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The scientists concluded that HIIT can help in improving the blood sugar levels and can also help in losing weight effectively.

Representational image. Reuters

Diabetes is one of the major health burdens in the entire world. According to the International Diabetes Federation, more than 463 million adults in the age group of 20 to 79 years were living with diabetes in the year 2019.

Among these, a majority of people have been reported to have type 2 diabetes. Type 2 diabetes is the result of reduced insulin sensitivity in the body, which mostly occurs due to excess body weight and physical inactivity.

It is already known that physical activity helps in managing and preventing type 2 diabetes. However, it has been reported that most commonly practised aerobic exercises such as walking or jogging provide only 10 percent to 20 percent improvement in insulin sensitivity.

As per the new study, presented at the annual meeting of the European Association for the Study of Diabetes (EASD) in September 2020, it was stated that insulin sensitivity, body composition and cardiorespiratory systems of people with obesity along with type 2 diabetes can be improved by combining high-intensity interval training (HIIT) with cycling and rowing.

Determining the effect of HIIT on obese and diabetic people

To determine the effects of HIIT, scientists from the Steno Diabetes Centre Odense, Odense, Denmark, enrolled 48 men in the study and divided them into three groups.

Out of the 48, 15 participants were obese with an average Body Mass Index (BMI) of 31 (kg/m2) and had been diagnosed with type 2 diabetes. The other two groups had non-diabetic participants, out of which 15 were obese with an average BMI of 31 and the rest 18 were lean with an average BMI of 24.

Body mass index, also known as BMI, is a way to measure whether or not a person is overweight or obese. An adult with a BMI that is between 18.5 and 24.9 is considered healthy, between 25 and 29.9 is considered overweight and 30 or over is considered obese.

All the participants underwent a highly supervised HIIT programme, which lasted for eight weeks. The participants had three training sessions per week, which were combined with cycling and rowing.

The effects of the training programme were evaluated with the help of Dual-energy X-ray absorptiometry (DXA) scans to determine the body changes, VO2 max tests to measure the amount of oxygen utilised during the session and euglycemic-hyperinsulinemic clamps along with indirect calorimetry to determine insulin sensitivity and metabolism.

The results of the study

In the beginning, people with diabetes showed around 35 to 37 percent reduction in insulin sensitivity as compared with the non-diabetic subjects.

However, after eight weeks of HIIT, the insulin sensitivity in lean men and those with only obesity was 32 to 37 percent on average whereas the average for the diabetic group was found to be 44 percent.

The scientists further found that after the training, the fasting blood sugar levels in patients with type 2 diabetes were also reduced. The HbA1c results, which measures the average level of blood sugar over the past 2 to 3 months, also showed a decline.

The body fat mass was reduced by 1.6 to 2.3kg in all three groups.

The VO2max results showed that oxygen utilisation increased by 10 percent in lean and obese people with no diabetes, while it increased to 15 percent in people with type 2 diabetes.

The scientists concluded that HIIT can help in improving the blood sugar levels and can also help in losing weight effectively. It is believed that the short bursts of intense anaerobic exercise with short recovery periods in between may prove to be better for people with obesity and diabetes in managing their condition.

For more information, read our article on High-Intensity Interval Training (HIIT).

Health articles in Firstpost are written by myUpchar.com, Indias first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

Excerpt from:
HIIT along with rowing and cycling can help type 2 d..etes patients lose weight, improve insulin sensitivity - Firstpost

New data by a team of researchers at Rutgers University is shedding light on a potential connection between gestational diabetes and biological age of offspring.

An analysis including more than 1100 children from Tianjin, China, researchers revealed children born to mothers with gestational diabetes mellitus had a higher epigenetic age than their counterparts born to mothers without gestational diabetes mellitus. Additionally, this increased epigenetic age was linked to increased risk of other comorbidities later in life, such as obesity and increased blood pressure.

"These findings suggest that gestational diabetes may have long-term effects on epigenetic aging in offspring and lead to poorer cardiometabolic health outcomes," said lead author Stephanie Shiau, an instructor at the Rutgers School of Public Health, in a statement.

In an effort to further investigate the effects of gestational diabetes mellitus on offspring, Shiau and a team of colleagues from the US and China designed the current study. To do so, they designed their study as an analysis of estimated DNA methylation (DNAm) age in offspring born to mothers with and without gestational diabetes mellitus from the Tianjin GDM Observational Study.

Of note, the Tianjin GDM Observational Study was conducted between 2005-2009 and sought to compare risks of early postpartum diabetes and prediabetes in Chinese women with and without gestational diabetes mellitus during pregnancy. Ultimately, the trial contained cohorts of 1263 women with a history of gestational diabetes mellitus and 705 women without gestational diabetes mellitus. With a mean follow-up time of 3.53 years postpartum, Shiau and team used this study to identify data related to 1156 children between the ages of 3-10 years born to mothers within the study.

Of the 1156 children included, 758 were born to mothers with gestational diabetes and 758 were born to mothers without gestational diabetes. All children included in the study underwent an exam at a median age of 5.9 years (3.1-10.2) that included anthropometric measurements and a blood draw for DNAm analysis. For the purpose of analysis, DNAm age was calculated using Horvath and Hannum epigenetic clock algorithms and the residual resulting from regressing DNAm age on chronological age was used as the metric for age acceleration.

Upon analysis, results indicated chronological age strongly correlated with both the Horvath DNAm age (r=.53; P <.0001) and the Hannum DNAm age (r=.38; P <.0001). Results also indicated offspring age acceleration was higher among those born to mothers with gestational diabetes mellitus compared to their counterparts who had mother without gestational diabetes mellitus when adjusting for potential confounders (Horvath, 4.96 months higher, P=.0002; Hannum, 11.2 months higher, P <.0001). Investigators noted the Horvath algorith was adjusted for sex, pre-pregnancy BMI, cell-type proportions, and technical bias while the Hannum algorithm adjusted for cell-type proportions and technical bias.

Results of the analyses suggest increased offspring DNAm age acceleration was associated with increased offspring weight-for-age Z-score, BMI-for-age-Z-score, waist circumference, body fat percentage, subscapular skinfold, suprailiac skinfold, upper-arm circumference, and blood pressure. Investigators pointed out these associations were strong among offspring born to mothers with gestational diabetes mellitus.

We found that offspring of women with gestational diabetes mellitus exhibit accelerated epigenetic age compared to control participants, independent of other maternal factors. Epigenetic age in offspring was associated with cardiometabolic risk factors, suggesting that gestational diabetes mellitus and gestational diabetes mellitus-associated factors may have long-term effects on offspring epigenetic age and contribute to health outcomes, wrote investigators.

This study, Prenatal gestational diabetes mellitus exposure and accelerated offspring DNA methylation age in early childhood, was published in Epigenetics.

Originally posted here:
Gestational Diabetes Linked to Accelerated Aging in Offspring - Endocrinology Network

When people with diabetes are discharged from hospital researchers say they are at much higher risk of early death or being readmitted.

A team from the University of Warwick say they have identified known risk factors which could indicate those who are at greater risk for once they leave the hospital.

Each risk factor was grouped into one of the following the categories, demographic, socioeconomic, lifestyle, patient medical factors, inpatient stay factors, medication related, laboratory results and glycaemic status.

Professor Theo Arvanitis, from the Institute of Digital Healthcare at WMG, University of Warwick, said: The most common risk factor is in the demographic category of age and the second most important factor is co-morbidity burden; this comes under the patient medical factors category, and means patients have more than one condition.

We also identified BMI as a significant risk within the patient medical factors category, with those who were at the heavier end of the scales to be more at risk.

Thirty-seven of the risk factors we identified from one research paper. This tell us that this research in general is still very early, and more studies are needed to identify the importance and possibly any other risk factors. This could decrease the mortality rate of diabetics discharged from hospitals in the future.

The research paper entitled A Systematic Review Considering Risk factors for Mortality of Patients Discharged from Hospital with a Diagnosis of Diabetes has been published in theJournal of Diabetes and its Complications.

Read more:
People with diabetes discharged from hospital at higher risk of death - Diabetes.co.uk

By: Lifestyle Desk | New Delhi | September 15, 2020 6:20:26 pm'As one of the most noteworthy causes of CKD, the rise in the number of diabetic patients in India directly correlates with the increase in the number of kidney disease patients.' (Representational image)

Many people around the world live with diabetes either type 1 or type 2 and the condition calls for many lifestyle changes for them to lead a normal and healthy life. Dr Nishit Mohanty, Nephrologist, NephroPlus Dialysis Centers, Bhubaneswar & Balasore, says the number of people in India crippled with Chronic Kidney Diseases (CKD) associated with diabetes, is high.

As one of the most noteworthy causes of CKD, the rise in the number of diabetic patients in India directly correlates with the increase in the number of kidney disease patients. In the times of COVID-19, both co-morbidities are a major risk concern and should be taken into serious consideration, he warns.

