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For many, including myself, this syndrome is an invisible but real burden. For some, it is even a disability. When we are forced to live out of sync with our internal clocks, our health suffers. The mismatch between internal time and environmental time has been linked to problems including depression, diabetes, obesity and poor cardiovascular health. Our immune systems become a mess. Many night-shift workers have similar problems; for us, a traditional 9-to-5 schedule is the equivalent of night-shift work.

This happens because, even if we force ourselves to wake up early, our metabolism is not ready to perform simple tasks such as properly digesting a meal, for example we do not produce as much insulin in the morning as normal people do. Our core body temperature also follows an internal rhythm, producing sleepiness or alertness much later. This is true as well for the release of cortisol, melatonin and other hormones essential to the sleep-wake cycle. In the morning, our eyes might be open, but, for all intents and purposes, we are still sleeping.

And its no use getting exhausted and deliberately undersleeping with the intention of falling asleep early the next day a recommendation Ive heard a lot, including from doctors. Circadian rhythms operate independently of the sleep-pressure system. This is the case even among normal people: Even if you slept miserably last night and woke up very early, it is unlikely that youll fall asleep at 6 p.m.; thats because your circadian rhythms are cycling on as usual, unaffected by your lack of sleep. Your attempt to hit the sack would clash with something called the wake-maintenance zone, a three- to four-hour interval of maximum physiological alertness. (In normal sleepers, it occurs from 6 p.m. to 9 p.m.)

Delayed sleep phase syndrome has a genetic basis, as my own unscientific sample demonstrates: My mom also has it, though her case is not so extreme. Apart from that, other mechanisms can account for the disorder. Some studies indicate that our built-in circadian period might be unusually long (say, 25 hours instead of 24); others find dysfunction in our homeostatic sleep drive, a reduced response to the phase-resetting effects of daylight, or an excessive response to the sleep-delaying effects of artificial evening light. There is, as of yet, no cure only short-term fixes that include the use of a light therapy box and the administration of well-timed melatonin pills. But in the long run, most of us fail to adapt.

Heres the thing, though. If left to our own devices if allowed to follow our own biological clocks we sleep just fine.

Individuals with extreme cases of the syndrome are unable to work conventional jobs. We are also famously unreliable at keeping appointments and participating in diurnal social activities. We learn to make excuses and tell lies. I often say that I work nights, which is true its just not the whole story. Most people respect work-related excuses, but sneer at health conditions theyve never heard of.

Thats the worst thing about having a circadian rhythm disorder: living in a society that places a moral value on the time your alarm clock goes off. Most cultures emphatically equate early rising with righteousness: As we say in Brazil, God helps those who wake up early.

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Early to Bed, Early to Rise Makes Me Exhausted, Depressed and Sick - The New York Times

Type 2 diabetes is a condition in which the body cant control the amount of glucose in the blood. The body doesnt respond to insulin properly and may not produce enough, causing a person's blood sugar levels to become too high. If blood glucose isnt controlled properly and stays too high, it can lead to a number of serious health problems, including kidney failure, nerve damage, heart disease and stroke.

Regularly eating a poor diet can increase your risk of developing type 2 diabetes, but diet can also play a part in lowering and controlling blood sugar.

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

As some general rules, the NHS advises eating a wide range of foods - including fruit, vegetables and some starchy foods like pasta.

Sugar, fat and salt should also be kept to a minimum, and its important to eat breakfast, lunch and dinner every day and not to skip meals.

READ MORE: Type 2 diabetes: Best fruit to include in your breakfast to lower blood sugar

But certain food and drink have also been found to hold blood sugar lowering properties, and when it comes to the first meal of the day, breakfast, one food proven to have a positive impact on blood sugar levels is eggs.

According to a 2015 study in men aged between 42 and 60 years, those who ate the most eggs were 38 percent less likely to develop type 2 diabetes than those who ate the fewest eggs.

The explanation for this may be that eggs provide essential nutrients that can benefit overall health, and can help replace higher-carb or more processed breakfast choices.

Another study found participants who ate two eggs a day for 12 weeks saw a significant reduction in their body fat and body mass index (BMI) compared with those who ate no eggs during this period.

DON'T MISS

Excessive egg consumption should be avoided as research suggests eating a high number of eggs may raise the risk of developing type 2 diabetes and heart disease.

While the connection isnt clear, researchers believe excessive cholesterol intake, when it comes from animal foods, may increase those risks.

Eggs are high in cholesterol, but whether or not this negatively effects the body is still being debated.

If you have type 2 diabetes and find it hard to change your diet, a dietician may be able to help.

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

I do think the data are so clear about what this benefit can be, said Matt Longjohn, the former chief medical officer of the Y, whose pilots of the diabetes prevention program established the benefits of the program for CMS actuaries. Longjohn, who ran for the House of Representatives as a Democrat from Michigan last year, said it seems like regulators are making decisions that are penny-wise and pound-foolish.

The program, approved late in the Obama administration and carried out in the Trump era, targets patients on the verge of developing diabetes. It provides weight loss training and education proven methods of prevention. Rules set in 2017 projected widespread popularity for the benefit, estimating that between 50,000 and 110,000 people would take advantage of it each year from 2018 to 2027. The resulting weight loss and fewer cases of type 2 diabetes would improve health and lower Medicare health care spending by $182 million during that period, the agency estimated.

But the first year of the program appears to have fallen dramatically short of the agencys estimates: Claims data from the Centers for Medicare and Medicaid Services for 2018 shows that only 202 people used the program, according to an analysis conducted exclusively for POLITICO by open data startup CareJourney, which has access to the agencys chronic care claims database. The pace has accelerated somewhat in the first quarter of 2019, with 396 using the service.

The statistics come with some caveats suggesting they may underestimate the true numbers of Medicare beneficiaries using the program. They dont include Medicare Advantage beneficiaries and dont reflect lags in paid claims. Some providers have said CMSs contractors have been slow to pay claims as they adjust to the new program; for example, the Y, which includes YMCAs nationwide, told POLITICO that claims submitted in 2018 still havent been paid.

CMS would neither confirm nor deny the figures and said its data would not be complete until 2020. It did not answer other questions about its implementation of the program.

But the paltry figures come as a disappointment to the diabetes prevention programs most vocal advocates. The American Medical Association, for example, says half of all Medicare beneficiaries have prediabetes, and has argued that CMS action would be helpful in promoting the success of the new benefit.

The benefit has added challenges as suppliers include community-based organizations that need training in applying and billing Medicare, said the associations president, Patrice Harris, in a statement.

The timing of the new benefit introduced at the end of the Obama administration may have slowed its impact. HHS had a huge amount of turnover from folks who understood the benefit, the rationale, the cost-saving and life-saving benefits, said Matt Longjohn.

Longjohn says he believes Trump administration officials appreciate the program, but I think they got caught flatfooted. I think they had a couple bureaucratic false starts, he said.

