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With 88 millionAmericans or approximately 1 in every 3 adults,suffering from prediabetes in this country (and 34 million Americans, or 1 in 10, with full-blown type 2 diabetes), many people are walking around with a ticking time bomb in their bodies, and don't even know they have the condition.

Prediabetes is when your blood sugar level is higher than it should be for optimal health, butnot high enough for your doctor to diagnose the disease.It's also known asimpaired fasting glucose or glucose intolerance. The scary part is, 90 percent of those with prediabetes dont know that they have it.

We have all heard that excessive thirst or urinating more often than normal is a sign that you could have diabetes, but what are the telltale signals that you may be pre-diabetic? Why does it matter? The sooner you find out the better, for your health and to know that changing your lifestyle can alter the course of the disease and head it off at the pass.

Prediabetes, unlike diabetes, is an asymptomatic condition. The soonersomeone finds out that they are prediabetic the better, experts say, since it's possible to make lifestyle changes that can reverse your health and get you back onto a healthy path, with simple switches like eating more plant-based foods, losing a small amount of body weight, and being more active, such as walking 30 minutes a day, five days a week.

"Prevention is the best medicine!If you are given a prediabetes or diabetes diagnosisdo not despair," since you can make simple lifestyle changes (exercise, diet, and losing a small amount of weight) to reverse course on the disease, saysKellie Antinori-Lent, MSN, RN, andPresident of the Association of Diabetes Care and Education Specialists (ADCES) and diabetes clinical nurse specialist at the University of Pittsburgh Medical Center, Shadyside Hospital in Pittsburgh.

"If someone is at risk for developing prediabetes or diabetes, they should schedule an appointment with their doctor to discuss their concerns and questions. The best first place to begin is with a visit to your providerwhether in person or virtualand dont delay," says Antinori-Lent. Prevention is the best medicine!If you are given a prediabetes or diabetes diagnosisdo not despair!" There are simple things you can do to dial back the condition such as exercise 30 minutes a day, lose 7 to 10 percent of your body weight, and eat a mostly whole-food, plant-based diet, high in fiber and low in added sugars and chemicals.

How do you know if you have diabetes or prediabetes? We asked Antinori-Lent,who makes it her life's work to educate people about the changes they can make to ensure their future health, and here is what she had to tell us:

Kellie: That is a really good question, however, prediabetes does not have symptoms. There is a physical sign of insulin resistance, which is associated with prediabetes. This sign is darkened skin in areas such as the neck, under the arms, and elbows. Some people mistake it as an area of skin they didn't wash wellbut you cannot wash acanthosis nigricans (the name of the dark skin areas). Instead, there are risk factors. These include:

Keep in mind that prediabetes can develop into type 2 diabetes if left untreated. People can prevent this from happening by evaluating their lifestyle habits, including changing their diet, increasing their exercise and activity levels and seeing their doctor regularly, and working withhim or her to prevent the progression.

Originally posted here:
Could You Be Prediabetic or Diabetic and Not Know It? The Signs - The Beet

Type 2 diabetes raises your odds of developing heart disease, as does prediabetes. If youve been diagnosed with either, start paying attention to your heart health now.

You dont need to have diabetes before you get heart disease, says endocrinologist Matthew Freeby, MD, an assistant clinical professor of medicine and director of the Gonda Diabetes Center at David Geffen UCLA School of Medicine. We know theres a higher risk of heart disease in people with prediabetes.

Prediabetes occurs when your body can no longer keep your blood sugar level within a normal range. Unchecked, over time it may rise high enough to warrant a diagnosis of diabetes. Elevated blood sugar, in both prediabetes and diabetes, can harm your blood vessels and the nerves that keep your heart and blood vessels functioning properly. Over time, this can cause heart disease.

But, says Freeby, thats only part of the picture. Most people diagnosed with prediabetes or diabetes also have other conditions that threaten the heart: high blood pressure, high cholesterol, and obesity. Such health problems, collectively known as metabolic syndrome, boost the likelihood of blood clots as well as damage to the arteries in your heart.

Managing the risk of heart attack and stroke is less about managing diabetes than it is about reducing the risk factors that go along with diabetes, says Freeby.

Both diabetes and heart disease may lead to heart failure, which may weaken your heart so it cant function properly. Its one of the earliest, most serious, and most common heart problems in diabetes. Diabetes often worsens heart failure, while heart failure can complicate your diabetes treatment.

We only have so many tools at hand for lowering your blood sugars, and some of these are medications that should not be used if you have heart failure, says Freeby.

Fortunately, you have your own tools to protect your heart. Reduce your risks of heart disease -- and diabetes if you have prediabetes -- by modifying your lifestyle in ways that will improve your overall health. It may not be easy, but you dont have to make dramatic changes overnight. Some areas to focus on:

Slim down. Excess weight burdens your heart. To shed pounds, start with small, attainable goals. You dont need to set a lofty goal for weight loss says Freeby. That 5 or 10 pounds you do lose will have a big, positive effect.

Get moving. Exercise will help keep your heart healthy. Dont aim to do too much too soon or youll risk injury. Focus, instead, on simply getting started. Find an activity that you like to do that wont cause you pain and that will keep you coming back day after day, Freeby says.

Eat right. Go easy on your favorite foods, especially processed foods and simple sugar treats. Discuss your daily meals with a dietitian and understand you arent alone. Every person is different, says Freeby, but we all struggle to make dietary modifications.

Get screened. Freeby recommends regular screening for diabetes, as early diagnosis can modify the course of diabetes-related complications.

Care for yourself. To help manage diabetes risk or the disease if you have it, try relaxation techniques to reduce stress, get a good night's sleep, and maintain an active social life, says Freeby.

Find more articles, browse back issues, and read the current issue of WebMD Magazine .

SOURCES:

Matthew Freeby, MD, endocrinologist, assistant clinical professor of medicine, and director of the Gonda Diabetes Center, Los Angeles.

Cleveland Clinic: How to Protect Your Heart When You Have Prediabetes.

National Institute of Diabetes and Digestive and Kidney Diseases: Diabetes, Heart Disease, and Stroke.

National Heart, Lung, and Blood Institute: Heart Failure.

Pagination

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The Link Between Type 2 Diabetes and Heart Disease - WebMD

Its said that dogs resemble their owners, but the similarities may also extend to their risk of diabetes, research suggests. The same cannot be said of cat owners and their companions, however.

Previous studies had hinted that overweight owners tend to have porkier pets, possibly because of shared health behaviours such as overeating or not taking regular exercise. To investigate whether this extended to a shared risk of type 2 diabetes, Beatrice Kennedy, of Uppsala University in Sweden, and colleagues turned to insurance data from Swedens largest pet insurance company, using owners 10-digit national identification numbers to pull their anonymised health records.

Comparing data from 208,980 owner/dog and 123,566 owner/cat pairs, they discovered that owning a dog with diabetes was associated with a 38% increased risk of having type 2 diabetes compared with owning a healthy hound. Personal and socioeconomic circumstances of the dog owners could not explain this link. No shared risk of diabetes was found between cat owners and their pets, however. The research was published in the British Medical Journal.

