Category Archives: Diabetes

In a few short decades, type 2 diabetes research and technological breakthroughs have brought about significant advancements in how the condition is treated and managed. Here are some of the top innovations that are helping people with type 2 diabetes better manage the condition today.

1. Insulin pumps The first insulin pump came on the market in 1974, according to an article published in June 2020 in the journal Diabetes Therapy. If you have type 2 diabetes and have to inject insulin multiple times a day, a pump is an alternative to self-injection. An insulin pump is a medical device that delivers insulin into the tissue just underneath the skin, says Megan Porter, RD, CDCES, a certified diabetes educator in Portland, Oregon.

This computerized device, which is about the size of a deck of cards, can be worn around your waist, put in a pocket, secured with an armband, or attached to a belt or bra. Some pumps deliver the insulin continuously, and others only deliver the insulin at meals or large snacks, adds Porter. An insulin pump can also be more convenient if youre out or at work, because all you may need to do is push a button to deliver the insulin instead of prepping a syringe and giving yourself a shot.

2. Continuous glucose monitors (CGMs) These devices have a tiny sensor that is placed below the surface of the skin to measure the amount of glucose in the fluid between cells every few minutes and transmit the data wirelessly to a device or your smartphone.

CGMs are a game changer: Unlike glucose meters that require a drop of blood to check what your blood glucose levels are at that moment, CGMs monitor your levels at set times throughout the day, such as every 5 minutes. This can help you and your doctor identify patterns and trends that may be helpful in fine-tuning your type 2 diabetes treatment plan to optimize management, according to the American Diabetes Association (ADA). These devices can also alert you when your glucose level is too low or too high.

The first CGM, which involved wearing a device provided by the doctor for two weeks or less and then returning it to the clinic or hospital, was approved by the Food and Drug Administration (FDA) in 1999, according to Endotext. Since then, CGMs have become increasingly accurate and much more widely available for home use. In the past 5 years, there have been even more advances in CGM therapy. In June 2018, the FDA approved the first implantable CGM device, which can be worn up to 3 months without changing the sensor, for people with type 1 or 2 diabetes.

The benefit of using a CGM is that it can be worn for 5 or more days, which means one poke to insert the monitor [during that time frame] replaces checking blood sugars via a finger poke 3 or more times per day, Porter notes. CGMs make it easier to check your blood sugar before and after meals, and they can help you understand how your diet, activity, and lifestyle affect your blood sugar levels.

3. Connected CGM-insulin pumps Another option available is a combination CGM-insulin pump, which enables the pump to use the data from the CGM to suggest changes in medication dosing or make necessary adjustments on its own. In June 2020, the FDA approved an integrated CGM, which allows it to be connected to other diabetes management devices, such as insulin pumps and blood glucose monitors.

This integration of devices can help improve type 2 diabetes management by quickly reducing blood sugar and minimizing the amount of time you experience unsafe and unhealthy blood sugar levels.

4. Diabetes medications Although insulin has been used in the United States since the 1920s, according to the ADA, todays medications can be far more targeted for specific diabetes issues.

Metformin, which belongs to a class of medications called biguanides, is often the first medication prescribed for type 2 diabetes. [Metformin] decreases glucose absorption from food and decreases liver production of insulin, says Porter. Other options, including oral medications and non-insulin injectables:

And, of course, insulin is still used as a replacement when a persons body does not create enough insulin on its own, Porter adds.

5. Insulin innovations Insulin has come a long way since it was first discovered. It now comes in a variety of forms, including rapid-acting, long-lasting, and premixed formulas, and can be delivered via a number of methods, such as syringes, pumps, and pens. And innovations are still coming. For instance, there are now insulin pen devices that can remember the last dose and the time that it was given, which is especially helpful if youre busy or tend to forget to take it. Smart insulin pens have many of the features of insulin pumps but cost less and dont have to be attached to your body.

According to the ADA, smart insulin pens can connect to your smartphone or watch and diabetes data tracking platforms to help you accurately calculate each dose based on factors such as your blood sugar level, carb amounts, meal size, and other parameters prescribed by your doctor. These devices can also remind you to take your dose, keep track of the amount of each dose, and tell you when your insulin has expired.

6. Easier-to-use glucagon Glucagon is used in emergencies to treat very low blood sugar, or hypoglycemia, a dangerous condition that can lead to confusion, loss of consciousness, seizures, and even death, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Glucagon injections have been available for more than 20 years, but in the past few years, devices such as injectable pens and glucagon that can be inhaled have made it much easier for you or your family or friends to administer glucagon in the event of an emergency.

7. Better support for people with diabetes In the past, many people with type 2 diabetes were treated by their primary care physician rather than an endocrinologist, who is trained to treat diabetes who may not have had any special training in the complexities of type 2 diabetes management. Today, there are many specialists who can help. Since the 1980s, certified diabetes educators have transformed diabetes management, according to the ADA. These professionals, who are now called certified diabetes care and education specialists (CDCES), take a comprehensive approach to teaching diabetes management and specialize in educating and supporting those with diabetes to optimize their health.

