Diabetes: If you’re prediabetic, you can manage your diet, get more exercise, be kind to your pancreas

From nkytribune.com

Millions of Americans do not know that they are prediabetic, according to The Centre for Disease Control and Prevention (CDC). In Kentucky, 13%, or 1 out of every 8 Kentuckians is living with type 2 diabetes. Preventing type 2 diabetes is possible by following diet and exercise guidelines.

“Be nice to your pancreas. Being nice to your pancreas would be limiting those types of foods and drinks [high in carbohydrates and sugars],” says Paula Bergen, RN, BSN, CDCES, Diabetes Educator, Consultant for the Northern Kentucky Health Department.

Bergen says foods high in carbohydrates and sugars make your glucose level “gush.” When you drink sugary drinks like juices, soda, and sports drinks and eat high carb foods like cakes, pies, doughnuts, and candies, the sugars are immediately absorbed into the stomach and go right to the pancreas which puts out insulin, says Bergen.

The insulin helps the sugar move from the blood into the cells. The cells then use the sugar to make energy. When the cells are no longer sensitive to sugar, the amount of insulin made increases, says Bergen.

Add more vegetables.

The American Diabetes Association (ADA) provides guidelines on nutritious foods to eat. Whole, unprocessed, non-starchy vegetables including lettuce, cucumbers, broccoli, tomatoes, and green beans are healthy choices. The ADA says these foods have a lot of fibre and few carbohydrates, having little impact on your blood sugar.

Other whole foods to eat include fruits like apples, blueberries, strawberries, and cantaloupe. Whole grains such as brown rice, whole wheat bread, whole grain pasta, and oatmeal are healthy. More good foods to feed your body are corn, green peas, sweet potatoes, pumpkin, plantains, beans, and green lentils.

“It’s about making choices and portions. People with diabetes can eat whatever they want, they just have to be mindful and understand their situation,” says Bergen. She says that women should stay under 45 grams of carbohydrates per meal and men under 60 grams per meal.

Bergen gives some real-life examples of making healthy choices. “Take something that’s a carbohydrate and add protein or fibre to it,” she says. For instance, sweet potato is a vegetable and a carbohydrate but is healthy because they have a lot of vitamins and minerals. The peel has more fibre, preventing a “gush” in blood sugar levels. Adding brown sugar and cinnamon would not be healthy, creating that “gush.”

When dining out, Bergen says to read the menu. “It is hard to find something decent to eat that is not been dripping in oil, filled with salt, or sugar,” she says.

At fast food places, load your sandwich with vegetables. At a sit-down location, get a vegetable omelette, fresh fruit, and sourdough toast, Bergen says. Sourdough is healthy because anything fermented is healthy.

At a steakhouse, order the smallest steak, about 6 ounces, with a small salad. Bergen says to also consider the portion amounts. In some places, the potato served can be considered four portions. Take these ideas and project them onto your situation. Think creativity of how you can slowly change your diet.

Bergen follows her grandmother’s advice. “My grandmother lived until she was 84 years old. She said, ‘eat close to the earth Paula, eat close to the earth.’ She said, ‘if you can’t dig it out of the ground or pick it off the tree or you grow it,’” then don’t eat it, she says.

Physical activity is just as important in preventing and controlling type 2 diabetes. When active, the cells become more sensitive to insulin, working more effectively. Losing 10-15 pounds can greatly impact your health, according to the ADA. Make it simple. The best exercise is finding what works for you.

The CDC says two key acts can cut your risk of developing type 2 diabetes in half. One is to lose just 5% to 7% of your body weight. The second is to get 150 minutes of moderate physical activity per week, or 30 minutes a day for five days.

The A1C number is an estimate of blood sugar levels over the past three months. Obtained from a blood draw, it is used to diagnose type 2 diabetes. Bergen says any number below 5.7% is normal. 5.7-6.4% is considered prediabetic. Over 6.5% is diabetic.

“If you find that you have pre-diabetes or diabetes, now you have the opportunity to make changes and do something about it,” Bergen says.

Everyone is different and no one will respond or be affected by the disease in the same way. “It’s just really difficult for human beings to make changes once they form habits,” Bergen says. You do not have to change your whole life all at once. “Go in small, attainable increments,” and you will be successful, she says.

https://www.nkytribune.com/2020/11/diabetes-if-youre-prediabetic-you-can-manage-your-diet-get-more-exercise-be-kind-to-your-pancreas/

Type 2 Diabetes: It’s preventable. Know warning signs, make lifestyle changes

From nkytribune.com

Type 2 diabetes was the 7th leading cause of death in the United States in 2017, according to the Centre for Disease Control (CDC). Kentucky has the 7th highest rate in the U.S., over 440,000 residents live with the disease, says the Kentucky Cabinet for Health and Family Services (KCHFS) 2019 report. Type 2 diabetes is preventable. Know the warning signs and risk factors. Making lifestyle changes can help prevent this disease from on-setting.

“It is a complicated issue. It’s not just how the body breaks down carbohydrates and uses them for fuel and stores energy, it’s also how our fat cells, in our muscle cells, in our brain and the rest of your body utilizes the glucose,” says Paula Bergen, RN, BSN, CDCES, Diabetes Educator, Consultant for the Northern Kentucky Health Department. There are other hormones besides insulin that come into play too, she says.

"Basic signs and symptoms [of type 2 diabetes] are: feeling thirsty, feeling tired, skin infections that don’t go away, blurred vision, dry itchy skin, and urinating more often,” says Bergen. Other symptoms can include feeling hungry (even after eating) and tingling, pain, or numbness in hands and feet according to the American Diabetes Association (ADA).

Bergen warns that some people may not have any symptoms.

There are several risk factors for type 2 diabetes. Type 2 diabetes can be hereditary, but that does not mean it will develop. Those 45 years of age and older, African Americans, Hispanic/Latinos, American Indian, Asian American, Pacific Islander, and having a parent and/or sibling with type 2 increases the chance for developing type 2.

However, many risk factors can be controlled. Among these, Northern Kentuckians rank high in each category.

One main risk factor attributed to the high rate of type 2 diabetes is being overweight or obese, says Bergen. The more excess weight, the more cells become resistant to insulin. The KCHFS 2019 report says 68% of Kentuckians are overweight.

Kentucky is the fifth most obese state in the U.S., according to data from the CDC.

Being overweight is defined as having a Body Mass Index (BMI) of 25 or higher. BMI is a measurement of body fat based on height and weight. Northern Kentucky is a little above the state average. 72% of Boone, 66% of Campbell, and 73% of Kenton County residents are considered overweight.

Smoking is directly related to diabetes, says Bergen. The Federal Drug Administration (FDA) says that high levels of nicotine cause insulin to not work as well as normal. The production of insulin increases, leaving the body not knowing how to respond to its effects. The pancreas stops making it, which causes blood sugar levels to become abnormal.

The KCHFS report says, 23% of Kentuckians diagnosed with type 2 diabetes are smokers

Locally, Kenton county has a smoking rate above the state level.

“Tobacco use is the leading cause of preventable death in the United States and around the world. Every year more than 8,000 Kentuckians die of illnesses caused by smoking,” says KCHFS.

Exercising is so important for many reasons, including reducing the risk of type 2 diabetes. Physical inactivity plays a role in its development.

The ADA says exercising makes insulin more sensitive. Cells can then better utilize available insulin to take up glucose, which is needed for energy. To stick with an exercise routine, the ADA recommends picking an enjoyable activity, that fits into a flexible schedule, and is within budget.

Walking is great exercise. (Creative Commons)

Other chronic illnesses influence diabetes. High blood pressure or hypertension and high cholesterol are both intertwined in the development of diabetes.

The American Heart Association (AHA) says that with diabetes, good cholesterol goes down while triglycerides, the bad cholesterol, go up. This increases the risk of heart disease and stroke. Having both high blood pressure and diabetes significantly increases the risks of heart-related problems.

