Ask the Doctors: Reversing Type 2 diabetes is possible

From berkshireeagle.com

Q: Can Type 2 diabetes be reversed? My son was recently diagnosed with it, but I'm not sure he's taking it seriously enough.

A: I understand your concern: Clearly, your son — and everyone with diabetes — should do whatever they can to combat the disease. Chronically elevated blood sugar leads to atherosclerosis, increasing the risk of heart attacks, strokes and vascular disease in the legs. It also damages the nerves and kidneys, leading to a loss of sensation and kidney failure. Controlling the disease, though difficult, is not impossible and should be paramount.

Even reversing the disease is doable. As proof, consider the effects of bariatric (weight loss) surgery among people with Type 2 diabetes. They quickly go into remission.

If surgery seems too dramatic, consider the non-surgical evidence from a 2015 study in which 29 patients consumed a liquid diet of 624 to 700 calories per day for eight weeks. In the United States, the reported average caloric intake for a man is 2,600 and in women it is about 1,800; for people with Type 2 diabetes, it's often much higher. After eight weeks of calorie restriction, the average study participant lost about 32 pounds.

Among those who had had diabetes for less than four years, 87 percent reversed their fasting blood sugars to non-diabetic levels. Among those who had had diabetes for more than eight years, 50 percent were able to reverse blood sugars to non-diabetic levels. Blood pressure and cholesterol numbers also improved and the participants were able to tolerate the calorie restriction well.

A 2016 study looked at what happened to these patients after they returned to a normal-calorie diet. All participants received dietary counselling and, six months after the initial start of the study, they had regained — on average — only 2 pounds of the 32 pounds they lost during fasting. Those who had reversed their diabetes were able to maintain their blood sugar at the same level even after returning to a normal-calorie diet. Even those who were not able to reverse their diabetes had lower blood sugar levels than before the study.

A current study that won't have complete data until 2018 has followed 140 patients who adhered to 12 weeks of an 825-to-853-calorie diet; it will follow them as they then try to maintain a balanced diet for the next 92 weeks. The results are expected to give Type 2 diabetics hope of reversing diabetes with initial calorie restriction, followed by a balanced diet.

These are tightly controlled university studies and may be difficult to replicate outside of a well-conducted clinical trial. However, newly diagnosed Type 2 diabetic patients eventually may be given directions for a low-calorie diet, followed by a diet overseen by a nutritionist.

In the meantime, to reverse his diabetes, your son needs to start by eliminating foods with added sugar. This seems obvious, but it takes self-control. Cookies, candies, cakes, doughnuts, ice cream, sodas and juices should have no place in his diet. He should also stay clear of low-fibre carbohydrates, especially snack foods. If he's diligent with his diet, he can reverse a disease that has become an epidemic within our country.

So the answer is: Yes, Type 2 diabetes can be reversed, as can the obesity that leads to it. But reality itself isn't that simple.

http://www.berkshireeagle.com/stories/ask-the-doctors-reversing-type-2-diabetes-is-possible,523023

How to Get a Better Night's Sleep When You Have Diabetes

From health.usnews.com

There could be many reasons why you’re not getting a good night’s sleep if you have diabetes.

You may experience low blood sugar that causes headaches. Or you may have high blood sugar that leaves you thirsty, and then you have to wake up and use the bathroom throughout the night, says Dr. Daniel J. Donovan, director of clinical research for the Diabetes, Obesity and Metabolism Institute at the Icahn School of Medicine at Mount Sinai in New York City.

You also could have one of the many sleep problems that are more common in people with diabetes, including obstructive sleep apnea and restless legs syndrome.
Of course, there are day-to-day stressors that make it hard for many people to go to sleep.

A lack of a good sleep creates a vicious cycle, says registered dietitian and certified diabetes educator Teresa McArthur, clinical director of Fit4D in New York City. “Diabetes can create challenges to a good night’s sleep and, in return, impaired sleep can make it challenging to manage diabetes,” she says.

Take, for instance, how sleep changes your eating habits. Too little sleep on a consistent basis can lead to unhealthy eating habits, McArthur says. “Tired people might crave sweets or eat carbohydrates in an attempt to increase their energy. This then leads to weight gain and an increased risk for various sleep disorders,” she explains. Of course, those sweets and carb cravings can make diabetes harder to manage.

Fortunately, sleep issues don’t have to last forever. There are plenty of changes you can make to try and improve your sleep. There are things your health care provider can recommend as well. Here are several suggestions for better night-time rest.

Don’t eat a heavy meal before bed. Aim for a well-balanced dinner that is not your largest carb-containing meal of the day, McArthur advises. “A meal high in carbohydrates at night could lead to elevated blood sugars in the morning,” she says.

Choose exercise carefully. Physical activity is important for everyone, but if you do something too strenuous within a couple hours of bedtime, you may have trouble sleeping. Try some yoga, stretching or a casual walk after dinner.

Wind down your time with devices. Set a time after which you’re not reading work emails, listening to loud music or doing anything with your devices that can make sleep harder. Aside from the mental stress those activities can create, electronic devices emit a blue light that makes our bodies want to stay awake, Donovan says. If you must use a device right before bed, there are apps and smartphone or tablet settings that can block the blue light.

Try to go to bed and wake up at the same time every day. This helps your body establish a routine.

Avoid alcohol and caffeine before bed time. Also, watch the fluid intake. Too much liquid before bed could mean getting up to use the bathroom a lot, Donovan says.

Think #sleepgoals for your bedroom. “Make your bedroom a relaxing, disruption-free place to relax and sleep. Keep it cool, dark and calm,” McArthur recommends. Pet owners, it may be best for your pets not to sleep in your bed, says Donovan – although he realizes this is a tough order to follow. However, it’s something to consider if your pets keep you up or wake you up a lot at night.

Consider tracking your sleep with an app. There are apps that will track sleep patterns. Some of them are free or low-cost, while others are pricier. There’s no harm in trying a sleep app if you want information on your nocturnal habits, Donovan says. However, keep in mind that they are not always 100 percent accurate.

Additionally, you may want to think about where you are in your diabetes management. “It can be just another item that you feel you need to track,” McArthur says. “This can be helpful for some and burdensome to others.” Someone newly diagnosed with diabetes may feel that tracking sleep just adds too much work, while someone who has managed diabetes for a long time could be in a better place to track sleep, she says.

Set up a night-time routine for your diabetes care. This will vary person to person, but it may include some of the following:

• Take any medications.
• Check your blood sugar.
• Brush and floss your teeth. Dental health is important for diabetes health, McArthur says.
• Inspect your feet. When you have diabetes, you may develop a condition called neuropathy that makes you not able to feel scrapes, cuts and other injuries on your feet. That’s why daily foot inspections are important.

Consider losing a little weight. Extra weight can make you more prone to sleep issues like obstructive sleep apnea, Donovan says. Some symptoms of sleep apnea including snoring, daytime sleepiness and irritability. However, losing weight could help sleep apnea as well as improve blood sugar control.

