People With Diabetes Should Ease Into Exercise

From riverbender.com

It’s no secret that everyone needs some form of exercise. It helps improve everything from sleep to mood to relieving stress. Exercise is also vital to people with diabetes, especially for its blood glucose-lowering effects and ability to minimize the risk of heart disease.

“It does help lower the risk of heart disease – that is the number one cause of death for patients with diabetes," said Tanya Munger, Nurse Practitioner, OSF HealthCare Endocrinology. "It helps to lower blood pressure, it helps to keep their LDL or bad cholesterol lower; exercise helps to increase the good cholesterol, which we call HDL cholesterol, keep their weight in a healthy range, and it helps to reduce their stress levels and elevate their mood. Patients with diabetes who regularly engage in physical activity often times we are able to reduce several of their prescription medications.”

According to Harvard Medical School, many studies have been done over the years that clearly demonstrate the benefits of exercise for people with diabetes. Among them:

• Resistance training and aerobic exercise both helped to lower insulin resistance in previously sedentary older adults with abdominal obesity at risk for disease.
• People with diabetes who walked at least two hours a week were less likely to die of heart disease than people who were sedentary.
• Women with diabetes who spent at least four hours a week doing moderate or vigorous exercise had a 40 % lower risk of developing heart disease than those who didn’t exercise.

“How that works is our body uses glucose or sugar for fuel or energy so our normal insulin that we make, it moves the sugar out of our blood and moves it into the muscle where we’re able to use it for energy or fuel," said Tanya Munger, Nurse Practitioner, OSF HealthCare Endocrinology. "The more physically active we are the more sugar we’re burning. So essentially for someone with diabetes, physical activity – I tell a lot of patients – this is a free medication for you that has absolutely no side effects.”

Munger recommends people with diabetes should start with a goal of 150 minutes of exercise a week, which can be broken up to best fit your daily schedule. And, she stresses, the workout doesn’t have to be strenuous – especially in the beginning.

“For patients who have not engaged in any physical activity at all we really recommend that they start off slow," said Tanya Munger, Nurse Practitioner, OSF HealthCare Endocrinology. "Maybe parking your car further away from the door. Opting to take the stairs instead of the elevator. Walking out to their mailbox and back and the next day walking a little bit further.”

Munger also suggests checking your blood sugar before you start to exercise. If your blood sugar is over 300, wait until your numbers improve before starting to workout. If your blood sugar is less than 100 Munger suggests having a small snack of 15 grams of carbohydrates before working out. It’s also important to stay hydrated while exercising and always check with your physician prior to starting any exercise program.

But the main lesson is to simply get started.

“Sitting is the new smoking," said Tanya Munger, Nurse Practitioner, OSF HealthCare Endocrinology. "There is a ton of research out there that shows the negative effects of sitting are the same as smoking cigarettes. People who are inactive and sedentary do have higher blood pressure, higher cholesterol, higher blood sugar, typically they are obese, which leads to heart disease.”

https://www.riverbender.com/articles/details/people-with-diabetes-should-ease-into-exercise-49211.cfm

Can You Reverse Type 2 Diabetes?

From verywellhealth.com

If you’ve been diagnosed with type 2 diabetes, you may wonder, can diabetes be cured? Or can diabetes be reversed? Type 2 diabetes cannot be cured. However, you may be able to control your diabetes to the point of remission.

Type 2 diabetes occurs when your body no longer uses insulin properly. It is the most common form of diabetes.

Through lifestyle interventions such as weight loss, diet, and exercise, it is possible to reach blood sugar levels below the diabetic range. For some people, opting for bariatric surgery may be the best choice for reaching this state of remission.

Remission

The American Diabetic Association defines remission in three stages. Partial remission is achieved by a year of sustained HbA1c levels at sub-diabetic levels, at 5.7% to 6.4% without medication. Complete remission is one year of normal glycaemic levels at less than 5.7% without medication. Prolonged remission is defined as achieving complete remission for at least five years.

With intense lifestyle modifications, studies have shown that remission from type 2 diabetes is possible. Achieving weight loss while living with type 2 diabetes is one of the biggest indicators of people who will control their blood sugar enough to reach a state of remission.

To help you on the path to reversing diabetes, it’s important to understand the factors that can improve your health with type 2 diabetes. Learning how you can implement each factor, like weight loss and diet, into your life can help you move closer to achieving remission.

