Tuesday, 7 September 2021

‘After I Was Diagnosed With Diabetes, Walking Changed My Entire Outlook on Life’

From prevention.com

“I can walk to the end of the earth and back, and that’s a good feeling to have as you get older.”

My fitness journey began when I turned 50. I was hit with almost every health issue I had a genetic predisposition for. I became diabetic, I found out I had high blood pressure and, on top of that, high cholesterol. I knew I had to change my lifestyle and become more active, so I started walking, biking, and swimming.

These fitness activities have helped me with my diabetes over the past 14 years, and it’s something I’d like to pass on to my grandchildren. Diabetes has affected my family for generations, and I’ve never seen anyone make an effort to overcome this streak, but I plan to. This is why my grandchildren are my go-to exercise partners. Exercising not only allows us to bond and connect, but I believe if my grandkids are fit and conscious of their activeness, we may be able to stop the proliferation of diabetes in my family.

domonic franklin and his granddaughter

Walking makes me feel fantastic. There’s also no better feeling than taking in new sights on a new walking path. When I walk by myself, I love to just put in my headphones, turn on some music, and get immersed in song. I also like to switch up my walking routine so that it doesn’t get old or boring. So I may do a two-mile walk around the track one day, and then I may do a one-mile walk around my neighbourhood the next day. My goal is to be excited about walking every time I hit the pavement. It should never feel like a chore.

When you’re walking, I think it’s important to keep an open mind, look at it positively, and set a goal—a realistic goal. I try to walk outside for one mile at least four times a week. Don’t push yourself to walk ten miles the first day you do it because, like me, you’ll probably end up being sore for four days because your body just isn’t used to it! Instead, give yourself time and focus on building up your mileage and working towards a goal. I’m a goal-setting person, and I always tell people that setting a goal will encourage you to keep going.

Everyone should take advantage of their ability to get outside and walk. Especially during a time like this, many of us need an outlet to relieve stress—walking can easily be that outlet. And just like it does for me, it can help you relax and centre yourself. Now I can happily say that I can walk to the end of the earth and back, and that’s a good feeling to have as you get older.

https://www.prevention.com/fitness/a36179864/why-i-walk-franklin/

Sunday, 5 September 2021

7 Tips for Talking to Your Kids About Type 2 Diabetes

From healthline.com
By CJ Walker

Diabetes is a condition that affects the whole family. Therefore, it’s vital for your children to know about your diagnosis

The day I was diagnosed with type 2 diabetes was a complete shock.

At the time, my future seemed bleak and I was terrified. This diagnosis would not just affect me, but also my husband and our three children who were 8, 6, and 4 at the time.

I spent the majority of that day alone, crying and grieving what had been my life before I was diagnosed with diabetes. I finally had the strength and composure to talk about it with my children, and my husband and I arranged a family meeting to share the life changing news.

After we told the kids, my daughter was very concerned and had a lot of questions. My younger sons did not understand the information immediately, but they needed assurance that I would not die from diabetes.

If you’re a parent who’s recently been diagnosed with diabetes, you’re probably wondering how that will affect your children. Even if we don’t want to tell our children about our illnesses, our children still need to know.

Here are 7 tips for having this important conversation with your children.

Plan when and where you’ll have the conversation. Prepare what you want to say and how you want to say it.

Consider asking someone for advice, playing a role, or researching resources before speaking. Remember to keep your tone appropriate and your body language positive.

According to the American Academy of Paediatrics, parents should frame health issues using language that fits the child’s developmental stage. For example:

  • Ages 2–6: Parents should explain things simply, such as: “Mommy is sick, but she will be OK. She was given some medicine that is going to help her get better.”
  • Ages 7–11: Parents can explain a little more, such as: “Mom is sick. She has diabetes. Do you know what diabetes is?” If your child doesn’t know what diabetes is, explain the condition in simple terms: “Diabetes results in high blood sugar levels.”
  • Ages 12 and older: Parents can be more transparent and upfront when discussing the condition, including treatment and uncertainty.

Take into account how your child comprehends and processes information. It’s important to inform children — but also give them time to digest it. Respond honestly, in simple language, to your child’s reaction.

