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In celebration of our 15 Year Anniversary, Academic Editor Ronald CW Ma highlights advancements published in PLOS Medicine in diabetes research and care, including improved precision medicine.

Happy 15th Birthday to PLOS Medicine! I still remember reading about the PLOS journals and the idea of making science accessible to all back when PLoS was first launched. It is amazing how far the Open Access movement has developed, how far that idea has advanced and how scientific publishing has been revolutionized. Congratulations PLOS Medicine on this important milestone!

Among the many articles that I have enjoyed reading in PLOS Medicine over the years, I would like to highlight two for sharing with other readers on this special occasion.

1) Event Rates, Hospital Utilization, and Costs Associated with Major Complications of Diabetes: A Multicountry Comparative Analysis

This paper by Philip Clarke and colleagues from the ADVANCE Collaborative Group, published back in 2010, highlighted the significant economic burden of diabetes and rates of hospitalization resulting from diabetes co-morbidities, using data from the Action in Diabetes and Vascular Disease: Preterax and Diamicron MR Controlled Evaluation (ADVANCE) study, a landmark multi-centre trial on the treatment of diabetes conducted in 20 countries. Within the ADVANCE trial settings, the study demonstrated important differences in the rates of hospitalization for different diabetes complications in different regions of the world (Asia, Eastern Europe, and established market economies such as Australia, New Zealand and Canada), mirroring epidemiological observations of comparative higher nephropathy rates, higher stroke risk, and lower risks of coronary artery disease among Asians (mostly from Chinese centres in this particular trial) with type 2 diabetes, thereby highlighting the heterogeneity of risk of diabetes complications (and costs) in different populations.

This study also provided important tools to facilitate estimation of healthcare expenditure associated with diabetes in different healthcare settings. At the time of the study, it was estimated that the average annual per capita health expenditure was approximately 216 international dollars in China, and 698 international dollars in Russia, but that the annual hospital costs for people with diabetes experiencing major macrovascular complications such as coronary or cerebrovascular events would be around four and ten times these average per capita expenditures. Perhaps not fully appreciated at the time was the significant burden associated with hospitalization with heart failure, which is a topic of much current interest in relation to recent advances in the treatment of type 2 diabetes.

Although the work was focused on evaluating the economic burden of diabetes in different parts of the world, this work can be considered as an important example of early attempts to deconstruct the heterogeneity of type 2 diabetes. As the diabetes epidemic continues unabated, the healthcare burden of diabetes complications has become a major concern globally.

2) Type 2 diabetes genetic loci informed by multi-trait associations point to disease mechanisms and subtypes: A soft clustering analysis

The second article, by Jose Florez and colleagues, utilized a state-of-the-art multi-omics approach to use available genetic and epigenomic data to probe the issue of heterogeneity of diabetes. The authors showed that identified genetic loci linked to diabetes can be segregated according to underlying biological mechanisms which can be used to classify individuals, to provide a way forward for individualized diagnosis, monitoring and treatment. The study highlighted the potential role of genetic variants related to the beta cell, pro-insulin, obesity, lipodystrophy and liver/lipid traits in accounting for different patient characteristics, as well as long-term diabetes outcomes.

What was particularly interesting is the soft-clustering approach adopted by the authors, which did not require genetic variants to fit into only one pathway, or for individuals to be classified to have diabetes due to only one specific pathophysiological defect, but instead, for individuals to be identified to have scores in each of the above-mentioned categories, and thereby accepting that individuals may have developed diabetes with different contribution from the different underlying pathophysiology. The use of such genetic risk scores may be useful in selecting the most appropriate therapies for individualized care in the future.

Over the last 15 years, the global burden of diabetes has more than doubled, from less than 200 million people affected back in the early 2000s to now more than 422 million people affected globally (with the majority in LMICs). These 2 articles represent important advances in our understanding of type 2 diabetes over the last decade. Whilst the ADVANCE study was a landmark study that generated much interest, the Clarke paper highlighted much of the burden of diabetes complications, and our lack of understanding regarding the heterogeneity in risk of diabetes complications. Together with the Action to Control Cardiovascular Risk in Diabetes (ACCORD) and Veterans Affairs Diabetes Trial (VADT) studies, these landmark studies, published between 2008-2010, have highlighted the potential dangers of hypoglycaemia, and heralded the debate and call for more individualized treatment in type 2 diabetes, and contributed to the American Diabetes Association (ADA) and European Association for the Study of Diabetes (EASD) to propose in their joint position statement on management of hyperglycaemia in type 2 diabetes in 2012 to move away from a one-size-fit-all approach to treatment, but instead adopt a treatment strategy that is more tailored to individual patient profile, disease duration, co-morbidities and expectations. This represented a major watershed moment in the evolution of diabetes research and care.

With recent advances in genomic medicine and the genetics of type 2 diabetes, some of which have been reported in PLOS Medicine, the era of precision medicine in diabetes is very much here to stay. We, as diabetes researchers and clinicians caring for people with diabetes, look forward to further advances in our understanding of how best to treat individuals with diabetes based on their underlying genetics, pathophysiology, and needs, and to improving outcomes for people with diabetes.

Congratulations again PLOS Medicine and we look forward to the next 15 years of exciting advances!

Ronald Ma is Professor and Head of Division of Endocrinology and Diabetes at the Department of Medicine and Therapeutics, The Chinese University of Hong Kong, and co-lead of the Chinese University of Hong Kong-Shanghai Jiao Tong University Joint Research Centre in Diabetes Genomics and Precision Medicine. He is a member of the Executive Board, Asian Association for the Study of Diabetes (AASD), and member of the editorial board of PLOS Medicine.

Acknowledgement: RCWM acknowledge support from the Hong Kong Research Grants Council Research Impact Fund (R4012-18).

Image Credit: stevepb, Pixabay (CC0)

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Charting the evolution of diabetes research and care | Speaking of Medicine - PLoS Blogs

BALTIMORE, Oct. 31, 2019 /PRNewswire/ --Deadly. Blinding. Costly. Epidemic. These are the words used to describe diabetes, a devastating condition affecting more than 30 million Americans (about 9.4% of the population). Of those, nearly 30 percent (or 10 million people), have diabetic retinopathy, a potentially blinding disease that costs Americans more than $500 million every year.

The new Versant Health white paper, The health and financial costs of diabetic retinopathy, outlines the toll both physically and financially that diabetic retinopathy can take on a person. Not only can the disease have a debilitating impact on vision, but medical costs associated with diabetic retinopathy are higher than with other diabetes-related conditions, including neuropathy and chronic kidney disease.

"Early intervention is critical when it comes to the successful treatment of diabetic retinopathy," says Mark Ruchman, MD, Chief Medical Officer at Versant Health and contributor to the white paper "In its early stages, when treatment has the greatest likelihood of success, patients are typically asymptomatic. Thus, a regular eye exam is a critical component of any health and wellness program to reduce blindness from this disease."

Versant Health supports the overall health of its diabetic members in several ways, striving to reduce the risk for and/or severity of diabetic eye disease, including Diabetic Outreach, medical management, and detailed provider portal questionnaires. To learn more, download the health and financial costs of diabetic retinopathy white paperfrom the Versant Health website.

About Versant HealthVersant Health is one of the nation's leading managed vision care companies serving more than 33 million members nationwide. Through our Davis Vision plans and Superior Vision plans, we help members enjoy the wonders of sight through healthy eyes and vision. Providing vision and eye health solutions that range from routine vision benefits to medical management, Versant Health has a unique visibility and scale across the total eye health value chain.As a result, members enjoy a seamless experience with access to one of the broadest provider networks in the industry and an exclusive frame collection.Commercial groups, individuals, third parties, and health plans that serve government-sponsored programs such as Medicaid and Medicare are among our valued customers.

For more information visitversanthealth.com.

SOURCE Versant Health

versanthealth.com

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Versant Health releases white paper: The health and financial costs of diabetic retinopathy - PRNewswire

Type 2 diabetes is a common condition in the UK and causes the body not to respond to insulin properly, so it doesn't produce enough. This causes a persons blood sugar levels to become too high. If blood sugar levels arent controlled and stay too high it can lead to a number of problems, including kidney failure, nerve damage, heart disease and stroke, so its important to make lifestyle changes to help keep blood sugar in check.

Regularly eating a poor diet can increase a persons risk of developing type 2 diabetes, so making changes to what you eat is advised.

