6 Diabetes Food Myths That Need to Go

From blogs.webmd.com
By Sally Kuzemchak, MS, RD Registered dietitian

When a family member of mine was recently told by a doctor that her blood sugar was high, she did some online research and came to me with questions: Was it true she should give up bananas? Were carrots full of sugar? And could cinnamon really cure for diabetes? (Answers: no, no, and no).

I was used to hearing this kind of misinformation. Early in my career as a dietitian, I counselled patients with diabetes and heard everything from “Clear sodas like Sprite are better for you than colas” to “Bread doesn’t have any carbs if you toast it” (needless to say, both are false!).

If you have pre-diabetes or diabetes--or have a loved one who does--you know that there are a lot of confusing rumors and opinions around eating. I reached out to my dietitian colleagues who work in diabetes to share the biggest myths and misconceptions they hear, so I can help clear up some of the confusion for you.

Myth: “Sugar-free foods don’t raise blood sugar.”
When reading nutrition labels, many people only look at the amount of sugar a product contains. But it’s actually the amount of total carbohydrate that affects your blood sugar. For example, one popular sugar-free chocolate chip cookie has zero grams of sugar but 20 grams of carbohydrates--which means it will still impact your blood sugar.

Myth: “I can’t eat white potatoes, only sweet potatoes.”
They may be different colours and offer different nutrition perks (white potatoes have loads of vitamin C, sweet potatoes are full of vitamin A), but both varieties contain about 24 grams of carbohydrates per cup.

Myth: “Honey is better than table sugar.”
It’s fine to have a flavour preference, but both of these are considered added sugars, and both have roughly the same grams of sugar and carbohydrates per teaspoon (honey actually has slightly more). One possible advantage of honey: It’s sweeter than white sugar, so you might be able to use a bit less of it.

Myth: “Gluten-free products have no carbs.”
Gluten-free foods are designed for people who can’t properly digest the protein gluten, found in wheat, barley, and rye. But that doesn’t mean those foods are carb-free. Gluten-free products like breads and crackers simply use different kinds of starches like potato or rice, so they may have just as many (or even more) carbs that their counterparts.

Myth: “You shouldn’t eat anything white.”
This was meant as a catch-all warning against breads, pastas, and rice (though this advice also discounts foods like cauliflower and onions, which doesn’t make any sense!). But you don’t have to ditch breads and pastas completely--just watch your portions. Ditto for darker-coloured, whole grain versions like brown rice or whole wheat bread.

Myth: “Fruit is full of sugar.”
It’s true that fruit contains a natural form of sugar called fructose that affects blood sugar. So you may need to be mindful of your portions around fruit, like opting for a small banana instead of a large one. But fruit is also loaded with fibre, vitamins, minerals, and disease-fighting compounds, so please don’t nix it from your diet.

https://blogs.webmd.com/food-fitness/20200629/6-diabetes-food-myths-that-need-to-go

COVID-19 and your diabetes risk: Here’s what you should know

From thehealthsite.com

Diabetes and COVID-19 have a two-prong relationship. While people with high blood sugar levels are more prone to catch a severe form of this infection, diabetes can be induced by the novel coronavirus. Read on to know more.

Evidences from around the world suggest that chronic conditions like diabetes and others increase your chance of catching severe COVID-29 infection. High blood sugar levels also increase your mortality risk from this infection, reveals a growing body pf research. A recent study published in the journal Lancet, on the other hand, observed that COVID-19 infection could actually trigger diabetes in otherwise healthy people too. Researchers claim that the novel coronavirus escalates blood sugar levels by attacking cells that produce insulin, the hormone that plays an instrumental role in diabetes. However, this study has not been conducted on humans yet.

Globally, it has been found that people hospitalized for COVID-19 infection are also diagnosed with diabetes. This is a clear sign that people with this infection are either have no insulin or insufficient levels of this hormone.  Additionally, a group of diabetes experts have also shared in a letter to the New England Journal of Medicine on June 12 that there have been quite a few instances where COVID-19 positive patients are experiencing the onset of diabetes.

Covid-19 And High Blood Sugar Levels: The Link

Several studies have shown that the novel coronavirus needs proteins known as ACE-2 to enter the human body. Though our lungs are highly populated with ACE-2, they also reside in other tissues and organs associated with glucose metabolism: Pancreas, the small intestine, the fat tissue, the liver and the kidney. Experts are of the opinion that the novel coronavirus sneaks into these organs imparts glucose metabolism. This is what triggers diabetes or high blood sugar levels. However, more research and data about COVID-19 patients with diabetes are required to reach a conclusive opinion.

One school of thought suggests that the novel coronavirus may not be the cause, but a catalyst to diabetes. The stress it induces on the body depletes your insulin levels, triggering high blood sugar levels. Moreover, the physical trauma associated with the treatment of COVID-19 can also result in stress-induced hyperglycaemia (high blood sugar levels).

Were you suffering from diabetes beforehand?

Some experts suspect that many COVID-19 patients might be suffering from diabetes beforehand. This can be detected with the help of a blood test known as HbA1c. It diagnoses your blood sugar levels for the last three months. Experts also suggest that if diabetes is induced by the novel coronavirus, then chances are that blood sugar levels will resume to normal once COVID-19 infection is cured.

High Blood Sugar Levels Increase Your COVID-19 Death Risk

A research published in the journal Science Advances reports that the risk of dying from COVID-19 infection increases if you have diabetes. It observes that this happens due to the overproduction of immune cells (cytokines) in the lungs, a physiological process known as cytokine storm. This process increases glucose metabolism and affects diabetes patients worse than others because they are likely to be infected by a more severe strain of the novel coronavirus, observe researchers. Cytokine storm results in localised inflammation, which can be fatal.

Diabetes And Other Viruses

A range of viruses has been associated with the onset of type 1 diabetes, an autoimmune condition where your body is unable to secrete insulin, which is essential for blood sugar regulation. Researchers have found that these viruses attack your immune system and trigger autoimmune diseases. According to the findings of a research published in the journal Acta Diabetologica, the SARS virus, a close cousin of the novel coronavirus, led to the onset of diabetes in many people.

https://www.thehealthsite.com/news/covid-19-and-your-diabetes-risk-heres-what-you-should-know-754318/

3D printed insoles offers new hope for patients with diabetes

From eurekalert.org

Scientists from Staffordshire University claim that new 3D printed insoles can significantly improve the foot health of people suffering with diabetes.

This study offers hope for millions of patients with diabetes who are at risk of developing foot ulcers, which in many cases end up in amputation. It presents the first quantitative evidence in support of optimised cushioning in diabetic footwear as part of standard clinical practice.

In their latest paper ['Optimised cushioning in diabetic footwear can significantly enhance their capacity to reduce plantar pressure'] published in Gait and Posture, researchers conclude that selecting the correct cushioning stiffness in footwear can significantly reduce pressures experienced on the feet which can lead to ulcers and other painful complications.

   3D printed insoles can be adapted for individual patients to reduce the risk of foot ulcers.

                                                 Credit: Staffordshire University

In the study carried out in Malta, 15 participants with diabetic foot disease were asked to walk in footwear fitted with made to measure 3D-printed insoles designed by the Centre for Biomechanics and Rehabilitation Technologies (CBRT) at Staffordshire University. These footbeds were used to change the stiffness of the entire sole across a spectrum of very soft to very stiff.

Dr Chatzistergos, Associate Professor at CBRT and the lead author of the study said: "The optimum stiffness is clearly related to the patient's body mass index (BMI). This study adds to our earlier findings and concludes that stiffer materials are needed for people with a higher BMI."

Collaborators Dr Alfred Gatt and Dr Cynthia Formosa from the University of Malta and Visiting Fellows at CBRT provided clinical support for this study and led the experiments in Malta. Dr Gatt noted: "We hope that the results reported within this study will generate interest amongst all professionals managing this debilitating condition."

Further work is now underway to develop a method to help professionals identify the optimum cushioning stiffness on a patient-specific basis. Professor Nachi Chockalingam, Director of CBRT and a co-inventor of the technology said "With numerous patients losing their limbs to diabetic foot disease, our research will help clinicians effectively manage this disease."

https://www.eurekalert.org/pub_releases/2020-06/su-3pi062520.php

Type 1 diabetes: AI could help people manage their condition

From medicalnewstoday.com

Researchers have developed an automated system for people with type 1 diabetes. The AI-based system provides advice to help these individuals avoid dangerously low blood glucose levels

A preliminary study suggests that the system’s weekly recommendations on insulin doses and diet closely match those that diabetes specialists provide.

People with type 1 diabetes produce insufficient insulin, the hormone that the body uses to regulate blood glucose levels.

