Category Archives: Diabetes

Diabetes can be a risk factor for other health conditions like heart and kidney disease. Effective diabetes management is one way to lower your personal risk and help maintain overall good health.

Heart valve disease, which can affect blood flow to the heart, can occur more commonly in people with diabetes. The condition can also progress faster and be more severe in those who have diabetes.

The exact reason for the connection is still being studied, but researchers are exploring some common mechanisms between diabetes and damage to heart valves.

If youre living with diabetes, collaborating with your doctor can be a great way to support your heart health and lower your risk of other serious health conditions.

People with diabetes are twice as likely to have heart disease as those without diabetes. Theyre also, on average, more likely to develop heart disease at a younger age.

Heart disease is a group of conditions that affect heart health. Coronary artery disease is one of the most common conditions in people with or without diabetes. Its when plaque builds up in the arteries that supply blood to the heart. The pathways become narrow, leading to atherosclerosis, or hardening of the arteries.

People with diabetes often have risk factors for heart disease, including:

Diabetes can also affect your heart valve health, specifically by contributing to heart valve disease.

The valves of the heart regulate blood flow to and from the heart and also inside it.

When any of these valves are damaged, its a form of heart valve disease. The valves may not fully open or close during a heartbeat, or may leak. A valve opening may be narrow or stiff, so it cant fully open. This is a condition called stenosis.

Heart valve disease is most common in the aortic valve, although it may occur in any of the hearts valves. High blood pressure and atherosclerosis are two risk factors for heart valve disease.

Researchers are still actively looking at a possible link between diabetes and heart valve disease. Theres a growing body of evidence that the two conditions are connected.

Specifically, diabetes may predict aortic valve stenosis, and this stenosis may be more severe in people with diabetes.

A 2019 paper cited research that found the prevalence of diabetes was higher among those with aortic stenosis than in the general population. The same paper also noted research that diabetes creates and worsens pro-inflammatory factors that also affect the aortic valve.

A study published in 2022 found diabetes was associated with rapid progression of aortic stenosis. The research was based on an analysis of 276 people with aortic stenosis between 2016 and 2021.

There may also be a connection between diabetes and degeneration of the aortic heart valve. A 2018 study found that theres an increase in a certain protein when aortic valves degenerate. In late-stage valve deterioration, diabetes increases the amount of this protein.

Living with diabetes and heart disease can also raise the risk of other conditions, such as chronic kidney disease. According to the National Institutes of Health, 1 in 3 adults with diabetes has kidney disease.

Some of the same causes that lead to an increased risk for heart valve disease also raise the risk of kidney disease.

Specifically, high blood sugar can damage blood vessels not just in the heart but in the kidneys. High blood pressure can put extra strain on these weakened blood vessels from the additional force as blood moves through.

People with diabetes may also carry a greater risk of stroke because of the risk factors for heart disease.

If you live with diabetes, there are many ways you can manage your risk for heart disease. Working with your doctor, you can develop a plan to support your overall health and manage your diabetes.

You may wish to talk with your doctor about screening for heart disease risk. Your doctor may recommend:

Living with a health condition like diabetes can sometimes feel overwhelming. Fortunately, you can often take steps to reduce your risk for other conditions.

Researchers are working to uncover the link between heart valve disease and diabetes. Damage to the heart valves can affect blood flow to the heart, a progression that can happen more quickly in people with diabetes.

If you live with diabetes, your doctor can help you create a plan for heart disease monitoring, balanced eating, and exercise that can help reduce your risk.

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Heart Valve Disease and Diabetes: What You Need to Know - Healthline

According to the Mayo Clinic, type 2 diabetes is a chronic condition that results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous, and immune systems. This leads to your pancreas not producing enough insulina hormone that regulates the movement of sugar into your cellsand cells also responding poorly to insulin, taking in less sugar. Although there is no cure, there are methods to manage your blood sugar, such as weight loss, a healthy diet, and exercising.

If you feel you are at a likelihood of getting the disease, there are also ways to lower your risk of type two diabetes, including eating certain foods and drinks in order to do so. According to a study done by The American Journal of Clinical Nutrition, the best drink to lower type 2 diabetes for both men and women is coffee.

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The research involved a follow-up observation from 74,749 women in the Nurses' Health Study from 1984 through 2008, and 39,059 men in the Health Professionals Follow-Up Study from 1986 through 2008. The participants were free of diabetes, cardiovascular diseases, and cancer at baseline. Over the time of the study to the follow-up, it was concluded that the consumption of caffeinated and decaffeinated coffee was associated with a lower risk of type 2 diabetes.

