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Fewer, larger meals may be better for diabetics




Type 2 diabetics may have less depression and less hunger if they opt for 3 large, rather than six smaller meals throughout the day, a new study suggests.

People with type 2 diabetes may have less depression and fewer hunger pains if they opt for a big breakfast and lunch rather than six smaller meals throughout the day, suggests a new study.

Two large meals
"Eating large breakfasts and lunches may be more beneficial than the usual snacking model," said Dr. Hana Kahleova, the study's lead author from the Institute for Clinical and Experimental Medicine in Prague.
"However, further larger-scale, long-term studies are needed before offering clear recommendations," she told Reuters Health in an email.
The analysis used data from a previous study that compared two restricted-calorie diets in 54 people with type 2 diabetes. Each study participant spent 12 weeks eating six small meals a day, and then another 12 weeks eating a large breakfast and lunch, with no dinner.
With both diets, people reported fewer depressive symptoms and better quality of life compared to how they felt at the beginning of the study, but the improvements in mood were significantly greater when they ate larger meals twice a day.
Disinhibition, which is the tendency to overeat in certain situations, improved more on the two-meal diet. People also reported feeling less hungry when they ate just twice a day, researchers reported in the European Journal of Clinical Nutrition.
Fuller and more satisfied
People who eat less frequently may feel fuller and more satisfied when they do eat, rather than feeling hungry all day long from eating small meals, said Kahleova, who added that people need to eat 30 to 40 grams of fibre per day to be successful.
"Eat a hearty breakfast: eat breakfast like a king, lunch as a prince and dinner as a pauper," she said. "If you feel hungry in the evening you can have a vegetable salad."
"I think it's fascinating research," said Margaret Powers of the International Diabetes Centre at Park Nicollet in Minneapolis in a telephone interview.
By looking at the effect of eating patterns on patients' depressive symptoms, the new research is starting to take into account the "big emotional component to eating", said Powers, who wasn't involved with the new study but is president-elect of healthcare and education for the American Diabetes Association.
The most important thing for people with type 2 diabetes is to have a plan in terms of when they eat and how they spread out their intake of carbohydrates throughout the day, Powers said, adding that the goal is to maintain steady blood sugar levels and a healthy weight.
"There's no one right way or wrong way, but I think this says that we do have to pay attention to this emotional side of eating," she said.
"If somebody's eating two large meals a day and they want to eat at other times and they can't and that's making them miserable, that's not the right plan."
Healthy balance
Powers said she wants to see her patients eat a healthy balance and variety of foods.
"One of the goals of nutrition therapy for diabetes is actually to maintain the enjoyment of food," she said.
"Our goal is to help a patient understand him- or herself, so they can help find the best self-management plan . . . Whatever the food plan is, it should be a lifelong eating pattern."



Study: High-fat dairy products reduces diabetes risk



Editorial Team Apr 05, 2015 at 12:58 pm

Diabetics have a basic problem – they are either unable to use insulin or inefficiently use it. They need to eat food which causes the sugar levels in the blood to be consistent and not spike suddenly. Consumption of high-fat dairy products is associated with reduced risk for Type-2 diabetes, says a study. The new findings are in line with previous studies that indicated a link between high consumption of dairy products and a reduced risk of Type-2 diabetes.
‘Those who ate the most high-fat dairy products had a 23 percent lower risk of developing Type-2 diabetes than those who ate the least. High meat consumption was linked to an increased risk of Type-2 diabetes regardless of the fat content of the meat,’ said researcher Ulrika Ericson from the Lund University in Sweden.
The researchers studied the eating habits of 27,000 individuals aged 45 to 74. The participants took part in the Malmo Diet and Cancer study in the early 1990s, in which they provided details of their eating habits. Twenty years on, over 10 percent, that is, 2,860 people, had developed Type-2 diabetes. Both meat and dairy products contain saturated fat, but certain saturated fatty acids are particularly common in dairy products. Here is a diet plan diabetics can use for better sugar control.
‘When we investigated the consumption of saturated fatty acids that are slightly more common in dairy products than in meat, we observed a link with a reduced risk of Type-2 diabetes. However, we have not ruled out the possibility that other components of dairy products such as yoghurt and cheese may have contributed to our results,’ Ericson explained. The researchers took into account many dietary and lifestyle factors.
‘However, there may be other factors that we have not been able to measure. Moreover, different food components can interact with each other. Our results suggest that we should not focus solely on fat, but rather consider what foods we eat. Many foodstuffs contain different components that are harmful or beneficial to health, and it is the overall balance that is important,’ Ericson said in a paper published in the American Journal of Clinical Nutrition.
Glycaemic index (GI) is an indicator of how high your blood sugar levels will rise when you eat something. When diabetics eat foods with high GI, it results in a sudden rise in their sugar levels. On the other hand, low GI foods are healthier as they are rich in vitamins, fibres, minerals, etc. They also provide energy slowly unlike high GI foods and keep one full for a longer time. This helps in losing weight and lowering the fat levels. Foods like fruits, veggies, beans, brown rice, oats, etc. are better-suited for diabetics. Also, follow these expert diet tips and exercise to manage diabetes.

