The skin condition that may be a sign of type 2 diabetes - are you at risk?

From express.co.uk

DIABETES type 2 symptoms may include feeling unusually tired, passing more urine than normal, and having cuts or wounds that take longer to heal than expected. But you could also be at risk of high blood sugar if you develop a "relatively common skin condition". These are the diabetes signs you should know about

Diabetes is a common condition that affects more than four million people in the UK, and 90 percent of all cases are caused by type 2 diabetes. You could be at risk of high blood sugar if you find an unusual dark patch of skin on your body, it's been claimed.

Type 2 diabetes could be caused by the body not producing enough of the hormone insulin, or the body not reacting to insulin.

Without enough of the hormone, the body struggled to convert sugar in the blood into useable energy. It's crucial that if you think you may have diabetes, you speak to a doctor as soon as possible.

You should consider speaking to your doctor about diabetes if you find a dark patch on your skin.

Some diabetes patients develop a common skin condition known as acanthosis nigricans.

It's characterised by a darkening of the skin in particular areas of the body. The skin condition is most likely to develop in the folds of the skin, including the armpits and the neck. The patch may also feel slightly leathery, and the skin may be itchy.

"The signs of acanthosis nigricans are quite distinctive and result in a darkening of the skin around folds of skin, typically affecting the neck, armpits, groin, [or] joints of the fingers or toes," said medical website Diabetes.co.uk.

"As well being darker, the skin may take on a leathery or velvety feel and the skin may itch or smell.

"Acanthosis nigricans will usually be diagnosed by an examination of the affected area of skin.

"In people with diabetes, controlling blood glucose levels and losing can help to reduce the symptoms of the condition."

                                      Speak to a doctor if you're worried about the signs of diabetes                                                                                                      (Image: GETTY Images)

But just because you develop acanthosis nigricans, it doesn't necessarily mean that you have diabetes. It could also be caused by obesity, an underachieve thyroid, or even certain medication.

You should still speak to a doctor if you're worried about darkened patches on your skin, however.

It's more likely to be caused by diabetes if it's accompanied by any other warning signs of the condition. Common diabetes symptoms include having cuts or wounds that take longer to heal, having an unquenchable thirst, and passing more urine than normal. 

But many people may have diabetes without even knowing it, because the signs and symptoms don’t necessarily make you feel unwell.

You should speak to a doctor if you’re worried about the warning signs or symptoms of diabetes, or if you think you may be at risk.

Diagnosing the condition early is very important, because patients are more at risk of some deadly complications, including heart disease and strokes.

https://www.express.co.uk/life-style/health/1340600/diabetes-type-2-symptoms-high-blood-sugar-signs-skin-dark-patch

What is diabetes? A comprehensive guide to lower blood sugar and manage the condition

From insider.com

Diabetes is a chronic condition where your blood sugar is too high. 

If you have type 1 diabetes, your body is not able to produce insulin, and if you have type 2 diabetes, your body is not able to use insulin effectively. 

There are many ways to lower your blood sugar and manage diabetes, such as eating a healthy diet, exercising regularly, and taking medication like insulin or metformin. 

This article was reviewed by Jason R. McKnight, MD, MS, a family-medicine physician and clinical assistant professor at Texas A&M College of Medicine 

Diabetes is a chronic condition that affects how your body uses insulin. This hormone controls how much blood sugar, also known as glucose, is released into your cells to be used as energy. 

Over 34 million people in the US have diabetes, according to the Centres for Disease Control and Prevention (CDC). While there is no cure for diabetes, it can be managed with lifestyle and dietary changes, or medication like insulin. 

Here's what you need to know to manage diabetes and lower blood sugar levels. 

Types of diabetes 

With all types of diabetes, your body either doesn't produce enough insulin, or isn't able to use insulin effectively. 

Insulin is necessary to move blood sugar into your cells, where it is stored and used for energy. Without insulin, a condition called hyperglycaemia can occur, where blood sugar builds up in your bloodstream instead of traveling into your cells. 

Type 1 diabetes

Type 1 diabetes makes up just 10% of all diagnosed diabetes cases in the US, according to the CDC. It is most commonly diagnosed in children, teenagers, and young adults.

Although the cause is unknown, type 1 diabetes may be due to an autoimmune response caused by an infection or other trigger. Your body mistakenly attacks and damages the beta cells in your pancreas that make insulin, so little or no insulin is produced. 

There are not many risk factors for type 1 diabetes, though genetics is believed to play a role. The odds of the children of men with type 1 diabetes developing the condition is 1 in 17, according to the American Diabetes Association (ADA). For the children of women with type 1 diabetes, the odds are 1 in 25 if the woman is under the age of 25, or 1 in 100 after the age of 25. 

A type 1 diabetes diagnosis requires some important lifestyle changes. You must take insulin every day in order to survive. Your blood sugar level needs to be frequently monitored. It's essential to carefully plan your meals and count carbohydrates.

"This can be a frustrating and tiresome adjustment, but it is crucial that patients educate themselves on how certain foods impact glucose levels," says endocrinologist Rocio Salas-Whalen, MD, of New York Endocrinology. 

Type 2 diabetes

Type 2 diabetes makes up about 90% of all diagnosed diabetes cases in the US. It is most often diagnosed in adults, but the CDC notes that it is becoming increasingly diagnosed in children and teenagers.

With type 2, your body can produce insulin, but it is not able to use it effectively. This is called insulin resistance, which happens when your liver, muscle, and fat cells don't effectively take in the blood sugar from your blood to use it for energy. As a result, your blood sugar level increases, which can eventually lead to type 2 diabetes. 

You are more at risk for type 2 diabetes if you: 

• Are 45 years old or older 
• Are overweight or obese
• Don't exercise regularly 
• Have a family member with type 2 diabetes

In addition to eating a healthy diet, it's very important for people with type 2 diabetes to maintain a healthy weight, Salas-Whalen says, because this can also help them control blood sugar levels. 

Gestational diabetes 

Pregnant people may develop gestational diabetes, which is caused by the body's inability to produce the extra insulin needed during your pregnancy. Gestational diabetes can put your baby at risk for health problems later in life, such as obesity or type 2 diabetes. 

About 7% of pregnant people in the US are diagnosed with gestational diabetes. It usually begins in the middle of your pregnancy, without any symptoms. You should be tested for it between your 24th and 28th weeks of pregnancy. It typically goes away after your baby is born, but you will have a higher risk of developing type 2 diabetes later in life. 

If you have gestational diabetes, you'll need to work with your doctor to develop a healthy eating plan, and you should also remain physically active to help keep your blood sugar levels low. If a healthy diet and exercise don't lower your blood sugar levels, you may need to take insulin.

Prediabetes 

Prediabetes is a condition where your blood sugar levels are elevated, but not yet high enough for a diabetes diagnosis. However, if left untreated, prediabetes can develop into type 2 diabetes. 

More than a third of all US adults — over 88 million — have prediabetes, yet 84% of them don't know they have it, the CDC notes. 

With lifestyle changes like a healthy diet, losing weight, and getting regular exercise, it's possible for prediabetes to be reversed or delayed. Your doctor may also prescribe medication to help lower your blood sugar level.

"A prediabetic still has the potential to avoid diabetes, which should be avoided in every possible way," Salas-Whalen says.

What are the signs of diabetes? 

The signs of all types of diabetes can include the following:

• Urinating frequently, especially at night
• Feeling very thirsty or hungry
• Losing weight without trying to
• Blurred vision
• Numbness or tingling in your hands or feet
• Fatigue
• Dry skin
• Sores that take a long time to heal

However, these symptoms develop slowly over time, and it may be difficult to recognize them, especially if you have type 2 diabetes.

The signs of type 1 diabetes may be more severe, and can also include nausea or vomiting. 

Normal blood sugar levels 

Target blood sugar levels are different for those with diabetes. The follow chart depicts normal blood sugar levels for diabetics and non-diabetics:  

Many people with diabetes with need to learn how to check their blood sugar multiple times a day using a glucose meter or a continuous glucose meter. 

"Try not to think of blood sugars as 'good' or 'bad' or as a reflection of how well or bad you are doing," says Shelley Nicholls, DNP, APRN, CDCES, director of patient education at the Diabetes Research Institute. "Having a good understanding of what affects blood sugars and which of them a person can control or influence is the best tool a person with diabetes can have."

How to lower blood sugar

To treat diabetes, it is important to lower your blood sugar level and make sure it stays in a healthy range. 

Doing this will not only increase your energy, but according to the ADA, each percentage point of A1C lowered reduces the possibility of long-term health complications — which could include serious heart, kidney, brain, eye, or foot problems — by 40%.

