke and heart attack.
Type 2 disproportionately affects Latinos, African-Americans and Native Americans, and it has spread along with obesity. Latinos and Native Americans, or any group with indigenous heritage, have an slightly higher risk because of a genetic predisposition for diabetes, experts say.
In California, about 9 percent of adults have been diagnosed with Type 2 diabetes, and an estimated 46 percent are prediabetic or undiagnosed, according to a recent study by the UCLA Center for Health Policy Research. In Los Angeles County, the figures are 10 and 44 percent, respectively.
Most worrisome to doctors is the number of kids and young adults being diagnosed with Type 2 diabetes in recent years. It's happening so often that Type 2 is no longer called “adult onset diabetes,” says Mittelman.
"It's very clear the obesity epidemic we are seeing in our kids is helping drive this epidemic," he says, noting that one out of three kids is overweight or obese.

Fitness programs and summer camps

Medical and public health experts are racing the clock to slow the growth of diabetes. They say it’s going to take a societal pivot to change the trend.
When patients at Children's Hospital are diagnosed with Type 2 diabetes or found to be at risk for it, Mittelman says one of the first things the staff does is try to help parents understand the relationship between the disease and being overweight.
"I have a barrier from step one because they don’t recognize their child has a problem," he says. "Oftentimes diabetes and obesity is rampant in that family and so that's their norm, and many of these kids, they expect they're going to get diabetes someday and that's just going to be part of their life and they'll deal with it just like their parents and grandparents did, so they don’t see that as necessarily a problem or as something that they can avoid."
To combat the growth of diabetes among kids, the hospital has a wide range of programs to educate kids and parents who are at risk and to help those who are already living with the disease, says Mittelman.
Along with the farmers market, the hospital hosts fitness programs in the community for kids of all ages and it just launched a new clinic at the hospital for kids with Type 2. One in five kids diagnosed with diabetes have Type 2, he says.
Children’s has also gotten into coordinating summer camps - more precisely, diabetes camps. This summer the hospital hosted or co-hosted several camps that lasted from two days to two weeks in locations ranging from L.A.-area churches to Big Bear.
The camps seek to teach kids that eating nutritious foods and exercise help minimize the amount of medication they need to control the disease.
The  Los Angeles County Department of Public Health is also trying to help, says Tony Kuo, who oversees chronic disease for the agency. Public Health is creating programs designed to make healthier foods more accessible in areas with high rates of diabetes, and it's working on getting schools to open their grounds after hours for physical activities.
Educating people about the disease and the tools to manage it is also important, says  Dr. Anne Peters, a USC Keck Medical Center diabetes expert.
Towards that end, she's writing a manual in very simple English and Spanish that explains how to use technologies like insulin pumps and monitors.

Research on vitamin D, genes and gastric bypass

Peters is also conducting research on vitamin D at the diabetes clinic she founded at the Roybal Medical Center in East L.A. Studies have shown that diabetics tend to have low vitamin D levels; she's studying people who are prediabetic to see if they have the vitamin deficiency and if that might affect their chances of developing diabetes.
Dr. Thomas Buchanan, who oversees the division of endocrinology and diabetes at USC Keck, says he has conducted several studies looking at genetics and Latinos, including one that "identified several genes that appear to influence either the risk of diabetes or that affect physiological processes that help control blood glucose."  These studies will help doctors identify ways to better treat the disease in some patients, he says.
Buchanan is also looking at how gastric bypass surgeries his team has performed might help those who need to lose 25 to 30 pounds avoid or minimize diabetes. This research is somewhat controversial because gastric bypass is usually reserved for those who need to lose much more weight. Buchanan is focusing on gastric bypass because people tend to keep the weight off after surgery, and he's studying the effect of sustained weight loss on the disease.
Getting people to adopt lifestyle changes because of Type 2 diabetes is particularly challenging because it can take many years for complications to develop.
"You don’t think, 'I’m going to be blind 20 years from now so I need to not eat this piece of pie,'" says Buchanan. "So that’s one of the hardest things about diabetes ... to understand the complications are severe and they really can affect your health and they are going on right now."

http://www.scpr.org/news/2016/09/23/64734/on-the-frontlines-of-the-fight-against-type-2-diab/

People who improve their diets reduce diabetes risk

By Kathryn Doyle

(Reuters Health) – Adopting a healthier diet may lower type 2 diabetes risk over time, while a worsening diet is often accompanied by increased risk, according to a new U.S. study.

“Although recent public health recommendations have increasingly focused on advocating overall diet quality improvement, evidence has been limited on whether changing overall diet in adulthood has a long-term preventative impact on diabetes prevention in general population,” said lead author Sylvia H. Ley of the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital and Harvard Medical School in Boston.

“We provide evidence that improving diet quality in adulthood is associated with type 2 diabetes prevention, while worsening diet quality is associated increased risk for diabetes,” she said by email.

The researchers analyzed data on more than 124,000 adults who did not have diabetes at the start of three large, long-term studies of lifestyle and health outcomes and who were observed for at least 20 years. Participants rated their diet quality on a healthy eating index every four years.

There were 9,361 cases of type 2 diabetes during the studies. When dietary quality scores declined by more than 10 percent between four-year surveys, diabetes risk went up by about 34 percent, the researchers found. Improving diet quality by the same amount led to a 16 percent decrease in diabetes risk.
A “healthier” diet included higher intakes of vegetables, fruits, whole grains, nuts, and legumes and lower intakes of red or processed meat, sugar-sweetened beverages and fruit juice, trans fat and sodium, as well as moderate alcohol consumption.

“Cumulative scientific evidence has supported that improving and maintaining overall quality of healthful diet is beneficial for long-term chronic disease prevention,” Ley said. “Chasing after the latest short-term fix is not likely to offer sustained benefits in the long term.”



Improving diet was associated with decreased diabetes risk regardless of how a person ate at the start of the study or how much excess weight they carried. Over time, losing weight explained some, but not all, of the change in diabetes risk, according to the results published in Diabetes Care.

“Improving overall diet quality as an adult regardless of where you start, whether you have poor or better initial diet quality, seems to be beneficial for diabetes prevention,” Ley told Reuters Health.
“It is known that Western dietary patterns and diets with high glycemic index are associated with a greater risk of developing type 2 diabetes, whereas the opposite has been observed for prudent dietary patterns and Mediterranean diets,” said Jordi Salas-Salvado of Rovira i Virgili University in Tarragona, Spain, who was not part of the new study.

“Three key points to prevent or delay the onset of type 2 diabetes are: stay lean, follow a frugal diet and include plenty and large variety of vegetables,” he told Reuters Health by email.

Diet quality, as well as body weight, are important for diabetes risk, said Dr. Marc Y. Donath of University Hospital Basel in Switzerland, who also was not part of the new study.

“However it remains to be shown how important are qualitative changes in diet compared to calorie restriction,” Donath told Reuters Health by email. “Based on clinical (experience), my impression is that changes in body weight are much more important.”

http://www.reuters.com/article/us-health-diet-diabetes-idUSKCN11T1MI

Air Pollution Is Linked to a Diabetes Marker

By NICHOLAS BAKALAR

Exposure to air pollution, a new study finds, may increase glucose intolerance, a precursor of diabetes.

