Obesity And Risk Of Type 2 Diabetes And Cardiovascular Disease In Children Andadolescents.
1. J Clin Endocrinol Metab. 2003 Apr;88(4):1417-27. Obesity and risk of type 2 diabetes and cardiovascular disease in children andadolescents. (1)Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA. [email protected] Overweight/obesity continues to increase in children and adolescents, and annual obesity-related hospital costs in 6-17 yr olds have reached 127 million dollarsper year. Overweight children and adolescents are now being diagnosed withimpaired glucose tolerance and type 2 diabetes, and they show early signs of the insulin resistance syndrome and cardiovascular risk. Several risk factors havebeen identified as contributors to the development of type 2 diabetes andcardiovascular risk in youth. These factors include increased body fat andabdominal fat, insulin resistance, ethnicity (with greater risk inAfrican-American, Hispanic, and Native American children), and onset of puberty. There is no clear explanation of how these factors increase risk, but they appearto act in an additive fashion. We hypothesize that the constellation of theserisk factors may be especially problematic during the critical period ofadolescent development, especially in individuals who may have compromisedbeta-cell function and an inability to compensate for severe insulin resistance. Therefore, the purpose of this paper is to review the pathophysiology of type 2diabetes and cardiovascular risk in obese children and adolescents. Continue reading >>
Diet, Overweight And Obesity
Diet and heart health The role of diet is crucial in the development and prevention of cardiovascular disease (CVD). Diet is a key modifiable risk factor for CVD. Change in eating habits Human beings’ average weight is increasing. The latter half of the 20th century saw major changes to daily diets, moving from plant-based diets to high-fat, animal-based diets The obesity epidemic is spreading to low- and middle-income countries as a result of new dietary habits and sedentary ways of life, fuelling chronic diseases and premature mortality Components of a healthy diet A healthy diet is low in saturated fats, salts and refined carbohydrates and high in fruit and vegetables. As well as this, eating whole grains, at least two servings of fish a week, and nuts can reduce the risk of CVD The World Health Organization (WHO) recommends individuals to: Limit energy intake from total fats and shift fat consumption away from saturated fats to unsaturated fats and towards the elimination of transfatty acids Increase consumption of fruits and vegetables, and whole grains and nuts. Adults should consume at least 500g of fresh fruit and vegetables a day. Limit the intake of free sugars and salt (sodium) consumption from all sources . Recent guidance recommends eating less than 1,500 mg of sodium per day Overweight and obesity Overweight and obesity are classified by an individual’s body mass index (BMI). BMI is measured by dividing a person’s weight by their height squared in metres In adults, overweight is defined as a BMI of 25.0 to 29.9 kg/m2; obesity is defined as a BMI of 30.0 kg/m2 or greater Facts & figures: prevalence Latest projections from the WHO indicate that globally in 2005 approximately 1.6 billion adults aged 15 and above were overweight; at least 400 million adu Continue reading >>
Obesity, Metabolic Syndrome, And Cardiovascular Disease
Obesity, Metabolic Syndrome, and Cardiovascular Disease Center for Human Nutrition, University of Texas, Southwestern Medical Center, Dallas, Texas 75390 Address all correspondence and requests for reprints to: Scott M. Grundy, M.D., Ph.D., Center for Human Nutrition, University of Texas, Southwestern Medical Center, Dallas, Texas 75390. Search for other works by this author on: The Journal of Clinical Endocrinology & Metabolism, Volume 89, Issue 6, 1 June 2004, Pages 25952600, Scott M. Grundy; Obesity, Metabolic Syndrome, and Cardiovascular Disease, The Journal of Clinical Endocrinology & Metabolism, Volume 89, Issue 6, 1 June 2004, Pages 25952600, Obesity is rampant in the United States and is becoming increasing common worldwide. The increase in obesity prevalence is due to two major factors, plentiful supplies of inexpensive foods and sedentary jobs. Both are driven in no small part by technology. Thanks to technology, production of large quantities of cheap food is possible, and manual work is rapidly disappearing. In areas of the world in which these advances have not penetrated, obesity is not a significant public health problem. Thus, obesity is a direct result of technological advance and represents a major challenge for technological society. Obesity must also be recognized as a product of free society in which a multitude of food choices and job opportunities are available. A public health approach to the problem of obesity that restricts choice will not be acceptable to a free society. This fact puts increased responsibility on the individual to recognize the underlying causes of obesity and modify behavior to reduce the personal burden of obesity. That obesity extracts a social cost is well recognized. The costs in physical health are less well recognized Continue reading >>
