Obesity Paradox: Where the Fat Settles—Not Weight—Matters Most in Diabetes

From endocrineweb.com/news

Scientists and doctors call it the obesity paradox—the idea that while obesity may increase the risks of developing heart disease and diabetes for most people, it might actually be protective, offering the possibility of longer survival, in a few lucky individuals.¹
Certainly, if you're among the throngs of people struggling to deal with a higher than recommended body weight, the idea that maybe, just maybe, you are probably hoping to be one of those lucky few who doesn’t need to be concerned.
Alas, the problem is that the obesity paradox is not so much a puzzle as it is more likely a myth for most of us.

Abdominal fat has a more direct impact on risk of diabetes and heart disease, even longevity, than body weight or BMI. Photo: 123rf

Can a High BMI Be Ignored—the Obesity Paradox—Even If You Have Diabetes?

The question of whether the obesity paradox holds true for those with type 2 diabetes (T2D) is especially important, since link between overweight and the development of diabetes and heart disease is well-established. This concern becomes more pressing when your fat settles around the waist, increasing your risk of heart problems.
In a recent intensive review of the research, investigators confirmed that the obesity paradox doesn't hold water for most everyone with type 2 diabetes. In addition, the higher your level of body fat, the greater the likelihood that you will develop diabetes, if you haven’t already, and that other chronic conditions will follow in due course.

Body fat, in simple terms, poses a real danger to your health, and anyone who tries to convince that you are safe from disease isn’t doing you any favours. Take the findings from another recent study—the authors show that when fat settles around the organs (so-called visceral fat)—it is dangerous enough to reduce your longevity even if you're weight is in the healthy range.
This type of abdominal fat, also known as central obesity, has long been known as the riskiest form of overweight. In fact, a bigger waist circumference is likely to shorten your lifespan by about 14 years.

BMI Not a Reliable Measure of Health and Disease

Dr. Bao agrees that the BMI is an imperfect measure, particularly because it cannot reflect where the body fat is located.
In reviewing the waist circumference study, Dr. Boyko points out that this measure, like BMI, can give you an indication of adiposity, but it too is far from perfect. "I've seen people with the same waist circumference," he says "but on further testing, such as with ultrasound imaging, I have found some patients with more hidden or internal visceral fat, while others present with mostly subcutaneous fat, which collects right under the skin instead of surrounding the organs."
Given the limits in body weight measures, Dr. Bao suggests that those who fall in the healthy weight range also know what your waist circumference is, so you have more information about your possible disease risks.

Dr. Boyko indicates that the number of women in the WHI study at normal weight and central obesity was relatively small, only 1,390, suggesting that it is fairly rare to be at a healthy weight but have an enlarged waist circumference.
Still, he would still advise anyone even in the healthy weight range to exercise daily and eat a mostly plant-based diet, such as the Mediterranean approach to eating to avoid any risk of diabetes, heart disease, and many forms of cancer.

Lastly, the newest data indicates that simply by cutting out 300 calories a day for at least two years, you are most likely to achieve healthier aging and greater longevity. While you don’t need to fast to live longer, just cutting out the soda or skipping dessert offers promise of a better quality of life.

https://www.endocrineweb.com/news/diabetes/62220-obesity-paradox-where-fat-settles-not-weight-matters-most-diabetes

FDA Approves BAQSIMI, The First and Only Nasally Administered Glucagon to Treat Severe Hypoglycemia

From asweetlife.org

The U.S. Food and Drug Administration (FDA) has approved Lilly’s BAQSIMI (glucagon) nasal powder 3 mg for the treatment of severe hypoglycaemia in people with diabetes ages four years and above. BAQSIMI is the first and only nasally administered glucagon, and it was designed with severe hypoglycaemia rescue in mind.

Severe hypoglycaemia is a serious medical condition that constitutes an emergency for people with type 1 and type 2 diabetes. It is characterized by altered mental and/or physical functioning that requires assistance from another person for recovery. If untreated, severe hypoglycaemia can lead to serious consequences, such as loss of consciousness, seizure, coma and death.

BAQSIMI is a portable, dry nasal spray form of glucagon, ready to use with no reconstitution or priming required in a single, fixed 3 mg dose. It is absorbed in the nose, so does not require inhalation. BAQSIMI does not need to be refrigerated and can be stored at temperatures up to 86°F/30°C in the shrink-wrapped tube provided.

Acquired by Lilly from Locemia Solutions in 2015, BAQSIMI is a new formulation of rescue glucagon. Dr. Claude Piche, CEO and co-founder of Locemia Solutions, credits co-founder Robert Oringer as the original inspiration behind BAQSIMI. Oringer has two sons diagnosed with type 1 diabetes. 

https://asweetlife.org/fda-approves-baqsimi-the-first-and-only-nasally-administered-glucagon-to-treat-severe-hypoglycemia/?utm_source=ASweetLife.org+List&utm_campaign=5f486e196b-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-5f486e196b-413392997

Mediterranean diet during pregnancy may lower gestational diabetes risk: Study

From tribuneindia.com/news

                                                 Photo for representation only. — iStock

LONDON

Women who follow a Mediterranean-style diet during pregnancy, including a daily portion of walnuts and almonds, and extra virgin olive oil, may have a lower risk of gestational diabetes, a study claims.
Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant.
The results, published in the journal PLOS Medicine, found women who followed a Mediterranean-style diet during pregnancy had a 35 per cent lower risk of gestational diabetes and on average gained 2.75 pounds less, compared to women who received standard prenatal care.

A Mediterranean-style diet rich in good, unsaturated fats, found in foods like walnuts and extra virgin olive oil, has been shown to reduce the risk of heart attack, stroke, and cardiovascular death in adults, according to researchers at Queen Mary University of London and the University of Warwick in the UK.
Walnuts, in particular, are a traditional food in the Mediterranean diet because of their omega-3 ALA content and bioactive compounds, they said.

While there has been extensive research on the Mediterranean diet to date, the diet's potential to improve maternal and offspring outcomes has not been widely evaluated, making this study particularly valuable.The study included 1,252 multi-ethnic inner-city pregnant women with metabolic risk factors, including obesity and chronic hypertension.
In addition to receiving folic acid and vitamin D supplementation, the women were randomly assigned to either a Mediterranean-style diet or a control group that received dietary advice per UK national recommendations for prenatal care and weight management during pregnancy.

Those who followed the Mediterranean diet consumed a daily portion of nuts, including 15 gram of walnuts, 7.5 gram of almonds, 7.5 gram of hazelnuts) and used extra virgin olive oil as their main source of cooking fat.
In addition, the diet emphasised fruit, vegetables, non-refined grains and legumes; moderate to high consumption of fish; small to moderate intake of poultry and dairy products; low intake of red meat and processed meat; and avoidance of sugary drinks, fast food, and food rich in animal-based fat.
Participants received dietary advice at 18, 20, and 28 weeks' gestation to help improve compliance and make sure the diet was made culturally sensitive.
The researchers measured dietary compliance using self-reported feedback from the participants, so it's important to note that there could have been human error in the reporting.

They also assessed the effect of a Mediterranean diet on other pregnancy complications such as high blood pressure, preeclampsia, stillbirth, small for gestational age foetus, or admission to a neonatal care unit, but did not find any significant associations.
One in four mothers enter pregnancy with pre-existing obesity, chronic hypertension or raised lipid levels, which can lead to pregnancy complications, long-term risk of diabetes and cardiovascular complications for mothers and their children. — PTI 

https://www.tribuneindia.com/news/health/mediterranean-diet-during-pregnancy-may-lower-gestational-diabetes-risk-study/808226.html

Could eating local food reduce blood pressure and diabetes risk?

