Category Archives: Diabetes

This article was originally published here

J Med Internet Res. 2020 Dec 21;22(12):e21328. doi: 10.2196/21328.

ABSTRACT

BACKGROUND: A diagnosis of type 2 diabetes (T2D) results in widespread changes to a persons life and can be experienced as an assault on their sense of self. The resources available to an individual influence how the individual adapts to their diabetic identity and subsequently engages in self-care. Digital interventions can be viewed as a resource that people can draw on to adapt to the diagnosis. However, there is an indication that people from disadvantaged groups find digital health technologies more challenging to access and use, which may increase health inequalities.

OBJECTIVE: This study aims to gain insights into how and why people with T2D use digital self-care technology and how experiences vary between individuals and social groups.

METHODS: A purposive sample of people who had used a digital intervention to help them self-care for their T2D were recruited for the study. Semistructured interviews were conducted, and data were analyzed thematically.

RESULTS: A diverse sample of 21 participants were interviewed. Participants used digital interventions to help them to understand and feel more in control of their bodies. Digital interventions were used by participants to project their chosen identity to others. Participants selected technology that allowed them to confirm and enact their preferred positive identities, both by avoiding stigma and by becoming experts in their disease or treatment. Participants preferred using digital interventions that helped them conceal their diabetes, including by buying discrete blood glucose monitors. Some participants used technology to increase their sense of power in their interaction with clinicians, whereas others used technology to demonstrate their goodness.

CONCLUSIONS: The technology that people with T2D have access to shapes the way they are able to understand and control their bodies and support preferred social identities.

PMID:33346733 | DOI:10.2196/21328

Original post:
Digital Health Interventions for People With Type 2 Diabetes to Develop Self-Care Expertise, Adapt to Identity Changes, and Influence Other's...

