Doctors have identified a protein in the blood they believe could serve as an early warning sign for patients who are at risk of diabetes and death from cancer.

Researchers in Sweden and China analysed two decades of health records from more than 4,500 middle-aged adults on the Malm diet and cancer study. They found that those with the highest levels of prostasin, a protein that circulates in the blood, were almost twice as likely to have diabetes than those with the lowest levels.

Some of those enrolled on the study already had diabetes, so the scientists looked at who among those without the disease went on to be diagnosed later. People in the top quarter for prostasin levels turned out to be 76% more likely to develop diabetes than those in the bottom quarter.

Dr Xue Bao, the first author on the study at the Affiliated hospital of Nanjing University medical school in China, said prostasin was a potential new risk marker for diabetes, but also death from cancer, particularly in people who have high blood sugar.

Prostasin plays several roles in the body, such as regulating blood pressure and blood volume, and it also suppresses the growth of tumours that are fuelled by high blood sugar. While type 2 diabetes is known to raise the risk of certain cancers, including pancreatic, liver, bowel and endometrial tumours, the biological mechanisms are far from clear.

After investigating the link between prostasin and diabetes, the researchers looked at whether people with high levels of the protein were at greater risk from cancer.

Writing in Diabetologia, they describe how those in the top quarter for prostasin levels were 43% more likely to die from cancer than those in the bottom quarter.

Participants with high levels of both prostasin and blood sugar were at significantly higher risk of dying from cancer, according to the study. For every doubling in prostasin concentration, the risk of cancer death rose by 24% in those without high blood sugar, and by 139% in those with high blood sugar. Particular attention should be paid to these individuals, the authors write.

It is unclear whether a high prostasin level plays a part in disease or is merely a biological marker that ramps up as the condition develops. One possibility, the authors suggest, is that prostasin levels rise in an attempt to suppress high blood sugar levels, but are not able to stop or reverse the damage caused.

The relationship between diabetes and cancer is poorly understood and this protein could provide a possible shared link between the two conditions, said Prof Gunnar Engstrm, a senior author on the study at Lund University.

We now need to examine to what extent prostasin is causally related to these diseases or whether it is a valuable marker of increased disease risk, Engstrm added.

It might also be possible to identify individuals with increased risk of diabetes and cancer, and offer preventive measures.

Because the findings are drawn from people in one city, they may not apply to wider populations. The researchers also point out that prostasin was measured from frozen blood taken at only one time point, and that the study was unable to distinguish between different types of diabetes.

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Jessica Brown, at Diabetes UK, said: We know there is a connection between diabetes and some types of cancer, and this study suggests levels of a particular protein, called prostasin, is linked to both conditions.

Gaining a better understanding of the changes inside the body that may put people at risk from diabetes and cancer will help scientists find ways to protect people from these serious conditions, but theres still much to discover.

We need further research to find out if prostasin is playing a direct role in the development of type 2 diabetes and poorer cancer outcomes in people with high blood sugar levels.

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Blood protein levels may flag risk of diabetes and death by cancer, shows study - The Guardian

If youre a beach-goer, you know that theres nothing quite like the sand, sun, and surf on a bright summer day. But before you grab your towel and flip-flops and head out, make sure youre prepared to deal with any potential challenges that can ruin your fun in the sun.

It may go without saying, but well say it anyway: wear sunscreen! Even if you stay under the umbrella most of the time, youll still get some exposure to harmful ultraviolet (UV) rays. And this means a high risk of getting a painful sunburn, but longer term, your risk of skin cancer is greatly increased. Heres how to protect yourself:

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Keep your cool! There are a lot of reasons to make sure you dont get overheated at the beach:

Sunlight and heat can affect certain types of diabetes medicines: insulin and non-insulin injectables, such as GLP-1 agonists (e.g., Ozempic, Trulicity, Victoza, Byetta), and injectable glucagon. These medicines need to be kept cool or at room temperature in order to work properly. Light and heat can reduce their effectiveness.

Heat can also damage blood glucose meters and test strips, CGM (continuous glucose monitors), and insulin pumps. Again, keep these devices out of direct sunlight to prevent overheating.