The doctor goes on to say that while one is on dialysis, it is important to take care of diabetes. As a result of diabetes, the blood vessels in the kidneys weaken and become damaged. Damaged blood vessels limit the kidneys to work as well as they should, that is, to filter out the toxins and waste from the body. A decline in kidney function may eventually cause kidney failure.

Maintaining and being vigilant of blood sugar levels, consuming a well-balanced diet and exercising are key factors in controlling diabetes, he says.

ALSO READ |A pandemic is never absolutely over, but it can be controlled: Dr Naresh Trehan

Here are some dietary tips from the doctor:

* Eat as per the nutrition plan curated by your nephrologist and dietician.* Eating three meals a day which is a must will help in preventing the blood sugar from going too high or too low.* High-caloric food must be avoided.* Non- processed foods such fresh vegetables and fruits, grains, lean meats and low-fat dairy options should be ideal for nutritious diet.* Foods low in potassium will add fiber to your diet.* Keep your liquid consumption in check, as advised.

Physical activities:

* Exercise daily to maintain a healthy weight; do not over-stress yourself.* Obesity should be looked at with utmost care; reduce if overweight.* Include aerobic and resistance training which will help in lowering blood sugar and keep blood glucose within a normal range.* Practising yoga will help calm the mind and body.

ALSO READ |How do COVID-19 triggered blood clots affect the heart? A doctor answers

Medication:

* Monitor your blood sugar regularly.* Medication must be taken as prescribed by your doctor.* Maintain good eye care; have your eyes checked if you experience any discomfort.* It is also important to maintain good oral hygiene. Brush your teeth in the morning and at night; gargle your mouth after meals.* Blood glucose should be monitored well on dialysis days, mainly before you begin your dialysis treatment.

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What patients on dialysis need to know about controlling diabetes - The Indian Express

A team of scientists at Queens University, Belfast, funded by us, have discovered a gene that increases the risk of blood vessel damage in people with diabetes.Switching off this gene could help people with diabetes live longer, healthier lives.

People with diabetes can develop life changing health complications, which can lead to limb amputations, because of blood vessels being damaged due to the disease. Belfast based Professor Andriana Margariti and her team discovered the cells in the damaged blood vessels were dysfunctional in diabetic patients and they then went on to cause cardiovascular conditions such as heart disease.

The three-year 264,000 research study, funded by us, discovered that blood vessel cells were dysfunctional because there was a high level of a protein gene, called QKI-7.

Margariti explained: We found that the level of this gene is very high in people with cardiovascular disease caused by diabetes. We discovered from blood vessels taken from the heart and amputated limbs of diabetic patients that the level of this protein gene is high.

So we learned that the QKI-7 protein gene was a key factor in the malfunction of the blood vessels cells that, in turn, cause cardiovascular complications in people with diabetes.

Of the around 74,000 people in Northern Ireland that have coronary heart disease, around a quarter (around 19,000) will also have diabetes.

Coronary heart disease is the leading cause of premature death in Northern Ireland and the single biggest killer worldwide, while adults with diabetes are up to three times more likely to develop heart and circulatory conditions.

Professor Margariti added: Identifying this gene has the potential to stop the damage to the blood vessels that causes the cardiovascular diseases and amputations.

It is a very important discovery. This will make a difference in the medical and scientific field.

The team also discovered that knocking down (removing) protein gene QKI-7 in diabetic mice resulted in restored blood vessel function.

The blood vessels were able to regenerate and therefore stopping damaging cardiovascular complications from happening. This also provided more evidence on how significant, protein gene QKI-7 is.

Having discovered the gene that causes the malfunction in blood vessels the next step will be to develop a drug that will target QKI-7 to stop the heart and circulatory damage caused by diabetes from developing.

Prof Margariti explained: This BHF funded study will allow the opportunity to propose novel medications to prevent the devastation of diabetic complications such as cardiovascular disease and it will significantly improve the quality of life in diabetic patients.

The results will potentially help treat the cardiovascular complications of diabetes and screen patients earlier, which can be lifesaving and life changing for those people living with diabetes.

Our Head of BHF NI Fearghal McKinney said: The results of this study from Prof Dr Margariti and her team show just how important funding research is. It delivers tangible results that have the potential to save and improve the lives of people living with diabetes.

Unfortunately, coronavirus has a long-lasting and devastating impact on charities like ours, with the BHFs funding for new research falling by a shocking 50m this year alone. That's why, not only do we need urgent help from our loyal supporters, were also urging the UK Government to ensure funding for vital research charities like ours.

For us, it will mean we can protect the progress that world class researchers like Prof Margariti are making and continue to transform the lives of those with heart and circulatory diseases. Its ultimately patients who will suffer if this doesnt happen.

These results were published today in the journal Nature Communications.

Our research in Northern Ireland

Read the rest here:
Gene discovery with potential to prevent complications for diabetes - British Heart Foundation

If youre a diabetic, people might have told you to avoid fruits because they are too sweet or contain sugar that can make your blood glucose go up. But this is a myth that you should stop believing right now. All fruits contain natural sugar (some more than others), but they also contain a good amount of other essential nutrients like vitamins, minerals, fiber, and antioxidants. In fact, eating fruits and vegetables is known to help reduce the risk of developing many health conditions including high blood pressure, heart diseases, strokes, obesity, and certain cancers. People with diabetes are more likely to be affected by these conditions. Therefore, its even more important for diabetes patients to eat more fruits and vegetables. Also Read - Diabetes diet: 6 spices that you should eat to manage your blood sugar levels

Most fruits have a low to medium glycaemic index, a number that tells about how slowly or how quickly a food raises blood glucose levels, compared to other carbohydrate-containing foods like white or wholemeal bread. Also Read - Heres what a typical Ayurvedic diet chart for diabetics looks like

However, portion size is very important when considering fruits as part of your diabetes diet. Because certain fruit choices may affect blood sugar levels more than others, its important to keep an eye on portion sizes. Also Read - Why Ayurveda experts are encouraging diabetics to eat black rice?

One serving of fruit should contain 15 grams of carbohydrates. The size of the serving will depend on the carbohydrate content of the fruit. For example, you can consume a larger portion of a low-carbohydrate fruit, and make it small if its a high-carbohydrate fruit. You can eat all fruits as long as the serving size is limited to 15 grams of carbohydrates. Heres what one serving for common whole fruits should be like:

1/2 medium banana

3/4 cup blueberries

1 cup raspberries or blackberries

1 1/4 cup whole strawberries

1 cup cubed cantaloupe or honeydew melon

1 small piece (4 ounces) apple, orange, peach, pear, or plum

2 small or 1 large tangerine (4 ounces total)

2 small (2 ounces each) kiwi

4 small (1 ounce each) apricots

~1 cup of melon (cantaloupe, watermelon, or honeydew)

17 small grapes or cherries

1/3 medium mango

Fruit juices contain less fiber than the whole fruits and are high in natural sugars. Therefore, its advisable to avoid juices when you have diabetes and instead eat the actual fruit. If you still want to drink fruit juice, have a maximum of a small glass per day. Drinking too much fruit juice may raise your blood glucose levels and make you gain weight.

While dried fruits even higher concentrations of vitamins and minerals, the sugar content also becomes more concentrated. For example, one cup of grapes contains 27 grams of carbs whereas one cup of raisins contains 115 grams of carbs. This means raisins contain more than three times as many carbs as grapes do.

So, avoiding dried fruit and juice may help you better control your blood sugar. The best way to include fresh fruit to your diabetes diet is to pair it with a protein and/or fat. You can top cottage cheese with pineapple, add berries to a protein smoothie, or dip apple slices into nut butter or tahini.

Published : September 14, 2020 3:01 pm | Updated:September 15, 2020 9:02 am

More here:
Should you have fruits if you have diabetes? - TheHealthSite

Losing weight is key to preventing or reversing type 2 diabetes, according to a major study involving nearly half a million people.

The University of Cambridge trial has shown the condition, commonly associated with poor lifestyle, could be avoided if more people kept their weight in a healthy range or below that target.

Lead researcher Professor Brian Ference said their findings of the study could have significant implications for screening, preventing and treating type 2 diabetes.

The trial involved dividing up the 445,765 participants into five groups relating to their genetic risk of diabetes and five groups according to their body mass index (BMI).

The research team discovered the group of those with the highest BMI had an 11-fold increased risk of diabetes compared to the lowest BMI group.

Professor Ference, who unveiled the research results at the annual European Society of Cardiology (ESC) Congress, said: The findings indicate that BMI is a much more powerful risk factor for diabetes that genetic predisposition.

This suggests that when people cross a certain BMI threshold, their chances of diabetes go up and stay at that same high-risk level regardless of how long they are overweight. You can prevent most cases of diabetes by keeping BMI below a persons threshold.

What the results have also shown is that everyone has a different BMI threshold depending on their height and build. This explains why some people who are a healthy weight develop the condition and some who are overweight do not.