TipRanks

With 2020 winding down, theres a growing belief that 2021 is going to be a growth year for the stock markets. The US elections have returned a divided government, one unlikely to have the broad majorities or the broad support needed to enact wide-ranging reform legislation from either the right or left, and that bodes well for the economy generally.The COVID vaccines are entering distribution, and while new anti-virus lockdowns are also getting set in place, theres a feeling that the end of the pandemic may be near. According to the analyst community, a few names reflect serious growth plays. These are stocks that have already notched impressive gains year-to-date, and are poised to see the growth keep on coming even after 2020 wraps up.Bearing this in mind, we usedTipRanks databaseto scan the Street for tickers that fall into this category. Locking in on three in particular, the analysts believe that each name, which also happen to boast a Strong Buy consensus rating, can keep the rally alive in 2021.SunOpta (STKL)The first stock on this growth list is a health snack company, SunOpta. The companys line of products includes plant-based beverages, fruit-based snacks, broth and stocks, teas, and sunflower and roasted snacks. The company markets through private label and co-manufacturing distribution, as well as through food service institutions.SunOpta boasts a market cap of $962 million, after a year of stunning share price growth. The stock is up an impressive 328% this year, far outpacing the general markets. The companys Q3 revenues came in at $314.9 million, a 6.4% year-over-year gain. EPS, at a net loss of 1 cent, was better than the 2-cent loss expected and far better than the 11-cent loss reported in the year-ago quarter.The companys solid performance has attracted the attention of Craig-Hallum analyst Alex Fuhrman. The analyst rates STKL a Buy along with a $15 price target. This figure implies a one-year upside of 40% from current levels. (To watch Fuhrmans track record, click here)Backing his stance, Fuhrman wrote, We believe the companys focus on high value plant-based foods and beverages should command a premium valuation with opportunities for upside to estimates as the economy recovers from COVID.In large part, Fuhrmans optimism is based on SunOptas niche. The analyst noted, We expect plant-based food stocks to command a premium valuation to other food companies for the foreseeable future given faster growth trends and compelling environmental benefits. At just $4.5B in sales today, plant-based products are less than 1% of the $695B grocery market, but it is easy to envision it representing a double-digit share of grocery sales over time. Wall Street doesnt always come together in unanimity, but in this case, it does. SunOptas Strong Buy analyst consensus rating is unanimous, based on 3 Buy reviews. The stock is selling for $10.70, and with an average price target of $15, SunOpta has a forward growth potential of 40%. (See STKL stock analysis on TipRanks)Green Brick Partners (GRBK)One bright spot in the economy this past year has been the home construction industry. As people moved out of the cities to avoid COVID, they headed for the suburbs and exurbs and that boosted the demand for single-family homes. Green Brick is a land development and home acquisition company, based in Texas. The company invests in real estate, primarily land, and then provides plots and construction financing for the development projects.The spread of the suburbs not just in this COVID year, but as a general trend, has been good to Green Brick. The companys Q3 revenue was $275.8 million, the best in more than year, beating the forecast by 20% and growing 31% year-over-year. EPS was also strong; the Q3 value, 68 cents, was 54% above expectations, and more than double the year-ago value.Green Bricks share price has been rising along with the companys financial outlook. For the year, GRBK has gained 111%.In his coverage of this stock, JMP analyst Aaron Hecht noted, [We] expect GRBK to capitalize on the trend of apartment renters shifting to single-family homes for safety and changing dynamics brought on by more workers telecommuting. The most important cohort shift within the buyer pool is millennials who have come off the sidelines to buy homes, a trend which we believe has multiple years of runway. The millennial demand trend is magnified in GRBKs case given its outsized exposure to markets, such as Texas & Atlanta, which are the net beneficiaries of migration out of high-priced coastal geographies.To this end, Hecht rates GRBK an Outperform (i.e. Buy), and his price target of $30 implies an upside of ~23% for the next 12 months. (To watch Hechts track record, click here)While not unanimous, the Strong Buy consensus rating on Green Brick is decisive, with a 3 to 1 breakdown of Buys versus Hold. The average price target of $27.5 gives a 12.5% upside potential from the current share price of $24.45. (See GRBK stock analysis on TipRanks)Brightcove, Inc. (BCOV)Shifting gears to the software industry, we come to Brightcove, a Boston-based software company. Brightcove offers a range of video platform products, including cloud-based hosting and social and interactive add-ons. The company is a leader in the delivery and monetization of cloud-based online video solutions.The strength of such a business model, during these pandemic days with their massive shift of white-collar workers toward remote offices, telecommuting, and video conferencing, is obvious. Brightcoves earnings hit 11 cents per share in Q3, nearly double the year-ago quarter. At the top line, revenues have been stable, holding between $46 million and $48 million per quarter in 2020, with no discernable COVID impact.Shares in Brightcove have been going up in steps all year, after a minor blip last winter. The pace has accelerated since the end of July, after the Q2 results were released, and the stock is now up 103% for 2020. The general macro headwinds are turning into video niche tailwinds, as noted by Northland Capital analyst Michael Latimore. We believe a market tailwind, BCOV's leading tech platform, and strong sales execution are driving strong bookings. We believe the salesforce is at full productivity. BCOV will add more channel managers this year. Management is focused on process improvements to achieve consistency in revenue retention rates, the 5-star analyst noted.Latimore rates the stock as Outperform (i.e. Buy), and his $24 price target indicates confidence in a 36% upside for the year ahead. (To watch Latimores track record, click here)Over the past 3 months, two other analysts have thrown the hat in with a view on the video tech company. The two additional Buy ratings provide Brightcove with a Strong Buy consensus rating. With an average price target of $20.17, investors stand to take home 14% gain, should the target be met over the next months. (See BCOV stock analysis on TipRanks)To find good ideas for growth stocks trading at attractive valuations, visit TipRanks Best Stocks to Buy, a newly launched tool that unites all of TipRanks equity insights.Disclaimer: The opinions expressed in this article are solely those of the featured analysts. The content is intended to be used for informational purposes only. It is very important to do your own analysis before making any investment.

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Increasing Prevalence of Diabetes Expected to Enhance the Growth of the Global Antidiabetics Market Exclusive Report [150 Pages] by Research Dive -...

Guang-Ran Yang,1 Dongmei Li,2 Lin Li3

1Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, Peoples Republic of China; 2Clinical and Translational Science Institute, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14620, USA; 3Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Ophthalmology and Visual Sciences Key Laboratory, Capital Medical University, Beijing 100730, Peoples Republic of China

