How I used food to fight off diabetes in one year

From sbs.com.au

This time last year, Jaybee Serrano was pre-diabetic. The 34-year-old nurse tells SBS about how reducing the amount of white rice he ate helped to improve his blood sugar levels.

My diabetes story started in early 2017 when I developed a pain in my neck. One morning at 3am, I presented to the emergency department at Blacktown Hospital, NSW. It’s a hotspot for diabetes in the area, so staff regularly conduct diabetes screening on patients.
They tested me for diabetes. My results showed that I was pre-diabetic. I was shocked.
I soon received a letter saying that my blood sugar levels were on the high side, and if I didn’t do something about it, I would get diabetes. It was as plain and simple as that.
I have a family history of diabetes – my mum has it and almost all of my relatives have it. I also work as a nurse and I’ve seen people in hospital who have had complications because of their diabetes. So I knew I didn’t want to develop the condition if I could avoid it. I knew I had to make changes to my diet. If I wanted to be healthy, I had to act – now.

I saw my GP. I was told that I had to change my lifestyle, start watching what I ate, do regular exercise and do follow-up screenings to check my blood sugar levels.
The rest – the ‘how’ to reduce my risk and turn my health around – was up to me. So with sheer determination, I tried to change my life and diet to prevent diabetes.

I acted, to save my health

Like many other Filipinos, my diet has always been full carbohydrates: rice. White rice is a staple food I used to eat three times a day with meat, mostly pork.
Since my diagnosis, I’ve since cut back on the amount of white rice, pork and highly processed foods. I eat more whole foods now with fruits and vegetables.
To do this, I started to surround myself with fruits and vegetables at home, putting them on the table and in the fridge so that I could be prompted to eat a little bit healthier. What I can control is the food I eat and what I can within my immediate environment.
I believe that healthy eating is not about missing out or depriving yourself of various types of food. It’s about balance, moderation and eating sensibly. I still go out with my wife and family and have dinners out. But I control the food I eat and what I can within my immediate environment.

My current eating plan

I work in a hospital so my breakfast needs to be something that is readily available and quick. I’m usually rushing to go to work so I might grab a can of baked beans, which fills me up. I also carry around a piece of fruit, usually a banana, and I’ll have a coffee in the morning – that’s my staple.
I try to bring a prepared lunch to work. I’ll have frozen vegetables or a serving of dinner leftovers from the night before. My lunch may not be fancy but it works for me.
Dinner is my main meal consisting of a home-cooked Filipino dish. I might have bitter melon with pork, as bitter melon is good for diabetes control. Another dish we have at home is Sinigang, a Filipino soup that is spicy and sour with meat and vegetables.

My health, today

It hasn’t been easy to change my diet. To be honest, there have been some struggles along the way because we live in an environment where there are so many foods around us that contain so much hidden sugar. But I have made small changes to my lifestyle and diet. Those changes have collectively made a big difference to my health.
Just recently, I received good news. My blood sugar is no longer on the pre-diabetes range.
I was so pleased. I truly believe that if I can improve my health with dietary and lifestyle changes then anyone can (or perhaps they can do even better than I have?).
One key change I made to the way I lived was my job. I used to do shift work in mental health nursing prior to my diagnosis. However, when I was told I had pre-diabetes, it marked a turning point for me. I became so passionate about diabetes that I applied for a job as a diabetes nurse educator and I’m happily working as one now.

I’m currently using my experience to help the people I look after in hospital. I initially did it because I wanted to help my mum who has diabetes but now, I’m a diabetes nurse educator because I want to help others too. To be honest, I don’t see this position s a ‘job’ as I wake up each day and feel so enthusiastic about working. It’s a real joy for me.
I think if you can prevent diabetes or – if you have it, if you can manage it properly – then that is the best thing for your health and for your family as well.
I’m going to have a son at the end of the year. I’m really excited. I know I will pass on my diabetes genes to him, sadly. But I know I will also pass on my good eating habits and all the knowledge I’ve acquired about diabetes as well. That’s the part I can control, to be able to teach him about how to prevent diabetes, so I’m good with it.

https://www.sbs.com.au/food/article/2018/07/27/how-i-used-food-fight-diabetes-one-year

Diabetes type 2 diet: Cheap snack that could lower blood sugar levels

From express.co.uk

DIABETES type 2 sufferers may need to make changes to their diet to help maintain blood sugar levels at the normal level. Almonds are a cheap snack that could help lower blood sugar levels.

Diabetes type 2 diet changes can include avoiding certain high sugar foods while adding others which could control blood sugar levels

Eating this type of nut could help reduce blood sugar

Your diabetes type 2 risk is increased if you are overweight or eat an unhealthy diet, among other factors

Diabetes type 2 sufferers’ could lower blood sugar by snacking on a handful of almonds.
The claim has been made by experts at medical website, Healthline.
“Almonds can help regulate and reduce rises in blood sugar after meals,” they stated online, adding the nuts may even help “prevent diabetes”.
“One study found people who consumed two ounces of almonds per day had lower levels of fasting blood sugar and insulin.
“Another study found that almond consumption could increase insulin sensitivity in people with prediabetes.”

Almonds contain more fibre than other nuts, roughly 3.5 grams, which helps stabilise blood sugar.
Describing the Mediterranean nut, health advice website Everyday Health, said it was a “superstar” for diabetes type 2 sufferers.
“Nuts can be a good snack for people with diabetes type 2 because they may help prevent heart disease, keep blood sugar controlled and even aid weight loss.
However, they advised against eating too many as this could lead to “weight gain, which is why experts suggest measuring out one ounce portion sizes instead of digging into an open bag”.
They said you should eat around 23 nuts.

                  Diabetes type 2 diet: Eat almonds to help lower blood sugar levels (Image: Getty)

“Almonds may be bite-sized, but these nuts pack a big nutritional punch,” continued Healthline.
“They’re man excellent source of several vitamins and minerals, including vitamin E and manganese.
“They’re also a good source of protein, fibre, copper, riboflavin and calcium.
“Almonds are especially good for people with diabetes,” they continued, “They may reduce your risk of heart disease.”
Other foods that could help diabetes type 2 sufferers reduce blood sugar levels include chia seeds.

Diabetes type 2 sufferers need to control blood sugar levels to avoid spikes, which could cause complications including a coma and blindness.
The condition can develop at any time in life, and is caused by problems with the hormone insulin.
Diabetes type 2 sufferers often need to make changes to lifestyle and diet to help treat the condition.
It is also possible to reverse the condition by eating a low-carb diet.
Diabetes.co.uk, a website for people with the condition, said low-carbohydrate diets are “known for lowering the amount of insulin the body needs to produce, resulting in less insulin resistance”.

https://www.express.co.uk/life-style/health/995503/diabetes-type-2-diet-blood-sugar-levels-lower-almonds-nuts

Type 2 Diabetes and Healthy Living - Four Diseases That Can Be Caused By A Vitamin D Deficiency

By Beverleigh H Piepers

According to a review article written by Michael Holick, MD, Ph.D., and published in the New England Journal of Medicine in July 2007 a deficiency of vitamin D leaves children and adults at risk for numerous diseases and disorders.

If you are someone who is not paying close attention to your vitamin D intake, perhaps it is time you gave some thought to supplementation. It is true the sun can help your body to activate vitamin D but as we age our body loses its ability to convert sunlight into the active form of vitamin D.
Most people do not understand all the risk factors associated with a vitamin D deficiency, so let us take a closer look so you can see where you stand...

1. Vitamin D Deficiency and Dementia. Dementia is a disease none of us like to think about as it is often a part of getting older and we would rather avoid thinking about it. However, ignoring it is not going to make it go away.
Research does suggest there may be some connection between a vitamin D deficiency and dementia development, so if you want to side-step this condition, you are best off looking to smart supplementation. Those who are low in vitamin D have a 53% increased risk of developing all-cause dementia, which includes Alzheimer's disease.

2. Prostate Cancer And Vitamin D. Another connection with low vitamin D status is prostate cancer. This seems to be mainly the case among European-American and African-American men, so if you fall into this group you will want to be especially careful.
Researchers looked at the likelihood of those who were undergoing screening for cancer and their corresponding vitamin D status and found there does appear to be a positive correlation. The lower the vitamin D status, the higher the chances of cancer was detected.

