By Beverleigh H Piepers
When we consider which changes to make to our eating plan to help bring about a positive effect on our blood sugar control, we usually make our choices from a variety of whole foods. And while this is one way to go about controlling Type 2 diabetes and its effects, what you also need to keep in mind is there are herbs available that too can play a significant role. The right herbs can have a powerful influence and could help you prevent or manage your diabetic symptoms. Researchers have found herbal therapy has helped to bring about stable blood sugar by repairing the pancreas. In turn, it has been found insulin secretion is increased.
So, which herbs should you turn to? Which will help you start feeling better? Let us take a closer look at the best herbs to help promote more stabilized blood sugar...
1. Cinnamon. By now you may have already heard cinnamon is one of the best spices to add to your dish if you hope to reduce the impact the carbohydrates you eat have on your body. Cinnamon consumed with a meal will give you better overall sugar control and may also improve insulin sensitivity over the long-term.
As cinnamon may have a positive effect on your blood sugar control, this is an excellent reason to add cinnamon to your eating plan every day. Try including it whenever you can. Fortunately, it is a spice most people enjoy so not a hard one to consume.
2. Cloves. Another tasty herb to look into is cloves. This spice contains high levels of eugenol which has anti-inflammatory as well as antiviral properties and will help your body cope with inflammations and infections.
Furthermore, it may help to lower blood sugar, so yet another herb to add to your cooking whenever possible.
3. Rosemary. Rosemary is an aromatic herb commonly used to add flavor to meat and different soups. Rosemary combined with cinnamon and garlic, and baked in with sweet potatoes is also tasty. Or, use it to flavor your chicken - it is very versatile.
Rosemary will help to normalize blood sugar levels and may also help to promote weight loss results. You will see a positive impact on your triglyceride levels after adding this herb to your eating plan.
4. Oregano. Oregano is another favorite herb that works well with a variety of recipes and has also been found helpful in the control of blood sugar.
It helps to remedy oxidative stress in Type 2 diabetes and could also help to delay the onset of renal damage. It too comes with plenty of antioxidants to help fend off free radical damage and may provide some blood sugar stabilization benefits.
There you have four herbs to consider sprinkling into or onto your meals to help in the control of your Type 2 diabetes.
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---The-Best-Herbs-To-Eat-To-Promote-Stable-Blood-Sugar&id=9930361
Sunday, 29 April 2018
Saturday, 28 April 2018
Diabetes type 2 - the best exercise to prevent high blood sugar
From express.co.uk
DIABETES type 2 symptoms include weight loss, headaches and passing more urine than normal. But, you could prevent high blood sugar by doing this quick and fun exercise, it’s been revealed.
DIABETES type 2 symptoms include weight loss, headaches and passing more urine than normal. But, you could prevent high blood sugar by doing this quick and fun exercise, it’s been revealed.
Diabetes type 2 is caused by the pancreas not producing enough of the hormone insulin, or the body not reacting to insulin, according to the NHS.
The body struggles to convert sugar in the blood into useable energy without enough of the hormone.
Diabetes symptoms can include blurred vision, having an unquenchable thirst, and dry mouth.
Controlling blood sugar is very important for diabetes patients, because they’re more at risk of life-threatening complications, including heart disease and strokes.
But, you could lower your risk of high blood sugar by cycling, it’s been revealed.
Being active lowers your blood sugar levels, the NHS said.
Every UK adult - including diabetes patients - should aim for at least two and a half hours of physical exercise every week.
Regular exercise also helps you to lose weight if you’re overweight.
Keeping to a healthy weight could also make it easier to manage your blood sugar.
Cycling is a great activity for diabetes patients, as it raises your heart rate and makes you sweat, said Diabetes.co.uk.
“The more you cycle, and the more energy you expend, will result in your blood sugars falling faster,” it said.
“There are some exercise precautions which people with diabetes must take, however, when done safely, exercise is a valuable aid to optimal health.
“You need to keep your energy levels high so consuming small amounts of sugar at frequent intervals will be advised.
“If you are cycling for a short time, say between 20-30 minutes, then sipping a sugar drink halfway through your ride should be sufficient.
“Longer rides, however, will require frequent blood testing.”
Keeping to a healthy, balanced diet will also help to manage your blood sugar, the NHS added.
You should eat a wide range of foods, including fruit, vegetables, and some starchy foods.
While there aren’t any foods diabetes patients should avoid, you should limit the amount of sugar, fat and salt in your diet.
If you’re planning on making changes to your diet, it’s best to make them in small stages - for example, one dietary change every week.
You should see a GP if you’re worried about the symptoms of diabetes.
https://www.express.co.uk/life-style/health/952001/diabetes-type-2-symptoms-high-blood-sugar-exercise-cycling
The body struggles to convert sugar in the blood into useable energy without enough of the hormone.
Diabetes symptoms can include blurred vision, having an unquenchable thirst, and dry mouth.
Controlling blood sugar is very important for diabetes patients, because they’re more at risk of life-threatening complications, including heart disease and strokes.
But, you could lower your risk of high blood sugar by cycling, it’s been revealed.
Being active lowers your blood sugar levels, the NHS said.
Every UK adult - including diabetes patients - should aim for at least two and a half hours of physical exercise every week.
Regular exercise also helps you to lose weight if you’re overweight.
Keeping to a healthy weight could also make it easier to manage your blood sugar.
Cycling is a great activity for diabetes patients, as it raises your heart rate and makes you sweat, said Diabetes.co.uk.
“There are some exercise precautions which people with diabetes must take, however, when done safely, exercise is a valuable aid to optimal health.
“You need to keep your energy levels high so consuming small amounts of sugar at frequent intervals will be advised.
“If you are cycling for a short time, say between 20-30 minutes, then sipping a sugar drink halfway through your ride should be sufficient.
“Longer rides, however, will require frequent blood testing.”
Keeping to a healthy, balanced diet will also help to manage your blood sugar, the NHS added.
You should eat a wide range of foods, including fruit, vegetables, and some starchy foods.
While there aren’t any foods diabetes patients should avoid, you should limit the amount of sugar, fat and salt in your diet.
If you’re planning on making changes to your diet, it’s best to make them in small stages - for example, one dietary change every week.
You should see a GP if you’re worried about the symptoms of diabetes.
https://www.express.co.uk/life-style/health/952001/diabetes-type-2-symptoms-high-blood-sugar-exercise-cycling
5 Tips for Managing Diabetes After a Hospital Stay
From diabetesforecast.org
Once you’re home, don’t try to go it alone. Ask a friend, family member, or professional caregiver to help you take your meds as prescribed. “If you are groggy or not safe to take your own medications, you should have someone assisting you,” says Sandra Weber, MD, FACP, FACE, vice president of the American Association of Clinical Endocrinologists and chief of the Section of Endocrinology at Greenville Health System.
Without insurance, you may need to pay a larger deposit before you’re admitted, says Richard Pugach, a professional health advocate and president and CEO of Health Navigaid LLC. A health advocate familiar with matters of health insurance can assist you in finding the most appropriate health plan for your needs and can help minimize the likelihood of receiving unexpected hospital or physician bills. “A good advocate can help you avoid these situations,” Pugach says. You can hire a qualified advocate through the Alliance of Professional Health Advocates at advoconnection.com. You can also talk to the hospital’s financial care counsellors during or after your stay—they’re the hospital’s experts in insurance, Medicare, and Medicaid.
Always review your hospital bills, and speak up if you notice incorrect charges. If you get a bill you can’t afford, talk to the hospital. Many offer assistance programs or will write off the cost as charity.
This is also a great time to make an appointment for diabetes self-management education and support, says Jan Nicollerat, MSN, RN, ACNS-BC, CDE, vice chair of the North Carolina Diabetes Advisory Council and a consulting associate at the Duke University School of Nursing. Even if you received diabetes education in the hospital, it’s a good idea to set a follow-up visit with an educator after discharge to make sure you’re on track with your diabetes management. Get a referral from your hospital care team. Diabetes self-management education and support is covered by insurance, Medicare, and Medicaid.
http://www.diabetesforecast.org/2018/03-may-jun/5-tips-for-managing-diabetes.html
1. Set Expectations
The day or so before your discharge from the hospital, the doctor who treated you will likely review your hospitalization and how it affects your diabetes and other health conditions, changes to your medication regimen, and what follow-up you’ll need. Your hospital care team will also talk to you about what the natural course of healing should look like, how long you might need care at home, or when you can resume activities such as lifting heavy objects. The team will usually review warning signs of problems and what to do if your recovery doesn’t go as expected.2. Mind Your Meds
You may have a new medication plan after being in the hospital, either temporarily or long term. You’ll be given a written copy of the new plan so you can refer to it when you go home. Instructions should include how to take your new medication, when to start and when to stop, and how to use as-needed drugs such as pain medications. Someone from your hospital care team—your doctor, pharmacist, or nurse—will review it with you and any home caregivers (family or professional) in person to make sure everyone understands the plan and that you’re able to follow it. Before you leave the hospital, be sure you have a supply of new medication or plan to pick it up from a pharmacy on the way home.Once you’re home, don’t try to go it alone. Ask a friend, family member, or professional caregiver to help you take your meds as prescribed. “If you are groggy or not safe to take your own medications, you should have someone assisting you,” says Sandra Weber, MD, FACP, FACE, vice president of the American Association of Clinical Endocrinologists and chief of the Section of Endocrinology at Greenville Health System.
3. Keep Records
At discharge, ask for copies of your test results and your discharge summary. Your hospital may provide this information in print or electronic form. If you receive papers, consider keeping all of your hospital records in a three-ring binder, arranged chronologically and by subject (lab results in one section, for instance, and imaging in another), along with other health records. “Bring this to your visit every time you see a doctor,” says Susan Elizabeth Spratt, MD, associate professor of medicine, assistant professor of community and family medicine, and director of diabetes services at Duke University. “He or she may not need it, but it’s always good to have it in case he or she does need to review it.” Flag anything you have a question about—it will help you stay organized and on top of your management.4. Pay Up
There is no standard for how billing is handled. It’s likely that the hospital’s financial care counsellor will talk to you about payment before a planned hospitalization. If you have health insurance, you may need to pay a deductible or co-pay up front, and your insurance will be billed before you see a final bill.Without insurance, you may need to pay a larger deposit before you’re admitted, says Richard Pugach, a professional health advocate and president and CEO of Health Navigaid LLC. A health advocate familiar with matters of health insurance can assist you in finding the most appropriate health plan for your needs and can help minimize the likelihood of receiving unexpected hospital or physician bills. “A good advocate can help you avoid these situations,” Pugach says. You can hire a qualified advocate through the Alliance of Professional Health Advocates at advoconnection.com. You can also talk to the hospital’s financial care counsellors during or after your stay—they’re the hospital’s experts in insurance, Medicare, and Medicaid.
Always review your hospital bills, and speak up if you notice incorrect charges. If you get a bill you can’t afford, talk to the hospital. Many offer assistance programs or will write off the cost as charity.
5. Plan Ahead
Before you leave the hospital, set follow-up appointments with your providers, those in the hospital as well as your usual diabetes care team. Information on rehabilitation, home health assistance needs, and transportation needs should be included in your discharge papers, which you’ll typically receive the day you leave the hospital.This is also a great time to make an appointment for diabetes self-management education and support, says Jan Nicollerat, MSN, RN, ACNS-BC, CDE, vice chair of the North Carolina Diabetes Advisory Council and a consulting associate at the Duke University School of Nursing. Even if you received diabetes education in the hospital, it’s a good idea to set a follow-up visit with an educator after discharge to make sure you’re on track with your diabetes management. Get a referral from your hospital care team. Diabetes self-management education and support is covered by insurance, Medicare, and Medicaid.
http://www.diabetesforecast.org/2018/03-may-jun/5-tips-for-managing-diabetes.html
The Best Starchy Vegetables for Diabetes
From dlife.com
Starchy vegetables are an excellent source of carbohydrate, fibre, minerals, vitamins, and antioxidants. While they are a good source of energy and can be part of a healthy diet, it’s important for someone with diabetes to eat them in moderation.
If you have type 2 diabetes, you may have been told by your doctor to limit the number of starchy vegetables you consume. This is because starchy vegetables have higher amounts of carbohydrates, which causes blood glucose levels to rise. They are also high in calories and can cause weight gain.
However, the Joslin Centre for Diabetes reminds people with diabetes to keep in mind that avoiding starchy foods is a myth. The truth is that everyone needs some carbohydrate in their diet.