Correspondence: Guang-Ran Yang Email gr.yang@ccmu.edu.cn

Objective: Diabetic retinopathy (DR) was reported to have higher prevalence of coronary heart disease (CHD) and stroke compared with people without DR. However, whether DR had similar effects on CHD and stroke in US adults with diabetes was not well known. This study was to compare the association between DR, CHD and stroke in US adults with diabetes using the 2015 Behavioral Risk Factor Surveillance System (BRFSS).Methods: Respondents with diabetes aged over 18 years and undergone a fundus examination over the past 2 years were included in this study. DR, CHD and stroke were self-reported. A weighted hierarchical logistic regression was used to examine the association of DR with CHD and stroke.Results: A total of 21,049 respondents with diabetes aged over 18 years having undergone a fundus examination over the past 2 years were included in the analysis. There were 4690 people reported having CHD, accounting for the weighted prevalence 22.1%. The weighted prevalence of stroke was 9.6%. There was 28.3% of CHD people who had DR which was higher than that in people without CHD. Differences in weighted frequency distributions of gender, age category (over 45 years or not), current smoking, hypercholesterolemia, hypertension and insulin treatment were significantly different between the CHD and without CHD groups (p< 0.001). Similar results were found in people with stroke. Logistic analysis showed that DR was related to CHD and stroke (crude OR =1.876, 2.263, respectively, p all < 0.001). After adjusting other variables, these associations persisted (Adjusted OR=1.632 (95% CI=1.625 1.639), 1.846 (95% CI=1.836 1.856), respectively, p all< 0.001).Conclusion: The BRFSS 2015 data indicated that DR was not only associated with CHD but also associated with stroke in US adults with diabetes, independently of other risk factor. DR might be more strongly associated with stroke than with CHD.

Keywords: diabetes, diabetic retinopathy, coronary heart disease, stroke, risk factor

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

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Comparison of Coronary Heart Disease and Stroke in Association with Di | DMSO - Dove Medical Press

This transcript has been edited for clarity.

Hello, my name is Kamlesh Khunti, Im professor of primary care diabetes and vascular medicine at the University of Leicester.

We are nearly at the end of the year and what a year it's been. The COVID-19 pandemic has had a major impact globally, with 71 million people being infected worldwide, and 1.6 million deaths due to COVID as of mid-December 2020. Little did we know in March that we would expand our vocabulary, with new words and phrases that would be used in daily conversations. These include social distancing, furlough scheme, R reproduction number, social isolation, quarantine, lockdown, and long COVID, are some of them.

Little did we envisage that wearing masks would become mandatory, or that working from home would become the norm for many who would become experts at MS Teams and Zoom virtual meetings, and learn even to change our virtual backgrounds.

Practice Changes

During the COVID-19 pandemic attention has been diverted away from primary cares key roles in early detection of disease and management of long-term conditions. Clinical practice has changed beyond recognition, with the majority of consultations being by telephone or virtually.

Our patients have been very understanding and have embraced the new ways of working.

Some primary care practices have been innovative and seen patients in the carpark to reduce exposure by having the consultations outside.

Unfortunately, this is not ideal for people with chronic long-term conditions, particularly cardiometabolic conditions. Although telehealth reduces patients direct exposures to infection, it cannot entirely replace face-to-face contacts. Physical examinations are still needed to make certain diagnoses and to enhance the human connections between patients and clinicians.

Certain conditions, such as diabetes, cardiovascular disease, hypertension, chronic kidney disease, and chronic obstructive pulmonary disease have been shown to be associated with the increased risk of infection, hospitalisation, and mortality.

However, there have been excess deaths due to also the disruption of services because of the pandemic. Unfortunately, delays in diagnosis and suboptimal management of people with long-term conditions will cause rises in non-COVID mortality going forward as well.

Global surveys have shown that diabetes was the condition most reported impacted by the reduction in healthcare resources due to COVID-19, followed by chronic obstructive pulmonary disease, hypertension, heart disease, asthma, cancer, and depression.

Additionally, the two most common co-occuring chronic conditions for which care was impacted by COVID-19 were diabetes and hypertension.

A lack of access to routine health care is a leading cause of morbidity and mortality after disasters, and we've seen this in other disasters. So things such as stroke, acute myocardial infarctions, and diabetes complications are all shown to increase after the immediate threat has been dissipated.

However, there is now some good news on the horizon, with the prospect of a COVID vaccine being our main hope of coming out of this dreaded pandemic.

2021

So what should we be planning for the new year?

Well, the priority will be to vaccinate the most vulnerable, including the elderly and those with chronic conditions. Psychological stress has also increased during the pandemic and many people with chronic long-term conditions such as diabetes, and cardiovascular disease have been shielding, and have been unable to continue with routine lifestyle interventions such as exercise.