Be prepared to answer questions about your condition, like “Why can’t you eat this?” and “What happens when you take insulin?” You may also have to answer some tough emotional questions, like “Will you die? Will you be sick? Will I get diabetes, too?”

Use age-appropriate movies, books, or online resources to help kids learn more about diabetes. Diabetes organisations, your local library, or online resources are all good places to find children’s resources.

The most important thing to tell your child is that diabetes can be managed, even if you still don’t know what to expect.

Be available to answer any questions your kids may have. Remain positive when addressing their concerns. Reassure them that they’re loved, that they’ll be kept safe, and that all feelings are acceptable.

When your child has a clear understanding of your diabetes, they’ll worry less.

A chronic condition diagnosis can cause huge changes in a family’s environment. For example, with diabetes, the foods you keep at home and your routines may change.

Explain to your child the changes that will be made to the home environment and discuss ways in which they can help support you.

Children of any age should understand the importance of diabetes gear, including meters, test strips, insulin pumps, continuous glucose monitors (CGMs), insulin, syringes, and oral medications.

Let your child know that these items are all off-limits, and do your part by keeping all supplies and medications out of reach in a secure place to avoid accidental injury or ingestion.

It’s important to teach your children how to recognize the signs of high or low blood sugar levels.

For example, there are times when I’m very sluggish and that normally means my blood sugar levels are low. If it appears that I’m especially moody, then my blood sugar may be high.

My children can recognize this and say, “Mom, have you checked your blood sugar?” or “Mom, are you OK? Do you need something to eat?”

Also teach your kids how to provide you with support in tough times and emergencies if they arise. Tell them about your type of diabetes, if you use insulin, and if you wear a pump, so they can communicate with others about your health in case of a crisis.

Keep a list of your medical conditions and medications in a place where it’s easily accessible to your kids, either on paper or a phone.

If you have older children, be sure they know where your glucose tablets, glucagon, and insulin are located. Kids of all ages should be taught to call 911 in an emergency — like if you’re not talking or responding appropriately, are unconscious or passed out, or having a seizure.

There’s a good chance your child will be worried that they will also automatically be diagnosed with diabetes.

While genes can play a role in the development of type 1 and type 2 diabetes, the Centres for Disease Control and Prevention (CDC) says this doesn’t mean your children will develop the disease.

Let them know that your type 2 diagnosis does not increase their risk for type 1 diabetes, and if they’re diagnosed with type 2 diabetes, you’d know how to keep them healthy.

Talk about how they can help prevent type 2 diabetes through healthy eating and regular exercise, and encourage your children to work on these as a family.

Diabetes is a condition that affects the whole family. Therefore, it’s vital for your children to know about your diagnosis.

Be transparent and allow your children to love and support you the best way they can. Living through such an illness together will ultimately bring you closer together as a family, as life takes on a whole new meaning.

Rather than letting diabetes control your family, embrace every moment you spend with them fearlessly and without limits.

CJ Walker, a mom of three and wife from Virginia, has been living with type 2 diabetes since 2019. She’s a fervent advocate for chronic illness, especially diabetes. Diabetes stigma, awareness, and prevention are at the forefront of her advocacy efforts, as well as chronic illness discrimination in the workplace, healthcare, and education. In addition to her work with The Genetic Diabetic Blog, she’s been published on Type2Diabetes.com, The Mighty, and Medium.

https://www.healthline.com/health/type-2-diabetes/tips-for-talking-to-your-kids-about-diabetes

Blue Cross NC, NC State team on diabetes prevention program

From fiercehealthcare.com

Blue Cross and Blue Shield of North Carolina is joining forces with North Carolina State University to roll out a new virtual program that aims to prevent type 2 diabetes.

The "Eat Smart, Move More, Prevent Diabetes" (ESMMPD) program is a 12-month, online initiative developed by the university that focuses on healthy eating, stress management, weight loss and physical activity to prevent diabetes. It is recognised by the Centres for Disease Control and Prevention.

Similar programs have reduced the risk of developing type 2 diabetes by 58%, Blue Cross NC said.

