Diabetes intervention works best at home

From source.wustl.edu

Unique partnership gets health information to those who need it most

A public health research team at the Brown School at Washington University in St. Louis has taken one of the most effective Type 2 diabetes intervention programs and made it more accessible by partnering with an existing home-visit organization dedicated to working with mothers of preschool-aged children.
The researchers, led by Debra Haire-Joshu, the Joyce Wood Professor at the Brown School, and director of the Centre for Diabetes Translation Research and the Centre for Obesity Prevention and Policy Research, adapted a lifestyle intervention from the Diabetes Prevention Program (DPP), which is held as the “gold standard” of diabetes interventions through weight management.
The DPP intervention, however, has had challenges when it comes to reaching groups such as busy mothers. It is time consuming and intense, consisting of individual and group meetings and personal health coaching.

“Our team adapted core DPP content and made it simple to fit within an existing organization,” Haire-Joshu said. That organization, Parents as Teachers, visits women with young children at their homes, working to empower the mothers to raise their children and ready them for school.

The researchers worked to incorporate their diabetes intervention program, called Healthy Eating and Active Living Taught at Home (HEALTH), into the existing Parents as Teachers program. The HEALTH program focuses on changing lifestyle behaviours as well as the environment at home.
“We focused on simple messages, such as limiting soda in the house, avoiding TV in the bedroom and getting up to walk around,” Haire-Joshu said. “It was consistent with the child development and family-oriented Parents as Teachers program.
“And it worked.”
Mothers who received the intervention were significantly more likely to achieve clinically meaningful weight loss after two years — about a 5 percent reduction — compared with those who received home visits without the HEALTH intervention. The intervention also prevented weight gain between treatment groups at both one and two-years. In the U.S., on average, people gain about 1-2 pounds per year. Prevention of that weight accumulation, as seen in HEALTH, can show a continuing impact on the risk for diabetes
Each 2-pound loss is associated with a 16-percent reduction in Type 2 diabetes incidence.
“Weight loss can sometime seem to be a daunting task,” she said. “This is all about the prevention of weight gain. Our end-goal is to prevent diabetes, but framing the challenge as the prevention of weight gain can also be effective.”
Both outcomes — weight maintenance and clinically significant weight reduction — were achieved through interventions embedded within a program that didn’t rely on traveling to a physician’s office or clinic, and instead allowed mothers to stay home with their children, changing their home environment for the better and setting an example as they changed their lifestyle behaviours.

https://source.wustl.edu/2018/03/diabetes-intervention-works-best-at-home/

Is this how abdominal fat leads to diabetes?

From medicalnewstoday.com

It is known that being overweight or obese leads to poor health, but it may be less known that abdominal fat is the most harmful type. Until now, researchers were unsure of the mechanisms responsible for this — but now, they reveal how an enzyme produced by our liver raises the risk of diabetes.

When it comes to the harmful consequences of excess fat, the way it is distributed across the body is key.
Medical News Today have recently reported on studies showing that abdominal fat is deeply tied to type 2 diabetes and heart disease.
We have also covered studies suggesting that women, in particular, could be at an increased cardiometabolic risk if they have a higher waist-to-hip ratio.

Inflammation in the fat around the belly is particularly harmful, and new research reveals why

Additional research has found that belly fat is particularly dangerous when inflamed. Older studies have shown that local inflammation in the adipose tissue leads to cardiometabolic abnormalities such as insulin resistance.
But the exact mechanism responsible for this connection between adipose tissue inflammation and cardiometabolic disorders has remained somewhat unclear — for instance, researchers have wondered whether the inflammation is "a cause or a consequence of insulin resistance."
Now, researchers at Columbia University Irving Medical Centre in New York City, NY, help to shed some much-needed light on the issue; they reveal that the liver contributes to this inflammation.
The team was led by Dr. Ira Tabas — who is the Richard J. Stock Professor of Medicine at Columbia University Vagelos College of Physicians and Surgeons — and the findings were published in the journal Nature.

https://www.medicalnewstoday.com/articles/321301.php

Recipe: Low Carb Sour Cream Marble Loaf

From asweetlife.org

Ingredients

• 1/2 cup sour cream
• 4 large eggs
• Sweetener equivalent to 3/4 cup sugar
• 1/2 tsp vanilla extract
• 3 cups almond flour
• 2 tsp baking powder
• 1/4 tsp salt
• 3 tbsp cocoa powder
• 2 tbsp water

Instructions

1. Preheat the oven to 350 and grease a 9x5 inch bundt pan well.
2. In a large bowl, whisk together the sour cream, eggs, sweetener and vanilla extract. Add the almond flour, baking powder, and salt and stir until well combined.
3. Transfer about 1/3 of the batter to a second bowl and whisk in the cocoa powder and water.
4. Dollop the two batters in an interchanging pattern, swirling together. Smooth the top.
5. Bake about 40 to 50 minutes, until the edges are golden brown and the top is set to the touch.