Source: With inputs from IANS

Blueberry Tea Shows Promise As Treatment For Diabetes, Researchers Say


By Wendy Lemeric on April 13 2015 1:03 PM

An herbal tea, with blueberry as the main ingredient, has caught the attention of researchers for its potential as a treatment for diabetes. Scientists at Menzies Institute in Hobart are trying to study the ability of blueberry tea in reducing insulin dependence.
Gerard Spicer is a diabetic who has been fighting type 2 diabetes mellitus for 13 years and is heavily dependent on insulin. Recently, he began drinking an herbal tea with blueberry base and observed this to be helping with his condition. The tea is a mixture of blueberry leaves and fruit, spearmint leaves, raspberry and cinnamon. This has sparked the interest of researchers at the Menzies Institute.
Michelle Keske, senior research fellow at the institute is studying the potential of blueberry tea in helping reduce a diabetic’s dependence on insulin. According to Keske, type 2 diabetes is difficult to treat, but pre-clinical trials have shown positive results. "The tea has enabled that hormone, insulin, to improve glucose uptake into muscle and by doing that it lowers blood glucose levels and it does that by stimulating blood flow," said Keske.
Finding treatment that act on blood flow stimulation can be hard, but Keske is positive about the blueberry tea and its potential. Blueberry is rich in flavonoids and polyphenols that she thinks would help with the blood flow stimulation.
Diabetes is a rapidly growing chronic condition. In Tasmania where population is estimated at more than 500,000 people, one fifth of the inhabitants is suffering from or has higher risk for diabetes. It is estimated that by year 2025, around 3 million Australians will develop the disease with type 2 as its most common form and unfortunately, there is no cure to the disease.
It has been established that blueberry offers several health benefits, but can the same thing be said for blueberry tea? Human trials are set to be conducted this year.

To contact the writer, email: wendylemeric@gmail.com



Diabetics Benefit by Biggest Meal Early



A small study finds that diabetics who ate a big breakfast and small dinner had better glucose control than those who ate the opposite. Steve Mirsky reports

April 1, 2015 |By Steve Mirsky

People with type 2 diabetes have to keep a close watch on their blood glucose levels. Now a small study finds that having the day’s biggest meal at breakfast and smallest meal at dinner offers much better glucose control than having a small breakfast and big dinner—even when the total intake during the day was exactly the same: 1,500 calories. The study, by researchers from Israel’s Tel Aviv University, Sweden’s Lund University and other institutions, is in the journal Diabetologia. [Daniela Jakubowicz et al, High-energy breakfast with low-energy dinner decreases overall daily hyperglycaemia in type 2 diabetic patients: a randomised clinical trial]
 Eighteen adult volunteers, 10 women and eight men all with type 2 diabetes, were assigned by a coin flip to either the big breakfast diet or the big dinner one. In the big dinner diet, participants spent a week having about a 200-calorie breakfast, a 600-calorie lunch and a 700-calorie dinner. The big breakfast diet was the reverse, with the 700-calorie meal in the morning, the 600-calorie lunch and a light, 200 calorie dinner.
 After two weeks, the groups switched meal plans, so that the big dinner folks became the big breakfast folks and vice versa. And overall, various measures of blood glucose and insulin levels were significantly better in those who had their big meal in the morning.
 The next steps are longer studies with more participants. But like a healthy breakfast, this research seems like a good start.
—Steve Mirsky



Rice Calories Can Be Reduced by Half


Posted by David

Rice is a big part of the diet of many across the globe, especially in China and the subcontinent. It is very easy to prepare and goes well with many different foods. However, it also leads to weight gain and an increased risk of diabetes.
One cup of rice contains about 200 calories of which most are starch, which turns into sugar and adds weight. Because of that, it is often eliminated for those on a diet and for those fighting diabetes.
However, two people from Sri Lanka have developed a new way to cook rice so that it cuts down the calorie content by up to 50%. The rice said the two is cooked as usual, but when the water boils, prior to adding the rice, coconut oil is added.
After the rice is ready, it must cool in a refrigerator for 12 hours and then it can be served. Coconut oil changed the structure of rice molecularly in such a way that its starch turns out healthier.
The rice takes more time digesting and releases its sugar slowly into the body. Normally, the starches are easily processed and release the sugar quickly into the blood, which in turn increases the risk of weight gain and diabetes.
Chilling the rice following it being cooked helps to foster the starch conversion. The result is rice that is healthier, even when heated up again.
The same logic can be applied as well to other foods that are rich in starch.
Potatoes for example go from having the right type of starch to less healthful when mashed or cooked. The process of the heating and cooling of particular vegetables such as sweet potatoes or peas can also alter the starches according to previous studies.
The prospect of have rice that is lower in calories could help out tremendously in dealing with obesity epidemics especially in certain developing nations like India where large quantities of people eat rice.
Although rice is not only the reason for gaining weight, cutting down on calories in rice even by just 10% can have great impact on generations of the future.



