Diabetics can now test their blood sugar levels with a mobile device

From qz.com

People living with diabetes have to prick their fingers to check their blood sugar levels anywhere from one to seven times a day.
But now, there’s a better way to monitor blood sugar. This week, the US Food and Drug Administration approved the first at-home, needleless system for continuously monitoring glucose for people with diabetes. The system, called FreeStyle Libre Flash, and manufactured by the DC-based Abbott Laboratories, allows users to forgo finger-pricking for up to 10 days at a time.
The Flash is essentially a small, circular plastic sensor that sits on top of the skin and detects blood sugar from a small wire that goes under the skin beneath the sensor. People can insert themselves using an applicator that works sort of like a rubber stamp.
Once people have applied the sensor on their arms, they can wave a mobile device a little smaller than a smartphone in front of it to read glucose levels. It takes about 12 hours for the wire to become adjusted to the person’s body, but afterward the device takes continuous data that tracks blood sugar over time for over a week. Afterward, you peel the sensor off slowly, and apply a new one.
Ideally, this would encourage people with diabetes to check their blood sugar more routinely, Jared Watkin, senior vice president of Abbott’s Diabetes Care unit, told Reuters. Often, people will forgo checking their sugar levels as often as they should because finger pricking can be such a nuisance. Right now it’s only marketed for adults, but the company hopes to receive approval for children under 18 as well.
Abbott already has one needle-free blood sugar monitoring system available for the public called the FreeStyle Libre Pro. However, users have to make a special trip to the doctor’s office to have the wire placed under the skin every two weeks. The convenience of using the Flash entirely at home is a significant upgrade, although people will still need to visit their doctor’s office for an initial prescription.
Already, the FreeStyle Libre Flash is available in 41 other countries, the Chicago Tribune reports. There’s no word on how expensive it will be for patients, but in Europe they go for about $69. Abbott says they hope to start selling these devices to the public by the end of the year.

https://qz.com/1090683/blood-glucose-tests-for-diabetes-no-longer-require-finger-pricks/

Can This Be Causing the Rise in Obesity and Diabetes?

From bigthink.com

In 1998 the Firman Bear Report, based on research conducted at Rutgers University, revealed startling data concerning nutrient make-up in organic versus conventional farming. According to the research, tomatoes grown organically contained 1,938 milligrams of iron per hundred grams of dry weight, compared to a single gram in pesticide-laden tomatoes. Potassium was 148.3 mg vs 58.6. Spinach was equally lopsided: 1,584 mg of iron vs 19 mg; 71 mg of calcium vs 16. 

A recent graduate of Rutgers, I was working as a reporter for a Princeton newspaper at the time. For my story I chatted with a local restauranteur, Himanshu Patel, whose wife held a nutrition degree. He was passionate about organic produce. Patel told me that in the fifties American farmers had 22 inches of topsoil to work with, compared to an average of nine inches in the nineties. He concluded: “If it ain’t in the tomato, it ain’t in the sauce.” 

The nutritional benefits of the food we eat is not the result of varied nutrients we can isolate at will, just as our brain is an emergent system: the combination is what matters. Sure, the hippocampus might be where memories are processed, but without the rest of the system it’s rather useless. Yet nutrient composition of food is relevant. If you’re iron deficient and reach for a tomato, soil makes a difference. 

A 2004 study of forty-three garden crops revealed that nutrients suffered greatly over the last half-century. Iron, yes, but also vitamin C, calcium, and protein levels were down. The blame was placed on a familiar culprit: monocropping, a popular agriculture method that yields large amounts of a single crop, season after season, which certainly depletes the soil. Yet some were sceptical this told the whole story. 

Many of the people I talked to in the Princeton region knew the nutritional value of food was plummeting. Yet my story predates a 2002 paper written by Princeton University postdoctoral fellow Irakli Loladze, now a math biologist at Bryan College of Health Sciences in Lincoln, Nebraska. He argues that rising carbon dioxide levels directly affect human nutrition, a stance that was widely rejected at the time. But times have changed.

When Politico recently contacted a number of nutrition experts about this topic, most were perplexed or ignorant of the premise. Loladze speculates that carbon dioxide levels in the atmosphere are increasing carbohydrate levels in plants, which has a direct effect on our nutritional intake as well as obesity and diabetes levels. 

What Loladze is hypothesizing is effectively a biological version of environmental climate change. We might think we’re eating a balanced, plant-heavy diet while we’re actually starving our bodies of the micronutrients we need. At the same time we’re boosting sugar intake thanks to the uptick in carbohydrates, a fascinating and frightening example of interdependence. The faces of climate change might be polar bears and ice calving, but the proof is much closer to home. Inside of our homes, in fact.

Which means the products in your crisper are nutritionally more like dehydrated fruit and vegetables than the freshly picked produce of old. A 2014 study investigating crops in Japan, Australia, and the United States found unnerving drops in iron, zinc, and protein. Loladze responded with his own paper. In it the editor notes that two out of every five calories around the planet come from rice and wheat, and the malnutrition occurring from elevated carbon dioxide levels “lead to reduced growth in childhood, to a reduced ability to fight off infections, and to higher rates of maternal and child deaths.” 

Loladze uses data to ask questions he believes nutrition experts and governmental agencies need to be pondering:

Will rising CO2 concentrations—one of the most certain and pervasive aspects of global climate change—alter the quality of crops and wild plants? Will the CO2-induced stimulation of carbohydrate synthesis increase the carbohydrates-to-minerals ratio in crops? Can such shifts in crop quality affect human nutrition and health?

Give the data he compiles, it is apparent that a spike in carbohydrates is not doing our bodies any good. Is this the root cause of increased obesity and type 2 diabetes we’re witnessing in America and, increasingly, around the world? As stated, the problem is multifactorial. But given the research emerging from this field, we might be in the midst of chronic changes in our physiology. 

During the reporting of my 1998 story, I chatted with Traute Ringwald, who owned a local natural food store. She put at least part of the blame on the customer:

"The consumer really has done a great injustice to farmers by not supporting them and making them triple crop. So now they don’t replace any of the nutrients in the soil because they must sell their product. But they don’t realize that there are 98 nutrients, not three."

If Loladze is correct, the blame falls on all of us. Humans are not separate from the environment, and how we treat it has a direct effect on our health. The alarming upward trend of obesity and diabetes levels over the last century makes it obvious that we’re not treating our planet, or our health, very well. 

http://bigthink.com/21st-century-spirituality/can-this-be-causing-the-rise-in-obesity-and-diabetes

Diabetes: Adding lifestyle changes to medication can deliver a knockout punch

From Harvard.edu

Plenty of research supports the common-sense notion that a healthy lifestyle can prevent or treat many diseases. A diet high in fruits, veggies, whole grains, and plant protein and low in processed carbs, added sugars, saturated fats; regular physical activity; and emotional well-being are the potent treatments that can prevent the need for or even replace many prescription medications.
Yet lifestyle interventions are still not “mainstreamed” into primary care.

The power of lifestyle changes for diabetes

Here is yet another study supporting intensive lifestyle intervention, this time for diabetes. The study authors seem to downplay their findings, which, frankly, baffled me. I’m happy to enthusiastically report that this study strongly confirms what I’ve often observed over the past 15 years in medicine: the way we live and what we put in our mouths can be way more powerful than many of the pills we’re prescribed.
Basically, the study authors recruited 98 people with type 2 (adult-onset) diabetes who were all pretty similar. They had had diabetes for less than 10 years and their blood sugars were not completely out of control (HbA1c* less than 9%); they were not on insulin; they all had a body mass index between 25 and 40 (that is, they were overweight).
They divided people into two groups for a year. Both groups stayed on their regular medications. The standard care group (34 people) received basic counselling and education in type 2 diabetes, including lifestyle advice by a nurse at the start of the study and again every three months.
The other group (64 people) also received a pretty intensive lifestyle intervention:
five to six exercise sessions per week, consisting of 30 to 60 minutes of supervised aerobic activity, along with two to three sessions of weight training

an individualized nutrition plan with dietary counselling, including calorie restriction for the first four months

a smart watch/step counter and encouragement to be physically active in their leisure time (with a goal of at least 10,000 steps per day).

