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American Diabetes Association (ADA), the nations leading organization for all people living with diabetes, published a scientific review addressing social determinants of health (SDOH) and diabetes. Toward the goal of understanding and improving the health of people with diabetes through addressing SDOH, a writing committeeconvened by the ADAreviewed past evidence and research on diabetes risk and outcomes, as well as the impacts of interventions in these determinants.

People living with diabetes face many challenges. Some of these relate to the disease itself, but increasingly we recognize the importance of many social determinants, said Robert A. Gabbay, Chief Scientific and Medical Officer for the ADA. The scientific review not only defines these issues but shines a bright light on the resulting health disparities and articulates an important research agenda to address these issues. The release of this important scientific review underlines the American Diabetes Associations commitment for #HealthEquityNow.

As defined by the World Health Organization (WHO), social determinants of health are the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at global, national, and local levels. The social determinants of health are mostly responsible for health inequitiesthe unfair and avoidable differences in health status seen within and between countries. The COVID-19 pandemic has further exposed unequal vulnerabilities that impact racial and ethnic minority groups and disadvantaged communities. Understanding and mitigating the impact of SDOH for people with diabetes are priorities due to disease prevalence, economic costs, and disproportionate population burden.

The ADA committee summarized the following recommendations from international and U.S. national committees that have convened to provide guidance on SDOH intervention approaches:

This is a critical time in our nations history. As researchers and providers, we have the opportunity to advance solutions to the longstanding inequities that impact diabetes and other health conditions, said Dr. Felicia Hill-Briggs, past ADA President of Health Care and Education and Chair of the SDOH writing committee. Through this SDOH review, the American Diabetes Association is taking an important step toward acknowledging and setting the stage for the important research, policy, and implementation work that must be done in order to change the trajectory of inequity.

The paper begins with a general outline of key definitions and SDOH frameworks and includes a literature review that focuses primarily on U.S.-based studies of adults with diabetes and on five aspects of SDOH: socioeconomic status (education, income, occupation); neighborhood and physical environment (housing, built environment, toxic environmental exposures); food environment (food insecurity, food access); health care (access, affordability, quality); and social context (social cohesion, social capital, social support). The paper concludes with recommendations for linkages across health care and community sectors, diabetes research, and research to inform practice.

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Scientific Review on Social Determinants of Health and Diabetes - The Ritz Herald

This article was originally published here

Curr Pharm Des. 2020 Nov 1. doi: 10.2174/1381612826666201102102233. Online ahead of print.

ABSTRACT

MicroRNAs represent a class of small (19-25 nucleotides) single-strand pieces of RNA, that are non-coding ones. They are synthesized by RNA polymerase II from transcripts which fold back on themselves. They mostly act as gene regulatory agents, that pair with complementary sequences on mRNA and produce silencing complexes, which in turn suppress coding genes at a post-transcriptional level. There is now evidence that microRNAs may affect insulin secretion or insulin action, as they can alter pancreatic beta cells development, insulin production, as well as insulin signalling. Any molecular disorder that affects these pathways can deteriorate insulin resistance and lead to type 2 diabetes mellitus (T2DM) onset. Furthermore, the expression of several microRNAs is up- or down-regulated in the presence of diabetic microvascular complications (i.e. peripheral neuropathy, nephropathy, retinopathy, foot ulcers), as well as in patients with coronary heart disease, stroke, and peripheral artery disease. However, more evidence is needed, specifically regarding T2DM patients, to establish the use of such microRNAs as diagnostical biomarkers or therapeutic targets in daily practice.

PMID:33138753 | DOI:10.2174/1381612826666201102102233

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The role of microRNAs in the development of type 2 diabetes complications - DocWire News

Among patients diagnosed with HIV-1 or hepatitis B, the adjusted risk of incident type 2 diabetes was 33% lower among those who had been exposed to nucleoside reverse-transcriptase inhibitor (NRTI) drugs compared with those not exposed, suggesting that NRTIs have the potential to be repurposed for diabetes prevention in the future, according to a study published in Nature Communications.

After examining patient data from the Veterans Health Administration (VHA) over a 17-year period, researchers concluded that NRTIs are associated with a reduced risk of developing type 2 diabetes after adjusting for sociodemographic factors and comorbidities. To confirm this finding among more diverse populations, researchers examined patient data from 4 additional insurance databases: Truven, PearlDriver, Medicare, and Clinformatics.

In the VHA database, a total of 79,744 patients had a confirmed diagnoses of HIV or hepatitis B and did not have a prior type 2 diabetes diagnosis; 12,311 of these patients eventually developed type 2 diabetes. NRTI users had a 34% reduced risk of developing type 2 diabetes.

In the Truven database, 1630 of 23,634 HIV-positive or hepatitis B-positive patients developed incident type 2 diabetes; NRTI users had a 39% reduced risk of developing diabetes compared to non-NRTI users. Similarly, 1068 of 16,045 eligible patients in the PearlDriver database developed type 2 diabetes; NRTI users had a 26% reduced risk. A total of 3097 Medicare patients were eligible; 707 of these patients developed type 2 diabetes, and NRTI users had a 17% reduced risk. Researchers identified 6341 eligible patients in the Clinformatics database, 1067 of whom developed type 2 diabetes. NRTI users in this group had a 27% reduced hazard of developing type 2 diabetes.

At 1, 2, 5, and 10 years of follow up, NRTI users maintained a reduced hazard of developing type 2 diabetes. In the VHA cohort, follow-up durations and mortality rates were comparable between NRTI users and non-users; researchers concluded that differences in mortality rates were not responsible for the observed risk reduction for type 2 diabetes among NRTI users.

Among patients in the VHA cohort who were hepatitis B-positive and HIV-negative, NRTI use was associated with a 28% reduced risk for developing type 2 diabetes. For HIV-positive and hepatitis B-negative patients, researchers observed a 38% reduced risk for type 2 diabetes in the veterans cohort.

