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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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Diabetes and Healthful Holiday Strategies | UKNow - UKNow

Peripheral neuropathy is common in US adults and is associated with an increased risk of death, even in the absence of diabetes, researchers report today in the Annals of Internal Medicine.

The findings do not necessarily mean that doctors should implement broader screening for peripheral neuropathy at this time, however, the investigators say.

"Doctors don't typically screen for peripheral neuropathy in persons without diabetes," said senior author Elizabeth Selvin, PhD, MPH, professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland, in an email.

"Our study shows that peripheral neuropathy as assessed by decreased sensation in the feet is common, even in people without diabetes," Selvin explained. "It is not yet clear whether we should be screening people without diabetes since we don't have clear treatments, but our study does suggest that this condition is an underrecognized condition that is associated with poor outcomes."

Patients with diabetes typically undergo annual foot examinations that include screening for peripheral neuropathy, but that's not the case for most adults in the absence of diabetes.

"I don't know if we can make the jump that we should be screening people without diabetes," said first author Caitlin W. Hicks, MD, assistant professor of surgery, Division of Vascular Surgery and Endovascular Therapy, Johns Hopkins University School of Medicine. "Right now, we do not exactly know what it means in the people without diabetes, and we definitely do not know how to treat it. So, screening for it will tell us that this person has this and is at higher risk of mortality than someone who doesn't, but we do not know what to do with that information yet."

Nevertheless, the study raises the question of whether physicians should pay more attention to peripheral neuropathy in people without diabetes, said Hicks, who is the director of research at the university's diabetic foot and wound service.

To examine associations between peripheral neuropathy and all-cause and cardiovascular mortality in US adults, Hicks and colleagues analyzed data from 7116 adults aged 40 years or older who participated in the National Health and Nutrition Examination Survey (NHANES) between 1999 and 2004.

The study included participants who underwent monofilament testing for peripheral neuropathy. During testing, technicians used a standard 5.07 Semmes-Weinstein nylon monofilament to apply slight pressure to the bottom of each foot at three sites. If participants could not correctly identify where pressure was applied, the test was repeated. After participants gave two incorrect or undeterminable responses for a site, the site was defined as insensate. The researchers defined peripheral neuropathy as at least one insensate site on either foot.

The researchers determined deaths and causes of death using death certificate records from the National Death Index through 2015.

In all, 13.5% of the participants had peripheral neuropathy, including 27% of adults with diabetes and 11.6% of adults without diabetes. Those with peripheral neuropathy were older, were more likely to be male, and had lower levels of education, compared with participants without peripheral neuropathy. They also had higher BMI, were more often former or current smokers, and had a higher prevalence of hypertension, hypercholesterolemia, and cardiovascular disease.

During a median follow-up of 13 years, 2128 participants died, including 488 who died of cardiovascular causes.

The incidence rate of all-cause mortality per 1000 person-years was 57.6 in adults with diabetes and peripheral neuropathy, 34.3 in adults with peripheral neuropathy but no diabetes, 27.1 in adults with diabetes but no peripheral neuropathy, and 13.0 in adults without diabetes or peripheral neuropathy.

Among participants with diabetes, the leading cause of death was cardiovascular disease (31% of deaths), whereas among participants without diabetes, the leading cause of death was malignant neoplasms (27% of deaths).

After adjustment for age, sex, race, or ethnicity, and risk factors such as cardiovascular disease, peripheral neuropathy was significantly associated with all-cause mortality (hazard ratio [HR], 1.49) and cardiovascular mortality (HR, 1.66) in participants with diabetes. In participants without diabetes, peripheral neuropathy was significantly associated with all-cause mortality (HR, 1.31), but its association with cardiovascular mortality was not statistically significant.

The association between peripheral neuropathy and all-cause mortality persisted in a sensitivity analysis that focused on adults with normoglycemia.

The study confirms findings from prior studies that examined the prevalence of loss of peripheral sensation in populations of older adults with and without diabetes, said Elsa S. Strotmeyer, PhD, MPH, associate professor of epidemiology at the University of Pittsburgh, Pittsburgh, Pennsylvania. "The clinical significance of the loss of peripheral sensation in older adults without diabetes is not fully appreciated," she said.

A limitation of the study is that peripheral neuropathy was not a clinical diagnosis. "Monofilament testing at the foot is a quick clinical screen for decreased lower-extremity sensation that likely is a result of sensory peripheral nerve decline," Strotmeyer said.

Another limitation is that death certificates are less accurate than medical records for determining cause of death.

"Past studies have indicated that peripheral nerve decline is related to common conditions in aging such as the metabolic syndrome and cardiovascular disease, cancer treatment, and physical function loss," Strotmeyer said. "Therefore it is not surprising that is related to mortality as these conditions in aging are associated with increased mortality. Loss of peripheral sensation at the foot may also be related to fall injuries, and mortality from fall injuries has increased dramatically in older adults over the past several decades."

Prior research has suggested that monofilament testing may play a role in screening for fall risk in older adults without diabetes, Strotmeyer added.

"For older adults both with and without diabetes, past studies have recommended monofilament testing be incorporated in geriatric screening for fall risk. Therefore, this article expands implications of clinical importance to understanding the pathology and consequences of loss of sensation at the foot in older patients," she said.

The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the National Heart, Lung, and Blood Institute. Hicks, Selvin, and a coauthor, Kunihiro Matsushita, MD, PhD, disclosed NIH grants. In addition, Selvin disclosed personal fees from Novo Nordisk and grants from the Foundation for the National Institutes of Health outside the submitted work, and Matsushita disclosed grants and personal fees from Fukuda Denshi outside the submitted work. Strotmeyer receives funding from the National Institute on Aging and the National Institute of Arthritis and Musculoskeletal and Skin Diseases and is chair of the health sciences section of the Gerontological Society of America.

Ann Intern Med. Published online December 7, 2020. Abstract

Jake Remaly is a staff journalist at Medscape Medical News and MDedge. He has covered healthcare and medicine for more than 5 years. He can be reached at jremaly@mdedge.com.

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Peripheral Neuropathy Tied to Mortality in Adults Without Diabetes - Medscape

Meghan Trainor insists her baby is healthy amid her battle with gestational diabetes.

The No Excuses singer revealed recently she has been diagnosed with the condition - which causes high blood sugar to develop during pregnancy, and usually disappears after giving birth - as she is currently expecting a baby boy with her husband Daryl Sabara.

And Meghan has now reassured fans that her condition is manageable, and both she and her unborn baby are doing fine.

She told the Today show: "Got a little tiny bump in the road - I got diagnosed with gestational diabetes, but it's manageable and it's okay. And I'm healthy and the baby's healthy. I just have to really pay attention to everything I eat.

"It's nice to learn so much about food and health, and [it's] nice to hear that so many women experienced this."

Meghan, 26, spoke about her gestational diabetes diagnosis late last month, when she said she knew she had to get tested for the condition because it runs in her family.

She said: "My family, we got gestational diabetes in my family, my mom had it for a month while she was pregnant and I mentioned it to my doctor and they tested me and were like, Okay, your blood sugars are pretty high. So I was like, Oh my God, Im sorry - I had a Pop-Tart and they were like, It doesnt work like that but lets focus on eating the right stuff and working out."

But unfortunately, the health scare hasnt helped to shun any of her cravings, which have all been for sugary foods.