“Diabetes is one of the most prevalent health issues facing North Carolinians today,” said Von Nguyen, M.D., chief medical officer at Blue Cross NC, in a statement. “By giving members the tools to stop type 2 diabetes before it starts, we’re working towards our goal of more affordable, better health care for all North Carolinians.”

Blue Cross NC has since 2005 operated a similar program, called "Eat Smart, Move More, Weigh Less," that achieved notable, and ongoing, financial savings. Members who completed the program in 2016 saved an average of $972 per year between 2016 and 2019.

Average weight loss was 10 pounds and the program has a 98% satisfaction rate, Blue Cross NC said.

A nutrition label with a salad in the background

Blue Cross NC and NC State are teaming up on a new diabetes program.
(Brian A Jackson/Shutterstock)

The insurer said it is reaching out proactively to members with prediabetes or who are at high risk of developing type 2 diabetes to enrol them in ESMMPD in an effort to prevent a type 2 diabetes diagnosis. More than 3.7 million people in North Carolina have prediabetes or type 2 diabetes, Blue Cross NC said.

“We are thrilled to be able to offer ESMMPD to more people thanks to the coverage from Blue Cross NC. We know that too many North Carolinians have prediabetes," said Carolyn Dunn, Ph.D., William Neal Reynolds Distinguished Professor Emerita at NC State and Eat Smart, Move More, Prevent Diabetes Principal Investigator, in a statement. "We also know that they can prevent type 2 diabetes by participating in this structured lifestyle-change program."

"We are here to help with trained lifestyle coaches that know how to help people make meaningful changes to their eating and physical activity habits. A diabetes-free life is possible," Dunn said.

https://www.fiercehealthcare.com/payer/blue-cross-nc-nc-state-team-diabetes-prevention-program

Wednesday, 1 September 2021

5 Myths About Diabetes That Can Be Harmful

From self.com

Many of these are all too common

There are a lot of myths about diabetes that can really affect the way people think about the disease. Some of the most prevalent diabetes myths stigmatize the condition, which can make you feel like you did something wrong if you have this health issue. The stress of managing a chronic condition (going to nonstop doctor appointments, trying new medications, dealing with symptoms) can be really demoralizing, even without the added weight of judgment about your health.

To help push back against these misperceptions, SELF talked to experts about the most common diabetes myths that they hear, along with the truth behind the myths as well.

1. Myth: People should be embarrassed about having diabetes.

You may feel embarrassed about having diabetes, but there are so many reasons for why having this medical condition (or any other) shouldn’t be shameful. For starters, diabetes is incredibly common. More than 34 million people living in the U.S. have the condition, according to the Centres for Disease Control and Prevention. That’s around 1 in 10 people. But even if it were a less common condition, the shame and stigma surrounding diabetes still wouldn’t be justified.

There are numerous reasons for why diabetes is often so stigmatized, including anti-fat bias, racism (diabetes is more likely to affect people of colour than white people), and our cultural obsession with wellness, among others. But having diabetes doesn’t mean you are somehow less than a person without the condition in any way.

If you have type 1 diabetes, then your pancreas doesn’t make enough insulin, a hormone that helps your body take sugar from your blood to use as energy. People with type 2 diabetes typically produce some insulin but aren’t able to use the hormone effectively, meaning they're insulin-resistant, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Type 1 diabetes typically tends to develop much earlier than type 2 diabetes.

Some diabetes myths are stigmatizing and affect how people think about the condition. nbspnbsp
Some diabetes myths are stigmatizing and affect how people think about the condition.   
Maskot / Getty Images

Experts aren’t sure what exactly causes the insulin issues that give rise to type 1 diabetes, but they generally believe it happens when your immune system mistakenly attacks healthy cells in your body. Type 2 diabetes is the result of a mix of genetic and lifestyle factors. Having a first-degree relative with diabetes—like your mother or father—increases your risk of developing both forms of diabetes, according to Jorge Moreno, M.D., an internal medicine physician with Yale Medicine who is also board-certified in obesity medicine. Either form can be stigmatized largely because people may not understand diabetes and assume only lifestyle factors are involved, according to Wendell Malalis, M.D., endocrinologist at Northwestern Medicine Regional Medical Group. “People may feel like [diabetes] was all their fault,” he tells SELF.