These are some of the best natural ways to lower and manage your blood sugar levels over time:

• Eat a healthy diet. This is critical for managing diabetes. "The best option is to meet with a dietitian to determine individual needs and goals," Nicholls says. Some of the best foods to lower blood sugar include whole grains, fruits and vegetables, oatmeal, and nuts. 
• Exercise regularly. Physical activity helps prevent or delay type 2 diabetes, improves type 2 diabetes blood sugar control, and improves insulin sensitivity for people with type 1 diabetes, according to the ADA. You should aim for about 150 minutes of moderate exercise per week if you have diabetes.
• Lose weight. Maintaining a healthy weight can help prevent diabetes-related complications like heart disease and stroke, or help get rid of diabetes entirely. For example, nearly half of 140 adults with type 2 diabetes who participated in the United Kingdom-based Diabetes Remission Clinical Trial (DiRECT) went into remission after following a weight-loss program for one year.
• Drink lots of water. People who drank at least one litre of water a day were 28% less likely to have high blood sugar, according to a 2011 study published in the journal Diabetes Care.
• Manage stress. The stress hormone cortisol impedes your body's ability to use insulin effectively and increases your blood sugar level.

• Diet for diabetes

  It's important for people with diabetes to be careful about the foods they eat because they can impact your blood sugar levels. "Some foods can worsen diabetes, while other foods can actually improve diabetes control," Salas-Whalen says.

  Carbohydrates and fibre especially affect your blood sugar levels in the following ways:

• Carbohydrates. These are quickly broken down into sugars in your body and affect your blood sugar level more than proteins and fats, Nicholls says. Because people with diabetes can't efficiently process blood sugar, carbs can cause levels to spike, so it's important to discuss how many carbs you should eat per day with your doctor. 

• Fibre. Foods with a high fibre content are difficult to digest, so the sugar is absorbed more slowly into your blood. Eating foods high in fibre, such as fruits, vegetables, beans, and whole grains can help regulate your blood sugar. 

It can be helpful to follow a diet to manage your diabetes, as planning out your meals and snacks will help you control blood sugar levels effectively. 

"Every person has different needs, so there is no one diet that is recommended for people with diabetes," Nicholls says. "The best option is to meet with a dietitian to determine individual needs and goals."

Here are some of the best diets for diabetics: 

Mediterranean diet 

The Mediterranean diet includes plant-based foods, lean meats, and healthy fats. 

According to a 2009 study published in Diabetic Medicine, people who strictly followed a Mediterranean diet for three months had lower A1C percentages and lower blood sugar levels after meals than those who followed it less strictly. 

DASH diet 

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is mainly used to lower blood pressure, but it can also help lower blood sugar. 

A 2017 study published in the ADA journal Diabetics Spectrum suggests that the DASH diet can lower insulin resistance and help you lose weight. A 2016 study published in the journal Nutrition found that a DASH diet can also help lower the risk for gestational diabetes by as much as 71%.

Keto diet

This high-fat, low-carb diet limits carbs to 20 to 50 grams daily in an effort to put your body in the metabolic state of ketosis, where you burn fat instead of carbs for fuel. 

A 2017 study published in Nutrition & Diabetes found that overweight adults with type 2 diabetes or prediabetes who followed a keto diet had lower A1C levels and lost over 4% more weight after one year than those who followed a moderate-carbohydrate/low-calorie/low-fat diet.

There are also some health risks associated with the keto diet. If you have type 1 diabetes, your lowered blood sugar level may lead to hypoglycaemia and serious brain, kidney, or liver complications.

Another issue associated with this diet are "keto flu" symptoms that may include headache, nausea, and vomiting. It's important to consult with your doctor or a registered dietitian before starting a keto diet.

Diabetes medications 

People with type 1 diabetes need to take insulin every day in order to survive. If people with type 2 diabetes are unable to reach their blood sugar target levels with diet and exercise, they may also need medication like insulin or metformin. 

Insulin

People with type 1 diabetes generally need to take three to four doses of insulin every day, according to the ADA. Women with gestational diabetes may need to take insulin daily during their pregnancy if their bodies aren't producing enough of it naturally. Many people with type 2 diabetes may need one dose each day with or without other medications.

Insulin is injected in the fat under your skin using a syringe, insulin pen, or pump. It should be injected in the same area of the body, but not the same place each day. It's best to inject insulin at mealtime so it is more effectively processed in your body.

"The challenge with taking insulin is that it's tough to know precisely how much to take," Nicholls says. The amount is based on factors that may change throughout the day, such as food, exercise, and stress. "So, deciding on what dose of insulin to take is a complicated balancing act." 

Taking an extra dose of insulin can also help you lower blood sugar fast if it's an emergency, though you may want to check in with your doctor beforehand. 

Metformin 

If you have type 2 diabetes, your doctor may prescribe metformin, a medication that lowers blood sugar by slowing your liver's production of glucose. It is the drug most commonly prescribed to treat type 2 diabetes.

Metformin is available in a liquid, pill, or extended-release tablet. You take it orally at mealtime two to three times a day. The extended-release tablet only needs to be taken once daily.

According to a 2012 scientific review published in Diabetes Care, metformin can effectively reduce A1C levels for people with type 2 diabetes by an average of 1.12%.

Takeaways

Although it's possible to control your diabetes and lower blood sugar levels, there is no specific cure. 

"Because of this reality, lifestyle changes must be permanent and not temporary in order to avoid the potential long-term complications of diabetes," Salas-Whalen says. 

To develop the best plan of treatment for diabetes, it's important to meet with your doctor for individualized recommendations. 

https://www.insider.com/what-is-diabetes

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Older People Taking Diabetes Drug Show Slower Cognitive Decline

From technologynetworks.com

Metformin is the first-line treatment for most cases of type 2 diabetes and one of the most commonly prescribed medications worldwide, with millions of individuals using it to optimise their blood glucose levels.

A new research study, conducted over six years in the Sydney Memory and Ageing Study in 1037 Australians (aged 70 to 90 years old at baseline), has revealed an additional effect: individuals with type 2 diabetes who used metformin experienced slower cognitive decline with lower dementia rates than those who did not use the medication.

The findings provide new hope for a means of reducing the risk of dementia in individuals with type 2 diabetes, and potentially those without diabetes who number nearly 47 million people worldwide.

The study was led by researchers at the Garvan Institute of Medical Research and the Centre for Healthy Brain Ageing (CHeBA), UNSW Sydney, and published in the Journal Diabetes Care.

"We've revealed the promising new potential for a safe and widely used medication, which could be life-changing for patients at risk of dementia and their families. For those with type 2 diabetes, metformin may add something extra to standard glucose lowering in diabetes care: a benefit for cognitive health," says first author Professor Katherine Samaras, Leader of the Healthy Ageing Research Theme at the Garvan Institute and endocrinologist at St Vincent's Hospital Sydney.

Protecting brain function

Type 2 diabetes occurs when the body can no longer produce enough insulin to meet its needs, leaving affected individuals unable to maintain blood glucose levels within a normal range. This can lead to long-term health complications, including cognitive decline.

"As they age, people living with type 2 diabetes have a staggering 60% risk of developing dementia, a devastating condition that impacts thinking, behaviour, the ability to perform everyday tasks and the ability to maintain independence. This has immense personal, family, economic and societal impacts," says Professor Samaras.

The researchers of this study investigated data from participants of CHeBA's Sydney Memory and Ageing Study. In this cohort, 123 study participants had type 2 diabetes, and 67 received metformin to lower blood sugar levels. The researchers tested cognitive function every two years, using detailed assessments that measured cognition over a number of capabilities, including memory, executive function, attention and speed, and language.

The findings revealed individuals with type 2 diabetes taking metformin had significantly slower cognitive decline and lower dementia risk compared to those not taking metformin. Remarkably, in those with type 2 diabetes taking metformin, there was no difference in the rate of decline in cognitive function over 6 years compared to those without diabetes.

New use for a common medication

Metformin has been used safely to treat type 2 diabetes for 60 years. It works by reducing the amount of glucose released from the liver into the blood stream and allows the body's cells to better respond to blood glucose levels.

Studies over the last decade have revealed evidence of metformin's benefit in cancer, heart disease, polycystic ovary syndrome and weight management. While the current study suggests metformin may have cognitive benefits for people living with type 2 diabetes, the researchers say it may also benefit those at risk of cognitive decline more broadly.