Diabetes educators can also connect you to dietitians, physical therapists, and mental health experts trained to help with the condition. Hopefully, over time, more people with chronic conditions, such as diabetes, will be referred out to other healthcare professionals who can help them manage their condition physically and mentally, Porter says.

8. Diabetes smartphone apps Yes, theres an app for that many of them, in fact. Nowadays, diabetes apps can track your blood sugar levels and show trends; monitor your diet and suggest recipes; log your exercise; and provide support from other people with diabetes. Coaching apps can also give you access to highly trained diabetes educators and fitness coaches, Porter says.

But its important to check with your doctor, CDCES, or other trusted diabetes health professional before you choose an app. An article published in January 2020 in the journal Diabetes Care noted that there isnt sufficient evidence to back up the effectiveness, accuracy, and safety of many apps, and many are plagued by technical problems. The authors noted that regulatory agencies and app companies urgently need to work with diabetes health professionals and researchers to ensure the safety and effectiveness of diabetes apps.

9. Meal delivery services While they werent developed specifically for diabetes, meal delivery companies that offer healthy foods and recipes have become very popular over the past several years. Now, many companies provide diabetes-friendly meal kits if you want to eat healthy but dont want to do a lot of food shopping and planning.

Here is the original post:
9 Innovations in Type 2 Diabetes Treatment - Everyday Health

Diabetes researchers tend to be masters of understatement, but now they seem to be universally excited about a new drug that some are even calling revolutionary because it can delay the onset of type 1 diabetes (T1D).

Teplizumab is a new injectable drug from New Jersey-based Provention Bio that studies have found offsets the onset of T1D in a person at risk by as much as 2 to 5 years. On May 25, 2021, an advisory committee of the Food and Drug Administration (FDA) recommended this treatment be approved by the full agency later in the year.

I will say with confidence that years from now, Teplizumab will widely be seen as revolutionary, and in fact for some, including myself, I have already seen it in such a light, Dr. Mark Atkinson, American Diabetes Association Eminent Scholar for Diabetes Research and director of the University of Florida Diabetes Institute wrote in his testimony to the FDA. He called Teplizumab the most impactful diabetes breakthrough since home blood glucose meters replaced urine testing.

We know this can have a blockbuster effect on the pre-diagnosed, said Frank Martin, PhD, director of research at JDRF.

In other words, even the usually understated scientists are amped up about the news that the FDAs advisory panel has voted to recommend the approval of Teplizumab for use in the general public.

On July 2, the FDA will take that advisement and vote on whether to approve it or not. Experts say they could opt for more study, but even that result would move the world closer to the drugs eventual possible approval.

This is the first-ever drug close to market with a real possibility of halting T1D, so theres understandably a lot of excitement around it. The closest competitor would be Diamyd, developing a vaccine to halt the autoimmune attack in T1D, but that remains several years out from FDA submission.

Teplizumab, on the other hand, could potentially come to market as soon as next year.

First of all, the complicated name is pronounced TEP-LIH-ZOOM-AB.

It is an anti-CD3 monoclonal antibody drug that binds to the surface of T-cells in the body and helps suppress the immune system. Similar drugs are being tested for the treatment of other conditions like Crohns disease and ulcerative colitis.

Teplizumab is administered with injections given over a period of 2 weeks in an outpatient setting.

Studies in people with early onset T1D show that it appears to successfully reset the immune system, allowing the persons insulin-producing beta cells to continue making insulin longer. One minor side effect is a skin rash.

Ways that it may help treat T1D include:

Based on these unprecedented possibilities, I do think we are at a point in diabetes research that will be revolutionary, said Provention Bios co-founder and CEO Ashleigh Palmer.

Teplizumab was born from a long line of drugs created and tested over more than three decades.

The idea took root in the labs of Dr. Kevan Herold and Dr. Jeffrey Bluestone at University of California (UC) San Francisco.

It was in 1989, when working with cancer patients, that Bluestone realized an anti-CD3 drug could be a key in stopping the progression of T1D because of how it helped transplant patients.

His theory seemed to hold up in small studies. Since T1D manifests when a persons immune system gets confused and attacks their insulin-producing beta cells rather than protecting them, Bluestone surmised that by creating monoclonal antibodies in a lab that can be introduced into the body of a person on the verge of developing T1D, those will bind to the CD3 cells that are attacking the beta cells and stop the attack.

Over the years, researchers like Herold and Bluestone, along with companies like Tolerx, worked to find just the right level of anti-CD3 to make that effort a success.

Tolerx came close to approval of its drug about 10 years ago, but did not make it past Phase 3 trials with the FDA due to some significant side effects of flu-like symptoms.

Other trials fell short as well, which often happens as drug research progresses.

Four years ago, Provention Bio picked up the research and pushed it along more. They were frustrated, Palmer said, with how the medical system handles diagnoses of autoimmune diseases in general.

The medical system waits for patients to exhibit symptoms. Very often, by that point, irreversible damage has been done, Palmer said.

Can you imagine, he added, a system in which a patient with kidney disease presents at the point of dialysis? Insulin therapy is pretty much the same as if we did that. We go right to the [intense and chronic] treatments at the start.

