Night-time Exposure To Bright Light May Raise Diabetes Risk

From medicaldaily.com

Night-time exposure to bright light increases the risk of developing type 2 diabetes, a recent study revealed.

In a large-scale study involving 85,000 healthy adults without diabetes, researchers from the Flinders University, Australia, discovered that exposure to light between 12:30 a.m. and 6 a.m., is linked to a 67% increased risk of developing diabetes.

"Type 2 diabetes risk was higher in people exposed to brighter night light and in people exposed to light patterns that may disrupt circadian rhythms. Avoidance of light at night could be a simple and cost-effective recommendation that mitigates the risk of diabetes, even in those with high genetic risk," the researchers wrote in the study published in the journal The Lancet Regional Health.

The participants were aged between 40 and 69 years at the time of recruitment. Their light exposure was captured by wrist-worn devices, which contained a silicon photodiode light sensor with a peak sensitivity wavelength of 560 nm.

The research team followed up with the participants for about nine years and found that those with the greatest night-time light exposure faced the highest risk, irrespective of the time they were exposed to light during the day.

"Night light exposure and genetic risk were found to be independent risk factors for developing type 2 diabetes," the researchers wrote.

The researchers attribute the association to the disruption of the body's circadian rhythm which can interfere with several body functioning.

"Light exposure at night can disrupt our circadian rhythms, leading to changes in insulin secretion and glucose metabolism. Changes in insulin secretion and glucose metabolism caused by disrupted circadian rhythms affect the body's ability to regulate blood sugar levels, which can ultimately lead to the development of type 2 diabetes," said Andrew Philips, a senior author of the study.

The study has certain limitations. The researchers could not explore the impact of food timing due to a lack of temporal dietary data. Food timing can affect human circadian rhythms, influencing glucose tolerance and body fat levels, potentially influencing the links between light exposure, circadian disruption, and diabetes. Since the participants in the cohort had an average age of 62.3 ± 7.85 years, it is uncertain whether the findings may apply to younger age groups.

However, based on their findings, the researchers suggest that "reducing your light exposure at night and maintaining a dark environment may be an easy and cheap way to prevent or delay the development of diabetes."

https://www.medicaldaily.com/nighttime-exposure-bright-light-may-raise-diabetes-risk-471901 

4 Herbal Supplements You Shouldn't Be Taking When You Have Diabetes, According to Dietitians

From eatingwell.com

Natural doesn’t always mean safe. If you have diabetes, think twice before taking these herbs  

With almost 12% of the U.S. population having diabetes, so many of us are looking for ways to manage our blood sugar. Natural alternatives like herbal supplements may be among the strategies people consider.

But while certain foods and spices can be helpful for diabetes, it’s important to approach herbal supplements with caution. One common assumption is that because something is “natural” it’s good for you, but supplements can come with safety risks, especially when used to treat diabetes.  

How so? “Herbal supplements can interact with diabetes medications and lead to hypoglycaemia, which can cause dizziness, fatigue and even a loss of consciousness,” says Whitney Stuart, M.S., RDN, a certified diabetes care and education specialist and founder of Whitness Nutrition. For your health and safety, it’s important to know about the herbal supplements experts say you shouldn’t take if you have diabetes. Learn about the four that made this list.

                                                                                        PHOTO: GETTY IMAGES

Herbal Supplements Not Recommended for Diabetes

1. St. John’s Wort

Having diabetes increases the risk of having depression by 2- to 3-fold. That’s where someone might turn to St. John’s wort, an herb that’s often used to treat depression and other mood disorders. However, it can interfere with certain diabetes medications, reducing their efficacy and potentially leading to poor blood sugar control. Additionally, St. John's wort may cause fluctuations in blood glucose levels, making it harder to manage diabetes effectively. One small study showed that taking this herbal supplement impaired glucose tolerance (a measure of how well your body can process glucose). Given the higher risk of depression that those with type 2 diabetes face, it’s important to talk to your doctor about any mood concerns you have, so they can help guide you toward the right treatment for you.