Remember to use portion control when enjoying dishes with starchy vegetables. The American Diabetes Association recommends letting starchy foods make up a quarter of your plate during main meals. Also consider healthier food preparation techniques to avoid the extra calories such as roasting, grilling or baking options. For example, if you have the urge for some comforting French fries, try a delicious recipe for baked potato and load it up with some toppings such as light-cheese, sour cream, Greek yogurt, chives, or olives.
Keep in mind that bread, rice, pasta, and pastry are also starchy foods so you may want to pair these foods with a non-starchy vegetable instead of starchy ones. See our favourite varieties of starchy vegetables to choose from for a diabetes-friendly diet.
Starchy vegetables are an excellent source of carbohydrate, fibre, minerals, vitamins, and antioxidants. While they are a good source of energy and can be part of a healthy diet, it’s important for someone with diabetes to eat them in moderation.
If you have type 2 diabetes, you may have been told by your doctor to limit the number of starchy vegetables you consume. This is because starchy vegetables have higher amounts of carbohydrates, which causes blood glucose levels to rise. They are also high in calories and can cause weight gain.
However, the Joslin Centre for Diabetes reminds people with diabetes to keep in mind that avoiding starchy foods is a myth. The truth is that everyone needs some carbohydrate in their diet.
Remember to use portion control when enjoying dishes with starchy vegetables. The American Diabetes Association recommends letting starchy foods make up a quarter of your plate during main meals. Also consider healthier food preparation techniques to avoid the extra calories such as roasting, grilling or baking options. For example, if you have the urge for some comforting French fries, try a delicious recipe for baked potato and load it up with some toppings such as light-cheese, sour cream, Greek yogurt, chives, or olives.
Keep in mind that bread, rice, pasta, and pastry are also starchy foods so you may want to pair these foods with a non-starchy vegetable instead of starchy ones. See our favourite varieties of starchy vegetables to choose from for a diabetes-friendly diet.
Parsnip:
The parsnip is a root vegetable closely related to the carrot and parsley. Parsnips can be roasted into wedges, glazed, mashed and made into heart-warming soups. A serving of one cup (133g) contains 24g of carbohydrates and 6g of sugar.
Plantain:
Plantains may be eaten while ripe or unripe and are generally starchy. They are often referred to as cooking bananas or green bananas. One cup of sliced plantain, (148 g) contains 47g of total carbohydrate 22g of sugar.
Potato:
The potato is a starchy, tuberous crop from the perennial nightshade Solanum tuberosum. One medium potato, (213 g) contains 37g of total carbohydrate and 1.7g of sugar.Pumpkin:
A pumpkin is a squash plant, most commonly of Cucurbita pepo, that is round, with smooth, slightly ribbed skin, and deep yellow to orange coloration. One cup, (116 g) contains 8g of carbohydrate and 3.2g of sugar.Acorn Squash
Acorn squash is also called pepper squash is a winter squash with distinctive longitudinal ridges on its exterior and sweet, yellow-orange flesh inside. One cup of raw squash (140g) has 15g of carbohydrate and zero grams of sugar.
Butternut Squash
Butternut squash is a type of winter squash that grows on a vine. It has a sweet, nutty taste similar to that of a pumpkin. One cup of raw butternut squash (140g) has 16 g of carbohydrate and 3.1g of sugar.Green Peas
The pea is most commonly the small spherical seed or the seed-pod of the pod fruit Pisum sativum. Each pod contains several peas, which can be green or yellow. One cup (145g) contains 21g of carbohydrate and 8 g of sugars.Corn
Corn, also known as maize is a cereal grain first domesticated in southern Mexico about 10,000 years ago. One cup of yellow corn (166g) contains 606 calories. 126 g of carbohydrate and 1.1g of sugar.
Beetroot
The beetroot is the taproot portion of the beet plant, usually known in North America as the beet, also table beet, garden beet, red beet, or golden beet. One cup (136 g) contains 13g of carbohydrate and 9g of sugar.Cassava
Cassava or Manihot esculenta is a woody shrub native to South America of the spurge family, Euphorbiaceae. It is extensively cultivated as an annual crop in tropical and subtropical regions for its edible starchy tuberous root, a major source of carbohydrates. One cup (206g) contains 78g of carbohydrates and 3.5g of sugar.Sweet Potato
The sweet potato belongs to the bindweed or morning glory family, Convolvulaceae. Its large, starchy, sweet-tasting, tuberous roots are a root vegetable. The young leaves and shoots are sometimes eaten as greens. One cube or 133g contains 27g of carbohydrate and 6g of sugar.
Friday, 27 April 2018
Type 2 Diabetes - Steps To Help Lower Your Blood Pressure
By Beverleigh H Piepers
Having high blood pressure can be especially concerning for those who are dealing with Type 2 diabetes. One of the first things your health care professional does when you visit is to check your blood pressure as the reading will tell a lot about your health at that moment. A healthy reading is considered to be 120 to 140 mmHg systolic (top number) and below 90 mmHg diastolic (lower number). When your reading is chronically high, it requires treatment as it can lead to serious health problems such as stroke or heart attack.
Fortunately, there are several steps you can take to help you manage your blood pressure. Fortunately, they will also help you better maintain healthy blood sugar levels as well...
1. Get Moving. Over time, any exercise will work to help you reduce your blood pressure reading. It does not have to be intense training preparing you for the next marathon. Regular, even moderate to medium-level exercise has a significant effect on diabetic management and your blood pressure.
A walk around the block a few times every night can work wonders at helping you get your blood pressure down to a reasonable range. What is most important is you find a form of exercise you enjoy as then you are more likely to include the exercise in your day on a regular basis..
2. Cut Back On Alcohol. While many people tend to think the odd glass of wine can help their heart health, the fact is alcohol, in general, can boost the blood pressure reading, so you are better off limiting your alcohol intake.
Remember what helps to boost your heart health with wine is the grapes wine is made from, not the alcohol itself. So get the benefits without the cost. Alcohol is not the best choice for any element of your health - except perhaps helping reduce your stress levels. But there are other ways to reduce your stress level beyond taking a drink or two, or three...
http://ezinearticles.com/?Type-2-Diabetes---Steps-To-Help-Lower-Your-Blood-Pressure&id=9927823
Having high blood pressure can be especially concerning for those who are dealing with Type 2 diabetes. One of the first things your health care professional does when you visit is to check your blood pressure as the reading will tell a lot about your health at that moment. A healthy reading is considered to be 120 to 140 mmHg systolic (top number) and below 90 mmHg diastolic (lower number). When your reading is chronically high, it requires treatment as it can lead to serious health problems such as stroke or heart attack.
Fortunately, there are several steps you can take to help you manage your blood pressure. Fortunately, they will also help you better maintain healthy blood sugar levels as well...
1. Get Moving. Over time, any exercise will work to help you reduce your blood pressure reading. It does not have to be intense training preparing you for the next marathon. Regular, even moderate to medium-level exercise has a significant effect on diabetic management and your blood pressure.
A walk around the block a few times every night can work wonders at helping you get your blood pressure down to a reasonable range. What is most important is you find a form of exercise you enjoy as then you are more likely to include the exercise in your day on a regular basis..
2. Cut Back On Alcohol. While many people tend to think the odd glass of wine can help their heart health, the fact is alcohol, in general, can boost the blood pressure reading, so you are better off limiting your alcohol intake.
Remember what helps to boost your heart health with wine is the grapes wine is made from, not the alcohol itself. So get the benefits without the cost. Alcohol is not the best choice for any element of your health - except perhaps helping reduce your stress levels. But there are other ways to reduce your stress level beyond taking a drink or two, or three...
3. Practice Deep Breathing. Finally, consider practicing deep breathing as often as you can throughout your day. Too many people get caught up in the busy pace of life and forget sometimes they need to slow down. Statistics reveal 25 to 40 percent of workers experience workplace burnout from stress.
Take a deep breath. Focus on how good it feels just to be alive. Then carry on. This can help you better manage your stress, which in turn can help you cut your blood pressure significantly. People with Type 2 diabetes should look at stress as an enemy that needs to be eliminated: it has been found mental stress affects blood sugar control.
There you have some of the key points to think about when it comes to managing your blood pressure. You are in control here, and the everyday activities you do will influence your health in no small way.
Take a deep breath. Focus on how good it feels just to be alive. Then carry on. This can help you better manage your stress, which in turn can help you cut your blood pressure significantly. People with Type 2 diabetes should look at stress as an enemy that needs to be eliminated: it has been found mental stress affects blood sugar control.
There you have some of the key points to think about when it comes to managing your blood pressure. You are in control here, and the everyday activities you do will influence your health in no small way.
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---Steps-To-Help-Lower-Your-Blood-Pressure&id=9927823
Friends and family may help counter diabetes stress
From kfgo.com
(Reuters Health) - People with diabetes may have healthier blood sugar levels when they get lots of encouragement from family and friends to help them overcome the stress of managing their disease, a U.S. study suggests.
Researchers surveyed 308 veterans with diabetes who all had a person in their life - often a spouse or adult child - they leaned on for support managing their condition. Researchers focused on how stressed patients felt about their disease and how much friends and loved ones acknowledged patients' feelings and praised their efforts to do things like eat right, exercise, take medications and check their blood sugar.
As expected, patients with the most emotional distress from managing diabetes tended to have higher blood sugar levels than people who didn't feel much diabetes-related stress.
But when the most stressed people had a supporter in their corner who offered positive encouragement, they had healthier blood sugar levels that were similar to patients who didn't experience much stress.
"High levels of diabetes related distress can cause people with diabetes to feel overwhelmed and powerless in their ability to manage their diabetes," said lead study author Aaron Lee of the VA Ann Arbor Centre for Clinical Management Research in Michigan.
"These thoughts and feelings can undermine the daily efforts needed to manage diabetes, such as taking diabetes medications, exercising, eating a healthy diet, and checking blood (sugar) levels," Lee said by email.
Helping patients overcome these feelings requires more than just good intentions. Friends and family members also need to say the right things.
Nagging, criticizing and blaming patients for their failure to manage diabetes well can often backfire, and make matters worse, Lee said. Instead, loved ones should offer what's known as "autonomy support," which praises good efforts and supports patients' self-care choices.
"Our research indicates that how people support family and friends with diabetes may be just as, or more important than, how much support they provide," Lee said.
At the start of the study, participants were 66 years old on average. Almost all of them were male, and most were white.
They typically had poorly controlled diabetes, based on blood tests that show the percentage of hemoglobin (a molecule on red blood cells) that is coated with sugar. So-called hemoglobin A1c levels reflect average blood sugar levels over about three months. Readings above 6.5 signal diabetes, and during the year-long study participants had average readings of 7.9.
Participants had moderate levels of stress about managing their illness, based on questionnaires asking them to rate their emotional distress from on a scale from 1 (not a problem) to 6 (a very serious problem).
When they didn't have much support from family or friends, each one-unit increase on the distress scale was associated with a 0.2 increase in A1c readings during the year.
But when participants had lots of the right kind of encouragement, increased stress was not linked to any meaningful spike in A1c readings.
The study wasn't a controlled experiment designed to prove whether or how support from friends and family might directly impact A1c readings.
It also focused on a narrow subset of the overall population with diabetes - white men who served in the military - and it's possible the results might be different for women, or people from other racial or ethnic groups, researchers note in Diabetes Care.
Still, the findings add to growing evidence suggesting that the right kind of help from family and friends can make a big difference to patients living with diabetes as well as other chronic health problems like cancer or heart disease, said Dr. Pouran Faghri, director of the Centre for Environmental Health and Health Promotion at the University of Connecticut in Storrs.
"This present study is in agreement with previous research that emotional support from family members may alleviate the emotional and physical distress related to the disease and help the person with diabetes better manage their chronic condition," Faghri, who wasn't involved in the study, said by email.
http://kfgo.com/news/articles/2018/apr/26/friends-and-family-may-help-counter-diabetes-stress/
(Reuters Health) - People with diabetes may have healthier blood sugar levels when they get lots of encouragement from family and friends to help them overcome the stress of managing their disease, a U.S. study suggests.
Researchers surveyed 308 veterans with diabetes who all had a person in their life - often a spouse or adult child - they leaned on for support managing their condition. Researchers focused on how stressed patients felt about their disease and how much friends and loved ones acknowledged patients' feelings and praised their efforts to do things like eat right, exercise, take medications and check their blood sugar.
As expected, patients with the most emotional distress from managing diabetes tended to have higher blood sugar levels than people who didn't feel much diabetes-related stress.
