Category Archives: Diabetes

This month marks the 5th anniversary of the Diabetes Discoveries & Practice Blog.

Over the past 5 years, the Diabetes Discoveries & Practice Blog (DDP) published more than 150 blog posts featuring the perspectives of subject matter experts on the front lines of diabetes research, management, and prevention. As diabetes technologies and treatments continue to advance, the blog will keep providing updates about current practices and emerging viewpoints for health care professionals. To celebrate this milestone, check out 5 of our favorite posts from the last 5 years.

Motivational Interviewing: Dos and Donts

Motivational interviewing (MI) is a set of communication techniques providers use in conversation with patients to help spark behavior changes in people with chronic conditions, such as diabetes. In motivational interviewing, the provider serves as a guide, and the patient steers the conversation. Ken Resnicow, PhD, highlights several strategies for using MI with patients.

The Social Determinants of Health and Diabetes

Social determinants of health are the primary contributors to unfair and avoidable differences in health status, including risk for developing diabetes and diabetes complications. Felicia Hill-Briggs, PhD, a clinical psychologist and behavioral scientist, explains how unequal distribution of social resources can lead to disproportionately negative health outcomes, and what can be done to address such inequities.

Helping Patients with Diabetes Manage Stress

People with diabetes face stress related to health status, as well as system-based challenges, such as structural racism or inadequate health resources. These stressors can result in increased blood glucose levels for people with type 2 diabetes. Krystal M. Lewis, PhD, discusses how health care professionals can support patients with diabetes to manage their stress.

Achieving Type 2 Diabetes Remission through Weight Loss

Health care professionals can help patients with type 2 diabetes achieve remission through lifestyle changes or metabolic surgery. William Cefalu, MD, director of the NIDDKs Division of Diabetes, Endocrinology, and Metabolic Diseases, breaks down the science behind type 2 diabetes remission and research-backed strategies to achieve it.

Reducing Disparities in Diabetic Amputations

About 200,000 people in the United States have amputations each year, and about 130,000 of those people have diabetes. Amputations are more common among people who live in the southern United States, come from certain racial and ethnic minority groups, are older, or have a lower socioeconomic status. Foluso A. Fakorede, MD, a cardiologist in Bolivar County, MS, discusses the risk factors for peripheral arterial disease that can lead to amputation in patients with diabetes and how health care professionals can help reduce disparities.

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Celebrating the DDP Blog's 5th Anniversary | NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Stacy Trovich encourages kids to be who they are. As a nurse practitioner in Pediatric Endocrinology, Geisinger, Trovitch has spent the last 17 years helping young people diagnosed with Type 1 diabetes learn how to manage their condition. I tell them their diabetes is not going to go away she works with them to become confident in themselves so they can live their lives to the fullest because they are not going to get their teen years back.

One of the young people she has worked with is 16-year-old Mason Friese, of Milton. At 13 months, Mason was admitted to Geisinger Danville with Diabetic Ketoacidosis, a life threatening complication when patients are unable to process glucose for energy, so their bodies begin to break down fat. This makes their blood become acidic causing lethargy and their blood pressure drops and their heart rate goes up.

In Masons case, it resulted in his admission to intensive care. While there, his parents learned how to manage his condition by monitoring his blood sugar, administering insulin and treating both low and elevated blood sugar. After a few days, Mason was released to begin what is a lifelong journey of living with Type 1 diabetes.

Things were rough for Mason at first. I was originally on an insulin pump that had a wire on it with a tube and a small needle that was placed in my side. Stacey Trovich, who was a constant in his care, helped him learn how to keep his condition under control. His goal was to eat better and make other changes so he wouldnt develop bigger issues later on.

When he started school, having the nurse there was also a help, but as Mason got older, things got more difficult. As he entered his teens, Masons glucose levels started to skyrocket due to his accelerated growth and hormonal changes.

The condition can be isolating for children because it makes them feel different and they dont want other kids to know they have diabetes. They need to regularly check blood sugar with a glucometer by pricking their fingers. If their blood sugar drops, it can make them unsteady on their feet and they can act as if they are drunk. They might have to leave class often to go to the nurse. All this draws attention to them at a time of their lives when they just want to be like everyone else.

The increased availability of continuous glucose monitoring (CGM) systems has made it easier and less obvious for kids to monitor their blood sugar. These small devices are worn on the belly or arm, have a tiny sensor that is inserted under the skin and tests glucose levels every few minutes. By checking an app on their phone they can keep track of their sugar levels.

At 15, Mason started getting interested in bodybuilding. Unsure as to what he could and couldnt do as a diabetic, Trovich recommended that Mason start using a Libre CGM and an Omnipod insulin pump that provides him with all the insulin he requires. So like the rest of his peers, Mason is constantly monitoring his phone. He just has something to check other than social media.