The study showed that women's risk of type 2 diabetes was reduced by 8%, while men lowered their risk by 4% when drinking regular coffee, or 7% if they consumed decaffeinated.

The research also suggested that coffee makes for a good replacement for sugar-sweetened beverages, such as sodas, as long as the coffee doesn't have too much sweetener or creamer. Sodas have added sugars, which increase your risk of type 2 diabetes and can lead to liver disease, heart disease, tooth decay, increased risk of pancreatic cancer, and overall making for a poor nutritional choice. Especially if consumed often.6254a4d1642c605c54bf1cab17d50f1e

It's important to note that coffee still has potential risks, mostly due to its high caffeine content (if not decaf), so it's good to drink in moderation. The Mayo Clinic states that it can temporarily raise blood pressure, and women who are pregnant, trying to become pregnant or breastfeeding need to be cautious about caffeine. Here's How Much Coffee You Can Have in a Day, According to the Mayo Clinic.

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The #1 Best Drink to Lower Type 2 Diabetes Risk, Says Science Eat This Not That - Eat This, Not That

TUALATIN, Ore. (PRWEB) April 18, 2022

Genteel LLC, one of the largest Bioscience & Health Technology companies in the Pacific Northwest, is improving health outcomes for diabetics far beyond the US. The vacuum lancing device manufacturer announces another international distribution partnership, this time in the United Arab Emirates with DiapointME.

Genteel manufactures the only vacuum lancing device FDA-cleared for use anywhere on the body. With blood sample readings from palms matching those of sensitive fingertips, Genteel significantly reduces pain associated with blood glucose monitoring.

Genteel LLC is proud to announce that their technology is now available to a population in great need of improved diabetes management. According to statistics from the International Diabetes Federation, the UAE holds one of the highest prevalence of diabetes globally. Nearly half of the adult population with type 2 diabetes mellitus are still undiagnosed and untreated.

DiapointME, headquartered in Dubai, is a space for diabetes advocacy, education, and products. As an authorized distributor of the Genteel lancing device, they have joined the Genteel mission of providing relief from discomfort and fear through comfortable glucose checks. Vice President of Sales and Marketing, Mark Berkovich, commented on the deal saying, I am absolutely thrilled to bring the Genteel solution to more people. Through the pursuit of less pain, we are improving patient adherence, and ultimately health outcomes for those who need it most

About Genteel

Genteel LLC is the leader in premium painless vacuum blood draw lancing devices. With over 27 worldwide patents granted in its technology, their unique and gentle device has helped tens of thousands of people living with diabetes give their fingers a break. Learn more about Genteel here.

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Vacuum Lancing Technology Enters the UAE, Making Virtually Painless Glucose Checks a Possibility for Emiratis Living With Diabetes - PR Web

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High concentrations of PFAS, a group of so-called forever chemicals, are associated with increased risk to diabetes in women in midlife, according to new research

The risk is similar to the risks cigarette smoking and being overweight pose, the study shows.

PFAS are ubiquitous in our environmentin our rivers, in our clothes, and seeping through the cooking utensils in our kitchens.

The findings suggest that lowering exposure to these chemicals could be a useful tool in combating diabetes, one of the leading causes of death in the United States, researchers say.

It is important for clinicians to be aware of PFAS as an unrecognized risk factor for diabetes and to be prepared to counsel patients in terms of sources of exposure and potential health effects, says lead author Sung Kyun Park, professor of epidemiology and environmental health sciences at the University of Michigans School of Public Health.

For the study in Diabetologia, Park and colleagues used a subset of participants from the Study of Womens Health Across the Nation, a longitudinal, multisite, multiethnic cohort study of midlife women. At baseline, the subset included nearly 1,300 women ages 45-56 from five sites including Boston; Pittsburgh; southeast Michigan; Los Angeles; and Oakland, California.

Using serum samples collected in 1999-2000, the researchers looked at the concentration of 11 different types of PFAS in the women. Over 16 years, about 100 women developed diabetes. They found that women with diabetes had higher serum concentrations of five types of PFAS than those without diabetes.

The researchers say they hope the findings inspire other scientists to confirm and expand on the results. If confirmed, public health measures to lower PFAS in drinking water and consumer products could help limit the number of new diabetes cases.

Each year, about 1.5 million people are diagnosed with diabetes. If PFAS were reduced, about 370,000 of these cases could be avoided, Park says.

If we were to do that, we could have a huge impact. Changing PFAS policy and making them stricter so the exposure level can go down to that relatively safe level, that would be huge, he says.

PFAS are a public health concern because they are very persistent in the environment and in the human body, which is why they are known as the forever chemical.