The lifestyle group did have slightly better overall blood sugar control after a year, but the real kicker was this: 73% of the lifestyle participants were able to decrease the dosage of their diabetes medications, compared to only 26% of the standard care group. And, over half of the lifestyle participants could safely discontinue their medications! As a matter of fact, 44% of the standard care group had to have their medications increased during the study, compared to only 11% in the lifestyle group.
*HbA1C is the abbreviation for hemoglobin A1c, the product formed by the attachment of glucose (blood sugar) to hemoglobin (a protein in red blood cells). A test for HbA1c is a useful measure of blood sugar control over time. An HbA1C level between 4% and 5.6% means that blood sugar has been in a good range over the past few months.

Other improvements in measure of health

In addition, the lifestyle group enjoyed significant improvements in pretty much all their measurements: weight (13.2 lbs. lost, compared to 4.4 lbs.), BMI (31 to 29, compared to 32.5 to 32), and abdominal fat (2 lbs. lost, as compared to 0.2 lbs.), with a gain in lean body mass (i.e. muscle). Over a third of the lifestyle group lost over 10% of their body weight, compared with 3% of the standard care group. And the lifestyle folks also experienced a significant improvement in their physical fitness, as measured by a fancy machine measuring oxygen uptake by the body during intense exercise.
The study authors seemed to emphasize that lifestyle improved blood sugar only modestly better than standard care at 12 months. What was incredibly striking, though, was the trend in the blood sugars over the entire year. At six months, the lifestyle group’s HbA1c levels decreased very significantly, from 6.6% to 6.2%, while the standard care group’s HbA1c increased from 6.7% to 6.9%. At 12 months, both groups drifted closer to where they had started, with the lifestyle group still a bit better than the standard care group at 6.3% as compared to 6.6%.

Why is this?

There are two possible reasons. One was that the lifestyle group had fully supervised exercise and dietary counselling sessions (including calorie restriction) for only the first four months, and after that, supervision was progressively decreased, and as a result people were less likely to stick with the program. In fact, the article shows that participation in the exercise and dietary counselling sessions dropped off over the year.
Another factor is that the participants’ diabetes medication was being adjusted throughout the study for health and safety reasons. If the HbA1c dropped below 6.5%, then their medication was decreased, and if it stayed that low or went lower, the medication was discontinued. Likewise, if the HbA1c went above 7.5%, then the medication was increased. The lifestyle group did have more episodes of low blood sugar than the standard care side, and while that can be dangerous, it also signals that the lifestyle participants needed less medication as time went on.
So, it’s reasonable to speculate that if the exercise and dietary session supervision was continuous throughout the study, and if the medications were not continually adjusted, then the results would have shown even greater improvements for the people in the lifestyle group.
And that jibes with previous studies looking at lifestyle intervention for the prevention and treatment of heart disease. There’s so much accumulated evidence supporting lifestyle intervention as a very effective treatment, that major insurance carriers will now cover such programs.
I do hope that patients will realize that lifestyle changes are as good as, and sometimes better than, prescription medications. Primary care doctors need to help them do just that.

https://www.health.harvard.edu/blog/diabetes-adding-lifestyle-changes-medication-can-deliver-knockout-punch-2017092812468

Obesity epidemic fuels record levels of amputations, official figures show

From telegraph.co.uk

Britain’s obesity epidemic is fuelling devastating numbers of amputations - almost all of which could have been prevented, experts have warned.
Official figures show the number of cases have reached an all-time-high, with more than 8,500 procedures carried out last year as a result of diabetes.
Nine in ten cases of the condition are type 2, which is linked to obesity and inactivity.
Official figures from Public Health England show 23 amputations are carried out every day, with a 16 per cent rise in interventions between 2013 and 2016, compared with the previous three years.
Diabetes UK said the findings were “devastating” and often life-threatening - with up to 80 per cent of diabetic patients dying within five years of surgery.
The charity warned that the trend was being fuelled by soaring obesity rates, with two in three adults now overweight or obese.
People with diabetes have an increased risk of foot ulcers, which can deteriorate quickly.
Tam Fry, from the National Obesity Forum, said he was “numb with fury” about the failure of successive Governments to prevent a growing obesity epidemic.
"People are losing limbs and going blind because of diabetes,” he said.
"Successive governments  have done nothing to reduce levels of obesity in the UK and we are now seeing the tragic consequences. I am left numb with fury that we have got to this stage because we failed to tackle obesity.”

Dan Howarth, Diabetes UK’s head of care, said: “The record rates of diabetes-related amputations we’re seeing are being largely fuelled by increasing numbers of people developing diabetes. This is in part linked to the growing number of people living with Type 2 diabetes, which is closely linked to obesity and so, in most cases, can be prevented by maintaining a healthy lifestyle.”
The charity called for urgent NHS improvements to ensure that all patients with diabetes had annual foot checks.
While most cases of diabetes are in themselves avoidable, four in five amputations could still have been prevented, if the right care had been taken, the charity said, urging those with the condition to carry out daily checks on their feet.
Earlier this month the NHS recommended that every single person aged 40 and over should be offered an NHS diabetes check, with millions ordered to go on strict diets by GPs.
The recommendations from the National Institute of Health and Care Excellence (Nice) say slimming lessons and cookery classes should be routinely offered to those whose weight or habits is jeopardising their health.

http://www.telegraph.co.uk/news/2017/09/28/obesity-epidemic-fuels-record-levels-amputations-official-figures/

Why does obesity cause diabetes? You asked Google – here’s the answer

From theguardian.com

‘Cause” is a strong word. It means that A results in B happening. Causality is also surprisingly difficult to prove. Most medical studies only show association between A and B, while causality often remains speculative and frustratingly elusive. Obesity and diabetes are no exception.
There are many types of diabetes. All are unified by elevated levels of blood sugar. Type 1 diabetes accounts for less than 10% of cases and results from autoimmune destruction of the beta cells in the pancreas, which produce and release insulin. (In an autoimmune process, antibodies that normally target and fight infection instead target one’s own cells). Type 3c (secondary) diabetes can occur when there has been destruction of the pancreatic beta cells through some other process, such as excessive alcohol, inflammation or surgical resection.
There are also many genetic forms of diabetes, each usually resulting from a single gene mutation that affects pancreatic function in some way. Finally, there is type 2 diabetes (T2D), which accounts for more than 90% of cases globally. Media reports of diabetes, particularly in the context of obesity, usually relate to T2D, the two terms often being used interchangeably.
Only T2D appears to be associated with obesity. Epidemiological studies across the world have shown that the greater one’s body mass index (BMI), the greater the chance of developing T2D. However, this is not the same as saying that obesity causes T2D. The majority of people who are obese will never develop T2D – a fact that exposes the statement “obesity causes diabetes” as absurd. Rather than referring to obesity as a cause of diabetes, it is more accurate to frame the issue as one of association between obesity and T2D (which is incontrovertibly true).
As we gain weight, the sensitivity of our tissues to the effects of insulin diminishes (so-called “insulin resistance”). In response, our pancreatic beta cells, which produce insulin, need to work harder to produce more of it.
Imagine driving a car up a hill: this is analogous to your body encountering insulin resistance following weight gain. To get up the hill, you change gear, step on the accelerator and make the engine work harder. In the same way, the pancreatic beta cells need to work harder to produce more insulin to compensate for insulin resistance. If you are lucky enough to drive a car with a good engine, you will make it up the hill, however steep, and never develop T2D regardless of how much weight you gain. If, however, your car’s engine has insufficient power to get up the hill, your car will eventually stop, and may roll back down.
The chance of this happening depends on the steepness of the hill (how much weight you gain) and the strength of your engine (or the strength of your beta cells and their ability to produce more insulin). The point at which your car stops (when your pancreatic beta cells are no longer able to produce enough insulin), is termed, aptly, “beta cell exhaustion”. From this point, there is usually an inexorable decline in the release of insulin from the beta cells, when blood sugar levels progressively increase and T2D eventually becomes manifest.
Our genetic makeup determines the strength of our pancreatic beta cells, and therefore influences which of us will make it up the hill and which of us will halt and roll back down. This is why T2D is in fact a genetic condition, and weight gain or obesity often contribute to its manifestation.
Why does insulin resistance occur with weight gain? To answer this, it is important to understand that abdominal (visceral) fat confers the greatest risk. Blood from visceral fat, laden with fatty acids, drains directly into the liver. Some of these fatty acids can spill over into the general circulation, where they can compete with glucose (sugar) uptake into more peripheral tissues, such as muscle. Given that glucose uptake is an insulin-mediated process, this competition promotes insulin resistance. Visceral fat also produces hormones called adipokines, some of which can further dampen the sensitivity of the insulin receptor to the effects of insulin.
Using our analogy, weight gain around the waist confers the steepest gradient up which to drive a car.
The development of T2D is complex. There are many processes implicated, ranging from excretion of glucose in the urine, appetite regulation, control of pancreatic hormonal function and the role of gut bacteria. However, weight gain and insulin resistance appear to be associated with many of these processes.
Currently, we cannot do much about the elements of our genetic makeup that influence pancreatic beta cell function, although this may change in the future. We can, however, improve our insulin sensitivity – and reduce the gradient of the hill ahead of us.
Aside from weight regulation, exercise and regular activity are important: exercise, in addition to numerous other benefits, improves our insulin sensitivity. Avoiding sleep deprivation, which can promote insulin resistance, is also important. On top of this, a varied diet – one that limits processed food and advanced glycation end-products (AGEs) – can help improve insulin sensitivity: preparation technique involving high moisture, short heating times and the use of acidic marinades (such as lemon juice and vinegar) are techniques that can reduce our consumption of AGEs.
Type 2 diabetes is a genetic condition – but there is plenty we can do to make our mountains into molehills.

