Type 2 Diabetes Remission Possible With ‘Achievable’ Weight Loss

From scitechdaily.com
By University of Cambridge

People who achieve weight loss of 10% or more in the first five years following diagnosis with type 2 diabetes have the greatest chance of seeing their disease go into remission, according to a study led by the University of Cambridge.
The findings suggest that it is possible to recover from the disease without intensive lifestyle interventions or extreme calorie restrictions.

Type 2 diabetes affects 400 million people worldwide and increases the risk of heart disease, stroke, blindness, and amputations. While the disease can be managed through a combination of positive lifestyle changes and medication, it is also possible for the high blood glucose levels that define diabetes to return to normal – through significant calorie restriction and weight loss. An intensive low-calorie diet involving a total daily intake of 700 calories (less than one cheeseburger) for 8 weeks has been associated with remission in almost nine out of ten people with recently diagnosed diabetes and in half of people with longstanding disease.

However, there is little evidence to show whether the same effect can be achieved by people undergoing less intensive interventions, which are more feasible and potentially scalable to the wider population. To answer this question, a team led by researchers at the University of Cambridge studied data from the ADDITION-Cambridge trial, a prospective cohort study of 867 people with newly diagnosed diabetes aged 40 and 69 years recruited from general practices in the eastern region.

The research was funded by Wellcome, the Medical Research Council and the National Institute for Health Research.
The researchers found that 257 participants (30%) participants were in remission at five-year follow-up. People who achieved weight loss of 10% or more within the first five years after diagnosis were more than twice as likely to go into remission compared to people who maintained the same weight.
“We’ve known for some time now that it’s possible to send diabetes into remission using fairly drastic measures such as intensive weight loss programs and extreme calorie restriction,” says Dr Hajira Dambha-Miller from the Department of Public Health and Primary Care.

“These interventions can be very challenging to individuals and difficult to achieve. But, our results suggest that it may be possible to get rid of diabetes, for at least five years, with a more modest weight loss of 10%. This will be more motivating and hence more achievable for many people.”
Senior author Professor Simon Griffin of the MRC Epidemiology Unit added: “This reinforces the importance of managing one’s weight, which can be achieved through changes in diet and increasing physical activity. Type 2 diabetes, while a chronic disease, can lead to significant complications, but as our study shows, can be controlled and even reversed.”

In order to clarify the best way to help patients with type 2 diabetes achieve sustained weight loss, the team is currently undertaking a study called GLoW (Glucose Lowering through Weight management). The study compares the current education program offered by the NHS to people after they have been diagnosed, with a program delivered by WW (formerly Weight Watchers®). The team is looking to recruit individuals who have been diagnosed with type 2 diabetes within the last three years, have not attended a structured education program and are able to visit one of our testing centers in Wisbech, Ely or Addenbrooke’s Hospital. Further details can be found at the GLOW Study website.

https://scitechdaily.com/type-2-diabetes-remission-possible-with-achievable-weight-loss/

Type 2 diabetes: Drinking this before bed may help lower blood sugar

From express.co.uk

TYPE 2 diabetes is a serious condition in which the body loses control of the amount of glucose (sugar) in the blood, and left untreated, serious complications can occur. Drinking a certain drink before bed may help keep blood glucose levels in check.

Type 2 diabetes causes the body not to respond to insulin properly - a hormone that helps the body uses glucose for energy - and the body may not produce enough. This causes blood glucose levels to become too high, triggering symptoms such as needing to go to the toilet more often, feeling constantly thirsty, and blurred vision. If type 2 diabetes is left untreated, serious health complications can occur, including kidney failure, nerve damage, heart disease and stroke. So what can be done to keep blood glucose levels in check?

Experts say a healthy diet can help manage blood glucose levels.

There’s nothing you cannot eat, but certain foods should be limited.
The NHS recommends you eat a wide range of foods, including fruit, vegetables and some starchy foods like pasta, and keeping sugar fat and salt to a minimum.
Eating breakfast, lunch and dinner every day is also important, and meals shouldn’t be skipped.
In addition to three meals a day, a recent trend has seen people drink apple cider vinegar before bed - and it’s been shown to help control blood glucose levels.

                                                                     (Image: GETTY)

It’s made my combining apples with yeast to create alcohol, which is then fermented into acetic acid by added bacteria.
Research has suggested consuming apple cider vinegar can slow the emptying of your stomach, preventing large spikes in blood glucose.
It’s also been shown to increase insulin sensitivity which can lower blood sugar.

Drinking apple cider vinegar before meals or before bed may benefit blood glucose levels the most.
One study in people with type 2 diabetes found taking two tablespoons of apple cider vinegar at bedtime for two days reduced fasting blood sugar levels by up to 6 per cent.

Losing weight if you’re overweight can make it easier for the body to lower blood sugar levels, and apple cider vinegar has also been shown to help with this.
In one study, obese adults drank a 500ml beverage with one tablespoon, two tablespoons or no vinegar daily.
After 12 weeks, the vinegar groups weighed significantly less and had less abdominal fat than the control group.
Its weight loss benefits are believed to be related to its acetic acid content, which reduces fat storage, suppresses appetite, slows digestion, increases fat burning and delays the release of hunger hormones.

https://www.express.co.uk/life-style/health/1183804/type-2-diabetes-diet-drink-apple-cider-vinegar-lower-blood-sugar

Why those with diabetes should add nuts to their diets

From wtop.com

A tasty treat in your pantry or on grocery store shelves could be key to lowering your risk for heart disease — especially for people with diabetes, according to a 2019 study.
The study in Circulation Research, an American Heart Association journal, found that people with diabetes who ate at least five small servings of tree nuts a week were 17 percent less likely to develop heart disease. Researchers followed patients from a younger age in their life and followed up with them over time to determine whether they developed heart disease.

The results are very interesting and play into doctors’ understanding of how diet plays a key role in a patient’s risk or avoidance of cardiovascular disease, said Dr. Patrick Bering, a cardiologist at the MedStar Heart & Vascular Institute at MedStar Washington Hospital Centre.

“I think the findings are very exciting and add to our understanding of what constitutes a healthy diet — especially for those patients who have already developed diabetes,” Dr. Bering said.
Nuts can be a great option for anyone to eat because they are “jam-packed with lots of quality nutrients,” Dr. Bering said.
“They have unsaturated fatty acids, they have plant chemicals that are called phytochemicals, they have fibre, certain vitamins including vitamin E and folic acid; they also have important minerals for our body like calcium, potassium and magnesium.” he said.

However, not all nuts are created equal, Dr. Bering pointed out. Tree nuts, like almonds, cashews, hazelnuts, pine nuts, pistachios and walnuts, grow above ground and have more high-quality nutrients that are beneficial. The Mediterranean Diet is an option that incorporates a lot of tree nuts and, as a result, populations who adhere to that diet often have a lower risk for cardiovascular disease, Dr. Bering said.

Tree nuts may do more than just help reduce the risk for heart disease — they can help those with diabetes in other ways, too.
“The minerals, fibres and chemicals are more likely to provide anti-inflammatory effects, and inflammation in diabetes is one of the key driving forces of a lot of the complications in the eyes, in the kidneys, and the vasculature,” Dr. Bering said.

While nuts have many nutritional benefits, it’s important to be aware of portion size and salt content. One serving of nuts is about a third of a cup; if you eat more than that, you could be overeating, Dr. Bering said.
Also, some pre-salted or pre-flavoured nuts are high in sodium. Dr. Bering recommends those with diabetes or kidney or heart disease problems get nuts without salt and add in some unsalted flavouring on their own.