German researchers found the effect particularly strong in people who are already considered prediabetic because of abnormally high blood sugar levels.

The study, in Diabetes, used data on 2,944 people in and around Augsburg, Germany, tracking their glucose levels and other metabolic measures along with levels of air pollutants — particulate matter and nitrogen dioxide — where they lived.

They found that over the entire population, for each 7.9 microgram per cubic meter increase in soot and other particulate matter, there was a 15 percent higher rate of insulin resistance, a marker of Type 2 diabetes. (On smoggy days, levels of particulate matter typically exceed 50 micrograms per cubic meter.) For prediabetics the risk increased by almost 46 percent for each unit increase in air pollution. The researchers controlled for sex, smoking, body mass index, socioeconomic status and many other variables.

The underlying mechanism is not well understood and the findings are correlational and do not prove cause and effect, but the authors suggest that air pollution may lead to insulin resistance by increasing body-wide inflammation and levels of oxidative stress.

“For people who already have bad metabolism, adding air pollution makes them respond more strongly,” said the senior author, Annette Peters, an adjunct professor at the Harvard T. H. Chan School of Public Health. “This means they really need a healthy lifestyle. The effect of air pollution can be countered with healthy diet and exercise.”

http://www.nytimes.com/2016/09/21/well/live/air-pollution-is-linked-to-a-diabetes-marker.html?_r=0

Conquering Diabetes with Carbohydrates

By Neal Barnard, MD

Carbohydrates do not cause type 2 diabetes. In fact, a new study found just the opposite: A diet rich in carbohydrates can actually fight diabetes. A wide range of other studies looking at plant-based diets and diabetes have consistently shown similar results.
But you would not know that if you read the New York Times this weekend. On Sunday, the paper published an opinion piece urging Americans to ditch not only sugars, but wheat, rice, corn, potatoes—even fruit—to fight diabetes and obesity. The article also recommended replacing these foods with meat, eggs, and butter.
Advice like this is dangerous. Another recent study of more than 200,000 participants found that consuming large amounts of animal protein increased diabetes risk by 13 percent. But by simply replacing 5 percent of animal protein with vegetable protein—including carbohydrates like potatoes and grains—participants decreased diabetes risk by 23 percent.

Epidemiological studies tell a similar story. Traditionally, minimally processed and unprocessed carbohydrates, including rice and starchy vegetables, were the main staples in countries like Japan and China—and type 2 diabetes was rare. But as time went on, Western diets filled with meat, cheese, and highly processed foods replaced these traditional carbohydrate-based diets, and diabetes rates soared.
So how does it work? Insulin’s job in our bodies is to move glucose, or sugar, from our blood into our cells. But when there’s too much fat in our diets, fat builds up in our cells. Evidence shows that this cellular fat can actually interfere with insulin’s ability to move glucose into our cells, leading to type 2 diabetes.

At the Physicians Committee, we have been putting this idea into practice for more than a decade. Participants in our clinical studies and nutrition education classes eat as many whole, unprocessed or minimally processed carbohydrates as they want—everything from fruit and sweet potatoes to beans and whole wheat pasta—and they soon see improvements in their blood sugar control.
In 2006, we partnered with the George Washington University and the University of Toronto to put these ideas to the test in a clinical setting by pitting a low-fat, plant-based diet against the standard diabetes diet recommended by the American Diabetes Association. The results were remarkable: Participants in the vegan group lowered haemoglobin A1C by 1.2 points, which was three times greater than the ADA group.
These participants also experienced weight loss, lower cholesterol, lower blood pressure, and improved energy. All the side effects were positive. On the other hand, those who follow low-carbohydrate diets are at increased risk over the long term for weight gain, heart disease, and even premature death.

http://www.forksoverknives.com/conquering-diabetes-carbohydrates/

Half of All Type 1 Diabetes Develops After 30 Years of Age

By Miriam E Tucker

MUNICH — Onset of type 1 diabetes is just as likely to occur in people older than 30 years of age as in those younger, new research shows.
The data were presented September 16, 2016, here at the European Association for the Study of Diabetes (EASD) 2016 Annual Meeting by Dr Nicholas JM Thomas, of the Institute of Biomedical and Clinical Science, University of Exeter Medical School, United Kingdom.
Obtained using genetic data from the UK Biobank, the startling results refute the long-held belief that type 1 diabetes is primarily a "juvenile" condition.

Clinically, the findings are particularly relevant for primary care, where people who develop autoimmune-mediated diabetes in adulthood are often misdiagnosed as having type 2 and prescribed metformin instead of insulin.
"I think it's an eye-opener and obviously has implications for how we diagnose and manage people and also the education people receive. We very much focus on childhood and adolescence and perhaps people diagnosed later don't get the same education," Dr Thomas told Medscape Medical News in an interview.

Still, identifying these individuals in primary care is challenging for a number of reasons: The vast majority of older adults with new-onset diabetes have type 2 diabetes, and antibody tests to identify autoimmune-mediated diabetes are too expensive for routine use. Moreover, overweight/obesity is nearly universal in type 2 but also common in type 1 diabetes.
"It really is spotting a needle in a haystack," Dr Thomas remarked.
He advised that clinicians should at least be aware that adults can develop autoimmune diabetes, as either classic type 1 or the slower-onset phenomenon known as "latent autoimmune diabetes of adulthood (LADA)."

"It's knowing this does happen, and therefore just keeping an open mind when you spot someone who's not behaving like type 1 or not responding as you would anticipate when you go through the usual treatment guidelines for type 2," he said, citing the example of British Prime Minister Theresa May, who was diagnosed with type 1 diabetes at age 56 and who "progressed very rapidly."

Asked to comment, session co-moderator Catharine Owen, MD, associate professor of diabetes at the Oxford Centre for Diabetes, Endocrinology, and Metabolism, United Kingdom, agreed.
"I think it's absolutely crucial for people to be aware that type 1 diabetes can present at any age. Physicians shouldn't be complacent when people aren't responding to oral agents, or they're not bringing A_1c down to target when they should."
Why the "Juvenile" Designation?
It's been nearly 20 years since the terms "juvenile" and "adult-onset" diabetes were officially changed to "type 1" and "type 2," yet the perception persists among the non-specialist medical community and the lay public that adults who develop autoimmune-mediated diabetes are rare or unusual.

Indeed, Dr Thomas explained in his presentation, most studies on type 1 diabetes are conducted in children and adolescents, and very few epidemiologic data are available about type 1 diabetes later in life.
The problem, he said, is that "in childhood, almost all the cases of diabetes are type 1 diabetes, so they're easier to spot because they stand out, whereas later in life we see a dramatic increase in the prevalence of type 2 diabetes, so the cases of type 1 diabetes are drowned out and less easy" to identify.
Using medical records to study type 1 diabetes in adulthood is error-prone because clinical classification and insulin prescribing aren't systematic since there are no clinical diagnostic criteria by diabetes type.

