StemCell Therapy

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The Diamond Princess cruise ship (shown docked in Yokohama, Japan, on February 10) was quarantined in the city after passengers tested positive for coronavirus.

When passengers booked their vacations on the ill-fated Diamond Princess, they were likely looking forward to hanging out in a hot tub, not a hot zone. Now most of them are quarantined off the coast of Japan, hoping to avoid testing positive for the 2019 novel coronavirus, which has already infected more than 200 people on the cruise ship.

Health officials in protective gear removed suitcases from the Diamond Princess cruise ship in Yokohama, Japan. Its believed they belonged to passengers evacuated and taken to hospitals after testing positive for coronavirus.

The fact that the largest outbreak of COVID-19 outside of mainland China is happening on a cruise cant be reassuring to travelers who are already skittish about health issues on boat-based trips, which are well known incubators of gastrointestinal illnesses. The Center for Disease Control and Prevention (CDC) offers a helpful database of cases, broken down by year.

The vast majority of cruises dont experience any problems. But confined spaces mean that even one sick person can create a serious situation, explains Tullia Marcolongo, executive director of the nonprofit International Association for Medical Assistance to Travelers. Its the domino effect, and you have nowhere to go, she says.

Cruise companies work to minimize the risk of illness by maintaining cleanliness and monitoring health on board their ships. In response to the coronavirus outbreak, Carnivalthe parent company of Princess Cruiseshas introduced expanded protocols, including enhanced onboard sanitation measures with non-toxic materials and pre-boarding medical evaluations, as needed. On its website, Royal Caribbean Cruises touts its health and safety program, such as internal and external inspections, frequent water systems testing, and strict food handling rules.

Passengers can do their part, too. The first thing I would say is that the power is in your hands, Marcolongo says. She means that literally. Frequent hand washing can be a critical preventative measure for norovirus, colds, and other yucky things circulating on a ship. To make sure you scrub long enough, sing Happy Birthday twice, she suggests, and dont miss the spots between your fingers. If theres no soap and water nearby, use an alcohol-based hand sanitizer. Many ships make sanitizer stands readily available to passengers, Marcolongo adds.

David Parenti, director of the George Washington University Travelers Clinic and professor of medicine at the George Washington University School of Medicine and Health Sciences, advises being aware of when youve held handrails and touched other surfaces. Until you can wash your hands, dont stick them in your eyes or mouth.

Unfortunately, Parenti says, there are lots of other ways to get sick, both on ship and on land. It all has to do with luck. If youre on a ship with norovirus, thats bad luck. If you are on a cruise ship, you will need to eat. Those risks are something you dont have a lot of control over, he says.

This is where you should sit on the plane to avoid getting sick.

To be proactive, travelers can set up a pre-vacation doctors appointment to make sure their immunizations are up to date. Depending on your destination, that flu shot might be important even if youre taking off in the middle of the summer. Keep in mind that the U.S. influenza season is the opposite of the Southern Hemisphere, Parenti notes. He recommends getting the vaccine for Hepatitis A and checking on your immunity to measles; you could possibly use another shot. (A measles case was responsible for a different cruise quarantine in May 2019.)

Because of the limited number of medications on board, its smart to pack whatever you think you might need, Marcolongo adds. That includes first-aid basics as well as some standard over-the-counter supplies, which for gastrointestinal issues include Loperamide (Immodium) and oral rehydration salts.

Miami-based attorney Jack Hickey once represented cruise companiesand now sues them over personal injury claims. His advice? What I tell people is get trip insurance and make sure it covers an air ambulance. Travelers who experience emergencies and need to pay for transportation will be in for some serious sticker shock otherwise.

Be realistic about what kind of care you can actually expect on board a ship. If you get sick or injured, get back to the U.S. as quickly as possible, Hickey advises. Although cruises undoubtably excel at hospitality, he says, they tend to be lacking when it comes to medical care. Its not a hospital, but a ship carrying 3,000 to 6,000 people and going to isolated areas of the world, says Hickey, who thinks there typically arent enough doctors and staff to handle a heavy workload, and that the facilities arent adequately equipped. Almost uniformly, they have X-ray machines. But [ships] do not have good machines or people who know how to read films well, he says.

The coronavirus quarantinewhich is keeping people cooped up in tight cabins for weeksis a reminder that mental health problems could also arise, especially for anyone with issues around anxiety or claustrophobia. Travel insurance doesnt necessarily cover that, Marcolongo notes.

Learn how the coronavirus compares to Ebola, flu, and other outbreaks.

As scientists learn more about the virus and how its transmitted, there may be more scrutiny of ventilation systems on cruise ships, Parenti adds. In a hospital, its possible to put a patient in a respiratory isolation room with frequent air exchanges.

Thats not an option for most cruise accommodations. The next best choice, according to Parenti? I would take a window, personally. At least you could open it and get a breeze that way.

Vicky Hallett is a Florence, Italy-based health and travel writer. Follow her on Instagram.

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Nearly 400 livestock farmers from around Wales have joined a scheme designed to help them improve their animals health and boost their production.

The 395 beef and sheep farmers have signed up to a pro-active animal health planning project called Stoc+, which is promoted by Hybu Cig Cymru Meat Promotion Wales (HCC).

Stoc+ forms one part of HCCs three-strand, Welsh Government and European Union-funded Red Meat Development Programme (RMDP).

During the course of the five-year project, HCC will bring together up to 500 commercial sheep and beef producers across Wales and encourage them to adopt a prevention is better than cure approach to animal health.

Each participating farmer will receive practical, expert advice and specialist support for up to three years. In addition, all farmers will benefit from a tailor-made Flock and Herd Health Plan and Action Plan to work towards various targets set by their local veterinary practitioner.

As part of the project, the team have identified a small number of ambassadors who include farmers and veterinary practitioners. The ambassadors role includes encouraging their peers to get involved and demonstrating the practical benefits of proactive health planning in terms of animal health and farm profitability.

Jonathan Lewis from Llandrindod Wells is one of the ambassadors. Mr Lewiss upland farm has 80 Simmental, Limousin and Stabiliser cows and 1,680 Lleyn, Mules and Welsh Mountain sheep and lambs.

He said:

There were many reasons behind joining the project. I wanted to improve the overall health of my flock as well as increase the number of lambs that I sold whilst reducing the number of days to slaughter. During the course of the project, I would also like to reduce the antibiotics used on the farm and be advised on how to improve biosecurity.

Claire Jones of Dolgellau Vets is a vet ambassador for the project, and as a vet and farmers wife has a passion for preventative medicine and herd and flock health work.

Claire said:

Health planning is something that I feel should be an integral part of all farm management, as it improves the efficiency of the farm and health of the animals and also helps to improve the vet and farmer communication and relationship.

Stoc+ is supported by the Welsh Government Rural Communities Rural Development Programme 2014 2020, which is funded by the European Agricultural Fund for Rural Development and the Welsh Government.

For more information on the project and to meet other project ambassadors visit the HCC website.https://meatpromotion.wales/en/industry-projects/red-meat-development-programme

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Farmers Join Scheme to Boost Their Animals' Health - Business News Wales

By GILLIAN SLADE on February 15, 2020.

gslade@medicinehatnews.com

The Alberta Association of Optometrists says Alberta Health is asking for a 22 per cent reduction in fees for eye care for seniors and children.

In late December, the AAO received this communication from the government, said president Dr. Troy Brady.

We do feel that their proposals will result in poor eye health care for Albertans and greater overall cost to the system, said Brady, noting that a lack of preventative eye care will mean more people seeking attention in emergency rooms or needing a referral to a specialist. This would result in higher overall health-care expenses.

Alberta Health would not provide an interview to the News but submitted an emailed statement in response to questions.

Alberta has the highest per-capita spending in Canada, almost twice as high as Ontario, B.C. or Nova Scotia. This isnt sustainable, said Steve Buick, spokesperson for Alberta Health.

Brady says a comparison of fees with other provinces is not as simple as that.

In comparing rates Alberta Health has used some of the oldest and lowest fees to inform their request, said Brady. They found rates from other provinces that have not been updated for 15 years.

Brady says in some cases there are increases that are not reflected yet but will likely show up later in the year.

The AAO has had only two increases in fees in the past six years, and each of those was for one per cent, said Brady.

It does not begin to cover cost-of-living increases or inflation.

Alberta Health pays optometrists $56.32 for one complete eye exam every year for a child up to age 18. The fee for a senior, who also qualifies for one complete eye exam annually, is $80.70.

Alberta Health is suggesting the seniors exam should be reduced to $56.32, the same rate paid for a child.

The Alberta Association of Optometrists says there are complexities to an eye exam for a senior that do not exist with a child. Brady says seniors have more complicated eye conditions including other health conditions that can affect eye health.

They take more time. It takes longer to explain whats happening with their eyes and they often have multiple problems that we need to discuss, said Brady.

Alberta Health requested a reduction in optometrist fees and services totalling about $22 million, which equates to a 22.8 per cent cut to the estimated $96.5 million budget.