"This study has provided promising initial evidence that metformin may protect against cognitive decline. While type 2 diabetes is thought to increase dementia risk by promoting degenerative pathways in the brain and nerves, these pathways also occur in others at risk of dementia and it is possible insulin resistance may be the mediator," says Professor Samaras.

"To establish a definitive effect, we are now planning a large, randomised controlled trial of metformin in individuals at risk of dementia and assess their cognitive function over three years. This may translate to us being able to repurpose this cheap medication with a robust safety profile to assist in preventing against cognitive decline in older people."

CHeBA's Sydney Memory and Ageing Study is an observational study of older Australians that commenced in 2005 and researches the effects of ageing on cognition over time.

Professor Perminder Sachdev, senior author of the study and Co-Director of CHeBA, says: "While an observational study does not provide conclusive 'proof' that metformin is protective against dementia, it does encourage us to study this and other anti-diabetic treatments for dementia prevention. Metformin has even been suggested to be anti-ageing. The intriguing question is whether metformin is helpful in people in those with normal glucose metabolism. More work is clearly needed."

https://www.technologynetworks.com/tn/news/older-people-taking-diabetes-drug-show-slower-cognitive-decline-340777

COVID-19 and diabetes: what is the evidence?

From eurekalert.org

In the COVID-19 special session taking place at the online Annual Meeting of the European Association for the Study of Diabetes (EASD), Prof. Juliana Chan, (The Chinese University of Hong Kong and Prince of Wales Hospital, Shatin, Hong Kong, China) will present a new review of the evidence on the devastating impact COVID-19 is having on people with diabetes.

"Major risk factors for mortality include advanced age and chronic conditions, notably obesity, diabetes, hypertension, heart and kidney disease as well as social deprivation, minority ethnic groups and those with poor access to care. These frequent coexisting conditions highlight the complexity of COVID-19," explains Professor Chan.

In a recent report from The Lancet Diabetes & Endocrinology*, in a UK population-based survey of over 60 million people registered with the primary care system, 0.4% had type 1 diabetes and 4.6% had type 2 diabetes. Yet amongst the more than 24,000 deaths due to COVID-19, 30% occurred in people with diabetes. After adjusting for multiple risk factors including social deprivation, ethnicity and other chronic conditions, people with type 1 diabetes had an almost 3-fold (2.86 times) risk of death, and those with type 2 diabetes, an almost 2 times (1.8) higher risk of death due to COVID-19 versus those without diabetes.

Despite the short duration of the pandemic, still less than one year, a search term of 'COVID-19 and diabetes' yielded over 1800 publications in PubMed. "Many of these reports indicated close relationships between high blood glucose levels and poor outcomes including mechanical ventilation, admissions to the intensive care unit and death in patients with COVID-19," explains Prof Chan.

Glucose is a fuel and its effective use depends on adequate oxygen supply and insulin action to promote glucose entry into the cells to maintain bodily functions and survival. Diabetes is due to absolute or relative insulin insufficiency. People with poorly controlled diabetes have low grade inflammation, poor circulation and body defences. During acute stress such as COVID-19, these interlinking systems can destabilise resulting in uncontrolled blood glucose and multi-organ failure. In a consensus statement published in The Lancet Diabetes & Endocrinology, international experts call for optimisation of outpatient and in-patient care including appropriate use of insulin to control blood glucose and use of organ-protective drugs to improve the outcomes of these high risk patients.

Prof Chan says: "SARS-CoV-2 may damage pancreatic beta-cells, the only insulin-secreting cells. As such, COVID-19 may precipitate diabetes in people with risk factors such as those with obesity, low socioeconomic status and psychosocial stress."

The use of social distancing and restricted travelling have controlled the outbreak to some extent but also resulted in economic hardships and emotional distress. These can have effects on personal health, societal productivity and access to routine care. She adds: "On a more positive note, the COVID-19 crisis has raised public awareness about the plight of these vulnerable people and motivated development of new strategies such as telehealth aimed at providing preventive care and ongoing support to reduce the impacts of acute and chronic complications in these high risk individuals."

Prof Chan concludes: "Diabetes and COVD-19 are silent epidemics with devastating consequences, if not diagnosed or controlled. These global epidemics have strong environmental, behavioural and system determinants. The COVID-19-diabetes story highlights the huge burden of diabetes which affects 460 million people worldwide, mainly coming from developing countries with unprepared healthcare systems. This dual epidemic also illustrates how widespread social and care disparity can affect the global healthcare and economic systems during acute crisis. In this interconnecting world, there is an urgent need to improve our ecosystem, promote health literacy and reform our health and social systems to protect the health and humanity of people with vulnerable conditions such as diabetes."

https://www.eurekalert.org/pub_releases/2020-09/d-cad092120.php

7 Mistakes To Avoid While Testing Blood Sugar Levels At Home

From ndtv.com

Diabetes: To avoid the complication of diabetes it is important to constantly check blood sugar levels. If you are a diabetic here are a few mistakes you should be avoiding while checking blood sugar levels at home.

Diabetes is a chronic condition that requires constant management of blood sugar levels. Uncontrolled blood sugar levels start affecting different organs of the body negatively. If you are a diabetic, it is important to check blood sugar levels regularly. It helps you understand whether the diet and lifestyle you are following is helpful in controlling blood sugar levels or not. It also helps you avoid major fluctuations in blood sugar levels.

These days blood sugar levels can be checked at home. A glucometer is commonly used to keep a constant check. But many often make several mistakes while measuring blood sugar levels at home. Dr. Girish Parmar, Senior Consultant, Endocrinology and Diabetes explains a few common mistakes you should be avoiding to achieve accurate results.

Mistakes to avoid while measuring blood sugar levels

1) Postprandial blood sugar

Postprandial blood glucose test measures blood glucose post-meal. While testing the two-hour postprandial sugar level, its ideal to start counting the time once you start eating your meal instead of upon completion of the meal.

2) Prick timing

For a more accurate reading of your blood sugars, it's ideal to take the test at different times throughout the day as a lot of environmental and physiological factors do change according to the time.

3) Prick finger

One of the most common mistakes is using the same finger for the blood sugar test every day, repeatedly. Doing so may cause pain or even a minor injury. Thus, it is best to keep rotating the finger from either hand for blood sugar level testing.

4) One prick, one needle

It has been observed that many patients use the same needle for more than five to six pricks or  avoid changing it for longer durations. It can increase the chances of infection multi-fold. It is ideal to discard the needle after ever prick with proper safety measures.

5) Needle depth

The lancing devices, used for the test come with adjustable needle depths which can be changed as per the thickness of the skin on your fingers. Make sure the needle is set between 3-4 to ensure a proper prick.

                      Choose appropriate depth of the needle while measuring blood sugars
                                                               Photo Credit: iStock

6) Sanitisation

Always sanitise the finger you are going to prick to ensure the area is clean and infection free. Most importantly don't hurry to prick once you have sanitised the finger with spirits. Wait for the spirit to evaporate from the skin surface before pricking.

7) Variations between sugar levels

There is an acceptable variation between the readings of a glucometer and laboratory test of blood sugar levels. Hence even if after following all possible norms if there is a difference in the readings don't panic.

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-7-mistakes-to-avoid-while-testing-blood-sugar-levels-at-home-2298741

Bananas, aloe vera and other home remedies to manage diabetes in natural ways

From timesnownews.com

Key Highlights

• According to WHO, around 422 million people worldwide suffer from diabetes

• Diabetes is cause due to insufficient production or ineffective use of insulin

• There are two types of diabetes, namely Type 1 diabetes and Type 2 diabetes

New Delhi: Did you know that diabetes is among the leading causes of death worldwide? According to the World Health Organization global reports, diabetes is one of the most popular diseases and growing rapidly. Around 1.5 million deaths are caused by diabetes. Diabetes can lead to various health issues such as stroke, heart attack, amputation, blindness, kidney failure and even premature death. It is mostly caused due to factors such as obesity, unhealthy diet, genetics or lack of physical activity.

A few ways that you can opt for to combat diabetes include intake of a healthy diet, regular exercise and weight management. Apart from medal help, you can also try a few home remedies that can help you manage diabetes in a healthy way. Some of which are listed below.