The presence of specific autoantibodies can give a clue, but they're not measured routinely in adults and, even when they are, they have less discriminatory power than in children, resulting in a higher false-positive rate.
Novel Genetic Approach
To get around those problems, Dr Thomas and colleagues used a "robust, novel, genetic approach" using a risk score comprising 30 single nucleotide polymorphisms associated with type 1 diabetes (T1D-GRS).

They have shown type 1 diabetes is primarily restricted to patients with a high T1D-GRS (the top 50%).
They applied the type 1 genetic risk score to a cohort of 120,000 British white adults aged 40 to 70 from the UK Biobank, a network designed to study many diseases that includes people with and without diabetes and records information about age at diagnosis, whether insulin was used within a year of diagnosis, current medications, and body mass index (BMI).
As expected, when they factored in age they found that nearly all the diabetes below age 30 years was type 1 (autoimmune), and with increasing age the prevalence of type 2 diabetes rose dramatically.

However, to their surprise, they also found that the number of type 1 diabetes cases remained constant from age 30 to 60 years of age, so that roughly half of type 1 diabetes was occurring after age 30 but was "drowned out" by the vast number of type 2 cases, Dr Thomas explained.
Type 1 Diabetes After Age 30: Slightly Slimmer and Younger Than Type 2
In all, 53% (242/457) of type 1 cases are diagnosed 30 years and younger, accounting for 74% (242/326) of all diabetes cases diagnosed in this age range, whereas 47% (215/457) of cases are diagnosed from 31 to 60 years of age, accounting for just 5% (215/4335) of diabetes cases diagnosed in this age range.
In a comparison of the people genetically classified with type 2 and type 1 between 31 and 60 years of age, the type 1 group was significantly younger at diagnosis (44 vs 52 years of age, P < .0001), had lower BMI (26.2 vs 32.6 kg/m², P < .0001), was far more likely to be on insulin within a year of diagnosis (79% vs 6%, P < .0001), and to be currently using insulin (100% vs 16%, P < .0001).
"So really, we were reassured we were capturing type 1 diabetes," Dr Thomas commented
T1D-GRS is a therefore a novel tool to investigate diabetes etiology in large cohorts without antibody measurement, he stressed.
He reiterated that type 1 diabetes is evenly distributed within the first 6 decades of life, but after age 30, the increase in type 2 diabetes makes the type 1 cases harder to recognize and treat correctly.
And Dr Owen noted that in the United Kingdom even people who develop type 1 diabetes in childhood or adolescence are often recoded in their medical record as having type 2 when they become adults.
"It's absolutely a basic misunderstanding. I think we have work to do in this area. [The new study] does highlight the issue in a nice way, although it doesn't help us identify these specific individuals."

http://www.medscape.com/viewarticle/869028#vp_1

Overweight people 'hold key' to tackling diabetes, according to experts

By Peter Henn

HAVING stem cells that are better at storing fat in the body could hold the key to tackling diabetes, experts believe.
Some obese people seem to be immune from the health complications usually associated with carrying extra weight, researchers from the University of Bristol discovered.
They now want to use their findings to help stop people at risk of Type 2 diabetes from developing the condition.
Scientists found that overweight people whose stem cells stored fat more efficiently had a lower risk of diabetes than their overweight peers.
Storing fat more efficiently means that it is less likely to form deposits on the heart, liver or kidneys which increases the risk of diabetes and cardiovascular disease which can cause heart attacks and stroke.
The joint study between Bristol and the Anti-Doping Laboratory Qatar (ADLQ) found the lower risk group had less of a blood protein called interleukin-6 which regulates inflammation.
It is found in raised levels in people who have diabetes, heart conditions and some forms of cancer.
Dr Mohamed Elrayess, from ADLQ, said: “In this study we have shown that the impaired ability of fat stem cells to store excess fat was partially due to increased levels of the inflammatory marker interleukin-6 in the blood.
“Indeed, when fat stem cells isolated from healthy obese individuals were exposed to interleukin-6 in the laboratory, they behaved like those obtained from individuals with risk of diabetes.”
Now there are plans to look into making the stem cells of people who are in a pre-diabetic stage more efficient in a bid to stop them developing the condition.
Dr Wael Kafienah, from Bristol’s School of Cellular and Molecular Medicine, said there had been a lot of interest in people who weighed more than would normally be considered healthy but did not have any health problems.
He said: “The existence of obese individuals with lower risk of diabetes has received great interest in the past few years, as they may hold the clue to understanding and possibly treating obesity-associated diabetes.
“Our clinical data confirmed the previously reported variability in obesity-associated pathology.
“Here, we have shown that the group with healthy fat stem cells had lower cholesterol and a better liver function.”
However, the report concerns fat stem cells alone and is not about people’s actual diets.
A source close to the study said: “This isn’t about people being able to eat what they like.”

http://www.express.co.uk/life-style/health/711945/Overweight-people-hold-key-tackling-diabetes-experts-research

Study shows link between diabetes, depression in pregnant women

By Amanda Cuda

There’s a tie between gestational diabetes and depression during and after pregnancy, according to new research from the National Institutes of Health.
According to the NIH study, published online in Diabetologia, women who reported feeling depressed during the first two trimesters of pregnancy were nearly twice as likely to develop gestational diabetes. A separate analysis found that women who developed gestational diabetes were more likely to report postpartum depression six weeks after giving birth, compared to a similar group of women who did not develop gestational diabetes.

Gestational diabetes is a form of diabetes (high blood sugar level) occurring only in pregnancy, which if untreated may cause serious health problems for mother and infant.
“Our data suggest that depression and gestational diabetes may occur together,” said the study’s first author, Stefanie Hinkle, in a news release. Hinkle is also staff scientist in the Division of Intramural Population Health Research at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development. “Until we learn more, physicians may want to consider observing pregnant women with depressive symptoms for signs of gestational diabetes. They also may want to monitor women who have had gestational diabetes for signs of postpartum depression.”
Although obesity is known to increase the risk for gestational diabetes, the likelihood of gestational diabetes was higher for non-obese women reporting depression than for obese women with depression.
Currently, the American College of Obstetricians and Gynecologists recommends that physicians screen patients at least once for depression during the perinatal period, which takes place between 22 weeks of pregnancy through 7 days after birth.
The researchers also found a higher risk for postpartum depression among the women who had gestational diabetes. Of the women who developed gestational diabetes, nearly 15 percent experienced depressive symptoms after birth, which was more than four times that of women who had not had gestational diabetes.

http://www.newstimes.com/living/article/Study-shows-link-between-diabetes-depression-in-9231764.php

Does diabetes affect oral health?

