Category Archives: Diabetes

ARLINGTON, Va., Dec. 8, 2021 /PRNewswire/ -- The American Diabetes Association (ADA), the nation's leading volunteer health organization, announced a new partnership with Dr. Comfort, to provide foot care resources on an ADA platform in a journey-driven experience for those living with diabetes and their caregivers.

Dr. Comfort is the national sponsor of Living with Diabetes: Foot Care & Amputation. The Foot Care & Amputation section of the platform leads each user to learn to care for their feet, understand foot conditions and complications, ways to stay physically active, and more. Individuals living with diabetes and their caregivers can access this platform by answering a few simple questions to help guide them on their journey to reach the tools, resources, and education they need for successful foot care.

Every four minutes in America, a limb is amputated due to diabetes. This statistic is even more shocking when you consider that amputation is almost completely preventable. Education and resources are vital for those living with diabetes and this partnership will help arm millions of people with the information they need to prevent foot care complications.

"The ADA is working hard to help the over 34 million Americans with diabetes deal with and overcome the unique health complications they face on a daily basis such as foot complications. Through this personalized diabetes journey experience, we hope to meet them where they are to deliver the resources and education they need to thrive," said Jacqueline Sebany, Chief Marketing and Digital Officer for the American Diabetes Association.

The journey was developed to deliver information to those living with diabetes based on self-identified need and interest, as well as where they are in their diabetesjourney.

About the American Diabetes AssociationThe American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 81 years the ADA has driven discovery and research to treat, manage, and prevent diabetes while working relentlessly for a cure. Through advocacy, program development, and education we aim to improve the quality of life for the nearly 122 million Americans living with diabetes or prediabetes. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us atdiabetes.orgor call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Spanish Facebook (Asociacin Americana de la Diabetes),Twitter (@AmDiabetesAssn), andInstagram (@AmDiabetesAssn).

Contact: Daisy Diaz, 703-253-4807[emailprotected]

SOURCE American Diabetes Association

http://www.diabetes.org

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American Diabetes Association and Dr. Comfort Team Up to Give Millions Living with Diabetes Much-Needed Resources to Prevent Foot Complications -...

New research from a Swedish cohort study suggests patients with obesity and diabetes who undergo bariatric surgery could dramatically reduce their risk of cancer.

An analysis of data from the matched, prospective Swedish Obese Subjects (SOS) study, which included a median of 21 years of follow-up data, results indicated those who underwent bariatric surgery lowered their risk of cancer by 37%, but also suggest those achieving normal glucose control and diabetes remission reduced their risk of cancer by 60%.

The global epidemic of both obesity and diabetes leads to an increased risk of cancer, as well as an increased risk of premature death. It has been estimated that, over the next 10 to 15 years, obesity may cause more cancer cases than smoking in several countries. This is a clear illustration of how serious the condition is, said Magdalena Taube, PhD, associate professor of Molecular Medicine at Sahlgrenska Academy, University of Gothenburg, in a statement. Strategies are need to prevent this development, and our results can provide vital guidance for prevention of cancer in patients with obesity and type 2 diabetes.

With an interest in shrinking an apparent knowledge gap related to the effects of bariatric surgery on cancer risk among patients with both obesity and diabetes, the current study was designed Taube and colleagues from the University of Gothenburg to assess incidence of cancer among patients from the SOS study. A nonrandomized, parallel assignment study launched in 1987, the SOS study enrolled more than 4000 patients, who were followed from enrollment through 2005. Results of the study suggested bariatric surgery was associated with meaningful reductions in body weight and mortality among patients with severe obesity.

For the current study, investigators included 701 patients with obesity and diabetes from the original SOS study. This cohort included 393 patients who underwent bariatric surgery and 308 who received conventional treatment. The median follow-up of this cohort was 21.3 (IQR, 17.6-24.8) years with a maximum follow-up of 30.7 years. Overall, 17% (n=68) of the bariatric surgery group developed cancer and 24% (n=74) of the conventional treatment group developed cancer.