6 home remedies that will help to manage diabetes

1. Banana: Contrary to popular belief, bananas are not very high in sugar content. They have a low Glycaemic Index, which helps to manage diabetes through a healthy diet. You must try to include bananas in your diet to manage the diabetes condition.
2. Aloe vera: If you keep the bitter taste aside, aloe vera brings a lot to the table and to your health. Its consumption can help you lower the sugar levels in your blood. It also reduces inflammation. You can consume aloe vera in the form of juice or buttermilk.
3. Cinnamon: This can help in the regulation of sugar levels in the blood by the stimulation of insulin activity. You can consume it by mixing 1/2 tsp of cinnamon powder in a cup of warm water and drinking it every morning. 
4. Fenugreek: This can help with diabetes management as it is a rich source of fibre and can help to improve the digestion, thereby, promoting better absorption of sugar and carbohydrates. You can consume it by mixing 1 tsp of fenugreek powder with a cup of lukewarm water and drinking it every morning.
5. Amla: Vitamin C consumption must be encouraged when working on diabetes management. Amla is a rich source of vitamin C. It also comprises of chromium which is beneficial for carbohydrate regulation. This increases the responsiveness of the body to insulin. You can also include other foods that are rich in vitamin C like orange, kiwi, lemons, etc. You can consume amla in the form of juice, powder or pickle.
6. Bitter guard: You may not prefer eating karela ki sabzi but you may consider it after you get to know about its health benefits. It is extremely effective for blood sugar management as it contains polypeptide-p. You can consume it in the form of its simple sabzi recipe or even prepare its juice. 

https://www.timesnownews.com/health/article/bananas-aloe-vera-and-other-home-remedies-to-manage-diabetes-in-natural-ways/648742

Feeling lonely greatly increases risk of developing Type 2 diabetes

From studyfinds.org

LONDON — Coronavirus lockdowns around the world have put millions of people into an uncomfortable isolation. While not every person in quarantine will experience loneliness, a new study says those that do may end up with a surprising side-effect — diabetes. Researchers find loneliness can predict the onset of Type 2 diabetes. Moreover, the worse you feel, the greater your risk of having the disease.

A team at King’s College London reveals measuring feelings of loneliness can be a strong predictor of developing Type 2 diabetes later in life. Researchers examined data on more than 4,100 adults over the age of 50. The patient records spanning from 2002 to 2017 show all of the participants were free of diabetes at the study’s start. Over the course of the 12 years however, 264 now have Type 2 diabetes.

Even feeling a little lonely can make a big difference

When comparing the results to the tests each patient took to examine their feelings of loneliness, study authors find “a one point increase in the averaged loneliness score was associated with a 41% increase in the hazard of Type 2 diabetes onset.” This connection is still present even after researchers factor out the effects of smoking, drinking, weight, blood glucose levels, high blood pressure, and heart disease.

The report describes loneliness as the feeling a person has when social needs are not being met. One in five adults in the United Kingdom and one in three in the United States say they feel lonely occasionally. Loneliness is not the same thing as depression and doesn’t necessarily result from simply living alone or experiencing social isolation. Researchers add the link between diabetes and loneliness is a unique problem facing people, including those who are not depressed.

“The study also demonstrates a clear distinction between loneliness and social isolation in that isolation or living alone does not predict Type 2 diabetes whereas loneliness, which is defined by a person’s quality of relationships, does,” Dr. Ruth Hackett says in a university release.

How does loneliness connect to diabetes?

“I came up with the idea for the research during UK lockdown for the COVID-19 pandemic as I became increasingly aware and interested in how loneliness may affect our health, especially as it is likely that many more people were experiencing this difficult emotion during this period,” Hackett adds.

The British team suggests that loneliness doesn’t just have a psychological effect, it damages us biologically too. They theorize constantly feeling lonely impacts the systems which control stress and, over time, this can increase your risk for diabetic issues.

“If the feeling of loneliness becomes chronic… then everyday you’re stimulating the stress system and over time that leads to wear and tear on your body and those negative changes in stress-related biology may be linked to Type 2 diabetes development,” Dr. Hackett explains.

The study also looks at how the mind can make these feelings worse. It finds a person’s own biases can cause someone to expect others to react negatively to them, even when people are trying to reach out supportively.

Researchers warn these findings could play a major role during the pandemic as COVID-19 patients with diabetes are at greater risk of dying. For some, life in lockdown may only compound their future health problems.

The study appears in the journal Diabetologia.

https://www.studyfinds.org/loneliness-increases-risk-diabetes/

Welcome news for pregnant women with type 2 diabetes

From medicalxpress.com

by Danielle Roddick, Western Sydney University

A world-first, international study of a common treatment for women with Type 2 diabetes, has found that the drug may also offer a range of health benefits should they become pregnant.

Researchers from Western Sydney University participated in the "Metformin in women with Type 2 diabetes in pregnancy" (MiTy) trial, led by Sinai Health in Canada—which tested the effects of the medication Metformin in pregnant women.

502 pregnant women with Type 2 diabetes from 29 centers in Canada and Australia participated in the study. The study was randomized, with the women taking either Metformin or a placebo, in addition to their usual insulin regimen.

The findings, which are published today in The Lancet Diabetes and Endocrinology, indicate that women who took Metformin during their pregnancy were more likely to experience a range of health benefits, including:

• better glucose control;
• lower insulin requirements;
• less gestational weight gain; and
• fewer cesarean births.

Diabetes in the mother is a common cause of babies who are large for gestational age—however the study also showed infants of mothers taking Metformin weighed 210 grams less than the average.

Lead researcher Professor Denice Feig, from the Lunenfeld-Tanenbaum Research Institute and Mount Sinai Hospital, said women with Type 2 diabetes often take Metformin prior to pregnancy—however, once pregnant, there is little evidence to guide their decision to either stop or continue use of the drug.

"This study found that women with Type 2 diabetes who take Metformin during pregnancy are more likely to see various health benefits, including requiring less insulin, gaining less weight and reducing their risk of a cesarean birth," said Professor Feig.

"Women can be told of these many benefits, but infants should be monitored closely while in utero to see if they are gaining enough weight. If infants are growing too small, they may need to stop the drug."

Professor David Simmons from the School of Medicine at Western Sydney University led the Australian component of the study, which tracked 24 women across four centres in Brisbane and Sydney.

Professor Simmons said it is important for women with Type 2 diabetes to receive treatment prior to conception—as a high blood glucose can lead to a number of severe congenital malformations, such as a hole in the heart.

"We know that Metformin is a safe drug to use when becoming pregnant, which helps to ensure that women conceive with a good healthy blood glucose that will not harm their baby. But, thus far, we have been unsure if women should stop taking the Metformin once they become pregnant," said Professor Simmons.

"This study provides good news for Australian women, who can be comfortable that Metformin has now been shown to be a helpful drug during the pregnancy. Lower insulin requirements also mean that women can sometimes avoid extra daily injections, which is another positive."

The next steps for the researchers is to look at the long-term effects of Metformin on infants, in the latest phase of the study referred to as "MiTy Kids."

"It was expected to find that management using Metformin can lead to smaller babies and this happened in about one in eight women," said Professor Simmons.

"In our clinical practice, we had already decided that if there is a risk of a small baby—for example, in the case of twins—then we avoid using Metformin. But more research is needed to understand if there are any long-term impacts on the infants into the future."

https://medicalxpress.com/news/2020-09-news-pregnant-women-diabetes.html

What patients on dialysis need to know about controlling diabetes

From indianexpress.com

'As a result of diabetes, blood vessels in the kidneys weaken and become damaged. Damaged blood vessels limit the kidneys to work as well as they should,' says Dr Nishit Mohanty, Nephrologist, NephroPlus Dialysis Centres, Bhubaneswar & Balasore

Many people around the world live with diabetes — either type 1 or type 2 and the condition calls for many lifestyle changes for them to lead a normal and healthy life. Dr Nishit Mohanty, Nephrologist, NephroPlus Dialysis Centres, Bhubaneswar & Balasore, says the number of people in India crippled with Chronic Kidney Diseases (CKD) associated with diabetes, is high.

“As one of the most noteworthy causes of CKD, the rise in the number of diabetic patients in India directly correlates with the increase in the number of kidney disease patients. In the times of COVID-19, both co-morbidities are a major risk concern and should be taken into serious consideration,” he warns.

The doctor goes on to say that while one is on dialysis, it is important to take care of diabetes. “As a result of diabetes, the blood vessels in the kidneys weaken and become damaged. Damaged blood vessels limit the kidneys to work as well as they should, that is, to filter out the toxins and waste from the body. A decline in kidney function may eventually cause kidney failure.”

'As one of the most noteworthy causes of CKD, the rise in the number of diabetic patients in India directly correlates with the increase in the number of kidney disease patients.'
(Representational image)

Maintaining and being vigilant of blood sugar levels, consuming a well-balanced diet and exercising are key factors in controlling diabetes, he says.