Experts say theres nothing you cannot eat if you have type 2 diabetes, but certain foods should be limited.

The NHS says you should: Eat a wide range of foods - including fruit, vegetables and some starchy foods like pasta, keep sugar fat and salt to a minimum, and eat breakfast, lunch and dinner every day - do not skip meals.

But individual food and drink have also been proven to have blood sugar lowering qualities, and when it comes to the first meal of the day, breakfast, a certain fruit has been shown to have a positive effect on blood sugar levels.

READ MORE:Type 2 diabetes: Adding this superfood to your breakfast could lower your blood sugar

A 2003 animal study showed fig extract can contribute to diabetes treatment by normalising blood fatty acid and vitamin E levels.

But this isnt the only part of the fig plant proven to help blood sugar levels.

A 2016 study in rats showed ficusin, an extract from fig leaves, improves insulin sensitivity and has other antidiabetic properties.

Some people may be sceptical over eating fruit because of its sugar content, but the sugar in whole fruit does not count towards free sugars, so it is not this type of sugar we need to cut down on, explains Diabetes UK.

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The charity explains: This is different to the free sugar in drinks, chocolate, cakes and biscuits, as well as in fruit juices and honey.

Its the amount of carbohydrate you eat that has the biggest effect on blood sugar levels after eating, says the charity.

It continues: A portion of fruit, such as a medium apple, generally contains about 15 to 20g carbs.

It is better to reduce your intake of chocolate, sugary drinks, cakes and other snacks than whole fruit when trying to restrict your carb intake to help manage your blood glucose levels.

Figs could be enjoyed on top of a bowl of oatmeal, which has also been proven to have a positive impact on blood sugar levels.

Oatmeal contains a soluble fibre called beta-glucan that can help improve insulin response and possible reduce blood sugar too.

A review of research on the benefits of oatmeal for people with type 2 diabetes found oatmeal has a positive effect on a blood sugar control.

Alongside eating healthily, being active can help lower blood sugar levels.

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Type 2 diabetes: The 50p fruit you could eat for breakfast to lower blood sugar - Express

According to the CDC in the recent season, about 30% of adults in the hospital for the flu had diabetes.

The fact is people with diabetes, even if well-managed are at a higher risk of serious influenza complications.

According to the Director of Education and Patient Care at UHC, Brenda Conch these complications can result in hospitalization and sometimes even death.

"If they have diabetes specifically when they get the flu their diabetes is now out of control because that's what happens when an individual is ill, their glucose goes up," said Conch.

The reason those with diabetes or other chronic illnesses can get sicker from the flu is because their body is already fighting an illness.

"Your body is attending to that illness, so it doesn't really pay attention to something else coming at it," said Conch.

Conch says the flu shot is our best defense against the flu.

"Obviously the other ones is good hand hygiene and make certain you, but the best is through the flu vaccine," said Conch.

If someone with diabetes wants to get the influenza vaccine, it is recommended they must get the actual shot. Not the intranasal form because that can give you a minor case of the flu.

Obviously there are some misconceptions about the flu shot and how it works.

"Back in the old days it was a live virus, so there are people that still recall they got a shot a long time ago and they did get the flu with it. When you lived that it's hard to convince someone that is not how it is anymore. It does work, and it does work against flu we're immunizing for," said Conch.

Conch says there is an exception to every rule, but pretty much everyone needs to get the flu shot. The exception being infants or if your doctor tells you otherwise.

In addition, after an individual receives the flu shot it takes 14 days to take full effect.

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Those with Diabetes are at greater risk for the flu and flu complications - WDTV

INTERVALE The Miranda Leavitt Diabetes Fund and the Conway Area Lions Club are hosting a Diabetes Awareness Event on Saturday, Nov. 16, from 10 a.m.-1 p.m. at the Miranda Diabetes Care Center, located at 3 N.H. Route 16 A in Intervale.

This free event will offer diabetes risk assessments, education on the link between diabetes and vision loss, blood glucose screening, blood pressure checks, plus information on diabetes prevention, nutrition advice and more.

Diabetes nurse practitioner Justine Fierman from the Miranda Diabetes Care Center and registered dietitian Brenda McKay from Memorial Hospital will be there to educate the community in the proper management of diabetes symptoms, and how many can decrease their risk in developing Type 2 Diabetes.

With November as National Diabetes Awareness Month, Conway Area Lions Club zone chair Linda Rafferty felt it was the right time to support an event around diabetes and vision loss.

The Conway Area Lions Club is a longtime supporter of the Miranda Leavitt Diabetes Fund and is known internationally for its work to improve health issues.

We are tackling tough problems like blindness and drug abuse as well as diabetes awareness and finding help and training for the deaf, disabled, underprivileged and the elderly. Whatever the community needs to make life better, were there to help, Rafferty said.

Rafferty said the event fits well into the Lions mission and supports a service project she personally is spearheading in her zone, which includes Lions Clubs in Laconia/Guilford, Moultonboro, Wolfeboro, Wakefield, Whittier, Meredith and Conway area.

I have chosen to spread diabetes awareness to all. This illness has affected some of my own family and friends and continues to strike many people. I was fortunate enough to meet with Brenda Leavitt and Justine Fierman from the Diabetes Care Center to work together on this project.

According to the American Diabetes Association, diabetes causes eye problems and may lead to blindness. People with diabetes do have a higher risk of blindness than people without diabetes. However, with regular checkups, most people with diabetes can keep minor vision problems minor.

Diabetic retinopathy is a general term for all disorders of the retina caused by diabetes. Huge strides have been made in the treatment of diabetic retinopathy. The sooner retinopathy is diagnosed, the more likely these treatments will be successful. The best results occur when sight is still normal. Several factors influence whether someone develops retinopathy:

Blood sugar control.

Blood pressure levels.

How long you have had diabetes.

People who keep their blood sugar levels closer to normal are less likely to have retinopathy or to have milder forms. This is why the November 16 event will be offering free blood glucose screenings and providing risk assessment information for developing diabetes.

But high blood glucose levels are just one of the risk factors of developing diabetes.

Factors such as age, weight, smoking, gender, family history, high blood pressure, activity level and ethnicity can all be indicators that diabetes could develop. Awareness and prevention efforts, such as weight loss, healthier diet choices, managing blood pressure and quitting smoking can all reduce the risk of developing Type 2 diabetes, and symptoms including vision loss.

Brenda Leavitt, founder of the Miranda Leavitt Diabetes Fund stated, We are gearing up for National Diabetes Month and the Miranda Leavitt Diabetes Fund, along with Conway Area Lions, is sponsoring this diabetes awareness event together. This disease is growing in our state and community, so the Diabetes Fund is putting together a series of screening, and education classes to follow. We are so pleased for the support from the Conway Area Lions Club and thank them for working with us on this event.

The U.S. Centers for Disease Control and Prevention reports that the number of Americans with diabetes continues to rise, with over 12 percent of the adult population estimated to have the disease, and more than a third of those aged 20 and over in the U.S. now thought to have prediabetes.

The Miranda Leavitt Diabetes Fund was founded in 2009 with a mission to provide resources, education and awareness for people with diabetes in the Mt. Washington Valley community. Miranda Leavitt passed away from complications of Type 1 Diabetes in 2007, and her parents, Rich and Brenda Leavitt, have tirelessly sought to raise funds and provide outreach around diabetes care and prevention.

The event takes place in the new location of the Miranda Diabetes Care Center in Intervale, NH. It is located at the intersection of Routes 16 and 16A. It is the practice of certified diabetes educator and nurse practitioner Justine Fierman. Fierman specializes in intensive diabetes management, insulin pump therapy, diabetes technologies, diabetes in pregnancy and continuous glucose monitoring.

For information on the Miranda Fund, go to Facebook page MLDFund. For more information on the Conway Area Lions, go to conwayarealions.org.

More:
Diabetes fund teams with Lions for awareness event - Conway Daily Sun

How the changes impacted her life and health

The pounds dropped off of Snita, losing three stone to weigh in now at eight stone. To top it off, Snita received her blood test results shortly before her 50th birthday which revealed she was no longer within the diabetic range.

Snita now considers herself a running addict and regularly runs 5ks, 10ks and half marathons. Later this year, she will take part in the iconic Simplyhealth Great South Run, part of a series of mass participation running events which has partnered with Diabetes UK, to encourage more people to become more active.