DIABETES 101: TIPS TO MANAGE BLOOD GLUCOSE


By Angelina Renteria

Many individuals have a connection with diabetes; either they have a relative who has it or know of someone who is affected by it, but what exactly is diabetes and how does nutrition and exercise play a vital role in managing it? In order to understand this concept, let’s address the basics of diabetes and how blood glucose functions in relation to this condition.
Diabetes is a condition in which your body is not able to produce enough insulin, causing blood glucose levels to be very high. Blood glucose, also referred to as blood sugar, is a driving force for our bodies to function.
There are 3 main types of diabetes - Type 1, which is insulin dependent, meaning the body does not produce insulin; Type 2, which is insulin resistant, meaning the body does not use insulin properly; and Gestational Diabetes, found during pregnancy, which starts when your body is not able to make and use all the insulin it needs for pregnancy. t is important that everyone understands what affects glucose levels, but especially important for those living with diabetes.
One option as a first line of defense for a person living with diabetes is to manage the condition using diet and exercise. It is important for those affected by diabetes to have blood glucose levels under control as reactions to low or high glucose levels will vary. Over time responses from dangerous levels left without medical attention can result in severe complications, for example, infection, diabetic coma or in extreme cases, death. A healthy diet and exercise is one of the most effective ways to manage blood glucose levels and prevent complications.
To prevent and treat diabetes, keep glucose levels under control by following these simple guidelines:
1) Stick to the healthy-plate method to keep your diet well balanced and glucose levels under control. Pairing carbohydrate and protein foods can aid in slowing the of absorption of glucose into the bloodstream.
•           1/2 of the plate should consist of non-starchy vegetables
•           1/4 of the plate should have lean protein (turkey, fish, chicken)
•           1/4 of the plate should have carbs (bread, pasta, potatoes)
2) Never skip breakfast as it is the most important meal of the day. Skipping meals or not eating enough can result in poorly managed blood glucose.
3) Understand the way your body functions. Check blood sugar levels before, during and after physical activity to monitor how your body reacts and adjust insulin, diabetes medications or food according to your body’s needs.
4) Partake in various forms of exercise as it aids in the management of blood glucose levels and, for Type 2 and Gestational Diabetes, increases insulin sensitivity.
•           Walking is the simplest and most effective exercise to manage blood glucose. It is a great option especially for those who are beginning a new exercise program.
•           Note: For some individuals, high intensity physical activities may elicit a stress response, which may be responsible for elevating blood sugar. To avoid this response, it is recommended that intensity levels increase slowly as the body’s fitness level increase.
•           Stress Management techniques, such as meditation, yoga, or deep breathing exercises can help prevent high glucose levels due to stress. 5) When engaging in exercise, the recommended pre-exercise blood sugar range for individuals with diabetes is between 100 and 249. Therefore, should your blood sugar be below 100, do not exercise. Eat a healthy carbohydrate snack to increase your levels, re-test after approximately 15 minutes to ensure you are within the recommended range. Once within range, begin your workout. Should your pre-exercise blood sugar level be greater than 249, you may face various risks and should consult with your doctor.to determine the reason for the elevated levels.
6) It is important to remember that while diet and exercise aid in the management of diabetes, there are also other treatment methods, for example oral medication and insulin that may be used in conjunction with exercise. Additionally, Type 1 requires the use of insulin at all times. The required dosing for Type 1 will depend on several factors including diet, energy expenditure and other factors.
7) It is advised that you work with a medical professional, Certified Diabetes Educator or Registered Dietitian to better understand how food fuels the body and effects blood glucose levels.
By applying the above points, those affected by diabetes can keep the diagnosis under control. Understanding the way the body naturally functions by regularly checking blood glucose levels is a good preliminary step to managing diabetes. For those without diabetes, applying the above points can aid in the prevention of a future diagnosis. Please note that those affected by diabetes should work closely with their doctors in managing the diagnosis.

Angelina Renteria is Senior Manager of Mission Delivery at the Greater San Diego Area of the American Diabetes Association. You may contact Angelina at (619)234-9897 or arenteria@diabetes.org.

Diabetes advocate urges Congress to take steps to stop diabetes


by jmaloni

Fri, Mar 27th 2015 07:00 am

Nearly 200 American Diabetes Association volunteer advocates from across the nation joined together in Washington, D.C., in March for the association's premier national advocacy event, Call to Congress. During this time, Tyler Sparks, a diabetes advocate from Wheatfield, met with his members of Congress, asking them to make diabetes a national priority and support efforts to stop diabetes in Western New York.
Attendees included children and adults with type 1 and type 2 diabetes, family members of individuals living with diabetes, researchers and health care professionals. All participants are deeply committed to diabetes advocacy efforts at the local, state and federal levels. Tyler Sparks is a type 1 diabetic who was diagnosed at age 8, and this was his first time participating in Call to Congress.
During scheduled meetings with members of Congress, Sparks and the other diabetes advocates urged them to make a strong federal investment in the Fiscal Year 2016 Labor Health and Human Services and Education Appropriations Bill. Specifically, advocates asked members to allocate funding for the National Institutes of Health's National Institute of Diabetes and Digestive and Kidney Diseases, provide funding for the Centers for Disease Control and Prevention's Division of Diabetes Translation and for the National Diabetes Prevention Program, and renew the Special Diabetes Program - all programs grounded in research and dedicated to fighting the nation's diabetes epidemic.
"Call to Congress brings diabetes advocates from across the country together in the movement to stop diabetes and provides them with the opportunity to tell our federal government how important it is to fight this deadly epidemic," said Janel Wright, chair of the American Diabetes Association board. "As diabetes takes a physical and financial toll on this country, federal funding is critical in our nation's response to this epidemic. Congress must provide leadership and invest in research and prevention programs that will ultimately stop diabetes."
With nearly 30 million Americans living with diabetes, and another 86 million with pre-diabetes, this disease affects every community across the nation. During Call to Congress, diabetes advocates shared their story with Congress to put a name and a face to this epidemic and urge members to join the Congressional Diabetes Caucuses. The Senate and House Diabetes Caucuses educate members about diabetes and support legislation that improves diabetes research, prevention, education and treatment.
While in Washington, D.C., in addition to meeting with members of Congress, Sparks also participated in a series of trainings with other Call to Congress participants that will help enhance advocacy efforts back home in their local communities.
For more information about Call to Congress, visit

www.diabetes.org/congress.