As in humans, diet and obesity can influence the risk of type 2 diabetes in both types of animals. Also like humans, the prevalence of diabetes in dogs and cats appears to be on the increase.

Given the previous research on the shared risk of [being overweight] between dog owners and their animals, we believe that shared dietary habits and also physical activity levels might be involved, said Kennedy.

The absence of a shared risk between cats and their owners may also point towards physical activity being an important factor. Cats usually prefer more independence from their owners when it comes to their movements, Kennedy said.

Shared environmental exposures to things such as pollutants or chemicals between dogs and their owners could be another avenue worth exploring, she added. Because this was an observational study, the researchers could not confirm the underlying cause of the association.

However, given that it exists, a diagnosis of diabetes in any household member including canine companions could signal a need to reassess the health behaviours of the whole family unit. The diabetes of the dog could be a marker of something important going on, Kennedy said. We know that there are quite strong emotional bonds between dog owners and their dogs. Perhaps that bond extends to other health behaviours and risks.

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Dogs and owners may share resemblance in diabetes risk - The Guardian

The Week

While looking at Florida's COVID-19 death tally, the South Florida Sun Sentinel found a pattern suggesting the state "manipulated a backlog of unrecorded fatalities" so the daily death numbers were artificially low ahead of the November presidential election, the newspaper reported Tuesday.There is a lag between the date a person dies of COVID-19 in Florida and the date the state reports the death as part of the public count. The Sun Sentinel found that with just a few exceptions, starting on Oct. 24, Florida stopped including deaths that occurred more than a month earlier in daily counts. It wasn't until Nov. 17, two weeks after the election, that these backlogged deaths were consistently included in the daily tally.These deaths have "long formed a significant part of the daily totals in Florida" because it can take some time for death reports to make it from a doctor's office to the health department, the Sun Sentinel reports. For example, from Sept. 23 to Oct. 20, the state included in its daily tallies 1,128 deaths that took place at least one month earlier. This accounted for 44 percent of the deaths that were announced over those four weeks.On Oct. 21, the state said it would start conducting additional reviews of each suspected COVID-19 death in Florida before adding it to the official count. Florida Gov. Ron DeSantis (R), a supporter of President Trump, has a history of downplaying the coronavirus pandemic, and the Sun Sentinel reports he has also speculated that the death statistics in the state were inflated. The Sun Sentinel said it asked several state officials about the data patterns, including the spokesman for the Florida Department of Health, and no one would comment.Scott David Herr, a Florida computer scientist who tracks the state's daily COVID-19 data, told the Sun Sentinel "it's hard to know if there was a limitation around election time or random other things were happening. The Department of Health hasn't explained why lags have been inconsistent. When they keep changing whatever is going on behind the scenes, when the lags keep changing, that is where it gets confusing." Read more at the Sun Sentinel.More stories from theweek.com Joe Biden still doesn't get it Republicans' hedonic treadmill problem The plan to disinfect the White House before Biden moves in is a 'huge waste of time and effort,' experts say

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CDC: People with diabetes may be at risk for a more severe case of COVID-19 - Yahoo News

The notorious Freshman 15 those extra pounds college students can pack on when they first live away from home has now morphed into the Quarantine 15 during the COVID-19 pandemic. Its not surprising, as many adults are stressed, have irregular schedules and limited access to gyms, but plenty of Facetime or Zoom meetings next to snack-filled cupboards.

Today, one in three U.S. adults has prediabetes. Of those, 84% do not know they are in this danger zone because there are no clear symptoms, according to the Centers for Disease Control and Prevention (CDC). This figure is more concerning now due to COVID-delayed check-ups when people are typically reminded by their doctor to eat healthy and exercise. Since weight gain and sedentary behaviors can increase the risk for prediabetes or even progression to Type 2 diabetes, developing healthy and sustainable habits is critical to prevention.

Prediabetes can develop when a persons body is not using insulin correctly or making enough to process glucose, also known as blood sugar, properly. Insulin is a hormone produced by the pancreas that helps the body turn blood sugar into energy. If a persons blood sugar is too high for extended periods, as seen with Type 2 diabetes, it can result in long-term damage to organs, as in heart and kidney disease, as well as limb and vision loss.

Prediabetes is a precursor to Type 2 diabetes, but it can be reversed or prevented by focusing on healthier lifestyle habits. Risk factors include age, family history, obesity, poor diet and consistent inactivity. While some of these factors are uncontrollable, incorporating healthy food choices and physical activity into each day can significantly reduce the risk for prediabetes.

The CDC recommends adults get at least 150 minutes of aerobic activity each week that's less than 22 minutes per day if practiced every day. Try these tips to get moving:

Take a walk around the block every couple of hours.

Set phone reminders for daily exercise.

Turn a conference call into a walking meeting, if possible.

Use laundry detergent containers, canned goods or other household items as hand weights for exercises such as squats or lunges.

Practicemindful eating, keeping aware of yourportions. Its important to understand that it takes about 20 minutes for the brain to register signals from the stomach that its full. This often results in overeating and excessive calorie intake. Here are some ways to keep the grazing under control:

Structure snacks and meals throughout the day to prevent hunger binges.

Track food intake and read labels to monitor calories and better understand the nutritional value of items.

Dont eat out of bags portion out nuts, pretzels and crackers.

Keep healthy snacks on hand such asraw nuts, cut fruits and vegetables, hummus or a homemade Greek yogurt dip. Dipping fresh vegetables like celery or carrot sticks in such dips will provide protein along with a satisfying crunch, fiber and minerals for a lower-calorie snack.

Shanthi Appel is a registered dietitian and health and wellness spokesperson for Blue Cross Blue Shield of Michigan. For more tips on lowering your risks of diabetes, visitahealthiermichigan.org.

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Learn ways to lower your risk of developing diabetes - The Oakland Press

In a new study, experts describe how drinking water can protect against metabolic syndrome. The researchers discovered that while fructose stimulates the release of vasopressin, a hormone linked to obesity and diabetes, water can suppress the hormone and alleviate these conditions in mice.

Study lead author Dr. Miguel A. Lanaspa is an associate professor at the University of Colorado School of Medicine who specializes in renal disease and hypertension.

The clinical significance of this work is that it may encourage studies to evaluate whether simple increases in water intake may effectively mitigate obesity and metabolic syndrome, said Dr. Lanaspa.

The researchers set out to investigate why vasopressin, which maintains the bodys water levels, is elevated in people with obesity and diabetes.

In an experiment based on a mouse model, the experts fed mice sugar water specifically fructose and noticed that it stimulated the brain to make vasopressin. As a result, the vasopressin stored the water as fat, causing dehydration that triggered obesity. When the mice were treated with non-sugary water, their obesity was reduced.

According to Dr. Lanaspa, this is the first time scientists have shown how vasopressin acts on dietary sugar to cause obesity and diabetes.

We found that it does this by working through a particular vasopressin receptor known as V1b. This receptor has been known for a while but no one has really understood its function. We found that mice lacking V1b were completely protected from the effects of sugar. We also show that the administration of water can suppress vasopressin and both prevent and treat obesity.