Snita is effusive in her praise for the impact running has had on her life and recently delivered a talk, with the help of Diabetes UK, on the life-changing effect it can have on other people living with diabetes.

The impact running has had on my life has been huge. If I hadnt joined my running club and got the support Ive had from my coach and the rest of the group I wouldnt have kept it up.

Running has really helped my diabetes by getting me fitter and forcing me to address my diet, which together have helped me diabetes enter into remission.

Snita has been running medication-free for 19 months now and as well as running the Simplyhealth Great South Run later this year, has also recently completed half marathons in London, Liverpool and Dublin.

She feels happier, fitter and healthier now than she has since her 20s and is determined to continue challenging herself. Its been a real journey which Im still on and I feel like a changed person.

I have so much energy and do so much more in a day than I ever did before. Its been truly life-changing.

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Type 2 diabetes: Women puts her diabetes into remission by doing this activity - Express

Named after pioneering poet and activist Audre Lorde, Spelman College plans to establish a chair in queer studies, the first for a Historically Black College or University (HBCU), The Root reports. The position was supported by a $2 million donation from philanthropist Jon Stryker. In a statement issued to Forbes, Stryker states his donation helps to further students' education on LGBTQ rights.

"The more that people understand queer history and LGBTQ issues, the more likely they are to accept and support the LGBTQ community," Stryker said. "By empowering and educating the next generation, we can help make a future where LGBTQ people have full and equal protections under the law."

Mary Schmidt Campbell, Spelman's president, discussed the significance behind this new department.

A chaired professorship in Queer Studies enables the College to build on one of its strengths and that is the Spelmans educational inclusiveness, spearheaded by the Womens Research and Resource Center under the stellar direction of Dr. Beverly Guy-Sheftall," Campbell said. "Spelmans Womens Center has been and continues to be a pioneering leader in advancing scholarship in the area of Queer Studies. Jon Strykers generous contribution to further his commitment to LGBTQ inclusion and education will allow Spelman students to deepen their understanding around the study of sexuality and gender. We are honored to name the chair after the literary luminary and fierce activist, Audre Lorde.

Spelman College announces a $2M match from philanthropist Jon Stryker to establish an Endowed Queer Studies Chair named after poet and activist Audre Lorde. The professorship is the first-ever chair of its kind at an HBCU. https://t.co/nb7FVHEOal pic.twitter.com/fBIEfPFBdm

Spelman College (@SpelmanCollege) October 29, 2019

The news arrives two years after Spelman announced the admission of transgender women students, beginning in 2018."In adopting this admissions policy, Spelman continues its fervent belief in the power of the Spelman Sisterhood," Campbell said in a letter. "Students who choose Spelman come to our campus prepared to participate in a women's college that is academically and intellectually rigorous, and affirms its core mission as the education and development of high-achieving black women."

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'Yo! MTV Raps' Doctor Dre Discusses Living With Type 2 Diabetes And Partial Vision Loss - Vibe

In a previous related study conducted with a team from the University of Gothenburg in Sweden researchers also found that dietary fibres from barley kernel generates an increase of the gut bacteria Prevotella copri, which have a direct regulatory effect on blood sugar levels and help decrease the proportion of a type of gut bacteria that is considered unhealthy.

According to Diabetes UK, certain breakfast cereals can pose hidden risks for people with type 2 diabetes, as they contain free sugars. Free sugar is any sugar added to a food. Extra sugar means extra calories and eating too many calories can lead to obesity - a major risk factor associated with type 2 diabetes.

Breakfast cereals rich in free sugars include granola and cereal clusters, which, despite appearing healthy, are often full of free sugars and unhealthy fat.

As Diabetes Uk explained: When buying cereal, the best thing to do is look at the 'front of pack' label, and try to go for cereal with as many green lights as possible. But also check the ingredients list, some newer versions of granola simple have nuts added in.

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Type 2 diabetes: Eating this cereal for breakfast could lower blood sugar - Express

(StatePoint) Two in five Medicare patients with diabetes (40.9 percent) reach the Part D coverage gap, and are responsible for the full cost of their prescription drugs.(1)To help ease this financial burden, Eli Lilly and Company offers several solutions, including insulins with a lower list price.

People with diabetes will need to make important decisions for healthcare coverage during the Medicare open enrollment period (October 15 to December 7, 2019). To help ensure treatments are affordable, its important to consider the following when choosing a Medicare coverage plan:

Make a list of important priorities including cost, coverage and network that your plan must have based on your individual health needs.

A checklist can help guide important conversations when choosing a plan. Lillys checklist can help identify different cost, coverage and network considerations specifically for people with diabetes.

When considering which plan to choose, Lillys Plan Guide can help identify which Medicare Part D plans cover the lower priced insulin in each state.

The transition to Medicare for people with diabetes can be difficult and there are many factors, such as cost, that go into making a coverage decision. Were working to ease the financial burden for the growing number of people with diabetes who are in the coverage gap phase of their plan, said Tony Ezell, vice president, U.S. Connected Care and Insulins, Lilly. The goal is that Lillys solutions will help people with diabetes access affordable insulin until long-term, systemic changes are made to the U.S. healthcare system.

Visit InsulinAffordability.com or call the Lilly Diabetes Solution Center to learn more about the solutions available that may help people with diabetes significantly decrease the amount they pay for Lilly insulin. Helpline representatives are available at (833) 808-1234 from 9 a.m. to 8 p.m. ET Monday through Friday.

PP-SP-US-0110 10/2019 (c)Lilly USA, LLC 2019. All rights reserved.

(1) American Diabetes Association. The Impact of Medicare Part D on the proportion of Out-of-Pocket Prescription Drug Costs Among Older Adults With Diabetes. Available at: https://care.diabetesjournals.org/content/40/4/502.long. Accessed October 1, 2019.

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Medicare and Diabetes: A Few Things to Know - Coronado Eagle and Journal

ARLINGTON, Va., Oct. 30, 2019 /PRNewswire/ -- The American Diabetes Association (ADA) strongly supports the introduction of the Insulin Price Reduction Act in the United States House of Representatives. The ADA thanks Congressional Diabetes Caucus Co-Chairs Representative Diana DeGette (D-CO) and Representative Tom Reed (R-NY) for their leadership in introducing the House version of this legislation, which will lower the cost of insulin for many Americans who rely on it to stay alive. The Insulin Price Reduction Act was first introduced in the United States Senate on July 22, 2019.

For more than 7.4 million Americans, including all individuals with type 1 diabetes, insulin is a life-sustaining medication for which there is no substitute. Ballooning costs have put lifesaving insulin out of reach for an increasing number of Americans. Between 2002 and 2013, the average price of insulin nearly tripled. A 2018 ADA survey showed that individuals with diabetes who face high out-of-pocket costs are forced to make decisions about their insulin regimen that can have damaging consequences on their health. Many individuals with diabetes ration or forego insulin doses to reduce costs.

"Insulin is a matter of life and death," said LaShawn McIver, MD, MPH, Senior Vice President of Government Affairs and Advocacy. "For the many Americans who cannot afford their insulin, the consequences can be dire, including serious complications, such as cardiovascular disease, blindness, kidney disease, amputation, and even death. The American Diabetes Association applauds Representatives DeGette and Reed for their leadership in addressing this urgent issue. We urge all members of the House of Representatives to support this critical legislation and advance it through the legislative process."

The Insulin Price Reduction Act seeks to address the skyrocketing cost of insulin by encouraging insulin manufacturers to reduce the list price of all insulin products to their 2006 list price. Importantly, these lower-priced products would not be subject to health plan deductibles and would not be placed on less favorable formulary tiers. Rolling back list prices for insulin products by over a decade will make insulin more accessible for many Americans, both insured and uninsured.

The ADA continues to work diligently on the critical issue of insulin affordability. In 2016, the ADA's Board of Directors released a resolution calling on all entities in the insulin supply chain to increase transparency in insulin pricing and to ensure that no one living with diabetes is denied affordable access to insulin. The resolution also called on Congress to hold hearings with all entities in the insulin supply chain to help identify the reasons for the dramatic increases in insulin prices and to take action to ensure that all people who use insulin have affordable access to the insulin they need. The ADA's Make Insulin Affordable petition has achieved more than 487,000 signatures to date. In 2017, the ADA's Board of Directors convened an Insulin Access and Affordability Working Group, and the Working Group's findings were detailed in a white paper published in 2018 in the journal Diabetes Care. The ADA subsequently issued a public policy statement providing detailed recommendations to lawmakers. The ADA has also testified at multiple congressional hearings in 2018 and 2019 focused on the high cost of insulin. Resources are available through the ADA's call center at 1-800-DIABETES, and at InsulinHelp.org.