All these factors and the added burden of mental health will lead to worse risk factor control.

We therefore need to resume normal services and start arranging routine bloods and review clinics for our patients with chronic conditions.

We need to ensure we improve risk factor control for our patients with chronic cardiometabolic conditions, including blood pressure, HbA1c, and lipid control.

We will also have a number of patients who have been affected with COVID, and we will need to monitor these people very closely for consequences of long COVID.

It is too early to predict what the 'new normal' will look like. We must learn the important lessons from COVID-19 and previous pandemics to avoid the suboptimal management of long-term conditions contributing to the avoidable excess mortality in the medium-term.

Practitioners will need to consider ways of proactively identifying these patients with long-term conditions, who are most at risk of suboptimal management, to ensure that the necessary care is maintained urgently after we come out of COVID.

In summary, people with cardiometabolic conditions have been impacted significantly during the pandemic, and now we need to plan to get back to normal services and ensure we reduce the risk of major indirect consequences of COVID in our patients with long-term conditions.

On that note, I wish you a happy, safe, and peaceful festive break. Thank you.

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How 2020 Changed Diabetes and Primary Care - Medscape

December 22, 2020 - 11:22 am

Approximately 34% of Maryland adults are believed to be prediabetic

Frederick, MD (KB) Governor Larry Hogan recently announced a $94 million-dollar investment in the treatment and prevention of diabetes amidst the COVID-19 pandemic.

The Maryland Department of Healths Kristi Pier said the percentage of Marylanders with diabetes is slightly higher than the national prevalence.

About 11.1% of Maryland adults have diabetes, so over 10 in 100 have diabetes in Maryland, she explained. Which is a little bit higher than the national prevalence, which is about 10.5%.

Pier said there is a risk for individuals with diabetes who contract the coronavirus.

Diabetes there is a big concern during the pandemic due to the high prevalence of diabetes in the state, she said. As well as the increased risk for serious illness if someone with diabetes contracts COVID-19.

Some early warning signs of diabetes, according to Pier, are feeling hungry or thirsty despite eating, and fatigue.

Individuals who think they may be prediabetic can take a risk assessment online at the either the CDC or American Diabetes Association website. Pier listed the individuals who are most at risk for the disease.

Those that are most at risk are those people who have prediabetes, those adults who are also overweight, who are 45 years and older, or maybe have a parent, a brother, or sister who have Type 2 diabetes.

Link:
COVID-19 Impact On Individuals With Diabetes - WFMD

The director of clinical research in the Center for Cancer Care at White Plains Hospital explained the design of the study which evaluated diabetic versus nondiabetic patients enrolled in the CONNECT Multiple Myeloma Registry.

A descriptive analysis of the CONNECT Multiple Myeloma Registry, presented at the 2020 ASH Annual Meeting & Exposition, aimed to evaluate differences in baseline characteristics, treatment patterns, and survival outcomes in diabetic versus nondiabetic patients enrolled in the registry.

In an interview with CancerNetwork, Lisa La, director of clinical research in the Center for Cancer Care at White Plains Hospital, explained the design of the study.

Transcription:

Sure, so the Celgene, its actually a Celgene observational study. It's a large multicenter prospective observational study, primarily enrolling newly diagnosed multiple myeloma patients. So, the sample size that they've enrolled from 2009 to 2016, was about 3011 newly diagnosed myeloma patients across 250 sites. Those sites are community, academic, and government sites across the entire US. And it's pretty accurate in terms of not focusing on certain regions of the US, but across all of the entire so I would say it's pretty representative of the general population. So, patients that were eligible, just as long as you were 18 years and older and had some sort of diagnosis of myeloma, and less than 2 months before you enrolled, so they are they're just being pretty much followed up for treatment and outcomes.

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Lisa La on the Design of a Study Evaluating Diabetes in Patients with Multiple Myeloma - Cancer Network

The long-term impacts of negative body image can be devastating. And what worries experts is that it only takes one comment to send someone down a dangerous road. If diabetes is involved, the effects can be compounded.

Its the well-meaning doctor who says something like you better clean up your act or youre going to have type 2 diabetes, Nicole Patience, a nutrition and diabetes educator, and eating disorders specialist at Joslin Diabetes Center in Boston, tells DiabetesMine.

Dr. Samar Hafida, staff physician at Joslin, agrees. She is the assistant medical director of global education and care and a weight management and clinical nutrition specialist.