From medicalnewstoday.com

A recent pilot study finds that consuming local foods with fewer additives might reduce abdominal fat, blood pressure, and diabetes risk. The study is small-scale, but the findings are intriguing.
The food that we eat has a huge effect on our overall health — that much is abundantly clear.
The prevalence of both type 2 diabetes and obesity is a clear sign that, overall, the dietary habits of people in the United States need attention.

People crave firm, actionable guidance on their diet.

This need has manifested into a never-ending hunt for the perfect dietary intervention: a diet that will cure all ills, boost well-being, and increase lifespan.

A diet that ticks at least some of these boxes is likely to include fruit, vegetables, whole grains, and limited amounts of sugar, salt, and fat.
However, as many of us are all too aware, sticking to a nutritional diet plan is challenging. And, as one author puts it, "Nutrition and policy science have advanced rapidly, creating confusion."
Popular diet options now include Mediterranean, low carb, no carb, Atkins, ketogenic, and intermittent fasting, all of which jostle for position in the public mind.

A focus on ultra-processed foods

In recent months, Medical News Today have covered several studies focusing on so-called ultra-processed foods. Overall, researchers conclude that they are bad news for health.
The most common explanation for this is the high levels of fat, sugar, and salt in ultra-processed foods.
A recent pilot study, which features in the journal Diabetes & Metabolism, took a different approach and, instead, focused on the food additives in processed foods.
According to the authors, these additives include chemicals that the food industry uses to make food "palatable, durable, and transportable over long distances."
For their study, which they carried out in Italy, the researchers set out to understand the effect of eating locally produced food. Rather than concentrating on fat and sugar content, they were solely interested in the additives.
In particular, the experiment focused on cheese, sausage, pasta, pastries, biscuits, and chocolate, the production of which takes place in distant locations. Rather than asking the participants to cut these products out of their diet, the team asked them to source the foods locally.

Testing additives

In all, 159 healthy participants completed the 6-month study. The scientists assessed a range of parameters, including height, weight, systolic blood pressure (the pressure in the arteries when the heart contracts), and diastolic blood pressure (the pressure in the arteries when the heart rests between beats).
Among other things, they measured the participants' overall fat and abdominal fat, and their levels of anxiety and depression. To assess depression, they used a standard questionnaire called the Beck Depression Inventory.
The scientists took blood samples to measure resting blood glucose and levels of potassium, sodium, insulin, creatine, and C-peptide (a measure of how much insulin someone is producing).
The scientists also calculated homeostasis model assessment (HOMA) scores. The medical community considers HOMA scores to be an indicator of insulin resistance and beta cell (the cells in the pancreas that secrete insulin) function.
At the start of the study, there were no significant differences between the two groups.

Buying local

The researchers randomly split the participants into two groups. They asked the members of the first group to purchase cheese, sausage, fresh pasta, pastries, biscuits, and chocolate from local producers.
As the authors explain, before the study, these producers had undergone vetting by "an expert from the food production industry to ensure that additives were not used" and that all the production had been local.
For instance, cheeses only contained milk, salt, and rennet, while pastries did not contain chemical flavors, antioxidants, or monoglycerides and diglycerides, both of which manufacturers often use to improve the volume and texture of a product.
The participants in the second group bought these products in supermarkets instead. The researchers asked the participants in both groups to follow the Mediterranean diet and keep a detailed food diary.
Overall, both groups consumed a similar number of calories.

After 6 months, the researchers repeated the barrage of tests that they had conducted at the beginning of the study.

A number of differences

Across both groups, body mass index (BMI) and levels of salt in the blood were lower than baseline readings. However, there were differences between the groups too.
The researchers found that at the 6-month mark, the participants in the first group had significantly better HOMA scores and lower fasting glucose levels than those in the second group. Also, compared with their baseline measurements, those in the local food group had lower levels of visceral fat, reduced systolic blood pressure, and improved depression scores.
Those in the second group, however, experienced increases in fasting glucose levels, diastolic blood pressure, and C-peptide compared with their baseline scores.

As the authors explain, the study does have substantial shortcomings. For example, they only designed it as a pilot study, so researchers will need to repeat the findings with a larger group of participants over a longer period.
Aside from the size and length of the study, there were other issues. For instance, it was not possible to "blind" participants. In other words, they were aware of the intervention because it involved them using different shops and changing their diet.
Future studies might avoid this issue by providing biscuits, meat, and the other products to participants so that they remain unaware of their ingredients or origin.

Regarding the improved depression scores, it is worth noting that differences between the groups' experiences during the study might have played a part.
One could argue that visiting independent local sellers might be a more positive experience than visiting a supermarket. Also, local, fresh, additive free food could, theoretically, taste better than additive filled foods, and, because the food we eat can influence our mood, perhaps this difference alone could explain the changes in reported mood.

Even when we take all of the above into account, if just 6 months of choosing additive free versions of a handful of items can improve metabolic factors that relate to disease risk, this line of investigation is worth following up.

https://www.medicalnewstoday.com/articles/325819.php

Vitamin D Pills Could Slow Progress of Type 2 Diabetes, Prediabetes, Scientists Say

From newsweek.com

People with prediabetes and newly diagnosed type 2 diabetes may be able to slow the progress of the condition by taking vitamin D, scientists believe.
Consuming the molecule could help the body metabolize glucose according to the authors of a study published in the European Journal of Endocrinology. The work builds on studies which shows there is a worldwide problem with vitamin D deficiency, and link the deficiency to an inability to process sugar.

The study involved 96 participants who were at high risk of diabetes, or who had recently been diagnosed with type 2. Researchers asked one group to take 5,000 IU of vitamin D for six months, while the others were given a placebo. Participants didn't know which group they were in. At the end of the experiment, the researchers measured variables including their insulin sensitivity, and participants filled out questionnaires on their weekly Sun exposure—as this can be a source of vitamin D—as well as their diet and physical activity.

5000 IU is considered a high dose, with between 600 to 4,000 IU considered safe, although it is thought some people may need to take more to prevent chronic disease.

The team found taking vitamin D improved how insulin worked in muscle tissue after six months. However, the study was limited because it only involved French Canadians, meaning the results might not relate to a wider population, the authors wrote.

Future studies could look at the mechanisms which mean people respond differently to vitamin D, and whether the changes observed would last long term, they said.
Study co-author Dr. Claudia Gagnon, assistant professor and endocrinology researcher at Université Laval in Quebec, told Newsweek: "We know that vitamin D regulates numerous genes involved in diabetes. Animal and in vitro studies have also shown that vitamin D may improve insulin secretion and insulin action directly or indirectly through reduction of low-grade systemic inflammation."

"This study is significant because it shows that vitamin D supplementation may potentially slow metabolic deterioration in individuals at high risk of diabetes or with newly diagnosed type 2 diabetes."
But she said it's not clear if patients who have had type 2 diabetes for a long period would benefit from vitamin D supplementation.

Gagnon went on to warn the study isn't a green light to take high amounts of vitamin D.
She said: "At this stage, results of our study need to be confirmed in other studies. Moreover, the safety of high-dose vitamin D supplementation (such as what was used in our study) beyond 6 months is not demonstrated. I would thus suggest at this time that current recommendation be followed."
Taking the recommended amount to promote good bone health "is important," she said.