Since lifestyle factors aren’t involved in developing type 1 diabetes, there’s no way to reduce your risk of developing the condition. Staying physically active and not being a weight that is medically classified as overweight or obese can decrease a person’s risk of developing type 2 diabetes by helping the body become more sensitive to insulin. But having any real control over these kinds of lifestyle factors is so much easier said than done. For instance, the way you eat and exercise can depend on where you live, your schedule, food accessibility, and how your family raised you to think about and behave around food and fitness. If you’re a single parent who works long hours, for example, you may not be able to cook many fresh meals (which can be more expensive and take longer to prepare) and exercise often. It’s also very much worth noting that weight doesn’t exist in a vacuum—no matter how you eat or move your body, factors like your hormones, sleep, and, yes, genetics can have a big impact on your weight. All of that is to say that it’s unfair and inaccurate to blame or judge anyone for having a condition like diabetes.

That said, if you have a family history of type 2 diabetes and want to lower your type 2 diabetes risk (or feel more in control of your type 2 diabetes if you have the condition), then you may want to talk to your doctor about what realistic and sustainable lifestyle changes might make a difference for you.

2. Myth: You can only develop diabetes if you’re overweight.

The vast majority of people with diabetes have type 2 diabetes. And while weight is one factor in developing type 2 diabetes, people can have type 2 diabetes at any weight. (There are plenty of people in bigger bodies who don’t have diabetes too.)

Being overweight is associated with insulin resistance, which can cause type 2 diabetes if your blood sugar remains excessively high. Although body mass index (BMI) is not a good measure of individual health, research shows there’s a correlation between having a higher BMI and developing type 2 diabetes. The reason for this isn’t fully understood, but one reason could be that some people with a higher BMI have more visceral fat (or the fat stored in our stomach surrounding our organs). Visceral fat affects hormone regulation and having more visceral fat is associated with insulin resistance. But having a higher BMI doesn’t guarantee you’ll get diabetes, and there are people with lower BMIs who do have diabetes.

Past research shows that some people who were at risk of developing diabetes lowered their chances of getting the condition after losing weight through diet and exercise. That’s why you’ll often hear that losing weight is recommended to help you lower your chances of getting diabetes if you’re at risk. For some people, weight loss also makes blood sugar easier to manage. But know that there is no specific amount of weight loss guaranteed to lower the odds of developing diabetes if you’re at risk or improve your diabetes if you have the condition. Talking to your physician can help you decide whether you might benefit from losing weight and, if so, how to realistically do that.

3. Myth: You can never eat sugar or carbs if you have diabetes.

If you have diabetes and have received a disapproving stare from someone when you order dessert, then you may have experienced the blowback from this myth. “There is no reason that you have to cut everything out,” Bithika M. Thompson, M.D., an endocrinologist with the Mayo Clinic in Scottsdale, Arizona, tells SELF. “It all comes down to balance.”

In order to avoid diabetes-related complications, you will need to keep your blood sugar levels within a target range that’s specific to you. (Your doctor will help you set this target.) For example, if you have type 2 diabetes and sugar builds up in your blood, then you may develop hyperglycaemia, or dangerously high blood sugar. Over time high blood sugar levels can raise your risk of heart attack, stroke, and other complications.

Although you don’t need to completely avoid eating carbohydrates or sugar if you have diabetes, you may need to make some dietary changes to keep your blood sugar levels in your recommended range. For example, your doctor or dietitian may recommend that you choose complex carbohydrates over refined carbohydrates when possible, like opting for whole wheat bread instead of white bread. Your body breaks all carbohydrates down into glucose (sugar) and uses it for energy. But complex carbohydrates take longer to break down, meaning your blood sugars rise more slowly.

You can use the glycemic index as a guide for choosing foods, says Dr. Moreno. The index assigns a number to certain foods based on how likely they are to make your blood sugars rise. (The lower the GI number, the less likely your blood sugar will rise.) But keep in mind that the GI is not an exhaustive list and doesn’t account for the nutritional content of foods, like whether something has vitamins or fats (which our bodies need). However, it is one tool that might help you make choices about what you want to eat.