While some people plant themselves in their beach chair once they hit the sand, you might prefer to be more active. Swimming, surfing, boogie-boarding, volleyball, running, or strolling on the beach are some ways to enjoy your beach day. But realize that an increase in physical activity, combined with hot temperatures, may impact your blood sugars. Heres how to help keep your blood sugars more stable:

Youre bound to get hungry and thirsty when youre at the beach. Instead of hitting the snack bar or packing bags of less-than-healthy snack foods, plan ahead and bring some healthier (and cheaper) options. The American Academy of Nutrition and Dietetics suggests these healthy snacks:

Other good options are:

Make sure to bring a cooler with an ice pack to keep perishable food nice and cool.

Also, stay hydrated. The sun, heat, and swimming can be dehydrating, even if you dont feel thirsty or arent sweating much. Pack plenty of water or no-carb drinks, and remember that vegetables and fruits are good sources of water, too (especially watermelon, and 1 cup of watermelon has just 12 grams of carb!).

Go easy with alcohol. A cold beer can seem refreshing, but alcohol has a diuretic effect, which means that it causes you to urinate more, which can lead to dehydration, depending on how much alcohol you drink. Plus, too much alcohol and swimming are a dangerous combination, as your risk of drowning can increase with the more alcohol that you drink.

Many insulin pumps and CGMs are water-resistant (meaning, you can go in the water with them), but make sure to read the user manual to make sure that swimming is OK. Also, keep in mind that water and sweating can cause your pump insertion set or CGM sensor to not stick well. You might need an additional adhesive, such as:

Dont forget to protect your feet while youre at the beach. This is especially important if you have neuropathy or circulation issues in your legs or feet. Hot pavement, sand, shells, rocks, and broken glass are all hazards that you might encounter, and can cause irritation, burns, blisters, or cuts. Left untreated, these can escalate into more serious foot problems.

Avoid or limit the amount of time that you go barefoot. Wear sturdy sandals or beach shoes, and be sure to check your feet regularly during the day and after you get home. If you notice any cuts or sores that arent healing, or areas of redness, warmth, or swelling after a day at the beach (or at any time), see your health care provider promptly.

Want to learn more about managing diabetes in the summer? ReadSummertime: Hazardous for People With Diabetes?,Diabetes In Hot Weather 12 Things to Know, Six Ways to Stay Cool When the Temperature Soars, and Summer Portion Control: From Beach to Barbecue.

Visit link:
Diabetes at the Beach: Tips to Stay Safe - Diabetes Self Management

American Diabetes Association updates recommendations regarding SGLT-2 inhibitors, GLP-1 RA, and finerenone for cardiovascular and renal comorbidities.

In late May 2022, the American Diabetes Association (ADA) released revisions to its previous guidelines. Although the core structure of diabetic treatment has remained the same, recommendations regarding sodium-glucose cotransporter-2 (SGLT-2) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RA), and finerenone for cardiovascular and renal comorbidities have been significantly updated.1

SGLT-2 Inhibitors, GLP-1 RAs, and Finerenone: Roles in Treatment

Previously, an SGLT-2 inhibitor or a GLP-1 RA was only recommended for type 2 diabetes mellitus (T2DM) patients with current or high-risk potential for atherosclerotic cardiovascular disease (ASCVD) if additional glucose lowering was needed. Current guidelines now recommend these agents for any T2DM patient with current or high risk ASCVD, chronic kidney disease (CKD), or heart failure (HF).2 This guideline stands regardless of the need for additional glucose lowering and/or metformin use.

If patients with ASCVD remain above goal A1C despite the addition of an SGLT-2 inhibitor or GLP-1 RA, then the addition of a dipeptidyl peptidase-4 (DPP-4) inhibitor, basal insulin, or sulfonylureas as adjuncts should no longer be considered. Instead, either a GLP-1 inhibitor or SGLT-2 inhibitorwhichever agent the patient is not currently onis recommended to add.3 Combined use of an SGLT-2 inhibitor and GLP-1 RA can produce an additive risk reduction for cardiovascular and renal adverse events.2

For renal benefit, finerenone use for patients with advanced CKD (i.e., moderately elevated albuminuria, eGFR of 25- 60 mL/min/1.73m2, and diabetic retinopathy or severely elevated albuminuria and eGFR of 25-75 mL/min/1.73m2) is encouraged.4,5

Patients with less-advanced CKD (i.e., stages 1-2 CKD with severely elevated albuminuria or stages 3-4 CKD with moderately elevated albuminuria) do not receive any benefit for CKD.6 Regardless of severity of CKD, SGLT-2 inhibitors remain first-line therapy.