The other big change his team in Endocrinology has encouraged Mason to make is to cook for himself. At first thinking it would be too difficult, Mason soon realized that doing his own cooking made it easier to eat healthier. It also gives more options as to what he can eat. Before I wasnt taking responsibility for my own health. I found out I really do like to cook and eating healthier has made everything a lot better.

We gave Mason the tools that he needed to do what he wanted to do. Stacey Trovich feels that the more knowledge you give a child, the more they understand, and the more they accept that Type 1 diabetes is just a part of their lives. Mason has gotten over that hump and he has been doing very well. Accepting that diabetes is just a part of him has enabled him to make so much progress. He has taken all of this on and is just thriving.

When asked what he would tell his 12 year-old self Mason replied, Follow a path that you think is going to be the best for you. Never, ever think that you are not good enough for something. You can be whatever you want if you strive for it. It doesnt matter if you have diabetes, mental health or other health challenges, your life has value. You can be whatever you want if you strive for it.

In the future Mason is looking forward to competing in International Body Building Federation Pro physique competitions. He is also looking to work in construction in Colorado before eventually moving back closer to home. Mason is quick to credit Stacey Trovich and the Endocrinology staff with helping him take on this life changing disease and learning to control it.

Trovich tells her young patients, You are keeping yourselves alive. Others have a functioning pancreas. You have to accept the responsibility to control your diabetes and not let it hold you back.

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Valley doc working with teen to treat Type I diabetes - Sunbury Daily Item

It is estimated that over 9% of the population in Ukraine is living with diabetes mellitus, a condition that can cause costly and debilitating complications including heart attacks, strokes, kidney failure, blindness and lower-limb amputations if untreated.

Access to insulin can save lives and prevent the development of disabling complications, explained Dr Jarno Habicht, WHO Representative in Ukraine. WHO is stepping up its efforts with the Ministry of Health to respond to mounting health needs throughout Ukraine. It is vital that access to insulin and other medicines is made available during these challenging times, as the coming months could test Ukraines health system as never before.

More than 370 000 insulin pens are being disseminated to hospitals in the Dnipropetrovsk, Ivano-Frankivsk, Khmelnytskyi, Kirovohrad, Kyiv, Mykolaiv, Poltava, Rivne, Ternopil, Volyn, Zakarpattya and Zaporizhzhia regions. The donations were made possible with support from the pharmaceutical company Novo Nordisk and the nongovernmental organization Direct Relief.

Supplying medical facilities and pharmacies with insulin requires a well functioning logistics system to comply with the necessary storage and transportation conditions, in particular the cold chain. WHO is making every effort to provide vital insulin as soon as possible and in full to all patients, including children, who need this therapy.

Diabetes is the seventh leading cause of death globally. More than 420 million people are currently living with diabetes, and this number is estimated to rise to 570 million by 2030 and to 700 million by 2045.

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Treating diabetes: WHO delivers insulin to hospitals in Ukraine - World Health Organization

Dr. Gabe Mirkin

Mikhail Gorbachev was the last leader of the Soviet Union before its break-up in 1991. He supported MarxistLeninist Communism but moved towards social democracy in his later life. From his early thirties onward, he suffered from diabetes that caused him to be hospitalized many times for various complications of the disease. His diabetes caused kidney failure that required several years of dialysis. On August 30, 2022 at age 91, he died of kidney failure.

His Mark On The WorldGorbachevs parents were poor Russian and Ukrainian peasants, and his first job was driving a tractor on a collective farm. He went to Moscow State University, married another student, Raisa Titarenko, in 1953 and received his law degree in 1955. He was a strong antagonist to Stalin and after Stalin died in 1953, he was a strong supporter of Nikita Khrushchev who rose from First Secretary of the Communist Party of the Soviet Union in 1953 to Chairman of the Council of Ministers from 1958 to 1964. In 1978, Gorbachev was appointed Secretary of the partys Central Committee. In 1979, he became a member of the governing Politburo, and in 1985, he was elected the leader of Russia as the General Secretary of the Politburo.Winner of the Nobel Peace Prize in 1991Gorbachev was a man of peace. After the Chernobyl nuclear bomb disaster in 1986, he withdrew troops from the SovietAfghan War in 1988 and embarked on summits with U.S. President Ronald Reagan to limit nuclear weapons and end the Cold War. He started a new policy in Russia of glasnost, enhanced freedom of speech and press. He started perestroika (restructuring) to decentralize economic decision-making to improve its efficiency and the economy in Russia). He tried to get rid of the one-party state by forming an elected Congress of Peoples Deputies He did not invade Eastern Bloc countries that abandoned communism in 19891990.