Dan Howarth, head of care at the charity Diabetes UK, who did not work on the project, told Newsweek: "This study shows that high doses of vitamin D supplements are safe and suggests that they could alter the biology underlying Type 2 diabetes, possibly helping to improve how the body produces and uses insulin.
"However, the evidence beyond this study is mixed and more research is needed to understand if vitamin D supplements help to reduce a person's risk of Type 2 diabetes, and who would benefit most from them.

"The best way to lower your risk of Type 2 diabetes is to eat a healthy, balanced diet and be as physically active as possible. If you are following a healthy diet then vitamin supplements should not be necessary, and doing regular physical activity can also help to improve your insulin sensitivity."
Some 30 million Americans have diabetes, with between 90 to 95 percent of those dealing with type 2, according to the Centres for Disease Control and Prevention. Over the past two decades, the number of adults in the U.S. diagnosed with diabetes has more than tripled.

The cells of people with type 2 diabetes don't react correctly to insulin, a hormone which helps turn sugar into energy. This spikes their blood sugar, which can damage the body and can cause heart disease, blindness, and kidney problems if left untreated.

Depending on the severity of the condition, a person can manage their diabetes with injectable insulin or pills which help to regulate blood sugar. As obesity is a risk factor, changing one's diet has also been shown to reverse type 2 diabetes in some people. Most people have prediabetes before they develop type 2, and making lifestyle changes such as eating healthily and being physically active can stop or slow the development of type 2 diabetes.

https://www.newsweek.com/vitamin-d-pills-type-2-diabetes-prediabetes-scientist-1451070

Heat and diabetes are a dangerous combination

From diabetesvoice.org

People with both type 1 and type 2 diabetes feel the heat more than people who don’t have diabetes. Here are a few tips.

Extreme heat with diabetes can be dangerous. High heat affects blood glucose levels.  Recently, extreme heat has been reported in the United States and Europe. Heat and moderate to high activity can make you sweat profusely, and people with diabetes may become dehydrated, leading to a rise in glucose levels.  People with both type 1 and type 2 diabetes feel the heat more than people who don’t have diabetes. Here are the reasons why:

• Certain diabetes complications, such as damage to blood vessels and nerves, can affect your sweat glands so your body can’t cool as effectively. That can lead to heat exhaustion and heat stroke, which are medical emergencies.
• People with diabetes get dehydrated (lose too much water from their bodies) more quickly in high heat. Not drinking enough liquids can raise blood glucose, and high blood glucose can make you urinate more, causing dehydration.
• High temperatures and heat can change how your body uses insulin. You may need to test your blood glucose more often and adjust your insulin dose and what you eat and drink.

Even when it doesn’t seem very hot outside, the combination of heat and humidity (moisture in the air) can be dangerous. When sweat evaporates (dries) on your skin, it removes heat and cools you. It’s harder to stay cool in high humidity because sweat can’t evaporate as well.

It’s always a good idea to check the heat index when temperatures soar—a measurement that combines temperature and humidity. Take steps to stay cool when it reaches 26°C (80°F) in the shade with 40% humidity or above. Usually the heat index can be up to 15°F higher in full sunlight, so stick to the shade when the weather warms up. For example, if the temperature is 32°C (90°F), a high humidity index may make it feel like 40°C (105°F).

Tips for high heat:

• Drink plenty of water—even if you’re not thirsty—so you don’t get dehydrated.
• Avoid alcohol and drinks with caffeine, like coffee and energy or sports drinks. They can lead to water loss and spike your blood glucose levels.
• Check your blood glucose before, during, and after you’re active. You may need to change how much insulin you use. Ask your doctor if you would like help in adjusting your dosage.
• Wear loose-fitting, lightweight, light-coloured clothing.
• Wear sunscreen and a hat when you’re outside. Sunburn can raise your blood sugar levels.
• Don’t go barefoot. Protect your feet always!
• Use an air conditioner or go to an air-conditioned building to stay cool. In very high heat, a room fan won’t cool you enough.
• Physical activity is usually associated with reduced need for insulin. The latter may increase the risk for low blood glucose.  in higher temperatures, people are at risk for both low and high blood glucose.

The key in high heat weather is to be vigilant and check your blood glucose often, and seek emergency treatment if necessary.

https://diabetesvoice.org/en/living-with-diabetes/extreme-heat-and-diabetes/

Plant-based diets tied to lower risk of type 2 diabetes

From physiciansweekly.com

(Reuters Health) – People who tend to eat mostly plants may be less likely to develop type 2 diabetes, a research review suggests.
Researchers examined data from nine previously published studies with a total of 307,099 participants, including 23,544 people who developed type 2 diabetes. The length of the studies ranged from 2 to 28 years. All of the studies used food frequency questionnaires to assess participants’ diets.

Overall, people who most closely adhered to a vegan, vegetarian or other type of plant-based diet were 23% less likely to develop type 2 diabetes than people who consumed the least amount of plant-based meals, researchers report in JAMA Internal Medicine.
“Plant-based diets can promote metabolic health and reduce diabetes risk through many pathways, including preventing excess weight gain, improving insulin sensitivity, reducing inflammation, and other mechanisms,” said Dr. Qi Sun, senior author of the study and a researcher at the Harvard T.H. Chan School of Public Health and Brigham and Women’s Hospital in Boston.
People who eat a healthy variety of plant-based meals can lower their diabetes risk even when they’re not strict vegetarians – avoiding meat, poultry and fish – or vegans – also avoiding animal products like milk and eggs.

But they may not benefit as much if their plant-based diet is full of foods like French fries, white bread, and white rice, Sun said by email.
“It does matter what veggies people eat and how the veggies are processed,” Sun said. “Therefore, consuming healthy plant foods that are not or minimally processed, such as fresh fruits and vegetables, legumes, nuts, and whole grains, should be emphasized.”

People in the study who followed this advice – with the healthiest mix of fruits, vegetables and whole grains in their plant-based diets, were 30% less likely to develop type 2 diabetes than participants who tended to ignore this idea.
Type 2 diabetes, the most common form, is linked to obesity and aging and happens when the body can’t properly use or make enough of the hormone insulin to convert blood sugar into energy. Left unchecked, diabetes can lead to serious complications like nerve damage, blindness, amputations, kidney damage and heart problems.

Doctors typically advise patients with type 2 diabetes to follow a low-calorie, low-fat and low-carbohydrate diet that includes lots of fresh fruits, vegetables and whole grains as well as lean poultry and fish. Fatty, sugary foods are discouraged along with consuming too much red or processed meat.
None of the smaller studies in the current analysis were controlled experiments designed to prove whether a plant-based diet helps prevent diabetes or serious complications from the disease.
Still, the results offer fresh evidence of the potential for good eating habits to help prevent and manage diabetes, said Samantha Heller, a nutritionist at New York University Langone Medical Centre in New York City.
“Adding more whole plants such as broccoli, edamame, quinoa, extra virgin olive oil, almonds, and berries, to our diet is a great way to help manage type 2 diabetes and weight,” Heller, who wasn’t involved in the study, said by email.

“Higher fibre foods are healthy for the gut microbiome, improve gastrointestinal function, improve insulin sensitivity, and help manage blood sugar,” Heller added. “However, it is important to remember that even (portion sizes) of healthy foods matter.”

https://www.physiciansweekly.com/plant-based-diets-tied-to/

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.