Brady says the AAO has submitted a counter proposal to Alberta Health that it believes will fairly compensate optometrists plus continue to ensure high quality and timely eye health care.

Depending on the outcome, there is the potential for patients affected to have to pay an additional fee for services.

They will then have to choose between paying this extra cost or asking to be referred to a specialist, a higher paid provider, said Brady.

Other changes suggested by Alberta Health include reducing the fee for computer-assisted visual fields and to delist completely retinal photography and retinal imaging.

The AAO had counter-proposed a 3.2 per cent reduction to fees over two years, which would allow Alberta Health to save about $8 million over the next three years.

Buick points out that no final decisions have been made by the government yet.

The AAO says many common eye diseases have no early signs or symptoms, which is why regular eye exams are recommended. Three quarters of vision loss and blindness can be prevented with early intervention.

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Dental caries occur when the acid from plaque erodes the tooth enamel and forms cavities. Caries is a common dental disease, prevalent in both developed and developing countries, affecting every stratum and age group of the society. The FISABIO Foundation discovered a new bacterial species named Streptococcus dentisani, which acts as a shield against caries-causing bacteria, producing a substance that inhibits them and prevents caries. Streptococcus dentisani bacteria is used as a preventive probiotic product to improve oral health in the food and cosmetic industries (mouthwash, toothpaste). Probiotic solutions are expected to be a groundbreaking approach toward anticaries treatment as these solutions have the potential to improve health and reduce health care expenditure. Anticaries treatment is considered an attractive concept for next-generation anticavity therapy, as it has the potential to prevent tooth replacement or other dental surgical replacements required due to cavity formation. The use and availability of different types of anticaries treatments have evolved over the past century; however, further research is ongoing in order to develop its more clinical applications and reduce the adverse effects associated with the use of anticaries treatments.

A major factor driving the anticaries treatments market is the high incidence of dental problems globally. Rise in incidence of periodontics among young adults and increase in demand for stem cell anticaries treatment techniques, especially among the geriatric population, are the other factors anticipated to drive the anticaries treatments market during the forecast period. Favorable price of anticaries products and emergence of new technologies using an anticaries product as a functional food, mouthwash, toothpaste, chewing gum, etc. are expected to propel the global anticaries treatments market. According to the World Health Organization, complete loss of teeth affects approximately 30% of the geriatric population in the age group of 65-74 years. However, prevalence rates of anticaries are increasing in low and middle income countries. Factors, such as, preference for endodontic treatment over anticaries treatment in major dental surgeries and local inflammatory activity which results in chronic complications and dental replacements are projected to restrain the growth of the anticaries treatments market during the forecast period.

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The global anticaries treatments market can be segmented on the basis of product type, end-user, and region. In terms of product type, the anticaries treatments market can be categorized into topical solution, gel-based, foam-based, toothpaste, and others. The gel-based segment accounted for a prominent share of the global anticaries treatments market in 2017, due to increasing prevalence of dental surgery and rising demand for cosmetic surgery, especially in the emerging economies, such as, China, Brazil, and India. In terms of end-user, the anticaries treatments market can be divided into cosmetic industry, home care, dental clinics, and others.

In terms of region, the global anticaries treatments market can be segmented into North America, Europe, Asia Pacific, Latin America, and Middle East & Africa. North America is projected to dominate the global anticaries treatments market during the forecast period due to increasing dental services and stem cell research in the region. According to the Dental Health Services, in 2015, total expenditure on dental services in Canada amounted to US$ 13.6 Bn. Expenditure of the private sector was estimated at US$ 12.7 Bn, while that of the public sector at US$ 846 Mn. In April 2017, Unilever launched an in-clinic remineralisation regime to regenerate professionally advanced enamel serum. The Unilever brand claimed 82% of the enamel mineral regenerated after 3 days. Furthermore, increasing prevalence of dental cavities and periodontics, especially in the developing countries, such as, China and India has boosted the demand for dental surgery. According to the World Health Organization, nearly 60% to 90% of school children and nearly 100% of adults have dental cavities. The incidence of dental surgery, general prosthetic fixation, periodontal inflammation, and other dental diseases is increasing in Asia Pacific. This, in turn, is anticipated to fuel the demand for cost-effective aesthetic and dental surgeries. These factors are projected to drive the anticaries treatments market in Asia Pacific between 2018 and 2026.

Key players operating in the global anticaries treatments market include Unilever, Ocata Therapeutics, ICPA Health, GlaxoSmithKline plc, and Church & Dwight, Inc.

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The report provides the following information: Tailwinds and headwinds molding the market trajectory Market segments based on products, technology, and applications Prospects of each segment Overall current and possible future size of the market Growth pace of the market Competitive landscape and key players strategies

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Anticaries Treatments Market to Witness a Healthy Y-o-Y Growth during 2018 2026 - Jewish Life News

Reports from theFood and Agricultural Organization of the United Nations,World Health Organization, andothers emphasize the critical role of plant-based diets in creating a sustainable food future for all. Plant-based diets are also key for human nutrition, highlighted in diet guidelines the world over includingUS,Canada, andBrazil. Yet livestock remains essential to aroundone billionof the worlds indigent and theglobal demand for meat and dairy is expected toincrease by 70% by 2050.

Meat production and consumption habits must shift, and solutions are sorely needed to feed the appetite for meat in the US and abroad.

Enter plant-based burgers, which exploded onto the food scene in the 2010s. While eaters love them, questions followed: Are they healthier? More sustainable? And are they even real food?

Opinions are heated, but what does the science show?

A Brave New Burger thats Just Plain Better

Forget bland veggies burgers of yore that only appealed to die-hard vegetarians. Todays food technology methods have brought consumers a beefy patty that sizzlesand theyre a game-changer.

Beyond MeatandImpossible Foodslead the plant-based burger market, and are quite similarin nutrient content and ingredients. A key difference is the use of genetic engineering, used in Impossible to create its umami punch from soy leghemoglobin. Not surprisingly,Impossible eaters care not at all about the tech that made it tastynor should they, given the copious evidence of its safety. (Beyond, conversely, boasts theyre non-GMO.) Major food companies also offer their own plant-based burgers using a variety of techniques and ingredients, now available in supermarkets alongside Beyond and Impossible.

Critics questioned wondered whether plant-based burgers would take off; the marketplace already offers myriad vegetarian choices, after all. Yet contemporary consumersare increasingly seeking ecoconscious options that supplant meat, while delivering the pleasure of eating meatat least, some of the time. Ninety percent of plant-based meat and dairy consumers are omnivores, in fact, and Beyond reports that more than 70 percent of its consumers are meat-eaters seeking a more sustainable option. Importantly, Beyond and Impossible burgers are found on restaurant andfast foodmenus, a good thing since49% of eaters globallydine at restaurants at least weekly, and most choose fast food fare.

Public health and environmental benefits of plant-based burgers are plentiful. Research funded by Beyond Meat and conducted by independent scientists at the University of Michigan found that its burger used 99 percent less water, 93 percent less land, and 46 percent less energy and produced 90 percent fewer greenhouse gas emissions compared to a beef burger; similar results were found in a study of the Impossible Burger. While no peer-reviewed studies are yet available, a significant body of evidencelike this report of 40,000 farms in 119 countries and covering 40 food products that represent 90 percent of all that is eatenshows significantly higher environmental impacts of meat production on land, water, and air compared to plants. While grass-fed beef can be more sustainable, its complicatedand hardly the panacea supporters claim it to be.

And dont forget about antibiotic resistance, among the biggest threats to global health driven largely bymisuse of medicinesin livestock production.

Whatever the individual motivation to select a plant-based burger, the secret sauce is clear: When food tech delivers taste and convenience, health and sustainability win.

Burger Bloviating: Push Back on Plant-Based Meat

As with many food tech innovations, some folks in nutrition and activist circles began disparaging plant burgers as yet another ultra-processed food that consumers dont need. However, there is considerable variation in nutritional quality across the four-categoryNOVA classification(unprocessed and minimally processed foods, processed culinary ingredients, processed, ultra-processed). Andnumerous studiesincluding areportfrom several professional nutrition and food tech organizationsshow that (ultra-) processed foods like bread and canned goods are nutritionally beneficial; its thewhole dietthat matters.

Plus, beef burgers dont grow on trees; the industry employs an extensive set of ingredientsconsumers simply choose not to consider. A wide range ofadditives and preservativesand food processing methods were needed to get that cow ground up onto your bun, for instance, alongside atrocious conditions in industrial animal farming systems. And were you aware that meatpacking is among the most dangerous jobs in the world? The reality is that getting a burger to your table made from animals involves far more processing than one made with plants, facts its polystyrene package doesnt provide.

But is plant-based meat real food? The concept was popularized by journalist Michael Pollan, whose other pithy yet patronizing advice includes eat plants, not food made in plants. Food writer Mark Bittman recently opined, [w]e have to determine whether theyre actually food,likening plant-based burgers to Cheetos. (Seriously?) Other foodies jumped on the bandwagon, creatingnutrition confusionby preaching that meat from animals is inherently superior simply because its from an animal.