She added: I just noticed that my whole life Ive been at nighttime, 'I want a giant bowl of popcorn, I want Salty Crunch' and now Im like, 'I really want a brownie or like Oreos, sugar...' and thats never been me.

"Im never like, 'Oh ice cream', and now Im like, 'I want a tub'. Also, like candy - I want a whole thing of Gushers right now."

View original post here:
Meghan Trainor on gestational diabetes diagnosis: 'I'm healthy and the baby's healthy' - messenger-inquirer

Muscat: About 60 per cent of COVID-19 patients with diabetes or blood pressure do not survive its effects, a study by a group of doctors in Oman has found.

The study, which was conducted by 13 medical professionals and three research students, discovered that 61 per cent of COVID patients admitted to intensive care who also had diabetes, and 59 per cent of those with blood pressure, died from the disease.

This indicates to us that diabetes and blood pressure are some of the most important factors causing severe COVID-19 infection and death, said Dr Fahad Al Kindi, a senior consultant doctor in cardiovascular diseases at Sultan Qaboos University, and one of the doctors involved in the research.

The death rate of COVID-19 patients in intensive care in some countries has gone up to 40 per cent, but by the grace of God, the death rate here is only 14 per cent, and we intend to bring this number down to as low a figure as we can, by all the means available to us, he added.

The study involved the examination of COVID patients admitted to intensive care units in three hospitals in Muscat, Sultan Qaboos University Hospital, Al Nahda Hospital, and the Royal Hospital. It was done in two phases, the first running from March to May, and the second from June to August.

In the second stage of our scientific research, we decided to expand the number of patients involved in the study, said Al Kindi.

The more patients included in it, the greater the accuracy of our findings. In fact, that the results of the second stage were identical to those of our first shows that our initial discoveries were accurate, Al Kindi further said.

We were also able to discern the average ages of patients who died from the disease, which was different from the ages of those who recovered from the coronavirus, he explained, The average age of COVID patients who died from the disease is 60, while the age of those who recovered is about 48 years.

Following this study, the team of researchers now plan on studying the effects of COVID-19 on those who have recovered from the disease, and look at any problems they now face that are linked to the symptoms they presented when they were first admitted to the ICUs.

Also included in this next study will be the long-term complications they suffer from because of COVID-19, how any chronic diseases they suffer from continue to affect their recovery, and whether their body parts have been damaged or rendered defective due to this virus.

We took into our study all of the medical information of the patients we examined, from the time they entered the hospital, until they left, recalled Al Kindi. The system of medical records maintained by hospitals in Oman is detailed and accurate, and so helped us monitor the status of patients, including their symptoms, what medications they were on, and the extent of their bodies response to the drugs.

We collected all of the relevant patient information, including the nature of tests done on them, and then compared the treatment plans used for patients who had died from the disease, to those who had recovered from them, he added.

Excerpt from:
Effects of COVID-19 found to be worse in patients with diabetes, blood pressure - Times of Oman

Doctors at Vanderbilt Medical Center said people with diabetes should be prioritized for the COVID-19 vaccine.

NASHVILLE, Tenn. Doctors at Vanderbilt Medical Center say people with diabetes need to be prioritized for the COVID-19 vaccine. They also said there are certain side effects they need to be aware of.

Researchers at Vanderbilt said they studied more than 6,000 COVID-19 patients since March. They have compared the overall impact of the illness between those with Type 1 Diabetes, Type 2 Diabetes, and those who dont have Diabetes.

Researchers say 90% of Diabetic patients in the United States have Type 2 Diabetes. Around 10% (or 1.6 million people) have Type 1 Diabetes in the U.S.

They say while studies have suggested that those with Type 2 Diabetes are at higher risk for more serious complications and being hospitalized with COVID-19, little is known about the risk for individuals with Type 1 Diabetes.

Before we know it, we are going to have to decide which patients we need to prioritize to receive immunization for COVID-19, said Dr. Justin M. Gregory MD, MSCI.

Dr. Gregory not only researches how COVID-19 impacts Diabetic patients; he also lives with Type 1 Diabetes. Now, with a COVID-19 vaccine on its way, he says people with diabetes dont need to be the very first to get vaccinated.

Not above healthcare workers, not above people in nursing homes, but soon thereafter, Dr. Gregory said.

He said thats because those with Type 1 or Type 2 Diabetes are three times more likely to have a severe illness than those who dont have the medical condition. When it comes to getting the vaccine, they should expect certain side effects, including flu-like symptoms.

When people with Diabetes have flu-like symptoms, we know that makes their blood sugar levels go up, Dr. Gregory said. When people with Type 1 Diabetes and to some extent Type 2 Diabetes are getting these vaccines, they need to be positioning themselves and being really really on top of their diabetes control, as if they were sick.

He mentions that even though patients blood sugar might be more difficult to control a few days after, he still encourages them to get vaccinated.

Read the original here:
Vanderbilt doctors urge priority COVID-19 vaccination for Diabetic patients - WBIR.com

The holidays can be a magical time, but if you are a person with Diabetes, you might be worrying about controlling your blood sugar. This is a common thought, but the holidays dont have to be a time for throwing in the towel on all the hard work youve done the rest of the year.

Series 3 of the Fresh Focus Podcast was created by Marion VA Healthcare System Diabetes Educators to help you tackle the 2020 holidays.

We understand the holidays can also be a challenging time, especially with modifications this year, including smaller gatherings. This year, instead of making a large turkey, you might find yourself utilizing an herb roasted turkey breast instead. Similarly, you could try mini pumpkin pie-letsto reduce the overall calories and carbs while still getting your pie fix.

For people with Diabetes, when you choose to eat all of your calories and carbohydrates at one meal, you are taking a chance of having hypoglycemia or low blood sugar during the day. Then there is a possibility to have hyperglycemia or high blood sugar after eating too much that night with one large meal. Take a listen to the podcast to learn these key points in controlling a blood sugar roller coaster:

1. Eat consistently: dont skip meals during the day, which can lead to overeating at the big holiday meal.

2. Remember to always take your medications as ordered.

3. Utilize the healthy plate method even at the holidays to help fill your plate with all those good foods. Bring a delicious holiday inspired salad to the meal for a pop of green and bright red.

Now that you have your game plan, stay tuned for more Diabetes inclusive holiday eating tips. We hope you have happy, healthy holidays!

Kerri Hayden is a Registered Dietitian Nutritionist, Certified Diabetes Care and Education Specialist

Read the original here:
Fresh Focus #13: Taste of the Holidays: Meal Planning with Diabetes - VAntage Point - VAntage Point Blog

It has been known for some time that there is a reduction in the risk of type 2 diabetes for those who follow a Mediterranean diet. However, it has not been clear which factors are key to those beneficial effects.

While a reduction in body mass index (BMI) may be somewhat obvious, other mechanisms include beneficial effects on insulin resistance, lipoprotein metabolism and inflammation.

However, the diets antidiabetic effect does not appear to extend to people whose weight is considered healthy (BMI under 25), according to a recent study, which supports the idea that by improving their diet, people can improve their future risk of type 2 diabetes. This is particularly true if they are overweight or obese.

While metabolism can change over a short time on the Mediterranean diet, the study indicates that there are longer term changes happening that may provide protection over decades.

The Mediterranean diet, with an emphasis on healthy olive oil as the predominant source of oil, favors fruits, vegetables, legumes, nuts, and seeds, fish and dairy products, while limiting intake of red and processed meats as well as sweets.