With each additional year of using NRTIs, patients diagnosed with HIV-1 or hepatitis B in all 5 cohorts had a 3% to 8% reduced hazard of developing type 2 diabetes. Researchers could not establish a consistent association between other drug classes aside from NRTIs that are used to treat HIV or hepatitis B and incident development of type 2 diabetes.

Researchers then studied insulin resistance-induced human cells to observe the effects NRTIs have on non-HIV-positive or hepatitis B-positive patients, and concluded that NRTI drugs such as lamivudine, azidothymidine, and stavudine were effective in improving insulin resistance.

We find that NRTI exposure is associated with reduced development of type 2 diabetes in people and that lamivudine inhibits inflammasome activation and improves insulin sensitivity in experimental systems, concluded the study authors.

Disclosure: Multiple authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors disclosures.

Ambati J, Magagnoli J, Leung H, et al. Repurposing anti-inflammasome NRTIs for improving insulin sensitivity and reducing type 2 diabetes development. Nat Commun. 2020;11(1):4737.

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HIV, Hepatitis-B Drugs Proven to Reduce Risk of Type 2 Diabetes - Clinical Advisor

BETHESDA, Md., Nov. 2, 2020 /PRNewswire/ -- As COVID-19 appears to be building momentum worldwide, America's podiatrists say they're treating some of the sickest patients of their careersbut those patients are not suffering from the coronavirus. Instead, they're patients with diabetes who have delayed care due to fear of exposure to the virus and are suffering serious complications, ranging from severe diabetic foot wounds to gangrene to sepsis. Data have shown amputation rates are anywhere from three to 10 times what they were prior to the pandemic.

Podiatrists witness parallel public health crisis as amputation rates skyrocket during COVID-19 pandemic.

The American Podiatric Medical Association (APMA) is marking November's Diabetes Awareness Month with a public education campaign designed to urge the 34 million Americans living with diabetes to keep their regular health-care appointments. The campaign, Keep Your Appointment, Keep Your Feet, will provide strategies for maintaining control of diabetes during the pandemic and information about when to seek care for a foot or ankle concern.

"People with diabetes are at high risk from COVID-19," said APMA President Seth A. Rubenstein, DPM. "They should absolutely take appropriate precautions, such as wearing masks in public and avoiding large gatherings. In addition to taking such precautions, they also must continue to monitor and care for their diabetes."

In fact, Dr. Rubenstein said, the risks of avoiding diabetes care are much higher than the risk of exposure to the coronavirus in a medical facility. Physicians' practices are taking extensive precautions to keep patients and providers alike safe during the pandemic. Safeguards include additional PPE, requirements for patients to wear masks, social distancing in waiting areas, temperature checks, pre-appointment questionnaires, disinfection between patients, and more. Virtual appointments may also be available.

"We're encouraging people with diabetes to keep their appointments to keep their feet," said Priya Parthasarathy, DPM, chair of the APMA Communications Committee. "During the pandemic, we want patients to stay active, stay alert, and stay in contact with their podiatrist."

Patients can stay active by engaging in regular exercise. They should stick to a sensible diet designed to help control their blood sugar and keep all their appointments with their diabetes care team. They can stay alert by being vigilant about daily foot exams, looking for changes in color or temperature of the feet and new injuries. They should wear shoes, even around the house. Patients can stay in contact by keeping their regular health-care appointments, especially with their podiatrist. If they notice a change in their feet or sustain an injury, they should contact their podiatrist immediately.

To learn more about the campaign, visit http://www.apma.org/diabetes.

The American Podiatric Medical Association (APMA) is the nation's leading professional organization for today's podiatrists. Doctors of Podiatric Medicine (DPMs) are qualified by their education, training, and experience to diagnose and treat conditions affecting the foot, ankle, and structures of the leg. APMA has 53 state component locations across the United States and its territories, with a membership of more than 12,500 podiatrists. All practicing APMA members are licensed by the state in which they practice podiatric medicine. For more information, visit http://www.apma.org.

Contact: Leon Valentinelvalentine@apma.org301-581-9221

Originally posted here:
Podiatrists Caution Patients with Diabetes Not to Avoid Care Due to Fear of COVID-19 - Herald-Mail Media

November is National Diabetes Month.In the U.S., its estimated that some 30 million adults ages 18 and older are living with diabetes and 84 million with pre-diabetes. While these dire statistics arent going to change overnight, the power to change our health is in our hands, a new study says. One of the simplest things we can do to change our risk? Go plant-based.

Back in August, we reported on a study out of the University of Bergen in Norway, that found that plant-based diets help you metabolize glucose, lose weight (particularly for people who are overweight), and prevent the onset of type 2 diabetes. Now, were back with more encouraging news for implementing a plant-based diet as an affordable, effective way to ward off type 2 diabetes.

In a recent review published in Practical Diabetology titled The Affordability of a Plant-Based Eating Pattern for Diabetes, the papers author, nutritionist Meghan Jardine, MS, MBA, RDN, LD, CDCES, Associate Director of Diabetes Nutrition Education, Physicians Committee for Responsible Medicine, recommends that anyone at high-risk go plant-based and that doctors and nutritionists should make it clear that there are affordable options when ditching meat and dairy.

Plant-based eating has become more popular as a healthy eating pattern for the prevention and treatment of diabetes, Jardine writes. Both observational and interventional studies have reported that plant-based diets reduce diabetes risk as well as improve diabetes outcomes, she later states, referencing this 2016 comprehensive review on the use of a plant-based diet for management of type 2 diabetes.

Worth mentioning: When it comes to eating a plant-based for diabetes management or prevention, its important to consider carbohydrates. Its heavily processed, refined carbohydrateslike white bread and chipsyou want to avoid. As Jardine points out, A healthy, affordable, plant-based diet is high in [carbohydrates]. Patients with diabetes are often told to avoid foods high in carbohydrate, as these foods have the greatest effect on postprandial glucose levels. She also notes that studies, such as this 2017 study from the Journal of Geriatric Cardiology, show that a high intake of carbohydrates, such as whole grains and cereal fibers, are associated with a reduction in diabetes risk, whereas refined carbohydrates increase risk. (For more on healthy carb options, check out our guide to whole grains here.)