Professor Ference added: You can prevent most cases of diabetes by keeping BMI below a persons threshold.

But it (the study) also implies something that we havent focused on in the past and that is we can also probably reverse most cases of diabetes if we lower somebodys BMI aggressively below their BMI threshold relatively soon after they develop diabetes.

I think the fact that BMI appears to have a threshold rather than a cumulative effect on the risk of diabetes really has potentially significant implications for how we think about changing screening, preventing, treating and reversing diabetes.

The multi-award-winning Low Carb Program is demonstrated to help patients with type 2 diabetes, prediabetes and obesity sustainably lose weight, improve blood glucose control and reduce diabetes medications. At 1 year, peer-reviewed research shows 26% of participants who completed the program were in remission.

Read more:
Weight loss is key to type 2 diabetes prevention and reversal - Diabetes.co.uk

"I really would like to stay with Dallas ISD," the third-grade teacher said. "I wish they were practicing more flexibility with teachers."

Jacqueline Martinez has spent the last nine years teaching in Dallas ISD but said Thursday she doesn't know if she will stay beyond next week.

"I will resign. I am not going to go back to campus, Martinez said.

The third-grade teacher is holding class from home right now as the district remains online through Oct. 5.

But, the school district requires teachers who have not already reported to campus to do so by Sept. 17.

Martinez says she has diabetes, making her high risk for complications if she got COVID-19.

Dallas ISD offered an option to teachers last month through an Alternative Work Arrangement, or AWA waiver, which allows employees to work remotely if they can complete 100% of their work.

Right now, Dallas teachers can do that but as the district plans to welcome students back to campus, some as early as Sept. 28, doing all the teaching work remotely will not be possible.

"I applied for the AWA and was denied," Martinez said. "I don't know anyone that's been approved."

On Thursday, the district's HR department, Human Capital Management, told school board trustees the majority of teachers who applied for the waiver did so because of a lack of available child care.

Cynthia Wilson, the head of the department, said the district changed its policy to allow teachers to bring their children to school while they teach remotely.

Wilson said teachers with underlying health conditions who were denied the district's waiver can seek alternatives, including a waiver as part of the Americans with Disabilities Act.

District 7 trustee Ben Mackey said the process for who is eligible to receive an alternative work arrangement needs to be clearer.

"The clarity would go a long way about what qualifies and what doesnt, Mackey said.

Diedrae Bell-Hunter with Human Capital Management says the district held virtual town halls about options for teachers but said it's likely the message wasn't entirely received.

It is a little bit complicated but we do have other options outside the AWA process," Bell-Hunter said. "We still have leaves available to employees that will protect those who have underlying medical conditions.

Martinez said late Thursday she is talking with the district's benefits department about her situation, but if it is not resolved in the next week, she won't have a choice but to resign from her position.

"I really would like to stay with Dallas ISD," she said. "I wish they were practicing more flexibility with teachers."

Here is the original post:
Dallas teacher with diabetes says she may resign after denied waiver to work from home - WFAA.com

Despite recommendations to the contrary, screening rates for diabetic retinopathy among pediatric patients with type 1 and 2 diabetes remain low. Point-of-care screening is available for diabetic retinopathy screening, but its cost-effectiveness compared with standard screening by an eye care professional (ECP) is unclear. According to a recent study, the use of artificial intelligence (AI) in diabetic retinopathy screening among pediatric patients with type 1 and 2 diabetes was effective and resulted in cost savings.

Data collection spanning 1994 through 2019 included out-of-pocket costs for autonomous AI screening, ophthalmology visits, and treating diabetic retinopathy; probability of standard retinal examination receipt; relative screening odds; and the sensitivity, specificity, and diagnosability of the ECP versus autonomous AI screenings. The main outcomes were patient costs or savings, per mean patient payment for diabetic retinopathy screening examination, as well as cost-effectiveness, per costs or savings correlated with the number of true-positive results that diabetic retinopathy screening yielded.

In standard ophthalmologic screening performed by an ECP, the expected true-positive proportions for type 1 and 2 diabetes were 0.006 and 0.01, respectively; for autonomous AI, they were 0.03 and 0.04, respectively. With a base case scenario of 20% adherence, autonomous AI use resulted in a higher mean payment than conventional ECP screening for both patients with type 1 ($8.52 vs. $7.91) and type 2 ($10.85 vs. $8.20) diabetes. But with an adherence rate of at least 23%, autonomous AI was the preferred screening strategy.

These results suggest that point-of-care diabetic retinopathy screening using autonomous AI systems is effective and cost saving for children with diabetes and their caregivers at recommended adherence rates, the study authors summarized.

View original post here:
Effectiveness, Cost Savings of AI to Screen for Pediatric Diabetic Retinopathy - DocWire News

A LIFE-CHANGING new diet shown to put type 2 diabetes into remission has given hope to millions of people.

The Diabetes Remission Clinical Trial, or DiRECT, has been carried out in Scotland with a high success rate and Professor Michael Lean, who heads the treatment, believes this proves the disease can be treated.

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And earlier this month it emerged that thousands of people will now be prescribed the life-changing programme on the NHS.

Prof Lean says: The treatment starts by putting patients on to a weight-loss plan of shakes and soups, 850 calories a day for 12 weeks.

The weight loss reduces the level of fat inside the liver and pancreas, which is what puts the diabetes into remission.

The critical next phase is to guide patients towards a new normal eating plan of different foods from when they had diabetes.

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With type 2 diabetes costing the NHS 10billion every year, Prof Leans treatment could save vital funds, but more importantly, lives, so it is to be rolled out to around 5,000 patients in ten areas of the UK.

People who have been diagnosed with type 2 diabetes in the last six years will be considered for the diet.

Patients will still have to meet certain criteria before their GP can refer them.

Under the year-long plan, patients will be given shakes and soups for three months, as well as support to increase their exercise levels.

They will also be given plans to re-introduce solid food, as well as support and virtual sessions with coaches and dietitians over the remaining months.

The diet is currently available across NHS trusts in South Yorkshire and Bassetlaw, Humber Coast and Vale, Greater Manchester, Frimley,

Gloucestershire, Derbyshire, Birmingham and Solihull, Bedfordshire, Luton and Milton Keynes (BLMK), North East London and North Central London.

Nearly four million people in the UK are living with a form of diabetes and it is estimated that 90 per cent of them have type 2.

Type 2 diabetes is an incredibly serious condition but unlike cancer its entirely reversible

Unlike type 1 diabetes, which is a serious, often life-long condition, it is widely accepted that type 2 diabetes is linked to lifestyle factors.

Being overweight, getting older and having high blood pressure all increase a persons risk of developing the condition.

And despite the fact that it can cause strokes and heart disease, increasing the risk of heart attacks, still too many people are oblivious to the risk.

Prof Lean, from Glasgow University, tells The Sun: Theres misinformation that diabetes isnt too serious a condition to have, and you can live well with it by taking medication.

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That couldnt be further from the truth. The fact is that ten-year survival rates for breast cancer are better than they are for type 2 diabetes.

Youre more likely to die younger, and with more pain and disabilities from type 2 than you are from breast cancer.

Its an incredibly serious condition but unlike cancer its entirely reversible.

So what is it like to live on a restrictive diet that cuts your calorie count to just 800 a day?

Here, three volunteers from Prof Leans studies share their journey into type 2 diabetes remission having lost 12st between them.

IN just seven months, Edward McGeachie has reversed his type 2 diabetes and lost five stone thanks to the trial.

The company director from Glasgow was diagnosed in January but he thinks he had it years before.

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A routine health check found he weighed 20 stone and that he had through the roof blood pressure and high blood sugar levels.

He emailed Prof Lean asking to take part in the trial after seeing it on the news and says the diet was the easiest thing Ive ever done.

Edward, 54, says: I was in a critical condition when I started.

"I was probably a few years away from a massive heart attack and morbidly obese I had nowhere to go.

"I was in the danger zone and it was all the motivation I needed.

He was so dedicated to the trial that when he went on holiday to Malaga in February he took his blender with him.

Edward says: Within a few months I was told Id extended my life expectancy by ten years.

"Knowing Ive made such huge changes to my health has been incredible. It has been life-changing in every way.

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Edward put solid food back into his diet in June and is like a new man.

Im healthier, fitter, I go to the gym, Ive got more energy, Ive stopped snoring which pleased my wife and all the health and weight related issues are gone.

Ive learned so much about food, I wont ever eat in the same way again.

YEARS of travelling with work and having little time to exercise meant Eddie Morrisons weight crept up and up, reaching 18 stone.

In December 2010 at the age of 55, a routine medical at work showed he was suffering type 2 diabetes, and he started on medication.

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After five years on drugs, it was the birth of his granddaughter Lucy that was the final straw for Eddie.

While his condition wasnt debilitating, he could see a future plagued with serious health concerns.

When his GP told him about the DiRECT trial in August 2015, he realised it was too good an opportunity to miss.