About the American Diabetes AssociationEvery day more than 4,000 people are newly diagnosed with diabetes in America. Nearly 115 million Americans have diabetes or prediabetes and are striving to manage their lives while living with the disease. The American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For nearly 80 years the ADA has been driving discovery and research to treat, manage and prevent diabetes, while working relentlessly for a cure. We help people with diabetes thrive by fighting for their rights and developing programs, advocacy and education designed to improve their quality of life. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us at diabetes.org or call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Twitter (@AmDiabetesAssn) and Instagram (@AmDiabetesAssn).

Contact: Alex Day, 703-253-4843press@diabetes.org

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The American Diabetes Association Applauds the Insulin Price Reduction Act, Introduced Yesterday by the House Diabetes Caucus - The Breeze

For kids with food allergies, dietary restrictions or Type I diabetes, Halloween trick-or-treating can put kids at risk for serious health issues.

Candies made with peanuts, eggs, and wheat and dairy products may expose children to food allergens, and sweet treats elevate blood sugar levels.

"There are ways to make (Halloween) fun even though they can't eat all the candy they collect," said Shelby Shelby, a registered dietitian with Owensboro Health.

She suggested families may want to consider inviting the "Switch Witch" to visit Halloween night. Kids lay out all the candy they've collected, and the Switch Witch comes while they sleep something like the tooth fairy to exchange the candy for money, movie tickets, trips to the zoo, gift cards or toys.

Somer Wilhite, manager of marketing at OH, has kids ages 6 and 10.

"We've already been trick-or-treating twice this week," Wilhite said.

She pays her kids $1 per 20 pieces of candy they hand over. Then, she gives away the treats. Nursing homes, hospitals and homeless shelters usually appreciate a little extra candy, she said.

Shelby participates in the Teal Pumpkin Project, a national effort to make Halloween safe and happy for all kids. Homeowners paint a pumpkin teal and put it on the front porch to indicate they give nonfood treats, such as boxes of crayons, bubbles, whistles, glow sticks and temporary tattoos.

"The project gives the same experience to kids who can't have candy. Having those options opens it up to all children to have fun," Shelby said.

The Teal Pumpkin Project has a national map of participating homes.

When Shelby finds trick-or-treaters at her door, she asks if any of the goblins have allergies or other reasons for needing a nonfood treat. She has two bowls ready one with candy and one with trinkets.

She often finds kids with no dietary restrictions are just as interested in a toy because they've gathered so much candy already.

Shelby goes to a party store to buy bags of trinkets. In many ways, they are better to hand out to everyone dietary restrictions or not, she said. Candy doesn't keep year to year. Plastic trinkets do.

The same is true for the kids. Candy gets gobbled quickly. Toys, crayons and other nonfood treats last much longer.

For families that deal with Type I diabetes, Shelby shared many tips for trick-or-treating.

"Plan ahead first and foremost," she said. "Sit down with your child and make a plan for Halloween night and school parties."

The joint plan needs to be shared with anyone the child comes in contact with so friends and family can help support the plan.

Children with diabetes should have a healthy dinner with protein before treat-or-treating because it can help buffer blood sugars.

Shelby recommends knowing the carbohydrate counts of common candies. Parents can find an online list at beyondtype1.org.

Children with diabetes or food allegies should wear a medical ID bracelet when they trick-or-treat with friends.

"Make a new tradition," Shelby said. "Make lower carbohydrate Halloween treats and have a party at home rather than trick-or-treating."

Link:
Halloween is tricky time for kids with food allergies, diabetes - Grand Haven Tribune

Additionally, rates of infection, mortality and readmission are 4x, 1.5x and 1.4x greater, respectively.

The question is, are we as a healthcare community doing everything we can to improve these outcomes? Are we paying enough attention to the unique needs of patients with diabetes?

The results of recent nationwide survey indicate we need to do better, and with the shift from volume to value, I would say the question becomes, can we afford not to?

Download the complete survey results here.

The truth is, managing diabetes within our inpatient populations is strife with challenges. This is a large-scale issue and the numbers are growing.

On average, one of every three hospitalized patients -- the majority with diabetes -- requires insulin to control blood glucose during their stay, a medication that although widely prescribed and absolutely necessary is inherently dangerous. Fifty percent of all medication errors involve insulin, including one-third of all fatal medication errors. Insulin is considered a high-alert medication because it has the potential to cause significant patient harm if misused.

Certainly hospitals and health systems face other patient safety challenges, but very few have as substantial an impact on both clinical and financial outcomes. Insulin therapy, whether intravenous or subcutaneous, is both complex and difficult to manage.

When insulin therapy lacks standardization and best practices are not the norm, poorly controlled blood glucose prevails, which can lead to coma, stroke, sepsis, cardiac arrest . . . even death. A recent study by AdventHealth Orlando showed that hospitalized patients who experience severe hypoglycemia (abnormally low blood glucose) incur $10,405 of excess cost per stay and a 61.5% higher readmission rate.

This toll is largely avoidable, but only if hospitals and health systems prioritize glycemic management. The results of this survey underscore there is vast room for improvement.

Download the complete survey results here.

Some of the findings that strike me as concerning include:

The good news is, improving the care of hospitalized patients with diabetes and achieving best practices in glycemic management are attainable goals, especially with the aid of purpose-built technologies such as the eGlycemic Management System.

You are welcome to arrange a complimentary consultation with a Glytec clinical executive to discuss your glycemic management needs and goals. Click here.

Dr. Rhinehart is a diabetologist and Chief Medical Officer of Glytec. He was the first U.S. physician board certified in advanced diabetes management (BC-ADM).

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Survey reveals better care needed for hospitalized patients with diabetes - HealthLeaders Media

HAMILTON, Ontario, Oct. 30, 2019 (GLOBE NEWSWIRE) -- Reliq Health Technologies Inc. (TSXV:RHT or OTCQB:RQHTF) (Reliq or the Company), a technology company focused on developing innovative mobile health (mHealth) and telemedicine solutions for Community Healthcare, today announced that it has partnered with leading US Diabetes Care company Smart Meter LLC. (Tampa, FL) to provide Reliqs iUGO CARE Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) solutions to patients coping with diabetes and other chronic conditions.

The iGlucose blood glucose meter is compact, portable, user friendly and cellular-enabled, so its an excellent fit for rural and remote diabetes patients who may not have conventional internet access, as well as for active diabetics who need a glucose meter that they can take with them wherever they go, said Dr. Lisa Crossley, CEO of Reliq Health Technologies, Inc. Integrating with the iGlucose meter allows us to offer our clients innovative new options for managing diabetes in the community. The partnership with Smart Meter also fits our new Call Centers business model. Reliqs Call Center in Port St Lucie, FL is focused on implementation of our iUGO CARE Remote Patient Monitoring (RPM) and Chronic Care Management (CCM) solution with patients, physicians and payors. The resources of the Call Center will facilitate enrollment and support patients and their healthcare providers. Not only will the Call Center offer paid support services to our clients, we have also secured commitments from partners, including Smart Meter, to utilize our contract outreach and engagement services. As a result, the Call Center will be self-funding and profitable from day one.

Were excited to partner with Reliq Health to offer their advanced technology platform to our enterprise clients, said Mr. Brahim Zabeli, CEO of Smart Meter LLC. Smart Meter has relationships with clinicians and disease management companies, and we look forward to helping these providers reduce costs and improve patient care through our partnership with Reliq. Combining our iGlucose meter and cost-effective test strips, and Reliqs iUGO CARE platform to support caregiver workflows, automatically collect key patient health data and connect residents to physicians through virtual visits, will create new revenue models for residential care, increase profits and enhance patient and family satisfaction. We are also pleased to be able to leverage Reliqs Call Center for outreach and engagement to expand our client base.

