Category Archives: Diabetes

Like most providers, Julie Valdes used toprescribe medicationbased on a patients diagnosis. But for those with uncontrolled diabetes, the approach wasnt working.Despitegivingthem the best medications available, they kept returning with high blood sugar levels.

It kind of forced me to say, You know what, medications arent number one. The person as a person is number one,said Valdes, who works as a clinical pharmacist at Zufall Health Center in Dover, New Jersey.

Now, whenshemeets with a patient, shebeginswith a series of questions, seemingly unrelated to diabetes: Where do you work? Where do you live? Do you have appliances in your home?These questions helpValdes get a better understanding of what kind ofmedication regimenwill be best for the patient, given their circumstances. If they dont have a fridge at home,for example,temperature-sensitive insulinis not going to be an effectivetreatment, despite being the gold standard in diabetes care.You cant always just go by the book. You have to go by where [the patient is] at, what theyre willing to do, what is in their capacity to do.

Valdes spends up to an hour with patients far longer than the typical 15-minute provider visit identifyingbarriers to gettingpatientsdiabetes under control.

Most of the time, its money.I would say poverty or socioeconomics is probably the number one risk factor for diabetes, she said.

Some patients simply cant afford their diabetes medication.Other times, socioeconomic troubles make it difficult for patients to live a healthy lifestyle, particularly when it comes to diet.If you make minimum wage or less, think about the quality of food you can buy, said Valdes. Many of her patients are financially strapped,oftenforcedto choose between payingutilities andbuying groceries. Aloaf of wonder bread, like cheap white bread, is a dollar.To get whole grainbread is $4.Soif you only have $10, are you going to buy the white bread or the wheat bread?

The healthcenterprovides patients with bags of food, grocery store gift cards, and information on how toaccessthe local food pantry.This combined with education on nutrition, which Valdesprovidesas a certified diabetes educator, has helped patients achieve dramatic results one patient reducedtheir A1C score, a measure of blood sugar over athree-monthperiod by three hundred percent.

Still, other patientsjust dont have the time to take their medication. Valdeshaspatients who work12-hour shifts and cant get a break to inject their insulin. For these patients, she prescribes a once-daily oral medicationthats easier for them to take on the job.The drug theyre actually willing to swallow and take, thats the drug thats going to work, even if that means taking a drug thats technically less effective. We can have another medication that is doubletheefficacybut if theyre never going to take that, [then] having the drug thats only half as good that theyre going to take a hundred percent of the time, thats the medication for them.

Valdes also workswith patientsto overcomepreconceived notionsabout diabetes medication.In my population, insulin is the number one feared thing, saidValdes.They said,Oh, my grandma started insulinand then a month later she lost her leg or,I Googledinsulinor I GoogledMetformin and it says it breaks your liver.Thoughthese side effects have not beenproven,all drugs have effects, says Valdes and alot of times the risk of uncontrolled diabetes is way worse.

But some patients need more than just a tailored medication regimen.For many, psychological struggles are the main barrier to achieving good health.

If you dont have good mental health and youre not in the right space, youll never be able to implement all the dietary things, taking your medication ontime.It requires like a lot of organization and a lot ofself-care,said Valdes.

Thats where the healthcenterssocial workerscome in.A lot of our patients have been through things that are traumatic that can increase their risk for chronic conditions, said Sarah Aleman, a licensed clinical social worker and the director ofbehavioralhealth at Zufall Health Center.Someof her patientshave experienceddomestic violence,childhood abuse, or witnessed gang violence.

Research shows thesetypes ofexperienceshinder a persons ability to manage stress, making it moredifficult to turn off the fight or flight response.Whenstress hormonesareconstantly surging through the body,chronic diseasebecomes more likely. The hormones that are going through your body when youre stressed can increase your sugar levels,andover timecan putsomeone at higher risk for diabetes, explained Aleman.

In addition,several studies have documented the link betweentraumaandfeelings ofhelplessness.When someoneis exposed to harm they have no way of escaping,they have a harder time removingthemselvesfromunhealthy situationslater onin life. As researcherand psychiatristDr.Bessel van der Kolkputs it,peoplebecome unable to take action to stave off the inevitable.For those with a chronic disease, thiscan manifest as putting off treatment or forgoing care altogether.When people have experienced trauma, the self-image and self-esteem, the depression, can make it much harder for them to reach out for help,explained Aleman.

Maria Menzel, a licensed clinical social worker at Zufall Health Center, notes another impact of trauma: self-sabotage. She has seen patientsrefuse to take their medication orevenstop takingitafter seeing improvements.Historically, this has led providers to blame or scold patients, but as Valdes found, this kind of approach has yielded poor results.Now, providers likethose atZufall Health Center, are practicingtrauma-informedcare.