The retired fuels logistics manager says: A few months into the treatment, Id already lost two stone it was the incentive I needed to carry on.

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Now 13st 2lb, Eddie, from Glasgow, weighs the same as he did in his 20s. He is medication-free and his type 2 diabetes is in remission.

He says: The dietitians taught me about weighing food and what a balanced plate looks like. And by January 2016, I was down to 13st 6lb and needed a whole new wardrobe.

Eddie is still on the trial now, and his weight has stayed even despite the odd blow out to celebrate beers with friends after a game of golf, or birthday cake with his granddaughter.

He says: I never thought when I had the diagnosis, after years on medication, Id be in remission, medication-free and walking up to 100 miles a week but Im fitter and healthier than ever and its all because my GP gave me the chance to take part in a trial that changed my life.

Different types of diagnosis

DIABETES is a serious condition where a persons blood sugar level is too high.

Type 1 diabetes is where the bodys immune system attacks and destroys the cells in the pancreas that produce insulin, meaning the body can no longer make the hormone.

But type 2 is a bit different it can be prevented and treated.

If you have type 2 it means your body cant make enough insulin, or that insulin cant work properly.

But why is insulin so important?We all need some glucose (sugar) in our blood, and we get that from food it gives us energy.

Once its broken down, it is released into the bloodstream.

From there insulin acts like a key, unlocking the door to our cells and letting the glucose in to fuel our bodies.

But if that insulin doesnt work, and the key doesnt fit, the glucose has nowhere to go and builds up in the blood, causing a spike in sugar levels.

Over a long period of time, left untreated, this can cause serious damage to your heart, eyes, kidneys and other organs causing heart disease among other complications.

A ROUTINE blood test led to Beverly Iceton being diagnosed with type 2 diabetes in October 2018.

But within months, she said the drugs she was taking for it stopped her sleeping and she constantly felt sick.

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Bev, 57, was desperate for a place when she came across the trial online in February 2019.

Most likely I had had it for a few years by the time I was diagnosed, says the admin assistant.

I tried different medications but my quality of life wasnt great and the side effects were getting tougher to deal with.

Other trials had morbidly obese participants but this one wanted to replicate the results in people with a BMI below 27 overweight is 25 to 29.9 who had diabetes for less than six years.

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Bev, from Barnard Castle, Co Durham, says: Living on 850 calories a day in shakes and soups for eight weeks sounds restrictive, and when you tell people, they say they could not do it but its about far more than just shakes.

The support, the re-education, the accountability it changes the way you see food.

Within eight weeks of starting the trial, I was down from 12st 5lb to 10st 5lb, my bloods showed I was in remission and Ive stayed that way ever since.

I look at food so differently now but I can treat myself or have a blow out.

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"Its just on occasion once every couple of months.

"I didnt think it was possible to reverse diabetes, let alone in such a short space of time.

"I cant thank the team enough.

GOT a story? RING The Sun on 0207 782 4104 or WHATSAPP on 07423720250 or EMAILexclusive@the-sun.co.uk

Read the original here:
We reversed our type 2 diabetes and lost 12st between us on life-changing new shake diet - The Sun

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Novo Nordisk A/S, the Danish drugmaker, is exploring whether a new class of medicines that helps people lose weight and control diabetes also has potential in fighting Covid-19.

Research shows people afflicted by obesity and diabetes often fare worse in trying to overcome SARS-CoV-2. Now initial analysis of electronic medical records shows that GLP-1 drugs, which help patients keep blood sugar levels in check, could be a very meaningful therapy in helping people with diabetes battle Covid-19, Novo Chief Scientific Officer Mads Krogsgaard Thomsen said in an interview. He pointed to evidence the virus attacks cells that produce the hormone insulin.

The early indication is that the GLP-1 class is actually beneficial in Covid-19, he said. Thats not unexpected because this is the class of agents that target the risk factors for bad Covid-19 outcomes.

Novo shares recouped earlier losses to trade down 0.2% at 11:40 a.m. in Copenhagen.

GLP-1 drugs include Novos Ozempic for diabetes and Saxenda for obesity. Sales of such drugs, which also include Eli Lilly & Co.s Trulicity and AstraZeneca Plcs Bydureon, totaled more than $11 billion last year, according to a report from Grand View Research.

Novo, the worlds biggest maker of diabetes drugs, is studying the role such medicines could play as researchers and governments rush to find treatments to combat the coronavirus. The U.S. last month cleared use of convalescent plasma -- which uses blood from people who have recovered from Covid-19 to help those currently infected -- on an emergency basis for some cases.

That added to a growing list of therapies available to doctors. In May, regulators granted emergency authorization to the Gilead Sciences Inc. antiviral drug remdesivir, while dexamethasone, a widely available generic anti-inflammatory drug, has shown life-saving promise.

Patients with Covid-19 can suffer from an inflammatory condition in which the immune system overreacts to the virus, causing damage that is worse than the infection itself. Studies show that semaglutide, the key ingredient in Ozempic, dampens systemic inflammation in people with diabetes and obesity, Thomsen said.

Novo is carrying out further studies and will make the results public if it can substantiate the preliminary data, he said. Thomsen added that theres no clinical evidence that GLP-1 drugs have an antiviral effect on Covid-19.

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Novo has bet on GLP-1 drugs including Ozempic, forecast by analysts to generate $3.4 billion in sales in 2020. Saxenda is expected to cross $1 billion in sales this year. The company expects regulators to decide whether to approve semaglutide in obesity at the end of next year, or the middle of 2021 if it decides to use a priority review voucher, Thomsen said.

Research indicates that obese and overweight people are at high risk of suffering severe cases of Covid-19, with a French study last month finding that only one in 10 who end up in intensive care with the disease were in a range of healthy weight. Another report in August highlights concerns future vaccines for Covid-19 could be less effective for individuals with obesity due to a weakened immune response.

Obesity, hypertension and diabetes are big risk factors for bad outcomes, according to Thomsen. But it is also so that the virus puts further stress on your cardiometabolic condition.

(Updates with shares in fourth paragraph, obesity drug timeline in ninth paragraph, research in tenth paragraph)

Before it's here, it's on the Bloomberg Terminal.

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Drugs That Fight Diabetes and Obesity May Treat Covid-19 - Bloomberg

Just because you have type 2 diabetes doesnt mean you cant ever let anything sweet pass your lips again. With a bit of strategizing, there are ways you can satisfy your cravings from time to time.

According to the American Diabetes Association (ADA), if you have diabetes, you can absolutely include sweets and desserts in your diet, as long as theyre part of a healthy eating plan and you dont overindulge. The ADA also recommends working with a registered dietitian, a certified diabetes care and education specialist (CDCES), or another diabetes healthcare professional to help you formulate an eating plan thats right for you.

When you eat or drink carbohydrates, such as sugar, starch, and fiber, your body breaks them down into glucose, raising levels in your blood, according to the ADA. If you have type 2 diabetes, your body isnt able to use insulin efficiently to move this glucose from your blood into cells, where its used for energy. So its important to take steps to make sure your glucose levels dont spike too high.

You also want to make sure you eat healthy foods that are nutritious and high in vitamins, minerals, and fiber, and avoid or eat only small amounts of foods that contain unhealthy ingredients such as added sugar, high amounts of sodium, and unhealthy fats.

Many sweets, including cakes, cookies, and candy, tend to be highly processed and chock-full of added sugar, refined flour, and saturated fats, which is why they should be enjoyed in reduced portion sizes as an occasional treat.

Try these tips from diabetes nutrition experts to include sweet treats in your healthy eating plan.

1. Allow yourself the occasional treat. Deprivation isnt likely to work, says Karen Lau, a registered dietitian and CDCES at Joslin Diabetes Center in Boston. Completely eliminating treats from your diet may backfire, and you may end up craving those foods more, notes Lau.

2. Plan ahead. Consider how many carbs youre getting in your meal, not just in your dessert, says Tami Ross RD, CDCES, author of What Do I Eat Now? A Guide to Eating Well with Diabetes or Prediabetes and a spokesperson for the Association of Diabetes Care and Education Specialists (ADCES). That total number should factor into your calculation of what you will eat on days you have dessert or a sweet snack.

Make sure the meal is balanced with other foods. Cut out carbs from the main dish, and save it for dessert instead, says Lau. For example, if youre planning to have dessert, skip the bread, pasta, or side of mashed potatoes at dinner.

3. Be mindful of sugar-free foods. Kristen Smith, RDN, a spokesperson for the Academy of Nutrition and Dietetics, suggests choosing foods that dont list sugar in the ingredients and have sugar substitutes instead. But keep in mind that these foods are often still made with flour and other carbohydrate-containing ingredients, says Smith.

4. Pay attention to what you drink. You probably know that regular soda, juice, and fruit punch are loaded with sugar, but sports drinks, energy drinks, and bottled tea can also raise blood glucose. Plus, these sugary drinks can contain as many as several hundred calories in just one serving, according to the ADA.