This said, the study did not prove if you do not have a deficiency of this vitamin you will be immune from cancer, so it is more an issue of reducing your overall risk factor than it is offering robust protection.

3. Erectile Dysfunction. Another connection to know about is erectile dysfunction and vitamin D status. It appears as though popping that vitamin may do the trick to help you protect against this problem.
While ED does tend to be more familiar with age, it does appear as though men who are not taking any vitamin D supplementation do suffer more frequently than those who are. When you are deficient in vitamin D, it may reduce the ability of the artery to dilate, which then prevents a proper erection.

4. Vitamin D And Heart Disease. Adults who are deficient in vitamin D may also be at an increased risk for heart disease. There is no direct evidence yet that supplementation will help to provide substantial benefits, but research illustrates vitamin D levels may be a culprit for health-related problems that could lead to a heart attack. Issues such as...

• atherosclerosis,
• hypertension,
• Type 2 diabetes, and
• stroke.

There you have a few points to keep in mind where your health and vitamin D supplementation is concerned. It makes excellent health sense.

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

http://ezinearticles.com/?Type-2-Diabetes-and-Healthy-Living---Four-Diseases-That-Can-Be-Caused-By-A-Vitamin-D-Deficiency&id=9981373

Twelve Ways to Age Well With Diabetes

From diabetesselfmanagement.com

Aging with diabetes is not a curse. It can be a positive time of growth, happiness, and peace. However, it’s important to note that managing diabetes in the golden years may present challenges ranging from changes in metabolism and increased insulin resistance to medication management. But thanks to better tools and technology advancements, people managing diabetes have the opportunity to live longer than ever before.
Here is a list of 12 strategies to help you manage your diabetes with confidence as you age.

1. Control your glucose levels.

If you can keep your glucose close to normal, you dramatically reduce the risk of diabetes-related complications.
How tight should control be? Some say lower is better, but lower also means more risk of hypoglycemia (low blood sugar), which can cause dizziness, falls, and other accidents. Because of risks like these, the American Diabetes Association (ADA) recommends looser diabetes control for older people. Whereas younger adults are usually advised to keep the hemoglobin A1C (a measure of average glucose levels for the previous two to three months) under 7 percent, people over 65 may be advised to shoot for 7.5 percent. Seniors in poor health may be told that 8 percent or even higher is the best target for them, despite the risfak that complications may increase with higher A1C numbers.
Some experts believe that how you keep sugars down is more important than the actual numbers. Many times, doctors will pile on medications to lower sugars or treat the health problems of aging with diabetes. Overprescribing creates a number of problems. Because older people have less kidney and liver function to process drugs, they have more risk of interactions and side effects.
However, controlling your A1C with exercise and healthy, low-carb, high-fiber eating does not carry the risks of control by drugs. You may want to work with your health-care practitioner to find a plan that’s right for you and talk with your pharmacist and doctor about lowering doses or discontinuing some drugs. The same applies to herbal medications — if you’re older, start with lower doses.

2. Stay physically active.

The more you move, the better your circulation will be, and the better your cells will soak up glucose. you will have more energy and more self-confidence. Walk or exercise after meals, drive less, and use the stairs.
The ADA recommends the following ways to stay physically active:
• Strengthening exercise builds stronger muscles, which use more glucose.
• Balance exercises such as standing on one foot (with or without arm support) help prevent falls.
• Aerobic exercises such as walking, running, or swimming help increase cardiovascular fitness.Check with your doctor before starting.
• Stretching, yoga, or tai chi help increase flexibility.

3. Prepare for aging.

If you can, get into a living situation that is accessible and affordable. Modify your home or look into senior housing or assisted living before you need it. Consider moving in with family or having them move in with you. Arranging for suitable housing as you age will ensure your comfort and safety for years to come.

4. Do the things that make you happy.

If you enjoy music, gardening, reading, or knitting, make time in your schedule to do what brings you joy. Another rewarding option is giving your time, whether to your family, friends, or the charitable organization of your choice. The benefits of volunteerism are long lasting.

5. Stay connected.

Keep family and friends in your life close. Schedule time with those you care about most. Conversation, friendship, and companionship are key to staying emotionally fit.
This also applies to pets. Some people gain a wonderful sense of connection from pets. Dogs especially can solve a lot of diabetes issues — they promote exercise, love, and joy and require a regular schedule. Dogs also help you meet new people when you take them for a walk.

6. Keep up with your health care.

As we age, it may become harder to get to medical appointments or to pay for them. Managing preventable and treatable conditions is important. Here is a list of important appointments to schedule:
• ophthalmologist (eye doctor) once a year to check for diabetic eye disease (retinopathy) and make sure you have the proper eyeglass prescription;
• endocrinologist (diabetes doctor or general practitioner/nurse practitioner) twice a year or more; and
• podiatrist (foot doctor) once a year, or more if prescribed.

7. Get more sleep!

It is important to shoot for eight hours of sleep a night. To ensure a restful night’s sleep, try not to watch TV or do things that wind you up right before bedtime. Avoid stimulants — coffee, tea, and other caffeinated beverages — in the evening, and take time to wind down before stretching out.
If you find yourself waking in the night or early morning, discuss this with your doctor. If you have trouble staying asleep or wake up exhausted, be evaluated for sleep apnea — a common condition in people with diabetes.

8. Watch out for depression.

According to the ADA, people with diabetes are at a higher risk for depression. If you are feeling sad, no longer want to do things you used to like, wake early for no reason, experience changes in appetite, or feel tired, anxious, or hopeless, get help. Poorly controlled diabetes can cause those symptoms, but they could also be signs of depression. Self-management, counseling, and/or medications, along with sunshine, exercise, and social contact are ways to combat depression.

9. Practice spirituality.

Prayer and meditation improve health and quality of life. People who belong to a congregation tend to live longer and be happier than people who are not religious, in part because of the social support religions offer.

10. Stay mentally active.

Puzzles or online brain training programs like Lumosity are great tools to keep the mind moving. Other fun activities include:
• dancing;
• learning a new language or finding a new hobby;
• joining a discussion group or a book club;
• preparing new recipes; and
• taking a class at a local school or senior center or online.

11. Reach out for assistance.

Aging and illness both increase the need for help. Help could include diabetes equipment, like a glucose monitor or insulin pump, or mobility equipment like a cane, walker, or grab bars. It could include financial assistance like disability or social security payments. Apply for the benefits you may be entitled to such as Medicare, Social Security, or disability as soon as you can. They often take time to come through.
The most important help often comes from other people. Your family, friends, neighbours, or volunteers may be happy to help with shopping, housework, traveling, to appointments and more.
In many cases, a spouse is the person we lean on the most. Be aware: over-reliance can cause burnout. The goal is to keep all in your household healthy.

12. Be safe.

It’s not always the complications of chronic illness that knock you down. It is the one-time injuries we call “accidents.” They’re not really accidents; they’re dangerous situations we haven’t dealt with. To avoid health risks associated with diabetes, including falls, auto accidents, and severe hypoglycemia, it’s important to prevent them. Here are some tips.
• Get all the clutter off your floors.
• Install good lighting and grab bars if you need them.
• Wear good-fitting shoes.
• Don’t drive when your sugar is borderline or when you don’t feel well or at night if you have visual problems. Get a ride, take the bus, or walk.
• Avoid hypos by checking sugars frequently, keeping glucose tabs handy, and possibly reducing insulin or other meds that cause lows (sulfonylureas and meglitinides).

https://www.diabetesselfmanagement.com/about-diabetes/general-diabetes-information/twelve-ways-to-age-well-with-diabetes/

Diabetes: the good news and the bad news – and what next for the future

From the conversation.com

Alarming stories about the diabetes epidemic that threatens millions of lives – and the NHS (National Health Service) itself – have become commonplace, and with good reason. Around 4.6m people in the UK are living with diabetes while a further 12.3m are at increased risk of developing it. The NHS spends an estimated £14 billion a year on treating diabetes and its complications.
But there is some positive news amid the gloom. I chaired the 2018 World Congress on Prevention of Diabetes and its Complications, where experts from around the world came together to discuss progress in both science and prevention programmes.

Type 1: preventable?