Weight Loss

The benefits of weight loss for those living with type 2 diabetes or those who have been told they are pre-diabetic or have metabolic syndrome are well known.

Weight loss has been shown to greatly affect type 2 diabetes. In one study, over half of the patients who were given specific guidelines on how to lose weight, mainly through dietary interventions, achieved remission. Those who lost the greatest amount of weight compared to their starting weight fared better.

Losing approximately 10% of your weight can prevent progression to type 2 diabetes if you are pre-diabetic. If you have type 2 diabetes, weight loss of 10% or more improves blood sugar and reduces the need for glucose-lowering medications.

One study, the Diabetes Remission Clinical Trial (DiRECT), showed that achieving substantial weight loss through a well-developed program can help people reach long-term remission of diabetes.

To achieve weight loss, you may need to change your diet or increase physical activity or exercise.

Diet

Diet is an integral part of your overall health, especially when living with type 2 diabetes. Some people are able to manage blood sugar by replacing refined with whole grains, reducing added sugar, and following a standard exchange diet. Others have more success with stricter diets.

Low-Calorie Diet

Studies have shown that low-calorie diets can reduce fat mass, which improves markers of type 2 diabetes such as blood sugar.

A low-calorie diet consists of reducing daily caloric intake by 25-30%.

Before starting a low-calorie diet, it is best to talk to your doctor or a dietitian who can advise you on the most effective way to reduce calories.

Your doctor will consider your current weight, daily energy requirements, and any other diseases you may have, along with current treatment plans for diabetes and other diseases.

Keto Diet

The ketogenic diet consists of eating a low carbohydrate diet with relatively high amounts of protein and fat. A standard keto diet contains 70% fat, 20% protein, and 10% carbohydrates.

The keto diet has been shown to produce rapid and sensible weight loss along with an improvement in biomarkers in type 2 diabetes, such as a lower HbA1c. If you are interested in starting a keto diet, it is best to talk to your doctor.

In a study where adults were provided an individualized program and support to complete the ketogenic diet program, patients did quite well. They experienced weight loss, had better control over their blood sugar, and significantly decreased their need for medications.

Intermittent Fasting

Intermittent fasting consists of limiting food intake to certain time periods in the day or alternating days in which you drastically reduce your calories.

For example, some people will only eat within a window of eight hours a day and fast the other 16 hours. Others practice intermittent fasting by choosing to fast completely on one day a week or drastically reducing their calories two days a week and eating normally the other days.

While intermittent fasting was not as effective as a low-calorie diet in reducing overall weight, it was comparable in reducing visceral fat, fasting insulin, and insulin resistance. In the few studies that have been done on intermittent fasting, the results are promising for reducing weight and insulin requirements.

Long-term benefits still need to be studied, but with proper medication adjustments and self-monitoring for blood glucose levels, intermittent fasting can be safely implemented into your diet. To get the most benefits from intermittent fasting, it is best to consult with your doctor. Your doctor or other healthcare professional can help you safely and effectively begin an intermittent fasting program.

If you take anti-diabetes medications, including sulfonylureas, you may need to adjust your doses on the days you fast to avoid hypoglycaemia.

Exercise

Exercise in and of itself has great benefits on glycaemic control. Incorporating exercise into your daily life has been shown to improve many aspects of your health, including insulin sensitivity.

In a review of several clinical trials, it was found that exercise considerably lowered HbA1c even if there wasn’t weight loss.

10,000 Steps a Day

Achieving 10,000 steps a day has been associated with weight loss, which has been shown to improve the chances of reaching remission with type 2 diabetes. In a small study, HbA1c was lower in a group that was prescribed 10,000 steps a day.

Aiming to hit 10,000 steps a day is a great goal to have when starting to exercise. However, hitting this goal might not be as easy as imagined. If you are just beginning a walking plan, you may consider adding just 100 extra steps a day for a week. Then the next week, you might add 200 per day.

Try increasing your daily steps each week until you reach the 10,000 step mark. Setting small attainable goals can help you reach your bigger goal.

30 Minutes Moderate Exercise

Studies have consistently shown that moderate exercise for 30 minutes or more, three or more times a week for eight weeks or more, improves glycaemic control markers, such as insulin resistance and blood glucose.