Talk to your health care provider if sleep is consistently a problem. If you find that sleep problems affect your blood sugar, food intake or overall health, seek professional help. Your provider may have helpful suggestions or may want to test you for sleep problems such as obstructive sleep apnea. Sometimes, irregular sleep is a sign of depression, and that’s something else you’ll want to get help for, McArthur says.

One last thought on sleep: If you wake up on the middle of the night and have trouble falling back asleep, don’t stress over it. Read a book, try a breathing exercise or leave the bedroom for a while and then go back to rest. The goal is to stay relaxed. “Don’t turn on the TV and watch the world news,” Donovan cautions.

If you think you’re awake in the wee hours because you’re experiencing low blood sugar, check your glucose level and follow steps to treat low blood sugar. “Once your blood glucose is normal, you should eat a small snack if your next meal is one to two hours away,” McArthur says. If you’re waking up in the middle of the night a lot, talk to your health care provider.

https://health.usnews.com/health-care/patient-advice/articles/2017-10-26/how-to-get-a-better-nights-sleep-when-you-have-diabetes

Three lessons from Houston that could help your city fight the diabetes crisis

From theguardian.com

Diabetes is such a global crisis that it unavoidably brings us together. Over the past two years Houston has been getting to grips with the problem, as one of the first members of a coalition called Cities Changing Diabetes.
On 26 and 27 October, our city is hosting the US’s first global summit on urban diabetes in order to share what we’ve learned. So here are three unexpected things our experience has taught us that could help other cities in their fight.

1. Challenge your assumptions - preconceptions can blind side you

I’ve worked in public health in Houston for 20 years and so have many of my peers. We thought we had a good picture of its obesity and diabetes problem. Then we saw the fresh fieldwork coming out of Stephen Linder’s research for Cities Changing Diabetes Houston.

It totally caught us off guard by shining the spotlight on groups that had never been on our radar: we expected to see poor, marginalised segments but were shocked to find affluent professionals among those most at risk. In fact, because of our transportation system, car dependency and food culture, pretty much any Houstonian is vulnerable to diabetes.

It’s not just about genetics and income level. This insight has given us a new set of optics with which to understand the issue and the cultural factors driving it. And an important part of my job has become to help the brilliant, action-oriented people in our partnership to trust me when I say that we don’t have all the answers, but we’re going to find them and take the right action.

2. Rethink who your friends need to be

The answer to diabetes lies outside health or medical clinics; otherwise, as a city with one of the most advanced health systems in the world, Houston would have cracked it by now.
That means we have to think about where people spend their lives, and it’s why we’re collaborating across city departments, with employers, academics and the faith community. Half of Houstonians belong to a house of faith of some form.
So in October 2016 Cities Changing Diabetes, the Institute for Spirituality and Health and Interfaith Ministries partnered to host a faith and diabetes summit, with more than 100 participants representing leaders from city houses of faith, including Buddhists, Muslims, Hindus, Jews and Christians.
All united in discussions on better understanding members’ need for support on diabetes prevention and management, and awareness and education. Now, we’re working towards our next milestone. Next January, we begin a six-week, train-the-trainer course that prepares two congregational members from each house of faith to implement prevention programmes among their peers.

3. Don’t just rely on the leadership

Of course strong mayoral leadership is often essential to kick-start a programme - and we’ve been lucky that Sylvester Turner, mayor of Houston, has made fighting diabetes a big priority for the city. But, because it’s a long-term challenge, mayors change, and so can influential public health officials. If action is to be sustained we need to take the mandate for action into community so that people at the grassroots can continue to hold the “grass tops” to account.

 This is why getting the city to set a goal on what it will take to bend the curve on diabetes is such a powerful idea. It can help fix minds on the outcome and the action required to get there.

The next challenges for us are catching the disease earlier, and securing funding to scale up interventions. I firmly believe that within five years Houston will see positive markers of progress against this ambition. And I hope that the experience we’ve gained, which has contributed to the urban diabetes toolbox launched at our global summit this week, can help other cities join this fight.

https://www.theguardian.com/public-leaders-network/2017/oct/26/lessons-houston-texas-help-city-fight-diabetes-obesity-crisis#img-1

Don’t overlook Type 3c diabetes

From hippocraticpost.com

The health of people with diabetes is being put at risk due to the failure of doctors to recognise an important subtype of diabetes which is known as Type 3c, according to a  new study in the journal Diabetes Care.

In the first ever study of its kind, researchers from the University of Surrey, examined the primary care records of more than 2 million people, assessing the frequency of different types of diabetes and the accuracy of diagnosis. Particular focus was given to those who developed Type 3c diabetes. Type 3c diabetes occurs as a result of pancreatic inflammation, abnormal growth of tissue on the organ or surgically removing part or all of the tissue, which affects the body’s ability to produce insulin.

The researchers discovered that up to 97.3 percent of people who have previously experienced pancreatic disease are misdiagnosed, typically with Type 2 diabetes, rather than the correct condition Type 3c. Such a misdiagnosis impacts on the treatment offered to patients, with those suffering from Type 3c diabetes requiring insulin therapy more urgently than those with type 2 diabetes. Delays in delivering the appropriate treatment can have devastating long term effects for patients with Type 3c diabetes with nerve, eye and kidney damage all possible consequences.

Researchers were also surprised to find that adults were more likely to develop Type 3c diabetes than Type 1 diabetes. In their sample, 205 more people were newly diagnosed with Type 3c diabetes than with Type 1. This discovery shows this under-recognised form of diabetes is more common than previously thought and could pose a potential threat to public health.

Senior author of the report, Professor Simon de Lusignan from the University of Surrey, said: “Greater awareness of Type 3c diabetes within the medical profession is required immediately to improve management of this disease, which now has a higher incidence than Type 1 diabetes in adults.

“Our research shows that the majority of people with Type 3c diabetes are being misdiagnosed with Type 2 diabetes, putting both their short and long term health at risk. Diabetes and its complications place a tremendous burden on the NHS and it is important that patients are diagnosed quickly and correctly, helping them get the specific care they need.

“This builds on our previous work that suggests that failure to flag the right diagnosis is associated with lower quality care.”

Latest figures from Public Health England indicate that 3.8 million people in England aged over 16 have diabetes, around 9% of the adult population, with an estimated £14 billion pounds being spent a year on treating the illness and its complications.

· Type 1 diabetes is a condition, causing the immune system to attack healthy body tissue in the pancreas by mistake preventing the creation of insulin where people have the cells that produce insulin destroyed and therefore require insulin for survival.

· Type 2 diabetes occurs when the body doesn’t produce enough insulin to function properly, or the body’s cells don’t react to insulin meaning that glucose stays in the blood and isn’t used as fuel for energy. Type 2 diabetes is often associated with obesity and tends to be diagnosed in middle-aged and older people.

