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UPPER NYACK, N.Y.--(BUSINESS WIRE)--CreakyJoints, the digital arthritis community for patients and caregivers worldwide and part of the Global Healthy Living Foundation (GHLF), today announced the launch of eRheum.org, a new digital destination to help patients get the most from their telehealth appointment. Data presented at the 2020 ACR Convergence by CreakyJoints from our ArthritisPower supported Autoimmune COVID-19 Project showed that as the pandemic ramped up (post-March 15, 2020) return patient appointments dropped and telehealth visits increased, but not enough to overcome the frequency of missed/cancelled in-person appointments. This is a problem because disruptions in rheumatology care slow the rate at which patients can be diagnosed and treated, adversely affecting health outcomes and chronic disease management. Optimizing the availability and effectiveness of telehealth appointments will help with continuity of care.

After consulting with rheumatologists and speaking with our patient members, we recognized the urgent need to help patients understand how to access telehealth and make the most of their virtual appointment, said Louis Tharp, executive director and co-founder of CreakyJoints and the Global Healthy Living Foundation. Written in patient-friendly language, eRheum defines telehealth and how rheumatologists utilize it, provides patients with access to difference video conferencing portals to try with their physician, and explains how to make the most of your limited face-to-face time with your physician during the appointment itself.

Taking Advantage of Telehealth

In May of 2020, GHLF asked its chronic disease patient community to rate their experience with telehealth over the previous two months on a scale of 1-10 (where 10 = excellent experience). Seventy-three percent of respondents said they have used telehealth in the past two months and of those who have used it, they rated with experience as eight. Given the positive response, CreakyJoints built eRheum.org with arthritis patient input and then shared it with provider groups to encourage them to share it with patients in their care. In addition to the main portal, eRheum has been adopted and co-branded by the Association of Women in Rheumatology (AWIR) and the Rheumatology Nurses Society (RNS).

"Weve taught our patients who are on immunosuppressants for so long to avoid communicable diseases, particularly during flu season. This pandemic has really affected their willingness to venture out of their homes, even to medical appointments. Understandably, those with chronic diseases like inflammatory arthritis, who also already belong to a group with some of the highest risks for COVID-19 serious complications, such as blacks, Hispanics, the elderly, or those who are overweight, are most reluctant to venture out, said RNS President Cathy Patty-Resk, MSN, RN-BC, CPNP-PC. We introduced eRheum to our nurses and advanced practice providers in our organization because we want to continue to be the resource they need for their patients. The tools available on eRheum promote confidence in patients to ask their questions to get the care they need to continue effectively managing their condition.

AWIR is dedicated to improving the health of all patients with rheumatic diseases and bridging the gaps experienced by patients from diverse backgrounds. Virtual care allows us to bring our caring to our patients wherever they are, and wherever we are. We embrace this initiative to optimize care for our patients, said Grace C Wright M.D. PhD., President of AWIR.

Understanding Telehealth Best Practices

Recently, the University of Alabama at Birmingham announced that the university and collaborators such as Cedars-Sinai Medical Center and CreakyJoints and its ArthritisPower Research Registry received a two-year, $400,000 grant from the American College of Rheumatologys Rheumatology Research Foundation to support telehealth-delivered healthcare. The Telehealth-delivered Healthcare to Improve Care (THRIVE) projects primary investigator, Swamy Venuturupalli, M.D., is the recipient of this years ACRs Norman B. Gaylis, M.D., Clinical Research Award, and the study is slated to begin in January of 2021.

THRIVE seeks to evaluate the quality of telehealth services when provided to a rheumatology patient in their home and deliver recommendations for physicians about best practices regarding what telehealth-related care delivery should include, how to deliver it, and how to standardize high quality care. It will produce a peer-reviewed white paper that describes those best practices. Overall, the goal is to expand the impact of rheumatology by increasing patient access to care, especially among those marginalized or most at risk by the COVID-19 pandemic. CreakyJoints will produce a patient-facing training video that will show rheumatoid arthritis (RA) patients how to perform joint self-assessment and compare its accuracy with an in-person clinician joint exam (the gold standard).

Telehealth offers patients the flexibility they need to stay in contact with their doctors, but this works only when both parties understand how to get the most out of the appointment, said W. Benjamin Nowell, PhD., Director, Patient-Centered Research at CreakyJoints, principal investigator of the ArthritisPower Research Registry, and a co-investigator of the THRIVE study. Telehealth in rheumatology has some unique features and this study is an important complement to eRheum as it enables us to further enhance the telehealth tools and education we offer to rheumatologists and people living with arthritis. Ultimately, we want to do all we can to ensure productive and satisfying telehealth appointments for arthritis patients and their doctors.