Finerenone use for T2DM patients with CKD is limited as an adjunct to SGLT-2 inhibitors or for those intolerant to the first-line agent. Table 1 summarizes the clinical trials supporting these guidelines.

Finerenone (Kerendia) selectively blocks sodium reabsorption and overactivation of mineralocorticoid receptors within epithelial and non-epithelial tissues. This, in turn, reduces fibrosis and inflammation of both the kidneys and blood vasculature.

Barriers in use may include increased risk of hyperkalemia, hypotension, and high-cost ($22.76/tablet). For Mayo Health Plan members, finerenone is a tier 2R drug with prior authorization approvals limited to the FDA approved indication, CKD with T2DM.

About the Authors

Author: Jana Kay Lacanlale, PharmD Candidate, Drake University Class of 2024

Preceptor: Amanda Davis, PharmD, BCACP

References

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Notable Revisions in Diabetes Treatment According to ADA Guidelines - Pharmacy Times

ABBOTT PARK, Ill., Aug. 4, 2022 /PRNewswire/ -- Abbott (NYSE: ABT) and WW International, Inc. ("WeightWatchers" or "WW") today announced a strategic partnership that will help people living with diabetes better understand and manage their diabetes and weight. The companies are working together to integrate WeightWatchers' diabetes-tailored weight management program with Abbott's portfolio of FreeStyle Libre products to create a seamless mobile experience that will give people living with diabetes the information and insights needed to make healthy adjustments to their diet, improve their glucose levels, and, ultimately, gain more control of their health.

Maintaining a healthy body weight and having proper nutrition are critical to living well with diabetes.3 Yet, for many people living with diabetes, determining what to eat and following a meal plan is the most challenging part of diabetes management.4Through this partnership, participants can receive glucose insights from Abbott's FreeStyle Libre sensor-based technology that show the impact of food choices, alongside the empirically validated5 WeightWatchers' diabetes-tailored nutritional guidance to help them achieve their healthier living goals.

"We strive to put our customers at the heart of everything we do, and that includes forming strategic partnerships with key industry leaders, like WeightWatchers, to provide new services and offerings that can greatly improve the quality of life for people living with diabetes," said Jared Watkin, senior vice president of Abbott's diabetes care business. "Bycombining our world-leading1 FreeStyle Libre glucose monitoring technology with WeightWatchers' number one doctor-recommended weight loss program,2 people withdiabetes, in particular, those with Type 2 diabetes and less intensively managed by doctors, can have the insights they need to take control of their health."

The two companies will work together to allow Abbott's FreeStyle Libre continuous glucose monitoring systems and the WeightWatchers mobile app to share information so that people living with diabetes can see their glucose data alongside WeightWatchers' diabetes-tailored program.

"It's proven that lifestyle changes, including shifts in patterns of eating and activity routines, are a crucial component of diabetes management and can help improve glycemic control,6" said Sima Sistani, chief executive officer of WeightWatchers. "We've partnered with Abbott, a leader in diabetes care, to make it possible for people with diabetes to reach their weight and healthy living goals while enjoying the foods they love and better managing their glucose levels."

The partnership will initially focus on solutions for people living with diabetes within the United States in 2023.

About AbbottAbbott is a global healthcare leader that helps people live more fully at all stages of life. Our portfolio of life-changing technologies spans the spectrum of healthcare, with leading businesses and products in diagnostics, medical devices, nutritionals and branded generic medicines. Our 113,000 colleagues serve people in more than 160 countries.

Connect with Abbott atwww.abbott.com, on LinkedIn atwww.linkedin.com/company/abbott-, on Facebook at http://www.facebook.com/Abbott and on Twitter @AbbottNews.

About WW International, Inc.WeightWatchers is a human-centric technology company powered by the world's leading commercial weight management program. For nearly six decades, we have inspired millions of people to adopt healthy habits for real life. Through our comprehensive tools, expert Coaches and community, members follow our proven, sustainable, science-based program focused on weight loss. To learn more about the WeightWatchers approach to healthy living, please visit ww.com. For more information about our global business, visit our corporate website at corporate.ww.com.

Indications and Important Safety Information

FreeStyle Libre 14 day system:Failure to use FreeStyle Libre 14 day system as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at855-632-8658orFreeStyleLibre.usfor safety info.