4. Myth: Insulin is actually harmful.

Insulin helps keep your blood sugar low by moving sugar from your bloodstream into your cells. And maintaining a healthy blood sugar is one aspect of decreasing your chances of developing other health conditions such as heart disease. However, some people mistakenly believe that insulin can make your diabetes worse.

Insulin is the recommended treatment for most people with type 1 diabetes, according to the American Diabetes Association. People with type 2 diabetes generally take other medications rather than insulin at first but may need to eventually take insulin in the long term.

It’s true that, like any medication, insulin can come with side effects and potential risks. Insulin therapy can also cause issues like trouble breathing, muscle cramps, and constipation, according to the U.S. National Library of Medicine. If you accidentally take too much insulin or your doctor prescribes you a higher dose than what you need, then you may develop low blood sugar. When this happens, you might feel fatigued, irritable, shaky, or confused. In this case, it’s safest to get medical assistance or talk to your doctor about how to counteract taking too much insulin. You may be advised to eat and recheck your blood sugar or to get urgent care, depending on your symptoms. Generally, doctors start by giving you low doses of insulin and gradually increasing your medication to avoid this happening.

Some studies show that insulin may be linked to cardiovascular complications, such as strokes, in people with type 2 diabetes. However, having type 2 diabetes increases your risk of developing heart disease, so insulin wasn’t necessarily the cause for any heart issues in these studies. If you’re worried about taking insulin, it’s worth discussing your specific concerns with your physician so you can work on creating a treatment plan you’re comfortable with.

5. Myth: You can cure diabetes.

You may have seen advertisements for products that claim to cure diabetes, but in reality diabetes is a chronic disease. In other words, there is no diabetes cure.

But you can successfully manage your condition and even achieve remission with the right treatment plan. Some people with type 1 diabetes may lower their blood sugar to a nondiabetic range when they’re not currently taking any drugs after they’ve already been on medication for a while. However, this remission isn’t generally sustainable because their body eventually won’t be able to produce insulin on its own, according to the American Diabetes Association. 

With type 2 diabetes, you may be able to achieve very long periods of remission when your blood sugar levels reach a nondiabetic range without using medications, according to the NIDDK.

Ideally, you can have an open and honest conversation with your physician about the best way to manage your blood sugar, such as taking medication, making dietary adjustments, or increasing physical activity. Finding what works for you can take some time, so you may have some trial-and-error before you notice any blood sugar changes, according to Dr. Moreno. “Sometimes it takes more than one try to get to the root cause of the [blood sugar] elevation,” he says.

Understandably, you may feel isolated if you don’t know other people with diabetes or if people you know believe these myths. While having a medical condition can feel really all-consuming, it can be helpful to remember that having diabetes isn’t a character flaw. “It doesn’t define you,” Akankasha Goyal, M.D., clinical assistant professor of medicine and endocrinologist at NYU Langone Health, tells SELF. 

https://www.self.com/story/myths-about-diabetes

Monday, 30 August 2021

Sure Signs You May Be Getting Diabetes, According to Doctors

From eatthis.com

Know the signs before yours gets out of control

Diabetes is one of the most deadly diseases in America—and yet if you don't have it, you think it might not happen to you. That said, there's no harm in knowing the signs you may be getting diabetes, according to doctors. "It's extremely important to know your risk for diabetes and to be screened for diabetes early if you are concerned over your risk. A simple blood test can tell you your risk," says Dr. Deena Adimoolam, a Yale-trained endocrinologist who specializes in diabetes, food as medicine and metabolic health. Read on for the 7 most worrying symptoms.

1

You May Have Excessive Thirst and Frequent Urination

Woman drinking water from glass.
iStock

If you're developing diabetes, you may have polydipsia—increased thirst—or polyuria—frequent, excessive urination. These are very common, and it's all because of your kidneys. Your kidneys are the organs that filter and absorb glucose. When you have diabetes, you have excess glucose. "High levels of glucose function like a diuretic which leads to excess urination. This excess urination can then lead to extreme thirst and dehydration if you can't keep up with your fluid intake," says Dr. Adimoolam.

