Cocoa compound has potential to combat diabetes

From newatlas.com

Diabetics are often warned against the dangers of eating too much chocolate. But it turns out that one of the treat's major components might be just the thing to help keep the disease at bay. Researchers at Brigham Young University (BYU) have isolated a compound in cocoa that could help fight type-2 diabetes by pushing certain cells to become insulin powerhouses.
Inside the pancreas are intriguingly named regions known as the islets of Langerhans. It is in these regions where the body's beta cells reside. These specialized cells are responsible for secreting insulin – the hormone that regulates blood sugar levels – directly into the bloodstream when there is a spike in glucose. Beta cells also secrete a hormone called Amylin, which puts the brakes on the amount of glucose entering the bloodstream. In type-2 diabetics, however, the beta cells malfunction and are not able to do their jobs effectively.
What the BYU researchers discovered is that compounds found in cocoa called epicatechin monomers were able to increase the ability of beta cells to secrete insulin.
In their study, they placed mice on a high-fat diet. Then they gave the animals the cocoa compound. They found that the epicatechin monomers not only helped the rodents better deal with elevated blood glucose levels, but it also decreased the extent of their obesity. The effect, they concluded, has to do with the compound's action on the mitochondria inside beta cells. Mitochondria are specialized structures inside cells that convert oxygen and nutrients into ATP, a small molecule used to transfer energy throughout the body.
"What happens is it's protecting the cells, it's increasing their ability to deal with oxidative stress," said study author Jeffery Tessem, assistant professor of nutrition, dietetics and food science at BYU. "The epicatechin monomers are making the mitochondria in the beta cells stronger, which produces more ATP, which then results in more insulin being released
Of course, this isn't the first time we've seen the health benefits of chocolate components emerge in a study. Scientists have previously found out that dark chocolate can help feed the good bacteria in our gut to produce anti-inflammatory compounds; that the flavonols found in chocolate could ward off age-related memory decline; and that higher consumption of the treat has been linked to lower body fat levels. They've even previously shown that it plays a role in reducing diabetes as well as reducing cardiovascular disease and lowering the risk of stroke.
In this study, though, the researchers are quick to point out that the benefits from the cocoa compounds are likely not to be had simply by eating copious amounts of chocolate.
"You probably have to eat a lot of cocoa, and you probably don't want it to have a lot of sugar in it," said study author Jeffery Tessem, assistant professor of nutrition, dietetics and food science at BYU. "It's the compound in cocoa you're after."
Neilson adds that the findings could, however, lead to new supplements that might be quite useful.
"These results will help us get closer to using these compounds more effectively in foods or supplements to maintain normal blood glucose control and potentially even delay or prevent the onset of type-2 diabetes," he said.
The study has been published in the Journal of Nutritional Biochemistry.

http://newatlas.com/cocoa-compound-diabetes/51087/

Research claims a third of people with type 2 diabetes are sexually dissatisfied

From diabetestimes.co.uk

One in three people with type 2 diabetes are sexually dissatisfied and almost two-thirds of these people report a need for help, new research has found.
Researchers now believe a simple screening checklist could be used to proactively identify sexually dissatisfied people in primary care.
The study, published in the Journal of Diabetes and its Complications, looked at data collected in 45 general practices in the Netherlands from January 2015 to February 2016. The Brief Sexual Symptom Checklist (BSSC) was used to screen a total of 786 men and women with type 2 diabetes aged between 40 and 75.
The prevalence of sexual dissatisfaction was 36.6 per cent, significantly higher among men than among women (41.1 per cent vs. 27.8 per cent). Sexually dissatisfied men most often reported erectile dysfunction (71.6 per cent); for sexually dissatisfied women, low sexual desire (52.8 per cent) and lubrication problems (45.8 per cent) were most common. More than half of all dissatisfied people had a need for care (61.8 per cent), significantly more men than women (66.8 per cent vs. 47.2 per cent).
The researchers concluded: “Sexual problems are one of the most frequently neglected complications in diabetes care. The use of a screening instrument could facilitate the identification of people in need for help, while simultaneously lowering the threshold for both patients and care professionals to discuss sexual issues in daily practice.  The BSSC could be used as a tool to proactively identify sexually dissatisfied people in primary care.”

http://diabetestimes.co.uk/research-claims-third-people-type-2-diabetes-sexually-dissatisfied/

Living With Type 1 Diabetes: How Our Loved Ones Really Feel

From diabeteshealth.com

With years of type 1 diabetes under my belt, 22 to be exact, I wanted to know how my husband felt about my health issues. This is especially important to me now that we’ve spent the last few years with my downward health spiral because of undiagnosed celiac disease. I know he’s supportive. He tries to make sure I’m happy and healthy though sometimes it is beyond our control. Here are my questions and his answers:

Do you ever feel helpless with my health issues?
No. We’re not helpless beings. You are not helpless. We figured out your gluten issue mainly on our own. We can figure things out together.
How hard were the last few years for you with all the weird celiac symptoms on top of my diabetes and no real answers from my medical team?
Without them knowing what it was, with you going to the doctor and not knowing what was wrong–it was crap. It’s frustrating to go to the doctor and not have them know anything, not to have them test everything. It was sad seeing you feel so bad for so long.
When it comes to my diabetes, what was the scariest moment for you?
I was scared most when you were in the hospital because of the flu, almost 16 years ago. You weren’t taking care of your blood sugars the correct sick-day way, and you ended up so high. You were in Intensive Care, and the hospital kept making mistakes, even disconnecting your insulin drip. Then you ended up with an infection and ended up back in the hospital. It was all scary. But then you learned how to take care of sick-day blood sugars, and now it doesn’t worry me so much.
Do you fear the future?
No. It’s pointless. The future is the future, and it is inevitable.
How do you feel about those diabetes ads or newscasts where they get everything wrong? Example: Cinnamon cure, anyone?
They are just stupid, and it doesn’t bother me as much as it bothers you. It’s just people being uneducated and misunderstanding diabetes.
One of my biggest fears is losing my health insurance. What would you do if I lost my health insurance plan?
Run away. Just kidding! (Laughs) We would just have to deal with it as best we could.
What would you do if I needed help with my diabetes?
Refer to my last answer. Hahaha, no, of course, I would help you.
Do you think there will ever be a cure for diabetes?
Yes, I’m hopeful. (Loud sigh) I just watch the world spend billions of dollars on senseless causes and almost nothing on diabetes research and cancer research and the things that kill people. That really upsets me.
What would you fear most about my diabetes?
I’d have to say the collapse of civilization. Being unable to help you without the medical community would be my biggest fear.
How do you feel about unwelcome food comments from the diabetes police?
Food shaming? That’s awful. People are so quick to critique others. People need to mind their own business.
Thank you. I love your honesty.

https://www.diabeteshealth.com/68751-2/

Cut the rice, cut risk of diabetes

From star2.com

One of my favourite meals as a child was a simple one, common across South-East Asia – rice with fish and a vegetable dish on the side, such as kangkong. Varieties of this dish are traditional here, as in Nasi Lemak, although I am partial to Nasi Dagang.
Rice is central to these dishes. Look at the names: the very first word is nasi (rice). What would they be without rice?
For many of us, myself included, rice is comfort food. As a child, I’d be content with a bowl of steaming hot rice with a bit of butter and salt. In sickness, what do many of us eat? Rice porridge.
My travels have given me a taste for all kinds of ethnic and exotic foods, yet my penchant for rice persists. After a few days, I yearn for rice. That’s how, when travelling in Peru, I discovered Chinese Peruvian fried rice, a popular meal there.
My love of rice is definitive of my Asian heritage. Rice has been a much-loved staple food in the region for more than 5,000 years. I always considered it a special grain. It is after all, a common first food for babies everywhere because it rarely causes allergies.

But now, I consider rice the Achilles heel of the Asian diet.
Studies show a link between high regular consumption of white rice with type 2 diabetes. It’s a “unique risk factor” in Asian populations, says Dr Frank B. Hu, professor of nutrition and epidemiology at the Harvard T.H. Chan School of Public Health.
Rice is a driving factor behind Asia’s escalating epidemic of type 2 diabetes.
A 2012 study by Harvard researchers found that the risk of developing diabetes rises by 10% with every extra serving per day of white rice.
The study looked at what people ate in Japan and China, where three or four servings of white rice per day was the average, and in Australia and the United States, where less than five servings a week was the average.
So it’s not simply that we eat rice, it’s that we eat a lot of it, and often. What you’re eating the rice with also matters, and importantly, what kind of rice it is.
White rice is a relatively modern invention – it is brown rice milled and stripped of the outer hull, fibre and bran. The problem lies in the refining of rice. (Other refined, starchy carbohydrates would also carry a risk for diabetes, researchers say).