Healthier options to help you stay hydrated while still giving your taste buds a treat include seltzer water with slices of lemon or lime or water infused with fruit, says Veronica Brady, PhD, an advanced practice registered nurse at MD Anderson Cancer Center and assistant professor of nursing at The University of Texas Health Science Center in Houston. She is also a spokesperson for ADCES.

5. Swap out ingredients. In the kitchen, use whole-grain flours, such as wheat or oat, or versions made from nuts, such as almond flour, to help with blood sugar control, advises Smith. You can also look for recipes that use fruit or fruit puree to reduce or eliminate sugar, says Smith.

6. Designate a sweet treat day. Depending on how well your diabetes is managed and what you and your diabetes management team decide is best for you, you can decide how many days you can budget in per week or month to indulge your sweet tooth.

7. Focus on fruit. Not only is fruit delicious enough to satisfy your sweet tooth, but it has the added bonus of being healthier, because it has fewer carbs and no added sugar, compared with processed sweets, explains Smith. Plus, fruit has fiber, which is helpful, because it takes longer to digest and is less likely to cause a rapid rise in blood sugar, she adds.

That said, its still important to watch portion size and sugar content when eating fruit. If youre making a smoothie, for instance, youll want to stick to about 4 to 6 ounces rather than drinking a giant tumbler of it, notes Dr. Brady. And if youre snacking on dried fruit or using it in a recipe, make sure you take into account how much sugar it contains: Just 2 tablespoons of raisins or dried cherries can contain as many as 15 grams of carbohydrates.

Some great ways to enjoy fruit:

8. Pick something you really like. Rather than settling for something that you might not like as much just because its labeled low sugar, eat smaller portions of something you love, notes Lau. Not only will eating what you prefer leave you feeling more satisfied, but opting for the diabetes-friendly version may also prompt you to eat more than you should.

9. Take a few bites and make them last. Split that piece of cake with a friend, or just have half of a large cookie. The first few bites are often what you enjoy most, notes Ross. Try to stick to two or three bites, and practice mindfulness about what youre eating.

The next time you take a bite of a treat, try this: Eat more slowly, think about what youre eating, and savor the taste, suggests Brady.

10. Freeze bite-size treats. One great way to have portion-controlled sweets on hand is to freeze bite-size Halloween candies, says Brady. Eat one of these slowly for a treat, she says.

11. Keep temptation out of sight. Ask family members to be supportive and help you stay healthy by not eating sweets in front of you or bringing cookies or candy into the house. Store ice cream at the back of the freezer, and dont put sweets in front or at eye level in the pantry, where you can see them, suggests Smith.

12. Identify your cravings. Are there circumstances where youre more likely to be tempted? Think about what makes you crave sweets, says Smith. Are you often influenced by a TV show or commercial? Be mindful of activities that might spark a craving, advises Smith. If you know youre always tempted when you pass a certain restaurant or billboard, for instance, try to avoid going that way.

13. Dont be too hard on yourself. You dont need to always aim for 100 percent, notes Lau. Instead, she recommends striving to strictly follow your diabetes diet at least 80 percent of the time and allowing yourself the occasional indulgence.

Excerpt from:
How to Satisfy a Sweet Tooth if You Have Type 2 Diabetes - Everyday Health

The "United Kingdom Diabetes Market, By Continuous Glucose Monitoring (CGM), Blood Glucose (SMBG) Device, Insulin Pen, Insulin Pump, Reimbursement Company Analysis & Forecast" report has been added to ResearchAndMarkets.com's offering.

The report provides a complete analysis of the United Kingdom Insulin Devices Market.

United Kingdom Diabetes Market expected to reach USD 4.33 Billion by the year 2025

The market of Insulin Pen, Insulin Pump, Continuous Glucose Monitoring (CGM) Device and Self Monitoring Blood Glucose Device are growing due to the rising awareness for diabetes in the United Kingdom.

In the United Kingdom, there are more than a million people diagnosed with diabetes, and the number continues to grow. Diabetes is one of the biggest health challenges the United Kingdom is facing today. The growing health crisis and its complications will increase awareness of the risks, improve self-management among people with diabetes, bring about wholesale changes in lifestyle and improve access to integrated diabetes care services.

The National Service Framework (NSF) program is improving services by setting national standards to drive up service quality and tackle variations in care. In 2019, The Association of British HealthTech Industries (ABHI) had launched a diabetes section, enabling diabetes technology companies to work together in the first forum of its kind. The ABHI group is for any health technology company with an interest in diabetes care, from CGM and insulin pumps to apps.

Key Topics Covered

1. Introduction

2. Research & Methodology

3. Executive Summary

4. Market Dynamics

4.1 Growth Drivers

4.1.1 Rising Diabetes Mellitus in an Aging Population

4.1.2 Rising prevalence of diabetes in various age groups

4.1.3 Benefits of Insulin Pump over Multiple Daily Injection

4.1.4 Lifestyle-Compatible Treatment Options and Technological Advancement in Insulin Pump Devices

4.2 Challenges

4.2.1 Technological advancements in insulin infusion devices

4.2.2 Blood Glucose Meter Accuracy Problem

4.2.3 Low Compliance of Glucose Monitoring & Inadequate Reimbursement for SMBG Supplies

4.2.4 Safety Issues in Insulin Pump Devices

4.2.5 Difficulties Associated with the Pump

4.2.6 Adherence

5. United Kingdom Diabetes Market

6. United Kingdom Diabetes Population

6.1 United Kingdom Diabetes Population & Forecast

6.2 Type 1 & Type 2 Diabetes Population and Forecast

7. Market Share Analysis - United Kingdom Diabetic

7.1 By Types

8. Continuous Glucose Monitoring Market (CGM) - United Kingdom Market & Users

8.1 CGM Market by Components

8.1.1 Glucose Sensor Market & Forecast

8.1.2 CGM Transmitter Market & Forecast

8.2 United Kingdom - CGM User (2011-2025)

8.3 CGM Reimbursement in United Kingdom

9. Blood Glucose Device (SMBG) - United Kingdom Market & Users

9.1 Market

9.1.1 Type 1 & Type 2 (Diabetes)

9.2 Test Strips Market and Forecast

9.2.1 Type 1 & Type 2 (Diabetes)

9.3 Lancet Market and Forecast

9.3.1 Type 1 & Type 2 (Diabetes)

9.4 Meter Market and Forecast

9.4.1 Type 1 & Type 2 (Diabetes)

9.5 Blood Glucose Device (SMBG) Users and Forecast

9.5.1 Type 1 & Type 2 (Diabetes)

9.6 Reimbursement of Blood Glucose Devices in United Kingdom

10. Insulin Pen - Market & User

10.1 Insulin Pen User

10.1.1 Disposable Insulin Pen Users

10.1.2 Reusable Insulin Pen Users

10.1.3 Smart Insulin Pen Users

10.2 Insulin Pen Market

10.2.1 Disposable Insulin Pen Market

10.2.2 Reusable Insulin Pen Market

10.2.3 Smart Insulin Pen Market

10.3 Insulin Pen Needle Market

10.4 Reimbursement Policies

11. Insulin Pump - Market & Users

11.1 Insulin Pump Market & Forecast

11.1.1 Type 1 & Type 2 (Insulin Pump Market & Forecast)

11.2 Insulin Pump Users

11.2.1 Type 1 & Type 2 (Insulin Pump User & Forecast)

11.3 Differentiation Points of Insulin Pump Products in the United States

11.3.1 Animas Vibe

11.3.2 Medtronic 530G with Enlite

11.3.3 Insulet OmniPod

11.3.4 Tandem t: slim

11.3.5 Roche Accu-Chek Combo

11.4 Training Model for Patients & HCP - of Medtronic, Animas, Insulet Corp. & Tandem Diabetes Care

11.4.1 Medtronic

11.5 Insulet Corporation

11.5.1 Training Structure for New Patients - Insulet Corporation

11.6 Animas Corporation

11.6.1 Training Modules for New Patients

11.6.2 Training Modules for HCP (Health Care Professional)

Story continues

11.7 Tandem Diabetes Care

11.8 Reimbursement Policies on Insulin Pump

12. Insulin Pen - Company Analysis

12.1 B. Braun Melsungen AG

12.1.1 Overview

12.1.2 Initiatives & Recent Developments

12.1.3 Revenue

12.2 Eli Lilly

12.3 Artsana S.p.A.

12.4 BD

12.5 Novo Nordisk A/S

12.6 Owen Mumford Ltd.

12.7 Ypsomed AG

13. Insulin Pump - Company Analysis

13.1 Medtronic

13.1.1 Overview

13.1.2 Insulin Pump - Product Details

13.1.3 Insulin Pump - Latest Development & Trends

13.1.4 Revenue

13.2 Insulet Corporation

14. SMBG - Company Analysis

14.1 LifeScan Inc.

14.1.1 Overview

Read more:
United Kingdom Diabetes Market 2020-2025 Featuring Analysis of Companies Involved in Insulin Pens, Insulin Pumps, SMBG and CGM -...