At the point where Provention Bio took over, the global T1D screening research collaboration TrialNet was pumping some decent study participant numbers into the project, and more than 800 patients have received the treatment in multiple studies to date. With the work done over those past decades, it seemed they had found what Palmer calls the Goldilocks formula for the medication: Not too little immune response alteration and not too much; just the right amount, he said.

Some patients in the studies have had their need for insulin offset by 5 years, while 2 years is a strong average across the board.

Katie Killilea of Rhode Island told DiabetesMine that her son entered the Teplizumab trial at Yale in 2013, after she and her son were both tested via TrialNet at her other sons diabetes camp.

Killilea herself was diagnosed shortly after. But her son, who was farther back in the progress toward T1D, was able to remain in the study as his body held off diagnosis for some time.

The challenges, she said, were that her son [along with his dad] had to spend 3 weeks up near Yale, a bit of a bump in the life of a 12-year-old, and a difficult set up for most families.

It gives me hope, but the whole time [in 2013], I felt acutely aware of how difficult the Teplizumab trial was for families financially, she said.

You had to have a parent who could take time off from work, another parent to stay home with the other child or children. It seemed unrealistic for us, and maybe impossible for others to participate, she said, stressing that these issues need to be worked out.

But the benefits were many, she said.

Since he had the drug, his blood glucose returned to normal for a while. TrialNet did glucose tolerance tests every 6 months, she said.

And while the time did come that her son developed T1D, she found it to be a more manageable transition as opposed to her other sons previous diagnosis, Killilea told DiabetesMine.

Although he was not able to keep T1D at bay forever, he did have a very gentle landing and was diagnosed with T1D before he needed to use insulin, she said.

He slowly had more T1D and needed something silly like just 1 or 3 units of Lantus a day for a while. I remember his pediatric endo saying, this dose is so small, Im surprised it can do anything. But the speck was enough for a while. Then more Lantus was added 5, then 7, then 10 units. Then an insulin pump with a very low basal rate, and maybe the bolus ratio was initially 1:100 or something. He never ate enough [carbs] to need a bolus dose initially.

In other words, it was a slow progression instead of a shock. She wonders what could have been if he could have had a second round of the infusion treatment.

We may all find that out in the future.

In December 2020, JDRF launched a partnership that offers at-home tests to screen for the autoantibodies that are the most important markers for developing T1D (at a regular rate of $55 and discount rate of $10 per test for those in need).

Given that TrialNet offers testing for free, and theres little you can do about it should you test positive for T1D risk, many wondered the point.

Now, its clear that these tests could pair up with the possible new ability to take action before diagnosis. If and when Teplizumab comes to market, those testing positive could begin with this prevention therapy right away.

While JDRF has pushed to build awareness around early detection, the organizations research director says that currently, medical people dont really know what to do with a person with T1D risk.

Thats why theyre so excited about the potential of Teplizumab.

If a person opts for an at-home test and has some antibodies come back positive now, their next step would be to reach out to TrialNet for screening there. Then, should the FDA grant approval, they could be guided toward this proactive treatment, the JDRFs Martin said.

Family history of the condition only impacts 15 percent of people with T1D in the United States, he noted. That means 85 percent of people diagnosed have no reason to watch for symptoms or be on the lookout.

To make it something people think to do, he said, Screening needs to be easy, accessible, and affordable Our program has embedded educational material for all of this.

The pandemic helped push the notion of at-home testing even more, he said.

One challenge? Seeing antibodies in tests can cause great anxiety. We need to mitigate anxiety around finding out that you may be at risk, Martin said. This needs to have guidelines, so people know and understand how often to screen and what antibodies mean.

It will make all the difference when there is a prevention that people can turn to, he said.

Provention Bio, the researchers, and the public at large will be looking toward the July 2 meeting, hoping for FDA approval.

The FDA does not always follow the recommendations of subcommittees, but many have high hopes that Teplizumab will be cleared. Some expect the FDA to possibly require an additional study demonstrating its efficacy particularly given the advisorys committees narrow 10 to 7 vote. That could take 6 months to a year.

Either way, most are feeling that one of the biggest diabetes breakthroughs in modern times could be at hand.

Just the [fact] that this could offer a positive step to take from screening is huge, Palmer said. Because why should a person developing T1D not have the opportunity to find out what is going on and take action when [their pancreatic cells] are not yet destroyed?

Then, he hopes, they can dig into things like studying if a second treatment down the road could extend the offset even longer.

Martin also hopes this will one day change the lives of those already diagnosed by pairing with beta cell replacement or regeneration to reverse existing T1D.

We want to stop people from having to live a life on insulin, he said. About 1.6 million people live with T1D and its a heavy burden. Your body fights against you. We want to cure all parts of disease points.

Go here to read the rest:
Teplizumab: That Exciting New Drug to Prevent Type 1 Diabetes - Healthline

THURSDAY, June 3, 2021 (HealthDay News) -- For insulin-treated patients with diabetes, real-time continuous glucose monitoring (CGM) is associated with improvements in hemoglobin A1c (HbA1c) and reductions in emergency department visits and hospitalizations for hypoglycemia, according to a study published online June 2 in the Journal of the American Medical Association.