While vegan eating may have the rap as a costly lifestyle, as Jardine argues and research supports, eating a healthy, plant-based diet can actually be quite wallet-friendly, and even save you money compared to other dietary regimes with animal products. Some healthy, affordable plant-based options the piece suggests include apples, bananas, oranges, broccoli, spinach, carrots, whole wheat bread, rolled or steel-cut oats, quinoa, black beans, pinto beans, and peanut butter, to name a few.

Buying foods when theyre in season and purchasing items like fruits, vegetables, legumes, and grains in bulk can also go a long way in reducing spending. Ditto for shopping the frozen aisle for fruits and vegetablesjust make sure there is no added salt, sugar, or other icky ingredientsand loading up on vegan pantry items when they are on sale. (If youre looking for more ways to save, check out 7 Ways to Save Money on Your Vegan Grocery List, According to Nutritionists.)

Bottom line: Eating a high-quality, plant-based eating pattern can be affordable and palatable and may offer specific benefits in preventing and treating diabetes, including quality of life and psychological health, offers Jardine. Frequent consumption of animal products has been associated with obesity, type 2 diabetes, heart disease, certain types of cancer and overall mortality. A diet thats good for our health and good for our wallets? Well take it. Spread the word, and spread the overnight oats recipes, dear readers.

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The Best Way to Prevent Diabetes: An Affordable Plant-Based Diet - The Beet

This article was originally published here

Int J Mol Sci. 2020 Oct 29;21(21):E8075. doi: 10.3390/ijms21218075.

ABSTRACT

Circulating calprotectin is a potential biomarker for endovascular inflammation in type 2 diabetes mellitus (T2DM). We investigated the determinants of calprotectin and its relationship with the presence of cardiovascular disease (CVD) in 362 T2DM patients included in the Diabetes and Lifestyle Cohort Twente-1 (DIALECT-1) study. Lifestyle exposures, including nutrition, were determined by validated questionnaires. CVD was defined as coronary artery diseases, strokes, and peripheral artery diseases. Median serum calprotectin levels were 1.04 mg/L [IQR: 0.73-1.46 mg/L] and were higher in women (1.11 mg/L) than men (0.96 mg/L, p = 0.007). Current smoking was a major independent determinant of circulating calprotectin, with a 51% higher calprotectin compared to never smoking (p < 0.001). Albuminuria (p = 0.011), former smoking (p = 0.023), and intake of mono- and disaccharides (p = 0.005) also contributed independently to circulating calprotectin. Each incremental increase in calprotectin level was associated with 1.36-times higher odds for CVD (95% CI 1.04-1.77, p = 0.026). In the current study, calprotectin was the only inflammatory parameter significantly associated with CVD. The strong association of circulating calprotectin with smoking, a well-known direct cause of vascular inflammation, and also with CVD, stresses the urge for further research to define its role as a biomarker in T2DM.

PMID:33138021 | DOI:10.3390/ijms21218075

Continued here:
Determinants of Increased Serum Calprotectin in Patients with Type 2 Diabetes Mellitus - DocWire News

With the help of Laura O'Hern, endocrinology physician assistant at CHI St. Vincent Little Rock, we are describing diabetes.

LITTLE ROCK, Ark. In order to fully understand today's gowns topic, we first have to visit a factory. Lets just say this is a factory that processes sugar, but it's a factory where all the workers don't show up and you show up with a truck load of sugar that needs to go into the factory.

It's going to be much harder for that factory that's already on short staff to process a lot at one time, Dr. OHern said.

With the help of Laura O'Hern, endocrinology physician assistant at CHI St. Vincent Little Rock, we have just described diabetes.

It inherently comes down to the body is unable to process sugar in the normal way, Dr. OHern said.

To show how widespread it is in Arkansas, Dr. OHern has another analogy.

If you're in a room right now with any more than two other people, then the chances are that one of you has diabetes or pre-diabetes, that's serious, she said. That's a large percentage of the population.

With diabetes you have to see your doctor regularly. It's a progressive disease that only gets worse over time.

Without a pandemic on board, diabetes is the leading cause of blindness, kidney failure, and lower limb amputation in the United States, Dr. OHern said.

That takes us back to our factory, where you can learn a valuable lesson.

You can control how much sugar you deliver to that defective factory at any time, she said.

CHI St. Vincent, like most clinics, are up and running and willing to help while observing pandemic protocols, and once you make a commitment to improve, you change your life's trajectory.

I had a patient who came to me at the beginning of the year to talk about their diet, Dr. OHern said. This patient was on over 300 units of insulin a day and multiple other diabetes meds plus had hypertension, high cholesterol, lots of problems.

Hopeless? No. A low-carb diet, exercise and monitoring with checkups and consultations, what had begun in January 2020 with expensive insulin and a bleak future had reached the magical point where he didn't need to worry about his factory.

At ten months later, this individual is now completely off of al insulin with a nearly normal Hemoglobin A1c and he achieved this with dietary control, Dr. OHern said. And the weight loss came with him getting his diet into line, so I was incredibly inspired by that story.

Note that he was not alone.

It's just so much better when we do it together as a community, she said.

One final word about the classic early symptoms of diabetes: A lower energy level, and dry mouth. If that has been bothering you, call your primary care physician or CHI St. Vincent for help.

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A deep dive into diabetes in Arkansas | Wear the Gown - THV11.com KTHV

Insulclock is preparing to open its first financing round. The Spanish company, specialized in the treatment against diabetes, has started a financing round of $5.8 million (5 million), as explained by Suso Prez, responsible for research and marketing of the company.

The company seeks to attract the interest of national and international funds. The economic boost it receives will serve to complete the national marketing of its device and begin internationalization, continue the second phase of technological development and continue with the development of products to improve the quality of life of people with chronic diseases, according to Prez.

Insulclock is an integral system that helps to improve the quality of life of people with diabetes and reduces the costs associated with this pathology helping to improve and efficient management by healthcare teams, according to the companys head of research.

Read more details about the biotech company Insulclock and find the latest financial news with the Born2Invest mobile app.