The researchers also discovered that dehydration can stimulate the formation of fat. This explains why vasopressin is so high in desert mammals as they do not have easy access to water, noted study co-author Dr. Richard Johnson. So vasopressin conserves water by storing it as fat.

The findings support previous observations that obese patients often exhibit signs of dehydration. The research also explains why high salt diets tend to cause obesity and diabetes.

The study revealed that water therapy effectively protects against metabolic syndrome, which is a collection of coexisting conditions including high blood pressure, high blood sugar, and high triglyceride levels. Metabolic syndrome greatly increases the risk of heart disease, stroke, and type 2 diabetes.

The best way to block vasopressin is to drink water, said Dr. Lanaspa. This is hopeful because it means we may have a cheap, easy way of improving our lives and treating metabolic syndrome.

Sugar drives metabolic syndrome in part by the activation of vasopressin. Vasopressin drives fat production likely as a mechanism for storing metabolic water, concluded said Dr. Johnson. The potential roles of hydration and salt reduction in the treatment of obesity and metabolic syndrome should be considered.

The study is published in the journal JCI Insight.

By Chrissy Sexton, Earth.com Staff Writer

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Water is a powerful weapon against obesity and diabetes Earth.com - Earth.com

HIGH POINT, N.C., Dec. 15, 2020 (GLOBE NEWSWIRE) -- vTv Therapeutics Inc.(Nasdaq: VTVT) today announced that the Phase 2 Elevage study of azeliragon in people with mild Alzheimers disease and type 2 diabetes did not meet its primary objective of demonstrating an improvement in cognition as assessed by the 14-item Alzheimers Disease Assessment Scale Cognitive Subscale (ADAS-cog14) relative to placebo. The 6-month trial investigated the efficacy and safety of 5 mg azeliragon administered orally once daily compared to placebo in 43 people with mild probable Alzheimers disease and type 2 diabetes. The azeliragon treated group (n=21) had a 1.8 point decline from baseline in ADAS-cog14 compared to a placebo (n=22) decline of 0.35. These differences were not statistically significant. Consistent with previous studies, azeliragon was generally well-tolerated with similar incidences of treatment-emergent adverse events overall and by system organ class in both treatment groups.

We will continue to analyze the data to determine if there are potential benefits or future applications for azeliragon in Alzheimers, dementia or related indications that we or other interested parties may seek to pursue, said Steve Holcombe, chief executive officer, vTv Therapeutics. On behalf of vTv Therapeutics, we would like to extend our most sincere and heartfelt gratitude to study participants, their families, physicians and caregivers for their commitment to this important study despite the challenging circumstances created by the COVID-19 pandemic.

AboutvTv TherapeuticsvTv Therapeutics Inc.is a clinical-stage biopharmaceutical company focused on developing oral small molecule drug candidates. vTv has a pipeline of clinical drug candidates led by programs for the treatment of type 1 diabetes, Alzheimers and related dementia, and inflammatory disorders. vTvs development partners are pursuing additional indications in type 2 diabetes, chronic obstructive pulmonary disease (COPD), genetic mitochondrial diseases, and chronic kidney disease. For more information, please visitwww.vtvtherapeutics.comor follow us on Twitter: @vTvTherapeutics.

Forward-Looking StatementsThis release contains forward-looking statements, which involve risks and uncertainties. These forward-looking statements can be identified by the use of forward-looking terminology, including the terms anticipate, believe, could, estimate, expect, intend, may, plan, potential, predict, project, should, target, will, would and, in each case, their negative or other various or comparable terminology. All statements other than statements of historical facts contained in this release, including statements regarding the timing of our clinical trials, our strategy, future operations, future financial position, future revenue, projected costs, prospects, plans, objectives of management and expected market growth are forward-looking statements. These statements involve known and unknown risks, uncertainties and other important factors that may cause our actual results, performance or achievements to be materially different from any future results, performance or achievements expressed or implied by the forward-looking statements. Important factors that could cause our results to vary from expectations include those described under the heading Risk Factors in our Annual Report on Form 10-K and our other filings with theSEC. These forward-looking statements reflect our views with respect to future events as of the date of this release and are based on assumptions and subject to risks and uncertainties. Given these uncertainties, you should not place undue reliance on these forward-looking statements. These forward-looking statements represent our estimates and assumptions only as of the date of this release and, except as required by law, we undertake no obligation to update or review publicly any forward-looking statements, whether as a result of new information, future events or otherwise after the date of this release. We anticipate that subsequent events and developments will cause our views to change. Our forward-looking statements do not reflect the potential impact of any future acquisitions, merger, dispositions, joint ventures or investments we may undertake. We qualify all of our forward-looking statements by these cautionary statements.

Contacts

Investors:

Corey DavisLifeSci AdvisorsCDavis@LifeSciAdvisors.com

or

Media:Glenn SilverLazar FINN Partners646-871-8485gsilver@lazarpartners.com

Source: vTv Therapeutics Inc.

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vTv Therapeutics Announces Topline Results of Phase 2 Elevage Study of Azeliragon in Patients with Mild Alzheimer's Disease and Type 2 Diabetes -...

Special Report

December 15, 2020 1:02 pm

People living with diabetes are at a higher risk of developing severe COVID-19. A study published in the Lancet Diabetes & Endocrinology journal examined the medical records of 61.4 million people in the U.K. and found that 30% of COVID-19 deaths occurred in people with diabetes.

About one in 10 Americans, or 34.2 million people, live with diabetes, according to the Centers for Disease Control and Prevention data through 2018. Other findings from the data show that one in three people in the country have prediabetes, higher than normal blood sugar level, which can turn into diabetes if left untreated, and that new cases have been skyrocketing among young people.

Some of the most severe diabetes complications include ketoacidosis, which can be fatal, kidney disease, amputation, and blindness. And there is a new risk associated with the disease.24/7 Tempo reviewed multiple studies and reports by independent health organizations, such as the American Diabetes Association, and JDRF, a leading Type 1 diabetes research group, to compile a list of the 10 biggest warning signs of diabetes.

There are three types of diabetes. People with Type 1 diabetes, about 5%-10% of those with the disease, make very little or no insulin a hormone made by the pancreas that helps regulate blood sugar levels in the body by allowing cells to store the broken down sugars, or glucose (the bodys energy source). They must take insulin every day to live. People with Type 2 diabetes dont use insulin well. Their body is not capable of regulating blood sugar levels. The third type, gestational diabetes, develops in pregnant women. Blood sugar levels usually return to normal after childbirth.

Some diseases, including diabetes, have a particular odor and vague symptoms that seem completely normal daily activities like drinking coffee and eating cookies. Here are 18 ordinary habits that can be signs of serious health problems.

Click here to read about the 10 warning signs you may have diabetes.

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10 Warning Signs That You Might Have Diabetes - 24/7 Wall St.

The proportion of adults with diagnosed diabetes trebled in England between 1994 and 2019, according to latest research.

The findings, which relate to both type 1 and type 2 diabetes, are based on analysis of the latest results from the Health Survey for England 2019, which is commissioned by NHS Digital.

