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.

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Diabetes Weight Loss: Research, Tips, and Where to Start - Healthline

LINKPING, Sweden As millions of people around the world line up for their coronavirus vaccination, could the next vaccine breakthrough make diabetes a thing of the past? Researchers in Sweden say a clinical study of a potential vaccine for type 1 diabetes has produced encouraging results.

A team from Linkping University finds injecting the protein GAD (or glutamic acid decarboxylase) into a patients lymph nodes effectively preserves their ability to produce insulin. In patients with type 1 diabetes, the bodys immune system starts attacking the cells which make insulin. Once all of these cells are destroyed, the body is no longer able to regulate its blood sugar levels.

Unfortunately, just like people with type 2 diabetes who have to monitor their blood sugar constantly, type 1 diabetes patients must take insulin for the rest of their lives. Researchers set out to see if they could slow or possibly completely stop this process.

Professor Johnny Ludvigsson says one strategy scientists have focused on is altering the way the immune system reacts to encountering GAD. In type 1 diabetes patients, the immune system commonly forms antibodies to attack the protein GAD65. For years, Prof. Ludvigsson has been studying the possibility of making the human body more tolerant of GAD so the immune system stops damaging insulin cells.

Studies have shown that even an extremely small production of insulin in the body is highly beneficial for patient health. People with diabetes who produce a certain amount of insulin naturally do not develop low blood sugar levels, hypoglycemia, so easily. They have also a lower risk of developing the life-threatening condition ketoacidosis, which can arise when the insulin level is low, says Ludvigsson, a senior professor in the Department of Biomedical and Clinical Sciences, in a university release.

In a phase 2 clinical study, called DIAGNODE-2, researchers gathered 109 participants between 12 and 24 years-old who had been diagnosed with type 1 diabetes within the past six months. One group received three monthly injections of a substance called GAD-alum in each patients lymph nodes. The other participants received a placebo to serve as a control group.

The team then measured the each persons natural insulin production at the start of the experiment and 15 months later. They also monitored the groups long-term blood sugar levels (HbA1c) and how much supplementary insulin patients needed each day.

Researchers note that genetic factors appear to play a role in how well patients respond to potential diabetes vaccines. With that in mind, the DIAGNODE-2 team looked at several variants called HLA genes. These genes know to look for proteins on the surface of cells and function as holders of those proteins. HLA genes then expose certain proteins to immune cells which pass by.

If a protein comes from something harmful like bacteria, immune cells go to work and attack it. Unfortunately, this process also leads to the immune system mistakenly attacking helpful proteins, like insulin producers.

Study authors discovered the HLA gene variant HLA-DR3-DQ2 is responsible for exposing GAD65 proteins to the immune system and triggering type 1 diabetes. Ludvigsson notes that nearly half of the patients in the new study had the HLA-DR3-DQ2 gene variant.

Moreover, although the GAD-alum vaccine did not create a significant difference in insulin production between the treatment and placebo groups, the injections did produce positive results in patients with the HLA gene variant. The shots also do not appear to produce adverse side-effects.

The patients in the subgroup with the DR3-DQ2 type of HLA genes did not lose insulin production as quickly as the other patients. In contrast, we did not see any significant effect in the patients who did not have this HLA type, Ludvigsson reports.

Treatment with GAD-alum seems to be a promising, simple and safe way to preserve insulin production in around half of patients with type 1 diabetes, the ones who have the right type of HLA. This is why we are looking forward to carrying out larger studies, and we hope these will lead to a drug that can change the progress of type 1 diabetes, the study author concludes.

The study appears in the journal Diabetes Care.

Link:
Diabetes vaccine shows promise at preserving the bodys insulin production - Study Finds

A startup that provides an app fordiabetes prevention, weight loss and concierge health coachingis teaming up with Gympass to expand its reach to employers.

Yes Health, launched in 2014,offers technology tools and personalized coaching aimed at preventing chronic conditions and promoting overall healthy lifestyles through better nutrition, fitness and well-being support.

"Working with health plans, employers and platform partners, we can help reduce the risk of chronic diseases and we do this by empowering the members to live healthier lives throughbehavior change and lifestyle change,"Alexander Petrov, founder and CEO of Yes Health, told Fierce Healthcare.

In 2020, the startup banked $6 millionin series A funding led by Khosla Ventures.