FreeStyle Libre 2 and FreeStyle Libre 3 systems:Failure to use FreeStyle Libre 2 or FreeStyle Libre 3 systems as instructed in labeling may result in missing a severe low or high glucose event and/or making a treatment decision, resulting in injury. If glucose alarms and readings do not match symptoms or expectations, use a fingerstick value from a blood glucose meter for treatment decisions. Seek medical attention when appropriate or contact Abbott at855-632-8658orFreeStyleLibre.usfor safety info.

1Data on file, Abbott Diabetes Care. Data based on the number of users worldwide for the FreeStyle Libre portfolio compared to the number of users for other leading personal use, sensor-based glucose monitoring systems.2 Based on a 2020 IQVIA survey of 14,000 doctors who recommend weight-loss programs to patients.3 Evert AB, Dennison M, Gardner CD, Garvey WT, Lau KHK, MacLeod J, Mitri J, Pereira RF, Rawlings K, Robinson S, Saslow L, Uelmen S, Urbanski PB, Yancy WS Jr. Nutrition Therapy for Adults With Diabetes or Prediabetes: A Consensus Report. Diabetes Care. 2019 May;42(5):731-754. doi: 10.2337/dci19-0014. Epub 2019 Apr 18. PMID: 31000505; PMCID: PMC7011201.4 American Diabetes Association. "5. Facilitating behavior change and well-being to improve health outcomes: standards of medical care in diabetes2021." Diabetes care 44, no. Supplement 1 (2021): S53-S72.5Apolzan JW, LaRose JG, Anton SD, et al. A Weight Management Program Tailored for Adults with Type 2 Diabetes: Effects on Glycemic Control. Poster presented at: American Diabetes Association 82nd Scientific Sessions; June 5-6, 2022; New Orleans, LA.6 American Diabetes Association. Lifestyle Management: Standards of Medical Care in Diabetes2019. Diabetes Care. 2019;42(1):S46S60. https://doi.org/10.2337/dc19-S005

SOURCE Abbott

Link:
Abbott and WeightWatchers Partner to Support People Living with Diabetes in Attaining their Health Goals - PR Newswire

The link between diabetes and reproductive health starts from the prevalence of diabetes in reproductive-age women. We know that 3% to 7% of women of reproductive age who could become pregnant have diabetes. So this is not an uncommon condition in this age group or in pregnancy.

Less than one-third of women with diabetes seek pre-pregnancy counseling. Approximately 50% of pregnancies in the United States are unintended or unplanned. So having an understanding of diabetes and how it can affect pregnancy and optimize and control of diabetes prior to pregnancy and in general in life is important. But the last thing that I would say about these important linkages has to do with equity and health disparities. Diabetes, especially type 2, has higher rates in women of color, including Black women, Native American women, and Latina women.

Some of the main consequences and risks associated with diabetes and pregnancy include:

We are still in the middle of an incredibly devastating global pandemic with COVID-19, and I think providers should have conversations with patients about COVID-19 vaccination. We know that people with pre-existing conditions are at highest risk for having severe COVID-19 infection, and we also know that women who become pregnant, who develop COVID-19, are at incredible risk for having complications.

A number of these things are only captured and diagnosed by frequent outpatient monitoring. This is why we really focus on having these conversations with patients about pre-pregnancy hemoglobin A1C levels. What are the best levels that can help reduce these risks?

Any woman with diabetes seeking pregnancy should be referred to a maternal fetal medicine specialist for a preconception consultation. At a visit like this, the maternal fetal medicine physician will have a conversation about what blood sugar control looks like in pregnancy, and also have a conversation about invoking the type of resources that they utilize to guide patients through this journey of diabetes management and pregnancy, not the least of which are nutritional counselors and registered dietitians who have this experience. There will also be a discussion about what prenatal care and monitoring looks like specific to the woman who has diabetes, and how we mitigate some of the risks that can be present or higher in women who have diabetes in pregnancy. It should also include an incredibly comprehensive inventory of the medications that patients take.

Postpartum is an incredibly important time frame for women who have diabetes. There has been over time some debate about contraception and what are safe contraceptives for women who are postpartum. I want to emphasize that the overwhelming majority of hormonal contraceptives are incredibly safe for women who have diabetes, and we should be supporting women to utilize the most effective contraceptives that they wish to use.