On the glycaemic index (GI), a scale of 1 to 100 that measures how foods cause your blood sugar to spike (with sugar at 100), white rice ranks high. Jasmine or Japanese (sushi) rice has a GI of almost 90; Basmati is much lower at 59; some parboiled rice is even lower and brown rice is 55. Sticky rice has a very high GI because it contains more of a certain carbohydrate (amylopectin rather than amylose).
The Harvard study found brown rice actually decreases the risk of diabetes by 16%.
My great-grandmother, who lived till 99 years in Sri Lanka, always ate red rice, which is similar to brown rice but has more vitamins. She was also very active.
“In the old days, when people spent a lot of time working in the fields, consuming a lot of white rice was not a problem,” explains Dr Hu.
“When people become sedentary and overweight, consuming a large amount of refined carbohydrates like white rice becomes problematic in terms of raising the risk of diabetes and other metabolic diseases.”
Asians actually have a higher risk for diabetes – they develop the disease at younger ages and at lower degrees of obesity than Caucasians.
The high intake of rice and sugar, particularly sweetened drinks, in the region, and the large number of men who smoke, has led to diabetes skyrocketing in the region in recent decades. Consider: in 1980, less than 1% of Chinese adults had diabetes; now that figure is about 12%, according to the International Diabetes Federation.
Asia is now the epicentre of the world’s diabetes epidemic. In Malaysia, prevalence runs at 18%; but among adults older than 30 years, it’s one in five.
We seem to be immune to such statistics. Interestingly, when Singapore’s Health Promotion Board targeted white rice in the island’s fight against diabetes, it caused an uproar.

I now take smaller rice portions and try to eat Basmati or red rice. But when eating out, it’s hard to avoid rice.
Researchers at a university in Shanghai are currently looking to breed a kind of black rice with normal rice, in order to create a high-protein rice lower in carbohydrate.
For now though, we need to cut back on the rice. For sure, we should think twice about having that extra portion.

http://www.star2.com/living/viewpoints/2017/08/27/cut-rice-intake/

Diabetes and pregnancy clinical guideline published

From diabetestimes.co.uk

A new guideline covering the management of glycaemic control in pregnant women with diabetes has been released.
The Joint British Diabetes Societies for Inpatient Care (JBDS–IP) has published the document to support existing processes in acute trusts providing care to pregnant women with diabetes admitted to hospital.
The guideline, Management of glycaemic control in pregnant women with diabetes on obstetric wards and delivery units, is the latest in the series of JBDS-IP guidelines developed to improve the standards of care for people with diabetes in secondary care.
Neonatal hypoglycaemia continues to affect up to 30 per of babies with the risk of impaired neurologic development of the child, but effective control of maternal glucose during pregnancy, delivery and birth has the potential to reduce this complication.
NICE has already produced evidence-based guidelines on the target blood glucose which should be maintained. The JBDS guideline attempts to provide a standardised template by which these targets can be safely and effectively achieved. Pregnant women are at higher risk of DKA and its adverse consequences. The guideline also provides a standardised protocol on how to recognise and treat DKA in the special situation of pregnancy.

Dr Umesh Dashora, Lead, Diabetes and Endocrinology, East Sussex Healthcare NHS Trust and senior lecturer, Brighton and Sussex Medical School, was one of the lead authors.He said: “Managing diabetes during delivery and while giving steroids for prematurity can be quite difficult. DKA may have significant adverse consequences for the mother and the baby in pregnancy. This guideline will help standardise management in these difficult clinical situations and help achieve NICE suggested glycaemic control targets.”
The other lead authors were Dr Rosemary Temple, consultant diabetes and Endocrinology, Norfolk and Norwich University Hospitals NHS Foundation Trust, as well as Professor Helen Murphy, Professor of Medicine (Diabetes and Antenatal Care), Norwich Medical School University of East Anglia and Honorary Consultant Addenbrooke’s Hospital Cambridge.

The guideline has been produced by JBDS-IP on behalf of Diabetes UK, the Association of British Clinical Diabetologists (ABCD) and the Diabetes Inpatient Specialist Nurse (DISN) UK Group.
As with all of the JBDS-IP documents, this guideline is dynamic and will be reviewed in response to feedback with a view to incorporating emerging evidence.
To download the guideline, click here.

http://diabetestimes.co.uk/diabetes-pregnancy-clinical-guideline-published/

Tips for Travelling with Diabetes

From mydario.com

Travelling with diabetes can be difficult, but there are some important tips that can relieve the stress and make the whole process a lot easier.

Vacations are a great stress reliever, and even a short few days away can be helpful to calm the mind and recharge your batteries. It is well known that stress can increase blood sugars, so if you can get away for even a few days, go for it! When traveling with diabetes, here are some helpful tips to make your journey safe.
Nowadays, many of our vacations require a flight. While air travel is extremely convenient, there are some things to keep in mind when flying with diabetes.

1. Make sure to have your medications/supplies clearly labelled; preferably with a pharmacy label and physician name visible.
2. Never pack needed medication in checked luggage. Insulin is unstable with extreme temperature changes; as are other injectable medications. In the case of lost luggage, you will have no quick access to your medicine if you pack it in your checked baggage.
3. Let airport screeners know you have diabetic supplies in your carry-on when going through security. If you have a pump, there should be no need to “”
4. Most insulin pumps should be fine going through a security scanner. Check with your pump manufacturer to make sure.
5. Always take extra supplies with you when traveling in the event of travel delays. I suggest taking an extra week’s worth of medication when traveling, just to be safe.
6. If you are using an insulin pump, it may be affected by sudden changes in air pressure, especially during take-off. This can sometimes cause inaccurate doses of insulin to be delivered. Some pump manufacturers may suggest disconnecting a pump during take-off. Check with your own health care provider and refer to your pump’s specific instructions for use for more explicit instructions.
7. Use a carry-on cooler or cold pack to keep insulin and refrigerated items from getting too warm.

Besides safety on a plane, there are some other tips to keep in mind, even for short, weekend trips away from home.

1. If you are traveling within the US; bring extra prescriptions if possible in the event you lose or misplace your medication.
2. Make sure to ask your hotel if there will be a refrigerator available in your room to safely store your medication.
3. Inform your pharmacist at home that you will be away and check with them if they can mail you medications in an emergency scenario.
4. Make sure to bring an adequate supply of snacks and/or glucose tablets.
5. Always wear medical ID.
6. Pack at least one extra glucose meter with you.

Traveling is a wonderful way to relax and spend quality time with your family and friends. Being prepared is the best way to avoid any unnecessary stress. Also, you should understand that when you travel, you may not always have access to the healthiest foods. Don’t beat yourself up over an occasional blood sugar reading that seems out of range!
So, pack your bags and enjoy yourself!!

http://mydario.com/tips-for-traveling-with-diabetes/

Sex With Diabetes: Women’s Awkward Bedroom Questions, Answered

From everydayhealth.com

Diabetes affects nerves and blood vessels throughout your body, but its impact on sexual health might come as a surprise. For some women with diabetes, the concern may not even come up during regular check-ups, but it’s important to speak up if your symptoms are getting in the way of your sex life.
“Just like if you had any other health issue, it’s totally justifiable to talk to your healthcare provider about [sexual health]," says Susan Davis, PhD, bachelor of medicine and bachelor of surgery, a professor of women’s health at the School of Public Health and Preventative Medicine at Monash University in Melbourne, Australia, and president-elect of the International Menopause Society.

According to a review published in April 2013 in The Journal of Sexual Medicine, female sexual dysfunction occurs more frequently in women with diabetes than in women without diabetes. “It’s really important to destigmatize the ability of women to talk to their doctors about what’s bothering them,” says Dr. Davis.

Before voicing your sexual concerns to your provider, here are some of the fundamental underlying reasons why diabetes may affect you down there.

Why Is It More Difficult to Become Aroused?