Gympass, a company that bills itself as the worlds largest corporate wellness benefits platform,is currently available in 14 countries, with more than 2,000 corporate clients and 50,000 fitness partners. Founded in Brazil in 2012, the fitness startup scored$300 million in funding in 2019 led by the SoftBank Group Corp.

RELATED:Virta Health pulls in $133M to expand its diabetes reversal platform

The partnership provides Gympass clients with an all-mobile diabetes prevention program, recognized by the Centers for Disease Control and Prevention (CDC), with in-the-moment coaching that combinesautomation, artificial intelligence and human support.

It marks a unique partnership between a fitness solution and a chronic disease management platform to offer employers a more holistic platform for wellness, Petrov said.

"As fitness platforms rethink their business models, there is an opportunity to add,in a low-cost fashion andwithout much overhead, nutrition programs and well-being programs for holistic chronic disease prevention. This partnership is a symbol of that. We have achronic disease prevention tech company and a fitness platform going beyond traditional boundaries to collaborate and I hope that is a starting point for others," he said.

Mill Valley, California-based Yes Healthhas tens of thousands of active users nationwide and provides its platform to dozens of top enterprises, including big health insurers and employers, according to the company.

Using AI that augments human health coaching, Yes Health delivers personalized therapy for members at the right time directly to their smartphones.

"Members want feedback and advice when they are making a nutrition or fitness decision, not after the fact," Petrov said. "Providingcoaches in the moment delivers faster adoption and more sustainable lifestyle change."

As an example, Yes Health's weight loss program provides a personalized meal plan and quick feedback on meals from nutrition experts.

RELATED:Blue Shield of California's Wellvolution growing its platform for members with diabetes

Yes Health uses research and science from Stanford University, the University of California, San Francisco, the National Institute of Healthand the CDC to design its programs. The company's team of physicians, health coaches, wellness experts and engineers developed theplatform to be easy to use and interactive, and thecombination of AI and human support has produced a high engagement rate with members. In addition, members havean 87% completion rate with the programs.

Yes Health's platform has outperformed the CDC's standards of care thresholds for over three years related to average weight loss and average weekly physical activity.

Gympass chose to partner with Yes Health because its easy-to-use platform has been proven to drive high engagement and better health outcomes for users without requiring complex technology or expensive resources, company executives said in a press release.

Our mission is to make wellbeing universal by providing a more engaging and accessible corporate wellbeing platform. With Yes Healths amazing personalized care plans, we are one step closer to making that a reality for our clients and their employees, said Rodrigo Silveira, senior vice presidentof new ventures at Gympass, in a statement.

Yes Health also is available to Spanish-speaking users and provides a full suite of tracking features to monitor user progress.

U.S. employers are facing unprecedented disruption with higher levels of employee stress, anxiety and other health concerns, causing the most innovative employers to recognize that their teams need access to sophisticated digital health tools that can help employees take control of their health, Petrov said.

RELATED:Livongo founder launches new venture to shake up employer-sponsored benefits space

By adding Yes Health to the Gympass network, members now have a single place on their mobile devices where they can go for quick, easy-to-use and personalized care plans that includes diabetes prevention, nutrition counseling, fitness coaching, sleep, wellbeing support and much more," he said.

The CDC reports that chronic health conditions and unhealthy behaviors significantly reduce worker productivity. Five chronic diseases or risk factorshigh blood pressure, diabetes, smoking, physical inactivity and obesitycost U.S. employers $36.4 billion a year because of employees missing days of work. The inability to work because of diabetes-related disability cost $37.5 billion in 2017, with absenteeism accounting for $3.3 billion and employee productivity losses costing $27 billion.

Recent studies have shown that most U.S. employers now are willing to provide their workforce with digital tools that can improve health, and this has only become more relevant with the challenges employers have faced with COVID-19, according to Petrov.

Yes Health has expanded its app-based programs to include a concierge health coaching program to help members stay on track with fitness and nutrition goals.

"Organizations came to us during the pandemic and said among their employees, stress is up, and routines are out the window. They said they needed a program for individuals who arenot at risk but might be if we dont pay attention to them. That led to the concierge health coaching program, which is a personal fitness trainer in your pocket," Petrov said.

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Yes Health inks partnership with Gympass to offer diabetes prevention app to employers - FierceHealthcare

ANN ARBOR, Mich. As one pandemic begins to fade away, a new study finds another is continuing to grip the entire world. Researchers find that almost half a billion people globally have diabetes, although many dont know they have it. The number of cases have more than quadrupled since 1980, when there were around 108 million living with the condition.