Sometimes known as juvenile diabetes due to the age patients are normally diagnosed, type 1 is an autoimmune disease that attacks insulin-producing cells, leaving patients facing a lifetime of injections and deteriorating health. Improved care has focused on the ways that insulin is delivered and on minimising the impact of health complications on daily life. Scientists are now more convinced than ever that this type of diabetes can be prevented. Although type 1 diabetes is only 5% of all diabetes, it still accounts for tens of thousands of patients who face health challenges every day and require a lifetime of medical support. The impact of prevention of type 1 diabetes would be significant.
The two breakthroughs that underlie this new optimism relate to early detection and prevention therapy. The genetic risk of type 1 diabetes is becoming clearer, and we now have the ability to measure a range of blood factors that appear during the early stages of the disease. Which means we are developing tools to identify those most likely to develop diabetes.
From there, we now have real hope that immunotherapy can stop the insulin-producing cells being destroyed. This covers a range of treatments – including vaccination – designed to change the way a person’s immune system works. The important thing is to find a therapy that specifically shuts off the part of the immune system that attacks the insulin-producing cells, leaving the rest of the defence system intact. Fears that immunotherapy would be too toxic and non-specific for children are being challenged by evidence in clinical trials. These have shown that the therapy can be safe, and encouragingly, have shown signs of slowing down the progress of the disease.

Type 2: devastating

This is the most common form of the disease, directly related to obesity and other lifestyle factors. Type 2 diabetes is devastating; within five to ten years patients could lose their kidneys, eyes, or legs. They may suffer cardiovascular and other deadly diseases linked to diabetes.
Since roughly four out of every five people with diabetes are overweight, the most effective single way to prevent the disease is to avoid weight gain. For 20 years, Finland, US and Australia have conducted diabetes prevention programmes to encourage lifestyle changes, and they are seeing positive results in the health of their nations.
Many countries with very high levels of type 2 have followed suit. This involves “encouraging” people to agree to alter habits of a lifetime, and then provide years of support to maintain physical activity and improve their diet.

          People with diabetes need support to change the habits of a lifetime. Shutterstock

However, this alone may only reach around half of all type 2 diabetes, so these countries are increasingly targeting the obesogenic environment that makes it easy to put on weight and hard to lose it. This starts with talking to the food industry, but also has to include legislation to reduce the impact of the most damaging aspects of our diet. A sugar tax has already been introduced in many countries and we’ll learn very soon how effective it is in reducing diabetes and its health problems.
The Scottish government was met with tabloid fury and corporate lobbying over its Minimum Unit Pricing for alcohol and recent plans relating to 2-for-1 pizzas and “all you can eat” buffets. These measures are never popular but they are increasingly necessary. Taxes and subsidies can help reset the balance between the cost of healthy and unhealthy food. Making high-fat and high-sugar foods more expensive could help to increase demand for healthy alternatives and consequently reduce price.

Preventing complications

People don’t drop dead because they develop diabetes. They can live for decades with the condition, but quality of life is another matter. Type 2 diabetes prevention programmes should also include people who already have the disease.
Lifestyle changes can slow progression and reduce serious health issues, and, in some cases, even reverse the disease. For many, strictly following a low-calorie diet immediately after a diagnosis can put type 2 in remission. But its success depends on individual commitment, so there needs to be support to help each person achieve this difficult goal, and then maintain the lifestyle to prevent the disease returning.

A low-calorie diet with lots of fresh fruit and vegetables can help put type 2 diabetes into remission. Shutterstock

The possibility of developing immunotherapy to prevent type 1, and proving that type 2 can be sent into remission, are the two most exciting developments in diabetes research for many years.
If it was possible to prevent at least half of type 2 cases – which we believe can be done by changing lifestyle and environmental factors – then the amount spent treating diabetes and its complications could be halved. That’s billions freed up for the NHS. Most importantly, it would improve patients’ quality of life and life expectancy.
The link between cheap, sugary and fatty food and obesity and type 2 diabetes is indisputable. The healthy/unhealthy food cost ratio has to change because the evidence is that education – while valuable – is not enough by itself. The evidence from many countries shows that in most chronic, lifestyle-related diseases, legislation is faster and often more effective.
The apocalyptic scenarios often painted are not inevitable, but they are likely if we carry on as we are. People need to accept some hard truths about their lifestyle, and bold political leadership is needed to make unpopular decisions for the benefit of the nation’s health.

http://theconversation.com/diabetes-the-good-news-and-the-bad-news-and-what-next-for-the-future-100416

Things You Need to Know About Diabetes and Sunburn

From asweetlife.org

Sunburns are the worst. That hot, prickly pain where you can’t graze the burnt area without wincing and you feel like you’re actually on fire?  Not comfortable.  In New England, we have the benefits of hot summers and awesome beaches, but with that asset comes the need for constant reapplication of sunscreen to help protect our skin.
As a kid, I had a few sunburns that were uncomfortable, and I always noticed a rise in my blood sugars for a few days.  Turns out, sunburns and high blood sugars unfortunately go hand in hand.  Sunburns are considered an injury to your skin, and just like with any other kind of injury, your body is under stress and duress while healing.
So we want to respect our diabetes and keep our skin safe this summer, right?  But how?  Here are some tips on having fun in the dog days of summer while still maintaining solid diabetes management skills:

Wear sunscreen! The best way to deal with a sunburn is to prevent one.  Make sure you’re wearing sunscreen anytime you’re outside, even in the winter, as the sun can affect your skin all year round.  Wear sunscreen with at least a 30 SPF (sun protection factor), and reapply if you’ve been outside for a while.  (Also be sure to apply to seemingly out-of-the-way areas like the tops of your feet or the part in your hair.)
Watch for wounds.  If you have a wound on your skin, don’t slather it with sunscreen to protect it. Instead, make sure that the wound is cleaned and properly bandaged to ensure that germs won’t invade the affected skin, in addition to keeping the sun’s rays off it.  If the wound looks wonky, check in with your doctor before exposing it to any sun, sand, or summer chaos.
Cover up.  Keep yourself covered when possible, and lean on lighter coloured fabrics, as dark colours attract the sun more. Hats and long sleeves provide excellent coverage, and don’t forget about protecting your eyes with UVA and UVB blocking sunglasses. (And if you’re wearing your pump with your bathing suit, don’t be afraid to flaunt it!  But also beware that your pump can become too hot in the sun, so be mindful of how the hot, hot heat can affect your insulin.  For tips on managing diabetes devices this summer, check out this article.)
Watch your feet.  People with diabetes are constantly being lectured about their feet, but there’s good reason for that.  Did you know that you can get a 2^nddegree burn on the bottom of your feet simply from walking on hot sand in the summer?  (I know!)  Make the most of protective footwear and be sure to inspect your feet every night to make sure everything looks healthy.  (And if you notice an injury, be sure to make an appointment to see your clinician.)
Check your meds.  In addition to making sure that your insulin doesn’t cook in the summer heat, you also need to know if you’re taking a medication that can make you more sensitive to the sun.  Did you know that some blood pressure medications and sulfonylureas can make you more prone to sunburns? Do a little research about the meds you’re taking to see if they warrant an uptick in SPF.
If you do get burned… there’s a plan.  Apply a moisturizer containing aloe vera or soy to the area to help soothe the skin (and avoid anything that includes petroleum products, like benzocaine or lidocaine, as they actually trap the heat in your skin). Stay well-hydrated in order to combat the discomfort, and if the pain is tough to tolerate, consider taking ibuprofen (but check with your doctor before taking any medication).  And keep careful tabs on your blood sugars, as the burn can cause hyperglycemia.  Consult with your medical team if you’re having trouble getting your blood sugars to come down.

https://asweetlife.org/things-you-need-to-know-about-diabetes-and-sunburn/?utm_source=ASweetLife.org+List&utm_campaign=90a12cc941-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-90a12cc941-413392997

Diabetes: Six times to measure your blood sugar levels

From express.co.uk

DIABETES type 1 sufferers need to measure their blood sugar regularly to help maintain levels. This means they avoid them falling too low or becoming too high, which can lead to complications. Check blood sugar levels at these six times.

Diabetes type 1 sufferers need to control blood sugar levels to avoid complications.
The condition is caused by the immune system attacking the pancreas, stopping it producing insulin and removing the body’s ability to control blood sugar.
Symptoms of the condition include extreme thirst, hunger and unexplained weight loss.
If blood sugar levels get too low this could cause a seizure or nervous system damage.
Dr David Cavan, a diabetes medical expert with over 20 years experience and author of ‘Take Control of Type 1 Diabetes’ said sufferers should measure blood sugar levels at these six times.