After an unsuccessful coup attempted to get rid of Gorbachev in 1991, the Soviet Union was dissolved against Gorbachevs wishes. He gave up his presidency and started the Gorbachev Foundation that criticized Russian presidents Boris Yeltsin and Vladimir Putin.

Consequences of Diabetes Out of ControlGorbachev was overweight much of his life and did not eat a healthful anti-diabetic diet until his later years. He did follow healthful lifestyle habits of limited alcohol drinking, not smoking and going for frequent walks.

In 2011, at age 80, Gorbachev had surgery for what may have been diabetes-associated osteoporosis. In June 2013, he was hospitalized in the Moscow Central Clinical Hospital, as reported by the Gorbachev Foundation. On October 22, 2013, he was hospitalized in a German clinic. On October 9, 2014 and May, 2015, he was again hospitalized. I do not know the reasons for these hospitalizations.

In November of 2015 he had a heart pacemaker installed. Diabetes causes heart disease. In 2016, he had cataracts removed from both eyes. Diabetes can cause cataracts. In 2019, he was hospitalized for pneumonia. Diabetes increases risk for infections. In 2021, he was in almost daily contact with doctors, had four more operations, and lost more than 90 pounds. He was in kidney failure and was on dialysis. Diabetes can destroy the kidneys. From then on he had round-the-clock medical care. He died of kidney failure on August 30, 2022.Other Recent High-Level Russian Deaths On June 19, 2022, Gennady Burbulis, the Russian official who confirmed the dissolution of the Soviet Union in December 1991, died suddenly at the age of 76 in Azerbaijan Ukraines Leonid Kravchuk and Belaruss Stanislav Shushkevich, two other leaders who signed the December 1991 Soviet Union dissolution, both died last month at ages 88 and 87. The other signer and first Russian president, Boris Yeltsin, died in 2007.

At least eight prominent Russian businessmen have reportedly died by unexplained accidents or suicide since January 2022, with six of them associated with Russias two largest energy companies.

The 29-year-old TV commentator Daria Dugina, daughter of an influential Russian nationalist, was killed by an explosive device planted in the SUV she was driving. Suspicions are that the intended target was her father, Alexander Dugin, a nationalist philosopher and writer.

Lessons from Gorbachevs Life with DiabetesSeventy percent of North Americans will become diabetic because of unhealthful lifestyles. Every time your blood sugar rises too high, sugar can stick to the outer membranes of cells throughout your body and damage them. It is very unusual for a person who developed diabetes in his thirties to live into his nineties.

Gorbachevs doctors convinced him that his unhealthful lifestyle of his early days was one of the reasons why he developed diabetes at such a young age, and he did make major lifestyle changes as he grew older. He went from his earlier lifestyle that caused him to be morbidly overweight, to: trying to walk every day avoiding overeating losing excess weight restricting sugar-added foods substituting fish for red meat restricting alcohol not smoking

However, an early lifetime ofpro-inflammatoryhabits that are associated with increased diabetes risk cannot completely reverse all the cell damage that a high rise in blood sugar has already caused.Lifestyle Changes to Prevent and Treat Diabetes

Dr. Gabe Mirkin is a Villager. Learn more at http://www.drmirkin.com

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Mikhail Gorbachev had been diagnosed with diabetes at relatively young age - Villages-News

A recent literature reviewed showed a plausible link between diabetic retinopathy and the gut microbiome. The authors speculate that the manipulating the makeup of microbiome might be a way to help keep diabetic retinopathy in check.

The gut microbiota of people with diabetes and those with diabetic retinopathy differs from those without diabetes. This offers an area of research for potentially addressing diabetic retinopathy, a complication of diabetes, according to a recent study in the online journal Investigative Ophthalmology & Visual Science.

The microbiome is the community of microorganisms (such as fungi, bacteria and viruses) that exists on and within the human body. The imbalance of the microorganisms in the intestines can trigger inflammation and the production of some toxins that can lead to some types of cancer, some studies have found. This has led increased research about the implication of such dysbiosis and whether therapeutics can be developed to prevent or treat diseases with microbiome-targeted therapies.

Over the last few years, research begun to show a connection between the gut microbiome and diabetes and possibly diabetic retinopathy, which is an eye condition caused by damage to the blood vessels in the back of the eye. The human gut microbiota consists of at least 1,500 different microbial species, and changes in this system have been associated with diabetes. Previous studies have indicated that the onset of type 1 diabetes follows an increase in inflammation associated micro-organisms.

Related: Microbiomes of Patients with MPN Have Inflammation-Related Variations Compared to Controls

In the paper in Investigative Ophthalmology & Visual Science, investigators conducted a literature review over the last five years to assess the connection between the gut microbiotas impact on the eye, called the gut-retinal axis. Investigators, led by Pratima Singh Thakur, LV Prasad Eye Institute, Hyderabad, India, wanted to determine if changes in the gut microbiome were more common in patients with diabetic retinopathy.