2

You May Always Feel Hungry

African Woman Eating Slice Of Cake Near Open Refrigerator
Shutterstock

It's natural to feel hungry after a long workout or having skipped breakfast. But diabetes may feel hungry for seemingly no reason—and find that food doesn't queel the pangs. There's actually a medical term for always feeling hungry when you have diabetes—it's called polyphagia. "Diabetes is defined by an issue with a hormone called insulin," says Dr. Adimoolam. "Insulin is important to allow glucose to enter into cells where it can be used for energy. In Type 1 Diabetes, there is a deficiency in insulin production. In Type 2 Diabetes the body is resistant to the effects of insulin (insulin resistance). Since this glucose cannot enter into cells to be used for energy, your body feels that you need more food for energy and you seek out food. But eating more won't help—what helps is taking medications to help get glucose back into cells to be used for energy."

3

You May Have Blurry Vision

woman over white with blurred vision and trouble focusing
Shutterstock

If you guessed blurry vision when you have diabetes was due to blood sugar issues, good job: you have been paying attention. Your eye lens swells when blood sugar levels are high, and body water is pulled into the lens. You may also have damage to the blood vessels in the retina; they can become weak and thin, and leak a fatty protein called exudate. This makes sight difficult.

4

You May Feel Very Tired

Woman sleeping on the couch in the living room.
Shutterstock

When your blood glucose is uncontrolled, you may have hyperglycaemia—which can lead to nausea, fruity-smelling breath, shortness of breath and dry mouth—or high blood sugar, and feel a lack of energy. "Patients with diabetes are unable to make use of the high glucose levels in the body for energy—this is why they feel exhausted," says Dr. Adimoolam.

5

You May Find Your Cuts and Wounds Heal Slowly 

heat burn wound on her hand.
Shutterstock

A scrape or scratch is nothing to most people, but to diabetics, it can result in a serious issue, leading to infection. Diabetics have been known to get foot ulcers for example—wounds on the feet that may never heal. Why? There's a direct connection between blood glucose and healing. "In primary closure of surgical wounds in high-risk patients, poor glycemic control is significantly associated with worse outcomes," said the definitive study. "Every effort should be made to ensure tight control in both the chronic and subacute perioperative periods." "Chronic exposure to high glucose values leads to disease of the blood vessels (what we call 'vascular complications of diabetes')," says Dr. Adimoolam. "When blood vessels are damaged, there is limitation of the flow of blood to those specific areas of the body which leads to slow wound healing."

6

You May Have Numbness or Tingling in Your Hands or Feet

Woman holding leg in pain
Shutterstock

You may have a numbness or tingling in your hands or feet due to diabetes. This is because of diabetic neuropathy, a nerve damage that can "affect as many as 50% of people with diabetes," say the doctors at the Mayo Clinic. You may also have pain or cramps. Or have proximal neuropathy (diabetic polyradiculopathy)—"This type of neuropathy — also called diabetic amyotrophy — often affects nerves in the thighs, hips, buttocks or legs. It can also affect the abdominal and chest area," says the clinic.

7

You May Have Patches of Dark Skin

woman worrying about her skin
Shutterstock

Patches of dark skin—called Acanthosis nigricans—can be a sign of diabetes or, far more rarely, certain cancers.you'll see the velvety folds usually in the creases of your skin—mainly of the back of ones neck and armpits. What causes them? Usually insulin resistance, which is why this is so common among diabetics. "Too much insulin stimulates an increase in the abnormal growth of these skin cells," says Dr. Adimoolam.

