How to Get Moving With (or Without) Diabetes

From health.usnews.com

Physical activity is an important part of a healthy lifestyle for everyone. However, for people living with or at risk of diabetes, regular physical activity is an essential tool for managing blood glucose (also known as blood sugar) and preventing and/or delaying diabetes-related complications and their progression. For many people who have an already busy schedule filled with many responsibilities, it may seem impossible to fit in regular physical activity. And, to add more stress, there are always new trends and fads making it difficult to figure out what you should be doing to be active. However, did you know that health risks decrease with even modest amounts of physical activity?

Since I'm often asked for guidance on how to include physical activity in a daily routine, here are a few tips on how to get started and keep active:

Get started with something that fits into your existing lifestyle.

Just as diabetes management is unique to each person, your physical activity routine should be customized to you. Not all activities are right for everyone, including people with diabetes, so be careful when starting new activities, and check with your doctor if you have questions.

A good way to start planning for more activity is to track your activity habits for a few days. You might be surprised by how much time you spend sitting. Once you have an idea of your habits, start with small changes in your activity. Take one step at a time, and it might not feel so overwhelming.

First, find time to do short 3-minute movement breaks every 30 minutes. These breaks will help you move your muscles and improve blood flow in your body, and can help with managing blood sugars. Activities can include taking the stairs, walking while on the phone or marching feet on floor while seated. Once you're able to add in activity during your daily life, you might be ready to plan in more structured exercise time. Whether your goal is to lose weight or to better manage your blood sugar, it's recommended that you gradually work up to getting at least 30 minutes of moderate-to-vigorous aerobic exercise at least five days a week.

Make sure to incorporate strength training your muscles into your week.

Strength training is movement using a resistance, such as a hand weight or your own body weight, to work your muscles. Strength training exercises can help increase insulin sensitivity, which helps to decrease blood glucose. Because strength training contributes to maintaining and building strong muscles, it is also key to preventing muscle loss as you age. Another added benefit to strength training is that the more muscle you have, the more calories from food your body uses – even when you're not moving.

Strength training exercises range from using resistance bands and free weights to activities that use your own body's weight such as wall push-ups, leg raises and wall sits. Try to include strength training of all your large muscle groups (like your legs, back, shoulders and arms) at least two days each week. Make sure they aren't two days in a row though, since your muscles need time to repair after the training. People that have certain diabetes complications, like diabetic eye disease, may have certain restrictions when doing resistance exercises. Check with your doctor before beginning strength training or if you have any concerns or questions.

A comprehensive physical fitness plan also includes flexibility and balance training.

In order to safely be active and prevent injury, it's important to stretch your muscles at least two to three times each week. Try to hold each stretch for at least 10 to 15 seconds without holding your breath. Older adults, and especially those with Type 2 diabetes, can benefit from balance training activities two to three days each week to stay steady on their feet and prevent risk of falls. Simple stretching and balance activities, such as standing on one foot at a time for 10 seconds, can be included into your day and are easy to fit into your busy schedule. If yoga or tai chi are interesting to you, they can help improve strength, flexibility and balance in one activity.

Trying the latest exercise trends can be fun, but find activities that work with your current level of physical fitness.

It seems like there's a new physical fitness fad every season – from trampolining to spinning to high intensity interval training boot camps. While it's definitely tempting to sign up for a workout that is equivalent to a dance party on a bike or reminds you of your carefree childhood days on a trampoline, remember to include new activities with caution to prevent injury. That might mean talking to the instructor before a class to help adapt the activity to your current fitness ability, or discussing it with your doctor or health care team before starting a new and intense exercise routine. These fitness trends can be fun ways to spice up your activity plan and get moving, as long as they are safe for you to do.

If you're at risk for hypoglycemia (low blood sugar), make sure to check your blood sugar before, during and after exercise, and have glucose tabs or another snack ready in case your blood sugars get low while you exercise. Most importantly, listen to your body in order to protect yourself from potential injury. Exercise can be challenging, but if one activity feels too difficult to do or causes pain, it might not be an activity you should continue.

Just try to get moving.

It can be overwhelming to add yet another activity to your calendar, so try to just get moving as often as possible throughout the day. An inactive lifestyle is unhealthy for anyone, and breaking up sitting habits is one of the most effective ways to improve your overall health. This is why the American Diabetes Association recently issued new recommendations on physical activity and exercise for people with diabetes, encouraging them to move around at least once every 30 minutes. If you work in an office, you can even do activities right at your desk to increase your activity. If time is of the essence, you can also break your 30 minutes a day into three 10-minute activity sessions.

Make a commitment to yourself to be more active each day, and make physical fitness a core part of your healthy lifestyle. For people living with or at risk for diabetes, taking small steps to incorporate daily physical activity into your schedule can make a big difference.

http://health.usnews.com/health-care/for-better/articles/2017-04-28/how-to-get-moving-with-or-without-diabetes

Diabetes Tied to Brain Abnormalities

From nytimes.com

Diabetes may be bad for the brain, especially if you are overweight.

Researchers studied 50 overweight and 50 normal weight people in the early stages of Type 2 diabetes. All had been given a diagnosis within the previous five years. They compared both groups with 50 healthy control subjects.

The scientists performed M.R.I. examinations of their brains and psychological tests of memory, reaction time and planning. Those with diabetes scored worse than the healthy controls on tests of memory and reaction times.

M.R.I. scans revealed significant differences in brain areas related to memory, planning and the visual processing of information. Compared with the controls, those with Type 2 diabetes had more severe thinning of the cortex and more white matter abnormalities. Overweight people with diabetes had more brain deterioration than diabetic people of normal weight.

Are these changes reversible? Probably not, according to a co-author, Dr. Donald C. Simonson of Brigham and Women’s Hospital in Boston.

“When structural changes are seen on an M.R.I. scan, the processes leading up to them have probably been going on for years,” he said. “On the positive side, patients who maintain good control of their diabetes do seem to have a slower rate of deterioration.” The findings were published in Diabetologia.

https://www.nytimes.com/2017/04/27/well/mind/diabetes-tied-to-brain-abnormalities.html?_r=0