Yield: 12

Cholesterol: 66mg

Food energy: 209 kcal

Total fat: 17.29g

Calories from fat: 155

Carbohydrate: 7.41g

Protein per serving: 8.56g

Total dietary fibre: 3.5g

https://asweetlife.org/low-carb-sour-cream-marble-loaf/?utm_source=ASweetLife.org+List&utm_campaign=5988160cf0-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017&utm_medium=email&utm_term=0_5125b14cf8-5988160cf0-413392997

Tooth health may indicate diabetes risk

From medicalxpress.com

Poor dental health may be linked with increased risk for diabetes, a new study suggests. The results will be presented in a poster Monday, March 19, at ENDO 2018, the 100th annual meeting of the Endocrine Society in Chicago, Ill.
"The health of your teeth maybe a sign of your risk for diabetes," said lead author Raynald Samoa, M.D., an assistant professor in the Department of Diabetes, Endocrinology & Metabolism at City of Hope National Medical Centre in Duarte, Calif.
"Our findings suggest that dental exams may provide a way to identify someone at risk for developing diabetes. We found a progressive positive relationship between worsening glucose tolerance and the number of missing teeth. Although a causal relationship cannot be inferred from this cross-sectional study, it demonstrates that poor dental outcome can be observed before the onset of overt diabetes," he said.
Samoa and colleagues investigated the impact of glucose tolerance on dental health in a representative population in the United States.
The researchers reviewed the records of 9,670 adults 20 years of age and above who were examined by dentists during the 2009-2014 National Health and Nutrition Examination Survey. They analysed their reported body mass index (BMI) and glucose tolerance states by fasting plasma glucose, two-hour postchallenge plasma glucose, hemoglobin A1c (HbA1c), established diabetes and whether the condition was treated with oral agents or insulin.
They recorded the numbers of missing teeth due to caries, or cavities, and periodontal disease for individual patients; and they determined the relationship between glucose tolerance and dental condition by considering age, gender, racial and ethnic group, family history of diabetes, smoking status, alcohol consumption, education and poverty index.
The authors found a progressive increase in the number of patients with missing teeth as glucose tolerance declined, from 45.57 percent in the group with normal glucose tolerance (NGT), to 67.61 percent in the group with abnormal glucose tolerance (AGT), to 82.87 percent in the group with diabetes mellitus (DM). Except for gender, all other covariates had significant impact on the number of missing teeth.
The differences in the average number of missing teeth among the three glucose tolerance groups were significant: 2.26 in the NGT group, 4.41 in the AGT group and 6.80 in those with DM.
The authors wrote in their abstract that as far back as the 1930s, periodontal disease and dental caries have been suggested to be linked with diabetes, and that that by 2050, one-third of Americans are expected to be affected by diabetes.

https://medicalxpress.com/news/2018-03-tooth-health-diabetes.html

Type 2 Diabetes and Healthy Living - The Turning Point in Your Health

By Beverleigh H Piepers

It is almost guaranteed you are missing something in your life. Before you let your mind wander off into all directions, please focus on your health. Is there something you find immediately alarming concerning your well-being? Most people feel there is, even if they are not able to pinpoint it right away.

How often do you pause to think deeply about your health anyway? Most people will go years without spending ten minutes contemplating the direction their health is heading. It is unfortunate it is usually not until a debilitating disease surfaces most people have a moment of clarity where they realize their health is more important than previously believed. We all have a reasonable understanding of the effects of Type 2 diabetes and atherosclerosis when there is a plaque build-up in the blood vessels. Perhaps you have been in this situation? Are you a Type 2 diabetic, maybe you are not? But the point is, no matter your current circumstance, in all likelihood you ought to determine if there is any potential for a turning point in your health.

Has your health recently shown consistent improvement? If so, continue reading at your leisure. Otherwise, considering your health perhaps has not been on the right track for some time and that it will pay to make some changes.
There is a good chance if you think about it you will know more than a few things you could immediately do or implement into your lifestyle. Make a list, and beside each item write down the expected or intended outcome. Even if it is obvious, it is still helpful to write it down as it reinforces your goals.

What are your goals? Do you want to...

• lose weight and improve your physique
• lower your blood sugar level or treat your Type 2 diabetes by learning more about healthy food choices
• reduce your triglycerides and cholesterol levels
• enhance your food choices,
• increase your activity levels, or
• boost your energy levels.

The above list is a starting point. Compile your list, and act on it. Structure your turning point in your health. Consider this has the potential to change your life forever. This one decision may not only improve your life which is necessarily a given but also adds years to it. This fact may not matter so much to you now, but do not forget how much quicker time seems to fly pass by as you age.

Take charge, and be responsible for the turning point in your health.

Type 2 diabetes is not a condition you must just live with. By making easy changes to your daily routine, its possible to protect your heart, kidneys, eyes and limbs from the damage often caused by diabetes, and eliminate some of the complications you may already experience.

http://ezinearticles.com/?Type-2-Diabetes-and-Healthy-Living---The-Turning-Point-in-Your-Health&id=9902942

Have a family history of type 2 diabetes? Sedentary lifestyle is more harmful for you

From hindustantimes.com

Scientists have found that a reduction in physical activity and an increase in sedentary behaviour has detrimental effects on the body, and could be more harmful if a first degree relative has type 2 diabetes. “The results of our study highlight the critical importance of avoiding low levels of physical activity and sedentary behaviour, for example, too much sitting, television viewing, computer gaming and so on,” said Kelly Bowden Davies from the University of Liverpool in the UK.
“We know the benefits of exercise. The challenge now is to encourage people to simply move more and sit less,” said Davies. The study looked at 45 people with active lifestyles, including 16 who have close blood relatives with type 2 diabetes.
After 14 days of reduced physical activity, all participants had higher levels of fat and their bodies were less able to respond to the hormone, insulin (known as insulin resistance). In those closely related to someone with type 2, a greater amount of fat was gained around their waist and in their blood, which are strong risk factors for the development of the condition.
The participants were assessed again 14 days after resuming normal activity and the researchers found the adverse effects were reversed. This stresses how beneficial physical activity can be, and the important role it plays in reducing the risk of developing type 2 diabetes. The study was presented at the annual Diabetes UK Professional Conference.
Type 2 diabetes is a serious, lifelong condition where your blood glucose level is too high. More than 4.6 million people in the UK have diabetes, and around 90% of these have type 2 diabetes. It is estimated that 12.3 million people are at an increased risk of developing type 2 diabetes.
“Our day-to-day physical activity is key to abstaining from disease and health complications. In a group of physically active, healthy young individuals that met the recommended physical activity guidelines, just 14 days of increased sedentary behaviour induces small but significant changes in their health,” said Daniel Cuthbertson from the University of Liverpool.

https://www.hindustantimes.com/fitness/have-a-family-history-of-type-2-diabetes-sedentary-lifestyle-is-more-harmful-for-you/story-dvXNSB1Qq7sO0puWuYVY4M.html

How Many Types of Diabetes Are There? Two? Five? Or Eleven?