The diet has been linked to as much as a 30% reduction in the risk of diabetes in previous observational studies.

To investigate the precise mechanisms that underlie the prevention of diabetes, the Harvard researchers examined data from 25,317 healthy women participating in the Womens Health Study who had baseline assessments between September 1992 and May 1995. They started out with an average age of 52.9 years.

Over the course of the study, 2,307 participants developed type 2 diabetes.

After a follow-up averaging almost 20 years, those who had the highest self-reported adherence to the Mediterranean diet (a score of 6 on a scale of 0 to 6) at baseline, had as much as a 30% lower risk of developing type 2 diabetes after some other factor adjustments compared to those with a lower Mediterranean diet score (a score of 3 or less).

The diabetes-related biomarkers that were most closely related to the reduced risk of type 2 diabetes included insulin resistance, accounting for 65% of the reduction, followed by BMI (55.5% reduction), high-density lipoprotein measures (53%), and inflammation (52.5%).

Other factors, though to a lesser degree, included branched-chain amino acids (34.5%), very low-density lipoprotein measures (32.0%), low-density lipoprotein measures (31.0%), blood pressure (29.0%), and apolipoproteins (23.5%).

Differences in glycohemoglobin A1c levels only had a limited effect on the risk (2%).

Further analysis looking at effects of the diet according to baseline BMI showed the reductions in type 2 diabetes associated with higher intake of the Mediterranean diet only extended to those with an above normal weight (BMI 25) as noted above.

The study was not originally designed to look at the baseline BMI as a factor. But the findings are consistent with the well-known increase in diabetes risk seen with a higher BMI.

Other studies, such as the Nurses Health Study, have shown that the risk for type 2 diabetes in women increases with age, even at BMI levels below 25. But the risk goes up exponentially at around a BMI of 25 and higher.

The strong role of insulin resistance was a surprise to the researchers. Since insulin resistance can precede by years and decades the elevated blood sugar and clinical diagnosis of diabetes, it could represent an opportunity to intervene earlier and more intensively by improving insulin resistance through dietary approaches such as the Mediterranean diet.

Another surprise was that glycohemoglobin A1c had no substantial effect on the reduction of diabetes risk with the Mediterranean diet. This could suggest that a rise in glycohemoglobin A1c likely occurs later in type 2 diabetes development.

Like every large population study, there are some limitations in what should be projected from the analysis results. But the findings suggest that more intensively following the Mediterranean diet might have substantial benefits over many years in preventing diabetes, among other health benefits such as lowering insulin resistance and inflammation, improving lipid metabolism, and lowering blood pressure.

Hopefully, more studies will help us understand the relationship. But for now, I would recommend that anyone who is overweight (especially with a family history of diabetes) may want to follow the Mediterranean diet.

More here:
Diabetes: Sunny news about food choices and better health - KPCnews.com

- FreeStyle Libre 2 system continuously measures glucose data every minute with customizable, optional real-time alarms1to alert users when their glucose is high or low without scanning

- Now for children (ages 4 and older) and adults with diabetes, this latest technology sustains excellent performance for up to 14 days, providing trends, insights and actionable data on a reader or with the FreeStyle LibreLink mobile app all at the same price as the current FreeStyle Libre system

- Latest sensor-based glucose monitoring technology will be available in the coming months to the more than 3.7 million Canadians with diabetes2

ABBOTT PARK, Ill., Dec. 2, 2020 /PRNewswire/ --Abbott (NYSE:ABT)today announced its next-generation, sensor-based glucose monitoring technology, FreeStyle Libre 2, received approval by Health Canada for adults and children (4 and older) with diabetes. With new features such as optional, real-time alarms1 that measure glucose levels every minute, FreeStyle Libre 2 gives users the option to be alerted in real-time of critical events such as hypoglycemia (low glucose levels3)or hyperglycemia (high glucose levels4). The wearable technology, which eliminates the need for painful fingersticks5, also provides people with diabetes with excellent accuracy and actionable information to better manage their condition, and will be priced at the same cost as the current FreeStyle Libre system.

"For the millions of Canadians with diabetes, Abbott's next-generation FreeStyle Libre 2 system expands on the life-changing capabilities of our original FreeStyle Libre system with enhanced accuracy, optional alarms and now available for children," said Marie-Flore Nabor, general manager of Abbott's diabetes care business in Canada. "This latest technology will transform the way diabetes is currently managed. The FreeStyle Libre 2 is designed to simplify this often complicated-to-manage condition and is accessible and affordable to people with diabetes in Canada."

How FreeStyle Libre 2 Works

As the world leader in sensor-based glucose monitoring,6Abbott continues to transform how people with diabetes test their glucose levels. Using Bluetooth technology, the FreeStyle Libre 2 system automatically alerts7users when their glucose is high or low without needing to scan the sensor.

The FreeStyle Libre 2 sensor is worn on the back of the upper arm for up to 14 days and measures glucose every minute to help users and their healthcare providers make informed treatment decisions. With a one-second scan using FreeStyle LibreLink, a smartphone app,8or handheld reader, users can see their glucose reading, trend arrow and eight-hour history. Users can also share data with their physicians or family members via the LibreLinkUp mobile app.

AbbottsFreeStyle Libre 2 system utilizes the same proprietary wired enzyme technology as the FreeStyle Libre system, which was the first to remove painful fingersticks5 and is associated with better glucose control9, decreased time in hypoglycemia and hyperglycemia10, more time in optimal glucose range7, and improved HbA1C11. A real-world study published in the British Medical Journal shows that the use of FreeStyle Libre system over one year is often associated with improved quality of life and that work absenteeism rate and diabetes-related hospital admissions decreased by two thirds.12

"Adding an alarm to this glucose sensing technology is definitely a major step to help people with diabetes live more confidently with less fear of high or low glucose levels," said Dr. Bruce Perkins, M.D., Director, Leadership Sinai Centre for Diabetes and Clinician-Scientist, University of Toronto. "We have seen from research with similar technologies that this kind of innovation can improve glucose level control, and even prevent emergency room visits and hospitalizations. For kids and adults alike, it means less pain from fingersticks, much greater insight into patterns, and much more reassurance."

AbbottsFreeStyle Libre 2 system will be available for people with diabetes ages 4 and up in Canada in the coming months.

As the #1 sensor-based glucose monitoring system used worldwide,6Abbott's FreeStyle Libre portfolio has changed the lives of more than 2.5 million people across more than 50 countries.Abbott has also secured partial or full reimbursement for the FreeStyle Libre system in 37 countries, including Canada where residents of Ontario and Quebec13who manage diabetes with insulin are covered. Other countries include France, Germany, Japan, the United Kingdom, and the U.S.

About Abbott Abbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 107,000 colleagues serve people in more than 160 countries.

Connect with us at http://www.abbott.com, on LinkedIn at http://www.linkedin.com/company/abbott-/, on Facebook at http://www.facebook.com/Abbottand on Twitter@AbbottNews.

1Notifications will only be received when alarms are turned on and the sensor is within 20 feet of the reading device.

2Diabetes Canada. https://diabetes.ca/DiabetesCanadaWebsite/media/Advocacy-and-Policy/Backgrounder/2020_Backgrounder_Canada_English_FINAL.pdf. accessed November 24, 2020.

3FreeStyle Libre 2 User Manual. Based on low glucose alarms set at 70 mg/dl.