About CreakyJoints

CreakyJoints is a digital community for millions of arthritis patients and caregivers worldwide who seek education, support, advocacy, and patient-centered research. We represent patients in English and Spanish through our popular social media channels, our websites http://www.CreakyJoints.org, http://www.creakyjoints.org.es/, http://www.creakyjoints.org.au, and the 50-State Network, which includes more than 1,500 trained volunteer patient, caregiver and healthcare activists.

As part of the Global Healthy Living Foundation, CreakyJoints also has a patient-reported outcomes registry called ArthritisPower (ArthritisPower.org) with more than 29,000 consented arthritis patients who track their disease while volunteering to participate in longitudinal and observational research. CreakyJoints also publishes the popular Raising the Voice of Patients series, which are downloadable patient-centered educational and navigational tools for managing chronic illness. It also hosts PainSpot (PainSpot.org), a digital risk assessment tool for musculoskeletal conditions and injuries. For more information and to become a member (for free), visit http://www.CreakyJoints.org.

Find us on social media:Facebook: https://www.facebook.com/creakyjoints and https://www.facebook.com/GlobalHealthyLivingFoundation/ Twitter: @GHLForg, @CreakyJoints, #CreakyChatsInstagram: @creaky_joints, @creakyjoints_aus, @creakyjoints_espTikTok: globalhealthylivingfndLinkedIn: https://www.linkedin.com/company/ghlf/

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CreakyJoints Launches eRheum.org to Educate Patients on Getting the Most From Their Telehealth Appointment - Business Wire

The risk for increased COVID-19 severity in people with type 1 diabetes appears similar to that of type 2 diabetes, contrary to some official advice from the Centers for Disease Control and Prevention (CDC). The new finding indicates that people with both types should be priority for receiving a vaccine, investigators say.

The study is the first to prospectively evaluate both inpatients and outpatients and to examine COVID-19 severity factors in addition to death in people with type 1 and type 2 diabetes separately, and was published online December 2 in Diabetes Care.

Among the patients, who were seen at Vanderbilt University Medical Center in Nashville between March and August 2020, those with both type 1 and type 2 diabetes had between a three- and fourfold greater risk for COVID-19 hospitalization and greater illness severity than people without diabetes after adjustments for age, race, and a number of other risk factors.

This finding is important since as of December 1, 2020, the CDC has classified the diabetes types differently in terms of underlying medical conditions that increase the risk for severe COVID-19.

Adults of any age with type 2 diabetes are considered "at increased risk of severe illness" from the virus that causes COVID-19 whereas CDC says those with type 1 "might be at an increased risk."

Lead author of the new paper Justin M. Gregory, MD, told Medscape Medical News: "I think this needs revision based on the current evidence. I think the data presented in our study and that of Barron et al in Lancet Endocrinology 2020 indicate the need to place type 1 diabetes at parity with type 2 diabetes."

"These studies indicate both conditions carry an adjusted odds ratio of three to four when compared with people without diabetes for hospitalization, illness severity, and mortality," he stressed.

There were no phase 3 vaccine data available for the vaccine at the time that Gregory, of the Ian M. Burr Division of Pediatric Endocrinology and Diabetes, Vanderbilt University School of Medicine, Nashville, and colleagues were writing their manuscript in late summer, so the article does not mention this.

But now, Gregory says, "Based on the initial press releases from Pfizer and Moderna, I am now optimistic that these vaccines might mitigate the excess morbidity and mortality from COVID-19 experienced by patients with diabetes."

"I am eager to see what we learn on December 10 and 17 [the scheduled dates for the meetings of the US Food and Drug Administration's Vaccines and Related Biological Products Advisory Committee to review the Pfizer and Moderna vaccines, respectively]."

But with the winter pandemic surge in the meantime, "Our investigation suggests that as COVID-19 hospitalizations rise, patients with both type 1 and 2 diabetes will comprise a disproportionally higher number of those admissions and, once hospitalized, demonstrate a greater degree of illness severity," he and his colleagues say.

"In light of these data, we call on our colleagues to emphasize the importance of social distancing measures and hand hygiene, with particular emphasis on patients with diabetes, including those in the most vulnerable communities whom our study affirms will face the most severe impact."

The new study data came from electronic health records at Vanderbilt University Medical Center, comprising 137 primary care, urgent care, and hospital facilities where patients were tested for SARS-CoV-2 regardless of the reason for their visit.

Between March 17 and August 7, 2020, a total of 6451 tested positive for COVID-19. Of those, 273 had type 2 diabetes and 40 had type 1 diabetes.

Children younger than 18 years accounted for 20.0% of those with type 1 diabetes and 9.4% of those without diabetes, but none of the type 2 group. The group with type 2 diabetes was considerably older than the type 1 diabetes and no-diabetes groups, 58 years versus 37 and 33 years, respectively.