2. Ginseng

Ginseng is one of the most popular herbs taken in the U.S. But it doesn’t play nice with diabetes. “One herbal supplement that could be dangerous to take if you have diabetes is ginseng, as it may contribute to lower blood sugar levels and therefore interact with diabetes medications,” says Mascha Davis, M.P.H., RDN, author of Eat Your Vitamins. Some research suggests that ginseng may lower blood glucose, which could raise your risk for hypoglycaemia, especially if you manage your blood sugar with medication.

3. Aloe Vera

While often praised for its topical skin-soothing properties, aloe vera can have significant side effects when ingested, particularly for those with diabetes. Some research indicates that oral consumption of aloe vera can lower blood sugar levels, which may result in hypoglycaemia if combined with diabetes medications. Furthermore, the lack of standardization in aloe vera supplements can mean that contents and dosages of these supplements can vary widely, resulting in unpredictable impacts on blood glucose control. If you have diabetes, talk to your health care provider first before taking aloe vera.

4. Berberine

Berberine is a natural compound that has been used in traditional medicine for centuries, particularly in Chinese and Ayurvedic practices. While popular, “berberine should be avoided by individuals with diabetes on medication such as insulin or metformin because of its ability to lower blood sugar and cause hypoglycaemia,” Stuart says.

The supplement can also interact with a variety of drugs, posing additional risks if you take multiple medications for diabetes or other health conditions. As with other supplements, the quality and concentration of berberine products on the market can be highly inconsistent. For these reasons, if you have diabetes, talk to your doctor before trying berberine.

Alternative Approaches to Manage Diabetes

For those focused on managing diabetes, here are some ways to do so safely and effectively:

• Make dietary changes: Incorporating a balanced diet rich in whole grains, lean proteins, healthy fats and plenty of fruits and vegetables may help manage blood glucose levels. These Meal Plans for Diabetes are a great place to start.
• Stay active: Regular exercise, such as walking, swimming or yoga, can improve insulin sensitivity and aid in healthy weight management.
• Relieve stress: Techniques such as meditation, deep-breathing exercises and mindfulness may reduce stress, which is known to affect blood sugar levels.
• Monitor blood glucose: Regularly checking blood sugar levels can help individuals make informed decisions about their diet, exercise and medication.
• Seek out education and support groups: Participating in diabetes education programs and support groups can provide valuable information and support from others who are managing the condition right along with you.
• Stick to your medication: Taking medications as prescribed and discussing any side effects or concerns with health care providers can ensure effective management of diabetes.

The Bottom Line

While herbal supplements are often dubbed "natural," that doesn’t mean they’re always safe. If you have diabetes, approach herbal supplements with caution. Certain herbs can interfere with blood sugar levels and diabetes medications, leading to potentially serious health complications. Because supplement companies are responsible for putting out safe and accurately labelled products, it’s up to you to take a few precautions to stay safe. “If you choose to supplement, be sure to speak with your provider who can educate you on drug interactions and recommend a third-party tested product,” says Davis.

https://www.eatingwell.com/herbal-supplements-to-avoid-for-diabetes-8667231

Why smoking and vaping can worsen your diabetes

From indianexpress.com

Dr V Mohan, Chairman, Dr Mohan’s Diabetes Specialities Centre, Chennai, on why you need to kick the butt now

For a long time through these columns, I have been trying to explain why smoking is the worst enemy of people with diabetes and needs to be given up at the earliest. Both conditions independently increase the risk of many diseases and together, these risks are almost quadrupled. For each day you delay in giving up smoking, the nicotine addiction gets deeper and your goal to kick the habit just gets pushed further.

Nothing illustrates this better than two case studies. One of them was a chronic smoker friend of mine, who developed throat cancer, but couldn’t control his nicotine craving and began smoking during radiotherapy itself. The other was a Sri Lankan patient of mine, a chronic smoker who had diabetes and went on to develop diabetic foot rather quickly, a condition where your feet can get ulcerous and infection-prone as blood sugar damages your nerves and cells. He was just 30 when he had already developed gangrene in his feet. I barely managed to save his foot and let him off with a warning that even one cigarette a day would push him over the edge. In a month, he came back to see me with a gangrene, saying he could go through amputation but couldn’t stop smoking. Such is the power of addiction.