· Type 3c diabetes is diabetes that occurs following damage to the pancreas. It is also termed ‘pancreatogenic diabetes’ or ‘diabetes of the exocrine pancreas’. Pancreatic disease is thought to produce a form of diabetes (Type 3c) which has some features similar to Type 1 diabetes (a need for medical insulin relatively soon after diagnosis) and some features similar to Type 2 diabetes (diagnosed in a similar age group and easy to miss unless blood sugar testing is performed).

https://www.hippocraticpost.com/ageing/dont-overlook-type-3c-diabetes/

Diabetes and mental health guidelines published

From diabetestimes.co.uk

A mental health and diabetes treatment guideline for inpatient staff has been issued. 
The first edition of the document has been developed by the Joint British Diabetes Societies for Inpatient Care (JBDS–IP) on behalf of RCPsych Faculty of Liaison Psychiatry, and was supported by Diabetes UK, the Association of British Clinical Diabetologists (ABCD) and the Diabetes Inpatient Specialist Nurse (DISN) UK Group.
Entitled The Management of Diabetes in Adults and Children with Psychiatric Disorders in Inpatient Settings, the document was created because the association between diabetes and mental illness is well recognised. However, together both conditions can lead to poor health outcomes and integrated care remains “poor and commissioned services to improve the care for these patients are almost non-existent”.
Drafted by Professor Khalida Ismail, consultant liaison psychiatrist and Dr Hermione Price, consultant diabetologist, they said: “We urge healthcare professionals working in both mental health and diabetes care to use these guidelines to start conversations with their own trusts and commissioners to ensure that local services meet the needs of this group of patients.”
The association between diabetes and mental illness is well recognised, and this co-morbidity leads to worse outcomes for both conditions. Despite this, integrated care for these patients remains poor and commissioned services to improve the care for these patients are almost non-existent.

The purpose of the guidelines is ensure the level of care for people who suffer from both severe mental illness and diabetes receives a better standard of care which will help “reduce the alarmingly high rates of morbidity and premature mortality”.
The authors wrote: “We expect equivalent levels of care for diabetes in people with and without mental illness in order to improve health and reduce the risk of diabetes related complications. We encourage good practice through collaborative working and a patient-centred approach.
“Local variation in diabetes outcomes in those with and without mental illnesses should be challenged and commissioners held to account if services are not meeting the needs of this high risk and vulnerable group. A change in culture is needed that adopts the mind-body model of integrated care and incentivises best practice.”
Immediate and long-term recommendations have been laid out in the document. Some of the suggestions include:
In mental health and residential settings, screening for diabetes in those not known to have the condition and performing a diabetes review (with particular emphasis on reducing the risk of hypoglycaemia) in those who do is always indicated in any older adult. This should include a medication review to ensure that anti- diabetes drugs with a low risk of hypoglycaemia are used, and where insulin is required, the regimen and dose schedule should be reviewed regularly to adjust to changing circumstances.

In acute trust inpatient settings, older adults with diabetes should have a mental health assessment for cognitive impairment, depression, psychosis and alcohol use if there are concerns that impaired cognition is hindering diabetes self-management or may have contributed to the need for hospital admission (for example hyperglycaemia due to missed insulin administration). This should be aligned with current local definitions for ‘older’ and pathways for memory screening services.

Acute trusts and older adult mental health and services should share the same clinical pathways for both diabetes and dementia. The focus should be on early recognition that a person has developed diabetes, applying a common set of key principles of care, safe medication usage, and implementing a 4-step approach for each condition that allows local policies of care to be adapted to enhance the quality of care in both conditions.

Implement a competency framework in acute NHS trusts, primary care and care home settings that outlines the training and educational needs of direct care staff in the management of patients with diabetes and dementia.

http://diabetestimes.co.uk/diabetes-and-mental-health-guidelines-published/

Coffee May Reduce the Risk of Diabetes

From ndtv.com

A new study, published in the journal American Chemical Society Journal of Natural Products and conducted by a team of researchers at the University of Southern California in the United States, shows that drinking coffee may reduce the risk of developing diabetes

A new study, published in the American Chemical Society Journal of Natural Products and conducted by a team of researchers from Denmark, shows that drinking coffee may reduce the risk of developing diabetes. In a previous study, researchers at the University of Southern California in the United States found that drinking coffee could lead to a longer life. In the new study, scientists have discovered a certain bioactive substance called 'cafestol' that could help delay the onset of Type-2 diabetes and improve cell function and insulin sensitivity.

For the study, the scientists used a mice model to examine if 'cafestol' would help prevent or delay the onset of Type-2 diabetes in mice. Scientists chose a model of mice called KKAy mice that are prone to develop diabetes. Forty-seven male mice were randomly divided into two groups - treatment and control groups.

While all the mice consumed a normal diet, the mice in the treatment group were fed with 'cafestol' daily for 10 weeks. The animals in the control group were not given 'cafestol'. At the end of 10-week period, blood samples for fasting glucose, glucagon and insulin as well as liver, muscle and fat tissues for gene expression analysis were collected. The researchers isolated islets of Langerhans which produce insulin and measured their insulin secretory capacity.

Ads by ZINC

The researchers reported that fasting plasma glucose was 28-30% lower in the 'cafestol' group as compared with the control group. Further, the findings showed that fasting glucagon was 20% lower and insulin sensitivity improved by 42% in the high-cafestol group. Cafestol increased insulin secretion from isolated islets by 75-87% as compared to the control group.

The researchers concluded that cafestol possesses anti-diabetic properties in mice. They believed that their findings could spur the development of new drugs to treat or even prevent the disease. 

https://www.ndtv.com/food/coffee-may-reduce-the-risk-diabetes-1765331

Audit report on pregnancy in diabetes is released

From diabetestimes.co.uk

Only one in 12 women with diabetes are receiving all three key recommended pre-pregnancy health measures, according to an audit looking at the standard of care in expectant mothers.
The National Pregnancy in Diabetes Audit 2016, published by NHS Digital and supported by Diabetes UK, also showed stillbirth rates are double in women with diabetes and neonatal deaths are more than four times higher, when compared to the general population. Women with type 2 diabetes experienced more neonatal deaths overall – with 21 deaths – compared to 10 deaths experienced by those with type 1 diabetes.
The findings also suggested nearly half of babies born to women with type 1 diabetes, and nearly a quarter born to women with type 2 diabetes were larger than gestational age (LGA). 
The audit looked at 3,356 pregnancies in 3,297 women across 172 antenatal diabetes services. Of these women, 1,608 had type 2 diabetes.

Other key findings: 

• Few women were well prepared for pregnancy and only one in twelve women (8 per cent) had achieved HbA1c < 48mmol/mol, use of 5mg folic acid and avoidance of potentially harmful medications before conception.
• Despite the fact that women with type 2 diabetes have better glucose control, other measures, including use of folic acid, suggest they were not getting the pre- pregnancy care they needed.
• 24.0 per cent of women with type 1 diabetes and 41.9 per cent of women with type 2 diabetes did not present to the joint diabetes antenatal team before 10+0 weeks gestation. 
This suggests reduced awareness of pregnancy risks and/or failure of diabetes antenatal care and referral pathways.
• Almost one in 10 women with type 1 diabetes had at least one hospital admission for severe hypoglycaemia.
• Ketoacidosis, a high risk for mother and foetus, occurred in 2.7 per cent of women with type 1 diabetes.

Douglas Twenefour, Diabetes UK’s deputy head of care, said: “This audit reveals the unacceptable reality that, for too many women living with type 1 or type 2 diabetes, pregnancy remains fraught with unnecessary difficulties for both mother and baby. The clear reason for this is that women – for a number of reasons – are not getting the support they need before and during their pregnancies.