Before adjustment for baseline characteristics that differed between groups, patients with type 1 diabetes appeared to have a risk for hospitalization and greater illness severity that was intermediate between the group with no diabetes and the group with type 2 diabetes, the researchers say.

But after adjustment for age, race, sex, hypertension, smoking, and body mass index, people with type 1 diabetes had odds ratios of 3.90 for hospitalization and 3.35 for greater illness severity, which was similar to risk in type 2 diabetes (3.36 and 3.42, respectively), compared to those without diabetes.

The investigators then conducted a detailed chart review for 37 of the 40 patients with type 1 diabetes and phone surveys with 15 of them.

The majority (28) had not been hospitalized, and only one was hospitalized for diabetic ketoacidosis (DKA) within 14 days of positive SARS-CoV-2 testing.

This contrasts with a report from the T1D Exchange, in which nearly half of 33 patients with type 1 diabetes and COVID-19 had been hospitalized with DKA. The reason for the discrepancy may be that more severe patients would more likely be referred to the T1D Exchange Registry, Gregory and colleagues hypothesize.

Clinical factors associated with COVID-19 severity (P < .05) in their study included a prior hypertension diagnosis, higher A1c, at least one prior DKA admission in the past year, and not using a continuous glucose monitor (CGM).

Hospitalizations were twice as likely and illness severity nearly twice as great among those with type 1 diabetes who were Black versus White. Just 8% of those with private insurance were hospitalized, compared with 60% of those with public insurance and 67% with no insurance (P = .001).

"Whereas previous reports have indicated proportionally higher rates of hospitalizations from COVID-19 among Black patients and those with public insurance, this study is the first to show a similar finding in the population with type 1 diabetes," Gregory and colleagues write.

Only 9% of patients using a CGM were hospitalized versus 47% who used blood glucose meters (P < .016). Similarly, hospitalizations occurred in 6% using an insulin pump versus 33% using multiple daily injections (P < .085).

But they note, "Our analysis cannot exclude the possibility that greater amounts of diabetes technology use are a surrogate for higher socioeconomic status."

This research was supported by the National Institute of Diabetes and Digestive and Kidney Diseases, JDRF, and the Appleby Foundation. The authors have reported no relevant financial relationships.

Diabetes Care. Published online December 2, 2020. Abstract

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Excerpt from:
Prioritize COVID-19 Vaccination in Both Types of Diabetes, Say Docs - Medscape

The University of Kentucky Public Relations & Strategic Communications Office provides a weekly health column available for use and reprint by news media. This week's column is by Laura Hieronymus, a doctor of nursing, master licensed diabetes educator and the associate director of education and quality services at the Barnstable Brown Diabetes Center and Daniel Stinnett a registered dietitian and master licensed diabetes educator in the Bluegrass Care Clinic.

LEXINGTON, Ky. (Dec. 7, 2020) Americans savor winter holiday meals; however, not always in a good way. Statistics show the December holiday season is one of the top three in terms of food consumption with the average adult taking in about 3,000 calories in one meal. Additional calories throughout the day can add up to two and a half times what an average adult needs for their daily energy needs. When you have diabetes, the added intake can affect blood glucose levels and potentially lead to symptoms such as fatigue, sluggishness, and even weight gain. During the holiday season, an overabundance of foods is often the rule rather than the exception. The following strategies may be helpful as you navigate your food intake:

Holiday celebrations often include beverages with alcohol. If you choose to drink do so in moderationgenerally considered no more than two drinks per day for men and one per day for women. Lighten up with lite beer, a wine spritzer, or calorie-free mixers. Avoid those specialty drinks such as Egg Nog (300+ calories), White Russian (4.5 ounces, 170+ calories), and 12 ounces of Christmas Ale (7.5% alcohol, 200+ calories) can be calorie-laden. Track your alcohol intake and avoid drinking on an empty stomach. If you become less attentive you will likely relax your focus on your overall calorie intake of food. Dont drink and drive.

Remember you can always counterbalance those extra holiday calories by staying active. Walk some extra steps after you eat, participate in interactive games or dance to your favorite music.

Stay informed by monitoring your blood glucose to help you make better decisions. Tomorrow is another day, so if things dont go as planned, learn from your experience and determine what you might do differently next time.

Above all, be safe and stay healthy. And, in the year of the 2020 pandemic do yourself and others a favor by staying socially distant, washing your hands, and wearing your mask. We all win.

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Diabetes and Healthful Holiday Strategies | UKNow - UKNow

By Tom McLaughlin

Successful diabetes management may soon begin closer to home with the help of easily accessible, online interactive learning thanks to a new Rutgers UniversityCamden research project.

The research project teaches family members communication strategies to help their loved ones manage Type 2 diabetes successfully.