At the same time, some health professionals return to the dog-tired diet advice that consumers need to eat more vegetables and fruits, like fresh peas instead of burgers made from pea protein. Similarly, anivory-tower academiccalled plant-based burgers transitional en route to a whole foods diet, ignoring evidence that burgers can be part of a healthy diet, in moderationand are integral to American traditions.

Viewpoints like these reflect a lack of compassion for the realities most people face in just trying to get a meal on the table. They also undermine how difficult it is to change the way we eat, They also discount the vibrant role cuisine plays in culture and disregard the power of technology to meet food needs healthfully and sustainably.

For a Brighter Food Future, Vote With Your Fork

Addressing todays complex food challenges requires all the tools we have to curb climate change, address unsustainable and unjust practices in agriculture, and reduce diet-related chronic diseases. Though novel food technologies will always have haters, its a brave new world with a new generation of eaters.Millennials and Gen Zare highly motivated by health and sustainabilityand both are far more accepting offood technologythan previous generations. Scientific innovations like plant-based burgers will always play a role in shaping human diets,as they always haveand often for the better.

But lets not forget that a burger is a burger is a burgerand its especially tasty with all the fixins. (And fries. Obviously.) Most of us in high-income nations who strive to manage weight, stave off disease, and live longer are better off eating a vibrant salad loaded in fresh veggies, beans, and whole grains rather than a plant-based burger. At least, most of the time.

But you already know that, right?

So when that craving hits, grab a plant-based burger, and enjoy. Voting with your fork is a delicious way to support technologies that will help move forward the food revolution necessary to create a healthy and sustainable food future for all.

P.K. Newby, ScD, MPH, MS, is a nutrition scientist and author whose newest book is Food and Nutrition: What Everyone Needs to Know. Learn more about her at pknewby.com.

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Burger Wars: Beyond Nutrition Idealism and Junk-Science Rhetoric, the Benefits of Choosing Plant-Based are Clear - The Spoon

While it seems increasingly difficult to find a crew to delve into role playing games these days, they hold a special place for me.

Few gaming experiences have been as well-remembered as the first months of playing Dungeons & Dragons, and the pure combination of wonder and amazement that provided.

There have been other RPGs since then of course, and in most every case they have been fun because you become immersed in the world of the game, and the character you play becomes near and dear to you.

As a result I often look at RPGs on Kickstarter, and on one such excursion GeneFunk 2090 from CRISPR Monkey Studios.

There was some great art to the game that was advertising itself as a Biopunk RPG so I looked a little deeper.

That led to the biggest discovery, that the studio doing the game is based in Saskatoon, which made me curious to learn more.

To begin with the game is a biopunk/cyberpunk RPG and setting made using the D&D 5E Open Gaming License. Players take on the role of elite mercenaries that specialize in investigation and violence. No magic or fantasy, but tons of cybernetics, genetic enhancements, nanobots, drones, hacking, androids, high tech guns and armor, and other amazing tech, explains a quick intro on the successful Kickstarter page.

Comparisons of course are natural, and this one immediately had me thinking a game in the same vein as Shadowrun, a long-running RPG, many will know.

So next I contacted James Armstrong regarding the game he has been involved in creating, to find out some information first hand.

He said the game is certainly Biopunk on nature.

I love biology, and the idea of genetic engineering, he replied via email. I actually have a M.Sc. in molecular biology, partially because I was interested in understanding the science behind genetic modification.

Also, Ive always loved speculative fiction, especially of the biopunk variety, from Brave New World, to Cronenberg movies. While I first started this game in 2001, I can tell its only now that biopunk is starting to come into the zeitgeist. Theres currently a Netflix special on biohacking, Jaimie Metzl is on Joe Rogan speaking about his Hacking Darwin book, and CRISPR is part of school curricula.

Theres been an open niche for biopunk RPGs, especially near-future ones and I wanted to address that, and see where I could take it. Endogenous DNA computers, genetic enhancement, mind-hacking, transgenic beasts, and anything else I could think of.

Not surprisingly Armstrong comes at creating an RPG based on his own long held interest.

Ive been an RPG fan since I was in Grade 3, he said. It was the Dungeons and Dragons box sets, red and blue. My older brother brought them home and I was immediately fascinated by the art, and the idea that I could be a character in a fantasy story.

From there, it was the Marvel Super Heroes game, T.M.N.T, WEG Star Wars, and whatever else I could get my hands on! Ive made plenty of my own systems along the way as well.

So where did the germ of the idea for GeneFunk come from.

It was really a convergence of creative influences, and an open niche! I grew up reading the Eastman and Laird T.M.N.T. graphic novels and RPG, loved cyberpunk fiction of every kind, and felt the Gattaca movie was well ahead of its time, related Armstrong. I wanted to play in a world filled will genetically enhanced humans and ubiquitous biotechnology.

Armstrong went into the creative process with a vision.

Create a modern take on the cyberpunk genre using the 5e ruleset, with a biopunk twist, he said. While I love the 80s vision of cyberpunk, most cyberpunk games I see tend to fit into this mold. It could use some updating, some new spice!

Its now apparent that a great deal of human enhancement will be at the genetic level, not necessarily grafted-on chrome arms and robot bodies. I want to show how the world might look if that genetic enhancement started before birth, and how biologically specializing humans might affect society, (and) an informal genetic caste system that emerges from a global market economy.

I also wanted to make some of the cyberpunk tropes a little more fluid. Rather than an explicitly dystopian world, I wanted to showcase a series of double-edged swords. Not technological and capitalistic doom-and-gloom, but something more ambiguous, with some parts being wonderful, and other parts being nightmarish, depending on your perspective. There are pros to living in a technological wonderland. Who needs Huntingtons disease? Alienation due to a collapse of a common human condition? Yes. Ultimate expression of personal identity and diversity through a fluid human form? Also yes.

With such a vast vision to capture the game took years to develop 18-years in fact.

I started in 2001, said Armstrong. I have homebrew versions of it in 3.5e and 4e as well, but once 5e came out, I knew it fit with the mechanics well and I wanted to take it to the next level. Granted, many of those years only had very part-time development, I really kicked it into high-gear over the last three years.

So what was the most difficult aspect of designing the game?

Capturing the powerful nature of genetic enhancement at character creation, said Armstrong. I wanted a characters base genome to provide a great deal of mechanical influence, much more so than a D&D race does. Genetic enhancement is unambiguously superior in GeneFunk, and I needed the mechanics to capture that. As such, starting characters are more powerful than they are in D&D. Theyre not close to X-Men level or anything like that, but they certainly wont be spending level 1 killing boars.

But the game is more than fights and battles.

Asked what is the best element of the game Armstrong said the biohacking, and the great variety of different genomes and upgrades.

There are 42 genetic enhancements and 58 upgrades. Theres even a tool included for players and GMs to make their own genomes.

Being able to play a character with completely different abilities at level 1, each time you make a character, is great for replayability. Ive always loved the meta-game of making characters, Ive probably made 10 characters for every 1 Ive played, regardless of system.

Also, diversity is fun! D&D groups are often a hodge-podge of dragon born, tieflings, gnomes, and goliaths, even if a campaign world might describe these races as rare. I built it so that there is baked-in fluff to support the fact that youre a party of genetic weirdos, stylishly exotic appearances and all.

The vibrancy of a new game world, and the built in diversity of characters to play make GeneFunk a game well worth looking into. Like any RPG the experience of course is only partly dictated by the ruleset, the game master, the one guiding things much as the director of a stage performance, being at least equally important to the overall experience.

It will help to know the base rules of 5e, the most recent incarnation of D&D and one admittedly turned me off the game completely. While I think 5e homogenized D&D into a world of overpowered clones, in a different world setting the core rules can shine.

So check out GeneFunk, it may not be the setting for every taste, but it offers an interesting vision of a future which may be closer than we think.

Check it out via the GeneFunk 2090 page on Facebook.

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New RPG from Sask. creators - Yorkton This Week

Whether baked, mashed, fried, boiled, or steamed, potatoes are one of the most popular foods in the human diet.

Theyre rich in potassium and B vitamins, and the skin is a great source of fiber.

However, if you have diabetes, you may have heard that you should limit or avoid potatoes.

In fact, there are many misconceptions about what people with diabetes should and shouldnt eat. Many people assume that because potatoes are high in carbs, theyre off-limits if you have diabetes.

The truth is, people with diabetes can eat potatoes in many forms, but its important to understand the effect they have on blood sugar levels and the portion size thats appropriate.

This article tells you everything you need to know about potatoes and diabetes.

Like any other carb-containing food, potatoes increase blood sugar levels.

When you eat them, your body breaks down the carbs into simple sugars that move into your bloodstream. This is whats often called a spike in blood sugar levels (1).

The hormone insulin is then released into your blood to help transport the sugars into your cells so that they can be used for energy (1).

In people with diabetes, this process is not as effective. Instead of sugar moving out of the blood and into your cells, it remains in circulation, keeping blood sugar levels higher for longer.

Therefore, eating high-carb foods and/or large portions can be detrimental to people with diabetes.