From diabetesincontrol.com

More specific classifications for the disease could lead to more personalized treatments in the future. Is it time?  

Diabetes is normally split into two categories: type 1 and type 2. But a group of scientists from Sweden and Finland say diabetes is actually five separate diseases. More specific classifications for the disease could lead to more personalized treatments in the future. Knowing which of these 5 categories of diabetes your patients have can be a benefit in choosing the treatment.

We know that each of the five proposed categories are genetically distinct. Their signs and symptoms can vary by age, weight, insulin resistance, how much insulin they can produce, or if the diabetes is caused by an autoimmune disorder.
This new classification of diabetes can be the first step toward personalized treatment of diabetes. Existing treatment guidelines are limited by the fact they respond to poor metabolic control when it has developed, but do not have the means to predict which patients will need intensified treatment.
This study moves us toward a more clinically useful diagnosis, and represents an important step toward personalized treatment of diabetes as our current diagnostics and classification of diabetes are unable to predict future complications or choice of treatments. We know that diabetes is a progressive disease and the type of diabetes changes as a person gets older, which means that the patient will need probably need new drugs that work differently.
Currently the way we determine a treatment for type 2 diabetes is a one-size-fits-all algorithm. We start a patient with metformin and then if that doesn’t get the patient to goal, other drugs are added. But recognizing that there are 5 types of diabetes and not just 2 types will help us to prescribe a treatment that is more specific to the patient’s type of diabetes.

The five types of diabetes include:

Cluster 1: Called “severe autoimmune diabetes,” this form is similar to type 1 diabetes. People in this cluster were relatively young when they were diagnosed, and they did not have excessive weight. They had an immune system (autoimmune) disease that prevented them from producing insulin.

Cluster 2: Called “severe insulin-deficient diabetes,” this form was similar to cluster 1 — people were relatively young at diagnosis and did not have excessive weight. They were also not producing much insulin. But, crucially, their immune system was not the cause of their disease. People in this cluster “looked for all the world like [they had] type 1” diabetes, but they didn’t have “autoantibodies” that indicate type 1. Researchers aren’t sure why this happens, but people in this group may have a deficiency in the cells that produce insulin.

Cluster 3: Called “severe insulin-resistant diabetes,” this form occurred in people who had excessive weight and had high insulin resistance, meaning their bodies were making insulin, but their cells were not responding to it.

Cluster 4: Called “mild obesity-related diabetes,” this form occurred in people who had a milder form of the disease, without as many metabolic problems as those in cluster 3, and they tended to have obesity.

Cluster 5: Called “mild age-related diabetes,” this form was similar to cluster 4, but the people were older at their age of diagnosis. This was the most common   form of diabetes, affecting about 40 percent of people in the study.

People in cluster 3 had the highest risk of kidney disease, a complication of diabetes, while people in cluster 2 had the highest risk of retinopathy, another complication of diabetes that can cause vision loss.

Clusters 2 and 3 are both severe forms of diabetes that were “masked within type 2 diabetes,” the researchers said. People in these clusters may benefit from aggressive treatment to prevent diabetes complications, the authors said.

Maybe it is time to make the change to categorizing diabetes more accurately.

http://www.diabetesincontrol.com/how-many-types-of-diabetes-are-there-two-five-or-eleven/

Managing Diabetes — It May Be Easier Than You Think

From businesswire.com

PHILADELPHIA--(BUSINESS WIRE)--Diabetes is quickly becoming an epidemic in the United States. According to the American Diabetes Association and the Centres for Disease Control and Prevention, more than 30 million Americans, or approximately 10 percent of the nation’s population, have diabetes.¹ Left unmanaged, diabetes can lead to blindness, kidney disease, heart disease and amputations. It also claims the lives of almost 200,000 Americans each year.²
The good news is that you can easily manage diabetes and live a healthy and fulfilling lifestyle.
“Many of the behaviours that can help control diabetes are ones we all should follow,” said Dr. Andrea Gelzer, chief medical officer for AmeriHealth Caritas, a national leader in health care solutions for those in need. “Some basic lifestyle changes can both control diabetes and improve your health in other ways.”
Here are some common tips for managing diabetes:
  
Watch your numbers
It is important to watch your weight, blood pressure and cholesterol numbers, but the most important metrics in diabetes are your blood sugar and A1C levels — A1C is a measure of your blood sugar level over the past three months. Ask your primary care provider (PCP) and/or endocrinologist (a doctor who specializes in diabetes and other diseases of the endocrine system) about how to check your blood sugar and how often to do so. They can also work with your health insurance plan to help you obtain the needed supplies.

Eat smart You should develop a healthy meal plan that includes:

• Foods lower in calories, saturated fat, trans fat, sugar and salt.
• Foods with more fibre, such as whole grain cereals, breads, crackers, rice or pasta.
• Fresh fruits and vegetables.
• Low-fat or skim milk and water instead of juice and soda.