Arousal and achieving an orgasm are tied to both nerves and blood vessels in the vagina and genital area, says Davis. High blood glucose can damage nerves and cause peripheral neuropathy, which can affect everything from your fingers to your toes to your genital area. “Sensation to touch can be diminished, and that clearly is going to affect sexual response,” she adds.
In addition to neuropathy, women with diabetes are more likely to have blood vessel damage than those women without the disease. This damage can impact the amount of blood flowing to your vagina and genital area. Less blood flow could affect your arousal and orgasms, says Davis.
She compares this phenomenon to erectile dysfunction (ED) in men, which is more common in men with diabetes than men without diabetes, and points out that although this issue hasn't been as well studied in woman as ED has been in men, it's still a genuine concern for women. In a small study published in June 2015 in The Journal of Sexual Medicine, researchers found differences in the physiology of vaginas (including blood vessels) in women with type 2 diabetes.
Keeping blood glucose in your target range may help protect your nerves and blood vessels, as well as prevent complications of diabetes. If you’re having difficulty with arousal or orgasm, ask your provider about whether any medication you currently take could be a contributor, says Davis. In particular, blood pressure medication can affect blood flow, and antidepressants can dampen sexual desire, she adds. Although you shouldn’t stop taking these drugs on your own, consider bringing up these side effects with your provider.

Why Is Intercourse Sometimes Painful?

Women with high blood glucose are more prone to vaginal infections, which might make sex uncomfortable or have the unwanted side effect of discharge. Both of these could get in the way of sex, says Neil Goodman, MD, an endocrinologist in Miami and cofounder of the reproductive medicine committee for the American Association of Clinical Endocrinologists.
Yeast infections occur because these bacteria thrive under high blood glucose in the vagina and aren’t detected by the immune system. “Every woman can have yeast in her vagina,” says Dr. Goodman, “but because of all of the other problems with diabetes, the yeast can take over a bit and overgrow, leading to infection.” Yeast infections can be treated with anti-fungal medication, including pills and creams, says Goodman. Keeping your A1C on target can also help prevent these infections.
Davis says that during menopause — when estrogen is low — thinning and dryness of the vagina can increase the risk for yeast infections. This thinning and dryness, which is called vaginal atrophy, can make sex uncomfortable, too. Tell your doctor if you find intercourse uncomfortable or painful. Davis recommends asking about vaginal estrogen therapy, which can come in the form of a topical cream or an inserted ring and may reduce the risk of infections, ease urinary incontinence, and alleviate vaginal dryness.

Why Isn’t My Sexual Desire Stronger?

Goodman says women with diabetes can have irregular menstrual cycles, and those changing hormones can affect mood, energy, and fatigue. In turn, these feelings could affect sexual desire.
Lack of sexual desire is like a jigsaw puzzle, says Davis, and is impacted by your relationship with your partner, workplace stress, family stress, financial concerns, past history of sexual abuse, fatigue, and changes in weight and body image, which can affect how comfortable you feel being in the nude. Even simple things like privacy to be intimate in your home with children sleeping in the next bedroom can affect desire. “It’s not usually one thing that fixes everything,” she adds. “You’ve got to really take a long, hard look at your situation.”
Medication options for low sexual desire in women are limited. Although doctors sometimes prescribe testosterone off label, the Food and Drug Administration (FDA) has not approved this therapy for use in women. Davis notes that Addyi (flibanserin), which was approved by the FDA in 2015 to help treat low desire in premenopausal women, might not be appropriate for women with diabetes because one of the side effects is fainting — something that could be problematic for patients prone to hypoglycemic episodes. Plus, the efficacy is marginal, she adds.
Goodman says he’s seen his patients have the most success seeking a specialist in sexual counselling. He also says that tuning into sexual desire comes down to patience and communication between partners: “A lot of couples have trouble talking to each other about sex.” Tactics might include telling your partner how you like to be kissed or touched. Goodman says decreased sexual desire is not unique to women with diabetes, and that it can affect all women.
But he points out that women with diabetes may be dealing with more health issues than women without diabetes — and that this can affect desire.

How Do I Talk About Sex With My Healthcare Provider?

“Women should not be embarrassed or ashamed to speak to their doctor about this, if they feel that their ability to become aroused or achieve orgasm has changed,” says Davis.
Davis says that she’s had patients tell her that their doctors have been dismissive of their sexual concerns because of misconceptions about women not being sexually active in their sixties and beyond, particularly during and after menopause. If your provider rebuffs you or he doesn’t feel comfortable addressing the issue, don’t be discouraged. “You should identify someone on your [diabetes] management team who you can talk to,” says Davis.

https://www.everydayhealth.com/type-2-diabetes/living-with/sex-with-diabetes-womens-awkward-bedroom-questions-answered/

Here's Exactly What I Ate To Cure My Type 2 Diabetes & High Cholesterol

From prevention.com

Mary Jenkins is 51 and lives in Kanab, Utah. Last December, before starting her new diet, she weighed 225 pounds. She has since lost 50 pounds—and the weight is still coming off. This is her story.
I was born in Charlotte, North Carolina, so I lived off a Southern-fried diet for most of my life. As a result, I had extremely high blood pressure for over 30 years. I tried every eating plan out there to get it under control: low-carb diets, high-protein diets—all that stuff. None of it worked for me. I was still obese, and my cholesterol levels didn’t improve.
Then two years ago, my doctor ordered an A1C test. He had a hunch I may have type 2 diabetes as a result of my weight. My score was a seven, which meant his suspicions were correct. (A normal A1C level is below 5.7. ) It got worse: Because I’ve had high blood pressure for so long, he said I could have long-term organ damage now that I also had diabetes. You’d think at that point, he would have sat me down and talked to me about how I could improve my diet, but he didn’t. He just said something like, “Watch your carbs and exercise.” That was it. So I basically kept living as I had before.
Then my doctor moved away, and I found another doctor in a larger town nearby. My new physician told me that I needed to go on metformin (the generic name for a drug used to treat high blood sugar levels) immediately. He also told me that I should ramp up my exercise routine. So last year, I started hiking and rock climbing with my neighbour, who happens to be a yoga instructor. I’m just a regular gal who sits at a desk all day, so this was not serious rock climbing or anything. But still, with the help of my new workout buddy, I lost 10 pounds. It felt great to be making progress, and my neighbour even started calling me “the amazing disappearing woman.” I have to admit it was a big ego boost.
I thought my doctor would praise my progress, too, but at my next appointment, which was this past December, he told me that my blood pressure was still too high. He said, “If you don’t make drastic diet changes, I’m going to send you to a nephrologist because your kidney function is very poor.”
That terrified me. I lost my pastor to kidney disease, and I knew it was a terrible affliction. So I Googled 'What do you eat to improve kidney function?’. I found information on the DASH (Dietary Approaches to Stop Hypertension) diet, which is the diet recommended by the National Heart, Lung, and Blood Institute for lowering blood pressure. In 30 years, no one had talked to me about a dietary approach to lowering my blood pressure. I started reading about it, and I thought, if it didn’t work, no harm no foul. I decided to start my new diet on January first, because everyone else starts their goals then, right?

My diet & exercise routine
The DASH diet is all about portion control and eating less fat, sugar, and salt. I bought smaller plates, spoons, and cups to make sticking to the plan easier. I also got smaller storage containers marked with various serving sizes so I could eat out of them and keep my portions in check.
I also posted to Facebook to let my friends know what I was doing and started keeping a food diary. These things helped keep me accountable—and continue to do so to this day.

On the DASH website, I also found and printed out this shopping list that provides a list of foods that fit into the diet. I took it with me to the grocery store and stocked up on everything I needed—which took me three long hours. (Thinking back on that now, it’s actually a bit humorous. Shopping is far easier for me now that I’ve been eating this way for nearly a year.) I bought lots of healthy grains, fruits and vegetables, and low-fat yogurt. I cut out cow’s milk and started using almond milk instead. I switched from processed peanut butter to natural almond butter.
I also started preparing most of my food myself, which is something I hadn’t done before. I’d always eaten out or bought ready-to-eat stuff. I found new things that I liked, and many were things I’d never eaten before. For example, I’d never had steel-cut oatmeal. As a Southern gal, I’d only had grits. I started eating strawberries and raspberries. I had never had asparagus or Brussels sprouts, but I started adding them to my shopping cart. I also began buying fresh meat and making grilled chicken or pork with cauliflower rice. (Which, by the way, is so good!)
I also started walking. Every two hours, I would walk for 10 or 20 minutes or even an hour. It didn’t really matter how long, it was just to get up out of my chair and move. I’d already proven I could hike and do more challenging forms of exercise, so walking seemed like a smaller task that would help me get healthier.