In fact, poorly managed diabetes is linked to heart failure, stroke, kidney disease, nerve damage, amputation, and vision loss (2, 3, 4, 5, 6).

Therefore, its usually recommended that people with diabetes limit their digestible carb intake. This can range from a very low carb intake of 2050 grams per day to a moderate restriction of 100150 grams per day (7, 8, 9).

The exact amount varies depending on your dietary preferences and medical goals (9, 10).

Potatoes spike blood sugar levels as carbs are broken down into sugars and move into your bloodstream. In people with diabetes, the sugar isnt cleared properly, leading to higher blood sugar levels and potential health complications.

Potatoes are a high carb food. However, the carb content can vary depending on the cooking method.

Here is the carb count of 1/2 cup (7580 grams) of potatoes prepared in different ways (11):

Keep in mind that an average small potato (weighing 170 grams) contains about 30 grams of carbs and a large potato (weighing 369 grams) approximately 65 grams. Thus, you may eat more than double the number of carbs listed above in a single meal (12).

In comparison, a single piece of white bread contains about 14 grams of carbs, 1 small apple (weighing 149 grams) 20.6 grams, 1 cup (weighing 158 grams) of cooked rice 28 grams, and a 12-ounce (350-ml) can of cola 38.5 grams (13, 14, 15, 16).

The carb content of potatoes varies from 11.8 grams in 1/2 cup (75 grams) of diced raw potato to 36.5 grams in a similar serving size of french fries. However, the actual serving size of this popular root vegetable is often much larger than this.

A low GI diet can be an effective way for people with diabetes to manage blood sugar levels (17, 18, 19).

The glycemic index (GI) is a measure of how much a food raises blood sugar compared with a control, such as 3.5 ounces (100 grams) of white bread (1, 11).

Foods that have a GI greater than 70 are considered high GI, which means they raise blood sugar more quickly. On the other hand, foods with a GI of less than 55 are classed low (1, 11).

In general, potatoes have a medium to high GI (20).

However, the GI alone isnt the best representation of a foods effect on blood sugar levels, as it doesnt take into account portion size or cooking method. Instead, you can use the glycemic load (GL).

This is the GI multiplied by the actual number of carbs in a portion, divided by 100. A GL of less than 10 is low, while a GL greater than 20 is considered high. Generally, a low GI diet aims to keep the daily GL under 100 (11).

Both the GI and GL can vary by potato variety and cooking method.

For example, a 1 cup (150 gram) serving of potato may be high, medium, or low GL depending on the variety (11, 20):

If you have diabetes, choosing varieties like Carisma and Nicola is a better option to slow the rise of blood sugar levels after eating potatoes.

You can check the GI and GL of different types of potatoes through this website.

The way a potato is prepared also affects the GI and GL. This is because cooking changes the structure of the starches and thus how fast theyre absorbed into your bloodstream.

In general, the longer a potato is cooked the higher the GI. Therefore, boiling or baking for long periods tends to increase the GI.

Yet, cooling potatoes after cooking can increases the amount of resistant starch, which is a less digestible form of carbs. This helps lower the GI by 2528% (21, 22).

This means that a side of potato salad may be slightly better than french fries or hot baked potatoes if you have diabetes. French fries also pack more calories and fat due to their cooking method.

Additionally, you can lower the GI and GL of a meal by leaving the skins on for extra fiber, adding lemon juice or vinegar, or eating mixed meals with protein and fats as this helps slow the digestion of carbs and the rise in blood sugar levels (23).

For example, adding 4.2 ounces (120 grams) of cheese to a 10.2 ounce (290 gram) baked potato lowers the GL from 93 to 39 (24).

Keep in mind that this much cheese also contains 42 grams of fat and will add nearly 400 calories to the meal.

As such, its still necessary to consider the overall number of carbs and the quality of the diet, not just the GI or GL. If controlling weight is one of your goals, your total calorie intake is also important.

A low GI and GL diet can be beneficial for people with diabetes. Potatoes tend to have a medium to high GI and GL, but cooled cooked potatoes, as well as varieties like Carisma and Nicola, are lower and make a better choice for people with diabetes.

Although its safe for most people with diabetes to eat potatoes, its important to consider the amount and types you consume.

Eating potatoes both increases your risk of type 2 diabetes and may have negative effects on people with existing diabetes.

One study in 70,773 people found that for every 3 servings per week of boiled, mashed, or baked potatoes, there was a 4% increase in the risk of type 2 diabetes and for french fries, the risk increased to 19% (25).

Additionally, fried potatoes and potato chips contain high amounts of unhealthy fats that may increase blood pressure, lower HDL (good) cholesterol, and lead to weight gain and obesity all of which are associated with heart disease (26, 27, 28, 29).

This is particularly dangerous for people with diabetes, who often already have an increased risk of heart disease (30).

Fried potatoes are also higher in calories, which can contribute to unwanted weight gain (27, 29, 31).

People with type 2 diabetes are often encouraged to maintain a healthy weight or lose weight to help manage blood sugar and reduce the risk of complications (32).

Therefore, french fries, potato chips, and other potato dishes that use large amounts of fats are best avoided.

If youre having trouble managing your blood sugar levels and diet, speak with a healthcare provider, dietitian, or diabetes educator.

Eating unhealthy potato foods, such as chips and french fries, increases your risk of type 2 diabetes and complications, such as heart disease and obesity.

Although you can eat potatoes if you have diabetes, you may still want to limit them or replace them with healthier options.

Look for high fiber, lower carb, and low GI and GL foods like the following (33):

Another good way to avoid large portions of high carb foods is to fill at least half of your plate with non-starchy vegetables, such as broccoli, leafy greens, cauliflower, peppers, green beans, tomatoes, asparagus, cabbage, Brussels sprouts, cucumbers, and lettuce.

Lower carb replacements for potato include carrots, pumpkin, squash, parsnip, and taro. High carb but lower GI and GL options include sweet potato, legumes, and lentils.

Potatoes are a versatile and delicious vegetable that can be enjoyed by everyone, including people with diabetes.

However, because of their high carb content, you should limit portion sizes, always eat the skin, and choose low GI varieties, such as Carisma and Nicola.

In addition, its best to stick with boiling, baking, or steaming and avoid fried potatoes or potato chips, which are high in calories and unhealthy fats.

If youre struggling to make healthy choices to manage your diabetes, consult your healthcare provider, dietitian, or diabetes educator.

Read more:
Potatoes and Diabetes: Safety, Risks, and Alternatives - Healthline

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Friday, February 14, 2020

The longer a woman with gestational, or pregnancy-related, diabetes breastfeeds her infant, the lower her risk for developing type 2 diabetes later in life, suggests an analysis by researchers at the National Institutes of Health and other institutions. The study was conducted by Cuilin Zhang, M.D., Ph.D., of NIHs Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and colleagues. It appears in Diabetes Care.

In addition to health risks for mothers and babies, gestational diabetes increases the risk for type 2 diabetes 10 to 20 years after pregnancy. Type 2 diabetes increases the risk for heart disease, stroke and other health problems.

The researchers analyzed data from the Nurses Health Study II, a long-term study of risk factors for chronic diseases in women. Of more than 4,000 women in the study who had gestational diabetes, 873 developed type 2 diabetes over the course of 25 years. Compared to women with gestational diabetes who had not breastfed, those who breastfed for six to 12 months were 9% less likely to develop type 2 diabetes, those who breastfed for one to two years were 15% less likely, and those who breastfed for more than two years were 27% less likely.

The researchers suggested that clinicians may want to encourage patients with gestational diabetes to breastfeed if they are able to, to potentially reduce their type 2 diabetes risk.

The analysis was funded by NICHD with additional support from NIHs National Institute of General Medical Sciences.

The studys senior author, Cuilin Zhang, M.D., Ph.D., of the NICHD Epidemiology Branch, is available for comment.

Ley, SH. Lactation duration and long-term risk for incident type 2 diabetes in women with a history of gestational diabetes mellitus. Diabetes Care. 2019. https://doi.org/10.2337/dc19-2237.

About the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): NICHD leads research and training to understand human development, improve reproductive health, enhance the lives of children and adolescents, and optimize abilities for all. For more information, visit https://www.nichd.nih.gov.

About the National Institutes of Health (NIH):NIH, the nation's medical research agency, includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. NIH is the primary federal agency conducting and supporting basic, clinical, and translational medical research, and is investigating the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit http://www.nih.gov.

NIHTurning Discovery Into Health

###

Read the original:
Breastfeeding may reduce type 2 diabetes risk among women with gestational diabetes - National Institutes of Health

In a surprising study, Oregon State University researchers found that no matter how much stress they placed on mice from either a high-fat diet or strenuous exercise, the animals mitochondria were able to adapt and continue their normal processes.

The findings could have major implications for the study of diseases like diabetes, Parkinsons and Alzheimers, all of which are associated with an impairment in the breaking-down and clearance of damaged mitochondria.

Mitochondria are the structures that house cellular respiration, the process used to turn nutrients into energy. Dysfunction in mitochondria may lead to lower energy production, greater inflammation and tissue damage. Yet as central as mitochondria are to living organisms, scientists still dont know exactly what keeps them healthy or makes them unhealthy.