Jos Luis Lpez, CEO and co-founder of Insulclock, with type 1 diabetes for more than 21 years, founded the company in 2014 to provide a solution to a real problem for patients with diabetes: the need for a complete and global system that improves self-management and adherence to treatment for users.

During all this time, Lopez and his team, which currently consists of more than twenty people, have developed a telemonitoring and telemedicine system. This ranges from the automation of insulin data for insulin-dependent patients and self-monitoring of patients on oral medication to the integration of all health data available on the market into the patients clinical history in public and private health systems.

The work team is distributed between Galicia, Basque Country and Madrid, being a 100% national capital company and with most of the partners working within it. Suso Prez assures that the majority of the capital is distributed among the founding team. For the Insulclock team, people with diabetes generate a lot of clinical information on a daily basis: glucose, physical activity, food intake and adherence to treatment, among other data. In this way, the need arises to put order, not only in the generation of clinical information for self-management of diabetes, but also in the integration of this information automatically into the clinical history of each patient, the company explains.

The Spanish company is thus opening its first round of financing, since until now it has been able to meet all the investment in research and development (R&D) through the contribution of the partners. Even so, the company has obtained aid from the European Commission through Horizon 2020. We want to continue contributing to national and international clinical research, as we have already done with different clinical trials in which we have participated on an international scale, Prez points out.

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(Featured image by stevepb via Pixabay)

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First published in PlantaDoce, a third-party contributor translated and adapted the article from the original. In case of discrepancy, the original will prevail.

Although we made reasonable efforts to provide accurate translations, some parts may be incorrect. Born2Invest assumes no responsibility for errors, omissions or ambiguities in the translations provided on this website. Any person or entity relying on translated content does so at their own risk. Born2Invest is not responsible for losses caused by such reliance on the accuracy or reliability of translated information. If you wish to report an error or inaccuracy in the translation, we encourage you to contact us.

Read more:
Insulclock, in search of five million euros to advance against diabetes - Born2Invest

Endoscopic bariatric therapies (EBTs) have been utilized for the treatment of obesity, but there has been limited data assessing their role in the treatment of diabetes.

A recent study presented at the annual American College of Gastroenterology (ACG) 2020 conference found that this procedure led to improved diabetes and weight loss parameters. The positive outcomes of EBTs in assessed diabetes patients were particularly noted for 3-12 months of use.

Additionally, the study determined that small bowel EBTs were more effective than gastric EBTs, which the investigators suggested might be due to different mechanisms of action.

The team, led by Benjamin Noor, MD, Resident at Ronald Reagan UCLA Medical Center, searched through MEDLINE, Embase, and Cochrane for randomized clinical trials and observational studies of EBTs.

Thus, included in their analysis were 1053 citations, 79 studies, and 7692 subjects.

Primary analyses included the pooled mean difference in baseline and final values in weight loss (percentage total weight loss, percentage excess weight loss, and BMI change from baseline) and glycemic control (fasting glucose, HbA1c) parameters.

Secondary analyses included changes in gut hormones measured by Hedges g. Specifically, they assessed the changes in ghrelin, glucagon-like peptide 1, peptide YY, and glucose-dependent insulinotropic peptide.

The results showed that EBT use for 3-12 months was associated with significant improvement in diabetes outcomes and weight loss indices in comparison with baseline or control groups. Although small bowel EBTs and gastric EBTs led to similar weight loss outcomes, greater improvements in diabetic parameters was associated with small bowel EBTs.

Furthermore, the authors noted that improvements in diabetes were associated with weight loss for gastric EBTs and an increase in postprandial glucagon-like peptide 1 and peptide YY for small bowel EBT.

In an interview with HCPLive, Noor provided further insight into these findings as well as the implications of them for a diabetic patient population.

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Outcomes of Endoscopic Bariatric Therapies in Diabetic Patients - MD Magazine

A podcast episode featuring a discussion related to racial and ethnic disparities in the care of children with type 1 diabetes.

This episode of the Endocrine Outlook features a conversation with Terri Lipman, PhD, CRNP, of the University of Pennsylvania. In the interview, Lipman discusses and offers perspective on a recent study she led examining disparities in insulin pump use among children with type 1 diabetes.

An analysis of data from a Philadelphia-based center, results indicate Hispanic and Black children were less likely than their non-Hispanic white counterparts. In the following podcast, Lipman, who serves as the assistant dean of community engagement at the School of Nursing at the University of Pennsylvania, sheds light on what she thinks are the most effective ways to confront these disparities at an individual and societal level.

The study referenced in this video, Insulin pump use in children with type 1 diabetes: Over a decade of disparities, was published in the Journal of Pediatric Nursing.

Continued here:
Addressing Racial Disparities in the Care of Children with Diabetes - Endocrinology Network

Amrood ki sabzi recipe is great for diabetes diet.

Highlights

You are in the middle of any season; you'll find plenty of foods around to add to your diabetes diet. Diabetes or high blood sugar can be efficiently managed through a thoughtfully curated diet. Nature's bounty is full of low Glycaemic foods, which can come in handy to tweak our diet to suit our condition. Indian produce is brimming with fresh guavas this time of the year. For the unversed, this fruit is considered to be one of the best foods for diabetes diet.

The green-coloured fruit, with the seeded flesh inside, tastes great when eaten raw. You are required to remove the seeds though, to enjoy the sweet, juicy fruit with or without the peel. But sometimes, we unknowingly end up getting unripe guavas home and we just don't know what to with them. They are hard and a bit sour in taste. Instead of just tossing them out, turn those semi-ripe guavas into a delectable Indian curry, which will surprise you with its overwhelming flavours.

(Also Read:Love Guavas? Here Are 5 Ways You Can Turn Them Into Delish Desserts)

Promoted

Guava is a great fruit for diabetes diet.

Guava For Diabetes Diet I Health Benefits Of Guava

Besides being a low glycaemic food, guava has low sodium and high potassium content. According to the data of the United States Department of Agriculture (USDA), 100 gm serving of guava provides a whopping 417 gm of potassium. On top of it, guava is extremely rich in fibre and low in calories - all these features add up to make guava an essential addition to a diabetes diet.