The study also shows, however, that only one in 10 are getting the level of care they need to make their lives healthier, longer, and more productive. Although researchers say diabetes was more common in affluent countries in the past, it is now more likely to affect impoverished nations in Africa, the Americas, and South East Asia.

Diabetes continues to explode everywhere, in every country, and 80 percent of people with it live in these low and middle income countries, says lead author Dr. David Flood from the University of Michigan in a release.

Failing to control blood sugar levels can have devastating health consequences. Diabetes triples the risk of a heart attack and leaves people 20 times more likely to undergo a leg amputation. It can also lead to stroke, kidney failure, blindness, nerve damage, and complications during pregnancy.

We can prevent these complications with comprehensive diabetes treatment, and we need to make sure people around the world can access treatment, Dr. Flood explains.

Around nine in 10 patients have type 2 diabetes, which can be a result of engaging in unhealthy lifestyles. As the worlds waistlines have ballooned, with one in three now registering as overweight, so too has the number of diabetes cases.

The CDC estimates that over 34 million Americans is currently living with diabetes and 90 percent have type 2 diabetes. The latest study, appearing in the journal Lancet Healthy Longevity, pooled data on 680,000 people between 25 and 64 years-old in 55 low and middle income countries.

Researchers discovered more than 37,000 had diabetes, but over half had never received an official diagnosis. Blood samples revealed a key biomarker of elevated sugar in these patients.

Study authors add cheap medicines that reduce glucose, blood pressure, and cholesterol could combat the growing crisis. Counseling on diet, exercise, and weight can also help lower the risks from under-treated diabetes.

The study also identified major gaps in specific areas. Fewer than one in two patients with the condition are taking a blood sugar or blood pressure lowering drug. Moreover, only one in 16 people are using cholesterol-lowering medications. The team adds less than a third have access to advice on diet and exercise, which can encourage healthy habits.

Among patients who have received a diabetes diagnosis, 85 percent are taking a medication to lower blood sugar and 57 percent have a prescription for a blood pressure drug. However, only nine percent are taking something to control their cholesterol. Additionally, a majority of diabetes patients have received diet or exercise and weight counseling. Overall, Dr. Flood says fewer than one in five are getting the full package of evidence-based care.

The studys model, examining economic and demographic data about these countries, reveals the poorer the people in these nations are, the bigger the diabetes problem becomes. Nations in the Oceania region of the Pacific had the highest prevalence of diabetes both diagnosed and undiagnosed but the lowest rates of diabetes-related care.

Researchers did find some exceptions, such as Costa Rica. The Latin American and Caribbean regions ranked second only to Oceania in diabetes prevalence, but had much higher levels of care available.

These efforts could improve care in wealthy countries like the U.S., which does not consistently deliver good care to patients with diabetes. The team finds women, wealthier individuals, older people, and the obese are more likely to get good quality treatment. However, diabetes in people of normal weight is not uncommon in low and middle-income countries. Dr. Flood is calling for more focus on these individuals.

The fact diabetes-related medications are available at very low cost, and individuals can reduce their risk through lifestyle changes, mean cost should not be a major barrier, Flood concludes. In fact, studies have shown the medications to be cost-effective, meaning the cost of their early and consistent use is outweighed by the savings on other types of care later.

SWNS writer Mark Waghorn contributed to this report.

Originally posted here:
Nearly half a billion people on the planet now have diabetes though many have no idea - Study Finds

Dietary interventions that restrict carbohydrate intake for the management of diabetes are of particular interest to researchers, healthcare providers, and patients. Based on evidence of moderate to low certainty from 23 randomized trials (n=1357), evidence synthesis suggests that patients who adhere to low or very low carbohydrate diets for six months might achieve diabetes remission without adverse consequences. But the definition of low and very low carbohydrate diets, the long term health effects of carbohydrate restricted diets, and the working definitions of diabetes remission are debated, requiring further investigation, particularly for longer term health outcomes based on evidence from randomized trials.