Covid-19 has rightly prompted greater focus on obesity reduction, which will also help with the problem of rising diabetes

Jenny Mindell

Researchers from University College London and the National Centre for Social Research analysed data from over 8,200 adults and 2,000 children living in private households in England

Their report shows the percentage of people who have been diagnosed with diabetes has risen since 1994, from 3% to 9% among men and from 2% to 6% among women.

They found total diabetes including both diagnosed cases and those found by the survey to have undiagnosed diabetes was much more common among people with lower incomes and obesity.

For example, 16% of people in the lowest income group had diabetes but only 7% in the highest income group.

Meanwhile, the proportion of adults with total diabetes increased from 5% of those with normal weight to 9% of adults with overweight and 15% of adults with obesity.

Additionally, the report highlighted that adults living in the most deprived areas were the most likely to be obese.

The difference was particularly pronounced for women, where 39% in the most deprived areas were obese, compared with 22% in the least deprived areas.

Professor Jenny Mindell, co-editor of the report, said: We have known for a long time that diabetes increases the risks of developing circulatory diseases and cancers.

We have seen this year that it also increases the risks of serious infection and death in people infected with Covid-19. Diabetes is much more common in people with obesity.

The Covid-19 pandemic has rightly prompted greater focus on obesity reduction, which will also help with the problem of rising diabetes, she added.

For the first time, the annual survey also asked about GP consultations, revealing that 69% of men and 82% of women had consulted a GP in the previous 12 months.

In addition, 84% of respondents had consulted their GP solely for a physical health problem, 5% for a mental health, nervous or emotional problem and 11% for both types of problem in the last 12 months.

Women were more likely than men to have discussed a mental health problem with their GP and to use counselling or therapy services for a mental health problem.

Consultations for mental health problems were more common among those from lower incomes 25% of adults in the lowest income group had one in the last year compared with 15% in the highest.

More here:
Data shows diabetes levels in England have trebled in 25 years - Nursing Times

Compared with White people, those who are Black have higher cardiovascular risk when early-onset type 2 diabetes (T2D) develops, according to the results of a study published in Diabetes Care.

Studies have shown an increase in the incidence of early-onset T2D diagnosis and a greater risk for T2D among Black people when compared with White people, but the evaluation of ethnicity-specific temporal trends of early-onset T2D diagnosis and the impact of comorbidities at the time of diagnosis had not yet been conducted.

To investigate and compare the trends in early-onset T2D diagnosis of Black and White people as well as the trends of various risk factors at the time of T2D diagnosis, data from 606,440 individuals aged 18 to 70 years who were diagnosed with T2D between 2000 and 2018 were analyzed. Atherosclerotic cardiovascular disease (ASCVD) was defined by the presence of a clinical diagnosis of ischemic heart disease.

Over the past 2 decades, the rate of T2D diagnosis among Black patients within the age groups 18 to 39 and 40 to49 years has consistently been higher than that of their White counterparts (P <.01). The proportion of both Black and White patients diagnosed with T2D before 50 years of age increased significantly from 2012 to 2018 (P <.05).

Black patients had significantly higher mean hemoglobin A1c (HbA1c) than White patients across all age groups. Although no difference was seen in other age groups, Black patients 18 to 39 years of age had significantly higher body mass index (BMI) than their White counterparts (P =.02).

MACE-3 refers to 3-point major adverse cardiovascular events heart failure, myocardial infarction, or stroke. Black patients had a significantly higher risk for MACE-3 compared with White patients across all age groups, with the youngest age group having the highest relative risk (hazard ratio [HR], 1.63; 95% CI, 1.42-1.88) and the lowest relative risk observed in the oldest age group (HR, 1.11; 95% CI, 1.06-1.15).

Taken as a whole, the results of this study illustrated the increasing burden of early-onset T2D and the increased risk of MACE-3 for Black patients. Understanding the trends in diagnosis of early-onset T2D and the differences in the prevalence of related comorbidities among people of different ethnicities may improve healthcare practitioners ability to detect and manage this disease.

Limitations of this study include the use of electronic medical records, which may have resulted in errors in data collection due to condition coding, and the fact that the database did not link directly to hospitalized data.

Future investigation into potential explanations for the differences between ethnicities observed in this study are warranted.

Reference

Dibato JE, Montvida O, Zaccardi F, et al. Association of cardiometabolic multimorbidity and depression with cardiovascular events in early-onset adult type 2 diabetes: a multiethnic study in the US. Published online November 11, 2020. Diabetes Care. doi: 10.2337/dc20-2045

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Differences in Comorbidities and Diagnosis of Early-Onset Type 2 Diabetes by Ethnicity - Endocrinology Advisor

This article was originally published here

BMC Cardiovasc Disord. 2020 Dec 9;20(1):514. doi: 10.1186/s12872-020-01805-6.

ABSTRACT

BACKGROUND: This study aimed to reveal the association of diabetes mellitus and dialysis-dependent renal failure with the lesion severity and chronic total occlusion (CTO) in patients undergoing femoropopliteal endovascular therapy for intermittent claudication.

METHODS: This multicenter retrospective study analyzed the data of 2056 consecutive patients with moderate to severe intermittent claudication, who underwent endovascular therapy for de novo lesions in the superficial femoral artery to the proximal popliteal artery between 2010 and 2018 at five cardiovascular centers in Japan. The association of the clinical characteristics with severity of the lesions, as assessed by the Trans-Atlantic Inter-Society Consensus (TASC) II classification, was investigated using the ordinal logistic regression model. Their association with CTO, lesion length, and severity of calcifications was additionally analyzed using the binomial logistic regression model.

RESULTS: The prevalence of diabetes mellitus and dialysis-dependent renal failure was 54.7% and 21.4%, respectively; 12.5% of the patients had lesions corresponding to TASC II class D, and 39.3% of the patients had CTO. Current smoking and severe claudication were associated with more severe lesions assessed according to the TASC II classification; diabetes mellitus and dialysis dependence were inversely associated with disease severity. The adjusted odds ratios of diabetes mellitus and dialysis dependence were 0.82 (95% confidence interval 0.70-0.97; p = 0.018) and 0.76 (0.62-0.94; p = 0.009), respectively. Diabetes mellitus and dialysis dependence were also inversely associated with CTO (both p < 0.05). Furthermore, diabetes mellitus was inversely associated with a long lesion (p < 0.05). Diabetes mellitus and dialysis dependence were positively associated with severe calcification (both p < 0.05).

CONCLUSIONS: Diabetes mellitus and dialysis-dependent renal failure were inversely associated with the lesion severity, as assessed by the TASC II classification, and CTO in patients undergoing femoropopliteal endovascular therapy for intermittent claudication.

PMID:33297956 | DOI:10.1186/s12872-020-01805-6

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Inverse association of diabetes and dialysis with the severity of femoropopliteal lesions and chronic total occlusion: a cross-sectional study of 2056...

Dear Doctors: We keep hearing about Type 2 diabetes, and I'm embarrassed to say, I don't actually know what it is. What does it do, and how do I know if I have it?