To maintain optimal glucose levels and avoid episodes of dangerously low or high blood sugar levels — known as hypoglycaemia and hyperglycaemia, respectively — people with this condition must take carefully controlled doses of insulin.

Many people with type 1 diabetes manage their condition successfully using a dosing regimen known as multiple daily injections, which involves injecting a long acting form of insulin once or twice a day, plus fast acting insulin at each mealtime.

In between mealtimes, they also have the option of injecting “correction doses” of fast acting insulin if their blood sugar levels rise too high.

However, repeated dosing errors over time increase a person’s risk of progressive damage to their eyesight, nervous system, and kidneys, and an acute episode of hypoglycaemia can lead to coma or even death.

Too much or too little

Diabetes specialists at Oregon Health & Science University (OHSU) in Portland say that several factors can lead to people giving themselves too much or too little insulin.
These factors include difficulty calculating doses, fears about overdosing, and changes in the body’s insulin sensitivity during exercise, illness, stress, and menstruation.

Endocrinologists (doctors who specialize in hormone disorders) can offer advice on any adjustments that a person needs to make to their dosing regimen and diet, but people may go for several months without an appointment.

To address this problem, researchers at OHSU used artificial intelligence (AI) to develop an algorithm that gives people weekly guidance based on data from a continuous glucose monitor, insulin pens for injecting insulin, and a wearable device that monitors physical activity.
In its final version, the algorithm issues its advice via a smartphone app called DailyDose.

The research appears in the journal Nature Metabolism.

Virtual patients

To train their AI algorithm to issue advice, the researchers used virtual patients — mathematical representations of how a real person’s metabolism responds to food, insulin injections, and exercise.
To check that the resulting algorithm’s recommendations were accurate and safe, they fed it data from 25 real patients who were receiving treatment at OHSU. They then asked a panel of endocrinologists to review the same data and issue their advice.

The researchers report that recommendations from the algorithm tallied with those from the endocrinologists 67.9% of the time.

For comparison, they cite evidence suggesting that endocrinologists fully agree with each other about insulin advice to patients only about 41% of the time.

“Our system design is unique,” says lead author Nichole Tyler, a medical and doctoral student in the OHSU School of Medicine. “We designed the AI algorithm entirely using a mathematical simulator, and yet, when the algorithm was validated on real-world data from people with type 1 diabetes at OHSU, it generated recommendations that were highly similar to recommendations from endocrinologists.”

Based on almost 100 weeks of patient data, the endocrinologists also judged the algorithm’s advice to be safe more than 99% of the time.

Real patients

Confident that their new algorithm was effective and safe, the researchers conducted a small clinical study involving 16 adults with type 1 diabetes.
Once a week for 4 weeks, a doctor reviewed the subjects’ glucose history together with recommendations from the algorithm, before issuing advice on insulin dosing and behavioural changes.

While the trial was too small to provide definitive results, the researchers report a reduction in the number of hypoglycaemic episodes among the participants.

To develop the algorithm, the OHSU Harold Schnitzer Diabetes Health Centre collaborated with the Artificial Intelligence for Medical Systems Lab that Peter Jacobs, Ph.D., associate professor of biomedical engineering in the OHSU School of Medicine, leads.

The clinicians and researchers at OHSU now plan to run several larger clinical trials of their DailyDose app spanning 8 and then 12 weeks.

The team will also compare the app with other insulin treatment strategies, including fully automated insulin delivery.

https://www.medicalnewstoday.com/articles/type-1-diabetes-ai-could-help-people-manage-their-condition#Real-patients

Why Sherri Shepherd says diabetes ‘changed my life for the better’

From yahoo.com/lifestyle

When Sherri Shepherd was diagnosed with diabetes in 2007, it wasn’t out of nowhere. “Prior to that, I was warned many, many times by doctors,” she tells Yahoo Life. “I was something called prediabetic. And prediabetes meant to me, ‘Can I still eat it? Okay, I'm not diabetic, right?’ So I could still eat, you know?”

Shepherd, who is the new co-host of Dish Nation on Fox, says she was regularly warned that her prediabetes could develop into diabetes but “that didn’t mean anything to me.” But, when she was finally diagnosed with diabetes, she says she had a “no nonsense” doctor who made it clear to her how serious her condition was.

“My doctor said, ‘You love wearing those stiletto heels?...Well, you won't be wearing them if you gotta get your foot cut off,’” Shepherd recalls. But Shepherd says the seriousness of her diagnosis still didn’t sink in. After her diagnosis, she says had a “full stack” of buttermilk pancakes. “And I had then went home and made a bowl of pesto pasta, which is my favourite,” she says. “I was sitting on the stairs nodding off because by that time my blood sugar had spiked so high. And I learned that I knew nothing about diabetes.”

Shepherd says that was a wake-up call. “In the African American community, we call [diabetes] ‘the sugar,’” she says. “So it’s nothing that seems deadly.” But Shepherd’s mom died of complications from diabetes, and the disease is common on her mother’s side of the family.

So, she started learning more about the disease and changed her lifestyle. Diabetes is a disease where your blood sugar, aka glucose, is too high, explains the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Blood glucose is your body’s main source of energy. Insulin, which is a hormone made by your pancreas, helps glucose get from the food you eat into the cells in your body, where it can be used for energy. But, when your body doesn’t make enough insulin or any insulin, glucose stays in your blood and doesn’t make it to your cells. Over time, having uncontrolled diabetes and high blood sugar levels can lead to serious complications like heart disease, stroke, nerve damage, and foot problems, the NIDDK says.

Now, Shepherd focuses on eating well.
She lost 40 pounds the year she was diagnosed. Now, even though Shepherd is busy working on Dish Nation, acting, and doing “Two Funny Mamas,” her self-produced podcast with comedian Kym Whitley on Youtube, she strives to eat healthy at every meal. “Having diabetes, you have to plan a little bit,” she says. “I will make my breakfast at night time. I started making oatmeal banana muffins with a little bit of banana, cranberry, raisins, and blueberries. I don’t do processed sugar. The only sugar I get is from fruit.”

For lunch and dinner, she focuses on having vegetables and protein. “I just started putting vegetables on a skewer and grilling them,” she says. “You drizzle those babies with some lemon juice and olive oil.” She’s also big into Brussels sprouts, which she says is a huge departure from how she used to eat. “This is not the girl back in 2007. I never ate vegetables unless it had a lot of cheese with it,” she says.

Dinner for her might include Brussels sprouts with garlic, roasted butternut squash with thyme, and chicken wings. Protein is important, she says, because then “your blood sugar doesn’t spike as high.”
Shepherd says she also educated the craft services crew when she started working on the set of her Netflix show, Mr. Iglesias, asking them to offer up more protein and vegetables.

While she eats well, Shepherd tries to keep her meals fun. “There are so many things that you can do. You just got to liven it up,” she says.

She also exercises regularly.
“Exercise is not an option,” Shepherd says. “I like to check my blood sugar after I work out hard to see the difference in my blood sugar levels. Once I saw that I was like, ‘OK, working out is good for me, it is really, really good for me.’”

Shepherd was so inspired by the change in her health that she wrote the book, Plan D: How to Lose Weight and Beat Diabetes (Even When You Don’t Have It). “I really wanted to write my book because I wanted to educate people,” she says. “So many people get scared so they don’t go into the doctor. Diabetes saved my life. It literally changed my live for the better.”

https://www.yahoo.com/lifestyle/sherri-shepherd-diabetes-145751152.html

Diabetes Diet: Nutritionist Explains How To Choose Diabetes-Friendly Fruits; Here's A List Of Best Fruits

From ndtv.com

Many believe that diabetics should avoid eating fruits. Whereas, it is advised to consume some fruits in moderation. The summer season offers a variety of fruits. Nutritionist explains best fruits for a diabetic.

Diabetics need to maintain healthy blood sugar levels to avoid the complications linked with it. Your diet majorly affects your blood sugars. It is advised to consume foods that can help in maintaining healthy blood sugar levels. Fruits are loaded with essential nutrients but also contain natural sugar.

Many believe that diabetics should avoid eating fruits. Whereas, it is advised to consume some fruits in moderation. The summer season offers a variety of fruits. To understand how to choose the best fruits for diabetics and list of fruits one can consume, we spoke to Priyanka Agarwal who is a nutritionist at Max hospital.

Diabetes diet: Best fruits for diabetes

According to ADA (American Diabetes Association), any fruit is fine to eat for a person with diabetes, as long as the person is not allergic to a particular fruit. But it is important to have fruits according to blood glucose level and potion size of fruits is important.