Here are some dietary tips from the doctor:
* Eat as per the nutrition plan curated by your nephrologist and dietician.
* Eating three meals a day — which is a must — will help in preventing the blood sugar from going too high or too low.
* High-caloric food must be avoided.
* Non- processed foods such fresh vegetables and fruits, grains, lean meats and low-fat dairy options should be ideal for nutritious diet.
* Foods low in potassium will add fibre to your diet.
* Keep your liquid consumption in check, as advised.

Physical activities:
* Exercise daily to maintain a healthy weight; do not over-stress yourself.
* Obesity should be looked at with utmost care; reduce if overweight.
* Include aerobic and resistance training which will help in lowering blood sugar and keep blood glucose within a normal range.
* Practising yoga will help calm the mind and body.

Medication:
* Monitor your blood sugar regularly.
* Medication must be taken as prescribed by your doctor.
* Maintain good eye care; have your eyes checked if you experience any discomfort.
* It is also important to maintain good oral hygiene. Brush your teeth in the morning and at night; gargle your mouth after meals.
* Blood glucose should be monitored well on dialysis days, mainly before you begin your dialysis treatment.

https://indianexpress.com/article/lifestyle/health/what-patients-on-dialysis-need-to-know-about-controlling-diabetes-6596869/

Loneliness predicts development of type 2 diabetes

From eurekalert.org
King's College London

Published in the journal Diabetologia (the journal of the European Association for the Study of Diabetes [EASD]), the study shows that it is the absence of quality connections with people and not the lack of contact that predicts the onset of type 2 diabetes, suggesting that helping people form and experience positive relationships could be a useful tool in prevention strategies for type 2 diabetes.

The results have implications in light of recent findings that people with diabetes are at greater risk of dying from COVID-19. The study indicates that prolonged loneliness may influence the development of diabetes, suggesting the experience of lockdown could potentially compound people's vulnerability in this pandemic if the loneliness continues for some time.

Loneliness occurs when an individual perceives that their social needs are not being met and reflects an imbalance between desired and actual social relationships. A fifth of adults in the UK and a third of adults in the USA report feeling lonely sometimes.

There is a growing interest in the role of loneliness in health and previous research has associated loneliness with increased risk of death and heart disease. This is the first study to investigate the experience of loneliness with later onset of type 2 diabetes.

The study analysed data from the English Longitudinal Study Ageing on 4112 adults aged 50 years and over which was collected at several times from 2002 to 2017. At the start of data collection all participants were free of diabetes and had normal levels of blood glucose.

The study showed that over a period of 12 years 264 people developed type 2 diabetes. and the level of loneliness measured at the start of data collection was a significant predictor of the onset of type 2 diabetes later on in life. This relationship remained intact when accounting for smoking, alcohol, weight, level of blood glucose, high blood pressure and cardiovascular disease. The association was also independent of depression, living alone and social isolation.

Lead author Dr Ruth Hackett from the Institute of Psychiatry, Psychology & Neuroscience (IoPPN) King's College London said: 'The study shows a strong relationship between loneliness and the later onset of type 2 diabetes. What is particularly striking is that this relationship is robust even when factors that are important in diabetes development are taken into account such as smoking, alcohol intake and blood glucose as well as mental health factors such as depression. The study also demonstrates a clear distinction between loneliness and social isolation in that isolation or living alone does not predict type 2 diabetes whereas loneliness, which is defined by a person's quality of relationships, does.

She continued: 'I came up with the idea for the research during UK lockdown for the COVID-19 pandemic as I became increasingly aware and interested in how loneliness may affect our health, especially as it is likely that many more people were experiencing this difficult emotion during this period.'

According to the study a possible biological reason behind the association between loneliness and type 2 diabetes could be the impact of constant loneliness on the biological system responsible for stress, which, over time affects the body and increases the risk for diabetes.

'If the feeling of loneliness becomes chronic,' explained Dr Hackett. 'Then everyday you're stimulating the stress system and over time that leads to wear and tear on your body and those negative changes in stress-related biology may be linked to type 2 diabetes development.'

Another explanation for the findings could be biases in our thinking that may perpetuate the association between loneliness and diabetes as when people feel lonely, they expect people will react to them negatively which makes it more difficult to form good relationships.

https://www.eurekalert.org/pub_releases/2020-09/kcl-lpd091520.php

The best exercises to manage diabetes and lower blood sugar

From insider.com

The best exercises for diabetes include any type of moderate physical activity, such as walking, gardening, or playing tennis. 

If you have diabetes or may be at risk, it's important to get about 150 minutes of moderate exercise every week, as it can help lower blood sugar levels. 

Make sure you talk with your doctor to learn how to exercise safely with diabetes, especially if you have type 1, which may come with more health risks. 

This article was reviewed by Jason R. McKnight, MD, MS, a family-medicine physician and clinical assistant professor at Texas A&M College of Medicine

Exercise and physical activity are extremely beneficial for overall health. And if you have type 1 or type 2 diabetes, or may be at risk, the benefits are quite useful.
"Regular exercise is especially important for those living with diabetes," says Alex Li, MD, an internal medicine specialist in Los Angeles.

But exercise can also present some complications for people with diabetes. Here's how to create a safe, effective workout routine if you have diabetes.

Why exercise is important for people with diabetes 

The American College of Sports Medicine and the American Diabetes Association both agree that exercise is "critical for optimal health" in individuals with diabetes.

When you exercise, your body burns glucose, or blood sugar, for fuel. This helps lower your blood sugar levels. As you exercise more, this effect is amplified over time, which leads to a decrease in insulin resistance. It's important to reduce insulin resistance, as it is what causes type 2 diabetes.
Regular exercise can also help you build muscle and decrease fat, both of which boost your body's ability to use insulin. In general, people with both type 1 and type 2 diabetes benefit from becoming more sensitive to insulin.

"In the short term, it can lower blood sugar, and in the long term, it can improve insulin sensitivity," says Emory Hsu, MD, an endocrinologist with Santa Clara Valley Medical Centre in San Jose, California.

A 2019 scientific review published in Annals of Physical and Rehabilitation Medicine found evidence that structured exercises — like engaging in an eight-week exercise class — can reduce insulin resistance for people with type 2 diabetes. The average participant saw their blood sugars drop by 5.12 points after intervention. 

Moreover, a 2017 study published in the Journal of Jiroft University of Medical Sciences followed 28 women with type 2 diabetes for eight weeks. Fourteen participants did not exercise, while the other 14 did aerobic exercise (cardio) three times a week and resistance training twice a week. After eight weeks, the exercise group had lower blood sugar and less insulin resistance than the control group.

How much exercise you need

People with diabetes, just like all other American adults, should aim to get 150 minutes of moderate exercise per week, according to a 2016 position statement by the ADA.
"If you're not exercising already, don't let this number intimidate you," Hsu says. "Any exercise is better than none, and you can start more slowly and ramp up."

The ADA recommends that people with type 2 diabetes or who are at risk for the condition exercise daily and never let more than two days lapse without physical activity. Most types of physical activity can count as exercise, even gardening or walking.

"If you are walking, this means you should walk briskly enough to start breaking a sweat or start to feel like you need to breathe more rapidly," Hsu says.
Other types of moderate exercise include:

• Mowing the lawn
• Swimming
• Playing tennis
• Casual bike riding

All of these types of exercise can be beneficial. A 2019 scientific study published in The International Journal of Exercise Science followed 905 people with type 2 diabetes who were previously inactive. They did aerobic exercises, resistance training, or a combination of the two for 49 minutes three times per week.

The study found that all three types of training reduced A1C levels, which measure average blood glucose over time. Combination training had the biggest impact, followed by aerobic exercise and then resistance training.

Overall, making exercise a sustainable part of your daily and weekly routine is important. Try going for a walk on your lunch break, or using resistance bands after work. Whatever allows you to hit the targeted 150 minutes of exercise is the right plan for you, Li says.

How to exercise safely with diabetes

Exercise is recommended for all people with diabetes, though some may have to take extra precautions. For example, people with type 1 diabetes should be particularly careful.

"For type 1 diabetics, exercise can lower blood sugar more dramatically," Hsu says. Dangerously low blood sugar, or hypoglycaemia, can cause health complications including seizures and coma in severe cases.

People with type 1 diabetes should carefully plan their exercises around food intake and insulin dosage, according to the ADA. It's also important to measure your blood sugar levels before, during, and after exercise — or check your blood sugar with a continuous glucose monitor. 
Overall, it's best to work with your doctor to develop a routine if you have type 1 diabetes.