Dear Reader: To understand diabetes, we should first talk about glucose. That's the sugar our bodies make from the foods that we eat, and which our cells use as their main source of fuel. Glucose travels throughout the body via the blood, which is why it's also often referred to as blood sugar. However, it's not immediately available to the cells. That's where insulin, a hormone manufactured by the pancreas, comes into play. Insulin helps transport glucose from the blood into the cells, where it can be used as energy.

When someone has diabetes, it means that the insulin part of that energy equation isn't working properly. Either the body isn't manufacturing enough -- or any -- insulin, or it isn't responding properly to the insulin that is present. That leads to blood-glucose levels that are too high.

Over time, high blood levels of glucose are dangerous. Adverse health effects include damage to the circulatory system, vision problems, nerve damage, stomach or intestinal problems, slow healing, kidney disease and an increase in the risk of heart disease and stroke. Extremely high blood sugar levels can lead to coma, and even death.

In Type 1 diabetes, the pancreas makes little or no insulin. It often develops early in life, but can occur at any age. This type of diabetes is managed with diet and exercise, plus the use of medications and insulin.

See more here:
Insulin is at the heart of both types of diabetes - The Times and Democrat

Data presented during the 2020 San Antonio Breast Cancer Symposium found that adhering to a diabetes risk reduction diet improved survival for women with stage 1 to 3 breast cancer compared to women who did not follow this specific diet.

Diabetes may be common in women with breast cancer, especially since 75%, or more than 2.6 million women, are at least 60 years or older, which means breast cancer survivorship must be managed in consideration with aging-related comorbidity such as diabetes, said Tengteng Wang, PhD, a research fellow at Harvard T.H. Chan School of Public Health during the virtual presentation of the study.

Type 2 diabetes, in particular, is a risk factor for breast cancer incidence and may be a predictive factor for breast cancer mortality. In addition, breast cancer increases the likelihood of developing type 2 diabetes.

Identifying modifiable strategies to prevent type 2 diabetes among breast cancer survivors may be very important to improve their survival outcomes, said Wang.

Researchers analyzed data from 8,320 women with stage 1 to 3 breast cancer from 2 large cohort studies: the Nurses Health Study (1980-2014) and the Nurses Health Study II (1991-2015). Validated questionnaires were completed every 2 to 4 years to collect information on diet among other factors.

This study focused on a diabetes risk reduction diet with 9 dietary components including higher intakes of nuts, cereal fiber, coffee, polyunsaturated-saturated fat ratio and whole fruits, in addition to a lower glycemic index of diet and lower intakes of sugar-sweetened beverages/fruit juices, trans fat and red meat.

The [diabetes risk reduction diet] has been associated with 14% lower type 2 diabetes risk in [a] previous publication of the Nurses Health Study, said Wang.

Researchers calculated an average score of adherence to this diabetes risk reduction diet through repeated measures of diet after a diagnosis of breast cancer. Follow-up was conducted for a median of 16 years after cancer diagnosis.

During follow-up, 2,146 deaths occurred, of which 948 were related to breast cancer. Women with higher diet adherence scores after diagnosis had a 33% lower risk for all-cause mortality (HR = 0.67; 95% CI, 0.58-0.78; P for trend < .0001) and a 17% lower risk for mortality related to breast cancer (HR = 0.83; 95% CI, 0.67-1.02; P for trend = .03) compared with women with lower diet adherence scores.

Our results did not differ by breast tumor ER status or stage, said Wang.

During the discussion portion of the presentation, Wang said that she and her colleagues analyzed what may be the potential mechanism for this association. She said, We looked at how [diabetes risk reduction diet][ influenced gene expression in [the] breast tumor for [a] subgroup of our breast cancer patients, and according to our pathway analysis, the [diabetes risk reduction diet] is more associated with the pathway related to immune regulation and also cell proliferation, so this is, I think, an interesting finding.

When further adjusting for neighborhood socioeconomic status, the association between diet adherence and mortality risk was slightly attenuated, with patients with greater adherence having a 31% lower risk for all-cause mortality (HR = 0.69; 95% CI, 0.6-0.8; P for trend < .0001) and a 14% lower risk for mortality from breast cancer (HR = 0.86; 95% CI, 0.7-1.07; P for trend = .06).

Women who improved their adherence to a diabetes risk reduction diet after breast cancer diagnosis had a lower risk for breast cancer mortality compared with those with consistently low adherence to this diet (HR = 0.81; 95% CI, 0.65-1).

In conclusion, we felt that a greater adherence to the [diabetes risk reduction diet] after breast cancer diagnosis was associated with better survival outcomes, which means promoting dietary changes consistent with prevention of type 2 diabetes may be very important for breast cancer survivors, said Wang.

A version of this story appeared on CURE as Dietary Changes to Reduce Diabetes Risk May Also Increase Survival for Breast Cancer.

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Diabetes Risk Reduction Diet Adherence Improved Survival for Patients with Breast Cancer - Cancer Network

TheStandards of Medical Care in Diabetes2021provides the latest in comprehensive, evidence-based recommendations for the diagnosis and treatment of children and adults with type 1, type 2, or gestational diabetes; strategies for the prevention or delay of type 2 diabetes; and therapeutic approaches that can reduce complications, mitigate cardiovascular and renal risk, and improve health outcomes.

This update presents:

Today, theStandards of Careis available online and is published as a supplement to the January 2021 issue ofDiabetes Care.

"The American Diabetes Association is committed to improving the lives of all those affected by diabetes through this publication of the most widely respected guidelines for health professionals," said Dr. Robert Gabbay, Chief Scientific and Medical Officer at the American Diabetes Association.

Updates to the Standards of Care are established and revised by the ADA's Professional Practice Committee(PPC). The committee is a multidisciplinary team of 16 leading U.S. experts in the field of diabetes care and includes physicians, diabetes care and education specialists, registered dietitians, and others with experience in adult and pediatric endocrinology, epidemiology, public health, cardiovascular risk management, microvascular complications, preconception and pregnancy care, weight management and diabetes prevention, and use of technology in diabetes management. Two designated representatives of the American College of Cardiology (ACC) reviewed and provided feedback on the "Cardiovascular Disease and Risk Management" section, and this section received endorsement from ACC. "As a world leader in diabetes care, the ADA is proud to set the standards!" said Boris Draznin, MD, PhD, Chair of the Professional Practice Committee.

The online version of the Standards of Care will continue to be annotated in real-time with necessary updates if new evidence or regulatory changes merit immediate incorporation through the living Standards of Care process. The ADA also publishes the abridged Standards of Careyearly for primary care providers in its journal, Clinical Diabetes, and offers a convenient Standards of Care appas well as a Standards of Care pocket chart. Other Standards of Care resources, including a webcastwith continuing education credit and a full slide deck, can be found on DiabetesPro.

About Diabetes CareDiabetes Care,a monthly journal of the American Diabetes Association (ADA), is the highest-ranked, peer-reviewed journal in the field of diabetes treatment and prevention. Dedicated to increasing knowledge, stimulating research and promoting better health care for people with diabetes, the journal publishes original articles on human studies in clinical care, education and nutrition; epidemiology, health services and psychosocial research; emerging treatments and technologies; and pathophysiology and complications. Diabetes Care also publishes the ADA's recommendations and statements, clinically relevant review articles, editorials and commentaries. Topics covered are of interest to clinically oriented physicians, researchers, epidemiologists, psychologists, diabetes care and education specialists and other health care professionals.

