A
daily dose of vitamin D may just be what helps you tide over
a long, bleak winter when you are mostly indoors, says new
research.
"Vitamin D deficiency continues to be a problem despite the
nutrient's widely reported health benefits," said Sue
Penckofer, professor, Loyola University Chicago, Marcella
Niehoff School of Nursing (MNSON), who led the study.
Diet alone may not be sufficient to manage vitamin D levels.
A combination of adequate dietary intake of
vitamin D,
exposure to sunlight, and treatment with vitamin D2 or D3
supplements can decrease the risk of certain health
concerns.
Depression is associated with increased insulin resistance,
so people with diabetes have a greater risk for the disease
than those without depression. Women also tend to have
greater rates of depression and poorer blood sugar control
than men with diabetes.
"There is evidence to suggest that vitamin D supplementation
may decrease insulin resistance," said Penckofer.
"If we can stabilize insulin levels, we may be able to
simply and cost effectively improve blood sugar control and
reduce symptoms of depression for these women."
Loyola faculty members plan to take vitamin D research a
step further by evaluating whether weekly vitamin D
supplements improve blood sugar control and mood in
women
with diabetes.
"Vitamin D has widespread benefits for our health and
certain chronic diseases in particular," Penckofer said.
Patients
will be given greater rights, including the entitlement to
cancer treatment within two weeks, under changes to the NHS
Constitution announced by Andy Burnham, the health
secretary.
Free health checks for those most at risk from heart
disease, stroke and diabetes will also be enshrined in the
constitution.
The Patients Association welcomed the decision but said it
would make little difference as the new rights already exist
as NHS pledges.
However, it is thought the move would make it more difficult
for opposition parties to set different targets.
Mr Burnham said: “Average waiting times, from referral to
treatment, are around eight weeks – and rapid access to
cancer specialists is saving lives across the country. Now
we are going to build on this strong foundation.
“By turning targets into rights, we are giving patients the
power to demand the services to which they are entitled.
“In particular, we want to press ahead with greater choice
around end-of-life care and in the next Parliament we will
bring forward proposals on a right for people to choose to
die at home if they wish.”
From 1 April 2010, patients will have the right to surgery
within 18 weeks and free health checks and urgent cancer
referrals within two weeks. Free private health care must be
provided if the NHS cannot meet these requirements.
From 1 April 2012, eligible patients aged 40-74 will have
the right to an NHS Health Check every five years to assess
whether they are at risk from heart disease, stroke,
diabetes or kidney disease.
The NHS Constitution, published last year, forces NHS trusts
and hospitals to “pay regard” to standards specified.
They
have become a common means of transport for Britain's ageing
population.
But new research suggests mobility scooters could do more
harm than good by increasing the risk of diabetes and
heart disease.
A study of scooter users in the U.S. found nearly one in
five developed diabetes after buying one to get around.
Many also needed to be prescribed higher doses of blood
pressure pills and statins, the cholesterol-busting drugs.
The research, published in the American Journal of
Cardiology, shows many of the benefits to patients' health
from being able to get around more easily are being wiped
out by the effects on the cardiovascular system.
Now researchers are calling on doctors to weigh up the risks
before recommending patients invest in a scooter.
It's estimated that there are around 90,000 powered scooters
and wheelchairs in use in the UK.
The numbers have risen in recent years as they have grown in
popularity among those unable to walk properly due to
illnesses such as arthritis, lung disease and heart failure.
The machines, which start at around £400, can reach speeds
of between 4mph and 8mph.
A committee of MPs is currently investigating the safety of
mobility scooters, following a spate of accidents.
Last July, 90-year-old Lilian Macey, from Harlow in Essex,
was killed when she was struck by a scooter driven by a
pensioner who escaped prosecution.
The machines are exempt from the Road Traffic Act, which
means police are often powerless to act.
The latest research, by a team at the Eglin Air Force Base
Hospital and the Cleveland Clinic Foundation, both in Ohio,
studied the effects on users' health.
They recruited 102 patients, with an average age of 68, who
had obtained medical approval for a scooter and monitored
their health for a six-year period.
They used them for an average of four hours every day, with
only around 30 minutes spent walking.
Although patients said they felt better physically and
mentally, tests showed 18.7 per cent developed diabetes
during the follow-up period.
Diabetes increases the risks of heart attacks and strokes
and is linked with a lack of exercise.
Researchers also found a fifth of patients on pills for high
blood pressure needed higher doses to keep it under control,
while half of those on statins also needed to up their
intake.
In a report on their findings the researchers said:
'Scooters can improve self-perceived quality of life. But
they can also have detrimental long-term effects by
increasing cardiovascular risk.
'Doctors should carefully weigh such risks before approving
their use and ensure healthy levels of activity afterwards.'
Cholesterol-busting
wonder drugs taken by millions to prevent a heart attack
also increase their chances of
developing diabetes, according to a new study.
A comprehensive review of the available evidence shows that
statins raise the risk of becoming diabetic by around 9 per
cent.
However, experts warn that the absolute risk of developing
the condition remains low and is heavily outweighed by the
protection from heart problems provided by the drugs.
Around 2.5 million people in Britain currently take the
medication every day.
Lauded as a “wonder” drug, statins work by reducing
cholesterol levels in the body, a major risk factor for
heart attacks.
Studies have shown that they can also dramatically reduce
the risk of suffering a blood clot and there have even been
suggestions that they could be used as a treatment for
rheumatoid arthritis.
However, researchers who looked at 13 studies involving more
than 91,000 patients found that there was also a small
increased risk of developing diabetes associated with the
drugs.
The increased risk mainly affected the over 60s.
However, the authors of the review, from the University of
Glasgow, warn that people prescribed statins should not stop
taking their medication.
They write: “In view of the overwhelming benefit of statins
for reduction of cardiovascular events, the small absolute
risk for development of diabetes is outweighed by
cardiovascular benefit in the short and medium term in
individuals for whom statin therapy is recommended."
That view was backed by diabetes and heart charities.
Dr Iain Frame, from Diabetes UK, said: "This small increased
risk is heavily outweighed by the benefits of statins in
those at high risk of heart problems.
“This
research, therefore, should on no account be taken as a
reason for those over 60 at high risk of heart disease to
stop taking statins."
The findings, published by The Lancet medical journal, show
that 255 patients would have to be treated with statins for
four years to result in one extra case of diabetes.
In the same group of patients over that time around five
deaths or heart attacks would have been prevented and around
the same number of strokes.
The authors stress that their findings do not show any
biological reason why statins increase the chances of
developing of diabetes, although they say it is possible
that there is one.
They suggest that older people on the drugs be monitored by
their doctor for warning signs that they are developing the
condition.
The increased risks should also be taken into account if
doctors are considering prescribing statins to those at a
low risk of heart problems.
In Britain only those at high risk of developing heart
disease are prescribed the medication.
However, some experts have suggested that statins could be
included in a so-called polypill, a five-in-one drug which
would also include aspirin and three blood pressure-lowering
medications and which could be given even to healthy people
to help protect them.
More than 2.5 million people in Britain are thought to have
diabetes, although experts predict that that could
rise to as many as four million by 2050 because of
lifestyle factors, including obesity.
British
singer ALEXANDRA BURKE is on a strict diet - because she's
terrified of developing diabetes.
The Hallelujah hitmaker's grandmother died from
complications from the disease and her mother ex SOUL II
SOUL singer MELISSA BELL, has kidney failure caused by
diabetes and needs dialysis sessions as she awaits a
transplant.
So Burke keeps a watchful eye on her diet in a bid to keep
diabetes at bay.
She says, "My nan and my great-nan both had exactly the same
thing. I have to be careful - I have to watch what I eat."
Lack of exercise, poor diet, smoking and alcohol abuse are
all contributing to increasing levels of obesity in the UK,
sending the number of people with diabetes “mushrooming”,
according to Professor Anthony Barnett, clinical director
for diabetes at Heart of England NHS Foundation Trust in
Birmingham.
Research
has revealed that depression furthers the complications of
diabetes. The risks associated with depression include
kidney failure, blindness, heart attack and stroke, but
other factors are obviously involved. Age, race, location
and gender play a large role in the study's results, but
most of the conclusions were the same: depression worsens
diabetes.
The serious complications between diabetes and depression
were studied in the past. There was a study conducted in
2006 on 226,646 people with type 1 and type 2 diabetes. The
results came from questionnaires and surveys that proved to
be accurate when used for other similar types of studies.
Researchers used the responses of the hand-outs to measure
minor and major types of depression and the intensity of
depression.
Serious depression seemed to comprise 8.3 percent of the
U.S. adults with diabetes involved in the survey. The rate
varied by age, gender, race, and location. The most
noticeable difference in rates of depression occurred
between race and location. Insulin users among adults with
type 2 diabetes were also found to be more depressed.
However, a flaw in the study was the fact that researchers
had to rely on people accurately reporting their symptoms.
The new study conducted by the journal Diabetes Care is
revealing similar results, but more severe. The level of
depression made the largest difference between depression
worsening diabetes. A higher risk of having micro-vascular
complications occurred in 36 percent of those studied over
the five period. When risks reach this level, end-stage
kidney disease develops. The next stage being life
threatening strokes.
The ways to help avoid developing these severe complications
are obvious: eat healthy, exercise regularly and take the
appropriate medications. Doctors and people suffering
diabetes are also being encouraged to bring depression into
the forefront when dealing with diabetes drug treatment.
It
could protect us against colon cancer, improve bone strength
and make us happier. Dr Mark Porter asks, 'should we all
take Vitamin D?'
New research showing that vitamin D may protect against
cancer of the colon is the latest in a long line of studies
suggesting that there is far more to this vitamin than its
traditional role in helping to maintain healthy bones. And
although this new study involved more than 500,000 people
from ten different European countries, it is pertinent to
the UK because so many of us have low levels of vitamin D —
especially at this time of year.
So should more of us be considering supplements?
Vitamin D is required to help the body make proper use of
calcium — the basic building block of bones — which is why
interest in it has traditionally centred on rickets, a
condition that results from severe deficiency. But we now
understand that it does far more than maintain the skeleton,
and that milder degrees of deficiency may predispose to a
range of other illnesses including diabetes, lung disease,
osteoporosis, multiple sclerosis (MS), rheumatoid arthritis,
various cancers, and even Alzheimer’s disease.
The
vitamin is manufactured in the skin when we’re exposed to
sunlight but our northern latitude and short summers mean
that for six months of the year UV levels are so low that
most of us don’t make enough of the vitamin to meet basic
requirements.
The problem is compounded by the use of sunscreens, which
further reduce natural UV exposure during the summer months
when vitamin D stores are replenished, and the popularity of
supplements containing vitamin A (it is thought that as many
as 1 in 5 of the population take one), which antagonise some
of the D’s actions.
As well as manufacturing the vitamin in our skin, we also
take it in from our diet. It occurs naturally in oily fish,
such as tuna and herring, and liver, milk and eggs. In most
industrialised countries it is added to margarine, some
powdered milks, bread and breakfast cereals.
The scale of the potential problem is nicely outlined by
researchers from the University of Sheffield, who looked at
vitamin D levels in the cord blood of babies born at the
hospital at the end of spring — the time when their mothers’
vitamin D stores were likely to be at their lowest. Seven
out of ten of the babies had lower than ideal levels of
vitamin D, 90 per cent of whom were white, dispelling the
myth that deficiency is principally a problem in ethnic
minorities with darker skin (the extra pigment reduces UV
penetration even further).
Meanwhile in Finland researchers tracking a group of people
born in the Sixties turned up evidence suggesting a link
between low levels of vitamin D and Type 1 diabetes later in
life. Children brought up in the gloomy winters of Finland
are more than a hundred times more likely to develop the
condition than their peers in sunny Venezuela. Since then UK
research has shown that children given vitamin D supplements
are around a third less likely to develop diabetes.
Vitamin D is a steroid and there are receptors on almost
every cell in the body. Its link with diabetes could be
explained by an action on receptors in the pancreas and on
the various cells in the immune system, but there are
similar vitamin D specific targets in almost every other
organ, including the brain, heart, muscles, kidneys and, of
course, the skeleton. Little wonder then that there is
growing interest in the role of the vitamin in diseases,
ranging from MS to Alzheimer’s.
Should we all be taking a supplement? It’s too early to tell
whether mass supplementation is the way forward, but it is
now widely agreed that the following key groups are those
most likely to benefit:
Women who are pregnant or breastfeeding
Children under 5 (particularly breastfed infants)
The over-fifties
Vegetarians who don’t eat oily fish
Anyone who is housebound or who covers up when outside
Those who are dark-skinned — particularly Asians.
The standard dose for an adult is 10mcg day and trials
looking at the safety of long-term supplementation have
reported no adverse effects at intakes of more than double
that. Much higher doses (50mcg a day or more) can weaken
bones and increase the risk of calcium deposits (such as
kidney stones) forming elsewhere.
During the summer most people will manufacture enough
vitamin D by exposing their face and arms to the sun for an
hour across the week. You don’t have to sunbathe, just
accumulate around ten minutes of exposure while going about
your normal business — assuming you are not wearing a
sunscreen, or a moisturiser that contains one.
Many healthcare
professionals are failing to advise people with medical
conditions that could affect their ability to drive whether
they should get behind the wheel, according to research from
the University of Warwick.
Researchers from the University's Warwick Medical School
have found many healthcare professionals are failing to tell
patients with certain conditions such as diabetes or visual
impairment if they are not fit to drive.
In a study undertaken for the Department for Transport, the
research team explored the knowledge and attitudes of
healthcare professionals towards advising patients about
their fitness to drive. The researchers recruited 1519
health professionals, 358 patients and 55 medical school
personnel to the study.
The research team, led by Dr Carol Hawley, Principal
Research Fellow at Warwick Medical School, found doctors in
training received little tuition on medical aspects of
fitness to drive.
They also found that although most healthcare professionals
were aware of the Driving and Vehicle Licensing Agency (DVLA)
guidelines stipulating fitness to drive, many were unable to
reliably distinguish between medically unfit drivers,
borderline drivers and fit drivers. When presented with
paper case studies of patients only 7.5% scored all of them
correctly.
When presented with an acted scenario of a patient who was
unfit to drive, 75% of healthcare professionals failed to
offer advice on driving. The results also showed 40% of
healthcare professionals agreed they did not have sufficient
knowledge of the DVLA Fitness to Drive guidelines.
As part of the current DVLA licensing system there is a
legal obligation on individuals to declare the onset or
worsening of any medical condition that may affect their
fitness to drive. This requirement is publicised on driving
licence application forms and in accompanying information
leaflets.
Advice for the public on the medical standards of fitness
to drive is published by DVLA in a booklet and made
available on Direct.gov.uk.
For medical professionals, the DVLA helped to develop the
General Medical Council's new guidance on patient
confidentiality and reporting medical conditions to the DVLA.
There are also various projects in development such as E
learning for junior doctors and the DVLA is working with the
Department of Health to develop a learning module on medical
conditions and driver licensing awareness.
Dr Hawley's research has been published as a main report,
along with nine sub-reports, by the Department for
Transport.
She said: "Although the information is there and results
suggest healthcare professionals are aware of the DVLA
fitness to drive guidelines, they had a poor knowledge of
how the guidelines applied to specific conditions.
"There is also uncertainty about which groups of healthcare
professionals are responsible for informing a patient about
how their condition can affect their ability to drive.
Interviews with patients revealed that only one third of
them had been advised about their fitness to drive without
having to ask for advice."
Dr Hawley said the DVLA had already taken steps to ensure
more widespread knowledge and implication of the current
guidelines for the public and healthcare professionals.
However, she added they may need to be simplified to make
them more user-friendly and more training was needed for
healthcare professionals and medical students.
The
UK’s obesity crisis is putting NHS hospitals under increased
strain from the number of patients admitted with
diabetes-related illnesses, a study has found.
Lack of exercise, poor diet, smoking and alcohol abuse are
all contributing to increasing levels of obesity in the UK,
sending the number of people with diabetes “mushrooming”,
according to Professor Anthony Barnett, clinical director
for diabetes at Heart of England NHS Foundation Trust in
Birmingham.
A diabetes audit of 200 NHS hospitals, led by diabetes tsar
Dr Rowan Hillson, found disparity between the number of
people diagnosed with the disease in the UK (4 per cent of
the population) and the number of hospital patients who have
the disease (20 per cent of those on the wards).
Professor Barnett said: “The situation we are facing as a
country is absolutely terrifying.
“The obesity rates get worse and worse, the numbers with
diabetes keep mushrooming, and given that these people are
prone to a whole range of serious medical conditions, it has
enormous impact on NHS resources,” he said.
Sitting
down for too long can cause a range of health problems, even
among those who exercise regularly, experts have claimed.
Recent research suggests that inactivity increases the
chances of developing diabetes and heart disease,
independently of how often someone works out.
One study found that that the chance of developing
metabolic syndrome, a condition which can lead to diabetes,
rose by 26 per cent for every extra hour a woman spent
watching television, no matter how much exercise she took.
Doctors from the Karolinska Institute and the Swedish
School of Sport and Health Sciences in Stockholm said that
the only way to minimise the effects was to cut the amount
of time that we spend inactive.
They suggest simple changes, such as taking the lifts
instead of the stairs, or walking around the office for a
few minutes during the working day.
The researchers admit that scientists do not yet fully
understand why spending long periods sitting down can
increase the chances of developing health problems.
But they warn that the chemical reactions triggered in the
body by being inactive for too long cannot be cancelled out
by taking more exercise.
The article, published in the British Journal of Sports
Medicine, claims: “In the future, the focus in clinical
practice and guidelines should not only be to promote and
prescribe exercise, but also to encourage people to maintain
their intermittent levels of daily activities [that involve
movement].”
“Climbing the stairs, rather than using elevators and
escalators, five minutes of break during sedentary work, or
walking to the store rather than taking the car will be as
important as exercise.”
Half
are left with complications from the disease as a result,
experts have warned.
Late diagnosis increases the chance that sufferers will have
dangerous complications, including stroke, heart disease,
blindness, kidney disease and amputation.
Yet these can be avoided if people recognise signals that
there may be a problem, including a strong need to urinate,
especially at night, feeling thirsty, extreme tiredness,
unexplained weight loss, blurred vision and slow healing
cuts.
The figures show that 56 per cent of people diagnosed last
year with Type 2 diabetes, the most common form of the
condition in adults, did not even suspect they could have
the disease.