For decades, two costly medical conditions have been rising on similar trajectories in America: obesity and type 2 diabetes (T2D). Over the last 40 years, adult obesity rates have more than doubled, with a similar rise in individuals with T2D. The link between these two conditions is further suggested by the fact that 70 percent of Americans are now living with obesity or overweight, and 90 percent of all T2D patients have obesity or overweight.

We also know there are strong medical connections between obesity and T2D. As an individuals BMI (body mass index) rises, their risk of developing prediabetes and type 2 diabetes also increases. This is especially true with increases in visceral, or abdominal, fat which is less responsive to insulin. The first line of treatment for T2D generally focuses on glycemic control, often with medications that promote weight gain.

Examining the connection between weight and T2D gives reason to look at more than glycemic control.

Going Beyond Simply Controlling Glucose Levels

Addressing obesity for patients with diabetes, however, enables the clinician to do more than simply control glucose levels: they can treat the underlying insulin resistance that drives T2D. Choosing medications that promote weight loss like GLP-1 agonists and SGLT-2 inhibitors over medications that promote weight gain like insulin and sulfonylureas can improve weight status providing added benefit to diabetes treatment. Unfortunately,two-thirds of people with obesity remain undiagnosed. Medical professionals cite lack of time as a major reason for why they dont discuss weight treatments with their patients, although patients who do receive obesity counselling from physicians trained in obesity medicine report receiving a higher quality of care.

More informed and effective obesity care translates to better diabetes prevention and care. Clinicians evaluating treatment for T2D should also consider obesity treatments ranging from lifestyle interventions to anti-obesity medications to bariatric surgery. For example, the risk of diabetes is reduced by 58 percent with a five to ten percent reduction of weight through lifestyle changes.

A Range of Cost-Effective Interventions

Bariatric surgery, typically associated with obesity treatment, can offer significant benefits for patients with T2D. Noted as a cost-effective intervention by the International Diabetes Foundation, bariatric surgery results in remission for most patients with T2D. Recently,a study published in the New England Journal of Medicine, compared an intensive lifestyle intervention to bariatric surgery and found similar improvements in weight loss and metabolic profile in patients with T2D.

All clinicians can guide patients towards better health outcomes when they understand the connection between obesity and diabetes. The Obesity Medicine Association(OMA) offers a wealth of resources that can help advance that understanding, including specialized continuing education tracks focused on managing adiposity-related diseases and the role of weight management in the treatment of diabetes.OMAs virtual fall conference, OvercomingObesity 2020, will highlight the latest research and best practices related to obesity. Additional OMA resources include The Obesity Algorithm, Obesity Treatment Proficiency Badges and American Board of Obesity Medicine (ABOM) preparation materials.

Health care professionals who embrace an approach to T2D treatment through medical, surgical and especially combined obesity interventions have the potential to make meaningful improvements for patients on multiple fronts.

For more obesity medicine resources or to become an OMA member, visit:www.obesitymedicine.org.

Nicholas Pennings, DO is board certified in Family Medicine and Obesity Medicine and is a fellow of the Obesity Medicine Association (OMA). He is an associate professor and chair of family medicine at Campbell University School of Osteopathic Medicine (CUSOM) and also serves as the director of the Campbell University Health Center. As a champion for advancing the education of current and future health professionals, particularly as it relates to obesity, Dr. Pennings is an executive director of clinical education for the Obesity Medicine Association. He has also infused obesity education into the medical school curriculum at CUSOM and has developed an online obesity education rotation through the OMA for clinicians in training.

Read the original here:
Improve diabetes prevention and care through obesity treatment - Medical Economics

Diabetes mellitus is an increasingly common disease in the United States and is one of the leading causes of death. It is more than just elevated glucose levels. Type 2 diabetes mellitus, as part of the metabolic syndrome, is often accompanied by obesity, hyperlipidemia and hypertension. It is a complex metabolic disease and is considered a heart disease equivalent.

Diabetes has such a huge impact on cardiovascular health that over a decade ago, the FDA started requiring cardiovascular outcomes data for any new antihyperglycemic drugs. While we have known for many years that improved glycemic control decreased cardiovascular risk, we did not have specific data that any particular drug decreased the incidence of cardiac morbidity or mortality. Now, several newer diabetes drugs have been shown to decrease the risk of either hospitalization due to cardiac events or cardiac death. This has changed the way pharmaceutical companies have been marketing their drugs and it has changed the way people look at diabetes.

People other than endocrinologists, that is. Endocrinologists have always treated diabetes as a cardiometabolic disease. As a matter of fact, the American Diabetes Associations (ADA) Standards of Medical Care in Diabetes includes a whole section on managing cardiac risk. For years, endocrinologists have been treating hyperlipidemia and hypertension as part and parcel of their diabetes management.

Ask an endocrinologist how many times they have started a patient on a statin after that patient had been told by other physicians that his cholesterol is normal. Or worse, how often another physician stops the patients statin because his level is good. Too many. Ive even had patients refuse statin therapy because their cardiologist told them they dont need it.

Patients with diabetes comprise a large portion of the population that endocrinologists see. There is now a push to create a new specialty, a new fellowship in cardiometabolic medicine. Most endocrinologists Ive communicated with are asking why? Why do we need this new separate fellowship? Isnt this what weve been doing all along?

If the argument is that there arent enough endocrinologists to go around (see my earlier post), then the answer isnt training more people in a different specialty, the answer is creating more endocrinologists. The answer is making endocrinology more attractive to medical students and residents.

Why go into endocrinology when our healthcare system rewards people for procedures and not cognitive work? It is my hope that the new CMS physician fee schedule and the new visit codes will correct some of this. In addition, we need more funding for endocrinology fellowship programs.

Only about 300 new endocrinologists complete training each year, meanwhile 1.5 million new cases of diabetes are diagnosed in the same time frame. Wouldnt it save the healthcare system millions of dollars to better compensate endocrinologists for managing diabetes and its comorbidities in order to decrease the need for cardiac testing and procedures and to prevent hospitalizations for cardiac events?

Diabetes is definitely a cardiometabolic disease. But we dont need a whole other specialty to start managing it. Endocrinologists have been at the front line of this all along.

The rest is here:
Cardiometabolic Health Fellowships: The Answer or Part of the Problem? - Endocrinology Network

Western eating habits have made their way to other countries, and an increase in diabetes is the unfortunate result.

September 5, 2020 by Diabetes Knowledge Leave a Comment

Worldwide rates of diabetes among the 65-plus population are on the rise, and have increased dramatically in the past 40 years. The US, China, and India have the highest rates of diabetes around the world. Diabetes puts seniors at a much higher risk for chronic wounds including life-threatening diabetic foot ulcers.

Diabetic foot ulcers can progress from an irritation on the bottom of the foot to a gangrenous limb. This would require amputation. Amputation, especially in developing countries is a result of diabetic foot ulcers. Wound experts can monitor the feet of diabetic patients for signs of a foot ulcer. Generally starting out as a red sore on the bottom of the foot. But seniors in developing countries dont always have easy access to wound care experts, making diabetes an even bigger threat to their overall quality of life.

A rise in diabetes is costly for any nations healthcare system. Threatening to reverse progress in countries like India and China. In both countries, many seniors rely on family members for care, and dont have access to expert wound care. Experts also estimate that both countries have high rates of undiagnosed cases, meaning that patients could be at risk for diabetic foot ulcers and not know it.

Patients in India are put further at risk for diabetic foot ulcers because of faulty footwear. However, one study found to be the cause of ulcers in one-fifth of patients.

The causes of diabetes in the U.S. are well known fast food and diets high in sugar provide an obvious explanation. But Western eating habits have made their way to other countries, and an increase in diabetes is the unfortunate result. Even in Japan, with a global reputation for a healthy diet, has also seen a dramatic spike in diabetes in the past few decades. This is due in part to the aging population the likelihood of developing diabetes increases with age. Along with the westernization of the Japanese diet.

In the Marshall Islands, a small group of islands near the Philippines, scientists have had a chance to study a dramatic dietary shift in a small population. Today, many locals subsist almost entirely on pre-packaged, imported food. As a result, over a quarter of the adult population suffers from diabetes.

It wasnt always this way. In the past, the Marshallese diet consisted mostly of seafood and local produce, and unsurprisingly, diabetes was practically non-existent. Researchers believe the introduction of white rice into the local diet may have started the trend toward more carbohydrate-rich, processed foods.

What can we learn from countries with especially low rates of diabetes? Italy has one of the lowest rates of diabetes in Europe, which tracks with recent studies. Research suggests that the Mediterranean diet is the best for lowering the risk of diabetes and obesity. A diet rich in healthy fats, in foods like fish and olives, as well as plenty of fresh produce. Seniors in long-term care may not have easy access to Mediterranean cuisine, but keeping those rough guidelines in mind can help seniors in long-term care make healthier choices and keep their diabetes symptoms in check.