He attributed the slow growth of the program to a lack of providers and a lack of promotion that might have stoked demand for the services of the 600 program providers thus far authorized by CMS.

But the figure obscures significant holes in the network. Ten states have zero providers, said Brenda Schmidt, the CEO of Solera Health, a network of diabetes prevention and social providers. Many major metropolitan areas have few or no providers: Dallas has no providers within a 100-mile radius, according to CMSs provider finder, to take one example. The closest providers for a Philadelphian might well be a thirty-mile schlep to Wilmington, Del.; a Washington resident might need to go to Baltimore.

The lack of providers can be traced back to a pair of CMS decisions restricting supply. The agency has not yet authorized digital providers, and imposes numerous regulations on bricks-and-mortar-based providers to prevent fraud. The latter have been medicalized, Schmidt said, saddled with regulations befitting medical doctors.

Providers have to run a gauntlet of requirements, including gathering the Social Security numbers of all board members, hiring a full-time privacy director, conducting penetration to test their organizations cybersecurity and building IT infrastructure to handle billing, Schmidt and the Ys Heather Hodge said. Complying with just one of those requirements penetration testing can cost $30,000, Schmidt said.

Non-profits just throw up their hands, said Longjohn, whos been consulting with providers on CMS requirements. The cost of keeping up with regulatory requirements leads them to leave the market. Pharmacies and supermarkets showed interest at one point but have opted out of the program, Schmidt said.

Twenty Y locations are qualified to provide diabetes prevention program services to Medicare recipients, said Hodge, the Ys lead on the program. But none, so far, have broken even, she said.

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Researchers have come to similar conclusions about the programs economics. In 2018, two studies examining programs based in Denver and the Bronx concluded that Medicares proposed reimbursements were hundreds of dollars per beneficiary lower than the costs of running the program.

Meanwhile, the agency has also shut out a class of startups seeking to offer a digital version of the program. Numerous companies like Omada Health, Livongo, Canary Health, and Noom offer virtual prevention programs that have won over private payers and employers. But Medicare hasnt even agreed to a demonstration model to test their products.

No progress, Canary health co-founder Neal Kaufman said of Medicares interest.

Interest groups have tried to convince the agency: in May 2018, the AMA sent a letter to Adam Boehler, then director of CMSs innovation center, arguing that a demonstration of virtual diabetes prevention, or DPP, would be helpful. That letter was followed by comments on two subsequent rules pushing virtual DPP in both traditional Medicare and Medicare Advantage. The main goal of allowing virtual DPP in traditional Medicare has proven elusive, however.

Schmidt said her Medicare Advantage clients collectively had hundreds of thousands of beneficiaries who qualify for the benefit, but are unable to use it.

The programs lack of success so far has implications that extend beyond individuals at risk for developing Type 2 diabetes. Although CMS and the private health sector frequently declare their interest in addressing social determinants of health and some state Medicaid programs have started such programs CMSs approach to DPP suggests it may have trouble reimbursing even simple things like pest abatement to lower asthma risks.

If those services get reimbursed, I wouldnt want to see them apply the same standards, said Schmidt.

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Medicare diabetes prevention program helps a few hundred instead of hundreds of thousands - Politico

Type 2 diabetes is a condition in which the body cant control the amount of glucose (sugar) in the blood, causing levels to become too high, and left untreated, serious complications such as kidney failure, nerve damage, heart disease and stroke can occur. High blood sugar levels can be prevented or managed with lifestyle changes such as regular exercise, but while the NHS recommends 30 minutes of moderate aerobic exercise five days a week, a recent report by the World Health organisation estimates a third of UK adults arent active enough. Now, new research by experts in New Zealand says consuming a specific type of blackcurrant could help sedentary adults walk for longer without getting tired. The effects took hold just an hour after taking the blackcurrant supplement.

Meanwhile the superfood also resulted in a dramatic 90 percent reduction in the build of enzymes linked to the onset of dementia and depression.

The studys lead author Dr Suzanne Hurst said: "Identifying foods or dietary supplements that specifically support the desire to exercise daily will enable an individual to adhere to an exercise programme and maintain and active and healthy lifestyle."

And she found that drinking blackcurrant juice one hour before exercise supports positive affective responses during a low impact walking exercise in healthy sedentary adults.

The blackcurrants themselves were grown in New Zealand - and because of the Southern Hemispheres intense UV light, this produces unusually high levels of protective and health-giving nutrients compared with berries grown elsewhere.

The key ingredients are anthocyanins, pigments in the fruit's skin responsible for their dark purple colouring, which belong to a group of flavonoids called polyphenols and possess high levels of antioxidants.

The participants - a group of male and female adults aged between 20 and 59 - were given either blackcurrant juice or a placebo an hour before they were asked to walk on a treadmill.

The average time walked by those whod taken blackcurrants was 11 minutes longer than those who hadnt.

While only 10 percent of those whod had the placebo walked a distance greater than 10km - compared with 30 percent of participants in the blackcurrant group.

The treadmill walkers whod had blackcurrants also reported lower exertion scores - and higher overall mood scores - than those whod had the placebo. Test subjects also underwent a blood test both before and after the experiment.

And its here they noted a huge decrease in something called monoamine oxidase-B, or MAO-B, activity - something they believe could help fight neurological diseases like dementia.

Dr Hurst, of the New Zealand Institute for Plant & Food Research, says: "We found that plasma collected 1 hour after blackcurrant consumption showed a dramatic acute decline - 90 percent - in platelet MAO-B activity, which was still detectable in participants plasma once they had stopped exercise.

"The pharmacological inhibition of brain MAO-B activity has been used to treat those diagnosed with neurological diseases and depression, potentially through their neuroprotective properties in reducing the metabolism of monoamines."

The findings were reported in the Journal of the International Society of Sports Nutrition and they have been welcomed by Nicki Bundock, of Surrey-based firm CurraNZ, the UKs leading supplier of New Zealand blackcurrants supplements.

Nicki explained: "Regular exercise is one of the best ways to reduce your chances of health problems like heart disease or type 2 diabetes. But if youre not an active person, starting an exercise plan and actually sticking with it can be incredibly difficult.

Studies have shown more than half of us drop out of exercise plans after just six months, reverting to inactive lifestyles. And its therefore vital we find ways to make exercise more tolerable and enjoyable.

This study suggests blackcurrant supplements can boost time spent exercising while also making it feel easier and more pleasurable. And the less stressful exercise is, the more likely it is to become a habit.

"The fact the study also suggested benefits to neurological health make it even more welcome."

Previous studies have also demonstrated the positive effect of blackcurrants on blood sugar.

A clinical trial carried out at the University of Aberdeen showed the fruit could affect how the body breaks down carbohydrates and sugars, reducing the amount of sugar that ends up in the bloodstream after a person eats a meal.