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 hyperglycaemia.  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=2b13ea423e-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-2b13ea423e-413392997

Diabetes could be predicted by regular blood tests: Here's all you need to know

From timesnownews.com/health

The research showed that glucose levels that normally would not be seen as indicating diabetes risk can in fact predict the disease's development.

Washington DC: A recent study has claimed that diabetes could be detected in blood tests, thereby re-emphasising the need for one to conduct routine blood tests. According to the study published in 'PLOS ONE', random plasma glucose tests could be used to predict which patients will develop diabetes.
Researchers showed that levels of glucose found during standard outpatient medical testing revealed patients' likelihood of developing diabetes over the next five years, even when glucose levels did not rise to the level of a diabetes diagnosis.

                                                         Photo Credit: Thinkstock

The research showed that glucose levels that normally would not be seen as indicating diabetes risk can in fact predict the disease's development.
"Although screening for prediabetes and diabetes could permit earlier detection and treatment, many in the at-risk population do not receive the necessary screening," noted Dr Mary Rhee, the lead author on the study.
Researchers examined data on these routine blood tests to see whether random plasma glucose levels could in fact predict which patients would develop diabetes in the future. They studied data on more than 900,000 patients who were not already diagnosed with diabetes.
All patients had at least three random plasma glucose tests during a single year. Most of these tests were likely obtained "opportunistically", that is, during regular doctor visits not specifically related to diabetes screening.

Over a five-year follow-up, about 10 per cent of the total study group developed diabetes. Elevated random plasma glucose levels, though not meeting the diagnostic threshold for diabetes, accurately predicted the development of diabetes within the following five years.
Patients with at least two random plasma glucose measurements of 115 mg/dL or higher within a 12-month period were highly likely to be diagnosed with diabetes within a few years. Glucose levels of 130 mg/dL or higher were even more predictive of diabetes.

As expected, demographics and risk factors are known to be related to diabetes also predicted the development of the disease. Development of diabetes was infrequent in subjects whose highest random plasma glucose levels were below 110 mg/dL.
In light of these findings, the researchers recommend that patients receive follow-up diagnostic testing for diabetes, such as fasting glucose or A1c test, if they have two random glucose tests showing levels 115 mg/dL or higher.

https://www.timesnownews.com/health/article/diabetes-could-be-predicted-by-regular-blood-tests-heres-all-you-need-to-know/456696

Leicester launches first UK diabetes village

From diabetestimes.co.uk

A brand new diabetes village for people with type 2 diabetes has opened in Leicester, UK.
Located in the Merlyn Vaz Health and Social Care Centre on Spinney Hill Road, the main aim is to provide easy access to a wide portfolio of support services all under one roof for those who have the condition, or are at risk of developing.
The village is being trialled for six months and has been developed by Leicester City Clinical Commissioning Group (CCG) in partnership with Silver Star Diabetes, a local health charity.

It will be home to a range of services that are important for effective diabetes management, including blood sugar checks, lifestyle coaching advice, foot care, eye screening and diabetes education classes.
Previously, people would have to have seen their GP multiple times to have their regular blood sugar and insulin checks, with separate visits to different services and locations to receive the wider range of care. The new village concept means people can  now drop in on a Thursday between the hours of 10am and 6pm. They can then pick and choose the services they require all in one location, equipping them with the right tools to manage their condition quickly and independently.
The services at the village can also be used by people who are at high risk of developing diabetes; they do not need to have a diabetes diagnosis.

In Leicester City, there is a higher than average number of people with diabetes (8.9% compared to 6.4% nationally) and this is expected to rise further to 12% by 2025. Leicester also has a higher proportion of Black Minority Ethnic (BME) residents compared to the UK national average and they are genetically more likely to get diabetes (at a higher risk).
Professor Azhar Farooqi, Chair of Leicester City Clinical Commissioning Group and lead on diabetes, said: “We want people to use the village and come to us and tell us whether the diabetes village is a service they want to keep and whether it’s a service they will use. This is a first for the UK and we want to make sure we get it right for patients.”

Rt. Hon Keith Vaz MP the Chair of the All Party Parliamentary Group on Diabetes and MP for Leicester East said: “I am thrilled that Leicester City CCG has taken up the challenge of creating the first diabetes village in the UK. The idea was born out of the needs of diabetics such as myself and others having to make up to eight visits to different professionals on different days at different times and at different venues.
“There will now be a one stop shop so it will take just one visit. The partnerships that have been created with local charities, such as Silver Star Diabetes, means that the NHS will reach parts of the community which they couldn’t previously. Prevention is critical. I want to see a diabetes village in every city in the UK. Leicester City CCG should be warmly commended for showing the way by putting patients first. From being the capital city of diabetes we will become the champions of diabetic care.”

During that time engagement will be undertaken with the public to see if it is a service that they would like to see continue as part of their diabetes prevention and management.

https://diabetestimes.co.uk/leciester-launches-diabetes-village/

Type 2 diabetes: Three foods you should consider adding to your diet to lower blood sugar

From express.co.uk

TYPE 2 diabetes can cause a person to lose control of their blood glucose (sugar) levels, making them too high. Left untreated, the condition has severe complications, so making simple changes to your lifestyle, such as what you eat, is very important. Here are three foods you may not eat very often but have been proven to lower and control blood glucose levels.

Type 2 diabetes is a condition that causes a person’s body not to respond to insulin properly. When this happens, the body doesn’t produce enough insulin, making blood glucose levels too high. If type 2 diabetes is left untreated, serious health complications can follow, such as nerve damage, kidney failure, heart attack and stroke. Eating a healthy diet is one way to prevent the condition and manage blood glucose levels.

While there’s nothing you can’t eat if you have type 2 diabetes, some foods should be limited.
To keep blood glucose levels in check, experts say you should eat a wide range of foods and keep sugar, fat and salt to a minimum.
This is a general rule to follow, but specific foods have also been found to have blood sugar-lowering properties.
Here are three exotic foods you may not often eat, but have been shown to improve blood glucose control.

Shirataki noodles 

Some studies have suggested shirataki noodles, traditional Japanese noodles, can help lower blood glucose levels.
These noodles have proven effective in diabetes patients because they’re high in the fibre glucomannan, which is extracted from konjac root.

                   Type 2 diabetes: Three exotic foods could lower blood sugar (Image: GETTY)

One study titled ‘Glycemic and lipid responses to glucomannan in Thais with type 2 diabetes mellitus’ showed glucomannan could reduce blood sugar levels after eating and improve heart disease risk factors in people with diabetes.
Another study, ‘Immediate and long-term effects of glucomannan on total ghrelin and leptin in type 2 diabetes mellitus’, showed how glucomannan makes you feel fuller and more satisfied and lowers the levels of hunger hormone ghrelin.
Feeling fuller for longer is important as it helps maintain weight - being overweight is a risk factor for developing type 2 diabetes.

Black beans 

Black beans, which are a popular ingredient in Latin American and Mexican cooking, are believed to be an excellent food option for people with diabetes.
Being a complex carbohydrate, studies have shown the body digests black beans slower than it does other carbohydrates, helping people manage their blood sugar levels.

  Type 2 diabetes: Black beans are believed to be an excellent choice to control blood glucose levels

Eating black beans can also help with weight loss and help regulate cholesterol, which are beneficial for someone with diabetes.