This study fits another piece into the puzzle, said OSU College of Public Health and Human Sciences researcher Matt Robinson, who co-authored the paper published last week in the FASEB Journal with Ph.D. student Sarah Ehrlicher.

It helps lay some future groundwork for how we can optimize (muscle and mitochondrial) health, to promote their health with diseases like obesity, diabetes, even some implications with aging conditions that we know have compromised mitochondria, Robinson said. This might provide some new pathways for how to improve the mitochondria and restore them.

The study looked at a specific pathway, called autophagy, through which cells recycle old mitochondria. Autophagy is thought to be impaired by a high-fat diet but activated by exercise. So Ehrlicher and Robinson intentionally blocked exercise-induced autophagy in the mice for a period of time, but continued exercising the mice.

They found that blocking a specific pathway to activate autophagy had no negative effect on mitochondrial function in the muscle of the mice.

Next they tried upping the ante, adding a high-fat diet alongside the exercise to further stress the mitochondria. And again, the mice were able to improve their mitochondrial function even without the autophagy pathway, Ehrlicher said, which shows that mitochondria have alternative pathways to stimulate recycling and adaptation.

She and Robinson were surprised by how adaptable the mitochondria seemed to be.

If these animals were given a high-fat diet, they got better at burning off those fats. If they were given just the exercise, they were able to make more mitochondria, which is good from an exercise perspective, Robinson said. And those adaptations seem to be very specific.

Future research will extend to human subjects, looking at how autophagy responds to diet and exercise in people, particularly those with obesity and diabetes.

While weight is a major risk factor for diabetes, research has shown that exercise is one of the strongest ways to help prevent or reverse development of the disease.

Even without changes in weight, exercise has this amazing ability to improve metabolic health, Ehrlicher said.

Even single sessions of exercise improve metabolism if a person is obese and, over time, can promote health.

With the current study as well as past research, Robinson and Ehrlicher have found that obese mice respond normally to nutrition and exercise, leading the researchers to conclude that there is no overt dysfunction or broken pathway; the muscle is just responding to the stimuli it is given, whether from diet or exercise.

The rest is here:
Mitochondria study could help boost understanding of diabetes and aging - The News Guard

Close to 10% of the U.S. population, around 30.3 million people, have diabetes. A new treatment delivery system created by bioengineers at the University of North Carolina and theUniversity of California, Los Angeles could help make life easier for them via a smart insulin patch thats about the size of a quarter. All a patient would need to use it would be to slap on a new patch at the start of the day, after which it would monitor and manage glucose levels for the next 24 hours.

It is smart and simple, which means it could help enhance the health and quality of life for people with diabetes, Zhen Gu, the study leader and a professor of bioengineering at the UCLA Samueli School of Engineering, told Digital Trends. It is a smart glucose-responsive insulin release device because it can respond to high blood sugar levels and release only the necessary insulin dosage, thus reducing the risk of hypoglycemia. This is a small and disposable device, so it is very simple and convenient to use; one can remove the patch any time to stop the administration of insulin.

The glucose-monitoring adhesive patch is covered in tiny microneedles, each one less than a millimeter in length. They are made from a glucose-sensing polymer and come pre-loaded with insulin. When the patch is applied, the microneedles penetrate the skin and start measuring blood sugar levels. If the glucose levels increase, the polymer triggers the release of insulin. At the point at which levels return to normal, the patchs insulin delivery also slows down. While this approach still involves pricking the patient with a needle, these needles are much smaller than regular needles. As a result, the patch is less painful than an ordinary injection.

So far, the patch has been successful in studies involving pigs. The researchers were able to use it to successfully control the glucose levels in these animals, which had Type I diabetes, for around 20 hours. Next, the researchers are hoping to progress to further trials, with the goal of commercializing their technology.

This patch has already been accepted by FDAs emerging technology programs for clinical trial applications, Gu said.

A paper describing the research was recently published in the journal Nature Biomedical Engineering.

Read more here:
Smart microneedle insulin patch could make it easier to treat diabetes - Digital Trends

A sample of low-income patients engaged with Omada Healths digital diabetes prevention program (DPP), achievedweight loss but no major difference in HbA1c levels after a year of use, according to study data recently highlighted by the company.

The results published late last year in the CDCs Preventing Chronic Disease journal and first previewed at a 2018 public health conference suggest an alternative approach to diabetes prevention for a population that more often has difficulty accessing in-person health services.

The Omada program lowers the barriers to access, and ultimately increases preventive health engagement among any population, Omada Director of Clinical Research Cynthia Castro Sweet, who was also an author on the paper alongside researchers from the University of Southern California, Los Angeles, said in a statement. Our program was developed to serve the needs of participants from all backgrounds, and all walks of life. The results of this trial dispels the myth that people with economic or educational disadvantages cant or wont use technology to engage in their health care.

TOPLINE DATA

From the 227 participants recruited and evaluated at baseline, 111 completed a follow-up roughly around the half-year mark (T1), 104 completed a roughly 12-month follow-up (T2) and 76 completed both follow-ups. One hundred and nine participants who completed the T1 follow-up were also matched to an unenrolled control patient using de-identified records.

At baseline, 81.3% of the participants were women, 51.5% identified as Hispanic/Latino and 43% had limited proficiency in English. The average age was 48.2 years. All groups and subgroups within the trial demonstrated similar sociodemographic variables, with the exceptions that those eventually lost to follow-up were significantly less likely to have Medicaid at T1 and T2, and more likely to be working full-time at T1.

At the first and second check-in, 41% and 37% of reporting participants, respectively, had lost more than 5% of their weight. The average loss was significant at both check-ins, with mean weight loss reported as 4.2% at T1 and 4.4% at T2. Similarly, mean BMI also dropped significantly by 1.5 from baseline at T1, and 1.6 at T2.

At both check-ins, completion of nine or more lessons was significantly associated with increased weight loss. HbA1c levels mostly remained stagnant, however, with roughly similar proportions of participants falling within a prediabetic range. The only decline came at the T1 check-in (but not the T2 check-in) among participants who lost more than 5% of their baseline weight.

HOW IT WAS DONE

Between February 2016 and March 2017, researchers recruited adults enrolled in Medicaid or another safety-net insurance plan who had evidence of prediabetes within their EHR.

These participants were enrolled in Omadas digital DPP, which includes virtual group support, lessons, personalized support from a live health coach and other tools to track their progress. It was modified for the studys low-income target population by reducing the reading level of the curriculum, introducing Spanish translation and cultural components, and by featuring bilingual and bicultural coaches.

The researchers recorded patient outcomes of interest at baseline, at 24 to 35 weeks (T1) and at 47 to 65 weeks (T2). Controls were generated by searching de-identified EHRs with an algorithm that sought cases of a similar age and sex within 12 months prior to the beginning of enrollment.

THE LARGER PICTURE

Omada isnt the only digital diabetes program maker in town. Solera Health and Livongo both offer a variety of tech-driven programs aimed at managing or preventing diabetes, while Virta Health often boasts of its products ability to reverse Type 2 diabetes.

But digital DPPs are just one of Omadas offerings, which include hypertension management, mental health support and other chronic disease products. The company raked in $73 million in funding last summer, which it said at the time would help scale its digital care program efforts.

ON THE RECORD

This study demonstrates that Omada achieves real outcomes with this difficult-to-reach population, Omada Health CEO Sean Duffy said in a statement. Digital health tools should be offered to all populations, especially when sufficient evidence shows that they can be as effective as in-person programs. By making virtual alternatives less accessible, we deny low-income patients an opportunity to lead healthier, more productive lives.

Read the original:
Digital diabetes prevention program use tied to weight reduction among low-income patients with prediabetes - MobiHealthNews

With the use of age-adjusted thresholds for noninvasive markers of liver steatosis and fibrosis, patients with type 2 diabetes (T2D) may be referred more efficiently to specialists, according to study results published in BMJ Open Diabetes Research & Care. Furthermore, the researchers found a consistent association between these markers and chronic complications of T2D.

Current guidelines for T2D care recommend routine screening for the presence of nonalcoholic fatty liver disease (NAFLD), as well as assessment of advanced liver fibrosis in high-risk patients, using ultrasound and serum biomarkers. Patients with T2D are at increased risk of progressing from NAFLD to steatohepatitis and liver-related mortality. The goal of the current study was to examine changes in specialist referrals after the use of suggested noninvasive biomarkers of steatosis and fibrosis in patients with T2D. In addition, the association between these biomarkers and cardiovascular and kidney morbidity was investigated.

The retrospective study included adults with T2D who were treated at the diabetes clinic at Policlinico di Monza in Monza, Italy, between 2013 and 2018.

Liver steatosis assessment was based on the Fatty Liver Index, Hepatic Steatosis Index, and NAFLD Ridge Score. Risk for advanced fibrosis was assessed by using the Fibrosis-4 (FIB-4) score, NAFLD Fibrosis Score, aspartate aminotransferase (AST) to alanine aminotransferase (ALT) ratio, and the AST to platelet ratio index.