Sorry, But These Things Will Not Cure Diabetes

From asweetlife.org

As editor of ASweetLife, the Diabetes Magazine, one of my jobs is to block the barrage of comments we receive from people claiming to have cured their own diabetes with a home remedy, or those espousing the instantaneously successful treatment of a doctor whose name appears to be an amalgamation of Latin suffixes. Daily, I delete suspicious comments, things along the lines of a man who claims a donut a day keeps diabetes away, which he can prove because he has been eating a donut a day for the past 52 years and does not have diabetes. He can also sell you donut extract for $4.99 per drop, if you want to avoid all those donut calories. It might be sold on Goop, but I have not checked.
If we get a message proclaiming a one-pill-cures-all-diseases from a devotee of someone with a name like Dr. Abiliusesco, who is only reachable by clicking HERE on this very safe link, it gets marked as spam. But as I bid adios to the snake oils, I do so not only with the satisfaction of obstructing the swindlers and scoundrels, but with a tinge of regret. I grew up with a mother who had an incurable disease. Over the duration of her illness, which progressively worsened, we tried to cure my mother with everything from experimental surgery to bee venom to acupuncture. Though only a young child, I understood we were fighting a battle that was already lost. Those scarce moments of hope, however, that perhaps a charlatan’s newest injection would give way to even the slightest improvement, were glorious. What I’m trying to convey is not that I believe in tossing aside scientific facts and reason, but having worn the shoes of desperation, I feel tremendous compassion for the desolate, and I don’t enjoy being the one to mark hope as spam. Luckily, it’s not all on me. The FDA monitors companies claiming to cure diseases, and a few days ago it issued 14 warning letters and four online advisory letters to companies illegally selling more than 65 products that claim to prevent, diagnose, treat, mitigate or cure cancer.
Last May the FDA issued a consumer update warning for people with diabetes to beware of illegally marketed diabetes products.  The statement said, “As the number of people diagnosed with diabetes continues to grow, illegally marketed products promising to prevent, treat, and even cure diabetes are flooding the marketplace.”
For anyone with type 1 diabetes even the slightest suggestion that there is a cure or a way to live without insulin should elicit an immediate red flag. Or more like a thousand red flags. Yet, the internet abounds with individuals who will attest to curing their type 1 diabetes with diet and supplements. For example, Michelle, a blogger, claimed to have cured herself with the paleo diet. If that doesn’t raise your eyebrows, the dubious comment below the post thanking Dr. Gaga for casting a lucky spell should do the trick. A year later Michelle shared a post called “I’m back on insulin and I quit the paleo-diet.” Chances are Michelle experienced a diabetes honeymoon period, where the pancreas starts working again—though not perfectly—after diagnosis. ASweetLife contributor Katie Bacon explains, “The theory, in layman’s terms, is that the hard-working pancreas has given up the ghost, but then revives a bit after getting the rest that outside insulin injections provide honeymoon phase.” A low carb diet, that puts less stress on the pancreas, may help extend a diabetes honeymoon. However,  anyone who publicly claims she’s cured type 1 diabetes with diet and understands that, in fact, she has not, has the responsibility to remove misleading posts, titles, or information.  To suggest that a person with type 1 diabetes can live without insulin is not only to give false hope, but it may put a person’s life in danger.
It’s not only personal blogs, that dole out purported cures. A website called GreenMedinfo, founded by Sayer Ji, published an article that says type 1 diabetes is a ‘so-called incurable disease’ whose cure may be in your kitchen cupboard. GreenMedinfo has an endorsement from  Dr. David Perlmutter, author of the best selling book, Grain Brain. Dr. Perlmutter calls GreenMedinfo, “An incredibly rich venue of leading-edge scientific, user-friendly, health empowering information.” GreenMedinfo also charges for membership. But the article that suggests a flaxseed treatment cure is free! Other ‘natural’ substances that may help cure type 1 diabetes, include avocado extract, chard extract, and… wait for it… honey!  To each her own, but I’ll take a grain brain over a honeyed pancreas any day. And the GreenMedinfo cure-related theory that involves kitchen cupboard remedies is hinged on their ability to regenerate beta cells. Fortunately, there are scientists who’ve looked beyond the kitchen and into the lab. And the challenge of creating insulin-secreting beta cells has, for the most part, been met. What remains to be solved is the problem of the autoimmune attack on beta cells, whether they be the original cells or the tumeric-regenerated ones.
Hopefully, there will be a diabetes cure one day very soon, but until someone other than Mr. Ji, Dr. Perlmutter, and bloggers (understandably) desperate to rid themselves of a chronic illness that requires constant attention, I’m going to side with the Mayo Clinic. “There are no treatments — alternative or conventional — that can cure diabetes, so it’s critical that people who are receiving insulin therapy for diabetes don’t stop using insulin unless directed to do so by their physicians.”
In other words, drinking unicorn milk won’t give you diabetes and it also won’t make it go away.  If someone offers you something that sounds too good to be true, then it’s probably a scam. The FDA recommends watching out  for these and similar red flags:
“Lowers your blood sugar naturally!”
“Inexpensive therapy to fight and eliminate type II diabetes!”
“Protects your eyes, kidneys, and blood vessels from damage!”
“Replaces your diabetes medicine!”
“Effective treatment to relieve all symptoms of diabetes!”
“Natural diabetes cure!”
To their list I will add that it’s worth being wary of anything with one or more of  the following words: natural, supplement, extract, miracle, overnight, free, tincture, elixir, healing, cinnamon, okra, bitter gourd, or the phrase, the simple thing pharma doesn’t want you to know about.
The FDA created a video to alert people with diabetes to fraudulent diabetes treatments. Interestingly, at 13 seconds into the clip, the featured person with diabetes hears a beep, which comes from his glucose meter. His meter shows 425, and he appears to have received this reading without the involvement of a drop of blood or a test strip, which brings the word fraudulent to mind… or maybe it’s just one of Dr. Gaga’s spells. Either way, the FDA should quickly investigate.

https://asweetlife.org/sorry-but-these-things-will-not-cure-diabetes/#

Shiver yourself free of diabetes: how turning down the thermostat can help tackle disease

From telegraph.co.uk

Sitting at home shivering may not seem like a recipe for health and happiness.
But scientists have found that people with Type 2 diabetes can improve their condition simply by turning the heating down.
Most houses in the winter are heated to around 21C but researchers at Maastricht University Medical Centre, in The Netherlands, advise turning the thermostat down to between 15C and 19C for a few hours a day.
When a group of type 2 diabetics were asked to make the change for 10 days, it increased insulin sensitivity by more than 40 per cent, a result comparable with the best medicines that are currently available.
The authors suggest that temperatures in modern buildings, such as homes and offices, should shift between warm and cool through the day in order to support health.
"It has previously been assumed that stable fixed indoor temperatures would satisfy comfort and health in most people,” said Wouter van Marken Lichtenbelt, Professor of Ecological Energetics and Health at Maastricht.
“However, this research indicates that mild cold and variable temperatures may have a positive effect on our health and at the same time are acceptable or even may create pleasure."
In 2014, the same team discovered that cooler home temperatures can help tackle obesity. Being colder raises the metabolic rate – the speed at which calories are burnt – by 30pc, and shivering can burn around 400 calories an hour as it increases the metabolic rate fivefold.
Often in overheated homes and offices, our bodies do not naturally burn calories to keep warm. It is a trend which has crept up on us over the past century as we have become more adept at controlling the temperature in our surroundings.

In the latest experiment researchers found that although shivering can feel uncomfortable, people quickly adapted to lower temperatures and even started to enjoy the experience, feeling less lethargic and more energised.
Richard Lorch, editor in chief, of Building Research and Information, where the study was published said: “This ground-breaking research provides a new approach to how we think about the heating and cooling of our buildings.
The health benefits from a short exposure to a more varied temperature range will redefine our expectations on thermal comfort. In turn, this will change our practices for heating and cooling our buildings."
In developed countries, buildings account for up to 40 per cent of energy demand and constitute a significant proportion of CO2 emissions so reduction in heating and cooling of buildings would also reduce greenhouse gas emissions.
In March Ashley Grossman Professor of Endocrinology at Oxford suggested that opening your bedroom window at night to allow in a cool breeze could help prevent obesity and Type 2 diabetes. But this is the first study to show it can actually reverse the condition.

http://www.telegraph.co.uk/science/2017/04/26/shiver-free-diabetes-turning-thermostat-can-help-tackle-disease/

Low Glycemic Foods For Better Vision

By Joel Travers King

One particular concern for aging Americans is the importance of keeping blood sugar levels in the healthy range. This is due to the fact that excessive sugar consumption, if left unchecked, can result in unhealthy blood sugar levels that lead to the development of Diabetes. Another important reason to keep your blood sugar levels normal is the fact that unhealthy blood glucose levels contribute to eye problems and eye diseases such a Diabetic Retinopathy. This is an eye disease whereby unhealthy blood sugar levels cause damage to the light sensitive tissues at the back of the eye called the retina. Therefore, it is essential to pay attention to reducing your sugar consumption in your diet.

The Glycemic Index is a number assigned to a particular food that shows that particular food's effect on a person's blood glucose level. A helpful way to regulate blood sugar levels in your diet is to find out the glycemic index value of your food. The higher the glycemic index number the higher is that food's effect on your blood sugar levels. The lower the numbered value of that particular food is the lesser the effect it will have on raising blood sugar levels. Nutritionists suggests that if you have concerns about blood sugar levels you should include foods with a low glycemic index number. Therefore, if you are concerned about maintaining healthy eyesight, and keeping blood sugar levels in the healthy range, here is a list of eye foods that you should avoid that have high glycemic index rating numbers. Additionally, here are a list of foods that have a low rating number on the Glycemic index that you should include in your diet.