Nutritionist, Priyanka explains, "For someone with diabetes one way to select safe and suitable fruits is to check Glycaemic Index. Glycaemic Index (GI) is the score indicates how quickly the food item may raise the blood sugar levels. High GI fruits are absorbed faster than medium and low glycaemic index food. Glycaemic Load (GL) takes into account the GI and the amount of available carbohydrate in the portion of food eaten. GL may be a more accurate way of assessing how food affects blood sugar management over time." She further explains a list of diabetes-friendly fruits.

1. Watermelon

GI of watermelon is 72 and the GL is 4 so a person who has diabetes can enjoy the seasonal fruit watermelon. It can help in ensuring proper hydration and is full of antioxidants. It is also rich in vitamins and minerals and contains 14-16% vitamin C daily requirement.

2. Strawberries

The GI of strawberries is 41 and GL is 3. So, a diabetic can enjoy strawberries with lots of other benefits like a good dose of vitamin C which helps to boost immunity. These are also a good source of folate which is important for normal tissue growth. Strawberries are also good for skin health and provide manganese and potassium too.

3. Cherries

Cherries have a GI of 20 and GL is 6. A person with diabetes can easily add cherries to their diet. These are rich in antioxidants and beneficial for heart health. Eating cherries can improve sleep quality as well.

4. Plums

With GI- 40 and GL- 2, a diabetic person can have plums too. Plums are rich in fibre, vitamin C, A and K and minerals like magnesium, phosphorus and calcium. Plums also enhance the functioning of the immune system.

5. Apples

The benefits of apples are quite famous. GI of apple is 39 and GL is 5. It is also a good source of vitamin C and fibre, helps in weight loss, has prebiotic effects and promotes good gut bacteria.
Diabetics should not consume fruits in large quantities. Always take care of the portion size. You may consult your doctor to understand the portion size according to the severity of your condition.

Disclaimer: This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.

https://www.ndtv.com/health/diabetes-diet-nutritionist-explains-how-to-choose-diabetes-friendly-fruits-heres-a-list-of-best-fruits-2250770

Loughborough Professor releases new book highlighting how to beat type 2 diabetes

From lboro.ac.uk

Emeritus Professor Michael Gleeson, Chair in Exercise Biochemistry, has written Beating Type 2 Diabetes, a new book that tells people exactly what they need to do to both reduce the health complications of the condition and how to get rid of it - without the need for medication.

An estimated 10% of the UK population has type 2 diabetes (quite possibly 5 million of us) with many millions more in early-stage pre-diabetes or at high risk of developing it within five years.

Gleeson’s book provides advice and tips about coping with type 2 diabetes and shows us how it can actually be reversed and put into remission.

The book explains the signs and symptoms of type 2 diabetes so we know what to look out for, describes how diagnosis of the condition is confirmed, and how it is treated and managed.

It also helps people to understand the causes and serious health consequences of type 2 diabetes and how people with the condition can reduce their risk of complications.

Essentially, it is a guidebook that will answer all and every question on the disease that a sufferer or their loved ones might have - and of course, tells us how to go about beating it.

At the heart of reversing and curing type 2 diabetes is weight loss and the book also guides on methods of achieving this goal both safely and effectively by adopting a unique personalised weight loss plan that involves multiple diets in combination with enjoyable and exhilarating (but not exhausting) exercise. No one single boring low-carb diet or draining high-intensity exercise programme is needed here.

Professor Gleeson said:
“My aim is to educate the reader about the basic underpinning science and give clear recommendations and advice about how they can cope with their condition.
“I also want to empower and motivate people with type 2 diabetes to modify their current lifestyle for the better and explain how they can get rid of it for good, improve their quality of life and actually live longer.”

Beating Type 2 Diabetes, published by Meyer & Meyer Sport, is available through online retailers and, post-lockdown, through good high street bookstores.

Professor Gleeson has written numerous academic books and papers. Earlier this year he released his first book for the general public - the acclaimed Eat, Move, Sleep, Repeat.
Beating Type 2 Diabetes follows on from that success and later this year, will be joined by The Pick ’n Mix Diet. All three books complement each other in providing expert, fact-based advice on how to make yourself as healthy as you can possibly be.

Further information on Professor Gleeson’s books can be found at www.meyer-meyer-sport.co.uk.

https://www.lboro.ac.uk/news-events/news/2020/june/lboro-professor-releases-new-book-on-diabetes/

Tea and Diabetes: Benefits, Risks, and Types to Try

From healthline.com

There are many tea varieties to choose from, some of which offer unique health benefits.
Certain teas may be particularly beneficial for people with diabetes and help promote blood sugar control, reduce inflammation, and enhance insulin sensitivity — all of which are essential for diabetes management.

This article explains the benefits of tea for people with diabetes, lists the best teas to drink for diabetes control, and explains how to enjoy tea in the healthiest and safest way.

How does tea affect diabetes control?

Consumed by over two-thirds of the global population, tea is one of the most popular beverages in the world.
There are many types of tea, including true teas made from the leaves of the Camellia sinensis plant, which include black, green, and oolong tea, and herbal teas, such as peppermint and chamomile tea.

Both true teas and herbal teas have been associated with a variety of health benefits due to the powerful plant compounds that they contain, and research has shown that some teas have properties that are particularly beneficial for people with diabetes.

Diabetes is a group of conditions characterized by chronically high blood sugar levels resulting from either the inadequate secretion of the blood-sugar-regulating hormone insulin, reduced sensitivity to insulin, or both.

For people with diabetes, tight blood sugar regulation is critical, and choosing foods and beverages that optimize healthy blood sugar control is key.
Opting for calorie-free or very low calorie beverages like unsweetened tea over sugary beverages like soda and sweetened coffee drinks is an excellent way to optimize diabetic control.

Plus, some tea varieties contain plant compounds that fight cellular damage and reduce inflammation and blood sugar levels, making them a great choice for people with diabetes.

What’s more, drinking unsweetened tea can help keep your body hydrated. Staying properly hydrated is essential for every bodily process, including blood sugar regulation.
In fact, research shows that dehydration is associated with high blood sugar levels in people with diabetes, highlighting the importance of regular fluid intake.

Best teas for people with diabetes

Research has shown that certain teas have anti-inflammatory, blood-sugar-lowering, and insulin-sensitizing properties, making them excellent choices for diabetes management.
The following teas are some of the best options for people with diabetes.

Green tea

Green tea offers a multitude of health benefits, some of which are particularly beneficial for those with diabetes. For example, drinking green tea may help reduce cellular damage, decrease inflammation, and optimize blood sugar control.
Some of the compounds in green tea, including epigallocatechin gallate (EGCG), have been shown to stimulate the uptake of glucose into skeletal muscle cells, therefore reducing blood sugar levels.

A review of 17 studies that included 1,133 people with and without diabetes found that green tea intake significantly reduced fasting blood sugar levels and haemoglobin A1c (HbA1c), a marker of long-term blood sugar control.

What’s more, studies show that drinking green tea may help reduce the chances of developing diabetes in the first place.

Note that these studies generally advise drinking 3–4 cups of green tea per day to reap the benefits mentioned above.

Black tea

Black tea contains potent plant compounds, including theaflavins and thearubigins, which have anti-inflammatory, antioxidant, and blood-sugar-lowering properties.

A rodent study suggests that black tea intake interferes with carb absorption by suppressing certain enzymes and may help keep blood sugar levels in check.

A study in 24 people, some of whom had prediabetes, demonstrated that consuming black tea beverages alongside a sugary drink significantly decreased blood sugar levels, compared with a control group.
Another rodent study suggested black tea may also help encourage healthy insulin secretion by protecting the insulin-secreting cells of the pancreas.

Human studies have demonstrated benefits as well, but the mechanism of action is not clear.
As is the case with green tea, studies on black tea generally recommend drinking 3–4 cups per day to reap notable benefits.

Hibiscus tea

Hibiscus tea, also known as sour tea, is a brightly coloured, tart tea made from the petals of the Hibiscus sabdariffa plant.

Hibiscus petals contain a variety of beneficial polyphenol antioxidants, including organic acids and anthocyanins, which give hibiscus tea its bright ruby colour.
Consuming hibiscus tea has been shown to have numerous beneficial effects on health, ranging from lowering blood pressure levels to reducing inflammation.

High blood pressure is common in people with diabetes. In fact, it’s estimated that over 73% of Americans with diabetes also have high blood pressure.

Drinking hibiscus tea may help those with diabetes control their blood pressure levels.

One study in 60 people with diabetes demonstrated that those who drank 8 ounces (240 mL) of hibiscus tea twice a day for 1 month experienced significant reductions in systolic blood pressure (the top number of blood pressure readings), compared with black tea.
Additionally, studies show that hibiscus may help reduce insulin resistance.

Note that hibiscus tea may interact with the blood pressure medication hydrochlorothiazide, a diuretic commonly prescribed for those with high blood pressure.