But PFAS are also the everywhere chemicals. These compounds are widely used in industrial and consumer applications. If youre going about your everyday life, theres no way to avoid them. Depending on where you live, your water might be contaminated, or you live near a manufacturing plant or a military base, youre more likely to be exposed to these chemicals and avoiding them might be difficult without a larger strategy set up by organizations like the EPA and FDA.

Source: University of Michigan

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'Forever chemicals' linked to higher diabetes risk for women - Futurity: Research News

World Liver Day 2022: Diabetes is a silent killer and damages more body functions than is apparent. If you have diabetes, your liver needs utmost care as not paying attention to this crucial organ could lead to a condition called non-alcoholic fatty liver disease (NAFLD) which in turn may cause liver cirrhosis or scarring of the liver. Eating a well-balanced diet with lots of fresh fruits and vegetables at regular intervals and staying active could play a key role in protecting your liver. (Also read: Nutrition tips for diabetes: How to create a healthy plate)

Diabetes is the second cause of liver failure and transplantation in India. Type 2 diabetes is a chronic condition that impacts the way ones body metabolizes sugar. It happens when the body becomes resistant to insulin. This can invite complications along with liver disease. Hence, one will not be able to do his/her daily activities with ease.

"Diabetes and obesity will not only lead to non-alcoholic fatty liver disease (NAFLD) wherein excess fat builds up in the liver but also, a more severe form of NAFLD is known as non-alcoholic steatohepatitis (NASH). Here, the liver fat triggers inflammation that creates scar tissue causing cirrhosis and end-stage liver disease over a period of time. Hence, one will need a liver transplant," says Dr. Roy Patankar, Gastroenterologist and Director of Zen Multispecialty Hospital, Chembur, Mumbai.

There are no symptoms of liver disease until it's too late hence making it hard to diagnose and treat the ailment early. This is the reason why majority of people with diabetes are unware of liver disease despite inflammation and even scarring. Liver cancer and liver failure are rampant in those having diabetes making it all the more important to monitor this disease.

Having liver disease can also trigger diabetes and go on to worsen the liver functioning.

"Your risk of having metabolic syndrome X - including heart disease, stroke, type 2 diabetes, high blood pressure, insulin resistance, obesity, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels - is higher if you've ever had non-alcoholic fatty liver disease," says Dr Patankar.

How to take care of your liver when you have diabetes

* Manage your blood sugar levels by eating nutritious food and avoiding junk, processed sugary and canned food.

* Limit the intake of colas, sodas, fruit juices, sweets, bakery items, and candies.

* Eat at regular intervals in the quantity recommended by the expert.

* Whole grains, fresh fruits, and vegetables should be a part of your daily diet, exercise every day for about half an hour.

* You can do activities such as swimming, cycling, yoga, gymming, aerobics, running or jogging.

* Cut down on sodium and caffeine to keep high blood pressure in check. Say NO to smoking and alcohol. Get yourself screened as suggested by the doctor to catch the liver disease.

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World Liver Day 2022: How to protect your liver when you have diabetes - Hindustan Times

When it comes to type 2 diabetes, the diagnosis can practically be reversed if certain lifestyle changes are implemented to minimize the symptoms. The largest aspect of a persons lifestyle which must be monitored for this to occur is their diet. BeatO, the diabetes management app, in partnership with Republic Media Network, has launched Food Labs, an initiative that features Chef Mirvaan Vinayak, MasterChef India Finalist, and provides diabetes-friendly, delicious recipes, so that people can live their healthiest lives without compromising good food. Understanding that a healthy diet is the key to a healthy life, these recipes aim to provide people with underlying health conditions options that allow them to enjoy food without putting their health at risk.

Below, you will find one of the healthy, diabetes-friendly recipes featured on Food Labs, to satisfy any sweet tooth cravings encountered this summer.

Yogurt is known to contain loads of nutrients and is also diabetes-friendly. By adding fruits, chia seeds and amaranth, you can give an amazing twist to your daily yoghurt and enjoy it in the best possible way.

Ingredients:

Method:

Benefits:

This dessert is loaded with antioxidants which makes it extremely nutritious. It is rich in both fiber and protein. It is one of the best dessert options for a diabetic person in this summer season.

Recommended serving size:

1 small Cup (75- 80 grams)

BeatO, is a digital app-based platform that provides clinically proven, comprehensive diabetes care programs to help prevent, control, and even reverse the condition under the guidance of experts. The company is a National Startup Award 2021 winner for bringing access to healthcare, an initiative by the Government of India started by Prime Minister Narendra Modi Ji. The results of BeatOs programs have been published by top medical institutions such as the American Diabetes Association, Advanced Technologies & Treatments for Diabetes (ATTD), and Dove Press.