About Smart MeterSmart Meter, LLC is the innovator of iGlucose; a simple, convenient and affordable solution addressing todays challenges in the monitoring and management of diabetes. The game-changer is cellular technology, which allows patients to just test, letting iGlucose seamlessly share patient data. Providers, in real time, now receive comprehensive, powerful, reliable data, allowing for individualized care and targeted population health management. iGlucose is a simpler, quicker path to improve outcomes, lower costs and access new sources of reimbursement through remote patient monitoring. To find out more about how iGlucose is simply doing the unimaginable through Better Data, Better Care, Better Outcomes, visit http://www.iglucose.com.

About Reliq HealthReliq Health Technologies is a healthcare technology company that specializes in developing innovative software solutions for the Community Care market. Reliqs powerful iUGO CARE platform supports care coordination and community-based healthcare. The iUGO CARE platform integrates wearables, sensors, voice technology and intuitive mobile apps and desktop user interfaces for patients, clinicians and healthcare administrators. iUGO CARE allows complex patients to receive high quality care at home, improving health outcomes, enhancing quality of life for patients and families and reducing the cost of care delivery. iUGO CARE provides real-time access to remote patient monitoring data, allowing for timely interventions by the care team to prevent costly hospital readmissions and ER visits. Reliq Health Technologies trades on the TSX Venture under the symbol RHT and on the OTCQB as RQHTF.

ON BEHALF OF THE BOARDDr. Lisa CrossleyCEO and Director

For further information please contact:Investor Relations at ir@reliqhealth.com

Neither the TSX Venture Exchange nor its Regulation Services Provider (as that term is defined in the policies of the TSX Venture Exchange) accepts responsibility for the adequacy or accuracy of this release.

Cautionary Statements Regarding Forward Looking InformationCertain statements in this press release constitute forward-looking statements, within the meaning of applicable securities laws. All statements that are not historical facts, including without limitation, statements regarding future estimates, plans, programs, forecasts, projections, objectives, assumptions, expectations or beliefs of future performance, are "forward-looking statements".

We caution you that such "forward-looking statements" involve known and unknown risks and uncertainties that could cause actual and future events to differ materially from those anticipated in such statements.

Forward-looking statements include, but are not limited to, statements with respect to commercial operations, including technology development, anticipated revenues, projected size of market, and other information that is based on forecasts of future results, estimates of amounts not yet determinable and assumptions of management.

Reliq Health Technologies Inc. (the "Company") does not intend and does not assume any obligation, to update these forward-looking statements except as required by law. These forward-looking statements involve risks and uncertainties relating to, among other things, technology development and marketing activities, the Company's historical experience with technology development, uninsured risks. Actual results may differ materially from those expressed or implied by such forward-looking statements.

SOURCE: Reliq Health Technologies Inc.

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Reliq Health Technologies, Inc. Partners with Leading US Diabetes Care Company to Deliver RPM/CCM Solutions - GlobeNewswire

NEW YORK CITYLife insurance company John Hancock is teaming up with VerilyLife Sciences to offer a life insurance solution anddigital wellness program to help people with diabetes manage and improve their condition.

The new product, John Hancock Aspire, isa unique collaboration between the Boston-based life insurer and Verily, the healthcare division of Google parent company Alphabet,and will leverage the capabilities of Onduo, a virtual diabetes clinic.

Onduo is ajoint venture between Verily and drugmaker Sanofi.that was spun off in 2016 and now partners with health insurers like Blue Cross Blue Shield to provide chronic care management toplan members with diabetes. Onduo also is collaborating with Walgreens on a virtual diabetes and medication adherence solution for the company's employees.

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RELATED:Blue Cross Blue Shield Association partners with Google affiliate for diabetes care pilot

Through the collaboration with Verily and Onduo, John Hancock is offering consumers living withdiabetes a life insurance plan combined witha technology-enabled wellness program that provides coaching, clinical support, education and rewards designed to help manage and improve their health. Plan members have the potential to save up to 25% on their premiums, according to the company.

Qualifying John Hancock Aspire customers with Type 2 diabetes will get access toOnduo's virtual clinic, which includes blood glucose monitoring devices paired with the Onduo app, and will be connected to Onduo's virtual care team forpersonalized guidance and support.

During an event in Manhattan Monday to announce the new partnership, Andy Conrad, Verily's CEO, said it was a "daring" collaboration that presented an opportunity to scale up Onduo's virtual diabetes clinic.

"Through this initiative, Verily and John Hancock are pushing the envelope on the role life insurance can play in both providing financial security and helping people live longer, healthier lives," Conrad said.

"This is a great opportunity to do this at scale and in a clever, thoughtful and different way," he said.

Brooks Tingle, president and CEO of John Hancock Insurance, said his industry hasn't traditionally served people living with diabetes well.

"We're actually among the most uniquely positioned to help improve their health outcomes because our customer relationships often last a lifetime," he said.

RELATED:Walgreens and Verily announce partnerships for diabetes, medication adherence

Tingle told FierceHealthcare the company saw an opportunity to work with a leading technology company to leverage a personalized approach to disease management and make life insurance more personalized and engaging.

"There are wonderful solutions out there and wanted to take those andplug them into alife insurance policy. We're trying to make life insurance as much about living as dying," he said.

"The organizations that will have the greatest impact on healthcare will be companies like Google," Tingle said. "These companies are making significantinvestments to use technology and analytics to improve health outcomes."

Google's work with Verily was driven by a desire to do "world-changing projects," Conrad said. "In areas like healthcare, we wanted to change the paradigm from an episodic perspective to prevention." The collaboration with John Hancock fits into that mission, he noted.

The two companies could potentially expand the partnership to other chronic diseases such as hypertension or depression, Conrad said.

For John Hancock Insurance, the more than30 million Americans living with diabetes represent a sizable market opportunity. Half of those consumers either don't have enough life insurance or don't have any life insurance coverage at all, according to data from the Centers for Disease Control and Prevention.

Diabetes remains the seventh leading cause of death inthe U.S., with 1.5 million Americans diagnosed every year, according to the American Diabetes Association.

Former emergency medicine physician Joshua Riff, M.D., now CEO of Onduo, said he joined the Verily-Sanofi joint venture because he saw firsthand the toll of chronic disease on patients.

RELATED:Alphabet's Verily collaborating with Atrius Health, Palo Alto VA on population health projects

The majority of patients he saw in the emergency roomhad some form of chronic disease or complications due to their disease, he said. "Why are they coming to see me? When I would ask, I would hear the same story. Patients would say'I have a hard time getting to my doctor.''I only see my doctor a few times a year, but I live with this disease 365 days a year andI have no support or guidance.'"

Onduo's platform was developed to transform how chronic care is delivered, Riff said, with a focus on health monitoring and tracking, personalized guidance andaccess to care teams. "It's designed to support people where they are and on their terms," he said.

"It's rare to be a part of something where all the incentives are aligned," Jessica Mega, M.D., chief medical officer at Verily, told FierceHealthcare. She noted that the program provides incentives and rewards that support consumers' financial health and physical health and well-being. And Onduo's technology platform uses data to tailor guidance and support to each patient, she said.

"The fact that the medical community is now embracing this is important. We're empowering patients to help them make healthier choices," she said.

Verily, originally Google Life Sciences, once part of Google X,spun outin 2015 to lead Alphabets healthcare and life sciences research. The company has beenquietly expanding its footprint in the world of healthcare and collaborating with health systems and other providerson initiatives to tackle major healthchallenges.

The company recently announced it was teaming up with Atrius Health and the Palo Alto Veterans Affairs healthcare system to improve patient outcomes through population health initiatives.

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Verily, John Hancock collaborating on life insurance solution that offers virtual diabetes management - FierceHealthcare

SAN DIEGO--(BUSINESS WIRE)--Tandem Diabetes Care, Inc. (NASDAQ: TNDM), a leading insulin delivery and diabetes technology company, today announced presentation of real-world data from pediatric users of the t:slim X2 insulin pump with Basal-IQ predictive low-glucose suspend technology at the 45th annual conference of the International Society for Pediatric and Adolescent Diabetes (ISPAD). Data from 2,696 users under the age of 18 years old showed an overall rate of hypoglycemia of only 0.9 percent when using Basal-IQ technology. A subgroup of users with at least 21 days of sensor-augmented pump data prior to use of Basal-IQ technology demonstrated a 31 percent reduction in hypoglycemia following introduction of the feature (n=491).

Data Highlights

The study included de-identified real-world data uploaded to Tandems t:connect web application between August 31, 2018 and March 14, 2019, which was retrospectively analyzed to assess hypoglycemia outcomes.