The innovative Family Members as Coaches for Patients with Type 2 Diabetes pilot project, funded by the New Jersey Health Foundation, teaches people with Type 2 diabetes and their family members a host of effective communication strategies in order to help their loved ones manage the disease successfully.

Most diabetes management occurs in the home and with the help and sometimes hindrance of family members, says Kristin August, associate professor of psychology and director of the Health Sciences Center at RutgersCamden. Consequently, our focus is on figuring out if family members can be versed in more positive forms of communication that will ultimately lead to better diabetes management and improved family functioning.

The research project partners RutgersCamden with Cooper University Health Care, Jefferson Health, and Virtua Health to bring together small groups of dyads pairs comprised of a person with Type 2 diabetes and a family member for four monthly, virtual sessions. The participants learn communication strategies such as active listening and providing positive feedback, among others. The patients behaviors and attitudes are assessed via surveys and focus groups at the beginning of the intervention, immediately following it, and three months later.

August notes that most diabetes management occurs in the home and with the help and sometimes hindrance of family members.

Diabetes education helps patients gain the tools necessary to manage their diabetes successfully, says August, who leads the project with Kathleen Jackson, a clinical assistant professor in the Rutgers School of NursingCamden. Coaching, which involves a structured, supportive relationship, helps them to become more confident and motivated in their abilities to follow their regimen. We posit that the most effective coaches can be patients family members.

The first cohort of 11 dyads attended the monthly meetings from October 2019 through March 2020, when the COVID-19 pandemic brought the sessions, data collection, and recruitment to a standstill. The researchers then adapted the project to implement virtual sessions, which began this November.

According to August, they spent several months figuring out the logistics of hosting the group sessions, breakout rooms, and one-on-one conversations. They also modified visual aids to present the information on a computer, and utilized an existing, online version of their assessment survey.

The RutgersCamden researchers further taught participants how to use the software and to minimize distractions in their home environment. Erika Pitzer, a senior health sciences major and one of four RutgersCamden undergraduate students assisting August on the project notes that the dyads and the diabetes educator are still in the same virtual room together and are thus still able to build a solid rapport.

Kathleen Jackson, a clinical assistant professor in the Rutgers School of NursingCamden, leads the project with August.

I was actually surprised at how well they all adapted to the online platform, says the Cumberland County resident. The participants were all talking and asking questions of one another, and not just the facilitator.

August says that Pitzer and her fellow RutgersCamden students have been particularly vital to the virtual implementation of the project. In addition to their regular responsibilities conducting literature reviews, taking notes on the sessions, transcribing what was said, and offering their own perspectives of what transpired the students have been busy recruiting patients since the in-person diabetes education classes were canceled. That includes developing a project Facebook page, creating a recruitment video, and personally reaching out to prospective participants and other diabetes programs across the state.

In the long run, we may be able to reach even more people with this virtual implementation of the program, says August. This is particularly important during the COVID-19 pandemic. People with diabetes have a higher risk for severe illness, so managing their condition right now is more important than ever.

As it turns out, the RutgersCamden students are learning invaluable life skills as well. Pitzer notes that the switch to remote learning and a virtual implementation of the research project has required her to strengthen her focus, organizational skills, and overall resilience.

Erika Pitzer, a senior health sciences major, is one of four RutgersCamden undergraduate students assisting researchers on the project.

Its a challenge, but I am better because of this course, she says. As a student, that will translate to the rest of my courses and even my future career in medicine.

She credits August, as well as RutgersCamdens supportive academic environment including her advisors in the Honors College for making the transition to remote instruction easy for students.

I have never felt alone in that transition, she says. I am constantly reminded of the resources available on campus and my Honors College advisors are always there to answer even the silliest, smallest questions. There is always constant communication.

The RutgersCamden researchers will report findings on the diabetes family coaching project next November. However, preliminary survey data show that patients feel empowered to have a person available to help coach them through their diabetes management. Moreover, the patients felt that the positive communication strategies were beneficial to their personal relationships in general.

Funded by a Rutgers Community Design for Health and Wellness award, the researchers further plan to host focus groups with primary-care offices in spring 2021 to assess the ability to introduce the program in those settings, as part of a larger-scale implementation of this project. The long-term goal, says August, is to supplement diabetes education more generally with coaching and a package of informational materials for diabetes programs as well as public health programs to use.

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Innovative Research Project Teaches Families How to Manage Type 2 Diabetes Together - Rutgers-Camden NewsNow

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Peripheral Neuropathy Tied to Mortality in Adults Without Diabetes - Medscape

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Cancer cells are relentless, possessing the vexatious ability to develop resistance to current therapies and making the disease hugely challenging to treat. However, an exciting new study may have identified cancers weak spot; the discovery has already led to the near-eradication of the disease in cell cultures.