Most people were also diagnosed “by accident”, the figures
show.
Just 16 per cent of those surveyed had asked for a diabetes
test, the rest had discovered they had the disease while
undergoing routine medical tests or being treated for other
medical conditions.
Douglas Smallwood, chief executive of Diabetes UK, who
obtained the figures, said: “We need to make sure that
people are aware of the risk factors and symptoms of Type 2
diabetes and we need to encourage them to ask for a diabetes
test if they are at risk of developing the condition.
“Diabetes awareness is key if we want to prevent people from
facing a future of ill health: being diagnosed early means
that you are less likely to develop the serious
complications of diabetes.”
A
major development in helping children with Juvenile, or Type
1, Diabetes. The Juvenile Diabetes Research Foundation
announces an artificial pancreas is now being developed and
is expected to change and save lives.
JDRF is partnering with Johnson & Johnson's Animas
Corporation, to develop the first artificial pancreas.
We found a mother in Sugar Land, who has been volunteering
and raising money for JDRF, to go specifically toward
funding the new device. Lisa Brettman's 16-year old son,
Trevor, has been dealing with Type 1 Diabetes most of his
life.
"This is life changing for us... for those of us who live
with Type 1 diabetes. We live in fear all the time," says
Lisa.
Living with Type-1 diabetes is definitely demanding.
"From playing the trumpet, to playing video games, and even
sleeping - pretty much everything I do... it has changed
every single thing," says Trevor.
The artificial pancreas will be software that stays on the
outside of the body, along with an insulin pump and a
continuous glucose monitor (which measures blood sugar
levels).
"This new project will allow the two to talk to each other,
so that the continuous glucose monitor can say to the pump -
hey, the kiddo's blood sugar is too high so it's time to
give him insulin now, and the pump will give him insulin. Or
if it's too low, it can stop administering insulin," says
Molly Naylor, who is the the Executive Director of the
Houston Chapter of J.D.R.F.
She goes on to say, this is a huge development!
"It means kids won't end up in hospitals with comas or
seizures, it means parents don't have to get up 5-6 times a
night to check blood sugars, because they're afraid these
kids won't wake up the next morning."
"It'll be really, really, really helpful, I can't even
describe it. It will make the future that much brighter, and
I could live every single day that much easier," says
Trevor. "It will help get rid of the fear, some of the fear,
we live with on a daily basis", says Trevor's mom.
This is just the first phase. To find out much more about
it, you can check out jdrf.org or
www.artificialpancreasproject.com.
"Silver Star
is a valuable and practical contribution to a health issue
which disproportionately affects Asians. Type 2 diabetes can
be effectively managed if diagnosed, and the Mobile Diabetes
Assessment Unit is helping to increase the chance of early
diagnoses of type 2 diabetes"
Rt Hon
David Cameron MP
Leader of
the Opposition
"Silver
Star's Mobile Diabetes Assessement Unit has begun doing some
important work educating people about type 2 diabetes. It
has highlighted the importance of an early diagnosis. I am
delighted to lend this Appeal my support."
Rt Hon Nick
Clegg MP
Leader of
the Liberal Democrats
"Silver Star
has begun to educate the general public about how best to
reduce the chances of getting type 2 diabetes. Already the
Mobile Diabetes Assessment unit has identified individuals
who are at a particularly high risk of having type 2
diabetes."
Carrying
extra weight on your hips, bum and thighs is good for your
health, protecting against heart and metabolic problems, UK
experts have said.
Hip fat mops up harmful fatty acids and contains an
anti-inflammatory agent that stops arteries clogging, they
say.
Big behinds are preferable to extra fat around the
waistline, which gives no such protection, the Oxford team
said.
Science could look to deliberately increase hip fat, they
told the International Journal of Obesity.
And in the future, doctors might prescribe ways to
redistribute body fat to the hips to protect against
cardiovascular and metabolic diseases such as diabetes.
The researchers said having too little fat around the hips
can lead to serious metabolic problems, as occurs in
Cushing's syndrome.
Shape not weight
Evidence shows that fat around the thighs and backside is
harder to shift than fat around the waist.
Although this may sound undesirable, it is actually
beneficial because when fat is broken down quickly it
releases a lot of cytokines which trigger inflammation in
the body, say experts.
These cytokines have been linked to cardiovascular disease,
insulin resistance and diabetes.
The slower burning hip fat also makes more of the hormone
adiponectin that protects the arteries and promotes better
blood sugar control and fat burning.
In comparison, carrying excess fat around the stomach, being
"apple shaped", raises the risk of diabetes and heart
disease.
Lead researcher Dr Konstantinos Manolopoulos, of Oxford
University, said: "It is shape that matters and where the
fat gathers.
"Fat around the hips and thighs is good for you but around
the tummy is bad."
He said in an ideal world, the more fat around the thighs
the better - as long as the tummy stays slim.
"Unfortunately, you tend not to get one without the other,"
he said.
Fotini Rozakeas of the British Heart Foundation said: "This
research helps us better to understand how fat acts in the
body in order to develop new approaches in reducing heart
and circulatory disease.
"If you are overweight, obese, or if you have a waist size
that is increased, it is important to make changes to your
lifestyle, such as eating a healthy diet and doing regular
physical activity, to reduce your risk of heart health
problems."
Mediterranean diet is no
diabetes cure, but should be considered a diabetes treatment
or diabetic diet, a new trial suggests. The diet has been
found more effective in helping control serum blood sugar in
overweight patients with type 2 diabetes
than a low-fat diet.
Low fat diet with less than 30 percent calories from fat is
recommended by the American Heart Association, according to
naturalnews.com. The diet contains less than 10 percent
calories from saturated fat and is low in sweets and
high-fat snacks; and high in fruits, vegetables and whole
grains.
Mediterranean diet consists of large quantities of fruit,
vegetables, whole grains, and moderate amounts of olive oil,
nuts, poultry and fish with no more than half the daily
intake of calories from carbohydrates.
In the published trial 215 overweight patients with newly
diagnosed diabetes who had not yet received
antihyperglycemic drug therapy were assigned either diet for
four years.
The researchers found 44 percent of diabetes patients in the
Mediterranean diet group needed diabetic drugs to help lower
blood sugar levels compared to 70 percent in the low-fat
diet group.
Additionally, diabetes patients in the Mediterranean diet
group lost more weight and experienced greater improvement
in some glycemic control and coronary risk measures than
those in the low fat diet group.
People with types 2 diabetes can produce insulin, the
hormone that is needed for sugar metabolism, but can’t use
it efficiently.
Because of this, diabetes patients tend to have higher blood
sugar levels, leading to complications such as heart
disease, stroke, blindness, kidney disease, nerve problems,
gum infections and amputation.
Typical type 2 diabetes symptoms include increased thirst,
increased hunger, fatigue, increased urination, particularly
at night, weight loss, blurred vision and sores that do not
heal.
There is no cure for type 2 diabetes. Diatetic drugs are
available to help manage serum blood sugar levels only.
The trial was conducted by Katherine Esposito, MD and
colleagues from the Second University of Naples and ASLNA5,
Vico Equense/Sorrento, Naples, Italy, and Warwick Medical
School, Coventry, United Kingdom.
Cigarette
smoking is a well-known risk factor for type 2 diabetes, but
new research from Johns Hopkins suggests that quitting the
habit may actually raise diabetes risk in the short term.
The researchers suspect the elevated diabetes risk is
related to the extra pounds people typically put on after
renouncing cigarettes and caution that no one should use the
study's results as an excuse to keep smoking, which is also
a risk factor for lung disease, heart disease, strokes and
many types of cancer.
"The message is: Don't even start to smoke," says study
leader Hsin-Chieh "Jessica" Yeh, Ph.D., an assistant
professor of general internal medicine and epidemiology at
the Johns Hopkins University School of Medicine.
"If you smoke, give it up. That's the right thing to do. But
people have to also watch their weight," she adds.
In the study, published in the January 5 issue of Annals of
Internal Medicine, researchers found that people who quit
smoking have a 70 percent increased risk of developing type
2 diabetes in the first six years without cigarettes as
compared to people who never smoked. The risks were highest
in the first three years after quitting and returned to
normal after 10 years. Among those who continued smoking
over that period, the risk was lower, but the chance of
developing diabetes was still 30 percent higher compared
with those who never smoked.
The study enrolled 10,892 middle-aged adults who did not yet
have diabetes from 1987 to 1989. The patients were followed
for up to 17 years and data about diabetes status, glucose
levels, weight and more were collected at regular intervals.
Type 2 diabetes is a common disease that interferes with the
body's ability to properly use sugar, and to regulate and
properly use insulin, a substance produced by the pancreas
which normally lowers blood sugar during and after eating.
In type 2 diabetes, also known as adult-onset diabetes, the
pancreas makes plenty of insulin to help the body when food
is eaten, but the body cannot use it normally. The result is
excess levels of blood sugar, which over time, can lead to
blindness, kidney failure, nerve damage and heart disease.
Overweight people and those with a family history of the
disease have an increased risk for developing it, as do
smokers, though the causal relationship is unclear.
According to the study, those who smoked the most and those
who gained the most weight had the highest likelihood for
developing diabetes after they quit. On average, over the
first three years of the study, quitters gained about 8.4
pounds and saw their waist circumferences grow by
approximately 1.25 inches.
Yeh and her colleagues want physicians to keep these
findings in mind when they are consulting with patients who
are giving up cigarettes, especially the heaviest smokers.
They recommend considering countermeasures such as lifestyle
counseling, aggressive weight management and the use of
nicotine-replacement therapy, which seems to blunt the
weight gain related to quitting. Another key step is more
frequent blood glucose screening to assure the earliest
detection of diabetes.
In addition to Yeh, other Hopkins researchers involved in
the study include Nae-Yuh Wang, Ph.D., and Frederick L.
Brancati, M.D., M.H.S., professor and chief of the division
of general internal medicine.
Funding for the study came from the National Heart, Lung and
Blood Institute and the National Institute of Diabetes,
Digestive and Kidney Disorders, both of the National
Institutes of Health.
Volunteers
who used the machines to walk for just half an hour a day
for a year radically reduced their chances of developing the
disease. The findings are all the more dramatic because the
tests were carried out on people at high risk of developing
diabetes.
More than 2.5 million people in Britain suffer from the
condition, which can lead to serious complications including
blindness. Experts predict that up to four million Britons
could be diabetic by 2025, in part because of the obesity
crisis. Already an estimated seven million suffer from
prediabetes, in which blood sugar levels are raised. The
condition puts patients at up to fifteen times the normal
risk of going on to develop full-blown diabetes.
The study tested the impact of using a pedometer on 98
people with prediabetes. The volunteers were split into
three groups, a control group given a short information
leaflet about diabetes, a second group given a three hour
education session on the disease, and a third who had the
three hour seminar and were also given a pedometer. Those in
the pedometer group were helped to set a series of
‘steps-per-day’ targets, designed to help them walk for at
least 30 minutes a day.
After a year those who used the pedometer saw their blood
sugar levels fall by 15 per cent.
If continued in the long term such a fall would cut their
chance of developing diabetes in half, the team behind the
study estimate.
There were no significant falls in blood sugar levels in
either of the two other groups. None of the groups lost
weight over the course of the experiment. Researchers
believe that increased levels of physical exercise helped
those using the pedometers the body regulate blood sugar
levels.
Dr Iain Frame, from Diabetes UK, which helped to fund the
study, said: “By finding new ways to educate and motivate
people with prediabetes we are aiming to stop the Type 2
diabetes epidemic in its tracks and prevent millions of
people developing serious complications of the condition
such as heart disease, stroke, kidney failure, blindness and
amputation.”
Dr Thomas Yates, from the University of Leicester, who led
the research, added: “Our study proves that using a
pedometer as part of a structured education programme can
really improve health outcomes for people with prediabetes.
“Using lifestyle interventions to stop people developing
diabetes and its complications could save the NHS a
fortune.”
Drinking
tea or coffee reduces the risk of diabetes, according to a
review of 18 studies that covered hundreds of thousands of
people.
Previous research had shown that people who drank the most
coffee were one-third less likely to develop diabetes than
those who drank the least. In the years since then, the
amount of research on coffee and diabetes risk has more than
doubled, and other studies have suggested that tea and
decaffeinated coffee may also be effective in preventing
diabetes.
To update the evidence, researchers reviewed 18 studies on
coffee (including decaffeinated coffee) and tea and the risk
of type 2 diabetes published between 1966 and 2009.
It was found that for every additional cup of coffee a
person consumed each day, a person's risk of diabetes was
reduced by 7 percent. In the six studies that looked at
decaffeinated coffee, the researchers found that people who
consumed more than three or four cups a day were at 36
percent lower risk of diabetes. And in seven studies that
examined tea drinking and diabetes risk, people who drank
more than three or four cups daily were at 18 percent lower
diabetes risk.
The above analysis could have overestimated the effect of
these beverages on diabetes risk due to statistical issues
with the smaller studies. It's also not possible to conclude
from the current evidence that heavy coffee drinkers (and
tea and decaffeinated drinkers) don't have other
characteristics that might protect them against developing
diabetes such as eating a healthier diet.
The fact that the effects were seen with decaffeinated as
well as coffee and tea suggest that if the effects are real,
they aren't just due to caffeine, but may be related to
other substances found in these beverages for example
magnesium, lignans (oestrogen-like chemicals found in
plants), or chlorogenic acids, which are antioxidants that
slow the release of sugar into the blood after a meal.
Patients
in England will be given the legal right to regular health
checks and maximum waiting times for treatment under plans
announced on Thursday.
Setting out a strategy for the National Health Service for
the next five years, Health Secretary Andy Burnham also said
that over time 10 percent of hospital income would become
linked to patient satisfaction, and payments would be
withdrawn if care did not meet minimum standards.
"With an ageing population and the increased prevalence of
lifestyle diseases, preventing illness and keeping people
healthy is our best long term insurance policy for the
nation's health and managing the financial challenges
ahead," he said.
"The NHS should intervene earlier to help people lead
healthier lives and prevent more disease."
In his pre-Budget report on Wednesday Chancellor Alistair
Darling said spending on frontline NHS services would be
increased by more than inflation from 2011.
Burnham said that from April 1 next year patients would
have the legal right to start treatment by a consultant
within 18 weeks of referral from their GP, and to being seen
by a cancer specialist within two weeks of GP referral.
From April 2012, everyone aged between 40 and 74 would have
a legal right to an NHS health check every five years to
assess their risk of heart disease, stroke, diabetes and
kidney disease, he added.
Under the new plans, people will also be able to register
with a GP wherever they like, rather than being restricted
to those around where they live, and will be guaranteed the
chance to see a doctor during evenings and weekends.
Hospitals will be able to expand their services out into
the community, Burnham added, with treatments such as
chemotherapy and dialysis being carried out at home or in GP
practices.
"Moving care from hospitals into homes and communities is
better for patients and more efficient," Burnham said.
Researchers
from The Children's Hospital of Philadelphia and the
University of Pennsylvania School of Medicine have revealed
that a gene known to cause type 2 diabetes has been found to
increase the risk of being overweight during childhood.
The finding may present an avenue for developing drugs to
counteract the disease, which has been on the upswing in
childhood and adolescence.
"It has been a bit of a mystery to scientists how or even
if these adult diabetes genes function during childhood,"
said study leader Struan FA Grant, a researcher and
associate director of the Centre for Applied Genomics of The
Children's Hospital of Philadelphia.
"This finding suggests that there may be genetic activity
during childhood that lays the foundation for the later
development of type 2 diabetes," Grant added.
During the study, researchers investigated 20 gene
variants, known as single nucleotide polymorphisms (SNPs),
previously reported to be associated with type 2 diabetes,
in nearly 7,200 Caucasian children, aged 2 to 18 years.
A previous study earlier this year by the same study team
found that another type 2 diabetes gene, CDKAL1, affects
fetal growth and increases the likelihood that a baby will
be underweight at birth.
The current study found that the gene HHEX-IDE does not
affect birth weight, but makes it more likely that a child
will become obese during childhood.
The gene does not appear to predispose to obesity in
adults, although by contributing to childhood obesity, it
may set the stage for type 2 diabetes in adulthood.
With
news that the prevalence of diabetes is expected to double
in the next 25 years, it's a good time to think about your
risk of diabetes and prediabetes and to start taking steps
to lower it. A new self-assessment tool, published in a
study in the December issue of the Annals of Internal
Medicine, helps you determine your risk—and whether you
should see a doctor for a blood glucose test right away.
The new tool is intended for anyone who wants to know his or
her risk, regardless of race, ethnicity, weight, or family
history. The goal is to boost awareness through a method
that can easily be used in the comfort of home or at a
community health fair, says Heejung Bang, the lead author of
the study and an associate professor of public health at
Cornell Medical College.
To develop the assessment, researchers examined data from
5,258 study participants ages 20 and older, including
fasting blood glucose results, demographic and socioeconomic
information, healthcare use, family medical history, health
habits, physical exams, and lab test results. People who had
diabetes—diagnosed or undiagnosed—tended to be more
sedentary and were typically older than people who didn't
have diabetes. They also were more likely to have
hypertension, a family history of diabetes, and higher body
mass indexes, waist circumferences, and cholesterol levels.
To take the assessment developed in the study answer the
questions below. If your score is on the high side, you can
take steps to address those risk factors—eating a healthful
diet and exercising regularly, for example, to shed excess
pounds.
Assessment for risk of diabetes and prediabetes:
1.
How old are you?
(Less than 40 years old earns zero points, 40 to 49 years
old gets one point, 50 to 59 years old two points, and 60 or
older three.)
2.
Are you a woman or man?
(Women get no points; men get one.)
3.
Do your family members (parent or sibling) have diabetes?
(Zero points for no; one point for yes.)
4.
Do you have high blood pressure, or are you on medication
for high blood pressure?
(Zero points for no; one point for yes.)
5.
Are you overweight or obese?
(Zero points if you're not overweight or obese; one point if
you're overweight; two points if you're obese; three points
if you're extremely obese.) People with a BMI of 40 or more
(or with a waist circumference of 50 inches or more for men,
49 inches or more for women) are considered to be extremely
obese. Those with a BMI between 30 and 39 (or with a waist
size of 40 to 49 inches for men, 35 to 48 inches for women)
are considered to be obese. And those with a BMI of 25 to 29
(or a waist size of 37 to 39 inches for men, 31.5 to 34
inches for women) are considered to be overweight.