https://www.theguardian.com/commentisfree/2017/sep/27/why-does-obesity-cause-diabetes-google-answer#img-1

Tackling Negative Effects of Diabetes

From ndsuspectrum.com

Roughly 29 million Americans have diabetes, according to the Centres for Disease Control and Prevention, and North Dakota State associate professor of pharmaceutical sciences Yagna Jarajapu and his research team are doing their best to help.
The National Institutes of Health awarded the research team with a $1.3 million grant to study countermeasures of the negative effects diabetes has on the blood vessels, specifically those in the lower legs.
The tests and hypothesis focus on peripheral vascular disease (PAD), but findings translate back to treatment associated with diabetic induced vascular complications. PAD is, essentially, the narrowing of blood vessels that exist outside of the heart and brain.
“We are using PAD as a model, but the theory will apply for any diabetic cardiovascular complications such as a heart attack or a stroke,” Jarajapu said.
Their findings can also help prevent diabetics from needing amputation due to cardiovascular complications. “After long-term diabetes, if they don’t control their diabetes strictly, they develop lack of blood flow in the limbs … and eventually they undergo amputation. Otherwise, it will spread over the rest of the body.”
Jarajapu and his team are acting now to help the aging baby boomers with these health problems. “We are trying to prevent irreversible damage,” he said. “We have to act now to fix this complication.”
Time Magazine reported in 2015 that 18.9 percent of baby boomers have diabetes, with those numbers expected to keep climbing. That is approximately 14.3 million diabetic baby boomers.
The project’s official title is, “Targeting Mass Receptor for Diabetic Vascular Disease in Older Adults,” and Jarajapu is the principal investigator. 
The research team consists of Jarajapu, two graduate students and a doctoral student from NDSU and one undergraduate student from Concordia College. Funding allows room for one more undergraduate student on the team.
To inquire about this position, contact Jarajapu via email at Yagna.Jarajapu@ndsu.edu.

http://ndsuspectrum.com/tackling-negative-effects-diabetes/

Is it possible to reverse Type 2 diabetes?

From theguardian.com

Type 2 diabetes is a progressive condition that can lead to heart disease, nerve damage, kidney disease and blindness. However, it is possible to beat it into remission. The pancreas can begin again making insulin, the hormone that regulates levels of glucose in the blood. The liver can reassert itself as the body’s reservoir for glucose and stop pumping out unwanted sugar. And many people who have been taking tablets to control their type 2 diabetes can potentially throw them away. This is good for the NHS, because 5% to 10% of people have type 2 diabetes. However, to beat it, you would need to lose about 10% of your body weight – and keep it off.

In an analysis paper in the BMJ, Mike Lean, professor of nutrition at Glasgow University, argues that giving tablets to reduce blood sugar (the main treatment for type 2 diabetes) only addresses the symptom. “Virtually everyone with type 2 diabetes is two or three stone [12-19kg] above their ideal weight,” says Lean. “One of the great tragedies is that we’ve known this for about a hundred years and all the treatments have ever done is reduce the blood sugar – this is the consequence, but what drives it is the weight.”

Lean says the easiest indicator of someone at risk of type 2 diabetes is a fat tummy. A man with a waist over 91cm (36in) or a woman with a waist over 81cm (32in) could both be on the path to the condition. Another paper in Frontiers in Endocrinology describes a programme of high-intensity exercise as a way of preventing type 2 diabetes developing in people with risk factors. But: “You can’t run off diabetes,” says Lean. He says evidence suggests most people need to lose more than 12kg. But studies show woeful remission rates (0.14% of 120,000 US patients who were followed up for seven years).

Lean is more optimistic, as his team is involved in a programme called Counterweight Plus, which a pilot study showed led to a third of people losing more than 12kg. The programme involves drinking formula shakes with a total of 820 calories for six to eight weeks, before reintroducing food that includes a lot less fat, and ideally no alcohol. The programme is being further evaluated and Lean says he is not pushing his own Counterweight Plus solution – people should ask their GPs for any evidence-based weight-loss programme. The rewards of weight loss are high. Not having type 2 diabetes any more (as long as you don’t regain weight) means not only no tablets for diabetes and no complications, but often the reversal of any high blood pressure, too.

https://www.theguardian.com/lifeandstyle/2017/sep/25/reverse-diabetes-type-2#img-1

How You Cook Red Meats Can Increase Your Risk of Type 2 Diabetes

By Paul D Kennedy

In a recently published long-term study, more than 59,000 females aged 30 to 55 years were monitored from 1986 to 2012 (26 years).
The study Cooking Methods for Red Meats and Risk of Type 2 Diabetes: A Prospective Study of U.S. Women was published in Diabetes Care, the journal of the American Diabetes Association, in June 2017.
All the women consumed at least two servings of red meats a week. In addition, they were all free of diabetes, cardiovascular disease and cancer at the start of the project.
Information on how often the subjects used various methods of cooking red meat... including broiling (grilling from the top down), barbequing, roasting, pan-frying, stewing and boiling... was also gathered at the start.

The Outcome
Just over 10.5% of the women developed type 2 diabetes (T2D) over the two-and-a-half decades of the study, more than the average for the population as a whole. Both total red meat and processed red meat were associated with an increased risk of T2D.
But the increase in risk varied depending on the cooking method used.
Compared to persons who ate red meat once a month or less often, those who ate two or more servings a week had:

• a 29% increased risk of developing T2D if the meat was broiled (under flame),
• a 23% increased risk if the meat was barbequed, and
• a 11% increased risk of T2D if the meat was roasted.

In addition, when meat was stewed or boiled there was no higher risk of developing T2D. And, strangely, when meat was pan-fried (a high heat method of cooking), the risk was reduced.

But what causes the increased risks when red meat is broiled, barbequed or roasted?
You can blame these three chemicals:

• Heterocylic amines (HCAs)
• Polycyclic aromatic hydrocarbons (PAHs)
• Advanced glycation end products (AGEs)

These chemicals have been linked to inflammation, diabetes, obesity and cancer.

Heterocylic amines (HCAs) and Polycyclic aromatic hydrocarbons (PAHs)
HCAs and PAHs are chemicals that are formed when muscle meat... beef, pork, fish or poultry... is cooked at high temperatures, over or under open flames.
HCAs are produced when amino acids (the building blocks of proteins), sugars and the creatine found in muscle react at high temperatures. HCAs are only found in foods that have been cooked at high temperatures.
PAHs are made when fat and juices from meat grilled directly over an open fire (ie barbeque) drip onto the fire causing flames. The flames carry the newly created PAHs back up and they adhere to the meat.
PAHs can also be formed when meat is being smoked. They can also be found in cigarette smoke and car exhaust fumes.
The formation of HCAs and PAHs during cooking varies depending

• on the type of meat,
• the cooking method used, and
• how much (rare, medium or well done) the meat cooked.