While there is some evidence that higher intensity exercise may produce even better results, it is often harder to stick to these more aggressive plans.

When they are just beginning an exercise routine, some people find that higher intensity exercises, like high-intensity interval training (HIIT), may be too much for them to handle. Finding a moderate exercise that you can do consistently is better than going all out once a week and then becoming sedentary.

Exercise is considered moderate when you begin to feel challenged. You might feel a little sweaty, and your breathing rate will increase. You shouldn’t be completely out of breath, but you should also feel like you’re putting some effort into your movements.

One great way to monitor the intensity of your exercise is to check your heart rate. This can be done with a heart rate monitor or by counting heartbeats for six seconds and multiplying by 10. With moderate exercise, your heart rate should be around 64% to 76% of your maximum heart rate.

Bariatric Surgery

Bariatric surgery is surgery that reduces the size of or restricts your stomach. These procedures have proven to lead to significant weight loss and remission of type 2 diabetes within days or weeks of surgery.

Clinical trials have shown that bariatric surgery can put 33% to 90% of people with type 2 diabetes in remission. While this is a significant statistic in the improvement and remission of type 2 diabetes, bariatric surgery is not for everyone.

Surgery comes with its own complications and risks. Talk to your doctor to find out if surgery is right for you.

A Word from Verywell

Although there is no cure for type 2 diabetes, you can do much to take control of your health. Losing weight, eating well, and staying active can help you lead a long healthy life with type 2 diabetes.

Through lifestyle modifications, you might even be able to put your diabetes in remission so that you no longer require medications. In some cases, bariatric surgery might be your best option for achieving remission.

To achieve these big lifestyle changes, you might find that taking small steps to improve your diet or lose weight can help prevent you from becoming overwhelmed.

Seeking the help of your doctor and other health professionals, like a dietitian or a physical therapist, can give you structure that’ll help you create and maintain these lifestyle changes. Don’t be afraid to ask for help and guidance.

https://www.verywellhealth.com/reverse-diabetes-5116687

World Health Day 2021: 5 Foods You Should Never Have If You Have Diabetes

From ndtv.com

World Health Day: If you have diabetes, there are certain foods you should completely avoid. Nutritionist Nmami Agarwal elaborates on them right here

World Health Day 2021: Every year on April 7, the world celebrates World Health Day. The day is aimed at ensuring that everyone, everywhere realises the right to good health. In this article, lets talk about diabetes, which is quite common in India and the rest of the world. Diabetes is a chronic condition which occurs when your blood glucose is too high. Carbohydrates, fats, processed foods, and even natural sugars can cause your blood sugar levels to rise. But, having diabetes doesn't mean a person has to stop eating the foods that they enjoy.

Having a healthy, balanced diet can help people with diabetes manage their condition and reduce the risk of heart disease, kidney disease, and other health-related complications. Unchecked diabetes can have many serious consequences; people with diabetes can eat most foods, but they may need to eat some of them in smaller portions.

Putting off foods that increase your blood sugar levels and drive insulin resistance can help keep you healthy and reduce your risk of future diabetes complications.

Let's take a look at the foods that people with diabetes should never include in their diet:

1. Fruit juices: Fruits are good for people who have diabetes but fruit juices are in equal measure bad for them. Fruit juices may make lose out on fibre and are loaded with fructose that elevates the blood sugar levels.

World Health Day 2021: Diabetics must avoid fruit juices

2. Refined flour: Foods such as white bread, white rice, pasta, bakery items and snacks that have been made from refined flour, should not be consumed by diabetes people. They can cause high blood sugar due to high glycaemic index and reduced brain function that can lead to mental health issues in diabetics. To be precise, fibre is needed to slow down the absorption of sugar in the bloodstream but refined flour contains very little fibre.

3. Favoured yogurt: We might think flavoured yogurts are a great source of probiotics, but they are not as healthy as you think. Most yogurts available today contain artificial flavouring and are loaded with sugar.

People with diabetes should avoid flavoured yogurt
Photo Credit: iStock

4. Fried foods: Deep-fried foods like French Fries are high in carbohydrates. These foods trigger blood sugar levels, thereby affecting health in more ways than one.

5. Full-fat milk: Milk is a complete food because of its abundance in nutrients. Diabetic people, however, need to be a little cautious with their intake of milk. They should hold back from full-fat milk as it is high in saturated fat. Saturated fats could worsen insulin resistance. Pick low-fat or skimmed versions of milk instead.