Another consideration in the postpartum timeframe for women who have diabetes is supporting them and their desires to breastfeed. There are a lot of outstanding lactation consultants who support women in their breastfeeding goals, and they are a wonderful resource for women who might be struggling or just need general support.

This is an area of significant optimism. There are a number of investigators nationally who are highly dedicated to understanding

So, lots of investigators doing work that is federally sponsored and making incredible contributions to the field of diabetes and understanding how we can improve the lives of women and make their pregnancies as safe as possible.

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Managing Diabetes Before, During, and After Pregnancy | NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

Malnutrition-related diabetes is a puzzling form of diabetes that affects tens of millions of individuals in sub-Saharan Africa and Asia.

Malnutrition-related diabetes is a mysterious form of diabetes that affects tens of millions of individuals in sub-Saharan Africa and Asia. Rarely do its victims, who are mostly skinny and poor teens and young adults, survive more than a year following diagnosis. Their young age and frail appearance point to type 1 diabetes (T1D), yet insulin shots often are ineffective and may even result in low blood sugar deaths. Additionally, none of the individuals seem to have type 2 diabetes (T2D), which is often linked to obesity. Despite the fact that the illness was originally documented about 70 years ago, physicians are still unaware of how to treat it due to a lack of research on the condition.

The founding director of Einsteins Global Diabetes Institute, Meredith Hawkins, M.D., M.S., has led an international collaborative effort for the past 12 years to identify the underlying metabolic defects that result in malnutrition-related diabetes, which is an essential first step in developing effective treatments. Dr. Hawkins and colleagues have shown that malnutrition-related diabetes is significantly metabolically distinct from T1D and T2D and should be regarded as a distinct type of diabetes in the first thorough examination of patients with this poorly known condition. Their research was recently published in the journal Diabetes Care.

Current scientific literature offers no guidance on managing malnutrition-related diabetes, which is rare in high-income nations but exists in more than 60 low- and middle-income countries, said Dr. Hawkins, professor of medicine and the Harold and Muriel Block Chair in Medicine at Einstein. The doctors in those countries read Western medical journals, so they dont learn about malnutrition-related diabetes and dont suspect it in their patients. We hope our findings will increase awareness of this disease, which is so devastating to so many people and will pave the way for effective treatment strategies.

In cooperation with Dr. Hawkins and other members of the Global Diabetes Institute, the study was carried out at the renowned Christian Medical College in Vellore, India. The researchers conducted comprehensive metabolic assessments on 20 males aged 19 to 45 who were selected as likely to develop malnutrition-related diabetesusing cutting-edge methods for measuring insulin secretion and action. The same metabolic tests were performed on groups of people with T1D, T2D, and healthy controls for the sake of comparison. Males make up roughly 85% of those who acquire diabetes from malnutrition, hence the studys subjects were exclusively male to reduce sex-specific variability.

We used highly sophisticated techniques to rigorously and carefully study these individualsand our conclusions differ from earlier clinical observations, said Dr. Hawkins.

More specifically, earlier findings had suggested that malnutrition-related diabetes stemmed from insulin resistance. (The hormone insulin enables glucose in the blood to enter the bodys cells to be used for energy; in insulin resistance, glucose in the blood rises to toxic levels because cells no longer respond to a persons own insulin.) But it turns out, said Dr. Hawkins, that people with malnutrition-related diabetes have a very profound defect in insulin secretion, which wasnt recognized before. This new finding totally revolutionizes how we think about this condition and how it should be treated.

The good news, according to Dr. Hawkins, is that many new drugs have recently become available for treating T2D, some of which boost insulin secretion from the pancreasraising the possibility of finding safe and effective ways of treating the condition.

Diabetes has become a true global pandemic, Dr. Hawkins noted. One in 10 adults worldwide has the disease, and three-quarters of themsome 400 million peoplelive in low- and middle-income countries, she said. In those countries where its been studied, the prevalence of malnutrition-related diabetes among people with diabetes is about 20%, meaning that about 80 million people may be affected worldwide. For comparison, an estimated 38 million people are now living with HIV/AIDS. So we clearly need to learn a lot more about malnutrition-related diabetes and how best to treat it.