Whatever the type of meat, cooking it at a high temperature (over 300 degrees F), or cooking it for a long time, tends to form more HCAs. Well done steak or chicken, whether barbequed or grilled, contains high concentrations of HCAs. Exposing meat to smoke or charring also forms PAHs.

HCAs and PAHs have been found, under laboratory conditions, to be mutagenic... ie, they cause changes in DNA.

Advanced Glycation End Products (AGEs)
Glycation is the bonding of a sugar molecule, such as glucose or fructose, to a protein or lipid molecule without the bonding being controlled by an enzyme.
Glycation impairs the functioning of biomolecules. A biomolecule is a molecule that is involved in the maintenance and metabolic processes of living organisms.
Advanced glycation end products (AGEs) are proteins or lipids that have become glycated by being exposed to sugars. AGEs affect nearly every type of cell and molecule in the body.
They can be a factor in aging and in the development or worsening of many degenerative diseases, such as diabetes, atherosclerosis, chronic kidney disease, and Alzheimer's disease. They are also believed to play a causative role in the vascular complications of T2D.
Most foodstuffs contain small quantities of AGEs.
Dry heat promotes the formation of AGEs across most food categories... some foodstuffs this can contain up to a 100 times more AGEs than the food in its uncooked state.
Foods derived from animals that are high in fat and protein are generally AGE-rich and prone to the formation of new AGE during cooking.
By contrast, carbohydrate-rich foods such as vegetables, fruits, whole grains, and milk contain relatively few AGEs, even after cooking.

How can you reduce the risk from red meat?
The World Cancer Research Fund and the American Institute for Cancer Research issued a joint report in 2007 that recommended limiting the consumption of red, processed and smoked meats.
Nevertheless there are no official guidelines as to how meat eaters can reduce the formation of HCAs, PAHs and AGEs.
Here are a few common sense measures you can use to reduce your exposure to these chemicals:

• Use a variety of cooking methods
• Use moist heat... braising (stewing slowly in a closed container), steaming or poaching... as often as possible
• Avoid direct exposing meat to an open flame or a hot metal surface
• Avoid prolonged cooking times (especially at high temperatures)
• Cook as slowly as possible (at lower temperatures)
• Use acidic ingredients... lemon juice or vinegar... in marinades
• Use a microwave oven to cook meat before finishing off with high heat
• Turn meat that is on a high heat source over continuously
• Don't eat charred portions of meat
• Don't make gravy from meat drippings

http://ezinearticles.com/?How-You-Cook-Red-Meats-Can-Increase-Your-Risk-of-Type-2-Diabetes&id=9794064

Understanding type 2 diabetes

From castlighthealth.com

Why does diabetes occur?

Diabetes develops when your blood glucose, also called blood sugar, is too high.
A hormone called insulin helps glucose from food get into your cells and be used for energy. Sometimes your body doesn’t make enough (or any) insulin or doesn’t use insulin well. Glucose then stays in your blood and doesn’t reach your cells.
Over time, having too much glucose in your blood can starve your cells and harm your eyes, nerves, kidneys, and heart.

What is type 2 diabetes?

Type 2 diabetes is also called “adult onset” diabetes, since it typically develops after age 35 (though a growing number of younger people are now developing type 2 diabetes.)

How is diabetes diagnosed?

To diagnose diabetes, your doctor may order a blood test called Fasting Plasma Glucose. These blood tests are done in the morning on an empty stomach. Glucose levels above a certain point on more than one occasion indicate diabetes.

How is diabetes treated?

Often, type 2 diabetes is associated with being overweight and having a sedentary lifestyle, so treatment focuses on diet and exercise. If lifestyle changes don’t control your blood sugar, then your doctor will recommend medications to help your body use its own insulin more efficiently.

Warning symptoms

If you have type 2 diabetes and have symptoms such as confusion, weakness, or extremely high blood sugar, get medical help immediately. These symptoms may mean that you have a life-threatening condition.

Finding the right care

Start by seeing your primary care doctor.

Get regular preventive care

If you have diabetes, plan to see your primary care doctor at least once a year for checkups that include regular blood sugar tests, blood pressure checks, foot examinations for nerve and artery disease, and diabetes education.
Your primary care doctor will also make sure you get annual flu and pneumonia vaccines. People with diabetes are at greater risk for complications from these illnesses, so these are especially important.

See a specialist if you need help managing your condition

If you have difficulty controlling your diabetes, you should also see an endocrinologist (a doctor who specializes in diabetes) once or twice a year for more specialized care. An endocrinologist can teach you about new advances in diabetes care and advise you on the best way to control your blood sugar.

Don’t skip annual vision and dental exams

Because diabetes can cause damage to the retina, people with diabetes should visit an eye doctor for regular (annual) eye exams.
Because high blood sugar can increase your risk for cavities and gum disease, it’s important to have regular dentist check-ups (every 6 months to one year) and tell your dentist that you have diabetes.

Choosing a treatment plan

To control diabetes, it’s important to monitor your blood glucose levels.

Treating diabetes

Your doctor will recommend a treatment plan based on several factors, but the main factor is the level of your blood sugar and how stable it is over time. For example, people with “well-controlled” diabetes (blood sugars less than 150 mg/dL) are often able to manage diabetes with diet and exercise and/or medication. Others who have high blood sugar levels (greater than 200 mg/dL) and other complications, despite medication, may need more specialized treatments and medications like insulin injections.

Monitor and manage diabetes

People with diabetes need regular blood tests called Hemoglobin A1c tests. These check average blood sugar levels over the course of three months. Frequency will depend on the severity of your condition, but four tests per year are typical.
If you have trouble controlling your diabetes or have complications from diabetes, you may need home monitoring to check your own blood sugar frequently. Your doctor will tell you how often, but you may need to check multiple times per day.
If you have symptoms of decreased blood flow, are over 50 years of age, have high blood pressure, or smoke, you may also receive an ankle-brachial index test. This test checks if enough blood is flowing to the legs.

Commonly prescribed medicines

Medicines for type 2 diabetes work by replacing or increasing insulin production, decreasing sugar production, and preventing the digestion of sugars. Some common medicines include:

• Metformin
• Glyburide
• Glargine insulin
• Pioglitazone

Living with type 2 diabetes

Even modest weight loss and physical activity can make a big difference.

Even modest weight loss yields big benefits

Many people with diabetes are told by their doctor to lose weight. The good news is that losing even 5%-10% of your body weight has a real impact on your health. Taking off pounds will:

• Lower your blood sugar, which may allow you to cut back on medication
• Help your body use insulin more effectively
• Control blood pressure and cholesterol, which can reduce your risk of heart attack, kidney failure, and other diabetes complications

Many people with diabetes also find nutritional counseling and personalized medical nutrition therapy helpful for learning which foods cause spikes in their blood sugar.

Get active to control blood sugar

Physical activity is an important part of managing your blood glucose level and staying healthy. Being active has many health benefits. Even a daily 30-minute walk makes a big difference in your health. Staying active:

• Lowers blood glucose levels
• Lowers blood pressure
• Burns extra calories so you can keep your weight down if needed
• Improves your mood

1 in 4 people with diabetes also have depression

Ups and downs are inevitable, but if you’re experiencing feelings of deep sadness that are getting in the way of daily activities, you may have depression. On top of the emotional toll depression takes, the condition can also make it difficult to stay on track with medication, nutrition, and doctor visits.
If you think you may have symptoms of depression, you are not alone. Depression is treatable. Talk to your doctor so you can get the support you need for your physical and emotional health.

https://my.castlighthealth.com/blog/type-2-diabetes/

10 Tips to Help You Take Your Diabetes Medications on Time

From everydayhealth.com

To keep your blood sugar levels controlled, it's vital to take your diabetes medications as prescribed. Follow these strategies to ensure you take them on time, every time.