Trauma-informed care means assuming people have been through something and shifting from whats wrong with this person to whats happened to them, said Aleman. When we can think[about]whats happened to them, we can get them connected to resources in anonjudgmentalway.

For Valdes, this kind of approachrepresents a shift inhealth care.I think as a field, medicine is learning that its not alwaysthe data and its now always the clinical trials and labs, she said. Its about the person.

Direct Relief, together with BD, has provided Zufall Health Center with a $150,000 grant to expand home monitoring diabetes care for at-risk patients by providing them with equipment and supplies, including blood glucose kits and blood pressure cuffs. The funding, part of the Helping Build Healthy Communities initiative, is also being used to deploy a dedicated care team that will tailor clinical interventions to meet the individual needs of patients and provide them with education and online assistance in multiple languages.

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Managing Diabetes Takes More Than Medication. This Health Center is taking a Patient-Centered Approach. - Direct Relief

An ounce of prevention

The very high incidence of heart disease in patients with long-standing diabetes makes preventative measures worthwhile. As a result, statin therapy is recommended for all individuals over age 40 with an LDL (low-density lipoprotein) of more than 70 mg/dL. In comparison, for those patients without diabetes, that LDL is considerably higher; the AHA 2019 guidelines for primary prevention set the bar at 190 mg/dL. The guidelines for treatment for those individuals with heart disease rather than primary prevention are different.

We have known for some time, based on observational trials and randomized controlled trials, that statins increase insulin resistance and raise glucose levels. The current research explored how those changes play out in the management of diabetes. Are the metabolic benefits of statins on lipids outweighed by statins harmful impact on glucose metabolism?

The Study

This was a retrospective chart review of patients within the VA system comparing a group of statin users to a matched cohort control being prescribed a medication for ulcers. Patients were entered into the study at their first prescription and followed until they left the VA system or the end of the study period 12 years.

From 700,000 eligible patients, the researcher created 83,000 pairs of statin users and controls. Being a VA population, it was predominantly male (94%), white (68%), or black (21%). Among the statin-user group, roughly 60% had diabetes at the study initiation, compared with 40% in the control group. By the end of the study, all patients in both groups had been diagnosed with diabetes that by itself should give us all a moment of pause. All of the statin users had significant reductions in LDLs, which the researchers rightly concluded represented not only being prescribed a statin but actually taking the medication.

Statin users had a 37% higher rate of progression of diabetes than their matched cohort. Progression as measured by

More importantly, there was a dose-response greater LDL reduction was associated with worsening diabetes management.

The Tradeoff

The metabolic imbalance between statins advantage for LDLs and disadvantage for glucose metabolism is most often cited as a statin advantage with a 15% reduction in heart attacks and stroke and a 9% reduction in mortality [1]. As the researchers point out, the metabolic cost on diabetic management is infrequently measured. They point to national statistics demonstrating increasing hospitalization and deaths for poorly or uncontrolled diabetes. To be fair, the deaths from these hospitalizations were a fraction of a percent.

There is little doubt within the medical community regarding the value of statins in secondary prevention, our euphemistic way of treating heart disease once it becomes clinically apparent. For individuals at higher risk for heart disease, statins do provide protection. But it is clear from this study that for patients with diabetes, those statins come with health risks in the short term their ability to manage glucose is impaired. This may require more close monitoring to tweak care. It may be an ideal setting for continuous glucose monitors, reducing the persistently elevated, poorly or uncontrolled blood sugar levels.

[1] These numbers are taken from one of many meta-analyses of statins and are ball-park figures for statins used before the onset of vascular disease primary prevention.

Source: Association of Statin Therapy Initiation With Diabetes Progression A Retrospective Matched-Cohort Study JAMA Internal Medicine DOI: 10.1001/jamainternmed.2021.5714

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The Unintended Entanglement of Diabetes and Statins | American Council on Science and Health - American Council on Science and Health

Ask people 'What was the big health story of the last year?', and nearly everyone will say COVID-19, understandably. But throughout the pandemic that has dominated our headlines and lives, another one has been raging. Last year, diabetes killed three times as many people as COVID-19. Type 2 diabetes generally develops in adulthood, as a result of simple choices you make every day. So what can you do to reduce your risk? Plenty, starting by avoiding this common habit that can lead to diabetes. Read on to find out moreand to ensure your health and the health of others, don't miss these Sure Signs You May Have Already Had COVID.

Diabetes is the body's inability to process sugar (a.k.a. glucose). When a non-diabetic person consumes sugar, their pancreas releases an enzyme called insulin to convert it to energy. A diabetic person's pancreas either doesn't make insulin, or the body becomes resistant to it. Sugar then builds up in the blood, potentially damaging the arteries and leading to heart disease, stroke, eye problems, and even amputation.