Its not uncommon; in fact, a majority of people have had this experience, she tells DiabetesMine. A person comes in (to their medical provider) with a non-weight-connected complaint, and the suggestion is lose weight and youll feel better.

The result of those kinds of experiences compounded by the worlds focus on thin as beautiful can be the proving ground for depression, self-loathing, and devastating eating disorders. Thats an impact that can hit anyone in society, she says.

For people with diabetes (PWDs), this can be devastating as they are also faced with blame over their disease by an uneducated general public, comments from the medical field on how weight reduction or diet change is the center of everything, and the challenge of living with a body one feels is failing them.

Could a new focus on body positivity be the solution?

Experts feel this movement can and will help PWDs not only feel better about themselves psychologically but be healthier overall.

While it may feel like a new buzz phrase to some, the body positivity movement has been around since the late 1960s when women first started pushing back on the notion that all women should be thin.

It took off in recent years for a number of reasons. First, in the late 90s, a psychotherapist named Connie Sobczak struggling with an eating disorder morphed her background and personal experience to create http://www.thebodypositive.org, a site dedicated to helping people with self-acceptance.

Then, around 2012, the Body Positive movement took root with bloggers, celebrities, medical experts, and researchers all pushing for the public to not just accept but embrace the concept of all bodies being beautiful.

In recent years, celebrities like singer Lizzo have been vocal and visible in the movement, bringing even more attention to it. The recent October 2020 Fenti fashion show from singer Rihanna featured models of all sizes, colors, and looks in a nod to body positivity.

Joslins Patience says that its all about taking care of the body you live in. Its about respecting it and recognizing how it serves you in very positive ways.

What body positivity is not, she says, is a call to ignore healthy suggestions and interventions that you may need.

Some see it as a double-edged sword, explains Hafida. Some worry that embracing oneself as you are will block people from accepting (medical help). But its not an either/or concept. Being body positive should not mean youre not receptive to taking advice and taking action.

What it does mean is this: Loving the body you are in as it is in this moment leads to better health outcomes overall.

Its a difficult thing to embrace for the overweight, Hafida says.

Society tells us we need to look a certain way, be a certain way. Thats hard to overcome.

For the PWD of any kind, the challenge of finding body positivity is exacerbated by the need to wear medical devices, the struggle with weight control some face, things like scarring on the body, and just the feeling, overall, that your body has failed you.

And there is of course the stigma and blame that the general public associates with any type of diabetes.

Even with type 1 (and often with type 2), others say, Oh, you must have caused your diabetes, says Patience.

She points out that her first step with a patient is reminding them that with type 1 or type 2 diabetes: This is not your fault.

There is no reason to blame yourself, she says. Body size is not a direct indication of whether you take care of yourself or not.

There are other specific other body image challenges that come with diabetes, she adds, pointing to these as just a few:

All this can lead to dangerous reactions in PWDs.

Marcia Meier, program manager at the Patient Services International Diabetes Center in St. Louis Park, Minnesota, has treated over 500 diabetes patients with eating disorders and other body-related struggles since 2005.

The ugly truth, she tells DiabetesMine, is that the impact of negative body image on PWDs, particularly women, can be profound.

About 36 to 40 percent of women with type 1 diabetes manipulate insulin to control their weight, she says.

There is this concept of insulin use equals fat, and right there, youve got a predisposition to some of those problems.

Meier traces the issue back to the general public, of course, but also to a place that may surprise many: the endocrinology office.

Just about every article you read, all that you can pick up right in your endocrinology office, clearly says that insulin causes weight gain, she says.

Most women want to be a body size that is smaller than they are, diabetes or not, she says.

The dangerous difference between the PWD? Access to a relatively simple yet life-risking way to drop the weight.

Most people do not have the kind of touch on the body that people with diabetes do, she says. All a person with diabetes had to do to lose weight is not do something. They dont have to exercise or starve. They just have to omit their insulin.

Of the patients shes treated, she says negative body image has been a part of (the struggle) of every single one of them.

Its not always insulin omission, though. Shes had a diabetes patient who purposely let her glucose levels run low because she only gave herself permission to eat when low.

This drive to be thin does not necessarily stem from being raised in a household judging you. In fact, Meier says, even the person raised with all the right cues can fall prey to public comment.

Thats a huge challenge I see. You can be raised (with body positivity) in your household and literally delve into an eating disorder from one thing a person says.