SMOKING AND DIABETES: A DOUBLE WHAMMY

Smokers are three times more at risk of developing diabetes than non-smokers. That’s because cigarettes are made with chemicals, many of which can even cause cancer. But primarily all of them result in inflammation and build oxidative stress (more free radicals than antioxidants) in several organs, damaging blood vessels. They cause insulin resistance in the liver, muscles and adipose tissue. They also affect functioning of the pancreas and increase the risk of chronic pancreatitis, which is a cause of secondary diabetes. Insulin may help blood sugar enter cells but nicotine changes cells, so they don’t respond to insulin, which increases blood sugar levels. Smoking also puts people with diabetes at a high risk of malignancies, mostly pancreatic, oral, stomach and bladder cancers.

Both cigarettes and tobacco that is chewed can cause vasoconstriction, or a narrowing of blood vessels, leading to lack of blood supply to vital organs. Inflammation begins as an irritant and when chronic, triggers multiple diseases, primarily heart disease.

Many patients of mine say they have resorted to vaping, considering its lower concentration of nicotine. Truth is, it is just as bad. Nicotine is addictive, period. E-liquids can contain sugars that have the potential to raise your blood sugar levels. A study published in March 2022 in The American Journal of Preventive Medicine and conducted by researchers from Johns Hopkins showed that e-cigarette use might increase a person’s risk of elevated blood glucose levels. Those who vape have a 22 per cent increased risk of developing prediabetes compared with those who do not.

Fortunately, targeted lifestyle changes can help manage diabetes and wean you off smoking. So focus on diet, exercise, sleep and reducing stress. The sooner you give up smoking, the sooner your body can start to heal.

https://indianexpress.com/article/health-wellness/why-smoking-and-vaping-can-worsen-your-diabetes-9415684/

How Artificial Intelligence Is Changing Diabetes Care

From diatribe.org

Key takeaways:

• New AI tools are emerging in diabetes care and research to analyse data in new ways
• A panel of experts said that the growing availability of these AI tools has the potential to increase the quality of diabetes care. 
• Security and privacy concerns persist and should be addressed for wider adoption of the new technology.

The emergence of artificial intelligence in healthcare has put diabetes care at the precipice of tremendous change, potentially offering people more control over their health and greater access to new options to manage their glucose levels and all aspects of their lives. 

Such topics were at the forefront of an expert panel discussion on the opening day of the ADA 2024 Scientific Sessions conference in Orlando, Florida, asking the question, “How will Artificial Intelligence Change Clinical Practice?” The answer was unequivocal: AI promises to deliver significant improvements in diabetes care for those who avail themselves of digital tools, such as apps, pumps, AID systems and CGMs.

For those now using continuous glucose monitors, the machine learning revolution is already under way, according to the expert panellists. The improved time in range that most people with CGMs experience from tracking their glucose levels is the basic building block of future AI, data-driven advancements.

The future of diabetes data science

While AI has meaningful uses across health care in general — using pattern recognition, large language models, expert systems and decision support — diabetes care is uniquely positioned to benefit from AI advances since technology has made it so quantifiable, said Dr. Boris Kovatchev of the University of Virginia. 

“AI applications are rapidly entering healthcare,” Kovatchev said. “Generative AI and large language models are at the forefront of this trend. Diabetes is one of the best quantified human conditions. Hence, diabetes care is making rapid progress with numerous applications.”

Advances that he listed include:

• Detection and prediction of events, classification and tracking disease progression,
• AI powering decision support systems,
• AI-driven neural network automated insulin delivery,
• AI-augmented clinical trials – “a most promising future,” he said.

Of particular note, Kovatchev presented results from the Virtual DCCT Project to illustrate how AI can augment clinical trials by reproducing virtual CGM traces for each DCCT participant to provide insights into how CGM metrics could relate to the risk for chronic complications and severe hypoglycaemia in the historic study data. 