Photograph courtesy of Mary Jenkins

The reward
Come March 1st I had my next doctor’s appointment, and I was excited to see the changes. I don’t have a scale at home; I refuse to buy one. So it had been three months since I’d seen the doctor, and two months since I’d started the diet, and he said I’d lost 33 pounds. He was in shock. And not only that, he told me that if I stuck with it, I could reverse my diabetes. I was determined to make it happen.
Two months later I had another appointment. I found out that I had lost an additional 20 pounds. He also shared the most amazing news with me: I didn’t have diabetes anymore! My A1C was 5.3, down from 7. My blood pressure was also down to 115 over 30—healthy numbers I haven’t seen since I was 21 years old. I felt ecstatic, but also relieved.
Even though my health has improved, I haven’t stopped my medications; that's not what my journey is about. With my long-term blood pressure issues, there’s no way to tell what harm’s already been done, so I need to continue taking them.
My doctor is shocked I’ve maintained my good health and weight loss for so long. He told me he doesn’t care if lose another pound; he just doesn’t want me to put weight back on. “You have made too much progress to go back,” he said. And I agree. I want to do everything I can to maintain my newfound health for the rest of my life.

How you can improve your diet, too
People will say, “I don’t have money to start one of these diets.” But don’t let that excuse hold you back. I shop for food at Walmart, and I promise that you don’t have to spend a lot on groceries. Just follow a healthy shopping list and find ways to keep your portions reasonable. One way I do this is by asking the butcher to cut things into really small portions. This way I don’t have to spend time measuring as many things at home, and I can cook only what I should be eating in one sitting. You just have to figure out what strategies work for you, and not let anything stand in your way.

https://www.prevention.com/health/diet-to-cure-diabetes-and-high-cholesterol

Is This Fruit a Diabetes Super-food?

From mydario.com

Did you know that avocados aren’t vegetables? In fact, they are fruits and technically are considered berries. Despite the fact that they are native to southern Mexico, avocados can be found all over the world and are grown in various different climates.
That’s because they are one of the world’s most-loved fruits. They make a great addition to any meal or can be eaten as a snack all by themselves.
But besides being a super-versatile food that can mix with all kinds of cuisine, avocados are also considered a superfood because of all the health benefits they pack in their creamy, green filling.
This superfood (or should we say super-fruit) is extremely rich in fibre, encourages weight loss, is known to help reduce high blood pressure and triglycerides, and is naturally gluten-free, dairy-free, and vegan-friendly! The best part of all, some of the above are diabetes risk factors which is why the fruit has been coined an “antidiabetic” powerhouse.
Here are six reasons why avocado is fool-proof fare for those living with diabetes:

1) They Are Extremely Rich in Nutrients

There’s no doubting that avocado is one of the tastiest additions to include in your cooking. But besides its thick, creamy, and tangy texture, there are some serious sources of nourishment packed inside.
Avocados are full of potassium, phytosterols, zeaxanthin, and fibre. In fact, avocados are so full of fibre that they are by far the most fibre-packed fruit you can find in the supermarket. Each avocado contains around 10 grams of fibre; that’s five whopping servings of both insoluble and soluble fibre!

These nutrients have a positive effect on the body and a beneficial impact on your blood pressure, blood lipid profiles, and inflammatory stress. The fruit is also a serious source of a variety of vitamins (B5, B6, C, E, and K), folate, and niacin.

2) They Fill You Up and Don’t Leave You Hungry

Thanks to the amount of fibre they contain, avocados are super satiating. By including them in a meal – whether it be a salad, sandwich, or a snack all on their own – avocados help us leave the table gratified, reducing the chances of snacking on less-healthy food later in the day.

3) They are Light on Sugar

You may be thinking that since avocados are considered fruit, they are probably full of natural sugars that are likely to send your blood glucose level soaring. In fact, the berry is super-light in naturally occurring sugars. In 100g of avocado, there are only 0.9g of sugar, of which only 0.1g comes from sucrose. If that’s not a diet-friendly fruit, we don’t know what is!
And remember that fibre we talked about before? It helps slow blood sugar absorption so even the small amount of fructose that is found in avocados enters the bloodstream relatively slowly, helping maintain stable blood glucose levels and preventing severe peaks and dips.

4) They Contain Fat, Good Fat

People that watch what they eat tend to stay away from foods that have elevated levels of fat. But did you know there are actually multiple kinds of fat? Saturated fat and trans-fat are unhealthy fats that you should try to avoid, but unsaturated fat is a healthy fat that can help you reduce your cholesterol levels. And guess what? Avocados are full of unsaturated fat.
Over 75% of the fat in avocados is good fat and a 50g serving of avocado contains 5 grams of monounsaturated fat and 1 gram of polyunsaturated fat. Besides being good for your heart, these fats may actually help diabetes patients control their blood-sugar and insulin levels. In addition, avocado oil (just like olive oil) is full of oleic acid. This monounsaturated fatty acid is associated with decreased inflammation and can help prevent the onset of many diseases.

5) They Help You Shrink Your Belly

Believe it or not, studies have shown that high-oleic oils like those found in avocados may even help you lose weight. According to a study from Penn State, participants that ate 3 tablespoons of high-oleic oil per day over a period of four weeks were able to decrease their belly fat by 1.6 percent. What could be better than reducing your belt size by eating this rich and tasty fruit?

6) They Are Nutrient Absorbers

Thanks to all the good fat that avocados supply, fat-soluble nutrients are more readily absorbed into the bodies of those that eat the fruit. The berry provides lutein, zeaxanthin, alpha- and beta-carotenes, and tons of other antioxidants which can help protect your vision, soften your skin and moisturize your hair.

What is the Glycemic Index of Avocados?

If you are a diabetes patient, you may be asking yourself, “What’s the GI of avocados?” Interestingly enough, there are so few carbohydrates in avocados that they have no official glycemic index value.
So, what does that mean for those of us who are living with diabetes and want to know the glycemic index of each and every piece of food we put in our bodies? Well, the American Journal of Clinical Nutrition puts avocado in a group of foods that “contain little or no carbohydrate.”
According to the group, “it would be exceedingly difficult for people to consume a portion of the foods containing 50g or even 25g of available carbohydrate. Even in large amounts, these foods when eaten alone are not likely to induce a significant rise in blood glucose.”
We know it sounds complicated, but just remember that in practice, avocado is a low-glycemic food and can be readily enjoyed by diabetes patients trying to limit the effects of different foods on their blood glucose levels. Woohoo!
There you have it: this buttery, green berry is the perfect match for all of your meals. Not only are they super tasty and fun to eat, avocados are a nutrient-packed food that could help you keep your diabetes under control. Be sure to incorporate avocado into your diet and keep an eye out for interesting recipes containing this diabetes superfood!

http://mydario.com/diabetes-superfood/

One Idahoan with Type 2 diabetes turns to exercise, another to chicken-fried steak

From idahostatesman.com

Dwayne Kluchesky’s symptoms developed suddenly. First, unquenchable thirst.
“I couldn’t get enough water,” he said.
He lost weight dramatically, which was odd. He had weighed more than 250 pounds, didn’t exercise and wasn’t dieting.
Kluchesky had seen those symptoms before, in his mother. And he was pretty certain they spelled diabetes. But he went to see his doctor anyway.

Read more here: http://www.idahostatesman.com/news/state/idaho/article168248587.html#storylink=cpy

That visit six years ago confirmed his suspicions with a diagnosis of Type 2 diabetes. His blood sugar level was in the 300s — far above the 80-130 that the American Diabetes Association advises before meals, and the 180 recommended for an hour or two after.

 “Mine was super, super high,” said Kluchesky, a Twin Falls chaplain. “Since then things have changed quite a bit, but I still have a hard time keeping my blood sugar down to 150 on a regular basis.”
He’s not alone. The number of American adults diagnosed with diabetes has more than tripled in the past 20 years as the population has aged and gained weight. In Idaho, an estimated 100,000 adults lived with diabetes in 2015 and an estimated 84,000 with prediabetes.
The cost is extraordinary.
People with diabetes have health care costs 2.3 times greater than those without diabetes. In Idaho, diabetes and prediabetes cost an estimated $1.3 billion each year and were the sixth leading cause of death in 2014. The American Diabetes Association estimates the total cost of diabetes and prediabetes in the U.S. at $322 billion.
But unlike Type 1 diabetes, Type 2 diabetes can be prevented or delayed by eliminating risk factors such as physical inactivity, unhealthy diets and tobacco use.