Remember, completely waring off foods when you have diabetes can sometimes seem tough. Yet, understanding a few guidelines can make it easier. The goal includes escaping from unhealthy fats, liquid sugars, processed grains, and other foods that contain refined carbs.

(Nmami Agarwal is nutritionist at Nmami Life)

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://www.ndtv.com/health/world-health-day-2021-5-foods-you-should-never-have-if-you-have-diabetes-2405303

How Do I Know If I Have Diabetes?

From health.usnews.com

A look at eight common symptoms and what to do if you experience them

You could have diabetes and not know it. The chronic disease in which blood sugars are elevated because the pancreas either doesn't make enough insulin or doesn't make any at all is one of the most common chronic health conditions in America.

However, not everyone who has diabetes knows it. Of the 32.2 million people in the U.S. who have the disease, 7.3 million are undiagnosed, according to the Centres for Disease Control and Prevention's National Diabetes Statistics Report 2020.

That's because the symptoms of diabetes can be very mild. Although symptoms are similar for both Type 1 and Type 2 diabetes, Type 2 diabetes symptoms can be especially hard to pinpoint, because they can be vague or are often symptoms of other chronic conditions.

"In many patients with Type 2 diabetes, the disease progresses slowly, and they may not realize that they have developed it without screening," says Dr. Asha M. Thomas, an endocrinologist with Sinai Hospital of Baltimore. "There are millions of patients who have diabetes who aren't aware they have it."

8 Most Common Symptoms of Diabetes

You can't know for sure whether you have diabetes just based on symptoms – you'll need to see a doctor who can check your blood sugar levels and make a definitive diagnosis.

Dr. Kathleen Wyne, an endocrinologist specializing in Type 1 diabetes and a professor of medicine in the division of endocrinology, diabetes and metabolism with the Ohio State University Wexner Medical Centre in Columbus, notes that while the symptoms listed below are among the most common, "it's not usually just one of the items on this list, but the combination that makes us look for diabetes."

You have to urinate more often.
This is because your kidneys are working harder to process extra sugar in your urine. The colour of the urine you produce if you've got diabetes is usually clear or very lightly coloured.

You feel thirsty more often than usual.
As you urinate more, you'll feel more dehydrated, and that makes you want to drink more liquids. Some people also feel hungrier than usual.

You develop urinary tract, yeast or vaginal infections frequently.
Sometimes, OB-GYNs help to diagnose diabetes based on an increased frequency of UTI infections or yeast infections, says Lucille Hughes, a certified diabetes educator and director of diabetes education at South Nassau Communities Hospital in Oceanside, New York.

Diabetes causes changes to the body's immune system that can increase your risk of developing other infections. Wyne adds that irregular menstrual cycles or miscarriages can also be signs of diabetes.

You experience unintentional weight loss.
While many people want to lose weight, the weight loss that occurs when you have uncontrolled diabetes is not a healthy way to lose weight. It happens because your body can't properly use insulin to help process glucose, a sugar found in food, for fuel. So your body starts to process fat and muscle for fuel, says Susan M. De Abate, a nurse, certified diabetes educator and team coordinator of the diabetes education program at Sentara Virginia Beach General Hospital.

You have flu-like symptoms or feel more fatigued.
If your spouse starts complaining that you used to love to do stuff, but now you just want to say home and sleep, that could be a sign that your health is compromised.

"They'll say, 'I knew something was different about them,'" Hughes says, describing the fatigue. The fatigue comes from a lack of glucose, your body's No. 1 energy source. "It's as if you're a car and you run on gasoline, but the gas is outside the car and can't make it in," Hughes says. And waking up frequently at night to urinate can also contribute to tiredness during the day, Wyne says.

You experience occasional blurred vision.
Uncontrolled diabetes can lead to a condition called diabetic retinopathy, which affects your vision. Eye doctors sometimes play a role in helping to diagnose diabetes because of the vision symptoms that can arise.

You experience erectile dysfunction.
Wyne says that in men under age 50, erectile dysfunction can be a sign of diabetes.

You need longer to heal.
If you notice that it seems to take a lot longer for cuts and scrapes to heal, that could be a sign of diabetes, Wyne says.