This diabetes care ecosystem includes BeatOs innovative and cost-effective smartphone-connected glucometers that work in unison with the BeatO app and its programs to help members control diabetes. Its smart health management system is powered by AI andprovides personalized insights and real-time data-driven care via its experienced team of diabetes care coaches, expert nutritionists, and specialist doctors. The BeatO app ecosystem also provides a complete solution for all the daily needs of a person with diabetes, ranging from medication, lab tests, affordable insurance, and specially curated foods and beverages.

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Chef Mirvaan makes a diabetes-friendly Yogurt Parfait with fruits this week on Food Labs - Republic World

New technologies can improve diabetes outcomes. Learn how health care professionals can help patients access and use these tools.

Diabetes technologies arent reaching everyone who could potentially benefit. Dr. Tamara K. Oser, a primary care doctor and diabetes researcher, discusses how health care professionals can put diabetes technologies into practice.

Q: What technology tools are available for people with diabetes?

A: Weve seen an expansion in the world of diabetes technologies that, if used the right way, can improve diabetes care. We now have continuous glucose monitors (CGMs), insulin pumps that are increasingly automated, connected insulin pens, and apps. Health care professionals and people with diabetes can use technology in many ways to foster diabetes self-management education and support.

Q: How can new technologies benefit people who have diabetes?

A: More evidence is emerging about the benefits of diabetes technologies. For instance, continuous glucose monitoring is associated with improved clinical, psychosocial, and behavioral outcomes, especially for people who have type 1 diabetes or type 2 diabetes that requires intensive insulin therapy. Evidence is also emerging about the benefits of continuous glucose monitoring for people with type 2 diabetes on basal insulin, and even for people with type 2 diabetes who are not on insulin.

However, just having a technology tool doesnt necessarily improve outcomes. Health care professionals and patients with diabetes also need education about how to use the device, how to engage with the data, and how to communicate with each other about the data. For example, when patients start to use CGMs, health care professionals should ask them how often they want to receive CGM alarms. If you dont have this conversation, patients may get too many alarms and develop alarm fatiguemeaning they no longer respond appropriately to alarmsand stop using the device.

There are also exciting advances in insulin pump therapy, including automated insulin delivery systems and work being done to expand access to these technologies as well.

Q: Are diabetes technologies made available to everyone who could benefit from them?

A: No. One study found that continuous glucose monitoring reached about 30% of people with type 1 diabetes in the T1D Exchange Registry, who mostly received care from endocrinologists at academic medical centers. However, we can assume that continuous glucose monitoring is less common among people who receive care from community medical practices, which is where most Americans receive care. We know that about 50% of adults with type 1 diabetes and 90% of adults with type 2 diabetes receive diabetes care from primary care providers, but most of the studies on diabetes technologies are conducted through endocrinology practices at academic medical centers.

So, there may be a geographic disparity in access to diabetes technologies. Our research team is working on many projects to address that geographic disparity and help implement diabetes technologies in primary care.

Q: Are there other disparities in the use of diabetes technologies? How do social determinants of health affect how people with diabetes access and use technology tools?

A: There are also socioeconomic, racial, and ethnic disparities in the use of diabetes technologies. Compared with the white population, racial and ethnic minority groups have higher rates of diabetes and often have worse diabetes outcomes. Patients from racial and ethnic minority groups and patients of lower socioeconomic status are less likely to be offered diabetes technologies.

However, studies have shown that when these patients are given access to diabetes technologies, they have outcomes that are similar to those of white patients or patients with higher socioeconomic status. At the Federally Qualified Health Center where I care for a large immigrant and refugee population, Ive used CGMs with my patients, and theyve done brilliantly.

One reason for disparities in access to diabetes technologies may be implicit bias that affects which patients are offered diabetes technologies. As health care professionals, we need to address our unconscious biases about which patients may or may not benefit from technologies. Other reasons for disparities include physician shortages and restrictive insurance eligibility criteria.

We have a lot of work to do to address disparities. This is a topic Im very passionate aboutmaking sure certain populations arent left behind as diabetes technologies advance.

Q: What are the barriers to using diabetes technologiesboth for health care professionals and for people with diabetes?

A: Compared with endocrinology practices in academic medical centers, primary care practices and community endocrinology practices have different resources and workflows, and how we implement diabetes technology in each setting will be different.