Another fruit found to have a positive impact on blood sugar is guava.

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Type 2 diabetes: Eating this superfood could help fight the condition - Express

Type 2 diabetes causes a persons body to lose control of the amount of blood sugar (glucose) in the blood. The body doesnt respond to insulin properly, and may not produce enough, causing blood sugar levels to become too high. If the condition is left untreated, complications which may occur include kidney failure, nerve damage, heart disease and stroke. So what can you do to lower blood sugar levels or keep them under control?

Eating a healthy diet is one way to manage blood sugar levels.

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

The NHS advises: 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.

When it comes to the first meal of the day, breakfast, one food you may want to consider eating is guava.

Some evidence suggests the tropical fruit can improve blood sugar control.

A number of test-tube and animal studies have shown guava lead extract to improve blood sugar levels, long-term blood sugar control and insulin resistance.

A few studies involving humans have also demonstrated impressive results.

One study involving 19 people showed drinking guava lead tea lowered blood sugar levels after a meal. The effects lasted up to two hours.

Another study in 20 people with type 2 diabetes found drinking guava leaf tea reduced blood sugar levels after a meal by more than 10 per cent.

Losing weight, if youre overweight, also makes it easier for the body to lower blood sugar levels.

Guavas have also been shown to help in this sense.

One fruit contains around 37 calories and is a good source of fibre, making it a filling, low-calorie food.

Alongside eating a healthy diet and losing weight, its also important a person is active.

The NHS says: Physical exercise helps lower your blood sugar level. You should aim for 2.5 hours of activity a week.

You can be active anywhere as long as what youre going gets you out of breath.

This could be fast walking, climbing stairs, and doing more strenuous housework or gardening.

Adding a certain superfood to your diet could also help lower blood sugar.

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Type 2 diabetes: Best fruit to include in your breakfast to lower blood sugar - Express

Tawyna said it herself you never know when youre going to need a jacket in Kansas. So why not grab one of these amazing Nordic Beach Jackets. The cozy soft jacket features a hood and pockets and a great sleeve that can be rolled up or worn down. The jackets come in many colors, olive, camel, burgundy, navy blue and more. The style is so versatile you are able to dress it up with jewelry and heels or dress it down with a flannel jeans and flats. Another really cool part to this amazing fall steal is the carrying bag. Every jacket comes in its own bag and not only does the bag have a handle for your shoulder, it is lightweight and keeps your jacket fresh. You can throw your jacket in the bag and fluff it to make sure it's looking its best whenever youre ready to wear it! Stop in and try on one of these cozy jackets, I promise you wont regret it! Checkout all the fun behind the scenes happenings at K lanes on their social media pages!

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Fit And Well: Live Well With Diabetes Event - KSN-TV

Type 2 diabetes means a persons pancreas cannot produce enough insulin to regulate blood sugar levels.Over time, unchecked blood sugar levels pose serious health risks, such as heart disease. Fortunately, certain dietary decisions can help to control blood sugar levels. Evidence singles out a particular fruit and its health benefits for type 2 diabetics.

Adding avocado to your breakfast could help stabilise blood sugar levels throughout the day.

Avocados have grown in popularity over the years as they are packed with vitamins, nutrients, and heart-healthy fats. While they are high in fat, its the good kind of fat that benefits people with type 2 diabetes.

For those suffering with the condition, adding an avocado to their diet may help them to lose weight, lower cholesterol and increase insulin sensitivity.

In a study published in the Nutrition Journal, it was shown that avocados are beneficial for type 2 diabetics as they are low in carbohydrates, which means they will not affect blood sugar levels.

In the study it was noted that avocados do not significantly impact blood sugar levels.

The healthy fats found in avocados helps a person feel fuller for longer which aids in weight loss and helps with type 2 diabetes.

In a study with the US National Library of Medicine National Institutes of Health, diet plans were analysed.

The researchers found that a weight loss diet high in monounsaturated fats improves insulin sensitive in a way not seen in a comparable high-carb diet.

A healthy diet is critical for type 2 diabetics and, in general, following a diet plan of foods that help control blood sugar levels is crucial.

Avocados help control the blood sugar levels throughout the day and lowers blood pressure and cholesterol.

According to the United States Department of Agriculture, one cup of avocado cubes weighing 150 grams contains 12.79g of carbohydrates, less than 1g of sugar, 10.1g of fibre, 22g of fat and only 240 calories.

With so few carbohydrates, a high fibre content and healthy fat, those with type 2 diabetes can enjoy an avocados in moderation without the stress and worry of raising their blood sugar levels.

Pairing an avocado with other foods may help rescue blood sugar spikes, too.

The fat and fibre content takes longer to digest and slows the absorption of other carbohydrates at the same time.

Avocados can be added to scrambled eggs, on toast or whipped up as a delicious guacamole.

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Type 2 diabetes: Best food item to add to your breakfast to lower blood sugar - Express

Type 2 diabetes occurs when a persons pancreas cannot produce or doesnt produce enough insulin to control blood sugar levels. Consistently high blood sugar levels is a precursor to deadly complications such heart disease or stroke. As a result, people with type 2 diabetes must turn to their diet to regulate blood sugar levels. Increasing evidence suggests chickpeas may help.

Chickpeas are a culinary ingredient long used in Mediterranean, Middle Eastern and Indian cookery. The legume has been been touted for its myriad health benefits, which include lowering blood sugar levels.

One of the primary benefits of eating chickpeas is that they have a relatively low glycemic index (GI). As Diabetes UK explained: Different carbohydrates are digested and absorbed at different rates, and GI is a ranking of how quickly each carbohydrate-based food and drink makes blood glucose levels rise after eating them.

Research has shown that choosing foods with a low GI index, such as chickpeas, can particularly help manage long-term blood sugar levels in people with Type 2 diabetes.

Second, chickpeas are a good source of fibre and protein, which are both known for their role in blood sugar regulation.

As Mayo Clinic explains, fibre can slow the absorption of sugar and help improve blood sugar levels. Equally, protein is broken down into glucose less efficiently than carbohydrate, which slows down the rise in blood sugar levels.

In one study, 19 people who ate a meal that contained 200 grams of chickpeas had a 21 percent reduction in blood sugar levels, compared to when they ate a meal that contained whole-grain cereal or white bread.

Furthermore, a 12-week study found that 45 individuals who ate 728 grams of chickpeas per week had a notable reduction in their fasting insulin levels, which is an important factor in blood sugar control.

Key dietary tips

A person should not focus solely on the GI of foods, however.

As the health body explains, this could make a persons diet unbalanced; high in fat and calories, which could lead to weight gain. This makes managing blood sugar levels harder and hikes the risk of heart disease.

Its important to think about the balance of your meals, which should be low in saturated fat, salt and sugar and contain more fruit and vegetables, wholegrains, pulses, nuts and oily fish, it advised.