Those with diabetes can take other precautions to reduce heart disease risk as well, such as avoiding ultra-processed foods. Those are the foods that “often have the worst health effects” and contain artificial sweeteners and can lead to adverse cardiovascular health or obesity-related illnesses, Dr. Bering said.

https://wtop.com/medstar-washington/2019/09/why-those-with-diabetes-should-add-nuts-to-their-diets/

Workplaces could be good setting for diabetes prevention

From reuters.com

People in certain occupations have a three-times-higher risk of type 2 diabetes compared to those in other jobs, probably because of lifestyle factors, a nationwide study in Sweden suggests.
Getting these workers to ramp up physical activity could be the first step to preventing the disease, the researchers say.

“The way to target the workplace is by finding employees at the highest risk,” study leader Dr. Sofia Carlsson from the Institute of Environmental Medicine at the Karolinska Institutet in Stockholm told Reuters Health by phone. “We wanted to go through all occupations in the entire Swedish population and see where the risks and prevalence of type 2 diabetes were highest.”

About 7% of Swedish adults, and 4.2% of the working population, have diabetes.
Carlsson’s team used population registries to identify more than 4.5 million Swedish citizens born between 1937 and 1979 who were gainfully employed between 2001 and 2013.
Rates of diabetes varied by profession, from 2.5% to 8.8% in men and from 1.2% to 6.4% in women, the researchers reported at the annual meeting of the European Association for the Study of Diabetes and in the journal Diabetologia.

Among male professional drivers, for example, 8.8% had diabetes, as did 7.8% of manufacturing labourers but only 2.5% of computer scientists. Among women, prevalence was highest in manufacturing workers, at 6.4%, followed by kitchen assistants (5.5%) and cleaners (5.1%). It was lowest among specialist managers, at 1.2%.

Professional drivers, manufacturing workers and cleaners were at the highest risk, and the irregular hours and shifts, stress and sleeping time associated with these occupations could be the cause, Carlsson said.

“We see risk factors early in the working career, and this could be targeted through workplace intervention,” she added.
While association is not the same as causation, the research provides direction for next steps, said Dr. Ronald Tamler, Professor of Medicine, Endocrinology, Diabetes and Bone Disease at the Icahn School of Medicine at Mount Sinai in New York City, who was not involved in the study. “Is there a causative effect in certain occupations and if so, how can we mitigate that?”

Carlsson pointed to attempts in the U.S. to implement diabetes prevention programs at work.
“A randomized clinical trial in the U.S. in the early 2000s showed lifestyle modification counselling reduced the risk of type 2 diabetes by around half,” she said. And it didn’t ask much from the people with diabetes: “A 5% reduction in weight, more physical activity, and a 70-minute brisk walk every day,” Carlsson said.

The findings are significant for the U.S. population, too, where according to the Centres for Disease Control and Prevention, one out of every 10 people has diabetes.
In earlier U.S. studies, professional drivers and shift workers were more likely to have diabetes.
“In the U.S. too, people with lower socioeconomic status, less physical activity, poor access to healthcare and lower health literacy are at greater risk,” Tamler said.

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“Ultimately, diabetes is a massive cost driver in healthcare and a considerable source of absenteeism at work,” Tamler said, adding the current study offers a chance for employers to start preventive programs.

https://www.reuters.com/article/us-health-diabetes/workplaces-could-be-good-setting-for-diabetes-prevention-idUSKBN1WC240

Scientists Identify Potential Way to Prevent Type 1 Diabetes

From virginia.edu

Researchers believe they have identified a way to prevent type 1 diabetes by restoring the immune system’s natural balance. The approach may also prove effective for battling other autoimmune diseases such as lupus and eczema, they hope.

It could also have benefits for people who have already developed diabetes: The researchers believe it could reduce or eliminate the need to take drugs that suppress the immune system after islet transplantation, a promising potential treatment for diabetes that is now being investigated.

The scientists, at the University of Virginia School of Medicine and Vanderbilt University, are seeking partners in the pharmaceutical industry who can make the product they need, a concentrated form of an antibody called human immunoglobulin, or IgM. That’s their next step before they can begin human testing to determine IgM’s effectiveness at preventing diabetes.

Preeti Chhabra, a research scientist in the Cellular Therapeutics and Transplant Core, and transplant surgeon Dr. Kenneth Brayman. (Photo by Dan Addison, University Communications)

“We’re reaching out to current manufacturers of IgM to see if we can work with them to develop products that are very concentrated in it, because it doesn’t work with regular immunoglobulin,” UVA transplant surgeon Dr. Kenneth Brayman explained. “With many immunosuppressive agents, if you give them at the right time, you can prevent the disease. But when you stop the drug, the disease recurs. But it’s different with IgM. IgM is reprogramming the immune system.”

Understanding Diabetes
Brayman began working several years ago with Vanderbilt’s Dr. Daniel Moore to try to understand the role of IgM in the development of diabetes. Their work spurred them to examine whether patients with diabetes were IgM deficient, and those findings have led them to believe that a concentrated dose of IgM may head off the development of the condition.

“The holy grail would be to identify patients at risk using biomarkers or genomics and then intervene in what is called the pre-hypoglycaemic phase of autoimmunity,” Brayman said. “These patients are clinically silent [exhibit no symptoms], in that their glucose is normal until they reach a threshold below which they don’t have enough beta cells to make enough insulin to prevent them from becoming diabetic.”

To understand that process, and find ways to stop it, the research team includes a wide range of expertise, including UVA’s Stephen Rich, a top expert in the genetics of complex human diseases, and Preeti Chhabra, a research scientist in the Cellular Therapeutics and Transplant Core who focuses on diabetes and transplant immunology. The work, part of the Virginia Precision Individualized Medicine for Diabetes (PrIMeD) Project, was inspired by UVA’s Dr. Peter Lobo, an early promoter of IgM and its anti-inflammatory properties.

Regulating the Immune Response
The researchers believe concentrated IgM could also help improve treatment for people who already have developed diabetes by facilitating the transplantation of clumps of pancreatic cells called islets. The islets include the insulin-making beta cells.

“To successfully transplant cells into humans with type 1 diabetes, you have to prevent rejection, and you have to prevent recurrence of autoimmunity,” Brayman explained. “If the IgM can lower or eliminate the amount of conventional immunosuppression that needs to be used, it would be very helpful, because there are people who would love to have islet transplant, but they don’t want to be on long-term immunosuppression.

“So it would change the risk-benefit paradigm for them,” he said. “And then, for other autoimmune diseases, currently the only way to control many of these is with conventional immunosuppression. So if you can give IgM and then the patient is tolerized to their own antigens that are acting as stimulants for the autoimmune process, then hopefully you can make the disease quiescent and prevent a lot of long-term complications.”

Next Steps
The researchers hope to start testing IgM to determine if can prevent diabetes in people within the next couple of years, but the timing will depend on their ability to find a suitable industry partner and then obtain the necessary federal approvals.

https://news.virginia.edu/content/scientists-identify-potential-way-prevent-type-1-diabetes

3 steps to manage your diabetes

From ksat.com/sponsored

Maintain balanced diet, regular physical activity, take time for yourself

This article is sponsored by VasoCorp. 

For people who have diabetes, it's normal to experience a range of emotions. Some days, you may feel sad or unsure of what to do to stay healthy.

It's OK common to feel overwhelmed. We have some tips you should follow to not only stay healthy, but to increase the quality of your life.

Maintain a balanced diet
Starches 
Yes, your body still needs starches as a diabetic, and it's best to select foods with higher fibre percentages such as whole grain cereal, breads, brown rice and quinoa, according to WebMD.
Tip: Choose a baked sweet potato over fries.