Investigators reviewed the literature using predetermined keywords, and they summarized the evidence generated that so far supports the role of gut dysbiosis in diabetic retinopathy. This review found that at least four mechanisms have been suggested to explain the relationship between diabetes and the gut. Several bacteria are known to downregulate and others can upregulate inflammatory cytokines in the gut. Various species of Bacteroides and Lactobacillus can increase glucose uptake, and Lactobacillus and Akkermansia can decrease carbohydrate metabolism. Many probiotic bacteria can induce fatty acid metabolism, reducing obesity.

Investigators have found that gut dysbiosis has been studied less in patients with diabetic retinopathy. A study in mice found that an increase in one bacteria, Firmicutes, led to an increase in tauroursodeoxycholate (TUDCA), which is known to stimulate retinal ganglion cells and act as a neuroprotective agent. In a study in rats, the microbiome in the control rats was different from that of the diabetic rats, and there were overlaps between the microbiomes of the diabetic rats with or without retinopathy.

In clinical studies in people with diabetes and diabetic retinopathy, investigators found the gut microbiome of the diabetic retinopathy cohort in one study differed from that of the controls and in type 2 diabetes. We linked increased inflammation in DR [diabetic retinopathy] to a reduced abundance of anti-inflammatory bacteria. An increase in abundance of only a single proinflammatory bacterium (Shigella) was demonstrated in our study in DR [diabetic retinopathy], investigators wrote.

The study also demonstrated a decrease of two probiotic bacteria (Bifidobacterium and Lactobacillus), and they concluded that diabetes and diabetic retinopathy changes could be attributed to an altered balance between proinflammatory, anti-inflammatory, and pathogenic gut bacteria. In another study the investigators reviewed, gut dysbiosis was found to vary among people with diabetes. The changes including an increase of Bifidobacterium and Lactobacillus and an decrease in Faecalibacterium, Escherichia, Shigella, Eubacterium, and Clostridium indicated a complex diversity in people with diabetes.

Investigators also found that two studies showed that the gut bacteria could be a marker for diabetic retinopathy. One identified 25 families of bacteria that can be potentially employed for differentiating people with and without diabetic retinopathy.

Investigators pointed out that one of the challenges of assessing the impact of gut bacteria on diabetic retinopathy is that other variables, including genomics and lifestyle factors such as diet, smoking, and physical activity, and other comorbidities can contribute to disease progression.

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The Eye-Gut Connection: Tinkering With the Gut Microbiome Might Be a Way to Address Diabetic Retinopathy - Managed Healthcare Executive

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By Karen Longwell

Published September 7, 2022 at 12:49 pm

A mobile clinic is offering free Type-2 diabetes tests in Brampton and Mississauga this month.

Dynacare, a medical testing company, is launching their Dynacare4Diabetes campaign in Mississauga on Thursday, Sept. 8.

The mobile clinic will be at Guru Singh Sabha Malton Gurdwara, 7280 Airport Rd. in Malton from 10 a.m. to 4 p.m.

Attendees can learn about the risk factors for Type 2 diabetes and receive a free A1C test.

There is no cost to participants and none of the services will be billed to Ontario Health Insurance Plan (OHIP).

Another mobile clinic will be in Brampton on Saturday, Sept. 24 at Sri Guru Nanak Sikh Centre Brampton Glidden Gurdwara, 99 Glidden Rd. from 10 a.m. to 4 p.m.

Its estimated 30 per cent of all Canadians, or 11.7 million people, are living with diabetes or prediabetes, according to Diabetes Canada.

People over the age of 40 have a greater risk of developing type 2 diabetes or if you have a parent, brother, or sister with diabetes, according to Diabetes Canada.

Ethnic background is also a factor and people of African, Arab, Asian, Hispanic, Indigenous, or South Asian descent can increase your risk of living with type 2 diabetes.

Dynacare will make a 50-cent donation to Diabetes Canada for every A1C test completed, up to a total of $25,000.

For more information, visit the Dynacare website.

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Free Type-2 diabetes testing offered in Brampton and Mississauga | insauga - insauga.com

High blood pressurealso known as hypertensionand Type 2 diabetes are two of the most common medical conditions in the U.S. Unfortunately, they often occur together. Some research has found that 85% of middle-aged or older adults who have Type 2 diabetes also have hypertension, and both conditions elevate a persons risk for heart disease, stroke, and kidney disease.

These increased risks are significant, and in some cases grave. Researchers have found that people with Type 2 diabetes are up to four times more likely to develop cardiovascular disease than those who dont have the condition. People with diabetes are also twice as likely to die of cardiovascular problems. The leaps in rates of stroke, kidney failure, and other deadly complications are also substantial for people who have both high blood pressure and diabetes.