How Symptoms Differ Between Type 1 and Type 2 Diabetes

The symptoms of Type 1 diabetes are usually similar to those of Type 2, but they come about more suddenly. For example, a child may have flu-like symptoms that move quickly and send the family to the emergency room where a Type 1 diabetes diagnosis is made, Hughes says.

In contrast, the symptoms for Type 2 diabetes can be drawn out over several years before they become bad enough to be noticeable.

Why Diabetes Symptoms Are Confusing

The symptoms of diabetes, particularly Type 2, can be hard to track because they appear slowly over time and because the signs of aging and the signs of diabetes can overlap. "People have dry skin or they use the bathroom a lot (when they're older). It's hard to tell which is which," De Abate says.

Your symptoms could also overlap with the effects of certain drugs. For instance, if you take a diuretic, which are often prescribed to help control blood pressure but makes you urinate more, you might think your increased urination is only from the medication. There might be something else going on too.

Some patients get so used to living with certain symptoms – be it fatigue or increased urination – it never occurs to them that it could indicate a health problem, De Abate says. "Some people go undiagnosed for years, and their bodies handle it because they still produce some insulin." Still, that doesn't mean they are producing enough insulin or processing it properly, and it needs to be addressed before the disease progresses and complications arise.

Get Checked by Your Doctor

Making a definitive diagnosis means having your blood sugars checked in a lab, not via an at-home finger stick, Wyne says. The machinery at a diagnostic centre is more precise and when guided by a doctor, you'll be able to get started right away on managing the condition if you have it.

Therefore, "if you have symptoms, "I would recommend seeking medical therapy as soon as possible," Thomas says.

Wyne agrees that if you're concerned you might have diabetes, see your doctor "immediately."

If you're high risk, you should also undergo screening for diabetes. Risk factors are listed below.

"Although current guidelines recommend screening starting at age 45 (or younger if you're high risk), the U.S. Preventive Services Task Force has draft guidelines under review that recommend screening starting at age 35," Wyne says. This is in response to the growing number of young people who are developing diabetes.

"Screening can start younger, even below age 18, if multiple high-risk factors are present," Wyne adds, so talk with your doctor about your risk levels.

If diabetes is suspected, your doctor will check your fasting blood sugar and run a haemoglobin A1C check, which measures your average blood sugar over the previous three months.

The A1C test could also reveal if you have prediabetes – which means you still have time to change your eating habits and increase physical activity so you don't develop full-blown Type 2 diabetes.

If you've been told that you have prediabetes, Wyne says that means "you have the warning signs that you're at risk of progressing to diabetes in the next few years." You can slow down this process by losing weight and keeping it off. The National Institute of Diabetes and Digestive and Kidney Diseases recommends shedding 5% to 10% of your current weight. So if you weigh 200 pounds, a 10% weight loss goal means losing 20 pounds.

In addition to dropping weight, increasing activity and staying as active as possible helps. Some people are successful in never progressing from prediabetes to full-blown Type 2 diabetes, but it takes sustained effort and self-care.

Am I at Risk of Developing Diabetes?

Although anyone can develop Type 2 diabetes, your risk is higher if:

• You have a family history of diabetes.
• You're African-American, Latino, Pacific Islander or Native American.
• You have cardiovascular disease.
• You have high blood pressure.
• You have high cholesterol or high triglyceride levels.
• You're overweight, obese or have an increased waist circumference. Belly fat is a warning flag for diabetes.
• You have signs of insulin resistance such as acanthosis nigricans, a condition in which folds or creases in the skin turn dark and velvety.
• You smoke.
• You have a history of gestational diabetes. For women who've had gestational diabetes, Wyne says your risk of developing diabetes is especially high, but losing the baby weight, eating healthy and staying active can help you avoid or delay that onset. She also says you'll need to monitor your blood glucose levels in the 3 to 6 months after delivering and then annually for the rest of your life.
• You have a history of polycystic ovarian syndrome.
• You had a baby that weighed more than 9 pounds at birth.
• You're over age 45.

"These are the patients we routinely counsel on the importance of prevention for Type 2 diabetes," Thomas says. Visit your doctor regularly to keep a closer eye on possible symptoms and risk factors, especially if you have one or more of the risk factors above.

"Once you're diagnosed with diabetes, or even prediabetes, please don't try to pretend it'll go away," Wyne says, "because it won't. It's very hard to accept that you have a chronic disease that will be there for the rest of your life, but it's up to you whether it's controlled or wreaks havoc on your life."