When Carol Gee, 67, of Stone Mountain, Georgia, was diagnosed with type 2 diabetes nine years ago, she implemented a system to take her medications and never once veered off course. A retired inventory management specialist in the military and a teacher, Gee was familiar with the efficacy of regimens, so she knew sticking to a schedule would help ensure she would always take her diabetes medications as prescribed.
In the morning after she wakes up, showers, and brushes her teeth, Gee immediately takes Metformin (glucophage), Victoza (liraglutide), and a medication for high blood pressure. Depending on her fasting blood sugar, she’ll also take fast-acting insulin and eat within 15 minutes. At night, after she brushes her teeth, she’ll repeat the same process but replaces the fast-acting insulin with a long-lasting insulin.

“I’ve always been organized, and I believe that organization is also important when you’re taking medication,” she says, explaining that practice and repetition have enabled her to follow the plan.

Thanks to this routine, Gee is the exception: Between 38 and 93 percent of people with diabetes struggle to take their medications, according to a review published in June 2015 in Diabetes Medicine.

Obstacles to Taking Diabetes Meds on Time

If you’re taking medication for diabetes — whether it’s pills or injections — it can be challenging to do it exactly the way your doctor prescribed and on the same schedule every day. If you take more than one medication, you might also have trouble remembering if, when, and how much you took.
Add to that rising drug costs and high insurance-plan deductibles, and you might be tempted to skip a dose or not take your medications altogether. Poor medication adherence can hinder glucose control, increase the risk of hospitalizations and complications, and even lead to death, according to an article published in July 2016 in Patient Preference and Adherence.
“People often think medication non-adherence means not taking your meds, but it can also be taking them incorrectly, taking them at the wrong times, and not taking the right dose,” says Hayley Ball, a clinical pharmacist and certified diabetes educator at Northeast Medical Group, part of Yale New Haven Health, in Trumbull and New Haven, Connecticut. Considering that definition, medication non-adherence may also lead to some unexpected and serious side effects.
For example, diabetes medications like sulfonylureas, including Glipizide (glucotrol), or meglitinides, such as Prandin (repaglinide) — both of which stimulate insulin production — are best taken before you eat a meal.
Yet if you don’t eat, don’t eat on time, or don’t eat the correct amount of carbohydrates, you run the risk of low blood sugar because “here’s this pill that’s producing more insulin  and now we haven’t made any adjustment with the food to match what that pill is doing,” says Diana O’Keefe, RN, CDE, and the clinical coordinator of the Diabetes and Endocrine Institute at Atlantic Health System Morristown Medical Center in Morristown, New Jersey.
After you do eat, your blood sugar could get too high, and set off a vicious cycle. “The more they eat, the higher their sugar goes, and it’s like they’re trying to catch up,” O’Keefe says.
Left untreated, diabetes can increase your risk for cavities and gingivitis, diabetic neuropathy and diabetic retinopathy, heart disease, stroke, and in men, erectile dysfunction, to name a few complications.

Tips for Diabetes Medication Adherence

Ask questions. If you’re unsure about any aspect of your medication prescription, ask for clarification from your primary care provider or pharmacist. “When someone understands what [their medications] do, how they work, what the side effects are and what the method of action is, they’re more likely to take them,” O’Keefe says.
Set and follow a schedule. If you take your medications at the same time every day and alongside another activity like taking a shower or feeding the dog, it can become second nature like it did for Gee. “Sometimes attributing your meds to that schedule can keep you more adherent,” Ball says.
Stay consistent. If you’re on insulin, but you’re not taking it regularly and your doctor has increased your dose, you run the risk of hypoglycemia, or low blood sugar. “Taking your prescribed insulin consistently can help with more stable blood sugar readings and monitoring that can help your doctor adjust your medications in a safer way,” Ball says.
Use a pill box. Experts agree using a pill box is one of the best ways to take your medications correctly. “Not only does it help you remember to take your meds, but it can help tell you when you’re missing your medications and prevent re-dosing,” Ball says.

Take advantage of visual reminders. If you put your pills in a place that’s highly visible — like your nightstand or dining room table — you may be more likely to remember to take them. “A little bit of caring at the beginning of the week and filling those [pill] boxes and getting them in the right spot can save you a week’s worth of angst,” O’Keefe says. Of course, if you have young children, it’s a good idea to put your medication in a medication lock box or out of their sight and reach.
Use an app. Set an alarm on your phone or download an app that sends you reminder emails, text messages, or push notifications, or one that syncs with your FitBit to send reminders.
Drink water. If you’re having a hard time taking your pills because they get stuck in your throat, make sure to take them with a full glass of water. “Eight ounces of water actually helps wash everything down,” Ball says.
Ask about the option of flexibility. For some medications, it may be possible to take them less frequently throughout the day, so speak to your doctor or pharmacist about a different schedule. “If it’s possible to tailor it to where you’re only taking them one to two times a day, you’re more likely to stay consistent with it,” Ball says.
Call your insurance company if expenses are the problem. Cost shouldn’t keep you from taking your medication correctly. Ask your doctor if you can switch brands or take the generic or formulary alternative. “Sometimes the formulary option will do the exact same thing, but it will cost the patient less,” Ball says.
Get support. Think about ways that will make taking your medication easier. Maybe it’s signing up for pharmacy delivery; a company that calls with medication reminders like Pleio GoodStart; or a medication timer cap.
If you’re worried about the side effects or how to make medication part of your everyday lifestyle, contact the American Association of Diabetes Educators for a diabetes education program in your area, contact your local American Diabetes Association office, or ask your doctor for a referral to an in-person support group. “There’s a lot of group dynamic when you put everyone who is similar in a room and let them start sharing some stories,” O’Keefe says.
The key to make sure you take your medications correctly is to find what works for your lifestyle. For Carol Gee, simply sticking to the same schedule and routine every day has been the best way to stay adherent. “In doing that every day, I don’t really have to think about it. I just know, this is what I do,” she says.

https://www.everydayhealth.com/type-2-diabetes/treatment/tips-help-take-your-diabetes-medications-on-time/

Type 2 Diabetes and Healthy Eating - Three High Protein Vegetables to Start Eating Today

By Beverley H Piepers

For most people, getting enough protein into their daily eating plan proves to be the biggest challenge they face, nutritionally speaking. Unless you are a lover of chicken breast or are diligently tracking your protein intake, there is a good chance you are currently not eating enough protein each day.
Fortunately, some vegetables will pack in more protein than many people realize. While they definitely will not give you the protein a juicy steak would, as far as vegetables go they do offer a good dose. Include these protein-packed vegetables in your daily eating plan, and you might just find it becomes easier than ever to get your needs met.

Here are three of the best vegetables to choose...
1. Edamame. Often regarded as a vegetarian-only food, do not neglect this vegetable. It packs in 10 grams of protein per cup and is super easy to prepare and eat. You can purchase this vegetable in steamer bags, making it easy just to pop them into the microwave, add a little salt and pepper, and then serve.
For something even tastier, try tossing them with a little of your favourite salad dressing before serving.
2. Corn. Few things are more delicious than fresh corn on the cob done on the BBQ. Corn is primarily a carbohydrate source, but this said, it will also give you a good dose of protein as well.
Corn packs in 8 grams of protein per half cup serving, so not to be ignored. If you combine corn with some black beans, which makes for a great combination, the beans will also provide you with a great dose of protein as well, and this can help to make a complete meal.
If you cannot find corn on the cob, canned corn works as well. Just avoid creamed corn as it has other ingredients added and is higher in fat and sugar.

3. Kale. Next up on the list is kale, which packs in 6 grams of protein per two cup serving. Kale is often regarded as one of the best superfoods you can be eating thanks to the high variety of vitamins and minerals it contains.
Serve it raw, cooked, or blended into a protein smoothie. Any which way you prefer; you will be doing your body good.
Keep these vegetables in mind and make sure you are not overlooking them. Remember there are other places you can get your protein from part from animal-based sources.

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

http://ezinearticles.com/?Type-2-Diabetes-and-Healthy-Eating---Three-High-Protein-Vegetables-to-Start-Eating-Today&id=9793368

Boy with type 1 diabetes walking 4,000 miles across United States to further efforts to find cure

From idahostatejournal.com

POCATELLO —An 11-year-old boy convincing his father to buy him a new set of Legos or allowing one extra hour of playtime with friends after dark can be an arduous task to accomplish.

But asking your dad to quit his job, sell or give away all your family’s belongings, including their home, and walk the longest possible distance in the contiguous United States is like the father trying to convince the same 11-year-old boy that vanilla ice cream is inferior to unsalted kale chips.