One way that primary care practices can address limitations, in terms of time and workflow, is to engage the entire health care teamincluding diabetes care and education specialists, clinical pharmacists, health coaches, and patient navigatorsin implementing diabetes technologies. A recent Association of Diabetes Care and Education Specialists technology summit brought together a multidisciplinary group of health care professionals to discuss broadening access to diabetes technologies. I also worked with the American Academy of Family Physicians on a Transformation in Practice Series course that provides a comprehensive approach to implementing continuous glucose monitoring in primary care.

For patients with diabetes, one barrier is lack of access, either because they arent offered diabetes technologies or because they lack insurance coverage for technologies. However, even if patients have access, lack of education and support can be a barrier to using diabetes technologies effectively.

Q: What role can a diabetes care and education specialist (DCES) play in helping people with diabetes overcome barriers to using new technologies?

A: A DCES can serve as a technology champion. Any practice that has a DCES is set up for a much greater likelihood of success. The DCES can partner with the patient and the rest of the health care team to address issues related to diabetes technologies, including

However, our team, in partnership with the American Academy of Family Physicians National Research Network and other practice-based research networks, conducted a national survey of 656 primary care providers, and only 36% had a DCES in their practice, even part time. Because the majority of primary care practices dont have access to that valuable resource, we need to consider how a DCES may be able to support multiple practices through telehealth or other novel ways of providing care.

Q: How can other health care professionals integrate technology into diabetes care?

A: Practices that dont have a DCES might have a pharmacist, a health coach, or a case manager who can serve as a technology champion or work as part of a multidisciplinary team to help integrate technology into diabetes care.

Health care professionals can also tailor their approach. If your primary care practice isnt currently using diabetes technology, you might start by choosing a technology that will be most relevant to your patient population. You can then identify members of your health care team who can help implement diabetes technology with patients.

Also, patients may benefit from a diabetes technology even if they arent able or dont want to use every aspect of the technology. I have patients who don't have a smartphone or dont want to use an app, and they just use a reader for continuous glucose monitoring. The reader captures important metrics that we go over together, and Ive seen huge improvements in diabetes management.

Q: What research is being conducted on the use of diabetes technologies?

A: This is an exciting field, and lots of research is going on right now. My research group is studying ways to implement CGM and automated insulin delivery systems in primary care. Other research groups are conducting a study to compare fingerstick blood glucose monitoring to CGMs in primary care practices. Other studies are looking at insulin dosing algorithms in patients using CGMs or fingerstick blood glucose monitoring in a wide range of practice settings.

Many studies are looking at how to use diabetes technology to help patients with self-management and education. The COVID-19 pandemic has demonstrated the benefits of remote monitoring and alternative care models outside the clinic walls.

How do you help patients with diabetes learn about and use diabetes technologies? Tell us below in the comments.

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How Can You Help Patients Use New Diabetes Technologies? | NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Diabetes is a chronic condition that affects a persons blood glucose levels. While the exact cause is still unclear, people living with diabetes may be at a higher risk of hearing loss. This might be due to high sugar levels potentially causing nerve damage to the inner ear.

Diabetes is a condition that affects blood sugar regulation in the body. This can cause fluctuations in blood glucose, known as hypo- and hyperglycemic episodes.

If a person is unable to maintain their blood sugar levels within a healthy range, this may increase their risk of complications, which could include hearing loss.

The exact relationship between diabetes and hearing loss still remains unclear. However, health experts believe that chronic hyperglycemia, which can raise blood pressure and cause damage to several parts of the body, may damage the blood vessels and inner ear structures, which could lead to hearing loss.

In this article, we look at the link between diabetes and hearing loss and suggest steps people with diabetes can take to protect their hearing.

Evidence suggests that individuals with diabetes are twice as likely to have hearing loss as those without diabetes. According to the Centers for Disease Control and Prevention (CDC), uncontrolled high blood sugar levels may lead to hearing loss.

This is because chronic high blood sugar levels may damage the nerves and small blood vessels in the inner ear. Over time, low blood sugar levels may also affect how nerve signals travel from the inner ear to the brain.

The CDC also states that prediabetes can be a risk for hearing loss. People whose blood sugar levels are elevated may be at a 30% higher risk of hearing loss than those with healthy blood sugar levels.

Health experts do not know the exact cause of hearing loss in individuals with diabetes. However, research suggests that sustained high blood sugar levels could lead to damage in the inner ear.

High blood sugar levels may affect blood supply to the small blood vessels and nerves in the inner ear, resulting in damage and affecting hearing. Nerve damage can occur in both type 1 and type 2 diabetes.

Blood sugar levels outside a healthy range may also affect how nerve signals travel to the brain from the inner ear. This damage can also lead to hearing loss.

Other risk factors for hearing loss may include:

To diagnose hearing loss, a doctor, such as an audiologist, may take a persons medical history and assess any symptoms.