Diabetes means you need to take even better care of yourself as time goes on, because the disease can progress. So, "the sooner you come to terms with the diagnosis, and take charge of it, the more likely you'll be able to slow it down and prevent the devastating complications," she adds. "The longer it goes untreated or only partially treated, the sooner you'll develop the complications."

https://health.usnews.com/conditions/diabetes/articles/how-do-i-know-if-i-have-diabetes

Mayo Clinic Q and A: Childhood diabetes

From newsnetwork.mayoclinic.org

DEAR MAYO CLINIC: I recently noticed that my 7-year-old daughter has been drinking more water than usual, even though her activity has not increased. A neighbour mentioned that I should have her screened for diabetes. My daughter is not overweight nor does she eat excessive amounts of sugar. Should I take her to her doctor?

ANSWER: Hydration is important for adults and children. But anytime children act out of the ordinary, it's logical to be concerned about their health. You should contact your daughter's paediatrician or primary health care provider to talk about any changes that may be a sign of a more serious condition.

More than 34 million Americans are living with diabetes. And many of them are children and adolescents. Cases of Type 1 diabetes and Type 2 diabetes are on the rise among those 20 and under in the U.S., according to a study last year by the Centres for Disease Control and Prevention. Diabetes is one of the most common chronic diseases among children and teens, and is the result of the body not being able to process sugar, or glucose, properly.

Most of the sugar in people's bodies comes from the food they eat. When food is digested, sugar enters the bloodstream. Moving sugar from the bloodstream to the body's cells requires the hormone insulin. People with diabetes lack insulin or are unable to process insulin.

There are two types of childhood diabetes.

Type 1 diabetes, which is the most common in children, is an autoimmune condition in which the body no longer produces insulin. The exact cause of Type 1 diabetes is unknown. There's no cure for Type 1 diabetes, but it can be managed. Advances in blood sugar monitoring and insulin delivery have improved blood sugar management and quality of life for children with Type 1 diabetes. This type of diabetes is not caused by being overweight, eating too much sugar or not taking part in enough physical activity.

Type 2 diabetes is a chronic disease that also affects the way the body processes sugar, but this type is fuelled by obesity. Although Type 2 diabetes occurs more commonly in adults, an increasing number of children are affected due to the obesity epidemic. However, most children do not develop Type 2 diabetes before puberty.

While the exact cause of Type 2 diabetes is unknown, family history and genetics appear to play an important role. Inactivity and excess fat, especially fat around the belly, also seem to be important factors. Often, changes in diet and exercise are enough to manage Type 2 diabetes in children. However, oral medications and insulin treatment may be needed for some children.

Although diabetes may not run in your family, it is still possible that your daughter could develop childhood diabetes. You should talk with her about other signs or symptoms that you may not have noticed, or she may not have mentioned. Being able to recognize the signs and symptoms of the disease can help get an earlier diagnosis and ultimately a chance of a better outcome.

Increased thirst and increased urination are often the first signs that something is amiss. Excess sugar building up in your child's bloodstream pulls fluid from tissues. As a result, your child becomes thirstier — and drinks more and uses the bathroom more than usual.

Other symptoms for children might be fatigue, weight loss and increased hunger. The lack of sugar in their cells can cause children to become exhausted. If you begin to notice that your daughter is showing signs of fatigue but her activity has not increased, that is an area of concern. Also, some children may lose weight, as they're not able to store what they're eating in their body anymore without insulin. So weight loss can be another sign of diabetes.

Symptoms of Type 1 diabetes tend to develop rapidly in young people; whereas, Type 2 diabetes symptoms develop over time and may be so gradual that you do not notice. For children with Type 2 diabetes, other symptoms might include blurry vision and darkened areas of the skin, particularly around the neck or in the armpits.

Young people who develop diabetes are at a higher risk of health challenges throughout their lives. Complications from diabetes may include high blood pressure, high cholesterol, heart disease, increased risk for stroke and kidney disease, as well as other conditions.

Even if your daughter has not exhibited any other signs of diabetes, you should call her paediatrician or health care provider to determine next steps. He or she may recommend blood and urine tests. If your daughter is found to have diabetes, you likely will be referred to a paediatric endocrinologist for ongoing care. If she is found to be at high risk or on the cusp for diabetes, you also may want to meet with a specialist to develop a proactive plan to lower her risk for the future.