According to Diabetes UK, people should include the following blood-sugar friendly options in their everyday meals:

What are the symptoms of type 2 diabetes?

According to the NHS, symptoms of type 2 diabetes include:

A plant extract has also been shown to lower blood sugar.

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Type 2 diabetes: Add this ingredient to your meals to lower blood sugar - Express

Type 2 diabetes is a condition that means the body cant produce enough insulin to regulate blood sugar levels. Overtime, unchecked blood sugar levels could hike a persons risk of developing life-threatening complications such as heart diseases. The blood sugar levels constantly change throughout the day and in the evening. In fact, night time is when the blood sugar levels could spike to dangerous levels overnight. This is why the food one eats before going to bed is crucial.

When a person sleeps at night the amount of glucose used is equivalent to the amount of glucose being released by the liver, so the blood sugar levels should theoretically be at the same level.

However there are two processes that occur during the evening that alter these levels and could potentially cause major problems for those with type 2 diabetes.

The Mayo Clinic explained: The dawn phenomenon, also called the dawn effect, is the term used to describe an abnormal early-morning increase in blood sugar - usually between 2 am and 8 am, in people with diabetes.

"Some researchers believe that the natural overnight release of the so-called counter-regulatory hormones - including growth hormone, cortisol, glycogen and epinephrine - increases insulin resistance, causing blood sugar to rise.

"High morning blood sugar may also be caused by insufficient insulin the night before, insufficient anti-diabetic medication dosages or carbohydrate snack consumption at bedtime.

When it comes to snacking at night, avoiding carb heavy foods is imperative.

These include bread, starchy vegetables, pasta, chips or crackers.

Doctor Michael Mosley said: If you eat lots of carbohydrates and sugars, particularly the sort without fibre that get quickly absorbed, they will rapidly push up your blood glucose levels.

"If the glucose is not burned through some activity, the pancreas responds by releasing insulin into the bloodstream to bring the levels down again, storing the excess sugar as fat.

"Too much stored fat, particularly visceral fat can lead to serious health problems.

For late night snacking, foods with a high-fibre, low-fat content are recommended to help keep blood sugar levels stable.

These include snacks such as nuts, certain fruits, vegetables or legumes.

A 2003 study looked at the impact of bedtime snack composition on prevention of nocturnal hypolgycemia in adults with diabetes.

The objective was to determine the impact of four bedtime snack compositions on nocturnal glycemic control.

The result was that the need for snacks at night is beneficial in reducing the incidence of nocturnal hypoglycaemia.

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Type 2 diabetes: Best snacks to eat at night and what to avoid - Express

During Monday night's 'Lightning Round' segment of Jiim Cramer's Mad Money program, one caller asked about Tandem Diabetes Care (TNDM) : "I like Tandem. I like the stock,"said Cramer. Let's spend a few minutes with the charts to see if we like Tandem, too.

In this daily bar chart of TNDM, below, we can see that prices have been stuck in an eight month sideways consolidationpattern. Prices are currently above the declining 50-day moving average line and above the rising 200-day moving average line. TNDM spent the first half of the month below the 200-day line but it did not start a serious decline. Prices are now back of this longer-term indicator.

The daily On-Balance-Volume (OBV) line has been in a slow rise from early July telling us that buyers of TNDM have been more aggressive and buying shares even when prices declined.

The daily Moving Average Convergence Divergence (MACD) oscillator just moved above the zero line for an outright go long signal.

In this weekly bar chart of TNDM, below, we can see that prices have had a big rally in the past two years. Prices are back above the rising 40-week moving average line.

The weekly OBV line has been pretty steady the past 12 months and it will probably not take too much of a rally to turn the OBV to the upside and a new high.

The MACD oscillator is nearly down to the zero line but renewed price strength should avert a sell signal.

In this Point and Figure chart of TNDM, below, we can see that an upside price target of $80 is being projected.

Bottom line strategy: Selling did not increase when TNDM broke below the rising 200-day moving average line, telling us that longs stayed with their positions and that they were morefocused on the bullish fundamentals. Traders and investors can approach TNDM from the long side.

Get an email alert each time I write an article for Real Money. Click the "+Follow" next to my byline to this article.

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Tandem Diabetes Care Could Eventually Break Out on the Upside - TheStreet.com

(Reuters Health) - Women who breastfeed may be less likely to develop diabetes and high blood pressure, a research review suggests.

Investigators examined data from four previous studies looking at the connection between lactation and diabetes in a total of about 206,000 women. They also analyzed data from five previous studies on the link between lactation and high blood pressure in a total of about 255,000 women.

Overall, mothers who breastfed for more than 12 months were 30% less likely to develop diabetes and 13% less likely to develop high blood pressure than women who didnt nurse babies that long.

This may be because breastfeeding burns a lot of calories and helps reverse metabolic problems that can develop during pregnancy like higher cholesterol, more fats circulating in the blood, and a diminished ability to process sugars, said Dr. Haitham Ahmed, senior author of the study and chair of cardiology at AdvantageCare Physicians in Brooklyn, New York.

In many ways it can be a reset to the adverse metabolic profile in pregnancy, Ahmed said by email. Many women are not able to breastfeed, but for those who are, that may be an excellent way to improve long term cardiovascular and metabolic health of new mothers.

Pediatricians recommend that mothers exclusively breastfeed infants until theyre at least six months old and continue to nurse for at least one year as they introduce some foods because it can reduce babies risk of ear and respiratory infections, sudden infant death syndrome, allergies, obesity and diabetes. For mothers, breastfeeding for at least one year has been linked to a lower risk of depression, obesity, and certain cancers.

In the current study, breastfeeding appeared to have a protective affect against high blood pressure and diabetes even after researchers accounted for other factors that can impact the risk of developing these conditions like obesity, smoking, and family medical history.

One drawback of the analysis is that none of the smaller studies were gold-standard controlled trials, so they couldnt prove that breastfeeding protects against diabetes or high blood pressure.

Researchers also didnt look at other factors that may impact womens health after pregnancy including the total number of births they have, race, age, or pregnancy complications, said Erica Gunderson, a researcher in cardiovascular and metabolic conditions at Kaiser Permanente Northern California. The study focused primarily on older women in populations with high levels of breastfeeding, and results might be different for other populations, Gunderson, who wasnt involved in the study, said by email.

Even so, the results should give women one more reason to breastfeed as long as possible, said Jennifer Yourkavitch of the Center for Womens Health and Wellness at the University of North Carolina at Greensboro.

It takes energy to make milk lactation burns calories, Yourkavitch, who wasnt involved in the study, said by email. And that could spur post-pregnancy weight loss and prevent excessive weight gain, which is a risk factor for cardiovascular and metabolic diseases.

Cardiovascular disease remains the leading cause of death in women, researchers note in JAMA Network Open.

