Month: May 2017

DIABETES is a serious health condition – affecting millions of people in the UK. The condition can develop gradually – but experts stress it is important for prediabetes to be diagnosed as soon as possible.

Prediabetes is also referred to by medics as borderline diabetes, is a metabolic condition.

If undiagnosed or untreated, prediabetes can develop into type 2 diabetes; which is treatable but not easily reversed.

Experts said it is a ‘critical stage’ in the development of diabetes because lifestyle choices – such as changing diet and exercising – can return blood sugar levels to normal.

It is therefore crucial to recognise it as early as possible, medics argue.

The condition is considered to be a grey area between having normal blood sugar levels and those verging on diabetic levels.

Diabetes.co.uk states : “Prediabetes is characterised by the presence of blood glucose levels that are higher than normal but not yet high enough to be classed as diabetes.

“Prediabetes may be referred to as impaired fasting glucose (IFT), if you have higher than normal sugar levels after a period of fasting, or as impaired glucose tolerance (IGT), if you have higher than normal sugar levels following eating.

“Each year in the UK, 5 to 10 per cent of people diagnosed with prediabetes go on to develop type 2 diabetes.”

Diabetes: Prediabetes can be reversed with a healthy lifestyle, experts say
Diabetes: Prediabetes can be reversed with a healthy lifestyle, experts say

Prediabetes is characterised by the presence of blood glucose levels that are higher than normal

Diabetes.co.uk

There are no clear symptoms of prediabetes, so people could be suffering with the condition without knowing it.

However people with prediabetes might be suffering with similar symptoms to type 2 diabetes.

These include urinating more frequently, feeling thirsty and feeling tired.

Symptoms can also include itching around the penis or vagina as a result of thrush, cuts or wounds which heal slowly and blurred vision.

Being overweight can also cause type 2 diabetes.

The risk factors for prediabetes are:

Being overweight or obese

Being overweight can cause type 2 diabetes because people have added pressure on their body’s ability to use insulin properly to control blood sugar levels – and are more likely to develop the condition.

Having a close relative – parent or sibling who currently has or has had diabetes.

Genetics play a strong role in the development of type 2 diabetes. If either mother of father has diabetes increases risk of diabetes by 15 per cent.

Have high blood pressure, low levels of good cholesterol – or high triglycerides

High blood pressure (hypertension) can lead to and make worse many complications of diabetes.

Are over the age of 40

Middle-aged and older adults are still at the highest risk for developing type 2 diabetes.

Have given given birth to baby who weight over nine pounds

Experts warn people with prediabetes should be checked for type 2 diabetes every one to two years.

Via: www.express.co.uk

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Diabetes affects approximately 422 million people worldwide and this number is expected to increase, according to the latest data.

And while most people with type-1 diabetes are born with it, type-2 can come on at any time.

Diabetes is a lifelong condition that causes a person’s blood sugar level to become too high. With type-2 diabetes, the pancreas doesn’t produce enough insulin or the body’s cells don’t react to insulin.

The hormone insulin – produced by the pancreas – is responsible for controlling the amount of glucose in the blood.

If diabetes is left untreated the glucose starts to build up in the blood instead of heading straight for the cells. If the blood sugar gets too high or too low, health complications arise.

This is why it’s so important to catch type-2 diabetes early. But what are the common signs?

Common symptoms of type-2 diabetes include excessive thirst, hunger, mood changes and feeling like you constantly need to pee.

But new research, published in the journal BMJ Open Diabetes Research & Care, suggests periodontitis might also be an early sign of diabetes.
Periodontitis is more commonly known as gum disease and leads to inflammation of the gums, which usually takes the form of redness, swelling and a tendency to bleed during brushing.

It is caused by certain bacteria (known as periodontal bacteria) and by the local inflammation triggered by those bacteria.

Researchers from the University of Amsterdam in The Netherlands assessed a total of 313 participants from a dental clinic at the university.

Of these, 126 patients had mild-to-moderate gum disease, 78 patients had severe periodontitis, and 198 individuals did not have signs of gum disease.

Findings revealed that the most diabetes cases were found among those with periodontitis.

In the group with severe gum disease 23% of people were suspected of diabetes, compared to just 14% of those with mild-to-moderate gum disease.

Only 10% of those with no gum disease had suspected diabetes.

Via: http://www.dailystar.co.uk/h

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A recent analysis of a massive study observing the effect of food on the health of nearly 200,000 American health professionals suggested eating more gluten was associated with a lower risk of type 2 diabetes.

But is it really this simple?

Can gluten be linked to diabetes?

A considerable amount of published research has looked at the potential links between coeliac disease and type 1 diabetes (a chronic condition where the pancreas produces little or no insulin). This has led to the discovery that they often share similar genetic markers linked to the immune system.