HIGH GLYCEMIC INDEX FOODS TO AVOID TO PROTECT EYESIGHT
According to DR. Oz high glycemic foods can spike blood sugar levels in the body and lead to an increase in the amount of insulin in your system. According to a scientific research study high glycemic index foods can increase the risks for diseases such as lung, breast, prostate and colon cancers. Therefore, if you do have blood sugar concerns you should avoid them.
Some examples of high glycemic foods are white bread, white rice, white potatoes and fruits such as bananas. Other high glycemic index foods include most breakfast cereals, including puffed rice, sodas, crackers and cookies. The list also includes sugary foods such as pancakes, donuts, cakes, pastries, muffins, ice cream, sugar sweetened candies and yogurt to name a few. Also included in this list are processed foods and concentrated fruit juice products such as raisins, dates and fruit juices to name a few.

LOW GLYCEMIC INDEX FOODS FOR BETTER VISION
Some examples of low glycemic index foods include sweet potatoes, legumes, beans, lentils, chickpeas, sesame seeds, peanuts, flax seeds, vegetables such as greens like cauliflower, asparagus, quinoa, Ezekiel bread, and skim milk. Some other examples include brown rice, whole grains, yam, wheat tortilla, buckwheat, spaghetti, meat ravioli, and egg fettuccini. In terms of snack foods some examples are slim fast meal replacement shakes, hummus, peanuts, walnuts, cashews, corn chips, oatmeal crackers. In terms of fruits some low glycemic food examples include, plums, grapefruit, peaches, apples, coconuts, kiwis, oranges and strawberries to name a few.

When it comes to protecting your eye health if you are concerned about keeping your blood sugar levels in the normal range incorporating low glycemic foods in your diet will not only enable you to control and regulate your diabetes but it will also contribute to healthier eyesight and enable you to reduce your risks for eye diseases such as Diabetic Retinopathy.

http://ezinearticles.com/?Low-Glycemic-Foods-For-Better-Vision&id=9691869

The Emotional Side of Diabetes

From susquehannahealth.org

Cheryl Barclay, RN, CDE

The diagnosis of diabetes or prediabetes is an alert that can help you slow the condition’s progression with adjustments to diet and lifestyle. Making those changes takes time and plenty of support. There is an emotional side to managing diabetes, and a certified diabetes educator (CDE) can help you understand and overcome these challenges.
Many patients are shocked to hear they have diabetes. They may not have the traditional symptoms, or there may not be anyone else in their family who has the condition. Denial is a common reaction, but unfortunately, it delays you in making recommended changes to improve your health. Sitting down with your primary care provider or a CDE to see how your blood sugar levels relate to established guidelines is a good starting point for understanding and accepting your diagnosis.
Fear is another common emotion. Many patients worry that they are going to need insulin, that they will have to give up all of their favourite foods, or that they are guaranteed to suffer severe complications because of their condition. Through diabetes education, you learn that you can still enjoy a little of everything in moderation. There are hundreds of thousands of people who have learned to manage their diabetes and lived for decades without using insulin or developing complications.
Well-meaning friends and family members can frustrate and confuse a new diabetes patient with conflicting advice, misinformation and frightening stories. The most reliable guidelines are tailored directly to you and your unique lifestyle. This can come from your primary care provider, a CDE or any primary sources that these experts recommend.
Managing diabetes requires forming new habits. Just as many people struggle with their first attempts to quit smoking, lose weight or start exercising, it’s important to accept that you may not do it perfectly or completely at first, but you shouldn’t give up! Diabetes educators have helped many people find sure footing on this journey, and they have tips and suggestions to help you overcome challenges, avoid common pitfalls and be successful. A diabetes support group is another resource that can help you adjust to your new condition with advice from experts and opportunities to share experiences with others.
Learning to deal with stress is an important part of managing diabetes. Stress can directly impact blood glucose levels. In addition, when under stress you may be less likely to take good care of yourself. Checking blood glucose levels is an important part of diabetes self care, but it can also become a source of stress when levels aren’t ideal even with your best efforts. The impact can have a cyclical effect as stress builds and then continues to have a negative impact on your numbers. Working with a diabetes educator can help you develop realistic expectations for your blood glucose levels so you can keep this one source of stress in check.
While not everyone who has diabetes suffers from depression, the condition does increase your risks. It’s important to recognize the signs of depression and get help early. Many symptoms of depression, such as lack of appetite, sleep and energy, can interfere with good diabetes management.
Learning to manage your diabetes is an ongoing process, and fortunately, CDEs are prepared to help you master both the physical and emotional challenges you may face. Talk to your primary care provider about a referral today.

https://www.susquehannahealth.org/in-the-community/blog/the-emotional-side-of-diabetes-0

Recipe: Ham, leek and Parmesan frittata

From diabetes.org.uk

This makes a tasty meal - serve warm with salad, or cold for a lunchbox or picnic.

Ingredients

• 1 tsp sunflower oil
• 1 slice ham, chopped into small pieces
• 1 small leek (approx 100-120g), finely sliced
• 2 medium free-range eggs
• 1 tbsp low-fat yogurt
• pinch white pepper
• 10g Parmesan, finely grated
• fresh chives, to serve 

Method

1. Add the oil to a small frying pan over a low-medium heat, then add the chopped ham and leek, and stir until the leek has softened, about 3–4 minutes.
2. In a bowl, beat the eggs with the yogurt, then mix in the pepper and half the cheese. Meanwhile, turn the grill on.
3. Pour the egg mixture into the pan and mix quickly with a fork. Allow to cook for 1 minute, then stir again. Cook for another 1–2 minutes, constantly easing the edges of the frittata away from the sides of the pan.
4. Sprinkle with the remaining cheese and place under the grill for 2–3 minutes until golden brown.
5. Slide the frittata onto a plate, sprinkle with some chopped, fresh chives and enjoy. Alternatively, allow to cool and then refrigerate. 

Chef's tips

• Parmesan has a strong flavour, so you don't need to use very much to get a fantastic cheesy flavour, but with less fat.
• Store unused Parmesan in greaseproof paper inside a polythene bag in the fridge, as clingfilm makes it sweat.
• Use a small frying pan for this recipe.

https://www.diabetes.org.uk/Guide-to-diabetes/Recipes/Ham-leek-Parmesan-frittata/

Lifestyle Tips to Control Diabetes

From stamfordhealth.org

Whether you have been diagnosed with type 1, 2 or gestational diabetes, it’s important to understand what role food, nutrition and exercise play in the management of diabetes.
Part of managing diabetes is maintaining proper blood sugar levels. Medication, physical activity, and balancing the foods you consume are also very important in the disease management. Consider these tips to help you better control your diabetes.

1. Eating Healthy with Diabetes

• Choose healthy carbohydrates such as whole-grain foods, brown rice, buckwheat, oatmeal and whole grain breads and cereals. 
• Make half your plate fruits and vegetables and choose whole fruit instead of fruit juices. 
• Eat less fat by choosing lean meats, poultry and fish. Take the skin off the chicken before eating.
• Lower your salt intake by using herbs and spices, such as pepper, basil, garlic, cinnamon.

2. Controlling Diabetes through Lifestyle Changes

• Avoid skipping meals to maintain steady blood sugar levels.
• Focus on your food and avoid multitasking. Eating while doing other tasks may lead to overeating. Also, do not eat while watching TV; eat at the kitchen table to enjoy the meal with family members.

3. Exercise and Diabetes

• Exercise helps your body utilize insulin more effectively.
• Exercise improves blood circulation to all organs, especially the kidneys, brain, heart and eyes which can be affected by poor diabetes management. 

https://www.stamfordhealth.org/healthflash-blog/nutrition/control-diabetes/

• Stay hydrated by drinking water before, during and after exercise.

When is it safe to drive with type 1 diabetes?

From medicalxpress.com

Having type 1 diabetes can raise your chances of crashing while driving, but new research offers a checklist that helps determine whether it is safe for you to get behind the wheel.


The wrong amounts of insulin and other blood sugar-lowering medications can trigger dangerously low blood sugar levels, which can cause people to pass out or have seizures, the researchers explained.

"People with diabetes need to recognize that they're part of a huge mass of people who have potentially impaired driving, like people with heart disease or narcolepsy. They shouldn't think of themselves as isolated. It's just an issue to deal with," said the author of a new study on diabetes and driving, Daniel Cox. He's a professor in psychiatry, internal medicine and ophthalmology at the University of Virginia Health System in Charlottesville.