4FreeStyle Libre 2 User Manual. Based on high glucose alarms set at 180 mg/dl.

5A finger prick test using a blood glucose meter is required during times of rapidly changing glucose levels when interstitial fluid glucose levels may not accurately reflect blood glucose levels, or if hypoglycemia or impending hypoglycemia is reported by the system, or when symptoms do not match the system readings.

6 Data on file, Abbott Diabetes Care. Data based on the number of users worldwide for the FreeStyle Libre portfolio compared to the number of users for other leading personal use, sensor-based glucose monitoring systems.

7The FreeStyle Libre 2 system has optional glucose alarms. Alarms need to be turned on in order to receive low and high glucose alarms.

8The FreeStyle LibreLink app is only compatible with certain mobile devices and operating systems. Please check the website for more information about device compatibility before using the app. Use of FreeStyle LibreLink requires registration with LibreView.

9Dunn, T., et al. Real-world flash glucose monitoring patterns and associations between self-monitoring frequency and glycaemic measures: A European analysis of over 60 million glucose tests. Diabetes Research and Clinical Practice; 137(2018) 37-46

10Ajjan R. Insights from real world use of flash continuous glucose monitoring. Symposium conducted at: American Diabetes Association 78th Scientific Sessions; June 2018; Orlando, FL

11Seibold A, Ells S, Schlaeger C, Welsh Z. A meta-analysis of real-world observational studies on the impact of flash glucose monitoring on glycemic control as measured by HbA1c. Poster presented at: 78th Scientific Sessions; June 2018; Orlando, FL.

12FokkertM,van DijkP,EdensM, et al, Improved well-being and decreased disease burden after 1-year use of flash glucose monitoring (FLARE-NL4), BMJ Open Diabetes Research and Care2019;7:e000809.doi:10.1136/bmjdrc-2019-000809

13The following three criteria must be met: intensive insulin therapy, frequent or severe hypoglycemia problems and the necessity of glycemia self-monitoring a minimum of eight times per day.

SOURCE Abbott

http://www.abbott.com

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Abbott's FreeStyle Libre 2 Now Approved for Adults and Children with Diabetes in Canada, Featuring Unsurpassed 14-Day Accuracy and Optional Alarms -...

New Delhi | Updated: December 7, 2020 10:26:46 am

Written by Ambrish Mithal

There are no established easy solutions to mitigate . While the world is battling the pandemic together, the graveness of the situation is felt more in countries such as India that simultaneously have a high burden of non-communicable diseases (NCDs) to tackle. Reports have revealed that people with pre-existing medical conditions such as diabetes, heart disease and kidney problems are more vulnerable to becoming severely ill with COVID-19 virus. And India, known as the diabetes capital of the world, has one in six people with diabetes. With an estimated 77 million diabetics, the ninth edition of the IDF Diabetes Atlas projected that India would continue to be at the second spot among the top 10 countries with diabetes till 2045.

As the alarming statistics of people with diabetes continue to rise across the country and the world, the role of nurses and healthcare professionals (who account for over half of the global health workforce) has become increasingly important in managing the impact of the disease. Adherence to insulin and correct injection technique plays a vital role when it comes to managing diabetes. The role of the diabetes nurse in India is performed by the diabetes educator, whose background is usually nutrition. Nurses role in insulin administration and managing hypoglycaemia is largely in the hospitalised patient, where it is very important too. Hence, the ward nurses require training on all aspects of insulin storage and administration technique. OPD is usually taken care of by diabetes educators/nutritionists.

Governments and healthcare industry must recognise the importance of investing in educating and training frontline workers who can make a huge difference in the lives of people with diabetes. Besides counselling patients with diabetes, nurses and diabetes educators can also guide them about the complications associated with incorrect injection technique, reuse of needles and wrong insulin storage. Therefore, there is a need to acknowledge how nurses as well as diabetes educators make a difference in managing diabetes.

Due to lack of awareness and training on the correct injection practices, a significant proportion of people reuse insulin pens and syringe needles that are intended for single use only. Reuse of the needle causes bending and blunting of the needle tip, increasing bleeding, pain, dosage inaccuracy and the chances of lipohypertrophy which is a thickened, rubbery swelling under the skin that develops under the usual injection site. Lipohypertrophy can lead to poor glycaemic control, hypoglycaemia, and glycaemic variability. Studies show that the frequency of needle re-use, significantly increase the risks of developing lipo., Moreover, used needles are prone to contamination by bacteria. At times, macroscopic blood regurgitation into a cartridge is also observed. In this case, if the needle is reused, it could lead to transmission of blood-borne infections.

Along with proper injecting guidance, it is imperative to know that insulin should be stored under favourable conditions. When exposed to extreme heat or cold, Insulin loses its ability to control the blood sugar. Unopened insulin should be stored in the refrigerator (2-8 degrees C) and once opened, a vial can be stored at a room temperature of around 15-25 degrees C or in the refrigerator (2-8 degrees C) for up to 28 days.

Now that we know how to store insulin and choose the right site for injecting insulin, here are a few other things to keep in mind if you have diabetes. Ensure that you do not use expired insulin as that may no longer be sterile and will likely not provide the expected outcome. As insulin needs to be given at room temperature, it is recommended to take it out from the refrigerator 30 minutes before the injection. Before injecting yourself, wash your hands properly with soap. After ensuring there are no bubbles in the syringe, draw the right dose of insulin. Push the needle into the skin while holding a skin-fold, inject slowly and steadily until it is all in and leave it in place for at least 10 seconds after injecting. Release the skin-fold after removing the needle from the skin.

Adherence to accurate medication is a major factor in determining treatment outcomes for people living with diabetes. At a time when the world is already grappling with COVID-19, patients with diabetes on insulin need to be all the more careful about managing their condition optimally. There is a need to educate patients and their families about the disadvantages related to inappropriate insulin injecting practice and to push patients to consult diabetes educators in case of any complications.

(The writer is chairman & head (endocrinology and diabetology), Max Healthcare)

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The diabetes nurse in Covid times - The Indian Express

Global Chiropody & Podiatry Market: Snapshot

Escalating number of sport injuries and diabetes patients is likely to generate promising demand opportunities in the global chiropody & podiatry market during the tenure of 2020 to 2030. Physiotherapy and surgery practices are two types of services available in the market for chiropody & podiatry.

An upcoming research report by Transparency Market Research on the chiropody & podiatry market intends to give inclusive analysis of drivers, trends, challenges, restraints, threats, and opportunities in this market. Moving forward, this report delivers reliable data on shares, volume, and revenues of the market for chiropody & podiatry. Thus, the study works as a helpful tool to gain complete synopsis of the chiropody & podiatry market for the forecast period of 2020 to 2030.

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Global Chiropody & Podiatry Market: Growth Dynamics

The global chiropody & podiatry market is all set to trace prodigious curve of expansion during the period of forthcoming years. This growth is attributed to plethora of factors. Chiropody and podiatry refer to healthcare services that are used in the treatment of numerous health issues including ingrowing toenails and thickened toenails, dry skin, calluses, corns, verrucae, cracked heels, ulcers, blisters, arthritic foot care, and diabetes. Thus, increased number of all these health issues is likely to fuel the demand opportunities in the chiropody & podiatry market in the upcoming years.

The chiropody & podiatry market is estimated to experience promising sales opportunities on the back of increased cases of sports injuries. In addition to this, the increased number of older population living in all worldwide locations is one of the key factors stimulating growth opportunities for vendors operating in the market for chiropody & podiatry.