Upon analysis, results indicated the incidence rate of first-time cancer was 9.1 (95% CI, 7.2-11.5) per 1000 person-years among patients with obesity and diabetes who underwent bariatric surgery compared to 14.1 (95% CI, 11.2-17.7) per 1000 person-years in those who received conventional treatment (aHR, 0.63 [95% CI, 0.44-0.89]; P=.008). Investigators pointed out surgery was associated with a reduction in cancer incidence among women (aHR, 0.58 [95% CI, 0.38-0.90]; P, but sex-treatment interaction was nonsignificant (P=.630). Further analysis suggested those who achieved diabetes remission at the 10-year follow-up suggested these patients experienced an even greater reduction in cancer incidence (aHR, 0.40 [95% CI, 0.22-0.75]; P=.003).

What we see is that, among patients with type 2 diabetes, many cancer cases are preventable. These results are an important contribution that enhances our understanding of the connection between glucose control and cancer prevention, added Kajsa Sjholm, PhD, associate professor of Molecular Medicine at Sahlgrenska Academy, University of Gothenburg, in the aforementioned statement.

This study, Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-Term Results From the Swedish Obese Subjects Study, was published in Diabetes Care.

Read this article:
Bariatric Surgery Associated with Lower Cancer Risk in Obesity and Diabetes - Endocrinology Network

Global Anti-biofilm Wound Dressing Market: Overview

The rise in the occurrence of chronic illnesses such as diabetes and cancer throughout the world is driving expansion of the global anti-biofilm wound dressing market. Non-communicable illnesses are becoming more prevalent due to various factors such as smoking, alcohol usage, antibiotic resistance, and unhealthy and sedentary lifestyles.

Healthcare facilities, such as hospitals, have been overburdened as a result of the COVID-19 pandemic, with many Covid positive individuals; as a result, several nations have postponed elective surgeries as well as other healthcare operations indefinitely. Patients with acute and persistent wounds must thus be treated either at outpatient clinics or at home. As a result, demand for wound care products at home, like anti-biofilm wound dressing, has risen. In addition to that, as the elderly population is at a higher risk of infection and is unable to attend a healthcare facility, the need for home healthcare is growing. Furthermore, many people have turned to online therapy for help with their health problems. These factors are likely to drive growth of the global anti-biofilm wound dressing market in the near future.

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This study from Transparency Market Research (TMR) provides a complete insight of the global anti-biofilm wound dressing market. It provides well-researched data on a variety of market aspects in order to provide useful business input for profit generation.

Global Anti-biofilm Wound Dressing Market: Notable Developments

ConvaTec Group Plc (Conva Tec) declared the official launch of an innovative product called "ConvaMax" in January 2020. Diabetic foot ulcers, pressure ulcers, leg ulcers, and dehisced surgical wounds are all treated with this new medication. Additionally, the product is available in non-adhesive forms as well, allowing total freedom in integrating compression bands or an extra main dressing to support care regimen.

The noted players that are operational in the global anti-biofilm wound dressing market are Coloplast A/S, Smith & Nephew PLC., ConvaTec Group plc., The 3M Company, Mlnlycke Health Care AB, and Urgo Medical.

Global Anti-biofilm Wound Dressing Market: Key Trends

Below-mentioned market trends and opportunities mark the global anti-biofilm wound dressing market:

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High Prevalence of Diabetes to Drive Growth of the Market in Near Future

Diabetic foot ulcers affect around 2% to 10% of diabetics, according to studies done by B. Braun Melsungen AG in 2018. Furthermore, according to the American College of Physicians, the number of new cases every year for diabetic foot ulcers is about 6.3 % in 2017, and the incidence rate of foot ulcers in diabetic individuals in their lifetime ranges from 19% to 34%. Because anti-biofilm wound dressing solutions are highly suggested for treating chronic wounds, market growth is expected to observe high growth rate..

The majority of surgical wounds following cancer surgery are big and deep, generating exudates that must be managed on a daily basis. Anti-biofilm wound dressings, such as iodine and silver-based wound dressings, aid in wound management and infection prevention. As a result, the growing prevalence of chronic illnesses is projected to enhance product demand, thereby pushing global anti-biofilm wound dressing market.

The market is expected to be driven by an increase in the number of road accidents, trauma events, and burns throughout the world. According to the World Health Organization (WHO), around 1,000,000 individuals in India suffering from serious or moderate burns each year.

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Global Anti-biofilm Wound Dressing Market: Geographical Analysis

North America dominated the market with a substantial share of the global anti-biofilm wound dressing market and is expected to dominate the market in the near future. Some of the reasons predicted to drive the market include existence of many major competitors in the area, an increase in the number of sports injuries, and a rise in the number of traffic accidents. Furthermore, the existence of a well-developed healthcare infrastructure as well as advantageous reimbursement policies is projected to drive market expansion during the forecast period.