Overall Group (n=2,696) The overall rate of hypoglycemia (defined as percent median time spent with sensor readings <70 mg/dL or 3.9 mmol/L) for this group was 0.9 percent. Algorithm-enabled insulin suspensions occurred on average 4.9 times per day for an average 15.5 minutes per suspension.

Subgroup (n=491) Pre-post analysis demonstrated median time spent <70 mg/dL or 3.9 mmol/L decreased from 1.6 to 1.1 percent upon introduction of Basal-IQ technology (p = <0.001), representing a 31 percent reduction in hypoglycemia. Sensor time-in-range (defined as 70-180 mg/dL or 3.9-10.0 mmol/L) remained steady between pre- and post-Basal-IQ technology use, however, there was a significant decrease in sensor glucose values greater than 300 mg/dL or 16.7 mmol/L (p=0.007).

About the t:slim X2 Insulin Pump with Basal-IQ Technology

The simple-to-use t:slim X2 insulin pump with Basal-IQ predictive low glucose suspend technology uses glucose values from an integrated Dexcom G6 continuous glucose monitor to predict and help prevent lows with zero fingersticks*. The t:slim X2 insulin pump includes advanced features like a large color touchscreen, rechargeable battery, Bluetooth wireless technology, USB connectivity and watertight construction (IPX7)1. It is capable of remote software updates using a personal computer, offering the potential for in-warranty users to access new features as they meet necessary regulatory requirements2. The t:slim X2 insulin pump is up to 38 percent smaller than other insulin pumps and holds up to 300 units of insulin.3

Launch of the t:slim X2 insulin pump with Basal-IQ technology has begun in select international geographies. It is currently available on new t:slim X2 insulin pumps and as a software update to all in-warranty t:slim X2 insulin pump users in the United Kingdom, Sweden, Denmark, Spain, Italy, the Czech Republic, and South Africa.

About Tandem Diabetes Care, Inc.

Tandem Diabetes Care, Inc. (www.tandemdiabetes.com) is a medical device company dedicated to improving the lives of people with diabetes through relentless innovation and revolutionary customer experience. The Company takes an innovative, user-centric approach to the design, development and commercialization of products for people with diabetes who use insulin. Tandems flagship product, the t:slim X2 insulin pump, is capable of remote software updates using a personal computer and features integrated continuous glucose monitoring. Tandem is based in San Diego, California.

Tandem Diabetes Care, t:connect, and Basal-IQ are registered trademarks, and t:slim X2 is a trademark of Tandem Diabetes Care, Inc. Dexcom and Dexcom G6 are registered trademarks of Dexcom, Inc. The Bluetooth wordmark is a registered trademark owned by Bluetooth SIG, Inc. and any use of such mark by Tandem Diabetes Care, Inc. is under license. All other third-party marks are the property of their respective owners.

Important Safety Information for the t:slim X2 Insulin Pump with Basal-IQ Technology

Federal (USA) law restricts this device to sale by or on the order of a physician. The t:slim X2 insulin pump with Basal-IQ technology (the System) consists of the t:slim X2 insulin pump, which contains Basal-IQ technology, and a compatible CGM. CGM sold separately. The t:slim X2 insulin pump is intended for the subcutaneous delivery of insulin, at set and variable rates, for the management of diabetes mellitus in persons requiring insulin. The t:slim X2 insulin pump can be used solely for continuous insulin delivery and as part of the System. When the System is used with a compatible iCGM, Basal-IQ technology can be used to suspend insulin delivery based on CGM sensor readings. The System is indicated for use in individuals 6 years of age and greater. The System is intended for single patient use and requires a prescription. The System is indicated for use with NovoLog/NovoRapid or Humalog U-100 insulin. The System is not approved for use in pregnant women, persons on dialysis, or critically ill patients. The pump is not intended for anyone unable or unwilling to: use the insulin pump, CGM, and all other system components in accordance with their respective instructions for use; test blood glucose levels as recommended by their healthcare provider; demonstrate adequate carb-counting skills; maintain sufficient diabetes self-care skills; see their healthcare provider regularly. The user must also have adequate vision and/or hearing to recognize all functions of the pump, including alerts. For detailed indications for use and safety information, visit tandemdiabetes.com/safetyinfo.

Forward Looking Statement

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, that concern matters that involve risks and uncertainties that could cause actual results to differ materially from those anticipated or projected in the forward-looking statements. These forward-looking statements relate to, among other things, the ability of the t:slim X2 pump to provide remote feature updates, the timing and outcome of regulatory approvals for new product features and updates, and the ability of our products to improve customer satisfaction and clinical outcomes. These statements are subject to numerous risks and uncertainties, including the risks that technical problems may prevent or delay remote software updates, regulatory agencies may fail to approve new product features or updates on our expected timeframe or at all, and the level of customer satisfaction from the use of our products and features may be different from what we expect, as well as other risks identified in Tandems most recent Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, respectively, and other documents we file with the Securities and Exchange Commission. Readers are cautioned not to place undue reliance on these forward-looking statements, which speak only as of the date of this release. Tandem undertakes no obligation to update or review any forward-looking statement in this press release because of new information, future events or other factors.

* If glucose alerts and CGM readings do not match symptoms or expectations, use a blood glucose meter to make diabetes treatment decisions. Dexcom G6 CGM sold separately.

1 Tested to a depth of 3 feet for 30 minutes2 Additional feature updates are not currently available for the t:slim X2 insulin pump with Basal-IQ technology and are subject to future FDA approvals. A prescription and additional training may be required to access certain future software updates.3 38 percent smaller than MiniMed 630G and 670G and at least 28 percent smaller than MiniMed 530G, Animas Vibe and Omnipod System. Data on file, Tandem Diabetes Care.

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Tandem Diabetes Care Presents Positive Real-World Data from Pediatric Users of t:slim X2 Insulin Pump with Basal-IQ Technology at International...

with Yeyi Zhu, PhD, Assiamira Ferrara, MD, PhD, and Unjali Gujral, MPH, PhD

Most often we associate having diabetes with overweight or obesity; however, theres a surprising twist to the diabetes storyyou may at risk even if you are at a healthy weight, or even underweight. Although hard to believe, it appears particularly true if you are in a racial or ethnic group other than Caucasian.1,2

If you are Hispanic, Asian, or Hawaiian, you are at increased risk of developing diabetes, even if you are thin. Be sure to have your blood sugar checked regularly. Photo: fstop123@iStock

Diabetes ranks as one of the most common chronic diseases in the United States, with at least 12% of the population likely to develop diabetes.2 The numbers do not give a full picture of the rising rate of diabetes. What does this mean for you?

According to data gathered by Kaiser Permanente, a California-based managed care medical organization, a startling new discovery has been made regarding risk of diabeteseven if you are at a healthy weight but you are biracial or fall into one of four racial/ethnic categories other than White, you may have a higher risk of developing T2D.3

Hoping to tease out an explanation for this unexpected relationship between obesity and ethnicity in diabetes, the researchers looked at the prevalence of diabetes and prediabetes among different racial groups in various ranges of body weight. Using records from three integrated healthcare organizations, they evaluated medical records of more than 4.9 million patients who met established criteria.

The racial makeup of the study group was diverse:

The rates of diabetes increased across all races as both age and body mass index (BMI) increased, which was as expected. Now for the plot twistCompared to their white counterparts, individuals from all other races were more likely to be develop diabetic across all body weight ranges. More stunning, the risk of diabetes was more pronounced among individuals who were underweight, at a healthy weight, or slightly overweight than anyone who reached the level of obesity,3 according to study measures.

The risk of developing prediabetes, similarly, rose with increasing age and body weight. Yet, among individuals who are Hispanic, Asian, or a Hawaiian/Pacific Islander, the chance of developing diabetes at lower ranges of body weight was significantly higher. These findings suggest that something other than body mass index must be behind the development of diabetes in these racial groups.

Our research identified a group of people at risk who dont get as much attention for diabetes: those who are underweight, says Yeyi Zhu, PhD, a research scientist with the Kaiser Permanente, and the study lead author. In particular, we found significant differences in diabetes prevalence among underweight men, from 7.3% in Whites to more than double that, or16.8%, in American Indians/Alaskan Natives.