Bergen says diabetes is related to poverty.

“When you look at people with diabetes, people living in poverty have a higher rate,” she says, partly because they cannot afford fresh foods. Instead, more staple grocery items like rice, noodles, and potatoes are purchased. The lack of proper nutrition and the consumption of sugary drinks are risk factors for developing diabetes.

Both Bergen and the ADA say that knowing your risk factors is important. Age, gender, family history, blood pressure, physical activity, race, and BMI give you clues.

To learn more, take the ADA risk assessment quiz. Of course, talk to your doctor about risk factors and potential lifestyle changes. There are blood tests that measure glucose levels, diagnosing pre-diabetic, or type 2 diabetes. Knowing this, allows steps to be taken to prevent or manage diabetes.

“When you look at it, diabetes really is an epidemic,” says Bergen. “If you find that you have pre-diabetes or diabetes, you have the opportunity to make changes and do something about it.”

https://www.nkytribune.com/2020/11/diabetes-its-preventable-but-a-leading-cause-of-death-know-warning-signs-make-lifestyle-changes/

Managing the depression that can come with diabetes can be equally difficult

From miamiherald.com

The coronavirus pandemic, particularly with its surging U.S. cases, is playing havoc with people’s stress.

But diabetics can’t afford high levels of stress, which can cause blood sugar levels to skyrocket.

Diabetes is the seventh-leading cause of death in the United States with more than 34 million people, or more than 10 percent of the population, suffering from the condition, according to the Centres for Disease Control and Prevention (CDC).

People suffering from diabetes have an increased risk for severe illness from the virus that causes COVID-19, the CDC reports. A Reuters study also revealed that 40 percent of U.S. COVID-19 deaths occurred in people with diabetes. 

African Americans and Hispanics suffer from diabetes at higher rates than non-Hispanic whites and have disproportionately suffered from COVID-19.

A patient measures their glucose levels with a blood test via a glucometer Andrey Popov Getty Images/iStockphoto 

Some people, especially within the Hispanic community, falsely believe they do not have diabetes, said Matilde Lewis, a registered nurse and certified diabetes educator at Baptist Health South Florida. Instead, they feel they are only experiencing emotional diabetes, described as spikes in blood sugar levels triggered by an emotional event or crisis.

Myth of emotional diabetes

“That’s a myth,” Lewis said. “Just like you can’t be a little pregnant. The same holds true with diabetes. You either have diabetes or you don’t.” 

Education is the first step in combating the myth of emotional diabetes, said Sonia Angel, a certified diabetes care & education specialist and licensed dietitian who is the coordinator for the Diabetes and Nutrition Centre at Memorial Regional Hospital in Broward.

“I tell patients they are in control of their diabetes instead of allowing their diabetes to control them,” Angel said. “A lot of people go into denial and think it’s not that serious because they don’t have symptoms. But, when stressful situations come up, then they have to deal with it.”

When blood-sugar levels are out of control they may experience excessive thirst, frequent urination, headaches, unintentional weight loss and wounds that don’t heal, Angel said.

“They may associate that with the emotions that they are going through, but it’s really uncontrolled diabetes that they are not treating or never diagnosed,” Angel said.

Depression, denial and anger

Patients diagnosed with diabetes often experience a range of emotions including depression, denial, anger and guilt, Angel said.

“They falsely believe that only people who are overweight or eat poorly are diagnosed with diabetes,” Angel said. “That is a myth. So they may feel guilty and think they wouldn’t have diabetes if they had lost the weight they needed to lose or eaten better. That is not true.”

Although emotional diabetes is a myth, diabetes-related distress is a real problem. It is the emotional and behavioural changes caused by diabetes , which include multiple expectations such as healthy eating, exercising, and monitoring blood sugar levels to treat the condition. 

“Diabetes-related distress is a part of diabetes,” said Dr. Rajesh Garg, director of the Comprehensive Diabetes Centre at the University of Miami Health Systems. “Patients can be helped with all these factors to make it easier for them to cope. 

“It has been shown that those with higher distress also have more complications from diabetes, higher blood sugar and need more medication.”

Emotional health tied to physical health

There also is a strong relation between the psychological health of the patient and their diabetes status, Garg said. Although the ADA has recommended that diabetic patients be screened for psychological health, it often isn’t done, Garg added. 

“It is important for patients to talk with their physicians and be very honest about how they are feeling,” Garg said. “There are small things that can be done to improve or remove their stress. 

“For example, many patients, especially these days, are struggling to pay co-pays. We don’t realize it until someone brings it up and says this is causing a lot of stress. There are always ways to find alternatives to reduce co-payments.” 

During the pandemic, Lewis noted there has been a direct correlation to stressful eating for patients due to the anxiety of not being able to go outside and fear of becoming sick or making a loved one sick.

“During the past nine months, we’ve noticed patients have gained weight and their blood sugars have gone up,” Lewis said. “It is due to the stressful time that we are in. They are eating more or mindlessly eating in response to anxiety and stress while not being able to go to the gym or exercise.”

Although the gym may not be an option for some, Lewis suggests that patients go out for a walk when feeling stressed and wanting to eat. Also, try drinking more water and eating vegetables and foods with higher fibre.

If patients are depressed or having difficulty coping with their diabetes diagnosis, reach out to family and friends, join virtual support groups or seek counselling.

“One of the most important things is finding out how you are going to live with diabetes rather than falling into anger or denial,” Angel said. “It is not just what you eat. It is a lifestyle change.”

https://www.miamiherald.com/living/health-fitness/article247185414.html

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Bluetooth Eases Management of Type 1 Diabetes

From healthier.stanfordchildrens.org

Technology enables communication between two advanced devices

“The closest thing yet to an artificial pancreas.”

“A remarkable, life-changing technology.”

“A big step toward lessening the burden of type 1 diabetes.”

Those are just some of the comments made by physicians and diabetes educators about a new way to cope with type 1 diabetes that has revolutionized how patients manage this chronic disease.

Through a partnership between Stanford Children’s Health and John Muir Health, Stella and Sophie are receiving Stanford care closer to home in the East Bay. Our Stanford experts offer cutting-edge treatment for patients with type 1 diabetes (including the use of Bluetooth technology to provide around-the-clock readouts of blood-glucose levels).

Two devices now communicate with each other to ease diabetes challenges

For the past couple of years, people with type 1 diabetes have had access to two tools that have dramatically changed how they administer insulin and monitor their blood glucose levels:

• the insulin pump, a device attached to the user that replaces self-administered insulin injections; and,
• the continuous glucose monitor (CGM), a digital device also worn by the user that monitors glucose levels 24/7, eliminating the need for pricking the finger every few hours to check glucose levels.

“There are just so many times you can stick your child’s finger,” says Jen, mother of 7-year-old Sophie, who was diagnosed with type 1 diabetes this year. “The CGM gives Sophie the freedom to lead a more normal life.”

These two breakthrough technologies were life-changing in themselves. But in 2020, manufacturers took these devices to a new level: They connected them via Bluetooth to create a hybrid closed-loop system that enables the CGM to trigger the insulin pump into action automatically, whenever insulin levels get too low or too high.

And with Bluetooth communications, the user’s mobile phone provides a readout of blood glucose levels around the clock.

“This development creates a huge source of motivation for my patients,” says Suruchi Bhatia, MD, an endocrinologist at Stanford Children’s Health.

And a recent study* published in the Journal of the American Medical Association found that teens and young adults using these monitors had better long-term blood sugar control than those who used manual blood sugar monitoring.

Meet Stella, diagnosed with type 1 diabetes at age 9

Stella, 15, was diagnosed with type 1 diabetes at the end of fourth grade, right before summer vacation. “I felt really bad about it then,” she recalls. “But now I feel the diagnosis has helped me get stronger in every way. I have a kind of can-do attitude about everything now, not just diabetes.”