Carbohydrate restriction has a long history of use in the management of diabetes, and authoritative organizations have recently highlighted the potential benefits and harms of low carbohydrate diets.1 The definition of such diets can, however, vary widely and can be confusing to both patients and providers.2

Over the past few decades, the average carbohydrate intake for adults in the United States has been estimated to range between 39% and 51% of daily kilocalories (subsequently referred to as calories).2 Historically, authoritative organizations have recommended carbohydrate intake varying from 45% to 65% of daily calories. Diets with a carbohydrate intake of less than 45% of daily calories therefore have been commonly considered as carbohydrate restricted.3

What is meant by a low carbohydrate diet can vary depending on the reference source. For example, a formal definition was proposed in 2015, defining a low carbohydrate diet as one where less than 26% of daily calories are derived from carbohydrates (<130 g/day),3 yet in its review of the literature the 2019 American Diabetes Association consensus statement on nutrition therapy for diabetes and prediabetes describes a low-carbohydrate eating pattern as reducing carbohydrates to 26-45% of total calories (<225 g/day of a 2000 calorie diet).1

The definitions of very low carbohydrate diets also vary (eg, thresholds ranging from <10% to <26% of daily caloric intake).1,3 This difference is substantive because diets with substantially lower intakes of carbohydrate (eg, <10% of daily calories) have been shown to induce nutritional ketosis.4 In this physiological state, ketone bodies are produced and used as an alternative energy source, especially by the brain,4 with these diets commonly referred to as ketogenic. Conversely, very low carbohydrate diets, defined as an intake of <26% of daily calories, do not consistently induce ketogenesis.

Until the consensus on definitions is clear, researchers should explicitly define their use of the terms low and very low carbohydrate diets, and readers of the literature should take note of these definitions when interpreting and applying the results from research. Further, when interpreting results, readers should look for evidence of adherence to carbohydrate restrictions and how adherence impacts study results.6

Very low carbohydrate diets, particularly those that induce ketogenesis, are controversial. The controversy is primarily related to the conventional, although debated,5 nutritional advice that is related to the suggested adverse health consequences of a diet high in saturated fat, which often occurs among those who follow carbohydrate restricted diets. We recently conducted the most comprehensive review of randomized trials among patients with diabetes who followed a low carbohydrate diet for six and 12 months and found no statistically significant or clinically important increase in total or serious adverse events.6 Such were, however, poorly reported, and major adverse cardiovascular outcomes could take longer to develop. So far, randomized trials of low carbohydrate diets for people with diabetes are limited to only a few trials with a duration of more than 12 months, and even these studies do not go beyond 24 months.6 Long term observational studies with a mean follow-up of 25 years suggest a U-shaped relation with both higher and lower extremes of carbohydrate intake, showing an increased mortality risk, although confounding cannot be excluded.7

In addition to the potential adverse health risks, advocates for plant based diets have raised environmental and ethical concerns about carbohydrate restricted diets, typically high in animal products.8 However, extensive carbohydrate restrictions can indeed be achieved, and individualized, using a vegetarian or vegan diet, although vegan ketogenic diets are more challenging without caloric restriction.

Diabetes remission is an outcome of importance to patients, clinicians, and policy makers. How remission is defined also varies. In general, among contemporary definitions of diabetes remission, three factors are considered: a glycated hemoglobin (HbA1c) threshold, use of antidiabetes drugs, and duration of remission. Although an international body of diabetes experts published a consensus paper in 2009 attempting to formalize the definitions of remission,9 these were never formally adopted. Further, a scoping review of definitions in 2020 showed continued heterogeneity in how diabetes remission is defined.10 For example, the most commonly used HbA1c thresholds were <42 mmol/mol (6.0%) and <48 mmol/mol (6.5%).10 In terms of drug treatment use, the cessation of certain beneficial treatments, such as metformin, might be seen as unethical; thus, there is some resistance to definitions that require drug treatment cessation. As to proposed durations of remission, these can range from 30 days to five years depending on the reference source.10

Until the diabetes research community agrees on a formal definition of remission, researchers should explicitly state the conditions of their own definitions. Given the debate, researchers might use several definitions. Our group, for example, has attempted to manage this lack of consensus by reporting meta-analytic results on diabetes remission using four a priori definitions among trials reporting outcomes at six and 12 months.6

The terminology, evaluation, and application of carbohydrate restricted diets for diabetes remission are at the center of evidence informed decision making among patients, clinicians, and policy makers. Until consensus is reached, when the efficacy and safety of carbohydrate restricted diets are evaluated for diabetes management, researchers should be clear in their a priori definitions of low and very low carbohydrate diets as well as diabetes remission, and consumers of the research literature should be aware of which definitions are being used, while being cognizant of any sensitivity or subgroup analysis used to compare results across definitions.