The dark spectre

Type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. People with Type 2 diabetes make insulin, but the body doesn’t use it the way it should. Prediabetes is when blood sugar is higher than normal. If left untreated, it often progresses to Type 2 diabetes.
Despite that dark spectre, Idaho is seeing a steady increase in overweight and obese populations, according to 2015 data from the Idaho Department of Health and Welfare. The majority of Idahoans are too heavy — 35.8 percent are overweight and 26.8 percent obese.
Yet even a diabetes diagnosis might not inspire dramatic lifestyle change.
Kluchesky watches what he eats, but not always. “It’s just the human condition,” he said. “Sometimes I want ice cream, so I eat some. In the old days, I ate a half-gallon of ice cream.”

Now, he’ll have just one scoop. Usually.
He has lost 30 pounds and now weighs 223.
“I’m still considered obese, but I’m not morbidly obese like I was,” he said. “Ideally, I should be 170 or 175.”
Now, at 67, Kluchesky often thinks of his mother, who had Type 2 diabetes and died at 69.
At her death, his mother’s feet were black from diabetic neuropathy, a Type of nerve damage caused by diabetes. She was blind due to diabetic retinopathy, a complication caused by damage to blood vessels in the eyes.
Kluchesky often wonders how long he has left to live. He has started to lose feeling in his toes, and he can’t tell how heavy his feet are — signs of diabetic neuropathy.
“I’ve noticed in the last two years I will suddenly become out of balance,” he said, “that I have to take an extra step. My feet are in a state of numbness.”
Kluchesky’s father died at 88. He wasn’t diabetic, but he loved candy.
“I didn’t have good examples growing up,” Kluchesky said. “They’d say, ‘Eat what you want and when you want as long as you finish it all.’ ”
He’s paying the price now.

‘I was killing myself’

Jody Bruffett, 55, and Helen Rector, 65, held purple weights as they walked quickly around the track at the Jerome Recreation Centre.
Five days a week, to help control their diabetes, the two walk for a mile, bike for 15 minutes, then row for 10 minutes. Sometimes Bruffett takes Zumba or water aerobics classes.
But there was a time Bruffett wouldn’t even walk down a store aisle, let alone a track. She used a motorized cart, because her knees hurt so badly.
“I was dying,” she said. “I was killing myself.”
Bruffett has Type 2 diabetes. She was diagnosed at 32. Attending a health fair at the rec center, she decided to have basic blood work done; the tests revealed high blood sugar.
She wasn’t completely shocked. Her mother is diabetic. Her grandfather was also diabetic, but they didn’t figure that out until he died. And with her last pregnancy, Bruffett’s blood sugar was elevated.
“It was borderline at that point,” Bruffett said. “I had been losing weight without trying, and sometimes that’s a sign also that you are becoming diabetic. I was just run-down, not having any energy.”
Rector, diagnosed at age 12, has Type 1. The two have been friends for more than 20 years.
“I do things with Jody,” Rector said. “She looks out for me.”
Bruffett used to take insulin to control her diabetes, but now she can do it with exercise and pills. Rector still requires insulin, despite exercise and weight loss.
Bruffett finally started seeing her diabetes improve after she had gastric bypass surgery. Rector saw similar results after the same surgery. Rector lost 60 pounds after surgery. Bruffett lost 150.
Bruffett was overjoyed the first time she flew in a plane and didn’t have to use a seat belt extender.
“I had to do a lot of soul searching and investigating before,” she said. “I knew that’s what I wanted to do.”

Help from bariatric surgery

Dr. Bob Korn, medical director of bariatrics at St. Luke’s Boise Medical Centre, said gastric bypass surgery has been found to cure Type 2 diabetes for at least a decade — the length of time cases have been tracked.
Korn, a member of the American Society for Metabolic and Bariatric Surgery, specializes in laparoscopic gastric bypass, laparoscopic sleeve gastrectomy and laparoscopic gastric banding. All three reduce stomach size and help the body become more sensitive to insulin, which means patients don’t feel hungry all the time.
“We are curing approximately 60 percent of patients that come to us with Type 2 diabetes,” he said.
The bariatrics program in Boise is the largest in Idaho. Seven years ago, Korn was performing fewer than 300 of these surgeries a year. Now, he and his colleagues do 600 a year, generally for patients 80 to 100 pounds overweight.
Nationally, 200,000 gastric bypass surgeries are performed a year, Korn said. They have become the most common abdominal surgery. In terms of invasiveness, he said, it’s comparable to having a gallbladder removed.
Why does it work?
“Obesity is the pinnacle cause of Type 2 diabetes,” Korn said. “Obesity is contributing to the death of 300,000 people this year. These people have a rapid improvement of their diabetes over a few days.”
Surgery patients can go home in two days and back to work in two weeks.

‘I feel healthy’

Bruffett still has 15 pounds she’d like to lose, but that’s where exercise and healthy eating help.
“Do I feel good?” she said. “I feel good, and I feel healthy.”
Bruffett said her biggest pitfall is carbohydrates. “People don’t often look at the carbs in food, and they can raise your blood sugar higher than simple sugar.”
For years, Bruffett worried that her son and daughter-in-law had Type 2 diabetes. Her son once weighed about 400 pounds, and her daughter-in-law was around 360 pounds.
“His father and me are diabetic,” Bruffett said. “He’s 28, and there is no doubt in my mind you better do something about it. You don’t know how much damage has been done.”
The son and daughter-in-law were tested, but the results were negative. Since then, Bruffett said, they have lost more than 50 pounds each.
That’s a relief. But she still fears they might one day experience what she’s suffering.
Diabetes had already damaged nerves in Bruffett’s feet when she was diagnosed. Now her feet burn. And there’s no way to repair that.

‘Never give up’

For Pauline Patheal, 80, the motivation to lose weight came from a support group she found 35 years ago.
Patheal is a member of Take Off Pounds Sensibly, or TOPS, a non-commercial weight loss, education and support organization; it costs $34 a year to enrol. A group of 15 TOPS members meets weekly at Jerome Public Library.
“We always have a lesson,” said Patheal, who said she has wasted her time on plenty of yo-yo diets. “How to eat right and take it off sensibly. They stress exercise. We are not a diet group. We don’t go on crazy fad diets.”
Patheal attended the international TOPS convention in Little Rock, Ark., in late July with 1,700 other people. She currently weighs 140 pounds and can go 7 pounds below or 3 pounds above her current weight and still stay on target.
At her peak weight of 199, she had hardening of the arteries and pain in her legs. Her Type 2 diabetes was also worse. She was so sick her husband of 61 years, Leroy, thought she was “going to kick the bucket,” he said.
Patheal slept a lot. She had diarrhea and stomachaches.
“I knew something was wrong,” she said.
Patheal’s mother and grandmother also had diabetes. “They didn’t know about this stuff back then,” she said.
Even after losing the weight, Patheal still needs to control her diabetes with pills, portion control and exercise.
Patheal was one of eight women exercising July 26 at Jerome Senior Center. Sitting in chairs, the women balanced their feet on red, green and orange balls. Each placed one foot on top of the ball, raising her heels, then her toes. She put the ball between her heels and lifted both legs.
Classes at the senior centre last 45 minutes, with the majority spent seated. Patheal has attended for 25 years.
“It helps, but you have to be careful,” Patheal said. “You just do what you can do. Everyone does it at their own level.”

‘I just don’t have the willpower’

On July 28, Kluchesky met a friend for breakfast. He didn’t eat the whole grain his diabetes mentor would recommend. Instead, he opted for chicken-fried steak with gravy.
Instead of using sugar in his coffee, he used a substitute sweetener called Stevia. He poured in six packets.
“I like sweet stuff,” he said. “I don’t like coffee, I just like the stuff I put in it.”
He usually eats a big breakfast, a smaller lunch and next to nothing for dinner.
Kluchesky takes metformin twice a day to help regulate his Type 2 diabetes.
“This is like a godsend to diabetics,” he said, pulling out a blue pillbox.