8

What to Do If You Have Any of the Symptoms Mentioned

woman Doctor in green uniform wear eyeglasses and surgical mask talking, consulting and giving advice to Elderly female patient at the hospital
Shutterstock

Watch for that symptom and the others mentioned here, and contact a medical professional if you experience any of them. "Some amount of physical activity everyday may help lower one's blood sugars and possibly prevent type 2 diabetes," says Dr. Adimoolam. "Daily activity may even help with weight loss and improving your heart's health."

https://www.eatthis.com/news-sure-signs-diabetes-doctors/

NHS England to train staff in all trusts to spot rare type of diabetes

From theguardian.com

About 12,000 people in England likely to have monogenic diabetes, which is difficult to diagnose

People with a rare form of diabetes may receive better treatment and discover whether their children are also affected under new plans from NHS England.

Monogenic diabetes is caused by a single gene mutation – although the specific gene affected can differ. The condition occurs in two types, neonatal – which can occur within the first six months of life  – and maturity-onset diabetes of the young that develops later, often before the age of 25.

While about 12,000 people in England are thought to have monogenic diabetes, accounting for 1% to 2% of all diagnoses, the condition can be hard to tell apart from type 1 and type 2 diabetes, which are more common and thought to involve genetic predisposition and other factors. 

Now NHS England has announced plans to improve diagnoses of monogenic diabetes by ensuring there is training and support for a designated nursing and medical lead in each NHS trust. Up to 280 staff are to be trained on how to spot the condition over the next year. Among the tools available to clinicians is an online probability calculator.

“Monogenic diabetes is difficult to diagnose, and we will more easily be able to identify those who need to be referred for genetic testing by training teams on monogenic diabetes in each trust,” said Prof Partha Kar, NHS national speciality adviser for diabetes.

Experts said the programme could help patients receive better, more personalised treatment to help them manage their glucose levels. For example, while most patients with type 1 diabetes, and some of those with type 2, require insulin injections, this is not necessarily the case for people with monogenic diabetes, who can often be treated with a group of tablets called sulfonylureas, although this can depend upon the gene affected. 

As well as confirming whether a patient has monogenic diabetes, and the gene affected, genetic testing can also be used to explore whether the affected gene has been passed on to other members of a family: should one parent carry the gene, his or her children each have a 50% chance of also having the gene and hence developing the condition.

Dan Howarth, head of Care at Diabetes UK, welcomed the announcement. “The rollout of this programme is a significant and hugely positive development,” he said.

“It will help ensure people will get the most appropriate treatment and support for this rare type of diabetes, meaning blood sugar levels can be better managed, and the risks of developing the devastating complications of diabetes can be reduced.

“And as this form of diabetes runs in families, other family members can be informed of the symptoms to look out for, to enable timely treatment and support.”

https://www.theguardian.com/society/2021/aug/30/nhs-england-to-train-staff-in-all-trusts-to-spot-rare-type-of-diabetes

Sunday, 29 August 2021

Is type 2 diabetes reversible?

From medicalnewstoday.com

Type 2 diabetes is reversible under certain conditions, depending on a person’s lifestyle. Medications alone do not reverse it. If a person does not make healthy lifestyle changes, type 2 diabetes will progress, and they will eventually need more medications to manage it.

However, if someone engages in healthy lifestyle practices, such as eating a low calorie diet and getting regular exercise, their diabetes may subside and go into remission. People should also note that a prediabetes diagnosis does not necessarily mean that developing type 2 diabetes is inevitable. According to the Centres for Disease Prevention and Control (CDC), people can also reverse prediabetes by making lifestyle changes.

Keep reading to learn more about the possibility of people reversing type 2 diabetes, as well as diet, health, and prevention tips.

A person telling their child they no longer have type 2 diabetes.
Igor Alecsander/Getty Images

Type 2 diabetes is very common. The International Diabetes Federation reports that 463 million adults had the condition in 2019, resulting in 4.2 million deaths the same year.

That said, people with type 2 diabetes can do many things to control and manage the condition. A 2020 study notes that lifestyle practices may prevent type 2 diabetes but also have the potential to reverse it. This is also known as remission. In fact, evidence supporting the value of such practices is so substantial that the study’s authors refer to them as “lifestyle medicine.”

While the study cites evidence that a low calorie diet can help reverse type 2 diabetes, it contends a superior strategy exists. According to the authors, the link between type 2 diabetes and obesity does not involve excess body weight alone. Rather, excess belly fat specifically plays a prominent role.