Why do these conditions so often show up in tandem? Experts are still trying to nail down the precise connections, but they say excess weight may play a part. Many people who have hypertension and Type 2 diabetes also have obesity, and this triumvirate, as some researchers have termed it, is associated with metabolic and endocrine problems that overlap and promote disease. Obesity seems to be fertile soil for both, says Dr. Srinivasan Beddhu, a professor of internal medicine at the University of Utah School of Medicine.

Also, the sheer commonness of hypertension all but ensures that most people with Type 2 diabetes will end up with both diseases. Roughly half of all U.S. adults have hypertension, and that percentage goes up with age. It can develop as early as [ages] 30 to 42, but in most cases, by the time youre in your 50s, its there, says Dr. George Bakris, a professor of medicine at the University of Chicago. Although hypertension often precedes Type 2 diabetes, Bakris says, diabetes is increasingly common in young adults and even children. Its more important than ever to keep an eye out for both conditions, perhaps especially if youre overweight or obese.

Here, experts explain how high blood pressure and Type 2 diabetes cause trouble in combination, as well as how to manage the conditions and reduce their associated risks.

Read More: These New Developments Could Make Living With Type 2 Diabetes More Manageable

Every time a heart beats, it sends blood out into the body via the circulatory system. In between beats, the heart fills with blood. A persons blood pressure refers to two different but related measurements of this cycle. The first, known as systolic blood pressure, is the pressure inside the arteries when the heart beats and pumps out blood. The second measurement, known as diastolic blood pressure, is the pressure inside the arteries when the heart is resting and filling with blood. These two numbers are usually presented together, and they almost always rise and fall in unison. In the U.S., blood-pressure scores higher than 130/80 mm Hg are considered hypertensive.

Bakris says hypertension is often called a silent killer because it may cause no symptoms. Even when a persons blood pressure is dangerously high, the symptoms that develop are so common and nonspecificmeaning they turn up for all sorts of reasonsthat you may not connect them with high blood pressure. Dizziness, headaches, and blurry vision are among these nonspecific symptoms. By the time they set in, a persons blood pressure may have been elevatedand doing damagefor several years. What sort of damage? High blood pressure can stretch or injure your arteries in ways that raise your risk for heart disease, arterial disease, stroke, and other cardiovascular complications. High blood pressure also increases stress on the kidneys and some other organs.

Type 2 diabetes is a medical condition defined by high blood-sugar levels. These high levels are caused by problems related to insulin, which is a hormone that signals to the bodys cells that they need to absorb blood sugar. In people with Type 2 diabetes, the cells become resistant to insulin, meaning they do not properly absorb blood sugar. As with hypertension, the early symptoms of Type 2 diabetesfrequent urination, blurry vision, dramatic hunger spikesmay not raise immediate red flags. If someone isnt staying on top of their doctors appointments, they may not be aware that one or both of these conditions is present.

How do these conditions combine in ways that contribute to health problems? Both affect the small blood vessels, says Dr. Mattias Brunstrom, a hypertension specialist and physician researcher at Umea University in Sweden. Diabetes affects the vessels in ways that make them stiffer, and high blood pressure impairs their function. This stacking of arterial damage helps explain why the combination of the two conditions is associated with cardiovascular problems, including higher rates of heart disease and stroke.

At the same time, both hypertension and Type 2 diabetes may also promote higher-than-normal levels of blood sugar. Elevated blood sugar can damage the cells of the kidneys (as well as the heart and blood vessels). Kidney diseaseand ultimately kidney failureis a common complication among people with both of these conditions. If you have [systolic] blood pressure consistently above 180, within 12 to 15 years, you will be on dialysis, Bakris says, referring to a medical procedure that removes, filters, and returns the blood to someone whose kidneys are no longer up to it. Elevated blood sugar caused by Type 2 diabetes further damages kidney cells, and increases the odds that the kidneys will struggle or fail to perform their job.

Although cardiovascular and renal problems are two of the most common complications, hypertension and Type 2 diabetes can cause or contribute to a wide range of health problemsfrom dementia to blindness. Both affect the vasculature, which can impair the health of any organ system, Brunstrom says.

Fortunately, there are effective ways to manage both conditions and therefore reduce all of these health risks.

Read More: The Truth About Fasting and Type 2 Diabetes

As is the case with most common health conditions, experts say that a combination of lifestyle changes and prescription drugs are often an effective one-two punch for people with both hypertension and Type 2 diabetes.

First, I would say that lifestyle changes are the basics of all disease management, Brunstrom says. He re-emphasizes the strong associations linking hypertension and Type 2 diabetes to obesity, and the role excess weight plays in exacerbating many health complications. Obesity or overweight is a huge driver of both these conditions, so weight management would be very crucial, he says. Diet, exerciseany way you can get your weight down is good.