With advances in technology, she can now sleep through the night, do the activities she likes, and take tests in school without having to explain to her teachers that no, she’s not looking at her phone—she’s just checking her glucose pump.

“I’m in Colour Guard at school, and it’s a big help not to have to take a break while we’re working out to go check my levels,” she says. “If I’m increasing my activity, my Bluetooth system just lets my glucose monitor talk to my insulin pump to make adjustments automatically.”

“Because of Bluetooth, Stella’s insulin pump now has brains,” notes Jeff, Stella’s dad.

Bluetooth provides benefits for the whole family

“Now we can sleep through the night without worrying about finger sticks and glucose levels,” says Sarah, Stella’s mom.

Parents can even keep track of their child’s blood glucose levels when the child is away, by connecting the child’s monitor to their own mobile phone.

And patients can set the monitor for a target overnight level without needing to awaken every few hours to check it.

Most of all, the new system lets kids socialize, exercise, and eat when they want to.

Diabetes and COVID-19

As we progress through the COVID-19 pandemic, we know that some parents are reluctant to seek care for their ill or injured children because of concerns about exposure to the coronavirus.

If you think your child may be showing signs of diabetes, seek care immediately! The risk of a diabetic coma or the onset of ketoacidosis (a side effect of diabetes) is far more serious than that of exposure to COVID-19.

It’s always prudent to be careful about exposing children to any disease. But it’s crucial to understand that physicians’ offices, urgent care centres, and hospital emergency rooms are all following scrupulous standards to maintain cleanliness and safety, to minimize the risk of exposure to the virus that causes COVID-19.

Signs your child may be developing diabetes include:

• Frequent urination, including awakening at night to urinate.
• Weight loss.
• Excessive thirst.

If you observe these conditions in your child, don’t wait. Call your physician, or go to an urgent care centre or emergency room for an assessment.

https://healthier.stanfordchildrens.org/en/bluetooth-further-eases-management-of-type-1-diabetes/

Drug lets kids with type 1 diabetes produce insulin

From futurity.org

A drug called golimumab currently on the market for other autoimmune conditions can help kids and young adults newly diagnosed with type 1 diabetes still produce insulin, according to new research

The drug can preserve the beta cells of children and young adults newly diagnosed with type 1 diabetes for at least a year after diagnosis, the study shows.

The findings represent a major step forward in the effort to find ways to preserve the insulin-making capabilities of children and young adults with type 1 diabetes.

The new study in the New England Journal of Medicine reports on the 52-week treatment period. Researchers will follow with a period where they monitor participants when they don’t take the drug.

The Phase 2 study demonstrates that golimumab, an anti-tumour necrosis factor (TNF) therapy, reduced the amount of injected insulin children and young adults with newly diagnosed type 1 diabetes need to take by preserving their ability to produce insulin on their own, called endogenous insulin.

The need for less injected insulin is a major quality of life improvement for patients with type 1 diabetes, according to the researchers.

Golimumab, marketed as Simponi, is currently approved to treat rheumatoid arthritis, ulcerative colitis, and other autoimmune conditions, but the US Food and Drug Administration has not approved it for the treatment of type 1 diabetes.

Golimumab and beta-cell function

“The most important finding of our work is that this drug, golimumab, is a potential disease-modifying agent for newly diagnosed type 1 diabetes,” says first author Teresa Quattrin, professor of paediatrics at the University at Buffalo. “The main goal of the study was to see if golimumab could preserve beta-cell function in these newly diagnosed patients, and it does.”

The team determined that beta-cell function was preserved based on the amount of C-peptide in patients’ blood during a four-hour mixed meal tolerance test. Because C-peptide reflects only insulin made by the body and not injected insulin, C-peptide levels reveal how well the pancreas is producing insulin.

Patients treated with golimumab had higher C-peptide levels at week 52 compared to placebo. “This was statistically significant, thus the study met its primary goal,” Quattrin says. “In fact, 41% of participants receiving golimumab had an increase or less than 5% decrease in C-peptide compared to only 11% in the placebo group.”

Type 1 diabetes ‘honeymoon period’

The current study is the culmination of decades of work that Quattrin has conducted at the University at Buffalo and at the Diabetes Centre at UBMD Paediatrics and John R. Oishei Children’s Hospital. She has been interested in finding ways to extend the remission, or honeymoon period, to preserve the ability of recently diagnosed type 1 diabetes patients to continue to make insulin on their own.

Patients newly diagnosed with type 1 diabetes generally have elevated levels of tumour necrosis factor alpha, which is directly toxic to the pancreatic beta cells that produce insulin. In 2009, building on positive findings in animal models treated with anti-TNF therapy, Quattrin and her team published a randomized pilot study where 10 patients received another TNF inhibitor and eight received placebo starting within 28 days from diagnosis. The results of that small proof-of-concept study strongly suggested that this class of drugs might be able to preserve beta-cell function in newly diagnosed patients with type 1 diabetes.

“Patients newly diagnosed with type 1 diabetes don’t stop making insulin all of a sudden,” explains Quattrin. “During the period just after diagnosis, called partial remission or the honeymoon period, patients are still able to make some insulin on their own. That is the period we have targeted with this study of golimumab.”

Nearly 43% of those in the current study who received golimumab were in partial diabetes remission versus 7% of those receiving placebo. The definition of partial remission was based on insulin dose and blood sugar control levels as indicated by haemoglobin A1C, a measurement of average blood sugar levels over three months.

Better blood sugar control

While both groups of patients in the current study achieved good blood sugar control, those receiving golimumab did so with less injected insulin, which Quattrin described as a critical benefit.

“During the 52 weeks of the study, insulin dose increased only slightly for those on golimumab, 0.07 units per kilogram (about 2.2 pounds) per day, versus 0.24 units per kilogram per day for those on placebo. Moreover, in a post-hoc analysis, an analysis conducted after the conclusion of the clinical trial, those who were younger than 18 years had 36% fewer episodes where blood sugar was less than 54 mg per decilitre, designated by the American Diabetes Association as level 2 hypoglycaemia,” Quattrin says.

This is important clinically because low blood sugar reactions are dangerous and can prove fatal if untreated. Episodes of low blood sugar require immediate attention, often causing disruption to the child (e.g., they have to be removed from class or recreation/sports activities), thereby compromising quality of life.

A child with type 1 diabetes requires about 1 unit of insulin per kilogram of body weight per day, Quattrin says. That means that a child weighing about 65 pounds typically requires about 30 units of injected insulin per day once they are out of the partial remission period, about three to six months after diagnosis.

Parents or the participants themselves administered Golimumab as a subcutaneous injection every two weeks. No serious side effects related to the study drug, such as serious infections, were reported.

Researchers conducted the randomized, controlled clinical trial at 27 centres throughout the US, including at the Diabetes Centre at UBMD Paediatrics and Oishei Children’s Hospital in Buffalo. It involved 84 patients, aged 6 to 21 years, with two-thirds receiving golimumab and one-third receiving placebo starting within 100 days from diagnosis.

Additional co-authors are from the University of Florida, the University of Colorado, Emory University, and Janssen Research & Development LLC. The World Without Disease Accelerator, a group within Janssen Research & Development LLC, funded the study.

https://www.futurity.org/diabetes-type-1-insulin-golimumab-2476222-2/

American Diabetes Month: why diet and exercise are so important to me

From sixmilepost.com

November marks American Diabetes Awareness Month, a time where diabetics come together to raise awareness of their disease, struggles, stories and success. Last Thursday, Kimberly Roberts, Assistant Professor of Nursing, hosted a webinar that explained what diabetes is, what types exist and how to treat it. During the webinar, Roberts focused on the detection and prevention of type 2 diabetes. Roberts also went into depth on the management of the different forms of diabetes.