While the study suggests breastfeeding might help protect against this fate, its not the only defense women have, said Yukiko Washio, a researcher at RTI International who wasnt involved in the study.

Mothers who cant breastfeed or choose not to breastfeed can still work on preventing diabetes and hypertension by abstinence from tobacco use and harmful drinking, as well as proper physical activity and nutrition, Washio said by email.

SOURCE: bit.ly/2qA6xZr JAMA Network Open, online October 16, 2019.

Link:
Breastfeeding tied to lower risk of diabetes, high blood pressure - Reuters

Individuals with type 2 diabetes who maintain weight loss after an intensive lifestyle intervention have sustained improvements in cardiometabolic risk factors, and those who regain weight not only miss out on the benefits but may have a worsening of their metabolic profile, say US researchers.

In a new analysis of data from the Look AHEAD (Action for Health in Diabetes) trial, Samantha E. Berger, PhD, of Tufts University, Boston, Massachusetts, and colleagues studied almost 1600 individuals who followed an intensive lifestyle intervention.

Particularly among participants who initially lost at least 10% of their body weight, maintaining the weight loss over 4 years led to significant improvements in cholesterol levels, blood glucose, and blood pressure, among other parameters, compared with those who regained weight.

The research, published October 9 in the Journal of the American Heart Association, also suggests that people who regain weight could still experience cardiometabolic benefits, as long as they regain no more than 25% of the original weight loss.

Hence, "maintaining 75% of weight loss was generally beneficial," the researchers conclude.

"These findings emphasize the dual importance of not only achieving a heathy body weight but maintaining a healthy body weight," said senior author Alice H. Lichtenstein, DSc, director of the Cardiovascular Nutrition Laboratory at the Human Nutrition Research Center on Aging at Tufts University, in a press release by the AHA.

And although she acknowledged that keeping off the pounds can be "challenging," she cautioned: "If you lose weight and don't maintain it, the benefits are diminished or disappear."

Lichtenstein told Medscape Medical News that, in general, "People understand that they need to lose weight."

However, they "frequently go on extreme diets and are successful in losing the weight, but we don't seem to be putting as much emphasis on how crucial it is to keep the weight off," she asserted.

"It may feel terrific" when people lose weight quickly, but "you don't get the metabolic benefits unless you make sustainable changes to daily food intake or the way you moderate your energy intake."

This means maintaining lifestyle changes "essentially over a lifetime" for individuals to be able to "get back in balance."

Weight loss programs, Lichtenstein added, will therefore "have to put a lot more emphasis on what happens after someone successfully loses weight and not just celebrate that point."

In the new article, researchers say few studies have directly compared individuals with successful weight loss maintenance (maintainers) and individuals who regained weight (regainers).

In addition, the impact of weight regain after weight loss on cardiometabolic risk factors "is not well established."

In part of the Look AHEAD randomized controlled trial, individuals diagnosed with type 2 diabetes who had a body mass index (BMI) of over 25 kg/m2, or 27 kg/m2 if taking insulin, were assigned to an intensive weight loss lifestyle intervention or standard care.

The intervention lasted for 1 year and involved group support sessions, calorie and fat gram restrictions, and meal replacement and physical activity recommendations, with the aim of losing approximately 7% of body weight.

The participants, who were recruited from 16 sites across the United States, then entered a 3-year maintenance phase.

For the current analysis, researchers focused on 1561 individuals from the trial who were assigned to the intervention group, had initially lost at least 3% of body weight, and had follow-up data to the end of year four.

Within these groups, participants were classified based on how much weight they regained after the initial weight loss.

Those who gained none (0%) were termed "maintainers" and the rest were termed "regainers." The degree of weight regained was divided into four increments: 25%, 50%, 75%, and 100% of percentage weight-loss regained (weight change from years 1 to 4 as a percentage of the first year of weight loss).

Change in cardiometabolic risk factors after initial weight loss was compared in maintainers and regainers, after controlling for demographics, medications, and baseline and year 1 change in BMI.

The effect was also assessed separately in participants with < 10% weight loss and 10% initial weight loss.

As expected, individuals who lost more weight initially were significantly more likely to have improvements in cardiometabolic risk factors at year one than other participants. And those who initially lost more weight were significantly less likely to have started on diabetes and antihypertensive medications, and were significantly more likely to have stopped them during follow-up.

Among those who lost 10% initial weight, the results across most risk factors indicated maximal risk factor reduction among maintainers who successfully maintained 100% of the lost weight.

Successfully maintaining most ( 75%) of the weight loss (25% regain cut-point) was also associated with significant maintenance of improved risk factors.

In contrast, regainers showed significant deterioration in some cardiometabolic risk factors from years one to four.

Meanwhile, "For those who lost < 10% initial weight, keeping it off is better than regaining, but it appears the degree of maintaining the weight loss has little impact on cardiometabolic risk factors," the researchers say.

Overall, the findings emphasize the importance of intervention programs focusing not only on weight loss but weight loss maintenance, "given the adverse consequences of the latter," the authors reiterate.

"The important thing is, once you successfully lose weight, to really put a lot of emphasis on keeping it off," Lichtenstein told Medscape Medical News.

Finally, the researchers also say more work in this area is sorely needed.

"The findings from this study emphasize the need to further investigate long-term impact of partial weight regain after a weight loss intervention given the challenge of keeping off all of weight lost," they write.

The Look AHEAD trial was conducted by the Look AHEAD Research Group and supported by the National Institute of Diabetes and Digestive and Kidney Diseases; National Heart, Lung, and Blood Institute; National Institute of Nursing Research; National Institute of Minority Health and Health Disparities; Office of Research on Women's Health; and Centers for Disease Control and Prevention.

The authors have reported no relevant financial relationships.

J Am Heart Assoc. 2019;8: e010951. Full text

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Maintaining Weight Loss in Diabetes Is Key to Keeping Benefits - Medscape

Power couple Priyanka Chopra and Nick Jonas walk the red carpet for Chopard party, along with Amber Heard, Elle Fanning, Julianne Moore and Richard Madden (May 18). AP, AP

Priyanka Chopra is opening up about what life is like with husband Nick Jonas, who is a type 1 diabetic.

The 37-year old actress described how much she admires Jonas' dedication to his healthon "The View"Tuesday.

Initially, when we first got married, I couldnt wrap my brain around the fact that he knew when his sugar dropped, even whilehe was sleeping, shesaid. He feels it.

Though she trusts Jonas' "crazy discipline" about monitoring his blood sugar, Chopra confessed she "used to wake up in the middle of the night" to make sure her husband was OK.

She also praised Jonas, 27, for not letting his disorder affect the way he lives.

"He lives the biggest life possible," she said."He's not restricted himself from anything. He plays sports. He's touring. He lives an incredible life, and it's so inspiring to see."