About the American Diabetes AssociationEvery day more than 4,000 people are newly diagnosed with diabetes in America. More than 122 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

Contact:Daisy Diaz, 703-253-4807[emailprotected]

SOURCE American Diabetes Association

http://www.diabetes.org

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ADA Releases 2021 Standards of Medical Care in Diabetes Centered on Evolving Evidence, Technology, and Individualized Care - PRNewswire

ANNAPOLIS, MDGovernor Larry Hogan today announced the commitment of more than $94 million in new investments across Maryland to help people with prediabetes and diabetes prevent or manage their disease during the COVID-19 pandemic.

The $94 million of new investments I am announcing today will be used to help Marylanders across the state battle diabetes, said Governor Hogan. Even in the midst of a pandemic, diabetes continues to be one of the most devastating health issues in our state. And having diabetes puts individuals at risk of serious illness from COVID-19, so this comes at an important time.

There are currently more than 2.1 million Marylanders with either diabetes or prediabetes, more than 34% of the total population, and many dont even know it. Diabetes is the 6th leading cause of death in Maryland, and people with Type 2 diabetes have a greater risk of serious illness from COVID-19, according to the Centers for Disease Control and Prevention (CDC).

Taken together, the measures being funded represent the first major community-based initiatives resulting from the Diabetes Action Plan, published last November.Developed with extensive input from community partners and diabetes experts, the Diabetes ActionPlan catalogs the state of this disease among Maryland residents and outlines comprehensive community-based prevention, management and treatment initiatives.

Todays initiatives announced by the governor include:

Regional Catalyst Grant Program

Recently the Health Services Cost Review Commission (HSCRC) announced the award of its new competitive Regional Partnership Catalyst Grant Program, an investment of more than $86.3 million in Maryland hospitals and their community health resource partners to support diabetes prevention, education, and self-management training programs. The HSCRC grant provides an initial five-year funding stream to help hospitals launch interventions that can be sustained at the end of the grant.

CareFirst Investments in Community Health

CareFirst BlueCross BlueShield will invest more than $6.6 million in four Maryland communities as part of a multi-year initiative to combat social and health disparities for people who are at risk for or have been diagnosed with diabetes. Thispledge will focus on steps and strategies that can be taken to intervene in areas where extensive data shows community and social factors contribute to the onset of diabetes. This work will be done in partnership with Local Health Improvement Coalitions (LHICs) and local health departments. LHICs are comprised of local partners, working with the health officers to create meaningful public-private partnerships supporting community wellness.

CHRC Partners with MDH and UMD to Support Local Health Coalitions

Marylands Community Health Resource Commission (CHRC), consistently supportive of the Diabetes Action Plan, recently awarded $1 million to Marylands local health departments to help LHICs expand capacity and build on innovative partnerships, services, and programming in communities at high-risk for diabetes.In an effort to maximize the impact of the grant funding, MDH will provide technical assistance to LHICs,in partnership with the Horowitz Center for Health Literacy in the School of Public Health, University of Maryland.

In addition, last year the CHRC issued 12 awards totaling $2.2 million to support projects in local communities in support of the Maryland Diabetes Action Plan through promoting food security and addressing other social determinants that impact diabetes.Addressing diabetes is a top funding priority of the CHRC, focusing on the Diabetes Action Plan recommendations to employ local action integrated with community approach in the fight against diabetes.

Along with these investments, Marylands Medicaid program added the National Diabetes Prevention Programs (NDPP) as a covered benefit last fall, providing both in-person and virtual access for eligible HealthChoice enrollees who may not have otherwise been able to afford it. The DPP is available through all nine of its Managed Care Organizations statewide.

Marylanders are urged to speak to their physician about their risk for diabetes, and go online to know their risk. An easy 60-second risk test from the American Diabetes Association can help everyone: https://www.diabetes.org/risk-test

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Governor Larry Hogan Announces $94 Million in Funding to Support Diabetes Prevention and Treatment for Marylanders - The Southern Maryland Chronicle

Why Global Citizens Should Care

Noncommunicable diseases (NCDs), such as cancers and diabetes, are now the leading cause of death in the world, according to the World Health Organizations (WHO) 2019 Global Health Estimates report published Wednesday.

The top10 diseases accounted for 55% of the 55.4 million deaths worldwide that were reported in 2019.

It is important to understand which diseases people die from to measure how people live and to ensure that health care systems areprepared to respond to patients needs, according to the WHO.

The WHOdefines NCDs as chronic diseases that are usually the result of genetic, physiological, environmental, and behavioral factors. In comparison, communicable diseases are transmitted between people, such as HIV/AIDS, tuberculosis, malaria, and tropical diseases.

At the global level, 7 of the 10 leading causes of death were NCDs in 2019. This is a dramatic rise from 2000, when only 4 of the top 10 diseases were classified as noncommunicable.

These new estimates are another reminder that we need to rapidly step up prevention, diagnosis,and treatment of noncommunicable diseases, WHO Director-GeneralDr. Tedros AdhanomGhebreyesussaid.

Related Stories Dec. 9, 2020 Thomson Reuters Foundation Poor Countries Are at Risk of Missing Out on COVID-19 Vaccines as Rich Nations Hoard Supplies

While the WHOs list outlines the top causes of death globally, the leading causes of death within eachcountry arevaried. The causes of death across high-,middle-,and low-income countries showthe difference between lifestyle and health care around the world.

In 2019, heart disease remained the number one killer globally and accounted for 16% of total diseases around the world, according to the report.

Heart disease has been the leading cause of death globally for the last 20 years. The number of people who died from the disease in 2019 rose to almost 9 million.

Related Stories Nov. 20, 2020 The WHO Just Introduced a Plan to Eliminate Cervical Cancer Around the World

For the first time, Alzheimers disease and other forms of dementia entered the top 10 causes of global death.The report also showed that women were more at risk of degenerative diseases, as 65% of Alzheimers and other forms ofdementia deaths were women.

Diabetes also entered the top 10 list in 2019. The number of people who died from the disease has increased by 70% since 2000. Men are more at risk of this disease and there was an 80% rise in death among men in the past two decades.

While Alzheimers disease, dementia, and diabetesare all classified as NCDs, none of themwere amongthe top 10 causes of death in low- or middle-income countries.

Related Stories Nov. 30, 2020 Malaria Will Kill More People Than COVID-19 in Sub-Saharan Africa This Year: WHO

Deaths from communicable diseases declined globally from 2000 to 2019, however, they are still a challenge in lower- and middle-income countries. In low-income countries, 6 of the top 10 causes of death were communicable diseases.

HIV/AIDS was nolonger listedamong the top 10 global diseases in 2019. Deaths from HIV/AIDS have decreased by 51% globally since 2000.However, in low-income countries, HIV/AIDS, malaria, and tuberculosis remainedin the top 10.