So while many individuals who are overweight may be screened by the doctor, as a matter of course, if you fall into one of the high risk minority groups, you might want to ask your healthcare provider to check your blood sugar, to evaluate your risk of prediabetes and diabetes, even if you are in a healthy body weight range, or BMI. This is particularly true as you get older, says Dr. Assiamira Ferrara, MD, PhD, a senior research scientist at Kaiser Permanente.

The study has important implications to both providers and patients, says Unjali Gujral, MPH, PhD, assistant professor with the Emory Global Diabetes Research Center in Atlanta, Georgia. From a provider standpoint, the US Preventive Services Task Force for Diabetes Screening currently recommends using overweight/obesity as the main screening criteria in all adults ages 40-70 years. Clearly, continuing to do so will likely lead us to miss a substantial number of racial/ethnic minorities at risk of diabetes.

Previous work has suggested a BMI cut-off point of 23 kg/m2 for Asian populations. However, it seems likely that a much lower body weight cut-point may need to be established to assure that we are identifying more high risk individuals in other race/ethnic groups, Dr. Gujral tells EndocrineWeb.

In addition, there isnt a lot of data about the most appropriate approach to treatment for those who are not overweight. While the first-line pharmaceutical treatment for type 2 diabetes is currently metformin, which targets insulin resistance, this may not work in non-overweight individuals; instead, may be a more prudent strategy for these individuals may be to introduce treatments aimed at promoting the preservation and recovery of -cells, which secrete insulin. But much more research is needed in this aspect, she says.

Weve been lead to believe that if our weight is under control, there would be no reason to think we should worry about having diabetes. But Dr. Gujral says that the evidence is strong enough to suggest we rethink this. She adds: People should still be mindful that you are eating a healthy diet and getting regular physical activityat all weights, and you should consider getting screened for diabetes even when you have a low BMI, particularly if you have a family history of the disease.

Why those who avoid being overweight may be at increased risk for diabetes isnt fully understood, says Dr. Zhu. Body composition and factors such as physiology and susceptibility to impaired insulin secretion may play a role. In previous studies, for instance, researchers have found that Asians have a higher visceral fat than Whites at a similar body mass index. Having a higher percentages of visceral fat [eg, adipose fat surrounding internal organs] are associated with having an abnormal glucose metabolism.

To gain a clearer understanding of the factors which may prompt diabetes, well need to look more closely at body composition, genetics, and other lifestyle factors that may contribute to disparities in this chronic disease burden, Dr. Zhu says.

In addition, Dr. Gujral believes that there are likely to be different mechanisms and causes in distinct populations, and with that, differences in the effectiveness of the current screening tools for those whose diabetes stems from causes other than overweight.

What we hypothesize at this point is that individuals with ancestry from regions of the world that historically had less access to food may have evolved to metabolize energy differently, say Dr. Gujral. These minority groups, therefore, may have innate susceptibility to poor insulin production, and may have higher levels of ectopic fat that settles around the organs such as the liverthese differences may contribute to increased diabetes risk. Since these factors likely vary by race and ethnicity, a lot more additional research is needed to truly understand the reasons behind this, so we can improve detection and treatments.

The experts advice remains the same for now: evaluate your lifestyle and adjust your food choices and activity level, regardless of your weight.

Focus beyond your weight, to be sure you are doing whatever you can to promote good overall health, Dr. Gujral tells EndocrineWeb.This can be practiced by eating a diet high in fiber-rich foods including more vegetables, having limited lean meats, and avoiding saturated fats and added sugars.

She adds:Also keep hydrated (ie, drink plenty of water), get adequate sleep, and it is important to aim for at least 150 minutes a week of mild to moderate physical activity.This should be something sustainable and enjoyable whether it is hiking, playing tennis, running, or simply walking around the block.

Last updated on 10/29/2019

Type 2 Diabetes Causes

More:
You Could Have Diabetes While at a Healthy Weight: Heres How - EndocrineWeb

On Wednesday night in Waco, Texas, the 2019 Division I national champion Baylor Lady Bears and the 2019 Division II national champion Lubbock Christian Lady Chaps face off in an exhibition game. Itll also be a family affair, as Baylor senior Lauren Cox takes the court against her younger sister, LCU freshman Whitney Cox.

But its also much more than a high-profile exhibition more than basketball, even.

Wednesday night is Baylors fourth annual Type 1 Diabetes Awareness Game. And in case youre doing some math in your head, yes, this is Laurens fourth season at Baylor.

My freshman year, Coach [Kim] Mulkey was really interested in my diabetes, she wanted to see my insulin pump, she wanted me to watch me test my blood sugar, Lauren told High Post Hoops. And it was kind of her idea, like, lets do a Type 1 awareness game.

Type 1 diabetes is a condition where the pancreas has trouble producing insulin, the hormone that lets glucose be used to produce energy. It typically develops in children and adolescents Lauren was seven years old when she was diagnosed.

Her sister Whitney, on the other hand, was a junior in high school when she learned she also had Type 1. She told High Post Hoops that after she came home from the hospital after her diagnosis, Lauren came home to surprise her.

We just kind of sat there, like hugging and crying, Whitney said. She just knew what I was going to be going through. She just gets it.

I think me being able to be there for her when she was first diagnosed, I think that was really important, just to show her that she can still do whatever she wants to do, Lauren said.

Type 1 diabetes can be very manageable, and both sisters take advantage of the latest medical technology to ensure it doesnt affect their game. They wear continuous glucose monitors and insulin pumps, and both devices work in tandem to avoid any issues on the court.

Having the new technology helps a ton, just making it so much more convenient, Whitney said. She and the teams trainer use an app on their phones to keep track of her blood sugar level.

Lauren felt the same way, saying the technology she uses hasdefinitely made life a whole lot easier for me, and for my trainers.

Baylor put on its first Type 1 Awareness Game in January 2017. Not much has changed since, aside from moving the game to the fall its a simple opportunity for diabetic fans to interact with someone succeeding at a high level while managing her condition. Type 1 fans will sit together during the games, then meet Lauren after.

And, this season, Whitney.

Its really special [sharing this years game with her], Lauren said. Whitney hasnt been diabetic for long, but it still means a lot that they were willing to work it out to get [LCU] here for a game, and to make it the Type 1 game, so its gonna be a really special night.

Lauren is coming up on four years of using her platform at Baylor to spread awareness of Type 1 diabetes, and Whitney, a freshman, hopes to follow in her footsteps.

In addition to wanting to start a Type 1 awareness game at LCU, in her first couple of weeks on campus, she participated in a health fair where she had the opportunity to talk about her diabetes.

They had a diabetic brunch that I spoke at, just kind of explaining day-to-day operations of being a diabetic, pretty much, Whitney said. That was the very first time I actually kind of spoke out about it. So that was pretty cool. I definitely hope to do some more things like that around campus, as well as in the basketball world.

The sisters have only faced off in a competitive game once they were on different club teams within the same organization when Lauren was in high school and met in a tournament championship game. But with the exhibition tag attached to Wednesdays game, the competition wont be the important part this time.

TAMPA, FL APRIL 05: Oregon forward Oti Gildon (32) guards Baylor forward Lauren Cox (15) in 2019 NCAA Womens National Semifinal Game One between the Oregon Ducks and the Baylor Bears at at Amelie Arena in Tampa, FL on on April 5. (Photo by Mary Holt/Icon Sportswire via Getty Images)

I think itsjust gonna be fun, Lauren said. Just because we have so many family and friends coming to that game, and everyones really excited. They got split shirts made that have the BU and the LCU colors on opposite sides and all that. Yeah, its just gonna be really fun and kind of our last time ever on the same court again.

Whitney expressed a similar sentiment at playing her first two collegiate games against two of Texas best teams (LCU visited Texas for an exhibition on Monday night).

My coach actually asked me earlier this week if I was nervous for any of it. And I told him, not at all, Whitney said. Im really excited for it.

When asked what they want people to know about being a diabetic athlete, the sisters answers were almost identical.

It cant stop you from doing whatever you want to do, Lauren said. As long as you stay on top of it and control it, then youre going to be perfectly fine and you can do anything that you set your mind to.

It doesnt stop you from doing anything, Whitney said. Its completely manageable. And its just another thing you have to take care of. At the end of the day, you can still do whatever you want to do.

Baylor hosts Lubbock Christian on Wednesday, Oct. 30, at 7 p.m. CT. The game wont be televised, but you can listen to it on Oldies 97.7 FM or follow the live stats.