This passion for living life to the fullest, Chopra said, is what inspired Jonas to found Beyond Type 1, a nonprofit organization dedicated to diabetes education, advocacy and the path to a cure.

More: Priyanka Chopra explains why she took Nick Jonas' name: I'm 'old-school like that'

More: Priyanka Chopra spars with upset fan at BeautyCon: 'Girl, don't yell'

"That's what he wanted to show people," Chopra said. "That even if you have type 1 diabetes doesn't mean that your life has to be different. You can live it to its fullest, and it's so inspiring to me."

According to Mayo Clinic, type 1 diabetes is a chronic condition in which the pancreas produces little or no insulin. Though there is no cure, treatment "focuses onmanaging blood sugar levels with insulin, diet and lifestyle to prevent complications."

More: Awww! Nick Jonas writes fairy-tale 'one year' love letter to wife Priyanka Chopra

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(Reuters Health) - People who increase their consumption of sodas, juices and other sweet drinks over time are more likely than those who dont to develop diabetes, a U.S. study suggests.

Researchers examined over two decades of data from more than 192,000 men and women who worked in nursing or other healthcare jobs. None of the participants had diabetes at the start of the study; by the end almost 12,000 people had developed the disease.

After accounting for how much people weighed and their overall eating patterns, researchers found that those who increased their total consumption of sugary drinks by a half serving a day over four years were 16% more likely to develop diabetes over the next four-year period. With the same daily half-serving increase in artificially-sweetened drinks, the odds went up 18%.

Even though consumption of 100% fruit juices has been considered a healthy alternative to sugar-sweetened beverages because of the vitamins and minerals in fruit juices, they typically contain similar amounts of sugar and calories as sugar-sweetened beverages, said Jean-Philippe Drouin-Chartier, lead author of the study and a nutrition researcher at the Harvard T.H. Chan School of Public Health in Boston.

The study results raise concerns about the negative health effects of sugary beverages, regardless of whether the sugar is added or naturally occurring, Drouin-Chartier said by email.

The researchers focused on type 2 diabetes in the study, the most common form of the disease, which is associated with obesity and aging.

They also found that when people replaced sodas, juices and other sugary beverages with other kinds of drinks, their risk of developing diabetes went down.

Replacing one serving a day of sugary drinks with water, coffee or tea, was associated with a 2% to 10% lowering of diabetes risk. The data did not include information about whether people added sugar to their coffee or tea, the study team notes.

The analysis also wasnt designed to prove whether or how drink selections might directly impact the development of diabetes.

Its possible that diet sodas and other artificially-sweetened drinks were tied to higher diabetes risk because people switched to these beverages after they developed diabetes or realized they were on track to get the disease, the study team acknowledges in Diabetes Care.

However, the results should still serve as a reminder that even some sugary drinks that people think of as healthy - like orange juice - can still lead to elevated blood sugar and contribute to the development of diabetes, said Dr. Robert Cohen, a diabetes researcher at the University of Cincinnati College of Medicine in Ohio, who wasnt involved in the study.

Sugary beverages that people might otherwise think of as being healthy provide a load of sugar (sucrose) which gets broken down to glucose and raises blood glucose, Cohen said by email. Removing or markedly reducing beverages like fruit juices can have a dramatic effect to improve blood sugar control.

SOURCE: bit.ly/321TZI0 Diabetes Care, online October 3, 2019.

Excerpt from:
Drinking more soda and juice tied to increased diabetes risk - Reuters

DUBLIN, Oct. 9, 2019 /PRNewswire/ -- The "Diabetes Management: Insulin Pumps Market (2019)" report has been added to ResearchAndMarkets.com's offering.

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Valued at nearly $3bn in 2018, the Global Insulin Pumps Market is growing at a fast pace - at a compound annual growth rate (CAGR) of approximately 12% - reaching more than $5bn by 2023

The Global Insulin Pumps market is being driven by strong demand, increasing awareness and adoption of next-generation hybrid closed-loop systems, solid clinical outcomes, and good reimbursement. Market penetration is low, leaving much room for growth.

According to the International Diabetes Federation (IDF), approximately 425 million adults (20-79 years of age) have diabetes worldwide, and this number is expected to rise nearly 50% to approximately 629 million by 2045. More than 1.25 million people have type 1 diabetes in the US alone.

There is a strong need for automated continuous insulin delivery as a replacement for cumbersome multiple daily (insulin) injections (MDI) using painful pens/needles, which are prone to user error and may leave many type 1 (and insulin-requiring type 2) patients at risk for dangerous complications.

Overall, the insulin pumps market is an evolving market driven by innovation. While Medtronic clearly dominates, technological advances are spurring intense competition. There is a rush to develop even smarter automated hybrid closed-loop systems (artificial pancreas or AP systems) driven by machine learning or artificial-intelligence-based algorithms. These systems lessen patient burden and autonomously adapt to individuals' glycemic needs and lifestyles to significantly improve blood glucose control and quality of life for millions of diabetes patients worldwide.

This comprehensive medical market and technology report provides:

Markets covered by this analysis include the US, Japan, the five major EU markets (France, Germany, Italy, Spain, and the UK), and the Rest of World (RoW) markets, which includes all other countries. Market forecasts are for the 2018-23 time period.

Highlights

Companies Mentioned

For more information about this report visit https://www.researchandmarkets.com/r/ghc0vu

About ResearchAndMarkets.comResearchAndMarkets.com is the world's leading source for international market research reports and market data. We provide you with the latest data on international and regional markets, key industries, the top companies, new products and the latest trends.

Research and Markets also offers Custom Research services providing focused, comprehensive and tailored research.

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The Number of Adults with Diabetes Worldwide is Set to Rise Nearly 50% to Approximately 629 Million by 2045 - Yahoo Finance

This transcript has been edited for clarity.

I first became passionate about diabetes and humanitarian crises when I spent a month practicing general internal medicine at a small district hospital near the Congo-Rwanda border. We had many refugees come through from the Congo at that time, including a number of young men who were clearly in diabetic ketoacidosis.

Because we did not have insulin or glucose strips with which to monitor them, they all died within hours of presenting to the hospital. None of them survived. Those with type 2 diabetes kept being readmitted to the hospital because we were unable to manage their hyperglycemia, although we were able to manage their infections or trauma.

This experience led me to dedicate my career to this issue. Today, about half a billion people worldwide are affected by diabetes, 80% of whom are living in low- and middle-income countries. This is projected to increase over the next 20 years as a result of urbanization, climate change, global warming, etc., so the crisis will get even worse.

At the same time, low- and middle-income countries are predominantly and disproportionately affected by humanitarian crises. Most people who are displaced due to conflict spend decades as refugees or internally displaced people. The average duration of this conflict-induced displacement is 27 years, and these people have diabetes. As a result, humanitarian actors are now having to take on broader roles.