“Diabetes UK wants to see urgent action on this issue; the steps women can take before getting pregnant are clear but the Audit suggests there are still variations in the level of care across services, and that far too many of them are simply not aware of what they can do to protect themselves and their babies.”
Diabetes UK has developed and rolled out the Pregnancy Information Prescription – a tool  to help healthcare professionals to discuss pregnancy preparations with all  women living with diabetes who may become pregnant, and to agree personal action plans to ensure a safe and healthy pregnancy.

http://diabetestimes.co.uk/audit-report-pregnancy-diabetes-released/

Experts say patients at risk of diabetes should be sent to Weight Watchers

From news.sky.com

People at risk of developing type 2 diabetes could benefit from signing up for the weight management programme, experts say.

People who are at risk of developing type 2 diabetes should be sent to Weight Watchers by their GP, according to a new study.

Patients whose blood sugar levels are above the normal range, but not high enough to be diagnosed with the condition, could benefit from signing up for the weight management programme, experts say.
Researchers discovered that there were "considerable reductions" in diabetes risk, as well as an average weight loss of 10kg (22Ibs), within a year of patients being referred.
Participants were recruited from 14 GP surgeries in Bromley, southeast London.
They had a body mass index (BMI) score of more than 30, which signifies they are clinically obese, as well as non-diabetic hyperglycemia (high blood sugar).
The participants were offered the chance to take part in a diabetes prevention programme with Weight Watchers, which comprised of a 90 minute "activation session" followed by 48 weekly group meetings.
A total of 117 people took part and of those, 38% saw their blood sugar levels return to normal within a year.
Another 15% had reduced their risk of developing type 2 diabetes by reducing their blood glucose, while just 3% went on to develop the condition.
After a year, more than 50% of the participants had managed a greater than 7% reduction in their body weight, with the mean weight loss 10kg (22Ibs).
The authors of the report concluded that the move resulted in "considerable reductions in diabetes risk", something they described as a "significant public health challenge".

Lead author Carolyn Piper, public health manager at Bromley council, said: "It's within our power to reverse the ever increasing tide of type 2 diabetes with the right education and support."
The number of people in the UK diagnosed with the condition has increased from 1.4 to 2.9 million since 1996, and the problem is only predicted to get worse.
By 2025 it is estimated diabetes will affect around one in every seven adults, approximately five million people.
Emily Burns, interim head of research communications at Diabetes UK, welcomed the findings, but said more work was needed to "work out how to apply this in a real world setting".
Professor Helen Stokes-Lampard, chairwoman of the Royal College of General Practitioners, echoed this, saying: "Today's findings that GP referrals to weight management programmes appear to have prevented a third of patients from developing type 2 diabetes are both positive and encouraging, and are certainly something for commissioners to consider.
"However, organised weight management programmes won't work for everyone.
"So GPs and our teams will continue to play a pivotal role in managing the vast amount of diabetes care in the community, advising patients about lifestyle changes that can improve their health, so we must ensure that general practice has the investment it needs, and the appropriate number of GPs and nursing colleagues, to do this properly."
The study - carried out by Weight Watchers, the University of Westminster and Bromley Council - is published in BMJ Open Diabetes Research and Care.

http://news.sky.com/story/experts-say-patients-at-risk-of-diabetes-should-be-sent-to-weight-watchers-11084454

If You Eat This One Food, You Could Lower Your Risk of Diabetes

From rd.com

Hint, hint: Not all fats are created equal.

Worried about diabetes? The key to prevention might be as simple as what’s on your plate. While scientists recommend plenty of science-backed eating habits that can prevent diabetes, one simple change in diet could do the trick. New research suggests that foods like walnuts (which are rich in omega-6 fatty acids) could significantly reduce your risk of developing Type 2 diabetes down the road.
The study, which was recently published in the journal Lancet Diabetes and Endocrinology, examined data from 20 previous reports that involved nearly 40,000 adults from 10 countries. Researchers tested participants’ blood for linoleic and arachidonic acids, which indicate the presence of omega-6.

Although 4,300 people had been diagnosed with Type 2 diabetes in the follow-up study, those who showed higher levels of linoleic acid were less likely to develop the condition. Meanwhile, levels of arachidonic acid did not increase nor decrease participants’ risk of diabetes, the researchers said.
“This is striking evidence,” senior author Dariush Mozaffarian, professor at the Friedman School of Nutrition Science and Policy at Tufts University in Massachusetts, said in a statement. “The people involved in the study were generally healthy and were not given specific guidance on what to eat. Yet those who had the highest levels of blood omega-6 markers had a much lower chance of developing Type 2 diabetes.”
Since linoleic acid is not formed in the body, it can only be absorbed through what you eat. So if you’re looking for protection against diabetes, a diet that includes foods rich in omega-6 acids—such as walnuts, fish, soybean and sunflower oils—could be a great place to start.
Not as nuts as you originally thought, right?

https://www.rd.com/health/conditions/omega-6-lower-risk-diabetes/

Artificial pancreas uses your phone to counter diabetes

From engadget.com

An app and a smart pump could help you live an ordinary life.

If you live with type 1 diabetes, you have to constantly keep track of your blood sugar levels and give yourself just the right amount of insulin. It's arduous, and more than a little frightening when you know that the wrong dose could have serious consequences. However, researchers might have a way to let diabetics focus on their everyday lives instead of pumps and needles. They've successfully trialled an artificial pancreas system that uses an algorithm on a smartphone to automatically deliver appropriate levels of insulin. The mobile software tells the 'organ' (really an insulin pump and glucose monitor) to regulate glucose levels based on criteria like activity, meals and sleep, and it refines its insulin control over time by learning from daily cycles. Effectively, it's trying to behave more like the pancreas of a person without diabetes.

The simulated pancreas isn't trying to hit a fixed glucose level, we'd add. Rather, it's trying to keep that level within an acceptable range based on a predictive model.

The trial results were promising. A 12-week test saw "significant" improvements, including reduced levels of a key hemoglobin and less time spent in a hypoglycemic state. And these were already disciplined patients who knew how to take care of themselves -- the algorithm was one step ahead of them. This doesn't mean that diabetics will never have to think about insulin again, and there's still plenty of testing and approvals necessary before an artificial pancreas like this can reach the market. If it does, though, it could reduce some of the stress in diabetics' lives.

https://www.engadget.com/2017/10/16/artificial-pancreas-uses-your-phone-to-counter-diabetes/

Health Check: People With Diabetes Can Live Full, Rich Lives

From norwoodnews.org

Diabetes is so common that most people know at least one family member or friend with this chronic illness. There are roughly 30 million Americans with diabetes (about 1 in 10 people). The Bronx has very high rates with approximately one in seven people, or 15 percent of the population, diagnosed with diabetes and many more who have not yet been diagnosed.
In order to help your body store and use the sugar and fat from food, your body produces insulin.   Diabetes occurs when the body either produces too little insulin or when the body does not respond appropriately to insulin.  This results in high levels of sugar in the blood which can damage organs like the kidneys, brain and the eyes, as well as blood vessels. A simple blood test can tell you whether you have diabetes, or whether you are on the road to developing diabetes (this is called “prediabetes”).
While diabetes has no cure, making lifestyle changes and working with a care team can make significant improvements. Here are some tips that could help:

1) Get Tested Regularly
The A1C is a blood test that gives insights into how a diabetes management plan is working. It is also the primary test used for diabetes diagnosis.
If you haven’t had your blood sugar tested in the last year, visit your doctor and ask them to check your A1C levels.  If you have diabetes, make sure you are getting your A1C tested every 3 to 6 months and if you have prediabetes, make sure you are getting checked twice a year.
2) Take Control

• Drink water (regular or sparkling) and avoid sugary juices and sodas. Drinking calories can increase your risk for diabetes and often does not satisfy cravings the same way food does.
• Keep starches to only 1 to 2 servings per meal. A serving is one slice of bread, ½ cup of rice, or 4-6 crackers. Stick to whole grain starches. The fibre is higher in these types of starches and this helps slow down the release of sugar in our body.
• Eating lots of vegetables is a great way to satisfy your hunger and nourish your body without impacting your blood sugar levels.
• Choosing fruits instead of sugary or salty snacks is a great way to stay healthy, particularly if you eat fruits low in sugar like blueberries.
• Exercising 30 minutes five times a week can also help your body use more energy and help maintain a healthy weight.

Small changes to our diet and physical activity can make a world of difference. Our behaviour can help us live the life we deserve.

http://www.norwoodnews.org/id=24401&story=health-check-people-diabetes-can-live-full-rich-lives/

6 Tips for Sick Days with Diabetes

From medtronicdiabetes.com

Being sick can be a real drag, even more so if you have diabetes. Managing your diabetes when you’re under the weather can be tricky, so we asked some of our people with diabetes to share their sick day management tips. Here are 6 tips they shared that may help you manage your diabetes sick days.

1. Check Your BG More Often

I always check my blood sugar about once per hour to make sure it isn’t running high or low during sick days. – Carling

For me, this means taking hourly blood glucose readings and ketone checks, and staying hydrated! – Jacob

2. Try To Eat Healthy Foods

My diet definitely changes when I am sick. I tend to eat foods that are easy on the stomach like plain bread or oatmeal. These foods do tend to have more carbs, so I make sure to balance my blood sugars by eliminating foods like dairy and high fat. – Carling

Eating may not sound fun when you are sick, but it is important you continue to eat to ensure you have energy. Find foods you are able to eat. I personally like soft foods like soups, yogurt, and applesauce. – Jacob
When my daughter can’t keep any food down, we alternate between sips of water to keep the ketones under control, and sips of juice so the insulin has something to work on. We have found that just checking and pumping in insulin without some type of carb in her stomach doesn’t help. – Sue

3. Keep Taking Insulin

If I’m able to keep down food, I like to put my pump temp basal rate on 110-120% to correct for this. If I’m not able to keep down food, then my blood sugars will even out with lack of exercise and I keep my settings the same. – Carling
Depending on my blood sugar and ketones, I may need to up my insulin dosage – this is something you should personalize with your doctor. – Jacob
If you find checking once an hour, and you are still running on the high side, check with your health care professional about temporary basal changes. – Mike

4.  Drink Plenty of Fluids

“Liquids Kelly! You need to drink more liquids!” My mom preaches as she carries over an assortment of cans and bottles. Everything from orange juice, to the trusty flat can of sprite, is at the tip of my fingers the moment I mention I am feeling a little under the weather. The constant consumption of water has helped me kick several illnesses, from your everyday cold, to influenza. I’ve found that the combination of pushing fluids and getting extra sleep at night are some of the simplest ways to keep yourself healthy! – Kelly

I drink extra fluids, as my body needs them, and pay attention to how I’m doing. If I’m feeling dry, I increase my fluids that won’t increase my sugar levels. – Dave

5. Keep Doctor’s Phone Number Handy

I normally would not call my doctor until the 2nd day of not feeling well. – Mike

I always contact my doctor when I cannot keep foods down. This can make it very difficult to regulate my blood sugars, so advice on temp basal rates can be quite helpful. – Carling
If my daughter has been vomiting for more than 4 hours, and we start to see moderate levels of ketones, we call the doctor and follow her advice on how to proceed. – Sue

6. Rest, Rest, Rest
What makes me feel better, if I’m not too sick, is tomato soup and I Love Lucy. Ever since I was a kid. – Mike
I am a very active person, so when I’m sick, I usually test more often, sleep, and rest a lot more. It’s about keeping my blood sugars on track! Feeling under the weather is one thing, but being sick with bad blood sugars can make you feel absolutely terrible. – Carling
On sick days, your only job is to get better, so make sure to get some rest, and maybe watch a few cartoons too! – Jacob

https://www.medtronicdiabetes.com/loop-blog/6-tips-sick-days-diabetes/

Gestational diabetes: what you need to know

From diabetes.org.uk

Gestational diabetes is a type of diabetes that affects pregnant women, usually during the second or third trimester. Women with gestational diabetes don’t have diabetes before their pregnancy, and after giving birth it usually goes away. In some women diabetes may be diagnosed in the first trimester, and in these cases the condition most likely existed before pregnancy.
Gestational diabetes is usually diagnosed through a blood test at 24–28 weeks into pregnancy.
Women who have had the condition in previous pregnancies may be tested earlier. With good management of gestational diabetes, you can increase your chances of having a healthy pregnancy and baby.

What causes gestational diabetes?

The hormones produced during pregnancy can make it difficult for your body to use insulin properly, putting you at an increased risk of insulin resistance. And, because pregnancy places a heavy demand on the body, some women are less able to produce enough insulin to overcome this resistance. This makes it difficult to use glucose properly for energy, so the glucose remains in the blood and the levels rise, leading to gestational diabetes.

Who is at risk of gestational diabetes?

Women can significantly reduce their risk of developing gestational diabetes by managing their weight, eating healthily and keeping active.
You are at an increased risk if you:

• are overweight or obese
• have had gestational diabetes before
• have had a very large baby in a previous pregnancy (4.5kg/10lb or over)
• have a family history of diabetes (parent, brother or sister)
• are from a South Asian, Black or African Caribbean or Middle Eastern background.

Gestational diabetes checklist

To make sure you get the right care and information, make sure you:

• understand gestational diabetes and how it is treated
• ask for a blood glucose meter and agree your individual targets
• have a Maternity Exemption Certificate or Card, which will entitle you to free prescriptions (ask your GP or diabetes healthcare team)
• know the members of your healthcare team and what they do to help you
• ask to see a dietitian to talk about your diet and physical activity
• know who to call if you need extra support
• understand how to treat a hypo and a hyper.

https://www.diabetes.org.uk/diabetes-the-basics/gestational-diabetes?gclid=CjwKCAjw64bPBRApEiwAJhG-fnVsbggxxvD5hiFwWfsGlgcd1OC-rep_E3gIxVMhpHnpphezRIabdxoC_uYQAvD_BwE

Type 2 Diabetes - The Effects of Nerve Damage and Excess Foot Pressure

By Beverleigh H Piepers

Foot and leg diseases are among the most common complications associated with Type 2 diabetes. They can lead to severe consequences, including amputation. Nerve damage is one important cause. Type 2 diabetics who cannot feel sensations from their feet can develop damage without realizing it until the problem becomes severe. People with diabetes are also known for putting too much pressure on their feet.
According to the faculty of medicine at Ain Shams University Hospitals in Cairo, Egypt, nerve damage is caused by the excess weight. Their study, reported on in the journal Diabetes and Metabolic Syndrome in September of 2017, compared 50 people with Type 2 diabetes with 30 healthy participants. They compared pressure put onto the volunteer's feet during sitting and standing. Foot pressure in both feet was significantly higher in the diabetics than in the nondiabetic participants. No links to...