6.
Are you physically active?
(Zero points for no. Deduct one point from your total score
if you answer yes.)
To calculate your total score, add up your points from all
six questions. If your total is four or more, you are at
high risk for undiagnosed diabetes or prediabetes. If your
total is five or more, you're at high risk for undiagnosed
diabetes. If your score falls into either category, see your
doctor for a blood test to check your glucose level or visit
Silver Star Diabetes Centre in Leicester or visit Silver
Star Mobile Diabetes Unit.
Adding
a little Vinegar helps in lowering blood sugar levels, this
in fact has been confirmed by many studies.
Carbohydrates are converted into sugar by digestive enzymes,
but vinegar helps in blocking these digestive enzymes, thus
producing less sugar and slowing down the absorption of
sugar by our body after meals.
Vinegar may help control diabetes by lowering sugar
levels. People who are suffering from diabetes and have a
tendency of spiking their blood sugar levels immediately
after a meal should seriously think of adding a drop of
vinegar in their meals.
Diabetes Care had published the result of a study in 2004
which revealed that adding vinegar with meals helped control
sugar levels by reducing the rise in blood sugar levels by
30%.
Participants in a study conducted by Italian researches who
consumed salad with vinegar showed a 30% reduction of rise
in blood sugar level. For the study all the participants
were given meals that included 50 grams of carbohydrates and
white bread, and salad. Some of the participants were given
salad with 4 teaspoons white vinegar.
So if you are diabetic you can control it by simply adding a
little vinegar into your meals.
While diabetes may seem like a complex and worrying illness,
these are just some of the many tactics you can employ to
deal with diabetes and restore good health. Consult your
healthcare practitioner prior to suitable treatments for
you.
Scottish
patients with severe diabetes could be freed from daily
injections of insulin with the launch today of a
groundbreaking new cell transplant service.
The treatment involves extracting islets – the cells that
produce insulin – from a donated pancreas. The cells are
then injected into the liver of the patient with Type 1
diabetes – those who rely on insulin injections to control
their condition.
The service will initially help a small number of patients
with the most serious cases of diabetes who have had to live
with constant blood sugar monitoring and the fear of coma
due to low blood sugar levels.
It is hoped that the service – which has cost £137,000 to
set up – will help around 12 diabetics in its first year.
The Islet Transplant Programme was set up by NHS Lothian,
the Scottish National Blood Transfusion Service and
Edinburgh University.
The Islet Isolation Laboratory in Edinburgh will be the
only one in the UK which will operate 24 hours a day.
New
research out today reveals that less than a third of UK
residents (30 per cent) know of type 1 diabetes with a
further 59 per cent confusing the autoimmune condition with
type 2 diabetes - which can be related to obesity
and lack of exercise.
Men are the most uneducated about the condition, with only
28 per cent correctly identifying it compared with 32 per
cent of women. Nearly one in ten men think that type 1
diabetes is caused by eating too much sugar whilst nearly
six in ten men and women believe that it is related to
obesity. Those aged under 25 have the least awareness with
78 per cent incorrectly identifying the condition whereas
those aged 45 to 54 have the highest levels of awareness of
type 1 characteristics (36 per cent).
One per cent of people even think that the condition can be
caught through physical contact or by sharing a knife and
fork.
The results also show that those in the North East of
England have the least knowledge of type 1 with 83 per cent
incorrectly identifying the condition - and 68 per cent of
these associating it with type 2 characteristics. The North
West follows with 79 per cent and 67 per cent of confusion
respectively.
Top of the class for awareness of type 1 diabetes are
residents in Wales where over half (51 per cent) know about
the condition, followed by those in Northern Ireland (38 per
cent) and residents in the South West with 36 per cent.
Type 1 diabetes can strike at at any age and there is
currently no cure. Insulin is not the cure for type 1
diabetes, it just keeps people alive. Currently
approximately 350,000 people in the UK have it including
over 25,000 children.
World
Diabetes Day (WDD) is the primary global awareness campaign
of the diabetes world. It was set up by
the International Diabetes Federation (IDF) and the World
Health Organisation (WHO) in response to concern over the
rise of diabetes globally.
The IDF campaign slogan for 2009 is 'Understand Diabetes
and Take Control'.
With
Diabetes Day on November 14
is as good a time as any to look at the epidemic that is
diabetes. With a newly diagnosed case in the UK every five
minutes and thousands of borderline hypoglycaemic cases
undiagnosed around the world, what is it we are doing wrong
and how do we address it?
Firstly, let’s look at how the switch from normal
metabolism to diabetes takes place. Ordinarily, when we eat,
our foods, especially carbohydrates, are broken down into
simpler sugars, or glucose, as glucose is the basic form of
energy required by the body. In response to this glucose,
the pancreas releases insulin to transport the glucose from
the bloodstream and into the muscles, either to be used for
energy or to be stored as fat. This highlights one area we
can readily control and that’s using the fuel we take in.
Eating too much of the wrong kind of fuel and not using it
up is just one step in the development of diabetes. So
keeping active is vital to avoid this.
Perhaps you haven’t seen any trouble yet as a result of
being overweight but it does increase your risk of insulin
resistance. This happens when your insulin no longer
performs the way it should. Your cells don’t respond
efficiently when insulin instructs them to take up glucose.
So your pancreas effectively, turns up the volume by
producing more insulin just to keep sugar levels normal.
This increased workload is exhausting for the
spleen-pancreas meridian, resulting in an inability to
produce insulin at all, leading to type II diabetes. While
there may be a genetic or hereditary aspect to insulin
resistance, there’s no doubt eating the wrong fuels will
just hasten the process. What do I mean by the wrong fuels?
Well, anything which breaks down too quickly will spike your
blood sugar levels and stability is what we are after, not
spikes.
Highly processed food, like biscuits, cakes, white rice,
white pasta, fizzy drinks, white bread and of course white
table sugar are the biggest culprits. Slow release foods
like wholemeal bread, beans and lentils, brown rice, nuts
and seeds are the ideal foods, both to prevent and treat
diabetes. Such foods are all either high in fibre or protein
or both, and so take a lot longer to break down into simple
glucose, helping to maintain an even blood sugar level.
However, it is not just what you eat, it’s how much and how
you combine it. A giant bowl of pasta is still a giant bowl
of pasta, whether wholemeal or otherwise. It takes a lot of
work and huge insulin release to break it down. However,
take a smaller portion of wholemeal pasta and serve it with
some beans or sprinkle some nuts and seeds on top and you
get a much more balanced meal. Chew you foods thoroughly
too, to insalivate them well and increase the release of
digestive enzymes. Slower eating also helps you realise
you’re filling up, so that you don’t eat such huge portions.
It takes the brain about twenty minutes to realise you’ve
eaten so if you hoover down your dinner in ten, there’s a
good chance you’ll eat more than you really need to. Eating
late at night is another no-no. Your digestive strength
peaks earlier in the day, so your pancreas is better able to
perform at this time. Eating late at night just puts extra
pressure on an already taxed pancreas.
Certain spices have a great affinity with the digestive
system but especially with maintaining healthy sugar levels.
Fenugreek, found in curry powders helps improve glucose
tolerance, while cinnamon helps stimulate insulin activity.
So make these a regular part of your diet. Remember,
prevention is better than cure so even if you don’t suffer
from diabetes, you can minimise your chances of developing
it by adding cinnamon to your porridge, on toast, in yoghurt
and with baked apple or try fenugreek in curries, soups,
stir-fries or casseroles.
Many diabetics still crave something sweet and resort to
overprocessed ‘diabetic friendly’ sweets, biscuits and
cakes, some laden with flavourings and artificial
sweeteners. These are not ideal foods for anyone to be
eating. Try instead making your own sweet treats with
Xylitol, a safer alternative sweetener widely available in
health food stores. Apple crumble made with oats and
cinnamon would an be ideal treat as these provide much
needed soluble fibre. Chromium, the mineral which helps to
stabilise blood sugar levels helps if your cravings are
especially strong but do consider too the psychological or
emotional aspect of the craving. Often people who feel there
is sweetness missing from their life, feel the need to
overindulge in sweet foods and go on to develop diabetes. Be
sure to include alternative ‘sweet’ treats in your life like
listening to uplifting music, going for walks, watching
funny TV shows, having a good chat with a friend or having
treatments like massage or reflexology, rather than
indulging just your taste buds.
While diabetes may seem like a complex and worrying
illness, these are just some of the many tactics you can
employ to deal with diabetes and restore good health.
Consult your healthcare practitioner prior to suitable
treatments for you.
DESMOND
stands for Diabetes Education and Self management for
Ongoing and Newly Diagnosed. It’s a way of finding out more
about Type 2 Diabetes, it’s a resource to help you manage
the changes diabetes will bring to your life and it’s an
opportunity to meet and share experiences with others.
The programme is held at local venues and the sessions are
led by Educators such as Nurses and Dieticians who are
trained to ensure you are provided with honest up-to-date,
evidence based information about the causes and options for
managing your diabetes. Desmond can be offered as a one-day
course but more often is offered in two half-day sessions.
When you first find out you have diabetes you need a good
start in making healthy lifestyle choice, DESMOND gives you
that start, opportunities are provided to discuss and
explore factors relating to diabetes, such as food choices,
activity and medication.
DESMOND is pretty unique. It’s an education program
designed to make you, the person with diabetes the expert.
The educators are there to help you increase your knowledge
and understanding of what having diabetes will mean for you.
But at the end of the day, you will be the person making the
decisions.
The DESMOND program is built around group activities but
no-one is forced to contribute if they feel uncomfortable,
although you will get more out of the sessions if you come
prepared to share your thoughts and opinions. If you would
like to bring a partner, a family member or a friend with
you – they will be very welcome.
Ask your Doctor or your Nurse to refer you (book you).
Dates are flexible and if you find it difficult to attend
due to work commitments let them know as occasionally
alternate days/times can be arranged.
For those with diabetes,
the holidays can bring about different memories and
emotions. With large helpings of wonderful food, odd meal
times, and wide assortments of dessert, it can be
challenging and frustrating to managing blood glucose
levels.
Having to remind family members yet again, that “its not
that you can’t eat a big slice of grandma’s famous pie, it’s
that you choose not to in order to keep your body healthy”
can be emotionally draining. Experiencing this year after
year can turn what was once a cherished holiday into a time
of dread. Here are some tips to take back the holiday season
as a time of joy.
Planning ahead is key. With all the wonderful holiday food
to choose from, be sure to have your plate planned out in
advance to avoid letting your taste buds take over. This
includes desserts. Find out recipes and carbohydrate content
of foods ahead of time. You might find that you can fit a
little sliver of every favorite holiday dessert into your
meal, and still stay on track.
Try to plan holiday meals around your normal meal times
instead of snack times.
Keep your carbohydrates spread out throughout the day, don’t
save them all for one meal. Remember that your body likes
consistency with carbohydrates to process the glucose
efficiently and work properly with your medications. Pack
some leftovers and enjoy the holiday meal again the next
day.
Take a walk after your meal to re-energize and help your
body digest and burn off extra calories from the variety of
holiday foods.
Keeping your blood glucose and weight management goals in
mind, try not to go to any holiday parties or events on an
empty stomach. An empty stomach increases your chances of
overeating and losing track of the carbohydrates and
calories.
Appetizers, such as broccoli, carrots, cauliflower and
celery are great low
carbohydrates, low calorie options.
If you are able to bring an appetizer, present some fresh
veggies and light dip. This will save your
carbohydrates for the main meal.
Keep in mind that sausage and cheese are meats and have a
minimal effect on blood glucose levels when eaten in
moderation, they are full of saturated fat and calories, so
try to keep the portions small.
According to latest data
released by the International Diabetes Federation (IDF),
diabetes now affects 285 million people worldwide costs the
world economy at least GB£226 billion in 2010, or 11.6% of
total world healthcare expenditure. A further 344 million
are at risk of developing diabetes (pre-diabetes). If
nothing is done to reverse the epidemic, IDF predicts that
by 2030, 435 million people will live with the disease as at
a cost projected to exceed GB£295 billion. IDF's World
Diabetes Day campaign, faced with these alarming numbers,
aims to establish access to diabetes education as a right
for all people with diabetes, to promote greater awareness
of the risk factors and warning signs of diabetes, and
encourage best-practice sharing in diabetes prevention.
- Every 10 seconds a person dies from diabetes-related
causes.
- Every 10 seconds two people develop diabetes.
- Every 30 seconds a limb is lost to diabetes
- Each year a 7 million people develop diabetes
- Each year 4 million deaths are attributable to diabetes
- Diabetes is the fourth leading cause of global death by
disease.
World Diabetes Day - 14 November
When: World Diabetes Day is celebrated on 14
November, a date chosen to mark the birthday of Sir
Frederick Banting, who is credited with the discovery of
insulin. An official United Nation's Day, World Diabetes Day
is represented by the blue circle logo that is the global
symbol of diabetes.
Who: World Diabetes Day is a campaign led by the
International Diabetes Federation (IDF) and its 212 member
associations in 163 countries and territories. Created by
IDF and the World Health Organization in 1991, World
Diabetes Day became an official United Nations Day in 2007
thanks to a UN resolution that calls on all member states to
organize events to mark the day. The World Diabetes Day
campaign is supported by 14 official partners: Abbott
Diabetes Care, AstraZeneca, Boston Scientific, Bristol-Myers
Squibb, LifeScan, Eli Lilly, Medtronic, Merck Sharp & Dohme
(MSD), Novartis, Novo Nordisk, Pfizer, Roche, Sanofi Aventis
and Takeda.
Theme For 2009 - 2013: Diabetes Education and Prevention.
Detailed explanations are found
here.
Where: Celebrated globally in over 163 countries.
Hundreds of events will take place worldwide to mark the
day, from individual acts of celebration, group and
community-based activities to governmental events. A
country-by-country list of activities is available here with
local organizer's contact information -
http://www.worlddiabetesday.org/events/upcoming
Website and Online: The Official Campaign website is
trilingual and provides materials, information and a
country-by-country list of activities taking place on or
around World Diabetes Day
-- IDF Diabetes Atlas 4th Edition, International Diabetes
Federation, 2009: Diabetes resource released on October 19
which charts Diabetes prevalence for 216 countries and
territories, provides economic costs, political solutions
and general information about diabetes. Available free at
http://www.diabetesatlas.org
Blue Monument Challenge: IDF began lighting monuments in
blue (the colour of the blue circle diabetes symbol) on
World Diabetes Day in 2007.
-- 2009 Monuments Lighting: - a country-by-country list of
monuments lighting is available
here (More than 500 monuments and iconic buildings have
already confirmed participation on November 14. They
include: Table Mountain in South Africa, the London Eye in
the United Kingdom, the Burj al Arab in the United Arab
Emirates, Christ the Redeemer in Brazil, the Hofburg in
Austria, the Alamo and Empire State Building in the USA and
Tokyo Tower in Japan. Across Japan close to 60 monuments
will light in blue; 82 will light in Argentina, 34 in
Kazakhstan and 21 in the USA.
New
evidence is emerging for how important it is for pregnant
women to eat good, nutritious food. Expecting mothers who
eat vegetables every day seem to have children who are less
likely to develop type 1 diabetes, is revealed in a new
study from the Sahlgrenska Academy at the University of
Gothenburg, Sweden.
The study was performed in collaboration with Linkoping
University, which is conducting a population study called
ABIS (All Babies in Southeast Sweden). The results have been
published in the journal Pediatric Diabetes.
"This is the first study to show a link between vegetable
intake during pregnancy and the risk of the child
subsequently developing type 1 diabetes, but more studies of
various kinds will be needed before we can say anything
definitive," says researcher and clinical nutritionist Hilde
Brekke from the Sahlgrenska Academy.
Blood samples from almost 6,000 five year-olds were
analysed in the study. In type 1 diabetes, certain cells in
the pancreas gradually get worse at producing insulin,
leading to insulin deficiency. Children at risk of
developing type 1 diabetes have antibodies in their blood
which attack these insulin-producing cells.
Of the 6,000 children tested, three per cent had either
elevated levels of these antibodies or fully developed type
1 diabetes at the age of five. These risk markers were up to
twice as common in children whose mothers rarely ate
vegetables during pregnancy. The risk was lowest among
children whose mothers stated that they ate vegetables every
day.
"We cannot say with certainty on the basis of this study
that it's the vegetables themselves that have this
protective effect, but other factors related to vegetable
intake, such as the mother's standard of education, do not
seem to explain the link," says Brekke. "Nor can this
protection be explained by other measured dietary factors or
other known risk factors."
The term "Vegetables "in this study included all vegetables
except for root vegetables.
Type 1 Diabetes
Around 50,000 Swedes have type 1 diabetes, a chronic
disease which normally emerges before the age of 35. It is
not yet known what causes type 1 diabetes, but some of the
factors believed to play a role are various immunological
mechanisms, environmental toxins and genetic variations.
Type 1 diabetes is found throughout the world but is most
common in Finland and Sweden.
Diabetes is a disease in
which blood sugar levels are higher than normal. People with
diabetes have problems converting food to energy. After a
meal, carbohydrate foods are broken down into a sugar called
glucose, which is then carried by the blood to cells
throughout the body.
Two main categories of diabetes are Type1 and Type 2. Type
1 is less common and occurs in approximately 5-10 percent of
all diabetics. Type 1 diabetes is thought to be an
autoimmune disease. In diabetes, the immune system attacks
and destroys the part of the pancreas that makes insulin.
The pancreas then produces little or no insulin. A person
who has Type 1 diabetes usually must take insulin daily to
survive.
The more common form of diabetes is Type 2, can develop at
any age, even during childhood. Type 2 diabetes develops
because the cells in the muscles, liver and fat don't use
insulin properly. Eventually, the pancreas can't make enough
insulin for the body's needs. As a result, the amount of
glucose in the blood increases while the cells are starved
of energy. The National Institute of Health reports that by
the time a person gets a diagnosis of diabetes, he or she
has already had the underlying problems of insulin
resistance and higher than average blood glucose for 5-10
years.
It is important that people understand the risk factors for
diabetes because over time, high blood glucose damages
nerves and blood vessels, can lead to complications such as
heart disease, stroke, blindness, kidney disease, nerve
problems, gum infections, impotence and amputations.