By Dr Sharon Robinson

DIABETES does, in fact, affect oral health. People with diabetes have a higher than normal risk of periodontal diseases.
If you have diabetes, it can affect many parts of your body. It can harm your eyes, nerves, kidneys, heart and other important systems in the body. This includes your teeth and gums. The effect is even greater when your blood sugar is not well controlled, making it harder to fight bacterial infections.
PLAQUE BUILD-UP
Plaque is a clear, sticky layer of bacteria that forms on teeth. If it is not removed, it can lead to infections such as gum disease.
If your high blood sugar is not controlled, you may have more plaque bacteria than most people. That means you are more at risk for oral health problems.
GINGIVITIS
Gingivitis is a form of gum disease. It is caused by a build-up of plaque and tartar on the teeth and gums.
If you have diabetes, it is harder for your body to control plaque bacteria. That is why people with diabetes are three to four times more likely to get gum disease.
Be sure to see your dental professional if you have any of these symptoms:
• Red gums;
• Swollen or tender gums; or
• Gums that bleed easily.
PERIODONTAL DISEASE
If gingivitis is left untreated, it can turn into periodontitis. This is a more serious form of gum disease. Periodontal diseases are infections of the gum and bone that hold the teeth in place. In advanced stages, they lead to painful chewing problems and even tooth loss because it can cause your gums to pull away from your teeth, causing teeth to become loose.
Like any infection, gum disease can make it hard to keep your blood sugar under control.
Serious periodontal disease not only causes tooth loss, but can also cause changes in the shape of bone and gum tissue. The gum becomes uneven, and dentures may not fit well. People with diabetes often have sore gums from dentures.
DOES ORAL HEALTH AFFECT DIABETES?
Yes. Oral health can affect diabetes, too. An infection like gum disease can affect your blood sugar. That’s why it’s vital to practise good oral care habits at home. It can help you protect your oral health, as well as manage your diabetes.
People with diabetes should have dental check-ups at least every six months, or more often if recommended by their dentist. Be sure to tell your dentist if you have diabetes. Frequent dental check-ups are needed to find problems early, when treatment is most effective. See your dentist as soon as possible if you have any problems with your teeth or mouth.
If you have diabetes, be sure to use your blood glucose meter. It can help you control your blood sugar levels and protect your oral health.

http://www.jamaicaobserver.com/news/Does-diabetes-affect-oral-health-_74303

Marriage May Help Diabetics Keep Weight Off

From WebMD.com

Spouses may be good for more than just love and companionship: A new study suggests married people with type 2 diabetes are less likely to be overweight than single people with the blood sugar disease.

The researchers found that diabetic men who lived with their spouses were also less likely to suffer from metabolic syndrome, a combination of related factors including high blood pressure and high blood sugar that boost the risk of heart disease and stroke.

For the study, Japanese researchers examined the medical records of 270 patients with type 2 diabetes from 2010 to 2016. The group included 180 married patients (109 men, 71 women) who were living with their spouses, and 90 single patients (46 men and 44 women).

The married people had a lower average body mass index (24.5) than the single people (26.5). The index is a measurement of body fat based on height and weight.

Compared with singles, married people also had lower levels of HbA1c, a measurement of blood sugar control (7.3 percent versus 7 percent, respectively); a lower number is better. In addition, married people had lower rates of metabolic syndrome (54 percent) compared with single people (68 percent), the findings showed.

After adjusting the statistics to compensate for factors such as the ages and genders of the study participants, the researchers found that the married people were 50 percent less likely to be overweight. The difference between the genders wasn't considered big enough to be significant.

For married men, the risk of metabolic syndrome was 58 percent lower than for single men. But the researchers didn't find evidence of a connection between marital status and metabolic syndrome in women.

The study was conducted by Dr. Yoshinobu Kondo and colleagues at Yokohama City University Graduate School of Medicine and Chigasaki Municipal Hospital. The findings were presented Thursday at the European Association for the Study of Diabetes meeting in Munich, Germany.

Research presented at meetings is considered preliminary until published in a peer-reviewed journal.

http://www.webmd.com/diabetes/news/20160916/marriage-may-help-diabetics-keep-weight-off

Diabetes and Your Diet: The Low-Carb Debate

By Gina Kolata

A few years ago, Richard Kahn, the now-retired chief scientific and medical officer of the American Diabetes Association, was charged with organizing a committee to prescribe a diet plan for people with diabetes. He began by looking at the evidence for different diets, asking which, if any, best controlled diabetes.

“When you look at the literature, whoa is it weak. It is so weak,” Dr. Kahn said in a recent interview.

Studies tended to be short term, diets unsustainable, differences among them clinically insignificant. The only thing that really seemed to help people with diabetes was weight loss — and for weight loss, there is no magic diet.

But people want diet advice, Dr. Kahn reasoned, and the association really should say something about diets. So it, like the National Institutes of Health, went with the Department of Agriculture’s food pyramid.

Why? “It’s a diet for all America,” Dr. Kahn said. “It has lots of fruits and vegetables and a reasonable amount of fat.”

That advice, though, recently came under attack in a New York Times commentary written by Sarah Hallberg, an osteopath at a weight loss clinic in Indiana, and Osama Hamdy, the medical director of the obesity weight loss program at the Joslin Diabetes Center at Harvard Medical School.

There is a diet that helps with diabetes, the two doctors said: one that restricts — or, according to Dr. Hallberg, severely restricts — carbohydrates.

“If the goal is to get patients off their medications, including insulin, and resolve rather than just control their diabetes, significant carb restriction is by far the best nutrition plan,” Dr. Hallberg said in an email. “This would include elimination of grains, potatoes and sugars and all processed foods. There is a significant and ever growing body of literature that supports this method.” She is in private practice at Indiana University Health Arnett Hospital and is medical director of a start-up developing nutrition-based medical interventions.

But there are no large and rigorous studies showing that low-carbohydrate diets offer an advantage, and, in fact, there is not even a consensus on the definition of a low-carbohydrate diet — it can vary from doctor to doctor.

“There have been debates for literally the whole history of diabetes about which kind of diet is best,” said Dr. C. Ronald Kahn, chief academic officer at Joslin, and no relation to Dr. Richard Kahn. But, he said, “the answer isn’t so straightforward.”

In support of a diet like Dr. Hallberg’s, there is one recent short-term study, by Kevin Hall of the National Institute of Diabetes and Digestive and Kidney Diseases and his colleagues, involving 17 overweight and obese men, none of whom had diabetes. They stayed in a clinical center where they ate carefully controlled diets. The researchers asked what would happen if calories were kept constant but the carbohydrate composition of a diet varied from high to very low. The answer was that insulin secretion dropped 50 percent with the very low carbohydrate diet, meaning that much less insulin was required to maintain normal blood glucose levels.