Type 2 diabetes, however, is exploding in the United States. Experts predict that one in 10 people will have diabetes by the year 2045. And it's directly connected to diet and lifestyle choices.

RELATED: Over 60? Reverse Aging With These Health Habits

There are many risk factors for type 2 diabetes. One of the biggest is a diet high in added sugar. When the body is swamped with sugar (and many processed foods contain simple carbs that break down into sugar), it can become resistant to insulin.

"Diabetes is when your body cannot provide enough insulin to allow glucose (sugar) into the hungry cells of your body," explains Thomas Horowitz, DO, a family medicine specialist at CHA Hollywood Presbyterian Medical Center in Los Angeles. "The best way to avoid it is to be on a diet that does not task your insulin supply."

That means avoiding sugar-sweetened drinks like soda, processed foods and refined grains like white breads, cookies, chips and baked goods. Choose foods that are low in added sugar and contain complex carbohydrates that break down slowly, like whole grains and vegetables instead of refined grains or sweets.

RELATED: This is a "Significant" Factor in Getting Dementia, Study Shows

It's especially important to limit or avoid beverages with added sugar, like sugar-sweetened sodas. One can of sugar-sweetened Coke contains 39 grams of added sugarmore than a person should consume from all sources in an entire day, experts say.

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To reduce your diabetes risk or manage your diabetes, getting more physical activity is key. "Together with diet and behavior modification, exercise is an essential component of all diabetes and obesity prevention and lifestyle intervention programs," said researchers in a 2017 study published in the Cleveland Clinic Journal of Medicine. Exercise improves insulin sensitivity and builds lean muscle, which can speed your metabolism, helping you reach and maintain a healthy weight. And to get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

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This Common Habit Can Lead to Diabetes, Studies Warn | Eat This Not That - Eat This, Not That

Many people may wonder how to control type 2 diabetes without medications. A healthy diet and lifestyle could help people manage type 2 diabetes and other aspects of their health.

To help people keep blood sugar blood glucose within a healthy range, the American Heart Association (AHA) recommends:

If making dietary and lifestyle changes do not help maintain a healthy blood sugar level, doctors may advise a person to take medications. However, if someone receives a diabetes diagnosis as an older adult and their blood sugar is only mildly elevated, medications may not be necessary.

In this article, we examine how to control type 2 diabetes without medication. We also look at the causes of type 2 diabetes and when people may need medication to manage their condition.

A 2020 study reports that healthy lifestyle practices could benefit people with type 2 diabetes or risk factors for the condition. Such measures may delay or prevent its development, as well as treat or potentially put it into remission. This method of controlling blood sugar can be so effective that the studys authors call it lifestyle medicine.

The following healthy lifestyle practices may help reduce blood sugar levels:

In people with overweight or obesity, significant weight loss may reduce blood sugar from the diabetic to the nondiabetic range.

Two ways to manage weight are eating a healthy, balanced diet and engaging in regular exercise. The key to weight loss involves consuming fewer calories than the body uses for activities and physiological processes.

A healthy diet consists of eating nutritious foods in appropriate portion sizes while avoiding or limiting non-nutritious foods.

Foods for people to eat may include:

Foods and ingredients for people to limit may include:

The American Diabetes Association (ADA) recommends a diet similar to the Mediterranean diet, which focuses on:

A 2020 review notes that following this eating plan improves blood sugar control.

Exercise promotes blood sugar management and burns calories, which contributes to weight loss. Physical activity also increases insulin sensitivity, which helps blood sugar to enter the cells from the bloodstream.

People should aim to get 30 minutes of moderate physical activity per day on most days, totaling at least 150 minutes each week. Experts classify a brisk walk as moderate exercise. Alternatively, 75 minutes per week of vigorous aerobic activity is equally beneficial.

Doctors advise people to stop smoking to help blood sugar control for several reasons. Smokers have a 3040% higher risk of developing diabetes than nonsmokers. Smoking also makes exercise more challenging.

Smoking also raises blood sugar temporarily, which poses an additional challenge in maintaining nondiabetic blood sugar levels. This increases the likelihood of a person developing complications of diabetes, such as kidney disease and nerve damage.

Research in 2019 suggests that although stress does not cause type 2 diabetes, it can worsen it. Stress stimulates the release of hormones that interfere with the bodys blood sugar regulation. It also makes a person more likely to engage in practices that make it harder to manage blood sugar, such as overeating and smoking.

One way to reduce stress involves taking a break from electronics and spending time in nature.

According to 2020 research, a person only needs medication if lifestyle practices do not put blood sugar levels in the nondiabetic range.

A doctors recommendation for medication for someone with type 2 diabetes may depend partly on their age when they receive a diagnosis. While many older adults with the condition have slightly higher blood sugar levels, this rarely causes problems.