Vegetables 
It's hard to get excited about eating your daily portion of veggies, but try to stick to greens such as kale, spinach and arugula. Also, stick to low sodium or unsalted canned vegetables, according to WebMD.
Tip: Choose a kale salad over iceberg lettuce salad, as iceberg lettuce is low in nutrients. 

Fruits
If you have a sweet tooth, aim for fresh fruits and applesauce without added sugar, according to WebMD.
Tip: Choose a fresh fruit plate over canned fruit with heavy syrup. 

Regular physical activity
When it comes to maintaining your overall health and physical activity, you don't have to run a marathon. Stick to physical activities you can enjoy such as walking, riding a bike or swimming. Try to have a daily goal with at least 30 minutes of activity. 

Take time for yourself
After a busy day of work, it can be difficult to find time for yourself. Each day, try to find some "you time" and focus on some relaxing things you love such as gardening, meditating, working on your hobby or listening to music.

https://www.ksat.com/sponsored/3-steps-to-manage-your-diabetes

Early signs of adult type 2 visible in children as young as 8 years old

From diabetestimes.co.uk

Early signs of adulthood type 2 diabetes can be seen in children as young as 8 years old, decades before it is likely to be diagnosed, according to new research.

A team from the University of Bristol analysed genetic information already known to increase the chances of type 2 diabetes in adulthood, together with measures of metabolism across early life.
They found that being more susceptible to adult diabetes affected a child’s levels of high-density lipoprotein (HDL), essential amino acids, and a chronic inflammatory trait measured in the blood. Certain types of HDL lipids were among the earliest features of susceptibility to type 2 diabetes.

Commonly diagnosed
Co-lead researcher Dr Joshua Bell, from the MRC Integrative Epidemiology Unit at the university, said: “It’s remarkable that we can see signs of adult diabetes in the blood from such a young age-this is about 50 years before it’s commonly diagnosed.
“This is not a clinical study; nearly all participants were free of diabetes and most will not go on to develop it. This is about liability to disease and how genetics can tell us something about how the disease develops.”

The study tracked more than 4,000 children and the research team combined genetics with an approach called ‘metabolomics’, which involves measuring many small molecules in a blood sample to try and identify patterns that are unique to type 2 diabetes.
The effects of a genetic risk score (including 162 genetic elements) for adult type 2 diabetes were examined on over 200 metabolic traits measured four times on the same participants-once in childhood (when aged 8 years), twice in adolescence (when aged 16 years and 18 years), and once in young adulthood (when aged 25 years).

"If we want to prevent diabetes, we need to know how it starts. Genetics can help with that, but our aim here is to learn how diabetes develops, not to predict who will and will not develop it"

The study was conducted among young healthy people who were generally free of type 2 diabetes and other chronic diseases to see how early in life the effects of diabetes susceptibility become visible.
In particular, HDL cholesterol was reduced at age 8 before other types of cholesterol including LDL (bad cholesterol) were raised, and inflammatory glycoprotein acetyls and amino acids were elevated by 16 and 18 years old. These differences widened over time.

Dr Bell added: “If we want to prevent diabetes, we need to know how it starts. Genetics can help with that, but our aim here is to learn how diabetes develops, not to predict who will and will not develop it. Other methods may help with prediction but won’t necessarily tell us where to intervene.
“Knowing what early features of type 2 diabetes look like could help us to intervene much earlier to halt progression to full blown diabetes and its complications.”

The results were presented at this year’s European Association for the Study of Diabetes (EASD) Annual Meeting in Barcelona, Spain (16-20 September).

https://diabetestimes.co.uk/early-signs-of-adult-type-2-visible-in-children-as-young-as-8-years-old/

In a first, drone delivers diabetes medicine to remote island

From theweek.com

For people who rely on insulin, it's scary to think about what might happen if they are suddenly unable to pick up their medication.

That's one reason why developers at the National University of Ireland, Galway, designed a special drone that can deliver life-saving medications to people on remote islands. Researchers wanted to ensure that if normal delivery channels are down, due to severe weather or other catastrophic events, supplies could still get to people in need.

The team said this was the first time an autonomous drone has ever flown across the north Atlantic Ocean. The drone went from Galway to the Aran Islands in western Ireland, traveling across roughly 11 miles of water in 15 minutes. During the entire flight, the drone was connected to the internet, and the Irish Aviation Authority's air space regulators were in contact, the Irish Times reports. Marion Broderick is a doctor on the Aran Islands, and she told the Times this technology offers "endless possibilities." Catherine Garcia

https://theweek.com/speedreads/867192/first-drone-delivers-diabetes-medicine-remote-island

Type 2 diabetes: The best diet to follow to help keep blood sugar levels low

From express.co.uk

TYPE 2 diabetes is a condition that requires daily monitoring to ensure blood sugar levels are in check. People living with the condition have to be extra vigilant about what they eat. A certain diet however, has been proven to keep blood sugar levels in control and could even put a diabetic into remission. What is it?

Type 2 diabetes means a person’s pancreas doesn’t produce enough insulin to regulate their blood sugar levels. As a result, people have to completely overhaul their diet to compensate and control their blood sugar levels. Over time, unchecked blood sugar levels can hike the risk of life-threatening complications including heart disease. Medical experts agree that the low-carb diet is the best diet to follow in order to keep blood sugar levels in check.

A German study looked at obese people with poorly controlled type 2 diabetes who were asked to follow a very low-carbohydrate diet which included only eating 20g of carb per day for two months, with no other restrictions on what they could eat.

After the two months they could then increase their carbohydrate intake. In the study they also took liraglutide injections.
After six months not only did the patients body weight fell drastically, their LDL-cholesterol levels dropped too.

The study confirmed that reducing carbohydrates in the diet helps improve diabetes control and body weight and these changes even occur if more fat is taken in the diet instead of carbohydrate.
A low-carb diet will help stave off high blood sugar levels and could even possibly put a diabetic into remission.

The reason why this diet is best suited is because of a type 2 diabetics problem with dealing with sugar in the body.

                           Type 2 diabetes: What is the best diet to follow (Image: Getty Images)

Doctor David Cavan said: “I have witnessed a big outcome in many of my patients since I started recommending carbohydrate restriction a few years ago.
"The effect of changing the diet in this way is far mar dramatic than any medication, including insulin.
"And some people, who had been on insulin for many years to treat their type 2 diabetes, have even been able to come oft altogether.”
A low-carb diet will help stave off high blood sugar levels and could even possibly put a diabetic into remission.

The reason why this diet is best suited is because of a type 2 diabetics problem with dealing with sugar in the body.

Top tips for following the low-carb rule include:
Reduce or eliminate the amount of sugar and high-carb foods which include breakfast cereals, bread, pasta, white potatoes, rice, crackers, biscuits, sweets, and fizzy drinks.
Try to load up every meal with non-starchy and salad vegetables such as kale, lettuce, broccoli, mushrooms, or peppers.
Eat good fats, including oily fish, olive oil, coconut oil, avocado, and animal fats. Also include nuts and cheese in moderation.

     Type 2 diabetes: Doctors advise on loading your plate with vegetables (Image: Getty Images)

Always go for naturally low in sugar fruits such as berries, apples, and pears.
Eat some for of protein in every meal.
Stop snacking between meals.
Before embarking on any new diets it’s important to speak with your GP.

https://www.express.co.uk/life-style/health/1181132/type-2-diabetes-diet-food-low-carb-lower-blood-sugar-injection-remission

4 foods people with type 2 diabetes should definitely include in their diet

From timesnownews.com/health

People with type 2 diabetes need to be extra careful about their diet and include foods that do not spike blood sugar and help in reducing or keeping blood sugar controlled.