It could be as simple as your aunt saying you should skip the dessert so you dont get fatter and worse with your diabetes. Or a magazine spread with the plus-sized models who are actually a size 8 or 10. Or the doctor who tells you your weight is the cause of all troubles. One negative comment is all it takes, she says, to set a person down a dangerous road.

Like so many other things, this takes a village. PWDs need the world, media and yes, their own doctors, to understand and embrace this, experts say. They also need themselves.

Some ways to build body positivity include:

It starts with you. Patience says when a person meets with her for the first time, shes quick to strike down any self-negativity.

People come in and make derogatory remarks about themselves because its been normalized so much, she says. I tell them right away: its not acceptable here.

She helps those struggling learn, understand, and, most of all, embrace seeing that their body does many good things for them every day and that loving it for that helps overall health.

Meier agrees, adding that while society needs change here, I cannot change the world. What I can do is help them deal with those comments.

They need to develop a belief system so that when things are said to them (even by doctors), they can recognize that even if coming as well-intentioned those comments may not be healthy for them, or even be the truth. Its about not believing everything you hear and read.

PWDs also need to recognize the good that both their body and insulin does, Meier says, as well as the good technology they may wear does.

For example, beauty queen Sierra Sandison was a teenager when diagnosed with type 1 diabetes, and due to body image notions, she pushed off getting a pump and CGM for a period of time.

I was a senior in high school and already having a hard time with body image when I was diagnosed, she tells DiabetesMine.

I was angry at my body before that, and once I was diagnosed, I was angry at it for what I saw as failing me on the inside too.

She decided to hide her diabetes until she heard about Miss America 1999 Nicole Johnson, who has type 1 and proudly displays it.

That led Sandison to make it into the 15 finalists for Miss America as Miss Idaho 2014, where she walked the stage in the bathing suit competition proudly showing her pump. Thousands followed her lead, making the hashtag #ShowMeYourPump go viral, and more importantly helping others heal as she did herself.

Now Im like: if someone does not want to date me because I have a pump, good riddance, she says.

Finding medical support that gets it. Patience is one of more than 17,000 medical providers who have signed on as part of the Healthy At Every Size movement that provides resources and encourages healthcare professionals to take a pledge to be aware, respectful, and compassionate of all issues surrounding body size.

More and more providers are adopting this, and Patience suggests you seek them out, or ask your medical provider to check it out.

Hafita said it can be life-changing when you seek out a medical expert who understands that if you are a bit overweight, it makes no sense to focus on fault.

Weight gain is a chronic disease, she says. No matter how many mistakes you think you have made, its not your fault.

She asks people to consider this: Some of our friends can gobble down all the goodies, barely work out and be thin. Others walk daily, count carbs and still struggle with weight.

Seeing someone who can understand is key, she says.

Avoid rash diets, particularly for children. Keto eating, for example, can be too extreme, Hafita said.

That is absolutely not normal eating, she explains, in large part because it is so difficult to maintain. There are people who think you can eat that way for the rest of their life, but the reality is, much of our social structure centers around food. We celebrate with it; we gather around it. Its not the best idea to raise a child to think they are failing if they enjoy those moments.

Know when to take action. If you struggle with body image issues and have ever omitted insulin or starved yourself, you may want to seek a therapist to help you build a better image of yourself.

That can range from a therapist you connect with to a trained expert in diabetes and body image.

In the end, learning to embrace our bodies as they are, big or small; dark or light; tall or short; whatever you are, is key to overall health, all agree.

Its important to understand, as I now do, that healthy looks different on everyone, says Sandison.

We have to get past this skinny is healthy concept and we should strive for all to do that, she concludes.

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How to Stay 'Body Positive' with Diabetes - Healthline

With 88 millionAmericans or approximately 1 in every 3 adults,suffering from prediabetes in this country (and 34 million Americans, or 1 in 10, with full-blown type 2 diabetes), many people are walking around with a ticking time bomb in their bodies, and don't even know they have the condition.

Prediabetes is when your blood sugar level is higher than it should be for optimal health, butnot high enough for your doctor to diagnose the disease.It's also known asimpaired fasting glucose or glucose intolerance. The scary part is, 90 percent of those with prediabetes dont know that they have it.

We have all heard that excessive thirst or urinating more often than normal is a sign that you could have diabetes, but what are the telltale signals that you may be pre-diabetic? Why does it matter? The sooner you find out the better, for your health and to know that changing your lifestyle can alter the course of the disease and head it off at the pass.