Seaweed

Seaweed is most commonly eaten in Asian countries such as Japan, Korea and China.
An eight-week study in 60 Japanese people found fucoxanthin, a substance in brown seaweed, may help improve blood sugar control.

           Type 2 diabetes: Seaweed improved blood sugar levels in one study (Image: GETTY)

As part of the research, participants received a local seaweed oil that contained either 0mg, 1mg or 2mg of fucoxanthin.
It was then found those who received 2mg of fucoxanthin had improved blood sugar levels, competed to the group who received 0mg.

https://www.express.co.uk/life-style/health/1154147/type-2-diabetes-diet-food-seaweed-black-beans-shirataki-noodles-lower-blood-sugar

Exercise you should and should not do if you have diabetes

From thejakartapost.com/life

Exercise and physical activity are deemed essential for people with diabetes, as it helps control sugar levels in the body.
However, not all types of exercise are recommended, because some movements will actually worsen the patient's condition.
Indonesian Endocrinology Association (PERKENI) chairman Ketut Suastika told tempo.co that one type of exercise that was not recommended was anaerobic or heavy physical activity. Examples of such activity are weightlifting, jump rope and push-ups.
According to Ketut, these activities can create oxidative stress in the body, which will increase blood sugar levels and can eventually complicate a patient’s health disorder.

For maximum results, Ketut recommends exercising for 30 minutes a day.  (Shutterstock/Martinina)

“Take the example of lifting weights. If done by diabetic patients with diabetic retinopathy or retinal disorders in the eye, it can accelerate blindness,” he said during a recent event in Jakarta.
The recommended exercise is the opposite, namely aerobics, which can help control blood sugar levels. Examples of such physical activity are walking and jogging.
Ketut recommends exercising for 30 minutes a day. 
"At least 150 minutes per week. So, if you skip two days at the weekend, it's still okay. This is a method that is really effective for [keeping in check] your diabetes, " he said.

https://www.thejakartapost.com/life/2019/07/13/exercise-you-should-and-should-not-do-if-you-have-diabetes.html

Cutting only 300 calories a day can cut your risk of diabetes and heart disease, study finds

From abcnews.go.com

It’s no secret -- watching what you eat can help keep your heart healthy.

But new research published in The Lancet Diabetes & Endocrinology has reached a surprising conclusion: even those of us with a healthy weight might benefit from cutting out a relatively small number calories from our daily diet.

“We wanted to investigate the effect of calorie restriction on disease markers in healthy, young humans,” Dr. William Kraus, preventative cardiologist and lead author of the study, told ABC News. “We found that a small calorie reduction -- around 300 -- appears to be beneficial to the heart.”

Researchers studied two groups of healthy people, all under 50 years old, over a period of two years. One group of 71 people continued a normal, unrestricted diet. The other group of 188 people underwent calorie restriction. In the beginning, the second group was asked to cut 25% of their daily calories.

“We didn’t alter the proportion of carbohydrate, fat or protein -- we just reduced the calorie content,” Kraus told ABC News. This was done by teaching study participants the essentials of calorie restriction, such as calorie counting and portion size.

People were asked to maintain the diet over two years, but the average person in the calorie restricted group managed to cut down only 12% of their calories, equivalent to roughly 300 calories per day.

That’s a modest decrease -- just a fraction of the 1,600 to 2,400 recommended daily calories for women, and 2,000 to 3,000 recommended calories for men.

Three hundred calories is equivalent to a slice of apple pie, 30 potato chips or “cutting out a snack after dinner,” Kraus told ABC News.

Even with this limited reduction, there were striking benefits: people lost over 11 pounds of fat and had reduced levels of bad cholesterol (LDL), increased levels of good cholesterol (HDL) and lower blood pressure. They were also more sensitive to insulin, a key blood sugar hormone, potentially reducing the risk of diabetes.

“Clearly what surprised us was the magnitude of response in people that already have normal parameters, are young and have a normal weight,” Kraus told ABC News.

Researchers found that even in young, healthy adults, a moderate calorie restriction can improve cardiovascular risk factors with a potential long-term benefit for heart health.

The next step is exploring why the benefit is so big.

“We expected some improvement in their biological parameters because they were losing weight,” Kraus said to ABC News, “but the weight loss only explained 25% of the improvement.”

Dr. Kraus has some theories about where the remaining 75% comes from.

“The effects of calorie restriction on DNA methylation is something we want to study in the future,” Kraus said. Methylation is a type of chemical modification made to DNA in response to environmental changes -- including nutrition -- which alters how genes are expressed.

Dr. Frank Hu a professor of nutrition and epidemiology at Harvard, called the study “ground-breaking in several respects,” but remained cautious.

“One practical challenge of translating calorie restriction is reliably counting daily calories and establishing optimal levels of calorie restriction,” said Hu.

He added that calorie counting alone is “unlikely to curb the global obesity epidemic.”

“Creating a healthy food environment and changing social norms…can make it easier for individuals to achieve and maintain a healthy weight,” Hu said.

Nevertheless, inexpensive and effective methods like calorie restriction could be invaluable in addressing some of issues surrounding the obesity epidemic.

The bottom line according to Kraus: when it comes to cutting down on calories, “anything is better than nothing.”

https://abcnews.go.com/GMA/Wellness/cutting-300-calories-day-cut-risk-diabetes-heart/story?id=64281135

Diabetes Exercise Tips to Stay Safe While Being Active

From news.yahoo.com

Actively manage diabetes.
For people with diabetes, in addition to being careful about diet, staying on the move is crucial to control blood sugar and reduce the risk for developing complications related to the chronic condition. "There is overwhelming evidence for the beneficial role of both physical activity and more structured exercise programs in the management of both Type 1 and Type 2 diabetes," says Dr. Roeland Middelbeek, a staff physician and research associate at Joslin Diabetes Centre in Boston. Besides helping keep blood glucose and weight in check, research finds regular exercise can reduce cardiovascular risks -- which tend to be higher for people with diabetes -- and decrease the need for insulin, particularly in people with Type 1 diabetes.

Know what's recommended.
Standard physical activity guidelines apply for people living with diabetes. "Most adults with diabetes should engage in 150 minutes or more of moderate-to-vigorous intensity activity weekly," according to the American Diabetes Association. This could range from brisk walking to cycling to swimming or running, depending on the person's level of fitness, spread across the week. Besides aerobic exercise and resistance training, like lifting weights or using machines or body weight for resistance, the ADA also recommends flexibility training and balance training. "Yoga and tai chi may be included based on individual preferences to increase flexibility, muscular strength and balance," the ADA notes. Kids should get 60 minutes of physical activity daily. That includes engaging in muscle- and bone-strengthening activities on three days.

Consult your doctor.
Those who have been inactive for a longer period -- especially, say, for years -- or who have any diabetes-related symptoms or complications or any other medical concerns, as well as older adults, should talk with a doctor before starting a new exercise regimen. Ideally, talk with the health provider you see regularly for diabetes about any restrictions you should follow or other advice. It's not only about making sure diabetes is controlled -- where exercise is, of course, a big help -- but also making sure other heart disease risk factors like blood pressure and cholesterol are under control before starting strenuous activity, says Dr. Elizabeth A. Stephens, an endocrinologist and medical director of diabetes education for Providence Medical Group in Oregon.