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Global Chiropody & Podiatry Market: Competitive Analysis

The global chiropody & podiatry market experiences presence of quite considerable number of active players. As a result, the competitive landscape of the market for chiropody & podiatry is moderately intense. Vendors working in this market are using diverse strategies to gain the leading position.

Some of the key strategies executed by players in the chiropody & podiatry market include partnerships, mergers, acquisitions, joint ventures, product launches, and collaborations. Apart from this, many companies working in this market are increasing investments in research and development activities. This move is helping vendors to improve the services they offer. Owing to all these activities, the global chiropody & podiatry market is likely to develop at moderate pace during 20202030.

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The research report profiles key players working in the global chiropody & podiatry market. The list of important players in this market includes:

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Global Chiropody & Podiatry Market: Regional Assessment

In terms of region, the global chiropody & podiatry market shows existence in many regions including Europe, Latin America, North America, Asia Pacific, and the Middle East and Africa. Of all regions, Europe and North America are major regions in the market for chiropody & podiatry. This growth can be attributed to increased older population and increased instances of sports injuries in these regions. Apart from this, the market for chiropody & podiatry is likely to witness prodigious expansion opportunities in Asia Pacific. This growth is attributed to increased number of people living with diabetes.

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Chiropody & Podiatry Market: Escalating number of sport injuries and diabetes patients is likely to generate promising demand opportunities -...

Diabetes type 2: Dr Zoe Williams discusses high blood sugar risks

Type 2 diabetes is a chronic condition whereby the pancreas does not release enough insulin to regulate blood sugar or the insulin it does produce is not absorbed by the cells. Blood sugar is the main type of sugar found in blood. It performs important functions in the body but it must be regulated - unconstrained blood sugar levels can inflict permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels.

Stripped of the regulating hormone insulin, a person with type 2 diabetes must make healthy dietary decisions to control blood sugar levels.

Carbohydrates that rank high on the glycemic Index (GI) - a relative ranking of carbohydrate in foods according to how they affect blood glucose levels - are to be avoided or eaten in moderation.

High GI carbs are broken down quickly by the body and therefore raise blood sugar levels quickly.

White bread ranks high on the glycemic index so it is best to swap it for brown bread, which causes a slower rise in blood sugar levels.

READ MORE:Type 2 diabetes warning - four fruits that could be raising your blood sugar levels

However, you should inspect the packaging of brown bread products before purchasing because "a lot of brown bread is just colour-dyed white bread", according to Dr Michael Mosley, founder of The Fast 800.

As he explains to the Express.co.uk, these colour-dyed culprits often contain more sugar to make them more palatable.

"You have to read the side of the packet. If it is dense brown bread, rye, things with seeds or nuts in it there's a good chance it's okay. But often they've just processed it, so be cautious."

Dr Mosley added: "Id switch instead to quinoa, bulgur (cracked wheat), whole rye, whole-grain barley, wild rice and buckwheat.

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According to Dr Mosley, other healthy swaps include opting for lentils, beans, quinoa, wild rice and buckwheat over white pasta and white rice.

"The complex carbohydrates contain more fibre which supports the growth of friendly bacteria in your gut," he explains.

Dr Mosley says to completely cut back on cakes, sweets, biscuits, crisps, fruit juices and soft drinks.

"These foods rapidly turn into sugar in your blood causing sugar spikes and weight gain - they are like the tip of the iceberg," he warns.

In addition to modifying your diet, exercising regularly is integral to blood sugar control.

According to Diabetes UK, there isnt one type of activity thats best for everyone with diabetes.

Its about finding what works for you and depends on lots of things, like what you enjoy, where you are and how much time you have.

"Its best to do a mixture of different types of activity, because different types have different benefits. And doing the same thing can get boring after a while," the health body advises.

Many people have type 2 diabetes without realising - this is because symptoms do not necessarily make you feel unwell.

Symptoms of type 2 diabetes include:

According to the NHS, you should see your GP if you have any of the symptoms of type 2 diabetes or you're worried you may have a higher risk of getting type 2 diabetes.

As it points out, the earlier diabetes is diagnosed and treatment started, the better.

Original post:
Type 2 diabetes warning: The 'so-called' brown bread that could be raising blood sugar - Express

This article was originally published here

Cureus. 2020 Oct 31;12(10):e11278. doi: 10.7759/cureus.11278.

ABSTRACT

BACKGROUND: Glycated haemoglobin (HbA1c) is a marker that reflects the control of diabetes mellitus (DM) over a three-month period. We sought to compare cardiovascular outcomes of diabetic patients with and without controlled levels of HbA1c post percutaneous coronary intervention (PCI) presenting to King Faisal Cardiac Center. Methods: A retrospective single-center study of all patients with type two DM who were treated with PCI during the period between January 2015 and January 2018. All data were obtained from health informatics system. Demographics, clinical data, and major adverse cardiovascular and cerebrovascular events (MACCE) were collected to compare outcomes among diabetic patients with and without controlled HbA1c.

RESULTS: The study included 177 patients with type two DM who underwent PCI. The mean age was 63.3 (SD12). Males represented 73.4% and 26.6% were females. The mean HbA1c on admission was 8.7%. At presentation 31% of the patients had relatively controlled blood sugar (HbA1c mean 7.5%, SD0.5) and 69% presented with poorly controlled type two DM (mean HbA1c 9.1%, SD0.25). The prevalence of hypertension and dyslipidaemia were higher among the uncontrolled group, but there were no differences between both groups in the control of blood pressure or dyslipidaemia. Patients in the uncontrolled group had higher rate of prior PCI (36.6%) compared to the controlled arm (16%, p=0.0195) The prevalence of cerebrovascular, cardiovascular, and renal impairment was similar. The use of insulin was higher among the uncontrolled arm. Patients in the controlled arm had lower incidence of composite endpoints of death and non-fatal myocardial infarction and stroke (MACCE) (14% vs 41%, p=0.001) compared to the uncontrolled arm.

CONCLUSION: Among patients with type two DM that were treated with PCI, achieving targets of blood sugar control reflected by glycated haemoglobin is associated with improved survival and lower incidence of composite MACCE.

PMID:33274153 | PMC:PMC7707909 | DOI:10.7759/cureus.11278

Continue reading here:
Glycated Haemoglobin and Outcomes of Percutaneous Coronary Intervention Among Type Two Diabetic Patients in Saudi Arabia - DocWire News

The holidays can be a particularly difficult time, especially for seniors with diabetes.

Dr. Martin Nejat, a family medicine doctor at Conviva Care Centers, has provided some insight on why its so important to stay healthy during the pandemic.

What exactly is diabetes?

Our body breaks down the food we eat into sugar or energy, stated Conviva Care Centers. The pancreas makes insulin to help push the sugar into your cells. When you have diabetes, your body either cant make enough of the insulin, or is not able to use it as well as it should.

Diabetes is a very serious condition its a complex medical problem that is very prevalent in the San Antonio area, according to Nejat.

There are four types of diabetes. In the San Antonio area, when we talk about diabetes, we are usually referring to Type 2 diabetes, Nejat said. Its a disease of basically obesity. The sugars are high because the body simultaneously has decreased insulin production and insulin resistance and both of these conditions are caused by obesity.

Is all sugar created equal?