Yet, at present, data on this issue are not being collected. There are no evidence-based guidelines on how to manage diabetes best in these circumstances, and there is no education. Medicines, including insulin, are not routinely supplied in these contexts, which is a death sentence for anyone with type 1 diabetes.

For this reason, we organized a symposium in early April at Harvard University, where we convened more than 100 leaders in global and humanitarian health, including various academic institutions, the Centers for Disease Control and Prevention, the World Health Organization, and pharmaceutical and diagnostics companies. The objectives were to discuss this issue, build partnerships, figure out how to collaborate, prioritize the most immediate needs as a community, and design projects going forward.

Out of that meeting, we published the Boston Declaration in TheLancet Diabetes & Endocrinology, which outlines this incredible and urgent need for insulin, especially for those with type 1 diabetes, and the need for chronic care for people with type 2 diabetes.[1] This care includes cardiovascular risk management and all comorbidities, which would hopefully pave the way for improved care for other chronic diseases.

The group, comprising 64 signatories from about 43 different organizations, outlined four major targets to work toward. The first is improved advocacy and global awareness, which is a major need. The second is improved access to insulin, essential medicines, and diagnostics for diabetes and hypertension. The third major target is to develop improved clinical and operational guidelines that are coherent among organizations, and the last target is improved data collection, surveillance, and monitoring across organizations. These are the four main targets that we're setting out to tackle over the next 3 years.

Many new projects are beginning, and we would love everyone's involvement. If you would like to get involved, you can contact me via the Global Endocrinology website, or contact any humanitarian organization, including Doctors Without Borders, the International Committee of the Red Cross, and Save the Children. They're all doing phenomenal work, they definitely need this money, and they will put it to good use.

Thank you.

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'None of Them Survived': Diabetes in the Time of Humanitarian Crises - Medscape

Type 2 diabetes means a persons pancreas cannot produce enough insulin to regulate blood sugar levels. Overtime, unchecked blood sugar levels pose serious health risks, such as heart disease. Fortunately, certain dietary decisions can help to control blood sugar levels. Evidence singles out a particular fruit.

According to research presented at the American Diabetes Association's 72nd Annual Scientific Session, eating raisins three times per day may reduce post-meal sugar spikes significantly.

The research, conducted by Harold Bays, MD, medical director and president of Louisville Metabolic and Atherosclerosis Center (L-MARC), involved 46 adults who had slight increases in glucose levels, but no previous diagnosis of diabetes mellitus.

The researchers randomly assigned participants to two groups.

The first group was told to snack on raisins three times per day for 12 weeks, while the second group snacked on pre-packaged snacks that did not contain raisins or other fruits or vegetables.

The researchers found that raisins slashed post-meal glucose levels by 16 per cent and reduced mean hemoglobin A1c by 0.12 per cent from baseline.

Pre-packaged commercial snacks on the other hand, did not significantly reduce mean post-meal glucose or hemoglobin A1c.

As Diabetes UK explained, HbA1c is a persons average blood glucose (sugar) levels for the last two to three months. A high HbA1c means a person has too much sugar in their blood.

Commenting on the findings, Dr. Bays said: "Compared to the snacking control group, the group consuming raisins had a significant statistical reduction in their after-liquid meal blood sugar levels among study participants who had mean baseline fasting glucose levels between 90 and 100 mg/dl.

Adding: This favourable glucose effect of raisins was further supported by the statistically significant reduction in hemoglobin A1c (a standard test for overall blood sugar control in diabetes mellitus) in the within group comparison to baseline. The within group comparisons from baseline with snacks did not demonstrate a reduction in hemoglobin A1c."

Accounting for the results, James Painter, Ph.D., R.D., and nutrition research advisor for the California Raisin Marketing Board, said: "Raisins have a relatively low glycemic index and contain fiber and antioxidants, all factors which contribute to blood sugar control. Decreasing blood sugar and maintaining normal hemoglobin A1c levels is important because it can prevent long-term damage to the heart and circulatory system."

Why eat fruit?

As Diabetes UK explained, there is a popular misconception that the sugar content of fruit means it is off-limits for people with type 2 diabetes. 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, said the health body.

Adding: This is different to the free sugar in drinks, chocolate, cakes and biscuits.

In fact, carbohydrate intake has the biggest impact on blood sugar levels, and fruit is a low-carb alternative to sugary foods, noted the health site.

It said: A portion of fruit, such as a medium apple, generally contains about 15 to 20g carbs, a chocolate muffin has 55g carbs and a 500ml ordinary fizzy drink has 54g carbs.

Here is another superfood proven to lower blood sugar levels.

What are the symptoms of type 2 diabetes?

Symptoms of type 2 diabetes include:

Read more:
Type 2 diabetes: Eat this fruit three times a day to lower your blood sugar levels - Express

Pfizer has signed a deal with Ionis affiliate Akcea Therapeutics, to develop a potential blockbuster antisense therapy to treat patients with certain cardiovascular and metabolic diseases including type 2 diabetes.

The terms of the deal give a clue as to Pfizers assessment of the drugs potential: Akcea and Ionis will receive a fairly modest $250 million up front, split between the two companies, and Akcea will settle its $125 million obligation to Ionis in common stock.

But the companies are also eligible to receive development, regulatory and sales milestone payments of up to$1.3 billionand tiered, double-digit royalties on annual worldwide net sales following marketing approval of the drug codenamed AKCEA-ANGPTL3-LRx.

AKCEA-ANGPTL3-LRx is designed to reduce the production of angiopoietin-like protein 3 (ANGPTL3) and is a regulator of triglycerides, cholesterol, glucose, and energy metabolism.

It is currently in a phase 2 study in patients with type 2 diabetes, hypertriglyceridemia, and non-alcoholic steatohepatitis (NASH) indications that could generate substantial sales following approval from regulators.

Akceas antisense drugs work by blocking the action of messenger RNA, which carries instructions to the cell from the DNA to code for a particular protein.

Antisense drugs are made from components such as synthetic strands of DNA, which target a specific RNA sequence and stop it from producing the protein.

Future milestone payments and royalties will be split equally between Akcea and Ionis, and Pfizer will pay for all development and regulatory costs beyond the ongoing phase 2 study.

Before a filing for marketing approval, Akcea has an option to take part in some marketing activities with Pfizer in the US, and some other markets if certain conditions are met.

Akcea already has two antisense therapies approved Tegsedi (inotersen) for the rare disease hereditary transthyretin-related amyloidosis (hATTR) and Waylivra (volanesorsen) for familial chylomicronemia syndrome.

Damien McDevitt, interim chief executive officer at Akcea, said: AKCEA-ANGPTL3-LRxhas the potential to treat people suffering from certain cardiovascular and metabolic diseases.

Given the unmet medical need for this patient population and the broad market potential, we believe Pfizers expertise and breadth of experience in cardiovascular and metabolic diseases makes it well suited to accelerate clinical development of AKCEA-ANGPTL3-LRx, and to deliver it to patients in need of additional therapies for these life threatening diseases.