Diabetes is commonly stereotyped and misunderstood. Many confuse type 1 and type 2 or simply do not realize there is more than one type of diabetes. However, the truth is that it afflicts millions of Americans, radically changing their way of life. For me, cultivating a better understanding of the disease for both those with and without it is very important.

Roberts emphasized the importance of diet and exercise for every type of diabetes. She talked about a dieting technique that has been modified for diabetics: the diabetes plate method. This is an aspect that I, a type 1 diabetic, can attest to personally.

As a diabetic of 16 years, life has been a constant race of trial and error. Every morning is the beginning of a brand new trial. For those who are newly diagnosed, this can make life seem daunting. However, one of the best treatments I have been able to utilize is safe self-treatment: exercise and diet. Life as a diabetic is even more sporadic and unpredictable, which makes the factors that can be controlled so important.

Exercise is important to everyone’s health, but for a diabetic, it is even more so. The complications of uncontrolled diabetes are terrifying and life-threatening. But regular exercise lowers blood sugars, insulin resistance and improves metabolism, giving more control over the diabetic’s life.

Diet is even more important, given that you eat more than you exercise. Diet is also one of the hardest things to control as a diabetic. Getting into an exercise routine requires time and willpower, but diet is influenced by too many factors and too heavily by chance. You might not be able to control every meal you will ever eat. This makes diet the most important aspect to control as a diabetic.

Roberts talked about the importance of fibre and starches in the diet of a diabetic. Dietary fibre is a complex carbohydrate that is not broken down by the body for energy. Starches, however, are broken down by the body for use as energy. Simple sugars — labelled as “total sugars” in nutrition facts — are directly absorbed by the body. Starches are an excellent carbohydrate source of energy for diabetics, as their impact on blood sugar is much slower than simple sugars, which makes them easier to control.

For newly diagnosed diabetics, carbs may easily be mistaken as the enemy. The issue with carbs is that they are necessary for a diabetic’s diet plan. The distinction is the importance of eating a diet high in fibrous and starchy carbohydrates and low in simple and added sugars. Roberts suggests eating a large diet of leafy green vegetables, like broccoli and spinach. She also utilizes a test to help those who fear they may be pre-diabetic: a term to describe someone at risk for type 2 diabetes.

Diabetes is an umbrella term for three different known diseases that are characterized by decreased or halted insulin production in the body. The general idea of diabetes is usually associated with either type 1 or 2.

Type 2 is more common, preventable and manageable. Age, weight, underlying conditions and race all play a part in the likelihood of becoming type 2. Individuals with type 2 are what is known as insulin resistant. Insulin, a hormone produced by the pancreas, is used by the body to properly regulate sugar levels in the bloodstream.

Gestational diabetes is a disorder that afflicts women during pregnancy by increasing insulin resistance. It is typically lost shortly after birth.

Type 1 is less common, afflicting over 1 million Americans. Type 1 is typically diagnosed in childhood. Type 1, unlike type 2 and gestational, is an autoimmune disease. This means the immune system of a person with type 1 attacks its host body, specifically the beta cells in the pancreas, which produce insulin.

https://sixmilepost.com/8388/opinion/american-diabetes-month-why-diet-and-exercise-are-so-important-to-me/

What is Gestational Diabetes and how does it affect my pregnancy?

From themonitor.com

By: Dr. Fawzi Saoud

DHR Health Maternal Foetal Medicine

• What is Gestational Diabetes (GD)?
A condition that develops for the first time during pregnancy, in which too much sugar stays in the blood instead of being used for energy. Women with GD need special care both during and after pregnancy.

• What causes GD?
Normally, the body produces a hormone called insulin that keeps blood sugar levels in the normal range. During pregnancy, higher levels of pregnancy hormones can interfere with insulin. But in some women, the body cannot make enough insulin during pregnancy, and blood sugar levels go up. This leads to GD.

• Who is at risk for GD?
It can occur in women who have no risk factors, but it is more likely in women who: are overweight or obese, who have PCOS (Polycystic Ovary Syndrome), are physically inactive, had GD in a previous pregnancy, had a very large baby (9 pounds or more) in a previous pregnancy, have high blood pressure, or have a history of heart disease.

• How can GD affect your baby?
Babies born to women with GD may have problems with breathing and jaundice. These babies may have low blood sugar at birth. Large babies are more likely to experience birth trauma, including damage to their shoulders, during vaginal delivery. Large babies may need special care in a neonatal intensive care unit (NICU). There also is a higher risk of stillbirth with GD.

• How can GD affect you and your pregnancy?
When a woman has GD, her body passes more sugar to her foetus than it needs. With too much sugar, her foetus can gain a lot of weight. A large foetus (weighing 9 pounds or more) can lead to complications for the woman, including labour difficulties, caesarean delivery, heavy bleeding after delivery and severe tears.

• When will you be tested for GD?
All pregnant women should be screened for GD. Your Ob-gyn will ask about your medical history to determine whether you have risk factors for GD. If you have risk factors, your blood sugar will be tested early in pregnancy. If you do not have risk factors or your testing does not show you have GD early in pregnancy, your blood sugar will be measured between 24 weeks and 28 weeks of pregnancy.

• Should you change your diet if you have GD?
When women have GD, making healthy food choices is even more important to keep blood sugar levels from getting too high. If you have GD, you should eat regular meals throughout the day. You may need to eat small snacks as well, especially at night. Eating regularly helps avoid dips and spikes in your blood sugar level. Often, three meals and two to three snacks per day are recommended.
Also, it is important to gain a healthy amount of weight during pregnancy. For a woman with GD, too much weight gained or weight gained too quickly can make it harder to keep blood sugar levels under control.

• What about exercise?
Exercise helps keep blood sugar levels in the normal range. In general, 30 minutes of moderate-intensity aerobic exercise at least 5 days a week is recommended. Walking is a great exercise for all pregnant women. In addition to weekly aerobic exercise, it’s a good idea to add a walk for 10–15 minutes after each meal. This can lead to better blood sugar control.

• Will medications be needed?
For some women, medications may be needed to manage GD. These medications can come in the form of pills by mouth or injections such as insulin.

• How will GD affect your delivery?
Most women with controlled GD can complete a full-term pregnancy. But if there are complications with your health or your foetus’s health, labour may be induced (started by drugs or other means) before the due date. Although most women with GD can have a vaginal birth, they are more likely to have a caesarean delivery than women without GD.

• What are future health concerns for you and your child?
GD greatly increases the risk of developing diabetes in your next pregnancy and in the future when you are no longer pregnant. One third of women who had GD will have diabetes or a milder form of elevated blood sugar soon after giving birth. Between 15% and 70% of women with GD will develop diabetes later in life.

Children of women who had GD may be at risk of becoming overweight or obese during childhood. These children also have a higher risk of developing diabetes. Be sure to tell your baby’s doctor that you had GD so your baby can be monitored.

https://www.themonitor.com/2020/11/23/gestational-diabetes-affect-pregnancy/

Diabetes is set to devastate India's metropolitan cities, and what to do about it

From eurekalert.org

More than half of men and two thirds of women currently aged 20 years are projected to develop the condition in their lifetime

Disturbing new research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that more than half of men (55%) and some two thirds (65%) of women currently aged 20 years in India will likely develop diabetes in their life time, with most of those cases (around 95%) likely to be type 2 diabetes (T2D). The research is from a team of authors in India, the UK and the USA, led by Dr Shammi Luhar, Department of Public Health and Primary Care, University of Cambridge, UK.

India already has a significant health burden caused by diabetes: estimates suggest 77 million adults currently have diabetes and this number is expected to almost double to 134 million by 2045. Urbanisation, decreasing diet quality and decreased levels of physical activity are all contributing to this hidden epidemic. Since urban centres are continuing to grow rapidly across the country, the authors, in this new research, aimed to estimate the probability of a metropolitan (urban-based) Indian of any age or body mass index (BMI) developing diabetes in their lifetime.