Navajo Nation Imposes 2% Tax On Junk Food To Fight Diabetes: Will States Follow?



Mar 27, 2015 12:59 PM By Susan Scutti

Next month the Navajo Nation will begin to impose a sales tax on junk food. President Ben Shelly signed the Healthy Dine Nation Act of 2014, mandating a two percent tax on gross receipts for all “minimal-to-no-nutritional value food items” sold. The act, which expires in 2020, trails a spring 2014 amendment to the Navajo Nation Code, which removed a five percent sales tax on fresh fruits and vegetables.
Both regulations are intended to help the Navajo people overcome diabetes. According to the Navajo Area Indian Health Service, 25,000 Navajos have been diagnosed with diabetes, while another 75,000 are pre-diabetic.
“Diabetes is an enemy that we will conquer by fighting this war together,” Shelly stated in November while signing the law. Revenues generated by the tax will be devoted to community wellness, including developing vegetable gardens and greenhouses, establishing farming projects and farmers markets, procuring exercise equipment, and starting health classes. 
Soda, Fried Foods, Chips, Sweets
The Navajo Nation, which covers over 27,000 square miles, extends into the states of Utah, Arizona, and New Mexico. The total area of Diné Bikéyah, or Navajoland, is larger than 10 of the 50 states in the union and its population surpasses 250,000. The discovery of oil on Navajoland in the early 1920s prompted the establishment of a tribal government in 1923. Today, the Navajo Nation Council Chambers, which hosts 88 council delegates representing 110 Navajo Nation chapters, is the largest of American Indian governments. This progressive law, a first in the United States, swells the council’s reputation.
As defined by the new law, “minimal-to-no nutritional value food” includes “sweetened beverages and prepackaged and non-prepackaged snacks stripped of essential nutrients and high in salt, saturated fat, and sugar,” including soda, sugar-added fruit juices, potato chips, crisps, pita chips, candy, frozen desserts, pastries, pudding, fried goods.
Cited within the new law are relevant health statistics, including a recent report that 31 percent of Navajo pregnancies were complicated due to overweight or obesity. In addition, the Centers for Disease Control and Prevention found a statistically significant increase in the prevalence of type 2 diabetes among children and teens. Each year, more than 13,000 young people are diagnosed with type 1 diabetes, while an increasing number are diagnosed as type 2.

“Eating well is what will sustain and empower us for the  generations to come,” said Denisa Livingston, a member of the Dine Community Advocacy Alliance. She added that food is not only a material pleasure, but nourishment for the body, mind, and spirit.

More diabetes cases diagnosed after Medicaid expansion


Reuters

U.S. states that expanded their Medicaid programs under the Affordable Care Act have seen larger increases in diabetes cases than states that didn’t expand their programs, a new study shows.
The findings suggest that expanding Medicaid, the government-run health insurance for the poor, allows people with diabetes to be diagnosed earlier than before, which may improve outcomes later on, the researchers say.
"This is important because diabetes is becoming more prevalent as the population gets older,” said Dr. Harvey Kaufman, lead author of the study and senior medical director at Quest Diagnostics, which funded the analysis.
In the early stages of the disease, people can make lifestyle changes and get care that helps delay complications, he added.
If left untreated, diabetes can lead to vision loss, kidney failure, nerve problems and amputations of the legs and feet, according to the U.S. Centers for Disease Control and Prevention. The agency says $176 billion is spent on diabetes and its complications each year.
Diabetes occurs when the body can't properly use or make enough of the hormone insulin to convert blood sugar into energy, according to the World Health Organization (WHO).
About one in nine adults has diabetes, according to the WHO. Type 2 diabetes accounts for the vast majority of cases and is linked to obesity and advanced age.
Kaufman and colleagues focused their research on the hemoglobin A1c test, which measures the average blood sugar level for the past two or three months.
Using Quest Diagnostics’ database of lab tests, which includes about 150 million patient encounters annually, they counted how many people had at least one blood sugar test that was negative before Medicaid expansion and positive afterwards.
In January 2014, 26 states expanded access to Medicaid and 24 did not.
Where more people got Medicaid, newly diagnosed diabetes cases among Medicaid recipients surged 23 percent, from 14,625 in the first six months of 2013 to 18,020 in the first six months of 2014. In states that didn't expand Medicaid, diagnosis increased just 0.4 percent.
People are considered diabetic when their A1c level is at least 6.5 percent. Where Medicaid was expanded, the average A1c levels of newly diagnosed diabetes patients was 7.96 percent, compared with 8.14 percent in non-expansion states.
"It was apparent in the non-expansion states that you are making diagnosis at a later stage when they are presenting at the hospital with complications," said Dr. Robert Ratner, chief scientific and medical officer of the American Diabetes Association.
"The earlier you catch the disease, the easier it is to treat, and the more responsive it is and the more stable it can be," said Ratner, who wasn't involved in the study.
While more women in the study had diabetes, the increase in diagnosis was steeper for men. Gains were also greater for older people, aged 50 to 64, than for individuals aged 19 to 49.
The study had some limitations, including its reliance only on records from blood sugar tests done by Quest Diagnostics and its lack of clinical information. It's also possible that some patients tested at Quest might have been diagnosed prior to the start of the study period.
Because it's only based on tests at Quest, "you don't know 100 percent if this was a new diagnosis, and not something the patient might have already known," said Dr. Benjamin Sommers, a health economist at Harvard University. "But the overall study design makes a lot of sense."
The number of newly diagnosed diabetes cases in the states where Medicaid expanded bodes well for the detection of other chronic health conditions which, like diabetes, may not immediately cause symptoms that are easy for patients to detect on their own, Sommers said.
"With the expanded coverage, you're not going to diagnose more broken bones because whether or not they have insurance, when somebody breaks a leg they are going to get an x-ray," said Sommers, who wasn't involved in the study. "These findings with diabetes may be the tip of the iceberg, and you can imagine similar outcomes for earlier detection of high blood pressure, or cancer, or mental illness."