Cinnamon tea

Cinnamon is a popular spice that has reported antidiabetic properties.
Many people take concentrated cinnamon supplements to help reduce their blood sugar levels, but studies show that sipping on a cup of cinnamon tea may have benefits as well.

A study in 30 adults with normal blood sugar levels demonstrated that drinking 3.5 ounces (100 mL) of cinnamon tea before ingesting a sugar solution led to decreased blood sugar levels, compared with a control group.

Another recent study showed that taking 6 grams of a cinnamon supplement daily for 40 days significantly decreased pre-meal glucose levels in healthy adults.

There are several mechanisms by which cinnamon may help reduce blood sugar levels, including slowing the release of sugar into the bloodstream, enhancing cellular glucose uptake, and promoting insulin sensitivity. 

Nevertheless, a 2013 review found that although cinnamon can significantly benefit fasting blood sugar levels and lipid levels, it doesn’t seem to be effective for controlling average blood sugar or HbA1C.

More human research is needed before strong conclusions on cinnamon’s effect on blood sugar levels can be made.

Turmeric tea

Turmeric is a vibrant orange spice that’s well known for its powerful antioxidant and anti-inflammatory properties. Curcumin, the main active component in turmeric, has been studied for its blood-sugar-lowering properties.

Studies suggest that curcumin may promote healthy blood sugar levels by improving insulin sensitivity and increasing glucose uptake in tissues.

A 2020 review of human and animal studies found that curcumin intake was associated with significantly reduced blood sugar and blood lipid levels.
Plus, the review noted that curcumin intake may help reduce cellular damage, decrease levels of pro-inflammatory compounds, and improve kidney function.

Turmeric tea  can be made at home using turmeric powder or purchased from health food stores.
It should be noted that piperine, a major component of black pepper, significantly increases curcumin bioavailability, so don’t forget to add a sprinkle of black pepper to your turmeric tea for maximum benefits.

Lemon balm tea

Lemon balm is a soothing herb that’s part of the mint family. It has a bright lemony scent and is popularly enjoyed as an herbal tea.

Research suggests that lemon balm essential oils may help stimulate glucose uptake and inhibit glucose synthesis in the body, leading to decreases in blood sugar levels.
A study in 62 people with type 2 diabetes found that taking 700-mg lemon balm extract capsules daily for 12 weeks significantly reduced fasting blood sugar, HbA1c, blood pressure, triglyceride levels, and markers of inflammation, compared with a placebo group.

Although these results are promising, it’s unclear whether drinking lemon balm tea would have the same effect on blood sugar levels.

Chamomile tea

Chamomile tea has been associated with a number of health benefits, including promoting healthy blood sugar regulation.

A study in 64 people with diabetes found that participants who drank 5 ounces (150 mL) of chamomile tea made with 3 grams of chamomile 3 times per day after meals for 8 weeks experienced significant reductions in HbA1c and insulin levels, compared with a control group.

Chamomile tea not only has the potential to optimize blood sugar control but also may help protect against oxidative stress, an imbalance that can lead to diabetes-related complications.
The same study mentioned above found that the participants who drank chamomile tea had significant increases in antioxidant levels, including those of glutathione peroxidase, a major antioxidant that helps combat oxidative stress.

Summary
Green tea, black tea, hibiscus tea, and chamomile tea, as well as cinnamon, turmeric, and lemon balm, have all been shown to have antidiabetic properties and may be smart beverage options for people with diabetes. 

Potential risks related to tea intake for people with diabetes

While a variety of teas may improve health in people with diabetes, it’s important to consume tea in a way that promotes healthy blood sugar regulation.

Many people like to sweeten their tea with sugar or honey to enhance the flavour.
While drinking a lightly sweetened beverage occasionally is unlikely to significantly affect blood sugar levels, choosing unsweetened tea is the best choice for people with diabetes.

This is because added sugar, especially in the form of sweetened beverages, causes blood sugar levels to increase, which can lead to poor blood sugar control over time.

A diet high in added sugar may also lead to other adverse health effects, such as weight gain and increased blood pressure levels.
Drinking unsweetened tea is best for everyone’s health, especially those with altered blood sugar control. If you want to add some flavour to your tea without adding sugar, try a squeeze of lemon or a dash of cinnamon.

Additionally, keep an eye out for added sugars on ingredient and nutrition fact labels when buying pre-bottled tea products.
Another thing to keep in mind when shopping for diabetes-friendly tea is that some herbal teas can interfere with common medications used to treat diabetes.

For example, aloe vera, rooibos, prickly pear, Gymnema sylvestre, and fenugreek are just some of the herbs available in tea form that may interact with common diabetes medications like metformin and glyburide.

Given that many herbs have the potential to interact with various medications, it’s important to talk to your healthcare provider before taking herbal supplements or drinking a new herbal tea.

Summary
Certain teas may interact with diabetes medication, so it’s important to consult your healthcare provider before adding any new teas to your diet. Choose unsweetened teas whenever possible to optimize blood sugar control and protect overall health.

The bottom line

Certain teas contain powerful compounds that may benefit people with diabetes.
Research suggests that green tea, turmeric tea, hibiscus tea, cinnamon tea, lemon balm tea, chamomile tea, and black tea may offer impressive antidiabetic effects, making them good choices for people with diabetes.

However, it’s important to choose unsweetened tea drinks whenever possible and always check with your healthcare provider before introducing a new herbal tea into your diet.

https://www.healthline.com/nutrition/tea-for-diabetics#bottom-line

Why the ketogenic diet can help with diabetes and how to tell if it's right for you

From insider.com

Numerous studies show that the keto diet's approach to limiting carbs can help people with type 2 diabetes reduce their medication and lose weight.

The keto diet reduced blood glucose levels, which helps people with type 2 diabetes control their symptoms.

Before trying the keto diet, know the risks and side effects including fatigue, vitamin deficiencies, and in certain cases, kidney stones.

The keto diet is a high-fat, low-carb eating plan. On the keto diet, you're usually eating around 80% fewer carbs than what national guidelines typically advise.
Research shows that the diet's approach to limiting carbs may help people with type 2 diabetes manage their condition. Here's a closer look at how the keto diet works — and what people with type 2 diabetes should know before giving it a try.

Relationship between type 2 diabetes and carbs

Type 2 diabetes means that the body doesn't respond to insulin like it should. The hormone insulin helps your body utilize blood sugar, or glucose, for energy. For patients with insulin resistance or type 2 diabetes, insulin is still produced — but it may be in insufficient amounts or the body doesn't use insulin properly. This causes blood sugar levels to increase. If not treated, chronically high blood sugar levels can lead to heart disease, kidney damage, nerve damage, eye damage, sleep apnea, and more.

To keep diabetes under control, you want to keep your blood sugar levels as close to normal as possible, says Osama Hamdy, MD, an associate professor at Harvard Medical School and senior staff physician at the Joslin Diabetes Centre in Boston.

"Glucose in blood comes predominantly from carbohydrates, so eating more carbohydrates increases blood glucose and reducing carbohydrates reduces blood glucose."
That's why the carb-cutting keto diet might be helpful for people with type 2 diabetes.

What the research says

As far as research goes, Hamdy says that there haven't been long-term studies on whether the keto diet can actually prevent type 2 diabetes. But there is some research on the diet's effect on those who already have the condition. Although many of the studies have been done on small groups of participants, the results seem promising.

4 months on keto

For example, in a small study published in Nutrition & Metabolism in 2005, overweight adults (mostly men) with type 2 diabetes followed a keto diet, where they aimed to keep carbs at or below 20 grams per day for four months. At the end of the study, participants were able to reduce or completely stop taking their diabetes medications. Moreover, they also experienced a 16% reduction in their A1c levels, which is the average amount of glucose in the blood in the last 3-months.

"Reduction in A1C indicates improvement in diabetes control, which in turn reduces the chances of diabetes complications on eyes, kidneys, nerves and the cardiovascular system," says Handy

6 months on keto

Another study, published in Nutrition & Metabolism in 2008, looked at how overweight adults with type 2 diabetes fared following a keto diet versus a low-cal-low-glycaemic diet for 6 months. (Low-glycaemic refers to foods with a low glycaemic index that are less likely to spike blood sugar levels.) The study found that while both groups did well, results for the keto group were better in certain areas, including the reduction of A1C levels. Plus: 95% of those on a keto diet were able to cut or lower their medication use, compared to 62% in the low-calorie-low glycaemic group.

1 year on keto

A study published in Nutrition & Diabetes in 2017, found that after a year, overweight adults with prediabetes or type 2 diabetes who adhered to a keto diet saw a reduction in their A1C levels and also reduced medication more than those who ate a moderate carb and low-calorie/low-fat diet. Plus, the keto dieters had an average weight loss of 8.3% compared with 3.8% in the low-calorie group. Weight loss can also help keep blood sugar levels in check.