Another recent study found that although coeliac disease was more common in people with type 1 diabetes there were no more cases of coeliac disease in people with type 2 diabetes (which usually presents in adulthood, and is typically associated with lifestyle factors) than the general population.

However, while studies in animals suggest gluten may increase risk of developing type 1 diabetes, human studies do not. A large review investigating when infants are first given gluten and their risk of developing type 1 diabetes found no link, unless infants were fed solids in their first three months, which is much younger than the six months recommended by the World Health Organisation.

And in animal studies of type 2 diabetes, it has been suggested gluten may increase the risk of developing diabetes.

How reliable are the study results?

Mice studies are interesting, but we need to look at data from people. This is typically done in either clinical trials, which can assess causality (that one thing caused the other), or by observing groups, which identify associations only (two things happened together, but one didn’t necessarily cause the other).

This new study fits into the latter. The study looked at data from three big studies that started 40 years ago with the Nurses’ Health Study, and continued with Nurses’ Health Study II (1989) and Health Professionals Follow Up Study (1986). These looked at the effect of nutrition on long-term health.

The latest news, suggesting gluten may lower risk of type 2 diabetes, was reported at an American Heart Association conference last week. The full research paper is not readily available, so we have to rely on a press release from the AHA.

This reported that the 20% of people with the highest intake of gluten had a 13% lower risk of developing type 2 diabetes compared to those eating less than 4g a day (which is equivalent to less than two slices of bread).

So, it could seem that gluten intake is protective against developing type 2 diabetes.

However, a more likely explanation could be that this is an effect of other things in foods that also contain gluten. Perhaps, eating wholegrains – including wheat, barley and rye could be responsible for the reported results. They are key dietary sources of gluten and are rich in fibre and a number of vitamins (such as vitamin E) and minerals (such as magnesium).

Evidence of this can be seen in an earlier analysis of the same data, which found that those consuming the most wholegrain had a 27% reduced risk of developing type 2 diabetes.

It’s also plausible that the foods people were eating that didn’t contain gluten were more likely to be discretionary foods, such as French fries, and that could be a factor. This was also seen in another analysis of this data, which found the highest consumers of French fries had a 21% increased risk of developing type 2 diabetes.

Avoiding gluten can mean losing important nutrients

So, any conclusions regarding effects of gluten in prevention of type 2 diabetes cannot be drawn from this study. The authors acknowledge this in the conference media release. The observed effect is likely to be related to other factors in foods consumed or not consumed.

The study also suggests that for people who do not have a clinical reason to avoid gluten (such as coeliac disease, wheat allergy or other gluten sensitivities), restricting the intake of foods that could have other benefits can be harmful. They need to look for replacement sources of fibre and other nutrients.

Avoiding gluten is an increasing trend, possibly linked to media attention associated with popular alternative dietary messages such as “paleo”, or following the latest fad diets observed in celebrities and athletes. This may not be a problem if nutrients are replaced by other foods. But that can be challenging, particularly if there are diet or food restrictions in such plans.

To get the best out of this way of eating, it’s important to have a comprehensive understanding of diet and nutrition, which may require a visit to a dietitian or other healthcare professional.

Including foods containing gluten, unless you have a medical reason to exclude them, can be the simplest way to benefit from the fibre and other nutrients they contain. If you wish to remove gluten from your diet, you should look to include healthy, naturally gluten-free grains such as quinoa or buckwheat.

Although this study is interesting, it’s important to remember that without a medical reason, going gluten free is unlikely to result in any therapeutic benefits. But if you do, you need to ensure you don’t replace these foods with discretionary foods high in fat, salt and sugar.

 

Via: http://theconversation.com/

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Scientists have reversed Type 2 diabetes in a study of patients who underwent intensive medical treatment to control their blood sugar levels.

By following a regimen of strict diet, exercise and medications, up to 40 percent of the participants managed to stay in remission for three months after stopping their medication.

The research was conducted by investigators at McMaster University in Ontario, Canada.

Researchers divided 83 individuals with Type 2 diabetes into three groups. Two of the groups received intensive metabolic intervention that included a personalized meal plan that cut their daily caloric intake by 500 to 750 calories per day. They were also given an individualized exercise plan, met with a dietitian regularly and took medication and insulin at bedtime to help control blood glucose.

The only difference is one group was intensively treated for 16 weeks while the other group received the same intervention for just eight weeks.

They were compared to a third group of participants that was given standard diabetic management information from a health care provider, including lifestyle advice.

All of the participants had their blood glucose measured at 20, 28 and 52 weeks to see how well their blood sugar was controlled.

After eight and 16 weeks of the intensive intervention, medication was stopped in both groups.

In the 16-week group, 11 of 27 participants met the criteria for complete or partial remission of their diabetes for a period of three months after the trial.