Kluchesky keeps track of his blood sugar in a log book. Sometimes his blood sugar reaches 80 — too low — and he begins sweating profusely and has tremors or shakes. He keeps a little piece of mint candy in his pocket just in case. When his sugar is high, his heart rate is fast and he feels thirsty.
Though gastric bypass surgery is an option, Kluchesky doesn’t see the point. If he doesn’t eat right and exercise now, not much would change after the surgery. He doesn’t even do the small things his doctor tells him to do, like walking after eating.
“They just keep telling me, ‘Well, if you limit your portions, or after you eat go and walk around the block’ — I don’t do that,” he said. “I got a paunch on me.
“I just don’t have the willpower to do the right thing.”

http://www.idahostatesman.com/news/state/idaho/article168248587.html

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Sleep Duration and Type 2 Diabetes: A Combination You May Never Have Considered But Should

From aappublications .org

The association between sleep duration and type 2 diabetes may come as a surprise to many of us, but this week we share a large study regarding this and what decreased sleep duration means for those of us monitoring patients for obesity-related complications such as type 2 diabetes. Rudnika et al. ( 10.1542/peds.2017-0338) share with us their cross-sectional analysis of more than 4500 multi-ethnic children in the United Kingdom who shared their time going to bed and getting up on a school day by self-report.  To validate such self-report, a subset of children also turned in sleep data using accelerometers.  In addition, the investigators obtained fasting blood levels of lipids, insulin, glucose and hemoglobin A1C in association with their height, weight, blood pressures and other markers for diabetes and cardiovascular risk adjusting for potential confounders.  

The results are dramatic and show graded relationships between sleep duration, being overweight or obese and type 2 diabetes risk factors.  While no cardiovascular risk factor was seen, there was an inverse relationship between sleep duration and risk markers for type 2 diabetes.  This represents a new finding and raises perhaps more questions than answers such as whether or not increasing sleep duration can prevent the development of type 2 diabetes if a patient is obese.  To shed further light on why this association might exist, we asked endocrinologists Dr. Nicole Glaser and Dennis Styne to weigh in with an accompanying commentary(10.1542/peds.2017-2015).  They explore why these findings may be more than just being due to obese children being less active and less sleepy or staying up later to play video games.  Neither the study nor commentary will put you to sleep when you think about this interesting association.

http://www.aappublications.org/news/2017/08/18/Sleep-Duration-And-Type-2-Diabetes-A-Combination-You-May-Never-Have-Considered-But-Should-Pediatrics-8-18-17

How being cold may one day help people lose weight and protect against diabetes

From washingtonpost.com

Could shivering in the cold be a way to shed pounds and possibly prevent diabetes?
Exposure to cold is the most well-known and well-studied mechanism for switching on energy-burning brown fat, which seems to protect mice from developing obesity. It remains to be seen whether the same process can help people.
Humans have three kinds of fat. White adipose tissue, or white fat, comprises the majority of fat in our bodies; its purpose is to store energy for future use. Brown fat is different: Its function is to generate heat to maintain body temperature. Until recently, it was thought that adults did not have brown fat, that it only existed in babies to help them stay warm before they could move around and then essentially vanished. But beginning in 2009, studies have found that many adults have brown fat and that people with more of it tend to be leaner and have lower blood sugar levels.
The third kind of fat, beige fat, appears to convert from white to brown when stressed by exposure to cold, and then back to white. This process is encouraging for scientists trying to figure out how to increase brown fat to improve healthy functioning of the body.
“A balanced diet and regular exercise are the cornerstones of healthy metabolism, but sustaining either is difficult for most people. Understanding how brown fat could benefit our health opens up a new direction in obesity research,” says Paul Lee, an endocrinologist at the Garvan Institute of Medical Research in Sydney, where he leads the Brown Fat Physiology Group. “It is not a solution to obesity, but it is an opportunity to explore an alternative strategy for curbing the obesity epidemic.”
When the body senses cold, Lee says, the brain releases nor­epinephrine, a chemical that essentially ignites the fat-burning process within brown fat. When there is not enough brown fat, the body has to turn to less-efficient heat-generating models, such as shivering.
Aaron Cypess, a clinical investigator at the National Institute of Diabetes and Digestive and Kidney Diseases, calls brown fat the principal organ responsible for generating heat in laboratory animals.
“In mice and rats,” Cypess says, “chronic activation of brown fat [by exposing them to low temperatures or to drugs that target brown fat] . . . is associated with a reduction in liver fat, a resistance to diet-induced obesity and improvement in insulin release.” All of these benefits and others may also apply to people, but it will take much longer to prove because studies in humans have to be conducted differently, he says.
He adds, “While white fat is easy to spot in humans — think abdomen, hips, buttocks and thighs — brown fat tends to be located around the neck and above the collarbone, along the spine and near the kidneys.” Additionally, Cypess says, humans are genetically more diverse than lab mice, which produces results with much higher variability.
Lee says that when people are cold and begin to shiver, their muscles release irisin, a hormone that turns white fat into brown fat. The more a person shivers, the more irisin is released into the bloodstream.
A 2014 study by Lee — dubbed “the ICEMAN study” — found that after a month of sleeping at cool temperatures, five men increased their stores of brown fat by 30 to 40 percent and metabolized sugars more efficiently after a meal, which could be helpful for people with diabetes. When the sleeping temperature was raised, the brown stores dropped.

(Interestingly, another recent study found that brown fat also may be stimulated by taking a drug used to treat overactive bladder.)
Cypess says that this research makes it clear that activating or increasing brown fat stores might prevent weight gain, lead to weight loss and provide a new avenue for treating diabetes and obesity.
Can the average person embark on a “shiver diet” to lose weight?
Lee says he believes the current evidence does not support the notion that shivering may be a route to losing weight. (Despite the study’s name, ICEMAN — the Impact of Chronic Cold Exposure in Humans — exposed participants to only mild cold, not shiveringly low temperatures.)
Cypess says that shivering to lose weight is an interesting idea, but there are many unknowns.
First, is it safe?
Lee says that “shivering causes stress and could harm the body, which explains why the human body has evolved mechanisms to turn on brown fat or to turn white fat into brown fat.”
In most people, Cypess says, shivering causes increases in blood pressure that over the years could damage blood vessels in the brain, heart and kidneys.
Additionally, Cypess says, there is no evidence to prove that a low-temperature regimen could be effective long-term. One of the biggest limitations of weight-loss interventions is that the body learns to compensate to maintain itself, and that might be true with a shiver diet. Lee and Cypess agree that no weight-loss regimen should be recommended without a great deal of evidence that it will work for more than a few weeks or months and that the weight loss can be sustained — evidence that doesn’t exist.
Finally, Cypess says, being cold is extremely uncomfortable. “While suggestions exist that long-term activation of brown fat could be beneficial to weight loss and diabetes reduction, this has yet to be proven,” he stresses.
Francesco Celi, chair of the division of endocrinology, diabetes and metabolism at the Virginia Commonwealth University School of Medicine, said in an email that he expects “future research will include conducting studies in humans that will test various interventions (drugs or environmental modifications) to expand and activate brown fat to help scientists determine what kind of metabolic improvements can occur. And by studying the various responses to interventions, researchers will be able to determine which patients respond better to brown-tissue expansion and perhaps why they do.”
Cypess says he expects scientists to focus on determining to what extent adult brown fat contributes to getting rid of excess calories, how brown fat could be used to bring down blood sugar levels and how brown fat interacts with other organs to keep people healthy.
But even with all that, he adds, “Basically, the issue of losing weight is about controlling the amount of food we put into our mouths.”

https://www.washingtonpost.com/national/health-science/how-being-cold-may-one-day-help-people-lose-weight-and-protect-against-diabetes/2017/08/11/a523ac9e-6c91-11e7-96ab-5f38140b38cc_story.html?utm_term=.c5ecb481f5d8

Diabetes and how it affects feet

From mydaytondailynews.com

If you have diabetes, you have probably noticed that it affects your health in many ways. But it can be easy to overlook one spot that often escapes close attention: your feet.

Understand the problem

Just a small foot sore can lead to a diabetic ulcer and even amputation if not treated properly and in a timely manner. So if you have diabetes, every cut or sore should be taken seriously.

“Diabetes can lead to pressure or small blood vessel disease in your feet, causing nerve damage and circulation problems,” says Baker Machhadieh, MD, with Kettering Physician Network Endocrinology and Diabetes in Hamilton. “A loss of feeling — often in the feet or legs — means minor injuries can go unnoticed, allowing infection to set in.”
A diabetic foot ulcer can occur almost anywhere on the foot. But very often they appear on the ball, the bottom of the big toe, or the top or sides of the foot. It can be caused by ill-fitting shoes pressing or rubbing against the skin, or it can be triggered by an injury.
The good news is most diabetic ulcers and foot sores are preventable.

Practice prevention
Dr. Machhadieh says the first line of defence against ulcers and other foot problems is controlling your blood sugar levels and keeping your feet clean and well cared for. Here are other steps you can take:
• Wash your feet daily with mild soap in warm — not hot — water.
• Don’t let your feet dry out and crack.
• Rub lotion on your feet daily but not between your toes.
• Wear shoes that fit well but are not too snug.
• Wear cotton socks, and change them every day.
• Never go barefoot, not even at home.
• Ask your healthcare provider to check your feet at every visit—or at least once a year.
• Don’t smoke. It reduces blood flow to your feet and slows healing.