New Delhi: Type 2 diabetes is a lifestyle disease that affects millions of people around the world currently. The disease is caused due to poor diet and lifestyle choices we make, due to which the different organs in the body can become resistant to insulin, or the pancreas may not be able to produce enough insulin to break down blood sugar. This can lead to a spike in blood sugar.

If you have been diagnosed with type 2 diabetes, you must know that self-management of the disease is extremely important. Prolonged high blood sugar can cause damage to blood vessels and even organs. For diabetes self-management, a healthy diet is essential. Here are 5 foods that people with type 2 diabetes should include in their diet.

Blueberries

  Picture credits: Getty

Berry is a fruit rich in antioxidants and is recommended for consumption to have a healthy body. For diabetics, it is a good source of energy with fewer carbs, and studies have found that regular consumption of berries can help improve insulin sensitivity. When cells of different organs are more receptive towards insulin, the blood sugar levels will automatically come down, as insulin will help these cells use the blood glucose.
Type 2 diabetes can also directly impact the heart. Berries help to keep the heart healthy and reduce the risk of heart diseases caused due to diabetes.

Chickpeas

                                                           Picture credits: Getty

Chickpeas, lentils, beans, etc are food with a low glycaemic index, which makes them fit for consumption for diabetics. These foods are also fibrous, which reduces the rate at which sugar is released into the blood. High fibre and low GI properties of chickpeas make them a must-have in every diabetic's diet. 

Olive oil

                                                               Picture credits: Getty

Consuming the right, healthy fat is a recommendation for everyone to be healthy. However, the type of fat you eat plays an even more important role if you have diabetes. Diabetes is directly linked with a higher risk of heart attack and stroke and consuming saturated and trans fats can only worsen your heart healthy.
Consumption of heart-healthy food like olive oils can not only help improve heart health and reduce the risk, it also helps in losing weight, leading to a reduced risk of diabetes.

Cinnamon

                                                              Picture credits: Getty

The spices used in our foods have their own set of benefits. While turmeric has antiseptic and anti-inflammatory properties, cinnamon is another super spice which can help improve insulin sensitivity in the body and therefore helps to keep blood sugar controlled. While researchers still try to find out the exact reason why the spice has this effect on the body, in the studies conducted as yet, they have no seen any side effects of its use in reducing blood sugar levels. Sprinkling some in foods like oatmeals, yoghurt, tea, etc can help people who suffer from diabetes.

Disclaimer: Tips and suggestions mentioned in the article are for general information purpose only and should not be construed as professional medical advice. Always consult your doctor or a dietician before starting any fitness programme or making any changes to your diet.

https://www.timesnownews.com/health/article/4-foods-people-with-type-2-diabetes-should-definitely-include-in-their-diet/493140

These diets helped women with diabetes cut heart attack, stroke risk

From medicalxpress.com/news

Eating patterns similar to the Mediterranean diet and the blood pressure-lowering DASH may help older women with Type 2 diabetes ward off heart attacks, strokes and related problems, new research suggests.
Diabetes afflicts one-quarter of Americans 65 and older. An estimated 68% of these patients will die of heart disease, and 16% will die of stroke.

                                              Credit: Inna Chernish/EyeEm, Getty Images            

The new study focused on data from the Women's Health Initiative, a massive long-term project exploring disease prevention in postmenopausal women. It included more than 5,800 women who developed diabetes as adults but reported no cardiovascular disease at the project's outset. The researchers scored detailed food questionnaires from the women according to how closely their responses fit each of four dietary patterns.

Three patterns – an "alternate" Mediterranean diet, adapted for Western tastes; the Dietary Approach to Stop Hypertension, or DASH; and American Diabetes Association recommendations – all advocate eating more fruit, vegetables, nuts and seeds, legumes, whole grains and some dairy, and less added sugars and red and processed meat. The fourth pattern, a Paleolithic-style diet, emphasizes meat, fruit, nuts, greens and other vegetables, and discourages consumption of grains, dairy, added sugars and alcohol.

The researchers tracked new cardiovascular disease in the women over an average of 12.4 years. About 11% developed heart disease, and more than 6% had a stroke.
Women whose scores were among the highest for the DASH diet were 31% less likely to develop cardiovascular problems than those with the lowest scores, the study found. Those with the highest scores for the ADA guidance and the Mediterranean-style diet had 29% and 23% lower risk, respectively.

The study, published Thursday in the Journal of the American Heart Association, found no link between a high paleo score and a risk that was either lower or higher.
Research is scarce about diet and heart health in people with Type 2 diabetes, said senior study author Andrew Odegaard, because food recommendations for these patients are based largely on information from populations without diabetes.

"These findings support current dietary-related clinical practice recommendations for populations with Type 2 diabetes as being one approach to improve cardiovascular risk," said Odegaard, assistant professor of epidemiology at the University of California, Irvine.
The researchers "do not see any reason why these results would not be applicable to other populations with Type 2 diabetes."

For people in general, diets should include more vegetables, fruits, legumes, nuts, whole grains, lean protein and fish, with less saturated fat, cholesterol and sodium, according to guidelines from the American College of Cardiology and American Heart Association. The guidelines also advise people to minimize trans fats, processed meat, refined carbohydrates and sweetened drinks.

Nurse practitioner Cindy Lamendola, who was not part of the research team, believes the study is a helpful addition to the body of evidence about diet in Type 2 diabetes.
"With all the dietary fads the public is exposed to, findings like those in this study should be reassuring to the public and also an important message to share with postmenopausal women with Type 2 diabetes," said Lamendola, clinical research nurse coordinator at Stanford University in California.

She and Odegaard said ideally, future research would randomly assign people to different diets and follow them for years.

Lamendola, whose research focuses on cardiovascular disease and diabetes, said expanding the number of subjects who are minorities and perhaps including people with conditions like prediabetes also could be revealing.
For people with Type 2 diabetes, Odegaard said key dietary questions relate to the amount and type of carbohydrates – nutrients that patients track closely to control blood sugar.

"The crux of the matter is that nutrition research in humans is hard, messy and difficult to garner funding to carry out," he said. "We'd love to do a rigorous trial of different patterns, including variations on carbohydrate amount and content, in this population."

https://medicalxpress.com/news/2019-09-diets-women-diabetes-heart.html

How much does diabetes cost the National Health Service?

From bbc.co.uk/news

All sorts of headlines have circulated on the spiralling cost of diabetes care. One even suggested it could bankrupt the NHS.

The extent to which the cost can be controlled by better prevention measures or more effective care has become a major policy debate.

So what is the best estimate of the cost? It has been widely asserted the bills for diabetes care swallow up a 10th of the NHS budget.
Total health spending in England in the 2018-19 financial year was £129bn, in Scotland £13bn and about £7bn in Wales.
A 10th of those budgets adds up to big numbers but it has not always been clear how they break down.

Now, a study has attempted to drill into the precise detail of some of the financial data associated with the condition.
Its stark message is "diabetes is the largest contributor to healthcare cost and reduced life expectancy in Europe".

                                                  Diabetes is a big problem for the NHS

The authors, Dr Adrian Heald, of Salford Royal Hospital, and Mike Stedman, of the health consultancy Res Consortium, focus on the cost of hospital care in England, based on admissions and visits to clinics and accident and emergency units.
They conclude in the 2017-18 year a total of £5.5bn was spent on diabetes care, almost 10% of the overall hospital budget. This includes treatment of complications arising from the condition, and out-patient appointments.

How much of the bill is avoidable?

It must be stressed that type 1 diabetes is an autoimmune condition not linked to weight or age and affects about 10% of the diabetes population. The rest have type 2, which can be associated with lifestyle.
And the new report does not consider how much money could be saved if more cases were prevented, for example by better diets.