Previously published on diabetesknow

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Diabetes Around the World on the Rise? - The Good Men Project

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Bengaluru: An analysis of over 1,30,000 adults from 21 countries over nearly a decade has indicated a high risk of diabetes linked with the consumption of white rice. The risk is most prominent for the South Asian population, according to findings from a new, large-scale, long-term study.

The study was an international collaboration between researchers from various countries including India, China, and Brazil in Asia, North and South America, Africa and Europe.

Led by Bhavadharini Balaji of the Population Health Research Institute, Hamilton Health Sciences and McMaster University, Canada, the study was a part of the institutes Prospective Urban Rural Epidemiology (PURE) project.

The findings were published in the Diabetes Care journal in its September issue.

White rice is milled rice that has its germ (the part that sprouts), bran (hard outer layer), and husk (outer covering) removed. The polishing of rice further results in a bright and shiny appearance. While white rice has an appealing appearance and can be stored longer, the milling and polishing process remove nutrients such as vitamin B.

White rice has been linked to an outbreak of beriberi in Asia, caused by vitamin B-1 deficiency. It also causes the blood sugar levels to spike upon consumption due to its high glycemic index.

Globally, 42.5 crore people currently have diabetes, and this number is expected to increase to 62.9 crore by 2045, according to the International Diabetes Federation.

Studies have alluded to risk of diabetes associated with white rice for a few decades now, although findings have been contradictory. A 2012 study found that each extra serving of white rice increased the risk for diabetes by 11 per cent.

However, findings change depending on which country studies were conducted in. For example, a study of over 45,000 participants in Singapore found no substantial increase in diabetes was associated with white rice consumption.

Most such studies were limited to single countries. To beat this barrier, the authors of the new study extended it to 21 nations Argentina, Bangladesh, Brazil, Canada, Chile, China, Colombia, India, Iran, Malaysia, occupied Palestine territory, Pakistan, Philippines, Poland, South Africa, Saudi Arabia, Sweden, Tanzania, Turkey, United Arab Emirates, and Zimbabwe.

However, the South Asian population seems to show a pattern with white rice consumption and diabetes, despite a number of other lifestyle factors that increase the disease risk.

South Asians are genetically more predisposed to get diabetes, so there are both lifestyle as well as biological reasons for the high diabetes incidence, said Bengaluru-based physician Dr Gowri Kulkarni.

To understand the link between white rice and diabetes in South Asia, the researchers compared the data from India, Bangladesh, and Pakistan with the rest of the world.

Also read:Unique protein in placenta could hold key to protecting organs from Covid infection

The study involved 132,373 individuals between the ages of 35 and 70, from these 21 countries, who were monitored for nine and a half years. Of these, 6,129 developed diabetes over the course of the study.

Participants were considered if they consumed more than one cup or 150g of cooked rice a day. Overall, the average white rice consumption was 128g a day among the study participants.

However, the team found that the highest consumption of white rice was seen in South Asia at 630g a day, followed by South East Asia at 239g and China at 200g per day. High consumption of rice resulted in lower consumption of other foods like wheat, fibre, red meat, and dairy products.

Carbohydrates make up nearly 80 per cent of calories consumed in many South Asian countries. Since the 1970s, carbs have become increasingly polished and refined as well, losing a lot of nutrition in the process.

Rapid urbanisation and economic development, especially in low- and middle-income countries, have led to a dramatic change in dietary intake and increased physical inactivity, which are related to the obesity epidemic.

Talking about the findings, Mumbai-based nutritionist Priya Kathpal said, I wouldnt say every white rice-eating family would have a diabetic person in their family A lot depends on the quantity of rice eaten, what its eaten with, and how frequently.

Also read:Brainwaves study can tell if a worker can handle crisis situation, IIT Madras research says

China and India are two of the worlds largest countries where rice is the staple food. Both also lead in the incidence of diabetes. However, the researchers found that there wasnt a significant association with white rice consumption and diabetes in China.

There could be many reasons for this, apart from other lifestyle factors. The scientists believe that the kind of rice the Chinese eat (sticky rice) could make a difference.

In India, studies have shown that during the last four to five decades of replacing hand-pounded rice with industrially milled white rice, the prevalence of diabetes in urban areas in India increased from 2 per cent in the 1970s to 25 per cent in 2015, and in rural areas from 1 per cent to 1416 per cent, respectively. White rice is considered to be one of the many main drivers of the trend, which followed improved socioeconomic growth and lifestyle modifications.

Studies have shown that substituting white rice with unpolished brown rice decreases the glycemic response by 23 per cent and the fasting insulin response by 57 per cent in overweight Asian Indians, but consumers do not tend to prefer brown rice due to its inconvenience of longer cooking duration, greater chewing difficulty, and lack of visual appeal.

Several patients that Ive asked to switch to brown rice have faced difficulty, as everyones grown up eating white rice, said Kathpal.

Taste is a huge factor, and brown rice often doesnt taste the same as white with vegetable curries and dals. Sometimes, white rice alternatives like even millets can be more expensive or not as easily available too, she said.

Doctors and dieticians are hesitant to recommend diets that are more expensive and less easily available even if they are healthier, as patients tend not to adopt them successfully.

A daily diet should always be easy to maintain and easily available. Only then can it be sustainable, said Kulkarni. Indians in general have poor protein intake in diet, and this has to do with available resources and choices. Most calories are from carbohydrates as they are cheap.

According to the researchers, in countries where rice is consumed the most or as a staple, the risk of increased diabetes among the public can be lowered by substituting white rice with alternate forms of healthier rice versions and adding more legumes or pulses to food.

Also read:One drink? Or two? Forget the guidelines, less is always better

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White rice linked to diabetes, especially in South Asia, says 21-nation study done over 10 yrs - ThePrint

Cypress resident Anne Imber takes a photo with her son Tristan Edgar, who was diagnosed with Type 1 diabetes in 2009 at the age of 12.

Cypress resident Anne Imber takes a photo with her son Tristan Edgar, who was diagnosed with Type 1 diabetes in 2009 at the age of 12.

Photo: Courtesy Of Anne Imber / Provided By Kimberly Pace, 9th Wonder

Cypress resident Anne Imber takes a photo with her son Tristan Edgar, who was diagnosed with Type 1 diabetes in 2009 at the age of 12.

Cypress resident Anne Imber takes a photo with her son Tristan Edgar, who was diagnosed with Type 1 diabetes in 2009 at the age of 12.

Cypress mother advocates with Beyond Type 1 DKA Campaign to differentiate diabetes symptoms from viruses like COVID-19

Excessive thirst, frequent urination, unexplained weight loss and exhaustion. If Cypress mother Anne Imber and her son had known what these symptoms might indicate, he could have been treated sooner for the serious health complications from his undiagnosed Type 1 diabetes.

Type 1 diabetes is a chronic autoimmune condition that causes the bodys immune system to mistakenly attack the insulin-making beta cells of the pancreas, explained Dr. Daniel DeSalvo, pediatric endocrinologist at Baylor College of Medicine and Texas Childrens Hospital.

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If a person with diabetes isnt receiving insulin, then they can develop a life-threatening condition called diabetic ketoacidosis, or DKA. It causes stomach pain, nausea, vomiting, tiredness, lethargy, sometimes it can cause rapid or heavy breathing, and if its severe it can lead to the point of confusion or even unconsciousness, DeSalvo said.

DeSalvo is on the science advisory board for Beyond Type 1, a nonprofit focused on building awareness and support for people with Type 1 and Type 2 diabetes worldwide.

Among the organizations initiatives is to prevent the development of DKA by educating people about the warning signs of Type 1 diabetes.

Imber became a Beyond Type 1 volunteer after her sons diabetes diagnosis and has been advocating on behalf of the DKA Campaign.

Texas was actually one of the first states to adopt the Beyond Type 1 DKA Campaign, Imber said. We have a really passionate group of diabetes advocates in the Houston area, and especially in the Cypress area, because we have a Type 1 diabetes school advocacy group.

One factor that can lead to the delayed diagnosis of Type 1 diabetes is the symptom similarities to some viral illnesses such as the flu or a stomach virus, DeSalvo said. During the COVID-19 pandemic, making people aware of Type 1 diabetes telltale symptoms is of vital importance.

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Its an issue that Imber knows all too well.

Imber said her son Tristan was 12 years old when he and his sister contracted the swine flu in 2009 during the H1N1 pandemic.

My daughter immediately bounced back, Imber said. She was on the mend in two days. My son, he went down with the swine flu and then he never recovered his full energy that hed had before. He started suffering from extreme exhaustion. He started having a lot of weight loss.

There were many factors that Imber thought might be at play he was slimming due to a growth spurt; he had started running cross-country; and, of course, hed just been sick with the swine flu.