The study which was recently published in the journal Nature Biomedical Engineering reveals how altering the structure of chromatin in cancer cells could make them easier to destroy.

In the cell nucleus, DNA is wrapped around proteins called histones. Together they form chromatin.

Chromatins job is to package the genetic code neatly into the cells nucleus. Chromatin can also regulate which genes are switched on and off. In cancer cells, however, chromatin helps them to evolve and adapt to cancer therapies, thereby allowing them to survive.

If you think of genetics as hardware, explains study co-author Vadim Backman, of the McCormick School of Engineering at Northwestern University in Evanston, IL, then chromatin is the software.

Complex diseases such as cancer, he adds, do not depend on the behavior of individual genes, but on the complex interplay among tens of thousands of genes.

So, Backman and his colleagues set their sights on chromatin as the key to combating cancer drug resistance, and an imaging technique they developed last year helped them to learn more about this intricate set of macromolecules.

The new technique is called Partial Wave Spectroscopic (PWS) microscopy, and it enables real-time monitoring of chromatin in living cells.

Additionally, the researchers explain that PWS allows them to assess chromatin at a length scale of 20200 nanometers, which they say is the precise point at which cancer formation influences chromatin.

They used PWS to monitor chromatin in cultured cancer cells. They found that chromatin has a specific packing density associated with gene expression that helps cancer cells to evade treatments.

The analysis revealed that a more heterogeneous and disordered chromatin packing density was related to greater cancer cell survival in response to chemotherapy. A more conservative and ordered packing density, however, was linked to greater cancer cell death in response to chemotherapy.

Just by looking at the cells chromatin structure, we could predict whether or not it would survive, says Backman. Cells with normal chromatin structures die because they cant respond; they cant explore their genome in search of resistance. They cant develop resistance.

Based on their discovery, the researchers hypothesized that altering the structure of chromatin to make it more orderly could be one way of boosting cancer cells vulnerability to treatment.

On further investigation, the team found that they could modify chromatins structure by altering electrolytes in the nucleus of cancer cells.

The team tested this strategy using two drugs that are already approved by the Food and Drug Administration (FDA): Celecoxib and Digoxin.

Celecoxib is currently used for pain relief, while Digoxin is used to treat atrial fibrillation and heart failure. Both drugs, however, are also able to change the packing density of chromatin.

The researchers combined these drugs which they refer to as chromatin protection therapeutics (CPTs) with chemotherapy and tested them on cancer cells in the laboratory. According to Backman, they witnessed something remarkable.

Within 2 or 3 days, nearly every single cancer cell died because they could not respond. The CPT compounds dont kill the cells; they restructure the chromatin. If you block the cells ability to evolve and to adapt, thats their Achilles heel.

Vadim Backman

While the researchers are excited by their findings, they caution that animal and human studies are needed before any firm conclusions can be made.

There is a big difference between cell cultures and humans, says Backman. You never know how the environment inside the human body will affect cancers behavior or if there will be unforeseen side effects.

That said, the researchers note that they have replicated their findings in seven different cancer types so far, which Backman says is very promising.

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Cancer cells destroyed in just 3 days with new technique

Ridding the world of Covid-19 is a lucrative enterprise.

As analysts divvy up the multibillion-dollar rewards in line for the leaders in the race to roll out the first pandemic vaccines, no one is forgetting to track just how much the top company founders have on the line now as stock prices gyrate ever higher.

Bloomberg, which tracks these numbers with missionary zeal, puts Sahins net worth today at $5.1 billion following the most recent rise of BioNTechs $BNTX share price. The biotechs partner, Pfizer, is aggressively pushing ahead with plans to get the first approved vaccine in play, and Bernstein believes that will put the two collaborators in line for the largest market share for next year.

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#ASH20: Orca's team showcases their first cut of the data on promising cell purification work for HSCT - Endpoints News

Results from a study using cutting-edge genome editing for hard-to-treat blood disorders were presented at the 62nd American Society of Hematology (ASH) Annual, Meeting and Exposition held virtually from December 5 8, 2020.

The researchers reported promising interim safety and efficacy data from 10 patients who received an investigational gene-editing based therapy, CTX001, the first to test a CRISPR-Cas9 gene-editing therapy in humans for a genetic disease.

Sickle cell disease affects approximately 100,000 people in the United States. And globally, approximately 400,000 infants are born each year with sickle cell disease. [3][4]

Recognized for its abnormally shaped red cells, sickle cell disease can cause a variety of health problems, including hemolytic anemia, episodes of severe pain, called vaso-occlusive crises, as well as progressive and irreversible organ damage, and strokes, leading to a decreased health-related quality of life (hrQoL), and early death.[5]

Standard of of careToday, the standard curative treatment for sickle cell disease is allogeneic hematopoietic stem-cell transplantation. If matched with a sibling donor, transplantation is known to be curative in more than 90% of patients. This approach is approach has limitations including a higher risk of complications in older patients, a risk of severe graft-versus-host disease (GVHD), and lack of an available matched sibling in approximately 80% of cases.[6][7]

Patients with transfusion-dependent thalassemia are dependent on blood transfusions from early childhood. The only available cure for both diseases is a bone marrow transplant from a closely related donor, an option that is not available for the vast majority of patients because of difficulty locating matched donors, the cost, and the risk of complications.