Instead, the authors look at what they call excess expenditure based on ineffective management of the condition by patients. This accounts for £3bn of the £5.5bn total hospital bill.
Poor control over blood sugar levels, they say, increases the risk of many long-term health problems including kidney disease and blindness.

Hospital treatment costs for diabetics, after adjusting for their older age, are at least twice as much as for those without diabetes.
And more than a third of these increased costs come from urgent and emergency care.

What isn't in the latest study?

It does not include the costs of medication or GP and community care. And indirect effects such as sick leave and the need for unpaid family care were not considered.
Other estimates of the bills associated with diabetes care are sometimes quoted. The charity Diabetes UK uses a figure of £10bn per year for the UK but this has not been updated for a couple of years.
The information and support group Diabetes.co.uk highlights a calculation of £14bn in 2012 for England and Wales. This includes a £1bn assumption for annual drug bills and an estimate for social-care costs.
There has been no calculation yet on the rate of increase of these annual NHS bills.

What about the future?

The Heald and Stedman report provides a baseline that can be tracked in future years at least for the hospital costs.

What is not in doubt is that diabetes prevalence is rising steadily. Numbers living with the condition in the UK have doubled in 20 years to 3.7 million, according to Diabetes UK.
Some are predicting that without policy and major lifestyle changes, that figure will rise to five million by 2025.
Accurate and timely data on diabetes care costs will be all the more essential as health authorities in the nations and regions try to allocate already stretched budgets.
They will also be a vital benchmark to help assess whether government policies to tackle the condition are working.

https://www.bbc.co.uk/news/health-49758070

Looking In Your Eyes Could Predict Diabetes Years Before Development, Study Says

From medicaldaily.com

Doctors may soon look into your eyes to see your risk of having diabetes. Researchers found that eye lens show changes in the body that may predict the disease even years before its development.
The new study, presented at the recent meeting of the European Association for the Study of Diabetes (EASD) in Spain, used a newly developed biomicroscope to observe advanced glycation end-products (AGEs) in the eye. High levels of AGEs can contribute to a number of diseases, including eye nerve damage and neuropathy.

The biomicroscope sends blue light to the eye lens to measure its autofluorescence and inform researchers about the levels of AGEs. Researchers tested the device in a healthy control group and 40 people diagnosed with either prediabetes or type 2 diabetes.
Each participant underwent comprehensive medical and neurological assessments prior to the study. They then took tests with the biomicroscope to measure their lens autofluorescence.

                                                                              Pixabay

Results showed that autofluorescence in the lens of the eye could help predict a person’s diabetes risk. The people with type 2 diabetes and impaired glucose tolerance or prediabetes appeared with significantly high AGE levels in their eyes.
"The results of this preliminary study showed the lens autofluorescence is significantly greater in patients with prediabetes and type 2 diabetes,” Mitra Tavakoli, lead researcher from the University of Exeter Medical School in England, said in a statement. “The level of AGE products were correlated with the levels of blood sugar."

The findings support previous studies that suggested initial signs of diabetes may appear up to ten years before the disease starts to affect the body. Researchers of the latest study said their approach may give earlier detection, which increases the chance of preventing future complications.
"Lens autofluorescence could be a robust marker of long-term diabetes control predicting future complication risks,” Tavakoli said. “This supports the feasibility of non-invasive lens autofluorescence to screen subjects for undiagnosed type 2 diabetes and prediabetes subjects.”

Researchers said the new approach to detecting diabetes earlier may also help reduce complications in people with type 2 diabetes because of timely intervention. However, they noted larger and long-term clinical studies are required to support their initial findings.

https://www.medicaldaily.com/looking-your-eyes-could-predict-diabetes-years-development-study-says-442601

Why Do People with Type 1 Diabetes Develop Insulin Resistance?

From asweetlife.org

Why do people with Type 1 diabetes develop insulin resistance despite seemingly good health overall? It’s an important question. Insulin resistance is associated with a host of negative health outcomes, including heart attack and stroke. If you have Type 1 diabetes, you cannot assume that staying fit and trim – or even maintaining excellent blood sugars – will eliminate the risks.

It has already been established that people with Type 1 diabetes tend to exhibit much higher levels of insulin resistance than expected from typical risk factors (such as age, body fat percentage, blood pressure, exercise rate, etc). There is something about Type 1 diabetes itself, or the way that it is treated, that itself causes insulin resistance independent of all of the usual factors that the general population is asked to look out for. This may be disheartening for those of us with T1D that seem conventionally healthy: we share a major risk factor for heart disease that “cannot be easily identified using standard clinical predictors (including poor glycaemic control).”

A recent study published by the American Diabetes Association represents an attempt to understand why this occurs. The authors isolated two proposed contributors to the phenomenon: hyperglycaemia and iatrogenic hyperinsulinemia.

To study the issue, the researchers matched groups of people with and without T1D with a third group afflicted with MODY2, a non-auto-immune variant of Type 1 diabetes that is typically mild and devoid of serious complications. The MODY2 group experience chronic mild hyperglycaemia but retain all beta cell function and usually require no insulin injections, which allowed the researchers to isolate the effect of hyperglycaemia on insulin resistance in a population that does not experience hyperinsulinemia. All three groups were hooked up to hyperinsulinemic-euglycemicclamps, in which patients are injected continuously with both glucose and insulin until their blood sugar stabilizes. It’s the gold standard for measuring insulin sensitivity.

The results seem fairly definitive. The Type 1’s experienced significant insulin resistance, but the MODY2 group exhibited no more insulin resistance than did the control group.  With no correlation at all between hyperglycaemia and insulin resistance, the researchers were able to attribute the increased insulin resistance of the T1’s to iatrogenic hyperinsulinemia. (Caveats: the study was fairly small, and the authors could not rule out some other, unknown factor.)
In short: injecting insulin makes your tissues insulin resistant.

A careful person with diabetes might reasonably object: ‘but I manage my blood sugars well, and rarely experience hypoglycaemia, so I know that I don’t use excess insulin.’ Unfortunately, that’s not quite the way it works. In a healthy body, insulin secreted by the pancreas is transported to the liver. But subcutaneously injected insulin bypasses the liver and goes straight into peripheral circulation. As a result, insulin users have abnormally high concentrations of insulin outside the liver, and abnormally low concentrations within it, an arrangement that only partially mimics the natural action of insulin in the healthy body. This has been called “suboptimal” by researchers, and it has a variety of complex consequences for the insulin-user’s metabolism.

One such consequence: your insulin injections may also promote inflammation. An earlier article concludes that the heightened levels of insulin associated with “optimal insulin therapy” can be the cause of dangerous inflammation: “The tight glycaemic control in type 1 diabetes may thus increase the risk for atherogenesis [clogged arteries] via inflammation.”

Scientists have proposed several fixes for this, and work continues on improved insulins. The startup Diosome, to take one notable example, is testing an additive that will allow injected insulin to travel directly into the liver. But until new insulins are available, we’re stuck with today’s options.
Blood sugar control remains the critical focus for people with Type 1 diabetes, and it would be extremely dangerous to purposely take less insulin in order to avoid the risk factors discussed in this article. We know conclusively that a lower A1C dramatically decreases the frequency of cardiovascular events and stroke. Insulin resistance is a minor concern for an otherwise healthy person with Type 1 diabetes in comparison to the ravages of chronic hyperglycaemia.

