Screentime linked to greater diabetes risk among children

From theguardian.com

Children who are allowed more than three hours of screentime a day are at greater risk of developing diabetes, new research suggests.
The study found that children who were glued to their screens for three or more hours a day scored higher on measures of body fat and had higher levels of resistance to the hormone insulin than their peers who spent an hour or less watching TV, videos or playing computer games.
But the authors cautioned that the research does not show that increased screentime itself results in raised levels of risk factors for the disease.
“Screentime could be capturing something about your behaviours – how much sedentary time you have and how much you break that up [or] what your dietary habits [are], potentially,” said Claire Nightingale, a medical statistician at St George’s, University of London and co-author of the research.
Writing in the journal Archives of Disease In Childhood, Nightingale and colleagues described how they sought to probe whether for children, as is known for adults, screentime is linked to an increase in risk factors for type 2 diabetes. To do so, they analysed data from the Child Heart and Health Study in England – a survey carried out between 2004 and 2007 of almost 4,500 children, aged between nine and 10, from primary schools in three UK cities: London, Birmingham and Leicester.
Among the questions asked, data was collected on the length of time the children spent watching TV, video games or playing computer games. A host of physical measurements were also taken including measures of the children’s body fat and resistance to insulin – a hormone that controls blood glucose levels. In addition, levels of physical activity were monitored for 2,031 of the children.
The results revealed that while 37% of children reported that they spent an hour or less watching TV or playing computer games a day, 18% reported spending three or more hours in front of a screen.
Comparing the groups, researchers found the children who reported three or more hours of screentime scored higher on various measures of body fat. What’s more, these children had 10.7% higher levels of insulin after fasting, 10.5% higher levels of estimated insulin resistance and 9.3% higher levels of leptin – a hormone involved in controlling appetite – all of which are risk factors for type 2 diabetes.
The associations held even when factors such as socioeconomic status and levels of physical activity were taken into account.However the study did not follow up on the children to see whether they actually went on to develop diabetes.
While the data was collected a decade ago, before electronic devices such as smartphones became ubiquitous, the team believe the link between screentime and diabetes risk is likely to remain. But Nightingale said it is difficult to offer advice to parents. “Potential decreases in screentime could be beneficial, but we can’t really say a cut-off point,” she said.
Dan Howarth, head of care at Diabetes UK, said that the study highlights a worrying trend.
“The rising number of type 2 diabetes in children is an alarming statistic and addressing the nation’s childhood obesity issues should be the responsibility of us all,” he said.
“Encouraging physical activity over a sedentary lifestyle, such as that relating to screen time, and a healthy balanced diet clearly plays a significant part.”

https://www.theguardian.com/science/2017/mar/13/screentime-linked-to-greater-diabetes-risk-among-children

Increased PE in schools can prevent diabetes and encourage healthy lifestyle

From scotsman.com

In recent years, public health campaigns have urged Scots to think about “the big three” killers – heart attacks, cancer and strokes. Our appalling health record has made us world leaders when it comes to death from these often preventable illnesses.
But it is another potentially deadly condition that threatens hundreds of thousands of Scots. Rising obesity levels mean that diabetes is becoming more prevalent. Many of those suffering from diabetes and its complications could have been spared from their misery by taking preventative measures in the form of physical exercise. Doctors at the Royal College of Surgeons in Edinburgh say more than 180,000 Scots could avoid diabetes if they began taking part in regular physical activity. The message on the importance of maintaining fitness has been painfully slow to get through to Scots but the Scottish Government must redouble its efforts to ensure that it does. All political parties at Holyrood pronounce their commitment to the provision of adequate physical education in Scotland’s schools, but the truth is that Physical Education (PE) remains an under-resourced part of the curriculum. Scotland’s education system is under considerable pressure right now; literacy and numeracy standards have fallen unacceptably low and there remains disagreement between teachers over the merits of the Curriculum for Excellence.
In the current debate, the importance of PE in schools is being ignored.
It is difficult, in adulthood, to change bad habits. Far better, then, to ensure that young Scots acquire good habits as soon as possible.
PE should not be an afterthought in our schools. An exercise habit developed early can last a lifetime. Education Secretary John Swinney has a considerable task in front of him as he attempts to improve standards in education. We hope he will add to his list of priorities a substantial, meaningful increase in the hours of PE offered throughout a child’s school career.

http://www.scotsman.com/news/opinion/leader-increased-pe-in-schools-can-prevent-diabetes-and-encourage-healthy-lifestyle-1-4389782

Downside to Gluten-Free Diets: Diabetes Risk?