On the other hand, doctors may prescribe medications to people who receive a diagnosis by the age 40 or 50. Even slightly elevated blood sugar levels can eventually lead to health problems, such as damage to nerves or blood vessels. Such damage may result in complications, such as kidney disease. The purpose of medications is to delay or prevent the harmful effects of diabetes.

According to the ADA, type 2 diabetes is progressive, making it more difficult to manage over time. Improvements in medical care enable people with the condition to live longer. However, despite the advancements, type 2 diabetes may reduce life expectancy by up to 10 years.

The effects of lifestyle practices alone on type 2 diabetes have not undergone extensive research, limiting statistics on the results of such interventions. However, a 2018 clinical trial examined the outcomes of a weight management program on 306 individuals with type 2 diabetes. After 12 months, the authors found about half the individuals who participated in the program went into remission.

Researchers cannot quantify the exact improvement that each healthy lifestyle practice may bring at this point in research. However, the outlook for people with type 2 diabetes who have a healthy lifestyle is better than those who do not.

Type 2 diabetes is a condition that involves high blood glucose or blood sugar.

The pancreas makes insulin, a hormone that enables cells to take glucose from the bloodstream for energy. In type 2 diabetes, the cells do not respond normally to insulin, called insulin resistance. As a result, the pancreas makes more insulin in an attempt to get glucose inside the cells.

After some time, the pancreas cannot keep up, and blood sugar increases, which leads to prediabetes and diabetes.

Symptoms frequently develop over several years, including:

Experts advise people interested in learning how to control type 2 diabetes without medications to adopt a healthy lifestyle.

Significant weight loss can help control blood sugar levels in some people. Two ways to pursue weight management involve people eating a healthy, balanced diet and getting regular exercise.

Good nutrition is vital for a person with type 2 diabetes. Some evidence suggests that a nutritious eating plan, such as the Mediterranean diet, may help control blood sugar in ways other than weight loss.

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Controlling type 2 diabetes: With and without medication - Medical News Today

TUESDAY, Oct. 5, 2021 (HealthDay News) -- Favorable cardiovascular health (CVH) is important for preventing type 2 diabetes among middle-aged individuals regardless of their genetic predisposition, according to a study published online Sept. 28 in the European Journal of Preventive Cardiology.

Kan Wang, from the Erasmus University Medical Center in Rotterdam, Netherlands, and colleagues calculated a CVH score and a genetic risk score for predisposition for diabetes among 5,993 individuals at baseline.

The researchers found that at age 55 years, the remaining lifetime risk for type 2 diabetes was 22.6 percent for ideal, 28.3 percent for intermediate, and 32.6 percent for poor CVH. The lifetime risk for type 2 diabetes was still the lowest for ideal CVH when stratifying by genetic risk score tertiles (lowest: 21.5 percent; second: 20.8 percent; highest: 23.5 percent) compared with intermediate and poor CVH.

"While genetics do contribute to the probability of developing type 2 diabetes, the findings indicate that maintaining healthy lifestyle habits, and especially having a healthy body weight, can help lower the lifetime risk of the condition," a coauthor said in a statement.

Abstract/Full Text

Editorial

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Heart Health May Help Prevent Diabetes, Regardless of Genetics - HealthDay News

Oct. 5 (UPI) -- Taking blood-thinners and diabetes drugs at higher-than-recommended doses or in error often leads to health complications that bring older adults to hospital emergency rooms, a study published Tuesday by JAMA found.

Adults age 65 and older account for nearly 28,000, or one-third, of the roughly 97,000 emergency room visits related to "medication harms" annually in the United States, the data showed.

Medication harms include people taking their medications in higher-than-recommended doses, taking medications prescribed for others or using medications to treat conditions for which the drugs have not been approved.

Of the 28,000 trips to the emergency room, roughly half result in hospital admissions, according to the researchers.

Anticoagulants -- blood thinners to prevent blood clots -- account for nearly 15% of emergency room visits related to medication harms, while pain medications make up 14%.

Sedatives used to treat mental health and behavior disorders are involved in about 12% of medication-related ER visits, and diabetes drugs are implicated in about 10%, the data showed.

"Among patients 45 years of age and older, therapeutic use of anticoagulants, or blood thinners, and diabetes medications were the most common causes of [ER] visits for medication-related harms," study co-author Dr. Dan Budnitz told UPI in an email.

"The rate of visits for harms due to therapeutic medication use increases with age, peaking among those 75 years of age or older," said Budnitz, who is director of the Center for Disease Control and Prevention's Office of Medication Safety.

Some medication misuse may be intentional and linked with acts of "self-harm," such as attempted suicide, according to Budnitz and his colleagues.

However, in some cases, medications may be prescribed or used in error, they said.