Even if youre not losing weight, exercise is still beneficial. It increases circulation around the body and improves function of the small vessels, which might get [blood] pressure down, he says. It might also improve the sensitivity to insulin and reduce glucose. Thats all good stuff. Even short of sweaty exercise sessions, spending less time sitting or in a sedentary positionwalking, for example, or doing chores around the house on your feetmay be helpful.

When it comes to eating, Brunstrom highlights the DASH diet, which is endorsed by the National Heart, Lung, and Blood Institute for the management of hypertension. (DASH stands for dietary approaches to stop hypertension.) The DASH diet involves limiting your intake of saturated fats, which are common in red meat and fatty dairy products, and also cutting down on your intake of salt and sugary foods and drinks. Meanwhile, the DASH diet recommends eating lots of fruits and vegetables. Other experts endorse these eating habits. I always tell my patients to eat healthy, which means more fruits and vegetables, less red meat, fewer high-carbohydrate foods, says the University of Utahs Beddhu.

Recently, some researchers have examined the benefits of intermittent fasting plans for the management of Type 2 diabetes. These approaches involve limiting or eliminating all caloric intake for an extended period of timeusually 16 hours or longer. Theres evidence that they may be beneficial. They also appear to be safe for people with early or mild disease. But if you have diabetes and are on medications, these diets can wreak havoc, Bakris says. If you want to try that, you need the help of a physician or accredited diabetes dietitian.

Weight-loss surgery may be a treatment option worth considering. Recent research shows that bariatric surgery has helped both young people and adults get better control of their diabetes and hypertension. In some cases, especially those involving teenagers, weight-loss surgery has removed the need for medications or even eliminated the diseases entirely.

Apart from surgery and lifestyle interventions, experts agree that prescription medications are almost always necessary to manage these diseases. You can reduce your pill burden if youre really good on the lifestyle sideso eating right, reducing sodium intake, exercising regularly, Bakris says. But even on the low end, most people with diabetes and hypertension are going to require four to six medications.

Others agree that pills are pretty much unavoidable. I always compare [taking] them to doing your taxes or brushing your teeth, says Dr. Tom Brouwer, a cardiology resident and researcher at Amsterdam University Medical Centres in the Netherlands. Its not fun, but you need to do it.

In the U.S., medical guidelines recommend that doctors aim to get people with both hypertension and diabetes down to blood-pressure scores below 130/80 mm Hg. Theres some ongoing debate about whether targeting even lower numbers would be beneficial. Brouwer has conducted research in this area, and he says that in many cases hes a proponent of aiming for a systolic BP of 120. If a patient tolerates it, I tend to try to lower their blood pressure all the way to 120, he says.

There are many different drugs used to treat people with both hypertension and Type 2 diabetes. But two of the most popular options are angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers, both of which help relax the arteries and so assist blood flow. Apart from being effective for hypertension, these drugs also help protect the kidneys. Diuretics (drugs that increase urination), as well as beta blockers and calcium channel blockers, are all common treatments.

Read More: People With Diabetes Are More Vulnerable to Heart Disease. How to Reduce the Risk

With these three drugs, an overwhelming majority of patients get to the target blood pressure, Brouwer says.

For those at risk for hypertension, diabetes, or both, experts say that all the lifestyle measures abovea good diet, exercise, and maintaining a healthy weightare among the best ways to lower your risks. By following your doctors drug recommendations and trying to live a healthier life, you can protect yourself from serious complications. I tell patients: you can help yourself, Bakris says. But you have to put in the effort.

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How Diabetes and High Blood Pressure Are Linked - TIME

Diabetesis a common condition that affects one in 10 people, that's over 37 million Americans, according to the Centers for Disease Control and Prevention While that's an alarming number, there are ways to help lower the risk. Dr. Tomi Mitchell, a Board-Certified Family Physician with Holistic Wellness Strategies tells us, "Diabetes is a serious medical condition that can lead to several health complications, including heart disease, kidney damage, and blindness. Fortunately, there are several things that people can do to reduce their chance of developing diabetes. Here are five lifestyle changes that can help to prevent diabetes. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Mitchell says, "Diabetes is a chronic disease that occurs when the pancreas does not produce enough insulin or when the body cannot effectively use the insulin it produces. Insulin is a hormone that regulates blood sugar. When blood sugar levels are too high, it can strain the organs and lead to complications such as heart disease, stroke, kidney disease, and vision problems. There are two main types of diabetes: type 1 and type 2. Type 1 diabetes usually develops in childhood or adolescence and is caused by an autoimmune reaction that destroys the beta cells in the pancreas that produce insulin. Type 2 diabetes usually develops in adulthood and is characterized by insulin resistance, when the body cannot effectively use the insulin it produces. Diabetes can be managed through lifestyle changes such as diet, exercise, and medication.