Get moving
Increasing your physical activity can help you get to and maintain a healthy weight. You should set a goal to be more active most days of the week. One possible approach is to start slowly by taking a 10-minute walk three times a day.

Take care of your eyes, mouth and feet
It may surprise you that your vision, mouth and feet can be indicators of uncontrolled diabetes. Make sure you brush and floss every day to keep your teeth and gums healthy. Check your feet for cuts, blisters, red spots and swelling. And contact your PCP if you experience blurred or otherwise impaired vision.
  
Obtain routine health care
Keep scheduled visits with your PCP and other physicians to help find and treat any problems early. At each visit, be sure you have a:

• Blood pressure check
• Foot check
• Weight check
• Review of your self-care plan

https://www.businesswire.com/news/home/20180316005577/en/Managing-Diabetes-%E2%80%94-Easier

Type 2 prevention programme yields ‘promising’ results

From diabetestimes.co.uk

Around 66,000 people have taken part in a national type 2 diabetes prevention programme that was launched three years ago, it has been announced.
The Healthier You: NHS Diabetes Prevention Programme (NDPP) is now on the verge of achieving complete national coverage and more than half of overweight people who routinely attended the sessions have achieved an average weight loss equivalent to nearly 15 double cheese burgers.
In the last 21 months of roll-out, more than 154,000 people have been referred to the flagship initiative and those who took up the opportunity of participating in the eight support sessions over a nine month period have lost on average around 3.3kgs.
When excluding those who already had normal weight and BMI, but still attended the programme due to other health and lifestyle risks associated with developing type 2 diabetes, the weight loss increased to 3.7kg.
The early findings show the programme has exceeded expectations with patients losing an average of 1kg more than originally predicted.

Speaking at the Diabetes UK’s Professional Conference, NHS England’s chief executive Simon Stevens, said: “The NHS is already leading the way in the battle against the obesity crisis by slashing the sale of sugary drinks and super-sized snacks in hospitals, and the results now coming out of our diabetes prevention programme are also positive. Obesity is the new smoking and the scale of our response needs to match the scale of the crisis.”
Pilot digital programme
Further data about the programme has shown just under half of those signing up are men – a much higher proportion than typically attend weight loss programmes, while roughly a quarter are from black, Asian and minority ethnic communities.
Since obesity is more prevalent among poorer communities, action to tackle it also directly reduces health inequalities.
The programme also recently launched digital support to people so more than 5,000 people are expected to benefit from a pilot project. Five companies and eight areas of the country are test driving a range of apps, gadgets, wristbands and other innovative digital products and in the first two months around 800 people have been referred and more than half of those have logged onto a service since.
Professor Jonathan Valabhji, national clinical director for diabetes and obesity at NHS England said: “While it is early days, this data from several thousand people is very promising. Not only is our prevention programme exceeding the initial targets set for referrals and equity of access, what we are now starting to see is the first set of encouraging weight loss results too.
“Type 2 diabetes is heavily linked to obesity and if those on our programme continue to lose weight, as this snapshot suggests, then it is a step in the right direction and this programme can be an effective part of the solution.”
Duncan Selbie, Public Health England’s chief executive said: “The diabetes prevention programme is working, and alongside other public health interventions like sugar reduction it will help to turn the tide on obesity. Diabetes is one of the key preventable illnesses, every year 22,000 people die early because of type 2.
“Joined up action by NHS England, Diabetes UK and Public Health England on the prevention programme is putting people in control of their health with tools and information they need to make small lifestyle changes that significantly reduce their risk of the disease.”

http://diabetestimes.co.uk/type-2-prevention-programme-yields-promising-results/

Enjoying Easter: Eat chocolate in a healthier way

From diabetes.org.uk

Easter is a time for family, friends, new beginnings, and you guessed it...chocolate. With the shops full of tempting chocolate Easter eggs, it's time to find out how to eat chocolate in a healthier way.
Although it's extremely important to eat a healthy, balanced diet, with a little extra attention it's easy to enjoy the Easter period.

But what if you have diabetes?

Well, it's a myth that you should eat diabetic chocolate. In fact, we recommend eating real chocolate and avoiding diabetic chocolate completely. This is because diabetic chocolate offers no health benefit over real chocolate – see 'Real chocolate versus diabetic chocolate', below.

How to eat real chocolate more healthily

But with 'health' being the name of the game, try to only eat chocolate in moderation: this has nothing to do with having diabetes, though – the advice applies to everybody.
Moderation means trying to keep it for special treats rather than using it to satisfy hunger, and also means not eating loads in one go. Don't panic, though – there are ways to make moderation easier – see 'Top choc tips...', below.

Real chocolate versus diabetic chocolate

Real chocolate...

• contains carbohydrate in the form of added sugar that affects blood glucose levels
• contains fat
• contains calories
• doesn't make you go to the loo more
• per 50g serving, costs 50 to 60p.

Diabetic chocolate...

• instead of sugar, contains bulk sweeteners like fructose or sorbitol, which still affect blood glucose levels
• tends to contain just as much fat – and is often high in the really bad type of fats, saturated and trans fat
• tends to contain just as many calories
• does make you go to the loo more (can have a laxative effect)
• per 50g serving, costs around £1.40.