• age,
• amount of time with diabetes,
• weight in relationship to height (body mass index or BMI), or
• HbA1c

were seen.

Ways of treating or preventing foot neuropathy include walking and medications. Walk until you feel pins and needles, burning pain, or numbness. Rest and continue after your feet feel better. Other signs and symptoms of diabetic neuropathy include...

• muscle wasting in feet or hands,
• cramping pain,
• unrecognized low blood sugar,
• urinary bladder leaks,
• sensitivity to touch, such as pain from bed linens,
• loss of reflexes, especially those in the ankles,
• loss of balance and coordination,
• ulcers,
• infections,
• deformities, and
• bone and joint pain.

There is a variety of methods to diagnose peripheral neuropathy...

• nerve conduction velocity measures how fast impulses can travel along nerves showing abnormality if impulses travel slower than usual.
• electromyography reveals electrical activity when muscles are working or at rest.
• magnetic resonance imaging shows muscle size and activity.
• nerve biopsy can show nerve damage when bits of nerves are seen under a microscope.
• a skin biopsy will show nerves in the skin.

See your doctor for medication such as Pentoxifylline, (trental), which helps the red blood cells reach the feet with oxygen and nutrients. Other treatments include...

• pain relievers with low risk of abuse or addiction, such as Tylenol and aspirin.
• anti-seizure medications, such as gabapentin (Neurontin) and pregabalin (Lyrica), generally used to treat seizure disorders, can relieve nerve pain too.
• medications applied to the skin, such as capsaicin, a derivative of hot peppers, and lidocaine. Capsaicin can cause burning at first, but users usually develop a tolerance for it.
• antidepressants, such as amitriptyline, doxepin, and nortriptyline (Pamelor), duloxetine (Cymbalta), venlafaxine (Effexor XR).

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---The-Effects-of-Nerve-Damage-and-Excess-Foot-Pressure&id=9806733

How Does Diabetes Affect My Pregnancy?

From refinery29.com

Getting tested for gestational diabetes is just another necessary discomfort that comes along with being pregnant, but it is a pretty important one. If you have gestational diabetes, you usually have to make slight lifestyle changes during the rest of your pregnancy to ensure that you — and your baby — are healthy postpartum.

The reason all pregnant people are tested for this, is because gestational diabetes — as the name suggests — is a form of the illness that develops specifically in pregnancy.

"During pregnancy, the placenta makes several hormones that counteract the effect of insulin," says Rebecca Brightman, MD, assistant clinical professor and Ob/Gyn at the Icahn School of Medicine at Mount Sinai. As a result, the pancreas needs to make more insulin to control blood sugar. When the balance gets out of whack, resulting in higher glucose levels, that would be gestational diabetes, Dr. Brightman says.

Photographed by Ashley Armitage.

For example, a person with gestational diabetes might be at an increased risk of high blood pressure, or preeclampsia, Dr. Brightman says. The baby is also at risk of being significantly larger than average, or "macrocosmic," which can increase the risk of needing an emergency C-section. "Macrosomic fetuses face a more challenging delivery and are at risk of traumatic birth injury, shoulder dystocia," she says. Because of these potential complications, people who are diagnosed with gestational diabetes often require more sonograms and more frequent visits to their doctors towards the end of the pregnancy. "This is all in an effort to ensure fetal well-being," she says.

Luckily, if you have gestational diabetes there are some ways to prevent these complications from happening. "Typically most women with GDM can control their blood sugars by watching carbohydrates and monitoring their blood sugar levels," Dr. Brightman says. Often this requires working with your doctor to come up with a food plan that includes what, when, and how much to eat, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDKD).

Diet is important when a person has gestational diabetes, because it can impact blood glucose levels. If your blood glucose is too high, your body might make ketones, which means it's using fat for energy instead of glucose, according to the NIDDKD. And if you don't take steps to manage your glucose, there is an increased risk of still birth, birth trauma, and electrolyte abnormalities in your baby, Dr. Brightman says. Your doctor might ask that you use a blood glucose meter to ensure that you're staying within your target levels. In some cases, people with gestational diabetes might need to take an oral hypoglycemic medication or get insulin injections to maintain normal glucose levels, she says.

So, yes: gestational diabetes affects a person's pregnancy quite significantly. The good news is that it can be well-controlled and diagnosed during the late second and early third trimester. And while it might be a pain to have to take the extra steps to keep your glucose in check, there is a light at the end of the tunnel. Though you'd always want to be tested to be sure you're in the clear, Dr. Brightman says "gestational diabetes usually resolves postpartum."

http://www.refinery29.com/2017/10/171733/what-is-gestational-diabetes-during-pregnancy

Omega-6 fats may help prevent type 2 diabetes

From georgeinstitute.org

The risk of developing type 2 diabetes could be significantly reduced by eating a diet rich in omega-6 polyunsaturated fats, a new study suggests.
These findings, published in Lancet Diabetes & Endocrinology, shed new light on the potential health benefits of omega-6, which is found in bean and seed oils such as soybean and sunflower oils and in nuts, and support clinical recommendations to increase dietary intake of omega-6 rich foods.

Lead author Dr Jason Wu, of The George Institute for Global Health in Sydney, said: “Our findings suggest that a simple change in diet might protect people from developing type 2 diabetes which has reached alarming levels around the world.” “This is striking evidence,” said senior author and Professor Dariush Mozaffarian, of the Friedman School of Nutrition Science and Policy at Tufts University in Massachusetts. “The people involved in the study were generally healthy and were not given specific guidance on what to eat. Yet those who had the highest levels of blood omega-6 markers had a much lower chance of developing type 2 diabetes.”
Recent studies have raised concerns that omega-6 may have negative health effects, such as inflammation leading to the increased risk of chronic diseases.
Yet, when the global collaboration led by The George Institute explored these concerns in studies from around the world, they found that individuals who had the highest blood level of linoleic acid, the major omega-6 fat, were 35 per cent less likely to develop type 2 diabetes in the future than those who had the least amount.
Researchers analysed data from 20 studies involving 39,740 adults from 10 countries, in whom 4,347 new cases of diabetes occurred over time. These included adults with a wide range of ages and without any diagnosis of type 2 diabetes at the onset of the studies, when they were laboratory tested for levels of two key omega-6 markers – linoleic acid and arachidonic acid. Linoleic acid was associated with lower risk, while levels of arachidonic acid were not significantly associated with either higher or lower risk of diabetes.