"By no means are we saying that people with type 1 diabetes shouldn't drive. But, just like pilots go through a pre-flight checklist, drivers with type 1 diabetes need to go through a pre-drive checklist," he suggested.

Cox explained that some people with diabetes have a higher-than-average risk of driving troubles. This includes people who've already had a serious low blood sugar event (hypoglycemia) while driving, people who mismanage hypoglycemia, people who drive a lot, and people with diabetes who've lost feeling in their feet or legs (diabetic neuropathy), because they can't feel the pedals.
But doctors don't have a standardized assessment to determine who's at high risk for a diabetes-related accident and who's not.
So, Cox and his colleagues developed an 11-question test called the Risk Assessment of Diabetic Drivers (RADD). The researchers administered the test to more than 500 drivers with type 1 diabetes from Boston, central Virginia and Minneapolis.
The investigators asked the study participants about their driving "mishaps." A driving mishap—as defined by this study—was a dangerous driving situation that resulted in an accident or could have resulted in an accident.
The assessment accurately identified 61 percent of those who were at high risk for having driving issues, and 75 percent of those who were at low risk of having driving problems.
The second part of the study included almost 500 drivers with type 1 diabetes from across the country who took the RADD test online. The study found that 372 were identified as high-risk and 118 were considered low-risk.
Half of these people were then given routine care, and the rest were asked to participate in an online intervention.
The intervention aimed to anticipate, prevent, detect and treat hypoglycemia. All of the intervention participants were given a toolkit for their car. It contained a blood sugar meter, a pre-drive checklist, a key chain with a stoplight symbol to remind drivers to stop and treat their low blood sugar if their reading was below 70 milligrams per deciliter (mg/dL), or to be cautious and eat some foods containing carbohydrates before driving if it was between 70 and 90. (Below 70 is considered hypoglycemia.) Over 90 mg/dL is considered a green light, Cox said.
The kits also contained a fast-acting glucose product, such as glucose tablets or gel.
"Many people with type 1 diabetes didn't know how to properly treat hypoglycemia. They eat something with a lot of fat or protein, and that doesn't make blood glucose rise quickly. If you want a fast rise in blood glucose, glucose tablets will do it," Cox explained.
He said people with type 1 diabetes should always have fast-acting carbohydrates in their car.
The study found that the intervention tool helped drivers avoid hypoglycemia while driving.
Dr. Joel Zonszein is director of the Clinical Diabetes Centre at Montefiore Medical Centre in New York City.
Zonszein said he was glad to see the study bringing attention to the issue. "It reminds us that people with diabetes should be assessed individually, taking into account each individual's medical history as well as the potential related risks associated with driving, as recommended by the American Diabetes Association," he said.
But, he added that "the patients at risk are few, and they are mainly limited to older individuals, and those with advanced complications and type 1 diabetes."
Zonszein said he'd rather that people and their driving abilities were assessed by their physician or a certified diabetes educator instead of an online program.
Dr. Minisha Sood, an endocrinologist from Lenox Hill Hospital in New York City, agreed that it's important to have a doctor or diabetes educator involved in the process.
"The anonymity [of an internet screening] may be a draw for patients who might feel embarrassed or anxious about their potential risk. It would be important for a care provider to have access to the assessment results, however, in order to keep a patient out of harm's way," she said.
Sood also agreed that anyone with "diabetes should always keep a fast-acting carbohydrate or source of glucose in the car for emergencies."
The study was published online recently in the journal Diabetes Care.

https://medicalxpress.com/news/2017-04-safe-diabetes.html

Type 2 diabetes, once considered a disease for adults, is increasingly common in tweens and teens

From stardem.com

For years, health experts have bemoaned the rise of childhood obesity in the United States. About 17 percent of kids and teens in the U.S. are now considered obese, a figure that has more than tripled since the 1970s, according to data from the Centres for Disease Control and Prevention.
A report in the New England Journal of Medicine lays out one of the consequences of all this excess weight: a corresponding increase in childhood cases of Type 2 diabetes.
Type 2 diabetes occurs when extra body fat makes it hard for cells to use insulin, a hormone that turns sugar into energy. Over time, blood sugar levels rise and cause blood vessels to become stiff, increasing the risk of life-threatening conditions like heart attacks, strokes and kidney failure, among others. More than 75,000 Americans die of diabetes each year, the CDC says.

Type 2 diabetes used to be called adult-onset diabetes, because it would take years to develop. (That’s in contrast to Type 1 diabetes, formerly known as juvenile diabetes, which occurs when the immune system destroys the cells that make insulin.) But these days, doctors are diagnosing Type 2 in school-age kids, and occasionally even in toddlers.
After reviewing data on 10- to 19-year-olds in primarily five states (California, Colorado, Ohio, South Carolina and Washington), researchers determined that 12.5 out of every 100,000 of them had a bona fide case of Type 2 diabetes in 2011 and 2012. That compares with nine cases per 100,000 youth in 2002 and 2003.
After accounting for age, gender, race and ethnicity, the study authors found that the incidence of Type 2 diabetes in this age group rose by an average of 4.8 percent per year during the study period.
Here are five takeaways from the new data.
Type 2 diabetes is increasing for youth
Although the difference between nine cases and 12.5 cases per 100,000 people might not sound like much, it means that about 1,500 more kids and teens were being diagnosed with Type 2 diabetes each year at the end of the study period compared with the beginning.
The incidence of Type 2 diabetes rose pretty much across the board for 10- to 19-year-olds, regardless of age, gender, race or ethnicity. The two exceptions were white kids and youth in Ohio.
Health disparities are increasing
The burden of all these extra cases of Type 2 diabetes is not being shared equally.
The racial and ethnic gap was evident in 2003, when the incidences ranged from 4.4 cases per 100,000 people for white youth to 22.6 cases per 100,000 people for Native Americans. By 2012, whites still had the lowest incidence and Native Americans still had the highest, but the gap had increased from 3.9 to 46.5 cases per 100,000 people.
In between were Asian American youth (with 12.2 cases per 100,000), Latinos (18.2 cases per 100,000) and African Americans (32.6 cases per 100,000).
Not only did white kids and teens start out with the lowest incidence of Type 2 diabetes, they were the only demographic that didn’t experience an increase in incidence over the 10 years of the study.
The gender gap is widening
At the beginning of the study period, the incidence of Type 2 diabetes was seven cases per 100,000 boys and 11.1 cases per 100,000 girls. By the end, the incidence increased modestly for boys (to nine cases per 100,000) but more markedly for girls (to 16.2 cases per 100,000).
After the researchers accounted for demographic factors, they calculated that the annual increase in Type 2 diabetes incidence was 3.7 percent for boys and 6.2 percent for girls.
It doesn’t matter if you’re a tween or a teen
When the researchers divided the data according to age, they found very little difference between 10- to 14-year-olds and 15- to 19-year-olds.
In 2003, the older teens had a slight edge, with an incidence of 10 cases per 100,000 people compared with eight cases per 100,000 for their younger counterparts. By 2012, that edge had narrowed to 12.9 cases per 100,000 to 12.1 cases per 100,000.
The adjusted annual increase was essentially the same for both age groups — 5.2 percent for the older kids and 5.1 percent for the younger ones.
Over time, the effects could be huge
The earlier the disease starts, the more potential it has to do damage.
Globally, the number of years people lived with diabetes-related disabilities rose by nearly 33 percent between 2005 and 2015, according to a report published last year in Lancet. In addition, the number of years of life lost to Type 2 diabetes rose more than 25 percent in the same period.
That means that even though doctors are doing a better job of treating diabetes and its related conditions, “the overall adverse effect of diabetes on public health is actually increasing,” according to an editorial in the New England Journal of Medicine that accompanies the new report.

http://www.stardem.com/news/national/article_a4c7bb4c-42aa-550d-acf5-85956504e909.html

A Slimming Plan For Overweight Kids

By Andy Gibson

Childhood obesity has approached epidemic proportions in United States. And for a growing number of youngsters, it is a serious problem.
And one that involves more than just simple schoolyard vanity. Excess weight in childhood is likely to be carried over into adulthood, studies show, and it will predispose children to high blood pressure, heart disease, diabetes and other obesity-related chronic illness. That's why it's important to act early, to ensure a lifetime of optimum health.
But take note: Kids are not just small adults, and slimming them down takes a special approach that's safe for their growing bodies. The first step is recognizing what's causing the problem.
Some people think it starts with heredity. It's a controversial question as to how much heredity actually contributes to the problem. But here's the important point:
Even if a child carries genes that create a tendency toward obesity, major environment factors, such as a sedentary lifestyle and a high-fat diet, must be in effect for obesity to take hold. There are plenty of fat-prone kids out there who never get fat because they practise good health habits.
For most overweight children (on the order of 70 per cent), the problem can be attributed directly to these environmental causes. For the 30 per cent, heredity is the problem. That's good news, parents, because it means there's a lot you and your child can do to get that excess weight off.