That doesn’t mean that there’s nothing to be done. The conventional advice given to non-diabetics that want to reduce their insulin levels – lose fat, exercise more frequently, put on muscle, and avoid carbohydrates (especially refined carbs) – should also work to decrease the insulin needs of people with Type 1 diabetes. The Pediatrics article analysing the TypeOneGrit Facebook community confirmed that a very low carbohydrate diet can decrease daily insulin requirements, and to us that seems like a good place to start.

https://asweetlife.org/why-do-people-with-type-1-diabetes-develop-insulin-resistance/?utm_source=ASweetLife.org+List&utm_campaign=00330d7fd6-ASweetLife+Weekly+Update++-+Nov.+14%2C+2017_COPY_01&utm_medium=email&utm_term=0_5125b14cf8-00330d7fd6-413392997

Types and rates of co-existing conditions in diabetes are different for men and women

From eurekalert.org

A new study presented at this year's Annual Meeting of the European Association for the Study of Diabetes (EASD) in Barcelona, Spain (16-20 Sept) shows that men and women experience different comorbidities (other diseases at the same time) as having diabetes or prediabetes, as well as an unexpectedly high rate of prediabetes among children aged 6-10 years.

The study, by Dr Alina Ofenheimer, Sigmund Freud University, Medical School, Vienna, Austria and colleagues, analysed the sex and gender differences in the prevalence of co-morbidities in subjects with prediabetes and diabetes, as well as determining the prevalence of prediabetes and diabetes in the study population.

A number of additional disease processes (comorbidities) are known to occur alongside prediabetes and/or diabetes including congestive heart failure, high blood pressure, cardiac arrhythmia (abnormal heart rate), osteoporosis (weaker bones), kidney dysfunction, and even severe anxiety and depression. Gender may affect the incidence of these comorbidities through differences in biology as well as differences in lifestyle and behaviour.

The authors conducted an observational population-based cohort study of 11,014 subjects aged 6 to 80 years who underwent a detailed examination. This included taking blood samples, measuring ankle-brachial index, performing an electrocardiogram (ECG), assessing body composition using a dual energy X-ray absorptiometry (DEXA) scan, and an interviewer-administered questionnaire. Prediabetes and diabetes were defined by one or all of fasting plasma glucose levels (prediabetes: 100-125mg/dl, diabetes: 126mg/dl or higher), glycated haemoglobin (HbA1c) levels (prediabetes: 5.7-<6.5%, diabetes: 6.5% or higher), and/or if the subject was taking glucose-lowering drugs.

The team found that for the study population as a whole, the prevalence of prediabetes was 20.2% (male 23.6%; female 17.1%) and 5.4% for diabetes (male 7.3%; female 3.7%). Prediabetes occurrence varied from 4.4% in male subjects age 6-<10 years, to 40.4% in those aged 70+ years, while in females it ranged from 4.8% to 42.3% in those same age groups.

The authors say: "Angina, heart attack and calcification (hardening) of the arteries were more prevalent in diabetic men than diabetic women, as well as mild anxiety and reduced cognitive processing speed. Similar to the comorbidity profile of prediabetic females, women with diabetes had a higher prevalence of irregular heartbeat (arrhythmia), and elevated signs of systemic inflammation compared with diabetic men. Prediabetic women also showed a higher prevalence of osteoporosis and depression compared with prediabetic men."

They add: "The unexpected 4.6% prevalence of prediabetes in children aged 6-10 underscores the need for population-based studies across all ages and the importance of starting diabetes prevention efforts at a young age, through a healthy lifestyle and diet for all, including children."

https://www.eurekalert.org/pub_releases/2019-09/d-tar091219.php

11 Foods That Diabetics Should Keep Away From.

From thyblackman.com

Living with diabetes can get tricky when it comes to adjusting your food preferences. When watching your blood sugar and insulin levels, there are various foods that you can no longer indulge in. Even if you have been diagnosed with pre-diabetes, it is best that you watch out and take note of the list of foods you should avoid. This is so that you can steer clear of developing health ailments like heart disease, kidney disease, and blindness, among other things. The top of the list will have to be carbohydrates as they have the most impact on your blood sugar. When consumed regularly and in large amounts, carbohydrates will cause a spike in your blood sugar levels which will result in many health complications. However, this is all avoidable as long as you know what foods to avoid. Here are 11 foods that people with diabetes should keep away from.

1. Sugar-Sweetened Beverages

The high carbs content in sugar-sweetened beverages will do a lot of harm to your blood sugar levels as they can lead to insulin resistance and belly fat. Insulin is produced by your body to absorb sugar into your cells but with insulin resistance, sugars like glucose and fructose remain in the bloodstream and cause your blood sugar levels to skyrocket. Not to mention that drinking such beverages can lead to significant weight gain that is detrimental for your condition due to the risk of getting fatty liver. Instead of sugar-sweetened beverages, you can opt for naturally sweetened drinks like fruit-flavoured water the next time you’re craving something sweet.

2. Trans Fats

Trans Fats are unsaturated fats found in most spreads like peanut butter and margarine as well as frozen dinners and baked goods like cakes. They are a more stable form of fat as hydrogen is added to them. One of their main uses is as a food preservative and they can cause inflammation, insulin resistance, and belly fat. Although more countries are banning the use of trans fats in food products, they still exist and it is imperative that you watch out for them on the ingredients list.

3. White Bread, Pasta and Rice

If you have type one or type two diabetes, consuming wheat products like white bread, pasta and rice will lead to higher blood sugar levels and even decreased brain function. This is because they are high in carbs and low in fibre; what this means is that eating these foods will increase your blood sugar levels while the lack of fibre will make it even harder for sugar to be absorbed into your cells. Regardless of that, you don’t have to completely ditch these food items; simply replace them with high-fibre alternatives and you are good to go.

4. Fruit-Flavoured Yogurt

There is a common misconception that yogurt is always a healthier dessert option but this is not true for fruit-flavoured yogurt. Despite the fact that it is low in fats, it is full of sugar and carbs. So, the next time you want to eat yogurt, be sure to purchase plain or whole-milk yogurt; you can still derive all the benefits that yogurt can give you while avoiding all the health detriments that come with sugar and carbs.

5. Sweetened Breakfast Cereals

Grabbing a bowl of cereal before you head out in the morning is the easiest way to get your energy fuel without spending much time. However, if you have the habit of eating sweetened breakfast cereals on a daily basis, your blood sugar levels will rise to astronomical levels. This is as they are low in protein and high in carbs. Protein is the nutrient that will give you the fuel you’ll need every day so look for breakfast options that are high in protein for a hearty and healthy meal.

6. Flavoured Coffee Drinks

Don’t worry, you don’t have to give up caffeine just to stay healthy. In fact, coffee is one of the best beverages that you should consume if you are diabetic but this is with the exception of flavoured ones. Sweetened coffee is loaded with carbs and calories so while it will keep you awake, it will also make you gain more weight. Keep it simple with plain coffee and your blood sugar levels will thank you for it in the long run.

7. Honey, Agave Nectar and Maple Syrup

Besides the usual white and table sugar that you should steer clear from, there is an array of other sweeteners and syrups that are equally bad for you. It is best to avoid sweet delights at all costs but they are not the only culprit as there is also brown sugar, honey, agave nectar and maple syrup which contain just as many carbs. Consuming these forms of sugar not only affects people with type one and two diabetes but people but prediabetes as well; even taking small amounts will go a long way in hiking up your blood sugar levels.

8. Dried Fruit

They may be easier to carry around and eat as a midday snack, but they definitely do not have the same health benefits that fresh fruit does. While you shouldn’t avoid fruit altogether as low-sugar ones like fresh berries are still beneficial for your health, keep dried fruit at bay. Sugar content becomes more concentrated and carb content increases when the fruit is dried; making it relatively unhealthy and damaging to your health.

9. Packaged Snack Foods

Snacks that boast of being the healthier choice may be true for non-diabetics but their high carb count makes them a bad choice for diabetics. Made with refined flour and providing extremely little nutrients, snacks like saltine crackers, pretzels, and graham crackers are not a good snack option between meals; avoid them and choose a low-carb salad or nuts and berries instead.