Overall, the risk for death among people with diabetes is
about twice that of people without diabetes. The good news
is that Type 2 diabetes can be prevented or delayed.
Symptoms for diabetes include:
· Increased thirst
· Increased hunger
· Fatigue
· Increased urination, especially at night
· Weight loss
· Blurred vision
· Sores that do not heal
Many people do not find out they have the diabetes until
they have complications, such as blurry vision or heart
trouble. If someone finds out early that they have diabetes,
then they can get treatment to prevent damage to their body.
There are risk factors which can increase someone's risk
for Type 2 diabetes. To find out the risk for Type 2
diabetes, check each item which applies to you:
· Have a parent, brother or sister with diabetes.
· Asian family background
· Have had gestational diabetes, or have given birth to at
least one baby weighing more than 9 pounds.
· Blood pressure is 140/90 mm Hg or higher, or have been
told to have high blood pressure.
· Cholesterol levels aren't normal.HDL cholesterol--"good"
cholesterol--is below 35 mg/dL, or triglyceride level is
above 250 mg/dL.
· Fairly inactive or exercise fewer than three times a week.
· Have polycystic ovary syndrome, also called PCOS--women
only.
· On previous testing, Have had impaired glucose tolerance (IGT)
or impaired fasting glucose (IFG).
· Have other clinical conditions associated with insulin
resistance, such as acanthosis nigricans.
· Have a history of cardiovascular disease.
The more items checked, the higher the risk. If 45 or older
and overweight, it is strongly recommended to get tested. If
younger than 45, overweight and have one or more of the risk
factors then consider getting tested. Speak with a doctor
about having a fasting blood sugar test if falling into
either of these categories.
Numerous resources are available to help manage diabetes,
and patients can get help from a variety of health care team
members. Diabetes health care team members include doctors,
nurses, physician assistants, pharmacists, dieticians,
exercise physiologists, mental health providers,
podiatrists, optometrists and technicians who are committed
to helping people learn how to manage their diabetes and
prevent or delay complications. Diabetes can be life
threatening, but if diagnosed and treated early, people can
live a long and healthy life free of complications.
Thirty minutes of moderate
exercise five days a week and diet control is the best way
to prevent or delay diabetes for up to 10 years, one of the
largest and most rigorous prevention studies has suggested.
The study by US researchers has shown that prevention or
delay of diabetes through either lifestyle changes or an
inexpensive drug called metformin can work up to 10 years,
but the cumulative incidence of diabetes was lower with
lifestyle changes.
The researchers followed up 3,150 volunteers for a decade
and found 23 per cent of those who pursued lifestyle
changes, 19 per cent of those who took metformin, and 19 per
cent with neither drug nor lifestyle changes had normal
sugar levels.
The lifestyle changes delayed onset of diabetes by about
four years, and metformin delayed it by two years, compared
with the onset among people who did not take any preventive
action, William Knowler at the diabetes epidemiology unit of
the National Institutes of Health and his colleagues said.
They reported their findings in medical journal Lancet
yesterday.
The lifestyle changes were aimed at helping the
participants achieve and maintain 7 per cent weight loss and
at least 150 minutes of moderate-intensity physical activity
per week. The volunteers on metformin received 850mg twice a
day.
“Intensive lifestyle intervention (change) remains the best
bet for prevention of diabetes,” said Anoop Misra, director
of diabetes and metabolic diseases at New Delhi’s Fortis
Hospital. He was not associated with the study but made the
observations in a commentary on the research in the same
journal.
The prevention study had already established the superior
effect of lifestyle changes compared with metformin a few
years ago. “The significance now is its long-term follow-up.
No other study has done this so far,” Misra told The
Telegraph.
He said the findings were relevant to India where experts
estimated that about 40 million people already had diabetes
and a large number might be susceptible to developing the
disease because of diet and inappropriate lifestyles.
“Indians are much more sedentary and, in general, do not
pay much importance to what they eat. India is on the
ascending limb of a diabetes epidemic — and both public
health initiatives and individual actions are needed to
reduce the risk.”
Although people who took metformin had a statistically
higher incidence of diabetes than those who merely altered
lifestyles, the incidence was lower in the metformin group
than in the group without any action.
But in his commentary, Misra wonders whether it is
cost-effective to take metformin for a decade to delay
diabetes by two years.
Silver
Star launched its
first mobile diabetes unit (MDU) in India at a glittering
function held at Verna on Sunday 25th October
2009.
Launched
by the charity's international patron, Bollywood megastar
Amitabh Bachchan, the MDU was named 'Captain Krishnan Nair'
in honour of the veteran freedom fighter, who is now the
chairman of Leela Hotel Group in appreciation of his
"fighting spirit and philanthropic deeds."
The MDU at
Goa is the first one to be launched outside the UK by the
Silver Star Appeal, since the introduction of the first MDU
in UK in 2008. The bus, which comes with testing equipment,
a bed and washing facilities, will travel across Goa
providing free diabetes testing.
Speaking
on the occasion, Amitabh Bachchan, who earlier announced his
contribution of Rs 11 lakh (£14 322) to the Silver Star
Appeal, underscored the need to get oneself tested for
diabetes "as many are not aware that the disease exists in
us." He said, "There is so much need for healthcare in
India, when we talk about healthcare we are talking about
people who are suffering. I am privileged to be part of the
launch of the first Mobile Diabetes Unit. I am here mainly
out of concern for the rise in diabetes. It is a silent, yet
a dangerous illness."
Chief
minister Digambar Kamat, speaking on the occasion, said that
the introduction of the MDU in Goa would help improve the
health of the Goans and added that the state government has
embarked on a programme to distribute free insulin kits for
diabetic patients.
Founder
patron of the Silver Star charity, Keith Vaz, exuded
confidence that the MDU in Goa would provide everyone an
opportunity to check his health status. "The mobile diabetes
unit will assess the people and tell them whether or not
they are in risk for diabetes. The unit will not be able to
cure diabetes," Vaz said.
Leading
diabetes charity Silver Star is to launch its Mobile
Diabetes Assessment Unit in Goa with the help of the
charity’s international patron, Indian superstar Amitabh
Bachchan.
Fourteen million people in India have been diagnosed with
diabetes. This huge figure does not take into account the
number of people living undiagnosed with the condition,
which is recognised to be the world’s fifth biggest killer
and is up to 6 times more common in South Asian people.
The Mobile Diabetes Assessment Unit, complete with testing
equipment, a bed and washing facilities, will travel the
state of Goa providing free diabetes testing. This follows
the successful operation of a number of testing camps across
the state.
Bollywood legend Amitabh Bachchan, who turned 67 last week,
has worked with the charity for some time. He launched the
Leicester based diabetes centre in August 2008 where he was
tested for the condition himself. The star of the silver
screen has just been announced as Shilpa Shetty’s
replacement as the presenter of Big Boss, the Indian version
of Big Brother.
Leicester East MP Keith Vaz launched the charity Silver
Star in January 2007 after a routine test diagnosed his own
diabetes. Already well-established in the UK, with two bases
covering Leicester and London, the charity launched its Goa
office in March 2009.
Mr. Vaz, Silver Star’s founder and patron, said:
“It is predicted that by 2025 India will be the diabetes
capital of the world. Work needs to begin now to prevent
this from happening.”
“Silver Star has had such great success in the UK, where
the Mobile Assessment Unit performs free testing nationwide.
I am so delighted that Amitabh Bachchan will be in Goa on
Sunday 25th to launch the bus. Lending his name to such a
good cause will actually save lives.”
HUNDREDS of thousands of Brits
are eating themselves into a early grave.
The latest statistics show that the number of people with
diabetes is climbing by almost six per cent a year. In the
past 12 months alone, 145,000 cases were confirmed, pushing
the UK total to an all-time high of 2.6million people.
Many diabetics need regular shots of insulin to survive. All
face an increased risk of heart disease, blindness and
circulation problems so severe they can lead to amputations.
Nine out of ten diabetics are Type-2 - which is almost
entirely self- inflicted.
And experts fear the numbers will continue to rise because
of the growing number of people who are too hefty.
But researchers are uncovering some surprising sides to this
chronic condition.
Wine
An American team believe red wine tablets could help control
blood sugar levels. Red wine and grapes contain a compound
called resveratol, which has been shown to improve diabetes
in animals.
It appears to work by activating proteins that aid blood
glucose metabolism.
So naughty is nice, but nice - when it comes in the form of
antioxidants may actually be naughty.
For years we've been told that antioxidants are great health
boosters because they seek out and destroy yob cells called
free radicals which are at the root of many medical
problems.
Studies have also suggested they contribute to insulin
resistance and diabetes.
But now Australian scientists have discovered that very high
levels of antioxidants can be just as bad.
For years antioxidants
have been marketed as a way to reduce the risk of disease,
but researchers have found that taking them may actually
help bring on Type 2 diabetes.
The oxidation or rusting of the body, caused by molecules
known as reactive oxygen species, has been thought to lead
to ageing and disease.
But now that notion has been turned on its head.
Tony Tiganis, an associate professor at the School of
Biomedical Sciences at Monash University in Melbourne, has
led a study to be published in the journal Cell Metabolism
today.
"A little bit of reactive oxygen species, in particular
hydrogen peroxide, can be a good thing," he said.
But the study shows that while the oxidation of the body is
bad for people with advanced diabetes, a certain level of
oxidation is important in the early stages of the disease.
He says for people prone to diabetes, taking antioxidant
supplements could actually bring on the disease.
"If you've been told you are developing insulin resistance,
you're at the early stages of Type 2 diabetes, then
antioxidants, we suggest - but I'll stress all the work
we've done is in mice - that antioxidants would be bad for
you in that context," Associate Professor Tiganis said.
Antioxidants are naturally found in fruits and vegetables
such as blueberries and broccoli.
But in recent years, food and even cosmetics producers have
seen the benefits of capitalising on the buzz surrounding
the health properties of antioxidants.
"Rich in antioxidants" or "with added antioxidants" can be
often found on the labels of food, juice and make-up.
But the research raises questions as to whether people
should be blindly consuming the multitude of products
stacked on supermarket shelves that claim to be antioxidant
rich.
The Australasian College of Nutritional and Environmental
Medicine (ACNEM) says while people should not stop eating
antioxidant-rich fruit and vegetables, they should exercise
caution when taking antioxidant supplements.
"In early onset Type 2 diabetes, those people at risk with a
large waist or a strong family history of diabetes need to
talk to their health professionals about the use of
antioxidants," said ACNEM president Dr Gary Deed.
"When you're buying products over the counter
including antioxidants, be informed, be cautious in what you
buy without supervision because studies like these are
emerging saying that taking things without careful medical
advice may in fact not be helping you."
Exercise
and weight control are the mainstays of diabetes prevention.
The scientific evidence I’ve seen indicates
that
more than half of new cases of diabetes mellitus could be
avoided through simple lifestyle changes.
Here are dietary steps you can take to reduce your risk of
diabetes.
General nutrition
What you eat directly affects your blood sugar. In
diabetes, blood sugar levels rise too high after every meal.
You can keep your sugar level on a more even keel by
choosing a low-fat diet rich in fiber, fruits and
vegetables, lentils and beans, and whole-grain breads and
cereals.
Another factor that increases your chance of getting
diabetes, and getting it at an earlier age, is excess
weight. Losing as little as 10 to 20 pounds can help a lot —
often improving your body’s ability to keep your blood sugar
normal.
Recent studies have uncovered several other nutrition
factors that reduce your risk for developing type 2 diabetes
mellitus. Since diabetes is projected to affect 1 out of 5
Americans by 2050, any changes in what you eat that could
help are well worth considering.
More dietary factors
Here from the field of diabetes research are some
intriguing dietary findings:
Coffee:
Some data suggest that coffee consumption may help prevent
diabetes. A substance in coffee called chlorogenic acid may
slow the liver’s release of glucose. Study participants who
were heavy coffee drinkers — 4 to 5 cups per day — had a 30
percent lower risk of diabetes. Until more is known,
however, researchers don’t recommend changing your coffee
habits.
Green
tea:
The drink may reduce insulin resistance — a phenomena that
commonly leads to diabetes. Insulin resistance occurs
frequently in overweight people and makes the body’s cells
less sensitive to the hormone insulin. When this happens,
blood sugar levels can rise to the abnormally high range
indicative of diabetes.
Alcohol:
Insulin resistance may also decrease with moderate drinking.
That means no more than two drinks a day for men or one for
women. If you don’t already drink, however, the evidence is
not strong enough to start imbibing. It’s also important to
watch out for weight gain that’s commonly associated with
alcoholic beverages.
Magnesium:
In a study that followed 40,000 women aged 45 or older for
six years, participants who consumed the most magnesium had
the lowest risk of type 2 diabetes. Foods that are best at
supplying you with magnesium include green leafy vegetables,
fruits, whole grains and nuts.
Red
meat:
The risk of diabetes goes up in people who frequently eat
red meat. Since meat is also high in saturated fat and
cholesterol and may lead to heart disease and cancer,
moderation is essential.
Soft
drinks:
Limiting the amount of high-sugar beverages you drink — such
as soft drinks and fruit juice cocktails — can help you
avoid diabetes. The drinks provide excess calories and large
amounts of rapidly absorbable sugars that can contribute to
weight gain and diabetes.
Nuts:
Consumption of nuts and peanut butter reduced diabetes risk
in the Nurses’ Health Study. This occurred even in obese
women, and was not influenced by age, family history of
diabetes, physical activity, smoking or other dietary
factors in the study.
Spices:
Scientists have found that black pepper, cloves, bay leaves
and cinnamon all improve the ability of insulin to lower
blood sugar levels. The level dropped 18 to 29 percent in a
study of people taking cinnamon, 1/2 to 3 teaspoons daily
for 40 days.
The
number of cases of diabetes diagnosed has risen by more than
145,000 in a year.
Data from GP practices shows that there are now more than
2.6 million people registered with diabetes in Britain — an
increase of 145,499.
More than 5.2 million people are also registered as
clinically obese, meaning that one person in ten is being
treated for obesity and one in twenty is being treated for
diabetes, according to the charity Diabetes UK.
GPs receive extra money for monitoring patients with
diabetes and the figures could partly reflect them
registering more patients with the condition. However,
Diabetes UK said it believed that unhealthy lifestyles and
obesity were causing a genuine rise in the number of
cases.people developing the condition. About 90 per cent of
people with diabetes have
type 2 diabetes, which is linked to obesity and eating an
unhealthy diet.
Eight
out of ten people are overweight or obese at the time they
are diagnosed with diabetes.
Douglas
Smallwood, chief executive of Diabetes UK, said: “These
latest figures are extremely worrying. Diabetes is a serious
condition that causes heart disease, stroke, amputations,
kidney failure and , blindness and more deaths than breast
and prostate cancer combined.
Many, but not all, people with type 2 diabetes are
overweight or obese. Therefore, we need to do all we can to
raise awareness of diabetes and help people understand how
following a balanced diet and leading an active lifestyle
can help reduce their risk of developing type 2 diabetes.
“If we don’t stop the rising tides of obesity and diabetes,
millions will face a future of ill health and put an
ever-growing strain on NHS resources.”
Diabetes sufferers may be
able to give up their cake and eat it, too. According to a
new study, people who lost weight in the 18 months after
being diagnosed with type 2 diabetes experienced sustained
benefits even if they regained the weight later. They were
up to twice as likely to reach their targets for blood
pressure and blood sugar as those who didn't lose weight,
although by the end of the four-year study, most of them had
regained the weight they had lost.
Researchers speculate that "metabolic memory" may help
explain the results; that is, achieving early metabolic
control may have a long-term effect on clinical outcomes. Or
it could be that the study didn't last long enough: "One
possibility is that if we'd looked further out, the benefits
would go away," says Greg Nichols, a researcher at Kaiser
Permanente Center for Health Research who coauthored the
study, which appeared online today in the journal Diabetes
Care.
Whatever the reason, the study simply adds more weight, as
it were, to the existing recommendation that those newly
diagnosed with type 2 diabetes shed some pounds. "You only
need to lose 5 to 7 percent [of your body weight] to have a
major impact on glucose levels," says Om Ganda, a senior
physician at Joslin Diabetes Center and an associate
clinical professor at Harvard Medical School.
If you've recently been diagnosed, there's more you can do
to reduce your risk of complications. Here are six other
tips, besides losing weight, based on American Diabetes
Association recommendations:
1) Losing weight improves blood
pressure and blood sugar, even if the pounds come back
2)Get a primary-care physician. If you don't already
have one, sign up with a primary-care physician who can work
with you on an ongoing basis to keep your blood pressure,
blood sugar, and cholesterol levels within recommended
guidelines. Check out my recent story about studies that
offer hints on how to prioritize your efforts. Most newly
diagnosed patients don't need a physician who specializes in
diabetes, says John Buse, an endocrinologist who's president
for medicine and science at the ADA.
3)Get educated. Find a diabetes educator in your area
to help you learn about the disease. Working with an expert
can make you feel more in control. "When someone gets a
diagnosis of diabetes, it's a little like cancer," Buse
says. "They have some understanding but lots of fear."
4)Exercise. The ADA recommends 30 minutes of
moderately vigorous physical activity most days of the week.
Even if you don't lose weight, exercise can help improve
your blood sugar levels.
5)Take the drugs you need. Get a prescription
for metformin. This
generic, inexpensive drug can help get your blood sugar
under control, with few side effects. If you've got high
cholesterol, you should have a prescription for a statin as
well. If you're over 40 and have heart disease, take a baby
aspirin every day.
6)Make a plan for regular specialist checkups. At a
minimum, you'll need annual eye and foot exams and a dental
exam every six months.
7)Get family members on board. "It's impossible to
make these lifestyle changes if everybody in the family is
doing something else," says Buse. In other words, it's tough
eating vegetables if everyone else is having chips. Besides,
it's a lot more fun to go for a daily walk with someone else
than all by yourself.
Intake
of at least three cups of tea every day can reduce the risk
of diabetes by almost 50 percent, a new study states.
Researchers studied more than 40,000 people whose
consumption of tea was monitored for 10 years, Health News
reported. After analyses, scientists discovered that
chemicals found in all types of tea cut the dangers of
developing type 2-diabetes by 42 percent. Drinking more than
three cups did not reduce the risk any further. The study
was carried out by a team of Dutch researchers from the
University Medical Centre in Utrecht. "Consumption of at
least three cups of tea or coffee was associated with a
lowered risk of type 2 diabetes. Blood pressure and intake
of magnesium, potassium and caffeine did not explain these
associations," the team concluded. The beneficial effects in
tea were probably explained by "flavonoidantioxidants", it
said.