How does a father even begin to frame that conversation when his son, Noah Barnes, only has the chance to eat vanilla ice cream every so often because doctors diagnosed him with Type 1 diabetes at 16 months of age?

The short answer is he doesn’t. And the long answer is the dad, Robert Barnes, does quit his job, cash out a 401K and deplete his savings accounts. Then the family of five launches Noah’s March Foundation, a non-profit that would spur a 4,000-mile trek from Key West, Florida, to Blaine, Washington, with the intent of raising awareness and funds to eradicate Type 1 diabetes.

What started out as research for a home-school project for Noah eventually led him to a documentary about Terry Fox, who — with one leg having been amputated — embarked on an east to west cross-Canada run to raise money and awareness for cancer research. It was called the Marathon of Hope.

“Noah comes to me and says, ‘There is this walk for a cure. Can we walk and I be cured?’” Robert recalled. “And I said, ‘No they’re doing fundraising.’”

“What’s fundraising?” Noah asked.

“It’s where they raise money for research,” Robert replied.

“Well can’t you just give them the money.”

“No, I don’t have this much money,” Robert said. “But he was persistent for about a week and then he just looked at me in the eyes and said, ‘Dad, don’t you want me to be cured?’ And what do you tell your 10-year-old? ‘No son, my career is more important.’”

Both Robert and his wife, Joanne, were sceptical at first but were willing to test Noah’s physical capabilities by walking for a few hours every day on the beach near their home in Jupiter, Florida. The temperature was often 95 degrees with the humidity at 60 percent.

“I’m being really hard on him,” Robert said. “I kept asking, do you want to quit? Do you want to quit? And he was like ‘I got this.’”

After three weeks, Noah remained persistent and reached a point where he could comfortably walk 5 to 7 miles. At six weeks, Noah could walk 8 to 10 miles a day. That’s when Robert and Joanne became convinced Noah was physically ready and mentally committed to the cause.

At sunrise on Jan. 1, Noah and Robert started walking, and on Saturday the family — having already covered more than 3,000 miles — reached Pocatello on day 259 of the journey.

While Robert and Noah are physically walking, Joanne and Noah’s two younger siblings, John and Angela, follow along in the family support vehicle.

While Joanne spends her day homeschooling John, securing lodging for the night, updating social media accounts and taking care of any other details necessary to keep the family on schedule, Noah and Robert work on home school lessons as they walk.

Instead of reading a history book about the civil war, Robert and Noah have walked past roadside monuments like those found at the Battle of Chickasaw Bayou, and all the while Robert said he is grilling Noah on dates, names and statistics.

Rather than hearing a lecture from a teacher about the Lewis and Clark expedition, Robert and Noah used Meriwether Lewis’ journal as a guide while walking some of the same trails explored on the journey.

A typical day for Noah starts around 8 a.m. when he wakes up, checks his blood sugar and eats a high-protein breakfast. Noah then packs snacks and lunch for the day and works on home school lessons. At about 11 a.m., the family drives to the starting point for the day.

Over the course of the day, Robert and Noah check his blood sugar about every 90 minutes. But because of the increasing elevation, there have been points on the journey where they needed to check it every 60 minutes.

Aside from their parenting roles, Robert and Joanne have assumed the roles of Type 1 diabetes advocates, marketers, teachers and travel guides. And while Noah’s March has been the catalyst for their newly found positions, it’s only the beginning of their journey.

The family anticipates arriving in Blaine, Washington, sometime in November. From there, they will drive to Southern California, where they hope to secure any additional publicity with morning and late-night TV shows.

Then, as Noah, his siblings and his mother follow along in the family support vehicle, Robert will travel on bicycle from Los Angeles, California, back to Key West, Florida, stopping in Southern states missed along the walk.

From there, the family will drive from Key West back to Blaine, stopping along the way to greet all the strangers-turned-friends who have helped them along the way.

Robert Barnes and son Noah talk to Carol Gunter, who stopped to see how they're doing and to give a donation to Noah's March Foundation. Noah, who has type 1 diabetes, is walking across America to raise funds and awareness to help find a cure for the disease. They were walking on Old Highway 91 between Inkom and Pocatello Saturday afternoon.

But aside from those who have assisted the Barnes family during their cross-country adventure, Robert said he will also revisit the organizations and research institutes that are working toward a cure for Type 1 diabetes.

“We want to talk to the researchers that actually have a direction for a cure,” Robert said. “There are about 25 institutions that are really focused on finding a cure and I would say 10 of them really need money because they have a legitimate process.”

Robert continued, “We want to focus on getting all the diabetes groups together and find out what’s working, who’s helping and who isn’t and start moving in the same direction. All the while we are filming these researchers and asking them what has changed in a year.”

Of the nearly $32.3 billion spent annually by the National Institutes of Health to study various conditions or diseases, HIV/AIDS research receives $3 billion a year and diabetes, of all types, gets $1 billion.

“HIV affects 1.2 million people and diabetes affects 30 million people,” Robert said. “There are these glamour groups that are getting a bulk of the research. I mean, $3 billion a year goes to AIDS offshore treatments. We have a health crisis in America — aside from our health care issues that we can’t figure out — we are burning billions of dollars on someone else’s health crisis.”

Robert continued,” We want to get people held accountable. Ten percent of the population has diabetes. If we don’t get a cure in the next 30 years it will be one-third of Americans that have diabetes.”

Once the Barnes have the proper audience they want to coordinate research groups to work together. They want to hold groups who are not spending the research money acquired through fundraising campaigns accountable with the production of a documentary film that will expose who is managing their finances appropriately.

“We are going to force accountability with researchers,” Robert said. “We are going to force accountability for funding and we are going to force everybody to move in the same direction and we will legitimately have a cure in a short period of time.”

You can read more about the organization, make a donation or track Noah’s exact location at noahsmarchfoundation.org

http://www.idahostatejournal.com/news/local/boy-with-type-diabetes-walking-miles-across-united-states-to/article_e413293d-06eb-5869-832f-8c3d2f58f33d.html

Type 2 diabetes symptoms: THIS is the age you should be tested - are you at risk?

From express.co.uk

People over 40 should be checked to see if they are at risk of type 2 diabetes, with almost two million offered a place on a diet and exercise programme, a health watchdog has said.
Every week 4,500 people are diagnosed with type 2 diabetes across the UK.
Experts also said risk assessments for the condition should be carried out in GP surgeries and pharmacies.
The health watchdog, NICE, said people should also be encouraged to test themselves for the condition - which is linked to obesity - in community venues and the workplace.

Anyone attending the free NHS Health Check with their GP once they hit 40 should be screened for existing type 2 diabetes or the chance of having it in future, it said.
Professor Mark Baker, director of the centre for guidelines at Nice, said: "We know that helping someone to make simple changes to their diet and exercise levels can significantly reduce their risk of developing type 2 diabetes.
"And that this approach is a cost-effective way of managing an illness that currently costs the NHS around £8.8 billion a year.
"We need to make sure that the people most at risk have access to the care they need."
Symptoms of diabetes include increased thirst, increased urination - particularly at night, and feeling tired.
The symptoms are not always obvious, and many people could be suffering with the condition for years before they learn they have it.
Pharmacists can screen for the condition and individuals are advised to take a self-assessment test, such as the Know Your Risk quiz on the Diabetes UK website.
The health watchdog said the 1.7 million people who have the highest risk of developing type 2 diabetes should be offered a place on an intensive lifestyle change programme.
These plans, such as the Healthier You: NHS Diabetes Prevention Programme, offer people a personalised scheme to reduce their risk of type 2 diabetes which includes education on healthy eating, help to lose weight and exercise lessons.
Nice said it was cost effective to offer this type of help to people with a fasting glucose reading between 5.5 to 6.9 mmol/l, but that prioritisation could be given to people with a higher reading - 6.5 to 6.9 mmol/l - due to their increased risk of developing the condition.
The new guidance also sets out ways people can take more exercise and offers advice on healthy eating, such as swapping crisps for healthier snacks such as unsalted nuts.
People should also eat more wholegrain bread and cereals, beans and lentils, vegetables and fruit, and swap red meat for lean meat and fish, experts have said.
Dan Howarth,  Diabetes UK’s Head of Care, said: "Type 2 diabetes is a serious condition that can lead to harrowing complications, so preventing it from developing in those at higher risk is hugely important.
"We welcome these updated guidelines from NICE, which recognise the importance of preventing the condition, and the serious harm it causes to those living with it.