“Some scientists have theorized that omega-6 is harmful to health,” said Dr Wu. “But based on this large global study, we have demonstrated little evidence for harms, and indeed found that the major omega-6 fat is linked to lower risk of type 2 diabetes.”

Linoleic acid is not formed in the body and can only be obtained from the diet. US dietary guidelines recommend between 5-10 per cent of energy should be derived from polyunsaturated fats.  “Based on concerns for harm, some countries recommend even lower intakes,” said Dr Wu. “Our results suggest that eating foods rich in linoleic acid may lower risk of type 2 diabetes.”
This research combined many large observational studies, and therefore it could not directly determine the effect of raising omega-6 fat levels in a trial. The study’s strengths include the use of objective blood or tissue biomarkers of fatty acids, that avoid memory errors associated with people’s own impressions of their diet; that researchers developed a pre-specified standardized analysis protocol, which increases consistency of the findings; and that data from many countries around the world was included, enhancing the relevance to different populations.

http://www.georgeinstitute.org/media-releases/omega-6-fats-may-help-prevent-type-2-diabetes

RECIPE: Roasted cauliflower, paneer and chickpea curry

From diabetes.org.uk

A deliciously tasty vegetable curry with paneer and chickpeas. Topped with spicy, crispy roasted cauliflower.

Serves 4        

Prep 20 minutes        

Cook 25 minutes

  

Ingredients

2 tsp oil

500g cauliflower, in small florets

2 tsp turmeric

2 onions, chopped

1 large sweet potato, cubed

1 red pepper, chopped

3 cloves garlic, crushed

1 tsp ground cumin

1 tbsp medium curry powder paste

1 low-salt vegetable stock cube, dissolved in 400ml water

100g paneer

240g chickpeas, drained

80g frozen peas, defrosted

2 tbsp 0% fat yogurt

Method

1. Preheat the oven 180°C/gas mark 4 and lightly oil a baking sheet with 1 tsp of oil.
2. Rinse the cauliflower in cold water, shake off any excess, then add to a bowl. Sprinkle with turmeric and mix well. Place on the baking sheet and roast for 20 minutes, until the edges are starting to char, then set aside.
3. Meanwhile, add 1 tsp oil to a pan and add the onion. Cook for 3-4 minutes until softened, but not browned.
4. Add the sweet potato, red pepper, garlic, cumin and curry paste, then cook for a further 2-3 minutes, stirring regularly.
5. Pour over the stock, mix well, cover, then simmer for 8-10 minutes until the potato is almost tender.
6. Add the paneer, chickpeas and peas, then continue to boil without the lid for 5-6 minutes. Stir in the yogurt and serve topped with the roasted cauliflower.

Chefs tips

• Experiment with mixed beans or cannellini beans rather than chick peas.
• Try adding different vegetables such as 150g fresh spinach or mushrooms.
• Freezing instructions: Suitable for freezing once cooked. Defrost in the fridge or microwave, then reheat until piping hot throughout.

https://www.diabetes.org.uk/guide-to-diabetes/recipes/roasted-cauliflower-paneer-and-chickpea-curry?utm_source=bronto&utm_medium=email&utm_term=A+deliciously+tasty+vegetable+curry+with+paneer+and+chickpeas.+Topped+with+spicy,+crispy+roasted+cauliflower.&utm_content=A+deliciously+tasty+vegetable+curry+with+paneer+and+chickpeas.+Topped+with+spicy,+crispy+roasted+cauliflower.&utm_campaign=Enewsletter+October+2017

Flu Shot Key for People With Diabetes

From healthday.com

With predictions calling for a potentially bad flu season this year, doctors are urging people -- particularly those with diabetes -- to get vaccinated.
Many people with diabetes don't get a seasonal flu shot each year, according to the American Association of Diabetes Educators (AADE). Some people with the blood sugar disease don't realize they're at risk for flu-related complications. Others have misguided fears that the shot will trigger an adverse reaction, the group explained.
However, people with diabetes are more likely to develop serious flu-related health problems if they get the virus, the AADE cautioned. The group said the flu shot is a safe and effective way to prevent or reduce the severity of these complications.

"Reducing risks is one of the AADE's seven key self-care behaviors for managing diabetes, and getting the flu shot every fall is an excellent way of reducing the risk of getting sick," certified diabetes educator Evan Sisson said in an AADE news release. "It's widely available, it takes just a few minutes and it can make a real difference in your health."
Good hand hygiene is another important way to stay healthy and hopefully avoid the flu, the diabetes experts noted.
There are several ways a seasonal flu shot can benefit people with diabetes, according to the AADE. They include:

• Better disease management. The flu and other infections can raise blood sugar levels and disrupt a healthy diet plan. Avoiding the flu can help people with diabetes stay on track and manage the condition.
• Complication prevention. People with diabetes are more likely to be hospitalized for flu-related complications, such as pneumonia. They are also more likely to die from the flu.
• Immune system boost. As people age, their immune system weakens. The flu can tax the immune system, increasing the risk for serious complications and even death. A flu shot can help weakened immune systems ward off the flu. People 65 or older should talk to their doctor to see if the high-dose flu vaccine is right for them.

The AADE added that people who do get the flu should see their doctor right away and discuss the possibility of taking antiviral drugs, which can help speed recovery.

https://consumer.healthday.com/infectious-disease-information-21/flu-news-314/flu-shot-key-for-people-with-diabetes-727175.html

Making Halloween a Treat for Kids With Diabetes

From healthday.com

A child with diabetes can still experience the fun of Halloween, one expert says.
Dr. Steven Mittelman is chief of pediatric endocrinology at UCLA Mattel Children's Hospital in Los Angeles. He suggests that parents of a child with type 1 or type 2 diabetes set the same rules for all the children in the house, regardless of diabetes status.
Those rules, he said, should be discussed with children in advance, so they feel they have a hand in establishing a plan.
And that plan, Mittelman added, should put the focus on activities rather than candy. Those can include costuming, decorating and holiday-related arts and crafts.

That said, a little bit of candy may be all right.
"Let your child enjoy some candy, making sure they monitor their blood glucose and take their medications as prescribed," said Mittelman.
"For children who take insulin with all meals and snacks, combining candy with a meal can reduce the need for extra injections, and helps reduce the blood glucose spikes from candy alone," he added.
Mittelman does, however, advocate limiting a diabetic child to one favourite candy. The rest should be tossed, donated or perhaps even "sold" back to the parents by the child in exchange for money, stickers or toys.
Vigilance, he added, is important.
"The candy you don't know your child is eating can be particularly concerning," Mittelman said in a hospital news release. "Make sure you and your child are on the same page with the plan and why it is important."
Some kids will have a tougher time with the Halloween plan than others.
"For children who have a hard time resisting, remove extra candy to a safe location your child can't get to. And consider checking your child's blood glucose an extra time or two during the night, to make sure you can get them back on target," Mittelman said.

https://consumer.healthday.com/diabetes-information-10/misc-diabetes-news-181/making-halloween-a-treat-for-kids-with-diabetes-727116.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/

One in three unaware of foot ulcer dangers

From diabetestimes.co.uk

More than a third of people in the UK are not aware that foot ulcers are a serious complication of diabetes, according to a recent survey.
The Diabetes UK poll, which involved more than 2,000 people, showed despite 79 per cent of people knowing that an amputation is a major complication of diabetes, 36 per cent did not know that people with diabetes are susceptible to foot ulcers, which when unhealed are responsible for as many as four-in-five diabetes-related amputations.
These findings are revealed as Diabetes UK launches its latest Putting Feet First campaign, through which the charity is calling for urgent improvements to community diabetes foot services. Nearly a quarter of hospitals in England still do not have a specialist diabetes footcare team, and the quality of community diabetes foot services across England vary significantly.