Prediabetes, unlike diabetes, is an asymptomatic condition. The soonersomeone finds out that they are prediabetic the better, experts say, since it's possible to make lifestyle changes that can reverse your health and get you back onto a healthy path, with simple switches like eating more plant-based foods, losing a small amount of body weight, and being more active, such as walking 30 minutes a day, five days a week.

"Prevention is the best medicine!If you are given a prediabetes or diabetes diagnosisdo not despair," since you can make simple lifestyle changes (exercise, diet, and losing a small amount of weight) to reverse course on the disease, saysKellie Antinori-Lent, MSN, RN, andPresident of the Association of Diabetes Care and Education Specialists (ADCES) and diabetes clinical nurse specialist at the University of Pittsburgh Medical Center, Shadyside Hospital in Pittsburgh.

"If someone is at risk for developing prediabetes or diabetes, they should schedule an appointment with their doctor to discuss their concerns and questions. The best first place to begin is with a visit to your providerwhether in person or virtualand dont delay," says Antinori-Lent. Prevention is the best medicine!If you are given a prediabetes or diabetes diagnosisdo not despair!" There are simple things you can do to dial back the condition such as exercise 30 minutes a day, lose 7 to 10 percent of your body weight, and eat a mostly whole-food, plant-based diet, high in fiber and low in added sugars and chemicals.

How do you know if you have diabetes or prediabetes? We asked Antinori-Lent,who makes it her life's work to educate people about the changes they can make to ensure their future health, and here is what she had to tell us:

Kellie: That is a really good question, however, prediabetes does not have symptoms. There is a physical sign of insulin resistance, which is associated with prediabetes. This sign is darkened skin in areas such as the neck, under the arms, and elbows. Some people mistake it as an area of skin they didn't wash wellbut you cannot wash acanthosis nigricans (the name of the dark skin areas). Instead, there are risk factors. These include:

Keep in mind that prediabetes can develop into type 2 diabetes if left untreated. People can prevent this from happening by evaluating their lifestyle habits, including changing their diet, increasing their exercise and activity levels and seeing their doctor regularly, and working withhim or her to prevent the progression.

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Could You Be Prediabetic or Diabetic and Not Know It? The Signs - The Beet

Metabolic surgery can free two-thirds of patients with type 2 diabetes from the use of insulin, new research suggests.

An analysis of post-surgery outcomes of nearly 2,000 patients with obesity and diabetes requiring insulin, co-ordinated by the Irish Society for Clinical Nutrition and Metabolism (Irspen) and the British Obesity and Metabolic Surgery Society found that surgery is more effective and cheaper than insulin.

Some 67 per cent of patients were no longer using insulin one year after metabolic surgery and 37 per cent achieved remission of their diabetes altogether, the analysis found.

Metabolic surgery is a term used to describe weight loss treatments and procedures, such as a gastric bypass, to treat metabolic diseases such as diabetes in obese people.

The research included a broad cohort of patients across Ireland and the UK and analysed their outcomes between 2009 and 2017.

Prof Helen Heneghan from the National Metabolic Surgery Centre at St Vincents hospital, said on average patients also lost around a quarter of their bodyweight and the improvements persisted for at least four years.

Prof Heneghan said prior to this analysis, questions remained if surgery would be as effective for patients with type 2 diabetes requiring insulin, as these patients also have a higher chance of diabetes complications.

This research now confirms metabolic surgery is also the most effective medical treatment for the majority of patients with more severe type 2 diabetes who use insulin, she said.

Type 2 diabetes develops when the body becomes resistant to insulin or when the pancreas is unable to produce enough insulin. Obesity and age both increase the risk of developing type 2 diabetes.

There are more than 200,000 people living with diabetes in Ireland, according to Diabetes Ireland, most of whom have type 2 diabetes.

In a second part of the study, Irspen member Prof Carel le Roux said surgery was also found to be more cost effective than medication.

The researchers costed the surgery against if the same patients had been treated with medicines alone. Although an operation costs 8,000, researchers found that this figure was less than the ongoing cost of medications, she said.

With costs of treatment side-effects and any complications of diabetes were also considered, the average patient treated with surgery was expected to save the health system 4,000 over five years, while also living with better health outcomes.