Check blood sugar often.
Blood sugar levels can fall or rise while working out -- and even flux long afterward. If it's too low or high, that can spell trouble. Hypoglycaemia, or low blood sugar, for instance, can cause issues ranging from drowsiness, shakiness and feeling lightheaded to confused thinking and, if not addressed, even more severe problems like seizures. "The challenges related to blood glucose management vary with diabetes type, activity type and presence of diabetes-related complications," the ADA notes. So it's best to discuss with your doctor what's the optimal blood glucose range for you to begin exercising. You should also ask about strategies for keeping blood sugar in that range -- from what you should eat before exercising, to having quick-acting sugar sources like glucose tablets or snacks on hand while exercising.

Stay well hydrated.
For those with diabetes, dehydration can be more common, in part because the body is trying to pee out excess sugar. Water is typically the first -- and best -- choice for hydration before, during and after working out. For athletes with Type 1 diabetes who are exercising for longer than 45 minutes, sports drinks with carbs and electrolytes may prevent low blood sugar, according to a 2017 research review on exercise and Type 1 diabetes published in The Lancet Diabetes & Endocrinology. However, the authors caution that guzzling too many sports drinks can result in high blood sugar, or hyperglycaemia. The review also notes that milk-based drinks with carbs and protein can help with recovery after exercising. Drinking whole milk can help in avoiding hypoglycaemia while not causing excess increases in glucose after a workout.

Make accommodations for diabetes complications.
In some cases, diabetes complications make staying active more challenging. For instance, diabetic neuropathy, or nerve damage, can cause numbness in the legs and feet -- so a person may not initially notice a blister or foot ulcer, notes Michael Riddell, a professor of kinesiology and health science at York University in Toronto, and the lead author of the Lancet review. Nevertheless, clinicians stress that the benefits of activity generally still far outweigh the risks for those with diabetes complications. "But they have to proceed a bit more cautiously, getting screened by the physician, checking the nerves, checking the feet," Riddell says. Similarly, consult a doctor about other complications like retinopathy, a disease of the retina that's sensitive to increases in blood pressure, which may be reason to avoid exercises like heavy lifting.

Forge thoughtfully ahead.
The point of taking a thoughtful, safe approach to exercise with diabetes isn't to stall activity. Rather, experts say, it's quite the opposite: to ensure people with the chronic condition can reach their fitness goals, and realize the profound benefits of improved health, longevity and quality of life. "I think that we all should challenge ourselves a little bit at any age, whether you're 20 with this disease or whether you are 65 or 70," Riddell says. "Exercise should be fun and it can be really fun, and just having diabetes doesn't preclude you from doing the things that you want to do," Stephens adds. "It just takes a little bit more preparation."

To recap, here are ways to safely exercise with diabetes.
-- Know what's recommended.
-- Consult your doctor.
-- Check blood sugar often.
-- Stay well hydrated.
-- Make accommodations for diabetes complications.

https://news.yahoo.com/diabetes-exercise-tips-stay-safe-while-being-active-152656921.html?guccounter=1&guce_referrer=aHR0cHM6Ly93d3cuZ29vZ2xlLmNvbS8&guce_referrer_sig=AQAAAD3fTa84uN5WCf0qZ2KnfASsMlcb5PM3i-W8XdRUdyDjuYwNX-E6hADrUeQ-wMXdcjwl5FSdlLpAApfoa5XOIp3NrvdiSQS9pXFzjWRtllssQLc0XtNWnRLQRwRULP_J4x2JNc73e_4rhtEwFhbDDLPhmNmu4z6ZU9-3gp7i5mnq

Prediabetes Doesn’t Have to Turn Into Diabetes: Here’s How to Make Sure It Doesn’t

From healthline.com

A new study concludes that a majority of prediabetes cases don’t eventually develop into type 2 diabetes.

Millions of people in the United States have prediabetes, but most of them don’t know they have the condition.

A diet high in fibre, grains, and vegetables as well as a regular exercise routine can help reverse a prediabetes diagnosis.

Being diagnosed with "prediabetes” makes it sound like you’re just one slippery step away from developing type 2 diabetes.
That’s true in some cases but not the majority, a new study finds.
People who have prediabetes are much more likely to return to normal blood sugar levels than to develop diabetes, according to researchers from the Aging Research Centre at the Karolinska Institute in Stockholm, Sweden.

Ying Shang, a PhD student and the lead study author, along with her colleagues, studied 918 participants in the Swedish National Study on Aging and Care.
All participants, who were ages 60 and older, had been diagnosed with prediabetes, meaning their blood sugar was between 100 and 125 milligrams per decilitre. (Blood sugar under 100 is considered normal, or “normoglycemia,” while blood sugar over 125 is considered diabetic.)

Researchers tracked the study group for 12 years and found that while 13 percent of the participants developed diabetes during the study period, 22 percent reverted to normoglycemia.
“During a 12‐year follow-up, most of older adults with prediabetes remained stable or reverted to normoglycaemia, whereas only one-third developed diabetes or died,” the researched concluded.

The study found that having lower systolic blood pressure, no heart disease, and manageable weight was associated with reverting to normal blood sugar levels, “suggesting possible strategies for achieving normoglycaemia in older adults with prediabetes,” according to the researchers.
Physical activity also reduced the mortality rate related to prediabetes.

Steps you can take

Jocelyn Nadua, a registered practical nurse and care coordinator at C-Care Health Services, a Toronto-based agency providing home healthcare and nursing services, told Healthline that a diet high in fibre and rich in whole grains and vegetables is essential for preventing diabetes.
“A person with prediabetes has high blood sugar levels, so they should limit their sugar intake as much as possible in order to control the levels and further prevent the risk of diabetes,” she said.
“When choosing foods, consider opting for ones with a lower glycaemic index (GI) of 55 or less.” (Information on how foods rank on the GI scale can be found at the websites of the American Diabetes Association and Diabetes Canada, Nadua notes.)

Reducing intake of carbohydrates — foods such as bread and pasta — is particularly effective in cutting blood sugar, said Erin Pitkethly, a pharmacist and nutritionist with the Robinsong Health Low Carb Clinic.
“Type 2 diabetes is essentially the body not properly coping with carbs,” she told Healthline. “Some individuals who are consuming a very high amount of carbs will be able to reverse their prediabetes by simply cutting back to what would simply be considered a healthy diet, such as a Mediterranean diet.”
She added, “For example, someone who drinks several cans of soda daily and consumes a lot of sugar and high-carb processed foods — candy bars, cookies, potato chips — may be able to reverse their prediabetes by simply cutting these out.”

“Cutting out processed foods is key for everyone,” added Pitkethly. “Others may want to or need to adopt a slightly stricter low-carb approach, limiting their intake of starches such as potatoes, rice, and bread, and processed foods with hidden sugars, such as many yogurts and almost all granola bars.”
The findings of the Swedish study suggest that the term “prediabetes” may be somewhat misleading, according to Bidaisee.
“Pre-something means that it’s a precursor, so there’s that assumption [that the condition will lead to diabetes],” he said.
On the other hand, he notes, people diagnosed with prediabetes can’t be complacent even if they are among the 22 percent who successfully revert to normoglycemia.
“Don’t think that prediabetes reversal is a cure,” he said. “It needs to be maintained.”

https://www.healthline.com/health-news/how-to-prevent-prediabetes-from-becoming-diabetes#Steps-you-can-take

Type 2 diabetes: Four simple ways to control the condition - are you aware of this?