Asia Pacific is expected to expand at the rapid growth rate during the forecast period. The presence of emerging nations such as China, India, and Japan in the Asia Pacific region is expected to boost market expansion.

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Anti-biofilm Wound Dressing Market: High Prevalence of Diabetes to Drive Growth of the Market in Near Future - BioSpace

Scientists have found that venom from the cone snail helps to stabilise blood sugar levels, which could pave the way for the development of new fast-acting drug options for people with diabetes.

Researchers from the University of New Hampshire examined the variants of the toxic insulin-like venom known as Con-Ins which is used by the cone snail to paralyse its prey.

Associate professor of chemical engineering, Harish Vashisth, said: Diabetes is rising at an alarming rate and its become increasingly important to find new alternatives for developing effective and budget-friendly drugs for patients suffering with the disease.

Our work found that the modelled Con-Ins variants, or analogues, bind even better to receptors in the body than the human hormone and may work faster which could make them a favourable option for stabilising blood sugar levels and a potential for new therapeutics.

The venom from the snail induces a hypoglycaemic reaction that lowers blood sugar levels. Researchers examined the venoms peptide sequence and used computer simulations of each Con-Ins variant complex with human insulin receptor to test their stability.

Lead author and postdoctoral research associate Biswajit Gorai said: While more studies are needed, our research shows that despite the shorter peptide sequences, the cone snail venom could be a viable substitute and we are hopeful it will motivate future designs for new fast-acting drug options.

The study has been published in Proteins: Structure, Function, and Bioinformatics.

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Snail venom could offer new way of treating people with diabetes - Diabetes.co.uk

Treating patients who have early breast cancer with metformin a drug used to treat and control high blood sugar levels in patients with diabetes after their initial cancer treatments did not improve invasive disease-free survival (IDFS) or overall survival (OS), regardless of estrogen or progesterone receptor (PR) status.

The results came from the phase 3 CCTG MA.32 trial, which was presented at the 2021 San Antonio Breast Cancer Symposium.

The primary analysis showed that outcomes in patients with estrogen receptor (ER)positive and PR-positive disease was similar between two groups, where patients received either metformin or a placebo.

Metformin does not improve IDFS, OS, or other breast cancer outcomes in moderate/high risk estrogen receptor (ER)/PR-positive or ER/PR-negative breast cancer patients and should not be used as breast cancer treatment in those groups, said Dr. Pamela J. Goodwin, lead study author and professor of medicine at the University of Toronto, during the presentation.

The research team attempted to determine if treatment with metformin could induce better tumor responses based on the association of obesity with poor breast cancer outcomes and the drugs ability to promote weight loss and lower insulin levels.

Read more: Obesity Linked With Higher Distress in Breast and Prostate Cancers

Patients were eligible for the study if they had a diagnosis of invasive breast cancer within one year and negative margins following surgery. Tumors had to be staged as T1c to T3 meaning tumors could range from 2 cm to more than 5 cm and N0 to N3 (cancer in no lymph nodes to 10-plus lymph nodes), with T1cN0 requiring additional adverse features. All patients must have received standard breast cancer therapy and could not have diabetes.

The primary analysis was in patients with ER/PRpositive breast cancer, with 1,268 patients in the metformin group and 1,265 in the placebo group. They had median ages of 52 and 53 years, respectively, and 62.1% and 60.2% were postmenopausal.

A total of 52.5% and 54.2%, respectively, had T2 tumor stage, and most disease was grade 2 or grade 3. Additionally, 16.5% and 17.4% had HER2-positive disease, with 97% receiving Herceptin (trastuzumab).

Invasive disease-free survival (IDFS) occurred in 18.5% and 18.3% of patients receiving metformin and placebo, respectively. Rates of distant, local/regional and tumors in the opposite breast from diagnosis as well as new primary cancer were similar between groups.

In total, 131 patients (10.3%) in the metformin group died, compared with 119 (9.9%) in the placebo group. Causes of death among those who received metformin were breast cancer (7.8%), other primary malignancies (1.2%) and cardiovascular disease (0.3%) among other factors (1%), with similar rates in the placebo group.