From WebMD.com

"Gluten-free" may be the latest diet fad, but new research casts some doubt on its presumed health benefits.
In a large study of U.S. health professionals, scientists found that those with the least gluten in their diets actually had a slightly higher risk of developing type 2 diabetes over a few decades.
The findings do not prove that a low-gluten diet somehow contributes to diabetes. But the study raises questions about the long-term benefits of avoiding gluten, which many people assume to be a healthy move.
Some people -- namely, those with the digestive disorder celiac disease -- do have to shun gluten, said lead researcher Geng Zong.
But there is little research on whether other people stand to gain from going gluten-free, said Zong. He is a research fellow in nutrition at Harvard T.H. Chan School of Public Health, in Boston.
That's a big evidence gap, according to Zong -- given the popularity and expense of gluten-free foods.
Gluten is a protein found in grains such as wheat, rye and barley. Gluten-free diets are a must for people with celiac disease -- an autoimmune disorder in which gluten-containing foods cause the immune system to attack the small intestine.
But gluten-free, or at least gluten-light, diets have caught on as a way for anyone to lose weight and improve their health.
One recent study found that the number of Americans who say they've gone gluten-free tripled between 2009 and 2014.
The new findings are based on nearly 200,000 U.S. health professionals whose health and lifestyle habits were followed over three decades.
The low-gluten fad did not exist when the study period began, in the 1980s, Zong pointed out. But participants' gluten intake naturally varied, based on how often they ate foods like bread, cereal and pasta.
Over 30 years, just under 16,000 study participants developed type 2 diabetes -- a disease in which blood sugar levels are persistently too high. Obesity is one of the major risk factors.

http://www.webmd.com/diabetes/news/20170309/downside-to-gluten-free-diets-diabetes-risk#1

Recipe: Try Pho, a delicious soup with noodles, vegetables and chicken in a spicy broth.

From diabetes.org.uk

Vietnamese soup with noodles, vegetables and chicken in a spicy broth – a delicious meal in a bowl.

Just click on this link: https://www.diabetes.org.uk/Guide-to-diabetes/Recipes/Pho/?utm_source=bronto&utm_medium=email&utm_term=Image+-+Pho+recipe&utm_content=Image+-+Pho+recipe&utm_campaign=Enewsletter+March+2017

Type 1 Versus Type 2: Complications in Youth with Diabetes

From pharmacytimes.com

Young individuals with type 2 diabetes are more likely to develop condition-related complications than their type 1 counterparts. The results are part of the latest findings of the SEARCH for Diabetes Youth study, which was funded by the National Institutes of Health and the CDC, and conducted research regarding diabetes complications in young patients.

The study’s researchers noted that teens and young adults with type 2 diabetes are at an increased risk of developing kidney, nerve, and eye diseases than their peers with type 1 diabetes. Researchers gathered the results by evaluating youth with type 1 and type 2 diabetes, and examining how quickly and often they developed signs of complications.

Among the participants, those with type 2 diabetes exhibited signs of complications more often in nearly every measure than those with type 1. The findings showed:
 

• Nearly 20% developed a sign of kidney disease versus 6% with type 1
• About 18% developed nerve disease versus about 9% with type 1
• About 9% developed eye disease versus 6% with type 1
• Measures for hypertension and arterial stiffness were greater in those with type 2 diabetes, but close to equal for cardiovascular autonomic neuropathy.

Barbara Linder, MD, study author and senior advisor for childhood diabetes research at the NIH’s Institute of Diabetes and Digestive Kidney Disease, noted that the results challenge assumptions that young people don’t develop complications from diabetes.

“Particularly for youth with type 2, this research demonstrates the clear need to learn how to reduce or delay the debilitating complications of diabetes, itself a huge challenge for young people to manage,” Dr. Linder said in a press release.
The authors concluded that the study demonstrates a greater need for early monitoring for the development of complications among young adults and teens with diabetes so that health care providers can delay the onset of these complications.

http://www.pharmacytimes.com/resource-centers/diabetes/type-1-versus-type-2-complications-in-youth-with-diabetes

Exercise Guide: Workout Tips for People with Type 1 Diabetes

From pastemagazine.com

For those with type 1 diabetes, exercise comes with a different set of challenges. Insulin sensitivity, glucose metabolism and carbohydrate intake all become important factors. In order to help people with type 1 diabetes find a safe and efficient exercise routine, an international team of researchers published exercise and nutrition guidelines that help prevent fluctuations in blood sugar.
This set of guidelines is the first of its kind. For two years, the 21-person research team looked at data from clinical trials and studies in order to come up with a consensus on exercise management for those with type 1 diabetes.
The researchers found that regular exercise is key for individuals with type 1 diabetes. It can help decrease total daily insulin needs and can lead to fewer diabetes-related complications. But in order to exercise safely, patients must monitor their blood glucose levels before, during and after exercise as well as alter their insulin plan to match their increased physical activity. These precautions are taken in order to avoid hypoglycemia, or when sugar levels go too low.
Dr. Rémi Rabasa-Lhoret from the Montreal Clinical Research Institute says that “these guidelines fulfil a major unmet need to help patients with type 1 diabetes, and their healthcare professionals, to overcome the various barriers for exercise and this, in turn, should help them to achieve the multitude of health benefits that exercise affords.”