Not only did the AI trial reproduce A1C outcomes of the groups in the treatment groups in the original DCCT trial, but Kovatchev showed how the AI-augmented study of the decades old trial was able to measure a “simulated” Time in Range that was significantly higher (60%-70%) in the “virtual” intensive treatment group compared to the “virtual” conventional treatment group.  

AI and diabetes devices

Dr. Peter Jacobs, director of the Artificial Intelligence for Medical Systems lab at Oregon Health & Science University, predicted a future in which a person with diabetes might be able to use an AI-enabled “automated hormone delivery system.” 

This hypothetical future system would take much of the guesswork and mental labour out of daily management by including:

• Automatic detection and dosing of insulin and pramlintide for meals
• Automatic detection and prevention of DKA with a ketone monitor
• Automatic detection of exercise and adjustment of insulin and glucagon to avoid hypoglycaemia
• Automatic pattern detection to forecast and solve future problems
• Automatic adjustment of insulin dosing in response to cyclical events, such as weekends, menstruation, or illness.
• Digital twin-based decision support on medication choices, exercise guidelines and nutrient intake
• Automated detection of pump occlusion, sensor failures and other system faults
• Alert system and user interface that learns to optimally satisfy the user

This future world is not yet here, but it might not be far off, said Jacobs, who has been working with his team to develop advanced control systems for the delivery of insulin and glucagon, among other uses of AI assistance in diabetes care and research. 

“There’s a lot of new technologies coming out right now that could significantly help people,” he said. “We’re at a time right now where you have an explosion of accurate sensors, an explosion of computation and access to all these tools. Combining computation with sensors, it's a tremendous opportunity and an exciting time for patients.” 

Connecting teams to deliver more powerful care

The third panellist at the session, Dr. Mudassir Rashid of the Illinois Institute of Technology, spoke about his research into how the use of AI impacts multidisciplinary team approaches to healthcare. The complexity of diabetes care and its need for coordination between healthcare teams make it well suited for AI enhancements, he said.

Rashid said the safe use of AI must include protections for data security and privacy as well as efforts to build trust in AI systems. In addition, he said, it is important to be aware of the potential for bias of algorithms and have clinicians ensure proper diagnosis, care and patient outcomes.

“People should be excited about the fact that it’s going to empower them,” he said of the emergence of AI technology in diabetes care. “It’s going to give them a lot more knowledge and insights about the chronic disease outside of the clinical setting, so they can get information outside of seeing their doctor. And this can also inform their diabetes treatment and care.” 

Security and privacy

Such data, Rashid explained, can be analysed by AI tools and then be available for the patient’s health care team and caretakers to glean specific insights about the individual to offer them better care. 

“There are some concerns with data privacy and security, but the best way to overcome them is to demonstrate to patients that there are safeguards,” he said. “It’s their data, it belongs to the patients, so more has to be done in securing their privacy. I’m optimistic that these are  technical and regulatory challenges that we can overcome. This is going to substantially improve care for people with diabetes.” 

https://diatribe.org/diabetes-technology/how-artificial-intelligence-changing-diabetes-care

How a 5:2 intermittent fasting diet can help people with type 2 diabetes

From medicalnewstoday.com

• A study from China suggest that a 5:2 intermittent fasting diet with meal replacement may be helpful for people with type 2 diabetes.
• Researchers reported that participants on the eating plan had better glycemic control and weight loss at 16 weeks compared to those on diabetes medications.
• Experts say the 5:2 diet is an option for people with type 2 diabetes, but it may not be suitable for everyone.

A 5:2 intermittent fasting diet with meal replacements may be helpful for people with type 2 diabetes.

A studyTrusted Source published today in the journal JAMA Network Open reports that following such an eating plan can improve glycaemic control as well as short-term weight loss.

“In this randomized clinical trial of 405 adults, the 5:2 meal replacement approach achieved better glycaemic control at 16 weeks compared with metformin and empagliflozin,” the study authors write.

“5:2 meal replacement may serve as an initial lifestyle intervention for patients wit h type 2 diabetes, providing an alternative to the use of metformin and empagliflozin medications,” they added.