A total of 21.7% of patients in the metformin group experienced grade 3 (severe) or worse side effects, compared with 18.7% in the placebo group. These side effects included nausea, vomiting, bloating and diarrhea.

Results among patients with ER/PR-negative breast cancer showed that futility or treatment without any benefit for the patient was established at 29.5 months of follow-up with 172 IDFS events. At the 96-month follow-up, there were 245 IDFS events in 1,116 patients, with no benefit noted with metformin.

The exploratory analysis looked at patients who had human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Interestingly, patients who had at least one C allele a type of genetic variation had a higher pathologic complete response rate with metformin than those who had no allele. Goodwin said any presence of a C allele is associated with a metformin benefit on glucose control in diabetes.

A total of 620 patients with HER2-positive cancer were analyzed, with 99.4% receiving chemotherapy and 96.5% receiving Herceptin (trastuzumab).

When looking at the entire HER2-positive population, patients who received metformin had fewer IDFS events than those who were administered placebo. There were also fewer patient deaths with metformin.

Exploratory analyses in HER2-positive breast cancer suggested a beneficial effect of metformin on IDFS and OS, notably in patients with at least one C allele of the rs11212617 snp. These observations should be replicated in future research, concluded Goodwin.

A version of this article was originally published on Cancer Network as, Metformin Does Not Improve Outcomes in Early Hormone ReceptorPositive or Negative Breast Cancer.

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Medication Used to Treat Diabetes Fails to Improve Breast Cancer Outcomes - Curetoday.com

Results of a cross-sectional study fond diabetic kidney disease (DKD) was associated with retinal changes in patients with type 2 diabetes (T2D).

Early neurovascular retinal damage was seen among patients with type 2 diabetes (T2D), while changes were more significant in patients with diabetic kidney disease(DKD), according to results of a cross-sectional study. Findings were published in International Journal of Retinal and Vitreous.

Diabetic retinopathy (DR) constitutes the leading cause of vision loss among patients with diabetes, and duration of the disease, chronic hyperglycemia, and hypertension can all increase the risk of DR.

The microvascular complications of diabetes affect the eyes and kidneys and are associated with different risk factors such as diabetes duration and blood pressure and lipid control, researchers explained.

Furthermore, previous research has suggested a strong association between DR and diabetic renal neurodegeneration (DRN) and similar molecular pathways appear to be involved in the development of DKD and retinal microvascular injury, they added.

To detect structural and vascular retinal changes in patients with T2D without or without DKD, the researchers used swept-source optical coherence tomography (OCT) and OCT angiography (OCTA) to assess the eyes of patients presenting to a hospital in southern Brazil.

All participants presented to the public teaching hospital between July 2018 and July 2019 and were older than 45 years. A control group was made up of healthy, age-matched volunteers with no prior or current history of diabetes or kidney disease. Controls also could not present any ophthalmologic condition that could interfere on images evaluation as opacities and spherical equivalent outside3 diopters, the authors said.

The Chronic Kidney Disease Epidemiology Collaboration equation was used to calculate estimated glomerular filtration rate (eGFR), and all examinations were carried out in the morning. Each participant also underwent a complete ophthalmologic examination.

Of 129 patients with T2D, 258 eyes were included: 128 of 64 individuals with mild or no DKD and 130 eyes of 65 patients with DKD. Seventy-four eyes of 37 controls were also included in analyses. Sixteen eyes of patients with T2D were excluded for potentially confounding factors.

Analyses revealed:

Overall, results showed significant thinning of the inner retina of T2D patients, especially the GCL+/++layer and RNFL; enlargement of the foveal avascular zone (both superficial and deep plexus); and lower capillarity in the superficial retinal plexus compared with controls, the authors wrote. They added these findings suggest neurovascular changes are an ongoing component of DR that may precede clinically moderate to severe microvascular changes.

Results are also in accordance with prior descriptions of microcirculatory impairment in the vasculature of diabetic eyes prior to severe indicators of DR, the researchers explained. Data also point to a possible link between signs of DKD and microvascular foveal changes that suggest a higher risk for more severe DR.

The cross-sectional design of the study and its limited sample, composed mainly of White women, mark limitations to the analysis. Future longitudinal studies are warranted to better elucidate the relationship between early retinal neurovascular changes and risk of kidney disease or if DKD can drive worse retinal prognoses.