Dr. Samira Asma, assistant director-general for the division of data, analytics,and delivery for impact at the WHO, explained the importance of collecting data on worldwide deaths in the report.

The WHO Global Health Estimates are a powerful tool to maximize health and economic impact, she said. We call upon governments and stakeholders to urgently invest in data and health information systems to support timely and effective decision-making.

Continued here:
Noncommunicable Diseases Like Cancer and Diabetes Are the Top Causes of Death Globally: WHO - Global Citizen

By: Express Explained | Updated: December 12, 2020 5:18:59 pmA significant finding of their study says that owning a dog with diabetes was associated with a 38 per cent increased risk of diabetes in the owner.(Thinkstock)

A new study published in the British Medical Journal (BMJ) says that diabetes in dogs may indicate an elevated risk of type 2 diabetes in their owners.

The study

The study included more than 175,000 dog owners and nearly 90,000 cat owners along with their dogs and cats. The dog and cat owners included in the study were all middle-aged or older at the start of the study and were followed through for a period of six years (January 1, 2007 December 31, 2012).

Through this period, researchers analysed the incidence of type 2 diabetes in the pet owners and canine and feline diabetes in their pets.

So what does the research say?

Authors of the study, which was conducted at Uppsala University in Sweden in collaboration with three other universities, say that owners of a dog with diabetes are more likely to develop type 2 diabetes than owners of a dog without diabetes. A similar shared risk of diabetes could not be detected for cat owners and their pets, the researchers have said.

What could explain this association?

A significant finding of their study says that owning a dog with diabetes was associated with a 38 per cent increased risk of diabetes in the owner. Beatrice Kennedy, one of the senior authors of the study was quoted as saying in a press release that the association of diabetes between dogs and their owners might be explained by physical activity patterns, possibly also by their shared dietary habits and adiposity. The WHO defines adiposity as having a body mass index (BMI) of over 30 kg per metre square.

Significantly, if the reason for the association of a shared risk of the disease between dogs and their owners is indeed a result of their physical activity patterns, it would also explain why the researchers did not see a shared risk association of the disease between cats and their owners. Follow Express Explained on Telegram

Humans and dogs have lived together for at least 15,000 years, and continue to share their everyday lives for better or worse. In this unique study, we show that there might be common lifestyle and environmental factors that influence the risk of diabetes in the household, both in the dogs and in their owners, Tove Fall, another author of the study was quoted as saying.

What is type 2 diabetes?

Type 2 diabetes is the most common type of diabetes and occurs when blood glucose or blood sugar is too high and is most likely a result of excess body weight and physical inactivity. According to the World Health Organisation (WHO), this type of diabetes was seen only in adults but is now also occurring increasingly frequently in children. Overall, 422 million adults in the world have diabetes, including type 1.

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Explained: What a new study says about the shared risk of diabetes between dog and cat owners and their pets - The Indian Express

THE WOODLANDS, Texas, Dec. 11, 2020 (GLOBE NEWSWIRE) -- Lexicon Pharmaceuticals, Inc. (Nasdaq: LXRX), announced today that it has received Fast Track designation from the U.S. Food and Drug Administration (FDA) for the development of LX9211 in diabetic peripheral neuropathic pain.

The FDAs Fast Track designation of LX9211 reflects the serious unmet medical need of people suffering from diabetic peripheral neuropathic pain, said Praveen Tyle, Ph.D., executive vice president of research and development. We look forward to working closely with the FDA throughout the clinical development process to bring this potential new innovative treatment to patients as quickly as possible.

Lexicon is currently enrolling patients with diabetic peripheral neuropathic pain in a Phase 2 proof-of-concept study of LX9211 and is preparing to initiate a second Phase 2 clinical trial of LX9211 in post-herpetic neuralgia.

The FDAs Fast Track designation is designed to facilitate the development and expedite the review of drugs that are being developed to treat serious conditions and fill unmet medical needs. The purpose of the designation is to expedite the timeline for bringing important new drugs to patients. Programs receiving Fast Track designation may benefit from early and frequent interactions with the FDA over the course of drug development. In addition, the Fast Track designation program provides eligibility for accelerated approval and priority review if relevant criteria are met and enables sponsors to submit individual sections of a New Drug Application (NDA) for review on a rolling-submission basis.

About LX9211

LX9211 is a potent, orally delivered, selective small molecule inhibitor of adapter-associated kinase 1 (AAK1). Lexicon identified AAK1 in its target discovery efforts as a promising approach for the treatment of neuropathic pain, and identified LX9211 and another development candidate in a neuroscience drug discovery alliance with Bristol-Myers Squibb from which Lexicon holds exclusive development and commercialization rights. Preclinical studies of LX9211 demonstrated central nervous system penetration and reduction in pain behavior in models of neuropathic pain without affecting opiate pathways.

About Lexicon Pharmaceuticals

Lexicon is a biopharmaceutical company with a mission of pioneering medicines that transform patients lives. Through its Genome5000 program, Lexicon scientists studied the role and function of nearly 5,000 genes and identified more than 100 protein targets with significant therapeutic potential in a range of diseases. Through the precise targeting of these proteins, Lexicon is pioneering the discovery and development of innovative medicines to safely and effectively treat disease. Lexicon advanced one of these medicines to market and has a pipeline of promising drug candidates in discovery and clinical and preclinical development in neuropathic pain, heart failure, diabetes and metabolism and other indications. For additional information, please visit http://www.lexpharma.com.

Safe Harbor Statement

This press release contains forward-looking statements, including statements relating to Lexicons financial position, long-term outlook on its business and the clinical development and therapeutic and commercial potential of its drug candidates. In addition, this press release also contains forward looking statements relating to Lexicons growth and future operating results, discovery and development of products, strategic alliances and intellectual property, as well as other matters that are not historical facts or information. All forward-looking statements are based on managements current assumptions and expectations and involve risks, uncertainties and other important factors, specifically including Lexicons ability to meet its capital requirements, successfully conduct preclinical and clinical development and obtain necessary regulatory approvals of LX9211, sotagliflozin and its other potential drug candidates on its anticipated timelines, achieve its operational objectives, obtain patent protection for its discoveries and establish strategic alliances, as well as additional factors relating to manufacturing, intellectual property rights, and the therapeutic or commercial value of its drug candidates. Any of these risks, uncertainties and other factors may cause Lexicons actual results to be materially different from any future results expressed or implied by such forward-looking statements. Information identifying such important factors is contained under Risk Factors in Lexicons annual report on Form 10-K for the year ended December 31, 2019, as filed with the Securities and Exchange Commission. Lexicon undertakes no obligation to update or revise any such forward-looking statements, whether as a result of new information, future events or otherwise.

For Inquiries:

Chas SchultzExecutive Director, Corporate Communications and Investor RelationsLexicon Pharmaceuticals(281) 863-3421cschultz@lexpharma.com

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Lexicon Pharmaceuticals Receives Fast Track Designation From the FDA for LX9211 for Diabetic Peripheral Neuropathic Pain - GlobeNewswire

The risk for increased COVID-19 severity in people with type 1 diabetes appears similar to that of type 2 diabetes, contrary to some official advice from the Centers for Disease Control and Prevention (CDC). The new finding indicates that people with both types should be priority for receiving a vaccine, investigators say.