TAKING ACTION
Before you do anything, though, it's critical to get your pediatrician advice. While you may think your child is overweight compared to her friends or siblings, children vary. A doctor can provide an objective assessment and determine how serious the problem is - or if there really is a problem at all.

If the child is overweight, restricting calories until the child loses weight is, at best impractical, and at worst, potentially dangerous. What overweight children need is flexible, low-fat eating plan to follow, in which portion size and between-meal snacking are kept to moderate levels.
It's not a diet that they go on or off. It's way of eating that can last a lifetime. (Calories and fat should never be restricted in a child less than age two, most doctors agree.)
In fact, losing weight shouldn't be a goal at all for most plump children. The goal should simply be to get the child to stop gaining weight. If a child's weight stabilizes while he's still growing, and his problem isn't too severe, he'll simply grow out of his obesity. (Most girls grow until they're about 16, boys until they're 19).
But an eating plan isn't the only answer or even the most important, necessarily. The number-one cause of childhood obesity may well be a sedentary lifestyle.
Children - especially children of affluent or even middle-class parents - have, like many adults, become couch potatoes. Getting your kids moving again should be your top priority.

IMPLEMENTING YOUR PLAN
By now it should be obvious that, in most cases, when a child is overweight, the whole family is going to have to make changes. The greatest influence on a child's health is his parents. Children learn what they see. If the parents' eating and exercise habits are poor, the child's will probably be lacking, too. Start by assessing your family's activity level. Do you regularly "sweat" together? Whether it's a community-sponsored "fun run" or a walk in a zoo, make a resolution to do family fitness activities together every week.

IN WITH THE NEW
On the food front, the first thing you need to do is look inward. In your refrigerator. In your kitchen cabinets. In your oven. Are you really buying and preparing low-fat, high-fibre foods? Are the cabinets clear of fatty chips, sweets and has your freezer been declared an ice-cream-free zone?
At home, move the focus away from food. When the family gathers to play games or talk, do it away from the dining room and the kitchen. Make a new rule no eating anywhere in the house except at the dining table. Everyone has to abide by this rule, including the grown-ups.
Speak up at PTA meetings for a school programme on good nutrition, campaign for PTA action against hawkers selling trashy foods in the school's immediate vicinity.
But a word of caution: Too much focus on a child's weight might lead to eating disorders. Over half of the people who develop eating disorders, such as anorexia and bulimia, can trace it to an episode of dieting.
That's why it's very important that you never use food as reward or punishment. That's a dangerous strategy that can lead youngsters to seek comfort in food.

HELP FOR TOUGH CASES
If a child's weight problem continues, both the parents and child may need counselling - separately. Separately, because you need to learn different things. Parents must learn how to encourage good habits without nagging or unwittingly encouraging eating disorders. If both parents are working, they may need to learn how to fit healthy meal preparation into a bust schedule.
The children need to learn new eating habits and to enjoy physical activity. But remember: Any formal programme for overweight children and their families should focus on appropriate behaviour and healthy foods, not ton dieting and calorie counting.
Only if a child's obesity is severe should weight loss be on the agenda. And that should be initiated only after weight gain has stopped, and after the entire family is eating healthy foods.

Then you can explore with a physician a safe way for a child to lose 5 to 10 per cent maximum of weight at the rate of half to one kg a week, over five or six weeks.
Weight loss should then stop, and children should stay at that level for several months before losing any more, if needed they still need to lose. Weight-loss diets for children must be constructed carefully by pediatricians and should always include a 10 per cent increase in physical activity.

The new discoveries and inventions have made our lifestyle full of convenience. But our bodies require work. Just like the sedentary water starts smelling, the sedentary lifestyle has given rise to many chronic diseases like the heart problems, diabetes and hypertension.
Today, the health researchers are suggesting that most of the chronic diseases that have appeared in man's life are due to STRESS. From where it has come. It is the bi-product of our so-called modern lifestyle.
We are standing at the edge of cliff. Immediate actions are required to bring back the healthy days. We must incorporate exercise, balanced diet, sound sleep, and the most importantly happy and positive thoughts to our lifestyle to get rid of all health problems.
Life is a balance between what we can and what we cannot. Learn to live between effort and surrender.

http://ezinearticles.com/?A-Slimming-Plan-For-Overweight-Kids&id=9686181

8 Complications of Diabetes

From health.usnews.com

Keep your blood sugar under control to help avoid these often serious complications.

Diabetes alone doesn't cause health complications – it's uncontrolled diabetes that causes health problems, says Lucille Hughes, a certified diabetes educator and director of diabetes education at South Nassau Communities Hospital in Oceanside, New York.

The health problems that can arise if your diabetes is uncontrolled can be serious: You could lose your vision or die from a heart attack or stroke. In fact, diabetes is the seventh-leading cause of death nationwide, according to the Centers for Disease Control and Prevention. What's scary is that you may not always know how high blood sugar is affecting your health. "Diabetes is called the silent killer for a reason," says Dr. Lorena Lewy-Alterbaum, an endocrinologist with Memorial Regional Hospital South who's also in private practice in Hollywood, Florida. "Patients feel relatively well with blood glucose in the 200 range, when the norm is 70 to 99." Your blood glucose, also known as blood sugar, is one measurement used to assess how well-controlled your disease is.

Here are more details on eight common diabetes complications.

Neuropathy. Neuropathy is another term for nerve damage, and it occurs in more than 50 percent of people with diabetes. Neuropathy can have a variety of symptoms; these symptoms often occur in your feet or legs – and sometimes your hands and arms – when you have diabetes. The symptoms include tingling, increased sensitivity to touch, pain, numbness and weakness. In its most extreme form, amputation of a limb may occur because of poor circulation or infections occurring when you have neuropathy, says Dr. Gregory Dodell, an assistant professor of endocrinology, diabetes and bone disease at Mt. Sinai School of Medicine, who is also in private practice at Central Park Endocrinology in New York.
Erectile dysfunction, which can be a complication of diabetes, is actually a form of neuropathy, Lewy-Alterbaum says.
Kidney disease. Kidney disease is a common complication because high levels of glucose cause the kidneys to filter too much blood, making them work extra hard, according to the American Diabetes Association. Waste products can build up and make the kidneys stop working. The effects of severe kidney disease are often devastating. "In the end stage, it requires a shunt in the arm for dialysis three times a week," Lewy-Alterbaum says. Part of a routine diabetes check is lab work to check for kidney function issues.

Vision problems. A condition called diabetic retinopathy can affect your vision over time when you have uncontrolled blood sugar levels. The excess glucose causes damage to the vessels in your retina, which is part of the back of the eye. Symptoms include blurry vision and poorer daytime and nighttime vision. Left untreated, diabetic retinopathy causes vision loss.

Heart disease. "Diabetes kills from the heart. The majority of patients will end up having some atherosclerosis-related event," Lewy-Alterbaum says. (Atherosclerosis is a hardening and thickening of the arteries.) She's treated patients who had heart trouble and only had vague or subtle symptoms. High blood glucose over time damages the heart – and those with diabetes are already more likely to have heart-related problems such as high blood pressure and high cholesterol.

Stroke. You're two to four times more likely to have a stroke when you have diabetes, the American Stroke Association reports. This is because excess glucose in the body can lead to more fatty deposits or clots in the walls of the blood vessels. The clots can cause narrowing or blockages in your blood vessels, which could eventually stop the flow of oxygen to the brain and cause a stroke.
Low testosterone levels. "I often tell patients that testosterone is a reproductive hormone, and if the body is focusing on dealing with other issues, it's not focused on reproductive function," Dodell says. "So, controlling diabetes and improving lifestyle will increase testosterone."