Top choc tips for eating it in moderation

• Wean yourself on to good-quality dark chocolate. It has a stronger taste than milk chocolate so you won't need to eat as much to satisfy your chocolate craving. 
• If you like your choc bar to have a filling, choose fruit rather than nuts because fruit is lower in calories and fat than nuts. For example, choose chocolate-coated cherries, raspberries, or cranberries rather than chocolate-coated Brazil nuts or peanuts. Chocolate-coated pretzels and rice or corn cakes and are other lower-fat alternatives.
• Try out low-fat chocolate alternatives such as low-fat chocolate yogurts and mousse, low-calorie chocolate drinks and chocolate sorbet.
• Eat slowly – let the chocolate melt in your mouth to give yourself time to enjoy the taste and texture.
• Store your chocolate in the fridge because it will then take even longer to melt in your mouth.
• Try to save chocolate-eating for after a meal, when you will naturally be less hungry.
• Decide how much you are going to eat and put the rest of the chocolate away, out of reach. This should help prevent you from having 'just one more piece' and wolfing down the whole lot before you realise it.
• Read the labels for carb content to help adjust your insulin levels. 
• Grate chocolate to make it go further. 

https://www.diabetes.org.uk/guide-to-diabetes/teens/me-and-my-diabetes/treats-at-easter?utm_source=bronto&utm_medium=email&utm_term=Tips+for+a+healthier+Easter&utm_content=Tips+for+a+healthier+Easter&utm_campaign=Enewsletter+March+2018

High fibre diet may help with management of type 2 diabetes

From upi.com

Researchers say a high fibre diet can promote a group of gut bacteria that lead to better control of blood glucose, greater weight loss and improved lipid levels

March 9 (UPI) -- A high-fibre diet has previously been recommended for type 2 diabetes, but researchers have now discovered exactly why it improves health.
The diet helps promote gut bacteria, leading to better blood glucose control, greater weight loss and better lipid levels in people with type 2 diabetes, according to research published Friday in the journal Science.
The six-year study, led by Rutgers University, shows that these dietary fibres may rebalance the gut microbiota, the ecosystem of bacteria in the gastrointestinal tract that help digest food.

"Our study lays the foundation and opens the possibility that fibres targeting this group of gut bacteria could eventually become a major part of your diet and your treatment," lead author Liping Zhao, a professor in the Department of Biochemistry and Microbiology, School of Environmental and Biological Sciences at Rutgers University-New Brunswick, said in a press release.
In research based in China, Zhao and scientists from Shanghai Jiao Tong University and Yan Lam, a research assistant professor in Zhao's lab at Rutgers, studied patients with type 2 diabetes in two groups.
In a 27-person treatment group, participants were was given a large amount of many types of dietary fibres, along with a similar diet for energy and major nutrients. A control group of 16, meanwhile, received standard patient education and dietary recommendations. Both groups also took the drug acarbose to help control blood glucose.
"Leafy greens, whole grains, fruits with fibres: There's lots of evidence that microbes will digest foods our bodies can't," Dr. Lynn Bry, director of the Massachusetts Host-Microbiome Centre at Harvard University, who was also not involved in the research, told STAT. "When you eat, you're not only feeding yourself, you're feeding your microbiota."

Twelve weeks after the study started, participants on the high-fibre diet had greater reduction in a three-month average of blood glucose levels than participants receiving standard care. In addition, their fasting blood glucose levels dropped faster and they lost more weight than the standard care group.
Only 15 of the 141 identifiable strains of short-chain fatty acid-producing gut bacteria are likely to be the key drivers of better health, researchers say, but they became the dominant strains in the gut after boosting short-chain fatty acids butyrate and acetate. They also led to increased insulin production and better blood glucose control.
Many bacteria break down carbohydrates, such as dietary fibres, and produce short-chain fatty acids that nourish cells lining the gut. In turn, they reduce inflammation and help control appetite.
But in diabetes and other diseases, there a shortage of bacteria's short-chain fatty acids.
Researchers say they plan further studies to determine if greater changes to the gut microbiota could do more to help treat type 2 diabetes -- possibly even curing it -- in addition to the current study's suggestion that increasing health of the microbiota as a way of managing the condition.

https://www.upi.com/High-fiber-diet-may-help-with-management-of-type-2-diabetes/4951520611897/

Lifestyle Changes Can Help Kids Avoid Type 2 Diabetes

From rbmc.org

Type 2 diabetes, once diagnosed much more often in overweight adults, now affects kids who have poor eating habits and get little exercise.  Why is it so important to watch kids’ weight? Eighty percent of overweight kids become overweight adults, increasing their risk of developing diabetes.  Parents can do a lot to reduce the risk of type 2 diabetes in their kids by following these tips.

• Ban habits that lead to overeating. Make kids use a plate and eat at the table.
• Make sure kids exercise. They need an hour a day, all or most days. Sports teams are one option, but outdoor play like running around and bike riding are other options.
• Control portions. Don’t let kids overeat. Switch to smaller plates to encourage smaller portions.
• Delay providing additional portions at mealtime. Wait 15 to 20 minutes before you offer seconds.
• Don’t buy junk food. Offer low-calorie snacks like carrots, celery, Italian ices, low-fat cheese, or fresh fruit.
• Limit or get rid of soda and other sweetened beverages. These have a lot of calories with little nutritional value.
• Cut back television time and other inactive “screen time” like video games and computers. Two hours a day or less is all that’s recommended.

The last tip is for parents, it’s important for you to set a good example and avoid diabetes as well. Be sure to eat in a healthier way and get daily exercise too, and take a Type 2 Diabetes Risk Test, available online at wellnesscenter.hackensackmeridianhealth.com/Conditions/Diabetes/.  An estimated 84 million Americans have prediabetes, and 90 percent of them don’t know they have it. Prediabetes can lead to type 2 diabetes and its many serious complications. It’s crucial for people to know their risk because prediabetes can be reversed with healthy food choices, weight loss, and exercise.  Held the last Tuesday of March each year (March 27 this year) American Diabetes Alert Day encourages everyone to take the risk test.
If you have questions about your child’s nutritional needs, be certain to check with their healthcare provider.

https://www.rbmc.org/lifestyle-changes-can-help-kids-avoid-type-2-diabetes/

Annual Eye Exam Is Vital if You Have Diabetes

From usnews.com

THURSDAY, March 8, 2018 (HealthDay News) -- A yearly eye exam is a key part of diabetes treatment, experts say.