http://www.nytimes.com/2016/09/16/health/type-2-diabetes-low-carb-diet.html?_r=0

Study Sees Link Between Long Naps, Type 2 Diabetes Risk

By Steven Reinberg

Could long afternoon naps raise your risk of developing type 2 diabetes?
It's possible but not yet proven, according to new research out of Japan. The study found that, compared with short naps or no napping at all, the risk for the blood sugar disease may be 45 percent higher if your naps last an hour or more.
But if you nap less than an hour, the risk disappears, the researchers suggested.
Dr. Joel Zonszein is director of the Clinical Diabetes Center at Montefiore Medical Center in New York City. He said the possible connection between long daytime naps and a risk for type 2 diabetes is interesting.
But, added Zonszein, who had no part in the study, "People need to be aware that this study, and these findings, are just associations or markers of lifestyles rather that the cause of diabetes."
The results of the study were to be presented Wednesday at the European Association for the Study of Diabetes meeting in Munich, Germany.
For the study, a research team led by Dr. Yamada Tomahide, from the University of Tokyo, analysed data on more than 300,000 people included in 21 published studies -- a process called a meta-analysis.
In this type of study, researchers try to find common patterns from other research and draw new conclusions. The problem with meta-analyses is that the conclusions are only as good as the original data.
Tomahide's team found that naps lasting an hour or more were associated with a 45 percent increased risk for type 2 diabetes. Shorter naps had no effect on diabetes risk, however.
"Further studies are needed to confirm the efficacy [effectiveness] of a short nap," Tomahide's group concluded.
Zonszein said that "type 2 diabetes is a very complex disorder that can be affected by many environmental factors, including sleep patterns -- particularly in those individuals that have genetic factors to develop diabetes."
Mixing all these different studies, which were done among diverse populations, may not yield the most reliable results because "naps may reflect certain lifestyles and different lifestyles in different countries and different societies," he noted.
There are long naps, and even longer naps, and a key question is why some people nap longer, Zonszein said. "Maybe longer naps are short periods of sleep and more common in those individuals with long working hours, stress all day, working more than one job, and maybe stress is associated with fast-food eating, etcetera. So, the long nap is just a marker of lifestyle," he said -- a lifestyle that could potentially contribute to the onset of type 2 diabetes.
Type 2 diabetes is a disease often linked to unwise lifestyle choices such as poor eating habits and lack of exercise.
Maybe those who take short naps have less stress and more leisure time than those who take longer naps. And "that may explain why the study found that short naps weren't linked to a possible type 2 diabetes risk," Zonszein said.
"It is difficult to use this meta-analysis to support causation; it can simply be an association," he said.
Dr. Gerald Bernstein is coordinator of the Friedman Diabetes Program at Lenox Hill Hospital in New York City. He also had no hand in the study.
However, he said, napping can cause blood sugar to rise and if you take long naps regularly and are predisposed to diabetes, that rise in blood sugar might trigger diabetes.
Bernstein agreed that the new study only shows a link between long naps and diabetes -- not that napping causes diabetes. Still, "if you're going to nap, make it short," he said.

https://consumer.healthday.com/diabetes-information-10/type-ii-diabetes-news-183/study-sees-link-between-long-naps-type-2-diabetes-risk-714862.html

3.8 million people in England now have diabetes

From Public Health England

New data from PHE reveals 3.8 million people in England aged over 16 had diabetes in 2015, around 9% of the adult population.
The new Diabetes Prevalence Model, produced by the Public Health England (PHE) National Cardiovascular Intelligence Network (NCVIN) and launched today at the PHE Conference at Warwick University, estimates the total number of adults with both Type 1 and Type 2 diabetes in England.
Whilst 3.8 million people are estimated to have both types of diabetes, approximately 90% of diabetes cases are Type 2; this is largely preventable or manageable by lifestyle changes and also provides additional benefits for health and wellbeing. The likelihood of developing Type 2 diabetes is increased by being overweight (although family history, ethnicity and age can also increase risk).
The figures reiterate that diabetes is an increasing burden of ill health, underlining the need for urgent action to lessen the impact on individuals, as well as the health and social care system supporting them.
The model suggests that 1 in 4 people with diabetes, an estimated 940,000, are unaware of their condition. The disease can lead to serious complications including foot amputation and kidney disease, and is associated with an increased risk of stroke and heart attack.

John Newton, Chief Knowledge Officer at PHE, said:

The number of people with diabetes has been steadily increasing and tackling it is fundamental to the sustainable future of the NHS. Diabetes can be an extremely serious disease for those that have it and treating it and its complications costs the NHS almost £10 billion a year. Developing Type 2 diabetes is not an inevitable part of aging, we have an opportunity through public health to reverse this trend and safeguard the health of the nation and the future of the NHS.

The proportion of people who have diabetes increases with age: 9% of people aged 45 to 54 have diabetes, but for over 75s it is 23.8%. Diabetes at older ages has even bigger health implications as people are more likely to be suffering from other diseases, particularly cardiovascular diseases.
Diabetes is more common in men (9.6% compared with 7.6% women) and people from south Asian and black ethnic groups are nearly twice as likely to have the disease compared with people from white, mixed or other ethnic groups, (15.2% compared to 8.0%).
Based on current population trends, by 2035 4.9 million people will have diabetes. Type 2 diabetes currently costs the NHS £8.8 billion each year and tackling the rise in the disease is vital to the sustainable future of the health service.
To help tackle the problem, the Healthier You: NHS Diabetes Prevention Programme (NHS DPP) was launched by PHE, NHS England and Diabetes UK earlier this year. The programme, now available to nearly half the country, will help those at high risk of Type 2 diabetes reduce their risk of developing the condition, by being offered a referral to an improved diet, weight loss and increased physical activity programme. The NHS DPP will have full coverage across England by 2020. By then, up to 100,000 people will have access to its services each year.
Healthier You: NHS Diabetes Prevention Programme Director, Jenifer Smith, said:

Whilst the extent of the problem is greater than ever, the good news is that Type 2 diabetes is largely preventable. Our prevention programme puts people in control of their health by giving them the tools and information they need to make small changes to their lifestyles to significantly reduce their risk of the disease and the potential complications associated with it like stroke and kidney failure.

Chris Askew, Chief Executive of Diabetes UK, said:

These new estimates clearly show the scale of diabetes and the huge impact on people living with the condition. Too often they only find out they have the disease after they have developed serious complications, such as heart or kidney disease, or foot problems which can lead to amputations. Avoiding or delaying such devastating complications depends on people getting diagnosed earlier, so they get help and support to manage their condition well. We urge people over 40 to attend their NHS Health Check when invited. We also want people to take the necessary steps to find out their risk of developing Type 2 diabetes, such as using Diabetes UK’s online Know Your Risk tool.

Alongside the NHS DPP, there are other healthcare programmes aimed at supporting adults to live healthily. The NHS Health Check, provides health advice to 40 to 74 year olds previously undiagnosed any condition. It checks circulatory and vascular health, the risk of ill health and provides advice and support to help lower risk and improve health. Earlier this year, PHE launched One You, a campaign to support adults across the country to avoid future diseases caused by modern day lifestyles. It provides a range of tools and advice to help people take action on everyday behaviours such as eating too much unhealthy food or continuing to smoke, all of which are major contributing factors to lifestyle related diseases like Type 2 diabetes.

https://www.gov.uk/government/news/38-million-people-in-england-now-have-diabetes

Eye problems a sign of diabetes

By Janice Gibbs

Damage to the diabetic’s eye starts slowly and without symptoms.