But when the most stressed people had a supporter in their corner who offered positive encouragement, they had healthier blood sugar levels that were similar to patients who didn't experience much stress.
"High levels of diabetes related distress can cause people with diabetes to feel overwhelmed and powerless in their ability to manage their diabetes," said lead study author Aaron Lee of the VA Ann Arbor Centre for Clinical Management Research in Michigan.
"These thoughts and feelings can undermine the daily efforts needed to manage diabetes, such as taking diabetes medications, exercising, eating a healthy diet, and checking blood (sugar) levels," Lee said by email.
Helping patients overcome these feelings requires more than just good intentions. Friends and family members also need to say the right things.
Nagging, criticizing and blaming patients for their failure to manage diabetes well can often backfire, and make matters worse, Lee said. Instead, loved ones should offer what's known as "autonomy support," which praises good efforts and supports patients' self-care choices.
"Our research indicates that how people support family and friends with diabetes may be just as, or more important than, how much support they provide," Lee said.
At the start of the study, participants were 66 years old on average. Almost all of them were male, and most were white.
They typically had poorly controlled diabetes, based on blood tests that show the percentage of hemoglobin (a molecule on red blood cells) that is coated with sugar. So-called hemoglobin A1c levels reflect average blood sugar levels over about three months. Readings above 6.5 signal diabetes, and during the year-long study participants had average readings of 7.9.
Participants had moderate levels of stress about managing their illness, based on questionnaires asking them to rate their emotional distress from on a scale from 1 (not a problem) to 6 (a very serious problem).
When they didn't have much support from family or friends, each one-unit increase on the distress scale was associated with a 0.2 increase in A1c readings during the year.
But when participants had lots of the right kind of encouragement, increased stress was not linked to any meaningful spike in A1c readings.
The study wasn't a controlled experiment designed to prove whether or how support from friends and family might directly impact A1c readings.
It also focused on a narrow subset of the overall population with diabetes - white men who served in the military - and it's possible the results might be different for women, or people from other racial or ethnic groups, researchers note in Diabetes Care.
Still, the findings add to growing evidence suggesting that the right kind of help from family and friends can make a big difference to patients living with diabetes as well as other chronic health problems like cancer or heart disease, said Dr. Pouran Faghri, director of the Centre for Environmental Health and Health Promotion at the University of Connecticut in Storrs.
"This present study is in agreement with previous research that emotional support from family members may alleviate the emotional and physical distress related to the disease and help the person with diabetes better manage their chronic condition," Faghri, who wasn't involved in the study, said by email.
http://kfgo.com/news/articles/2018/apr/26/friends-and-family-may-help-counter-diabetes-stress/
Wednesday, 25 April 2018
A Look at Sugar-Free Alternatives for Those with Diabetes
From dlife.com
As the rate of diabetes increases so has the awareness that sugar is usually the culprit. Artificial sweeteners have therefore made it to the forefront of many diabetes-diets.
Excess sugar consumption has not only been linked to increased risk of insulin resistance in type 2 diabetes but has also been linked to mild cognitive impairment and increased risk of kidney damage and obesity.
However, the obvious truth is that sugar can be difficult to avoid because it’s in found in all the foods people like to consume, from decadent sodas and dessert to processed foods that are loaded with sugar and other additives.
But as most people living with diabetes know, it is very important to keep an eye on their sugar consumption to make sure their blood sugar levels are regularly kept in a balance.
There are lots of sugar substitutes available on the market today, ranging from natural to artificial sweeteners to help you cut down the amount of sucrose you eat in your diet.
You may be forced to ask if honey is okay to use as substitutes for sugar. Honey and sugar are not better than themselves as both of them will affect your blood sugar levels. As a matter of fact, honey contains more carbohydrate and more calories in one teaspoon than the same amount of granulated sugar does.
Below are 10 sugar-free alternatives you can consider as a diabetic to help you preserve your blood glucose levels:
Therefore, because you are living with diabetes, it doesn’t mean you can’t satisfy your sweet tooth. You only need to substitute your sugar with these alternatives and thus, help yourself stay healthy and alive.
http://dlife.com/a-look-at-sugar-free-alternatives-for-those-with-diabetes/
As the rate of diabetes increases so has the awareness that sugar is usually the culprit. Artificial sweeteners have therefore made it to the forefront of many diabetes-diets.
Excess sugar consumption has not only been linked to increased risk of insulin resistance in type 2 diabetes but has also been linked to mild cognitive impairment and increased risk of kidney damage and obesity.
However, the obvious truth is that sugar can be difficult to avoid because it’s in found in all the foods people like to consume, from decadent sodas and dessert to processed foods that are loaded with sugar and other additives.
But as most people living with diabetes know, it is very important to keep an eye on their sugar consumption to make sure their blood sugar levels are regularly kept in a balance.
There are lots of sugar substitutes available on the market today, ranging from natural to artificial sweeteners to help you cut down the amount of sucrose you eat in your diet.
You may be forced to ask if honey is okay to use as substitutes for sugar. Honey and sugar are not better than themselves as both of them will affect your blood sugar levels. As a matter of fact, honey contains more carbohydrate and more calories in one teaspoon than the same amount of granulated sugar does.
Below are 10 sugar-free alternatives you can consider as a diabetic to help you preserve your blood glucose levels:
#1: Splenda
Splenda is the brand name for sucralose. It is an artificial sweetener people living with type 2 diabetes often use. Even though Splenda appears to be much sweeter than sugar, it doesn’t cause your blood sugar levels to rise.#2: Stevia
Stevia is a high density, novel sweetener derived from the leaf of stevia plants. Since this plant extract is calorie-free, it has no impact on blood sugar or obesity, thus making it a perfect choice for people living with diabetes. Because it’s much sweeter than sugar, only a little of it is required to produce the same sweetness as sugar, and it is often used in foods and beverages.#3: Coconut Sugar
Similar in taste to brown sugar because it’s unrefined, coconut sugar contains a variety of vitamins, minerals, and antioxidants which are lacking in white table sugar. Though the same in calories, it has a lower glycemic index than refined sugar, and so does not cause unnecessary fluctuations in insulin and blood sugar levels.#4: Aspartame
Aspartame is a non-nutritive artificial sweetener that is much sweeter than sugar (up to 200 times sweeter). Though not zero in calories, Aspartame still has a very low-calorie content, and it also doesn’t cause a spike in blood sugar levels. However, this sugar-alternative has been identified to have some side effects on people with Phenylketonuria where they are unable to metabolize the phenylalanine in Aspartame.#5: Date Paste
Date paste is a natural sweetener and an easy alternative to sugar. This sugar-free alternative for people with diabetes is great for keeping the blood sugar steady while still enjoying the good sugary sensation in your foods. And another thing is that it’s easy to make at home.#6: Saccharin
This is no doubt, the oldest artificial sweetener that has been used for decades as sugar alternatives by diabetics because of its sugary and zero-calorie properties. However, few studies have recorded Saccharin to be associated with weight gain.#7: Pure Organic Maple Syrup
The organic maple syrup is also another great natural alternative for sugar, as long as it is not the type packed with corn syrup in a bottle which is often served with pancakes. The pure maple syrup does not only help maintain a steady blood glucose levels, but the numerous antioxidants present in it can help improve the skin, fight cancer, and prevent bloating.Therefore, because you are living with diabetes, it doesn’t mean you can’t satisfy your sweet tooth. You only need to substitute your sugar with these alternatives and thus, help yourself stay healthy and alive.
http://dlife.com/a-look-at-sugar-free-alternatives-for-those-with-diabetes/
Sunday, 22 April 2018
Bask in the sun! Lack of Vitamin D may up diabetes risk by 5 times
From indiatimes.com
The current recommended average daily amount of Vitamin D is 600 IU.
SEOUL: Are you deficient in Vitamin D, also known as the sunshine vitamin? Beware, you may be at a greater risk of developing diabetes, warn researchers.
A team of researchers found that individuals with 25-hydroxyvitamin D levels below 30 ng/ml in blood plasma were at up to five times greater risk for developing diabetes than people with levels above 50 ng/ml.
A team of researchers found that individuals with 25-hydroxyvitamin D levels below 30 ng/ml in blood plasma were at up to five times greater risk for developing diabetes than people with levels above 50 ng/ml.
"We found that participants with blood levels of 25-hydroxyvitamin D that were above 30 ng/ml had one-third of the risk of diabetes and those with levels above 50 ng/ml had one-fifth of the risk of developing diabetes," said lead author Sue K. Park from the Seoul National University College of Medicine in South Korea.
For the findings, reported in the journal PLOS One, the team examined a cohort of 903 healthy adults (mean age: 74) with no indications of either pre-diabetes or diabetes.
For the findings, reported in the journal PLOS One, the team examined a cohort of 903 healthy adults (mean age: 74) with no indications of either pre-diabetes or diabetes.
The researchers identified the minimum healthy level of 25-hydroxyvitamin D in blood plasma to be 30 nanogrammes per millilitre (ng/ml) and found to reach this, dietary supplements of 3,000 to 5,000 international units (IU) per day, less with the addition of moderate daily sun exposure with minimal clothing (approximately 10-15 minutes per day outdoors at noon) would be required.
The current recommended average daily amount of Vitamin D is 400 IU for children up to one year; 600 IU for ages one to 70 years (less for pregnant or breastfeeding women) and 800 IU for persons over 70, according to the National Institutes of Health.
Higher daily amounts of Vitamin D are generally considered safe, but blood serum levels exceeding 125 ng/ml have been linked to adverse side effects, such as nausea, constipation, weight loss, heart rhythm problems and kidney damage, the researchers said.
Common Diabetic Foot Issues
By Anna Bird
Diabetes is a serious health epidemic affecting millions of Americans. New advancements in technology have been able to better diagnose diabetes and more is being learned about the health condition than in decades past.
While diabetes can be result of a sedentary lifestyle and poor dietary choices, it can also be hereditary, being passed down to family members.
Diabetes is a condition where the body's normal production and absorption of insulin is hindered. This alters the amount of sugar in the blood and the body's cells intake of glucose for energy and proper functioning.
With diabetes, patients are at higher risks of infections, blindness, oral health issues and nerve damage.
Diabetics are also at higher risk of severe foot injuries.
Common Diabetic Foot Conditions
Some of the foot conditions experienced with diabetics include those involving foot nerve damage and common foot issues that get infected and progress into more serious foot health issues.
Neuropathy. When diabetes aren't controlled, loss of nerve functioning can result. The damaged nerves in the feet will result in the inability to feel heat, cold or pain. This foot neuropathy can be dangerous as one can have a foot injury which gets infected and not even know anything is wrong because of the lack of sensation. Similarly, one's feet can get burned and frost-bitten without the patient even knowing.
Foot ulcers, and cuts in the feet, and swollenness are common diabetic foot conditions that can result from diabetic foot neuropathy.
Athlete's Foot. This common foot health condition is a fungal infection that creates itching, red, and cracked feet. Germs can enter these cracks leading to infections.
Fungal Nail Infections. Fungal infections of the nails make the nails discolored, thick and brittle. Sometimes the infection will cause the nail to separate from the rest of the nail.
Calluses. With calluses, hard skin will develop on the underside of the foot. There are many causes for calluses besides diabetes including improperly fitting shoes, a skin abnormality or an uneven distribution of weight.
Corns. This common foot condition is where there is a build-up of hardened skin either between the toes or near a bony area of the toe. Corns are the result of pressure and rubbing of the toe with the shoe or other toes. With diabetics, however, corns can get out of control, especially if they experience nerve damage in the foot.
Blisters. Blisters are common foot issues experienced by diabetics and non-diabetics alike. While blisters are often painful and cause discomfort, those with diabetes may not feel the pain of the blisters, increasing their risk of the blisters worsening and getting infected.
Bunions. With bunions, the big toe angles towards the second toe, making the joints of the big toe to become misaligned. Calluses, swollenness and redness at the base of the crooked big toe can also result. Bunions can cause severe pain and deformity requiring surgery.
Dry Skin. Everyone suffers from dry skin on the feet at some time or another. Diabetics, however, can have particularly cracked feet that can result in splits and cuts of the skin, which allow germs and bacteria to enter, leading to possible infections.
Foot Ulcers. Foot ulcers are deep cuts and sores on the foot that can easily get infected without immediate care. Foot ulcers can be the result of an infection of an originally small, minor scrape that wasn't treated, or from the pressure and rubbing of the foot against the inside of the shoe.
Hammertoes. Weak, bent toes are called hammertoes. The weakened tendons and muscles of the toes keep the toes from fully extending, making them curl under the foot. Hammertoes can lead to blisters, sores, calluses and difficulty walking.