In the studies, the researchers goal is to functionally cure the blood disorders using CRISPR/Cas9 gene-editing by increasing the production of fetal hemoglobin, which produces normal, healthy red blood cells as opposed to the misshapen cells produced by faulty hemoglobin in the bodies of individuals with the disorders.

The clinical trials involve collecting stem cells from patients. Researchers edit the stem cells using CRISPR-Cas9 and infuse the gene-modified cells into the patients. Patients remain in the hospital for approximately one month following the infusion.

Prior to receiving their modified cells, the seven patients with beta-thalassemia required blood transfusions approximately every three to four weeks and the three patients with sickle cell disease suffered episodes of severe pain roughly every other month. All the individuals with beta-thalassemia have been transfusion independent since receiving the treatment, a period ranging between two and 18 months. Similarly, none of the individuals with SCD have experienced vaso-occlusive crises since CTX001 infusion. All patients showed a substantial and sustained increase in the production of fetal hemoglobin.

SafteyResearchers report that the safety of CTX001 infusion was generally consistent with the chemotherapy regimen received prior to cell infusion. Four serious adverse events related or possibly related to CTX001 were reported in one patient with thalassemia: headache, haemophagocytic lymphohistiocytosis (HLH), acute respiratory distress syndrome, and idiopathic pneumonia syndrome.

The patients have now recovered.

Unmet medical needThere is a great need to find new therapies for beta-thalassemia and sickle cell disease, said Haydar Frangoul, MD, Medical Director of Pediatric Hematology and Oncology at Sarah Cannon Research Institute, HCA Healthcares TriStar Centennial Medical Center.

What we have been able to do through this study is a tremendous achievement. By gene editing the patients own stem cells, we may have the potential to make this therapy an option for many patients facing these blood diseases, Frangoul concluded.

Because of the precise way CRISPR-Cas9 gene editing works, Frangoul suggested the technique could potentially cure or ameliorate a variety of diseases that have genetic origins.

Given that the only Food and Drug Administration (FDA) -approved cure for sickle cell disease, a bone marrow transplant, is not widely accessible, having another curative option would be life-changing for a large number of the sickle cell disease population, noted Catherine Bollard, MD, of Childrens National Research Institute and George Washington University.

While longer follow-up data are needed, this study is extremely exciting for the field, she added.

The trial was sponsored by CRISPR Therapeutics and Vertex Pharmaceuticals.

Abstract[1] Frangoul H, Bobruff Y, Cappellini MD, Corbacioglu S, Fernandez CM, De la Fuente J, Grupp SA, Handgretinger R, et al, Safety and Efficacy of CTX001 in Patients with Transfusion-Dependent - Thalassemia and Sickle Cell Disease: Early Results from the Climb THAL-111 and Climb SCD-121 Studies of Autologous CRISPR-CAS9Modified CD34+ Hematopoietic Stem and Progenitor Cells (Abstract #4)

Reference[2] Frangoul H, Altshuler D, Cappellini MD, Chen YS, Domm J, Eustace BK, Foell J, De la Fuente J, Grupp S, et al. CRISPR-Cas9 Gene Editing for Sickle Cell Disease and -ThalassemiaH. N Engl J Med. 2020 Dec 5; DOI: 10.1056/NEJMoa2031054[3] Heeney MM, Ware RE. Hydroxyurea for children with sickle cell disease. Hematol Oncol Clin North Am 2010;24:199-214.2.[4] Piel FB, Patil AP, Howes RE, et al. Global epidemiology of sickle haemoglobin in neonates: a contemporary geostatistical model-based map and population estimates. Lancet 2013; 381: 142-51[5] Esrick EB, Lehmann LE, Biffi A, Achebe M, Brendel C, Ciuculescu MF, Daley H, et al. Post-Transcriptional Genetic Silencing of BCL11A to Treat Sickle Cell Disease. N Engl J Med. 2020 Dec 5; DOI: 10.1056/NEJMoa2029392[6] Gluckman E, Cappelli B, Bernaudin F, et al. Sickle cell disease: an international survey of results of HLA-identical sibling hematopoietic stem cell transplantation. Blood 2017; 129: 1548-56.4.[7] Bernaudin F, Dalle J-H, Bories D, et al. Long-term event-free survival, chimerism and fertility outcomes in 234 patients with sickle-cell anemia younger than 30 years after myeloablative conditioning and matched-sibling transplantation in France. Haematologica 2020; 105: 91-101.