Before injecting insulin
“It is the most important time to know your blood sugar level,” Dr Cavan wrote in his new book.
“It is potentially dangerous to inject insulin if you do not know your current level of blood sugar.
“Furthermore, intensive management of diabetes type 1 requires that you adjust the dose of insulin if your blood sugar level is too low or too high.”

When you're in bed or after waking up
These are often times to inject insulin, said Dr Cavan, “but if not it is still a good idea to check your blood sugar at these times”.
This, he continued, would enable a “correction dose” to be given to help maintain blood sugar levels.

Just before driving
Dr Cavan added it was important to check blood sugar levels before jumping behind the wheel.
“The main concern here is hypoglycaemia, or low blood sugar,” he explained, “as this can severe impair coordination and reaction times, increasing the risk of an accident that might cause injury to you or another person”.

Before, during and after physical activity
As exercise affects blood sugar levels, these should be monitored.
“Any physical activity will affect your blood sugar level, and sometimes more than you might anticipate,” said Dr Cavan.
“It is essential to check blood sugar before and during more active activities such as sports.”

When feeling ill
“Any infection or illness can cause a rise in blood sugar levels that might require you to take additional insulin, even if you are off your food,” Dr Cavan wrote.
“This is even more important if you also have evidence of increased ketones.”
He added that if blood sugar levels are “higher than expected” they should be checked every two hours.

After eating
“As a rule it is generally sufficient to check your sugar levels before meals, but sometimes it will also be important to do so about two hours afterwards,” the Doctor continued.
“This will be the case if you are not entirely sure of the carbohydrate content of what you have eaten.”
Blood sugar levels should be maintained at 3.5/5.5 mmol/l before meals, according to charity Diabetes UK.


Dr David Cavan’s book, ‘Take Control of Type 1 Diabetes’, can be purchased for £14.99 from diabetes.co.uk.

https://www.express.co.uk/life-style/health/992342/diabetes-type-1-measure-blood-sugar-levels-when-should-i

Diabetes and Dental Care

From diabetesselfmanagement.com

Dental care is an important part of diabetes care. Lack of attention to your oral health can impact your diabetes and vice versa.
According to Amy Wachter, MD, clinical leader of Christiana Care Endocrinology Specialists in Wilmington, DE, oral health among those with diabetes does not get enough attention. “Typically people think that diabetes only negatively impacts the eyes, kidneys, feet, and vascular system. But diabetes can also severely harm oral tissue."

What are the risks of poor dental care?

People managing diabetes are at higher risk for several oral diseases.

Infections: If you frequently take antibiotics to fight infections there is an increased risk for developing fungal infections of the mouth and tongue. Called “thrush,” the fungus feeds on high levels of glucose.
Dry mouth from decreased saliva flow: This can lead to soreness, ulcers, fungal infections, and increased tooth decay.
Poor healing of oral tissues: Incisions from surgeries or injuries do not heal as quickly because blood flow to the area may be restricted.

Perhaps the biggest concern for your overall health is periodontal disease (PD). This is a chronic, low-grade infection caused by bacteria collecting around the gums and teeth. If not treated, the bacteria produce chemicals that can affect your jaw and gums, resulting in loosened or missing teeth. Symptoms include bleeding and swelling in your gums, bad breath, a constant bad taste, frequent abscesses, loose teeth, and receding gums.
Especially for individuals with diabetes, a periodontist is part of the treatment team early on. Periodontists treat those with severe gum disease and complicated medical histories.
“The periodontist has additional training beyond dental school (2–3 years) in treating periodontal disease and diseases affecting the jaw bone,” says Sally J. Cram, DDS, a consumer advisor and spokesperson for the American Dental Association. “They have the training and skills to do more complex treatments including surgery, bone grafting, and implants.”

It is important to ask if your general dentist feels comfortable treating your periodontal problems. If he or she is unable to answer your questions, address your concerns, and provide education around controlling periodontal disease, then you may want to see a specialist.

The impact of periodontal disease on diabetes control

“The biggest risk factor for PD is control of the diabetes,” says Cram, who is also in private practice in the Washington, DC, area. “On the other side, those with untreated gum disease have a much harder time controlling their blood sugar levels because of the constant challenge of inflammation. The non-controlled diabetes can put you at higher risk for PD, but having untreated PD can make it much more difficult to control your diabetes.”
There are indications that severe inflammation linked to PD may increase insulin resistance and has the potential to destroy insulin-producing cells. Either of these can make diabetes worse.
The changes diabetes brings about in the blood vessels also play a part in periodontal disease. With less circulation to the gums, fewer white blood cells are drawn to the area to fight the infection. The lack of adequate circulation also brings about an increase in the activity of collagenase. Since the gums mainly consist of collagen, a substance essential for gum healing, they are more actively being broken down.
Other risk factors at work (in addition to diabetes) include: smoking; poor oral hygiene; stress; heredity; crooked teeth; underlying immune system disorders such as AIDS; bridges or dental appliances that no longer fit properly; and female hormonal changes, such as with pregnancy or the use of oral contraceptives.

Diabetes type not important difference

Presently, there are no indications that one type of diabetes puts you at higher risk for dental problems than the other. “We have always assumed that Type 1 diabetes was medically more severe than Type 2,” says Miriam R. Robbins, DDS, chair of the Department of Dental Medicine at NYU Winthrop Hospital in Mineola, NY, and president of the American Academy of Oral Medicine. “What we are finding is that the length of time you have diabetes increases the likelihood of these complications. In the past, Type 1 was most often seen in younger patients who had it for longer times. As we see more and more patients with Type 2 at earlier ages, this difference will probably diminish.”
The earlier onset also means that dental health care becomes important at younger ages. Parents and guardians should remember that even children need to be watched and treated for oral health the same as adults.
Robbins also suggests being seen as soon as possible after the initial diagnosis of diabetes to get a good baseline of your dental health. Since there can be a delay between onset of the disease and diagnosis, it is important to make sure that PD hasn’t already established itself.

Daily dental care recommendations

Standard daily care is basically the same as the general population. Brush your teeth after every meal. You should brush at a 45-degree angle against the gums and move it back and forth in short strokes. Make sure you clean the front, back and chewing surfaces of your teeth. Use the brush’s tip to clean the inside of the front teeth.
Flossing is another important part of the process. You should: pull off enough floss to wind it around the middle fingers of each hand; hold the floss tightly between your thumbs and forefingers; curve it into a C shape against one tooth and gently move the floss back and forth across the tooth and then the side of the tooth in an up and down motion; and repeat until you have flossed all your teeth.
Before using any kind of mouthwash, check with your dentist to see what, if any, he or she recommends. Anti-bacterial mouthwash can contain up 20 percent alcohol, which can further dry out your mouth. If your dental care professional thinks it is needed, medicated mouthwashes such as Peridex may be prescribed. Many dentists will suggest fluoride supplements to help keep the teeth stronger.
“Part of the prevention of periodontal disease is knowing how to take care of your gums and teeth,” says Cram. “We can do all of the best treatments in the world, but if you aren’t doing what you need to do every day at home, this disease won’t get better.”

https://www.diabetesselfmanagement.com/managing-diabetes/complications-prevention/diabetes-and-dental-care/

Type 2 Diabetes - Four Lifestyle Changes You Can Make to Help Put Diabetes Into Reverse Gear

By Beverleigh H Piepers

Having Type 2 diabetes should not turn your world upside down. It should not have you upset or worried about life or frustrated with your mistakes. Type 2 diabetes is manageable, so no reason to hang your head. However, are you ready for what your Type 2 diabetes treatment entails? Are you willing to do what it takes to treat the disease? It is no easy feat, but you can do it. Better yet, tell yourself you will, and do not question it - ever.
If you are curious about which changes you can make and the actions you can take, look no further.

To start, here are four lifestyle changes you can make to treat and lower your blood sugar...

1. Eat well. Making healthy food choices will not surprise anyone, but managing your blood sugar levels requires you to eat well. It is not possible to reduce your blood sugar and improve your insulin function by accident. There is no magic pill, and it would be foolish to expect one any time soon.
If the best we have is prescriptions for antidiabetic medications, which only treat the symptoms and not the root of the problem, it is a sign we should not be turning to artificial methods.
If you are to treat Type 2 diabetes, you need to eat healthily, better than you do right now. What does this mean? It could mean eating fewer carbohydrates or making sure the carbs you do eat are the healthy kind like fruits and vegetables. Alternatively, you could start cooking more and eating fewer processed meals.