Here are some of the research team’s healthy exercise tips for those with type 1 diabetes:
• Monitoring glucose throughout exercise is essential.
• A blood glucose level between 7 to 10 mm/L is recommended when beginning exercise.
• Before exercise, ingest carbohydrates if insulin concentrations are high.
• Different types of exercise affect blood glucose levels differently.
• Resistance exercise, such as weight lifting or elastic resistance bands, is best for glucose stability.
• The risk of hypoglycemia is increased 24 hours after exercise.
• Insulin plans should be adjusted with increased exercise.

https://www.pastemagazine.com/articles/2017/02/exercise-guideline-for-people-with-type-1-diabetes.html

Childhood type 1 diabetes control improves again

From diabetestimes.co.uk

Diabetes control for children has improved for the sixth year running, according to the National Paediatric Diabetes Audit (NPDA).
The report, which looked at data from all 28,439 young people with diabetes in England and Wales, also showed the number of children attending essential care checks has also risen.
However, the audit did state there is still considerable variability providing care in terms of diabetes outcomes which require better working relationships, sharing of good practice and instigation of quality improvement strategies to improve care.
Dr Justin Warner, clinical lead for the NPDA and member of the Royal College of Paediatrics and Child Heath, said: “The fact that care for children with diabetes continues to significantly improve is excellent news and is what we aim to demonstrate when delivering this audit year on year.
“We want centres delivering paediatric diabetes care to learn from best practice, share good experience and improve results, so this is heartening to see.”
The data used in the report showed the following:

• The number of children and young people with type 1 diabetes achieving excellent diabetes control has increased from 17 per cent (2013/14) to 27 per cent (2015/16).
• The number of children and young people with type 1 diabetes with poor diabetes control fell from 24 per cent (2013/14) to 18 per cent (2015/16).
• Almost all children and young people with type 1 diabetes had an HbA1c (99 per cent) and a height and weight measured (98 per cent) during the audit year.
• Two thirds of young people underwent essential foot checks (66 per cent) compared with 55 per cent in the previous year.
• Two thirds (66 per cent) were screened for complications relating to their eyes (retinopathy screening), up from 64 per cent in the previous year.
• A total of 66 per cent were screened for kidney complications (urinary albumin), an improvement from 52 per cent in the previous year.

Dr Warner added: “The impact of the improvement in blood glucose levels over the last six years should not be underestimated and will reduce the risk of future complications significantly. The improvements reflect the massive amount of work and quality improvement provided by healthcare teams, parents and patients.
“This has been supported by high level strategies including the formation of the National Regional Networks1, the Best Practice Tariff in England2, Paediatric Diabetes Health Board investment in Wales3, Quality Assurance (peer review) programmes4, national and local Quality Improvement programmes5 and National Institute for Health and Care Excellence (NICE) guidance6.
“Furthermore, the improvements seen in completion of essential health checks – foot, eye and kidney disease screening – is excellent news and means that children and young people with diabetes are receiving improved care, reducing the risk of complications and allowing early recognition and intervention where necessary.”
Despite seeing improvements, the report also recognised there remain some deficiencies in care:
There remains considerable variability between centres across England and Wales providing care in terms of diabetes outcomes which require better working relationships, sharing of good practice and instigation of quality improvement strategies to improve care.

A total of 9.7 per cent of young people with type 1 diabetes are already demonstrating early signs of  kidney disease and 13.8 per cent show early signs of eye disease putting them at increased risk of kidney failure and blindness.

Children with type 1 diabetes were more likely to be overweight or obese compared to the general population.

Children and young people living in the most deprived areas were at increased risk of diabetes complications and poor diabetes control compared to those in the least deprived areas.

Two thirds of young people aged 12  and above with type 1 diabetes are not receiving all seven recommended health checks on an annual basis – HbA1c, height and weight, blood pressure, kidney function, eye screening, foot examination, and thyroid function

Although much less common in childhood, those with type 2 diabetes tend to come primarily from non-white ethnicity, are obese and have higher blood pressure compared to those with type 1 diabetes putting them at a higher risk of long-term complications.

The audit includes specific recommendations to commissioners of health services, diabetes networks, and paediatric diabetes centres, to address the inequalities across England and Wales.

http://diabetestimes.co.uk/childhood-diabetes-control-improves-again/