Diabetes
requires constant monitoring, especially for those who use
insulin. In addition to medication, there are lifestyle
prescriptions that must be adhered to. We talked about the
importance of medical adherence with Dr. Sherita
Hill-Golden, chair of the Glucose Management Committee and
director of the Diabetes Management Center at Johns Hopkins
University School of Medicine.”Medication and behavioral
treatments are essential to proper diabetes self-management
and prevention of complications,” said Dr. Golden, who is
also an associate professor of medicine and epidemiology at
Johns Hopkins. “Adherence to taking medications, consuming a
proper diet and maintaining an exercise routine result in
improved glucose control and ultimately, a lower risk of
diabetic complications.”
Good glucose control is important for preventing
complications of diabetes, particularly small vessel
complications — eye disease (retinopathy), kidney disease
(nephropathy) and nerve damage (neuropathy).
Dr. Golden shared five tips that can improve adherence to
medication and lifestyle prescriptions:
1. Using a medication organizer helps people remember to
take their pills. Some dispensers even have compartments
for medications that are taken twice a day so that morning
and evening medications can be grouped.
2. People with active lifestyles who take insulin
may benefit from an insulin pen because it is more easily
transportable and less cumbersome than carrying an insulin
syringe and vial. This can enhance compliance with insulin
administration at lunchtime, during work hours or when
eating at restaurants. For similar reasons of convenience,
insulin pumps (subcutaneous devices that are an alternative
to multiple daily insulin injections) can increase
adherence.
3. Meal planning is essential to adhering to the proper
food choices. For those who work, bringing lunch allows
them to control their portion sizes and carbohydrate
consumption. This is more difficult to do when you eat out.
Planning and cooking meals on the weekend for the upcoming
week can also reduce the likelihood of eating out or
overeating.
4. People are more likely to adhere to a physical
activity regimen that they enjoy. Picking enjoyable
activities and scheduling time each week increases the
likelihood of maintaining an exercise routine. Some find
that group exercise activities increase their adherence by
providing motivation as well as accountability and support.
5. Managing depression is extremely important. A
recent study of patients with both diabetes and depression
found that adherence to medications, diet, exercise and
glucose monitoring was reduced in those who were depressed.
Speak with your health care provider if you are experiencing
significant depression, as appropriate treatment may
ultimately improve your ability to stay on track and improve
your condition.
“Following a proper diet — low in saturated fat and sodium
and high in fiber and nonfat or low-fat dairy products — can
help to reduce cholesterol and blood pressure, both of which
are strong risk factors for development of heart disease and
stroke,” Dr. Golden said.
A
new study in animals demonstrates that a diet rich in
coconut oil protects against 'insulin resistance' (an
impaired ability of cells to respond to insulin) in muscle
and fat. The diet also avoids the accumulation of body fat
caused by other high fat diets of similar calorie content.
Together these findings are important because obesity and
insulin resistance are major factors leading to the
development of Type 2 diabetes.
The study is also interesting because it helps explain
human studies showing that people who incorporate medium
chain 'fatty acids', such as those found in coconut oil,
into their diets can lose body fat.
Dr Nigel Turner and Associate Professor Jiming Ye, from
Sydney's Garvan Institute of Medical Research, compared fat
metabolism and insulin resistance in mice fed coconut oil
and lard based diets. Their findings are now published
online in the international journal
Diabetes.
"The medium chain fatty acids, like those found in coconut
oil, are interesting to us because they behave very
differently to the fats normally found in our diets," said
study leader Nigel Turner.
"Unlike the long chain fatty acids contained in animal
fats, medium chain fatty acids are small enough to enter
mitochondria - the cells' energy burning powerhouses -
directly, where they can then be converted to energy."
"Unfortunately the downside to eating medium chain fatty
acids is that they can lead to fat build up in the liver, an
important fact to be taken into consideration by anyone
considering using them as a weight loss therapy."
Fat storage is determined by the balance between how much
fat is taken in by cells and how much of this fat is burned
for energy. When people eat a high fat diet, their bodies
attempt to compensate by increasing their capacity to
oxidise fat. The medium chain fatty acid (coconut oil) diet
was more effective at increasing the oxidative capacity of
muscle than the long chain fatty acid (lard) diet leading to
less fat storage in muscle and better insulin action.
According to Turner, the lard-based diet used in this
research is similar to the diet eaten by people in the
Western world. "Its fatty acid composition is about 40%
saturated fats, 40% monounsaturated fats and 20%
polyunsaturated fats, of which the vast proportion is
omega-6, rather than omega-3," he said.
"Obese humans usually eat 40-50% of their calories as fat.
Our mice were fed 45% of their calories as fat."
"No high fat diet is good, and the normal dietary
combination of long chain fats leads to an overload that our
bodies can't cope with. Therefore high consumption of common
dietary fats is contributing directly towards the global
escalation of obesity and Type 2 diabetes."
"If someone is trying to prevent weight gain, we can see
they may benefit from substituting oils containing medium
chain fatty acids for other oils in their diet, as long as
consideration is given to the potential problem of excess
fat in the liver. Other natural dietary alternatives, such
as fish oil, might be helpful because the fatty acids in
fish oil are thought to exert a lot of their beneficial
effects through improving fat oxidation in the liver."
A moderate aerobic
exercise program, without weight loss, can improve insulin
sensitivity in both lean and obese sedentary adolescents,
according to a new study accepted for publication in The
Endocrine Society's Journal of Clinical Endocrinology &
Metabolism (JCEM). Insulin is a hormone produced in the
pancreas that permits glucose to enter cells to be used for
energy or stored for future use by the body.
Because obese adolescents are resistant to insulin, in
order to maintain normal blood sugar levels, they have to
increase their production of insulin. Increased insulin
production however, places higher demands on the pancreas.
These higher demands can exhaust pancreatic beta cells to
the point that they no longer produce sufficient amounts of
insulin to keep blood sugar levels normal, which might
subsequently lead to type 2 diabetes.
"Because weight loss can be difficult to achieve and
maintain in obese sedentary children, the purpose of this
study was to determine whether a controlled exercise
program, without any diet intervention and with no intention
of weight loss, would improve fat distribution and
sensitivity to insulin," said Agneta Sunehag, MD, PhD, of
Baylor College of Medicine and senior author of the study.
"We found that a 12-week moderate aerobic exercise program
consisting of four 30-minute workouts a week increased
fitness and improved insulin sensitivity in both lean and
obese adolescents."
In this study, 29 adolescents (14 lean and 15 obese)
completed the 12-week moderate aerobic exercise program.
During the exercise sessions, subjects worked out on a
treadmill, elliptical or bicycle. The goal of each exercise
session was to get the participants' heart rate to increase
to at least 70 percent of their maximum capacity. Glucose
and insulin concentrations were measured both before and
after the exercise program. Cardiovascular fitness was
determined using an oxygen consumption test which consists
of measuring oxygen uptake of the participant during a
treadmill exercise where speed and incline is increased
every three minutes until the subject reaches his maximum
exercise capacity.
"Many studies include both diet and exercise interventions,
which makes it difficult to determine which intervention is
most effective and best accepted by adolescents," said
Sunehag. "Our findings show that exercise alone can increase
fitness and improve insulin sensitivity, making an aerobic
program like the one used in this study a potential useful
tool in preventing obesity-related illnesses."
Other researchers working on the study include Gert-Jan van
der Heijden of Baylor College of Medicine in Houston, Tex.;
Gianna Toffolo and Erica Manesso of the University of Padova
in Padua, Italy; and Pieter Sauer of the University of
Groningen in The Netherlands.
The article, "Aerobic exercise increases peripheral and
hepatic insulin sensitivity in sedentary adolescents," will
appear in the November 2009 issue of JCEM.
Eating
a Mediterranean-style diet low in carbohydrates may be
better for people with Type 2 diabetes than following a
low-fat diet.
Mediterranean diets favour fruits, vegetables and whole
grains, limited amounts of red meat, poultry and processed
foods. It also includes a relatively high amount of fat from
olive oil and nuts and few carbohydrates, and low to
moderate intake of wine.
On the other hand, a typical low-fat diet advises cutting
down on all types of dietary fat.
In Tuesday's issue of the Annals of Internal Medicine, Dr.
Dario Giugliano, from the Second University of Naples,
Italy, and his team said they found fewer overweight people
newly diagnosed with Type 2 diabetes who followed a
Mediterranean-style diet needed to use medication to lower
their blood sugar levels after four years, compared to
people randomly assigned to follow a low-fat diet.
After an average of four years, 26 per cent fewer people
needed to go on diabetes medication in the Mediterranean
diet group compared to the low-fat group. That translates
into a 37 per cent decreased risk of needing medication.
Don't overlook benefits of diet change
When the study ended, body-mass index scores also decreased
1.2 points for those in the Mediterranean diet group
compared to 0.9 for the low-fat diet group.
Cholesterol levels and blood pressure readings also showed
greater improvement for participants eating a Mediterranean
diet — heart-healthy changes that were maintained over the
study.
The absolute difference in terms of weight loss was two
kilograms, or 4.4 pounds, with the Mediterranean dieters
also sporting slimmer waistlines.
These results "reinforce the message that benefits of
lifestyle interventions should not be overlooked despite the
drug-intensive style of medicine fueled by the current
medical literature," the study's authors concluded.
The 215 study participants (107 people on a low-fat diet
and 108 on the Mediterranean diet) also received counselling
from nutritionists and dietitians once a month for the first
year and then bimonthly for the next three years.
But the study was not blinded, meaning doctors prescribing
medications knew which diet a participant was following.
Knowing who is in each group may lead researchers to
conduct a study skewed so that the treatment they think is
better seems to be better. The researchers also relied on
participants to report what they ate.
The Mediterranean diet in the study consisted of no more
than 50 per cent of daily calories from carbohydrates and no
less than 30 per cent of calories from fat.
The low-fat diet was based on American Heart Association
guidelines, and was rich in whole grains and limited in
sweets with no more than 30 per cent of calories from fat
and 10 per cent from saturated fats, such as animal fats.
Low levels of vitamin D
are known to nearly double the risk of cardiovascular
disease in patients with diabetes, and researchers at
Washington University School of Medicine in St. Louis now
think they know why.
They have found that diabetics deficient in vitamin D can't
process cholesterol normally, so it builds up in their blood
vessels, increasing the risk of heart attack and stroke. The
new research has identified a mechanism linking low vitamin
D levels to heart disease risk and may lead to ways to fix
the problem, simply by increasing levels of vitamin D.
"Vitamin D inhibits the uptake of cholesterol by cells
called macrophages," says principal investigator Carlos
Bernal-Mizrachi, M.D., a Washington University
endocrinologist at Barnes-Jewish Hospital. "When people are
deficient in vitamin D, the macrophage cells eat more
cholesterol, and they can't get rid of it. The macrophages
get clogged with cholesterol and become what scientists call
foam cells, which are one of the earliest markers of
atherosclerosis."
Macrophages are dispatched by the immune system in response
to inflammation and often are activated by diseases such as
diabetes. Bernal-Mizrachi and his colleagues believe that in
diabetic patients with inadequate vitamin D, macrophages
become loaded with cholesterol and eventually stiffen blood
vessels and block blood flow.
Bernal-Mizrachi, an assistant professor of medicine and of
cell biology and physiology, studied macrophage cells taken
from people with and without diabetes and with and without
vitamin D deficiency. His team, led by research assistants
Jisu Oh and Sherry Weng, M.D., exposed the cells to
cholesterol and to high or low vitamin D levels. When
vitamin D levels were low in the culture dish, macrophages
from diabetic patients were much more likely to become foam
cells.
In the Aug. 25 issue of the journal Circulation, which
currently is available online, the team reports that vitamin
D regulates signaling pathways linked both to uptake and to
clearance of cholesterol in macrophages.
"Cholesterol
is transported through the blood attached to lipoproteins
such as LDL, the 'bad' cholesterol," Bernal-Mizrachi
explains. "As it is stimulated by oxygen radicals in the
vessel wall, LDL becomes oxidated, and macrophages eat it
uncontrollably. LDL cholesterol then clogs the macrophages,
and that's how atherosclerosis begins."
That process becomes accelerated when a person is deficient
in vitamin D. And people with type 2 diabetes are very
likely to have this deficiency. Worldwide, approximately one
billion people have insufficient vitamin D levels, and in
women with type 2 diabetes, the likelihood of low vitamin D
is about a third higher than in women of the same age who
don't have diabetes.
The skin manufactures vitamin D in response to ultraviolet
light exposure. But in much of the United States, people
don't make enough vitamin D during the winter — when the
sun's rays are weaker and more time is spent indoors.
The good news is when human macrophages are placed in an
environment with plenty of vitamin D, their uptake of
cholesterol is suppressed, and they don't become foam cells.
Bernal-Mizrachi believes it may be possible to slow or
reverse the development of atherosclerosis in patients with
diabetes by helping them regain adequate vitamin D levels.
"There is debate about whether any amount of sun exposure
is safe, so oral vitamin D supplements may work best," he
says, "but perhaps if people were exposed to sunlight only
for a few minutes at a time, that may be an option, too."
He has launched a new study of diabetics who are both
deficient in vitamin D and have high blood pressure. He
wants to learn whether replacing vitamin D will lower blood
pressure and improve blood flow. For this study, Bernal-Mizrachi
is recruiting patients with type 2 diabetes ages 30 to 80
who are not taking insulin to control their blood sugar.
Study volunteers also must have high blood pressure.
So
you think you know what diabetes looks like? Maybe you have
a picture in your mind of an elderly, overweight woman,
sitting in a wheelchair. Or a hefty man, smoking like a
chimney. Maybe you’ve read that it is preventable — that the
fat-clogged, carbohydrate-rich diet of many Mainers has
produced an obese population, many of them with diabetes.
That, however, is Type 2 diabetes.
This is Type 1: Ayla Zanoni, 3, wearing an orange sundress
with matching elastics on her ponytails. She has on purple
sandals and carries a Barbie doll by one leg. Sitting on her
mother’s lap, she counts the buttons on Mama’s blouse.
She asks for an apple but needs an insulin shot first.
Ayla’s older sister, Zoie, only 10 years old herself, pricks
Ayla’s finger to determine her glucose level.
Daddy rubs her tiny arm and injects her, something so
routine in Ayla’s life that she doesn’t even stop chewing
her apple.
Cindy Hale of the Maine Center for Disease Control and
Prevention’s Diabetes Prevention and Control Program said
recent survey data revealed that 7.8 percent of adults in
Maine are diagnosed with diabetes — about one in every 13
people.
Hale said no statistics are kept on children with diabetes
in Maine, but based on national data, she estimates it is
one in every 400 or 500 children.
A lifetime disease
Ayla Zanoni lives on an organic farm Down East in Lubec.
She is one of Dante and Jessika Zanoni’s five children —
four girls and one boy. The nightmare the family has lived
through since the child’s diagnosis in January 2008, at just
19 months old, will never
end, her mother, Jessika Zanoni, said.
“She will be insulin-dependent for the rest of her life,”
Zanoni said. “So far, in her three short years of life, she
has been subjected to 4,360 finger and toe pricks and been
on the receiving end of 3,150 injections of insulin. Ayla is
so full of life, and such a character. I can’t tell you how
many times I have cried alone at night, wondering why this
would ever happen to such a great little soul.”
The first indication the family had that something was
wrong was when Ayla began bringing a tiny teacup, from her
play tea set, to each family, member looking for a drink.
“One morning she just wasn’t breathing well. Her respiration
was about twice as fast as it should have been,” Jessika
Zanoni said.
A trip to the emergency room led to a diagnosis of a cold,
and the family was told to use a vaporizer.
“We held her all night,” Zanoni recalled. “She was
vomiting, and by morning her breathing was worse. It was
rattling. Her face was completely white. She was dying.”
They went to Lubec Medical Center where staff immediately
called an ambulance and the child ended up at Eastern Maine
Medical Center in Bangor.
“A normal blood sugar range is 70 to 110,” Zanoni said.
“Ayla’s was over 400. I sat in that ambulance and could hear
them working on her, heard them say ‘We’re losing her. She’s
fading.’”
On constant alert
It took weeks for Ayla to recover and weeks for her parents
to get used to the new routine of blood tests and insulin
injections. Today, Ayla gets 10 to 20 finger pricks a day
and at least six injections a day.
When a toddler falls asleep, most parents are relieved. Not
the Zanonis.
“That means an automatic blood check,” Jessika Zanoni said.
She will prick her daughter’s fingers every two hours
throughout the night. Ayla won’t even wake up. If she needs
an insulin shot or a sip of juice through a straw to raise
her sugar level, Ayla dozes right through it, drinking in
her sleep. “For her, this is normal,” Zanoni said.
But it isn’t normal for the rest of the family.
“We have spent the last year and a half just trying to cope
and survive this,” Jessika said. “Ayla had two very serious
hypoglycemic seizures that shook me to my very core. Both
happened while everyone was asleep, and the last was almost
a year ago, but only six days after the birth of our
youngest daughter. That is when I stopped sleeping for more
than two hours at a time. I remember holding her as she
seized, Dante on the phone with a 911 operator, begging for
her life and the seizure to stop.”
This constant vigilance has taken a toll on the family.
“I feel all the kids have been robbed of a part of their
childhoods,” Jessika said. “Seeing my other children crying
hysterically as their little sister is rushed away, dying in
an ambulance ... a part of their innocence and belief that
Mom and Dad can make everything better is gone.”
The Zanonis said they needed to make Ayla’s story public.
“We chose to lay it all out for you, and not sugarcoat
anything. We need you to understand why we need a cure for
diabetes now. We can’t wait. Ayla can’t wait.”
AgaMatrix are best known
for their range of WaveSense products, mainly dealing with
blood glucose monitoring products. Recently the company
announced that they are to offer their products for the
Apple iPhone, with the release of WaveSense Diabetes
Manager.
As IntoMobile reports, the WaveSense Diabetes Manager is
the first app for the iPhone of that kind. Development and
Planning for the app’s release has taken over a year, so its
a product that AgaMatrix have spent a good deal of time on.