With this in mind, the authors say a diabetes-reversing strategy that includes exercise is a better approach. They base this on other findings that indicate a combination of diet and exercise reduces belly fat. The authors also note that exercise lowers blood glucose levels and improves the sensitivity of insulin, the hormone that regulates blood sugar.

Healthy lifestyle practices could curb the type 2 diabetes epidemic, the authors conclude. While they advocate people following a low calorie diet and exercise, they add that such practices should include people getting enough sleep, abstaining from smoking, and monitoring their alcohol intake.

These lifestyle practices may also reverse prediabetes. In this condition, a person has slightly elevated blood sugar and is at increased risk of developing type 2 diabetes. The CDC notes that pursuing a healthy weight and getting regular exercise may offer this benefit.

Remission is the preferred term for diabetes reversal. This is because a person’s type 2 diabetes can always return. When someone is in remission, their A1C has reduced to a level of an individual who does not have type 2 diabetes, which is less than 6.5%.

A1C reflects a person’s average blood sugar level for the most recent 2-3 months. Doctors use the A1C test to diagnose and monitor the progress of the condition.

Aside from the lower A1C, a person in remission no longer needs to take any diabetes medication.

The CDC states several differences between type 1 and type 2 diabetes:

CharacteristicType 1 diabetesType 2 diabetes
PhysiologyThe body stops making insulin.The body makes insulin but does not use it well, so it cannot maintain normal blood sugar levels.
Percentage of people with diabetes5–10%90–95%
Onset of symptomsSymptoms develop quickly.Symptoms develop over many years.
When diagnosedDoctors usually diagnose it in children, teens, and young adults.Doctors usually diagnose it in adults, but they are increasingly diagnosing it in children, teens, and young adults.
TreatmentTreatment involves daily insulin.Treatment involves diet, medications, insulin, or a combination.
PreventionThere is no known prevention.Prevention is possible with healthy lifestyle changes.

The CDC provides diet and self-care health tips for people with diabetes. Diet recommendations include:

  • choosing nutritious foods, which involves fruits, vegetables, whole grains, and low fat or non-fat dairy products
  • eating high fibre foods, such as whole grain breads and cereals
  • selecting foods low in saturated fat, trans fat, calories, sugar, and salt
  • drinking water rather than regular soda or juice
  • filling a plate for meals as follows:
    • one-half with fruits and vegetables
    • one-quarter with whole grains
    • one-quarter with lean protein, such as beans or chicken without skin

Self-care is also important to live well with diabetes. Tips include:

  • taking medications as prescribed
  • visiting a doctor at least twice per year
  • monitoring and recording blood sugar if a doctor advises this
  • checking blood pressure if a doctor recommends this
  • checking their feet daily for blisters, redness, swelling, and cuts
  • maintaining healthy teeth and gums with regular brushing and flossing
  • abstaining from smoking
  • engaging in ways to reduce stress, such as deep breathing
  • seeking support from family, friends, or a mental health counsellor

The National Institute of Diabetes and Digestive and Kidney Diseases offers people the following type 2 diabetes prevention tips:

  • Lose weight if overweight: Losing 5–7% of weight can delay or prevent a person from developing type 2 diabetes.
  • Exercise regularly: This means a minimum of 30 minutes on 5 days per week. Individuals should start slowly and gradually increase their physical activity until reaching a goal. People should also ask a healthcare professional for specific exercise recommendations.
  • Eat nutritious foods most of the time: Following the dietary advice in the ‘Diet and health tips’ section above also helps prevent type 2 diabetes.

A person’s type 2 diabetes can go into remission if they seek and maintain a healthy weight, as well as engage in regular exercise.

Following a nutritious diet may help a person with weight control. In a single meal, this involves filling half the plate with fruits and vegetables, a quarter with whole grains, and a quarter with a lean protein, such as beans or chicken without the skin.

It is also beneficial for someone with type 2 diabetes to abstain from smoking and monitor their blood pressure. Stress management and seeking support from others are also important for people to live well with diabetes.

https://www.medicalnewstoday.com/articles/type-2-diabetes-reversible