Details on the study on fasting diet and type 2 diabetes

The study involved 405 adults in China who had obesity, or were overweight. The participants had been diagnosed with type 2 diabetes within the previous year.

The participants were randomly allocated to either receive metformin, empagliflozin or a 5:2 meal replacement eating plan for a 16-week period. All of the participants were also given guidance on exercise, diet and diabetes education every four weeks.

Those in the 5:2 meal replacement group had two non-consecutive days each week in which they used meal replacements. Meal replacements are pre-packaged food or beverages that may be used to give energy in place of a usual meal.

On the meal replacement days, the participants had one meal replacement instead of eating three regular meals. This amounted to an intake of 500 calories for women and 600 calories for men.

On the other five days, the participants in the 5:2 group were encouraged to monitor their calorie intake but eat whatever they wanted for breakfast and lunch. At dinner they then had a meal replacement.

The researchers reported that those in the 5:2 meal replacement group showed the greatest reduction in average HbA1C blood glucose levels over three months. Those in this group also had greater weight loss than the other two groups with a significant reduction in both waist and hip circumference.

The health benefits of intermittent fasting

Dr. Marilyn Tan, an endocrinologist at Stanford University in California who was not involved in the study, says intermittent fasting may be beneficial for some people with type 2 diabetes.

“There has been significant interest in intermittent fasting or time restricted eating for type 2 diabetes, and many studies have shown a benefit. The metabolic benefits may be due to both the specific timing of the eating and also reduced caloric intake. Many patients also find intermittent fasting to be more sustainable than other popular diets because the focus is more on timing rather than diet content,” she told Medical News Today.

“Extreme diets that are very restrictive in content can be difficult to follow long term and can lead to nutritional deficiencies, so the fact that the intermittent fasting diets focus less on dietary content often makes them more sustainable,” Tan added. “There’s no one size fits all diet for diabetes and it’s critical that whatever diet one chooses is sustainable long term. Many people can follow a more restrictive diet in the short term, but if they go off the diet, glycemic control and weight often revert to the prior state.”

More than 38 millionTrusted Source people in the United States have diabetes and of those 90% to 95% Trusted Sourcehave type 2 diabetes.

Risk factors for type 2 diabetes include being 45 or older, having a family history of diabetes, being overweight, and being physically inactive.

Type 2 diabetes can be managed with exercise and healthy eating. Insulin and diabetes medications may also be used to manage blood glucose levels.

Dana Hunnes, PhD, a senior dietitian supervisor at RR-UCLA Medical Center in Los Angeles who was not involved in the study, says diet is an important factor for a person living with type 2 diabetes.

“Diet and eating/meal patterns do matter quite a lot for someone with type 2 diabetes. What we eat can increase inflammation and make us more insulin resistant, have higher blood sugars, or it can lower inflammation, improve our insulin sensitivity, and make us require less insulin or less medication to help control glucose levels. So, what we eat, when we eat it, how we eat it, can make a difference,” she told Medical News Today.

Nutrition and type 2 diabetes

The American Diabetes Association recommends those with diabetes use the “diabetes plate” as a framework for building meals.

This involves beginning with a 9-inch plate and filling half with non-starchy vegetables. Another quarter of the plate should be made up with lean protein and the final quarter should be made up of quality carbs that can include whole grains, fruits, starchy vegetables, or low fat dairy.

Tan notes that while those in the 5:2 meal replacement group experienced weight loss and glycemic control benefits, meal replacements may not be be a long-term solution.

“Meal replacements usually provide fairly accurate calorie counts and can help restrict carbs and calories. However, they don’t necessarily help patients with a long term solution to real life situations. It’s much easier to follow a specific diet when one is in isolation. However, once you throw social and work situations, travel/vacation, special events, etc, into the mix, patients still need tools to navigate these solutions. For most people, it’s neither financially sustainable nor satisfying to stay exclusively on meal replacements long term,” she said.

Grant Brinkworth is a professor and director of research at Diabetes Australia. He told Medical News Today that people living with type 2 diabetes should consult with their doctor about the best method for them to attain sustainable weight loss and diabetes management.