Diabetic eye disease is the leading cause of blindness among people aged 40 to 60, cautioned Dr. Malav Joshi, an ophthalmologist at the Krieger Eye Institute in Baltimore.

And the longer people have diabetes, the greater the odds of developing vision problems.
However, "diabetic eye disease is preventable, and you can take steps to slow it down or even reverse it by taking care of your diabetes, your blood pressure and your cholesterol," Joshi said in a LifeBridge Health news release.

A dilated eye exam can help doctors spot problems early on -- before vision loss. This is particularly important since eye damage related to diabetes may not cause symptoms right away.

The eye conditions associated with diabetes include:

• Diabetic retinopathy: In the early states, this causes the blood vessels to weaken, leak or bleed into the retina. Later, bleeding blood vessels can cause serious vision problems.
• Diabetic macular edema: This occurs when fluid or cholesterol leaks out of the blood vessels, causing the part of the retina essential for fine vision to swell.
• Glaucoma: This affects the optic nerve and can lead to permanent blindness without early detection and treatment.
• Cataracts: People with diabetes are at much greater risk for cataracts, which occur when the lens becomes cloudy.

During a dilated eye exam, doctors can look at the inside of the eye for signs of trouble, such as abnormal blood vessels, retinal swelling and nerve tissue damage. "It also helps us see your cataracts a little better," Joshi said.
Other steps you can take to protect your vision if you have diabetes:

• Stop smoking,
• Follow a healthy diet,
• Exercise regularly,
• Take all medication as directed.

https://health.usnews.com/health-care/articles/2018-03-08/annual-eye-exam-is-vital-if-you-have-diabetes

Cinnamon: Spice that cures

From thestatesman.com

Cinnamon is the dried bark of a tropical evergreen tree. It is a tree native to the Indian subcontinent. Its bark contains cinnamanic aldehyde, eugenol, and tannis .It is antibacterial, carminative, stimulates appetite and is used in gastrointestinal complaints. However many people do not know the wonderful health benefits it has. Let’s now check them out and incorporate it into our daily food habits to enjoy health benefits.

Keeps check on diabetes: Cinnamon improves one ’s glucose levels and lipid levels by activating his insulin receptors. It also reduces the total serum, glucose, triglycerides and total cholesterol.
Tip – Cinnamon tea is the most effective method to beat diabetes. Boil cinnamon in water for 15 minutes. Add few tulsi leaves for flavour and honey for sweetness. Strain and drink.

Helps in delaying Alzheimer: Extracts of cinnamon, when consumed on a daily basis slows down the progression of the disease Alzheimer. Cinnamon is a type of protein that aggregates around that part of the nerves that is responsible for transmitting impulses of the brain.
Tip – Have a teaspoon of freshly ground cinnamon with a little bit of honey every day on an empty stomach. If u find this mixture too spicy, have it as a tea.

Relieves arthritic pain: Cinnamon has very strong antibacterial and anti-inflammatory properties. They make it a great home remedy for arthritic pain. It relieves aching joints because of its natural heating mechanism.
Tip – Grind cinnamon and make it a paste with water. Apply on the aching joints and place a soft muslin cloth on the paste to keep it wet for a longer.

Protects from cancer: A study done by the USDA (United States Agricultural Department) founded that cinnamon extract blocked the path of certain components that were important for the generation of the cell,  restrained further multiplication of cancerous cells and slowly reduced their spread. The extract only subdued the growth of unhealthy cells untouched unlike conventional therapies like chemotherapy, etc.
Tip – Sprinkle cinnamon on any food you eat or consume with honey.

Fights tooth decay: Cinnamon not only beats tooth decay but also prevent gingivitis and bad breath because of its antibacterial properties.
Tip – Gargle with cinnamon boiled water for bad breath and chew a small piece of cinnamon, to get relief from a toothache and gingivitis.

Great for a heart: Packed with fibre and calcium, cinnamon translates to lower cholesterol levels which protect the heart from blockages and the arteries from atherosclerosis.

Relieves cold and cough: Cinnamon is an effectual remedy against a cold and cough. It is great for relieving cold oriented congestion and sore throat when combined with ginger.
Tip – Boil a teaspoon of cinnamon powder, a few tulsi leaves, some crushed pieces of ginger, crushed black pepper in two cups of water. Simmer for about 10 minutes. Strain the liquid. Add a teaspoon of honey and drink to clean up blocked nasal passage and sinuses.

Helps beat acne: Pimples often arise from an infection within the pores of the skin. Combination of cinnamon and honey is an effective remedy.
Tip –  Crush a little cinnamon and add a bit of honey to make a paste. Apply it on pimples and leave for few minutes. You can leave it on overnight for better results. Wash off with warm water and watch that pimples disappear.

Helps in weight loss: Cinnamon regulates the breakdown of carbohydrates and production of insulin. It improves digestion and assimilates food within the body helping in losing weight.
Tip – Drink cinnamon tea half an hour before breakfast. Add cinnamon powder to your meal by sprinkling on fruits, salads, coffee or other foods.