Features include dynamic graphing of glucose data,
easy-to-use data entry, automatic mealtime tagging of
results and much more. You’ll also recieve emails when
results are finished and best of all, the app is free to
download.
Family doctors will be
financially rewarded for treating some patients with
diabetes, Down’s syndrome and epilepsy under proposed
changes to their performance-related pay scheme.
A review by the National Institute for Health and Clinical
Excellence (Nice) found that some parts of the arrangement,
in which doctors are rewarded both for assessing and
achieving certain targets, should be scrapped.
Instead, new targets from 2010-11 should be linked to
lowering the blood pressure of patients with diabetes and to
provide regular checks for patients with Down’s, who are at
risk of an underactive thyroid gland. The recommendations
were made in the first independent review of targets and
bonuses in the Quality and Outcomes Framework (QOF), which
accounts for a third of GPs’ pay.
Under the scheme, GPs are rewarded for tasks such as giving
specific check-ups to patients with heart disease, dementia
or certain other conditions.
The Nice review said GPs should also be paid to offer
family planning advice or contraceptives to women of
childbearing age who have epilepsy, as some drugs to treat
the condition can interfere with the development of a
growing baby, if women do not realise they are pregnant.
The changes will be subject to future consultations and
agreement from doctors’ leaders, but are likely to
disappoint some health campaigners who have lobbied for
conditions such as obesity, arthritis and depression to be
included in the QOF.
Colin Hunter, the head of the Nice advisory committee
making the recommendations, said that overall the review had
pursued a “softly, softly"” approach, not wishing to remove
or replace entire parts of the system in case it affected
patient care.
But he suggested that in future years, parts of the scheme
related to smoking cessation would be “retired” from the QOF
in favour of other priorities as Nice undertakes an annual
review of the framework, which has been running since 2004.
The scheme currently includes incentives for GPs to monitor
asthma patients and those with coronary heart disease,
diagnose diabetes, measure patients’ blood pressure once
every 15 months and register and review patients with
dementia.
There are 1,000 QOF points available every year with each
one worth up to £124, depending on its size, location and
disease incidence for a practice, which may consist of more
than one GP.
But whereas previously the Government had selected the
priorities in negotiation with the British Medical
Association, now indicators will be suggested by Nice on the
basis of medical evidence and assessments of the
cost-effectiveness of the changes, and tested in sites
around the country, Dr Hunter said.
Following criticisms that some GPs were earning more than
£300,000 a year, he added that most of the extra money from
the QOF is used to support staffing or the costs of running
extra clinics to provide the required services.
“It’s very interesting to look at cost-effectiveness but
it’s not an exact science,” he added.
“Some parts of the QOF measure processes and some measure
outcomes, but there's no point in encouraging the GPs to
measure patients' cholesterol levels on one hand and then
have a separate incentive to reduce cholesterol levels to
less than 5.2 [mmol/L]; if you're doing the reduction,
you're already measuring the cholesterol."
There are an estimated 2.5 million people with diabetes in
the UK. Dr Hunter added that the new target for lowering the
blood pressure of diabetes patients was more ambitious than
at present. "We want to see them achieve a blood pressure of
140/80 rather than 145/85, as there's evidence that lowering
blood pressure further protects patients from further
complications.
"We also want to ensure that with Down's syndrome, patients
are getting a regular thyroid check every year, because that
is something that's very haphazard at the moment. It's
happening in some areas but not in others."
Critics have also claimed that the QOF relies too much on
processes and does not take into account patients'
experiences or whether they were treated with dignity, but
Dr Hunter added that it was difficult to measure such
qualitative outcomes. He added that there were no plans to
include measures of obesity or weight management in the
framework as there was not enough evidence to suggest that
such a move would be cost-effective.
"But Nice has a process where people and doctors can submit
ideas of what they think should be measured but the problem
is a lot of conditions don't really fit well into the
framework. It is primarily suited towards managing chronic
disease."
Val Moore, Nice’s implementation director, said that the
first new "menu" of revised QOF indicators was "a
significant milestone . . . in ensuring optimum health
outcomes for patients".
"High quality care depends on decisions made on the basis
of the best evidence. The menu will now be the subject of
negotiation between NHS Employers and the [British Medical
Association's] General Practitioners' Committee who will
make a final decision on which indicators should be included
in the QOF for the period 2010-11."
Diabetes UK Cymru will
this week tour Wales in a bid to help people control their
diabetes and prevent the risk of life-threatening
side-effects. Health Editor Madeleine Brindley spoke to Sara
Griffiths, who knows from bitter experience the consequences
of ignoring diabetes
SARA GRIFFITHS uses just one word to describe how she felt
when she was diagnosed with kidney failure – devastated.
Renal failure is one of the most common complications for
people with diabetes, and for most it develops slowly and is
usually associated with people who have had diabetes for 20
years or more.
But Sara, who lives in Raglan, Monmouthshire, was only in
her late 20s. Her kidney failure was a legacy of years of
poor diabetes control – she was diagnosed with Type 1
diabetes when she was 12.
“The doctors told me if I didn’t look after my diabetes
there would be complications, but at the age of 12 you don’t
take it on board,” said Sara, who works as a freelance stage
manager.
“You think you are invincible. But if I had known what I
know now, at that age I would have taken it more seriously.
“I needed a kidney transplant and laser surgery for my
eyes. Fortunately, I have come out the other side. But it’s
a harsh lesson to learn.”
Sara, 46, says she was in denial about diabetes as a child
and teenager and the risks she exposed herself to by not
managing the condition properly.
“I was self conscious about eating something like a banana
in class because I had diabetes,” she said.
“Part of me felt ‘This is great’ as no-one else could eat
in class but the other part of me felt it was different.
“I wasn’t good with my diabetes. I didn’t want to accept
it. I didn’t test my blood sugar as regularly as I should
and I just thought it will never happen to me.
“Being diagnosed at 12, I was nearing that teenage
rebellious phase. You don’t listen to anybody.
“But you can’t get away with diabetes. It affects so many
parts of your life.”
Sara first experienced complications in her mid 20s, when
she was diagnosed with retinopathy, a condition caused when
the blood vessels in the retina become blocked, leaky or
grow haphazardly.
She needed extensive laser eye surgery to stop the
condition worsening.
Just a few years later Sara was diagnosed with
life-threatening kidney disease.
Kidney disease is more common in people with diabetes
because of the impact the condition has on the body.
Diabetes causes damage to small blood vessels, which in
turn causes them to become leaky or, in some cases, to stop
working, making the kidneys work less efficiently.
It is now known that keeping blood glucose levels as near
normal as possible can greatly reduce the risk of kidney
disease developing as well as other complications. Diabetes
UK states that it is also important to keep blood pressure
controlled.
Sara, who is now involved in the Kidney Wales Foundation’s
Donate Wales campaign to boost the number of organ donors,
said: “It was a devastating blow, but it was the wake-up
call I needed,” she said.
“From that moment on I became fanatical about my diabetes
control. I wanted to delay things getting worse.
“I was put on dialysis three times a week and I did it for
three-and-a-half years – they were the hardest years of my
life.
“I was one of the youngest patients there, holding down a
full-time job and having dialysis in evening sessions, so it
was particularly gruelling.
“Dialysis keeps you alive but it doesn’t keep you living.”
Sara had a kidney transplant in 1995, freeing her from the
need for dialysis. And 12 years later Sara was effectively
cured of diabetes when she underwent a pancreatic
transplant.
“The past few years have been the best of my life,” she
said.
“But as hard as it sounds, you have to take diabetes
seriously. It really matters.
“People can live fulfilled lives but with diabetes comes
responsibility and that can be difficult for children to
take on board.”
Awareness
bus tour
Diabetes UK Cymru will this week join forces with 700
pharmacies in Wales to raise awareness about diabetes and
its devastating complications.
The charity will also be touring Wales from today with the
BBC Cymru Wales radio bus to find the 50,000 people with
undiagnosed diabetes and raise awareness about its
life-threatening complications.
These include heart attacks, strokes, amputation, blindness
and kidney disease.
Diabetes UK Cymru is also working with four other charities
– the Stroke Association, British Heart Foundation, Kidney
Wales Foundation and RNIB Cymru.
The bus will be in Bangor today, Aberystwyth tomorrow,
Neath on Wednesday, Carmarthen on Thursday and Barry on
Friday and Sunday, between 10am and 2pm.
I
am a 46-year-old professor, trying to avoid type 2 diabetes
but fighting a strong family history of it. My paternal
grandmother, my father and my mother all have it. I am 5
feet 2 inches, 123 pounds, eat little meat or "bad" foods
and lift weights and do cardio exercise five days a week.
Yet my A1C creeps up every year - 5.4, 5.5 and most recently
5.6. My cholesterol is normal, as is my LDL cholesterol and
triglycerides. What can I do to slow or avoid diabetes that
I am not doing? - M.H.
ANSWER: You're winning the fight, professor. You're
making an A plus.
A1C or HbA1C (hemoglobin A1C) is a blood test that tells
how well a person's blood sugar was controlled in the
previous four months. It has been used to monitor sugar
control. It's about to be used to diagnose diabetes. Hb,
hemoglobin, is the stuff inside red blood cells that grabs
onto oxygen as blood courses through the lungs. It releases
oxygen when blood reaches parts of the body in need of it.
Sugar sticks to hemoglobin - the HbA1C is hemoglobin with
sugar on it, sort of like a glazed doughnut. A HbA1C of 5
percent corresponds to a blood sugar of 97 mg/dL (5.3 mmol/L)
- normal. Those increases of 0.1 are insignificant. You're
doing fine.
You've done all the things possible to stave off
diabetes. Your weight is perfect. You're
physically active. Your diet is admirable.
There's nothing more to do.
For others, prevention of diabetes entails not allowing
yourself to become overweight, adopting a diet low in fats
and high in fruits, vegetables and whole grains, and staying
as physically active as you possibly can.
A
diabetes doctor in the city of Rajkot, Gujarat has found a
rather unconventional way of treating patients by designing
specialised footwear for the foot in the treatment of
diabetes, rather than the conventional way of prescribing
medicines.
He is one of the five other doctors in the country and the
only one in Gujarat who treats ulcers related to diabetes in
the legs with the help of footwear. He has also employed a
trained cobbler for making these footwear in the hospital
itself.
Fibre2fashion spoke to the doctor, Mr Vibhakar Vachrajaniw
who said, “I am basically a general surgeon, with a special
training in diabetic foot related problems and since last 10
years, I am managing only patients with foot problem and
diabetes”.
He explained by saying, “The foot ulcers/wounds of diabetic
patients are different, in the sense they do not heal
because of neuropathy, diabetes and less blood supply in
feet and the foot is like a machine on which the body moves
all through out the life”.
“I am the only surgeon who has a full fledged
rehabilitation centre, where we prepare specialised
footwears for diabetic patients and we also produce
artificial limbs and calipres for amputees and have also
trained a cobbler”.
“We design footwear that provides comfort to patient by
which they can easily move and the damage on leg due to
diabetes is lessened. The insole and outsole are so prepared
that it gives rest to the wound and prevents pressure injury
to insensitive foot”, he said.
New cookbook for those with diabetes floats healthy seafood
options
Fishing for great seafood recipes can be difficult for
those with diabetes, since figuring out the nutritional
exchanges can be a guessing game. But a new cookbook for
those who have the autoimmune disorder,  "The Diabetes
Seafood Cookbook," is an essential and useful guide for
those who love cooking fish.
Listed with each recipe are the number of dietary
exchanges, along with saturated fat, trans fat, protein and
fiber. For summer fish cookery, grilling and steaming are
two cooking methods that don't involve turning on the oven,
and they yield awesome results.
Author Barbara Seelig-Brown explains how to arrange a
whole, cleaned and gutted branzino in a steamer basket and
how to brush it with orange juice, soy sauce, honey,
scallions and garlic. The fish steams, covered, for about 10
minutes. Next,vegetables such as snow peas, water chestnuts
and baby corn are added, and the entire meal steamed for
another few minutes.
As a choice for the grill, Seelig-Brown's salmon with black
bean salsa is beautiful, and the leftover salsa served with
the fish can be added to a green salad the following day.
One serving of this easy recipe counts as a half starch,
half fruit, 4 lean meat, and 1 fat. Per serving, the salmon
contains 295 calories, 12 grams total fat, no trans fat, 360
mg. cholesterol, and a whopping 28 grams of protein.
This recipe is from "The Diabetes Seafood Cookbook."
Salmon with Black Bean Salsa
Serves: 4
Prep Time: 20
Instructions
In a plastic bag, mix the soy sauce and orange juice. Add
salmon and marinate for at least 20 minutes and up to 2
hours.
Mix the salsa ingredients together in a large bowl. (You
can prepare the salsa early in the day to allow the flavors
to blend.
Preheat the grill or grill pan. Add the salmon and grill
until nicely browned.
Place 1/2 cup black bean salsa on a plate and place salmon
on top. Garnish with fresh cilantro sprigs, if desired.
A
NEW DVD has been created in
to help raise awareness and dispel myths about diabetes
amongst the South Asian community.
Sharrow community organisation ShipShape has created the
health information disc "Diabetes in the South Asian
Community" with the support of the NHS Sheffield.
The DVD been produced in Urdu with English subtitles,
capturing experiences of women from the community who live
with diabetes, and how their lives improved once they
understood the condition.
People of South Asian origins have a higher risk of
developing diabetes than the general population due to their
genetic heritage.
It means raising awareness of the condition is important so
people can manage the condition which causes problems as the
amount of glucose in the blood is too high because the body
cannot use it properly.
Symptoms include increased thirst, weight loss, passing
urine more frequently, blurred vision and extreme tiredness.
Tanyat Basharat, Sheffield Community Health Educator for
Sharrow, said: "Three diabetes education programmes run each
year. They are very successful in helping to transform lives
of people in the community by monitoring and managing the
condition. The DVD features real women from our community
who have benefited from attending the programme.
"The DVD will act as a tool for people in the community who
can't access the programme for whatever reason, and will
help us to help even more people in this community to better
understand diabetes."
Diabetes is highlighted in The Star's Save Your Life
campaign – which is informing readers what they can do to
stay healthy and avoid developing life-threatening diseases.
One woman who has completed the Diabetes Education
Programme and stars in the DVD said: "I was very scared and
felt alone when I first found out that I had diabetes – I
locked myself in the house, I couldn't speak English to go
anywhere for any support.
"I found out about the support available at ShipShape with
an Urdu speaker. I was given one-to-one support that was
tailored to my needs and I attended the seven week
programme, which transformed my life."
The DVD explains that type one diabetes develops when the
body is unable to produce any insulin – it usually appears
before the age of 40 and is treated with insulin injections,
diet and regular physical activity and cannot be prevented.
Type two diabetes develops when the body can still make
some insulin, but not enough, or when insulin that is
produced doesn't work properly. In most cases this is linked
to being overweight.
"It can be treated with diet and exercise, but tablets and
insulin injections may also be necessary."
Rates
of severe childhood obesity have tripled in the last 25
years, putting many children at risk for diabetes and heart
disease, according to a report in Academic Pediatrics by an
obesity expert at Brenner Children's Hospital, part of Wake
Forest University Baptist Medical Center.
"Children are not only becoming obese, but becoming
severely obese, which impacts their overall health," said
Joseph Skelton, M.D., lead author and director of the
Brenner FIT (Families in Training) Program. "These findings
reinforce the fact that medically-based programs to treat
obesity are needed throughout the United States and
insurance companies should be encouraged to cover this
care."
The research was published online and will appear in the
September print edition. Skelton and colleagues compared
data from the National Health and Nutrition Examination
Survey (NHANES). They looked at the prevalence of obesity
and severe obesity in a study population of 12,384 children,
representing approximately 71 million U.S. children ages 2
to 19 years.
Severe childhood obesity is a new classification for
children and describes those with a body mass index (BMI)
that is equal to or greater than the 99th percentile for age
and gender. For example, a 10-year-old child with a BMI of
24 would be considered severely obese, Skelton said, whereas
in an adult, that is considered a normal BMI. An expert
committee convened by the American Medical Association, the
Centers for Disease Control and the Department of Health and
Human Services proposed the new classification in 2007.
The
research by Skelton and colleagues is the first of its kind
to use the new classification and detail the severity of the
problem. They found that the prevalence of severe obesity
tripled (from 0.8 percent to 3.8 percent) in the period from
1976-80 to 1999-2004. Based on the data, there are 2.7
million children in the U.S. who are considered severely
obese.
Increases in severe obesity were highest among blacks and
Mexican-Americans and among those below the poverty level.
For example, the percentage of Mexican-American children in
the severely obese category was 0.9 percent in 1976-80 and
5.2 percent in 1999-2004.
Researchers also looked at the impact of severe obesity and
found that a third of children in the severely obese
category were classified as having metabolic syndrome, a
group of risk factors for heart attack, stroke and diabetes.
These risk factors include higher-than normal blood
pressure, cholesterol and insulin levels.
"These findings demonstrate the significant health risks
facing this morbidly obese group," wrote the researchers in
their report. "This places demands on health care and
community services, especially because the highest rates are
among children who are frequently underserved by the health
care system."
"Stem
cell transplants 'have freed patients with type 1 diabetes
of daily insulin injections'" The Daily Telegraph has said.
The news comes after research which allowed volunteers to
go, on average, for two and a half years without using the
multiple daily injections normally needed to manage their
condition.
The small study involved 23 patients with newly-diagnosed
type 1 diabetes, a condition in which the immune system can
rapidly destroy the insulin-producing cells in the pancreas.
These stem cell transplants apparently work by ‘resetting’
the immune system so that the body stops attacking the
pancreas. The researchers themselves say that this treatment
can only be used when the condition is caught early enough
(within six weeks of diagnosis), before the pancreas has
been irreversibly damaged and before any complications from
very high blood sugar have developed.
The study provides another avenue for research, but this
treatment is still at a early stage of development and does
come with some side effects and risks.
What kind of scientific study was this? This was a
prospective case series of 23 individuals who had received
stem cell treatment to treat new onset cases of type 1
diabetes. This used follow-up data on 15 patients who were
first transplanted with stem cells in a study that was
previously published in 2007, and combined it with eight
additional recruits who joined the study up to April 2008.