The data for the study came from using age-, sex- and BMI-specific incidence rates of diabetes in urban India taken from the Centre for Cardiometabolic Risk Reduction in South Asia (2010-2018); age-, sex- and urban-specific rates of mortality from period lifetables reported by the Government of India (2014); and prevalence of diabetes from the Indian Council for Medical Research INdia DIABetes study (2008-2015).

The authors estimate that lifetime risk of developing diabetes in 20-year-old men and women free of diabetes today is 56% and 65%, respectively. Women generally had a higher lifetime risk across the lifespan. Remaining lifetime risk of developing diabetes declined with age: the authors estimated that for those currently aged 60 years and currently free of diabetes, around 38% of women and 28% of men would go on to develop diabetes.

Obesity had a substantial impact on these projections. Lifetime risk was highest among obese metropolitan Indians: 86% among 20-year-old women and 87% among men. People with lower BMI had considerably higher diabetes-free life expectancy: obese 20-year-olds were estimated to have around half (46-52%) of their remaining life years free from diabetes. However, those with normal or underweight BMI were projected to live out most of their remaining years (80-85%) diabetes-free.

The authors say: "The remarkably high lifetime risk of developing diabetes and the low diabetes-free life expectancy in India's metropolitan cities, especially for individuals with high BMI, implies that interventions targeting the incidence of diabetes may be of paramount importance moving forward."

They note that metropolitan Indians at every age and BMI have an alarmingly high probability of developing diabetes compared with results from high income countries, and that proactive efforts to prevent diabetes in metropolitan cities are urgently needed, given the rapid increase in urban obesogenic environments across the country. In addition to these risk factors, Indians and other South Asian populations already have a relatively high predisposition to developing diabetes at both lower ages (up to a decade earlier) and lower BMIs when compared with white European populations.

One study from the USA, using data from 2000-2011, reported a lifetime risk diabetes of 40% among men and women aged 20 years from the general population. The authors say: "Our new estimates from India are much closer to estimates of lifetime risk of diabetes of 20-year olds among the black and Hispanic populations in the USA (above 50%), groups considered at a higher risk of developing diabetes than the general population."

Dr Luhar says: "Such high probabilities of developing diabetes will have severely negative implications for India's already strained health system and also out-of-pocket expenditure on diabetes treatment by patients, unless diabetes is immediately acknowledged for what it is: one of the most important threats to public health in India."

Professor Viswanathan Mohan of the Madras Diabetes Research Foundation in Chennai and co-author of the paper added: "Despite these very high predicted lifetime risks of diabetes, it is possible to prevent or postpone diabetes by effective lifestyle modification, such as following a healthy diet, by increasing physical activity and reducing body weight in those who are obese or overweight."

Professor Nikhil Tandon from the Department of Endocrinology and Metabolism, All India Institute of Medical Sciences in New Delhi, and co-author of the paper also added: "We need policy and investment with clearly spelt out targets and commitments to meet by 2030. Perhaps an aspirational target of '90-90-90' (90% of people with diabetes detected, 90% of those detected treated, and 90% of those treated controlled), is imminently needed. Such a target could operate in the same way as the 90-90-90 targets introduced some years ago for HIV, which has since been replaced by even more ambitious 95-95-95 targets."

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

https://www.eurekalert.org/pub_releases/2020-11/d-dst112020.php

Mediterranean diet reduces risk of diabetes in women - Here is what you must eat to prevent high blood sugar

From timesnownews.com

The Mediterranean diet, known for many health benefits and popular for heart health particularly, can also reduce the risk of diabetes in women

Key Highlights

• Type 2 diabetes affects millions of people around the world

• Diet and the food we eat have a direct impact on our blood sugar levels

• A recent study has found that consumption of a Mediterranean diet can reduce risk of diabetes in some women

New Delhi: Type 2 diabetes has reached epidemic levels around the world. With millions being diagnosed for the condition every year, the burden of diabetes on the healthcare systems is increasing manifold. Obesity, which is a major risk factor for the condition is also on a steep rise. Both these factors, obesity and diabetes can be prevented, treated, and managed with the help of a  healthy, balanced diet.

While a healthy diet that comprises of whole foods, lots of fibre, and other nutrients can help in the prevention and management of various conditions such as diabetes, many diets, specific to the purpose are also followed by people for specific effects. The Mediterranean diet, known for many health benefits and popular for heart health particularly, can also reduce the risk of diabetes in women, a long-term study has found.

Mediterranean diet may reduce risk of diabetes in some women

According to researchers from Bringham and Women's Hospital in Boston, after studying outcomes of more than 25,000 participants in the Women's Health Study, they have found that Mediterranean diet may reduce risk of type 2 diabetes in some women. The Women's Health Study, WHS, is a longitudinal cohort study conducted over 20 years. 

The researchers found that women who adhered to a more Mediterranean-like diet had a 30 per cent lower rate of type 2 diabetes, than those who did not. 

Women were enrolled in the study between 1992-95 and data was collected through December 2017. While the main aim of the study was to evaluate effects of vitamin E and low-dose aspirin on the risk of heart disease and cancer, the study also revealed the link between dietary intake and diabetes since participants had to answer questions about their diet, lifestyle, medical history, demographic, and more. Blood samples were taken at the beginning of the study. Among 25,000 participants, 2,307 developed type 2 diabetes. 

Researchers say participants who had a higher Mediterranean diet intake at the beginning of the study developed diabetes at rates that were 30% lower than women who had a lower MED intake. 

Mediterranean diet reduces risk of diabetes in women - Photo Credit: iStock Images

What you must eat to prevent high blood sugar

If you wish to follow a Mediterranean diet in order to reduce your risk of type 2 diabetes, here are some foods you should include in your diet.

• Olive oil
• Fruits
• Vegetables
• Legumes
• Fishes such as tuna, salmon, etc
• Nuts and seeds

If you want to keep your blood sugar managed, whether or not you have developed diabetes, it is imperative to follow a healthy diet. While it is important to know what you must eat, you must also pay close attention to what you should not. Processed foods high in sugar and salt, fatty foods that contain unhealthy fats, junk and fast food, etc are all of the table. You should also refrain from consuming too many sweets, carbonated drinks and desserts. Smoking and drinking also play a major role in the development of diseases such as type 2 diabetes and should be avoided.

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

https://www.timesnownews.com/health/article/mediterranean-diet-reduces-risk-of-diabetes-in-women-here-is-what-you-must-eat-to-prevent-high-blood-sugar/684997

Fruits And Vegetable Sugars: How Are They Different From Regular Sugar?

From food.ndtv.com

By Rupali Datta 

High amounts of sugar in the blood means more insulin, and we know that constant high insulin in the blood causes serious damage and oxidative stress

Every health advisory speaks of how we need to reduce sugar consumption in our daily meals to protect ourselves against non-communicable diseases like CVD, Diabetes and Strokes. On the other hand, we are advised to take lots of fruits and vegetables, which also contain sugar; so what is the difference that makes one source a health hazard and another a health benefit? Let's find out!

But before that let me explain a few points:

- Carbohydrates are the major and the most efficient source of energy for our body.

- Carbohydrates are classified as Monosaccharides, Disaccharides and polysaccharides, depending on the number of sugar molecules.

- Monosaccharides include Fructose and Glucose. These are the basic units from which all other complex carbohydrates are made. Di saccharides are two monosaccharides combined and polysaccharides are multiple molecules of monosaccharides combined.

- Table sugar and the sugar most used in processed foods is Sucrose, a di saccharide made up of Fructose and Glucose. Sucrose is metabolised through similar processes in our body irrespective of its source.