Diabetics have an issue with not producing enough insulin to regulate their blood sugar. The elevated blood sugar will cause damage to blood vessels in the body, with capillaries being the first to be injured, Scott & White optometrist William White said.

White recently spoke to the Diabetes Support Group at Scott & White about reducing risk of diabetic eye disease.

The blood vessels carry the blood, which includes oxygen, to the tissue, White said. If the vessel is damaged and oxygen doesn’t reach the tissue it can’t survive.

Organs damaged early on as a result of blood vessel damage are the eyes, kidneys, heart and the extremities.

“Most doctors will tell diabetics to have their eyes and feet checked once a year,” White said.

Early in the disease process there might be swelling of the eye’s lens, which can change vision, he said. Some patients say they know their blood sugar is high when their vision gets blurry.

As the disease goes on microaneurysms, balloon-like swellings, will show up in the retina’s blood vessels. As it progresses the swellings might break open and there’s bleeding.

“The retina is like the film in a camera; it absorbs the light and allows you to see,” he said.

If the blood flow to the retina is restricted the body tries to fix it by making new blood vessels, which usually leak and block the light.

“If it’s a large leak you can’t see through the blood,” White said.

Diabetic retinopathy is the most common type of diabetic eye trouble and is caused by damage to blood vessels in the retina.

“There’s no need for surgery; your body does a wonderful job of absorbing the blood,” he said. “If I see that I’m not overly concerned, we just have to control your blood sugar.”
It’s all about optimal blood flow.

Macular edema is the leading cause of blindness for people age 45 and older. Diabetic macular edema is caused by fluid leaking from damaged blood vessels into the macula. The macula is the center of the retina and provides sharp detailed focus.

The macula can swell and gaps form in the layers and cells won’t work together, White said. It can be reversed pretty easily with diet and exercise, he said.

Once you have new blood vessels forming you’re in another category of diabetic retinopathy, proliferative diabetic retinopathy, and you need to see a retina specialist, he said. It will require treatments with laser or injections.

When black spots appear and hamper vision, it’s likely that the blood leaking is coming from the newly formed blood vessels. Sometimes the body can reabsorb the blood, but it takes time.

 In an effort to save central vision, peripheral vision may be sacrificed during treatments that reduce oxygen demand within the eye.

“It can be a trade-off when trying to save vision,” White said.

Injections can be used to stop the signals for more blood vessels to form.

The worst stage of disease is neovascular glaucoma, blood vessel developing in the iris.

“The eye is painful and it’s going blind because of damage to the nerve and retina,” he said.

How long a person has been diabetic is the major risk factor.

In the first 11 to 13 years, about 23 percent of patients will develop retinopathy.

About 60 percent of people who have been diabetic for 16 years will have diabetic changes in their eye.
“Those who have tight control of their blood sugar can reduce risk of developing retinopathy by 76 percent,” White said. “Those who have bleeding in their eyes can reduce their risk by half by getting sugar under control.”

http://www.tdtnews.com/news/article_1137e830-7960-11e6-afa0-27f138bf2611.html

Monday Medical: Managing diabetes? Try home-cooked meal

By Susan Cunningham

If you’re dealing with diabetes, the kitchen might be your new best friend. There are a number of benefits of cooking from scratch, especially when it comes to managing diabetes.“When people are cooking more from scratch and using fresh foods, I think they’re happier with the food that they’re eating and take pride in it,” said Pam Wooster, registered dietician/nutritionist and certified diabetes educator with Yampa Valley Medical Centre. “Their blood sugars come down, they’re more aware of what they’re eating and cholesterol and triglycerides improve, too.”
Following, Wooster shares her tips for cooking diabetes-friendly meals from scratch.
• Start with a well-rounded diet. That means lots of vegetables and fruits, some lean meats, low-fat dairy or dairy alternatives, nuts and seeds and healthy grains.

“It’s about being well-rounded,” Wooster said. “We want to have a well-rounded diet that includes good foods that help your health. The person with diabetes has the same nutrition and health recommendations as most other people at the dinner table. We want to see more fruits and vegetables in everyone’s diets.”

• Swap ingredients to decrease carbs and increase nutrients. If you’re a big fan of cream-based sauces, try a nut-based sauce, instead. For instance, an Alfredo sauce made from cashews or almonds has a creamy texture and flavour, with fewer carbs and more nutrients than a standard milk, butter and flour base.

Another idea is making a risotto with rice and cauliflower: You’ll lower the carbohydrate content, while maintaining flavour.

Wooster also recommends choosing more non-starchy vegetables, such as green beans, broccoli, tomatoes and asparagus, instead of starchy vegetables, such as potatoes, peas and corn. Or, blend non-starchy vegetables with rice or quinoa to lower carbohydrate concentration and increase nutrition.

“It doesn’t mean you can’t have starchy vegetables,” Wooster said. “You want to be aware of it and relate it back to your blood sugar.”

• Prepare ahead to have success during the week. One deterrent to cooking is that it can take time. If you’re home late from work, and the fridge is empty, it’s easier to call for pizza than run to the store and try to make a meal.

That’s why preparation is key. Wooster recommends steps such as chopping vegetables on the weekend and keeping them in the refrigerator, making a big batch of grains, such as brown rice or quinoa, to enjoy throughout the week or making a casserole or crockpot dish ahead, so it’s ready to pull out of the freezer.

It also helps to have a few tried-and-true dishes you know you can make easily.

“Have things you know are easy to prepare,” Wooster said. “Once you’re in the routine of cooking, you know you can pull it out and get it done.”

Try a quick stir-fry with lots of vegetables and thinly sliced meat or a vegetable soup that cooks in the crockpot while you’re at work. Salads are also a good option — start with a bag of pre-washed greens, and add beans or meat, hardboiled eggs, some chopped fresh vegetables for colour and flavour and a homemade dressing.

• Know that, once you start, it’s easier to keep going. Cooking from scratch helps people cut back on processed foods, which tend to cause higher blood sugar spikes and can contain a preservatives and additives. It also helps people learn about food.

“The knowledge of food goes up when preparing food,” Wooster said. “When you cook more, it just gets easier … If you’re building on routine and paying attention to basic concepts as they relate back to nutrition, it can be simple.”

http://www.steamboattoday.com/news/2016/sep/11/monday-medical-managing-diabetes-try-home-cooked-m/

Type 2 diabetes: Gene discovery could yield new treatments

By Honor Whiteman

Researchers from the United Kingdom have discovered a gene that aids the destruction of insulin-producing cells in the pancreas, contributing to type 2 diabetes.
Reporting their findings in the journal Cell Death and Disease, the researchers reveal how blocking the gene - called TNFR5 - halted the destruction process, a discovery that could lead to new treatments for type 2 diabetes.
According to the American Diabetes Association, around 29.1 million Americans are living with diabetes. The majority of these cases are type 2 diabetes, where the beta cells in the pancreas either do not produce enough insulin or the body is unable the use the insulin that is produced. Insulin is the hormone that helps regulate blood sugar levels.
While regular blood glucose testing and medications can help people with type 2 diabetes manage their blood sugar levels, there is a need for more effective therapies.
Lead researcher Dr. Mark Turner, of the School of Science and Technology at Nottingham Trent University in the U.K., and colleagues believe their gene discovery may have the potential to meet this need.