Self-harm accounts for nearly 14,000, or about 13%, of medication-related ER visits each year, but "therapeutic use," or intentional use of prescribed drugs, makes up more than 66,000, or nearly 70%.

Harms related to therapeutic use of drugs include side effects, which lead to roughly one-third of medication-related ER visits annually. Allergic reactions are involved in about 14%, the researchers said.

Medication errors, or not taking drugs at the recommended dose or on the prescribed schedule, account for 6% of these ER visits, according to the researchers.

The findings are based on an analysis of patient data from 60 hospital emergency departments participating in the CDC's National Electronic Injury Surveillance System-Cooperative Adverse Drug Event Surveillance Project between 2017 and 2019, they said.

These projects track injuries and drug-related health reports nationally, the CDC said.

"Improved labeling can be part of the answer to reducing medication-related harms. Clearly identifying active ingredients and dosing instructions can help individuals choose the best medication and administer the correct dose," Budnitz said.

"However, most emergency department visits for medication-related harms would not be prevented by labeling changes alone. Identifying the most common medication-related harms for patients of different ages can help target prevention efforts," he said.

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Blood thinners, diabetes meds among top causes of drug-related ER visits - UPI News

New strategic campaign innovatively integrates nutrition facts about fresh avocados in efforts to reduce Type 2 diabetes risk among Hispanics, who have a 50% chance of developing the disease in their lifetime

Published: Oct. 5, 2021 at 8:03 AM MDT|Updated: 9 hours ago

MISSION VIEJO, Calif., Oct. 5, 2021 /PRNewswire/ -- As November marks National Diabetes Month, AltaMed Health Services, the nation's largest independent federally qualified community health center, and Aguacates Frescos - Saborea Uno Hoy, a leading source of the healthiest reasons and tastiest ways to enjoy fresh avocados developed especially for Hispanic families, will join forces to improve nutritional education and access to glucose testing for the early detection and possible prevention of type 2 diabetes, a condition that impairs the body's ability to regulate sugar.

Beginning in the fall, the AltaMed mobile unit will travel throughout Southern California to offer free glucose testing and education that integrates messaging on how dietary fiber, like that found in avocados, may help maintain healthy blood glucose levels.Delicious recipes and meal planning tools featuring fresh avocadoswill be shared in English and Spanish to inspire families to eat healthy and boost fiber intake with the traditional favorite.

"We are excited to partner with Aguacates Frescos - Saborea Uno Hoy in the fight against type 2 diabetes by educating the community on the value of fresh fruits and vegetables with bilingual tools, like nutritious recipes that include fresh avocados," said Cesar Sauza, Registered Dietitian, Manager, Clinical Nutrition of Health Education and Wellness with AltaMed. "Creatively integrating the benefits of fresh avocados into our conversations about improving the quality of diet supports our commitment to be respectful of cultural preferences in our approach to help the community grow healthy."

If unmanaged, diabetes can be life-threatening and according to the CDC,US adults overall have a 40% chance of developing type 2 diabetes. But for a Hispanic/Latino American adult, there is more than a 50% chance, and it is likely to develop at a younger age. Diets rich in healthy foods containing fiber, may reduce the risk of type 2 diabetes.

"Fiber, like that found in avocados, slows down food digestion which promotes satiety and prevents rapid rises in blood glucose following a meal," said Krista Linares, Registered Dietitian and Saborea Uno Hoy spokesperson. "Since most adults don't get enough dietary fiber, it is beneficial to raise awareness of easy ways to boost intake. Delicious avocados add fiber to the diet and are already a much-loved staple in Hispanic homes."

The Dietary Guidelines for Americans point to strong evidence that healthy eating patterns are associated with positive health outcomes. The Hass Avocado Board's Avocado Nutrition Center is continually studying how eating fresh avocados can have a positive effect on reducing risk factors for type 2 diabetes. Meal planning tools, recipes, articles by dietitians as well as access to clinical research that looks at how replacing carbohydrates with avocado affected glucose and insulin levels are available at SaboreaUnoHoy.com/AltaMed.

About Saborea Uno Hoy and the Hass Avocado BoardSaborea Uno Hoyis a leading source of the healthiest reasons and tastiest ways to enjoy fresh avocados developed especially for Hispanic families. A science-based resource, it provides delicious and culturally-relevant recipes and articles in Spanish and English to help make it easy for consumers and health professionals to learn more about the nutritional benefits of fresh avocados and ways to include them in everyday menus.