Of 2770 patients with T2D included in the study, data on liver steatosis markers were available in 1519, 2076, and 1082 for Fatty Liver Index, Hepatic Steatosis Index, and NAFLD Ridge Score, respectively. Data needed to calculate liver fibrosis scores were available for 2096, 1429, 1421, and 370 patients for AST/ALT ratio, AST/platelet ratio index, FIB-4, and NAFLD Fibrosis Score, respectively.

High probability of liver steatosis was evident in most patients based on each of the 3 steatosis scores (65%-88%). However, there was a wide variation in the high probability of advanced fibrosis according to different noninvasive markers, ranging from 1% with the use of the AST/platelet ratio index to 33% using the NAFLD Fibrosis Score. A significant number of patients were classified as having indeterminate risk, ranging from 23.1% using the AST/platelet ratio index to 55.8% using the AST/ALT ratio.

With a sequential combination of 2 noninvasive markers of steatosis (Fatty Liver Index) and fibrosis (FIB-4) with standard cutoffs, 28.3% of patients would require referrals to specialized hepatologists because of either intermediate (253 patients) or high risk (36 patients). With the use of age-adjusted cutoffs, this rate significantly decreased to 13.4% of the entire population (102 patients with intermediate risk, 35 with high risk).

Biomarkers of steatosis were significantly associated with risk for albuminuria. Among patients with Fatty Liver Index scores in the intermediate- or high-risk category, prevalence of microalbuminuria was significantly higher (odds ratio [OR], 3.49; 95% CI, 2.05-5.94).

Cardiovascular disease was more common in patients within the intermediate- (OR, 2.0; 95% CI, 1.6-2.5) and high-risk (OR, 2.6; 95% CI, 1.7-4.0) categories for FIB-4 score and within the intermediate (OR, 1.73; 95% CI, 1.4-2.1) and high (OR, 1.86; 95% CI, 1.4-2.5) categories of the AST/ALT ratio. For patients within the lower-risk category for fibrosis, risks for coronary heart disease and stroke were significantly lower.

The researchers acknowledged the results may be limited given that other etiologies of liver disease were not examined.

While the use of different non-invasive fibrosis scores among patients with type 2 diabetes identify different proportion of patients with advanced fibrosis, the use of age-adjusted FIB-4 cut-offs leads to a drop in gray-zone results, making referrals to hepatologists more sustainable for the healthcare system, the researchers wrote.

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Reference

Ciardullo S, Muraca E, Perra S, et al. Screening for non-alcoholic fatty liver disease in type 2 diabetes using non-invasive scores and association with diabetic complications. BMJ Open Diabetes Res Care. 2020;8:e000904.

Read more from the original source:
Noninvasive Markers of Liver Disease May Improve Referrals, Predict Complications in Diabetes - Endocrinology Advisor

When my husband, Dale, was diagnosed with type 2 diabetes in 2007, at the age of 46, his doctor prescribed medication, he attended a nutrition class and was instructed on testing his blood glucose level.

Dale had annual physical exams, which monitored his blood pressure and A1C level (an average of blood glucose over time).

We assumed doing all of this would also mitigate the increased risk of heart disease that presents with type 2 diabetes.

It most likely was a fatal assumption.

Dale died of a sudden, massive heart attack, the main artery blockage known as the widow maker, two days before Thanksgiving, on Nov. 20, 2018.

The longer a person has diabetes, the higher their chances are of developing heart disease.

According to the Centers for Disease Control and Prevention, 30 million Americans have diabetes and 90% to 95% of them have type 2 diabetes. Most cases are diagnosed after age 45. According to the American Heart Association, adults with diabetes are two to four times more likely to die from heart disease than those who dont have diabetes.

The longer a person has diabetes, the higher their chances of developing heart disease. This is because high blood glucose from diabetes can damage blood vessels and the nerves that control the heart, according to the National Institute of Diabetes and Digestive and Kidney Diseases, which is part of the National Institutes of Health.

Total management of the disease should include diet, exercise, regular cholesterol testing and glucose monitoring, said Dr. Jane E.B. Reusch, a cardio-endocrinologist at the University of Colorado Anschutz Medical Center in Aurora, Colo. She also practices at the Rocky Mountain Regional Veterans Affairs Medical Center in Aurora.

Hyvelle Ferguson, now 46, was just 33 and pregnant when she was diagnosed with type 2 diabetes. I began taking care of myself, but after I had my baby, I reverted back to my old ways, eating anything I wanted, says Ferguson. I thought Id be OK if I was taking my medication.

At 41, Ferguson suffered a stroke, and three weeks after being released from rehab, suffered a heart attack. Her main artery was 99% blocked. She underwent quadruple bypass surgery, but that wasnt the end of her health problems.

I called myself a professional patient, in 2014 to 2015, I was in the hospital every month, she says. Every time I went to the doctor, something else was wrong.

Ferguson began taking stock of her life, researching how she could control diabetes instead of allowing the disease to control her. She adopted a healthier diet and began walking for exercise. At first, it was just to the mailbox, and I went a bit farther each time, she says.

Although she still has many challenging days, Ferguson now volunteers with the American Heart Association and is an advocate for its Know Diabetes by Heart. The new program is partnership between the group and the American Diabetes Association to help inform doctors on educating their patients with diabetes about the risks of heart disease. It also tells patients with diabetes questions to ask their doctors.

Of course, not all patients with diabetes will develop heart disease, and Reusch points out that many other factors play into the risk. A1C is very important, but cholesterol should also be monitored closely in diabetes patients, she says. So many factors play into it, including genetics.

Care guidelines endorsed by many cardiologists require all diabetes patients to be placed on a low-dose statin drug, despite a patients lipid numbers (measuring cholesterol and fats in the blood), says Dr. Jorge Plutzky, a cardiologist with the Brigham and Womens Hospital and Harvard Medical School in Boston. Statins lower cholesterol levels in the blood.

We make recommendations based on what we know, Plutzky says. He points out numerous studies showing that diabetes patients who hadnt previously suffered a heart attack and were placed on low-dose statin drugs had a striking reduction for the risk of heart attack.

I thought Id be OK if I was taking my medication.

Plutzky says doctors have known for years that diabetes increases the risk factors for heart disease, but didnt understand why blood glucose drugs didnt reduce the heart disease risk. We just didnt have the right drugs yet, he says. Great strides have been made just within the past three years.

Plutzky says doctors and patients should know that certain new inhibitor drugs combined with statins can reduce the risk of heart disease in patients with diabetes. The Know Diabetes by Heart (web page) has this information, as well as all the latest information that needs to be put out there, he says.

He advises people with type 2 diabetes not to wait for their doctors to bring up the topic of heart disease. And he says patients should continue to see their primary care doctors or endocrinologists to help manage their disease.

Another preventive measure is one that coulld have saved my husband Dales life. Its called coronary artery (or cardiac) calcium screening, and more hospital systems, including the one near my small town, offer it at a relatively affordable cost ($99 at my hospital). The test is for individuals at high risk for heart disease and uses computerized tomography (CT) scans to measure the calcium build-up in the coronary arteries. A health systems screening program may also involve a cholesterol screening, body mass Index reading, an A1C screening and other tests.

Gary Heimbach, 70, of Bull Shoals, Ark., was diagnosed with type 2 diabetes in 1993 at 58. When his wife heard about coronary artery calcium screening, they both scheduled an appointment to have it done.

Although Gary had no previous symptoms, his results indicated hed already suffered a previously unknown heart attack. Further testing revealed a 95% blockage in a main artery and a 50% blockage in another. They put a stent in and I havent had any problems since, he says. It was painless and saved my life.

Ferguson stresses taking proactive measures, such as informing yourself and taking advantage of all available resources to reduce the risk of heart disease. I want people to know they can live, they can fight the smart fight, she said.

Kerri Fivecoat-Campbell is a freelance writer whose work has appeared on Forbes.com, AOL.com, Mainstreet.com, Creditcards.com, Bankrate.com and elsewhere.

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If You Have Diabetes, Pay Attention to Your Heart - Next Avenue

According to the World Health Organization, diabetes was directly related to the deaths of around 1.6 million people around the world in the year 2016 alone. In addition to family history, sedentary lifestyle, and diet, there is increasing evidence that micro-organisms in the gut (microbiota) play an important role in the development of type 2 diabetes. However, despite the growing evidence for the role of gut bacteria in type 2 diabetes, consensus on the role of different families of bacteria in the development of this disease is lacking. To address this problem, researchers from Oregon State University, USA have published a systematic review of 42 human studies on the associations between microbial families and type 2 diabetes. This review was published in the journal EBioMedicine.

While the researchers were unable to find any consensus on specific microbial communities being implicated in the development of diabetes, some groups of bacteria show an association with either presence or absence of the disease. For example, a decrease in at least one of these five distinct families of bacteria that include Bacteroides, Roseburia, Faecalibacterium, Akkermansia and Bifidobacterium families of bacteria is consistently associated with protection from type 2 diabetes. In contrast, the Lactobacillus family of bacteria shows divergent associations with type 2 diabetes and the specific effects of the bacteria on diabetes appear to be species-specific. For example, L.acidophilus, L.gasseri, L.salivarius were increased and L. amylovorus was decreased in diabetes patients.