However, data did show DKD was associated with inner retinal and superficial plexus vascular changes in T2D patients with mild or no DR, suggesting an association of eye and early kidney changes, the authors concluded.

Reference

da Silva MO, do Carmo Chaves AEC, Gobbato GC, et al. Early neurovascular retinal changes detected by swept-source OCT in type 2 diabetes and association with diabetic kidney disease. Int J Retina Vitreous. Published online December 5, 2021. doi:10.1186/s40942-021-00347-z

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Experts Examine the Association Between Retinal Damage, DKD Presence in Patients With T2D - AJMC.com Managed Markets Network

Posted: Dec 6, 2021 / 10:00 AM CST / Updated: Dec 2, 2021 / 09:42 AM CST

(Baptist Health) Many people put off healthcare during the COVID-19 pandemicincluding care for diabetes. Among adults under 30 with diabetes, nearly 9 in 10 delayed care during the pandemic, according to theCenters for Disease Control and Prevention(CDC). More than 60% of people ages 30 to 59 with diabetes did the same.

If you have diabetes, you probably know that managing your condition is important for your long-term health. But in the era of COVID-19, diabetes care is more important than ever. People with diabetes are more likely to have serious complications from COVID-19. According to theAmerican Diabetes Association, controlling your condition may lower that risk.

If you delayed diabetes care during the pandemic, getting back on track doesnt have to be stressful. Start with these four steps, based on advice from CDC.

Keep up with daily care.Eating well and getting exercise every week can help keep diabetes in check. And make sure to take any medications your doctor has prescribed.

Schedule regular checkups.See your doctor at least once every six months. If youve been finding it harder to manage your diabetes during the pandemic, go every three months. Get a checkup for your mouth too: See your dentist at least once a year.

Catch up on tests.Make sure you have an A1C test at least every six months. And ask your doctor what other tests you may need. These may include eye or foot exams, a cholesterol check, or a kidney test.

Get vaccinated.The COVID-19 vaccines are safe and effective. Theyre the best way to avoid serious illness from COVID-19. If youre already vaccinated,get your booster shot.

Take charge of your health

Staying on top of diabetes care can help you stay well during the pandemic and in the yearsand decadesto come. Get more help to live well with diabetes in ourDiabetestopic center.

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Diabetes care and COVID-19 - KARK

JNS.org A novel approach to treating Type 2 diabetes is being developed at the TechnionIsrael Institute of Technology in Haifa.

The disease, caused by insulin resistance and the reduction of cells ability to absorb sugar, is characterized by increased blood-sugar levels. Its long-term complications include heart disease, strokes, damage to the retina that can result in blindness, kidney failure and poor blood flow in the limbs that may lead to amputations.

It is currently treated by a combination of lifestyle changes, medication and insulin injections, but ultimately is associated with a 10-year reduction in life expectancy.

Ph.D. student Rita Beckerman from the Stem Cell and Tissue Engineering Laboratory in the Technions Faculty of Biomedical Engineering, who conducted the research with professor Shulamit Levenberg, presented a novel treatment approach, using an autograft of muscle cells engineered to take in sugar at increased rates. Mice treated in this manner displayed normal blood sugar levels for months after a single procedure.

The groups findings were recently published inScience Advances.

Muscle cells are among the main targets of insulin and they are supposed to absorb sugar from the blood. In their study, Levenbergs group isolated muscle cells from mice and engineered these cells to present more insulin-activated sugar transporters (GLUT4). These cells were then grown to form engineered muscle tissue and finally transported back into the abdomen of diabetic mice.

The engineered cells not only proceeded to absorb sugar correctly, improving blood sugar levels; they also induced improved absorption in the mices other muscle cells by means of signals sent between them. After this one treatment, the mice remained cured of diabetes for four monthsthe entire period they remained under observation. Their blood sugar levels remained lower, and they had reduced levels of fatty liver normally displayed in Type 2 diabetes.

By taking cells from the patient and treating them, we eliminate the risk of rejection, explained Levenberg. These cells can easily integrate back into being part of the body and respond to the bodys signaling activity.

Currently, some 34 million Americansa little more than one in 10suffer from diabetes, 90 percent of them from Type 2 diabetes. An effective treatment, and one that is a one-time treatment rather than daily medication, could significantly improve both the quality of life and life expectancy of those who have diabetes. The same method could also be used to treat various enzyme deficiency disorders.