Reference: An Atypical Form of Diabetes Among Individuals With Low BMI by Eric Lontchi-Yimagou, Riddhi Dasgupta, Shajith Anoop, Sylvia Kehlenbrink, Sudha Koppaka, Akankasha Goyal, Padmanaban Venkatesan, Roshan Livingstone, Kenny Ye, Aaron Chapla, Michelle Carey, Arun Jose, Grace Rebekah, Anneka Wickramanayake, Mini Joseph, Priyanka Mathias, Anjali Manavalan, Mathews Edatharayil Kurian, Mercy Inbakumari, Flory Christina, Daniel Stein, Nihal Thomas and Meredith Hawkins, 27 May 2022, Diabetes Care.DOI: 10.2337/dc21-1957

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Researchers Identify a Baffling New Type of Diabetes That Affects Millions - SciTechDaily

Living with diabetes demands that you have the right information, alongside your diet and lifestyle changes; be it in the form of education, self-awareness or daily monitoring, that is, knowing your numbers (blood sugar level).

Contrary to popular opinion, your blood sugar level is not the only important number. There are other numbers you should be conversant with and equally track. Being aware of numbers associated with the condition helps you and your doctor feel more in control and able to maintain it better.

Know your blood glucose number: Your blood glucose level is the measure of the amount of glucose in your blood at a particular time. Two blood glucose testsfasting blood glucose and random blood glucose testscan be done to monitor the levels of glucose in the blood.

The random blood glucose level can be checked at any time, while the fasting blood glucose level is recommended to be checked before 10am and is best checked first thing in the morning. Some recommended times to check your blood glucose levels include immediately you wake up/early in the morning (between 6am and 8am); before a meal; two hours after a meal and before bedtime.

For people living with diabetes, the target is that their fasting blood glucose falls between 80-120mg/dl. Two hours after eating, levels less than 180mg/dl are ideal targets.

Know your HbA1C number: When you visit the clinic for a routine health check, your doctor might require that you do the HBA1C (haemoglobin A1C) test, which tracks your average blood sugar levels over the past three months by measuring the glucose attached to haemoglobin found on red blood cells. This helps to check how you have been managing your glucose levels and the effectiveness of your treatment plan.

Red blood cells typically survive for around three and four months. The more glucose there is in the blood, the more glucose that will be available to attach to haemoglobin.

The normal range of HbA1C is less than 5.7%. Levels above 6.5% indicate diabetes while levels between 5.7% and 6.4% indicate prediabetes. If you have type 2 diabetes, a good target range should be 7% and lower. However, this is subject to your treatment plan, age and the goals you set with your doctor.

Ideally, everyone should know their normal blood pressure range and monitor it from time to time, but it is significantly more important for people living with diabetes, who should work to keep their blood pressure levels less than 130/80mmHg.

Blood pressure monitoring is very important because hypertension might complicate your diabetes management plan and increase your financial burden. High blood pressure also means youre at risk for other diseases such as kidney diseases, stroke, aneurysms and vascular dementia.

Monitoring your weight can give insights into how much you abide by good diet and lifestyle choices. An unhealthy weight or being obese is an important risk factor for metabolic diseases. Apart from the fact that obesity can contribute to the development of type 2 diabetes, an unhealthy weight can make you susceptible to other diseases and make diabetes harder to control.

Your doctor would usually recommend that you lose around 5% of your total weight if you are overweight, which is favourable in reducing insulin resistance, blood pressure and consequently the amount of diabetes medications needed.

Cardiovascular diseases are a leading cause of death in adults living with diabetes. The link between cholesterol levels and heart problems has been established and diabetes increases the risk of heart disease by almost four times.

Monitoring your cholesterol levels, with directives from your doctor, keeps you a step ahead. Total cholesterol levels should be at less than 200 mg/dl.

The two major types of cholesterolHDL (good) and LDL (bad)cholesterol are measured independently. While HDL cholesterol should be above 40-50 mg/dl, LDL cholesterol is ideal below 110mg/dl. A distortion in these values indicates strong risks for cardiovascular diseases.

If you have type 2 diabetes, youre likely planning or adhering to a healthy diet plan. A common practice in dieting is counting calories. Counting calories might be better than counting food nutrients: carbs, vitamins and proteins. This is because calories are actually what determines your weight outcomes. If you eat more calories, without losing some in exercise, you will gain weight and vice versa.

As a start, you can know the calories in popular foods around you or know the foods that seem healthy but are very high in calories.