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Pfizer inks deal with Ionis and Akcea for potential blockbuster diabetes and NASH drug - - pharmaphorum

Two new studies, one surgical, the other medical come to similar conclusions - significant weight loss alters the course of Type 2 diabetes.

In the first study, 867 40 to 69-year-old, patients with new-onset diabetes were randomized into treatment or control groups. Seven hundred thirty had both their weights and HbA1c measured initially and at five years and represented the study group. It was predominately Caucasian (97%), male (61%), and with a BMI of about 34. At the end of 5-years, 30% of patients who lost 10% or more of their body were in remission from diabetes. And the incidence of remission followed the degree of weight loss the kind of dose-response to treatment that suggests underlying physiologic changes. The researchers considered several associated behavioral changes, smoking cessation, less alcohol or caloric intake, fewer fats, more exercise, you know the litany. But with the exception of a small improvement with diminished alcohol intake, none of those changes made a difference it was solely that drop in weight.

"These findings suggest that remission is achievable without intensive lifestyle interventions or extreme calorie restrictions."

Of course, the study has some fine print. First, while a weight loss of this magnitude during the five years achieved this result for some patients, it was more effective earlier in the course of the disease. The more important caveat and one many of us know first-hand, losing that amount of weight and keeping it off is far easier said than done. And that brings us to the second study.

When is a "bug" a feature?

One of the most frequently performed operations in the mid-20th century was a host of procedures for treating peptic ulcers, stomach ulcers. They have been substantially entirely supplanted by medications like ranitidine (Zantac currently under recall). But even though all those different operations on the stomach "cured" the ulcers, many had an adverse side effect, significant weight loss. Innovative surgeons turned that adverse effect, that operative "bug" into an operative benefit with the introduction of bariatric surgery alterations of the GI tract meant to reduce a patient's weight.

There are several operations categorized as bariatric surgery, some designed to diminish the size of the stomach, increasing the onset of satiety and reducing caloric intake; others that re-arrange the GI tract to reduce capacity and alter metabolism. All are associated with significant weight reduction and have been offered to patients who are significantly obese. A new study looks at how patients, with Type 2 diabetes, undergoing bariatric procedures fare for adverse cardiovascular outcomes the usual concerns of heart attacks, strokes, and other problems.

Roughly 2300 patients undergoing bariatric surgery and with a history of Type 2 diabetes were followed for approximately four years and compared with control patients who did not undergo bariatric surgery. An inspection of the two groups suggests that the control patients were at best "similar" rather than the same, so the effect size I am reporting should be taken with a grain of salt. These patients were far more overweight at a BMI of 40 or higher than the previous study. The surgical group had more dyslipidemia and hypertension; the control group more smokers and blacks. The cumulative incidence of all-cause mortality, coronary artery disease, heart failure, cerebrovascular disease (strokes) atrial fibrillation, and nephropathy (kidney disease) were all reduced over the 8-year follow up for the surgical patients as compared to the controls.

But for me, the critical finding is the profound and long-standing weight loss from the surgery, as depicted on the right. These patients not only had remission from diabetes but significant reductions in the need for medications for both hypertension and dyslipidemia.

"We speculate that the lower rate of MACE after metabolic surgery observed in this study may be related to substantial and sustained weight loss with subsequent improvement in metabolic, structural, hemodynamic, and neurohormonal abnormalities."

The surgery is not a free ride, as with all procedures, there can and were complications; 0.7 % of patients died within 90 days of surgery (for open-heart surgery that percentage is about 3.7%). Five percent needed open surgical revision, while 16% had revisions of their operation by more non-invasive means. The authors are not suggesting that bariatric surgery be the primary treatment.

What I think is clear is that in well-motivated patients, a 10% weight loss can "reverse" Type 2 diabetes and show significant improvements in many associated cardiovascular diseases. And weight loss, whether or not assisted by bariatric surgery, had a more substantial impact on adverse cardiovascular outcomes than the new generation of medications for diabetes advertised with an "added cardiovascular benefit." The signal from the studies is strong; at least for me, losing a significant amount of your "over" weight is strong medicine.

Source: Behaviour change, weight loss and remission of Type 2 diabetes: a communitybased prospective cohort study Diabetic Medicine DOI:10.1111/dme.14122 and Association of Metabolic Surgery With Major Adverse Cardiovascular Outcomes in Patients With Type 2 Diabetes and Obesity JAMA DOI: 10.1001/jama.2019.14231

Excerpt from:
The Weighty Cost of Diabetes - American Council on Science and Health

Type 2 diabetes is a condition which causes the body to lose control of the amount of glucose in the blood. The body doesnt respond to insulin properly and may not produce enough, and this causes blood glucose levels to become too high. If blood glucose levels stay to high, a number of health complications can occur, including kidney failure, nerve damage, heart disease and stroke. So what can you do to prevent the condition and reduce high blood glucose levels?

Simple lifestyle changes can help get a persons blood glucose levels back into the normal range, with one of these changes being to lose weight.

In a new study carried out by the University of Cambridge, nine of 10 people who reduced their body weight by just 10 per cent within five years of being diagnosed with diabetes were able to achieve remission from the condition.

Diabetes remission in people with type 2 diabetes means blood glucose levels are healthy without the need for diabetes medication.

This reinforces the importance of managing ones weight, which can be achieved through changes in diet and increasing physical activity, said Dr Simon Griffin, a University of Cambridge researchers and study senior author.

Previous research has shown people who follow an intensive, low-calorie diet for eight weeks be successful in normalising blood sugar.

But the new study, led by Hajira Dambha-Miller, of the universitys department of public health and primary care, is one of the few demonstrating a less intensive intervention can also be effective in controlling the disease.

Researchers studied data on 867 people aged 40 to 69 who were newly diagnosed with diabetes.

They found 257 participants in the ADDITION-Cambridge clinical trial were in remission from diabetes five years after diagnoses.

Hajira said: Weve known for some time now that its possible to send diabetes into remission using fairly drastic measures such as intensive weight loss programmes and extreme calorie restriction.

These interventions can be very challenging to individuals and difficult to achieve.

But our results suggest that it may be possible to get rid of diabetes, for at least five years, with a more modest weight loss of 10 pre cent.

This will be more motivating and hence more achievable for many people.

Looking at the overall findings, this who lost 10 per cent or more of their body weight within five years of diagnosis were twice as likely to be in remission as those who did not achieve significant weight loss.

Losing this amount of weight was shown to be most effective among newly diagnosed participants.

But it also worked to stabilise blood sugar in around half of people who have had diabetes for a number of years.

Alongside weight loss, drinking a certain drink before bed has also been shown to lower blood sugar.

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Type 2 diabetes: The simple lifestyle change to put the condition in remission - Express