FDA approves new treatment for diabetic retinopathy in patients with diabetic macular edema


For Immediate Release
March 25, 2015
Release
The U.S. Food and Drug Administration today expanded the approved use for Eylea (aflibercept) injection to treat diabetic retinopathy in patients with diabetic macular edema.
Diabetic retinopathy (DR) is the most common diabetic eye disease and is a leading cause of blindness in adults in the United States. According to the Centers for Disease Control and Prevention, diabetes (type 1 and type 2) affects more than 29 million people in the United States and is the leading cause of new blindness among people ages 20 to 74 years. In 2008, 33 percent of adults with diabetes aged 40 years or older had some form of DR. In some cases of DR with diabetic macular edema (DME), abnormal new blood vessels grow on the surface of the retina. Severe vision loss or blindness can occur if the new blood vessels break.
“Diabetes is a serious public health crisis, affecting more patients every year,” said Edward Cox, M.D., M.P.H, director of the Office of Antimicrobial Products in the FDA’s Center for Drug Evaluation and Research. “Today’s approval gives patients with diabetic retinopathy and diabetic macular edema another therapy to treat this vision-impairing complication.”
In February, the FDA approved Lucentis (ranibizumab injection) 0.3 mg to treat DR in patients with DME.
Eylea is administered by a physician as an injection into the eye once a month for the first five injections and then once every two months. It is intended to be used along with appropriate interventions to control blood sugar, blood pressure and cholesterol.
The safety and efficacy of Eylea to treat DR in patients with DME were evaluated in 679 participants in two clinical studies where participants were randomly assigned to receive Eylea or macular laser photocoagulation, a laser-based treatment used to burn small areas of the retina. At week 100, participants being treated with Eylea showed significant improvement in the severity of their DR, compared to patients who did not receive Eylea.
The most common side effects associated with Eylea include bleeding of the conjunctiva (the tissue that lines the inside of the eyelids and covers the white part of the eye); eye pain; cataracts; floaters; increased pressure inside the eye (increased intraocular pressure); and separation of the interior jelly of the eye from the retina (vitreous detachment). Serious adverse reactions include infection within the eye (endophthalmitis) and retinal detachments.
The FDA granted breakthrough therapy designation to Eylea for the treatment of DR with DME. The FDA can designate a drug a breakthrough therapy at the request of the sponsor if preliminary clinical evidence indicates the drug may demonstrate a substantial improvement over available therapies for patients with serious or life-threatening conditions. The FDA also reviewed the new use for Eylea under the agency’s priority review program, which provides for an expedited review of drugs that demonstrate the potential to be a significant improvement in safety or effectiveness in the treatment of a serious condition.
The FDA previously approved Eylea to treat wet (neovascular) age-related macular degeneration, a condition in which abnormal blood vessels grow and leak fluid into the macula. Eylea is also approved to treat DME and macular edema secondary to retinal vein occlusions, both of which cause fluid to leak into the macula resulting in blurred vision.
Eylea is marketed by Tarrytown, N.Y.-based Regeneron Pharmaceuticals Inc. Lucentis is marketed by South San Francisco, California-based Genentech, a subsidiary of Roche Pharmaceuticals.

The FDA, an agency within the U.S. Department of Health and Human Services, promotes and protects the public health by, among other things, assuring the safety, effectiveness, and security of human and veterinary drugs, vaccines and other biological products for human use, and medical devices. The agency also is responsible for the safety and security of our nation’s food supply, cosmetics, dietary supplements, products that give off electronic radiation, and for regulating tobacco products.

Repeated Use of Antibiotics May Raise Diabetes Risk


by Agata Blaszczak-Boxe, 

People who have taken certain antibiotics repeatedly may be at an increased risk of type 2 diabetes , according to a new study.
Researchers found that people in the study who had ever been prescribed two or more courses of specific types of antibiotics were more likely to be diagnosed with type 2 diabetes  than people who had never been prescribed these antibiotics, or had taken just one course. The antibiotics in the study came from one of four categories: penicillins, cephalosporins, quinolones and macrolides.
The study "raises a red flag about the overuse of antibiotics, and it should make us much more concerned about this overuse," said Dr. Raphael Kellman, a New York City internist who was not involved in the study. "We should certainly be more judicious, more cautious when we use antibiotics."