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Weight-loss surgery most effective treatment for type 2 diabetes patients - The Irish Times

Diabetes is a chronic condition where the body either doesnt make enough insulin or doesnt use insulin properly or both. This can lead to a higher than normal blood sugar level.

Uncontrolled blood sugar levels can lead to complications, such as:

For these reasons, its important to monitor your blood sugar if you have diabetes.

Prior to using meters, people with diabetes would monitor their blood sugar by testing their urine. This method, however, wasnt as accurate, nor did it provide real-time results.

If you self-test your blood sugar several times a day using a glucometer, or meter, it requires that you prick your finger to draw blood to test. Due to the discomfort of this method, you might look for a way to monitor your level without this tool.

If finger pricks are very bothersome for you, dont worry theres hope. Advances in blood sugar monitoring technology could mean no more finger pricks in the future.

If you have diabetes, there are several portable devices you can use to check your blood sugar level and not all of them require a finger prick.

The one device that does require a finger prick is a meter. This is the most widely available and affordable option.

To use this device, youll insert a test strip into the meter. Youll prick your finger to retrieve a sample of blood, and then place the sample on the edge of the test strip to check your blood sugar.

Glucometers are convenient because theyre small and portable, allowing you to use them anywhere. Your blood sugar results are also accurate and instant.

You can also use a continuous glucose monitor (CGM) to check your blood sugar. This is different from glucometers, which can only monitor blood sugar when you test your blood.

Continuous glucose monitoring, on the other hand, provides real-time glucose, or blood sugar, readings every few minutes. These systems involve the insertion of a tiny sensor underneath your skin (usually in the abdomen).

This sensor measures your interstitial glucose level, and then sends the information to a pager-like monitor, or an app on your phone. An alarm sounds if your blood sugar becomes too high or too low.

Even though continuous glucose monitoring systems place a sensor under the skin, most still require a finger prick at least once a day to calibrate the device.

This is less than the number of finger pricks with a glucometer, which can require four or more per day.

The Freestyle Libre system is another way to check your blood sugar. While this method has certain features in common with a CGM and a meter, it stands out for one reason: It doesnt require a finger prick.

Youll still have a tiny sensor inserted underneath your skin with the Freestyle Libre. Its different from a CGM in that you wont get continuous readings.

But, rather than prick your finger, like you would with a meter, youll use a reader to scan the sensor when you want to check your blood sugar level.

Again, urine is another way to measure sugar levels. This involves inserting a test strip into your urine. The problem, though, is that test strips can only detect sugar in your urine they cant provide an exact blood sugar reading.

Unfortunately, this method of checking blood sugar isnt convenient since youll need a container to collect the urine. Also, it only works when urine hasnt been sitting in your bladder for too long.

Fingertips have more nerve endings, so this part of the finger tends to be the most sensitive.

If you use a finger prick to check your blood sugar level, a few techniques can make the process less painful whether youre using a glucometer or a continuous glucose monitor.

Blood sugar testing is crucial to diabetes management because high or low blood sugar can cause severe complications. If too much blood sugar accumulates in your bloodstream, you can experience major complications such as:

Signs of high blood sugar include:

Signs of low blood sugar can include:

Blood sugar can fluctuate throughout the day especially after meals, after exercising, and during stressful events. So its important to carefully monitor your blood sugar and keep it within a healthy range.

A blood sugar level less than 140 milligrams per deciliter (7.8 millimoles per litre), but greater than 70 mg/dL (3.9 mmol/L) is typically considered in the target range.

You should check your blood sugar regularly, even if you arent experiencing symptoms of a high or low glucose level. Some people with high and low blood sugar dont have any symptoms.

Even though you can monitor blood sugar level with glucometers and CGMs, the future might provide additional ways to manage your diabetes.

Testing your blood sugar is crucial to diabetes management. Using a meter or continuous glucose monitoring can provide accurate results. But you might seek a pain-free method to check blood sugar.

Talk with your doctor or a certified diabetes educator. You might be a candidate for a glucose monitoring device that involves fewer finger pricks or no finger pricks.

Additionally, making a few adjustments in the way you collect your blood sample might reduce the level of pain and discomfort.

Diabetes is a life-long, chronic condition that involves careful monitoring of your blood sugar. This can prevent serious complications such as nerve damage and stroke.

Discuss options for monitoring blood sugar with your doctor to find a device that suits your comfort level.

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How to Check Blood Sugar Without a Meter: Is It Possible? - Healthline