Gut bacteria can influence the development and progression of type 2 diabetes in several ways. Certain species of bacteria can cause changes in glucose metabolism either directly by affecting the digestion of sugars or indirectly by affecting the production of hormones that control the process of digestion. For instance, Bifidobacterium lactis can cause an increase in glycogen synthesis the main storage form of glucose in the body while also increasing glucose uptake, thus reducing blood sugar levels.

Gut bacteria can also affect intestinal barrier functions. Type 2 diabetes causes an increase in intestinal permeability, resulting in leakage of gut microbial products such as lipopolysaccharides into the blood. Floating lipopolysaccharides in the blood can create chronic long-term inflammation in the body. Two bacterial species, B. vulgatus and B.dorei, upregulate the genes involved in maintaining the intestinal barrier, thus reducing intestinal permeability.

Gut bacteria can also affect the activity of drugs. A recent study showed that a probiotic- B.animalis along with prebiotic polydextrose and sitagliptin (a diabetes drug) was effective in reducing several diabetes parameters. There are also indications that combining prebiotic polysaccharide with metformin and sitagliptin reduced high blood sugar levels to a larger extent than using the drugs alone.

The systematic literature review described here concludes that while there is greater understanding in the role of certain microbial families in the pathophysiology of type 2 diabetes, simple interpretations and solutions are still elusive due to the high degree of variation in both the disease manifestation and the impact of gut microbes on the disease.

Written by Bhavana Achary, Ph.D

References:

Gurung M, Li Z, You H, Rodrigues R, Jump DB, Morgun A, Shulzhenko N. Role of gut microbiota in type 2 diabetes pathophysiology. EBioMedicine. 2020 Jan;51:102590.

Prevalence of diabetes in the US https://www.cdc.gov/diabetes/basics/type2.html

Global prevalence of diabetes https://www.who.int/news-room/fact-sheets/detail/diabetes

Image byArek SochafromPixabay

Here is the original post:
The role of gut microbiota in the development and progress of type 2 diabetes - Medical News Bulletin

Sweet Potatoes Benefits In Hindi: Sweet Potato, which is wealthy in carbohydrates and Vitamin A (candy potato) candy potatoes vitamin ) Is a celebrity. Its consumption within the weight loss program helps to scale back irritation in colon most cancers cells along with sustaining mild of your eyes, decreasing blood sugar and stress, retaining digestion good.

->Sweet potatoes include vitamin reminiscent of ascorbic acid, thiamine, riboflavin and vitamin B6. According to a examine, its recent leaves include a considerable amount of ascorbic acid, which is more likely to be supply of water-soluble nutritional vitamins. The remaining starchy water after cooking the candy potato may help scale back fats fats. Let's know the advantages of candy potato stuffed with vitamin (ie candy potato) Sweet Potatoes Health Benefits ) about:-

Sweet Potatoes Regulate Blood Sugar Levels Controls Blood SugarSweet meals with low glycemic index ( Low Glycemic Index Foods ) is. It controls blood sugar by blocking insulin resistance. Sweet potato comprises a wealthy supply of soluble fiber, reminiscent of pectin, which might forestall blood sugar spikes by growing your satiety. It additionally comprises magnesium which is helpful for diabetics. Despite being candy, its useful for diabetics as a result of it is filled with many vitamins together with fiber. It reduces the danger of coronary heart illnesses by controlling your waste ldl cholesterol.

Reduces stress: Sweet Potatoes Reduce StressSweet potato comprises magnesium, which reduces stress and nervousness. Magnesium deficiency is a significant reason behind despair. This mineral protects the mind from stress, in addition to it helps in getting good sleep.

Sweet Potatoes Anti-Inflammatory Food is an anti-inflammatory mealsSweet potato comprises nutritional vitamins which have robust anti-inflammatory properties. It can be supply of choline, which reduces inflammatory within the physique. Purple candy potato comprises anthocyanin, which reduces and prevents irritation in colon most cancers cells. Additionally its also recognized to scale back cell proliferation in particular most cancers cells.

Sweet Potatoes Promote Gut Health promotes intestine micro organismSweet potato comprises fiber and antioxidants that promote the expansion of fine intestine micro organism and assist in wholesome bowels. Which improves your digestion.

Eye well being ( Sweet Potatoes Good For Eyesight )Sweet potatoes are wealthy in beta-carotene and anthocyanin antioxidants, which may help forestall Eyesight Loss and enhance eye well being.

Sweet Potatoes Boost ImmunitySweet potato is a wonderful supply of beta-carotene, which, being transformed to vitamin A, strengthens your immune system.

How to Eat Sweet PotatoesShankarakand means Sweet Potatoes You can embody some ways in your weight loss program. You can roast it, boil it or eat it as uncooked. But its best to roast it and eat it to benefit from the well being advantages of Shankarkand. Because its also straightforward to digest together with tasty.

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Sweet diabetes is a medication in diabetes, roasting has many advantages - Sahiwal Tv

Investors in Tandem Diabetes Care, Inc. TNDM need to pay close attention to the stock based on moves in the options market lately. That is because the Mar 20, 2020 $60 Put had some of the highest implied volatility of all equity options today.

What is Implied Volatility?

Implied volatility shows how much movement the market is expecting in the future. Options with high levels of implied volatility suggest that investors in the underlying stocks are expecting a big move in one direction or the other. It could also mean there is an event coming up soon that may cause a big rally or a huge sell-off. However, implied volatility is only one piece of the puzzle when putting together an options trading strategy.

What do the Analysts Think?

Clearly, options traders are pricing in a big move for Tandem Diabetes shares, but what is the fundamental picture for the company? Currently, Tandem Diabetes is a Zacks Rank #2 (Buy) in the Medical Instruments industry that ranks in the Top 43% of our Zacks Industry Rank. Over the last 60 days, no analysts have increased their earnings estimates for the current quarter, while one analyst has revised the estimate downward. The net effect has taken our Zacks Consensus Estimate for the current quarter from a loss of 8 cents per share to a loss of 7 cents in that period.

Given the way analysts feel about Tandem Diabetes right now, this huge implied volatility could mean theres a trade developing. Oftentimes, options traders look for options with high levels of implied volatility to sell premium. This is a strategy many seasoned traders use because it captures decay. At expiration, the hope for these traders is that the underlying stock does not move as much as originally expected.

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Want the latest recommendations from Zacks Investment Research? Today, you can download 7 Best Stocks for the Next 30 Days. Click to get this free reportTandem Diabetes Care, Inc. (TNDM) : Free Stock Analysis ReportTo read this article on Zacks.com click here.Zacks Investment Research

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Are Options Traders Betting on a Big Move in Tandem Diabetes (TNDM) Stock? - Yahoo Finance

WESTFIELD, Mass. (WWLP) The Westfield Centennial Lions will be hosting a dance Sunday afternoon to support diabetes research.

According to a news release sent to 22News, the dance will kick off at the Shaker Farms Country Club located on 866 Shaker Road from 2:00 p.m. to 6:00 p.m. Everyone will have the chance to enjoy raffles, a cash bar, light appetizers, a free dance lesson and more!

This event is not a competition. Participants will be showing off their choice of dance including the waltz, foxtrot, country two-step, Rumbo, hustle, cha-cha, mambo, and many others so be prepared to have fun. Dancers do not have to pay admission however, the entrance fee is $10 for others.

Lions focus on raising money for eye research and give back to their community by providing eye exams and glasses to those who qualify. They also focus on supporting other causes such as diabetes. If left untreated, diabetes can cause blindness.

For more information, contact Gary Francis at 413-562-1346.

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Dance kicks off in Westfield to support diabetes research - WWLP.com

The performance of the European Society of Cardiology (ESC) algorithm, ESC 0/1-h, in ruling out acute myocardial infarction (AMI) without ST-elevation was comparable in patients with and without diabetes mellitus (DM), according to a study published in Diabetes Care.

The ESC 0/1-h and 0/3-h algorithms are used to diagnose patients with suspected acute non-ST-elevation myocardial infarction (NSTEMI). The levels of high-sensitivity cardiac troponin (hs-cTn) are often chronically elevated in individuals with DM, rendering it difficult to identify NSTEMI in this patient population. Investigators sought to assess whether the presence of DM affects the diagnostic abilities of 2 ESC algorithms in patients presenting to the emergency department with symptoms indicative of AMI.

In this secondary analysis of 2 studies, the Biomarkers in Acute Cardiac Care (BACC) and stenoCardia trials (ClinicalTrials.gov identifiers NCT02355457 and NCT03227159, respectively), 3,681 patients (mean age, 64.0 years; 64.2% men) with prospectively evaluated suspected acute NSTEMI with (n=563) and without DM, were enrolled. Data from the Advantageous Predictors of Acute Coronary Syndromes study (APACE; n=2895; ClinicalTrials.gov identifier NCT00470587) were used to calculate and externally validate alternative cutoffs for the algorithms.