2. Exercise often. Second and again not surprisingly, is you must exercise. This point stands regardless of the presence of diabetes. This alone should stress its importance.
Do not forget about resistance training, for it has benefits that are most likely of interest to you. Cardio is excellent, especially for weight loss, but should not be your only consideration.

3. Get into yoga. An extension of exercise, yoga deserves mention. You may find this to be an odd entry into the list, but here is why it has been included...

• yoga helps you get in touch with your body in ways you probably didn't know you could.
• it awakens energy within you that compels you to look after your body. It does this by making you feel great.

You may think we are exaggerating. However, you will see what we mean if you give it a try. Relaxing through yoga will help you de-stress, which can help you reduce your blood sugar. However, the best thing about yoga is it can motivate you further to take care of your body.

4. Get frequent check-ups. Lastly and not least in importance is you should get regular check-ups. Less is not more in this case. The average person should get two check-ups per year at the minimum, never mind a person with Type 2 diabetes. Frequent check-ups will help you...

• monitor your progress accurately,
• fine-tune your strategies with your doctor's advice, and
• help you stay on track.

Make these changes to your habits and routine, and put your Type 2 diabetes into remission. You can do it...

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---Four-Lifestyle-Changes-You-Can-Make-to-Help-Put-Diabetes-Into-Reverse-Gear&id=9974116

Eating out with Diabetes

From dailypioneer.com

Being cautious with your ordered platter means you can eat out despite the sugar problem.Dr Gaurav Thukral tells you how

Diabetics often associate the disease with suppression of all kinds of temptations for their favourite dishes or eating out at their favourite restaurant. But contrary to this popular belief, Diabetes diagnosis does not mean the end of eating out and or partying. As opposed to what people usually think, managing blood glucose levels is not complicated. A few tweaks here and there can satisfy your taste buds without worrying you.

Tips

• Choose a restaurant with a large menu of healthy items.
• Restaurants are open to serve the food as per your suggestions. Talk to your server and request simple changes in your meal.
• Fill half your plate with salads and sautéed veggies. Rest of the plate can have a combination of carbs and proteins. Avoid buffet-style restaurants.
• To keep your sugar levels balanced, have all your meals on time. Do not skip meals to plan a dine-out.
• It is important for people with Diabetes to eat on time. Hence, opt for restaurants that accept advance bookings or avoid peak hours. Along with having your meals on time, it is important to take your medication or insulin at the right time.
• It is always motivating to have health conscious people as company when you dine out.
• Take a small snack or fruit, low fat cheese, carrots and cucumbers half-an-hour before your dining time, so you aren’t too hungry.
• Check your blood sugar before going out. This will help you optimise your portion size.

Order Smart

• Pay attention to carbs. Although they are a very necessary part of our diet, the problem arises when you have too many at one time. Choosing to eat low-carb foods like vegetables or high-quality carbs like whole grains is important to help keep your blood sugar within range. There are three main types of carbs: Sugars, which can be the natural sugars in fruits or added sugars in processed foods; Starches, like whole grains and legumes and fibre. When eating out with Diabetes, you’ll want to stay away from or limit sugars and refined grains.  Eat  controlled amount of high-quality starches like pasta, breads, popcorn, cookies, crackers, tortillas, cereals, rice, oatmeal, barley, millet, peas, corn, potatoes, plantains, lentils and kidney beans. Fill up on fibre, which can help you control your blood sugar. Choosing a vegetable salad with added protein like grilled chicken or fish or tofu or paneer can be a great low-carb option for lunch or dinner.
• Choose grilled, baked or broiled over fried or pan cooked which has butter.
• Skip the special sauces, gravies, pickles and cheese or ask to be served on the side — use minimally.
• Include steamed veggies with spices and  flavourings like oregano, thyme, rosemary, chillies, black pepper etc on your platter.
• Beware of hidden sugar and fat: Avoid dishes described as crispy, au gratin, hand-battered, creamy, cheesy, golden or with mayonnaise.
• No need to sprinkle salt on top of the food. Avoid salt sprinklers. Go for low-salt menu choices, and avoid monosodium glutamate.

Welcome Drink

• Drink plain water as it has zero calories and keeps you hydrated. You can also opt for buttermilk or unsweetened lemon water.
• If you wish to have a drink, never opt for cocktails made with juices, tonic or soda. A simple Scotch on the rocks is better than a Margarita.
• Your best option, however, is a glass of red wine. In fact, moderate wine consumption in individuals with Diabetes under control does not contribute towards weight gain.

Appetizers

• Watch your portion sizes. Order an appetizer for a main course, split an entrée, or eat half and take the rest home.
• Choose clear soups over cream ones.
• Say no to bread and rolls.
• Enjoy grilled or roasted starters such as mushrooms, paneer/chicken tikka instead of pakoras, kebabs and spring rolls.

Salads

• Choose fresh fruits, greens vegetables or sprouts.
• Select lemon, vinegar or olive oil dressings.
• Order other salad dressings on the side and use minimally.

Main Course
Indian

• Choose plain tandoori/tawa roti/missi roti. Avoid laccha paratha or butter naan.
• Opt for brown rice over white and steamed rice over biryani or pulaos.
• Choose seasonal vegetables.
• Choose plain yellow dal, chhole or rajma instead of dal fry or dal makhni. Opt for light gravy paneer without butter or cream.
• Opt for  chicken or fish instead of red meat.
• Eat vegetable raita or plain curd instead of boondi or sweet pineapple raita.

Chinese

• Opt for noodles with extra veggies over fried rice.

South Indian
Choose from idli, veg uttapam, plain or paneer dosa. Enjoy it with sambhar and tomato chutney instead of coconut chutney.

Fast food

• Customise pasta with extra veggies and red sauce instead of white sauce.
• Order thin crust low cheese pizza with extra grilled toppings.
• Burger, avoid top bun. Order burger with grilled tikki. Ask for extra veggies instead of mayonnaise.

Desserts

• Choose fresh fruit custard, low fat fruit yogurt or sugar free ice cream or kheer.
• Share with someone to limit your portion

Check your blood sugar two hours after your meal. If it’s within target range, you can order the same thing again anywhere. If not, you can make adjustments next time.

The writer is the COO, HealthCare at Home

https://www.dailypioneer.com/pioneer-health/eating-out-with-diabetes.html

‘You have diabetes’

From messengernews.net

There are many things we do not want to hear when we go to a medical appointment, and the three words, “You have diabetes” are among them. The diabetes diagnosis is based on lab numbers, but the impact of the diagnosis means major changes to the person who hears those words. Better understanding of the disease itself helps in improving outcomes by decreasing complications of diabetes. I believe that if a person knows why they need to make a change, they will be more interested in how to make those changes. Below, I briefly describe what diabetes is, the different types, possible complications, and three aspects of treatment.

Diabetes develops when a person’s pancreas does not make enough insulin to get their blood sugar (the body’s fuel) into their cells to do all the work of the body. Before diagnosis, a person may be eating more because their cells are not being fuelled to do their work. They feel very tired. In Type 1 diabetes, the pancreas stops making insulin altogether. In Type 2 diabetes, the pancreas does not make enough insulin and the person becomes more resistant to the insulin they make. Prediabetes occurs when the blood sugar levels are rising, but are not high enough to be diagnosed with diabetes. Prediabetes is a “Golden Opportunity” as lifestyle changes alone are quite effective in stopping or slowing the progression to diabetes.