As scary as it might sound to have a child diagnosed with diabetes, the condition is manageable, and patients can go on to be active and have good quality of life. ― Dr. Ana Creo, Paediatric Endocrinology, Mayo Clinic, Rochester, Minnesota

https://newsnetwork.mayoclinic.org/discussion/mayo-clinic-q-and-a-childhood-diabetes/

Could COVID-19 trigger diabetes?

From leisureopportunities.co.uk

There is growing evidence that a COVID-19 infection could trigger diabetes in some patients.

One of the studies to have made the link is a report relating to the outcomes of 47,780 COVID-19 patients within five months of hospital discharge in England. It found that 4.9 per cent of patients were diagnosed with diabetes post-discharge.

Clinical observations also show that diabetes is associated with an increased risk of COVID-19 severity and mortality, meaning pre-existing diabetes can determine COVID-19 outcomes, while the condition can also be a consequence of the disease.

A study led by researchers at the University of Exeter shows that people aged 40 living with Type 2 diabetes face a "disproportionately increased risk of dying from COVID-19" – equivalent to the risk faced by a non-diabetic 20 years older.

A registry has been set up to collect data on people newly-diagnosed with diabetes and with confirmed COVID-19 / Shutterstock/Gecko Studio

The link between the two diseases has now become such that scientists, academics and doctors around the world have set up a registry to record and analyse reports which suggest that COVID-19 induces diabetes.

Called CoviDiab, the registry is designed to establish the extent and characteristics of new-onset, COVID-19-related diabetes, and to investigate its pathogenesis, management and outcomes.

The goal of the registry is to collect data on people newly-diagnosed with diabetes and with confirmed COVID-19.

It will also collect data on people with existing diabetes who present with COVID-19 and severe metabolic dysregulation, with the aim of investigating the pathogenesis of the interaction between the two conditions.

Ultimately, researchers hope to understand whether COVID-19 causes a new form of diabetes or more simply a stress response that triggers classic type 1 or type 2 diabetes. (*To view the registry, click here).

In a statement, the researchers said: "Given the very short history of human contact with COVID-19, this registry will rapidly help us understand how COVID-19 related diabetes develops, its natural history and its best management.

"Studying COVID-19-related diabetes may also uncover novel mechanisms of disease."

Paul Zimmet, professor of Diabetes at Monash University in Melbourne and co-lead investigator in the CoviDiab project said: “We don’t yet know the magnitude of the new-onset diabetes in COVID-19 and if it will persist or resolve after the infection; and if so, whether or not or COVID-19 increases risk of future diabetes.

"By establishing this Global Registry, we are calling on the international medical community to rapidly share relevant clinical observations that can help answer these questions”.

https://www.leisureopportunities.co.uk/news/There-is-growing-evidence-that-a-COVID-19-infection-could-trigger-diabetes-in-some-patients-research-covidiab/347419

Can apps really help with diabetes management?

From patient.info

Technology often plays a big part in how we manage our health. We use fitness trackers to log how much exercise we do. Calorie counters help us keep on top of our snacking habits - and we even use apps to help support our mental well-being. Tech can also support us when managing more specific health conditions like diabetes. But how do these apps work - and can they really help?

"For many people living with all types of diabetes, apps can be a huge help in supporting their self-management, helping with carbohydrate counting, blood glucose tracking and diabetes education," says Dan Howarth, head of care at Diabetes UK.

"Several apps allow people with diabetes to automatically share information with their healthcare teams, which has been particularly useful during the pandemic. There are also many apps being used by people at risk of developing type 2 diabetes, to support their weight loss."

Why apps can help with diabetes management

Diabetes is a condition which causes a person's blood sugar level to become too high. There are two different types. In type 1 diabetes, the body's immune system attacks and destroys the cells that produce insulin. Therefore, the body is unable to produce enough insulin to adequately regulate blood glucose levels. People with type 1 diabetes must take insulin daily and monitor their blood sugars to ensure appropriate dosing.

In type 2 diabetes, the body can no longer respond effectively enough to its own insulin to prevent blood glucose levels from going too high. However, unlike type 1 diabetes, you can take action to get your body to respond better to insulin. Type 2 diabetes is complex and management can vary: while it always includes lifestyle changes, drug options include tablets, injectable therapies and insulin.