Even interrupting sitting time may improve health in type 2 diabetes


BY JANICE NEUMANN

 (Reuters Health) - - People with Type 2 diabetes could trim down and improve their metabolic health by replacing long periods of sitting with periodic standing, taking the stairs or even just changing the television station manually, a new study suggests.
“It is important to stress that physical activity incorporates all different forms of movement and that people do not have to participate in structured exercise to be sufficiently active,” said Catherine Falconer, who led the study.
“Whatever you can do to increase the amount of physical activity you do and reduce the length of time sitting will have an impact on your diabetes and general health,” she wrote in an email.
Previous research has shown that increasing physical activity can help people with type 2 diabetes better handle their weight, glucose and lipid levels, Falconer and her team point out in Medicine and Science in Sports and Exercise. But people with diabetes may have a particularly hard time staying active.
“Type 2 diabetes is commonly associated with an obesogenic lifestyle, including low levels of physical activity. For some people with type 2 diabetes, mobility issues may prevent them from achieving sufficient physical activity, but for others it may be a result of behavior and environmental factors,” Falconer said.
Studies have also shown that people may have trouble increasing their activity level enough to actually improve their health and that long periods of just sitting may be particularly harmful.
So the researchers decided to examine the potential effect of replacing long periods of sedentary behavior with short interrupted periods, light exercise and moderate-to-vigorous physical activity.
They looked at data on 519 adults with type 2 diabetes from a larger 2006-2008 study. The participants included in the new analysis wore accelerometers on their waists to measure their activity levels and also gave fasting blood samples to check their cholesterol, triglyceride, insulin and glucose levels.
Researchers found the participants spent 65 percent of the waking day sedentary and 45 percent of that time was spent in long blocks of 30 minutes or more being inactive. The study team then used a statistical analysis technique to compare what might be the effects of replacing 30 minutes of one behavior with 30 minutes of another.
With just some interruptions in 30-minute sedentary blocks, the weight and waist circumference of subjects went down slightly, and fell even more when light or moderate-to-vigorous physical activity was swapped-in for the sedentary time.
When the researchers analyzed how much the adults’ metabolic health could improve with the different levels of activity, they found that HDL (“good”) cholesterol rose with light physical exercise, though not with more vigorous exercise.
“I think the message that we don’t even have to push for the moderate-to-vigorous physical activity, that breaking up your sitting time has demonstrable benefits is actually pretty compelling,” said Dr. Eddie Phillips, who founded and directs the Joslin Diabetes Center’s Institute of Lifestyle Medicine in Boston, Massachusetts.
Phillips pointed out in a phone conversation with Reuters Health that the 2008 Physical Activity Guidelines for Americans suggested 150 minutes of moderate-intensity aerobic and “while there’s been an uptick . . . the majority of Americans don’t get that.”
“It is a valid criticism to say we have not convinced the public to walk more appreciably, and those recommendations will remain, but if we can now recommend to patients that, ‘Gees, if you just get up out of your chair when the commercial comes on or drink more water and have to go to the bathroom,’ even that is enough to break up the prolonged sedentary bouts they describe in the research,” said Phillips, who was not involved in the study.
Phillips said he made physical exercise a part of his regular discussions with diabetic patients, suggesting they increase their activity by even small increments.
“The discussion is usually about, ‘Could you walk a little more, a little faster, a little more frequently. From there I would start asking what you like to do . . . get outside, be involved in a competition, do ballroom dancing?” he said. “The exact type of exercise is actually not that important and more to do with what you find enjoyable.”
SOURCE: bit.ly/1Bcq2zd Medicine and Science in Sports and Exercise, online March 6, 2015.



For diabetics, middle ground is a livable option



By Rosemary Boggs

Pasta doesn't make you fat. It's how much pasta you eat that makes you fat.
-- Giada De Laurentiis,chef and cookbook author