When first diagnosed, many thoughts arise. Will I go blind? Will I lose my toes, my foot, and then my leg like my grandpa? There is a lot of grief in coping with the diagnosis both in parents of children diagnosed, and in children or adults with the disease. Regarding the complications of diabetes, the sooner your blood sugars come down and the lower you keep your blood sugar levels, the lower your risk of complications. Picture the blood sugar inside your arteries, stuck there and unable to cross into your cells because there isn’t enough insulin. This high concentration of sugar is what damages the walls of the arteries, especially the smallest arteries in the eyes, brain, heart, kidneys and nerves of the feet. This damage is what increases the risk of blindness, stroke, heart disease, kidney failure, and neuropathy or numbness of the feet. These complications are caused by long term high blood sugars of diabetes, but hopefully they are not a part of your future.
After the initial shock of the diagnosis, there are many questions and concerns. Do I ever get to eat bread or candy or Thanksgiving dinner? Do I have to give myself shots? I don’t have time to give myself medication at work. I don’t know what foods I can eat. I can’t afford healthy food. What will my life be like? What can I do so that I don’t have diabetes anymore? In my job, I work to sort out these things with patients. The Diabetes Centre is also an awesome local resource to help provide support and education. Treatment consists of focusing on three things: a food plan, daily exercise, and frequently, medications.

Developing a food plan will help you learn what foods you can eat that will help keep your blood sugars at target. Foods that contain carbohydrates become blood sugar. They include foods like bread, pasta, rice, corn, peas, potatoes, chips, fruits, milk, yogurt, and sweets including cakes, candies, cookies, and ice cream. Beverages with sugar, like soda or fruit juice, raise blood sugars very quickly. People with diabetes can continue to eat these foods, but in smaller amounts and with less frequency. Learning to read a food label will help you identify which foods contain carbohydrates. If you eat fewer foods with carbohydrates, you will have lower blood sugars.

Exercise is the second part of treatment. The stronger your muscles are, the more calories they will burn. When a person exercises, insulin resistance goes down. Exercising every day is equal to taking one additional diabetes pill. Exercise is an inexpensive therapy. You do not need a gym membership to exercise. All you need is a pair of comfortable shoes and a commitment to making exercise a priority. Use walking trails or simply walk around your neighbourhood. Do as much as you can to keep moving.

The third aspect of treatment for diabetes is medication management. There are many categories of diabetes medications, each working in different ways to lower blood sugars. Your medical provider can work with you to develop the best plan for you personally. It is important that you take your medications regularly, and follow up with your provider to monitor whether the dose is right, whether you are having side effects, or whether you need additional treatment. There is not a cure for diabetes at this time. We also cannot give you enough of any medication that will allow you to eat unlimited carbohydrates. Working closely with a provider, a diabetes educator, and a dietician will help you to figure out the balance of food, exercise, and medications that can lower your blood sugars to normal.

If you have diabetes, it will be OK. Ask questions. Develop a food plan and an exercise plan. Take action now to improve your blood sugars so that you will live a long life with diabetes. At UnityPoint, you matter to us. Let us know how we can help you with your diabetes.

Darlene A. Turner, ARNP, CDE, is affiliated with UnityPoint Clinic Nephrology.

http://www.messengernews.net/opinion/local-columns/2018/07/you-have-diabetes/

Top performing hospital unveils winning diabetes care formula

From diabetestimes.co.uk

One of England’s top performing hospitals for diabetes care has unveiled its winning formula for helping people with the condition.
Brighton & Sussex University Hospitals (BSUH) featured in the National Diabetes Audit Data, published in March, for successfully helping people control their blood glucose levels.
Dr Ali Chakera, consultant in diabetes and endocrinology at Brighton and Sussex University Hospitals, said: “It can be difficult for some diabetes patients to keep tight control over their glucose levels.
“Two years ago, we looked at the problem from the patients’ point of view, and developed a multi-specialist team who could offer holistic support to meet an individual’s specific needs.
“This approach gave us the opportunity to offer care in a highly coordinated and flexible way which could adapt over time as our patients’ needs changed.”

Tailored care
The team includes a wide range of specialists, from doctors, nurses and dieticians through to psychologists and foot care specialists, working with people who have been referred from other departments within the hospital. Their care is tailored to each individual’s requirements, helping them to self-manage their condition as much as possible.
This approach has proven so effective that Brighton and Sussex University Hospitals is now ranked in the top 15 per cent of hospitals in the entire country by the National Diabetes Audit. This was based on how many of the people with diabetes are able to keep their glucose levels within strict boundaries.
Dr George Findlay, chief medical officer and deputy CEO at BSUH, said: “These results are outstanding and show the power of working together in new ways to improve patient care.
“The diabetes management team have worked incredibly hard over the past two years to improve outcomes for our patients, and I’m delighted to see that externally audited data is showing the progress that we’ve made.”

Significantly, the data shows that the team’s efforts are helping women control their glucose levels in different stages of pregnancy, a time in their lives which diabetes makes more complicated and dangerous.
In the two years, since the holistic service was first developed, there have been no diabetes related birth defects experienced by babies of mothers under the BSUH team’s care. In addition, over three quarters of all pregnant mothers are able to consistently meet exceptionally stringent targets, thanks to the holistic care provided by the team.
Ruth Copeman, a paramedic who has type 1 diabetes, said: “Little did I know that the team at the Royal Sussex County Hospital were going to change my insulin filled life so positively. Never have I felt more cared for, and also being seen as an individual rather than a condition is so refreshing. The positive impact this wonderful team of people have had on my life cannot be stated enough. Thank you!”

https://diabetestimes.co.uk/top-performing-hospital-unveils-winning-diabetes-care-formula/

Diabetes type 2: Drink this many glasses of fruit juice a day to control blood sugar

From express.co.uk

DIABETES type 2 is a condition that causes a person's blood sugar level to become too high. While it’s common, if it isn’t managed properly or it’s left untreated it can lead to various health complications. A healthy diet can help manage your blood sugar level, and as part of this you should drink a certain amount of fruit juice a day.

Diabetes type 2 is often linked to being overweight or inactive, or having a family history of this type of diabetes.
It’s a lifelong condition that can affect your everyday life, and left untreated it can cause a number of complications, for example eye problems, foot problems, heart attack and stroke.
To control your blood sugar level it’s advised people with diabetes type 2 make changes to their diet. Eating a healthy, balanced diet is key.
Fruit is associated with healthy eating, but when it comes to drinking fruit juice you should be wary.
All fruit, fruit juices and smoothies contain a naturally occurring sugar called fructose.

Fructose from whole fruit doesn’t add to your intake of free (or added) star, but in fruit juice or a smoothie it does, according to Diabetes UK.
It explains: “Whole fruit contains fibre (roughage), vitamins and minerals, which are good for your overall health. The fibre helps to slow down the speed the fructose is absorbed into your blood stream and can help you feel fuller for longer.
“This is why it’s better to eat whole fruit, rather than fruit in the form of juice or a smoothie.
“Fruit juice and smoothies, on the other hand, have most of the fibre (roughage) removed when they are made and it’s very easy to drink large quantities in a short space of time.
“This means you could be drinking a lot of extra calories, carbs and sugar.”

So how much fruit juice should you limit yourself to a day?
The charity says while it’s better to eat whole fruit than drink fruit juice or smoothies, if you want to have some it’s better to limit the quantity to the recommended portion of one small glass a day (150ml) and make sure your drink goes further by diluting it with water.”
Diabetes type 2 is usually diagnosed following blood or urine tests carried out by your GP.
But if symptoms do show, they can include peeing more than usual, particularly at night, feeling thirsty all the time, feeling very tired, and losing weight without trying to.
The signs may come on slowly, or may not show at all, so it can be up to 10 years before you find out you have it.
So it’s important to know the risk factors for diabetes type 2 so you can do something about it.

Age

The first risk factor is age, according to Diabetes UK. You risk increases with age.
It says: “You’re more at risk if you’re white and over 40 or over 25 if you’re African-Caribbean, Black African, or South Asian.”

Family links

You’re also at increased risk if people in your family have it.
It says: “You’re two to six times more likely to get type 2 diabetes if you have a parent, brother, sister or child with diabetes.

Heritage

Type 2 diabetes is up to four times more likely in people of South Asian decent and African-Caribbean or Black African descent.

High blood pressure

You’re more at risk if you’ve ever had high blood pressure.