- All foods of plant origin contain some amount of natural sugars.

- The total carbohydrates in a fruits rage from 1-20g/100 g edible portion and in vegetables rage from 1-25g/ 100gm edible portion approximately. These include simple sugars, starch and fibre.

There isn't any difference between the natural sugars and the one that is added externally (chemically). The main difference is that sugars from whole fruits and vegetables come packaged with lots of health-boosting nutrients. They are released slowly in the blood preventing a sugar rush.

Commercially available sugars like rice sugar, beet sugar, agave nectar all come from plants. These are extracted, concentrated before being used commercially. This means a higher more refined version of the same sugars that are absorbed very soon and as the quantity added is larger than a normal serving. High amounts of sugar in the blood means more insulin, and we know that constant high insulin in the blood causes serious damage and oxidative stress.

_{The two sugars present in fruits include Fructose and Glucose​.}

Let's know more about the natural sugars in fruits and vegetables:

Sugar In Fruits

All fruits contain simple sugars. The two sugars present in fruits include Fructose and Glucose. These may be in different ratios in various fruits; approximately they are present in 1:1 ratio. Glucose raises blood sugar directly while fructose is metabolised through the liver. While consuming a whole fruit the body, in addition to some amount of sugar, gets a huge dose of vitamins, minerals, antioxidants and phytonutrients. All of these are essential for healthy living and for protection against infections and NCDs. And hence, while refined sugars are just empty calories, fruit sugars come with nutrients and are hence a healthier choice to make. Meaning, if you are a diabetic, it is safe for you to consume fruits, but in moderation.

Sugar profile of some common Indian fruits:

NAME	LOW SUGAR	HIGH SUGAR
Avocado	1.33g/1 pc
Guava	4g/ medium pc
Raspberries	5g in 1 cup
Musk Melon	2gm/100gm
Papaya	4g/100gm
Strawberries	7gm/cup
Strawberries	7gm/cup
Orange	6g/100gm pulp
Pears	7g/100gm
Apple Kashmiri	9.5/100gm
Mangoes		10g/100gm
Grapes		10g/100gm
Banana		14/100g
Cherries		18g/1 cup
Sapota		12g/100gm

Sugar In Vegetables

Vegetables also contain simple sugars Fructose, Glucose and Sucrose (also known as table sugar). The quantity of sugars in the vegetable is negligible. Most vegetables contain little or no sugar and are loaded with health-giving vitamins, minerals, fibre, antioxidants and phytonutrients. Vegetables are, for this reason, very low in total calories and high on nutrition. It is recommended that everyone gets at least 3 servings a day. Roots and tubers also counted as vegetables have a higher amount of sugar in them.

Beetroot, yam, tapioca, potato and sweet potato have higher sugars and are restricted while calorie counting.

Bottom line: Eat 5 servings of whole seasonal fruits and vegetables daily. Choose fruit to satiate your sugar cravings. Read labels on processed foods to see the hidden sugars like agave syrup, coconut sugar, sweet beet syrup. Maple syrup, golden syrup, Molasses, maltodextrin among others.

Eat fresh, eat nutrient-rich foods and stay healthy!

Disclaimer:

The opinions expressed within this article are the personal opinions of the author. NDTV is not responsible for the accuracy, completeness, suitability, or validity of any information on this article. All information is provided on an as-is basis. The information, facts or opinions appearing in the article do not reflect the views of NDTV and NDTV does not assume any responsibility or liability for the same.

https://food.ndtv.com/food-drinks/diabetes-diet-fruits-and-vegetable-sugars-how-are-they-different-from-regular-sugar-expert-reveals-2328334

Is Intermittent Fasting Safe for Diabetes?

From eatingwell.com

By Vanessa Rissetto M.S., R.D., C.D.N.

Learn more about intermittent fasting and if there are benefits and drawbacks to trying it when you have diabetes

Thinking of trying intermittent fasting to manage your diabetes? From weight loss to cardiovascular disease and even cancer, intermittent fasting is starting to feel like the cure-all for just about every ailment. As a registered dietitian, I'm always sceptical about new nutrition trends because most of them don't have a lot of science to back them up. While the research on intermittent fasting is growing rapidly, we still have a lot to learn about this popular "diet."

Intermittent fasting has been especially buzzworthy for its potential benefit in preventing and treating type 2 diabetes.

In the United States alone, more than 34 million people have diabetes and the numbers are steadily growing every year. Adopting a healthy diet, exercising regularly and managing stress are key to managing the disease, but it's not always entirely clear if certain eating patterns can be more beneficial to managing diabetes than others.

Could intermittent fasting have an edge over other diet changes for treating diabetes? Keep reading to find out more about intermittent fasting, the benefits to intermittent fasting and potential drawbacks.

What Is Intermittent Fasting?

First let's start with the basics of intermittent fasting. Most people think IF is a diet, but it's actually more of an umbrella term for several different eating patterns that involve some form of fasting during a designated period of time (here's more information on intermittent fasting).

A lot of the research on IF looks at the daily time-restricted feeding approach, where people or mice are fed meals within a designated time frame throughout the day, usually an 8-hour feeding window and a 16-hour fasting window. For example, one might fast for 16 hours, then eat in an 8-hour window from 11 a.m. to 7 p.m.

Other common IF protocols are the alternate-day fasting approach and the 5:2 fasting approach. For ADF, you consume about 500 to 700 calories every other day, and eat a regular diet on non-fasting days. The 5:2 approach has a similar concept, but fasting is limited to twice a week instead of every other day.

Regardless of the method, IF may be an attractive alternative to traditional methods of reducing calories (e.g., counting calories or cutting out entire food groups) because it can be less cumbersome, more flexible and more intuitive, especially for people who tend to skip breakfast or eat less on the weekends.

That being said, it's definitely not for everyone, and people with diabetes have other factors to consider (more on that later).

What happens in your body when you fast?

Intermittent fasting activates something called metabolic switching in your body. Metabolic switching typically occurs when a person fasts for around 8 to 12 hours. During this process, the body runs out of glucose (also known as blood sugar) and switches to burning ketone bodies for fuel by breaking down stored fat.

According to recent research published in The New England Journal of Medicine, this metabolic switch from using glucose to using ketones for fuel also has some added benefits for the body—decreased inflammation, improved glucose regulation and a more adaptive stress response.

Researchers suspect that the metabolic changes that occur during fasting may give IF an extra edge over other diets for weight loss and for managing metabolic conditions like diabetes.

What are the benefits of intermittent fasting for diabetes?

Fasting can have a big impact on our blood sugar, but what does the science say about intermittent fasting and diabetes specifically?

Let's start with the basics …

How does diabetes work?

Diabetes is a condition in which people have trouble metabolizing or processing carbohydrates. When we eat carbohydrates, we eventually break them down into a simple sugar called glucose, which is released into our bloodstream (aka blood sugar) so our cells can eventually use it for fuel.

Once glucose enters our bloodstream, our body releases a hormone called insulin which helps our muscles, liver, fat tissues and brain take up glucose from the bloodstream and get it into our cells where we can burn it for energy.

Several factors, including obesity and excess weight gain, can impair the ability of our cells to use insulin, causing glucose to build up in the bloodstream and leading to high blood sugar. This condition is called insulin resistance, the driving force behind prediabetes and type 2 diabetes (learn more about blood sugar basics for diabetes).

Does intermittent fasting help with diabetes?

Like a lot of questions in the nutrition world, the answer isn't entirely clear. Currently, most of the studies on IF and diabetes have been done on animals. While this has given us some insight on how intermittent fasting might help treat diabetes, the research in humans is definitely mixed.

Animal studies have shown that IF improves insulin sensitivity and prevents obesity in mice. In humans, one recent case report published in BMJ found that IF successfully treated insulin resistance and lowered haemoglobin A1C (a measure of blood sugar control over several months) in participants with insulin-dependent type 2 diabetes. Another promising outcome: after following IF for several months, all of the participants in the study were able to discontinue their insulin medication entirely.