Ingrown Toenails. With ingrown toenails, the corner of the toenails grows into the skin of the toe. Pressure, pain, swelling, drainage and infection can result.
Plantar Warts. With plantar warts, an infected virus produces painful clusters of tiny black spots or pinholes of the sole of the foot. They are caused by a virus that infects the outer layer of the skin on the bottom of the feet.
Diabetics need to take extra care of their feet as they are more prone to infection and foot nerve damage. Common foot problems can easily get infected and turn into more serious foot issues for diabetics if they don't take proper care of their feet.
Regardless of whether you have diabetes, if you notice anything abnormal about your feet or if a foot condition isn't healing as fast as it should, it is highly recommended that you contact your podiatrist and make an appointment as soon as possible.
http://ezinearticles.com/?Common-Diabetic-Foot-Issues&id=9926194
Diabetes is a serious health epidemic affecting millions of Americans. New advancements in technology have been able to better diagnose diabetes and more is being learned about the health condition than in decades past.
While diabetes can be result of a sedentary lifestyle and poor dietary choices, it can also be hereditary, being passed down to family members.
Diabetes is a condition where the body's normal production and absorption of insulin is hindered. This alters the amount of sugar in the blood and the body's cells intake of glucose for energy and proper functioning.
With diabetes, patients are at higher risks of infections, blindness, oral health issues and nerve damage.
Diabetics are also at higher risk of severe foot injuries.
Common Diabetic Foot Conditions
Some of the foot conditions experienced with diabetics include those involving foot nerve damage and common foot issues that get infected and progress into more serious foot health issues.
Neuropathy. When diabetes aren't controlled, loss of nerve functioning can result. The damaged nerves in the feet will result in the inability to feel heat, cold or pain. This foot neuropathy can be dangerous as one can have a foot injury which gets infected and not even know anything is wrong because of the lack of sensation. Similarly, one's feet can get burned and frost-bitten without the patient even knowing.
Foot ulcers, and cuts in the feet, and swollenness are common diabetic foot conditions that can result from diabetic foot neuropathy.
Athlete's Foot. This common foot health condition is a fungal infection that creates itching, red, and cracked feet. Germs can enter these cracks leading to infections.
Fungal Nail Infections. Fungal infections of the nails make the nails discolored, thick and brittle. Sometimes the infection will cause the nail to separate from the rest of the nail.
Calluses. With calluses, hard skin will develop on the underside of the foot. There are many causes for calluses besides diabetes including improperly fitting shoes, a skin abnormality or an uneven distribution of weight.
Corns. This common foot condition is where there is a build-up of hardened skin either between the toes or near a bony area of the toe. Corns are the result of pressure and rubbing of the toe with the shoe or other toes. With diabetics, however, corns can get out of control, especially if they experience nerve damage in the foot.
Blisters. Blisters are common foot issues experienced by diabetics and non-diabetics alike. While blisters are often painful and cause discomfort, those with diabetes may not feel the pain of the blisters, increasing their risk of the blisters worsening and getting infected.
Bunions. With bunions, the big toe angles towards the second toe, making the joints of the big toe to become misaligned. Calluses, swollenness and redness at the base of the crooked big toe can also result. Bunions can cause severe pain and deformity requiring surgery.
Dry Skin. Everyone suffers from dry skin on the feet at some time or another. Diabetics, however, can have particularly cracked feet that can result in splits and cuts of the skin, which allow germs and bacteria to enter, leading to possible infections.
Foot Ulcers. Foot ulcers are deep cuts and sores on the foot that can easily get infected without immediate care. Foot ulcers can be the result of an infection of an originally small, minor scrape that wasn't treated, or from the pressure and rubbing of the foot against the inside of the shoe.
Hammertoes. Weak, bent toes are called hammertoes. The weakened tendons and muscles of the toes keep the toes from fully extending, making them curl under the foot. Hammertoes can lead to blisters, sores, calluses and difficulty walking.
Ingrown Toenails. With ingrown toenails, the corner of the toenails grows into the skin of the toe. Pressure, pain, swelling, drainage and infection can result.
Plantar Warts. With plantar warts, an infected virus produces painful clusters of tiny black spots or pinholes of the sole of the foot. They are caused by a virus that infects the outer layer of the skin on the bottom of the feet.
Diabetics need to take extra care of their feet as they are more prone to infection and foot nerve damage. Common foot problems can easily get infected and turn into more serious foot issues for diabetics if they don't take proper care of their feet.
Regardless of whether you have diabetes, if you notice anything abnormal about your feet or if a foot condition isn't healing as fast as it should, it is highly recommended that you contact your podiatrist and make an appointment as soon as possible.
http://ezinearticles.com/?Common-Diabetic-Foot-Issues&id=9926194
Saturday, 21 April 2018
Cold temperatures could reduce obesity and type 2 diabetes
From diabetes.co.uk
Being exposed to cold temperatures for a long period of time could reduce the risk of obesity and type 2 diabetes, researchers say.
Scientists from the University of Tokyo and Tohoku University believe this link involves the way temperature affects the role of fat cells in the body.
In a new study using mice, the researchers assessed how fat cells reacted to different temperatures. They discovered that long-term exposure to cold temperature caused white fat cells, which store energy, to produce brown-like fat cells, which burn energy.
This is a significant finding because brown fat cells are thought to be healthier than white fat cells, which are usually associated with metabolic conditions such as type 2 diabetes.
The researchers explain that the process begins when the cold kick-starts a change in a protein called JMJD1A. When combined with other proteins, this altered protein changes the way a gene functions in producing heat. Subsequently, a chemical process called thermogensis is initiated which changes epigenetic patterns so white fat cells are transformed into beige fat cells, which function like brown fat cells.
"Understanding how the environment influences metabolism is scientifically, pharmacologically, and medically interesting," said study author Professor Juro Sakai.
"Our next experiments will look more closely at epigenetic modifications within the thermogenesis signalling pathway so that we may manipulate it."
Prof Sakai and colleagues noted that the same white-to-beige fat cell transition can be caused without exposure to cold temperatures, so devising a treatment that specifically targets amino acids within proteins could improve health outcomes.
Of course, further research in humans will be required to validate these findings before any fat cell treatments can be developed.
Moreover, people can reduce their risk of obesity and type 2 diabetes by eating a healthy diet low in sugar and getting regular exercise, which can help with weight loss and ensuring normal blood glucose control.
The study was published in the journal Nature Communications.
Being exposed to cold temperatures for a long period of time could reduce the risk of obesity and type 2 diabetes, researchers say.
Scientists from the University of Tokyo and Tohoku University believe this link involves the way temperature affects the role of fat cells in the body.
In a new study using mice, the researchers assessed how fat cells reacted to different temperatures. They discovered that long-term exposure to cold temperature caused white fat cells, which store energy, to produce brown-like fat cells, which burn energy.
This is a significant finding because brown fat cells are thought to be healthier than white fat cells, which are usually associated with metabolic conditions such as type 2 diabetes.
The researchers explain that the process begins when the cold kick-starts a change in a protein called JMJD1A. When combined with other proteins, this altered protein changes the way a gene functions in producing heat. Subsequently, a chemical process called thermogensis is initiated which changes epigenetic patterns so white fat cells are transformed into beige fat cells, which function like brown fat cells.
"Understanding how the environment influences metabolism is scientifically, pharmacologically, and medically interesting," said study author Professor Juro Sakai.
"Our next experiments will look more closely at epigenetic modifications within the thermogenesis signalling pathway so that we may manipulate it."
Prof Sakai and colleagues noted that the same white-to-beige fat cell transition can be caused without exposure to cold temperatures, so devising a treatment that specifically targets amino acids within proteins could improve health outcomes.
Of course, further research in humans will be required to validate these findings before any fat cell treatments can be developed.
Moreover, people can reduce their risk of obesity and type 2 diabetes by eating a healthy diet low in sugar and getting regular exercise, which can help with weight loss and ensuring normal blood glucose control.
The study was published in the journal Nature Communications.
Carbohydrates and Diabetes: Benefits and Side-Effects
From dlife.com
A healthy, balanced diet includes the proper concentration of fats, carbohydrates, and protein. Increasing or reducing any of the nutrients may not be good for the body. For people with diabetes, a diet high in carbohydrates can be either beneficial or dangerous, depending on the type of diabetes.
When you eat food that contains carbohydrates, your digestive system will break down the digestive part into sugar, and this enters the blood. As the blood sugar level rises, the pancreas will produce insulin, a hormone which enables cells to use blood sugar for storage or energy.
As the cells absorb blood sugar, the bloodstream levels start to fail. Then, the pancreas begins to make glucagon, a hormone which alerts the liver to begin the release of stored sugar. The interplay of glucagon and insulin ensures that cells in the body, especially in the brain, receive a constant supply of blood sugar.
After many years of high-level production of insulin, the beta cells inside the pancreas may wear out. The production of insulin will drop gradually and will eventually stop.
Insulin resistance may lead to several health issues, including:
The consumption of high carbs has been known to solve the problem of insulin resistance. The more carbs we eat, the more sensitive the body is to insulin. So, when type 1 diabetes patients begin with a high-carb diet (more than 75% calories in the form of carbohydrate), they usually have to reduce their dosage of insulin by up to 30%. You can learn more about how many carbs a person with diabetes should eat here.
http://dlife.com/carbohydrates-and-diabetes-benefits-and-side-effects/
A healthy, balanced diet includes the proper concentration of fats, carbohydrates, and protein. Increasing or reducing any of the nutrients may not be good for the body. For people with diabetes, a diet high in carbohydrates can be either beneficial or dangerous, depending on the type of diabetes.
When you eat food that contains carbohydrates, your digestive system will break down the digestive part into sugar, and this enters the blood. As the blood sugar level rises, the pancreas will produce insulin, a hormone which enables cells to use blood sugar for storage or energy.
As the cells absorb blood sugar, the bloodstream levels start to fail. Then, the pancreas begins to make glucagon, a hormone which alerts the liver to begin the release of stored sugar. The interplay of glucagon and insulin ensures that cells in the body, especially in the brain, receive a constant supply of blood sugar.
Symptoms of Excess Carbohydrate:
- Feeling constantly hungry
- Your skin will become prone to acne
- You crave for more sugar, going into withdrawal mode
- Feeling bloated
- You get easily tired
- You lose muscle despite exercise
- Mood swings
- Memory loss gradually sets in
How Can a Diet High in Carbohydrates Lead to Diabetes?
When you consume high-carbs, the digestive system will break down some into glucose, and the blood sugar (glucose) levels will rise. When blood sugar level rises too quickly, the cells can become faulty eventually and not properly respond to alerts from the insulin. As time goes on, the cells will require more insulin to react. This is called insulin resistance.After many years of high-level production of insulin, the beta cells inside the pancreas may wear out. The production of insulin will drop gradually and will eventually stop.
Insulin resistance may lead to several health issues, including:
- Weight gain
- Low level of HDL cholesterol
- Triglycerides or high blood fat level
- Numerous chronic diseases
- High blood pressure or hypertension
Benefits of Carbohydrates:
The more carbohydrate is consumed, the more the body responds to the insulin hormones. Also, high carbs minimize insulin requirements in type 1 diabetes patients. Note that it is essential to discuss with your doctor before switching to a high-carbohydrate diet if you are using insulin. Otherwise, it could result in low blood sugar level which is dangerous.The consumption of high carbs has been known to solve the problem of insulin resistance. The more carbs we eat, the more sensitive the body is to insulin. So, when type 1 diabetes patients begin with a high-carb diet (more than 75% calories in the form of carbohydrate), they usually have to reduce their dosage of insulin by up to 30%. You can learn more about how many carbs a person with diabetes should eat here.
Bottom Line:
Carbohydrates are needed for good health, but they should be the perfect type and also in a controlled concentration. Eating unprocessed carbohydrates, getting enough rest and being physically active are more likely to result in proper body weight and minimize the risks of diabetes than eliminating or focusing on a certain nutrient. As always, speak to your diabetes health care team or diabetes educators to come up with a balanced plan that is right for you and your individual needs.http://dlife.com/carbohydrates-and-diabetes-benefits-and-side-effects/
Friday, 20 April 2018
Reversing Type 2 Diabetes Through Weight Loss
From diabetesselfmanagement.com
Type 2 diabetes can be reversed, according to a new study published in the British medical journal Lancet. The secret? Weight loss.