Overweight

You’re more at risk of type 2 diabetes if you’re overweight, especially if you’re large around the middle.
One of the best ways to prevent the condition developing is making simple lifestyle changes to your diet. For those who are diagnosed with diabetes type 2 this can also help control your blood sugar levels.
Alcohol isn’t a risk factor for this type of diabetes, but it can contain a lot of calories which can lead to putting on weight - this can increase the risk of the condition developing.
Certain types of alcoholic drink can cause blood sugar to spike more than others.

https://www.express.co.uk/life-style/health/987156/diabetes-type-2-diet-fruit-juice-blood-sugar

Human Trials Show a 30-Year-Old Heart Disease Drug Could Help Treat Type 1 Diabetes

From sciencealert.com

Finger pricks and daily insulin injections are currently the leading regimen for those with type 1 diabetes, a condition in which the body's insulin producing cells beta cells are destroyed. And it's not foolproof.
Patients can often face risks over overcorrecting their blood sugar levels, which can potentially lead to hypoglycemia – low blood sugar – and coma.
Insulin is responsible for regulating the amount of sugar in the blood, and dysfunctions with it can cause diabetes.
There are two types of diabetes, type 2 diabetes, in which the body becomes insulin resistant and can't effectively use it, and type 1 diabetes, in which the immune system destroys large portions of the beta cells responsible for making insulin in the pancreas.
In 2015, the Centres for Disease Control and Prevention reported that over 30 million people in the US had diagnosed diabetes, and about 5 percent of them had type 1 diabetes.
Scientists sought to remedy this by repurposing an old drug to do new tricks.
A new study published in Nature Medicine found that verapamil, a drug used to treat high blood pressure, could also be effective at stabilizing blood sugar levels in patients with type 1 diabetes by improving beta cells survival and function.
Dr. Anath Shalev, an author of the study and a professor of Endocrinology, Diabetes & Metabolism at the University of Alabama-Birmingham, said they found previously that an elevation of a key protein called TXNIP in response to increased calcium ion flow into beta cells was a key factor that was present in both type 1 and type 2 diabetes.

Verapamil, which blocks calcium channel activity, was also shown to reduce TXNIP levels, stopping the loss of beta cells in patients with type 1 diabetes.
"This is the first indication that we have of something in hand now that acts very differently from any currently available diabetes treatment, and allows us to improve the patient's own insulin producing beta cell function," said Shalev.
"This is the only one that targets this process because so far, most of the treatments are designed to replace the insulin or really squeeze the cells to secrete insulin."
A clinical trial conducted in 24 adult patients who had developed type 1 diabetes in the past three months showed that if verapamil was taken alongside insulin, patients required less insulin daily, had fewer episodes of hypoglycemia, and maintained good blood sugar control.
Verapamil has been on the market for over 30 years, and according to Shalev, it's been very well tolerated and has little to no side effects.
Shalev said that since the drug will be used off label, meaning that it will have to be used to treat conditions others than it's intended for, doctors and patients with type 1 will have to discuss whether it makes sense for them to include the new drug into their treatment plans.
Shalev said that although verapamil is only FDA approved for lowering blood pressure, it is inexpensive and widely available to the public.
According to goodRx, a 30 capsule of 240 microgram pills will cost around US$26. Verapamil should still be used with insulin, but it will require less insulin.
There has been past studies showing that the drug might improve conditions of patients with type 2 diabetes as well, Shalev said.
Moving forward, Shalev and her team want to expand the study to include more patients, especially younger children.
This article was originally published by Business Insider.

https://www.sciencealert.com/this-30-year-old-heart-disease-drug-could-help-treat-type-1-diabetes-verapamil

Nutrition: Prevent diabetes by following science-based strategies

From ocregister.com

Most Californians have diabetes or prediabetes. This statistic is an alarming wakeup call about the health of Californians.
Nearly half of adults in California have prediabetes or undiagnosed diabetes. Plus, an additional 9 percent have already been diagnosed with diabetes.
Combined, this group amounts to a whopping 15.5 million people, or 55 percent of the state’s population. If those numbers are not bleak enough, about one-third of young adults 18-39 have prediabetes as well.
Prediabetes is a condition in which blood glucose levels are above normal but not high enough to be diagnosed as diabetes. An important difference is that prediabetes is considered reversible, while diabetes is a chronic condition which can be managed but typically not cured. The good news is that many of the risk factors for diabetes such as diet, physical activity and body weight are controlled by lifestyle. The bad news is that many people are unaware of their health status when it comes to their blood sugar levels.
Unfortunately, 30 percent of those with prediabetes will go on to develop type 2 diabetes within five years, while 70 percent will develop diabetes in their lifetime. The potential health consequences of diabetes are serious and costly.
The potential long-term effects of diabetes include damage to blood vessels that affect the heart, brain, eyes, kidneys and nerves.
The first indication of a statewide out-of-control diabetes epidemic came from research conducted by the UCLA Center for Health Policy Research a few years ago that analysed data from the National Health and Nutrition
Examination Survey along with other health data of over 40,000 respondents. Experts are concerned that prediabetes and diabetes prevalence is growing at epidemic proportions and major interventions are needed to reverse this disturbing trend.

Although this is a large-scale problem, researchers found racial and ethnic disparities in prediabetes rates, with statistically higher rates of prediabetes among young Pacific Islanders, African-Americans, multiracial Americans, Latinos and Asian-Americans compared to young white adults. Diabetes rates also increase with age. Interventions that focus on both diabetes prevention and access to screening and education are key to improving the health of our communities.

We know that common sense good nutrition through minimizing processed foods high in fat and sugar and promoting consumption of high-quality foods like vegetables, lean protein, fruits, whole grains and healthy fats is important.
Unfortunately, those with inadequate access to nutritious food due to food insecurity, for example, struggle to get the right balance. In addition, overeating and carrying around excess body fat increase diabetes risk. Besides what we eat, how we move has an impact on diabetes risk too.
Studies have shown that lifestyles that lack movement contribute to the development of diabetes. Plus, walking after meals for just 15 minutes can help control blood sugar levels for people with prediabetes.

Here are some science-based strategies to help prevent diabetes:
• Talk to your doctor about your diabetes risk and get a health screening or physical to check your blood glucose levels.
• Engage in a regular physical fitness regimen. If it’s been awhile since you’ve been active, speak with your physician about how to best get started.
• Avoid sedentary behaviours like watching television, playing video games and extended periods of sitting. If your job requires you to sit, make sure you stand up for at least a few minutes every hour.
• Eat more plant-based foods that are rich in fibre such as vegetables, whole grains, beans, fruits, nuts and seeds.

• Cut back on your consumption of highly processed products including foods with added sugars and refined flours, processed meats and sugar-sweetened beverages.
• Maintain a healthy weight.
• Drink water as your primary beverage.
• Incorporate daily activities that help reduce stress levels like meditation, art, listening to music or seeking guidance from a mental health professional.
• If you smoke, make a plan to stop.

https://www.ocregister.com/2018/07/09/nutrition-prevent-diabetes-by-following-science-based-strategies/

Could your diabetes medication be the next anti-aging pill?

From theglobeandmail.com

The most common treatment for type 2 diabetes – a generic drug called metformin – may do a lot more than just regulate insulin levels. Scientists studying its potential as an anti-aging pill say the drug slows the “burn rate” in living cells in ways that increase longevity.

Derived from a plant called French lilac, metformin costs pennies a pill. Studies in animals suggest the drug could delay the onset of chronic diseases, such as cancer and dementia, by “targeting the biology of aging,” said Dr. Nir Barzilai, director of aging research at Albert Einstein College of Medicine in New York. “You give it to nematodes [microscopic worms], you give it to rats, to mice – they all live longer.”

But worms and rodents are short-lived creatures. Could metformin have the same effect in humans?

Barzilai has teamed up with colleagues from more than a dozen research centres across North America to answer that question. They’re gearing up for a US$77-million clinical trial called TAME, short for “targeting aging with metformin,” and plan to start recruiting 3,000 adults aged 65 to 80 in the next year or so.

Barzilai predicts that people on the drug “will have less disease.” In observational studies, he pointed out, patients taking metformin for diabetes have shown lower rates of cancer, dementia and cardiovascular disease.

But observational studies of patients taking a drug for a specific disease are “very hard to interpret,” said Dr. Judy Wong, an associate professor of pharmaceutical sciences at the University of British Columbia. After all, one of the first things a physician tells a patient with type 2 diabetes is “you have to change your lifestyle,” said Wong, who studies how cellular changes and DNA damage contribute to aging. Patients often start exercising and watching what they eat in addition to taking metformin, so the drug alone may not account for the lower disease rates, she said.