How To Make Guava Curry Or Amrood Ki Sabzi:

First off, this guava dish is made a whole host of diabetes-friendly ingredients apart from guava: curd, tomatoes, fennel seeds, lemon juice and other healthy spices. Terrific, isn't it? Now, let's see how to make this amazing Indian-style guava curry.

Here's the step-by-step recipe of amrood ki sabzi with easy-to-follow cooking instructions.

Guavas are cooked in a tangy gravy of tomatoes and curd, seasoned with a range of spices like heeng, fennel seeds, cumin, turmeric powder etc, along with a smattering of lemon juice.

Pair the amrood ki sabzi with roti and enjoy a hearty Indian meal with your family.

About Neha GroverLove for reading roused her writing instincts. Neha is guilty of having a deep-set fixation with anything caffeinated. When she is not pouring out her nest of thoughts onto the screen, you can see her reading while sipping on coffee.

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Diabetes Diet: Guava (Amrood) Ki Sabzi Has All The Diabetes-Friendly Ingredients - Try The Recipe Today! - NDTV Food

The modern diabetes care experience is broken. Today, patients with diabetes are asked to navigate a maze of specialty providers and bear the burden of complicated self-monitoring simply to keep their condition in check. The siloed care model isnt simply costly for patients and those responsible for their care; its demoralizing, exacerbating mental health effects of a chronic disease, and creating a reinforcing cycle of non-adherence.

On top of this, the COVID pandemic has made regular physician visits which normally serve as a critical touch point for diabetes patients less safe, and easily canceled. More than 200 healthcare professionals from 47 countries rank diabetes as the condition that will be most impacted by the reduction in healthcare resources due to COVID-19. According to a recent JAMA study, there have been substantial decreases in primary care delivery during the COVID pandemic, despite the rapid uptick in the use of virtual care visits. In the absence of effective in-person care for diabetes during the pandemic, and with synchronous telemedicine visits with physicians alone unable to provide the continuous support needed for effective diabetes self-management, forward-thinking employers are turning to digital care programs for diabetes to support their workers.

Read more: Springbuk, One Drop partner on diabetes management

In the last few months, weve seen how vital and motivating human connection is to our mental and physical health. COVID-19 has shone a light on the gaps in the traditional healthcare system, and the need for deeply human, digital solutions on a scale we couldnt have previously imagined. According to Evidation Health, gaps are looming on the horizon, with more than half of the individuals with type 2 diabetes, hypertension, migraine and many more conditions not yet substituting care.

Fortunately, digital diabetes care, often supported by a connected continuous glucose monitoring (CGM) system, offers a different path forward. Continuous glucose monitoring in combination with virtual coaching holds the potential to improve health outcomes for employees with diabetes during and after this pandemic. Weve always known that the best diabetes care has been focused on each patients individual needs. But COVID has made the need for personalized care even more important. Every individual has unique challenges they are dealing with during this new normal.

Read more: Here's your employee checklist for open enrollment

The expansion of digital diabetes care that incorporates continuous glucose monitoring along with proactive feedback from a coach and personalized resources can support people with diabetes as they navigate these challenges. By helping employees understand the connection between their day-to-day choices and glucose levels, effective digital diabetes care can serve as the connective tissues these individuals need to thrive, even in todays circumstances. By pairing accurate, and easily recorded, remote monitoring with personalized coaching guidance and all other elements of an accredited Diabetes Self-Management program, employers have the opportunity to both lift the burden of diabetes from their workforce, and make critical gains in employee health and productivity.

Chronic conditions like diabetes require constant, long term management with a focus on areas like reducing stress, taking medications, monitoring, and getting routine lab tests. Its why the CDC strongly recommends Diabetes Self Management Education and Support (DSMES) as a cost-effective tool to improve A1c levels, blood pressure, medication adherence, as well as reduced hospital admissions and healthcare costs. Yet access remains a major challenge. Only 6.8% of privately insured individuals used in-person DSMES programs and those percentages preceded the latest care disruptions discussed above.

As the pandemic makes regular clinic visits less accessible for patients, its critical that employees managing diabetes have access to support that fits their lifestyle, and is accessible when they need it most. Its never been more important to educate and empower employees to embrace high-value, sustainable care. Accessible, safe, and effective digital diabetes care holds the potential to improve health outcomes for people with diabetes and the employers and health plans that support them during and after this pandemic. By investing in deeply personalized digital care solutions, you can deliver not only a better employee experience, but ultimately better health outcomes and savings for your employees.

Excerpt from:
How digital care programs are revolutionizing employee diabetes care in the age of COVID - Employee Benefit Adviser

HAMPTON ROADS, Va. - We all need to continue to be cautious as the COVID-19 pandemic still lingers all around us.

Diabetes is one of the medical conditions that has received additional attention during the COVID-19 pandemic.

"Diabetes in itself affects your immune system, and because of that impact and increased blood sugar, it lowers your ability for your immune system to work appropriately," said Dr. Ryan Light.

Light, a doctor with Greenbrier Family Medicine in Chesapeake, says those with diabetes don't have an increased risk of catching COVID-19 - but could have worse complications.

"You can see this in Asians who are thin, African Americans who are obese, or in really an combinations," said Light.

Type 2 is the most prevalent, says Light. That's when your body can't make enough insulin to convert glucose to energy.

In Type 1, more rare insulin-producing pancreatic cells are destroyed.

"As we age, our pancreas doesn't work quite as well, so we all see that we age and obesity increases. When that combines, it's the greatest risk for diabetes," Light said.

Data from the U.S. Centers for Disease Control and Prevention shows that three-fourts of people who died from COVID-19 had at least one preexisting condition. Diabetes was noted as underlying in 4 out of 10 patients.

"If your diabetes is well-controlled and you have an A1C of less than 7, you are doing a good job controlling diabetes, so it decreases your risk of having serious complications from COVID," Light said.