If you have diabetes and are starting an exercise routine, you should take the following steps:

• Speak with your doctor. Let them know if you've had any other health complications with diabetes, like eye problems, heart disease, or stroke. 
• Start slow. Familiarize yourself with how exercise affects your blood sugar by measuring your blood sugar before and after exercise, and monitoring any major changes. Your blood sugar should stay within the healthy range that you and your doctor have established. 
• Monitor your feet for ulcers or sores. Many diabetics have decreased sensation in their feet, Li says, so you might not notice pain from sores. Visual monitoring can help you spot them and prevent infection.   

Takeaways

Working your way up to at least 150 minutes of exercise per week can help you manage your diabetes and lower blood sugar. Exercising with diabetes — particularly type 1 diabetes — can take some extra planning, but the health benefits are well worth it, Li says.

https://www.insider.com/exercise-for-diabetes

Manage your medical conditions during COVID-19 pandemic

From thecharlottepost.com

Precautions for diabetes, heart disease

Diabetes and heart disease are two pre-existing medical conditions that researchers believe contribute to elevated risk of severe complications from COVID-19.

In fact, patients with two or more pre-existing conditions have 4.5 times greater risk of needing treatment at a hospital if they contract COVID-19, according to estimates by the Centres for Disease Control and Prevention.

How diabetes affects heart health
If you have diabetes, your body either makes too much or not enough insulin, which results in too much glucose in your bloodstream. Over time, high blood glucose levels can increase damage to your organs, including your heart, brain and kidneys.

Diabetes is associated with a build-up of plaque that can clog arteries, so the longer you live with type 2 diabetes, the higher your cardiovascular risk. At least one-third of people with heart failure have diabetes, and heart disease is the leading cause of death and a major cause of heart attacks, heart failure, strokes and disability for people living with type 2 diabetes.

Managing high blood pressure and high cholesterol, which are common in people with type 2 diabetes, along with keeping blood glucose levels in check, supports heart health and may also prevent or slow down progression of chronic kidney disease – another condition that heightens the risk of severe COVID-19 complications.

COVID-19 precautions
Considering that people with conditions like diabetes and heart disease are at higher risk for severe illness from COVID-19, it’s especially important to keep health-related numbers in healthy ranges and manage these conditions, in addition to taking precautions against contracting the virus. Consider these tips from the American Heart Association and American Diabetes Association:

• If you’ve delayed or postponed medical appointments due to COVID-19, it’s vital to resume them, either in person or through virtual options.
• Continue to take medication as prescribed. If you’ve lost your medical insurance or can’t afford it, talk to your doctor or pharmacist about available resources. Stopping your medication without talking to your health care provider could lead to serious illness or death.
• Know your numbers. If you have diabetes, check blood glucose levels frequently and make necessary adjustments to insulin and diet to keep levels under control. If you have high blood pressure, make sure to monitor that number regularly from home.
• Manage stress, which can also impact blood glucose and blood pressure levels. In addition to maintaining your social support network (even if it’s through social distancing), exercise, adequate sleep and meditation can help improve your mental health.
• If you or someone around you has symptoms of heart attack or stroke, remember to call 9-1-1 as the hospital is still the safest place to go in a medical emergency.
• If you have diabetes, talk with your doctor about ways to reduce your risk of heart attack, heart failure, stroke and COVID-19.

Visit KnowDiabetesbyHeart.org for resources like diabetes-friendly recipes, success stories and a list of questions to ask your doctor.

http://www.thecharlottepost.com/news/2020/09/13/health/manage-your-medical-conditions-during-covid-19-pandemic/

Type 2 diabetes symptoms: Do you feel like you're always dehydrated? It could be a sign

From express.co.uk

TYPE 2 diabetes develops gradually over time, with one in four diabetics not knowing they have the condition. Could you be one of them? You may be if you're feeling thirsty right now

The tell-tale definition of diabetes is high blood sugars, which can be confirmed with a blood test or finger-prick device. For those who haven't been diagnosed with the condition, how can you tell if you've got it?
One of the earliest warning signs of diabetes is feeling "abnormally thirsty".

Medically known as polydipsia, the charity Diabetes UK added that the symptom is usually accompanied by "dryness of mouth".

This type of thirst isn't quenched by drinking a glass of water. In fact, no matter how much you drink, you still feel thirsty.

Abnormal thirst is one of the three big signs of type 2 diabetes: polyuria and polyphagia are the other two.
Polyuria – an increased need to urinate – tends to pair with abnormal thirst.

Why does this happen?

When the amount of sugar in the blood becomes too high, the kidneys work extra hard to remove excess sugar via urine.
This causes a person to urinate more often than usual (exceeding five litres per day).

             Type 2 diabetes: Do you find yourself drinking more and more? (Image: Getty)

Bear in mind the bladder – considered a storage tank for urine – can comfortably contain 500ml of wee. The NHS Trust commented that "the bladder should be emptied three to four hourly", meaning every four hours in a day.

People are recommended to drink between up to two litres every day, so doing the maths, four toilet trips in a day should be considered normal.
Those who suffer from diabetes are unable to effectively transport sugar from the blood into the cells.

Sugar (i.e. glucose) is an energy source for the body's cells, but in diabetes, the cells aren't able to absorb the sugar. As sugar keeps mounting in the bloodstream, instead of the cells, polyphagia can occur. Polyphagia is the feeling of intense hunger, as the body craves an energy source.
Simply eating will not satisfy feelings of polyphagia, as this will just increase blood sugar levels.

Sugar is sourced from the foods you eat, so eating will worsen symptoms.
If you're experiencing these symptoms, do book an appointment with your GP to get your blood sugar levels tested.

Other symptoms of the condition include fatigue, dizziness, blurred vision and slow-healing wounds.
Understandably, fatigue can occur as the body tires from not being able to use its energy source.
To recognise fatigue, it'll feel as though you're lacking in energy and you may find it difficult to carry out simple everyday tasks.
Feelings of dizziness may occur as the body becomes dehydrated and the brain struggles to function properly – this can show up as light-headedness.

Diabetes can cause the lens inside your eye to swell, affecting your vision – this can lead to temporary blurring of eyesight.
Slow-healing wounds can occur as diabetes affects the nerves, leading to poor circulation – and blood is vital in healing wounds.

https://www.express.co.uk/life-style/health/1334694/type-2-diabetes-symptoms-abnormal-thirst-polydipsia

New Risk Factors For Type 2 Diabetes Uncovered

From southfloridareporter.com

Globally, around 463 million adults lived with diabetes in 2019, according to the International Diabetes Federation (IDF). In 2015, approximately 9% of all adults had the condition.

Diabetes is a condition where sugar or glucose builds up in the bloodstream instead of being absorbed into cells. This occurs when cells either lose their ability to produce the hormone insulin or, in type 2 diabetes, they develop insulin resistance and are unable to use it productively.

Over the years, researchers discovered certain factors increase the risk of developing type 2 diabetes. These potential risk factors include alcohol consumption, skipping breakfast, daytime napping, anxiety disorders, urinary sodium, certain amino acids and inflammatory factors, and lack of sleep.

A new study that appears in the journal Diabetologia identifies 19 risk factors for type 2 diabetes. The Sweden-based researchers further evaluated 21 risk factors that have scarce evidence, and another 15 that reduce the risk of the condition.

Mendelian randomization

The team used a method called ‘Mendelian randomization’ (MR) to obtain their findings. This technique blends genetic information and conventional epidemiological methods. It also addresses questions related to causality without biases that could compromise the validity of epidemiological approaches.

Associate professor Susanna Larsson and Shuai Yuan of the Karolinska Institutet in Stockholm, Sweden, used data from the Diabetes Genetics Replication And Meta-analysis consortium. The duo evaluated 74,124 cases of type 2 diabetes and 824,006 control participants with European ancestry for the study population. The participants’ mean age was around 55 years, and 51.8% of them were male.

The researchers then screened 238 studies before including 40 individual papers in their MR investigation. Among the 97 factors they looked at, only 19 increased diabetes risk.

Insomnia was identified as a novel risk factor — people living with the condition are 17% more likely to develop type 2 diabetes than those without it.