10. Fruit Juice

You will probably be surprised to know that fruit juice, even unsweetened ones, can contain more sugar than sweetened beverages like soda. Rich in fructose, fruit juice can cause insulin resistance, obesity and heart disease so replace them with plain water and mint or lemon for an equally refreshing taste.

11. French Fries

Potatoes alone are loaded with carbs and the process of making french fries result in high amounts of Advanced glycation end-product (AGEs) and aldehydes which will lead to inflammation and put you at risk of developing various diseases.

Nothing beats keeping yourself healthy, especially when you have diabetes. There are steps you can take to maintain your blood sugar levels and food plays a big part. It might be difficult at first but we guarantee that making some sacrifices in your diet will be rewarding in the long run.

https://thyblackman.com/2019/09/14/11-foods-that-diabetics-should-keep-away-from/

Rates of type 2 diabetes seem to be dropping, but does that really mean we're healthier?

From medicalxpress.com/news

Prevention strategies could be contributing to a recent fall in the number of people developing type 2 diabetes in some high income countries, suggests a review of the evidence published by the BMJ today.
The findings show that after 2005 many populations started to see a decline in the number of people developing diabetes, prompting the researchers to suggest that we may be starting to benefit from type 2 diabetes prevention activities.
But they warn that there is limited evidence from low and middle income countries, where trends in diabetes incidence might be different.

                                                          Credit: CC0 Public Domain     

Monitoring of the global diabetes epidemic has mainly focused on diabetes prevalence (number of people living with the condition), which continues to rise. However, this is partly driven by improved treatment and better survival.
In contrast, studies on diabetes incidence (number of newly diagnosed cases) are scarce. Among those that do exist, some report a fall or stabilization of new cases, but results remain inconsistent.
So a research team led by Dianna Magliano at the Baker Heart and Diabetes Institute in Melbourne, Australia set out to review the evidence on diabetes incidence trends over time.

Their findings are based on published data on the incidence of type 2 diabetes in more than 100 populations in mostly high income countries over five different time periods from 1970-2014.
After taking account of differences in study design and quality, the researchers show that the number of people developing diabetes increased consistently until 2005 (with a peak between 1990 and 1999) but the number of new cases has been generally stable or falling since then.       

For example, from 1990 to 2005, diabetes incidence increased in two-thirds (67%) of populations, was stable in 31% and decreased in 2%. But from 2006 to 2014, increasing trends were reported in only a third (33%) of populations, whereas 30% and 36% had stable or declining incidence, respectively.
Countries that showed recent stable or decreasing trends were mainly from Europe and East Asia. However, the researchers say they lacked data from many low and middle income countries, where large increases in incidence could still be occurring.

They also outline some limitations, such as being unable to analyse different sex and age groups separately, and variations in diagnostic criteria for diabetes. Nevertheless their results were largely unchanged after further analysis, suggesting that the findings withstand scrutiny.
As such, they suggest that preventive strategies and public health education and awareness campaigns "could have contributed to this flattening of rates, suggesting that worldwide efforts to curb the diabetes epidemic over the past decade might have been effective."
Researchers in a linked editorial are cautiously optimistic.

Louise McCombie at the University of Glasgow and colleagues point out that falling or stalling rates "can be deceptive" and that "several potentially confounding factors could further complicate interpretation of the reported trends."
What's more, they say social and financial factors "can influence the likelihood that new people with diabetes are identified."
"While we all long for signs that diabetes is in retreat, this sensibly optimistic systematic review does not provide definitive evidence that true incidence is finally falling," they conclude.

https://medicalxpress.com/news/2019-09-diabetes-healthier.html

Brexit and Diabetes – how could a no-deal Brexit affect people with diabetes?

From blogs.diabetes.org.uk

If you’re living with or affected by diabetes, we know you might be worried about how Brexit might affect things like your diabetes medicines, in particular insulin. 
In this blog, we cover the potential impact of a no-deal Brexit, what’s happening across England, Scotland, Wales and Northern Ireland, and how here at Diabetes UK we’re getting your voice heard.  
We will keep updating you as events develop in the next two months. But we want to hear from you – use our online form to ask us more questions.

What has Diabetes UK been doing?

Earlier this year, following a series of letters and public statements, along with JDRF, we had a meeting with senior officials with expertise in logistics and supplies of medicines and consumables at the Department of Health and Social Care and NHS England.
Recently we have been raising your concerns directly with officials in various meetings. Most recently, we attended a meeting with senior officials within DHSC and NHS England with responsibility for ensuring supply of medicines in the event of a no-deal Brexit continuation of supply of medicines.

At this meeting we were further assured about being prepared for the possibility of a no-deal Brexit, including the supply of insulin.
Following the appointment of the new Prime Minister, we’ve written to seek his assurances on continued, uninterrupted access to insulin in the event of a no-deal Brexit.
We’ve been clear that, alongside assurances to date, the government should continue to make sure that information about progress of its plans is made available to the public.
We will continue to engage with senior officials to ensure we are able to share up-to-date information with you as 31st October approaches.

What have the government said about its plans and preparations?

The UK Government intends to leave the EU on the 31st October 2019. While leaving the EU with a deal remains its priority, they are planning for every eventuality, including ‘no-deal’. But what does this really mean and how might it affect you?
The government has said that the capacity that is available for importing goods will be prioritised, to make sure people have access to the medicines they need.
Recent announcements from the government have outlined that they are preparing by:

.     Putting plans in place that include additional stocks of medicines, strengthening the process and resources used to deal with shortages if they happen,

Securing freight capacity. The Department for Transport are leading a procurement exercise that will set up a framework to access secure additional ‘roll-on, roll-off’ freight capacity. The aim is to support supplier contingency plans to re-route their supply chains away from the Channel short straits. Medicines and medical products will be prioritised on any further capacity gained through this process.

The Department of Health and Social Care (DHSC) is setting up a ‘Dedicated Health Channel’. This will be an express freight service that will be able to bring medicines and medical products into the UK within 24 to 72 hours if needed after 31st October. This is designed to support the uninterrupted supply of medicines and medical products where there is an urgent need or where a suppliers’ own plans are disrupted or delayed. This service will be able to refrigerate products, and so would be able to import insulin in the event of shortages.

Health ministers are regularly attending an EU Exit Operations committee, which discusses operational issues in preparation for Brexit such as continuity of supply of medicines. The DHSC is also centrally coordinating contingency measures to mitigate risks to supply. They say this removes the need for any stockpiling at local level which could cause medicine shortages and put patient care at risk.

Working closely with all suppliers of medicines and devices to ensure uninterrupted supply in the event of a no-deal Brexit.

You can find all of the EU Exit-related publications from the DHSC at GOV.UK

What is the situation in Scotland?

In April, our colleagues in Scotland met with the Principle Pharmaceutical Officer, Prof Alison Strath, and the lead civil servant for provision of medicines and were reassured that contingency plans were in place at that time.  With the fresh focus on the possibility of a no-deal Brexit in recent weeks, Diabetes Scotland has been back in contact with Prof Strath and the Scottish Government to seek an update. The Scottish Government has now established a NHS Scotland Medicines Shortages Response Group to ensure that UK wide plans are carried out effectively in Scotland.
Get more information at gov.scot

What is the situation in Wales?

Diabetes UK Cymru has been working with the Welsh NHS Policy Confederation to raise issues with the Welsh Government as a result of a no-deal Brexit.
We’ve raised concerns about potential post-Brexit scenarios with the ABPI (Association of the British Pharmaceutical Industry) representative in Wales and the Welsh Government’s Cabinet Secretary for Health, Social Care and Sport.

What is the situation in Northern Ireland?