Inspect
Make a habit of checking your feet, including between your toes, every day. “If possible, check once in the morning and once at night before you go to bed to catch changes as soon as they happen,” advises Dr. Machhadieh.
Here are a few things to look and feel for:
• Redness, bruises, or changes of colour
• Cuts, blisters or scabs
• Swelling or other signs of damage
• Bumps or irregular skin textures
• Dry, rough or cracked skin
• Brittle, cracked, discoloured, or ingrown nails.
Be sure to keep a list of your observations. If you find a wound, treat it and cover it with a bandage immediately. Be sure to check it with each foot inspection to make sure it is healing. If the wound does not heal or you begin to develop an open wound, get medical help immediately.

http://www.mydaytondailynews.com/lifestyles/diabetes-and-how-affects-feet/7hgvcTTJN1Z7mQteN5vn3L/

Diet drinks and food actually trigger weight gain and diabetes, says new study

From telegraph.co.uk

          When there is a mismatch between calories and sweetness the brain dials down the metabolism 
Diet drinks or foods may actually promote weight gain and trigger diabetes because the brain misreads the number of calories present and reduces metabolism, a new study suggests.
Researchers at Yale University in the US discovered that the body stops burning energy from food if there is a ‘mismatch’ between food sweetness and calories.
In nature, sweetness signals energy and the greater the sweetness the more calories are available, so the brain has evolved to expect the two to come together. When they do not, the brain can become confused, thinking there are fewer calories to burn.
The scientists say it could help explain previous studies that have suggested that artificial sweeteners can increase blood sugar levels and possibly trigger diabetes.
“A calorie is not a calorie,” said senior author Dana Small, Professor of Psychiatry at Yale University School of Medicine.
“The assumption that more calories trigger greater metabolic and brain response is wrong. Calories are only half of the equation; sweet taste perception is the other half.
“Our bodies evolved to efficiently use the energy sources available in nature. Our modern food environment is characterized by energy sources our bodies have never seen before.
“When sweet taste and energy are not matched less energy is metabolized and weaker, or inaccurate, signals are sent to the brain.  Either one of these effects may affect metabolic health.”
For the new study, scientists scanned the brains of 15 people when they were drinking diet drinks, and compared them to regular beverages. They also monitored how much energy was burned by the body.
They found when there was a ‘mismatch’ between sweetness and calories - as is often the case with diet drinks or foods because they are not as sugary - the calories fail to trigger the body’s metabolism. Reward circuits in the brain also did not register that calories had been consumed, which could lead to eating more.
Commenting on the paper, Dominic Dwyer, Professor of Psychology at Cardiff University, said: “What the paper does imply, correctly in my view, is that mismatches between calories and sweetness interfere with metabolism of calories in a way that could have negative impact on weight gain, diabetes, heart disease etc. but that determining the link between the unprocessed calories and metabolic health needs future work.
“The most important implication is namely the fate of calories consumed in the mismatch conditions.
“These are not efficiently metabolised at the time of ingestion and thus processed later and/or stored either of which could drive weight gain and interfere with metabolism.”
Tam Fry, of the National Obesity Forum, added: "This research should be enough to convince you that artificial ingredients, whether they be in food or drink, can screw up your system even though they may sound healthy.
"They may be free of calories but not of consequences and diabetes is only one of them. "
However other British experts were more sceptical about the findings and warned people to stick to drinking water if they were concerned about artificially sweetened drinks.
Naveed Sattar, Professor of Metabolic Medicine at Glasgow University, said: “There is currently no strong evidence that diet drinks are necessarily bad for you whereas there is stronger and consistent evidence for sugar sweetened drinks being linked to higher diabetes risk.  
“Overall, my advice to people drinking sugar-rich drinks would be to replace with water but that if this is not possible, diet drinks are still a better choice to prevent tooth decay.
“Whether diet drinks also help weight loss or other benefits is uncertain and requires proper long term trials which are currently lacking.”
Tom Sanders, Professor emeritus of Nutrition and Dietetics, at King's College London, added: “The statement that a calorie is not a calorie is gobbledegook. Calories are a measure of the energy value of food. The remark is as stupid as saying a pound of feathers is lighter than a pound of lead.
“The claim is not supported by the observational evidence on people who are long-term consumers of artificial sweeteners.
“Furthermore, an analysis of trials of replacing sugar sweetened drinks with artificially flavoured drinks show that there is some weight loss. Weight gain is certainly is not caused by drinking artificial sweeteners.”
The research was published in the journal Current Biology.

http://www.telegraph.co.uk/science/2017/08/10/diet-drinks-food-actually-trigger-weight-gain-diabetes-says/

Cure Diabetes, Not Just Control It

From indiawest.com

In the past two articles, I explained how diabetes occurs—not due to insulin resistance but to your body burning fatty acids made from carbohydrate, largely grains, leaving glucose in your bloodstream.
So why do endocrinologists still maintain the insulin resistance theory, which has not been proven and is scientifically illogical?
About 80 years ago, the astonishing benefit of injecting insulin into children with Type 1 diabetes, in which the pancreas does not produce insulin, was discovered. Later, when adults were discovered to have adequate levels of insulin AND high blood sugar, endocrinologists needed to come up with an explanation—and so the insulin resistance theory was born and the name Type 2 diabetes was introduced. No evidence was shown to prove the theory in a scientific way, however.

As a result, endocrinologists, not knowing why or how insulin resistance occurs, had to resort to other means to deal with it, mainly trying to “control” blood sugar. The pharmaceutical companies began producing drugs to do that. Meanwhile, the Centres for Disease Control and Prevention incorporated study findings based on this faulty concept into clinical and public health directives. The National Institutes of Health also failed to provide funds for basic research that would have invalidated the concept of insulin resistance. Therefore, “control” of diabetes became incorporated into the medical textbooks and clinical practice all over the world.
But Diabetes can be Cured
As I explained in the first two parts of this blog, by avoiding grains and grain products, no matter what country you live in, you can cure type 2 diabetes. This means consuming as little wheat, rice, corn, and products made with flour from them as possible.
Beware: You will hear from health and nutrition experts that grain and grain-flour products are good foods to eat, as they get every other nutrient into your body. They will claim a diet without grains is not sustainable. To counter that, I give you two bits of information to ponder. One, the ancestors of modern humans survived without cultivating grains for almost 40,000 years. In my view, this is proof that no carbohydrate is considered an essential nutrient for humans, and we certainly do not need carbohydrates from grains. Second, what would be better for you – giving up most grains or living with diabetic medications and the complications of diabetes even when the condition is “controlled?”
I am not recommending any special diet other than avoiding grains. I believe you can eat and enjoy any food you want other than grains. It’s healthiest and most diabetes-free if you focus on getting your nutrients from the infinite variety of seasonal naturally-occurring vegetables in your local area. Choose vegetables grown using composted plant fertilizer rather than those grown using factory-made fertilizers because the former are more likely to contain an assortment of nutrients in the right proportions. After all, humans evolved consuming what nature provided.
An added way to ensure your intake of needed nutrients is using spices, just as Indian cuisine does. A wide assortment of spices can provide over 25% of essential nutrients needed in the human body. I believe that the reason spices make foods more enjoyable is because they are nutritious. Vegetable oils are useful too, as they provide a variety of different carriers for spice/nutrient molecules.
I am not against consumption of non-vegetarian food items like meat, seafood or dairy, and even a few grain-based foods here and there are ok. But make sure your total energy intake is not excessive and the percentage of energy from carbohydrate is not over 25% of the total. An increasing level of triglyceride in the blood is an early indicator of excess total energy intake. Increasing levels of fasting blood sugar is another marker.
I hope you will convey this information to anyone you know who has diabetes, whether it is your friends who live in the US or your friends and relatives in India. Encourage them to reduce their consumption of rice, wheat, and other grains in any shape or form. There is no need to diet or purchase a diet program. Anyone with diabetes will see their blood sugar level drop if they do this. In most instances, diabetes can be cured in as little as 8 weeks.

http://www.indiawest.com/life_and_style/health_beauty/cure-diabetes-not-just-control-it/article_e357f1ac-7e23-11e7-ab38-8bd9d112b7bd.html