The levels of hs-cTn were measured at admission, 1 hour (only in the BACC study), and 3 hours (in both studies). Negative and positive predictive values (NPV and PPV, respectively) for NSTEMI were calculated for both algorithms. The studys primary safety outcome was the NPV for NSTEMI (ie, for ruling out the condition), and the primary efficacy outcome was the PPV for ruling in NSTEMI. The sensitivity and specificity of both algorithms were the studys secondary endpoints.

Of 563 participants with DM, 137 (24.3%) had comorbid acute NSTEMI, compared with 15.9% of patients without DM (P <.001). Participants with DM were older and had more cardiovascular risk factors and comorbidities.

The ESC 0/1-h algorithm had a comparable NPV for NSTEMI in patients with and without DM (absolute difference [AD], -1.50; 95% CI, -5.95 to 2.96; P =.54), but the ESC 0/3-h algorithm had a lower NPV in patients with vs without DM (AD, -2.27; 95% CI, -4.47 to -0.07; P =.004). The diagnostic performance to rule-in NSTEMI was comparable for patients with vs without DM with both algorithms: ESC 0/1-h (AD, -6.59; 95% CI, -19.53 to 6.35; P =.34) and ESC 0/3-h (AD, 1.03; 95% CI, -7.63 to 9.7; P =.88).

The sensitivity for ruling out NSTEMI was comparable in patients with vs without DM with both ESC0/1-h (AD, -0.9; 95% CI, -5.1 to 3.3; P =1.00) and ESC 0/3-h (AD, -4.0; 95% CI, -10.4 to 2.4; P =.19) algorithms. The specificity for ruling in NSTEMI was higher for patients without vs with DM when using both the ESC 0/1-h (AD, -6.9; 95% CI -12.5 to -1.2; P =.0035) and ESC 0/3-h (AD, -4.4; 95% CI, -8.2 to 0.6; P =.01) algorithms. The use of alternative cutoffs improved the PPV of both algorithms.

Study strengths include large sample sizes and external validation of proposed alternative cutoffs. Study limitations include the sole use of data from the BACC study to evaluate the 0/1-h algorithm, possible misclassification of AMI and DM, and a lack of accounting for disease duration.

Although alternative cutoffs might be helpful, patients with DM remain a high-risk population in whom identification of AMI is challenging and who require careful clinical evaluation, noted the authors.

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Reference

Haller PM, Boeddinghaus J, Neumann JT, et al. Performance of the ESC 0/1-h and 0/3-h algorithm for the rapid identification of myocardial infarction without ST-elevation in patients with diabetes. Diabetes Care. 2019;43(2):460-467. doi: 10.2337/dc19-1327

This article originally appeared on The Cardiology Advisor

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Effect of Diabetes on the Performance of Algorithms for the Detection of AMI Without ST-Elevation - Endocrinology Advisor

The risk of experiencing a stroke has been shown to be higher in individuals with diabetic retinopathy.

The latest findings from the ACCORD Eye study (Action to Control Cardiovascular Risk in Diabetes) were unveiled at the International Stroke Conference.

Diabetic retinopathy is a common diabetes complication which is caused by consistent high blood sugar levels damaging the back of the eye.

According to the World Health Organisation, diabetic retinopathy is the cause of visual impairment for 4.2 million people.

Lead author Dr Ka-Ho Wong, said: As we know, large-artery atherosclerosis and atrial fibrillation are the primary causes of ischemic stroke. However, microvascular disease of the brain is also a cause of stroke and of vascular dementia.

Diabetic retinopathy is a common microvascular complication of diabetes, and we hypothesized that retinopathy would be an important biomarker of stroke risk in diabetic patients, and one that may precede ischemic stroke.

The research involved analysing the eyes of 2,828 people with diabetes. Just over five years later the researchers followed up with the participants and found that 117 people had experienced a stroke.Among those who experienced a stroke, 41% had diabetic retinopathy, whereas only 30.5% of people who did not have experience a stroke had diabetic retinopathy.

Dr Wong said: Patients with established diabetic retinopathy should pay particular attention to meeting all stroke prevention guidelines established by the American Heart Association.Because diabetic retinopathy is more common in patients with uncontrollable diabetes, and diabetic retinopathy increases the risk of having a stroke, it is important for patients to maintain good control of their diabetes.

This research raises the question of whether there is a specific vascular disease pathogenesis in patients with diabetic stroke. Currently, we do not have ongoing follow-up studies, but we are interested in proposing a prospective observational trial in stroke patients with baseline diabetic retinopathy to determine the most common mechanism of stroke in these patients, which would have important implications for prevention efforts.

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Diabetic retinopathy as an indicator of other serious health risk - Diabetes.co.uk

OpinionType 2 diabetes is not an inevitable life sentence. In 2020, the condition looks very different

Wednesday, 12th February 2020, 7:00 am

The idea that type 2 diabetes is a lifelong disease has been ingrained for so long. But the research explained in my new book, Life Without Diabetes, shows this is not necessarily true. As this is a condition that costs 10 per cent of NHS expenditure, that is good news.

Return to normal health is possible for almost everyone in the first few years of type 2 diabetes. Some people can achieve this even after many years of diabetes. Our research in Newcastle has shown exactly what causes type 2 diabetes for the first time and has traced both the underlying processes of returning to normal and the gruesome processes of developing the disease.

The role the liver and pancreas play

i's opinion newsletter: talking points from today

We measured the critical items in the two important organs of type 2 diabetes - liver and pancreas. In liver, we measured the fat content and the response to insulin control of sugar production. In the pancreas we developed new techniques to measure the fat content and the production of insulin. We were amazed to see that the hypothesis we tested was exactly correct: in the liver, fat content and insulin response were normal within seven days (so blood glucose first thing in the morning dropped to normal); and in the pancreas there was a gradual fall in fat content over eight weeks which was mirrored by a return to near normal insulin production.

The nub of the matter is removing the damaging effects of excess fat delivered to the insulin producing cells of the pancreas. Excess fat builds up first in the liver. Then the liver supplies excess fat to all tissues of the body including the pancreas. Not everyone is susceptible to this fat induced damage to the pancreas, but for those unlucky enough to be so disposed, the major hormone insulin can no longer be produced rapidly enough.

And the solution? Weight loss of about 15kg sounds impossible, but by developing a humanly possible, effective method we have been show that this can be done in a matter of weeks by anyone with motivation to return to health.

The greater challenge is preventing weight regain in the face of the slings and arrows that are part of everyday life. This is not easy, but many people have demonstrated that by following simple changes to habits it can be done. There is no magic diet individuals suit different approaches but a long term way of living life to the full can be successful.

Type 2, obesity and BMI

It's widely believed type 2 diabetes is due to obesity.But a glance at the hard information shows that this is simply untrue. One in two people developing the disease have a body mass index (BMI) under 30 and are not obese. So if half are obese and half are not, maybe there are two different diseases? Not so, as the underlying mechanisms have been shown to be the same over the range of BMIs. In fact one in 10 people have a normal BMI at the time of diagnosis and in contrast around three quarters of people with BMI over 45 do not have type 2 diabetes.

The truth is that we are all individuals, and simple statistical categorisation by BMI is inappropriate. Those of us with a genetic set to live in a body of BMI 25 may well get type 2 diabetes if their weight rises to 28. And those who have normal metabolism with a BMI of 34 may get the disease if they put on weight to say, a BMI of 37. The reverse process is useful to consider, as it is now very clear that someone with a BMI of 37 can return to normal sugar control and normal blood fats with a BMI of 34. That is why the 15kg weight loss target is appropriate for most people: as everyone has a personal threshold above which they will develop type 2 diabetes. It is nothing to do with the fixed BMI concept of obesity.

In other words, we all have a personal fat threshold above which mischief will start happening. This has been rather obscured by the present popularity of population level information to drive beliefs about what is relevant for individuals. But there is a clear bottom line: if a person has true type 2 diabetes, then they have become too heavy for their body.

Eating sweet things and high blood sugar

It's also widely believed that eating sweet things is the cause of high blood sugar. When you wake in the morning, all the sugar in your blood has been made by you by your liver. No molecule of sugar in the blood will have come directly from what was eaten yesterday. In type 2 diabetes the normal restraint on overproduction of sugar by the liver is lost, because the liver becomes resistant to the action of insulin. In turn, that is because there is too much fat inside the liver preventing insulin working normally. When you eat you get a double whammy: all your carbs are turned into sugar during digestion, and this load is additional to the outpouring of sugar from your liver which continued throughout the 24 hours. Certainly eating a lot of sugar or carbs with type 2 diabetes will make the blood sugar even higher, but the basic problem is lack of normal functioning of the hormone insulin. Loss of fat from liver and pancreas restores this.

So type 2 diabetes is not all doom, gloom and an inevitable life sentence. In 2020, the condition looks very different.

Life Without Diabetes by Professor Roy Taylor is published by Short Books, 9.99

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Type 2 diabetes can be reversed even after years of having the condition - this is how - inews