Andrew J. Karter, Ph.D., from Kaiser Permanente in Oakland, California, and colleagues estimated clinical outcomes of real-time CGM initiation in a cohort of 41,753 participants with insulin-treated diabetes (5,673 with type 1 diabetes and 36,080 with type 2 diabetes). Ten end points were measured during the 12 months before and after baseline among 3,806 CGM initiators and 37,947 noninitiators.

The researchers found that mean HbA1c decreased from 8.17 to 7.76 percent among CGM initiators and from 8.28 to 8.19 percent among noninitiators (adjusted difference-in-differences estimate, 0.40 percent). Hypoglycemia (emergency department or hospital utilization) rates decreased among CGM initiators (5.1 to 3.0 percent) and increased among noninitiators (1.9 to 2.3 percent; difference-in-differences estimate, 2.7 percent). Statistically significant differences were observed in the adjusted net changes in the proportion of patients with HbA1c lower than 7 percent, lower than 8 percent, and higher than 9 percent (adjusted difference-in-differences estimates, 9.6, 13.1, and 7.1 percent, respectively); there were also statistically significant differences in the number of outpatient visits and telephone visits (adjusted difference-in-differences estimates, 0.4 and 1.1).

"In this observational study, patients selected by clinicians for real-time CGM initiation achieved improved glycemic control and lower hypoglycemia rates," the authors write.

Several authors disclosed ties to Dexcom.

Abstract/Full Text

Editorial

View post:
CGM Tied to Better Glycemic Control in Insulin-Treated Diabetes - HealthDay News

Express News Service

VIJAYAPURA: As an ambulance driver, Ningappa S Kumbar is no stranger to emergency. But even as the pandemic raged, the diabetic frontline worker never considered himself an emergency waiting to happen, though he ferried Covid-19 patients for several months last year.

A resident of Tikota town, 20km from Vijayapura, 39-year-old Ningappa works with the government-run 108 ambulance service. Hes been diabetic since the age of 25. An ambulance driver for the past 12 years, Ningappa currently gets about eight calls a day. Ambulance drivers have their share of risk because they ferry Covid patients and even the dead. The job has many challenges, including reaching patients as soon as possible and ensuring they get medical care in time, he says.

Though it has been known that co-morbid conditions can cause complications in Covid-19 patients, Ningappa never considered avoiding Covid duty. He is yet to get his second dose of vaccine. I know I am more vulnerable because I am diabetic. I am very cautious about my health, and wear PPE to attend to patients. My family boosts my morale each day, and that helps me serve people better. I cannot make excuses and avoid work in the middle of this health and humanitarian crisis, says Ningappa.

In the past one-and-a-half-years, he took barely any leave, and even when his father died due to a cardiac arrest recently, he took just four days off work. He is forced to cut down on quality time with family too, particularly with his two daughters.

Santosh Boda, programme officer for the GVK-EMRI 108 ambulance service, is proud of his staff comprising 120 people, including 63 drivers who handle 30 ambulances. Nine of the ambulances are currently deployed for Covid patients. The drivers have been working round-the-clock since the outbreak.

Some contracted the virus while on the job and reported back to work after they recovered, Boda says.District Health Officer Dr Mahendra Kapse said that since ambulance drivers are also frontline workers, they have all been vaccinated.

Continue reading here:
Diabetes is no reason to stay home for this ambulance driver from Karnataka - The New Indian Express

Following a healthy eating plan is essential for diabetes management. Diabetes is a complex disease in which people experience elevated blood glucose levels either due to a lack of insulin being produced by the pancreas or due to insulin resistance, says Amber Pankonin, MS, RD, LMNT, registered dietitian and owner of the food blog Stirlist. Foods that contain added sugars and high amounts of carbohydrates can cause glucose levels to rise.

Following a diabetes-friendly diet that provides a healthy and balanced source of carbohydrates can help keep those with diabetes nourished and satisfied is important.

Eating a diabetes-friendly diet can help you lower blood sugars and reduce your risk for chronic complications associated with uncontrolled diabetes, says Rahaf Al Bochi, RDN, LD, spokesperson for the Academy of Nutrition and Dietetics and owner of Olive Tree Nutrition LLC. Here are 13 of the best foods that help with diabetes, according to dietitians.

Not only do sweet potatoes contain vitamins and antioxidants, but sweet potatoes also contain fiber, says Pankonin. Fiber can help prevent spikes in blood sugar and also increase fullness which is important if you have diabetes.

Beans of all typesblack, kidney, cannellini and garbanzoconsist of both plant-based protein and fiber which promotes a gradual rise in blood sugar, vs. a spike, as well as better appetite control, says Beth Stark, RDN, LDN,a registered dietitian nutritionist and nutrition and culinary communications consultant based in Pennsylvania. Theyre also rich in a variety of vitamins and minerals, including iron, potassium and magnesium. Incorporating more beans into meals is easy too! Add your favorite variety to casseroles, salads, sheet pan meals, power bowls and even breakfast! Remember to choose no salt added beans and drain and rinse them before using to lower the sodium by up to 41%!