Seeing a dietitian is the best way to learn about calories and what foods are best for you. Sometimes, it is not just about calories, some foods might be more likely to impact blood sugar levels and drastic weight loss by being in a calorie deficit state may not be the best option for you depending on your health outcome.

Self-monitoring is a critical part of the diabetes journey but you shouldnt have to figure it out alone. Joining a diabetes community is very beneficial to educate, guide and support you, on how to best stay alert and manage the condition to prevent any complications.

Mojisola Agabato is a certified Diabetes Nurse Educator, she can be reached on 07012362694

Excerpt from:
Staying healthy with diabetes: Numbers to know - Punch Newspapers

Kaiser Permanente study finds racial and ethnic differences in medication initiation

By Sue Rochman

For adults newly diagnosed with diabetes, getting blood sugar levels under control is the first goal. Guidelines recommend diabetes medications to help patients meet their target blood sugar range. Yet a new Kaiser Permanente study found that adults of certain racial and ethnic groups are less likely to start medication within the first year of diagnosis.

We know there are race and ethnic disparities in diabetes-related health outcomes and that many factors contribute to these differences, said the studys co-lead author Anjali Gopalan, MD, MS, a research scientist at theDivision of Researchand a senior physician with The Permanente Medical Group. With our growing awareness of the lasting benefits of early glycemic control, and the important role of medications in lowering blood sugar levels, we wanted to look at whether there are differences in early medication initiation by race and ethnicity and there are.

The study, published August 4in the Journal of General Internal Medicine, included 77,199 members of Kaiser Permanente Northern California newly diagnosed with type 2 diabetes between 2005 and 2016. The researchers used the patients electronic medical records to determine if they were dispensed any diabetes medication during the year following their diagnosis. Self-reported race and ethnicity information was used to separate the members into 12 groups.

The study showed that, overall, 47% (36,283) of the adults started a glucose-lowering medication during the first year following their diagnosis. However, initiation rates varied widely by group: 32% of Chinese adults and 35% of Japanese adults started taking a diabetes medication compared to 44% of white adults, 50% of Black adults, 56% of Hispanic/Latinx adults, and 58% of individuals of other racial or ethnic groups.

Seeing that Black and Latinx adults had higher than average initiation rates intrigued us because, overall, these groups tend to have higher rates of diabetes-related complications, said Gopalan. Our findings also suggest we need to better understand the factors that may be keeping Chinese and Japanese adults from starting medication after their initial diagnosis.

The study found that among adults newly diagnosed with diabetes who had high HbA1c (blood sugar) levels a group for whom it is clear medication should be started there was little difference in medication initiation between race and ethnic groups. In addition, race and ethnic differences in medication initiation did not meaningfully differ among individuals based on their age at diagnosis, body mass index (BMI), socioeconomic status, and the presence of other ongoing health problems.

Diabetes treatment is tricky as it is not one size fits all, said Gopalan. But if we dont understand what is driving the treatment differences we are seeing, we dont know if the decisions are clinically appropriate or if they are rooted in provider implicit biases or patient misconceptions about the risks and benefits of medication.

As a physician, I want everypatient to understand that having to take medication is not an indicator of how bad your diabetes is, or a sign that you have failed at making important behavior changes, she added. Medications are just another tool in diabetes management thatcan help keep patients healthy and preventcomplications.

The study was funded by the National Institute on Minority Health and Health Disparities, the National Institute of Diabetes and Digestive and Kidney Diseases, and the National Institute on Aging.

Co-authors include co-first author Aaron N Winn, PhD, of the Medical College of Wisconsin, Milwaukee; Andrew J Karter, PhD, of the Division of Research, and Neda Laiteerapong MD, MS, of The University of Chicago.

# # #

About the Kaiser Permanente Division of Research

The Kaiser Permanente Division of Research conducts, publishes and disseminates epidemiologic and health services research to improve the health and medical care of Kaiser Permanente members and society at large. It seeks to understand the determinants of illness and well-being, and to improve the quality and cost-effectiveness of health care. Currently, DORs 600-plus staff is working on more than 450 epidemiological and health services research projects. For more information, visitdivisionofresearch.kaiserpermanente.orgor follow us @KPDOR.

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Not all adults newly diagnosed with diabetes equally likely to start treatment NCAL Research Spotlight - Kaiser Permanente Division of Research