How keto helps with type 2 diabetes

Generally, if you're following the keto diet, you're eating less than 50 grams of carbs per day. Some versions of the diet call for an even smaller amount — around 20 or 30 grams of carbs per day, says Hamdy. For comparison, the Dietary Guidelines for Americans puts the recommended daily carb intake at somewhere between 225 and 325 grams per day.

The Academy of Nutrition and Dietetics describes how the diet works like this: With carbs pretty much out of the picture, the body needs another way to fuel itself. So, it uses fat, which is broken down into ketones — and these ketones become the body's primary energy source. Once that happens, your body enters ketosis. "Ketosis indicates that the body switched its fuel source to stored fat," says Hamdy.

The good news for diabetes? Since blood glucose levels are lower when carb intake is less and ketones don't increase blood glucose levels, diabetes is better kept in control, says Hamdy.
The fact that ketones don't increase blood glucose levels, combined with eating a low-carb diet that also helps keep glucose levels lower, could help explain why research points to the positive effect of the keto diet on type 2 diabetes.

But if you do have type 2 diabetes, your doctor should be monitoring you while you're on the keto diet. That's in part because ketone levels that are too high can be dangerous — changing the degree of blood acidity, and possibly leading to conditions like cardiac arrhythmia, says Hamdy.

Should I try keto if I have type 2 diabetes?

Hamdy says the keto diet isn't harmful for the majority of type 2 diabetes patients. However he also says that "replacing carbohydrates in the diet with any type of fat, like meat or bacon, can result in a significant increase in bad cholesterol." That's why substituting the carbs you're cutting from your diet with healthier proteins and fats, like olive oil, avocados, and nuts, is better than gorging on bacon, steak, and barbecue.

The keto diet also comes with a series of side effects — sometimes referred to as the keto flu — like headache, constipation, and bad breath. Other risks include eventually developing conditions like kidney stones and vitamin deficiencies, according to the Academy of Nutrition and Dietetics. The academy also advises against the diet for people with certain conditions, like eating disorders or those with pancreatic disease, because of the detrimental effect on the pancreas from the high intake of fat.

For his part, Hamdy recommends a modified version of the keto diet for overweight or obese type 2 diabetes patients — one where carb intake is specific to the individual, unhealthy fats — like saturated fat in red meat — is limited, and protein intake, particularly plant-based protein like beans, is higher.

"What most people don't know is that with the keto diet, you are not only losing fat but also losing muscle mass, which is dangerous. The capacity to regain muscle mass again is limited," Hamdy says. "So, replacing carbohydrates with protein instead of fat is a better idea, especially in conjunction with strength training."

In his clinic, Hamdy says that type 2 diabetes patients have had success with weight loss and diabetes control by cutting carbs to 40% of their diet, stick with low-glycaemic index carbohydrates, and increased protein.

"For example, Joslin's Why WAIT program, which implements this structured nutrition plan along with exercise and behavioural changes, helped participating patients with diabetes to maintain a 6.9% weight loss for 10 years. They also cut their medications significantly, and many had partial or complete remission from type 2 diabetes," he says.

If you're suffering from prediabetes or type 2 diabetes, the keto diet may be worth considering. Consult with a doctor before trying any type of extreme diet.

https://www.insider.com/keto-diet-for-diabetics

Should all diabetics be labeled 'high risk' for COVID-19? Maybe not, but it's complicated

From eu.azcentral.com
By Joanna Allhands Arizona Republic

Should diabetics be in the “high risk” group for COVID-19?
The Centres for Disease Control and Prevention says that people over 65, plus those with underlying conditions, such as heart disease, asthma or diabetes, are “at high risk for severe illness from COVID-19.” Reopening guidelines strongly suggest that those in these high-risk groups continue to stay home.

But is that necessarily the case for all diabetics?
It’s tough to say. The research is all over the place.

There's a lot we don't know

That’s understandable. There are still so many things we don’t know about how the novel coronavirus spreads and affects the body – especially the bodies of those with chronic conditions like diabetes, notes Johanna DiStefano, who heads the diabetes and fibrotic disease program at TGen.
COVID-19 hasn’t been around long enough to conduct the massive, peer-reviewed studies we’ll need to help answer these questions. Much of what exists so far relies on relatively small patient samples or focuses on patients in certain settings – such as only those who have been hospitalized.

Not all studies sufficiently exclude other underlying conditions. And few make differentiations between type 1 and the much more common type 2 diabetes, even though they are quite different diseases.

So, why do we think that diabetes elevates the risk of a severe COVID-19 reaction?

Part of it is based on what we already know about diabetes, and about how similar coronaviruses, such as SARS and MERS, have previously impacted diabetics. It stands to reason that if diabetes is a chronic inflammatory condition, and inflammation tends to exacerbate COVID-19, that diabetics would be at risk for more severe illness.

There are dire headlines

There are plenty of dire headlines to this effect. A widely debated British study concluded that type 1 diabetics – whose bodies don’t produce insulin – were more likely to die from COVID-19 than type 2 diabetics, whose bodies make insulin but don’t process it correctly.

While the study noted that age was a larger risk factor for death than either type of diabetes, it renewed calls in that country to force diabetics to self-isolate at home.

Another widely reported French study found that 1 in 10 diabetics with COVID-19 died within a week of being hospitalized. Age and obesity were among the factors that seemed to worsen outcomes.

The study followed whether patients had type 1 or type 2 diabetes but didn’t make conclusions based on these differences because a small sample of type 1 diabetics were hospitalized.

Controlling blood sugar levels is crucial in preventing diabetic retinopathy, because elevated blood sugar levels can damage the blood supply to the retina. Getty Images

But not all diabetics are the same

That leads to a key point.
It’s widely accepted that while diabetics are not more susceptible to COVID-19, they are at higher risk of more serious outcomes once they contract the disease. But the risk for all diabetics may not be the same.
It could vary widely depending on:

• Their age.
• Whether patients are type 1 or type 2, though the differences remain unclear.
• How well they are managing their blood sugar levels.
• Whether they have other underlying conditions, such as heart disease or obesity.

Again, we don’t know this for sure. The research is still catching up. But there are enough studies to suggest these factors could play a part in a diabetic’s reaction to the virus that causes COVID-19.

Think of it this way:
All diabetics likely face a higher risk of severe illness than their non-diabetic peers. But a younger diabetic whose diabetes is well managed and who has no other underlying conditions likely faces a lower risk than an older diabetic with a high A1C level who also has heart disease.

Should I change my routine?

So, what does that mean for the 34.2 million Americans with diabetes (not to mention the millions more who live with a diabetic)?

“It's about minimizing unnecessary contact and exposure,” said Aliria Muñoz Rascón, a clinical associate professor and assistant director of Arizona State University’s Global Health Collaboratory.
At minimum, that means following the CDC guidelines to not touch your face, frequently wash your hands and disinfect surfaces. Get some exercise and frequently monitor your blood sugar and ketones, even more so when you’re ill.

Getting a good night’s sleep and managing stress also are important, because they can impact glucose levels. So are continuing your medications and regularly visiting with your doctor – particularly if you have other underlying conditions. Putting off this care can impact your health and, potentially, put you at higher risk for a severe COVID-19 reaction.

That said, should all diabetics continue to shelter at home, as the White House and CDC reopening guidelines suggest? Or is there some wiggle room for those who are younger, with well managed diabetes and no underlying conditions to return to the office, go to the grocery store or eat at a restaurant?

Possibly. But because of the potential health impacts, these decisions are best made with your doctor.

https://eu.azcentral.com/story/opinion/op-ed/joannaallhands/2020/06/14/should-all-diabetics-labeled-high-risk-coronavirus-maybe-not-complicated/5329558002/

10 Superfoods for Diabetes

From blogs.webmd.com

If you’ve read any health or nutrition headlines the past few years, you’ve likely seen the term “superfoods” used to describe foods that have been shown to provide significant health benefits.

While there is no true definition of a “superfood,” the consensus within the food industry is that these foods are powerhouses for things like vitamins, minerals, healthy fats, enzymes, and antioxidants. If eaten often (and in combination), they can also play a critical role in stabilizing blood glucose, help to ward off other conditions like certain cancers and heart disease, and simply promote overall healthy eating habits.

Here are ten “superfoods” to consider adding into the rotation for your weekly meal plans:

1. Leafy greens
Dark, leafy greens like spinach, kale, and Swiss chard are chock-full of nutrients like vitamin A, vitamin C, and calcium. Some studies have even shown leafy greens to play a role in reducing the risk of type 2 diabetes.