From express.co.uk

TYPE 2 diabetes is a common condition in the UK. It requires daily monitoring and a number of lifestyle tweaks to keep problems at bay. Here are four simple ways to keep on top of it.

The key is to control blood sugar levels. If blood sugar levels are too high over a long period, it can cause a host of serious health problems such as heart disease and strokes. According to Dr Oz, with these four simple changes, you can start to see improvements in your blood sugar right away:

1. Hydrate properly
One of the first changes to make is to look at what you are drinking throughout the day. This includes avoiding sodas and fruit juices and taking a close look at what you put in your coffee, which can all be hidden sources of sugar and extra calories. These extra calories can contribute to obesity, a major risk factor for diabetes. Try to replace your sweetened beverages with healthier options. While water is always the number-one choice, you can also switch to flavoured seltzer water, unsweetened almond milk, or herbal teas.

2. Make a move
There’s no need to run a marathon or hit the gym every day of the week. Slight improvements in your daily movement can start to improve blood sugar right away. Start with small, realistic changes, like taking 10 to 15 minute walks after one or two meals each day. Physical activity will help you actually burn the calories you are eating, reducing obesity (which is a major risk factor for diabetes).

3. Maintain a healthy weight
We all know that watching what you eat is an important part of long-term diabetes management. But studies show that overall weight reduction, independent of dieting, is also beneficial for those with diabetes. What this means is that you don’t need to completely retrain your palette and decide which exact diet to follow right away. As long as you just start eating a little less every day and do anything else that might also help you lose some extra weight, your diabetes will be better controlled.

4. Ask questions
The key to making health improvements is to know where you are beginning. Ask your healthcare team questions to gain a clear understanding of your type 2 diabetes situation. Learn the answers to questions such as:

How was I diagnosed?
What is my goal blood sugar range?
Why was I prescribed this medication?
What do I need to know about how food affects my blood sugar?

Type 2 diabetes: Four simple ways to keep blood sugar under control (Image: Getty Images )

Testing your blood glucose levels is also regarded as being very beneficial for helping to make diet and medication dosing decisions, according to Diabetes.co.uk.
Blood glucose testing is the process used to measure the concentration of glucose in a person’s blood. Blood glucose testing can be carried out at home using a blood glucose meter.
“A blood test involves pricking your finger with a small needle called a lancet, drawing a drop of blood from the finger and applying it to a test strip that has been engaged into a blood glucose meter,” said the health body.
According to the health site, blood glucose testing can help to control diabetes in a number of ways:

• Informing food choices and portion quantities
• Assisting medication dosing decisions
• Identifying periods of high or low blood glucose levels

In turn, this can lead to:

• A reduction in HbA1c (improved long-term glycaemic control)
• A lower risk of serious diabetic complications
• Reduced depressive symptoms
• Improved confidence in self-management of diabetes

The NHS also recommends going for check-ups to make sure your condition doesn't lead to other health problems. If neglected, the condition can lead to the following:

• Heart disease and stroke
• Loss of feeling and pain (nerve damage) – causing problems with sex
• Foot problems – like sores and infections
• Vision loss and blindness
• Miscarriage and stillbirth
• Problems with your kidneys 

Once a year it recommends getting checked if you've lost any feeling in your feet, and for ulcers and infections.
It is also worthwhile getting your eyes tested once a year to check for damage to blood vessels, and getting checked for blood pressure, heart and kidney disease, the health body said.
“This can be done by your GP or diabetes nurse,” it added.

https://www.express.co.uk/life-style/health/1151797/type-2-diabetes-symptoms-what-it-is-diet-uk-signs

Still Think of Chocolate As Health Food?

By Joan Kent

This isn't exactly news because it came to light several years ago, but chocolate isn't the health food it was proclaimed to be, say, 5 or so years ago.
Yet people still seem to think it is - so they eat it and tell themselves it's good for them.
Why they do that? Well, they like it; it's easy to like.
Chocolate also feels like an easy answer to various problems because it's a mood changer. The mood-changing chemicals include theobromine (similar to caffeine) and phenylethylamine (likened to the feeling of being in love). It also triggers endorphins (beta-endorphin) and serotonin, two brain chemicals associated with mood.

Were You Caught in the Chocolate Trap?
I was not, and here's why.
Chocolate - even 70-plus percent dark chocolate - contains sugar, and I'm fiercely anti-sugar. In fact, I've been anti-sugar for well over 25 years, long before anyone was talking about its negative effects on health or its addictive properties.
A few clients have called me The Sugar Nazi. What can I say? I wear the label proudly.
When health gurus were pushing chocolate, I was against it because I was certain the drawbacks of the sugar in chocolate would override any benefits we were then hearing about cacao itself.

What the Chocolate Story Turned Out to Be
Basically, it's an unsurprising story. Chocolate manufacturers and the cocoa industry funded scientific studies to "prove" the benefits of chocolate. One company, Mars, maker of Snickers, M&Ms, Milky Way and many other candies, actually funded hundreds of such studies.
It doesn't feel worth it to me to hash through the alleged benefits of chocolate, but here's a partial list. It was said to lower blood pressure and cholesterol, enhance weight loss, decrease risk of diabetes, stroke, atrial fibrillation and heart failure, as well as alleviate immune disorders.

Gee, will it make my brown eyes blue, too?

Claims like these keep springing up even in current articles - and are still affecting the eating behaviours of my colleagues in the fitness industry.
My recommendation is to forgo chocolate because of the sugar. If you must consume cocoa or cacao, make sure it's unsweetened. Problems with sugar affect health, appetite, food preferences, mood disorders, hormones, brain chemistry, and a lot more.
Sugar's negative effects can't be overstated. Chocolate can't and won't override those.

https://ezinearticles.com/?Still-Think-of-Chocolate-As-Health-Food?&id=10142862

Hiking the Appalachian Trail with Type 1 Diabetes, Afrezza, and Keto Food

From asweetlife.org

We found Mike Joyce in the famous TypeOneGrit Facebook group, where he was advising on the best ways to stay low carb on long wilderness trips. When Mike switched to a low carb diet to help manage his Type 1 diabetes, he lost about 100 pounds and discovered that he had an aptitude for extreme endurance sports. In just a short time, he’ll take on the Appalachian Trail. We talked about his amazing lifestyle changes, his preference for Afrezza insulin, and how to maintain a low carb diet on the trail. 

Can we start at the beginning? When were you diagnosed?
February 2nd, 1996, Groundhog Day. At 9 years old, I began my journey with Type 1 diabetes. Like in the movie with Bill Murray, I kept trying to get things right so that life could go on.
For the most part I did well. My parents were very supportive and gave me every tool they could at the time.

What did your management look like in the past, especially with regard to carbohydrate consumption?
Initially I started with R and NPH twice a day. Carb consumption was a necessity and my life revolved around eating. Since both those insulins were relatively unpredictable, especially NPH, I was eating every 2 hours due to fear of hypoglycemia. No one really knew any better.
In the beginning, it was just carb exchanges with a sliding scale of “fast” acting. This changed to carb counting and ratios with the pump and Humalog. All while eating a “balanced” diet of moderate carb consumption.

When did you make the switch to the Dr. Bernstein approach?
I overheard a couple people talk about the Bernstein diet in the diabetes online community, but I was sceptical and unwilling to part with certain lifestyle choices (I really dove into the craft beer scene after college). Also it was hard to wrap my mind around the idea of nutritional ketosis, after being taught to fear ketones for so long.