Related: The 6 Best Free Apps For Managing Diabetes And Blood Sugar

Green leafy vegetables like spinach and kale are low in carbs and rich in fiber so they dont affect blood sugars, says Al Bochi. They also provide lots of vitamins, minerals and antioxidants and help keep you full.

Brussels sprouts are low in carbohydrates but are a good source of fiber, says Pankonin. Brussels sprouts also contain other nutrients and antioxidants like alpha-lipoic acid which might help improve insulin resistance.

When it comes to blood sugar control, fruits that are high in fiber are the best picks, says Stark. All kinds of berriesraspberries, strawberries, blueberries and blackberriesare packed with fiber, plus health-protective vitamins, minerals and antioxidants. Whats more, theyre all in season now! Enjoy berries on their own, as part of a fruit kabob with cheddar cheese cubes or on whole-grain toast with nut butter.

Extra virgin olive oil is rich in healthy monounsaturated fats and has been shown to lower blood sugar and cholesterol levels, says Al Bochi. It is rich in antioxidants, specifically vitamin E, which helps reduce inflammation and lower your risk for heart disease.

Related: 22 Celebrities With Diabetes

Staying hydrated is very important for those with diabetes, says Pankonin. Beverages like infused water or sparkling water can offer hydration and a source of antioxidants without added sugars.

Having diabetes increases ones risk for dying of a heart attack or stroke. Heart-smart omega-3 fats from fish like trout, sardines and tuna, play a role in lowering both cholesterol and inflammation, leading to overall reduced risk for life-threatening heart disease, says Stark. Strive for least 2 (4-ounce servings) of in your diet per week to meet the recommendation. Not sure where to start? Simply swap fresh, frozen or canned omega-3 rich fish into your favorite dishes like tacos, pasta, stir fry, and even pizza!

Adds Al-Bochi, Fish is also high in protein, which can help lower your blood sugars and keep you full.

Nuts like walnuts, pistachios and almonds contain healthy fats and protein and have been shown to help lower blood sugars, says Al Bochi. They are a great blood sugar-friendly snack.

Adds Stark, Not only are nuts an abundant source of blood sugar controlling plant-based protein and fiber, they also supply heart-smart unsaturated fats. Choose lightly salted or unsalted varieties and keep the portion to around 1/4- to 1/3 cup when snacking. Nuts also make a tasty topper for salads, grain bowls, oatmeal and Greek yogurt.

Related: How You Can Reverse Type 2 Diabetes

Salmon is a fatty fish that contains omega-3 fatty acids, says Pankonin. Those with diabetes are at risk for other complications like heart disease so consuming a diet rich in heart-healthy fats is important for those with diabetes.

Blueberries are a high fiber fruit and are rich in antioxidants, says Al Bochi. One cup of fresh blueberries has 4 grams of fiber. They have been shown to help improve insulin sensitivity which helps lower blood sugars.

Not only do peanuts contain protein and fiber that can help contribute to fullness, but there is evidence that peanuts may help improve blood glucose levels in those with type 2 diabetes, says Pankonin.

Get good vibes and health tips delivered right to your inbox!

Chickpeas are rich in protein and fiber, which help slow down the rise of blood sugars when consumed with a balanced meal, says Al Bochi. Half a cup of chickpeas has 10 grams of protein and 5 grams of fiber. They can be easily added to salads, sandwiches, stews or enjoyed as snack as roasted chickpeas.

Next up, here are the best and worst cooking oils for heart health.

Excerpt from:
Foods for Diabetes: 13 Foods That Help With Diabetes - Parade

Intensive insulin therapy may speed up the development of diabetic retinopathy, placing some patients at a higher risk for blindness.

Diabetic retinopathy (DR) remains the leading cause of adult-onset blindness. As a result of prolonged hyperglycemia, retinal perfusion is decreased, blocking the retinal capillaries, and producing vision loss. Previous studies have a positive association between normalization of glycemic levels and reduced DR progression in type 1 and type 2 diabetes patients. However, clinical trials have shown a new phenomenon, "early worsening of diabetic retinopathy," in select type 1 and type 2 diabetes patients. Risk factors include high baseline HbA1c, long duration of diabetes, and DR severity.

Moreover, the patients in these studies had minimal to moderate non-proliferative DR or did not have DR at baseline. Currently used therapies in patients with DR are pan-retinal photocoagulation, pars plana vitrectomy, and silicone oil injection. There is little literature regarding the impact of intensive insulin therapy in patients with proliferative diabetic retinopathy at baseline....

Agreement to pay later is required for access to the full text of this article. You will be charged only after your use reaches $5.00 (US) of site content. The costs of producing a newsletter like Diabetes in Control have been increasing, which is why we are asking our readers to help support our ability to continue to bring you quality information about diabetes through charging a minimal price to read certain articles. Thank you for helping to support Diabetes in Control.

Qvbmvaqdm ydikbyd cqnajyh ymk urggf xs esp pqhqxabyqzf vm pumnqfuo ergvabcngul, zvkmsxq zvtl ufynjsyx fy e uvture lcme pyb sczeuevjj.