A recent clinical trial randomized men with prediabetes in two groups—one group followed a 6-hour timed feeding IF protocol and the other followed a 12-hour feeding protocol for 5 weeks (a 12-hour window is typical eating for most people, think 8 a.m. to 8 p.m.). Results from the study found that the men in the IF group had less insulin resistance compared to those in the 12-hour feeding group. The IF group had better results, regardless of weight lost over the study. IF also produced better glucose control in a similar study done on a group of 107 overweight and obese women.

However, a comprehensive review of the current research on IF and diabetes shows that several studies have also found that IF has no additional benefit to insulin resistance and haemoglobin A1C compared to a typical calorie-controlled diet.

It's important to note that much of the research on IF has been done on overweight and obese individuals with insulin resistance, meaning results may not apply to people who have diabetes, but are not overweight. Furthermore, some studies have found IF to be more beneficial for men than women.

Essentially, we just don't have enough good-quality research in diverse groups of men and women to definitively say that IF is better for managing diabetes compared to a typical healthy diet. Additionally, we haven't yet figured out the optimal duration, frequency and severity of fasting needed to produce metabolic benefits that are especially helpful for people with diabetes.

Finally, there are potentially some theoretical and research-backed drawbacks to intermittent fasting for people who have diabetes. Here's what we know so far.

What are the downfalls of intermittent fasting for diabetes?

Many clinicians, myself included, have found that intermittent fasting can exacerbate disordered eating patterns in vulnerable individuals. Waiting too long to eat can alter hunger hormones and increase cravings and appetite. For many people this can lead to overeating and sometimes binge eating.

As far as the research goes, some studies have found that IF may increase binge eating in women with bulimia. Others have found that IF may actually help decrease disordered eating in overweight and obese individuals.

So, the existing data tells us that IF has the potential to be harmful to normal-weight individuals and those with pre-existing disordered eating behaviours and diagnosed eating disorders. Women may also be at an increased risk for negative outcomes associated with intermittent fasting.

A few studies have found that long-term intermittent fasting in overweight and obese women resulted in a longer than average menstrual cycle and altered reproductive hormone levels in normal-weight women. More research needs to be done to understand the full impact of IF on women's menstrual cycles, but this is definitely something to look out for if you're thinking of trying IF.

Additionally, one study looked at the effects of three weeks of IF in overweight men and women. Results found that men had improved measures of glucose control, but women actually had impaired glucose control.

Another important thing to keep in mind—the majority of studies that look at intermittent fasting in humans recommend healthy eating (not feasting) on the non-restricted days. Research has found that overindulging on days when you are not fasting can have a negative impact on your health, even if you are losing weight.

Other reported negative side effects for intermittent fasting include:

• constipation
• water retention
• dizziness
• general weakness
• increased feelings of hunger
• worse mood
• heightened irritability
• difficulties concentrating
• increased fatigue
• eating-related thoughts
• fear of loss of control and overeating during non-restricted days

Bottom line

Overall, we still need more research to understand the potential benefits and risks of intermittent fasting for people with diabetes, but some women, people with disordered eating, and individuals with a so-called "normal" body weight may not be the best candidates for intermittent fasting. Before drastically switching up your eating habits, check in with your health care team or a registered dietitian, who can provide more individualized recommendations.

http://www.eatingwell.com/article/7873910/is-intermittent-fasting-safe-for-diabetes/

Consumer health: Alcohol, tobacco and diabetes

From medicalxpress.com

November is National Diabetes Month, which makes this a good time to learn more about preventing and treating diabetes.

Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar. The underlying cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in your blood. Too much sugar in your blood can lead to serious health problems.

The two types of chronic diabetes conditions are Type 1 diabetes and Type 2 diabetes. Type 1 diabetes can develop at any age, although it often appears during childhood or adolescence. Type 2 diabetes, which is more common, also can develop at any age, although it's more common in people over 40. Prediabetes means you have a higher-than-normal blood sugar level, but it's not yet high enough to be considered Type 2 diabetes.

Healthy lifestyle choices can reduce your risk of Type 2 diabetes. If you've already received a diagnosis of diabetes, healthy lifestyle choices can reduce your risk of complications. If you have prediabetes, lifestyle changes can slow or stop the progression to diabetes. Lifestyle risk factors for diabetes include being overweight and sedentary.

Alcohol and tobacco use also may increase your risk of developing Type 2 diabetes. And the more you drink or smoke, the greater the risk.

Credit: Unsplash/CC0 Public Domain

https://medicalxpress.com/news/2020-11-consumer-health-alcohol-tobacco-diabetes.html

Managing Diabetes Calls for Extra Attention During Flu Season

From uabmedicine.org

Diabetes can weaken the immune system’s ability to fight infection, increasing the risk of serious complications from the influenza virus. However, by paying extra attention to nutrition habits during flu season, most people with diabetes who do catch the flu can avoid serious complications.

People with type 1, type 2, or gestational diabetes are at high risk of serious flu complications, even if they are doing a good job of managing their condition. There is the risk of sinus infections, bronchitis, pneumonia, and other flu-related illnesses. In recent flu seasons, almost 30% of adults in the United States hospitalized with flu had diabetes.

Alabama and many other southern states have high rates of diabetes. Alabama ranks No. 4 in the nation, based on the Behavioural Risk Factor Surveillance System (BRFSS), which collects state data about U.S. residents regarding their health-related risk behaviours. People with diabetes are at a higher risk for catching a contagious illness.

Making Matters Worse

Flu also can make diabetes worse, because some illnesses can make it harder to control blood sugar. Flu may raise sugar levels, but sometimes people don’t feel like eating when they are sick, and a reduced appetite can impact glucose (sugar) levels.

It’s still not clear just how effective certain nutrients, vitamins, anti-oxidants, flavonoids, and other food elements are at boosting immune systems, especially for fighting influenza. In fact, the National Institutes of Health (NIH) says there currently is no strong scientific evidence that any natural product is useful for preventing the flu.

Still, an immune system with greater nutritional resources has a better chance of battling the effects of influenza. That’s especially true for people with diabetes.

Nutrition for Fighting Flu Symptoms
Fever can raise metabolic rates, so the body needs more calories to function normally and support the immune system. A sudden reduction in that caloric intake may cause flu to last longer. However, once flu symptoms are present, appetite may decrease, along with any motivation to prepare even the simplest meal. It’s extremely important to get some nutrients in the system, even when you don’t have an appetite. Beverages are essential because dehydration, a common side effect of the flu, can raise blood sugar.

Anyone with diabetes who is not eating meals because of flu symptoms should at least eat or drink about 50 grams of carbohydrates every four hours, such as 1½ cups of unsweetened applesauce or 1½ cups of fruit juice. Options to avoid dehydration include water, unsweetened tea, and low-sodium chicken broth.

Foods that contain 15 grams of carbs include:

• ½ cup fruit juice

• ½ cup regular Jell-O

• Six saltine crackers

• ½ cup applesauce

• 1/3 cup noodles or rice

People with diabetes can better manage flu season by preparing ahead. It’s a good idea to have enough insulin, other diabetes medicines, and easy-to-fix foods on hand to last several weeks. The supply list below can help you get organized.

Medicines and Supplies

• Milk of magnesia

• Medicine to control diarrhoea

• Antacids

• Pain relievers

• Thermometer

• Suppositories to treat vomiting

Foods 

• Sports drinks

• Juice boxes

• Canned soup

• Regular gelatin

• Regular soft drinks

• Instant cooked cereals

• Crackers

• Instant pudding

• Unsweetened applesauce

This is also a time when comfort foods – and beverages – may help. They can provide sufficient nutrition because, even on the worst flu days, these items may still be appealing enough so that people don’t skip meals or get dehydrated.