The Department of Health in Northern Ireland has published more information about the EU exit. This includes guidance from the Department, as well as links to letters issued by the department to GPs, pharmacists, opthalmologists and other healthcare professionals.

What impact will there be on insulin supplies specifically?

Earlier this year we wrote to the three main insulin manufacturers – Lilly, Novo Nordisk and Sanofi – to understand what contingencies and additional stocks they planned to have in place. This month we wrote back to them to check the situation again.
All three have confirmed that these are still in place, and the manufacturers tell us they have gone beyond the recommendations made by the government – they are keeping at least 16 weeks of additional stock. People should continue to get prescriptions and use their medicines in the normal way.

What about my diabetes tech?

The government have said they are in contact with key medical technology companies. We are seeking assurances about supplies and stocks of key pieces of technology and diabetes equipment. We have asked the government to clarify that their work includes having regular discussions with all the major companies who provide continuous glucose monitors (CGM), flash glucose monitors (we call it Flash for short), insulin pumps and blood glucose monitoring technology. When we have received a response we will update this blog.

What if I’m travelling out of the UK after Brexit?

The government has said that access to healthcare in EU countries will change if there is a no-deal Brexit, as European Health Insurance Cards may not be valid. Anyone travelling to the EU, EEA or Switzerland should get health insurance to cover this. UK nationals who live in EU countries will also have new arrangements.
The advice may also vary depending on the country – find out more from the NHS website.

https://blogs.diabetes.org.uk/?p=11050&utm_source=bronto&utm_medium=email&utm_term=Read+our+Brexit+blog&utm_content=Read+our+Brexit+blog&utm_campaign=Enewsletter+September+2019

Shorter people are at a greater risk of Type 2 diabetes, study says

From edition.cnn.com

(CNN)Tall people might be at greater risk of developing cancer, but short people aren't off the hook.

Shorter people are at greater risk of developing type 2 diabetes, according to a study published Monday in the journal Diabetologia.

Researchers looked at more than 2,500 middle-aged men and women in Germany from a pool of about 26,000 people. After adjusting for age, lifestyle, education and waist circumference, researchers found that greater height was associated with a lower risk for diabetes.

The team evaluated height by taking into account both sitting height and leg length. The heights ranged from under 5'6" (169.7 cm) to above 5'11" (180.3 cm) for men and under 5'2" (157.8 cm) to above 5'6" (168.1 cm) for women.

It found that, for both men and women, the risk of diabetes was lower by more than 30% for each three inch (10 cm) difference in height.

Part of the association between greater height and a lower risk for diabetes may come from the associations between greater height and lower liver fat content and other diabetic risk factors, like blood lipids, said Matthias Schulze, an author on the study, in an email.

The study also argues that shorter people should be monitored for diabetes and risk factors related to cardiovascular disease. Because liver fat contributes so much to the higher risk in shorter individuals, reducing liver fat may provide a way to reduce the risk of diabetes.

Gail Melkus, associate dean for research in NYU's Rory Meyers College of Nursing and a diabetes researcher, called the study "a piece of the pie" in researching diabetes. Melkus is unaffiliated with the study.

"I think that the conclusions have to be cautiously interpreted because it's a secondary data analysis, meaning they didn't get a group of people and follow them going forward," she told CNN.

She said the study poses an interesting question: Should short stature be another risk factor for screening for type 2 diabetes, along with family history or obesity? More research needs to be done to determine the answer.

Still, she said short people shouldn't automatically think they're destined for diabetes, nor should tall people think they're safe and sound, especially other risk factors apply to them.

"It's not just one risk factor that we need to consider when screening people for any health condition," she said.

https://edition.cnn.com/2019/09/09/health/shorter-people-diabetes-trnd/index.html

Low Carb School Lunch Ideas

From asweetlife.org

We know that school lunch can be a minefield, and it can take some creativity to keep your kid excited (and distracted from the chocolate milk and potato chips otherwise circulating the cafeteria). We’ve surveyed the blogosphere to find the best low carb school lunch ideas, both classic and creative.

The Staples:

Vegetables: There’s little more nutritious than crisp raw veggies. Choose celery, cucumbers, radishes, carrots, bell peppers, cherry tomatoes, snap peas… the list goes on! It’s easy to find recipes for low-carb dips – peanut butter, mayo, cheese, avocado and even yogurt-based – to keep things interesting.

Cheese: It’s the rare child that would turn down a cheese stick or a Babybel. Of course, these simple, individually wrapped cheeses barely scratch the surface of the cheese world, which offers an almost endless variety.

Cured Meats: Ham, bologna, and smoked turkey are already classic kiddo fare. The discerning child might add salamis and dry-cured hams to the list. And how about beef jerky? There are some mild health concerns associated with excessive consumption of cured meats, so a light touch might be best here, but it’s tough to beat the convenience and appeal of these protein sources.

Hardboiled Eggs: What’s else is as wholesome as an egg?

Fruit: A naturally sweet and refreshing highlight, if your T1 kid can tolerate a bit of fruit without a bad glucose spike. Blackberries and raspberries are your best bets: each has only a few net carbs per tiny child-sized handful.

Avocado: A special fruit that deserves its own category. Avocado is high in fibre, high in health fats, and uniquely low in carbs, with a rich texture and mild flavour that kids can’t get enough of.

Nuts (if your school allows them): Dr. Bernstein, in his wisdom, suggests that we avoid nuts because they are too delicious to resist. Luckily, this won’t be an issue for a portion-controlled lunch. Pecans, hazelnuts, macadamia nuts, peanuts, walnuts, almonds: they’re all terrific sources of protein and are packed tight with energy from healthy fats. Just be sparing with cashews and pistachios, which have sneaky big carbohydrate contents.

Some Assembly Required: 

Leftovers: Roasted chicken, grilled salmon, medium-rare steak, boiled sausages: just make a little extra for dinner and you’ve got a no-effort source of healthy protein for tomorrow’s lunch.

Low-carb “Dorito” cheese crisps: Does your ketokid ever get jealous of his friends’ junk food? That’s a problem easily solved with these flavourful and simple cheesy crackers. Taco seasoning transforms sliced cheese into a punchy crispy snack. Recipe from the great Carolyn Ketchum for ASweetlife.

Lettuce wraps: Put an end to the sandwich’s unlawful tyranny over lunch by wrapping your child’s favourite meat, cheese and/or veggies in leafy greens. Adventurous eaters might prefer the Asian Lettuce Wraps at Joy Filled Eats.

Meat wraps: Is the lettuce a tough sell? Use your turkey, ham or bologna as the wrap, rolling up cheese, olives, veggies, dips and securing with toothpicks. Our Paleo Life has some nice ideas.

Low-carb pizza: Introduce your children to the beloved adult ritual of cold pizza with the original Fathead Pizza recipe. Make two pies at night – one for dinner, one for school lunch – and let your kids get in the act, choosing and sprinkling their own toppings.

Mini quiches: Basically little frittatas baked in a muffin tin, the mini quiche uses a healthy base of eggs and accepts whatever added ingredients your little person prefers. Bacon? Cheese? Peppers? Tasteaholics shows how it’s done.

Keto Meatballs: Meatballs are a naturally almost-keto recipe that just need the breadcrumbs removed. Some replace the crumbs with crushed pork rinds, almond flour or even zucchini. Others just up the cheese, like this recipe from Perfect Keto. Either way, you’re set for lunch, and a big batch freezes very well.

Low-carb Baked Goods: Kids will recognize the extra effort you put in to make them a sweet treat. There’s a whole world of excellent low-carb baking out there. Some of our favourite recipes include Snickerdoodle Muffins and Salted Chocolate Peanut Butter Cookies.

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