Whey protein could help control type 2 diabetes

From diabetestimes.co.uk

Eating whey protein before breakfast could help prevent or control type 2 diabetes, two separate studies by Newcastle University have shown.
The findings, which were unveiled at the Diabetes UK Professional Conference, found obese men and males with type 2 diabetes had better blood sugar levels after eating the protein first thing. One of the studies also showed it helped stifle appetite.
The first study looked at how 20 grams of the whey protein affected 12 obese men, before they took part in 30 minutes of light walking and then ate a carbohydrate heavy breakfast. The researchers said the combination of the protein and exercise helped control blood sugars.
A total of 11 men with type 2 diabetes participated in the second study. They were given 15 grams of whey protein before breakfast and again, their blood sugars remained stable.
Lead researcher Dr Daniel West from Newcastle University said: “We know that high blood glucose levels after eating can contribute to poor blood glucose management and can also be detrimental to cardiovascular health.
“We’ve shown that consuming small amount of whey protein before a meal could help people avoid those high blood glucose levels and may help them to feel more satisfied after mealtimes.”
Diabetes UK’s director of research Dr Elizabeth Robertson said: “Finding ways to keep blood glucose levels as stable as possible after eating is an important area of scientific research, to help people manage their diabetes well. This new research adds to other small scale studies that have promising results.
“However, larger scale studies involving a lot more people are needed to test this idea further, so we can understand if anyone with type 2 diabetes would benefit from including whey protein in their diet and how best to do that.”

http://diabetestimes.co.uk/whey-protein-could-help-control-type-2-diabetes/

Summer eating and diabetes

From diabetes.org.uk

Now the weather’s nicer and the evenings are longer, we’re often eating and drinking outside – enjoying barbecues, picnics, parties, festivals and days out at the beach with family and friends.

But for people with diabetes, summer eating and drinking presents a few challenges – from how to tackle being confronted by an array of tempting but unhealthy food, to dealing with fluctuations in your blood glucose levels caused by the heat.

It goes without saying that having diabetes doesn’t stop you enjoying parties, barbecues and festivals, but if you want to manage your diabetes well, here are our top tips and healthy swaps...

In the heat

• If you use insulin, it will be absorbed more quickly from the injection site in warm weather. This increases the risk of hypos, so test your levels more often.

• Insulin is damaged in the heat, so keep it in the fridge or a cool bag, making sure it doesn’t freeze. You can buy portable insulin protectors from our online shop.

• The heat can also affect your blood glucose meter and test strips. Keep them as close to normal room temperature as possible and out of direct sunlight. Don’t keep them in the fridge as cold temperatures can also lead to misleading results.

• If you have neuropathy, you may not be aware when your feet are burning, so apply sunscreen and wear flip-flops on hot ground.

Being less active

• If you are sitting around at a barbecue, picnic or party and are normally active, this could affect your diabetes control and make your blood glucose levels higher than usual. So test regularly and be ready to adjust what you eat or the amount of insulin you need to take.

Change of routine

• If the timing of the barbecue means you’ll be having lunch or dinner later than usual, you will generally be able to delay your mealtime insulin dose until food is ready. However, you may need to have a carb-containing snack, such as a piece of fruit, a pot of yogurt or bread especially if you are on twice-daily insulin injections. This will help to prevent a hypo. 

Keep hydrated

• In hot weather, you are at risk of dehydration, so drink plenty of water, no added sugar squashes and diet drinks. If you are drinking alcohol, keep to safe drinking guidelines, alternate with non-alcoholic drinks and use sugar-free mixers.

Eating

• Most of us, whatever type of diabetes we have, are trying to keep an eye on our weight and a barbecue or picnic often means there’s a huge variety of food and an abundance of alcohol on offer – much of which isn’t healthy or what we usually eat. This can mean we relax our healthy eating resolve and are more likely to reach for the crisp bowl and more alcohol… Psychologist Dr Jen Nash, who has Type 1 diabetes, has advice on how to keep in control of your eating and drinking.  

• If you have Type 1 diabetes and are carb counting, you may find it useful to gen up on the carb content of carb-containing foods that are likely to be served at the party. Check the food labels when you get there, but if food is not packaged, resources like our Carb and Cals Guide – or an app on your phone might be useful. This advice is also helpful for people with Type 2 diabetes who are keeping an eye on diet, too. 

• Don’t forget that the fatty foods served at barbecues, eg some dips, mayonnaise, crisps and fatty meats, can slow down the absorption of carbohydrate into your blood stream, so take this into consideration when working out your insulin doses and when to inject. 

• Try not to graze all day long or you’ll never feel satisfied and may end up eating more than you realise. 

• Take a plate and pile half of it with tasty salad veg and dress with a lower-fat dressing. One option is to divide the other half in two between protein – in the form of meat or vegetarian alternatives – and carbs, such as pasta or bread. You can purchase a plate from our online shop, which gives you guidance on portion sizes.

So you can be sure there will be something healthy at the party, why not make a large colourful salad or low-fat coleslaw with reduced-fat mayo, half-fat crème fraiche or natural yogurt to take with you?

• Some people find it useful to gauge their portion sizes using their hand. As a guideline, a suggested portion of cooked meat would be the size of a clenched hand or for fats the size of your thumb. 

Healthier swaps

Whether you’re at a barbecue or a picnic, knowing how to make clever choices and swaps will mean significant savings on fat, sugar and calories.

Barbecue food

Top tips for healthier barbecue food.

Burger/kebabs

A barbecued, grilled beef quarter pounder has nearly three times the amount of calories compared with a Quorn burger, and a chicken kebab is an even better choice.

• Beef burger (114g): 240 Kcal; 17g fat
• Quorn burger (50g): 78 Kcal; 3.7g fat
• Barbecued grilled chicken kebab (48g): 78 Kcal; 1.7g fat

Mayo

Save over half the amount of calories and fat by switching from ordinary mayo to a reduced-fat version.

• 1 tbsp standard mayonnaise: 100 Kcal; 11g fat
• 1 tbsp reduced-fat mayonnaise: 40 Kcal; 4g fat

Potato salad

Save over half the fat and nearly half the calories by switching from a standard potato salad to the reduced-fat version.

• 2 tbsp standard potato salad: 180 Kcal; 14.2g fat
• 2 tbsp reduced-fat potato salad: 110 Kcal; 6g fat

Coleslaw

Big calorie and fat savings can be made by switching from the deluxe coleslaw to a reduced-fat version.

• 2 tbsp deluxe coleslaw: 248 Kcal; 25.6g fat
• 2 tbsp reduced-fat coleslaw: 78 Kcal; 6.3g fat

Cheese slices

By swapping sliced, processed cheese to the reduced-fat version, you can save over half the amount of fat and some calories. If you have several slices, the savings will soon add up.

• 1 slice processed cheese: 50 Kcal; 3.3g fat
• 1 slice reduced-fat processed cheese: 34 Kcal; and 1.5g fat

A can of cola drink

Swap a regular ‘full fat’ can of cola drink for the diet version and save a significant number of calories and carbs (sugar).

• 1 x 330ml can regular coke: 139 Kcal; 35g carbs; 35g sugar
• 1 x 330ml can diet coke: 1 Kcal; 0g carbs; 0g sugar 

Picnic food

Top tips for a healthier picnic lunch.

Sandwiches
Swap a bacon, lettuce and tomato (BLT) on malted brown bread for a reduced-fat chicken and bacon sandwich and save over 100 calories and more than two-thirds of the amount of fat.

• A standard BLT: 454 Kcal; 19.6g fat
• Reduced-fat chicken and bacon sandwich: 314 Kcal; 5.8g

Crisps

You can make calorie and fat savings with a simple swap. Popcorn can save you more calories.

• 25g standard packet of crisps: 130 Kcal; 7.6g fat
• 25g baked packet of crisps: 102 Kcal; 2g fat 
• 11g lightly salted popcorn: 58 Kcal; 3.4g fat

Smoothies

Swapping a fruit smoothie for a glass of no added sugar squash will save you a considerable amount of calories, carbs and sugar.

• 250ml raspberry and blackcurrant smoothie: 114 Kcal; 26.3g carbs; 20.6g sugars
• 250ml blackcurrant no-added sugar squash: 5 Kcal; 0.6g carbs and 0.6g
• sugars 

https://www.diabetes.org.uk/Guide-to-diabetes/Enjoy-food/Cooking-for-people-with-diabetes/Seasonal-cooking/Summer-eating-and-diabetes/?utm_source=bronto&utm_medium=email&utm_term=Summer+eating&utm_content=Summer+eating&utm_campaign=Enewsletter+August+2017