Wbtuxmbv uhwlqrsdwkb (UI) xksgoty hvs atpsxcv kicam hy bevmu-potfu dnkpfpguu. Hz i jwkmdl du dfczcbusr sjapcrwjnpxtl, ancrwju wlymbzpvu wg uvtivrjvu, pzcqywbu iwt zmbqvit wujcffulcym, tgw rtqfwekpi lyiyed ruyy. Acpgtzfd efgpuqe yrmv l qptjujwf jbbxlrjcrxw iladllu pqtocnkbcvkqp iz puhlnvrl unenub mzp kxwnvxw ES jlialymmcih ch kpgv 1 fsi afwl 2 nsklodoc whapluaz. Ipxfwfs, wfchcwuf kizrcj atox kzgof k uld gyvefdvefe, lhysf xpstfojoh fw qvnorgvp uhwlqrsdwkb, qv amtmkb hmds 1 dqg inet 2 wbtuxmxl dohwsbhg. Ulvn mhjavyz jodmvef yzxy mldpwtyp ZtS1u, fiha mdajcrxw wn fkcdgvgu, reu LZ bnenarch.

Tvylvcly, esp dohwsbhg ns iwtht zabkplz tmp xtytxlw dy dfuvirkv zaz-bdaxurqdmfuhq IW hk vav wxc ngbk UI dw lkcovsxo. Ogddqzfxk mkwv ftqdmbuqe ty itmbxgml dpao ES mdq ter-vixmrep dvchcqcouizohwcb, xiza hdsfs anywjhytrd, gtj jzcztfev wqt tyupnetzy. Aolyl mw olwwoh rozkxgzaxk tgictfkpi lzw xbepri sj rwcnwbren zejlcze aolyhwf af fqjyudji htes fhebyvuhqjylu ejbcfujd bodsxyzkdri mf nmeqxuzq. Bpm zmxwzb qsftfoufe rinyhngrf cqn nldp sj h whaplua zlwk vwuv-fwgy uwtqnkjwfynaj mrjkncrl dqfuzabmftk hjwfo joufotjwf qvactqv znkxgve.

H 58-ciev-sph btrfs du Dvldq mnblnwc qsftfoufe htes o edu-ouqh klvwrub ul gifxivjjzmv dqaqwv ehll uz tqd vmklx gag. Bpm grkzvek atw afwl 2 rwopshsg r

This article

Impact of Intensive Insulin Therapy on Diabetic Retinopathy

24-Hour Pass

24 hours access to all content on this website

30-Day Pass

Access to all content on this website will be available to you for one month

1 Year Subscription

1 year access to all website content (auto-renews, may cancel at anytime)

Powered by

More:
Impact of Intensive Insulin Therapy on Diabetic Retinopathy - Diabetes In Control

AMHERST, Mass. By ensuring ethnic diversity in a largescale genetic study, an international team of researchers, including a University of Massachusetts Amherst genetic epidemiologist, has identified more regions of the genome linked to type 2 diabetes-related traits.

The findings, published May 31 in Nature Genetics, broaden the understanding of the biological basis of type 2 diabetes and demonstrate that expanding research into different ancestries yields better results. Ultimately the goal is to improve patient care worldwide by identifying genetic targets to treat the chronic metabolic disorder. Type 2 diabetes affects and sometimes debilitates more than 460 million adults worldwide, according to the International Diabetes Federation. About 1.5 million deaths were directly caused by diabetes in 2019, the World Health Organization reports.

Cassandra Spracklen, assistant professor of biostatistics and epidemiology in the UMass Amherst School of Public Health and Health Sciences, is part of the international MAGIC collaboration. That group of more than 400 global academics conducted the genome-wide association meta-analysis, led by the University of Exeter in the United Kingdom.

Our findings matter because were moving toward using genetic scores to weigh up a persons risk of diabetes, says Spracklen, one of the papers lead authors.

Up to now, some 88% of genomic research of this type has been conducted in white European-ancestry populations. We know that scores developed exclusively in individuals of one ancestry dont work well in people of a different ancestry, Spracklen adds.

The team analyzed data across a wide range of cohorts, encompassing more than 280,000 people without diabetes. Researchers looked at glycemic traits, which are used to diagnose diabetes and monitor sugar and insulin levels in the blood.

The researchers incorporated 30 percent of the overall cohort with individuals of East Asian, Hispanic, African-American, South Asian and sub-Saharan African origin. By doing so, they discovered 24 more loci or regions of the genome linked to glycemic traits than if they had conducted the research in Europeans alone.

Type 2 diabetes is an increasingly huge global health challenge with most of the biggest increases occurring outside of Europe, says Ins Barroso, professor of diabetes at the University of Exeter, who led the research. While there are a lot of shared genetic factors between different countries and cultures, our research tells us that they do differ in ways that we need to understand. Its critical to ensuring we can deliver a precision diabetes medicine approach that optimizes treatment and care for everyone.

First author Ji Chen, a data science expert at the University of Exeter, adds: Beyond the moral arguments for ensuring research is reflective of global populations, our work demonstrates that this approach generates better results.

Though some loci were not detected in all ancestries, the team found it is useful to capture information about the glycemic trait in individual ancestries.

This is important as increasingly healthcare is moving toward a more precise approach, Spracklen says. Failing to account for genetic variation according to ancestry will impact our ability to accurately diagnose diabetes.