It can be hard to keep on top of diabetes management when you're busy, but apps can help with everything from medication and GP appointments to diet and exercise. "Diabetes is a relentless condition, and when combined with the stresses of everyday life, for many, managing their diabetes can easily become a second priority," says Howarth.

"There is so much to remember when trying to manage diabetes, so it's understandable that things may sometimes get missed. The important thing is to discuss with your healthcare team how to overcome ongoing concerns and find the routine that works for you."

Keeping track of diet and exercise

There are a huge number of different apps to help track your diet and log your exercise, which can seem overwhelming. However, using tech to monitor your progress can be motivating when things seem tough.

The MyDiabetes app is an app for people with diabetes and diabetes-related issues such as high blood sugar, excess weight and high cholesterol. With over 150,000 members, it provides personalised diabetes management and weight loss advice, including plans created by nutritionists to help you create and maintain a healthy diet. It is suitable for people with type 1 or type 2 diabetes, as well as pre-diabetes and less common types of diabetes such as latent autoimmune diabetes of adults (LADA).

The MyDiabetes app helps you to transition to a moderate-carb diet with a personalised meal plan (adapted for you over time) that covers your calorie and carb/sugar intake as well as your macronutrient composition. It also allows you to log your blood glucose and HbA1c levels, weight and medications; to track your progress; offers 5- to 15-minute exercise workouts to build up your physical activity; and includes educational videos via the MyDiabetes Academy.

The Low Carb Program, which is free if you are given an access code by your GP or nurse, is a platform available in the UK that helps you make lifestyle changes that can improve your health. You can personalise the information you receive. The app covers sleep, stress, mental health, blood glucose testing, cholesterol and stopping smoking, as well as recipes and meal plans for weight loss.

Changing Health is another app for people aged over 18 who have type 2 diabetes, which you can access following a referral from your GP. It helps you manage your physical activity, diet and weight.

Managing insulin, medication and blood glucose

With so much going on in our lives, it can be easy to forget to take medications or attend appointments. However, it's important to take your medications, injections or treatments when necessary to avoid complications.

If insulin injections or medications are missed, complications can include hypoglycaemia - blood sugar levels which are too low - and ketoacidosis - a serious complication that occurs when your body produces high levels of blood acids called ketones. Longer-term complications include heart disease, stroke, kidney disease and eye problems, which can potentially lead to loss of vision.

The thought of injecting each day can be daunting, but once you get the hang of it, it becomes a manageable part of life. Apps can make managing insulin easier by allowing you to log when you have taken your medication, set reminders and check your blood glucose.

You can track your progress and activity, access workouts, find meal plans and create shopping lists to help you stay on track with your diet.

The Mumoactive app is one option for tracking type 1 diabetes. It allows you to add your diabetes values quickly and easily to keep track of blood sugar, carbohydrates and insulin. You can see all your recent results presented in simple graphs and decide what to do next, such as do a test, exercise, eat or take insulin.

Accessing information

Learning about diabetes can make a huge difference to how well you manage your condition. Mapmydiabetes, endorsed by the National Institute for Health and Care Excellence, is an online programme of information, guidance and self-help tools to support people in the management of their type 2 diabetes. The app is free on prescription from your GP.

"Diabetes UK's Learning Zone is a great online tool for people living with all types of diabetes to learn more about their condition and how they can self-manage it," says Howarth.

What are the downsides of using diabetes apps?

Apps can be really helpful, but it's important to remember the pitfalls. Some applications may only be compatible with US blood sugar measurement units, so make sure you check that the app gets the units right for you (mmol/L for UK).

Mobile apps are also constantly evolving, with new software updates being rolled out on a regular basis. These updates can improve user experience, but they can also introduce bugs too.

Some apps allow people with diabetes to meet others for peer support, which can be great for boosting mental well-being. However, it can be easy for misinformation to circulate because of limited moderation in online communities. It's also important to make sure your app comes from a reputable source, too.

"There are hundreds of diabetes-related apps, and it can sometimes be overwhelming to know which one to choose," says Howarth. "The NHS Apps library is also a good place to start, and your clinician can help you find the right diabetes app for you."

For those living with diabetes, the MyDiabetes app is available to download on iOS or Android to help you track and manage your condition and treatment.

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