Featured image: The ASH Store at the American Society of Hematology 61th Annual Meeting at the Orange County Convention Center. Photo courtesy 2019. ASH/Scott Morgan. Used with permission.

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ASH 2020: Results from a Study of Inherited Blood Disorders Treated with CRISPR/Cas9 - OncoZine

Hematologic malignancy was associated with more severe symptoms and death from coronavirus disease 2019 (COVID-19), likely due to immunosuppression attributable to the hematologic disease, according to results of a retrospective study presented at the virtual 62nd American Society of Hematology (ASH) Annual Meeting and Exposition.

The worse disease evolution should be taken into account for a population that is highly exposed to SARS-CoV-2 contagion due to [a] high number of hospital visits for treatment, Cristina De Ramn, of the Hospital Universitario de Salamanca in Spain, and presenter of the study, said.

Prior studies have suggested that hematologic disease is associated with higher COVID-19 mortality rates than the general population, but the data so far are limited. The aim of this study, called ECOVIDEHE, was to assess the effect of hematologic disease and its associated treatment with the outcomes of COVID-19.

The multicenter, retrospective observational study evaluated data from 543 patients with hematologic disease who developed COVID-19 between March and June 2020. Samples and data were collected at the time of assistance in the emergency department or hospital admission.

At baseline, the median age of patients was 70 years, 57% of patients were male, and 76% had at least 1 comorbidity. There were 65% of patients in the cohort with a lymphoid malignancy, of which, 53.6% were on active anticancer treatment. SARS-CoV-2 infection was confirmed with a positive nasopharyngeal swab or serologic testing among 94% of patients, and 15% were nosocomial.

There were 89% of patients who required hospital admission, including 6.3% who were admitted to intensive care units (ICU). Overall, 65% of patients were considered to have severe COVID-19. The most common symptoms were fever, cough, dyspnea, and pneumonia.

Overall, the mortality rate was 36.3%. Patients with acute myeloid leukemia (AML) or myelodysplastic syndrome (MDS; 49%) were significantly more likely to die from COVID-19 than patients with other hematologic malignancies (34%) or other hemopathies (29%; P <.001). Patients with active or progressive disease were also more likely to die from COVID-19 (51%) compared with patients in complete remission (21%) or those with partial remission or stable disease (37%: P =.018).

Patients who had undergone an allogeneic (22%) or autologous hematopoietic stem cell transplant (20%) experienced improved survival compared with patients who had not undergone transplant (39%; P <.01). Ms De Ramn said that these findings may be because the patients who underwent transplant were younger and many were in complete remission.

In addition, mortality was associated with higher Charlson Comorbidity Index and Eastern Cooperative Oncology Group performance status. Mortality was also associated with low lymphocyte or platelet counts, as well as high lactate dehydrogenase, C-reactive protein, procalcitonin, and D-dimer levels. A multivariate analysis confirmed these findings, and also found that being older than 70 years was associated with mortality.

Most treatments for COVID-19 did not improve survival outcomes, except corticosteroids. Ms De Ramn suggested that this may be because the treatments were preferentially administered to patients with more severe disease.

Ms De Ramn concluded that SARS-CoV-2 infection causes more severe disease and higher mortality rates in hematological patients, especially those with AML/MDS or active or progressive disease.

Read more of Cancer Therapy Advisors coverage of the ASH 2020 meeting by visiting the conference page.

Reference

De Ramn C, Hernandez-Rivas JA, Garca JAR, et al. Impact of Sars-CoV2 infection on 491 hematological patients: the Ecovidehe Multicenter Study. Presented at: 62nd American Society of Hematology (ASH) Annual Meeting and Exposition; December 5-9, 2020. Abstract 312.

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Poor COVID-19 Outcomes Among Patients With Hematologic Malignancies: Results From ECOVIDEHE - Cancer Therapy Advisor

Ridding the world of Covid-19 is a lucrative enterprise.

As analysts divvy up the multibillion-dollar rewards in line for the leaders in the race to roll out the first pandemic vaccines, no one is forgetting to track just how much the top company founders have on the line now as stock prices gyrate ever higher.

Bloomberg, which tracks these numbers with missionary zeal, puts Sahins net worth today at $5.1 billion following the most recent rise of BioNTechs $BNTX share price. The biotechs partner, Pfizer, is aggressively pushing ahead with plans to get the first approved vaccine in play, and Bernstein believes that will put the two collaborators in line for the largest market share for next year.

Unlock this story instantly and join 94,800+ biopharma pros reading Endpoints daily and it's free.