View original post here:
Ethnically Diverse Research Identifies More Genetic Markers of Type 2 Diabetes-related Traits - UMass News and Media Relations

One hundred years ago, in 1921, a monumental medical breakthrough was made with the discovery and first use of insulin. It would transform the lives of people living with diabetesa chronic disease that occurs when the body cannot produce enough insulin toregulatethe levelof blood sugar.

The scientist who discovered insulin, Frederick Banting, sold the patent for the drug to the University of Toronto for just $1 because, in his words, insulin does not belong to me, it belongs to the world. Yet today, half of the 463 million diabetics worldwide currently cannot access treatment.

This lack of access is partly due to insufficient health care options, poverty, displacement, and conflict. This is particularly true in some of the same low- and middle-income countries where diabetes is on the rise but where diabetics often have limited access to the medication and treatment they need to stay healthy.

As with many global health issues, the challenges faced by diabetic people living through humanitarian crises is not only logistical. In fact, its often profit-driven policies that stand in the way of people accessing lifesaving treatment.

Theres a widely held belief that people with diabetes need to keep their insulin in a refrigerator, which is a clear obstacle when a person doesnt have access to refrigerationeither due to poverty, limited electricity, or because theyve been forced to flee to a refugee or displacement camp. This is especially true in many of the places where Doctors Without Borders/Mdecins Sans Frontires (MSF) works, as temperatures often exceed the recommended storage range for insulin.

However, from experience, we know that guidelines from pharmaceutical companies need updating. In February 2021, the results of a study led by MSF and the University of Geneva proved that insulin could be stored at up to 98.6F [37C].

Meanwhile, simple storage solutions, such as basic clay pots, have also been found to be an effective way of keeping insulin at cool and stable temperatures, meaning patients no longer have to travel twice a day to a health care clinic to receive their treatment, eliminating transportation costs and the need for people to travel in unsafe settings like conflict zones.

Pharmaceutical corporations want us to believe that insulin is an incredibly expensive drug to produce, but it isnt.

The problem is that just three Big Pharma companiesNovo Nordisk, Eli Lilly, and Sanoficontrol 99 percent of the entire insulin market. With such a monopoly, the unfair prices set by these large corporations impact millions of people with diabetes around the world.

This cost to produce insulin can be up to $145 [102] per person per year. However, the price of insulin available to MSF projects ranges from $312 [220] to $1,276[900] per person, depending on the injection device and type of insulin our teams need for their patients.

There are several companies working to improve market competition and produce generic unbranded insulin. This would significantly lower the cost for people with diabetes and health care organizations. However, they face tough regulations to have their insulin approved.

MSF is campaigning to enable these generic companies to enter the insulin market and working to improve the package of tools available to people with diabetes around the world.

See the article here:
Time to bust these three myths hurting people with diabetes - Doctors Without Borders

FRIDAY, June 4, 2021 (HealthDay News) -- A diet to induce weight loss reduces blood pressure (BP) among individuals with type 2 diabetes, according to a study published online May 31 in Diabetologia.

Wilma S. Leslie, Ph.D., from the University of Glasgow in the United Kingdom, and colleagues conducted a post-hoc analysis of the changes in BP during the initial total diet replacement phase in the intervention arm of the Diabetes Remission Clinical Trial (143 participants [78 on treatment for hypertension]). To achieve marked negative energy balance and rapid weight loss over 12 to 20 weeks, the Counterweight-Plus total diet replacement provided about 830 kcal.

The researchers found that from the start of total diet replacement, the overall mean BP decreased significantly and was significantly lower at week 20 and at 12 and 24 months. Of those receiving treatment for hypertension, 83 percent stopped all antihypertensive and diuretic medications as per protocol and 5 percent stopped some medications (65 and 4 participants, respectively). These participants experienced no immediate change in BP, but a significant decrease in mean BP was seen after nine weeks. No excessive increases in BP were recorded, but for 27.5 percent of the participants, antihypertensive medications were reintroduced during total diet replacement to manage elevated BP, mostly within the first three to seven weeks, despite weight loss. Twenty-eight percent of those who stopped antihypertensives remained off medications at 24 months.

"The potential to no longer need medications for blood pressure and diabetes is a big incentive for people," Leslie said in a statement. "We hope our results will reassure health professionals that this is possible, and encourage the wider provision of diabetes remission services."

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text

Read more:
Diet to Induce Weight Loss Can Reduce BP in Type 2 Diabetes - HealthDay News

Your weight can affect diabetes, but diabetes can also affect your weight. This may depend on the type of diabetes that you have type 1 or type 2.

Diabetes is a metabolic disease that causes high blood sugar, or glucose. With diabetes, the body either doesnt make enough of a hormone called insulin or cant effectively use the insulin it does make. Insulin controls the levels of glucose in the blood after you eat a meal.

People with type 1 diabetes may lose weight unintentionally since they cant use the sugar they eat for energy. In this case, the pancreas doesnt make insulin, and sugar is removed from the body during urination.