The study is the first to prospectively evaluate both inpatients and outpatients and to examine COVID-19 severity factors in addition to death in people with type 1 and type 2 diabetes separately, and was published online December 2 in Diabetes Care.

Among the patients, who were seen at Vanderbilt University Medical Center in Nashville between March and August 2020, those with both type 1 and type 2 diabetes had between a three- and fourfold greater risk for COVID-19 hospitalization and greater illness severity than people without diabetes after adjustments for age, race, and a number of other risk factors.

This finding is important since as of December 1, 2020, the CDC has classified the diabetes types differently in terms of underlying medical conditions that increase the risk for severe COVID-19.

Adults of any age with type 2 diabetes are considered "at increased risk of severe illness" from the virus that causes COVID-19 whereas CDC says those with type 1 "might be at an increased risk."

Lead author of the new paper Justin M. Gregory, MD, told Medscape Medical News: "I think this needs revision based on the current evidence. I think the data presented in our study and that of Barron et al in Lancet Endocrinology 2020 indicate the need to place type 1 diabetes at parity with type 2 diabetes."

"These studies indicate both conditions carry an adjusted odds ratio of three to four when compared with people without diabetes for hospitalization, illness severity, and mortality," he stressed.

There were no phase 3 vaccine data available for the vaccine at the time that Gregory, of the Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, and colleagues were writing their manuscript in late summer, so the article does not mention this.

But now, Gregory says, "Based on the initial press releases from Pfizer and Moderna, I am now optimistic that these vaccines might mitigate the excess morbidity and mortality from COVID-19 experienced by patients with diabetes."

"I am eager to see what we learn on December 10 and 17 [the scheduled dates for the meetings of the US Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee to review the Pfizer and Moderna vaccines, respectively]."

But with the winter pandemic surge in the meantime, "Our investigation suggests that as COVID-19 hospitalizations rise, patients with both type 1 and 2 diabetes will comprise a disproportionally higher number of those admissions and, once hospitalized, demonstrate a greater degree of illness severity," he and his colleagues say.

"In light of these data, we call on our colleagues to emphasize the importance of social distancing measures and hand hygiene, with particular emphasis on patients with diabetes, including those in the most vulnerable communities whom our study affirms will face the most severe impact."

The new study data came from electronic health records at Vanderbilt University Medical Center, comprising 137 primary care, urgent care, and hospital facilities where patients were tested for SARS-CoV-2 regardless of the reason for their visit.

Between March 17 and August 7, 2020, a total of 6451 tested positive for COVID-19. Of those, 273 had type 2 diabetes and 40 had type 1 diabetes.

Children younger than 18 years accounted for 20.0% of those with type 1 diabetes and 9.4% of those without diabetes, but none of the type 2 group. The group with type 2 diabetes was considerably older than the type 1 diabetes and no-diabetes groups, 58 years versus 37 and 33 years, respectively.

Before adjustment for baseline characteristics that differed between groups, patients with type 1 diabetes appeared to have a risk for hospitalization and greater illness severity that was intermediate between the group with no diabetes and the group with type 2 diabetes, the researchers say.

But after adjustment for age, race, sex, hypertension, smoking, and body mass index, people with type 1 diabetes had odds ratios of 3.90 for hospitalization and 3.35 for greater illness severity, which was similar to risk in type 2 diabetes (3.36 and 3.42, respectively), compared to those without diabetes.

The investigators then conducted a detailed chart review for 37 of the 40 patients with type 1 diabetes and phone surveys with 15 of them.

The majority (28) had not been hospitalized, and only one was hospitalized for diabetic ketoacidosis (DKA) within 14 days of positive SARS-CoV-2 testing.

This contrasts with a report from the T1D Exchange, in which nearly half of 33 patients with type 1 diabetes and COVID-19 had been hospitalized with DKA. The reason for the discrepancy may be that more severe patients would more likely be referred to the T1D Exchange Registry, Gregory and colleagues hypothesize.

Clinical factors associated with COVID-19 severity (P < .05) in their study included a prior hypertension diagnosis, higher A1c, at least one prior DKA admission in the past year, and not using a continuous glucose monitor (CGM).

Hospitalizations were twice as likely and illness severity nearly twice as great among those with type 1 diabetes who were Black versus White. Just 8% of those with private insurance were hospitalized, compared with 60% of those with public insurance and 67% with no insurance (P = .001).

"Whereas previous reports have indicated proportionally higher rates of hospitalizations from COVID-19 among Black patients and those with public insurance, this study is the first to show a similar finding in the population with type 1 diabetes," Gregory and colleagues write.

Only 9% of patients using a CGM were hospitalized versus 47% who used blood glucose meters (P < .016). Similarly, hospitalizations occurred in 6% using an insulin pump versus 33% using multiple daily injections (P < .085).

But they note, "Our analysis cannot exclude the possibility that greater amounts of diabetes technology use are a surrogate for higher socioeconomic status."

This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, JDRF, and the Appleby Foundation. The authors have reported no relevant financial relationships.

Diabetes Care. Published online December 2, 2020. Abstract

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Prioritize COVID-19 Vaccination in Both Types of Diabetes, Say Docs - Medscape

The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Laura Hieronymus, a doctor of nursing, master licensed diabetes educator and the associate director of education and quality services at the Barnstable Brown Diabetes Center and Daniel Stinnett a registered dietitian and master licensed diabetes educator in the Bluegrass Care Clinic.

LEXINGTON, Ky. (Dec. 7, 2020) Americans savor winter holiday meals; however, not always in a good way. Statistics show the December holiday season is one of the top three in terms of food consumption with the average adult taking in about 3,000 calories in one meal. Additional calories throughout the day can add up to two and a half times what an average adult needs for their daily energy needs. When you have diabetes, the added intake can affect blood glucose levels and potentially lead to symptoms such as fatigue, sluggishness, and even weight gain. During the holiday season, an overabundance of foods is often the rule rather than the exception. The following strategies may be helpful as you navigate your food intake:

Holiday celebrations often include beverages with alcohol. If you choose to drink do so in moderationgenerally considered no more than two drinks per day for men and one per day for women. Lighten up with lite beer, a wine spritzer, or calorie-free mixers. Avoid those specialty drinks such as Egg Nog (300+ calories), White Russian (4.5 ounces, 170+ calories), and 12 ounces of Christmas Ale (7.5% alcohol, 200+ calories) can be calorie-laden. Track your alcohol intake and avoid drinking on an empty stomach. If you become less attentive you will likely relax your focus on your overall calorie intake of food. Dont drink and drive.

Remember you can always counterbalance those extra holiday calories by staying active. Walk some extra steps after you eat, participate in interactive games or dance to your favorite music.

Stay informed by monitoring your blood glucose to help you make better decisions. Tomorrow is another day, so if things dont go as planned, learn from your experience and determine what you might do differently next time.

Above all, be safe and stay healthy. And, in the year of the 2020 pandemic do yourself and others a favor by staying socially distant, washing your hands, and wearing your mask. We all win.

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