Metformin is hardly the first compound hailed as an anti-aging wonder drug. The “red wine pill” (concentrated resveratrol) failed to live up to the hype after GlaxoSmithKline paid US$720-million in 2008 to acquire a biotech company touting its benefits. Meanwhile, rapamycin, a substance discovered in Easter Island soil, has prolonged life in dogs. But serious side-effects make this immune-suppressing drug an unlikely contender in the hunt for the pharmaceutical fountain of youth.

Metformin, by contrast, has both an enviable safety profile and a decades-long history of human use, said Dr. Michael Pollak, director of cancer prevention in the department of oncology at McGill University.

Metformin shows effects on energy production at the cellular level that may extend life, said Pollak, who has collaborated with Barzilai on studies of metformin. Cells generate energy using oxygen to burn glucose from the foods we eat. “Each cell is a bit like a furnace,” he said. Metformin reduces oxygen consumption to a “slow burn,” dialling down the pace of cell division, and with it, the aging process itself.

That’s if you believe the “rate of living” hypothesis, a controversial model of aging first proposed in the 1920s. Signs of aging, such as wrinkles and forgetfulness, do not appear after a set number of calendar years, said Pollak. Rather, they “occur after a certain number of cell divisions from the time you’re just a fertilized egg.”

Metformin may indeed affect energy production in cells, Wong said. “But there are other things that might be contributing to cellular aging as well.” If scientists manage to come up with a “magic potion” to fight aging, she said, “it will likely be a combination of drugs.”

Barzilai is so confident in metformin that he has lobbied the U.S. Food and Drug Administration to add wording such as “retards aging” on the packaging, provided he can prove the drug does for humans what it does for mice. Without this FDA indication, he said, insurers would refuse to cover metformin for patients who do not have diabetes.

The goal, he explained, is to prevent a whole cluster of diseases that grow common with age, including cancer, dementia and cardiovascular disease. “Any drug that will do this is basically targeting aging.”

But Pollak, the only Canadian researcher involved in the metformin trial, remains circumspect about the drug’s potential. Even if the TAME study ends up proving that metformin prevents age-related diseases, the drug’s effects might pale in comparison to the benefits of regular exercise and a healthy diet, he said. “I believe that [metformin] is not likely to be an antidote to a bad lifestyle.”

https://www.theglobeandmail.com/life/health-and-fitness/article-could-your-diabetes-medication-be-the-next-anti-aging-pill/

Can yoga replace exercise to control diabetes? Not yet

From hindustantimes.com

Can people with diabetes replace physical activity with yoga to improve glycaemic (sugar) control and lower heart disease risk? A systematic review of eight international studies involving 842 patients between the ages of 30 and 78 years showed yoga brought short-term improvements in glycaemic control (fasting plasma glucose) but had inconclusive effects on longer-term endpoints, such as HbA1c readings and diabetes-related complications.
HbA1c is a glycated haemoglobin test gives the average of the past three months sugar control, with a reading below 6% indicating healthy glucose control. If untreated, diabetes causes complications such as blindness, kidney failure, heart disease, stroke and foot amputation.
An estimated 70 million people have diabetes in India, with 47.3% of the cases being undiagnosed, according to the Indian Council of Medical Research-IndiaB study of 57,117 adults over 20 years from 14 states and the Union Territory (UT) of Chandigarh. Diabetes was the seventh biggest cause of early death in India in 2016, up from 11th spot in 2005, shows data from Institute of Health Metrics & Evaluation.
Diabetes affects 425 million adults globally, with adult prevalence being 8.5%, according to the World Health Organisation. The economic burden of diabetes was US$ 673 billion in 2015, equivalent to 12% of the global healthcare expenditure, according to International Diabetes Federation (IDF) estimates.

Exercise matters
Conventional treatment for diabetes involves prescription medicines and lifestyle modifications, including a nutritious high-fibre diet, healthy weight, and moderate-to-intense exercise for 150 minutes at least three days a week. A few studies have shown that yoga, which includes asanas (physical postures), pranayama (regulated breathing) and meditation, improves blood glucose and lowers cholesterol, oxidative stress, blood pressure, body weight, waist-to-hip ratio, heart rate, coagulation profiles and pulmonary function.
Since few adults, especially in south Asia, get the recommended duration and intensity (for example, running, cycling, playing active sport like football or badminton, or walking at a speed of at least 4-5/km an hour) of activity, researchers from India, Sri Lanka and Brisbane did a meta-analysis of existing studies to determine whether yoga can replace physical exercise to control blood sugar.
“Yoga is increasingly used additional therapy in diabetes management, with many patients replacing aerobic physical activity with yoga,” said Dr Anoop Misra, study co-author from India and chairman of the Fortis C-DOC Centre for Diabetes, Metabolic Diseases and Endocrinology. “While numerous trials show the benefits of physical activity in diabetes control, the benefits of yoga regarding blood sugar control remain to be proven conclusively because many of the studies done were scientifically poor in design or do not have enough patients or adequate follow up,” he said.
“The medical evidence on yoga using randomised controlled trials with adequate number of patients is still being acquired. I think it is part of a bouquet of physical activity interventions that re useful, but there is uncertainty about yoga leading to significant weight loss,” said Dr Nikhil Tandon, professor and head of endocrinology, metabolism and diabetes at the All India Institute of Medical Sciences.

Good, not best
The new study, published in the journal Diabetes Metabolic Syndrome, found a significant reduction of 15.16 mg/dl in fasting blood glucose, and of 29 mg/dl in post-prandial blood glucose with yoga as compared to physical activity overall. HbA1c fell by 0.39% with yoga.
There was some weight loss, but yoga did not lower waist circumference. There was no difference in cholesterol and other lipid (blood fats like triglycerides) profiles and blood pressure between two groups.
Though the results favour yoga since it has beneficial effects on glycaemic control in comparison to physical exercise in type 2 diabetes, controlled studies are needed for conclusive evidence, say researchers. “Different studies used types of yoga while some included specific diets and lifestyle. We need a proper and uniform protocol for yoga that can be compared with physical aerobic activity keeping diet and other lifestyle factors constant. The trial should be of sufficient duration, about one year for the results to be conclusive,” said Dr Misra.

In conclusion
Aerobic activity cannot be replaced by yoga, which should be done in addition to physical exercise.

https://www.hindustantimes.com/fitness/can-yoga-replace-exercise-to-control-diabetes-not-yet/story-SnEVTVdiIVBwqvZmsVsW3K.html

Type 2 Diabetes - Fight the Temptation to Quit

By Beverleigh H Piepers

What are you doing right now for your health? If you are on a journey to treat Type 2 diabetes, it is going to take some time. Reducing your blood sugar, improving your insulin resistance, and losing weight are no small tasks. Together, they are part of a process that requires your full dedication. You may stall, and you may struggle, particularly with the components that need you to eat well consistently. The only way to treat Type 2 diabetes effectively is with a healthy diet.
Again, you are going to stall, and you are going to struggle. It is wise to plan for this ahead of time if you are early in your journey. When that time comes, fight the temptation to quit. And keep on going!
If weight loss is your primary goal, there are different degrees of difficulty involved, and what you will face often depends on your...

• starting point,
• end goal,
• previous history with weight loss, and to some extent,
• your age.

It is evident the more progress you need to make, the longer it will take you and the more effort you will need to put in. If you have succeeded with weight loss in the past, you are more likely to have the courage required to overcome the challenges that arise. If not, you will have to anticipate them.

Consider this your warning - it will get difficult, likely more than you expect. The mental battle will be just as hard to fight as the physical one.

When you start having doubts about whether you will make it or not, fight the temptation to quit, and keep going.
Weight loss and Type 2 diabetes are two prevalent sources of significant health problems for many adults around the globe: especially when you factor in aging. But, just because some things are more difficult to achieve as you get older, does not mean they are out of your reach.
Fight the temptation to quit, every single time.
As long as you are setting reasonable goals you know are right for you, there is no reason to quit. We are sure you will agree with this. Just remember what you signed up for, and what awaits you when you succeed...

• don't let Type 2 diabetes and high and unstable blood sugar readings chip away at your health and well-being and shorten your life.
• don't let your body weight invite similar health problems, and make you uncomfortable in your skin.

Eat well, exercise, establish a routine, and see it through. Quitting should never be an option. Never mind it can be a temptation - that is fine. But never give in, as you know it will not serve you any favours.

You can do it.

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---Fight-the-Temptation-to-Quit&id=9966845