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Its just gonna be really fun: Cox sisters to face off in Baylors Type 1 Diabetes Awareness Game - High Post Hoops

ATKINSON The Atkinson Lions, in partnership with the Salem Lions, will be offering free diabetes testing (A1C) on Nov. 13.

The testing will be done on a first-come, first-served basis from 4 to 7 p.m. at the Atkinson Community Center on 4 Main St.

The Lions will bring in health professionals to do the A1C testing and will also bring in a nutritionist to provide information on nutrition to the public.

The diabetes A1C test measures the average blood sugar level over the past two to three months.

Its like a memory of your blood sugar levels and shows how well your body is controlling your blood sugar levels over time, the Lions said in a news release.

The American Diabetes Association recommends an A1C level of 5.7% or less.

If you test higher than this level, you will be advised to see your primary care doctor, the news release states. Note that all information will be kept strictly confidential. The test takes about five minutes to provide results.

Fasting is not required for the A1C test.

By some accounts, 1 in 4 Americans do not know they have pre-diabetes or diabetes. Complications include eye disease, cardiovascular disease, kidney disease, nerve damage, pregnancy complications, and amputations.

Free information concerning diabetes and diabetic-appropriate refreshments will be on hand at the event.

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Free A1C diabetes testing offered in Atkinson | Health - The Union Leader

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Alzheimers disease and type 2 diabetes could be linked in ways were only beginning understand, according to scientists presenting the latest research findings at Neuroscience 2019, the annual meeting of the Society for Neuroscience. Untangling the connection could lead to earlier Alzheimers diagnosis and better treatments for both diseases.

The crux of the connection is how the brain metabolizes its energy sourceblood glucose (aka blood sugar)and the variety of factors that influence that process, including diet, sleep, and cardiovascular health.

Not much is known about the connection between dementia and the metabolic system that fuels the brain, said panel moderator David Holtzman, MD, a professor at Washington University and scientific director of the Hope Center for Neurological Disorders. Further research can help us understand how to manipulate these functions for treatment purposes, as well as better identify the underpinnings of the disease.

Researchers presented findings approaching the problem from several angles.

Sami Gabbouj, a researcher from the University of Eastern Finland, discussed a study showing that the typical Western diet, high in fat and carbohydrates, leads to decreased brain insulin signaling and eventually impaired memory in mice genetically prone to Alzheimers. Insulin signaling is key to how the brain monitors and manages insulin release to balance blood sugar. Previous research has found a link between damaged insulin signaling and the development of Alzheimer's.

The typical western diet made worse age-related memory impairment in the mice, Gabbouj said.

The results suggest the possibility that the Western diet may handicap the brains energy metabolism and serve as a trigger for worsening memory in those genetically predisposed to Alzheimers.

Steven W. Barger, PhD, from the University of Arkansas for Medical Sciences, presented research showing that Alzheimers disease mimics diabetes by impairing how the brain metabolizes blood sugar. By examining mice genetically altered to develop Alzheimer's, researchers observed that a flaw in glucose delivery to neurons leaves extra glucose in the blood.

Alzheimers mice show diabetes traits on a normal diet, [with the] same physical activity levels and same feeding habits, Barger added. The findings shed light on why human Alzheimers patients often have higher blood sugar levels, and further confirm a link between the diseases.

Sleep research has also revealed connections between blood glucose metabolism and Alzheimers.A study presented by Shannon L. Macauley, PhD, from the Wake Forest School of Medicine, showed that glucose resistance and abnormal sleep patterns are prevalent in Alzheimers [predisposed] mice prior to the appearance of any other disease symptoms, such as cognitive decline.

This research points to the early role sleep loss seems to play in the development of Alzheimers, and suggests that poor sleep combined with type 2 diabetes may be especially dangerous for those at genetic risk for dementia.

The researchers were careful to note that the cause and effect across all of these studies isnt entirely clear. We dont yet know whether diabetes is a precursor to Alzheimers or if impaired blood sugar metabolism is a side-effect of Alzheimers. Its just too early to know either way. Ultimately we may find that both are true. And since much of the research to-date relies on animal models, were also not sure how closely these results will translate in humans.

What we do have is a strong starting point for understanding the link between these diseases that affect millions, and that may eventually lead to improved diagnosis and treatments.

Research was presented at Neuroscience 2019, the annual meeting of the Society for Neuroscience in Chicago. Studies are considered preliminary prior to being published.

Read more from the original source:
Untangling The Link Between Alzheimers Disease And Diabetes: What The Latest Science Tells Us - Forbes

November is National Diabetes Month, with World Diabetes Day on Nov. 14.

Conemaugh Health System encourages all individuals to learn more about diabetes and potential symptoms that could point to a problem.

More than 30 million Americans have diabetes, and 84 million adults have prediabetes, according to the Centers for Disease Control and Prevention. Diabetes is the seventh-leading cause of death in the United States.

Diabetes is a medical condition in which the body does not make insulin or has a reduced response to insulin, causing sugar levels to be too high. Symptoms of diabetes including urinating often, blurry vision, being very thirsty, losing weight unexpectedly, being very hungry, experiencing more fatigue than usual, and being irritable.

Individuals at risk for diabetes or pre-diabetes include being over 45 years of age, having high blood pressure, being overweight, low physical activity, family history of diabetes or history of diabetes during pregnancy.

While people with diabetes can exhibit noticeable symptoms, most patients diagnosed with type 2 diabetes do not show overt warning signs that they have developed the disease.Unfortunately, many do not know they have diabetes until they have developed one or more of its serious complications.

Conemaugh Diabetes Institute provides extensive education and support services to patients diagnosed with diabetes and individuals at risk for developing diabetes.

Staff members of the institute work with family members and primary care physicians to coordinate an effective plan of care for each patient. Individual and group education and appointments are available.

Conemaughs education programs are recognized by the American Diabetes Association and are led by Certified Diabetes Educators including registered nurses, registered dietitians, and additional healthcare professionals.

One of the key components of preventing and managing diabetes is following a healthy meal plan that focuses on achieving good nutrition, said Ashley Staruch, registered dietitian at the Conemaugh Diabetes Institute and Certified Diabetes Educator. Its not about following a fad diet that is popular at the current moment. Its about finding the right balance between eating the foods we enjoy and maintaining optimal blood-sugar control. Quality of life is such an integral part of healthy nutrition.

All foods, in moderation, can fit into a healthy meal plan.

Education for diabetes patients includes understanding healthy and unhealthy food options, meal planning, reading food labels, tips for grocery shopping, the best options when eating out and how to make the foods they enjoy fit into their daily meal plan.

We show patients that diabetes is manageable and they can still eat great tasting foods, Staruch said.

Its about balance and finding the healthiest ingredients for meals they are preparing. Once they experience small successes of seeing their blood sugars improve, feeling great and having more energy, it makes sustaining the healthy lifestyle easier.

One main concern for a person with diabetes is carbohydrates, which come primarily from starch, fruit and milk.

Carbohydrates are broken down into sugar by an individuals digestive system and cause an increase in blood glucose.

The more carbohydrates eaten, the higher the patients blood sugar.

A person with diabetes should focus on consuming healthy sources of carbohydrate found in fruit, vegetables, whole grains, beans and low-fat milk.

Foods that should be limited are those that provide calories, but have little nutritional value. These foods include sugary beverages such as soda and juice, sweetened breakfast cereals, desserts and snack foods.

Its important to be aware of the foods we are eating and to keep track of what goes into our bodies, Staruch said.

Eating too many calories, specifically too many calories from carbohydrates, can cause the blood sugar level to significantly increase.

We need to focus on choosing healthy options, especially when it comes to carbohydrates.

Patients that appropriately manage diabetes and their blood sugar levels can lead normal lifestyles with limited or no complications. However, uncontrolled or unmanaged diabetes can lead to serious, irreversible long-term health conditions such as damage to blood vessels in the heart, brain, legs, eyes, kidneys, feet and nervous system.

Prevention and management are key, Staruch said. Whether trying to prevent diabetes or manage diabetes, we can help patients get back on track and enjoy their daily lives.

Diabetes meal planning tips and related informationare available on the CDC website at CDC.gov, and the American Diabetes Association at diabetes.org.

Read more here:
Family Life | Health tips: Know the risks of diabetes and follow a healthy meal plan - TribDem.com