Light says diet and exercise are key to controlling diabetes, as well as regular doctor visits, proper handwashing, hygiene and mask-wearing to prevent the spread.

Original post:
Why diabetes is at the forefront of the COVID-19 pandemic - wtkr.com

As we ease into November (aka National Diabetes Awareness Month), its worth taking a moment to look back on what October has brought us from the Diabetes Online Community(DOC). Theres been a whole lot of action, given the unpredictable nature of 2020 when anything and everything appears to be on tap. Despite todays Halloween theme, the posts weve seen have served to inspire and entertain more than scare us.

COVID-19 may be shutting down Halloween trick-or-treating this year, but there are still some fun diabetes-themed costumes on display for 2020! Check out this Halloween-y post at Type 1 Everyday Magic.

With the weather cooling down this time of year, these clever diabetes witch shirts and hoodies may be a perfect option to stay warm and snugly.

As the global health pandemic continues, its fascinating to read about experiences of people with diabetes (PWDs) participating in clinical research exploring the virus and possible vaccines. One of those type 1 study participants, Helene Cooper, shares her story in a recent podcast at Diabetes Connections.

The election season and political-everything can make the blood pressure rise, as Molly at Hugging the Cactus blog knows too well. She shares an important POV on a recent political claim about the cost of insulin.

Say hello to the Beta Cell Foundation, a new grassroots diabetes non-profit organization. Founded by fellow type 1 and podcaster Craig Stubing, it has some lofty goals of helping to fund community-based programs and activities that help PWDs. See their Twitter thread and Instagram posts for more details.

No way around it: This shirt is awesome! Thanks to D-peep Anita Nicole Brown for sharing it on Instagram.

How do you know what diabetes news is reliable? D-Moms Stacey Simms and Moira McCarthy Stanford share their thoughts on that topic in a new Diabetes Connections podcast.

Diabetes data can be both enlightening and hand-clenching at times, and its important to keep in mind that there are gatekeepers out there who make decisions about who can access your data. Our Australian type 1 friend Renza Scibilia has an insightful blog post on that topic.

Eating disorders can be compounded by diabetes because theres such a food focus in managing this condition, and our relationship with food can be, well, tricky. D-Dad Scott Benner at the Juicebox Podcast shares an important story on this issue, talking with a PWD whos experienced this herself.

Our hearts go out to OG diabetes advocate Scott Johnson, who lost his beloved father this past month. Read his moving tribute titled, He was the best I could ask for.

Congrats to D-peep Rob Howe over at Diabetics Doing Things, who recently got married and celebrated that special moment in life even with everything happening in the world. Be sure to wish Rob and his new wife the best!

If any particularly share-worthy D-posts catch your eye in November, please ping usviaemail, on Instagram@DiabetesMineNews,on Twitter@DiabetesMine, or on ourFacebook page.

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Around the Diabetes Online Community: October 2020 Edition - Healthline

Black patients are more likely to be hospitalized with COVID-19 than white patients with similar underlying health and socioeconomic conditions, according to a new Michigan Medicine study.

The research also found that having type 2 diabetes or kidney disease and living in high-population density areas are also associated with higher risk for COVID-19 hospitalization.

SEE ALSO: Keeping Our Patients Safe During COVID-19

The study indicates that racial disparities in COVID-19 hospitalization cannot be explained even after considering age, sex, neighborhood socioeconomic status and comorbidities, said Tian Gu, the study's first author and a doctoral candidate at the University of Michigans School of Public Health. Researchers did not find differences between African American and white patients in intensive care units and mortality outcomes.

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"Knowing risk profiles associated with severe COVID outcomes can help us protect ourselves and protect the most vulnerable," Gu said. "This calls for strategic action plans to eliminate health inequities that have persisted in our social system."

Gu and colleagues used electronic health data from Michigan Medicine hospitals. They looked at a cohort of 5,698 patients tested for or diagnosed with COVID-19 between March 10 and April 22. A group of randomly selected, untested individuals were included for comparison.

The researchers examined factors such as race/ethnicity, age, smoking, alcohol consumption, body mass index and residential-level socioeconomic characteristics. They also compared comorbidities such as circulatory disease, liver disease, type 2 diabetes and kidney disease.

"We were able to connect the geocoded residence to census tract data to derive these residential variables, which was a new aspect of our study," Gu said. "We also noticed some differences in the effect of obesity and prior cancer diagnosis having stronger association with COVID susceptibility in Black patients. On the other hand, the chances of hospitalization with overall comorbidity burden and type 2 diabetes were stronger in white patients."

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Senior author Bhramar Mukherjee, professor and chair of the department of biostatistics at U-M's School of Public Health, said the results support targeted screening for elderly adults, members of the Black community and those with type 2 diabetes and kidney disease.

"Our findings highlight that poor COVID-19 outcomes are disproportionately associated with at-risk populations: elderly adults, those with preexisting conditions and those in population-dense communities," she said. "We call for increased investments in testing and prevention efforts in lower socioeconomic status, densely populated and racially diverse communities. It is these same communities that are home to a greater proportion of essential workers and thus need increased testing and protection."

The study is published in the current issue of JAMA Network Open.

SEE ALSO: Seeking Medical Care During COVID-19

Paper cited: Characteristics Associated With Racial/Ethnic Disparities in COVID-19 Outcomes in an Academic Health Care System, JAMA Network Open. DOI: 10.1001/jamanetworkopen.2020.2519

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African Americans with Type 2 Diabetes, Kidney Disease at Higher Risk of COVID-19 Hospitalization - Michigan Medicine

I am better able to handle my diabetes, both physically and mentally, with the pointers discussed in class. For six weeks, it has been a life-changing experience, which I look forward to keeping for many years. Its a wonderful course.

The evidence-based workshop was developed by the Stanford University Patient Education Research Center and licensed by the State of New Jersey. Participants will receive a book, Living a Healthy Life with Chronic Conditions, to help manage diabetes within the context of their lifestyle.

For more information or to register for the Diabetes Self-Management Education & Support Program, contact Maggie Weaver, RN, at 609.350.8937 or mweaver@jfsatlantic.org.