Competing interests: All authors have completed the ICMJE uniform disclosure form at http://www.icmje.org/coi_disclosure.pdf and declare: support from Texas A&M University; BCJ has received funds from Texas A&M AgriLife Research to support investigator initiated research related to saturated and polyunsaturated fats for a separate research project. Support from Texas A&M AgriLife institutional funds are from interest and investment earnings, not a sponsoring organization, industry, or company); no other relationships or activities that could appear to have influenced the submitted work.

Provenance and peer review: Not commissioned; externally peer reviewed.

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Low and very low carbohydrate diets for diabetes remission - The BMJ

Photo (c) RapidEye - Getty ImagesA new study conducted by researchers from Michigan Medicine evaluated global health care trends related to diabetes. Based on results from more than 50 surveys that included responses from over 680,000 people around the world, the researchers learned that many diabetics arent receiving the care they need -- especially those from low- and middle-income countries.

The team found that many consumers struggling with diabetes arent even aware that they have the disease.

Diabetes continues to explode everywhere, in every country, and 80% of people with it live in these low- and middle-income countries, said researcher Dr. David Flood. It confers a high risk of complications such as heart attacks, blindness, and strokes. We can prevent these complications with comprehensive diabetes treatment, and we need to make sure people around the world can access treatment.

The researchers had more than 680,000 participants between the ages of 25 and 64 involved in the study; they evaluated medical tests, exams, and responses to surveys about health care to determine how diabetes care differs around the world. More than 50% of the participants in the study had high blood sugar but hadnt yet been formally diagnosed with diabetes at the start of the study; another 37,000 participants were diabetic when the study began.

The team explained that there are six primary components to effectively treating diabetes: a combination of counseling efforts for diet, weight, and exercise and medications that work to lower cholesterol, blood sugar, and blood pressure. Less than 20% of the participants with diabetes were receiving treatment in all six areas, and more than 90% werent receiving the full spectrum of blood pressure treatments.

The study showed that regional and economic impacts play a role in the available treatments for diabetic consumers around the world. Low- and middle-income countries and regions struggled the most to provide adequate diabetes treatments and had the fewest resources available to detect the condition.

The biggest deficits in treatment, both for those with and without diabetes diagnoses, were for blood pressure and cholesterol treatments. Maintaining healthy blood pressure and cholesterol levels is important for all consumers, but it remains a crucial part of diabetes care.

The researchers hope their findings highlight the disparities in diabetes care around the world. They explained that many of the medications necessary to manage blood sugar, blood pressure, and cholesterol can be administered inexpensively, which would benefit those in low- and middle-income areas.

Finding ways to improve diabetes testing can also work to identify those who may not be aware that they have the disease and ensure that more consumers are receiving treatment.

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Diabetes is severely under-treated around the world, study finds - ConsumerAffairs

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Since the early days of the coronavirus pandemic, patients with diabetes have been of high concern due to their increased risk of developing severe COVID-19 outcomes. Now, health experts have stated that diabetes, coupled with coronavirus infection could be one of the reasons for the sudden spike in mucormycosis or 'black fungus' infections in the country.

India is known as the world's diabetes capital. Nearly one in six people with diabetes in the world is from India. The available scientific literature reveals that diabetes damages the pancreatic beta cells and leads to insufficient insulin production, resulting in hyperglycemiaa condition which, causes dysfunction of the immune response. Besides, diabetes medication also suppresses immune responses.

COVID-19 also decreases immunity and the drugs used for its treatment such as steroids and IL-6 inhibitors (tocilizumab), thus leading to further immune suppression.

The second wave of coronavirus has been more lethal in India. The country has also seen more people with diabetes getting affected by the infectionalmost 76%, Dr V. Ramana Prasad, senior pulmonologist, KIMS hospital Hyderabad, told IANS.

"COVID-19 itself is more common and severe in diabetic patients, and there is a high likelihood that diabetic patients who developed covid required ICU admission and use of drugs like steroids and tocilizumab. Such drugs also decrease immunity and make an individual more prone to opportunistic infection like mucormycosis," Dr Asmita Mehta, Head, Department of Respiratory Medicine at Amrita Hospital, Kochi.

Mucormycosis was present even in the pre-Covid era but is an opportunistic infection. The fungal infection is caused by a group of mold called mucormycetes. These molds live throughout the environment. Mucormycosis mainly affects people with damaged tissue or decreased immunity.

India has a very high incidence of mucormycosis cases when compared to other countries even prior to Covid. The incidence of mucormycosis in India is around 14/100,000 population while that in Australia is 0.06/100,000 population. The reason behind this is India's hot humid climate where the spores of mucor survive for a longer time.