SUBSCRIBE SIGN IN

Read the original post:
Backed by a $200M investment from a Korean conglomerate, Vivek Ramaswamy has quietly built a 'mother ship' for vant creation with a whole new...

Updated data for a second anti-BCMA therapy, idecabtagene vicleucel (ide-cel) from Bristol Myers Squibb/bluebird bio, will be presented, including health-related quality of life results from the KarMMA study in patients with heavily pretreated R/R multiple myeloma. FDA has assigned a March 27, 2021, target date for action on this therapy.

Also anticipated are results from the APOLLO study in relapsed multiple myeloma, which will show that adding daratumumab and hyaluronidase-finj, called Darzalex Faspro by Janssen, to pomalidomide and dexamethasone reduces the risk of disease progression or death by 37% compared with pomalidomide and dexamethasone alone.

Notably, this phase 3 study involves subcutaneous administration of daratumumab, which offers significantly reduced treatment time and burden for patients. Janssen has submitted results from APOLLO to FDA and the European regulators.

The subcutaneous formulation of daratumumab offers patients and physicians a 3- to 5-minute administration experience and the potential to reduce systemic administration-related reactions compared to intravenous administration of daratumumab, said Meletios A. Dimopoulos, MD, professor and chairman of the Department of Clinical Therapeutics at the National and Kapodistrian University of Athens School of Medicine, Athens, Greece, who is the studys principal investigator.

The REACH3 study, a phase 3 randomized study of ruxolitinib (Jakavi) vs best-available-therapy, will have important implications in chronic graft-vs-host-disease (GvHD). This condition occurs when new T cells from a stem cell transplant identify the patients cells as foreign and attack them, creating reactions from rashes to gastrointestinal issues to harm to the liver.

Results involving transplant in myelodysplatic syndromes (MDS) could have important implications for reimbursement. Corey Cutler, MD, MPH, FRCPC, of Dana-Farber Cancer Institute will present results that show transplantation of hematopoietic stem cells from compatible donors nearly doubled the survival rate of patients aged 50 to 75 years.

Even though transplant is frequently used in younger patients, it has not been widely used among older patients. Lack of Medicare coverage is a major barrier, Cutler explained. This study adds to a growing body of evidence that suggests its time to revisit the reimbursement question.

Asked his thoughts on whether CMS might change its policy, Cutler said, I cant speak for the agency, but I will tell you there are several studies that do suggest it should be covered.We are, of course, reaching out to CMS.

Fridays press briefing ahead of the opening of ASH highlighted the results for MDS and daratumumab and others that are expected to be practice changing. To know that older patients do well with transplant is a really important message, said Lisa Hicks, MD, MSc, a hematologist from St. Michaels Hospital in Canada, who moderated the briefing.

Ian Flinn, MD, of Tennessee Oncology, who is an author on several studies being presented at ASH involving venetoclax (Venclexta) and Brutons tyrosine kinase (BTK) inhibitors in chronic lymphocytic leukemia, said he was interested to see the results of the CAPTIVATE trial.

He said that right now, venetoclax is a fixed-duration therapy. Now, we need to figure out whether thats a good idea or not, Flinn said. CAPTIVATE will help clinicians understand whether they should keep patients on venetoclax plus ibrutinib after they have reached the point of minimal residual disease.

The ASH meeting will also highlight research examining disparities in care, as well as the effects of COVID-19 on outcomes. On Saturday, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), will discuss the latest information on COVID-19 and its impact on hematologic conditions in a fireside chat with ASH President Stephanie J. Lee, MD, MPH.

This week, President-elect Joe Biden announced that Fauci will be a chief medical adviser, in addition to retaining his longtime role at NIAID during the new administration.

Maggie L. Shaw contributed to this report.

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ASH Goes Remote as CAR T-Cell Therapy Competition Heats Up - AJMC.com Managed Markets Network

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

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

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

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

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

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

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

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

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

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

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

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Vanderbilt doctors urge priority COVID-19 vaccination for Diabetic patients - WBIR.com

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

2. Remember to always take your medications as ordered.

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

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

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

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

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

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

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

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

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

How FreeStyle Libre 2 Works

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

SOURCE Abbott

http://www.abbott.com

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

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

Written by Ambrish Mithal

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

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

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

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

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

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

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

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

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The diabetes nurse in Covid times - The Indian Express

Global Chiropody & Podiatry Market: Snapshot

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

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

The study performs segmentation of the global chiropody & podiatry market based on many important parameters such as type, application, and region. Based on application, the market for chiropody & podiatry is classified into hospitals, clinics, and others.

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Global Chiropody & Podiatry Market: Growth Dynamics

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

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

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Global Chiropody & Podiatry Market: Competitive Analysis

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

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

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

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Global Chiropody & Podiatry Market: Regional Assessment

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Symptoms of type 2 diabetes include:

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

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

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