“We know that globally, diabetes prevention programmes do work, and we know that with the right advice and support, people at increased risk of developing type 2 diabetes can take simple but significant steps to prevent the condition developing.

“The success of initiatives such as the Diabetes Prevention Programme depend on everyone across the health service pulling together with a shared goal. We hope this updated guidance will give clinicians the confidence to make prevention their priority, identify those at high risk, and refer them into the Diabetes Prevention Programme.”

http://www.express.co.uk/life-style/health/854498/type-2-diabetes-symptom-test-40

Type 2 diabetes is 'reversible through weight loss'

From medicalnewstoday.com

Many doctors and patients do not realize that weight loss can reverse type 2 diabetes. Instead, there is a widespread belief that the disease is "progressive and incurable," according to a new report published in the BMJ.

This is despite there being "consistent evidence" that shedding around 33 pounds (15 kilograms) often produces "total remission" of type 2 diabetes, note Prof. Mike E. J. Lean and other researchers from the University of Glasgow in the United Kingdom.
The thrust of their paper is that greater awareness, when combined with better recording and monitoring of remissions, could result in many more patients no longer having to live with type 2 diabetes and a massive reduction in healthcare costs.
The global burden of type 2 diabetes has nearly quadrupled over the past 35 years. In 1980, there were around 108 million people with the disease, and by 2014, this number had risen to 422 million.
The vast majority of diabetes cases are type 2 diabetes, which is a disease that results when the body becomes less effective at using insulin to help cells to convert blood sugar, or glucose, into energy. Excess body weight is a main cause of this type of diabetes.
In the United States, an estimated 30.3 million people, or around 9.4 percent of the population, have diabetes - including around 7.2 million who do not realize it.
Diabetes accounts for a high portion of the national bill for taking care of the sick. The total direct and indirect cost of diagnosed diabetes in the U.S. was estimated to be $245 billion in 2012.
In that year, of the $13,700 average medical spend for people with diagnosed diabetes, more than half (around $7,900) was directly attributed to the disease.

Treatment 'focuses on drugs'

Prof. Lean and colleagues note that the current management guidelines for type 2 diabetes focus on reducing blood sugar levels and cardiovascular risks primarily through the "use of anti-diabetes drugs, with only lip service paid to diet and lifestyle advice."
The result is that many patients develop further health problems and live, on average, 6 years less than people who do not have diabetes.
In the meantime, while remission of the disease "is clearly attainable for some, possibly many, patients," the authors note that currently, it is "very rarely achieved or recorded."
For example, they highlight a U.S. study that followed 120,000 patients over 7 years and found that only 0.14 percent of them were recorded as remissions.
Another example is that of the Scottish Care Information database, which holds records for every patient in Scotland. It shows that only 0.1 percent of type 2 diabetes patients are coded as being in remission.

Better coding guidance needed

Part of the problem, argue the study authors, is that clinicians hesitate to code patients as being in remission because of a lack of agreed criteria and guidance.
However, they suggest that the main likely cause of low remission recording in type 2 diabetes is that few patients are actually trying to achieve it.
They urge health authorities worldwide to agree clearer guidelines about how to measure type 2 diabetes remission and make sure that it is officially recorded.
"Appropriate coding," they note, "will make it possible to monitor progress in achieving remission of type 2 diabetes nationally and internationally and to improve predictions of long-term health outcomes for patients with a known duration of remission."

Clear benefits to patients

Better coding could also raise awareness and result in more people trying to reverse the condition, such as by losing weight, rather than accepting that they have to live with it.
Not only are there clear health benefits to reversing type 2 diabetes, but it can also give people a sense of achievement and empowerment.
In addition, it removes the stigma of being labelled "diabetic" and may even result in lower premiums for health insurance, travel insurance, and mortgages.

https://www.medicalnewstoday.com/articles/319432.php

Why It Is Essential To Get A Comprehensive Eye Exam

By Joel Travers King

The care of your eye health is something that you should never take for granted. When it comes to doing the things that you need to do to protect and preserve your precious eyesight one thing that reduces your risks for eye diseases is a regular comprehensive eye exam. Often, we become complacent about our vision health and assume that due to the fact that we can see clearly that our eyes are healthy. However, we may not be aware of the fact that there may be underlying problems with our eyesight. Form this point of view; there are some eye problems that don't have symptoms which go undetected. The eyes are not just the windows to the soul but they are also the windows to our health. And as such they are indicators of health problems in our bodies that we might not be paying attention to. Also, there are some eye conditions that don't have visible symptoms that could be indicators of eye health problems. These vision health issues may cause negative changes in our vision that we may not be aware of either. From this point of view, there is an important case here for getting a regular comprehensive exam. Therefore, here are reasons why such an eye exam is vital to maintaining healthy eyesight:

The eyes are indicators of health conditions in the body and by examining the health of the blood vessels in the eyes an eye doctor via a comprehensive eye exam, can detect whether or not a patient is developing health conditions such as diabetes, high blood pressure, cancer or glaucoma. The advantage of such a test is the fact that it encourages early detection so that the treatment of eye conditions can be administered as early as possible before an eye condition or disease becomes progressively worse.
Macular Degeneration: this eye disease can be detected by a comprehensive eye exam. Such a test is essential due to the fact that this procedure is able to detect problems with the eye associated with the development of age related vision disorders. This is due to the fact that such a procedure identifies problem areas in the eyes in terms of the health of the blood vessels and the blood capillaries. This can also determine if there is any leakage in the blood vessels that requires medical attention. In the case of macular degeneration this is an age related vision disorder that can lead to a loss of a patient's central vision. This condition is also the leading cause of blindness in the United States. It can be detected by a comprehensive eye exam.
Glaucoma: In the case of Glaucoma this is another age related eye disease whereby the pressure in the eye is too high. This is another eye condition that can be detected by a comprehensive eye exam. In the case of Glaucoma there are no visible symptoms that one can detect with this condition and often this eye disease goes undetected but can be diagnosed with a comprehensive eye exam.

We can never underestimate the importance of getting a comprehensive eye exam. Such an important eye exam encourages early detection of eye diseases and even health conditions in the body that you may not be aware of such as diabetes, high blood pressure, cancer and glaucoma. This kind of eye exam provides the kind of early detection necessary to prevent eye diseases and vision conditions from worsening because early treatment is administered. By making a regular comprehensive eye exam an integral part of our eye care we can do the things necessary to prevent eye diseases and ensure that our vision health remains healthy for a lifetime.

http://ezinearticles.com/?Why-It-Is-Essential-To-Get-A-Comprehensive-Eye-Exam&id=9787842

Type 2 Diabetes - Is It Possible To Predict Who Will Develop Severe Eye Problems?

By Beverleigh H Piepers

One of the complications of Type 2 diabetes is called diabetic retinal neurodegeneration, meaning the back of the eye where light forms a picture, loses its nerve function as it becomes thinner. When this happens, the eye is unable to send images to the brain. One recent study showed this particular degeneration could be at least partially predicted by the presence of other complications, allowing doctors to know which specific people with Type 2 diabetes are particularly vulnerable.
In August of 2017, the journal Acta Diabetology published the results of a study conducted at Kyung Hee University Medical Centre in Seoul, Korea. One hundred and sixty-two people with Type 2 diabetes who had the condition for over 15 years, were carefully examined and their eyes photographed. Their results were measured against...

• their blood pressure (force of the blood against the walls of the arteries),
• diabetic retinopathy (caused by damaged blood vessels in the eyes),
• statins (cholesterol-lowering drugs),
• their kidney function (filtering waste from the blood),
• nerve function in their legs (three leg nerves for movement), and
• any heart nerve malfunction (heart requires constant adjustment in rate of beating)

All the above were linked with thinning of the retina. In particular leg and heart nerve function were most closely linked with thinned retinas.

The investigators concluded slowed nerve function raised the risk of having retinal thinning.