However, it has become one of the rapidly spreading infections observed in those recovering from COVID-19. India has so far reported approximately 8,848 cases of mucormycosis or black fungus.

Gujarat has reported a maximum of 2,281 mucormycosis cases followed by Maharashtra (2,000), Andhra Pradesh (910), Madhya Pradesh (720) Rajasthan (700), Karnataka (5,00), Haryana (250), Delhi (197), Punjab (95), Chhattisgarh (87), Bihar (56), Tamil Nadu (40), Kerala (36), Jharkhand (27), Odisha (15), Goa (12) and Chandigarh (8).

"94% of the people who developed black fungus infection after COVID had diabetes and 67% of them had uncontrolled sugars," Mehta told IANS.

"When the sugars are not controlled, the increased level of sugar in the blood provides acidic media which is a favourable environment for the growth of black fungus. Thus, the reason behind increased black fungus cases now can be attributed to uncontrolled diabetes and the use of drugs, which causes further decrease in immunity," Mehta added.

The common symptoms of this fungal infection include unilateral facial swelling, loose teeth, headache, burning sensation in nose, nasal stuffiness, blackish discharge from nose, blurring or double vision. Few signs of severe mucormycosis infection are decreased vision, blindness, seizure or blood vomiting and altered sensorium.

In post-Covid patients, "Oculo-rhino-cerebral" mucormycosis is most commonly found. Rhino-oculo cerebral mucormycosis (ROCM) is a rare, invasive, and rapidly progressive fungal infection affecting nose, paranasal sinuses and often extending to orbit, brain, and palate.

People who have had moderate to severe Covid illness must avoid crowded places, visiting construction sites, garbage dumping sites or indulge in gardening and should wear masks properly and keep a safe distance while interacting with others.

Those who have diabetes should try to keep their sugar levels under control. Judicial use of steroids and other immunomodulators in the treatment of COVID-19 has been recommended by all medical bodies, Mehta said.

Maintenance of good hygiene and cleanliness is a must. Regular oral hygiene care with mouthwash, povidone-iodine gargles must be done. While administering oxygen, water for humidification must be sterile and there should be no leakage from the humidifier, Prasad advised.

But for those infected, early diagnosis is a key point in initiating treatment, as the deadly disease has more than 50 per cent mortality even after the best treatment possible. Early surgical debridement followed by antifungals like liposomal amphotericin B (3-5mg/kg) is the mainstay of treatment.

**

The above article has been published from a wire agency with minimal modifications to the headline and text.

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Diabetes May Increase Risk of Developing Black Fungus Infection Post COVID-19: Health Experts | The Weather Channel - Articles from The Weather...

Mashantucket Both of her parents had diabetes. Her grandmother lost both legs to the disease.

So, Heather Mars-Martins, a member of the Narragansett Indian Tribe and a longtime employee of the Mashantucket Pequot Tribe, grew up skinny, eating as naturally as possible, following what she called an ancestral way of life. Mindful of the importance of fitness in keeping the disease at bay, she participated in track and field and cross country.

You think youre doing everything right ..., she said.

But when Mars-Martins woke up one day in 2003, her vision was blurry. The eye doctor asked her how long shed been diabetic. Her primary doctor ordered tests that confirmed she had type 2 diabetes.

Among tribal populations, in particular, she is anything but alone.

While its been estimated that more than 10% of the U.S. population has diabetes, the prevalence among Native Americans American Indians and Alaska Natives is nearly 15%, twice what it is among whites, according to the U.S. Centers for Disease Control and Prevention.

Today, more than 17 years after she was diagnosed, the 55-year-old Mars-Martins, a North Stonington resident, has benefited from a virtual approach to treatment thats based on frequent communications with clinicians who remotely monitor her blood sugar level, blood pressure and other biomarkers and a coach who provides highly personalized feedback and advice on her diet and lifestyle choices.

Basically, its an online diabetes clinic, said Dr. Jeff Stanley, medical director of Virta Health, the San Francisco-based start-up that Mashantucket-owned Pequot Health Care engaged to helpimprove tribal members health and contain costs.

Pequot Health Care manages the tribes self-funded health care plan, which is available to tribal members and Foxwoods Resort Casino employees. It also manages plans for other tribes and other commercial enterprises. Mars-Martins is the administrative assistant to Pequot Health Cares president, Christopher Manzi.