I love the quotation above because it reminds me of how I've tried to come to terms with my eating habits. Having one cookie isn't the worst thing, but having the whole bag can be.
Like a petulant child, I really resent having to watch what I eat and drink. If someone tries to tell me that a food is forbidden or a no-no, they've basically, in my mind, just challenged me to eat it.
I am a diabetic. Thousands and thousands of people are diabetic. I struggle with my eating and I know that I truly am not alone in this.
Thousands and thousands of people have heart disease, cancer and an array of other health issues and diseases that can be affected by our eating habits.
When I was first diagnosed, I had this fear that if I ate one candy bar or cookie I could quickly slip downhill and die. It was a matter of life and death.
And really, it still is.
But as time has gone by, I've let my guard down and lapsed back into a couple of old habits. I don't always do what's best for me.
It's like Paul said in Romans 7:15: "For I do not understand my own actions. I do not practice or accomplish what I wish, but I do the very thing that I loathe."
And, like they sang in Disney's Beauty and the Beast, "it's a tale as old as time." But at least I am more aware of what I'm doing, which is a start.
WAKE UP
I received a copy of the book 21 Things You Need to Know About Diabetes and Your Heart and decided to read it. It's by Jill Weisenberger, a registered dietitian who has a practice in Virginia.
Her goal is to teach and encourage diabetics to care for their hearts. After reading the book I see she's on the right track. Sadly, much of the content is stuff we may already know but don't practice.
She begins by explaining the term "heart disease," or cardiovascular disease. These are catchalls used to describe several diseases of the heart or blood vessels. And she says that people with diabetes are at double the risk of having these diseases.
So what is the diabetes-heart connection?
Blood vessel damage throughout the body occurs more frequently, at an earlier age and with greater severity in people with diabetes. People with diabetes tend to have problems with blood vessel dilation and a greater likelihood of forming clots that obstruct blood flow. Research also links insulin resistance to heart disease as well as high blood pressure, excessive blood cholesterol and high triglyceride levels.
Good lifestyle habits can help put us in control of our lives. And medical management of risk factors and health problems greatly improves our chances of leading a full life without the worst effects of heart disease, which often culminate in having a heart attack.
So what are the symptoms of a heart attack?
The author says they vary from person to person. Common signs include chest pain or discomfort, upper body discomfort and shortness of breath. Less common signs include nausea, breaking out in a cold sweat, feeling unusually tired for no apparent reason, and sudden dizziness or feeling lightheaded.
Diabetic nerve damage or neuropathy may cause symptoms to be milder or even mask them. The main thing is to get to the hospital immediately if you think you are having a heart attack.
TAKE CHARGE
She asserts that monitoring our blood glucose is empowering, but many of us just don't do it regularly. If we can approach it with the right attitude, self-monitoring our blood glucose can put us in charge. And by using the results effectively we can work to control our diabetes and health.
The book has no actual list of 21 things to do, but there are 21 chapters full of solid advice and information that will benefit many. There are several chapters about eating and how changing our habits in a few small ways can make a big difference.
Weisenberger says that moderate weight loss can improve insulin resistance. She's talking 5 percent to 10 percent of our body weight. And losing just 10 pounds can be effective in controlling high blood pressure.
There is no magic plan, food or pills that will melt fat from our bodies. And we don't need to follow long lists of restrictive dietary rules and/or give up our favorite foods entirely.
We mainly need to understand, the author says, that any diet that helps us lose weight does so because we consume fewer calories than our body burns. And that does not necessarily mean we have to drastically cut calories to lose weight.
What it does mean is that we need to change our diets to consume fewer calories, increase our physical activity or, preferably, both.
Our best diet will be one that we can live with long term. It should include foods we enjoy in reasonable quantities and not restrict the foods we need for optimal health.
Weight loss cannot be the only goal though, Weisenberger says. Our best diet should balance enjoyment and good health.
I second that!
For more information, go to Diabetes.org the website of the American Diabetes Association.
Email me at:

rboggs@arkansasonline.com

Statins increase risk of diabetes by almost 50 per cent, study finds


Research on 9,000 men has found those taking statins are 47 per cent more likely to develop diabetes - but critics say the study fails to take proper account of the reasons

By Laura Donnelly, Health Editor

Statins prescribed to guard against heart attacks and strokes could increase the risk of diabetes by almost 50 per cent, a major trial suggests.
A six-year study from Finland on almost 9,000 men found that those prescribed the cholesterol-lowering drugs were far more likely to suffer from poor blood sugar control, and signs of diabetes.
Researchers found that after results were adjusted for age, body mass index, family history of diabetes, and smoking, alcohol and exercise habits, those on statins were 46 per cent more likely to develop diabetes.
However, some experts criticised the research, as it was not a randomised controlled trial.
Those being prescribed statins were already likely to have a higher risk of diabetes, they said, given that both conditions are linked to lifestyle.
The study led by Professor Markku Laakso, Institute of Clinical Medicine, University of Eastern Finland and Kuopio University Hospital, Finland, tracked 8,749 men aged between 45 and 73 for six years.
None had been diagnosed as diabetic at the start of the trial, and just over 2,100 of the participants were on statins.
By the end of the trial, 625 men were diagnosed with diabetes, the research published in Diabetologia, the journal of the European Association for the Study of Diabetes, found.
The risk of diabetes rose in line with the dose of the statins prescribed, the study found.
Researchers said the drugs appeared to alter insulin sensitivity, and reduce secretion of the hormone, triggering diabetes.
Previous studies have suggested a small increased risk of diabetes from statins.
Researchers said the new findings suggested such risks may have been previously underestimated, and said the size of the study, and way it was carried out meant its conclusions were likely to be reliable.
Last July, health watchdogs recommended that statins should be offered to around 17 million people – anyone estimated to have a 10 per cent chance of developing heart disease within a decade.
Experts said up to 50,000 lives a year could be saved if the guidelines are followed.
The controversial guidance triggered heated arguments about the benefits and risks of the drugs, and criticism that insufficent trial data has been published about their side-effects.
Dr Aseem Malhotra, Honorary Consultant Cardiologist, Frimley Park Hospital, who has criticised the guidance, said: “This study confirms that statins directly increase the risk of developing diabetes.”
He said GPs should ensure patients were properly informed about the risks and benefits from the drugs before they decided whether to take them.
But some scientists criticised the new research, and said the apparent increase in the risk of diabetes in those prescribed statins may not have been caused by the drugs.
Prof Stephen Evans, Professor of Pharmacoepidemiology at the London School of Hygiene & Tropical Medicine said: “The users of statins were generally at higher risk of heart disease and differed in a number of ways, probably including several ways that were not measured,” pointing out that the study did not track the diets of those involved.
Prof Keith Frayn, Emeritus Professor of Human Metabolism at the University of Oxford, pointed out that the 46 per cent increase measured the relative rise in risk.
Overall, 11 per cent of those taking a statin developed diabetes, compared with 6 per cent of those not taking the drug, with differences reduced further when confounding factors were taken into account, he said.
Professor Peter Weissberg, medical director at the British Heart Foundation, said: “This study showed that it was patients taking a high dose statin who were most at risk of developing type 2 diabetes and, importantly, many of the patients who developed diabetes already had risk factors for diabetes at the start of the study. This suggests that statins may act by unmasking a pre-existing tendency to diabetes.”