TNFR5 gene destroys beta cells in response to high levels of sugar, fat

The team says it is well established that long-term exposure to a high-fat and high-sugar diet can exacerbate destruction of beta cells among people with type 2 diabetes, but the mechanisms behind this process have been unclear.
For their study, Dr. Turner and colleagues set out to determine whether there is a genetic explanation.
Using high-density microarray analysis, the researchers evaluated more than 31,000 genes associated with the pancreas, with the aim of pinpointing which ones were most sensitive to glucose and fatty acids - the products of diets high in fat and sugar.
The researchers found that the gene TNFR5 had the highest sensitivity to glucose and fatty acids, and overexpression of this gene in response to high levels of fat and sugar led to beta cell destruction.
The authors say these findings suggest that people with type 2 diabetes - particularly those with poor blood glucose management or who have not been diagnosed - are more likely to overexpress the TNFR5 gene, and, therefore, beta cell damage is exacerbated.
But there is some good news; in laboratory tests, the team found that blocking TNFR5 in beta cells exposed to glucose and fatty acids halted their destruction.
This suggests that inhibiting TNFR5 activity could be a promising treatment strategy for type 2 diabetes.

http://www.medicalnewstoday.com/articles/312786.php

Diabetes study zeroes in on key to healthy aging, longer life

By Serena Gordon

Intensive management of type 2 diabetes can make a difference in how long and how well you live, even if you don’t start until middle age, researchers report.
People who were already at risk of type 2 diabetes complications were randomly selected to continue with their normal treatment or to be placed in an aggressive and multipronged treatment group.
Two decades after the study began, the researchers found that people in the aggressive treatment group lived almost eight years longer.
Not only that, they lived better -- their risk of heart disease, kidney disease and blindness all dropped. The only complication that didn’t seem to improve was nerve damage caused by diabetes.
“Early, intensified intervention in type 2 diabetes patients with microalbuminuria with both target-driven pharmacological (medication) and behavioural actions increased life span. And, that extra life length is free from severe and feared complications,” said study senior author Dr. Oluf Pedersen. He’s a specialist in internal medicine and endocrinology for the Novo Nordisk Foundation Centre for Basic Metabolic Research at the University of Copenhagen in Denmark.
Microalbuminuria is the presence of small amounts of protein in the urine. It’s a signal the kidneys aren’t working properly and the first sign of diabetic kidney damage, according to the American Diabetes Association.
Someone with microalbuminuria is at risk of developing other diabetes complications, because it’s a marker for generalized blood vessel damage, Pedersen explained.
The new study included 160 Danish people who had type 2 diabetes and microalbuminuria. Their average age was about 55 when the study began in 1993. All were overweight, bordering on obese​, according to the study.
Pedersen said the goal of the intensive treatment was to address all known modifiable risk factors for complications or early death. Those factors include blood sugar​, blood pressure, cholesterol and triglycerides, and the risk of blood clots.
When appropriate, medications such as cholesterol-lowering statins or blood pressure​ drugs were prescribed.
Behaviour modification was also a big part of the intensive treatment. Study volunteers were instructed on how to make healthy diet and exercise changes, and they were given help to quit smoking.
They were treated at the Steno Diabetes Centre in Copenhagen for almost eight years. “They were constantly educated and motivated,” Pedersen said.
All of that motivation paid off.
The participants’ blood pressure went down. Good cholesterol rose, while bad cholesterol and triglycerides went down. Not surprisingly, blood sugar levels also dropped.
After slightly more than two decades, 38 people had died in the intensive treatment group, compared to 55 in the conventional therapy group.
In addition to longer survival, the intensive group had an average eight-year delay in the onset of heart disease or stroke, Pedersen said.
The benefits were so clear after the intensive treatment officially ended that both groups were offered continued intensive treatment if they wanted it, Pedersen said.
Dr. Joel Zonszein is director of the Clinical Diabetes Centre at Montefiore Medical Centre in New York City. “These results are impressive, and the message is important. Physicians are not being aggressive enough, and aren’t treating to targets at the beginning,” he said.
“If you look at all the factors they (the Danish researchers) treated, about 80 percent of the U.S. population isn’t treated correctly, according to national surveys,” said Zonszein, who wasn’t involved with the study.
Zonszein added that another researcher did a sub-analysis from this data to see which factor made the most difference. “It was mostly giving statins that made a difference,” he noted.
And that’s good news, since statins are available in generic form, making them affordable for most people, he said.
But it’s not clear if the study results would be as impressive if done in an American population, Zonszein said.
“There would definitely be an improvement with intensive treatment, but the population here is very diverse, and would lead to different results,” he said.
The study was published recently in the journal Diabetologia.

http://www.cbsnews.com/news/diabetes-healthy-aging-living-longer/

13 hidden signs you could have type-2 diabetes

By Laura Mitchell

Diabetes is a lifelong condition that causes a person's blood sugar level to become too high. While most people with type-1 diabetes are born with it, type-2 can come on at any time.
With type-2 diabetes, the pancreas doesn't produce enough insulin or the body’s cells don't react to insulin. The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood.
If diabetes is left untreated the glucose starts to build up in the blood instead of heading straight for the cells. If the blood sugar gets too high or too low, health complications arise.
Here are 13 signs that you might have type-2 diabetes:
1. EXCESSIVE THIRST
Feeling constantly thirsty is one of the most common symptoms of diabetes. It's usually coupled with dryness in the mouth and can be one of the first signs to develop.
2. HUNGER
A sudden increase in appetite, particularly sweet cravings, can also be a symptom of the condition. This is because of the really high or really low blood sugar levels.
When your blood sugar levels dip, this sends the signal to the body that you need to eat something, which explains hunger pangs at any time of the day.
3. WEIGHT LOSS
If you are eating more but seem to be losing weight this could be an indication that something isn't right.
Because your body lacks insulin or it’s becoming insulin-sensitive, it can't transport blood sugar into the muscle cells.
As a result, your blood sugar level becomes alarmingly high and all the excess sugar goes into your urine. Hence, the weight loss.
4. FREQUENT TOILET BREAKS
If you seem to need to pee constantly, this could by a symptom too. Frequent urination is one of the major symptoms of both type-1 and type-2 diabetes.
When there are abnormally high blood sugar levels, some of the excess glucose in the blood are not reabsorbed and just end up in the urine, drawing more water.
Hence, you end up with large amounts of urine, causing you to urinate more frequently.
5. MOOD CHANGES
Have you been having mood swings for no particular reason? This is another, largely unknown symptom of the condition.
The fluctuating moods could be due to changes in blood sugar levels. You may also lack energy.
6. PROBLEMS SLEEPING
People with diabetes often experience problems getting to sleep and remaining asleep. This can be caused by pain, discomfort, the need to urinate, Restless Leg Syndrome, and sleep apnea.
7. FOOT NUMBNESS OR PAIN
Experiencing numbness and loss of strength in your feet can also be a warning sign. Because they are the farthest from the heart they are often hit the hardest when it comes to blood problems.
8. SKIN PROBLEMS
You might experience skin dryness and itchiness or darkening of the skin (acanthosis nigricans). This is due to circulation problems.
9. SLOW TO HEAL WOUNDS
If you do have type-2 diabetes, you might notice that your wounds don't heal as quickly as other people.
The high glucose levels in the blood result in poor blood circulation and make it hard for the blood to reach parts of the body that are affected by wounds, cuts or sores.
10. FATIGUE
This is one of the most common symptoms of diabetes. The rise is blood glucose can make you feel sluggish and groggy.
11. BLURRED VISION
Although this might seem extreme, it's actually one of the earliest indicators of diabetes. If you experience blurred vision see a doctor or eye specialist.
12. INFECTIONS
People with type-2 diabetes are more prone to yeast infections because of the amount of sugar in their bodies. They are also more likely to get urinary tract infections.
13. HIGH BLOOD PRESSURE
If you have a number of the symptoms above, maybe get your doctor to test your blood pressure. A normal blood pressure reading is 140/90, but if you have type-2 diabetes, it should be no higher than 135/80.