About Jewish Family Service

Jewish Family Service of Atlantic & Cape May Counties (JFS) encourages strong families, thriving children, healthy adults, energized seniors and vital communities. With dozens of program areas, JFS specializes in counseling, mental health services, homeless programs, vocational services, adult and older adult services and also hosts an on-site food pantry. The agency impacts 8,000 lives throughout Atlantic and Cape May Counties each year.

JFS mission is to motivate and empower people to realize their potential and enhance their quality of life. In keeping with Jewish values and the spirit of tikkun olam (healing the world), JFS provides services with integrity, compassion, respect and professionalism regardless of their religion, race, gender, sexual orientation, ethnicity, age or background.

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Jewish Family Service and The Rothenberg Center offer Diabetes Self-Management Education and Support Program - Press of Atlantic City

This article was originally published here

J Endocr Soc. 2020 Sep 24;4(11):bvaa139. doi: 10.1210/jendso/bvaa139. eCollection 2020 Nov 1.

ABSTRACT

National estimates describing the overall prevalence of and disparities in influenza vaccination among patients with diabetes mellitus (DM) in United States are not well described. Therefore, we analyzed the prevalence of influenza vaccination among adults with DM, overall and by sociodemographic characteristics, using the Medical Expenditure Panel Survey database from 2008 to 2016. Associations between sociodemographic factors and lack of vaccination were examined using adjusted logistic regression. Among adults with DM, 36% lacked influenza vaccination. Independent predictors of lacking influenza vaccination included age 18 to 39 years (odds ratio [OR] 2.54; 95% confidence interval [CI], 2.14-3.00), Black race/ethnicity (OR 1.29; 95% CI, 1.14-1.46), uninsured status (OR 1.88; 95% CI, 1.59-2.21), and no usual source of care (OR 1.61; 95% CI, 1.39-1.85). Nearly 64% individuals with 4 higher-risk sociodemographic characteristics lacked influenza vaccination (OR 3.50; 95% CI 2.79-4.39). One-third of adults with DM in the United States lack influenza vaccination, with younger age, Black race, and lower socioeconomic status serving as strong predictors. These findings highlight the continued need for focused public health interventions to increase vaccine coverage and utilization among disadvantaged communities.

PMID:33123656 | PMC:PMC7575128 | DOI:10.1210/jendso/bvaa139

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Prevalence of and Sociodemographic Disparities in Influenza Vaccination Among Adults With Diabetes in the United States - DocWire News

With Amy Hess-Fischl RD

It's no secret that people with type 2 diabetes are at an increased risk for major health complications. But one class of medicine might be able to change that, researchers say. According to a recent studypublished in the British Medical Journal (BMJ), a type of medication called SGLT2 inhibitors reduced the risk of heart failure and stroke among patients with type 2 diabetes, suggesting they have cardio-protective benefits.

Otherwise known as sodium glucose co-transporter 2 inhibitors,SGLT2 inhibitorsare a class of medication, delivered in pill form, that can help lower blood glucose levels in diabetic patients.

SGLT2 inhibitors are a relatively new class of medication that can have really impressive results, says Amy Hess-Fischl RD, a certified diabetes educator at the University of Chicago. While most diabetes medications either increase insulin or insulin sensitivity, SGLT2 inhibitors cause the kidneys to excrete glucose into the urine, preventing it from being reabsorbed back into the bloodstream.

By decreasing blood sugar levels, SGLT2 inhibitors can help improve your A1C levels as well, and potentially even aid in medically advised weight loss. According torecent research from Johns Hopkins University, SGLT2 inhibitors typically improve A1C levels anywhere from 0.5% to 1% when taken daily over the course of six months.

Because SGLT2s help decrease sugar in the blood, this also helps reduce some of the complications and long-term damage that can come from having high blood sugar.

Glucose is very attracted to hemoglobin, which is in our red blood cells, says Fischl. The more sugar we have in our blood, the more it can attach to the hemoglobin, and the harder our red blood cells get. Those hard red blood cells, pounding up against our blood vessels for years on end, can cause a lot of damage.

One recent study published in the 2019 issue of theNew England Medical Journal(NEJM) found that the risk of renal failure was 30 percent lower in patients with type 2 diabetes who took the SGLT2 inhibitor Canagliflozin, compared with patients in the control group who took a placebo.

The latest research, published in the September 2020 issue of theBritish Medical Journal(BMJ), reinforces what earlier studies have shown: SGLT2s can protect against heart attack, heart failure, and stroke among patients with type 2 diabetes.

The study authors used five years of healthcare data from type 2 diabetes patients across Canada and the United Kingdom. They surveilled over 200,000 patients who took SGLT2 inhibitors and compared them to the same number of patients who took another class of medication known as DPP-4 inhibitors. (DPP-4s help reduce blood sugar levels in diabetic patients by increasing insulin.) The researchers then recorded any major cardiac events such as heart attack, stroke, and heart failure for an average of 11 months.

The results showed that SGLT2 inhibitors were associated with a lower risk of cardiac events in type 2 diabetics when compared to DPP-4 inhibitors. For example, the rate of heart failure was 3.1 events per 1,000 people among patients who took SGLT2s and 7.7 events per 1,000 people among patients who took DPP-4s. Heart attacks, strokes, and overall mortality rates were also lower in patients who took SGLT2s. These results were consistent across age, sex, past insulin use, and history of cardiovascular disease, the study found.

While the new study produced notable results, it also has some limitations. Observational studies are just that observational, according to Hess-Fischl. They're nice because they give researchers a place to start, but we really need comparative data next.

Additionally, while it may be true that SGLT2s have some cardioprotective benefit, people with type 2 diabetes should be aware that the medication is not without risk.

What we've been finding is that SGLT2s tend to increase the risk of a condition called Euglycemic Diabetic Ketoacidosis, which is a life-threatening condition caused by a buildup of ketones in the bloodstream," Hess-Fischl says. SGLT2s can also cause urinary tract infections particularly in females due to increased sugar being excreted in urine. They are also contraindicated for patients in kidney failure.