                                                                   Before and After

However, I was really blowing up like a balloon, exercise was next to impossible without having to eat calories to treat lows, and I finally got a CGM. Once I could visualize the impact food (and drink) had on my blood sugars, I decided it was time to let go of some of the comfort I was finding in food. I actually started implementing it in 2016.

And what was the result?
My first goal was to get a <7.0% A1C without using a pump. It had taken a lot of work to get down to 6.6% on my “balanced” diet. When I cut the carbs I dropped down to 5.6% almost immediately, without doing much different. So improved blood sugars were the instantaneous reason to stick with what I was doing.
Two years later, my A1C is at 5.0% and I have lost almost 100 pounds. I now have a better relationship with food, seeing it more as fuel than treatment for feeding excess insulin. My ability to focus improved and my overall mood seemed to stabilize. Some could claim this to be the result of ketosis, but I think it was so noticeable because I had spent 20 years on a roller coaster of blood sugars. I finally got off the ride and the turbulence settled.

Can you tell me what your diet looks like? Are you doing the full Dr. Bernstein – very low carb, plenty of protein?
I mostly eat a pretty high protein ketogenic diet. A lot of red meat, chicken, fish and eggs. Veggies like zucchini, cauliflower, broccoli, dark greens, avocados. My fats come from a mix of avocado oil, butter, bacon fat, and animal protein. I often do intermittent fasting (from 8:00pm to noon) and only rarely eat both lunch and dinner unless I’m running or hiking big miles or working out hard.

And I understand you primarily use Afrezza. I find that surprising, as most people pair the high-protein high-fat diet with Regular insulin, the slowest “fast” insulin. But you’re using the very fastest. Can you explain why you prefer Afrezza?

Afrezza’s action curve is the closest available to natural, endogenous insulin. The onset of action is incredibly quick, and its tail is so short that I don’t have to worry about stacking or calculating insulin on board.
Typically I dose Afrezza “as-actually-needed” not “as-predicted-to-need.” Using CGM data, Afrezza allows me to implement Dr. Ponder’s method of Sugar Surfing in real-time.

Can you detail your bolus strategy?
I typically dose soon after eating, watching my CGM and waiting to see the line bend upward. Since the insulin peaks in 15 minutes, the dose usually stops the incline and the line flattens out. Then when the protein starts bending the line up again, I hit it with another dose to flatten it back out. Depending on how much fat slows down my digestion, that can be anywhere between one and four hours after the meal. I just have an alert vibrate my watch as soon as my blood sugar hits 110, and I usually get it back down to 80-100 within the hour.

Fascinating, so you use the Afrezza in a purely reactive manner, giving little boluses as necessary.
With Afrezza, I don’t really count carbs anymore. It works fast so that I don’t have to predict, only react. It frees up my headspace to focus on the things I love like running and hiking and playing soccer. Until I started using Afrezza, I never realized how much of my mental space was taken up by planning and anticipating what might happen with my blood sugar. This is a much smaller part of my management now. I don’t think I can emphasize more how much Afrezza allows me more time to live.

Let’s talk about your big miles. How long are the runs and hikes you go for?
Typically I run about 6-8 miles two or three times a week and then a long run 10-20 miles on the weekend, and I did some 50K trail races locally this winter.
This summer I’ll be hiking the Appalachian Trail. My days will range from 12 to 30 miles depending on how I’m feeling.

How do you find your body responds to this type of heavy cardio on the low-carb diet?
Most runs over 5 miles do require me to eat some carbohydrate for blood sugar maintenance. So, I usually carry a small honey bear in the breast pocket of my running vest. Honey can get into my blood stream quickly, and a little goes a long way.

Does Afrezza offer any unique advantages when you’re exercising?
The lack of tail on Afrezza’s action curve is what makes exercise much easier. I don’t have to consider insulin on board before running 10 miles after work. I know my bolus from lunch, or a correction at 2pm is totally out of my system come 5pm. Previously I struggled with bad lows during exercise.

How the heck do you plan on sticking to a low-carb diet on the Appalachian Trail?
This is the biggest difficulty and my focus currently. I’m buying bulk supplies of freeze dried ingredients and making my own meals.
I’m also going to do protein shakes. I can add a quarter cup of oil to a shake and get some 600 calories in to fuel me through the morning with little need for insulin.
Snacks are fun. With keto becoming so popular over the last few years there are so many new options out there. I’ll also supplement with some almonds, cheese, pepperoni, tuna, and chicken salad from grocery stores along the trail.

I know that at least a handful of people with T1D have thru-hiked the AT. Have you leaned on any of them for advice?
There are quite a few T1Ds that have hiked the AT, and I have talked to some of them. My approach to diabetes is a bit different than theirs when it comes to diet, but overall we shared the fact that insulin needs are cut drastically when out there. There’s the worry of having a hypo snack on you in bear country, how resupplying is extra complicated. There are also people (non-diabetics) who are following keto on the trail so I’ve also been reaching out to them.

How can we follow your progress on the trail?
I’m using Instagram @sweet.hiking and I’ll be blogging for thetrek.co for my thru hike.

https://asweetlife.org/hiking-the-appalachian-trail-with-type-1-diabetes-afrezza-and-keto-food/?utm_source=ASweetLife.org+List&utm_campaign=116057650a-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-116057650a-413392997

Type 2 diabetes: The best source of protein to lower blood sugar

From express.co.uk

TYPE 2 diabetes is a serious condition which causes a person’s blood sugar (glucose) level to become too high, and left untreated, long-term health complications can occur. Diet can play a huge part in lowering blood sugar - in particular eating a certain protein source.

Type 2 diabetes is a condition in the which the body can’t control the amount of glucose in the blood. The body doesn’t respond to insulin (a protein hormone) properly, and may not produce enough. This then causes blood glucose levels to become too high. Someone with type 2 diabetes may experience symptoms such as excessive thirst, needing to pee more and tiredness. Left untreated, the condition can lead to serious complications, including kidney failure, nerve damage and heart disease.

So what can you do prevent the condition and lower blood sugar?
Eating a healthy diet is one way recommended by experts.
You should eat a wide range of foods - including fruit, vegetables and some starchy foods like pasta - and keep sugar, fat and salt to a minimum.
But specific foods have also been shown to have blood sugar lowering properties - one being cod.
Cod, a good source of protein, may help manage or prevent diabetes better than other types of meat.

This was demonstrated in a 2014 study which included data taken from 33,704 Norwegian women over a five year period.

Type 2 diabetes: Cold-water fish like cod could help prevent the condition (Image: GETTY)

The researchers found eating 75 to 100g of cold-water fish, including cod, reduced the risk of developing type 2 diabetes.
Other cold-water fish they found to be effective were saithe, haddock and pollock.
But it was also noted the reduced risk could also have been influenced by other lifestyle factors such as exercise.
Regular exercise has also been found to lower blood sugar.
You should aim to do 2.5 hours of activity a week, which could include fast walking, climbing stories, or doing more strenuous housework or gardening.

Another source of protein which has proven effective at lowering blood sugar is legumes.,
A 2012 study found incorporating legumes into a person’s diet improved glycemic control and lowered the risk of coronary heart disease in people with type 2 diabetes.
Examples of legumes include beans, chickpeas and lentils.
Experts believe their benefits may come from their nutrients - fibre, complex carbohydrates and protein.

https://www.express.co.uk/life-style/health/1150504/type-2-diabetes-diet-food-fish-cod-lower-blood-sugar