The number of diabetes-related amputations in England is now at an all-time high, with more than 8,500 procedures being carried out each year. This equates to 23 minor and major amputations per day, or more than 160 a week.
Dan Howarth, head of care at Diabetes UK, said: “Diabetes-related amputations devastate lives. While it’s positive that the majority of people are aware that amputation is a complication of diabetes, it’s very worrying that so many don’t know the dangers posed by foot ulcers.
“That’s why it’s essential that people living with diabetes know how to look after their feet, and that they check them daily. It’s also crucial that they know to seek urgent medical attention if they notice any problems with their feet; a matter of hours can make the difference between losing and keeping a limb.
“With the right support, four out of five amputations are preventable. But the quality and availability of services still varies significantly across England. We want to see greater commitment from Government to improving diabetes foot services, ensuring routine, high-quality care to those who need it, regardless of where they live.’
To mark the launch of its footcare campaign, Diabetes UK has released a video to show people with diabetes how to check their feet at home.

http://diabetestimes.co.uk/one-in-three-unaware-of-foot-ulcer-dangersmany-unaware-of-foot-ulcer-dangers/

What to Know About Pregnancy When You're Diabetic

From health.usnews.com

If you have diabetes and you’re pregnant – or you’d like to become pregnant – here’s a bottom-line message.

“Women with diabetes are more likely to have a healthy pregnancy if they prepare for pregnancy before they conceive,” says Lory Gonzalez, a nurse educator and certified diabetes educator at the Diabetes Research Institute at the University of Miami Miller School of Medicine.

That means healthy eating, physical activity and good blood sugar control before you even become pregnant.

If your health and blood sugar aren’t in great shape and you become pregnant, you could have serious complications. That may include high blood pressure (a dangerous condition also known as pre-eclampsia), an emergency C-section due to the baby’s large size, more infections and worsening of common diabetes health problems. There’s even the risk for a miscarriage or stillbirth. Tight blood sugar control is so important because your baby's organs are forming in those early weeks of pregnancy, before you may even know that you're pregnant.

Naturally, there’s a lot on your mind when you’re pregnant, and there’s even more to consider if you have diabetes. The good news is that you can ask for help even before you get pregnant. “Make an appointment with a diabetes educator and/or a maternal fetal medicine specialist for a refresher and reminder about the American Diabetes Association diet and to ask any questions,” recommends Dr. Lara Friel, an author for Merckmanuals.com and an assistant professor in the department of obstetrics, gynecology and reproductive sciences at the University of Texas Health Science Centre at McGovern Medical School in Houston. Those health professionals can set you on the right course for pre-pregnancy health.

Next, keep these tips in mind for a healthier baby.

Check your blood sugar numbers frequently, even before you get pregnant. “Prior to getting pregnant, a woman needs to control her blood sugars and is usually advised to reach a certain hemoglobin A1C level before getting off birth control to ensure the blood sugars are close to normal when conception begins,” says Mercy T. Molina, a registered dietitian and certified diabetes educator at the Diabetes Research Institute at the University of Miami Miller School of Medicine. Blood glucose recommendations before getting pregnant are generally 70 to 100 milligrams per decilitre before meals and below 140 mg/dL at two hours after a meal. Your hemoglobin A1C should be 7 percent or sometimes lower, as directed by your endocrinologist, Gonzalez says.

During pregnancy, the optimal blood sugar levels are 60 to 90 mg/dL when you wake up and haven’t eaten, below 105 mg/dL before lunch and dinner and below 120 mg/dL at two hours after meals.
Frequent blood sugar checks may be inconvenient, but they’re important for both your health and the health of your baby.

Ask for help from your health team. Getting your blood sugar numbers consistently low can be a challenge, but again, you can get guidance from health professionals. “Working with a certified diabetes education team of a nurse and a nutritionist will ensure that a woman is following her treatment plan, monitoring her blood sugars, achieving her blood sugar targets and following a healthy meal plan,” Molina says.

Eat regularly, but don’t overeat. “Most people can put off eating if they are busy with something else,” Friel says. “However, food is a big part of a diabetic’s treatment and is necessary to maintain blood sugar levels.” Although you shouldn’t skip meals, that also doesn’t mean you should raid the fridge. In fact, if you’re already overweight, you may need little to no increase in your calories while pregnant, says endocrinologist Dr. Saima Farghani, on staff at CentraState Medical Centre in Freehold, New Jersey. Stick to nutrient-dense food choices and avoid what Farghani calls “man-made carbohydrates” like cereals, cookies, snacks and chips. Instead, aim to eat foods with complex carbohydrates such as oatmeal and fruits and vegetables and healthy fats like avocados and nuts.
Exercise if it’s OK with your doctor. Regular exercise will help you feel better and build your strength for having a baby. Most women can stick to the guideline for all adults of 150 minutes a week or 30 minutes, five days a week. (If you’re having trouble fitting in 30-minute periods of exercise, you can break that into 10- to 15-minute bursts throughout the day.) One exception to this is if you did not exercise before getting pregnant. In that case, work up slowly to longer exercise time periods and do so under your doctor’s guidance, Farghani says. Of course, always listen to your doctor’s advice regarding exercise while pregnant. If you’re on bedrest, you won’t be able to exercise regularly.

You'll also want to plan what kind of physical activity you're doing. Avoid exercises that require bouncing, are high-impact or that cause your back to arch backwards. “Walking, swimming, cycling or prenatal yoga are your best bets,” Gonzalez says.

Check with your doctor about diabetes medications you should continue to use. Generally speaking, many of the medications you take for diabetes can be continued while you’re pregnant. In fact, you may need changes to your diabetes medications while you’re pregnant as your insulin resistance increases. However, there may be some limitations, so it’s always important to verify with your doctor what you can safely take. Also let your doctor know about herbal or dietary supplements so you can make sure you take only what is necessary, Gonzalez advises.
Follow these tips if you have gestational diabetes as well – and monitor your risk for diabetes after you have your baby. Gestational diabetes is the kind of diabetes that develops when you are pregnant, but then it goes away once you have the baby. “Approximately 50 percent of women with gestational diabetes will develop diabetes in the next 10 years,” Friel says. The children of women with gestational diabetes also are at higher risk for diabetes development. Make sure you see your doctor regularly to test your diabetes risk after giving birth.

https://health.usnews.com/health-care/patient-advice/articles/2017-10-03/what-to-know-about-pregnancy-when-youre-diabetic