The work was funded by Rina and Avner Schneur as part of the Rina and Avner Schneur Center for Diabetes Research.

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Technion Biomed Engineers Assess Novel Approach to Treating Type 2 Diabetes - Algemeiner

JOENSUU, Finland Type 2 diabetes is a condition that around one in 10 Americans deal with on a daily basis. When you factor in the costs of changing diets and lifestyles, doctor visits, and drugs for managing blood sugar, diabetes is not just a health burden but a financial burden as well. Now, researchers in Finland say eating more whole grains significantly reduces the risk of developing type 2 diabetes.

Moreover, their review finds adding more whole grains to the publics diet will substantially cut down the economic costs that come with treating diabetes. Study authors say the target should be three to six servings of whole grains each day to reduce the risk of developing diabetes. However, even one serving can help keep blood sugar levels in check.

Our study shows that already one serving of full grains as part of the daily diet reduces the incidence of type 2 diabetes at the population level and, consequently, the direct diabetes-related costs, when compared to people who do not eat whole grain foods on a daily basis. Over the next ten years, societys potential to achieve cost savings would be from 300 million (-3.3%) to almost one billion (-12.2%) euros in current value, depending on the presumed proportion of whole grain foods in the daily diet. On the level of individuals, this means more healthier years, says Professor Janne Martikainen from the University of Eastern Finland in a release.

For comparison, Finland has a population of just 5.5. million people. The U.S. has a population of the roughly 330 million, with around 34 million dealing with diabetes, according to the CDC. The cost savings of preventing type 2 diabetes would be immeasurable.

Globally, diabetes is one of the fastest-growing chronic illnesses. Previous studies estimate that up to half a billion people worldwide have diabetes, including many who dont even know they have the condition.

Although proper diet can play a major role in staving off insulin resistance, study authors find few people, both in Finland and worldwide, get the recommended amounts of daily nutrients that doctors suggest.

According to nutrition recommendations, at least 36 servings of whole grain foods should be eaten daily, depending on an individuals energy requirement. One third of Finns do not eat even one dose of whole grains on a daily basis, and two thirds have a too low fiber intake, says research manager Jaana Lindstrm from the Finnish Institute for Health and Welfare.

The team analyzed national follow-up studies to see the health and economic effects of eating more whole grains. This data allowed researchers to see the link between diet and the development of diabetes later on.

By combining population-level data on the incidence of type 2 diabetes and the costs of its treatment, as well as published evidence on the effects of how consumption of whole grain foods reduces the incidence of type 2 diabetes, we were able to assess the potential health and economic benefits from both social and individual viewpoints, Martikainen concludes.

The findings appear in the journal Nutrients.

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3 to 6 servings of whole grains can cut the risk and medical costs of treating diabetes - Study Finds

People with diabetes are at increased risk for gastroparesisa digestive disorder that can cause severe symptoms and affect quality of life.

Diabetes is the most common known cause of gastroparesis, a digestive disorder that may lead to poor nutrition, problems managing blood glucose, and a reduced quality of life. Here, Dr. Adil E. Bharuchaone of the authors of the chapter, Gastrointestinal Manifestations of Diabetes, in the NIDDK publication Diabetes in America, 3rd Editiondiscusses how health care professionals can diagnose and treat gastroparesis in patients with diabetes.

Q: What is gastroparesis? How common is gastroparesis in people who have type 1 or type 2 diabetes?

A: Gastroparesis is a condition in which the muscles in the wall of the stomach work poorly or dont work at all, slowing or delaying the rate at which food empties from the stomach to the intestine. This is called delayed gastric emptying. In gastroparesis, gastric emptying is delayed because the muscles don't work effectively, not because a blockage prevents food from moving from the stomach to the intestine.

While delayed gastric emptying is relatively common in people with type 1 or type 2 diabetesaffecting up to half of this population in some studiesa diagnosis of gastroparesis requires both delayed gastric emptying and moderate to severe digestive symptoms, such as feeling full shortly after starting a meal, nausea or vomiting, abdominal pain, or bloating. Based on this definition, gastroparesis is uncommon.

In one study, over a period of 10 years, about 5% of people with type 1 diabetes and about 1% of people with type 2 diabetes developed gastroparesis. Less than 1% of people without diabetes developed gastroparesis during the study.