In the eight-week intensive therapy group, six out of 28 individuals were in remission for three months after the intervention was completed. Only four out of 28 patients in the control group showed remission.

The results of the study were published in the Journal of Clinical Endocrinology and Metabolism.

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Could change diabetes treatment

Lead researcher Natalia McInness thinks the finding may shift the way adults with diabetes are treated from simply managing their blood sugar levels to a program of intensive therapy to put the disease into remission. Under that strategy, patients would be watched for signs of relapse and treated accordingly.

In Type 2 diabetes, the body either doesn’t make enough of the hormone insulin, in severe cases, to ferry nutrients into cells or the cells become resistant to insulin.

Either way, McInness believes the intensive therapy intervention “gives the pancreas a rest,” decreasing fat stores in the body that in turn improve insulin production and sensitivity. The pancreas is the organ that produces insulin.

She said the findings support the notion that Type 2 diabetes can be reversed, at least in the short term, through strict medical management. The idea of putting diabetic patients into remission, said McInness, could be very appealing, motivating them to make significant lifestyle changes.

Diabetes is a growing epidemic worldwide and patients struggle to maintain blood sugar levels in the normal range to avoid severe complications like heart disease, blindness and kidney failure.

Via: http://www.voanews.com/

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Taking medication to tightly control and lower blood glucose levels is the advice frequently given by doctors to the 400,000 B.C. residents with Type 2 diabetes — but it’s a “misguided” approach, according to the University of B.C. Therapeutics Initiative.

More than $1 billion is spent annually on diabetes drugs in this province, but in its latest bulletin to doctors, the TI says a growing body of research casts doubt on the effectiveness of Type 2 diabetes treatment. Doctors should focus instead on prescribing lifestyle modifications such as weight loss, exercise and healthier diets instead of medications to many patients, it says.

Type 2 diabetes, characterized by resistance to insulin, is largely caused by obesity, lack of exercise, high-carbohydrate diets and aging.

With the exception of a drug called metformin, many glucose-lowering medications like insulin can lead to weight gain or potentially cause low blood sugar (hypoglycemia), which can lead to falls, driving accidents or even loss of consciousness, the TI says. More than half of Type 2 diabetes patients take such medications. (Insulin is an essential medication for those with Type 1 diabetes, which accounts for less than 10 per cent of all diabetes cases in B.C.).

The TI, an independent body that provides advice to doctors, said the optimal blood glucose level target is actually unknown in Type 2 diabetics, and there’s still no conclusive evidence that taking medications to lower blood glucose levels will decrease complications of the condition. Such complications include kidney disease, blindness, cardiovascular disease, strokes and amputations.

Dr. Tom Perry, a Vancouver internist and clinical pharmacologist with the TI, said doctors tend to minimize harms when prescribing drugs to patients.

At the same time, he says that he’s had few “star” diabetic patients willing to put in the hard work to shrink waistlines, exercise and change diet patterns.

“It’s kind of frightening because we don’t really have the right evidence for treating the Type 2 epidemic. What we’ve been doing is not very scientific,” he said, adding that publicly funded (as opposed to pharmaceutical industry-sponsored) research trials are needed to study the best treatment approaches.

Vancouver endocrinologist Dr. Tom Elliott said he’s in general agreement with the TI that some doctors may be over-treating Type 2 diabetics.

“But there are lots of patients we may be under-treating too. The problem is we don’t know how low the glucose levels should go in order to reduce the risk of bad things happening to patients.”

In an article he wrote last fall, Elliott discussed the growing controversy, saying it is true that in borderline patients, there is little high quality evidence regarding glucose lowering drugs for preventing long-term complications.

“What’s clear is that a concerted effort needs to be made to help high-risk groups to achieve better blood sugar control,” Elliott wrote.

Lawrence Leiter, a professor of medicine and nutritional sciences at the University of Toronto and a specialist in the division of endocrinology at the city’s St. Michael’s Hospital, was critical of the TI bulletin. He said the TI group has been overly selective in choosing which studies to base its recommendations upon.

“In the past two years, we have evidence from large, well-conducted, randomized controlled trials that three different medications for the management of diabetes — empagliflozin (Jardiance), liraglutide (Victoza) and semaglutide (not yet approved) — significantly reduced the risk of cardiovascular events in patients with a history of diabetes and cardiovascular disease, and that empagliflozin also reduced the risk of kidney problems.

“Canadian Diabetes Association clinical practice guidelines have for many years emphasized that we must not just lower blood glucose levels but also improve all risk factors, including blood pressure and cholesterol (and) the most recent update to our guidelines, published in November 2016, now recommend the use of empagliflozin and liraglutide to reduce the risk of complications in appropriate patients.”

Via: http://vancouversun.com/

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