2. Citrus
Citrus fruits like oranges are naturally low-glycaemic and are rich in vitamin C to help boost the immune system. They also contain nutrients like folate and potassium, which have been shown to support healthy blood pressure.

3. Nuts & Seeds
Nuts and seeds are packed full of healthy fats and fibre that help to protect the heart and can help in stabilizing blood sugars. They are also a good source of plant protein. Try adding a handful to your morning oatmeal or pair with a piece of a fruit for a balanced snack.

4. Legumes
Legumes are foods that include things like black, pinto, and garbanzo beans, as well as peas and lentils. They contain an abundance of fibre and plant-based protein that can aid in healthy digestion and stable blood glucose levels.

5. Oatmeal
Another great source of fibre, oatmeal has been shown to boost heart health and help people living with type 2 diabetes hit target A1C levels when eaten regularly. For the healthiest option, choose steel-cut or “old fashioned” oats that don’t contain added sugars. Sweeten yourself with a teaspoon of honey or fresh berries and add a splash of milk, nuts, or seeds for some added protein.

6. Avocados
Eating healthy fat is paramount in promoting heart health, especially for those living with diabetes, as they are at higher risk for developing heart health conditions. The monounsaturated fats found in avocado can help to lower cholesterol, reduce overall inflammation in the body, and promote a healthy blood pressure. They also contain a decent amount of fibre that can keep blood sugars steady.

7. Broccoli
Broccoli, along with other cruciferous veggies, is loaded with antioxidants. They are also an excellent source of fibre and contain certain phytochemicals that may help in preventing certain kinds of cancer.

8. Tomatoes
A key nutrient found in tomatoes is lycopene, which is a powerful antioxidant that boosts heart health and lowers risk for certain types of cancer. Tomatoes are also high in Vitamin C, which has been known to lower elevated blood sugar levels and minimize blood sugar spikes after meals in those with type 2 diabetes.

9. Sweet potatoes
Sweet potatoes are a starchy, root vegetable that are best known for their sweet taste and high levels of fibre, especially when compared to regular potatoes. They also provide a plant-based source of protein, which can help to keep you feel full longer between meals while keeping blood sugars stable.

10. Cherries
A summertime favourite, cherries are low-glycaemic and especially helpful in fighting inflammation. Look for tart cherries, which contain high levels of antioxidants. The best options are usually fresh or frozen since they don’t contain added sugar like many of the canned or dried varieties.

https://blogs.webmd.com/diabetes/20200612/10-superfoods-for-diabetes

Blood Sugar Rise After Eating: Diabetes Questions & Answers

From diabetesselfmanagement.com

Q. I am a 58-year-old woman who has had type 2 diabetes for two years. I am a vegetarian and walk regularly after meals. Last year, my doctor put me on metformin, which lowered my HbA1c (a measure of blood sugar control over the previous two to three months) from 9.4% to 6.4%. Now I have a peculiar problem: My blood sugar is normal an hour after eating but seems to rise to 130 to 140 mg/dl an hour later before coming back down. I have searched the internet for answers and remain mystified. My doctor doesn’t seem concerned, but I was hoping you could shed some light on this.

A. First of all, congrats on getting your HbA1c into a healthy range. Exercise and a nutritious diet remain the cornerstones of diabetes management.

The delayed blood sugar rise you’re seeing two hours after meals could actually be a direct result of your healthy lifestyle. Foods that are rich in fibre and slowly digesting (low-glycaemic-index) carbs, such as legumes, dairy products and fresh vegetables, tend to cause a gradual/delayed rise in blood sugar. Instead of seeing a rapid spike, your blood sugar rises modestly a few hours after you eat.

Exercising right after eating can also contribute to a delayed blood sugar rise. During physical activity, blood flow to the stomach and intestines is reduced. Nutrients, including sugar, absorb into the bloodstream more slowly. The combination of slowly digesting food and physical activity is likely what is pushing your post-meal blood sugar rise back to the two-hour point. As your doctor indicated, since your blood sugar is not peaking excessively high and returns to normal soon afterward, you probably don’t need to worry about it.

https://www.diabetesselfmanagement.com/education/blood-sugar-rise-after-eating-diabetes-questions-answers/

Author Provides Practical Tips for Managing Type 2 Diabetes in New Book

From globenewswire.com

Anne Marie Herman’s memoir, ‘Positive Affirmation - Fear No More,’ reflects upon her experience caring for her brother and what she learned about Type 2 Diabetes

Madison, WI, June 10, 2020 (GLOBE NEWSWIRE) -- Reflecting on her brother’s death and her mother’s insufficient knowledge of a diet’s direct relation to health and wellbeing, Anne Marie Herman’s book, “Positive Affirmation - Fear No More: Memoir” aims to provide the knowledge about diabetes her family lacked when it mattered most. This perspicacious guide for those recently diagnosed with Type 2 Diabetes or families of those that have to face this high-maintenance disease, looks into Herman’s upbringing as the sole caregiver to her brothers and how she had to learn through trial and error how to feed them while nurturing herself as an adolescent forced to embrace adulthood. Herman is an inherent nurturer and felt the need to care for others the way she cared for her family.

Herman hopes to encourage those living with Type 2 Diabetes to live in a healthy way, develop a strong support system to help them, and have a good handle on the small tips and tricks that can make the biggest difference when navigating this condition.

“Learning to care for my brother and feed him was the only way to keep my family healthy and together. I want others who need advice on caring for someone with Diabetes to have the tools to do so,” Herman said. “My brothers told me they preferred my cooking to a restaurant, and it was healthier believe it or not!”

Herman is an inherent nurturer and felt the need to care for others the way she cared for her family. Readers will be eager to read “Positive Affirmation - Fear No More” because of Herman’s comforting, easily understood and informative approach to a disease commonly misunderstood by those most affected.

“Positive Affirmation - Fear No More: Memoir”
By Anne Marie Herman
ISBN: 9781728341248 (softcover); 9781728341255 (hardcover); 9781728341231 (electronic)
Available at the AuthorHouse Online Bookstore, Amazon and Barnes & Noble

https://www.globenewswire.com/news-release/2020/06/10/2046355/0/en/Author-Provides-Practical-Tips-for-Managing-Type-2-Diabetes-in-New-Book.html

Choose high-quality carbs to help prevent diabetes

From thestar.com

Eating high-quality carbohydrates such as whole grains, appears to be associated with a lower risk for type 2 diabetes. according to new research.

Carried out by researchers from Erasmus University Medical Centre in Rotterdam, the Netherlands, and Harvard T.H. Chan School of Public Health in Boston, United States, the new large-scale investigation analysed data from participants taking part in three existing studies, i.e. 69,949 women from the Nurses’ Health Study, 90,239 women from the Nurses’ Health Study 2, and 40,539 men from the Health Professionals Follow-up Study.

The researchers found that when participants replaced calories from saturated fatty acids, monounsaturated fats, polyunsaturated fats, animal protein and vegetable protein with high-quality carbohydrates, they appeared to have a lower risk of type 2 diabetes.

Replacing calories from fats and proteins with high-quality carbohydrates like whole grains appears to help lower one’s risk of types 2 diabetes. — AFP

Replacing low-quality carbohydrates with saturated fats, although not with other nutrients, was also linked with a lower risk of type 2 diabetes.

“High intake of carbohydrates has been suggested to be associated with a higher risk of type 2 diabetes,” said research team leader Dr Kim Braun.
“We looked at whether this effect is different for high-quality carbohydrates and low-quality carbohydrates, which include refined grains, sugary foods and potatoes.”

She added: “These results highlight the importance of distinguishing between carbohydrates from high- and low- quality sources when examining diabetes risk.
“Conducting similar studies in people with various socioeconomic backgrounds, ethnicities and age will provide insight into how applicable these findings are for other groups.”

Dr Braun presented the findings at Nutrition 2020 Live Online, a virtual conference hosted by the American Society for Nutrition on June 1-4 (2020).

The Mayo Clinic explains that whole grains are either present in their whole form or ground into a flour while retaining all parts of the seed (bran, germ and endosperm).
They can be single foods such as brown rice, or used as ingredients such as buckwheat in pancakes or whole-wheat flour in bread.

Compared with other types of grains, whole grains are higher in fibre and other important nutrients such as B vitamins, iron, folate, selenium, potassium and magnesium.

Examples of whole grains include barley, brown rice, buckwheat, bulgur (cracked wheat), millet, oatmeal and whole-wheat bread, pasta, or crackers.

Whole grains are also linked to a lower risk of heart disease, certain cancers and other health problems. – AFP Relaxnews

https://www.thestar.com.my/lifestyle/health/2020/06/08/choose-high-quality-carbs-to-help-prevent-diabetes

What People with Type 2 Diabetes Can Do to Lower Their Risk for Cancer, Dementia

From healthline.com

Researchers in Australia say people with type 2 diabetes have a higher risk for developing cancer as well as dementia.