The researchers were interested in the effects of the
‘autologous nonmyeloablative hematopoietic stem cell
transplantation’ (HSCT), a form of stem cell transplant
where stem cells derived from the patient’s own bone marrow
are collected from the blood. Around the same time,
chemotherapy is used to partly destroy the patient’s own
bone marrow cells. This type of stem cell transplantation is
a medical procedure most often performed for people with
diseases of the blood, bone marrow or blood cancers such as
leukaemia.
The researchers recruited 23 patients aged 13 to 31 years
(average age 18.4 years) into the study between November
2003 and April 2008. The recruits were mainly men with a
short duration of disease (average 37 days) and mostly
without previous diabetic ketoacidosis, a dangerous
complication of type 1 diabetes.
Participants had a diagnosis of type 1 diabetes confirmed
by using tests for high blood sugars and a specific antibody
that indicates autoimmune diseases such as diabetes. The
average level of this antibody was 24.9 U/mL suggesting the
presence of antibodies to the islet cells that produce
insulin in the pancreas. Average body mass index at
diagnosis was 19.7.
In this study, the researchers released stem cells from the
marrow using the drugs, cyclophosphamide and granulocyte
colony-stimulating factor. A process known as leukapheresis
was used to collect blood and then extract the white blood
cells it contained. White blood cells were harvested until
progenitor stem cells reached at least 3 million CD34 type
cells per kilogram of body weight. To partly suppress the
response of the patient’s immune system to stop is attacking
the pancreas, they were also given a course of ‘cytotoxic’
conditioning drugs.
The average time from diagnosis to mobilisation of the stem
cells from the blood was 37.7 days, and the patients’ stays
in hospital for their transplantation lasted around 19 days
on average.
The researchers measured C-peptide levels, which are
related to the number (mass) of insulin producing cells that
remain in the pancreas, with higher levels suggesting that
the pancreas is still producing its own insulin. Levels were
measured before and during a meal test at different times
following transplantation.
The researchers also aimed to record any complications
(including death) from transplantation, and any changes in
insulin injections required by the participants to maintain
their control of blood sugar.
What were the results of the study?The researchers had
follow-up data for between seven and 58 months on each of
the 23 patients who received a transplant. They found that
20 patients with no previous ketoacidosis and no use of
corticosteroids during the preparative regimen became free
of insulin and injections. Twelve patients remained
insulin-free for an average of 31 months, and eight patients
relapsed and then restarted insulin use at a low dose.
Among the 12 patients who remained free of insulin
injections, C-peptide levels had increased significantly at
24 and 36 months after transplantation compared to levels
pre-transplantation. C-peptide levels also increased in
eight patients who were only temporarily free of insulin
injections and this increase was sustained at 48 months
after the transplant.
During treatment and follow-up, two patients developed
bilateral pneumonia (on both sides of the lungs) and three
patients developed problems with endocrine function after
more than a year (mostly thyroid problems). Nine patients
became “sub-fertile” with extremely low-sperm counts. There
were no deaths.
What interpretations did the researchers draw from these
results?The researchers say that at about 30 months
following treatment, C-peptide levels increased
significantly and the majority of patients achieved insulin
independence with ‘good glycemic control’.
The researchers say that at this point in time, their
autologous nonmyeloablative HSCT treatment “remains the only
treatment capable of reversing type 1 [diabetes mellitus] in
humans."
What does the NHS Knowledge Service make of this study?
This was a non-randomised study that did not feature a
control group for comparison. As the researchers have
stated, randomised trials are necessary to confirm the role
of this new treatment in changing the natural history of
type 1 diabetes.
There are other points to note:
Of the 160 patients that volunteered for this trial only 71
were suitable, and of these suitable candidates only 23
opted to participate: the researchers say that although some
did not fulfil the strict requirements of the study, such as
recent onset of the disease, others declined to participate
once they were made aware of the potential adverse effects.
White male participants were the main recruits so the
applicability of this treatment to women and other
ethnicities will need further study. One of the criticisms
of the researcher’s previous study was that the short period
of follow-up and the lack of convincing C-peptide data,
meaning that there were alternative explanations for the
effect seen. For example, the selected patients could have
entered a phase of improved diabetic control due to close
medical monitoring and physician-directed changes in
lifestyle. The researchers claim that this recent study with
longer follow-up confirms the treatment effect of HSCT and
that the long insulin-free period (over four years one
person in this study) is unlikely to have occurred without a
true effect of the transplant. Overall, despite the small
number of patients and lack of a control group, this study
illustrates a promising approach to treating type 1diabetes
in cases where it is caught early enough and patients are
willing to accept the adverse effects of treatment.
Randomised trials to test the new treatment against current
care in a larger group of patients will help establish
whether this is truly a ‘cure for diabetes’ or simply a way
of prolonging insulin production by a few years.
The
Juvenile Diabetes Research Foundation, a leader in setting
the agenda for diabetes research worldwide and the largest
charitable funder and advocate of type 1 research, has
announced that it has launched an on-line service for people
with type 1 diabetes and their families to easily find
information about clinical trials for drugs, treatments, and
therapeutics for diabetes and its complications.
The on-line service, JDRF's Clinical Trials Connection,
will enable people to search the database of trials of the
National Institutes of Health (including JDRF-funded trials)
that involve diabetes cures and treatments to get
information, make comparisons, and - if they are interested
- directly contact trial centers. It is available at http://www.trials.jdrf.org.
Through this web site, people can provide criteria like the
type of trial they are interested in, how long they have had
diabetes, and how far they'd be willing to travel, and the
site will let them know about studies that match those
characteristics. Clinical Trials Connection can help them
search for trials, compare one trial with another, and
update them on new trials that might match their interest.
Plus, the service provides contact information for the
researchers conducting the trial, so people interested in
trials can contact them directly for more information, after
discussing options with their healthcare provider.
The quickly increasing number of clinical trials, and the
overall progress in diabetes research, make it harder for
people with diabetes to keep up-to-date on what trials are
available, and to make decisions on whether or not to
participate in a study. People tell JDRF a simple-to-use
service to find and compare trials would be a significant
benefit to them; in fact, more than 5,000 people have
pre-registered for the site.
At the same time, Clinical Trials Connection will help
advance JDRF's research agenda, which is funding more human
clinical trials than ever before, but finding it tougher and
tougher to enroll participants in a timely and
cost-efficient way.
But
what should be terrific news for the people with this
life-long autoimmune disease, is only bittersweet, as
diabetes researchers are finding it difficult to recruit
enough participants to take part in trials quickly and
cost-effectively.
Among a number of ways to promote the free service, JDRF is
focusing one of its public service announcement
advertisements on encouraging people to take part in the
search for a cure by finding out about clinical trial
opportunities. The theme of the campaign is "What does hope
look like?" The answer is that it looks like children and
adults with type 1 diabetes taking an active role in science
leading to a cure.
In type 1 diabetes, the immune systems stops a person's
pancreas from producing insulin, the hormone that enables
people to get energy from food. To survive, people with type
1 diabetes must test their blood sugar levels multiple times
per day by pricking their fingers to draw blood, and then
administering insulin through multiple daily injections, or
the use of a continuous infusion insulin pump.
While trying to balance insulin with the amount of food
eaten (which raises blood sugar) and exercise (which lowers
blood sugar), people with type 1 diabetes must constantly be
prepared for potential life-threatening low or high blood
sugar levels. Just as devastating, the long-term
complications of diabetes include blindness, heart attack,
kidney failure, stroke, nerve damage and amputations. While
usually diagnosed in childhood, type 1 diabetes can also be
diagnosed in adults.
Long
known for its antioxidants, immune boosting and, most
recently, antihypertensive properties, black tea could
have another health benefit. Black tea may be used to
control diabetes, according to a study in the Journal of
Food Science, published by the Institute of Food
Technologists.
Next to water, tea is the second most consumed beverage in
the world. Researchers from the Tianjin Key Laboratory in
China studied the polysaccharide levels of green, oolong and
black teas and whether they could be used to treat diabetes.
Polysaccharides, a type of carbohydrate that includes starch
and cellulose, may benefit people with diabetes because they
help retard absorption of glucose.
The researchers found that of the three teas, the
polysaccharides in black tea had the most glucose-inhibiting
properties. The black tea polysaccharides also showed the
highest scavenging effect on free radicals, which are
involved in the onset of diseases such as cancer and
rheumatoid arthritis.
“Many efforts have been made to search for effective
glucose inhibitors from natural materials,” says lead
researcher Haixia Chen. “There is a potential for
exploitation of black tea polysaccharide in managing
diabetes.”
A
drug used to remove iron from the body has the potential to
fight the problem of diabetes-related poor wound healing,
according to researchers from Stanford University School of
Medicine and the Albert Einstein College of
Medicine.
Poor wound healing is diabetes' cruellest complications,
which could lead to amputation of patients' toes, feet, and
even legs.
The drug, deferoxamine, helped diabetic mice heal small
cuts 10 days faster than those who did not receive
treatment, said the researchers.
''The team is now working to arrange human trials for
deferoxamine.
And the findings could help doctors combat such diabetic
complications as foot ulcers, an unmet medical need of
gigantic proportions," said Dr. Geoffrey Gurtner.
The researchers have attributed poor wound healing among
diabetes patients to the fact that diabetic tissue fails to
reconnect oxygen-deprived areas to the bloodstream with new
vessels.
The poorest people in the
UK are more than twice as likely to have diabetes at any age
than the average person, a charity has warned.
And those with the condition who live in the most deprived
homes are also twice as likely to develop complications,
Diabetes UK said.
Obesity, lack of exercise, poor diet and smoking are to
blame, it added.
One public health expert said efforts to prevent and treat
the disease should be targeted at the most vulnerable.
As of 2008, there were 2.5 million people diagnosed with
diabetes in the UK.
Numbers have been climbing in recent years due to increased
efforts to find people who were unaware they had the
condition.
It has been predicted that by 2025, there will be more than
four million people with diabetes in the UK.
The most common type is type 2 diabetes, which is generally
associated with lifestyle factors, such as being overweight.
It is caused by the body not producing enough insulin or
when the insulin that is produced does not work properly.
If not managed effectively it can lead to complications
such as heart disease, stroke, kidney failure, blindness and
amputation.
Deprivation
The report also found that women in England who live in
homes with the lowest income are more than four times as
likely to get diabetes as those who live in homes with the
highest income.
And diabetes in Wales is almost twice as high in the most
deprived areas compared to the least deprived.
Douglas Smallwood, Diabetes UK chief executive, said action
is needed to prevent a generation of people living in
deprivation "ending up in an early grave".
He said health authorities needed to raise awareness among
those at high risk.
"In addition, the NHS must ensure that appropriate, high
quality care is available across the country and that
everyone, regardless of their socioeconomic status, is
accessing it.
"Research has shown that people with diabetes in deprived
or high ethnicity areas are less likely to have key health
checks, putting them at increased risk of developing
devastating complications such as heart disease, stroke,
kidney failure, blindness and amputation.
"Finally, in these times of economic uncertainty when
people are more likely to turn to cheaper, processed foods,
food labelling must be clear and consistent to allow people
to make informed choices about what they are eating."
Professor Alan Maryon-Davis, president of the UK Faculty of
Public Health, said the figures were not surprising as the
risk factors for diabetes were very closely associated with
deprivation and hard to tackle.
"We do need to target efforts at the most vulnerable."
He added that the national vascular screening programme
which started in April and is still gearing up would help
diagnose people and help them manage the illness.
"But we need to set up a proper call and recall system, we
can't just wait for people to go to the GP, it has to be
done in a more active way."
Researchers
are hoping that cells from pigs from a remote group of
islands 300 miles from New Zealand could lead to a new
treatment for Type 1 diabetes.
Some of the pigs have been moved from the islands to
mainland New Zealand, where they are being kept in fully
enclosed sterile housing. The scientists are trialling the
cell transplantation technique on a small group of people
with unstable Type 1 diabetes in the hope of stimulating
insulin production in their pancreases.
Professor Bob Elliott who is running the trial has
undertaken two similar studies in the past, one in 1995 and
one in 2007. He says one volunteer from the first study
continued producing insulin 12 years after transplantation -
"proof of principle that this can work," he claims.
Dr Iain Frame, Research Director at Diabetes UK, said:
"Research into pig cell transplantation has been going on
for several years, and is an exciting area of investigation.
"However, two previous trials in 1995 and 2007 used only 15
volunteers and this small study will be carried out in just
eight people in the first instance. It really is far too
early to assume that this research will produce a real and
lasting benefit to people with Type 1 diabetes in the near
future. We will, however, be watching the progress of this
area of research with great interest."
Designed
to boost the immune system and promote health, probiotics
are gaining popularity at the grocery, and
Nevella® with Probiotics, made by Heartland Sweeteners, is
the first and only such sweetener currently on the market.
Diabetes educators will get an early preview of Nevella®
with Probiotics at their annual conference in Atlanta in
early August, immediately prior to widespread availability
across the country.
"We wanted to give Diabetes Educators a first look at
Nevella® with Probiotics, since people with diabetes know
the importance of maintaining a healthy weight and
controlling blood sugar, and no-calorie sweeteners can help
with that," said Mike Servie, President of Heartland
Sweeteners. "Probiotics also show promise for enhancing the
immune system, which is important for those with type 1
diabetes."
Unlike other foods enhanced with probiotics, the
GanedenBC30® probiotic used in Nevella® is shelf stable, and
survives the digestive process to arrive in your gut where
you need it. A single sachet of Nevella with Probiotics
delivers greater efficacy than most other probiotics,
including a cup of yogurt. Ganeden BC30 withstands baking
temperatures better than other probiotics, so now consumers
can add probiotic benefits to their favorite baked goods.
Compared
with patients with moderately controlled glucose levels,
diabetic patients who have heart failure and either
too high or too low glucose levels may be at increased risk
of death, said researchers at Baylor College of Medicine in
a report published in the current issue of Journal of the
American College of Cardiology.
To determine average glucose levels in the blood over a two
to three month period, doctors measure glycosylated
hemoglobin (the oxygen-carrying protein in the blood that is
bound to the sugar glucose). In general, higher levels have
been associated with increased risk of heart disease, said
Dr. David Aguilar, assistant professor of medicine -
cardiology at BCM.
"Most doctors try to keep glucose levels of those with
diabetes as low as they can to lower the risk of
complications such as eye problems, kidney disease or the
development of heart disease," said Aguilar, senior author
of the study. "However, we found that in diabetic patients
with heart failure, glucose levels slightly higher than what
are normally recommended had the lowest risk of death."
Researchers at BCM and the Michael E. DeBakey Veterans
Affairs Medical Center in Houston identified 5,815 veterans
with heart failure and diabetes who were receiving treatment
at VA medical centers across the nation. They followed the
patients for two years, dividing them into five categories
based on their glycosylated hemoglobin levels.
Most medical professionals recommend levels at 7 and below
as the target for optimal health for diabetic patients.
However, the results of the study of diabetic patients with
heart failure showed that those with levels 7.1 to 7.8 had
the lowest rate of death. Those patients at both ends of the
spectrum had the higher death risks.
"This
doesn't mean that diabetic patients with heart failure
should change their target goal for glucose levels," Aguilar
said. "The results could simply be telling us that the
glycosylated hemoglobin levels are a marker for other risks
that are contributing to increased risk of death, but not
necessarily the cause of the problem."
Aguilar said the correlation needs to be further
investigated to confirm the findings and see what other
factors could be contributing to the mortality rate.
The research is supported by a V.A. Health Services
Research and Development Service grants and a National
Institutes of Health Mentored Career Development Award.
Other researchers who took part in this study include, Drs.
Biykem Bozkurt, Kumudha Ramasubbu and Anita Deswal, all from
the Winters Center for Heart Failure Research and Section of
Cardiology, and the Department of Medicine at BCM. Deswal is
also at the Houston Center for Quality of Care and
Utilization Studies at the Michael E. DeBakey V. A. Medical
Center in Houston.
A
new blood glucose monitor, unveiled today, connects directly
to Nintendo DST and Nintendo DST Lite gaming systems and was
designed specifically for children with diabetes.
The Didget meter aims to encourage children to build good
blood glucose testing habits by awarding points that
children can use to unlock new game levels and customise
their gaming experience.
A welcome innovation
"For many people with Type 1 diabetes, particularly
children, having to do finger prick testing and inject
insulin several times a day is an unpleasant but vital part
of good diabetes management," said Pav Kalsi, Care Advisor
at Diabetes UK.
"Diabetes is a serious condition and can lead to long-term
complications such as heart disease, kidney failure and
blindness if not effectively managed.
"Any safe and effective innovation which could encourage
children to develop good testing habits now and for the rest
of their lives is welcomed."
Broadcasting
legend Larry King turns the tables to talk about himself in
his new autobiography, "My Remarkable Journey," but doesn't
mention the chronic disease he's lived with for nearly
fifteen years: type 2 diabetes. In an interview with
Diabetes Forecast, the consumer magazine of the American
Diabetes Association, King discusses his diabetes publicly
for the first time, and explains how his health, lifestyle,
and personality influence one another.
King suffered a heart attack and underwent bypass surgery in
1987, which inspired him to stop smoking and start a
healthier routine. So when he was diagnosed with diabetes in
the mid-1990s, it was a surprise. "I was already exercising.
I was pretty much watching my diet," he says, "So I kind of
took it as, 'Now? Now I get diabetes?'" Although there was a
history of diabetes in his family, it wasn't something he'd
thought much about. His aunt lived with the disease, but
because she never actually looked sick, King says, "Diabetes
was just a word to me."
Now, however, it is an integrated part of his life, and
something he deals with every day. In Diabetes Forecast, he
talks about the time he experienced hypoglycemia when he was
on the air, interviewing Betty Ford. "She asked me if I was
OK," he says. "I guess I got a little pale... I thought I
was going to faint." As someone who leads a busy life with a
great deal of stress, King has had to learn how to
incorporate his disease management into the fast pace of his
life. "The one thing you can't change is a Type A
personality," he says.
So why hasn't the famous talker talked about his diabetes
before now? "When I do a show, I don't use the word 'I,'"
says King. "My show is about the guests." But as the guest
of Diabetes Forecast, King shares a great deal of himself;
his health, his attitude about what he does, and even his
interest in stand-up comedy.
Also in the August 2009 issue of Diabetes Forecast.
Going to college is a big transition for everyone, but it's
an especially significant step for teens with diabetes. A
feature story in this issue provides tips and advice from
experts and stories from college students with diabetes.