Absolutely not. One way to monitor this is by using the glycemic index, said a representative for Conviva Care Centers.

Nejat said any organ in the body can be affected by high sugar.

Right now we are in a pandemic, and one of the ways that makes you more likely to have serious complications of COVID is poorly controlled diabetes, Nejat said.

How should I read a nutrition label to assess if this food is OK for me to eat?

You want to pay close attention to the carbohydrates, which are broken down into sugar, specifically, the added sugar.

Another rule of thumb is to do most of your grocery shopping around the perimeter of the grocery store, picking up fresh fruit and produce, meats, etc., and stay away from the packaged goods, known as processed foods.

How do I lower my blood sugar?

Take medication, have a balanced diet, drink plenty of water and exercise frequently.

If you are looking for a new health care group, Conviva Care Centers has eight locations in San Antonio -- and each location has activity centers that are free and open to anyone ages 55 and older for primary care. To learn more, click here.

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Have diabetes? Health care group provides tips on how to manage the disease - KSAT San Antonio

A novel lower-cost noninvasive continuous glucose monitor (CGM) combined with a digital education/guidance program is set to launch in the United States and Europe this month for use in type 2 diabetes.

With the goal of improving management, or even reversing the condition, Neumara's SugarBEAT device is thought to be the world's first noninvasive CGM.

Its cost is anticipated to be far lower than traditional CGM, and it's aimed at a different patient population: those with type 2 diabetes or prediabetes who may or may not be performing fingerstick glucose monitoring, but if they are, they still aren't using the information to guide management.

"This isn't about handing out devices and letting patients get on about it on their own accord. This is really about supporting those individuals," Faz Chowdhury, MD, Nemaura's chief executive officer, told Medscape Medical News in an interview.

He pointed to studies showing improvements in glycemic control in patients with type 2 diabetes who were instructed to perform fingerstick blood glucose testing seven times a day for 3-4 days a month and given advice about how to respond to the data.

"This is well-established. We're saying we can make that process a lot more scalable and affordable and convenient for the patient...The behavior change side is digitized," Chowdhury said. "We want to provide a program to help people reverse their diabetes or at least stabilize it as much as possible."

Asked to comment, Nicholas Argento, MD, diabetes technology director at Maryland Endocrine and Diabetes, Columbia, told Medscape Medical News: "It's interesting. They're taking a very different approach. I think there's a lot of validity to what they're looking at because we have great CGMs right now, but because of the price point it's not accessible to a lot of people."

"I think they're onto something that could prove to be useful to a larger group of patients," he added.

Instead of inserting a catheter under the skin with a needle, as do current CGMs, the device comprises a small rechargeable transmitter and adhesive patch with a sensor that sits on the top of the skin, typically the upper arm. Glucose molecules are drawn out of the interstitial fluid just below the skin and into a chamber where the transmitter measures the glucose level and transmits the data every 5 minutes via Bluetooth to a smartphone app.

Despite this noninvasive approach, the device appears to be about as accurate as traditional CGMs, with comparable mean absolute relative difference (MARD) from a gold standard glucose measure of about 11%-12% with once-daily calibration versus 10%-11% for the Abbott FreeStyle Libre.

Unlike traditional CGMs, SugarBEAT is meant to be worn for only 14 hours at a timeduring the day and for 2-4 days per month rather than every day.

It's not aimed at patients with type 1 diabetes or those with type 2 diabetes who are at high risk for hypoglycemia. It requires once-daily fingerstick calibration and is not indicated to replace fingersticks for treatment decisions.

SugarBEAT received a CE Mark in Europe as a Class IIb medical device in May 2019. That version provides real-time glucose values visible to the wearer. In the United States the company submitted a premarketing approval application for the device to the Food and Drug Administration (FDA) in July 2020, which awaits a decision.

However, FDA is allowing it to enter the US market as a "wellness" device that won't deliver real-time values for now but instead will generate retroactive reports available to the physician and the patient.

And last month, UK-based Neumara launched the BEATdiabetes site, which allows users to sign in and link to the device once it becomes available.

The site provides "scientifically validated, personalized coaching" based on a program developed at the Joslin Diabetes Clinic, and will ultimately include monitoring of other cardiovascular risk factors with digital connectivity to a variety of wearables.

"Fingerstick monitoring for type 2 diabetes is only so useful," Argento told Medscape Medical News.

"It's difficult to get people to monitor in a meaningful way." If patients perform them only in the morning or at other sporadic times of the day, he said, "Then you get a one-dimensional picture...and they don't know what to do with the information anyway, so they stop doing it."

In contrast, with SugarBEAT and BEATDiabetes, "I think it does address a need that fingerstick monitoring doesn't."

Argento did express a few caveats about the device, however. For one, it still requires one fingerstick a day for calibration. "If people don't like needles, that might be a disincentive."

Also, despite the apparently comparable MARD to that of conventional CGMs, that measure can still "hide" values that may be consistently either above or below target range.

"MARD is like A1c in that it's useful but limited...It doesn't tell you about variability or systemic bias."

Argento also said that he'd like to see data on the lag time between the interstitial fluid and blood glucose measures with this noninvasive method as compared to that of a subcutaneous catheter.

However, he acknowledged that these potentials for error would be less important for patients with type 2 diabetes who aren't generally taking medications that increase their risk for hypoglycemia.

In all, he said, "Stay tuned. I think this is part of a movement going away from point-in-time to looking at trends and wearables and data to enrich decision-makingThere are still some unanswered questions I have but I think they're onto a concept that's useful for a broader population."

Chowdhury is an employee of Neumara. Argento consults for Senseonics and Dexcom, and is also a speaker for Dexcom.

For more diabetes and endocrinology news, follow us on Twitter and Facebook.

Read the original post:
Noninvasive, Low Cost CGM for Type 2 Diabetes Coming in US and EU - Medscape

November was National Diabetes Month. WJZs Nicole Baker spoke with LifeBridge Health Dr. Asha Thomas about what diabetes is and how to prevent getting at least one form of it.

Thomas, who is the Division Head of Endocrinology & Metabolism and Vice Chair of the Department of Medicine at Sinai Hospital, answered questions about diabetes prevention and treatment.

You can watch the full interview above. Heres some of the Q&A:

Nicole Baker: So we know that you work in Endocrinology and Metabolism at Sinai, which means you really know how diabetes works, but for people who may not specifically know about diabetes explain in simple terms, what it is.

Dr. Asha Thomas: Absolutely, in terms of diabetes, a word we hear a lot, I think automatically when we hear the word, we think of sugar and blood sugar and all of this. But in general, diabetes is a disorder where there is a mismatch between how our body handles carbohydrates and sugars. And how insulin works in our bodies, and you know there are different types of diabetes which we can talk about, but in essence, that is really the issue. Its just our bodys inability to kind of manage and handle our sugars or carbohydrates.

NB: What are some of the habits lifestyle changes folks can make if they are prediabetic or is it too late at that point?

Dr. Thomas: That is the population, honestly that for myself, Im most excited to try to capture because there are certain things that are actually pretty low tech and not very expensive that are very, very effective. So primarily diet, exercise and weight, either at least even maintenance or weight loss. So if we capture folks in that range, were really able to prevent diabetes.