Local economies spend hundreds of millions of dollarstreating acute sickness, said Dr. Setu Vora, the Mashantuckets chief medical officer. We asked: How can we start moving upstream? How can we focus on disease prevention, on controlling disease or reversing it. Diabetes is a real crisis; we were looking for real solutions.

Voras search led himto Virta Healths diabetes-reversal program. Seventy-four type 2 diabetes patients initially enrolled in Virtas program. Eventually, the Mashantuckets, through Pequot Health Care,intend to add coverage of prediabetes and obesity treatments.

After one year, 93% of Mashantucket enrollees in the program had reduced their blood sugar, as measured by A1c tests, while reducing by 78% the insulin and other diabetes-specific medications prescribed for them, Virta Health reported. Nearly 70% of patients lost more than 5% of their body weight.

The tribe benefited, too, reducing its spending on medications by 50%, saving more than $3,800 per patient per year, according to Virta.

Usually, (a patient's) insulin increases year after year, Stanley said. Once on insulin, you're on it for life. So, to see the opposite trajectory is unheard of ... If youre told youll be on it for the rest of your life, and then youre told you dont need it, it can be one of the most impactful days of your life.

Mars-Martins said she stopped taking fast-acting insulin injections prior to meals two months after starting the Virta Health program nearly two years ago, and has reduced the dosage of the long-acting insulin she takes once a day at bedtime. She said she has telemedicine visits with Virta Health doctors four times a year and otherwise communicates with Virta staff by text and video chat. And theres the monitor she wears on her abdomen at all times, transmitting data to Virta Health.

Telemedicine has really changed my ability to manage my disease, she said. I havent had a diabetic low or high in two years.

Mars-Martins said the Virta Health program provided her with videos and other material that helped her better understand the science behind the treatment of her disease.

The idea is to see food as medicine, not poison, she said. What I didnt know is which foods my body could break down and which it couldnt. Its not like going on a diet. Its not like I can reach a goal and stop. Certain foods my body doesnt know how to process. Its about a lifestyle change.

Fortunately, indigenous foods are the ones Mars-Martins can process. Shes gone back to nuts and berries, meat and seafood. New England clam chowder family love, she calls it is OK, sans the potatoes she personally favors. Also fond of baked bread, she learned to forgo not-so-indigenous white flour for almond flour and coconut flour.

Shes shed the more than 30 pounds she had added over17 years.

In the first year of the Virta Health program, Mars-Martins communicated almost daily and sometimes multiple times a day with her Virta coach, Leah Wakefield. They texted back and forth and talked on video calls, the discussions ranging from why the patients blood sugar was spiking to the effect of stressful events like the coronavirus pandemic or a relatives pregnancy.

Stress eating can be a problem, and so can lack of access to a gym, Wakefield said.

She said Mars-Martins has succeeded so well because she's committed to the program. Wakefield, too, recalled that one of the first dishes Mars-Martins was concerned about was New England clam chowder.

Early on, we discussed her preparing it without the potatoes or how she could eat it before she added the potatoes for the rest of the family, Wakefield said.

Such patient support is the great differentiator in treating diabetes, Stanley, the Virta Health medical director, said.

Decades of research showed us that with diabetes, limiting your sugar and carbohydrate intake can have a dramatic effect. But you need help navigating the food landscape, he said. It wouldnt have been possible 10 years ago with a bricks-and-mortar clinic. Todays technology allows us to do it.

"I've got my life back," Mars-Martins said.

b.hallenbeck@theday.com

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Since we are working from home from last year, people have been suffering from diabetes due to uncontrollable glucose levels. So, endocrinologist Dr. Altamash Shaikh talks about managing your diabetes while working from home.

A year plus as we are fighting with the novel Coronavirus. As per the COVID-19 safety protocols, we all working from home (WFH) to curb the spread of the virus.Unfortunately work from home has negative as well as positive impact on health.One of the negative impacts is diabetes. Prolonged working from home has made many diabetics impossible to control it. Along with that, weight gain, lethargy, addiction to mobile phones, unhealthy lifestyle, poor diet routine, etc. have also been added to the list. And all of these play a major role in making your diabetes uncontrollable. So,Dr. Altamash Shaikh, Endocrinology & Diabetes, Wockhardt Hospital, Mumbai Central, shares some tips to manage your diabetes while WFH.

Sleep well and little early

For our good health, getting enough sleep is necessary. Lack of rest and poor sleeping habits can affect the insulin sensitivity and blood glucose levels. It can increase the appetite which results in weight gain. Lack of sleep results in decreases of growth hormones and increase of cortisol levels. It is better to get an adequate amount of sleep every night for 7-8 hours.