"Having diabetes is almost like adding another course to
your schedule," says Lori Laffel, MD. But with good planning
-- and by reaching out to others on campus -- diabetes
doesn't have to keep you from enjoying all that college has
to offer.
Every
30 seconds a person somewhere in the world loses a lower
limb to amputation due to diabetic foot disease.
In Australia about 275 people develop diabetes type-2 every
day, and so the work of a team of mathematicians at QUT
holds hope for the healing of these debilitating wounds that
plague people with diabetes.
A QUT-led team of international researchers from the
Institute of Health and Biomedical innovation at Kelvin
Grove has modelled the use of hyperbaric oxygen therapy (HBOT),
which is the intermittent exposure of the body to pure
oxygen under pressure, to heal the chronic wounds that lead
to the need for amputation.
QUT mathematician Jennifer Flegg said a small cut on the
foot of a diabetic could have catastrophic effects because
their wounds did not heal the same way as normal wounds
because of many factors including reduced blood flow.
"The investigation showed that HBOT applied intermittently
under pressure to a diabetic wound speeds up its healing,"
Mrs Flegg said.
"Our modelling showed firstly that only HBOT, and not
oxygen applied with no extra pressure, stimulates healing of
these chronic wounds.
"We
also found that HBOT must be continued until the wound has
completely healed in order for it to be effective.
"However, we found that individual wounds need to be
treated differently.
"Each patient has different healing capacities with HBOT
and so our modelling shows that there should be a research
focus on individual treatment protocols in order to optimize
the outcome for each patient."
An article on these findings by Mrs Flegg, Professor Ian
Turner and Emeritus Professor Sean McElwain from QUT and
Professor Helen Byrne from the Centre for Mathematical
Medicine and Biology at the University of Nottingham will be
published in the Public Library of Science (PLoS):
Computational Biology, the top-ranked journal in the field
of mathematical and computational biology.
It is a peer-reviewed, open-access journal focusing on
research of exceptional significance that furthers our
understanding of living systems through the application of
computational methods.
A team of Canadian
scientists have discovered that naringenin, a flavonoid
found in citrus fruit, and especially grapefruit, makes the
liver burn fat instead of storing it after a meal. (This
chemical compound also gives grapefruit its bitter taste.)
Potentially, without having to change diets or cut out
particular foods, a dose of naringenin could prevent weight
gain and even help to lose it.
Two groups of mice were both fed the equivalent of a
Western diet to speed up their "metabolic syndrome" - the
process which leads to Type 2 diabetes in humans.
'Reprogrammed' liver
The food given to one of the groups was treated with
naringenin. The non-naringenin mice became obese and
developed the metabolic syndrome which saw their cholesterol
rise and their bodies become resistant to insulin.
The mice given naringenin, however, had none of these
problems. Any rise in cholesterol was corrected by the
naringenin which also 'reprogrammed' the liver to burn up
fat rather than store it.
In the long-term the Canadian team behind the tests believe
the compound could help fight diabetes because the process
also helped balance insulin and glucose levels.
"What was unique about the study was that the effects were
independent of caloric intake, meaning the mice ate exactly
the same amount of food and the same amount of fat,"
explained lead researcher Professor Murray Huff.
"There was no suppression of appetite or decreased food
intake, which are often the basis of strategies to reduce
weight gain and its metabolic consequences," he said.
Safe supplement needed
However, Diabetes Research Manager Victoria King warned:
"The results of these experiments carried out in mice
involve much higher doses of naringenin than those found
naturally in grapefruit.
"A concentrated and safe supplement would therefore need to
be developed for humans before it could even be shown that
these effects seen in mice are reproducible in humans and
that they are applicable to the treatment of Type 2
diabetes.
"Simple lifestyle changes such as maintaining a healthy
weight, eating a balanced diet and being more physically
active can help to reduce your risk of developing Type 2
diabetes and can also help people diagnosed with the
condition to manage it more effectively."
The International Diabetes
Federation (IDF), the International Union Against Cancer (UICC)
and the World Heart Federation (WHF) havecalled on the UN's
Economic and Social Council (ECOSOC) to take immediate
action to avert the fastest growing threat by
non-communicable diseases (NCDs) to global health.
NCDs which include cardiovascular disease, diabetes, cancer
and chronic respiratory disease, cause 60% of all deaths
globally and 80% of these are in low- and middle-income
countries. WHO projects that globally NCD deaths will
increase by 17% over the next 10 years. The greatest
increase will be seen in the African region (27%) and the
Eastern Mediterranean region (25%). The highest absolute
number of deaths will occur in the W. Pacific and S.E. Asia
regions.
The global call, issued by the three organizations at the
meeting of the UN ECOSOC in Geneva, demands five essential
actions:
1. Call for an 'MDG Plus' containing NCD progress
indicators in the 2010 Millennium Development Goals (MDGs)
review
2. Support the availability of essential medicines for
people living with NCDs
3. Support a UN General Assembly Special Session on NCDs
4. Support the immediate and substantial increase of
funding for NCDs
5. . Integrate NCD prevention into national health
systems and the global development agenda
The UN MDGs state that health is critical to the economic,
political and social development of all countries, yet they
contain no goals or targets for NCDs, which are the largest
threat to health systems.
Public health experts are expecting ECOSOC leaders to show
the way in confronting this health crisis faced by millions.
The emerging epidemic of NCDs is threatening to overwhelm
healthcare systems worldwide unless action is taken.
"This tsunami didn't arise yesterday; it evolved over time
and is getting worse. We need a revolution to change the
trajectory if we are serious," stated Dr Leslie Ramsammy,
Minister of Health, Guyana at this morning's WHO Ministerial
breakfast meeting. The World Economic Forum's 2009 Global
Risks report supports this with evidence that the incidence
of chronic disease is rising across both the developed and
developing world. Medical advances and awareness can reduce
the risk severity but chronic non-communicable diseases are
still the main cause of death worldwide.
Evidence shows that up to 80% of NCDs can be prevented by
addressing risk factors like unhealthy diet, physical
inactivity and tobacco use and those that are
non-preventable can be treated inexpensively with essential
medicines. While medicines such as aspirin, penicillin,
insulin and morphine have been on the Essential Medicines
List for years, they still remain beyond the reach of many.
The three NGOs request that the final declaration of the
ECOSOC High Level Segment include a call for NCD indicators
to be included in the 2010 review of the MDGs to form an 'MDG
Plus', as this fast emerging global threat has not, to date,
been addressed.
The three organizations together represent 730 member
organizations in over 170 countries and vast networks of
health care professionals, patient, and civil society
organizations. They have joined forces to create a powerful
voice for change and urge ECOSOC to take action in the face
of the NCD epidemic.
A new treatment for Type 2
diabetes has hit the headlines. Liraglutide (Victoza), a
once-daily injectable treatment
for Type 2 diabetes, is pharmaceutical company Novo
Nordisk's latest brain child.
From the Glucoagon-like peptide-1 (GLP-1) family of drugs,
it can be taken any time of day, irrespective of meals. It
helps to control Type 2 diabetes by stimulating the release
of insulin when blood glucose levels are too high.
In addition, makers claim liraglutide aids weight loss by
making you feel more full and delaying the rate at which
your stomach empties. Studies have also shown that the drug
can reduce blood pressure and improve the function of beta
cells - the cells that produce insulin in the pancreas.
Cathy Moulton, Care Advisor at leading health charity
Diabetes UK, said: "Liraglutide widens the choice of
treatments for people with Type 2 diabetes that not only
offer improved blood glucose control but also aid weight
loss. In addition, research has shown that this treatment
has a positive effect on blood pressure levels.
"Diabetes UK welcomes safe and effective treatments that
give people with diabetes choice in how to best manage their
condition. In addition to any prescribed medication, people
with diabetes should eat a healthy balanced diet and do
regular physical activity. Good diabetes management reduces
the risk of developing serious complications including heart
disease, stroke, kidney failure, blindness and amputation."
The Scottish Government
has launched Better Diabetes Care - a consultation to
improve diabetes care over the next three years - and
Diabetes UK Scotland is encouraging everyone affected by
diabetes to take part.
Diabetes UK Scotland is consulting widely and is talking
and listening to people affected by diabetes about their
experiences of diabetes care and their priorities for the
future.
Take
part in our survey and meetings
Diabetes UK Scotland is taking a lead in the consultation
process. You can use our online survey form, and we are
holding meetings across the country to encourage people
living with diabetes to respond to the consultation.
Upcoming
meetings
Lanarkshire - 5 August, Wishaw.
Responding
to the challenges of diabetes
"Diabetes is changing in Scotland," said Jane-Claire
Judson, Director of Diabetes UK Scotland.
"Increasing numbers of people are being diagnosed earlier
in life; this means that getting it right at diagnosis or
when complications develop will become ever more important.
"Since 2002, Scotland has responded to the challenges of
diabetes through, first, the Scottish Diabetes Framework and
then the Diabetes Action Plan. Better Diabetes Care is an
opportunity to bring this work fully up to date. Diabetes UK
Scotland will be consulting widely across Scotland about the
direction that diabetes services should take in Scotland."
The
next step
The results of the consultation process will be fed in to
the development of a new action plan for diabetes in
Scotland.
University
of Minnesota Medical School researcher Michael Mauer, M.D.,
has found a treatment that significantly slows the
progression of eye injury in people with type 1 diabetes, a
common complication caused by this disease. By administering
an antihypertensive, medication commonly prescribed to treat
high blood pressure, Mauer and colleagues
were
able to slow progression of diabetic eye damage in more than
65 percent of participants involved in the study.
Diabetes is the primary cause of acquired blindness in
adults and accounts for nearly half of all new cases of
chronic kidney failure in the Unites States each year, and
people living with the disease often struggle with these
complications as it progresses. Previous studies of people
with type 1 diabetes who were already exhibiting symptoms of
vision and kidney function loss showed that these types of
antihypertensive medications slowed further function loss in
the kidneys, but often could not prevent kidney failure.
Mauer and colleagues were interested in testing whether or
not they could delay diabetic kidney injury in participants
who had normal blood pressure and had not yet shown signs of
kidney disease at the beginning of the study.
Three groups of participants were observed over the course
of five years. Two groups were administered one of two
antihypertensive medications, losartan or enalapril, and the
last group, a placebo. The results were unexpected, but
conclusive. Mauer's study demonstrated that these drugs did
not protect the participants' kidneys from damage or from
losing function. However, participants who were administered
either enalapril or losartan experienced a significant
slowing of the progression of diabetic eye injury, by 65 and
70 percent, respectively.
"The
secondary results of this study showed that people taking
these antihypertensive medications experienced a
substantially positive effect in slowing diabetic eye
injury," said Mauer, professor of pediatrics and medicine in
the Medical School. "Although neither medication delayed
early kidney tissue injury or early loss of kidney function,
the advantage to a study with negative findings such as this
one is that physicians now know that this treatment is
ineffective for this purpose, and they can pursue other
treatment options that may improve their patients'
outcomes."
Although the data does not support the use of these types
of antihypertensives to prevent kidney damage in people
living with diabetes, Mauer and colleagues find it
reasonable for physicians to consider prescribing these
classes of medication to people with type 1 diabetes in
order to slow the onset and progression of diabetic eye
disease. He notes, though, that this also poses several
other unanswered questions such as at what age a person with
diabetes should be prescribed this class of drug and how
long they should continue taking it.
Mauer's study "Renal and Retinal Effects of Enalapril and
Losartan in Type 1 Diabetes" is published in the July 2nd
issue of The New England Journal of Medicine. An editorial
accompanies the article.
The study was supported by research grants from the
National Institutes of Health (National Institute of
Diabetes and Digestive and Kidney Diseases), Merck (in the
United States), Merck Frosst (in Canada), and the Canadian
Institutes of Health Research.
More than 2.2 million
people in Britain suffer from type 2 diabetes, a chronic
progressive disease which usually affects the over 40s. The
number of people diagnosed with the disease has increased
dramatically in recent years and this has been linked to the
increase in sedentary lifestyles and obesity.
Caught early enough, lifestyle changes that promote good
blood sugar control may be enough to stop the
development of diabetic complications, which can potentially
be as serious as blindness and heart disease. However
maintaining these changes can be challenging
Traditional acupuncture, which has been shown by research
to be effective in alleviating diabetic symptoms, can be
easily implemented into a person's routine and can form an
effective part of an overall diabetes management plan.
Because type 2 diabetes starts out with mild symptoms, many
people (estimated at up to a million in the UK) have the
condition without knowing it. The first noticeable symptoms
are typically constant thirst, needing to urinate
frequently, tiredness and weight loss.
Type 2 diabetes is a
metabolic disorder, which develops when the body can no
longer make enough insulin (the hormone that regulates blood
sugar) or when the insulin that is produced does not work
properly any more (insulin resistance). Although insulin
injections may be needed in the later stages of the disease,
it is initially treated by diet and lifestyle modifications
or by oral drugs.
Acupuncture, which involves inserting fine needles into
different parts of the body, has been found to increase
insulin production, regulate blood sugar and improve blood
circulation, as well as helping treat obesity.
Lisa Sherman, acupuncturist and British Acupuncture
Council member says: "Acupuncture can be safely and
effectively combined with Western medicine and can play an
effective role in an integrated diabetes treatment plan.
"As well as applying the technique of needling, which has
been demonstrated to have beneficial effects on blood sugar
control, an acupuncturist will often suggest beneficial
lifestyle changes such as changing to a healthier diet,
losing weight and increasing physical activity. Maintaining
these changes is important; to prevent type 2 diabetes from
getting worse and working with a supportive acupuncturist
can help people commit to taking positive steps.
"The
main aim of treatment for type 2 diabetes is to achieve
blood glucose, blood pressure and cholesterol levels as near
to normal as possible. This prevents development of diabetic
complications which damage the eyes, kidneys, nerves, heart
and blood vessels," she concluded.
Acupuncture is a tried and tested system of traditional
medicine, which has been used in China and other eastern
cultures for thousands of years to restore, promote and
maintain good health. It aims to treat the root cause of a
condition and promote long-term wellness, rather than just
alleviating symptoms. Its benefits are now widely
acknowledged all over the world and, in the past decade,
traditional
acupuncture has begun to feature more prominently in
mainstream healthcare in the UK.
*There are two types of diabetes, of which type 2 makes up
about 90%. Type 1 diabetes is an autoimmune disease,
typically diagnosed in young people, in which the immune
system destroys the insulin-producing cells in the pancreas.
About the BAcC
The British Acupuncture Council (BAcC) has a membership of
over 2,800 professionally qualified acupuncturists. It is
the UK's largest professional body for the practice of
acupuncture. BAcC members practise a traditional, holistic
style of acupuncture diagnosis and treatment based on a
system developed and refined over 2,000 years. To achieve
BAcC membership, practitioners must first undertake
extensive training in traditional acupuncture (minimum three
years full-time or part-time equivalent), which includes
physiology, anatomy and other biomedical sciences
appropriate to the practice of acupuncture.
Traditional acupuncture
Traditional acupuncture is a complete system of medicine,
which uses a holistic Eastern diagnostic system. Traditional
acupuncture promotes the maintenance of good health and
wellbeing, rather than just dealing with symptoms. Western
or medical acupuncture is a more recent development
practised predominantly by doctors and physiotherapists, who
use acupuncture techniques within their existing scope of
practice on the basis of a western medical diagnosis.
heart disease.
“This
research, therefore, should on no account be taken as a
reason for those over 60 at high risk of heart disease to
stop taking statins." 
and lack of exercise.
the International Diabetes Federation (IDF) and the World
Health Organisation (WHO) in response to concern over the
rise of diabetes globally..jpg)
first mobile diabetes unit (MDU) in India at a glittering
function held at Verna on Sunday 25th October
2009.
charity’s international patron, Indian superstar Amitabh
Bachchan.
"Cholesterol
is transported through the blood attached to lipoproteins
such as LDL, the 'bad' cholesterol," Bernal-Mizrachi
explains. "As it is stimulated by oxygen radicals in the
vessel wall, LDL becomes oxidated, and macrophages eat it
uncontrollably. LDL cholesterol then clogs the macrophages,
and that's how atherosclerosis begins."
threatening
side-effects. Health Editor Madeleine Brindley spoke to Sara
Griffiths, who knows from bitter experience the consequences
of ignoring diabetes
to help raise awareness and dispel myths about diabetes
amongst the South Asian community.
The
research by Skelton and colleagues is the first of its kind
to use the new classification and detail the severity of the
problem. They found that the prevalence of severe obesity
tripled (from 0.8 percent to 3.8 percent) in the period from
1976-80 to 1999-2004. Based on the data, there are 2.7
million children in the U.S. who are considered severely
obese.
But
what should be terrific news for the people with this
life-long autoimmune disease, is only bittersweet, as
diabetes researchers are finding it difficult to recruit
enough participants to take part in trials quickly and
cost-effectively.
have another health benefit. Black tea may be used to
control diabetes, according to a study in the Journal of
Food Science, published by the Institute of Food
Technologists.
Nevella® with Probiotics, made by Heartland Sweeteners, is
the first and only such sweetener currently on the market.
Diabetes educators will get an early preview of Nevella®
with Probiotics at their annual conference in Atlanta in
early August, immediately prior to widespread availability
across the country.
too high or too low glucose levels may be at increased risk
of death, said researchers at Baylor College of Medicine in
a report published in the current issue of Journal of the
American College of Cardiology.
"We
also found that HBOT must be continued until the wound has
completely healed in order for it to be effective.
gain and even help to lose it.
for Type 2 diabetes, is pharmaceutical company Novo
Nordisk's latest brain child.
were
able to slow progression of diabetic eye damage in more than
65 percent of participants involved in the study.
"The
secondary results of this study showed that people taking
these antihypertensive medications experienced a
substantially positive effect in slowing diabetic eye
injury," said Mauer, professor of pediatrics and medicine in
the Medical School. "Although neither medication delayed
early kidney tissue injury or early loss of kidney function,
the advantage to a study with negative findings such as this
one is that physicians now know that this treatment is
ineffective for this purpose, and they can pursue other
treatment options that may improve their patients'
outcomes."
"The
main aim of treatment for type 2 diabetes is to achieve
blood glucose, blood pressure and cholesterol levels as near
to normal as possible. This prevents development of diabetic
complications which damage the eyes, kidneys, nerves, heart
and blood vessels," she concluded.