The researchers, who were from the University of Glasgow in Scotland, recruited 306 people with Type 2 diabetes from various medical practices throughout the United Kingdom. The subjects ranged in age from 20 to 65 and had had diabetes for no more than six years. None were using insulin. The researchers then assigned 149 of the participants to follow what they called a “Counterweight-Plus weight management program,” which began with a three-month period in which the subjects’ daily food intake was cut by about 800 calories. Physical activities were left unchanged. The total intervention lasted one year.
After the year was up, the researchers discovered that 46 percent of those in the dietary intervention group were able to achieve remission of Type 2 diabetes, compared to only 4 percent in the control group. And the more weight the subjects lost, the more impressive the results. Those who gained weight had a 0 percent remission rate. Those who lost 0–11 pounds had a 7 percent rate; 11–22 pounds brought a 34 percent remission rate; 22–33 pounds meant a 57 percent rate; and the remission rate from Type 2 diabetes for those who lost 33 pounds or more was a whopping 86 percent.
The researchers plan to follow their subjects for at least four more years to see how they fare with their diabetes in the longer term. But for now, the results are most heartening for those scientists seeking a “non-pharmacological” approach to treating diabetes. According to Michael E. J. Lean, MD, one of the study authors, “Our findings suggest that even if you have had Type 2 diabetes for 6 years, putting the disease into remission is feasible.”
https://www.diabetesselfmanagement.com/blog/reversing-type-2-diabetes-through-weight-loss/
Type 2 diabetes can be reversed, according to a new study published in the British medical journal Lancet. The secret? Weight loss.
The researchers, who were from the University of Glasgow in Scotland, recruited 306 people with Type 2 diabetes from various medical practices throughout the United Kingdom. The subjects ranged in age from 20 to 65 and had had diabetes for no more than six years. None were using insulin. The researchers then assigned 149 of the participants to follow what they called a “Counterweight-Plus weight management program,” which began with a three-month period in which the subjects’ daily food intake was cut by about 800 calories. Physical activities were left unchanged. The total intervention lasted one year.
After the year was up, the researchers discovered that 46 percent of those in the dietary intervention group were able to achieve remission of Type 2 diabetes, compared to only 4 percent in the control group. And the more weight the subjects lost, the more impressive the results. Those who gained weight had a 0 percent remission rate. Those who lost 0–11 pounds had a 7 percent rate; 11–22 pounds brought a 34 percent remission rate; 22–33 pounds meant a 57 percent rate; and the remission rate from Type 2 diabetes for those who lost 33 pounds or more was a whopping 86 percent.
The researchers plan to follow their subjects for at least four more years to see how they fare with their diabetes in the longer term. But for now, the results are most heartening for those scientists seeking a “non-pharmacological” approach to treating diabetes. According to Michael E. J. Lean, MD, one of the study authors, “Our findings suggest that even if you have had Type 2 diabetes for 6 years, putting the disease into remission is feasible.”
https://www.diabetesselfmanagement.com/blog/reversing-type-2-diabetes-through-weight-loss/
Avoiding type 2 diabetes – there is more than one diet to choose from
From theconversation.com
If you have high blood glucose, but not high enough to be diagnosed with diabetes (so-called pre-diabetes) you may have been advised by your doctor to lose weight and to eat less fat and more fibre. If this sounds a bit one-size-fits-all, you may be encouraged by the fact that other diets may work just as well, if not better, at warding off full-blown type 2 diabetes.
The advice to eat less fat, more fibre and lose a moderate amount of weight comes from a series of large-scale, randomised controlled trials showing that weight loss following this approach helps prevent type 2 diabetes in up to two thirds of people. However, the most important predictor of prevention in these trials was not the diet itself, but the weight loss. The more weight a person loses, the lower their risk of type 2 diabetes. Even more exciting, weight loss prevents type 2 diabetes even if the person regains the weight.
So what diets could be equally or more effective than a low-fat, high-fibre diet? Low-carbohydrate diets have been shown to produce more weight loss in the short-term. If weight loss is the primary driver of type 2 diabetes prevention, then a well-formulated low-carbohydrate diet (high in non-starch vegetables, fruits, nuts and seeds) would probably be as effective as the current standard advice.
There is also growing evidence that adding protein to the diet may help control blood glucose levels, lower liver fat (strongly linked to insulin resistance) and even help the pancreas produce insulin. The latter point is important because when a person has pre-diabetes, they lose the first-phase insulin response. This is the rapid spike of insulin that is produced as soon as blood glucose level rises.
If you have high blood glucose, but not high enough to be diagnosed with diabetes (so-called pre-diabetes) you may have been advised by your doctor to lose weight and to eat less fat and more fibre. If this sounds a bit one-size-fits-all, you may be encouraged by the fact that other diets may work just as well, if not better, at warding off full-blown type 2 diabetes.
The advice to eat less fat, more fibre and lose a moderate amount of weight comes from a series of large-scale, randomised controlled trials showing that weight loss following this approach helps prevent type 2 diabetes in up to two thirds of people. However, the most important predictor of prevention in these trials was not the diet itself, but the weight loss. The more weight a person loses, the lower their risk of type 2 diabetes. Even more exciting, weight loss prevents type 2 diabetes even if the person regains the weight.
So what diets could be equally or more effective than a low-fat, high-fibre diet? Low-carbohydrate diets have been shown to produce more weight loss in the short-term. If weight loss is the primary driver of type 2 diabetes prevention, then a well-formulated low-carbohydrate diet (high in non-starch vegetables, fruits, nuts and seeds) would probably be as effective as the current standard advice.
There is also growing evidence that adding protein to the diet may help control blood glucose levels, lower liver fat (strongly linked to insulin resistance) and even help the pancreas produce insulin. The latter point is important because when a person has pre-diabetes, they lose the first-phase insulin response. This is the rapid spike of insulin that is produced as soon as blood glucose level rises.
The first-phase insulin response is a critical function that rapidly suppresses glucose release from the liver. It also encourages glucose to be taken up by the muscles after you eat. Without it, hyperglycaemia results and glucose stays elevated for several hours after the meal.
. Emerging evidence seems to indicate the protein somehow seems to help the pancreas increase this initial insulin spike. Small but promising trials suggest that increasing protein may be better than a low-protein diet at controlling blood glucose levels.
A recent large clinical trial (DiRECT), as well as a series of smaller physiological trials, have shown that people with type 2 diabetes who rapidly lose a lot of weight are able to restore the first-phase insulin response. The effect seems to be greatest in people who haven’t had type 2 diabetes for long. This suggests that the effect would be greater still in people with pre-diabetes.
The reduction in calories consumed seems to be an independent driver of improved pancreatic function. In studies where people consume only 400kcal a day for seven days, the weight loss is minimal, but pancreatic function seems to improve just the same.
The “best” diet is, of course, one that a person enjoys and fits with their lifestyle. So the dietary approaches above may not only be more effective than a low-fat, high-fibre diet (and this should be tested in large-scale trials), but would provide more choice for people looking to stop their pre-diabetes morphing into type 2 diabetes.
https://theconversation.com/avoiding-type-2-diabetes-there-is-more-than-one-diet-to-choose-from-94780
. Emerging evidence seems to indicate the protein somehow seems to help the pancreas increase this initial insulin spike. Small but promising trials suggest that increasing protein may be better than a low-protein diet at controlling blood glucose levels.
A recent large clinical trial (DiRECT), as well as a series of smaller physiological trials, have shown that people with type 2 diabetes who rapidly lose a lot of weight are able to restore the first-phase insulin response. The effect seems to be greatest in people who haven’t had type 2 diabetes for long. This suggests that the effect would be greater still in people with pre-diabetes.
The reduction in calories consumed seems to be an independent driver of improved pancreatic function. In studies where people consume only 400kcal a day for seven days, the weight loss is minimal, but pancreatic function seems to improve just the same.
More choice
A recent large study from Spain (PREDIMED) showed that a Mediterranean diet with extra virgin olive oil and added nuts helped prevent type 2 diabetes even though people did not lose weight. We don’t know for sure how extra virgin olive oil or nuts could help prevent type 2 diabetes, but there is a growing body of research suggesting that a group of compounds called polyphenols found in these foods (and also coffee, tea, berries and red wine) have a variety of beneficial health effects. Potentially these polyphenols may help reduce the inflammation that can damage the pancreatic cells and cause insulin resistance.The “best” diet is, of course, one that a person enjoys and fits with their lifestyle. So the dietary approaches above may not only be more effective than a low-fat, high-fibre diet (and this should be tested in large-scale trials), but would provide more choice for people looking to stop their pre-diabetes morphing into type 2 diabetes.
https://theconversation.com/avoiding-type-2-diabetes-there-is-more-than-one-diet-to-choose-from-94780
Tuesday, 17 April 2018
People with Type 2 diabetes who eat breakfast later, more likely to have a higher BMI
From sciencedaily.com
Researchers led by Dr. Sirimon Reutrakul, associate professor of endocrinology, diabetes and metabolism in the University of Illinois at Chicago College of Medicine, wanted to determine if morning or evening preference among people with Type 2 diabetes was associated with an increased risk for higher BMI and if so, what specific factors about evening preference contributed to the increased risk.
Reutrakul and her colleagues recruited 210 non-shift workers living in Thailand with Type 2 diabetes for their study. Morning/evening preference was assessed using a questionnaire that focused on preferred time for waking up and going to bed; time of day spent exercising; and time of day spent engaged in mental activity (working, reading, etc.). Scores on the questionnaire can range from 13, indicating extreme evening preference, to 55 indicating extreme morning preference. Participants with an evening preference were those who scored less than 45 on the questionnaire, while those with morning preference scored a 45 or higher.
Participants were interviewed regarding their meal timing, and daily caloric intake was determined via self-reported one-day food recalls. Weight measurements were taken and BMI was calculated for each participant. Sleep duration and quality were measured by self-report and questionnaire.
Self-reported average sleep duration was 5.5 hours/night. On average, participants consumed 1,103 kcal/day. The average BMI among all participants was 28.4 kg/m2 -- considered overweight. Of the participants, 97 had evening preference and 113 had morning preference.
Participants with morning preference ate breakfast between 7 a.m. and 8:30 a.m., while participants with evening preference ate breakfast between 7:30 a.m. and 9 a.m.
Participants with morning preference had earlier meal timing, including breakfast, lunch, dinner and the last meal.
The researchers found that having more evening preference was associated with higher BMI. Caloric intake and lunch and dinner times were not associated with having a higher BMI.
Morning preference was associated with earlier breakfast time and lower BMI by 0.37 kg/m2.
"Later breakfast time is a novel risk factor associated with a higher BMI among people with Type 2 diabetes," said Reutrakul. "It remains to be investigated if eating breakfast earlier will help with body weight in this population." Reutrakul speculates that later meal times may misalign the internal biological clock, which plays a role in circadian regulation. Circadian misalignment can lead to dysregulation of energy metabolism according to previous studies.
https://www.sciencedaily.com/releases/2018/04/180416145454.htm
Being an "evening person" is linked to higher body mass indices among people with Type 2 diabetes, and having breakfast later in the day seems to be what drives this association, according to a new paper in the journal Diabetic Medicine.
Obesity is common among people with Type 2 diabetes. Having an evening preference -- waking up later and going to bed later -- has been linked to an increased risk for obesity, but research is lacking regarding this phenomenon among people with Type 2 diabetes.Researchers led by Dr. Sirimon Reutrakul, associate professor of endocrinology, diabetes and metabolism in the University of Illinois at Chicago College of Medicine, wanted to determine if morning or evening preference among people with Type 2 diabetes was associated with an increased risk for higher BMI and if so, what specific factors about evening preference contributed to the increased risk.
Reutrakul and her colleagues recruited 210 non-shift workers living in Thailand with Type 2 diabetes for their study. Morning/evening preference was assessed using a questionnaire that focused on preferred time for waking up and going to bed; time of day spent exercising; and time of day spent engaged in mental activity (working, reading, etc.). Scores on the questionnaire can range from 13, indicating extreme evening preference, to 55 indicating extreme morning preference. Participants with an evening preference were those who scored less than 45 on the questionnaire, while those with morning preference scored a 45 or higher.
Participants were interviewed regarding their meal timing, and daily caloric intake was determined via self-reported one-day food recalls. Weight measurements were taken and BMI was calculated for each participant. Sleep duration and quality were measured by self-report and questionnaire.
Self-reported average sleep duration was 5.5 hours/night. On average, participants consumed 1,103 kcal/day. The average BMI among all participants was 28.4 kg/m2 -- considered overweight. Of the participants, 97 had evening preference and 113 had morning preference.