Possible symptoms of hearing loss can include:

A doctor may then carry out a hearing exam. This may include a number of different hearing tests, such as:

A doctor may also test blood glucose levels. An A1C test is a useful tool to help monitor diabetes, as it measures the bodys average blood sugar levels over the past 3 months.

The aim of treatment is to improve peoples hearing and their ability to communicate with others.

The type of hearing loss usually associated with diabetes is sensorineural hearing loss (SNHL). This is a type of hearing loss that occurs due to damage to the inner ear or the nerves between the inner ear and the brain.

Treatment for SNHL may include:

If hearing loss is due to nerve damage from diabetes, treatment will also involve close monitoring of blood sugar levels. This may also include lifestyle changes, such as following a balanced diet and getting regular exercise.

While managing blood sugar may help stop progression, it will not reverse existing damage to hearing.

Keeping blood sugar levels within healthy ranges may help protect hearing and prevent damage to the inner ear and hearing nerves.

The National Institute of Diabetes and Digestive and Kidney Diseases offers the following suggestions to help people with diabetes control their blood sugar levels:

Learn more about managing diabetes here.

It is also important that individuals with diabetes attend a hearing test when they first receive a diabetes diagnosis. It is then advisable that they regularly test their hearing every year.

People can also take other steps to protect their hearing, such as using earplugs or ear defenders around loud noise.

Health experts do not know the exact cause, but evidence points to a relationship between diabetes and hearing loss.

Researchers suggest that blood sugar levels outside of healthy ranges may damage nerves and small blood vessels in the inner ear. Over time, this damage may affect hearing and result in hearing loss.

If people have diabetes or prediabetes, they need to attend regular hearing tests and manage their blood sugar levels. If a person has any symptoms of hearing loss, they should contact a doctor as soon as possible to find out the cause and start any treatment.

Individuals can also attempt to prevent hearing loss by using earplugs around loud noise.

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Diabetes and hearing loss: Link, treatment, and more - Medical News Today

In Diabetes and Me, RNZ's Megan Whelan shares her journey of learning to live with type 2 diabetes.

It's not a particularly productive question, but it's the one that plagues me: How much is this my own fault?

Photo: 123rf

If I hadn't eaten those cheeseburgers, would I be here? If the sport that spoke to me was marathon running and not yoga, might my pancreas have been in better shape?

I try to resist being that person who talks about my diet all the time because, my God, those people are boring, but I also can't help it. How to best eat for this condition, and the many hours of exercise I do, and how many grams of protein is in an egg (about six) occupies a pretty large part of my brain space.

And so I feel myself turning into a person I would have avoided a few months ago - and asking questions that I know I won't like the answers to.

To get some good answers, I spoke to Dr Jeremy Krebs, an endocrinologist. Endocrinology is the specialty of "glands and hormones" and diabetes is one of the areas endocrinologists study. He did a doctorate at the UK's prestigious Cambridge University investigating obesity, and he's now a consultant in Wellington, and researches nutrition, obesity and diabetes. So, a very good person to talk to, and - I promise, I wasn't trying to get some free medical advice.

Here's our conversation (edited for length and clarity, and to cut a massive discussion about exercise, which is a whole other column).

RNZ Head of Content Megan Whelan. Photo: RNZ / Rebekah Parsons-King

Megan: I think prior to my diagnosis, if someone had said "hormones" to me, I probably would have thought of progesterone and estrogen and maybe cortisol if I was having a good day. But there are so many, and they're so important, right?

Jeremy: The key one here is obviously insulin and that comes from the pancreas. But when you're thinking about type 2 diabetes, there are many, many different organs and hormones that are involved in the process, and there are many many different versions of it. And so not everybody with type 2 diabetes is the same, whereas type 1 diabetes, which is fundamentally about the failure of the beta cells in the pancreas because of an autoimmune process, is a much more homogeneous condition.

And that's partly what makes type 2 diabetes such a harder beast for people to get their head around. And I mean people in the broader sense, both people with diabetes, but also health professionals and people trying to, you know, find solutions and help and support because there's no one size fits all.

Megan: So, then, what is type 2 diabetes?

Jeremy: The simple version is that diabetes, by definition, is an increase in blood glucose, or blood sugar.

Blood sugar is controlled by two key hormones, the most important being insulin and the other being its counterpart or its counter-hormone, glucagon. The balance of glucose in the body is determined by how good your pancreas is at making insulin, and secondly, how good your tissues are (your liver and your muscle and other tissues in your body) - how good they are at responding to insulin and taking up and storing and using glucose.