Experts say excess sugar in the body can lead to microvascular damage that can cause dementia by damaging small blood vessels in the brain.

They add that excess sugar can also help feed the growth of cancer cells.

Experts advise people to eat a healthy diet, exercise regularly, and get plenty of sleep to lower their risk for disease.

People with diabetes already face an increased risk for a number of serious health conditions, including nephropathy, retinopathy, and neuropathy.
Now recent research from Australia has concluded that people with type 2 diabetes are up to three times more likely to develop several types of cancer and 60 percent more likely to develop dementia compared to the general population.

The research from the Baker Heart and Diabetes Institute in Melbourne also highlighted serious concerns: Due to the COVID-19 pandemic, fewer people are visiting their doctors for routine screenings and testing.

Researchers say that means diagnosing diabetes, cancer, and early signs of dementia is less likely.
As a direct result of the COVID-19 pandemic, oncology referrals were down by 30 percent, and diabetes screenings have dropped a third in Australia, researchers reported.
Additionally, both pathology and radiology testing — which play a critical role in diagnosing cancer — have dropped by 70 percent.

The risk of dementia

The researchers from the Baker Institute link dementia and diabetes through microvascular damage, which they say can lead to “many small strokes.”
They say that can pave the way to dementia by way of damage in the small blood vessels in the brain.

Other experts say the connection between these two conditions goes deeper.
“The biggest problem is ‘advanced glycogenated end-products’ and inflammation,” explained Dr. Alex Reeves, a neurologist and former professor of neurology at Dartmouth Medical School in New Hampshire.

Advanced glycogenated end-products (AGEs) are essentially the glucose that accumulates and damages both the blood vessels and nerve endings throughout the body.

AGEs accumulate in the bloodstream and contributes to the overall HbA1c level. That damage is what leads to the development of diabetes complications in the eyes, kidneys, fingers, toes, and other parts of the body.

The more AGEs present in your body, the higher your A1C will be.

AGEs are also present in over-cooked meat - especially meat that’s been grilled, broiled, baked, or fried at high heat.

“People with dementia tend to have very high levels of AGEs and microvascular disease. Very few don’t have both,” Reeves told Healthline. “Though some may have more of one than the other.”
AGEs also go hand-in-hand with inflammation, a major contributor to most chronic diseases, explains Reeves.

“You can actually predict dementia, atherosclerosis, neuropathy, and cancer on the basis of AGE levels. AGEs are made up of protein, glucose, and lipid-glucose, and they are highly inflammatory.
“They are an inevitable part of the aging process and you can’t eliminate them 100 percent, because we all need glucose in our bloodstream. What you can do, though, is reduce this process by lowering blood sugar levels and reducing overall inflammation,” Reeves said.

Anti-inflammatory agents reduce the formation of AGEs, which is why some researchers say reducing inflammation is also directly linked with reducing the risk of diabetes.
Reducing blood sugar levels through healthier lifestyle habits inevitably reduces overall inflammation.

Experts say this is why it’s important to exercise: It helps your body burn up excess sugar in your bloodstream, which in turn reduces the development of AGEs.

Excess sugar and cancer

Excess sugar in the bloodstream can also contribute to the risk of cancer.
There are several theories for the increased risk of cancer in people with diabetes, but one possibility echoed in the latest research from the Baker Institute is that excess sugar in the bloodstream feeds the growth of cancer.

“Cancer cells love sugar, so there is suggestion that increased sugar levels mean there is plenty around for cancer to grow more rapidly,” said Dr. Jonathan Shaw, head of clinical diabetes and population health at the Baker Institute.

In addition to a generally increased risk of cancer, the researchers found that people with diabetes were three times more likely to develop pancreatic cancer and twice as likely to develop liver or endometrial cancer.
The risk of developing bowel cancer was 30 percent higher, and 20 percent higher for breast cancer.

Lowering the risk

Experts say lifestyle habits are one of the most impactful areas of your life that you can focus on to improve your current well-being and protect your future health.
Among the recommended lifestyle habits:

• Eat a diet high in plant-based foods.
• Quit smoking.
• Reduce sugar intake in both food and beverages.
• Exercise daily.
• Limit alcohol consumption.
• Get plenty of sleep.
• Lose weight, if necessary.
• Reduce blood sugar levels.

Reeves also recommends a variety of antioxidant supplements known to reduce AGEs by reducing overall inflammation:

• vitamin c
• turmeric
• fat-soluble B-1
• quercetin
• resveratrol
• alpha-lipoic acid

Shaw also emphasizes the need to continue with your routine care appointments despite COVID-19 concerns.
“If we are not careful, we end up with more of a problem from people letting other things lapse than from the coronavirus itself,” he told Healthline.

This means regular blood tests and other medical check-ups are still a must, even during a pandemic.

https://www.healthline.com/health-news/what-people-with-type-2-diabetes-can-do-to-lower-their-risk-for-cancer-dementia#Lowering-the-risk

Nine Health Checks you Need for Diabetes by Johanna Hicks, Family & Community Health Agent

From frontporchnewstexas.com

Nine Health Checks you Need for Diabetes

               Numbers are a fact of life for people with diabetes – blood glucose levels, grams of carbs, units of insulin.  Those are important, but so are the target numbers for screenings.  Whether type 1 or type 2 diabetes, there is in increased risk of developing a slew of other serious health conditions, including heart, kidney, and eye disease. 

  The American Diabetes Association provides a list of necessary medical screenings and how to make sure you’re in the target zone based on the ADA Standards of Medical Care in Diabetes:

1. A1C:  this is the test that measures your average blood glucose level over the past tow to three months.  An A1C of less than 5.7% is considered normal; 5.7 to 6.4 is considered pre-diabetes; and 6.5 or higher on two tests indicates diabetes.  A high A1C is a sign of frequent high blood glucose and puts you at risk for complications (nerve damage, kidney disease, vision impairment).  A more relaxed goal may be necessary for kids or adults who experience frequent low blood glucose (hypoglycaemia).  Frequency of testing depends on your treatment goals – every six months if you last A1C was in goal range, every three months if medication changes or your last A1C is not in target range.
2. Albumin-to-Creatinine Ratio (ACR): this is a urine test that check how much albumin (a type of protein) is in your urine.  Too much is a sign of kidney damage.  More than 35% of people with diabetes ages 20 and older have chronic kidney disease.  Early treatment can prevent of slow the disease’s progression.  The target number is 30 mg/g of urine creatinine.  The test should be done annually.
3. Ankle-brachial Index: this is a blood pressure reading at your ankle compared to reading from your arm to screen for peripheral artery disease (PAD).  This disease can cause leg pain, weakness, and numbness when walking and can make it more difficult for foot sores to heal.  The target is 0.9 to 1.3.  This test is only needed if you have symptoms of PAD.
4. Bone Mineral Density:  measures density of bones.  People with diabetes are at a higher risk for hip fractures and osteoporosis.  A T-score of -1.o or above is desired.  A T-score between -1.0 and -2.5 indicates low bone density.  If below -2.5, medication for osteoporosis is needed.
5. Blood Pressure: measures force of blood flow in your blood vessels.  Diabetes raises the risk for high blood pressure which increases the risk for heart disease, stroke, vision loss, and kidney disease.  The target is 130/80mmHg if you have heart disease or high risk for it.   Get this checked with every doctor visit.
6. Body Mass Index: measure body fat based on your height and weight.  Added weight increases chances of complications from diabetes.  The target is 18.5 to 24.9.  If you know your height and weight, you can determine your BMI with the calculator found at http://www.cdc.gov.bmi.
7. Dilated Eye Exam: The eye doctor examines your eyes for signs of diabetic eye disease or diabetic retinopathy and other problems, such as glaucoma or cataracts.  Getting this done annually is a good practice.
8. Estimate Glomerular Filtration Rate: Estimates how well your kidneys function.  The target for the eGFR is higher than 60 ml/min/173m²  (normal is 100 to 120 ml/min/173m².  This test is recommended annually for type 2 diabetes or type 1 for at least five years, and twice per year if previous tests showed signs of kidney disease.
9. Cholesterol & Triglycerides: this test measures the waxy substance in your blood and the blood fats in your bloodstream.  High LDL (“lousy” cholesterol) and triglycerides raise chances of developing cardiovascular disease.  Target for cholesterol is less than 100 mg/dl (or under 70 mg/dl if you have heart disease).  HDL (“happy” cholesterol) should be higher that 4o mg/dl for men and 50mg/dl for women.  Triglycerides should be under 150 mg/dl.  Age 40 and under with diabetes should be checked at diagnosis and at least every five years.  If abnormal results, more frequent screenings may be needed.  If taking statin medications, you’ll need testing 4 to 12 weeks after beginning medication.  If numbers look good, repeat annually.