Q: In people with diabetes, what is the relationship between gastroparesis and blood glucose levels?

A: There is a two-way relationship between blood glucose and stomach emptyingthat is, blood glucose levels affect stomach functions, and vice versa. Some studies suggest that high blood glucose levels increase the risk for gastroparesis. Conversely, gastroparesis may make it difficult for some people with diabetes to manage their blood glucose levels.

That said, there are several unanswered questions about the relationship between blood glucose and stomach emptying, and research is ongoing in this area.

Q: When should health care professionals suspect that a patient with diabetes has gastroparesis?

A: It is important for health care professionals to ask people with diabetes whether they have some of the digestive symptoms of gastroparesis, such as

the feeling of fullness shortly after starting to eat a meal

the inability to complete a regular meal

a sense of fullness that persists long after completing a meal

other symptoms such as abdominal pain, nausea, bloating, vomiting, heartburn, and a lack of appetite

In some studies, up to 50% of people with diabetes have delayed gastric emptying, but most of these people have no digestive symptoms or have only mild symptoms. In some patients, problems managing blood glucose levels may be a sign of delayed gastric emptying. Health care professionals might consider assessing stomach emptying in patients who have problems managing their diabetes.

People who have diabetes and diabetes-related complicationssuch as a peripheral or autonomic neuropathy, retinopathy, or nephropathyhave a greater likelihood of having stomach complications. However, people without other diabetes-related complications may also develop delayed gastric emptying. So, health care professionals cant rely on the presence or absence of these complications to effectively determine whether patients have delayed gastric emptying.

Q: How is gastroparesis diagnosed?

A: Health care professionals cant diagnose gastroparesis based on symptoms alone. A gastric emptying studyusing gastric emptying scintigraphy, a gastric emptying breath test, or a wireless motility capsuleis necessary to determine whether the stomach empties normally, slowly, or rapidly. If a gastric emptying study shows that the stomach empties slowly, health care professionals may need to order an upper gastrointestinal (GI) endoscopy to make sure nothing is physically blocking the movement of food from the stomach to the small intestine.

Q: How does gastroparesis affect health and quality of life?

A: Many people with gastroparesis feel uncomfortable, have severe nausea, or vomit after eating. These symptoms can be devastating to some patients. Most people with gastroparesis tend to consume less nutrients than they need. So, gastroparesis can markedly impair a persons quality of life.

Q: What are the treatment options for gastroparesis?

A: Treatment typically starts with making changes to a patient's diet, which is often effective. Changes include

limiting fat intake to 25% to 30% of total calories

limiting fiber intake to 15 grams for every 1,000 calories consumed

eating foods like mashed potatoes that are easy to mash with a fork into small particles

If changing a patients diet doesnt work, health care professionals can recommend medicines to reduce nausea or improve gastric emptying. Health care professionals should also review the list of medicines a patient is taking and, if possible, discontinue medicines that might delay stomach emptying, especially opioids.

To help prevent high or low blood glucose levels in patients with diabetes and gastroparesis, health care professionals may recommend changes in how patients manage their diabetes, including changes in how they take insulin or other diabetes medicines. Typically, people take a dose of regular insulin 15 to 20 minutes before a meal. With that timing, the insulin should be effective when food empties from the stomach, nutrients are absorbed, and glucose enters the blood stream. However, if the stomach empties slowly and the nutrients take longer to be absorbed, the insulin may begin to exert its effect before glucose enters the bloodstream.

Q: What research is being conducted on gastroparesis in people who have diabetes?

A: Exciting, ongoing research studies are investigating why people with diabetes develop gastroparesis. For example, some studies are investigating whether immune cells called macrophages might injure the stomach muscles and delay stomach emptying in people with diabetes. Understanding the process by which macrophages injure stomach muscles could lead to new treatments that address that process.

My research group is evaluating whether epigenetic changesthat is, changes that affect the expression of genes, not the genes themselvesmight affect stomach emptying in people with diabetes. Several drugs that are safe and approved for use in humans may affect these epigenetic changes, and these drugs are undergoing clinical trials.

How do you check for and manage gastroparesis in patients who have diabetes? Tell us below in the comments.

Originally posted here:
How Does Gastroparesis Affect People with Diabetes? | NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)