About the Hass Avocado BoardThe Hass Avocado Board (HAB) exists to help make avocados America's most popular fruit. HAB is the only avocado organization that equips the entire global industry for success by collecting, focusing and distributing investments to maintain and expand demand for avocados in the United States. HAB provides the industry with consolidated supply and market data, conducts nutrition research, educates health professionals, and brings people together from all corners of the industry to collectively work towards growth that benefits everyone. The organization also collects and reallocates funds to California and importer associations to benefit specific countries of origin in promoting their avocado brands to customers and consumers across the United States. For more information, visitSaboreaUnoHoy.comor follow HAB on Facebook,Instagram,Twitter,PinterestandYouTube.

About AltaMedAltaMed understands that when people have health care that looks at their individual health needs and respects their cultural preferences, they grow healthyand help their families do the same. So we're delivering complete medical services to communities across Southern California. Since 1969, our team of qualified multicultural and bilingual professionalsfrom these same communitieshas focused on eliminating barriers to primary care services, senior care programs, and even essential community services. With nearly 50 accredited health centers and service facilities, we remain committed and ready to help you grow healthy at any age.

Contact: Vickie Fite (310) 613-0937

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SOURCE Aguacates Frescos - Saborea Uno Hoy; AltaMed Health Services

The above press release was provided courtesy of PRNewswire. The views, opinions and statements in the press release are not endorsed by Gray Media Group nor do they necessarily state or reflect those of Gray Media Group, Inc.

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AltaMed Health Services' Mobile Unit Adds Free Glucose Testing and Highlights the Nutrition Benefits of Avocados for National Diabetes Month - KKCO-TV

The relationship between type 2 diabetes and alcohol is complex. When people with this condition drink alcohol, it comes with risks. However, it does not mean people with type 2 diabetes cannot drink alcohol. The risks depend on how much alcohol a person consumes, as well as the type.

Diabetes is very common. According to the National Diabetes Statistics Report 2020, 34.2 million people in the United States had diabetes in 2018. The percentage of the population with diabetes increases according to age, reaching 26.8% in adults aged 65 and older.

Moderate alcohol consumption does not raise the risk of type 2 diabetes; however, heavy consumption might.

Overall, alcohol consumption leads to less predictable blood sugar levels, and this can be a risk.

Keep reading to learn more about how alcohol affects people with diabetes, including types of alcohol and how alcohol may cause hypoglycemia, or low blood sugar levels.

Learn more about hypoglycemia here.

Alcohol does not cause diabetes. However, according to American Diabetes Association (ADA), heavy consumption and zero consumption increase the risk. The ADA also states that a drink or two may improve insulin sensitivity and sugar management.

A 2015 meta-analysis reviewed 38 cohort studies to determine whether alcohol is a risk factor for diabetes. It found moderate consumption appeared to offer some protection against the condition in women and Asian populations, while heavy consumption raised the risk in almost all groups.

Because even moderate alcohol consumption can adversely many aspects of health, the negatives seem to outweigh the positives. More research must continue into this area.

Learn more about how alcohol affects blood sugar levels in diabetes.

The ADA does not forbid a person with diabetes from consuming alcohol, but they do not advise it either. If someone with diabetes chooses to drink alcohol, the ADA recommends limiting consumption to a moderate intake. This translates to one drink per day for females and up to two per day for males.

However, the ADA adds that if an individual with diabetes does not already drink, this does not mean they should start.

Below are some detrimental effects of alcohol on diabetes:

Doctors advise some people with diabetes to abstain from alcohol for reasons unrelated to their blood sugar. The Department of Veterans Affairs (DVA) warns that individuals with diabetes may have other conditions that alcohol could affect. In addition, certain non-diabetic medications do not mix well with alcohol.

Because alcohol is highly addictive and research links heavy consumption to an array of adverse health effects, avoiding the beverage is the healthiest choice for anyone.

The bottom line is that any person with diabetes who wishes to consume alcohol should first discuss it with a doctor.

Learn more about the risks of chronic heavy drinking here.

The below information can help someone adhere to the one-drink-per-day limit for females and the two-drinks-per-day limit for males.

These amounts comprise one standard drink:

When individuals calculate how much alcohol they can consume while staying within the recommended guidelines, they should know that some common alcoholic beverages contain more than one standard serving of a drink. For example:

A person should avoid sweetened liquor or alcohol mixed with sodas or punch.

Learn more about how alcohol affects health here.

The biggest concern associated with alcohol for someone with diabetes involves the risk of hypoglycemia, which is low blood sugar. Hypoglycemia is when blood sugar falls below 70 mg/dL.

Alcohol consumption can decrease blood sugar, as can some diabetes medications. If these decreases occur at the same time, it can cause hypoglycemia.

This happens because the liver stores carbohydrates and releases them into the blood between meals and overnight to stabilizes blood sugar. The liver is also responsible for breaking down alcohol so the kidneys can flush it out of the body.

The problem is that the liver cannot perform both functions at the same time. When a person consumes alcohol, the liver begins to break it down. When it is busy doing this, it does not release stored carbohydrates to maintain blood sugar, meaning that blood sugar levels can drop to dangerous levels.