http://www.dailystar.co.uk/diet-fitness/543594/Diabetes-symptoms-do-I-have-type-2-diabetes

8 easily available diabetes-friendly foods

From ibtimes.co.in

Diabetes has been affecting many lives worldwide by causing kidney failure, blindness, heart attack, etc. According to the statistics by the WHO, 422 million people were diagnosed with diabetes in 2014. The WHO also revealed that diabetes was found to trigger quickly in low-income and middle-income countries over the years. Around 90 to 95 percent diabetics suffer from type-2 diabetes.
Patients suffering from diabetes often inject insulin almost daily (depending on the severity of the disorder) in order to keep the sugar levels in their body under control. Here are some items that they can consume and painlessly maintain the sugar levels:

Why advertise with us?

1. Bitter gourd
Though this vegetable is not admired much because of its bitter taste, it is extremely beneficial if consumed by diabetics. Intake of bitter gourd juice daily aids the body in producing insulin. This vegetable contains a chemical called Charantin, which helps in reducing blood glucose. Unlike drugs, bitter gourd helps in rectifying the glucose metabolism all over the body and not just at a particular tissue or body organ. It's best to consume bitter gourd juice in the morning empty stomach.

2. Cinnamon
According to a study published in a journal called Diabetes Care in 2003, consumption of 1 gram or more cinnamon by type 2-diabetics daily led to depletion of blood sugar in them by 30 percent in comparison to those who didn't consume cinnamon at all. This spice has a mineral called chromium, which helps in boosting the effects of insulin, which, in turn, helps in controlling blood sugar.
3. Jambul or Black Plum
This fruit is really good for diabetes patients. Presence of a type of glucose called jamboline in this berry is what aids in controlling the sugar levels by converting starch into energy and control the blood sugar level. Its crushed dried seeds were found to be great in controlling the blood sugar levels as per a study that was conducted by the Central Drug Research Institute (CDRI), Lucknow, in India. Not just this, even its leaves and bark extracts were found to reduce the sugar levels in urine. Diabetics are advised to consume this fruit during the summer when it is available.
4. Turmeric
Most of us never knew about the fact that this spice doesn't only add colour and flavor to the food we have, it also got anti-diabetic, anti-biotic and anti-bacterial properties. A study conducted by University of Newcastle's Nutraceuticals Research Group in July 2015 revealed that the presence of a compound called curcumin helps in preventing type-2 diabetes. This active compound also curbs insulin resistance.
5. Walnut
Walnut is found to have inflammation lowering properties due to presence of alpha-linolenic acid in it. It provides fibre, omega-3 fatty acid, L-arginine, vitamin E , antioxidants and other active compounds, which provide walnuts with anti-cancerous, anti-viral and cholesterol depleting properties. These properties help in curbing chronic disorders like diabetes and heart diseases.
6. Sweet Potatoes
Sweet potatoes are said to be good for controlling blood sugar. As per an article by the American Journal of Clinical Nutrition, which was published in 2002, low glycemic index of sweet potato makes it good for diabetics. Moderate consumption of this veggie will help in keeping the blood sugar levels under control.
7. Fish
Fish is very good for our health, it provides us with omega-3 fatty acids in abundance that helps in reducing inflammation. This inflammation worsens diabetes and also causes obesity. Apart from this, it's also found that fish consumption can lower the rate of heart stroke. Fish should be consumed while steamed, baked or broiled to get maximum health benefits. Fried fish is said to be unhealthy.
8. Broccoli
Cruciferous vegetables such as broccoli also aid in combating diabetes. Broccoli posses a compound called sulforaphane, which helps in bettering the blood sugar levels, and shields from cardiovascular damage by causing various anti-inflammatory processes. This compound also helps the body in carrying out its detox mechanisms, which removes all the health harming cancer triggering chemicals.

http://www.ibtimes.co.in/8-easily-available-diabetes-friendly-foods-692700

'Fat but fit' won't prevent type 2 diabetes risk, study finds

From theguardian.com

Maintaining a healthy weight is the single most effective way to reduce your risk of type 2 diabetes, no matter how much you hit the gym, new research has found.
An Australian study of more than 30,000 people has found being physically active won’t protect you from developing the disease if you are already overweight or obese.
According to the research, those who were obese – even if they were physically active and spent little time sitting – had five times the risk of developing type 2 diabetes compared with people of normal weight, even those who had lower levels of physical activity and who sat more.

People who were overweight had twice the risk as people who were of normal weight and less active.
The Sax Institute said the 45 and Up Study, presented in Sydney on Tuesday, debunked the myth that being “fat and fit” would reduce your risk of type 2 diabetes.
Lead researcher Thanh-Binh Nguyen from the University of Sydney said their research suggested being physically active is not as important as maintaining a healthy weight when it came to preventing diabetes and highlighted the importance of a healthy diet.
“Once you are overweight being physical active doesn’t help you that much in terms of preventing type 2 diabetes. It helps you if you can manage to reduce your weight, so it’s important to continue to be physically active and to adopt a healthy diet,” the researcher said.
Diabetes Australia says one of the most important aspects of diabetes management is to maintain a healthy body weight.
Being overweight not only increases your risk of heart disease, stroke and some cancers, but it also makes your diabetes harder to manage.
Previous research has found that if you have prediabetes (impaired fasting glucose or impaired glucose tolerance), losing 5 to 10% of your current body weight can prevent type 2 diabetes in up to nearly 6 out of 10 people.
This equates to losing five to 10kg for a person who weighs 100kg.
Diabetes Australia says small changes in diet, such as reducing portion sizes and swapping to low-fat dairy products, can help people to achieve a healthy body weight and manage diabetes.

https://www.theguardian.com/society/2016/sep/06/fat-but-fit-wont-prevent-type-2-diabetes-risk-study-finds