Gastroparesis. Gastroparesis is a condition where your stomach slows or stops the movement of food to the small intestine. Symptoms include nausea, vomiting, stomach pain and feeling full after just a few bites. Diabetes is the most common cause of gastroparesis, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
Sleep apnea. Sleep apnea is a common problem among patients with Type 2 diabetes; those who are overweight or obese are already more prone to sleep apnea. "I ask patients if they are exhausted during the day or if their significant other mentions that they snore so they can be assessed if indicated," Dodell says. "Treatment of sleep apnea can help control diabetes and daytime energy levels."

How to Avoid Complications From Diabetes

Regular checkups with your doctor can help avoid many diabetes complications. "When we see patients every three months, we can recognize blood sugar patterns, make lifestyle recommendations and intensify treatment before sugars get out of control," says Dr. Sarah R. Rettinger, an endocrinologist with Providence Saint John's Health Centre in Santa Monica, California.

Those regular checkups allow doctors to detect and treat early signs of problems. "With good control, patients should be able to live healthy, happy and long lives – without complications," she says.

It's important to start those regular checks early, when you're diagnosed with the disease. The earlier you can get your blood sugar under control, the more you can lower your risk for future complications, Lewy-Alterbaum says.

Lifestyle changes like a healthier diet, more physical activity and stress management all help reduce the risk of complications, Hughes says. Along with healthier choices, aim to get your hemoglobin A1C – an important blood sugar measurement – within your personalized healthy range, Dodell says. That's because research shows that healthy hemoglobin A1C goals can help you avoid complications in the first place.
It's also crucial to see not just see your primary care doctor or endocrinologist regularly, but also any other health professionals and specialists recommended to you, such as eye doctors, nutritionists and diabetes educators, Dodell says.

Although a diabetes diagnosis may seem overwhelming, Hughes focuses on the positive. She lets patients know that their diagnosis – and subsequent treatments and healthy changes – may help them avoid a lifetime of unexpected diabetes complications.

http://health.usnews.com/health-care/patient-advice/articles/2017-04-13/8-complications-of-diabetes

Recipe: Shellfish Risotto

From diabetes.org.uk

Prawns, squid and mussels combine with pepper and courgette to create a tasty shellfish risotto. Read on!

Ingredients

• 1 tsp rapeseed oil
• 1 onion, finely chopped
• 1 fish stock cube dissolved in 900ml of water
• 1 red pepper, finely chopped
• 1 courgette, finely chopped
• 1 clove garlic, crushed
• good pinch white pepper
• 15g parsley, finely chopped and 1 tbsp to serve
• 150g Arborio rice
• 350g bag mixed frozen seafood, defrosted (mussels 37%, squid 25%, prawns 25%)
• 1 tbsp 0% fat Greek yogurt
• pinch parsley and black pepper to serve

Method

1. Add oil to a pan and cook the onion for 5 minutes. In a separate pan, heat the stock and simmering gently.
2. Add the red pepper, courgette, garlic, white pepper and half the parsley to the onion. Stir for 1 minute before adding the rice. Stir for 2 minutes, then add 2 ladles of stock, enough to just cover the rice, and stir.
3. Add hot stock a little at a time, so the rice is just covered, whilst stirring regularly. The risotto should be bubbling very gently.
4. After 20 minutes, add any remaining stock and the seafood, then stir for another 3-4 minutes. Test the rice to make sure its cooked ‘al dente’ (slightly firm) and ensure all the seafood is fully cooked through.
5. Finally, vigorously stir in the remaining parsley, saving a little to serve. Add the yogurt, stir, then cover and allow to stand for 2 minutes, before serving with a sprinkle of parsley and good grind of black pepper.

Chef's tips

• Keep the stock simmering in a separate saucepan so it’s piping hot when added to the rice to ensure the rice cooks consistently. Add a little at a time - if you run out, just add some boiling water.
• Stirring regularly with a wooden spoon ensures the rice releases its starch to ensure a creamy texture.
• Freezing instructions: Suitable for freezing once cooked. Then defrost in the fridge and reheat until piping hot throughout. Discard any leftovers and do not reheat/refreeze.

https://www.diabetes.org.uk/Guide-to-diabetes/Recipes/Shellfish-risotto/?utm_source=bronto&utm_medium=email&utm_term=Prawns,+squid+and+mussels+combine+with+pepper+and+courgette+to+create+a+tasty+shellfish+risotto.&utm_content=Prawns,+squid+and+mussels+combine+with+pepper+and+courgette+to+create+a+tasty+shellfish+risotto.&utm_campaign=Enewsletter+April+2017

Daily diet of fresh fruit linked to lower diabetes risk

From nhs.uk/news

"Eating fresh fruit daily could cut risk of diabetes by 12%," the Mail Online reports.
A study of half a million people in China found those who ate fruit daily were 12% less likely to get type 2 diabetes than those who never or rarely ate it.
It was also found that people with diabetes at the start of the study who ate fruit regularly were slightly less likely to die, or to get complications of diabetes, such as eye problems (diabetic retinopathy), during the study than those who ate fruit rarely or never.
Many people with diabetes in China avoid eating fruit, because they are told it raises blood sugar. However, the study suggests fresh fruit may actually be beneficial for people with and without diabetes.

Fruits which release sugars more slowly into the blood, such as apples, pears and oranges, are the most popular in China, according to the researchers. So this may be the preferred option if you are worried about diabetes risk, or have been diagnosed with diabetes.
The study doesn't show that fruit directly prevents diabetes or diabetes complications, as an inherent limitation of this type of study is that other factors could be involved. And it doesn't tell us how much fruit might be too much.
Overall, the research suggests fresh fruit can be part of a healthy diet for everyone.

What kind of research was this?

This was a large-scale prospective cohort study. Researchers wanted to look for associations between fruit eating, diabetes and complications of diabetes.

However, while this type of study is good for spotting links, it cannot prove that one factor causes another.

What did the research involve?

Researchers used information from a big ongoing cohort study called the China Kadoorie Biobank Study, which recruited half a million adults aged 30 to 79 between 2004 and 2008.
Participants filled in questionnaires about their health, diet and lifestyle and had measurements taken of their blood sugar, blood pressure, cholesterol and other health-related factors. The diet questionnaires were repeated over the course of the study. After an average seven years of follow-up, researchers looked to see how fruit consumption related to diabetes.
Some people in the study (almost 6%) had diabetes at the start of the study. While not actually specified in the study, we assume the majority of these cases were type 2 diabetes. Type 1 diabetes usually begins in childhood and is less common than type 2.
About half of them had previously been diagnosed, and half were diagnosed due to their blood sugar readings taken during the study. China's Disease Surveillance Points system was used to identify any deaths and cause of death during the study. Disease registries and health insurance claims were used to look into diabetes-related health complications.

The researchers took the average responses from the diet questionnaires to establish how regularly people ate fruit, to account for possible changes in dietary habits.
They adjusted the figures to take account of potential confounding factors including age, age at diabetes diagnosis, gender, smoking, alcohol consumption, physical activity and body mass index. 

What were the basic results?

Only 18.8% of people surveyed reported eating fruit daily, and 6.4% said they never or rarely ate fruit. Some 30,300 people had diabetes at the start of the study, and there were 9,504 new cases of diabetes in the seven years of follow up, or 2.8 for each 1,000 people each year.

• People who ate fresh fruit daily were 12% less likely to develop diabetes than those who never or rarely ate fresh fruit (hazard ratio (HR) 0.88, 95% confidence interval (CI) 0.83 to 0.93).
• Of the people with diabetes at the start of the study, 11.2% died during follow up (16.5 for every 1,000 people each year).
• People with diabetes who ate fresh fruit on three days a week or more were 14% less likely to die of any cause, compared to those who ate fresh fruit less than one day a week (HR 0.86, 95% CI 0.80 to 0.94). They were also less likely to die from diabetes-related causes or cardiovascular disease, specifically.
• People with diabetes who ate fresh fruit daily were also 14% less likely to have complications of damage to their large blood vessels (such as heart attack or stroke) than those who ate fresh fruit never or rarely (HR 0.86, 95% CI 0.82 to 0.90). They were also 28% less likely to have small blood vessel complications, such as eye or kidney disease (HR 0.72, 95% CI 0.63 to 0.83).