Type 2 diabetes is fraught with possible complications. This is why it is important to keep the condition under control, even before signs and symptoms of complications occur. As scientists continue to find connecting complications, doctors will be better able to predict which complications especially to watch out for.
Type 2 diabetes is the most common cause of preventable blindness, and anyone with the condition should have a thorough eye exam once a year or more if recommended. Keeping blood sugar levels and blood pressure under control are important ways of protecting your sight...

• normal blood sugar levels range between 70 and 99 mg/dL (3.9 and 5.5 mmol/L).
• after meals the number should not go above 140 mg/dL (7.8 mmol/L)
• HbA1c, a measure of blood sugar control over the previous 3 to 4 months, should be under 7 percent to prevent complications.
• normal blood pressure for an adult should remain below 140/90.

Blood sugar can often be controlled with food choices, exercise, weight control, and medications when necessary. The same is true for blood pressure.
Now stop reading and go for a walk, ride a bicycle, or head for the gym. You will be glad you did.

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

http://ezinearticles.com/?Type-2-Diabetes---Is-It-Possible-To-Predict-Who-Will-Develop-Severe-Eye-Problems?&id=9785433

Diabetes Diet: 7 Foods That Can Help Control Your Blood Sugar Levels Naturally

From food.ndtv.com

Your diet plays an important role in managing diabetes. In fact, your diet and lifestyle are important aspects of diabetes management and treatment.  One reason is that the food you eat on a day to day basis has a direct impact on your blood sugar levels. For instance, high carb foods raise your blood sugar levels. The digestive system breaks down the digestible ones into sugar, which enters the blood. But then again, not all carbohydrates are bad. Complex carbohydrates like whole grains take longer to digest while simple carbs like white flour and refined sugar may cause sudden spikes in your blood sugar levels. Diabetics tend to have high blood sugar levels due to the inefficiency of insulin, a hormone secreted by the pancreas, to control them. Here are six foods that can help in controlling your blood sugar levels naturally.

1. Barley
A study done by Lund University in Sweden states that eating a special mixture of dietary fibres found in barley can help reduce your appetite as well as high blood sugar levels. "Whole grains like oats, brown rice or millets like jowar and ragi contain both soluble and insoluble fibre that helps with sugar control," shares Consultant Nutritionist Dr. Rupali Datta.

2. Bananas
Accordingly to a study done by the University College Dublin in Ireland, resistant starch found in foods such as bananas, potatoes, grains and legumes, may benefit your health by aiding blood sugar control, supporting gut health and enhancing satiety. This is a form of starch that is not digested in the small intestine and is, therefore, considered a type of dietary fibre.

3. Nuts
 Nuts contain unsaturated fats, proteins and a range of vitamins and minerals that lower cholesterol, inflammation and insulin resistance. According to a study published in the journal BMJ Open, you should include at least 50 grams of almonds, cashews, chestnuts, walnuts or pistachios in your daily diet to control high levels of blood fats (triglycerides) and sugars.

4. Bitter gourd (Karela)
Bitter gourd contains an insulin-like compound called Polypeptide-p or p-insulin which has been shown to control diabetes naturally.  A report issued in the Journal of Chemistry & Biology gives evidence that consumption of bitter gourd tends to increase the uptake of glucose and improves glycemic control.

5. Fenugreek seeds
 
In his book, "Home Doctor: Natural Healing with Herbs, Condiments and Spices", Dr. P.S Phadke recommends taking a teaspoon of fenugreek seeds, turmeric powder and amla powder in equal quantities with warm water thrice a day to control high blood sugar levels. Dr. Rupali Datta adds, "You could consume one to two teaspoons of fenugreek seeds soaked in water every morning but those who are on insulin therapy should consult their doctor before doing so."

6. Protein rich foods
 According to Dr. Rupali Datta, "Proteins from eggs, meat fish and chicken or from vegetarian sources like dals, paneer or besan help control blood sugar levels. Whole dals like rajma, Kabuli chana, sabut moong, and masoor are recommended at least once daily. Studies have proven that proteins have a neutral effect on blood glucose levels."

7. Amla 

Amla is the fruit of the Indian gooseberry tree and is a traditional remedy to control high blood sugar levels. It also contains a type of mineral called chromium which regulates carbohydrate metabolism and helps in making your body more responsive to insulin.

Apart from these foods, it is important to indulge in some kind of exercise daily as physical activity is known to increase insulin sensitivity. This simply means that exercising regularly helps your body to use up the available sugar in your blood stream.

http://food.ndtv.com/health/diabetes-diet-7-foods-that-can-help-control-your-blood-sugar-levels-naturally-1748824

Emergency Preparedness Guide for People With Diabetes

From asweetlife.org

We can’t complain that nature isn’t giving us fair warning of impending disasters. Big storms are queued up in the Atlantic. A monster wildfire has taken two months to consume more than 800,000 acres of Montana and other exceptionally large fires are burning in Washington, Oregon and California.
It’s an uncommon region that isn’t prone to one natural disaster or another, which means emergency preparedness is important for pretty much all households. That goes double for people with diabetes, who have more to prepare than the usual flashlights, batteries and canned food, and who have special needs around hydration, food and hygiene.

Here are some of the items to consider:-

—Generator. If you have the ability to invest in one, this can make a huge difference during the aftermath of a disastrous event, when it can take days or more to get electricity back on. You don’t need to power the whole house; consider a smaller, less expensive unit that can keep a small refrigerator going and recharge cell phones.
—A basic diabetes emergency kit. Our 2015 report on disaster preparedness lists all the most pertinent items, but pack them in a waterproof, insulated carry bag. If you need batteries for your diabetes devices, be sure to have some in your emergency kit.
–This is one of the most elementary items, yet so easy to overlook: a plentiful stash of bottled water, which is especially important for people with diabetes, who need to stay adequately hydrated. Individually wrapped energy bars are a good idea, too.
–Keep in mind that cooler wallets keep insulin cooled for a limited amount of time. The FDA recommends the squeezable cool packs if additional cooling is needed, or dry ice. Of, if you must use ice, make sure that it’s in a waterproof bag and that you take other steps to keep any of the moisture from reaching insulin and any other medical supplies. Also, make sure that insulin stays cool but not frozen.
–That brings us to another extremely useful item: Insulated shoulder bags or backpacks to stow cooling packs and so forth with the insulin, and generally to carry items that you want to keep cool.
–The pictures of Houston are a reminder that you simply can’t have too many waterproof bags of various sizes. They weigh practically nothing and the uses are almost endless. Use them for your medical gear, cell phones, household records, really pretty much everything is best off stored in them.

https://asweetlife.org/emergency-preparedness-guide-for-people-with-diabetes/

Your Daily Cup of Coffee May Help Keep a Check on Diabetes

From ndtv.com

Can't imagine starting the morning without a cup of coffee to kick in some energy? No matter how popular coffee is among the masses, it always comes under scrutiny by health experts to unravel its benefits as well as harmful effects. Here's some good news for coffee lovers. Researchers from Aarhus University Hospital in Denmark have identified a compound in the beverage that may cut risk of developing Type 2 diabetes. According to the researchers, this previously untested compound in coffee improves cell function and insulin sensitivity.
Previous studies show that a compound in coffee called cafestol increased insulin secretion in pancreatic cells when they were exposed to glucose. Cafestol also increased glucose uptake in muscle cells just as effectively as a commonly prescribed anti diabetic drug. The tests were carried out in laboratory mice. The finding could spur the development of new drugs to treat or even prevent the disease.
Through the study, the researchers wanted to see if cafestol would help prevent or delay the onset of Type 2 diabetes in mice. They divided mice that are prone to develop Type 2 diabetes into three groups. Two of the groups were fed differing doses of cafestol. After 10 weeks, both sets of cafestol-fed mice had lower blood glucose levels and improved insulin secretory capacity compared to a control group, which was not given the compound.

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Cafestol also did not result in hypoglycemia, or low blood sugar, a possible side effect of some anti diabetic medications. The researchers concluded that daily consumption of cafestol can delay the onset of Type 2 diabetes in these mice, and that it is a good candidate for drug development to treat or prevent the disease in humans.
The study was published in the Journal of Natural Products.

http://www.ndtv.com/food/your-daily-cup-of-coffee-may-help-keep-a-check-on-diabetes-1747578