Exercise can also increase the risk of hypoglycemia when coupled with other factors, such as drinking alcohol. Doctors strongly encourage people with diabetes to engage in regular physical activity because it reduces blood sugar. However, exercising, drinking alcohol, and taking blood sugar-lowering medication could cause hypoglycemia.

Symptoms of hypoglycemia include:

The risk of hypoglycemia is why experts advise people with diabetes not to drink alcohol if their blood sugar is already low. If a person chooses to drink, they should always eat at the same time and include carbohydrates, such as fruits, vegetables, or grains, in their meal.

They should also keep a closer watch on their blood sugar so they can quickly react if levels fall too low.

Learn more about testing glucose levels here.

The CDC list the below risk factors for developing type 2 diabetes:

Learn more about the risk factors for type 2 diabetes here.

Type 2 diabetes and alcohol is not always a beneficial combination. While moderate alcohol consumption lowers blood sugar, heavy consumption is harmful to diabetes and other aspects of health.

The ADA neither forbids nor advises people to drink alcohol. However, the organization recommends that females with diabetes limit their consumption to one drink per day and males limit their consumption to two drinks per day.

If someone chooses to consume alcohol, they should have food with it and keep a close watch on their blood sugar.

Most importantly, if individuals wish to engage in moderate drinking, they should first discuss it with their doctor.

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Type 2 diabetes and alcohol - Medical News Today

Diabetes is an umbrella term for three primary conditions: type 1 diabetes, type 2 diabetes, and gestational diabetes. According to guidelines established by experts in the field, there are multiple stages of diabetes, each of which are defined by physiological changes within the body.

In this article, well explore the stages of type 1 and type 2 diabetes as defined by diabetes experts, as well as information about long-term diabetes management.

Within the past decade, professional organizations, like the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE), have created guidelines that outline the various stages of diabetes development.

According to the literature on these guidelines, understanding the various stages of diabetes can allow physicians and patients to take a more comprehensive approach to preventive care and disease management.

Below, weve outlined the various stages of beta cell dysfunction, type 1 diabetes, and type 2 diabetes, as established by current experts in the field of diabetes research.

In 2015, the ADA released a joint statement with the JDRF and Endocrine Society outlining the various stages of type 1 diabetes. Using the guideline below, clinicians can more easily diagnose this condition at an earlier stage, even when symptoms might not be present.

Its important to note that type 1 diabetes is an autoimmune disease where the immune system attacks and destroys beta cells in the pancreas, which are responsible for producing insulin.

In this stage, genetic analysis can help identify underlying genotypes that are commonly associated with type 1 diabetes.

According to the research, a specific region on chromosome six called the HLA region is associated with up to 50 percent of the risk for developing this condition. Other factors, like having a sibling or close relative with type 1 diabetes, can also increase disease risk.

In this stage, at least one diabetes-related autoantibody is present in the blood. At this point, these autoantibodies have already begun to attack the beta cells in the pancreas. But blood sugar levels still remain within the normal range, and no symptoms are present.

In this stage, at least two or more diabetes-related autoantibodies are present in the blood. As the beta cells continue to be destroyed by the immune system, a lack of insulin leads to rising blood sugar levels due to glucose intolerance. Although beta cell dysfunction is more serious at this stage, there are still no symptoms yet.

In this stage, theres a significant loss of beta cells due to autoimmunity and symptoms are present, resulting in a type 1 diabetes diagnosis. During this stage, the symptoms of type 1 diabetes may include:

In 2018, the AACE created the dysglycemia-based chronic disease (DBCD) multimorbidity care model. Much like the previous guidelines above from 2015, the DBCD care model helps clinicians take preventative steps to reduce type 2 diabetes complications.

This stage, defined as insulin resistance, is where muscle, fat, and liver cells become resistant to insulin and have trouble bringing glucose into the cell. But the pancreas compensates for this by producing more insulin, which helps keep blood sugar levels within normal range.

In this stage, also known as prediabetes, cells become so insulin resistant that the extra insulin isnt enough to lower blood sugar levels back to normal. In some cases, beta cell dysfunction may also be present. During this stage, blood glucose levels remain higher than normal, but not high enough to be classified as diabetes.

In this stage, blood sugar levels remain abnormally high, leading to a diagnosis of type 2 diabetes. Both insulin resistance and beta cell dysfunction can lead to high blood sugar levels in type 2 diabetes. Without treatment, these elevated levels can cause long-term damage to the body.

In this stage, vascular complications can occur as a result of high blood sugar. As blood sugar levels remain high, damage can occur within the vascular system, leading to potential complications like:

While end-stage diabetes isnt a commonly used term, diabetes can lead to whats known as end-stage diabetic complications, or advanced complications. In people with diabetes, advanced complications, like end-stage renal disease, occur after many years of living with diabetes.