Helps in digestion: Cinnamon is rich in fibre, manganese, calcium and essential oils. It improves digestion and reduces inflammation caused due to indigestion, Irritable Bowel Syndrome, and ulcers. The fibre content helps to relieve constipation and diarrhea.
Tip – Have cinnamon tea infused with mint leaves about two to three times a day.
Having these ample benefits cinnamon is a blessing of nature to the humankind. Now it is in our own hand to extract health benefits out of it. Cinnamon has a fragrant perfume and a sweet and aromatic taste. Delicate in flavour , it is used in desserts and biryanis. This spice is used in Indian curries and forms a part of garam masala. It’s flavour when added to anything, makes that unique.

https://www.thestatesman.com/lifestyle/health/cinnamon-spice-cures-1502595797.html

How To Stop Over-Eating and Over-Treating Low Blood Sugars

From asweetlife.org

Ever have one of those low blood sugars where you stumble from your bed and consume the contents of your fridge?  You know the lows I’m talking about… the ones where the logical portion of your brain knows that a few grams of quick-acting carbs will fix the problem, but the rest of your brain is in panic mode and wants to dive straight into a vat of Golden Grahams.
Having the wherewithal to only consume the carbs I need in order to treat a low blood sugar has always been a struggle for me.  Sometimes my low blood sugars come with a heavy-handed dose of adrenaline, making me feel like the only way to survive is to chomp on a peanut butter and jelly sandwich, chasing it with a handful of jellybeans.  It’s a horrible, panic-infused experience, often ending up in out-of-range blood sugars as a result of over treating, which also comes with its own side of guilt.
We talked with some A Sweet Life readers and they also feel the intense need to shovel food during episodes of hypoglycemia (and hyperglycemia).  “When I’m low I sometimes have these ridiculous cravings. I usually want to just eat everything in sight,” wrote one reader.  “I feel like I am starving to death and could eat everything in the house,” said another.  Seems like I’m not alone.

How do we curb our body’s enthusiasm about overeating when we’re experiencing a low blood sugar?  We have a few ideas.  (And if you have your own tips and strategies for managing the urge to overeat and over-treat during a low, we’d love to hear them!)

Portion control.  Keep a stash of treatments for low blood sugar that are pre-measured and single-portioned.  For example, keeping 15 grams worth of raisins or glucose tabs in a Ziploc bag on your bedside table is a good way to have hypo treatments at the ready without the option of over-indulging.

Don’t pick your favourites.  When choosing your glucose sources, steer clear of your favourite treats. Swedish Fish are quick-acting glucose sources in a pinch, but they are my favourite candy indulgences, so I refuse to purchase them to treat lows.  Instead, I’ll pick glucose tabs or raisins, knowing I won’t ever want to eat those things unless I’m hypoglycemic.

Keep it convenient.  Arming your bedside table, kitchen counter, office desk, or other areas you frequent with pre-portioned low blood sugar treatments can also help keep you from over-eating during a low.  Keeping your glucose stash close at hand can prevent you from venturing into the kitchen, where you’re more likely to start panic-grazing.

Graze responsibly.  If you know you’re the type of person who needs to crunch on something in order to work through hypoglycemic panic, have snacks on hand that you can eat while waiting for your fast-acting snack to work.  Keep carrot sticks or cucumber slices on hand so you can continue to munch without compromising your attempt to responsibly treat a low.

Set a timer.  Hearing a clinician say, “Eat 15 grams of carbs and wait 15 minutes” when your blood sugar is in the trenches can be so frustrating because it’s hard to wait those 15 minutes without climbing the walls.  Even when you’re doing your best to wait fifteen minutes, time feels like it slows to a crawl.  Use technology to your advantage and set a timer on your phone to help you wait out the dreaded 15 minutes.

Distract yourself.  Waiting out a gross-feeling low blood sugar?  Try and distract yourself.  Listen to a song on the radio.  Doodle on a scrap of paper.  Pick up some yarn and crochet up a scarf (yeah, I’ve been known to actually do that).   I know a guy who keeps crayons at work and he colours in a colouring book while low.  (He says he’s outside the lines most of the time, but whatever works, right?)
While some of these tips might work for you, I know it can be hard to be reasonable and rationale during a low blood sugar.  (We all have those lows where we’ve had to bolus mid-way through because of mass consumption, right?  No?  Just me?)  If you find that you’ve over-treated a low, don’t add guilt to that high blood sugar.  Do what you can to correct it quickly and move on.

https://asweetlife.org/how-to-stop-over-eating-and-over-treating-low-blood-sugars/?utm_source=ASweetLife.org+List&utm_campaign=8f0443c2db-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017&utm_medium=email&utm_term=0_5125b14cf8-8f0443c2db-413392997