Hopefully this information from the American Diabetes Association helps clear up confusion about different testing. 

http://frontporchnewstexas.com/2020/06/05/nine-health-checks-you-need-for-diabetes-by-johanna-hicks-family-community-health-agent/

Take charge of your diabetes: now more than ever

From 13wham.com/health-matters

In upstate New York, an estimated 440,000 adults live with diabetes and tens of thousands of them jeopardize their health status by failing to take the necessary steps to keep their chronic illness in check.

Diabetes is a serious health condition where the body doesn't produce or properly use insulin to digest sugar (glucose), causing blood sugar levels to rise higher than normal. Without proper management, diabetes can lead to blindness, kidney disease, and non-traumatic lower extremity amputation. It's also a major contributor to heart disease and stroke.

Physicians can help manage diabetes, but patients must be active partners who take charge to improve their overall health. Experts recommend the following for managing diabetes:

• Monitor your blood sugar levels
• Watch what you eat
• Take medications as prescribed
• Visit a health professional at least yearly for—an A1C blood test, foot exam for sores or irritations, a complete eye exam, including eye dilation
• Get a flu vaccine
• Stay physically active as approved by your doctor

Bob Russell, the Upstate New York Area Executive Director of the American Diabetes Association (ADA) was diagnosed with Type 1 diabetes at age 25 and is keenly aware of the importance of managing the risks associated with diabetes.
"Diabetes can affect anyone at any time," Russell said. "Being aware, paying attention to your body and taking time to take care of yourself is even more important in our current environment."

Diabetes and COVID-19
According to the Centres for Disease Control and Prevention (CDC) older adults and people with severe chronic medical conditions, including diabetes, are at higher risk of experiencing complications from COVID-19.
"Managing our diabetes now is critically important," said Russell. "This virus poses a challenge to those of us who are living with diabetes."

Generally, people with diabetes are more likely to experience severe symptoms and complications from a virus. However, the ADA says the risk of getting very sick from COVID-19 is likely to be lower if diabetes is well-managed.

If you have diabetes, the CDC recommends the following steps to help prevent COVID-19-related complications:
1. Stick to your daily routine, which includes taking medications as prescribed and insulin as usual.
2. Test your blood sugar every four hours and keep track of your results.
3. Make sure you have at least a two-week supply of your diabetes medication and insulin.
4. Follow sickday guidelines for people with diabetes.
As always, check in with your doctor or health care team if you have questions or concerns about managing your condition or if you are feeling sick.
The CDC and ADA offer these everyday precautions to help keep you healthy:

• Stay home, if possible.
• Avoid close contact with people who are sick.
• Avoid touching your face, nose, eyes, etc.
• Wash your hands often with soap and water for at least 20 seconds, especially after blowing your nose, coughing, or sneezing, or having been in a public place.
• If soap and water are not available, use a hand sanitizer that contains at least 60% alcohol.
• To the extent possible, avoid touching high-touch surfaces in public places
• Routinely clean and disinfect frequently touched surfaces (for example: tables, doorknobs, light switches, cell phones).
• Practice social distancing, avoid close contact and stay at least 6 feet (about 2 arms' length) from other people.
• Avoid crowds, especially in poorly ventilated spaces. Your risk of exposure to respiratory viruses like COVID-19 may increase in crowded, closed-in settings with little air circulation if there are people in the crowd who are sick.
• Cover you mouth and nose with a mask or cloth face cover when around others.
• Avoid all non-essential travel including plane trips, and especially avoid embarking on cruise ships.

Stay Connected
Social interaction is as important as social distancing, especially for those with a chronic condition. "With what's going on, it's easy for us to get stressed or even panicked," Russell said. "Connect with friends or loved ones. We have to focus on our spirit and our psyche. It's good for our mental health."
He encourages those with diabetes or any chronic condition to reach out to support organizations for help.

https://13wham.com/health-matters/a-healthier-rochester/take-charge-of-your-diabetes-now-more-than-ever

Diet-and-Exercise Treatment Reverses Type 2 Diabetes in 61 Percent of Patients

From news.weill.cornell.edu

An intensive, one-year, lifestyle-modification treatment for type 2 diabetes patients, featuring a low-calorie diet and physical exercise, resulted in a large average weight loss, and remission of diabetes for most patients, in a clinical trial led by researchers at Weill Cornell Medicine-Qatar.

In the study, whose results appear in the June issue of Lancet Diabetes and Endocrinology, the average one-year weight loss for patients receiving the lifestyle intervention was about 26 pounds. Patients in a comparison group, who received standard, medication-centred diabetes care, lost only 9 pounds on average. About 61 percent of the patients receiving the lifestyle intervention no longer had diabetes after the one-year trial, compared to just 12 percent of the standard care group.

“I think it’s a real game-changer for the management of type 2 diabetes,” said study principal investigator Dr. Shahrad Taheri, professor of medicine at Weill Cornell Medicine-Qatar, and professor of medicine and of epidemiology and health services research at Weill Cornell Medicine in New York. “It shows that if you lose weight early enough in the disease process, you can actually reverse the disease, and thus avoid all the other health issues and quality of life reductions that come with it.”

Current standard care for diabetes emphasizes drugs to control blood sugar, cholesterol, and blood pressure—medications that most patients will take indefinitely. The assumption underlying this medication-centred approach is that the insulin-secreting cells in the pancreas that fail to work properly in diabetes are usually irretrievably damaged by the time of diagnosis. Dr. Taheri and other researchers in the field have proposed that more emphasis should be placed on weight loss, especially for younger patients who have only recently developed diabetes. Their hypothesis is that the abdominal fat accumulation that harms insulin-producing cells may be reversible through weight loss – much more easily than doctors have assumed.

“This trial shows that weight loss can work and can be sustainable—and the kicker is that there was a 61 percent remission of diabetes, which is huge,” said study co-author Dr. Mary Charlson, chief of clinical epidemiology and evaluative services research and the William T. Foley Distinguished Professor of Medicine at Weill Cornell Medicine.

The trial, known as the DIADEM-1 trial, was conducted in a primary care centre and a community care centre in Doha, Qatar. Diabetes prevalence in Qatar is estimated to be more than 17 percent and the rate of obesity is more than 40 percent.

Dr. Taheri set up the trial with his colleagues in 2017. They enrolled 158 patients—three-quarters of them men—whose average age was 42 and average weight was 223 pounds. All had had a diagnosis of type 2 diabetes for fewer than three years, and all were of Middle Eastern or North African ancestry and lived in Qatar.

The patients were randomized to receive either standard care, which emphasizes medications, or an intensive lifestyle intervention (ILI). The latter began with a 12-week, dietitian-supervised, low-calorie Cambridge Weight Plan diet, of the type that forces participants to burn fat stores for energy and thus lose weight rapidly. In a subsequent 12-week phase, participants gradually replaced the diet program foods with a more usual but healthy and calorie-restricted diet, which participants were coached to follow for the remainder of the one-year study period. Trainers encouraged ILI group participants to walk at least 10,000 steps per day and spend at least 150 minutes per week getting physical exercise.

ILI group participants stopped taking their diabetes medications at the start of the study, and throughout the study, based on clinical evaluations, doctors adjusted doses for, or discontinued, any cholesterol- or blood-pressure-lowering drugs these patients were taking.

At 12 months, participants in this group had lost an average of 26 pounds, 61 percent were no longer considered diabetic, and 33 percent had completely normal blood-sugar levels—all these measures being far better than those seen in the control group. On average, ILI participants were down to just two medications each, compared to about five each for control group participants.

A recent clinical trial in the United Kingdom known as the DIRECT trial had a similar design and achieved a large average weight loss and 46 percent diabetes remission rate after 12 months. Dr. Taheri notes that DIADEM-1’s results may have been better because its participants were about a decade younger on average and had had diabetes for less time.

He and his colleagues are continuing to track the study participants’ weight loss and diabetes status, and are planning new studies of similar interventions in different populations and with different diet plans. The nature of the intensive lifestyle intervention in the DIADEM-1, DIRECT and other trials, involving consistent support by multiple providers specializing in nutrition and exercise, may help explain why participants were able to sustain their weight loss when people dieting on their own can rebound and sometimes regain more weight than they lost.

“We’re hoping that studies such as these can bring about a big change in the clinical approach to type 2 diabetes across the world—so that we will combine early screening with lifestyle interventions essentially to get rid of this condition straightaway, instead of putting people on multiple medications for life,” Dr. Taheri said.

https://news.weill.cornell.edu/news/2020/06/diet-and-exercise-treatment-reverses-diabetes-in-61-percent-of-patients