Risk factors outlined

Speaking with Medical News Today, Larsson says, “Daytime napping also appears to be a risk factor for type 2 diabetes. However, because it is strongly related to insomnia, it’s unclear whether daytime napping is an independent risk factor for type 2 diabetes.”
The other risk factors include:

• depression
• smoking
• high blood pressure
• caffeine consumption
• childhood and adult obesity
• body fat percentage
• internal fat mass
• blood plasma levels of four saturated and polyunsaturated fatty acids
• blood plasma levels of three amino acids —valine, leucine, and isoleucine
• blood plasma levels of alanine aminotransferase, an enzyme that facilitates liver function

“It is important to highlight that obesity is still the predominant risk factor for type 2 diabetes. The observed association with insomnia was partially, but not fully mediated by obesity (higher body mass index),” adds Larsson. “The association between depression and type 2 diabetes might, in part, be mediated by insomnia.”

The exposures associated with a decreased risk of type 2 diabetes include:

• the amino acid, alanine
• high-density lipoproteins, or good cholesterol
• total cholesterol
• the age when females start menstruating
• testosterone levels
• birth weight
• adulthood height
• lean body mass for females
• four plasma fatty acids
• vitamin D
• education level

In their study, the authors further explain:

“Findings should inform public health policies for the primary prevention of type 2 diabetes. Prevention strategies should be constructed from multiple perspectives, such as lowering obesity and smoking rates and levels, and improving mental health, sleep quality, educational level, and birth weight.”

While the study’s findings offer important information that might be useful in drafting public health policies, its major limitation is the study population’s homogenous nature.

According to the IDF, 79% of adults with diabetes live in low- and middle-income countries. Studies have also found that the chance of developing diabetes is significantly higher for Black people — around 66 more cases of diabetes per 1,000 people — compared with white adults.
Larsson admits that major risk factors for type 2 diabetes might partly differ by ancestry. “Unfortunately, we were unable to […] perform similar analyses in populations of non-European ancestry,” she says.

https://southfloridareporter.com/new-risk-factors-for-type-2-diabetes-uncovered/

Recipe: Chicken, borlotti bean & vegetable soup with pistou

From diabetes.org.uk

Get your greens with this delicious low-fat soup, which uses pistou, a French version of pesto. With thanks to WW (Weight Watchers UK)

Serves 4  

Prep 15 minutes

Cook 55 minutes

Ingredients

Small handful of fresh flat-leaf parsley, roughly chopped

Small handful of fresh mint leaves, roughly chopped

Grated zest of 1/2 a lemon 2 garlic cloves, crushed

Calorie-controlled cooking spray

1 small leek, thinly sliced

2 x 165g skinless chicken breast fillets

1.5 litres chicken stock, made with 1 reduced salt stock cube

100g broccoli, cut into florets

200g asparagus, trimmed and chopped

120g frozen peas

400g tin borlotti beans, drained

100g sugar snap peas, sliced

Method

1. Make the pistou. Put the parsley, mint, lemon zest and half the garlic in a food processor with 1tsp water and process until smooth.
2. Mist a large saucepan with cooking spray, then put over a medium heat. Add the leek and the remaining garlic,
   and cook, stirring, for 5 minutes or
   until softened.
3. Add the whole chicken breasts and the stock to the pan with the leek, and simmer, covered, for 15 minutes or until the chicken is cooked through. Transfer the chicken to a board with a slotted spoon. Set aside to rest for 5 minutes, then slice thinly.
4. Add the broccoli, asparagus, peas and borlotti beans to the soup and bring to the boil. Reduce the heat and simmer, uncovered, for 3 minutes. Add the sugar snaps and sliced chicken, then simmer, uncovered, for 2 minutes or until the vegetables are just tender. Serve the
   soup topped with the pistou.

https://www.diabetes.org.uk/guide-to-diabetes/recipes/chicken-borlotti-bean-vegetable-soup-pistou?utm_source=bronto&utm_medium=email&utm_term=Try+the+recipe&utm_content=Try+the+recipe&utm_campaign=Enewsletter+September+2020

Flu jab and diabetes

From diabetes.org.uk

 Everyone with diabetes – including those who are pregnant – should get their free NHS flu jab to reduce their risk of getting the flu. This is because people with diabetes are more at risk of getting the flu and having diabetes will make it worse.

You can’t get the flu from the flu jab. But it takes two weeks to work – so you could still get the flu during that time. That’s why it’s important to get the jab as soon as you can, ideally during September.

Why you should get the flu jab when you have diabetes

Flu is serious and can make your blood sugar go all over the place. If your blood sugar isn’t within target, the effects of flu can be dragged out and increase your risk of developing serious complications like pneumonia. This puts you at risk of going into hospital. Getting a flu jab will help you avoid this.

A vaccine protects you against the most common types of flu currently around. As this changes each year, it means you need a new jab each year too.

Flu jab and coronavirus (Covid-19)

If you have coronavirus (Covid-19) you shouldn’t have the jab until you’re better. We don't know whether the flu jab will offer any protection against Covid-19. That's why it's important to continue to follow local guidance. But we do know that the flu jab is the best way of protecting yourself against flu.

Tips for getting the flu jab

You need to be aware of the following:

• If you have an illness or infection – including Covid-19 – and you feel like you have a fever, don’t get the flu jab. Wait until you’re better or speak to a healthcare professional about when to have it.
• If you’ve had a serious reaction to a flu jab in the past, tell the nurse and they will give you a different jab – don’t just go without it.
• The jab is made using eggs, but if you’re allergic to eggs, you can get an ‘egg-free’ jab. Your healthcare professional can help you find out more about this.

Where and when to book your flu jab (UK)

Book your flu jab appointment for early autumn if possible (September onwards). Contact your GP to book your jab if they haven't already got in touch. Or if it’s quicker and easier, get one from your local pharmacy, like Tesco or Boots.

If you can't leave your home

If you are housebound, speak to your GP as community workers may be able to come out and give you the jab at home.

If you're a parent

If your child is 8 or under or you’re caring for someone with learning difficulties, they may be offered a nasal spray by their GP or healthcare team instead of a flu jab to protect them against the flu. Children over 8 will be offered the flu jab.

Possible side effects

After any vaccination you may have side effects. This is natural and they’ll usually go after a few days. Using over-the-counter medications, like paracetamol, and drinking plenty of sugar-free drinks will help if you get a high temperature.

You might find your blood sugar levels are higher than normal. This will usually settle. But if your blood sugar levels remain consistently high, or you experience anything other than these mild side effects, you must tell your doctor or healthcare professional.

If you get flu

If you don’t get the jab in time, you might get flu. Your doctor or nurse should tell you what to do if you’re unwell, and we have lots of information about it too. You might hear these called your sick day rules.
If you take an SGLT2 inhibitor tablet, you should stop this when you’re not well. Your blood sugars may rise when you’re not well so don’t stop taking any other diabetes treatment. And see your doctor or nurse soon, before it gets serious.

Keep warm

You really need to keep warm during the winter, both indoors and outdoors. If your house is too cold, turn up the heating to at least 18°C (65°F).

Keep testing your blood sugars

Being unwell can cause your blood sugars to go up and down. If you normally test your blood sugar, you may need to do it more often depending on your diabetes treatment.

Keep hydrated and eat

Living with diabetes and being unwell can be made worse if you don’t keep your fluids up. Some medications mean you need to eat regularly, so try to eat a little and often. Carbohydrate-based drinks, like milk or juices, may help you manage your blood sugars alongside any medication.

Go to your GP

If your symptoms don’t improve, you need to see your GP. Don’t waste time. Leaving things until they get worse might lead to more serious infections.

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/flu-jab?utm_source=bronto&utm_medium=email&utm_term=Find+out+more&utm_content=Find+out+more&utm_campaign=Enewsletter+September+2020#where

How metformin works and why it's effective for type 2 diabetes

From insider.com

Metformin works by decreasing the amount of sugar in your blood and increasing your body's response to insulin. 

Metformin is one of the most commonly used oral medications for people with type 2 diabetes, and it is very effective at lowering blood sugar and A1C levels.

There are a few side effects of metformin, but these can be reduced by taking it with a meal. 

This article was reviewed by Jason R. McKnight, MD, MS, a family-medicine physician and clinical assistant professor at Texas A&M College of Medicine. 

Metformin is an oral medication most often used to treat type 2 diabetes. Roughly 80 million Americans take the drug, making it the most commonly prescribed medication to treat diabetes.
"Overall, metformin is a safe drug, and it reduces A1C up to 1.5% to 2.0%, which proves that it is very effective," says Dr. Anis Rehman, an assistant professor of clinical medicine in the division of endocrinology, diabetes, and metabolism at Southern Illinois University.

What is metformin? 

Metformin is approved by the Food and Drug Administration for the treatment of type 2 diabetes, though it's sometimes used "off-label" to treat polycystic ovarian syndrome. The purpose of the medication is to lower blood-sugar levels.
Metformin lowers blood sugar in three ways:

It decreases the amount of glucose, or sugar, that you absorb from your food.