How did the researchers interpret the results?

The researchers say their results "provide strong evidence in support of current dietary guidelines that fresh fruit consumption should be recommended for all, including those with diabetes."

They say that people with diabetes in China eat much less fruit than people without diabetes, because of concerns about sugar in fruit. They say the study shows that better health education is "urgently needed" in China and other Asian countries where diabetes is common, and many people misunderstand the effects of eating fresh fruit.
They speculate that "natural sugars in fruit may not be metabolised in the same way as refined sugars," although their paper did not investigate this.

Conclusion

The study findings – that eating fresh fruit every day does not raise the risk of diabetes, and may reduce it – are reassuring and in line with dietary advice in the UK. It's also helpful to see evidence that people who already have diabetes are likely to benefit from fresh fruit as well, because there has not been much research into fruit-eating for people with diabetes.
However, it's a step too far to say that fresh fruit prevents diabetes or diabetes complications. Fresh fruit is just one part of a healthy diet, and diet is just one of the things that may affect someone's risk of getting diabetes. This type of study can't tell us whether fresh fruit actually protects against diabetes, because it can't account for all the other health and lifestyle factors involved.
Though it would be expected that the results of this large scale study should be applicable to other populations, there may be differences between people from China and other populations. This could include differences in prevalence of diabetes and its risk factors, differences in healthcare (for example, diagnostic criteria and methods for coding health outcomes in databases), and other environmental and lifestyle differences, including fruit consumption.
The study didn't ask people which types of fruit they ate, but the researchers say the most commonly eaten fruits in China are apples, pears and oranges, which release sugars more slowly into the blood stream than bananas, grapes and tropical fruits.
It's important to make a distinction between whole fresh fruit, which contains lots of fibre, and fruit juice, which is very high in sugar. Previous research that we reported on in 2013 found that fruit may lower diabetes risk, but fruit juice may raise it.
The most effective method of reducing your diabetes risk is to achieve or maintain a healthy weight, through a combination of regular exercise and healthy eating.

http://www.nhs.uk/news/2017/04April/Pages/Daily-diet-of-fresh-fruit-linked-to-lower-diabetes-risk.aspx

Those with diabetes have a special need to protect their vision

From buffalonews.com

If you have diabetes – Type 1-insulin dependent or Type 2-non-insulin dependent – you may be at risk for eye disease.
It is imperative that those with diabetes get a dilated eye exam every year to check for eye health as well as overall health.
The eyes are the only place in the body that circulation can be viewed without doing an invasive procedure. Dilation “paralyzes” the focusing ability of the eye and therefore freezes the pupil open for a few hours. By doing simple dilation of the pupil, an eye doctor can view the retina and circulation. If the doctor suspects retinal damage or sees findings of diabetic degeneration, a simple angiogram can be done in an office setting to get even more details  as to what is happening in the back of the eye.
Elevated blood sugars can cause damage to eyesight that is not always reversible. At times, a special laser beam procedure can be done at an ophthalmologist’s office that can stop the damage and seal blood vessels that are leaking in the retina. It is a fairly quick procedure that leaves the vision blurry for a few hours. If the eye doctor finds damage in the retina, chances are the rest of the body may be at risk for damage as well.
People with diabetics need to take care of their health to maintain good eyesight. If diabetes is not controlled, it can cause havoc with the rest of the body as well. Good circulation is needed for a healthy body.
Maintain good eye health by performing a few simple tasks: See your doctor regularly; get blood work done every three to four months to get an overall picture of the blood sugar control, call a hemoglobin A1C test; be mindful of your diet; get regular exercise; and use your medications as directed.
Take care of your eyes. You only get one set.

http://buffalonews.com/2017/04/11/diabetes-special-need-protect-vision/

Type 2 diabetes could be prevented by switching to high-fibre diet - and THIS is how

From express.co.uk

TYPE 2 DIABETES - a condition which is a affecting a growing number of Brits - could be prevented with a diet high in fibre, experts have revealed.
A high concentration of a substance called indolepropionic acid which is produced by bacteria in the intestine protects against type 2 diabetes, a new study from the University of Eastern Finland has revealed.
Indolepropionic acid is produced by intestinal bacteria, and its production is boosted by a fibre-rich diet - which includes nuts, cereals and beans.
According to the researchers, the discovery provides additional insight into the role of intestinal bacteria when looking at diet and metabolism.
The study was carried out by experts at the University of Eastern Finland together with a large number of partners from Finnish and Swedish research institutes.

The study compared two groups participating in the Finnish Diabetes Prevention Study, DPS.
At the onset of the study, all participants were overweight and had impaired glucose tolerance.
The researchers investigated 200 participants with impaired glucose tolerance, who either developed type 2 diabetes within the first five years, or did not convert to type 2 diabetes within a 15-year follow-up.
The greatest differences in the metabolic profiles of those who developed type 2 diabetes and those who didn’t were observed in the concentrations of indolepropionic acid.
A high concentration of indolepropionic acid in the serum was discovered to protect against diabetes.
A diet rich in whole grain products and dietary fibre increased the indolepropionic acid concentration.
“Earlier studies, too, have linked intestinal bacteria with the risk of disease in overweight people,” said Kati Hanhineva, Academy Research Fellow from the University of Eastern Finland.
“Our findings suggest that indolepropionic acid may be one factor that mediates the protective effect of diet and intestinal bacteria.”
Experts said the most important lifestyle changes included weight loss, more exercise and dietary adjustments to include more whole grain products, fruits and vegetables.
Every week 4,500 people are diagnosed with diabetes across the UK.
The condition, which can be caused by being overweight and poor diet can cause blindness, limbs to be amputated and even kidney failure.
The findings were published in Scientific Reports.

http://www.express.co.uk/life-style/health/790598/type-2-diabetes-symptoms-high-fibre-diet-cure-intestine

What Are the Causes of Diabetes?

From health.usnews.com

The actual cause of diabetes depends on the type of diabetes you have. To some extent, it's not always clear to doctors what causes a patient's diabetes. Some factors that increase your risk for diabetes are outside of your control, like age and ethnicity. Still, there are ways you can lower your risk for Type 2 diabetes.

Here are the causes of Type 1 and Type 2 diabetes.

Type 1

Type 1 diabetes is considered an autoimmune disease. With an autoimmune disease, your immune system – which helps protect your body from getting sick – is engaged in too little or too much activity. In Type 1 diabetes, beta cells, which are a kind of cell in the pancreas that produces insulin, are destroyed. Our bodies use insulin to take the sugar from carbohydrates we eat and create fuel. With Type 1 diabetes, your body does not produce insulin, and that's why you need to use insulin as part of your treatment.

Type 1 diabetes has some connection to your family genes, but that doesn't mean you'll get it if one of your parents had it. "Since not all identical twins get diabetes, we do think that exposure to an additional environmental factor may trigger an immune response that ultimately causes destruction of the insulin-producing cells of the pancreas," says Dr. Sarah R. Rettinger, an endocrinologist with Providence Saint John's Health Centre in Santa Monica, California.

Researchers are still trying to understand the exact causes of Type 1 diabetes, according to the National Institute of Diabetes and Digestive and Kidney Diseases.

Type 1 diabetes is more common in children and teens, but it can also occur in adults. It often comes about suddenly. "Unfortunately, there's no way to prevent Type 1 diabetes," Rettinger says.

Type 2

Type 2 diabetes is caused by a complicated interaction of genes and the environment, Rettinger says.