The other thing to talk about that I think is very important is whos at risk for this. So its a whole host of people these are people who have a strong family history of diabetes. Folks, particularly women, whove had gestational diabetes or diabetes during a pregnancy. They have a higher risk of developing diabetes later on. Different ethnic groups have a higher risk of diabetes including African American, Hispanic, Asian Americans, Native Americans. Then obviously young people, children who are overweight during their youth and teen years as another high risk group, so if we can target that and really work with them early big benefits later on.

NB: What is the difference between Type 1 Diabetes and Type 2 Diabetes? People may not know how they differ.

Dr. Thomas: Thats actually a distinction thats becoming more and more complicated. But generally Type 1 Diabetes is a disorder. That is an autoimmune problem, where our bodys pancreas is really getting sort of damaged from an autoimmune process, such that we just dont make enough insulin. Traditionally, we think of it as younger people who get it, that they may develop it, you know when theyre young sort of between 4 and 6. And then theres another sort of peak like in the early teen years where they present and many times they present, theyre not feeling well and they need insulin from the beginning.

Type 2 Diabetes is more traditional, what we think of like a more of an adult who presents with diabetes with an abnormal blood test. It can be because they had issues with weight loss, fatigue, blurred vision, going to the bathroom a lot to urinate and feeling really thirsty. Generally those are folks that are diagnosed and they can be managed either with pills or with insulin, depending on how far along. Sometimes its not that easy to tell between the two and there are different genetic components of each one as well.

Visit link:
Ask A Doc: Everything You Need To Know About Diabetes - CBS Baltimore

A growing body of research suggests that people with diabetes are more likely than others to develop severe COVID-19. Those with difficulty managing their diabetes may be at particularly high risk.

In a study published earlier this month, researchers from Kings College London in the United Kingdom evaluated patients with diabetes who had been admitted to the hospital for COVID-19.

They found that patients who had a complication known as diabetic retinopathy were more likely than other patients with diabetes to develop severe breathing problems from COVID-19.

Patients with diabetic retinopathy were five times more likely than other patients with diabetes to be intubated and put on a ventilator to help them breathe.

This is the first time that retinopathy has been linked to severe COVID-19 in people with diabetes, lead author of the study, Dr. Antonella Corcillo, said in a press release.

Retinopathy is a marker of damage to the blood vessels, and our results suggest that such preexisting damage to blood vessels may result in a more severe COVID-19 infection requiring intensive care treatment, she added.

Diabetic retinopathy is a type of eye disease that develops when small blood vessels in the eye are damaged. Its one of many potential complications of type 1 and type 2 diabetes.

Diabetic retinopathy itself may not cause more severe COVID-19. Rather, its possible that the underlying blood vessel damage that causes retinopathy also contributes to an increased risk of complications from COVID-19.

Over time, high blood sugar levels in people with diabetes can damage blood vessels in not only the eye but also other parts of the body.

Preexisting blood vessel damage may put people with COVID-19 at heightened risk of complications from the infection.

Dr. Mangala Narasimhan, SVP, director of critical care services at Northwell Health in New Hyde Park, New York, told Healthline that developing diabetic retinopathy may indicate that diabetes is affecting a persons overall health.

We know people with more comorbidities do worse with COVID, so this study would be consistent with that overall theme, Narasimhan said.

The Centers for Disease Control and Prevention (CDC) warns that people with type 2 diabetes are at heightened risk of severe illness from COVID-19. Those with type 1 or gestational diabetes might also be at increased risk.

To protect their health, its important for people with diabetes to manage their blood sugar levels and other risk factors including blood pressure, blood cholesterol, and weight.

This can help reduce the chances of developing complications from diabetes, including blood vessel damage. It may also lower their risk of developing severe COVID-19 if they contract the novel coronavirus.

Gaining control of [unmanaged] diabetes can be a daunting task, but its important for patients to remember that even small efforts can result in significant improvement and therefore a reduction in risk of complications from COVID-19, Dr. Minisha Sood, an endocrinologist at Lenox Hill Hospital in New York City, told Healthline.

To maintain healthy blood sugar levels, blood pressure, cholesterol, and weight, practicing healthy habits is key. Its also important for people with diabetes to schedule regular health checkups and follow their doctors recommendations for blood sugar testing, said Narasimhan.

Regular physician follow up, ophthalmology follow up, and control of diet and exercise, along with social distancing and mask wearing, are the best steps you can take to prevent severe COVID infection, Narasimhan advises.

The more you manage your diabetes, the better you will do with COVID, she added.

Read more from the original source:
The Link Between Diabetes and Severe COVID-19 - Healthline

The impact Covid-19 has had on people with chronic conditions has been dramatic. Among those younger than 65 who died from the virus, 20% had diabetes, according to data from the U.S. Centers for Disease Control and Prevention, based on data collected through November 14.

The virus poses myriad challenges for people struggling with Type 2 diabetes, which requires constant, long-term management. But the stress caused by Covid-19s impact on the economy, and indirectly by the CDC guidance to reduce risk of contracting Covid-19 by social distancing, can also cause depression, which many people with chronic conditions struggle with as it is.

More than 200 healthcare professionals from 47 countries have ranked diabetes as the condition that will be most impacted by the reduction in healthcare resources due to Covid-19, according to a new report from Omada Health: 5 reasons why Covid-19 makes digital diabetes treatment critical.

The public health crisis drives home the need for diabetes management programs with an effectiveness that can help vulnerable people weather this trying time.

The rapid scaling up of telehealth options by hospitals to reduce the number of people coming to the hospital has been a significant development that could be a great source of comfort long after the virus is no longer a public health crisis. And yet, gaps remain in telehealth services.

Covid-19 has made the need for personalized care even more important. Its critical that people with diabetes have access to support that fits their lifestyle, and is accessible when they need it most, according to the Omada Health report.

Omada for Diabetes program participants achieved meaningful outcomes four months after beginning the program, even prior to the inclusion of continuous glucose monitoring (CGM), according to a new study conducted between November 2019 and July 2020. Four months after beginning the program, participants decreased total cholesterol by 39 points on average for people with high cholesterol.

All study participants also reduced average Hemoglobin A1c by 0.8 percent, including a 1.4 percent average reduction for individuals with starting values at or above 9 percent.

To learn more about the impact of Covid-19 on people with diabetes and the Omada for Diabetes program, Fill in the form below to download 5 reasons why Covid-19 makes digital diabetes treatment critical.

Photo: NicoElNino, Getty Images

Excerpt from:
Covid-19's terrible toll on diabetes patients. What can be done? - MedCity News

Author Irene Richardson - November 30, 2020November 30, 2020Exercise is an important step in preventing type 2 diabetes. Photo via Blue Cross and Blue Shield of Alabama (photo taken in 2019)

As we close out National Diabetes Awareness month, its important to remind ourselves of the risks attached to diabetes. By changing a few habits, you can prevent type 2 diabetes and manage it. We caught up with Blue Cross and Blue Shield of Alabamas senior medical director, Dr. Anne Schmidt, to learn what resources are available.

One of the things that always stands out to me is when you look at national statistics from the CDC, they state if we changed diet and activity level along with peoples use of tobacco we could prevent 80% of type 2 diabetes.

You read that right80%. A 2019 report from the CDC states that from the over 34 million Americans who have diabetes, approximately 90-95% of them have type 2 diabetes. Lets look at how we can lower this statistic.

Diabetes isnt just about blood sugar. It affects kidney health and can cause higher rates of kidney failure and dialysis. Diabetes also affects blood sugar and how your body metabolizes fat. There are all kinds of different impacts of diabetes beyond just blood sugar. So, thats why its really important we help patients manage that.