He would come home incredibly exhausted, falling asleep, and I really attributed it to the swine flu his recovery from the swine flu just not taking the path that his sister had taken, Imber said.

He continued to go downhill over the next month, losing 20 pounds in just four weeks. Hed tell his mom he was starving but was too nauseous to eat. He became more emotional than usual, Imber said. She knew something was wrong, so she made a Friday appointment with a pediatrician.

They knew immediately how bad it was, but they wanted us to come back Monday morning for a fasting blood glucose (test), she said.

Halloween happened to fall on that weekend. Thank god he did not eat his candy, Imber said. He was waiting for his braces to come off on Tuesday.

By Tuesday morning, his pediatrician had called to relay his diagnosis Type 1 Diabetes.

They realized Tristan had been going into phases of DKA because of his untreated condition.

Because he was running cross-country, his blood sugar would go really high and then it would drop again because of the activity, Imber said. So, it was a really unusual case and thats one of the reasons it took so long to manifest in really obvious terms of, something was seriously wrong.

Imber believes something as simple as an informational poster in the doctors office waiting room, like the ones distributed by the DKA campaign, could have tipped them off sooner.

He hadnt been sharing the excessive thirst and the frequent urination because 12-year-old boys dont do that with their moms; they dont talk about those things, she said. And I know had he been sitting in that office at that time with the DKA Campaign poster there, he would have been able to say, Mom, Ive been having these symptoms and that wouldve really prompted us to get immediate help Friday versus waiting until Tuesday to seek out support for him.

Nowadays, Imber said a DKA diagnosis warrants immediate hospitalization; but at the time, doctors felt the severity level of Tristans condition was low enough to treat him outside of a hospital. Imber said her son was fortunate to not have experienced the organ failure that some do from DKA. She knows of several cases in which lives have been lost because of an incorrect or delayed diagnosis. If her son had not been diagnosed in a timely manner, Imber doesnt doubt he wouldve ended up in the hospital.

We were lucky that he did not incur that seriousness of it, but we immediately saw relief from being able to be treated with the insulin under the care of an endocrinologist, and then started that learning process on how to manage it with the insulin dosing since his pancreas was no longer able to provide that hormone to regulate his food intake, Imber said.

Imber had attributed several of Tristans diabetes symptoms to the residual effects of his flu recovery a relatively common misidentification among people with undiagnosed diabetes, she said.

When its flu season, youll see a lot of people struggling and thinking, It is just the flu, but in reality there are some symptoms that really stand out that frequent urination, that excessive thirst that really differentiate from a flu symptom, Imber said.

The COVID-19 pandemic presents similar challenges for the diagnosis of Type 1 diabetes and DKA, explained Beyond Type 1 Leadership Council Member Michelle Berman.

We are seeing many families protecting themselves and wanting to avoid visits to doctors or the hospital, Berman said. And on top of that, if they arent armed with the knowledge of the warning signs, they also arent taking action when they appear. We really want families to get to the hospital or contact their physician right away, in spite of COVID or in addition to looking for the COVID warning signs. Type 1 diabetes does not stop just because theres a pandemic.

Berman serves as the National Family Advocate for the DKA Campaign.

Her child was diagnosed with Type 1 diabetes in 2007. She took him to the doctor after hed fainted from what she thought was abnormal blood pressure. After his diagnosis, Berman felt frustrated that shed never been made aware of the warning signs for Type 1 diabetes.

Berman learned of the Beyond Type 1 organization in 2016.

So, I partnered with Beyond Type 1 as a family advocate and began working on partnerships with the American Academy of Pediatrics and individual chapters in each state, Berman said. Together, Beyond Type 1 and the AAP partnered and brought awareness to families. Currently, I think theres 25 states across the country that partnered with Beyond Type 1 and disseminated materials warning signs, posters, fliers and handouts to families at well visits.

The campaign began its push to disseminate the information in November of 2016 and has distributed the material in 25 states to more than 28,000 pediatric offices serving over 90 million patients a year, according to Berman.

And thats just phase one.

With a grant from the Helmsley Charitable Trust Foundation, we were able to expand the campaign into phase two, into 10 states across the country, Berman said.

Phase two targets the general public, schools and businesses such as gyms.

In February of this year, the National Association of School Nurses partnered with Beyond Type 1 with the awareness campaign, and so thats been very exciting to expand beyond the pediatricians, Berman said. With the school nurses, were raising awareness of the warning signs, really to be distributed to tens of thousands of school nurses nationally in the United States. So, weve been really thrilled with the awareness and partnerships with this campaign.

For more information or to get involved, visit http://www.beyondtype1.org/dkacampaign or email dka@beyondtype1.org. Find Beyond Type 1 on social media: @beyondtype1.

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Cypress mother advocates with Beyond Type 1 DKA Campaign to differentiate diabetes symptoms from viruses like COVID-19 - Chron

Thousands of diabetes patients in the U.K. have been given hope that their illness could be put into remission by a soup-and-shake diet plan being offered by the National Health Service (NHS).

Those with Type 2 diabetes, which is more likely to affect people who are obese or overweight, are being encouraged to take up the low-calorie liquid diet after a trial involving 5,000 people showed that almost half of the participants saw their diabetes go into remission after a year.

Around 12.3 million people in the U.K are at risk of developing Type 2 diabetes, while in the U.S., one-third of Americans could be on their way to developing the disease, with 84 million Americans having pre-diabetes, a condition where people have higher than normal levels of blood sugar, according to the Center for Disease Control (CDC).

Around 10 percent of the U.S. population has diabetes, according to the CDC.

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Diabetes is also expected to cost the NHS 10 billion a year.

The year-long diet plan is being offered by the NHS to an initial 10 areas of England and only those who have been diagnosed with the condition in the last six years will be considered for the scheme.

Participants will be provided with diet replacement products such as shakes and soups for three months alongside support with exercise plans as well as managed plans to reintroduce ordinary, nutritious food.

Professor Jonathan Valabhji, NHS national clinical director for diabetes and obesity said: "This is the latest example of how the NHS, through our Long Term Plan, is rapidly adopting the latest evidence-based treatments to help people stay well, maintain a healthy weight and avoid major diseases.

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"There has never been a more important time to lose weight and put their Type 2 diabetes into remission, so it's good news for thousands of people across the country that practical, supportive measures like this are increasingly available on the NHS."

It comes as Public Health England data revealed that those with diabetes were more vulnerable to the COVID-19 virus, with a third of people who died in hospital with COVID-19 also having diabetes.

A new study published by the University of North Carolina showed that people with obesity are 113 percent more likely to be admitted to hospital with coronavirus and 74 percent more likely to need intensive care treatment.

Bev, who was one of the first patients to benefit from the diets during trials, said: "My goal for the first eight weeks of the low-calorie diet was to lose 5 percent of my body weight which I achieved in six weeks and in total I've lost over 10kgs, my Type 2 diabetes is now in remission and I no longer have to take any medication I am over the moon.

"Since the low-calorie diet program, my mindset has totally changed for the better and I look at food differently now my shopping habits are far healthier and, when I eat out, I'll go for a healthier option. The program has taught me moderation."

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Britain Begins Diabetes Trial After 50 Percent Recover Within One Year - Newsweek

LEONARDTOWN, MD (September 3, 2020) The St. Marys County Health Department is pleased to announce that the Overdose Response Program, Tobacco Cessation Program and Diabetes Prevention Program will be offered virtually for community members this Fall.

Overdose Response Program

The Overdose Response Program provides free training, open to anyone who would like to learn how opioids affect the body, how to recognize the signs of opioid overdose, and how to care for someone who may be experiencing an overdose until emergency help arrives. Participants can receive an overdose response kit via scheduled curb-side pickup that includes naloxone (Narcan) a life-saving medication that may be able to restore the breathing of someone who has overdosed on opioids.

Next Session: Wednesday, September 30, 2020, from 6:00 7:00 p.m.Learn moreor register at:www.smchd.org/overdose

Tobacco Cessation Program

The Tobacco Cessation Program is free and that takes place over the course of 8 weeks (weekly 1 hour sessions). Participants learn behavioral modifications, stress management, and other techniques to help them quit using tobacco products.

Next Series: Tuesdays, September 15, 2020November 10, 2020 from 5:306:30 p.m. Learn moreor register at:www.smchd.org/tobacco

Diabetes Prevention Program New!

The Diabetes Prevention Program helps participants establish and stick with positive lifestyle changes, such as healthy eating habits, physical activity and positive stress management, which can prevent or delay the onset of Type 2 diabetes. This free program includes 16 weekly sessions, followed by monthly sessions for ongoing support from a lifestyle coach.

Next Series: September 25, 2020 September 24, 2021 from 2:00 3:00 p.m.Learn more or register at:www.smchd.org/dpp

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Virtual Programs Announced for Overdose Response, Tobacco Cessation and Diabetes Prevention - The Southern Maryland Chronicle