"We know that there is a very large genetic component," Rettinger says. "A person with a first-degree relative with Type 2 diabetes has a five to 10 time higher risk of developing diabetes than a person the same age and weight without a family history of Type 2 diabetes." Heredity actually plays a larger role in Type 2 diabetes than Type 1, Rettinger says.
When you have Type 2 diabetes, you may start out with something called insulin resistance. This means your cells do not respond well to the insulin you are making. "Insulin levels may be quite high, especially in the early stages of the disease. Eventually, your pancreas may not be able to keep up, and insulin secretion goes down," Rettinger explains. Insulin resistance becomes more common as you put on more weight, especially weight around your belly.

"Insulin resistance is the major link to Type 2 diabetes," says Dr. Dennis Gage, an endocrinologist with Park Avenue Endocrinology & Nutrition in New York. "Stress, infection and any environmental factor that causes stress will cause insulin resistance and increase the development of Type 2 diabetes."

A growing number of people in the U.S. and throughout the world are overweight and more prone to develop Type 2 diabetes, particularly if they have the genetics for it. "Type 2 diabetes can be caused by genetic inheritance, but by far the obesity epidemic has created massive increases in the occurrence of Type 2 diabetes. This is due to the major insulin resistance that is created by obesity," Gage says.

With such a surplus of food nowadays, it's easy to overindulge without physical activity, leading to weight gain and, for some people, eventual Type 2 diabetes. "It's a lack of exercise and still eating like you're 20 years old," says Susan M. De Abate, a nurse and certified diabetes educator and team coordinator of the diabetes education program at Sentara Virginia Beach General Hospital.
However, that doesn't mean everyone who has Type 2 diabetes is overweight. De Abate says her father was always slim and a runner – and yet, he developed diabetes. "I told him, 'Your pancreas got old,'" she says.

People of certain ethnicities are also more likely to develop diabetes. African-Americans, Mexican-Americans, American Indians, Native Hawaiians, Pacific Islanders and Asian-Americans have higher incidences of diabetes, according to the American Diabetes Association.

Your risk for Type 2 diabetes increases as you get older. It also increases if you smoke. Although smoking doesn't cause diabetes per se, the negative effects on your health are enough to make it more likely that Type 2 diabetes will occur if you have the other risk factors. "We try to be aggressive with smoking cessation, in particular in patients with diabetes," says Dr. Asha M. Thomas, an endocrinologist with Sinai Hospital of Baltimore.

Type 2 diabetes is more common in adults, but younger people can get it too. "There's a rate in children that's growing by leaps and bounds," De Abate says. That also ties in with trends in unhealthy eating and lack of exercise.

Type 2 is also the most common type of diabetes, accounting for about 90 percent of all diabetes cases, the World Health Organization reports.

The good news is that you play a role in helping to prevent Type 2 diabetes. "Reducing carbohydrates and total calories combined with exercise of 150 minutes or greater per week are recommended as a prevention for Type 2 diabetes," Gage says.

"Poor diet, weight gain and a sedentary lifestyle – these are largely within our control," Thomas says.

As always, talk to your doctor if you think you may have diabetes. He or she can help check your blood sugar levels and provide a correct diagnosis. If your blood sugars indicate you have prediabetes – a condition that occurs before Type 2 diabetes – you should be extra vigilant in making changes for healthier living.

http://health.usnews.com/health-care/patient-advice/articles/2017-04-11/what-are-the-causes-of-diabetes

Pork Tacos Topped With Fries: Fuel For Mexico's Diabetes Epidemic

From npr.org

Anais Martinez is on the hunt in Mexico City's Merced Market, a sprawling covered bazaar brimming with delicacies. "So this is the deep-fried tamale!" she says with delight, as if she'd just found a fine mushroom specimen deep in a forest.
The prized tamales are wrapped in corn husks and piled next to a bubbling cauldron of oil.
"It's just like a corn dough patty mixed with lard, put in a corn husk or banana leaf, steamed and then deep fried," says Martinez of this traditional Mexican breakfast. "And then after you fry it, you can put it inside a bun and make a torta [sandwich] out of it. So it's just like carbs and carbs and fat and fat. But it's actually really good."
And it only costs 10 pesos — roughly 50 cents.

Martinez is a designer in Mexico City. She studied gastronomy here and now moonlights for a company called Eat Mexico giving street food tours.
Deeper in the market there's an area packed with taco stalls. Customers stand at the counters or sit on wobbly plastic stools. The young cooks fry, flip and chop various meats into tortillas. They pound strips of flank steak out on wooden cutting boards. Piles of red chorizo sausage simmer in shallow pools of oil. Yellow slabs of tripe hang from meat hooks.

We've just come to one of Martinez's favourite taco stands. Its specialty is pork tacos served with french fried potatoes piled on top.
"The pork is really thinly sliced, rubbed with chillis and spices and then they fry it," Martinez says as the meat sizzles on a long steel griddle in front of her. "Also, really good."
Rich, fatty street food like this is available all over Mexico — at bus stops, at schools and on street corners. And it's affordable to the masses. A heaping plate of Martinez's favourite pork tacos costs less than a dollar.
All that cheap food — in a country where incomes are rising — is contributing to Mexico's massive diabetes epidemic.
Diabetes is now the leading cause of death in Mexico according to the World Health Organization. The disease takes an estimated 80,000 lives each year. Nearly 14 percent of adults in this country of 120 million suffer from the disease — one of the highest rates of diabetes in the world. And it's all happened over the last few decades.
For roughly $2 a day, people in Mexico can now afford a diet heavy in carbohydrates, sugar and fat that delivers way more calories than the WHO's recommended daily intake of 2,000. A study in 2015 showed Mexico to be the leading consumer of junk food in Latin America, consuming 450 pounds of ultra-processed foods and sugary beverages per person each year.
Until just recently Mexico was the largest per capita consumer of soda in the world, chugging down 36 gallons of sugary drinks per person per year. That dubious distinction now falls to Argentina, with the U.S. and Chile not far behind.
Excessive body fat is one of the main contributors to the onset of Type 2 diabetes. And obesity rates have been climbing steadily in Mexico. It's now one of the world's most overweight countries, coming in just behind the United States.
Mexican health officials are well aware of the crisis. Late last year, the health minister declared diabetes and obesity to be public health emergencies — the first time they'd made such a declaration that wasn't targeting an infectious disease.
"Diabetes is one of the biggest problems in the health system in Mexico," says Dr. Carlos Aguilar Salinas at the National Institute of Medical Sciences and Nutrition in Mexico City. "It's the first cause of death. It's the first cause of disability. It's the main cost for the health system."
Treating a patient with a severe case of diabetes in Mexico, he says, can cost upward of $40,000 a year. But the bigger problem, Aguilar says, is that the Mexican health system isn't prepared to treat the sheer number of diabetes patients with serious medical complications who show up in its clinics every day.
"The Mexican health system is very efficient to treat infectious disease," he says. But chronic disorders like diabetes, which require lifelong attention and medical monitoring, call for a different skill set from doctors. And Mexico's health system is still adjusting to this shift toward treating chronic disease.
Recognizing how daunting it is to treat diabetes, Mexican officials are trying to prevent it in the next generation. In 2014 the country slapped a controversial 5 cents per litre tax on soda. New rules bar advertisements for high calorie junk food aimed at children. Public service announcements encourage people to exercise more. And there's a major push to restrict the sale of soda and junk food in schools.
The head of the World Health Organization's office in Mexico, Dr. Gerry Eijkemans, says diabetes is a huge challenge to health care systems throughout Latin America.
"Diabetes used to be a disease of the rich," she says. "In Western Europe and the U.S., it was really the people who had the money who were obese, and now it's actually the opposite."
This is forcing already overstretched public health systems in Latin America to devote more resources to this complex disease.
"In order to prevent an infectious disease, you reduce the mosquitoes and basically you're done," Eijkemans says. "Not that it's easy, but it's much easier than changing a lifestyle, changing the way a society is basically organized [to encourage] people to consume unhealthy food with lots of fat and sugar."
An article earlier this year in the medical journal The Lancet warned: "Rising levels of increasingly severe obesity mean that, worldwide, populations are on the brink of a catastrophic epidemic of diabetes."
In Latin America, Mexico isn't on the brink of that epidemic, it's already there.

http://www.npr.org/sections/goatsandsoda/2017/04/08/522184483/pork-tacos-topped-with-fries-fuel-for-mexicos-diabetes-epidemic