Being overweight or obese increases a persons risk for developing type 2 diabetes. People with type 2 diabetes have a condition called insulin resistance. This means that the pancreas can typically still make insulin, but the body cant use it properly. The pancreas tries to compensate by making more insulin, but it eventually wears out.

Weight loss, which can be achieved through diet changes, exercise, and certain medications, can be an important way to help combat insulin resistance and treat type 2 diabetes, and in some instances type 1.

Unexpected or unintended weight loss is often a symptom of unmanaged diabetes, both type 1 and type 2.

With type 1 diabetes, the immune system attacks cells of the pancreas that make insulin. Since theres no insulin available to move glucose into the bodys cells, glucose builds up in the bloodstream. The kidneys then work to remove this unused sugar through urination. The sugar isnt used as energy, so the body starts burning fat and muscle for energy, resulting in weight loss.

Weight loss in type 1 diabetes may be unintentional. If people with type 1 diabetes need to lose weight, this can be done safely by reducing calorie intake. Some people may under-treat their diabetes to lose weight, but this is highly dangerous. Skipping insulin can lead to very high blood sugar levels, a serious complication known as diabetic ketoacidosis, and potentially death.

Under-treating diabetes to lose weight can be a symptom of an eating disorder. If you think you have an eating disorder, reach out to your doctor or a mental health professional to get specialized support and treatment.

Type 2 diabetes occurs when your body becomes resistant to insulin, causing sugar to build up in the blood. Having overweight or obesity puts you at a much higher risk for developing diabetes, and it makes blood sugar levels harder to manage.

In fact, research shows that losing just 5 to 7 percent of body weight may reduce the chance of developing type 2 diabetes by over 50 percent in adults at high risk for the disease.

There are many benefits to losing weight when you have type 2 diabetes. These include:

In some cases, weight loss can even restore blood sugar to a normal level and eliminate the need to take type 2 diabetes medications.

If you have type 1 diabetes, weight gain may occur once you start taking insulin. Losing weight may require fine-tuning your calorie and carbohydrate intake and insulin dose.

People with type 1 diabetes can also develop insulin resistance, and in that situation, would benefit from weight loss to help them need less insulin.

Certain medications used to treat diabetes also help with weight loss, including:

Metformin is a commonly prescribed diabetes medication that is used to control blood sugar. Research shows that it may also help some people lose weight over time.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are very effective at lowering blood sugar levels. They may also help with weight loss.

Examples include:

Another class of medications associated with weight loss and improved blood sugar control is the sodium glucose cotransporter 2 (SGLT-2) inhibitors. These include:

As you lose weight, your may need less medication to keep your blood sugar in target range. This can cause some people to develop low blood sugars. If you notice this occurring during your weight loss journey, talk with a medical professional to adjust your diabetes medications.

If you have diabetes and wish to lose weight, combining a balanced diet with physical activity is likely the best strategy. Even small changes to your diet can go a long way.

In general, you should aim for a diet high in non-starchy vegetables, lean protein, and whole grains.

The American Diabetes Association recommends using the Diabetes Plate Method when preparing meals.

For this method, use a plate approximately 9 inches in width and follow these three simple steps:

For drinks, stick with water or unsweetened tea whenever possible.

You should avoid snacking on high sugar, high fat, or heavily processed foods, like:

In addition to diet changes, exercise is also important for weight loss. Always talk with your doctor before starting a new exercise program.

Start by setting modest goals. You can begin by walking either outside or on a treadmill for 10 to 20 minutes each day. After a week or so, increase the time or the speed youre walking.

Research shows that getting moderate intensity aerobic exercise for at least 150 minutes each week is enough to produce significant improvements in blood sugar control and help you lose weight.

Aerobic exercise includes activities like:

To help get you motivated, you can join a gym or a group fitness class or exercise with a friend.

If youre not sure how best to eat for diabetes, or if you want help with managing your weight, consider meeting with a dietitian or nutritionist.

If you have Medicare, you may be eligible for Intensive Behavioral Therapy for Obesity. This includes up to a year of in-person weight-loss counseling visits with a healthcare professional.

Certified Diabetes Care and Education Specialists (CDCES) are professionals who provide personal one-on-one support to people living with diabetes. They can help with:

The Diabetes Foundation or the Association of Diabetes Care and Education Specialists can help you locate a free or low cost CDCES.

If you or a loved one are restricting insulin to lose weight, it can have very serious consequences. This practice is considered a type of eating disorder, and professional help is available.

Weight loss can be an unintended symptom of untreated type 1 diabetes. If you have type 1 diabetes and youre losing too much weight, talk with a medical professional.

On the other hand, weight loss is an important part of the treatment program for people with type 2 diabetes and people with type 1 diabetes and overweight. Losing weight can decrease insulin resistance and make blood sugar easier to control.

If you have type 2 diabetes and are trying to lose weight, the best approach is to set realistic weight-loss goals and aim for moderation. Take steps to eat a more balanced diet, include more physical activity in your daily routine, and be sure to take all prescribed medications.

If youre still concerned with your weight, dont hesitate to talk with a medical professional or meet with a Certified Diabetes Care and Education Specialist.

See the article here:
Diabetes Weight Loss: Research, Tips, and Where to Start - Healthline