So there's two main sides to the equation and type 2 diabetes is where you get a problem, usually on both sides of the equation, but one may dominate the other. So what I mean by that is, if your body becomes resistant to the action of insulin, which is something we generally see as people gain weight, then your pancreas can respond to that by simply pumping out more and more insulin. And it does. [It] does that incredibly well.

But there comes a point where the pancreas says 'bugger, this, I've had enough of that I'm going on strike,' and that's when it can't keep up with that demand. And that's when your blood sugar starts going up.

There's a researcher by the name of Defronzo, who coined a phrase called the ominous octet. It incorporates all of these sorts of ideas that we're talking about: the various hormones that are involved, but it also incorporates ideas of physical activity or inactivity, and then the other key thing which we haven't touched on yet, which is genetics and the role of family history and genes in terms of who might develop diabetes.

So we often think about some of these risk factors in terms of what is modifiable and what's not modifiable, and clearly your genes are not modifiable. There are modifiable things which can influence ... your chance of getting diabetes or your journey with diabetes.

Megan: In my journey I've kind of been swinging wildly between 'you're such a piece of shit, this is your own fault. You absolutely should have known that this was going to happen', it's in my family, I had allowed myself to become inactive, and I have a really stressful job and would come home every night and get takeaways because it's easier than cooking. I look back now and think 'how the hell did you let it get like this?'

And I guess one of the reasons I want to do this whole column is so someone like you can say "well, because you're a human being and that's what happens and it's not your own fault," but also it kind of is my own fault and maybe the ominous octet is a really nice way to do it. Maybe there's bits of it that were my own fault and bits of it that aren't my fault?

Endocrinologist, professor Jeremy Krebs. Photo: Otago University Wellington

Jeremy: There is no question that there are things we have conscious control over and that we can influence, but there's a heck of a lot we don't. Appetite is an incredibly subtle thing. How does anyone maintain a vaguely constant weight in the world that we live in? It's a miracle, frankly.

When we're bombarded with readily available - I used to say cheap, but that's changing - calorie dense, cleverly marketed food that appeals to the palate (because people understand what our tastebuds respond to) and a physical environment that has become less and less demanding for us to do things.

Megan: By doing this column, I'm gonna get some emails that are really, really nasty. What's the best response to those people who will say you should regret every cheeseburger you have eaten?

Jeremy: In a clinical environment that's very much where I start to talk about the genetic side of this and the subtleties of the influence of genes on our appetite regulation. Of course, those people will simply say, 'well, everyone says that, everyone hides behind that, but at end of the day, you know it's still [that] you're still sticking it in your mouth'.

And as you said there are bits of truth to some of that. I wish I hadn't had that 4th glass of red wine last night, but I did. And I had to spend an extra half hour on the treadmill this morning because of it.

But people who would hide behind those sorts of emails to you are lying to themselves, frankly, if they don't think they're not human, and aren't fallible to some of those choices.

Everyone makes choices they know retrospectively weren't the best choices. God, we're human.

Megan: I was doing my grocery order last night and a cauliflower was $7.50 and I thought to myself 'that's a happy meal, that's a combo at a fast food restaurant.' I'm incredibly lucky. I earn a decent amount of money. I don't have kids, so I have disposable income. I can spend $7.50 to buy a cauliflower, but lots of people can't, and that has to be really difficult.

Jeremy: There's no question about it. I was reviewing a paper last night from a group in Auckland and one of the key determinants of both developing diabetes, but also outcomes of diabetes, that overrode ethnicity was deprivation (and we know that ethnicities are a really important factor, which is largely driven by genetics).

You can know till the cows come home what you should be buying in the supermarket. But if the prices keep doing what they're doing at the moment, then you know we're all going to be buying white bread.

Megan: I am aware I am going to anger some people when I ask this, but I watched a talk of yours, and you had a graph of the overwhelming correlation between obesity and type 2 diabetes. And I wonder if there's a disconnect between what we want to believe about weight and what's actually true.

Jeremy: You're right, you will anger a lot of people by that. But there are some truths that you just have to accept. And unfortunately excess fat mass is not healthy. In a number of ways, not just metabolically, in terms of joints, in terms of the hormones of fertility, there's a whole range of stuff.

But turning that into self-blame and self-loathing is not going to achieve anything or help anybody. So if you have to frame it in a way that a person can still live with themselves and make some change which is taking them in a healthier direction, then I'm totally on board with that.

But where you have to be careful is where someone hides behind that and denies some of the harder effects.