Participants with morning preference ate breakfast between 7 a.m. and 8:30 a.m., while participants with evening preference ate breakfast between 7:30 a.m. and 9 a.m.
Participants with morning preference had earlier meal timing, including breakfast, lunch, dinner and the last meal.
The researchers found that having more evening preference was associated with higher BMI. Caloric intake and lunch and dinner times were not associated with having a higher BMI.
Morning preference was associated with earlier breakfast time and lower BMI by 0.37 kg/m2.
"Later breakfast time is a novel risk factor associated with a higher BMI among people with Type 2 diabetes," said Reutrakul. "It remains to be investigated if eating breakfast earlier will help with body weight in this population." Reutrakul speculates that later meal times may misalign the internal biological clock, which plays a role in circadian regulation. Circadian misalignment can lead to dysregulation of energy metabolism according to previous studies.
https://www.sciencedaily.com/releases/2018/04/180416145454.htm
Monday, 16 April 2018
Recipe: Low Carb “Dorito” Cheese Crisps
From asweetlife.org
Baked cheese crisps are the ultimate easy low carb snack. These ones are made even easier by using pre-sliced cheese of the sort that’s ready to go for sandwiches. Simply cut each of these squares into 4 smaller squares and bake them. Then sprinkle on a little taco seasoning and they taste just like Doritos! Make sure to find a taco seasoning without sugar or other additives.
Baked cheese crisps are the ultimate easy low carb snack. These ones are made even easier by using pre-sliced cheese of the sort that’s ready to go for sandwiches. Simply cut each of these squares into 4 smaller squares and bake them. Then sprinkle on a little taco seasoning and they taste just like Doritos! Make sure to find a taco seasoning without sugar or other additives.
Ingredients
- 6 slices Cheddar or Colby Jack cheese (pre-sliced, packaged cheese)
- 2 to 3 teaspoons taco seasoning
Instructions
- Preheat the oven to 350F and line a large rimmed baking sheet with parchment paper.
- Cut each of the slices evenly into 4 pieces so that you have 24 squares. Arrange about an inch apart on the prepared baking sheet.
- Bake 25 to 30 minutes, until golden brown and just firm to the touch. Remove from the oven and sprinkle the taco seasoning evenly over the warm crisps.
- Let cool completely on the pan. They will continue to crisp up as they cool.
Friday, 13 April 2018
Gestational diabetes risk cut by exercise says study
From diabetestimes.co.uk
The risk of gestational diabetes can be reduced by 21 per cent through exercise, a US study has found.
Researchers from the University of Iowa made the conclusion after analysing data from 1,333 women from 1985 to 2011, who enrolled in a National Heart, Lung, and Blood Institute study called Coronary Artery Risk Development in Young Adults (CARDIA).
The women completed seven study visits, informing the researchers of their pregnancy status and then also took part in a fitness test.
Overall, 164 women developed gestational diabetes, with the researchers determining that pre-pregnant women with high levels of fitness had a 21 per cent lower risk of developing gestational diabetes than those with lower fitness levels.
The longitudinal analysis was published in the Medicine & Science in Sports & Exercise journal.
Researchers from the University of Iowa made the conclusion after analysing data from 1,333 women from 1985 to 2011, who enrolled in a National Heart, Lung, and Blood Institute study called Coronary Artery Risk Development in Young Adults (CARDIA).
The women completed seven study visits, informing the researchers of their pregnancy status and then also took part in a fitness test.
Overall, 164 women developed gestational diabetes, with the researchers determining that pre-pregnant women with high levels of fitness had a 21 per cent lower risk of developing gestational diabetes than those with lower fitness levels.
The longitudinal analysis was published in the Medicine & Science in Sports & Exercise journal.
Kara Whitaker, assistant professor at the university’s Department of Health and Human Physiology and corresponding author on the study, said: “Women are very careful during pregnancy with what they eat and the exercise they get. But the study shows women should engage in these healthy behaviours before they get pregnant as well.
“We would expect to see this reduction in gestational diabetes risk if women had moderate improvements in fitness – going from fair to good fitness, for example. The main point is, it’s important to get in better shape before you get pregnant.”
'Well done' red meat linked to liver disease, diabetes risk factor
From businessinsider.com
(Reuters Health) - People who eat lots of processed and red meat are at increased risk of developing chronic liver disease and insulin resistance, a diabetes risk factor - especially if they like their steak well done, an Israeli study suggests.
Researchers focused on what's known as non-alcoholic fatty liver disease, which is associated with obesity and certain eating habits. While red and processed meat has long been linked to an increased risk of diabetes, certain cancers and heart disease, evidence to date has been mixed about its connection to liver disease.
The study team examined data on 789 adults who completed questionnaires about their eating and cooking habits and also underwent liver ultrasound scans as well as lab tests for insulin resistance.
Overall, 39 percent of the participants were found to have non-alcoholic fatty liver disease (NAFLD) and 31 percent had insulin resistance, which happens when the body is less effective at using the hormone insulin to convert sugars in the blood into energy for cells.
People who ate more processed and red meat than at least half of the other participants were 47 percent more likely to have liver disease and 55 percent more likely to have insulin resistance, researchers report in the Journal of Hepatology.
Both NAFLD and insulin resistance are among the suite of symptoms and traits that make up so-called metabolic syndrome, which raises risk for both heart disease and diabetes, the authors note.
"Evidence is mounting with regard to the harmful effect of over-consumption of red and processed meat," said lead study author Shira Zelber-Sagi, a nutrition researcher at the University of Haifa.
Cooking meat at high temperatures for longer periods of time until it's "well done" was also associated with a higher risk of liver disease and insulin resistance than eating meat more "rare" or cooked more briefly, the study also found.
Preparing meat "well done" forms compounds known as heterocyclic amines (HCAs) that are tied to both liver disease and insulin resistance, Zelber-Sagi said.
"In order to prevent insulin resistance and NAFLD, (people should consider) choosing fish, turkey or chicken as an animal protein source," she said in an email. "In addition, steaming or boiling food (is better than) grilling or frying meat at a high temperature until it is very well done."
Most people have a little bit of fat in their liver. Fatty liver disease can occur when more than 5 percent of the liver by weight is made up of fat. Excessive drinking can damage the liver and cause fat to accumulate, a condition known as alcoholic fatty liver, but even when people don't drink much, they can still develop non-alcoholic fatty liver disease.
The study participants were 59 years old on average and typically were overweight. About 15 percent had diabetes.
High consumption of red and processed meat was associated independently with liver disease and with insulin resistance regardless of saturated fat and cholesterol intake and other risk factors such as obesity, exercise, smoking and alcohol consumption.
The study wasn't a controlled experiment designed to prove whether or how red or processed meat might directly cause liver damage or insulin resistance.
Researchers also relied on participants to accurately recall and report how much meat they ate and how it was prepared, which might not always be an accurate picture of their eating habits.
Still, the results add to a large and growing body of evidence suggesting that people should limit how much red and processed meat they eat, said Dr. Jeffrey Schwimmer, a researcher at the University of California, San Diego, and director of the Fatty Liver Clinic at Rady Children's Hospital.
"Dietary recommendations are too complicated to develop from any one study," Schwimmer, who wasn't involved in the current research, said by email.
"However, there is not a need for red meat, so one could choose to avoid it all together," Schwimmer said. "Based upon this and other studies, for those that do eat meat, it would be reasonable to limit red meat to once a week and to limit processed meat to occasional use only."
http://uk.businessinsider.com/r-well-done-red-meat-linked-to-liver-disease-diabetes-risk-factor-2018-4
(Reuters Health) - People who eat lots of processed and red meat are at increased risk of developing chronic liver disease and insulin resistance, a diabetes risk factor - especially if they like their steak well done, an Israeli study suggests.
Researchers focused on what's known as non-alcoholic fatty liver disease, which is associated with obesity and certain eating habits. While red and processed meat has long been linked to an increased risk of diabetes, certain cancers and heart disease, evidence to date has been mixed about its connection to liver disease.
The study team examined data on 789 adults who completed questionnaires about their eating and cooking habits and also underwent liver ultrasound scans as well as lab tests for insulin resistance.
Overall, 39 percent of the participants were found to have non-alcoholic fatty liver disease (NAFLD) and 31 percent had insulin resistance, which happens when the body is less effective at using the hormone insulin to convert sugars in the blood into energy for cells.
People who ate more processed and red meat than at least half of the other participants were 47 percent more likely to have liver disease and 55 percent more likely to have insulin resistance, researchers report in the Journal of Hepatology.
Both NAFLD and insulin resistance are among the suite of symptoms and traits that make up so-called metabolic syndrome, which raises risk for both heart disease and diabetes, the authors note.
"Evidence is mounting with regard to the harmful effect of over-consumption of red and processed meat," said lead study author Shira Zelber-Sagi, a nutrition researcher at the University of Haifa.
Cooking meat at high temperatures for longer periods of time until it's "well done" was also associated with a higher risk of liver disease and insulin resistance than eating meat more "rare" or cooked more briefly, the study also found.
Preparing meat "well done" forms compounds known as heterocyclic amines (HCAs) that are tied to both liver disease and insulin resistance, Zelber-Sagi said.
"In order to prevent insulin resistance and NAFLD, (people should consider) choosing fish, turkey or chicken as an animal protein source," she said in an email. "In addition, steaming or boiling food (is better than) grilling or frying meat at a high temperature until it is very well done."
Most people have a little bit of fat in their liver. Fatty liver disease can occur when more than 5 percent of the liver by weight is made up of fat. Excessive drinking can damage the liver and cause fat to accumulate, a condition known as alcoholic fatty liver, but even when people don't drink much, they can still develop non-alcoholic fatty liver disease.
The study participants were 59 years old on average and typically were overweight. About 15 percent had diabetes.
High consumption of red and processed meat was associated independently with liver disease and with insulin resistance regardless of saturated fat and cholesterol intake and other risk factors such as obesity, exercise, smoking and alcohol consumption.
The study wasn't a controlled experiment designed to prove whether or how red or processed meat might directly cause liver damage or insulin resistance.
Researchers also relied on participants to accurately recall and report how much meat they ate and how it was prepared, which might not always be an accurate picture of their eating habits.
Still, the results add to a large and growing body of evidence suggesting that people should limit how much red and processed meat they eat, said Dr. Jeffrey Schwimmer, a researcher at the University of California, San Diego, and director of the Fatty Liver Clinic at Rady Children's Hospital.
"Dietary recommendations are too complicated to develop from any one study," Schwimmer, who wasn't involved in the current research, said by email.
"However, there is not a need for red meat, so one could choose to avoid it all together," Schwimmer said. "Based upon this and other studies, for those that do eat meat, it would be reasonable to limit red meat to once a week and to limit processed meat to occasional use only."
http://uk.businessinsider.com/r-well-done-red-meat-linked-to-liver-disease-diabetes-risk-factor-2018-4
Wednesday, 11 April 2018
Diabetes skin patch could abolish finger-prick tests
From medicalnewstoday.com
Finger-prick tests for blood glucose monitoring may soon be a thing of the past, thanks to scientists who have developed an adhesive skin patch that measures glucose levels every 10–15 minutes.
Created by researchers from the University of Bath in the United Kingdom, the novel patch has proven to be a feasible non-invasive strategy for blood glucose monitoring in tests of both pig and human skin.
Study co-author Prof. Richard Guy, of the Department of Pharmacy & Pharmacology, and colleagues recently reported their findings in the journal Nature Nanotechnology.
It is estimated that around 30.3 million people in the United States are living with diabetes, and there are around 1.5 million new cases diagnosed every year.
The frequency of blood glucose testing depends on the type of diabetes a person has and the type of medication they are using, but daily testing — which may be up to 10 times per day for people with type 1 diabetes — is common.
This form of testing can be a burden for people with diabetes; research has shown that a fear of pain and needles, the cost of blood test strips, and the inconvenience of the self-monitoring process are barriers to good blood glucose control.
As such, researchers have been striving to find a non-invasive method for blood glucose monitoring.
"The closest that has been achieved has required either at least a single-point calibration with a classic 'finger-stick,' or the implantation of a pre-calibrated sensor via a single needle insertion," notes Prof. Guy.
The new skin patch created by Prof. Guy and colleagues, however, has the potential to change the face of glucose monitoring.
The patch collects the glucose in small "reservoirs" and measures levels every 10–15 minutes. The hope is that this patch will be able to send glucose readings to a user's smartphone or smartwatch and let them know when they need medication.
Importantly, the patch does not pierce the skin. What is more, its ability to measure glucose from such a small area on hair follicles makes it highly accurate, so there is no need to confirm the readings via blood sampling.