It decreases the amount of glucose produced in the liver. 

It increases your body's response to insulin, making you better able to use blood sugar for fuel, just as people without diabetes do.

Metformin is a prescription medication that comes in a liquid, pill, or extended-release tablet. It's usually taken two to three times a day with meals, though the extended-release tablet is taken only once a day. It is available as a generic drug or under a variety of brand names, including:

• Fortamet®
• Glucophage®
• Glumetza®
• Riomet®

In addition, some combination tablets contain metformin along with other oral diabetes medications, such as glipizide or Pioglitazone. These combination medications include:

• Actoplus Met® 
• Avandamet® 
• Invokamet®

According to the American Diabetes Association, combination therapy can lower blood-sugar levels when metformin alone does not. People with initially high A1C levels of 7.5% to 9% may be advised to start combination therapy, though research is mixed on whether this lowers A1C levels faster than metformin alone.

How effective is metformin?

Metformin is very effective for most people with type 2 diabetes. In fact, a widely cited 2012 scientific review in Diabetes Care found that metformin reduced A1C levels by an average of 1.12% for patients with type 2 diabetes.

A more recent 2019 study published in the Pakistan Journal of Medical Sciences found that type 2 patients with the highest A1C levels saw the most dramatic increase after starting metformin.

The best way to measure the efficacy of metformin is to take an A1C test, which shows average blood-glucose levels over the past 12 weeks. As a result, you'll need to wait about three months after starting metformin to measure your A1C levels and get an accurate result, Rehman says.

Most people are prescribed metformin long term and should not stop the medication without talking to their doctor. "Diabetes type 2 is a chronic life-long disease, which means metformin is mostly prescribed for the long term," Rehman says.

 

It should be used along with lifestyle changes, like exercising more and counting carbohydrates, both of which can help control blood-sugar levels. In rare cases, in which patients effectively make major lifestyle changes, their doctor might wean them off metformin.

"In a small set of patients, with new diabetes type 2 diagnosis, lifestyle changes such as 10% body weight loss and carb-controlled diets can lead to diabetes type 2 remission," Rehman says.

Side effects of metformin 

The most common side effects of metformin are gastrointestinal issues including diarrhoea, flatulence, and nausea. As many as half of patients experience these, but they generally resolve in one to two weeks, Rehman says, and can be decreased by taking metformin with meals.

One serious but rare side effect of metformin is lactic acidosis, says Dr. Jordan Messler, a hospitalist at Morton Plant Hospitalist group in Clearwater, Florida.
Lactic acidosis occurs when lactic acid builds up in the body. This most commonly occurs in metformin patients when they are taking too much of the medication or also have kidney disease. Warning signs can include an elevated heart rate or respiratory rate, so contact your doctor immediately if you experience those.

Lactic acidosis occurs only about six times for the equivalent of every 100,000 years of patient use of the drug, however. "This is a rare event," Messler says.

During August 2020, two lots of extended-release metformin tablets were recalled because of contamination with the chemical N-nitrosodimethylamine. People on extended-release tablets should check with their doctor or pharmacist to see whether their pills were affected but should not stop taking them until they have replacement pills.

Takeaways

Overall, metformin is effective and has few side effects, which is why it has stood the test of time.
"Metformin has been in use as a treatment for type 2 diabetes since the 1950s," Messler said. "It has a strong safety profile, is well tolerated by patients, and has minimal interactions with other medications."

https://www.insider.com/how-does-metformin-work

Mental Wellness in Diabetes

From diabetesselfmanagement.com
By Laura Hieronymus, DNP, MSEd, RN, MLDE, BC-ADM, CDCES, FADCES, Katy Walker, LCSW

Your thoughts, feelings and beliefs affect your happiness and health — especially if you’re dealing with a chronic illness. Diabetes is hard. Taking care of yourself with diabetes is even harder. When trying to keep up with self-care demands, the amount of stress that comes with dealing with a chronic illness can be overwhelming. If left unchecked, such mental fatigue can lead to burnout. Symptoms of diabetes burnout include negative feelings about diabetes (“why me?”), avoiding diabetes self-care (for example, skipping medication or not checking your blood glucose levels), feeling isolated due to diabetes, and feeling like your life is controlled by diabetes. In fact, people with diabetes are two to three times more likely to deal with mental health issues like anxiety and depression. Unfortunately, only 50% of patients with diabetes are properly diagnosed and treated for mental health concerns. This means that understanding the link between diabetes and mental health and being able to advocate for yourself is more important than ever.

Hopefully, this article will help you navigate mental wellness and also give you information on how you can be an advocate for your mental health — information about what mental health treatment means when managing a chronic illness, different types of mental health professionals, what concerns may alert you to mental health issues, and how to discuss your concerns with your diabetes care provider will all be discussed.

What is mental health treatment?

What is “mental health treatment” all about? A vision of a person lying on a couch and talking about his childhood often comes to mind, but this is far from the truth. Although a mental health provider may help you open up about issues that began in your youth, mental wellness is all about helping you navigate how to lead a healthier and happier life now. Assessing and addressing psychosocial issues is a standard part of optimal diabetes care. A clinical professional who is credentialed to focus on mental health is considered an essential member of the diabetes care team.

Who is a mental health professional?

The two most common clinical mental health professionals are therapists and psychiatrists.

Therapists

To put it simply, a therapist is someone who helps you talk through your problems, adjust negative thinking patterns and manage stress using evidence-based interventions. “Therapist” is a broad term that includes several different titles or professions. Therapists include clinical professionals such as psychologists, counsellors (both individual and marriage/family) and social workers. Therapists have specialized mental health training and are educated at a master’s level or above; however, they do not prescribe medication. Specific education required for therapists varies by state.

Beyond therapy, you may also be referred to a psychiatrist to help you address symptoms when medication is needed. 

Psychiatrists

The primary function of a psychiatrist is assessing mental health issues and prescribing medicine for those diagnoses. A psychiatrist is a physician who studied general medicine and then decided to specialize in mental health issues. Advanced practice nurses and physician assistants may specialize in mental health medication management as well. After your initial assessment, you will usually see your psychiatrist no more than once a month. It is not common in most practices for a psychiatrist to provide “therapy;” rather, these specialists typically provide medication management for any identified mental health concerns. 

How do I know if I need mental health treatment?

Depression and anxiety are two of the most common issues that people with diabetes face. And who could blame them? Diabetes requires a lot of work. The most common assessments used to determine if someone may be experiencing a mental health issue are the Patient Health Questionnaire 9 (PHQ-9) and the Generalized Anxiety Disorder 7 (GAD-7). The PHQ-9 assesses depression symptoms, and the GAD-7 evaluates symptoms of anxiety disorders. Neither is meant to be a definitive diagnosis or outline treatment plans. However, both tools can act as a starting point for taking control of your mental health (see below).

Keep in mind that treatment recommendations are not one-size-fits-all, and referral to a mental health professional is sometimes needed. Both of these tools should be administered or evaluated by healthcare professionals.

How do I ask for help? 

Sometimes it can be difficult to admit you’re going through a hard time. But don’t let that discourage you. Everyone needs a little help sometimes, and health issues are hard for anyone. Mental well-being should be a focus in diabetes management, and your diabetes care provider has heard it before. Here are some suggestions on what to talk to your diabetes care provider about if you have some of the symptoms above:

Tell your diabetes care provider how you feel. Be honest. Let the provider know that diabetes can be overwhelming, and strategies for dealing with the stress (or other negative emotions) would be helpful. It may be useful to bring your results from the PHQ-9 and the GAD-7 to give you reminders of specific issues to discuss. Most providers understand that diabetes self-management is both physical and mental.

Ask if there are any mental health resources available. Many diabetes clinics have a therapist who can be utilized by patients (even if they are not in the clinic full-time). Whether you are having trouble affording your medicine or feeling overwhelmed with caring for your health, be sure to speak up. Knowing your options puts you in a better position to take charge of your mental health.

Takeaways

The bottom line is that YOU are in charge of your own well-being — including your mental health. You should feel comfortable speaking to your diabetes care provider about your mental well-being. To locate a therapist in your area, start with the following organizations, adding your zip code or city/state, insurance provider and therapy needs:

psychologytoday.com

professional.diabetes.org/ada-mental-health-provider-directory

You are in charge of your life, so exercise your right to help yourself by seeking out any mental health resources that may be helpful.

https://www.diabetesselfmanagement.com/healthy-living/emotional-effects/mental-wellness-in-diabetes/