Megan: If I had been honest with myself, I knew I wasn't healthy - that is no fault of the people who talk about this, and the really important activism that's happening in that space. But I think the people who think this is all my own fault might miss a point, which is that every experience I've ever had with a GP was negative because of my size. And so of course, I didn't look after myself [by getting help when I need it] because I would have to go to see my GP, who would weigh me and say something and that [made me] felt like shit.

Jeremy: Yep, it's not in any way supporting you.

Megan: So how do we bridge that gap between wanting to help people and not making them feel awful for needing help.

Jeremy: I think in the last 20-plus years of doing this there will be people that I have met that I've tried to help where I've got it right and it's helped them and there will be people where I've tried to help and for whatever reason for that person, I've got it badly wrong and they've gone away hating me because for whatever reasons we didn't quite manage to get that balance, that connection. It's tricky. It's very emotive.

***

Dr Krebs tells a story that many people will recognise. He was overweight, and a child poked him in the stomach, and said "you're fat". For him, that was the trigger to start running and losing weight.

It feels comforting to me that at least one doctor understands that feeling. I have countless stories like that. Like the time a woman walked past me in the supermarket carpark and said "see, that's why we don't buy chocolate biscuits. You don't want to end up like that." As I type this, I can feel the shame that pricked my cheeks, the tears I fought back that someone could be so casually cruel. But it certainly didn't make me want to don my leggings and hit the treadmill.

The question I want to ask isn't "is it my fault?" It isn't the "is being fat unhealthy" that I asked Dr Krebs, because I couldn't, in the moment, articulate what I meant. It's, did I get diabetes because I am fat, or because my fatness meant I couldn't access the care I needed that would have helped me avoid getting it?

That's a question that's much bigger than me, but it's one worth asking - and I am going to keep asking it in this column.

Diabetes and me will be a weekly column on Wednesday mornings.

Originally posted here:
Diabetes and me: Wrestling with the causes of diabetes - RNZ

The diabetes social media sphere has been active as ever this past month, from recognizing international conflict to learning to fine-tune our insulin doses.

Heres our monthly roundup of posts that caught our eye throughout March 2022, in no particular order.

March marked Womens History Month, and we were honored to share this tribute to a host of women whove made an incredible impact on the Diabetes Community through the years.

With the continuing attack on Ukraine, our Diabetes Online Community (DOC) has extended the grassroots #SpareARose campaign through March to raise an impressive amount of money to help those with diabetes in that part of the world. The nonprofit org Beyond Type 1 also has this great resource listing ways to help.

People with diabetes often feel like were under pressure with the demands of daily life alongside handling this condition. This fun Instagram post touches on that topic, as advocate Kylie talks about her life with a lesser-known type of diabetes and how demanding it can be for her. Sure, were told to not strive for perfection, but its easier said than done right?!

We couldnt help but smile at our friend Mila Clarke, who shared on Instagram a recent win of nailing her insulin pre-bolus before a meal. For those on multiple daily injections (MDI) or even using an insulin pump, this is a challenge that so often leaves us missing the mark. Way to go, Mila! (btw: Make sure to turn your volume on, to hear the perfectly-fitting sound choice Mila used to mark the moment).

Tom Karlya over at Diabetes Dad had a great post marking the history of diabetes treatments and advocacy, honoring those whove paved the way and helped shape the community and world of diabetes through the years.

Actor Noah AK, who starred in Star Trek: Discovery with his wife Mary Wiseman, launched a successful crowdfunding campaign during the month, raising money for a new type 1 diabetes-themed movie that envisions the apocalypse, while addressing the important issue of insulin affordability. Many people donating were from the Star Trek community, as well as the #insulin4all movement online. You can read more about his plans on the Kickstarter campaign page.

It wouldnt be March without the madness of college basketball, and keeping with that theme are our friends at Integrated Diabetes Services whove created their own brackets with a diabetes spin. Who do you think will make it to the Sweet Sixteen, Elite Eight, Final Four, and get to the top spot in our D-Community?

The Juicebox Podcast featured an eye-opening episodein which host D-Dad Scott Benner delves into a controversial topic: being a stripper or sex worker who also happens to have type 1 diabetes. This may not be for everyone, but its a worthwhile listen.

Life with diabetes can be everything from frustrating, challenging, adventure-like, or easy-to-handle no big deal all in the same day. We loved this latest post from Molly Johannes at Hugging the Cactus, about a recent rookie mistake that she made in managing her own long-term diabetes. No matter how many years one lives with the big D, it seems were always facing new issues that can make it a bumpy ride.

*We share our favorites each month, and DiabetesMine would love to hear from you via email or on Facebook, Instagram or Twitter.*

Originally posted here:
Around the Diabetes Online Community in March 2022 - Healthline