“There is no one approach to losing weight that suits every person with type 2 diabetes. It is established that type 2 remission can be achieved through significant weight loss, although remission is not possible for everyone. What method a person uses to achieve sustainable weight loss is a personal decision and it is recommended that this decision is made in consultation with a healthcare professional,” said Brinkworth, who was not involved in the study.

https://www.medicalnewstoday.com/articles/how-a-52-intermittent-fasting-diet-can-help-people-with-type-2-diabetes 

Diabetes and the Skin: Complications and Prevention Tips

From drugtopics.com

Skin complications are common in patients with diabetes, but pharmacists can recommend several easy measures to help

Diabetes is one of the leading causes of death and disability across the world, affecting approximately 530 million people in 2021. The global burden of the disease is also projected to increase significantly in the coming years, with some estimates putting the number of people diagnosed with the condition at 1.31 billion by 2050.

The chronic disease, characterized by elevated blood glucose concentrations, can lead to numerous serious health complications if left uncontrolled. Patients with diabetes are at an increased risk for heart and blood vessel damage, nerve damage, kidney damage, and osteoporosis, as well as Alzheimer disease and dementia.

Another common area of concern for patients with diabetes is the potential for complications of the body’s largest organ: the skin. Between 30% and 70% of patients with diabetes will experience a skin condition at some point in their life. Skin conditions can also often be the first sign that someone has diabetes, which is why it is important to always keep an eye on any noticeable changes. 

“Given the high prevalence of diabetes and its associated skin complications, it is crucial to address this issue and explore strategies for its prevention and management,” wrote researchers in a review article published in the journal Cureus. “Early detection and treatment of skin complications can improve outcomes and reduce the risk of serious complications.”

Diabetes Skin Complications

Acanthosis nigricans

One of the more classically known skin complications of diabetes, acanthosis nigricans is more common in patients with type 2 diabetes and can impact men and women of all ages. The condition presents as multiple plaques that are grey to dark brown in colour with a thickened, velvety surface. It commonly appears on the back of the neck, elbows, and groin.

Diabetic dermopathy

The most common diabetic skin condition, diabetic dermopathy affects as many as 50% of patients with diabetes. Men and individuals older than age 50 are at highest risk for the complication, which usually occurs as a late complication of diabetes. It presents as rounded, dull, red papules that eventually turn into brown macules with a fine scale. They commonly appear over bony areas, such as the front of the shin or forearms.

Diabetic foot syndrome

Diabetic foot syndrome has a prevalence of approximately 4% to 10% and is slightly more common in patients with type 1 diabetes. The condition represents a significant cause of morbidity, mortality, hospitalization, and reduction in quality of life. It initially presents as calluses and dry skin, but in later stages turns into chronic ulcers and other malformations of the feet. Diabetic foot syndrome also makes patients more prone to fungal infections, which can infect and complicate the ulcers.

Scleredema diabeticorum

A chronic, slowly progressing skin disorder that affects approximately 2.5% to 14% of patients with diabetes, scleredema diabeticorum affects mostly women and those over the age of 20, although it can impact patients of all ages. The condition presents as worsening, thickened skin. The most commonly affected areas are the upper back, shoulders, and back of the neck.

Taking Care of Your Skin

According to the CDC, the skin is a good indicator of overall health. When skin complications arise in patients with diabetes, they may be the result of high blood sugar, or they may mean that a change in treatment is needed. The American Diabetes Association notes that it is important to take good care of the skin, and there are several measures that can be taken to prevent any potential complications.

These include the following:

• Managing diabetes effectively.
• Keeping skin clean and dry.
• Using moisturizer to prevent dry, cracked skin.
• Avoiding excessively hot showers or baths.
• Treating any cuts, wounds, or burns by washing and applying antibiotic cream or ointment, as well as covering any minor cuts with sterile gauze.
• Keeping the home humid during cold, dry months.
• Using mild shampoos.

If patients are unable to solve these skin issues on their own, consider referring them to a dermatologist for additional care.

https://www.drugtopics.com/view/diabetes-and-the-skin-complications-and-prevention-tips