“It is important that people taking statins because of existing cardiovascular disease should continue to take them as the benefits will outweigh the risks.” 

Sanofi diabetes drug awaits imminent EU green light


BY BEN HIRSCHLER

(Reuters) - Sanofi's new Toujeo diabetes drug is on track to receive a potential green light from European regulators this week, building on a U.S. regulatory approval awarded on Wednesday.
Toujeo is a more potent follow-up to the French drugmaker's top-selling Lantus insulin product, which accounts for a fifth of group sales, and the new drug is pivotal to Sanofi's diabetes business as Lantus faces loss of patent protection.
A committee of experts at the European Medicines Agency is considering whether to recommend Toujeo at a regular monthly meeting in London, according to the agency's website. Decisions from such meetings are normally announced around midday on Fridays.
 Assuming Toujeo gets a positive opinion, it is likely to be formally approved by the European Commission a couple of months later, allowing Sanofi to launch in its chosen first European markets of Germany and Britain.
The U.S. approval for Toujeo disappointed some Sanofi investors because the wording on the drug's label failed to spell out the benefits of Toujeo over Lantus.
In Europe, however, the labeling rules are different and Sanofi may be able to make more claims for Toujeo.
Pascale Witz, Sanofi's executive vice president of global divisions, said she was confident doctors would recognize the benefits of using Toujeo, even if this was not spelt out on the U.S. label, because clinical studies about the drug had been published in major journals.
Toujeo has the same active ingredient as Lantus, called insulin glargine, but at three times the concentration and with a design to release the insulin more gradually.
The medicine provides similar blood glucose control as Lantus with lower rates of hypoglycemia, a potentially dangerous drop in blood sugar.
Witz declined to comment on the price of Toujeo but said "pricing will not be a barrier to access".
Even with a competitive price, investors fear Sanofi may struggle to switch sufficient patients from Lantus to Toujeo. Many analysts see a modest switch rate of only around 20 percent, although Witz said that figure was too low.
"That's a pessimistic view. We think it's going to be more than that," she said on the sidelines of an Economist pharmaceuticals conference in London.

(Reporting by Ben Hirschler)

Got Diabetes? There's an App for That


U.S. health researchers said they are targeting millions of smartphone users with Apple Inc's new software tool, hoping to collect an unprecedented amount of data on major diseases by tracking their behaviours via iPhone.
The ResearchKit software tool, an open source platform, allows researchers to design applications that use built-in sensors on the iPhone along with data from other wearable devices to gather real-time health data. Scientists from Stanford University School of Medicine and Weill Cornell Medical College are among the first to offer apps for diseases like diabetes and heart disease.
For example, Massachusetts General Hospital's GlucoSuccess app allows diabetics to participate in a research study that gives feedback on how their diet and exercise patterns impact daily glucose readings. It asks volunteers whether they have taken all of their medications or inspected their feet.
"It's very hard in practise for people to carry out all the recommendations and stick with them over time," said Dr. Stanley Shaw, co-director of the Center for Assessment Technology and Continuous Health at Massachusetts General.
Other apps released on Monday involve studies on asthma, breast cancer and Parkinson's disease. For volunteers, the apps are designed to help people with chronic disease follow through with important health behaviours.
For researchers, the data improves upon the many pages of survey questions study volunteers had to fill out, often based on their recollection of what they ate in the prior week or how many minutes they put in at the gym. Shaw said the fact that Apple made ResearchKit open source will allow "a whole host of medical researchers" to develop apps for their own research projects.
"We view this as the opening salvo," he said.
The MyHeart Counts app will collect data about physical activity and cardiac risk factors for Stanford scientists studying heart disease. It allows users to complete tasks, such as performing a six-minute walk if they are able, and answer surveys from their iPhone, and provide them with an assessment of their heart health and information on how to improve it.
The app can tap into data gathered by other wearable gadgets such as Jawbone or Fitbit, but it can also be used with the iPhone, as long as people remember to keep their phones turned on, said Dr. Euan Ashley, chair of Stanford's biomedical data science initiative.
Dr. Francis Collins, director of the National Institutes of Health, sees mobile health playing a major role in the president's $215 million precision medicine initiative. He anticipates tech companies will use large patient studies as a "test bed for a lot of the technologies they are developing."
"The Googles and the Apples and the Qualcomms are certainly paying close attention to the potential of this," Collins said in a recent interview with Reuters.
Researchers say ResearchKit simplifies their recruiting work. Volunteers can decide how much data to share directly with the research institutions. "The data does not go to Apple," Ashley said. Dr. Eric Schadt, a genomics professor at the Icahn School of Medicine at New York's Mount Sinai, used the platform to develop an asthma app along with Weill Cornell Medical College and LifeMap Solutions, a subsidiary of BioTime .

The fact that researchers can recruit, consent and enroll participants remotely should produce study sample sizes that are "orders of magnitude" greater than in the past at a fraction of the cost, Schadt said.