According to the Centers for Disease Control and Prevention (CDC), more than 30 million people in the United States have diabetes. However, it is estimated that one in four is undiagnosed and unaware of the condition. This is particularly concerning because diabetes can lead to several serious health complications, including heart disease, stroke, kidney disease, and blindness. That is why it is so important to get screened for diabetes if you think you may be at risk. If you have a family history of diabetes, your doctor might recommend getting screened at an earlier age. There are several ways to test for diabetes, but the most common is the A1C test. This test measures your average blood sugar levels over two to three months and can be done at your doctor's office or a local clinic. If you have diabetes, it is essential to work with your healthcare team to manage your condition and prevent complications. People with diabetes can live long and healthy lives with proper treatment and care."

Dr. Mitchell explains, "Being overweight or obese is the number one risk factor for type 2 diabetes. About 80 percent of people with this form of diabetes are overweight or obese. There are several reasons why carrying extra weight increases your risk of developing diabetes. First, excess body fat makes it difficult for the body to use insulin effectively. When the body can't use insulin properly, blood sugar levels rise. This is known as insulin resistance. Insulin resistance is a major cause of type 2 diabetes. In addition, carrying extra weight puts extra strain on the body's organs and systems, including the pancreas, which produces insulin. Over time, this can lead to damage and dysfunction. Finally, fat tissue produces hormones contributing to insulin resistance and high blood sugar levels. For all these reasons, people who carry extra weight are at a much higher risk of developing diabetes than those of a healthy weight."

According to the Centers for Disease Control and Prevention, "Not getting enough physical activity can raise a person's risk of developing type 2 diabetes. Physical activity helps control blood sugar (glucose), weight, and blood pressure and helps raise "good" cholesterol and lower "bad" cholesterol. Adequate physical activity can also help reduce the risk of heart disease and nerve damage, which are often problems for people with diabetes."

Dr. Mitchell reminds us, "Eating a healthy diet is essential for many reasons. It can help you maintain a healthy weight, have more energy, and avoid heart disease, stroke, and diabetes. Diabetes is a condition that affects how your body uses blood sugar. If you have diabetes, your body either doesn't make enough insulin or can't use it as well as it should. This causes blood sugar levels to rise. Over time, high blood sugar levels can lead to serious health problems, such as heart disease, kidney disease, nerve damage, and eye problems. Eating a healthy diet is one of the best ways to prevent or delay type 2 diabetes. A healthy diet includes fruits, vegetables, whole grains, and lean proteins. Limiting sugar, saturated fat, and trans fat is also essential. If you already have diabetes, eating a healthy diet can help you control your blood sugar levels. It can also help you prevent or delay complications of the disease."6254a4d1642c605c54bf1cab17d50f1e

Dr. Mitchell says, "Smoking is a leading cause of preventable death in the United States and a significant risk factor for developing diabetes. Smokers are more likely to develop type 2 diabetes than non-smokers, and the risk increases with the number of cigarettes smoked daily. Quitting smoking not only lowers your risk of developing diabetes but also helps to improve blood sugar control if you already have the disease. In addition, quitting smoking decreases your chances of developing other serious health problems, such as heart disease, stroke, and cancer. If you smoke, quitting is one of the best things you can do for your health. Talk to your doctor about ways to help you quit smoking for good."

Dr. Mitchell shares, "Monitoring blood sugar is essential in preventing diabetes because it allows people to see how their diet and lifestyle choices affect their blood sugar levels. For example, if someone eats many sugary foods, they might see a spike in their blood sugar levels. By monitoring their blood sugar, they can change their diet or lifestyle to help prevent their blood sugar from reaching diabetic levels. In addition, monitoring blood sugar can also help people with diabetes to keep their condition under control. They can adjust their insulin doses accordingly by knowing their blood sugar levels. Thus, monitoring blood sugar is an essential tool in both preventing and managing diabetes."

Heather Newgen

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The #1 Root Cause of Diabetes, Say Physicians Eat This Not That - Eat This, Not That

A blockbuster diabetes drug significantly reduced the risk of hospitalization and death in people with all types of heart failure, according to a large international study led by a researcher at Brigham and Womens Hospital.

The clinical trial found that AstraZenecas drug Farxiga reduced cardiovascular death or worsening heart failure by 18 percent when compared with a placebo in 6,000 patients followed for a median of 2.3 years in 20 countries. Farxiga was first approved in 2014 for the treatment of type 2 diabetes and generated $1 billion in quarterly sales in the first three months of 2022.