See these recipes for diabetes-friendly comfort foods. 

A bowl of soup is a healthy option, keeping in mind to limit carbohydrates to fewer than 15 grams of carbs per serving, and control for sodium, calories, and saturated fat, so that all soup recipes remain diabetes friendly. See these recipes for diabetes-friendly soups.

https://www.uabmedicine.org/-/managing-diabetes-calls-for-extra-attention-during-flu-season

‘I’ve lost 100 pounds and no longer have type 2 diabetes’

From dietdoctor.com

When Kirk found out he had type 2 diabetes, he thought his poor health was at a point of no return. He’d been following his doctor’s advice to a tee. Still, his metabolic health had deteriorated over time.

After the shock passed, Kirk started searching for answers online. The first hit was Diet Doctor. There, he learned that you could reverse type 2 diabetes by going on the low-carb, high-fat keto diet. He was ready to try anything and decided to jump on board.

As little as 18 months later, Kirk had fully reversed his diabetes, shed 100 pounds (45 kilos), and enjoyed much more robust health.

Keep reading to find out what Kirk ate to get his health back and how he’s now paying things forward as a moderator in the Diet Doctor Facebook group. His story has been lightly edited for length and clarity.

Kirk’s keto story

Dear Diet Doctor,

I wanted to write to share my success story and thank Diet Doctor for the informative resources that have taught me a lot.

My name is Kirk. I’m 56 years old and live in Canyon Lake, Texas, USA. I was diagnosed with pre-diabetes in 2010. My doctor told me that it was reversible as long as I changed my diet and started an exercise program. At that time, he also prescribed 2000 milligrams of metformin per day. He suggested that I go to the American Diabetes Association (ADA) website and follow their guide for eating with type 2 diabetes. ‘I can do this! ‘, I thought.

I ate more fruits and vegetables and a good dose of carbohydrates and lean meats, as suggested. As the years progressed, so did my diabetes. I managed to keep my haemoglobin A1C (HbA1c), a measurement of blood sugar levels, in the pre-diabetic range for several years, but each time I would be tested, my number slowly crept up. I didn’t understand why the regimen I followed wasn’t working.

In addition to this, my cholesterol was out of whack, and my triglycerides were through the roof! I felt horrible most days and had no energy. My doctor had been diagnosed with cancer and was out of the office for most of 2018. Once he came back, one year later, I went in for my regular testing. My HbA1c had soared to a whopping 10%, which is in the diabetic range! My triglycerides, which were already high, had jumped to over 400 mg/dl (4.5 mmol/L). I was in total panic mode!

Enter Diet Doctor. I was so scared that I had really ruined my health. My father had had type 2 diabetes and heart disease, which eventually killed him. I figured that this must be the way for me also. But I started researching how to reverse type 2 diabetes on Dr. Google. The very first hit was Diet Doctor.

I immediately started reading that it was completely possible to turn type 2 diabetes and metabolic syndrome around, but I had been doing the exact opposite of what Diet Doctor suggested. How could this be true? Why had my doctors told me to continue to eat carbs and stay on a low-fat diet? This had to be some voodoo medicine!

At this point, I was ready to try anything! I signed up for the two-week Get Started Keto Challenge! I told my wife that I was serious about this and that we needed to make a huge change in our eating habits as a family. Of course, this wasn’t the first time I had said this, so it was met with deaf ears. But I was dead serious.

I cleaned out the cabinets of all refined sugars, pasta, rice, flours, and starches. I printed out the meal plan, went shopping, and started prepping our meals for the week. The most surprising thing was that these recipes made absolutely no sense: they were all high-fat meals! I had such a hard time getting around that because I was always told that low-fat diets were healthy. But I am so glad I did. Not only that, but the recipes were delicious. I had no problem what so ever eating bacon and butter. Who would have thought!?

I also bought a cheap blood glucose monitor and started testing my fasting blood glucose and blood sugar levels before lunch and after dinner. Each day I would watch and wait to see if things changed.

To my surprise, I started to see a major difference in my blood glucose in just four short months. Not only that, I had lost a total of 65 pounds (29 kilos)! What was happening? This was the most amazing thing that had happened to me in years. People were asking me if I was sick because I had lost so much weight. I was so happy to tell them about Diet Doctor, and the new science taught and how what the doctors had been telling me for years was making me sick. I was actually getting better! I was healing.

At my doctor’s appointment, I let him know that I had started this way of eating. He wasn’t happy. I told him that what he had me doing wasn’t making me very happy either and that I was ready for a change! As suggested on the Diet Doctor website, I asked him to watch the video course for physicians. I also brought him a copy of Dr. Jason Fung’s book, The Diabetes Code. I asked him to give me three months, and if my way wasn’t working, I would do what he advised. He agreed. The blood test taken that day also floored him as my HbA1c had come down to 5.8% from 10% in just four months. Also, my HDL went up, and triglycerides came down. Not perfect, mind you, but certainly in the right direction.

Three months later, I came for retesting. At that time, I was down another 20 pounds (9 kilos), at a total of 85 pounds (39 kilos) lost. My HbA1c sat at 5.6% and triglycerides down from 265 mg/dl (2.9 mmol/L) to 173 mg/dl (1.9 mmol/L). HDL up from 35 mg/dl (0.9 mmol/L) to 48 mg/dl (1.2 mmol/L). He couldn’t believe it nor deny that this way of eating was doing exactly what it said it would. He still had his doubts as he said this way of eating was not sustainable.

Ha! I’m am a year and six months in at this point. I’ve lost 100 pounds (45 kilos) and no longer have type 2 diabetes. My doctor has made me the poster patient! Since he and I have taken this journey together, he is now recommending Diet Doctor to his patients.

Since my journey began, I also didn’t realize I had a tumour growing on my left kidney. This was a recent turn of events and was quite shocking! I wanted to make sure that I didn’t bring this on by changing my eating habits. So once again, I dug in and researched everything I could. It turns out that renal cell carcinoma can take years to develop to the size of the tumour I had. This thing had been growing in me for at least ten years, and I had no idea! So no, it wasn’t keto that did it.

In fact, most studies will show that we don’t really know what causes kidney cancer. I can tell you this, though, had I not lost 100 pounds (45 kilos) and reversed my type 2 diabetes, I’m not sure I would have survived the surgery, much less the recovery. My urologist and oncologist have given me the thumbs up to continue with this way of eating. I’m so happy! Actually, they are both in agreement that I may have bought myself some extra years to enjoy my family and friends.

How did I do it? I simply followed the meal plans. I never was much for breakfast even before I started, so that was easy to skip. After becoming fat-adapted, I just fell into a regular intermittent fasting style of eating. Most days, I follow an 18:6 or 16:8 intermittent fasting protocol and throw in a couple of 24-hour fasts per week. I’ve even started prepping meals for a few ladies at church. I’ve loved being able to be a part of this wonderful way of life! Every day I’m so excited to help and tell everyone I can about the keto lifestyle!

I’m honoured to have been selected by Diet Doctor to help moderate the Diet Doctor Facebook group. It’s been a pleasure to wake up and share all that I have learned and support all of you and those who are just beginning their journey. I look forward to many more years of great health and delicious foods! All without worrying about diabetes and my cholesterol.

Finally, I want to say: Don’t be afraid of change. Let’s get healthy together. You can do it!

Sincerely yours,
Kirk

Comment

Congrats on your amazing success, Kirk! I especially appreciate how you engaged and educated your doctor about your methods for success, and how you give back to the community through our Facebook group. You are a shining example of how one person’s success can influence hundreds of others! Keep up the great work

Best,
/ Dr. Bret Scher

https://www.dietdoctor.com/ive-lost-100-pounds-and-no-longer-have-type-2-diabetes