Most people look at any lifestyle change as a daunting task. Even getting up 10 minutes earlier than your normal routine can prove difficult.

Its true that redirecting daily habits isnt always as easy as it appears on the surface. But, in order to prevent type 2 diabetes, these modifications wont require a complete overhaul of your life.

Incorporate changes into your daily life. We know if you lose 5-7% of your body weight and get 150 minutes of physical activity a week, it can make significant improvements.

This might look like finding ways to add in an extra green vegetable at lunch and dinnertime as you begin to develop new healthier habits.

In terms of exercise, its the same deal. You hear it over and over for a reasonuse the stairs, park a little further away, walk around the block on your lunch break.

When it comes to 20 minutes of exercise a day versus kidney disease, Ill side with the former. We even rounded up 19 trails in Birmingham you can enjoy while also staying socially distanced.

A common myth Dr. Schmidt says people tend to believe is that if diabetes runs in your family, youre doomed. Too often, people give up trying to prevent type 2 diabetes with the notion that their fate is already crystal clear.

Even if you already have type 1 or type 2 diabetes, its not unrealistic to manage it and live a comfortable life.

Its possible to manage diabetes. Some people who have relatives with diabetes might have a fatalistic attitude of, I might as well give up because Im going to end up like my aunt or dad or grandfather.'

While you cant prevent type 1 diabetes, BCBSAL has great resources like lifestyle management programs for living with type 1 diagnosis that well talk about later. Type 2 diabetes, on the other hand, is avoidable. Prevention practices should take place as early as possible.

We are seeing Type 2 diabetes in elementary school-aged children now. Its never too young to start thinking about preventing the diagnosis.

Its really about exercise, in addition to your diet. Exercise changes the way your body processes the sugar that you eat.

Whether youre hoping to prevent diabetes or looking to navigate your condition, BCBSAL has many valuable resources for its members including myBlueWellness. This program provides important information about making better choices when it comes to managing habits and becoming compliant with a treatment plan.

BCBSAL offers chronic condition coaching programs. Type 2 diabetes is one of the diagnoses most prevalent in our state. We use clinical guidelines and offer educational materials and self-management support strategies for members.

If you have type 1 or type 2 diabetes, BCBSAL ensures youre on the best track to managing it.

If you manage your diabetes well, you can live a long and healthy life. BCBSAL can definitely help through diabetes prevention programs and chronic condition coaching. We also have lifestyle management programs.

Its also imperative you maintain routine doctors visits. If youre not comfortable heading into the doc right now, take advantage of BCBSALs telehealth services.

Related

Visit link:
Prevent type 2 diabetes with 5 tips from Blue Cross and Blue Shield of Alabama - Bham Now

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Risk of intubation for COVID-19 in very sick hospitalized patients was increased over fivefold in those with diabetic retinopathy compared to those without, in a small single-center study from the UK.

Importantly, the risk of intubation was independent of conventional risk factors for poor COVID-19 outcomes.

"People with pre-existing diabetes-related vascular damage, such as retinopathy, might be predisposed to a more severe form of COVID-19 requiring ventilation in the intensive therapy unit," said lead investigator Janaka Karalliedde, MBBS, PhD.

Karalliedde and his colleagues note that this is "the first description of diabetic retinopathy as a potential risk factor for poor COVID-19 outcomes."

"For this reason, looking for the presence or history of retinopathy or other vascular complications of diabetes may help health care professionals identify patients at high risk of severe COVID-19," added Karalliedde, of Guy's and St Thomas' NHS Foundation Trust, London, UK.

The study was published online in Diabetes Research and Clinical Practice.

The prevalence of diabetic retinopathy is thought to be around 55% in people with type 1 diabetes and 30% in people with type 2 diabetes, on average.

Karalliedde is part of a research group at King's College London that has been focused on how vascular disease may predispose to more severe COVID-19.

"COVID-19 affects the blood vessels all over the body," he said, so they wondered whetherhaving pre-existing retinopathy "would predispose to a severe manifestation of COVID-19."

The observational study included 187 patients with diabetes (179 patients with type 2 diabetes and eight patients with type 1 diabetes)hospitalized with COVID-19 at Guy's and St Thomas' NHS Foundation Trust between March 12 to April 7 (the peak of the first wave of the pandemic in the UK).

"It was an ethnically diverse population who were very sick and provides a clinical observation of real life," Karalliedde said.

Nearly half of patients were African Caribbean (44%), 39% were White, and 17% were of other ethnicities, including 8% who were Asian. The mean age of the cohort was 68 years (range, 22-97 years), and 60% were men.

Diabetic retinopathy was reported in 67 (36%) patients, of whom 80% had background retinopathy and 20% had more advanced retinopathy.

They then looked at whether the presence of retinopathy was associated with a more severe manifestation of COVID-19 as defined by the need for tracheal intubation.

Of the 187 patients, 26% were intubated and 45% of these patients had diabetic retinopathy.

The analysis showed those with diabetic retinopathy had an over fivefold increased risk for intubation (OR, 5.81; 95% CI, 1.37 - 24.66).

IOf the entire cohort, 32% of patients died, although no association was observed between retinopathy and mortality.

"A greater number of diabetes patients with COVID-19 ended up on the intensive therapy unit. Upon multivariate analysis, we found retinopathy was independently associated with ending up on the intensive therapy unit," stressed Karalliedde.

However, they note that "Due to the cross-sectional design of our study, we cannot prove causality [between retinopathy and intubation]."

"Further studies are required to understand the mechanisms that explain the associations between retinopathy and other indices of microangiopathy with severe COVID-19."

Diabetes Res Clin Pract. Published online November 2, 2020. Full text

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Read more:
Diabetic Retinopathy May Predict Greater Risk of COVID-19 Severity - Medscape

Following authorization allowing pharmacists to administer childhood vaccines, some pediatricians have expressed concerns that this deprives children of medical care or could lead to missed vaccines.

The researchers launched the Perinatal Experiences and COVID-19 Effects Study to better understand the mental health and well-being of pregnant and postpartum individuals within the United States during the COVID-19 pandemic.

Despite the COVID-19 pandemic, several promising drugs are expected to hit the market in late 2020 and early 2021.

Beta-blockers could be used as a potential treatment for COVID-19, according to a study by Italian and Australian researchers.

Patients with relapsed/refractory leukemia and lymphomas generally have a grim prognosis, which has paved the way for immunotherapy treatments.

Researchers find no clear therapeutic benefit of intravenous immunoglobulin for the prevention of postnatal relapses of multiple sclerosis.

Further, the findings suggest that cancer survivors are also likely to be at an increased risk of severe coronavirus disease 2019 (COVID-19) outcomes, given that both influenza and COVID-19 are both epidemic respiratory viruses.

Four case studies demonstrate common OTC treatments for cough.

Compared with patients with focal epilepsy, those with genialized epilepsy have a higher risk of obstructive sleep apnea.

FDA grants fast track designation to irinotecan liposome injection (Onivyde; MM-398) as second-line monotherapy for patients with small cell lung cancer whose disease progressed following a platinum-based chemotherapy regimen.

Warning letters requested that companies immediately stop selling these unapproved products and said consumers concerned about COVID-19 should talk to their health care provider.

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People With Type 2 Diabetes Have a Greater Risk of Cardiovascular Disease Even With Risk Factors Optimally Controlled - Pharmacy Times