Prof. Guy and colleagues confirmed the patch's accuracy by testing it on pig skin. They found that it was able to track glucose levels at ranges seen in humans with diabetes, and with high accuracy.
Further testing on healthy human participants found that the patch was able to accurately track glucose levels over a period of 6 hours.
Looking forward, the team hopes to extend the glucose monitoring period to 24 hours, as well as enhance the number of sensors it holds to increase accuracy further.
With such modifications, the researchers believe that their skin patch could provide a much-needed non-invasive glucose monitoring technique for people with diabetes.
"A non-invasive — that is, needle-less — method to monitor blood sugar has proven a difficult goal to attain," notes Prof. Guy.
"The monitor developed at Bath promises a truly calibration-free approach, an essential contribution in the fight to combat the ever-increasing global incidence of diabetes."
https://www.medicalnewstoday.com/articles/321440.php
Finger-prick tests for blood glucose monitoring may soon be a thing of the past, thanks to scientists who have developed an adhesive skin patch that measures glucose levels every 10–15 minutes.
Created by researchers from the University of Bath in the United Kingdom, the novel patch has proven to be a feasible non-invasive strategy for blood glucose monitoring in tests of both pig and human skin.
Study co-author Prof. Richard Guy, of the Department of Pharmacy & Pharmacology, and colleagues recently reported their findings in the journal Nature Nanotechnology.
It is estimated that around 30.3 million people in the United States are living with diabetes, and there are around 1.5 million new cases diagnosed every year.
Researchers have created an adhesive skin patch that can monitor glucose levels without pricking the skin.
Image credit: University of Bath
Image credit: University of Bath
Type 2 diabetes is the most common form of diabetes, accounting for 90–95 percent of all cases; it arises when the body is no longer able to use insulin effectively, or it fails to produce enough of the hormone, causing blood glucose levels to become too high.
The burden of the finger-prick test
To manage the condition effectively, people with diabetes need to monitor their blood glucose levels regularly. This involves the use of a blood glucose meter, which tests a drop of blood released through a needle prick of the finger.The frequency of blood glucose testing depends on the type of diabetes a person has and the type of medication they are using, but daily testing — which may be up to 10 times per day for people with type 1 diabetes — is common.
This form of testing can be a burden for people with diabetes; research has shown that a fear of pain and needles, the cost of blood test strips, and the inconvenience of the self-monitoring process are barriers to good blood glucose control.
As such, researchers have been striving to find a non-invasive method for blood glucose monitoring.
"The closest that has been achieved has required either at least a single-point calibration with a classic 'finger-stick,' or the implantation of a pre-calibrated sensor via a single needle insertion," notes Prof. Guy.
The new skin patch created by Prof. Guy and colleagues, however, has the potential to change the face of glucose monitoring.
Patch accurately tracks glucose levels
The skin patch consists of miniature sensors that use electric currents to "draw out" glucose from fluid that is secreted from cells on hair follicles.The patch collects the glucose in small "reservoirs" and measures levels every 10–15 minutes. The hope is that this patch will be able to send glucose readings to a user's smartphone or smartwatch and let them know when they need medication.
Importantly, the patch does not pierce the skin. What is more, its ability to measure glucose from such a small area on hair follicles makes it highly accurate, so there is no need to confirm the readings via blood sampling.
Prof. Guy and colleagues confirmed the patch's accuracy by testing it on pig skin. They found that it was able to track glucose levels at ranges seen in humans with diabetes, and with high accuracy.
Further testing on healthy human participants found that the patch was able to accurately track glucose levels over a period of 6 hours.
Looking forward, the team hopes to extend the glucose monitoring period to 24 hours, as well as enhance the number of sensors it holds to increase accuracy further.
With such modifications, the researchers believe that their skin patch could provide a much-needed non-invasive glucose monitoring technique for people with diabetes.
"A non-invasive — that is, needle-less — method to monitor blood sugar has proven a difficult goal to attain," notes Prof. Guy.
"The monitor developed at Bath promises a truly calibration-free approach, an essential contribution in the fight to combat the ever-increasing global incidence of diabetes."
https://www.medicalnewstoday.com/articles/321440.php
How can I reduce my risk of Type 2 diabetes?
From diabetes.org.uk
You've just found out that you're at risk of developing Type 2 diabetes. But you don't have it yet. That's the really good news. It means that you now have the chance to make changes that can delay or prevent Type 2 diabetes.
We're here to help too, with lots of tools and stories to keep you motivated. Think about sharing your story – it could really help motivate others. And remember, the trained counsellors on our helpline are ready to support you if you have questions or just need a chat.
Set yourself realistic goals that fit in with how you live your life. Choose the healthy food and activities that you like best. This will really help you stay on track.
And think ahead about anything that could stop you from achieving your goal, and plan how you could overcome this.
Try using our action plan (PDF) to set healthy goals and stick to them. It will help you think about:
We know it can be hard to stay motivated, but remember you're in this for the long run. Your risk of developing diabetes is serious and you can't reduce your risk by eating better or moving more for just a couple of weeks.
By building healthy meals into family life and moving more to help you get from A to B, you can maintain these changes and look forward to a healthy future.
https://www.diabetes.org.uk/preventing-type-2-diabetes/can-diabetes-be-prevented
You've just found out that you're at risk of developing Type 2 diabetes. But you don't have it yet. That's the really good news. It means that you now have the chance to make changes that can delay or prevent Type 2 diabetes.
Take action now and it will make all the difference to your health in the years ahead.
Remember, if you enjoy something, you're more likely to stick to it.
Here are some tips to get you inspired:
Where to start?
You can reduce your risk of developing Type 2 diabetes by:- eating well
- moving more
- losing weight, if you're overweight.
Remember, if you enjoy something, you're more likely to stick to it.
Here are some tips to get you inspired:
- Don't forget, you're not alone in this - there's lots of support out there to help you.
- Set goals which are realistic and work for you.
- Change one thing at a time and make the changes part of your everyday.
Get support
Make the most of all the support and services available in your area. Ask your GP about:- a weight-loss programme or group
- a registered dietitian or exercise specialist
- a Type 2 diabetes prevention programme
- other local services to help you move more and eat better.
We're here to help too, with lots of tools and stories to keep you motivated. Think about sharing your story – it could really help motivate others. And remember, the trained counsellors on our helpline are ready to support you if you have questions or just need a chat.
Set realistic goals
Like everything in life, you'll have good days and bad days, but don't let a bad day put you off.Set yourself realistic goals that fit in with how you live your life. Choose the healthy food and activities that you like best. This will really help you stay on track.
And think ahead about anything that could stop you from achieving your goal, and plan how you could overcome this.
Try using our action plan (PDF) to set healthy goals and stick to them. It will help you think about:
- what you want to do to eat better and move more
- why it's important
- how you can achieve your goals.
Make changes part of your everyday
Changing too many things at the same time can make them difficult to stick to in the long run. Start with small things you can change about your everyday routine and build up to more.We know it can be hard to stay motivated, but remember you're in this for the long run. Your risk of developing diabetes is serious and you can't reduce your risk by eating better or moving more for just a couple of weeks.
By building healthy meals into family life and moving more to help you get from A to B, you can maintain these changes and look forward to a healthy future.
https://www.diabetes.org.uk/preventing-type-2-diabetes/can-diabetes-be-prevented
Monday, 9 April 2018
Your Child’s Diabetes is Not Your Fault
From asweetlife.org
We cannot fall into the trap of blaming ourselves. But if and when we do? Try to think of all the good things you do to care for your child, and how much effort goes into daily life. D-parents and children with diabetes have no choice but to be strong and resilient. It’s a difficult situation, and it’s nobody’s fault.
https://asweetlife.org/your-childs-diabetes-is-not-your-fault/?utm_source=ASweetLife.org+List&utm_campaign=15c582a2c3-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017&utm_medium=email&utm_term=0_5125b14cf8-15c582a2c3-413392997
There’s a scene toward the end of the movie Good Will Hunting that sticks with me. Will is with his therapist. They’ve spent months dancing around both their issues, slowly opening up to one another and sharing insights. Will has progressed, and learned to understand how his bad luck in life has impacted him and how to move forward despite it. But there’s one thing he has yet to do, and the therapist isn’t going to let go until it happens.
“It’s not your fault,” the therapist, played to Oscar standards by the late, great Robin Williams says. Will looks away. The therapist grabs him by his shoulders and forces him to look in his eyes. “It’s not your fault,” he says again. Will tries to deflect. Over and over he keeps repeating it until, finally, Will looks him in the eye, nods, and breaks down in tears, realizing the deep truth of those four simple words.
It’s a heartbreaking, beautiful, and hopeful scene. I was thinking today, as I read up on some conversations in the diabetes world: it’s one we diabetes parents could use. Because truly, for so many of us, from the moment those words, “Your child has Type 1 diabetes” hit our ears, we are all about the blame.
It starts out with the obvious: What did I do wrong? Should I have noticed? Could I have avoided this? And of course: Was it my genes? My partner’s? I remember when a neighbour had a child diagnosed a few years after us. I went down to visit and the mom told me the dad was beside himself: she had no history of Type 1 in her family. He had been adopted and had no knowledge of his family history so, she said, “He knows it’s his fault. And he cannot move past that.”
I didn’t hold her and repeat over and over “It’s not your fault,” but I did point out that both my husband and I knew our medical history and neither of us had Type 1 in it. She, like Will, burst into tears realizing it was not her spouse’s fault either.
As the years go on, D-parents face choices. To send our child to diabetes camp or not. To pump or not. To allow them freedom, at what age (or not?). Time after time after time, we face choices that most parents make, but with umpteen more levels to manoeuvre than those who aren’t managing a chronic illness on top of life’s ordinary challenges. And sometimes, we are wrong.
Good, strong, smart, supported parents struggle in this world. We listen to our doctors, but sometimes get swayed by the internet that we are doing diabetes wrong. We count the carbs and sometimes we’re way off. We feel guilty about the highs and lows that make our child feel bad. But no matter how strict we are about diet, dosing insulin isn’t an exact science. And sometimes glucose meters are off. It’s not our fault.
Sometimes as teens, or even as young adults, our children rebel. Sometimes they hate not just diabetes, but us, too. It’s terrifying to give them the freedom they crave, and sometimes we hold them back, and in hindsight learn it was a mistake. But you know what? Diabetes is scary, and it’s not our fault.
And then there are the people who tell us that diabetes actually IS our fault. They scream about vaccinations we shouldn’t have given. They preach about things we’ve done or should or shouldn’t be doing. But it’s unwarranted. The cause of Type 1 diabetes is still a mystery, and there is no cure. It would be easier in many ways if we had something to blame.“It’s not your fault,” the therapist, played to Oscar standards by the late, great Robin Williams says. Will looks away. The therapist grabs him by his shoulders and forces him to look in his eyes. “It’s not your fault,” he says again. Will tries to deflect. Over and over he keeps repeating it until, finally, Will looks him in the eye, nods, and breaks down in tears, realizing the deep truth of those four simple words.
It’s a heartbreaking, beautiful, and hopeful scene. I was thinking today, as I read up on some conversations in the diabetes world: it’s one we diabetes parents could use. Because truly, for so many of us, from the moment those words, “Your child has Type 1 diabetes” hit our ears, we are all about the blame.
It starts out with the obvious: What did I do wrong? Should I have noticed? Could I have avoided this? And of course: Was it my genes? My partner’s? I remember when a neighbour had a child diagnosed a few years after us. I went down to visit and the mom told me the dad was beside himself: she had no history of Type 1 in her family. He had been adopted and had no knowledge of his family history so, she said, “He knows it’s his fault. And he cannot move past that.”
I didn’t hold her and repeat over and over “It’s not your fault,” but I did point out that both my husband and I knew our medical history and neither of us had Type 1 in it. She, like Will, burst into tears realizing it was not her spouse’s fault either.
As the years go on, D-parents face choices. To send our child to diabetes camp or not. To pump or not. To allow them freedom, at what age (or not?). Time after time after time, we face choices that most parents make, but with umpteen more levels to manoeuvre than those who aren’t managing a chronic illness on top of life’s ordinary challenges. And sometimes, we are wrong.
Good, strong, smart, supported parents struggle in this world. We listen to our doctors, but sometimes get swayed by the internet that we are doing diabetes wrong. We count the carbs and sometimes we’re way off. We feel guilty about the highs and lows that make our child feel bad. But no matter how strict we are about diet, dosing insulin isn’t an exact science. And sometimes glucose meters are off. It’s not our fault.