Exercise to manage Diabetes and Stress

Due to limited space, some people may feel restricted for working out. However, WFH and workout from home both are possible. People can do spot walking or jogging in the house itself. Those who feel they must go out can do brisk walking, jogging by maintaining the mandatory social distance. Do exercises such as push-ups, pull-ups, squats,abdominal crunches, on-spot jumps, etc. at home. Spend quality time with family and friends over phone or video. As stress affects glucose levels, pamper and love yourself which will help to build inner peace so that stress will be avoided. Meditation, Yoga asanas will keep you away from stress.

Manage the carbs intake

Eating at the right time is important for weight reduction and maintenance. To maintain the glucose levels managing food with sleep and exercise is important and you need to be aware of it. Our body breaks carbs into the glucose, and later insulin helps body to use and store it for energy. When we eat too many carbs or if we have insulin-function problem, this process fails and there occurs ea sudden rise in the glucose levels. To control the glucose levels, manage carbs intake by counting on it and be aware of how much you need it. Planning your meals appropriately can help improve the sugar management. Regularly monitor your glucose levels and be in touch with your family doctor.

Stay Hydrated

Drink enough water as it helps in keeping the blood sugar levels controlled and the risk for developing high sugar gets low. Preventing dehydration, helps your kidneys flush out the extra glucose through urine.

Remember to:

Ask for the health plan.

Get regular check-ups.

Exercise daily.

Make healthy choices.

Avoid stress.

Also Read:Here is how yoga pranayama can help to win the fight against Covid

Have a COVID related Experience or Advice? Discuss & Share on PINKVILLA Rooms.

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4 Tips to manage diabetes while working from home to lead a healthy life amid COVID 19 - PINKVILLA

Approximately ten percent of Americans, 34 million, suffer from diabetes, per the Centers for Disease Control and Prevention. Type 2 is the most common, accounting for 90-95 percent of cases. There are multiple risk factors, some preventable and others not. However, one of them can increase your chances of developing by a whopping six timesand it might be within your control. Read on to find out what it isand to ensure your health and the health of others, don't miss these Sure Signs You Had COVID And Should Tell Your Doctor.

Jonathan Bogan, MD, Yale Medicine endocrinologist specializing in diabetes and weight management as well as associate professor of medicine and cell biology, Yale School of Medicine, explains that diabetes is a disease that results in altered metabolism, including excessive amounts of glucose (sugar) in the bloodstream. "This can lead to problems with the eyes, kidneys, heart, nerves, circulation, and other organs," he says.

The biggest risk factor for type 2 diabetes, per Dr. Bogan? Obesity. According to a 2020 study, obesity increases your risk of developing type 2 diabetes by a whopping six timesregardless of genetic predisposition to the disease. Those who were overweight had a 2.4 times increased risk.

In most cases, obesity is preventable. And, it can also be remedied. "The results suggest that type 2 diabetes prevention by weight management and healthy lifestyle is critical across all genetic risk groups. Furthermore, we found that the effect of obesity on type 2 diabetes risk is dominant over other risk factors, highlighting the importance of weight management in type 2 diabetes prevention," the study concluded. Dr. Bogan also endorses diet and exercise to help maintain a healthy weight.

RELATED: The #1 Cause of Diabetes, According to Science

According to the CDC, "people who have obesity, compared to those with a healthy weight, are at increased risk for many serious diseases and health conditions." They are more likely to die from all-causes of death, more likely to have high blood pressure, high LDL and low HDL cholesterol, or high levels of triglycerides (Dyslipidemia), coronary heart disease, stroke, gallbladder disease, osteoarthritis (a breakdown of cartilage and bone within a joint), sleep apnea and breathing problems, many types of cancer, mental illness, body pain, and in general, a lower quality of life.

RELATED: 9 Everyday Habits That Might Lead to Dementia, Say Experts

Scientists at The Irish Longitudinal Study on Aging (TILDA) at Trinity College Dublin recently discovered that being overweight or obese can also significantly reduce blood flow to the brain, a term called "cerebral hypoperfusion." The new study pointed out that it is considered an early mechanism in vascular dementia and Alzheimer's disease. And to get through life at your healthiest, don't miss: This Supplement Can Raise Your Cancer Risk, Experts Say.

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This One Thing Can Seriously Increase Your Chances of Diabetes | Eat This Not That - Eat This, Not That