Dr. Scott D. Solomon, a professor of medicine at Harvard Medical School and Brigham and Womens, and principal investigator for the study, said a separate meta-analysis he helped conduct of more than 12,000 patients confirmed that Farxiga and a rival drug called Jardiance, sold by Boehringer Ingelheim and Eli Lilly and Co., decreases the number deaths, as well as urgent trips to hospitals.

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We now have really very definitive evidence that regardless of what type of heart failure a patient has, they would benefit from being on this class of drugs, said Solomon. The studies were published in the New England Journal of Medicine, The Lancet, and Nature Medicine. Solomon helped present the findings at the European Society of Cardiology Congress in Barcelona over the weekend.

Heart failure, sometimes known as congestive heart failure, occurs when the heart muscle doesnt pump blood as well as it should. Blood often backs up, and fluid can build up in the lungs, causing shortness of breath, fatigue, and swelling in the legs. The condition, which becomes more common with age, is the leading cause of hospitalization in people over 65 years old, according to the US Food and Drug Administration. It affects more than 650,000 in the United States each year.

Both Farxiga and Jardiance are known as SGLT2 inhibitors and cause the body to excrete sugar in urine. For reasons not entirely understood by scientists, Solomon said, the drugs also appear to slow the progression of heart failure. And thats true for the two main groups of patients: those whose heart muscles dont contract properly, and those whose muscles contract properly but whose chambers dont relax. Both forms of the disease can diminish blood flow.

In February, the FDA allowed Jardiance, which had previously been approved for those patients whose heart muscles dont contract properly, to be prescribed to all of them. Solomon said AstraZeneca has requested similar approval for Farxiga, which is only cleared for the first subset of heart failure patients. He expected the FDA to make a decision in the first half of 2023.

Heart failure remains one of the leading causes of death worldwide with high unmet need for some 64 million people, Mene Pangalos, AstraZenecas executive vice president overseeing research and development of biopharmaceuticals, said in a statement.

Jonathan Saltzman can be reached at jonathan.saltzman@globe.com.

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Brigham and Womens researchers say diabetes drug helps reduce heart failure - The Boston Globe

Investigators have identified at least 2 new risk factors for liver-related mortality in patients with hepatitis C virus (HCV).

A team, led by Nobuhiro Hattori, Department of Internal Medicine, Division of Gastroenterology and Hepatology, St. Marianna University School of Medicine, identified the risk factors linked to liver-related and non-liver-related mortality in patients with HCV following sustained virologic response to direct-acting antiviral agents.

In the retrospective, single-center cohort, the investigators examined 330 patients with HCV cured by DAAs. There was a median follow-up of 3.38 years. Each patient was administered IFN-free DAA treatment between September 2014 and January 2021 at the St. Marianna University Hospital. In addition, the patients with a history of hepatocellular carcinoma (HCC) did not have active HCC at the time of initiation of their final DAA therapy.

The study included 1481 person-years of follow-up, with 25 patients dying during the course of the study.

The investigators also collected data on age, sex, HCV genotype, history of HCC, previous DAA treatment, diabetes mellitus (DM), and hypertension history.

The team also collected laboratory test results, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, total bilirubin, platelet, alpha-fetoprotein (AFP), and mac-2 binding protein glycan isomer (M2BPGi) before the final DAA treatment and at 12weeks after the end of treatment.

The investigators sought primary outcomes of the incidence and predictors of liver-related and non-liver-related deaths of patients with HCV cured by IFN-free DAA treatment.

They also identified the cumulative all-cause, liver-related, and non-liver-related mortality using Kaplan-Meier methods and univariate and multivariate Cox proportional hazard models to identify the predictors of liver-related and non-liver-related deaths.

The results show a cumulative liver-related or non-liver-related mortality rate of 0.00 or 1.29% at year 1, compared to 2.87 or 3.60% at year 3 and 5.10 or 9.46% at year 5.

For liver-related deaths, 90% (n = 9) were from liver cancer, while the most common cause of non-liver-related deaths was malignancy.

After conducting a multivariate analysis using the Cox proportional hazard model, the investigators found diabetes mellitus (HR, 13.1; 95% CI, 2.8161.3) and a history of hepatocellular carcinoma (HR, 12.8; 95% CI, 2.7659.2), independently predicted liver-related death. There were no variables linked to non-liver-related death.

Our findings suggest that DM and a history of HCC are risk factors for liver-related mortality of HCV patients cured by DAAs, the authors wrote. These results indicate that early management of HCV and HCC surveillance of diabetic patients after SVR are important to increase the chance of survival. Further studies are needed to confirm the association of DM and HCC history with survival.

The study, Risk factors for liver-related mortality of patients with hepatitis C virus after sustained virologic response to direct-acting antiviral agents, was published online in JGH Open.

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Diabetes Mellitus, HCC Linked to Liver-Related Mortality in HCV Patients - MD Magazine