Sometimes as teens, or even as young adults, our children rebel. Sometimes they hate not just diabetes, but us, too. It’s terrifying to give them the freedom they crave, and sometimes we hold them back, and in hindsight learn it was a mistake. But you know what? Diabetes is scary, and it’s not our fault.
We cannot fall into the trap of blaming ourselves. But if and when we do? Try to think of all the good things you do to care for your child, and how much effort goes into daily life. D-parents and children with diabetes have no choice but to be strong and resilient. It’s a difficult situation, and it’s nobody’s fault.
https://asweetlife.org/your-childs-diabetes-is-not-your-fault/?utm_source=ASweetLife.org+List&utm_campaign=15c582a2c3-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017&utm_medium=email&utm_term=0_5125b14cf8-15c582a2c3-413392997
Night shift may hike Type 2 diabetes risk
From mcknights.com
Night-shift work is linked to an increased risk for Type 2 diabetes, according to a study published in Diabetes Care.
British and American researchers compared diabetes prevalence among 47,000 night-shift workers against that of 225,000 day workers. They used the UK Biobank, which includes information on diabetes diagnoses, age, sex, race, family history of diabetes, alcohol use, sleep duration, body mass index and other health characteristics.
The scientists found that the more often people worked overnight, the more likely they were to be diabetic.
“Our findings show that night shift work, especially rotating shift work including night shifts, is associated with higher Type 2 diabetes odds and that the number of night shifts worked per month appears most relevant for Type 2 diabetes odds,” wrote the authors, who were led by Céline Vetter, an assistant professor at the University of Colorado.
All people working night shifts experienced higher rates of diabetes, but the likelihood rose to 44% among those who worked frequent night shifts. Odds of a worker developing diabetes ticked upward with number of nights worked.
https://www.mcknights.com/news/night-shift-may-hike-type-2-diabetes-risk/article/756984/
Night-shift work is linked to an increased risk for Type 2 diabetes, according to a study published in Diabetes Care.
British and American researchers compared diabetes prevalence among 47,000 night-shift workers against that of 225,000 day workers. They used the UK Biobank, which includes information on diabetes diagnoses, age, sex, race, family history of diabetes, alcohol use, sleep duration, body mass index and other health characteristics.
The scientists found that the more often people worked overnight, the more likely they were to be diabetic.
“Our findings show that night shift work, especially rotating shift work including night shifts, is associated with higher Type 2 diabetes odds and that the number of night shifts worked per month appears most relevant for Type 2 diabetes odds,” wrote the authors, who were led by Céline Vetter, an assistant professor at the University of Colorado.
All people working night shifts experienced higher rates of diabetes, but the likelihood rose to 44% among those who worked frequent night shifts. Odds of a worker developing diabetes ticked upward with number of nights worked.
https://www.mcknights.com/news/night-shift-may-hike-type-2-diabetes-risk/article/756984/
Sunday, 8 April 2018
World Health Day: Insufficient sleep and wrong lifestyle choices can push you towards diabetes
From indiatimes.com
Twenty-three-year-old Abhinav was diagnosed with diabetes and borderline high cholesterol levels during his pre-employment check-up by his new organisation. A brilliant student throughout his academic career, Abhinav studied for 12-14 hours every day, frequently ate outside, and had minimal physical activity. However, Abhinav's is not an isolated case. Like him, many young people with similar habits, including children, are increasingly developing diabetes.
The people in our country urgently need to focus on non-communicable lifestyle disorders like diabetes. With more than seven crore diabetic patients, India is home to second largest number of people living with diabetes worldwide, after China. Diabetes can affect to anyone and we cannot ignore this pandemic.
The theme for this year's World Health Day is 'Health for all' - and on this day, let's dig deeper into factors responsible for this life-long disorder.
Twenty-three-year-old Abhinav was diagnosed with diabetes and borderline high cholesterol levels during his pre-employment check-up by his new organisation. A brilliant student throughout his academic career, Abhinav studied for 12-14 hours every day, frequently ate outside, and had minimal physical activity. However, Abhinav's is not an isolated case. Like him, many young people with similar habits, including children, are increasingly developing diabetes.
The people in our country urgently need to focus on non-communicable lifestyle disorders like diabetes. With more than seven crore diabetic patients, India is home to second largest number of people living with diabetes worldwide, after China. Diabetes can affect to anyone and we cannot ignore this pandemic.
The theme for this year's World Health Day is 'Health for all' - and on this day, let's dig deeper into factors responsible for this life-long disorder.
Understanding Diabetes
In simple terms, diabetes is a disease in which the sugar level in blood increases. When a person develops diabetes, the glucose that is released from the breakdown of carbohydrates (the food we eat) does not get absorbed by cells of the body and stays in the blood instead. This leads to the typical symptoms of diabetes - lack of energy, increased hunger and/or thirst, frequent urination and delayed healing of wounds.
In simple terms, diabetes is a disease in which the sugar level in blood increases. When a person develops diabetes, the glucose that is released from the breakdown of carbohydrates (the food we eat) does not get absorbed by cells of the body and stays in the blood instead. This leads to the typical symptoms of diabetes - lack of energy, increased hunger and/or thirst, frequent urination and delayed healing of wounds.
The different types of diabetes include:
1. Type-1 diabetes is an autoimmune disorder in which the body produces minimal or no insulin. A person with type 1 diabetes definitely requires insulin for survival. It usually occurs in children. However, in a few cases, it can happen develop in adults too. Modern insulin help in maintaining good control of sugar levels with better safety for people with type 1 diabetes.
2. Type 2 diabetes is a disorder which is progressive. It starts nearly a decade before diagnosis when the cells start becoming resistant to insulin. This can be due to many reasons including obesity, sedentary lifestyle, stress and a family history. Most of the people with diabetes have type 2 diabetes. In Abhinav's case, his lifestyle must have caused diabetes at a younger age. It is the most common type of diabetes in India. We have excellent personalised treatment regimen t ..
3. Gestational Diabetes (GDM) occurs during pregnancy and usually goes away after childbirth. Women who develop GDM are at a higher risk of developing type 2 diabetes later in life. Apart from lifestyle modification, a few women require insulin treatment when pregnant. A combination of lifestyle changes and regular monitoring can delay or prevent the onset of type 2 diabetes in these women.
4. MODY (Maturity Onset Diabetes of the Young) is a rare form of diabetes that generally occurs before the age of 25 in individuals of normal weight. This diabetes is characterised by abnormal insulin secretion due to a genetic mutation. The treating physician will decide whether the patient requires oral drugs or insulin.
5. Other types of diabetes can also occur in individuals suffering from certain health conditions such as cancer or pancreatitis.
5. Other types of diabetes can also occur in individuals suffering from certain health conditions such as cancer or pancreatitis.
Regardless of type, untreated diabetes can lead to severe, many a time irreversible complications such as eye disorders, heart diseases, stroke, kidney damage and even nerve damage.
As per the latest International Diabetes Federation (IDF 2017) estimates, the projected number of people with diabetes by 2045 in India would be 13.43 crore, surpassing China (11.98 crore). With this, we will take on a huge healthcare burden of having highest number of people with diabetes in the world. We cannot change our genes; however we should have a definitive focus on changing our lifestyle and improving awareness of the symptoms, complications and management of diabetes. This focused approach, along with new treatment options, can significantly impact prevention or control of diabetes, and enable people with diabetes live long and healthy lives.
The key to a healthy life is to be active, be involved in some form of physical activity every day, avoid sweetened drinks, eat hygienic food in moderation, and get a good night's sleep of 6-8 hours.
Taking care of these basic requirements will go a long way in ensuring health for all.
As per the latest International Diabetes Federation (IDF 2017) estimates, the projected number of people with diabetes by 2045 in India would be 13.43 crore, surpassing China (11.98 crore). With this, we will take on a huge healthcare burden of having highest number of people with diabetes in the world. We cannot change our genes; however we should have a definitive focus on changing our lifestyle and improving awareness of the symptoms, complications and management of diabetes. This focused approach, along with new treatment options, can significantly impact prevention or control of diabetes, and enable people with diabetes live long and healthy lives.
Taking care of these basic requirements will go a long way in ensuring health for all.
Saturday, 7 April 2018
Getting kids to a good weight by 13 may help avoid diabetes
By The Associated Press
(AP) - There may be a critical window for overweight kids to get to a healthy level. Those who shed their extra pounds by age 13 had the same risk of developing diabetes in adulthood as others who had never weighed too much, a large study of Danish men found.
Diabetes can develop when the body can’t properly use insulin to turn food into energy. Being overweight at any age raises the chances of the most common form, Type 2. But it’s not known whether or how much that risk is reduced if people lose weight, and when.
“This study seems to suggest that overweight in adolescence is particularly harmful” and that reversing it by then can do a lot of good, said Dr. Stephen Daniels, pediatrics chief at the University of Colorado School of Medicine in Denver.
He had no role in the study, which was led by researchers at the University of Copenhagen, sponsored by the European Union, and published Wednesday by the New England Journal of Medicine.
It involved 62,565 men in Denmark, where mandatory school and military service exams enabled tracking their health for decades. Heights and weights were measured when they were 7, 13, and between 17 and 26. National health records were used to see how many developed diabetes in adulthood.
Men who were overweight at age 7 but weren’t by age 13 had similar odds of diabetes later in life as men who’d never been overweight.
Those who were overweight only at 13, or only at 7 and 13, had a lower risk than those who stayed overweight throughout young adulthood but a higher risk than men who’d never been overweight.
“They are hopeful results” that show there are benefits if parents can help chubby kids “grow into a healthy weight,” said Steven Gortmaker, a childhood obesity researcher at the Harvard School of Public Health. “If you can slow the rise of obesity in very young children you have a chance of really preventing future cases of diabetes.”
Why might the teen years matter so much?
“At adolescence you become more insulin resistant, just sort of a natural part of puberty,” Daniels explained.
The muscles and organs don’t use insulin as well after then, so it takes more to get the same job done, he said.
The study had many limitations — it was only in men, and there was no information on what they weighed in adulthood, when the diabetes developed.
It was a different time and place — decades ago in Denmark, only 5 percent to 8 percent of these men had been overweight as children or teens. Today in the United States, about 35 percent of kids are, and more than 23 percent are worldwide.
http://www.wric.com/health/getting-kids-to-a-good-weight-by-13-may-help-avoid-diabetes-1/1102163944
(AP) - There may be a critical window for overweight kids to get to a healthy level. Those who shed their extra pounds by age 13 had the same risk of developing diabetes in adulthood as others who had never weighed too much, a large study of Danish men found.
Diabetes can develop when the body can’t properly use insulin to turn food into energy. Being overweight at any age raises the chances of the most common form, Type 2. But it’s not known whether or how much that risk is reduced if people lose weight, and when.
“This study seems to suggest that overweight in adolescence is particularly harmful” and that reversing it by then can do a lot of good, said Dr. Stephen Daniels, pediatrics chief at the University of Colorado School of Medicine in Denver.
He had no role in the study, which was led by researchers at the University of Copenhagen, sponsored by the European Union, and published Wednesday by the New England Journal of Medicine.
It involved 62,565 men in Denmark, where mandatory school and military service exams enabled tracking their health for decades. Heights and weights were measured when they were 7, 13, and between 17 and 26. National health records were used to see how many developed diabetes in adulthood.
Men who were overweight at age 7 but weren’t by age 13 had similar odds of diabetes later in life as men who’d never been overweight.
Those who were overweight only at 13, or only at 7 and 13, had a lower risk than those who stayed overweight throughout young adulthood but a higher risk than men who’d never been overweight.
“They are hopeful results” that show there are benefits if parents can help chubby kids “grow into a healthy weight,” said Steven Gortmaker, a childhood obesity researcher at the Harvard School of Public Health. “If you can slow the rise of obesity in very young children you have a chance of really preventing future cases of diabetes.”
Why might the teen years matter so much?
“At adolescence you become more insulin resistant, just sort of a natural part of puberty,” Daniels explained.
The muscles and organs don’t use insulin as well after then, so it takes more to get the same job done, he said.
The study had many limitations — it was only in men, and there was no information on what they weighed in adulthood, when the diabetes developed.
It was a different time and place — decades ago in Denmark, only 5 percent to 8 percent of these men had been overweight as children or teens. Today in the United States, about 35 percent of kids are, and more than 23 percent are worldwide.
http://www.wric.com/health/getting-kids-to-a-good-weight-by-13-may-help-avoid-diabetes-1/1102163944
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