A study from 2019 found that microvascular complications from diabetes, like nephropathy, increase risk for cardiovascular events and death in people with type 1.

While theres no cure for diabetes, it can be managed through the appropriate treatment, which may include medications, dietary changes, and lifestyle interventions.

Although it can feel overwhelming to manage a chronic health condition like diabetes, your healthcare team is there to help you create a diabetes treatment plan that works best for you.

If youre concerned about managing your diabetes, the first step is to reach out to your doctor or care team to create a diabetes treatment plan. Depending on your diagnosis and personal needs, your treatment plan may include reaching out to:

According to experts in the field of diabetes research, diabetes staging plays an important role in the prevention, diagnosis, and treatment of diabetes. Understanding the various stages of both type 1 and type 2 diabetes allows physicians and patients to see the progression of the disease so that treatment and long-term management can be improved.

If youve been diagnosed with diabetes, its important to stay educated about your condition so that you can more easily manage it in the long-term.

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Stages of Diabetes: Stages, Symptoms, and Treatments - Healthline

New research Is sounding the alarm on increased rates of gestational diabetes among first-time mothers in the US.

Conducted by investigators from Northwestern University, Kaiser Permanente, and the Centers for Disease Control and Prevention, the cross-sectional analysis of data from 12.6 million singleton births suggests the rate of gestational diabetes has increased from 47.6 per 1000 live births in 2011 to 63.5 per 1000 live births in 2019, with increases in prevalence observed across all racial and ethnic subgroups included in the analysis.

Given that gestational diabetes is associated with increased short-term and long-term risks for individuals and their offspring, the observed trends and disparities may portend a greater burden of future cardiometabolic disease, wrote investigators.

With the increased risk of Cardiometabolic conditions associated with gestational diabetes widely recognized, a team of investigators led by Sadiya Khan, MD, MSc, assistant professor at Northwestern University Feinberg School of Medicine, conducted the present study to develop a greater understanding of contemporary trends in the rate of gestational diabetes among individuals at first live births between 2011 and 2019. To do so, investigators designed their study as a serial cross-sectional analysis of information from the National Center for Health Statistics (NCHS).

From the NCHS, investigators identified 12,610,235 individuals aged 15-44 years with singleton live birth from 2011-2019. For the purpose of analysis, these patients were stratified into the following groups: Hispanic/Latina, non-Hispanic Asian/Pacific Island, non-Hispanic Black, and non-Hispanic White. Of note, the Hispanic/Latina group included those identifying Central and South American, Cuban, Mexican, and Puerto Rican and the non-Hispanic Asian/Pacific Islander group included those identifying as Asian Indian, Chinese, Filipina, Japanese, Korean, and Vietnamese.

The primary outcomes of interest for the analysis were the age-standardized rates of gestational diabetes per 1000 live births and respective mean annual percent change and rate ratios of gestational diabetes among the aforementioned groups and subgroups relative to those in the non-Hispanic White group.

The 12,610,235 individuals included in the analysis had a mean age of 26.5 (SD, 5.8) years, 21% were Hispanic/Latina, 8% were non-Hispanic Asian/Pacific Islander, 14% were non-Hispanic Black, and 56% were non-Hispanic White. Overall, the age-standardized gestational diabetes rates increased from 47.6 (95% CI, 47.1-48.0) per 1000 live births in 2011 to 63.5 (95% CI, 63.1-64.0) per 1000 live births in 2019, which represents a mean annual percent change of 3.7% (95% CI, 2.8-4.6%) per year.

In analyses of subgroups based on race, increases were observed across all groups from 2011 to 2019. Investigators noted rates were greatest among Asian Indian patients, with a rate of 129.1 (95% CI, 100.7-104.7) per 1000 live births. Investigators also pointed out rates were greatest among Puerto Rican (75.8 per 1000 live births [95% CI, 71.8-79.9]) patients than any other Hispanic/Latina subgroup.

In an editorial comment, CamillePowe,MD, and EbonyCarter,MD, MPH, express their concern over the rising rates of gestational diabetes and potential racial and ethnic barriers to care.

The study by Shah et aldocuments a concerning trend of increasing gestational diabetes rates over the past decade, as well as persistent racial and ethnic inequities in gestational diabetes prevalence. Because of the strong links between glucose intolerance during pregnancy and future diabetes, these observations ominously foreshadow a potential future increase in diabetes incidence wrote Powe and Carter.

This study, Trends in Gestational Diabetes at First Live Birth by Race and Ethnicity in the US, 2011-2019, was published in JAMA.

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Rates of Gestational Diabetes on the Rise Among First-Time Mothers in the US - Endocrinology Network