2008 Great Recession led to increase in obesity, diabetes and mental health issues

From medicalxpress.com

The 2008 Great Recession resulted in changes to individuals' health behaviour, with a significant increase in the likelihood of obesity, diabetes and mental health problems, according to a new study from City, University of London and King's College London.
In particular, the researchers discovered that the probability of being obese and severely obese increased by 4.1 and 2.4 percentage points respectively. Similarly, the probability of having diabetes was 1.5 percentage points higher after 2008, with the prevalence of mental health problems increasing by 4 percentage points.
It was also found that there was a decrease in smoking and drinking, as well as fruit intake. These changes were also seen to impact particularly on women and those less educated, with the authors suggesting that uncertainty and negative expectations generated by the recession rather than unemployment might explain the changes seen.
The findings are also relevant for policymakers and clinicians, as universal health coverage and free provision of healthcare - and prescriptions in some cases - via the NHS might have worked as a protective factor during economic hardship.
However, the authors point out that as some health outcomes deteriorate during recessions, demand for health services might increase, leading to longer waiting times that can further worsen any negative effects. An increase in welfare benefits is another factor that may have protected people during the recession.
The reductions in smoking and drinking are also relevant given that lifestyle-related health problems cost the NHS £11 billion a year, but the authors emphasise that the right level of support from health specialists needs to be delivered if these positive behavioural changes are to be preserved beyond the duration of economic downturns. The research is published in the journal Social Science & Medicine.
As the second largest economy in the EU and one of the largest financial hubs in the world, the UK was one of the countries hit the hardest by the Great Recession in 2008. The UK shrunk by 4.3% in 2009 alone and the government had to bail out and nationalise large domestic banks, leading to increased government debt and deficit.
To explore this issue and its impact on health, the researchers looked at data from the Health Survey for England (HSE), a cross-sectional survey taken yearly from a representative sample of about 9,000 English households. They specifically used data on respondents above 16 years of age for the period 2001-2013. In addition to socio-economic characteristics, the HSE includes information on a wide range of health lifestyles and health conditions.
The results of the study suggest that the start of the recession was associated with worse dietary habits and increased BMI and obesity. It was also associated with a shift away from risky behaviours, as a decrease in smoking and alcohol consumption was seen. In addition, there was an increase in the use of medicines and a higher likelihood of suffering diabetes and mental health problems, all of which were generally experienced more acutely by those with less education and by women.
Speaking about the research, Professor Mireia Jofre-Bonet from the Department of Economics at City, University of London and lead author of the study, said:" Our study confirms the close relationship between health and the economic environment as we found that the 2008 Great Recession led to a decrease in risky behaviour, such as smoking and drinking, but also an increase in the likelihood of obesity, diabetes and mental health problems.
"With the NHS and health-related services under increasing pressure - and with another recession becoming increasingly likely - our findings have a number of important policy considerations. In particular, the fact that those less educated were more vulnerable to the health effects of the recession highlights the need for an urgent policy response as it is clear that this population need to receive information on health behaviours and risk factors to avoid the negative consequences and also the potential future impacts."

https://medicalxpress.com/news/2018-03-great-recession-obesity-diabetes-mental.html

Diabetes is actually five separate diseases, research suggests

From bbc.co.uk

Scientists say diabetes is five separate diseases, and treatment could be tailored to each form.

Diabetes - or uncontrolled blood sugar levels - is normally split into type 1 and type 2.
But researchers in Sweden and Finland think the more complicated picture they have uncovered will usher in an era of personalised medicine for diabetes.
Experts said the study was a herald of the future of diabetes care but changes to treatment would not be immediate.
Diabetes affects about one in 11 adults worldwide and increases the risk of heart attack, stroke, blindness, kidney failure and limb amputation.

Type 1 diabetes is a disease of the immune system. It errantly attacks the body's insulin factories (beta-cells) so there is not enough of the hormone to control blood sugar levels.
Type 2 diabetes is largely seen as a disease of poor lifestyle as body fat can affect the way the insulin works.
The study, by Lund University Diabetes Centre in Sweden and the Institute for Molecular Medicine Finland, looked at 14,775 patients including a detailed analysis of their blood.

The results, published in The Lancet Diabetes and Endocrinology, showed the patients could be separated into five distinct clusters.

• Cluster 1 - severe autoimmune diabetes is broadly the same as the classical type 1 - it hit people when they were young, seemingly healthy and an immune disease left them unable to produce insulin
• Cluster 2 - severe insulin-deficient diabetes patients initially looked very similar to those in cluster 1 - they were young, had a healthy weight and struggled to make insulin, but the immune system was not at fault
• Cluster 3 - severe insulin-resistant diabetes patients were generally overweight and making insulin but their body was no longer responding to it
• Cluster 4 - mild obesity-related diabetes was mainly seen in people who were very overweight but metabolically much closer to normal than those in cluster 3
• Cluster 5 - mild age-related diabetes patients developed symptoms when they were significantly older than in other groups and their disease tended to be milder

Prof Leif Groop, one of the researchers, told the BBC: "This is extremely important, we're taking a real step towards precision medicine.
"In the ideal scenario, this is applied at diagnosis and we target treatment better."
The three severe forms could be treated more aggressively than the two milder ones, he said.
Cluster 2 patients would currently be classified as type 2 as they do not have an autoimmune disease.
However, the study suggests their disease is probably caused by a defect in their beta-cells rather than being too fat.
And perhaps their treatment should more closely mirror patients who are currently classed as type 1.
Cluster 2 had a higher risk of blindness while cluster 3 had the greatest risk of kidney disease, so some clusters may benefit from enhanced screening.

Better classification

Dr Victoria Salem, a consultant and clinical scientist at Imperial College London, said most specialists knew that type 1 and type 2 was "not a terribly accurate classification system".
She told the BBC: "This is definitely the future of how we think about diabetes as a disease."
But she cautioned the study would not change practice today.
The study was on only Scandinavians and the risk of diabetes varies considerably around the world, such as the increased risk in South Asians.
Dr Salem said: "There is still a massively unknown quantity - it may well be that worldwide there are 500 subgroups depending on genetic and local environment effects.
"Their analysis has five clusters, but that may grow."
Sudhesh Kumar, a professor of medicine at Warwick Medical School, said: "Clearly this is only the first step.
"We also need to know if treating these groups differently would produce better outcomes."
Dr Emily Burns, from Diabetes UK, said understating the diseases could help "personalise treatments and potentially reduce the risk of diabetes-related complications in the future".
She added: "This research takes a promising step toward breaking down type 2 diabetes in more detail, but we still need to know more about these subtypes before we can understand what this means for people living with the condition."

http://www.bbc.co.uk/news/health-43246261