All in all, Fischl says, while SGLT2s can be a godsend for some patients with type 2 diabetes, they're far from a miracle drug. More research, such as double-blind placebo studies, is still needed to determine whether or not they can truly guard against cardiac events.

Last updated on 10/20/2020

All About Type 2 Diabetes

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SGLT2 Inhibitors Shown to Reduce Risk of Heart Attacks and Strokes in People with Type 2 Diabetes - EndocrineWeb

Dr Masakazu Aihara

Measuring glycated albumin (glycoalbumin, GA) in tears could be a future way for those with diabetes to monitor their blood sugar levels noninvasively.

In a 100-patient trial, levels of GA in tears were found to be strongly correlated (r = .722;P< .001) with those in the blood.

"GA levels in blood are widely measured in clinical practice in Japan," said study investigator Masakazu Aihara, MD, PhD, in an interview.

"It's a biomarker that reflects the 2-week average blood glucose level like fructosamine," explained the researcher from the department of diabetes and metabolic diseases in the Graduate School of Medicine at the University of Tokyo.

This could make it a better biomarker for detecting earlier changes in blood glucose than glycated hemoglobin (HbA1c), which reflects changes in blood glucose over the preceding 2-3 months.

Prior studies had shown that glucose levels can be measured in tear samples and that tear glucose levels correlated with blood glucose levels, Aihara and fellow researchers observed in a poster presentation at the virtual annual meeting of the European Association for the Study of Diabetes.

"While looking for noninvasive diabetes-related markers, we found that tears contained albumin. Based on this fact, we thought that GA could be measured in tears," Aihara explained.

Usingtears to test for biomarkersis not a new idea tears not only protect the eye, they contain a variety of large proteins, and their composition can change with disease. Indeed, researchers have been looking at their usefulness in helping find biomarkers forParkinson's diseaseanddiabetic peripheral neuropathy.

Duringtheir study, Aihara and associates collected tear and blood samples at the same time. Tear samples were assessed using liquid chromatography (LC) and mass spectrometry (MS). An enzymic method was used to measure GA levels in blood. Several diagnosis assay kits for GA are sold in Japan, Aihara said, and at leastone of thesehas U.S. Food and Drug Administration approval.

Multiple regression analysis revealed that the correlation between GA levels in tears and in blood was maintained even after adjustment for age, gender, nephropathy stage, and obesity (P< .001). The results obtained from the tests were thought unlikely to be affected by any changes in the concentration or dilution of tear samples.

"Since GA levels in blood are clinically used in all types of diabetes, GA levels in tears is also expected to be useful in all types of diabetes," Aihara said, noting that the effects of receiving treatment on GA levels in tears is something that he would like to look at.

The team would also like to optimize how tear samples are collected and reduce the volume of tears that are required for analysis. At the moment tears are collected via a dropper and about 100 mcL of tear fluid is required for measurement.

"At present, it is difficult to measure for dry eye patients because sufficient tears cannot be collected, but if the required amount of tears decreases in the future, it may be indicated for dry eye patients," Aihara noted.

Discussing further research plans, he added: "We would like to examine the conditions of LC-MS/MS so that the correlation coefficient with GA in blood can be improved.

"Since LC-MS/MS is a large equipment in the laboratory, I would like to develop a device that can measure at the clinic or at home in the future."

The study was funded by a grant from the Japan Agency for Medical Research and Development. Aihara had no conflicts of interest.

SOURCE:Aihara M et al. EASD 2020,poster presentation 624.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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Substance in Tears Could Be Used for Diabetes Monitoring - Medscape

Celiac.com 10/20/2020 - Doctors diagnosing children for type 1 diabetes are increasingly finding other autoimmune conditions that can complicate the outlook for these patients. A team of researchers recently set out to study rates of comorbid autoimmune diseases, including celiac disease, and type 1 diabetes mellitus (T1D) in children.

Rates of type 1 diabetes mellitus (T1D) in children are on the rise, but it's unclear what relationship, if any, this might have with other coexistent autoimmune conditions, since diabetes onset is not well understood.

The team studied 264 boys and 229 girls between 0 and 18 years old with newly diagnosed with T1D in one of the Polish centers from 20102018. They determined diagnoses for related autoimmune illnesses from initial data recorded when patients first received diagnosis for T1D.

The team found that the standardized incidence rate of T1D in children rose 170% over the 9-year study period, while the incidence rate ratio rose 4% per year.

As rates of T1D have risen rapidly in all children of all ages in recent years, so, too have rates of the autoimmune diseases that frequently accompany these conditions. Having an additional autoimmunity disorder is a serious burden for patients with new-onset T1D.

Stay tuned for more information on the challenges faced by children with more than one auto-immune disease.

Read more in Front Endocrinol (Lausanne). 2020; 11: 476.

Reference:Gowiska-Olszewska B, Szabowski M, Panas P, et al. Increasing co-occurance of additional autoimmune disorders at diabetes type 1 onset among children and adolescents diagnosed in years 2010-2018single-center study. Front Endocrinol. Published online August 6, 2020. doi:10.3389/fendo.2020.00476

The research team included Barbara Gowiska-Olszewska,Maciej Szabowski,Patrycja Panas,Karolina oadek,Milena Jamiokowska-Sztabkowska,Anna Justyna Milewska,Anna Kadubiska,Agnieszka Polkowska,Wodzimierz uczyski,and Artur Bossowski. They are variously affiliated with the Department of Pediatrics, Endocrinology, Diabetology With Cardiology Division, Medical University of Bialystok, Biaystok, Poland; the Department of Pediatrics, Rheumatology, Immunology and Metabolic Bone Diseases, Medical University of Bialystok, Biaystok, Poland; the Department of Statistics and Medical Informatics, Medical University of Bialystok, Biaystok, Poland; and the Department of Medical Simulations, Medical University of Bialystok, Biaystok, Poland.

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Kids with Type 1 Diabetes Increasingly Have Other Autoimmune Diseases - Celiac Disease and Gluten-Free Diet Support - Celiac.com