- Ultraviolet Radiation Suppresses Obesity and Symptoms of Metabolic Syndrome Independently of Vitamin D in Mice Fed a High-Fat Diet
- Why High-Fat vs. Low-Fat Dairy May Be Better Suited for Those with Diabetes, Obesity, and Cardiovascular Disease
- Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*
The Connection Between Diabetes, Heart Disease, And Stroke
Aaron contacted TheDiabetesCouncil with some questions related to diabetes and heart disease. Aaron is 57 years old. He has had Type 2 diabetes for 12 years. Aaron visited his doctor related to swelling in his ankles and feet, shortness of breath, and weight gain. After some tests, the doctor informed him that on top of his Type 2 diabetes, he now has congestive heart failure. He was now wondering why did he have heart disease now and was it because of his diabetes? In order to help Aaron and other people with diabetes understand the connection between diabetes and heart disease and how to prevent it, we decided to look into the specific link between the two diseases. What is the connection between diabetes and heart disease? According to the American Heart Association, there exist a relationship between cardiovascular disease and diabetes: 68% percent of people with diabetes who are aged 65 and older die from heart disease and 16% die of a stroke. People with diabetes are more likely to die from a heart disease than those without diabetes. The National Institute of Health states the following for people with diabetes: They have additional causes of heart disease They are at higher risk of heart disease than those who do not have diabetes They may develop heart disease at a younger age Risk assessment must take into account the major risk factors (cigarette smoking, elevated blood pressure, abnormal serum lipids and lipoproteins, and hyperglycemia) and predisposing risk factors (excess body weight and abdominal obesity, physical inactivity, and family history of CVD). Identification of risk factors is a major first step for developing a plan for risk reduction in persons with diabetes. – Scott M. Grundy et al, Diabetes and Cardiovascular Disease In two words, the conn Continue reading >>
Obesity And Risk Factors For Cardiovascular Disease And Type 2 Diabetes: Investigating The Role Of Physical Activity And Sedentary Behaviour In Mid-life In The 1958 British Cohort
Highlights • We studied obesity, physical activity and TV-viewing associations with CVD biomarkers. • Obesity and TV-viewing were associated with a poorer CVD profile. • TV-viewing associations with HbA1c were stronger in the obese than non-obese. • Physical activity had a greater protective association with HbA1c in obese men. • Findings suggest that the obese will benefit most from less TV and more activity. Abstract A key public health priority is to minimise obesity-related health consequences. We aim to establish whether physical activity (PA) or less sedentary behaviour ameliorate associations of obesity with biomarkers for cardiovascular disease (CVD) and type 2 diabetes. Data on obesity (33 y), PA (42 y), TV-viewing and health biomarkers (45 y) are from the 1958 British birth cohort (N = 9377). Obesity was associated with an adverse biomarker profile for CVD and type 2 diabetes. For PA, men active ≥1/week had 1.09% (0.28, 1.90) lower diastolic blood pressure (DBP) than less active men; triglycerides were 2.08% (0.52, 3.64) lower per unit higher PA (on 4-point scale). TV-viewing was independently associated with several biomarkers, e.g. per unit higher TV-viewing (on 4-point scale) DBP was raised by 0.50% (0.09, 0.90) and triglycerides by 3.61% (1.58, 5.64). For both TV-viewing and PA, associations with HbA1c were greatest for the obese (pinteraction ≤ 0.04): compared to a reference value of 5.20 HbA1c% in non-obese men viewing 0–1 h/day, HbA1c% differed little for those viewing >3 h/day; among obese men HbA1c% was 5.36 (5.22, 5.51) and 5.65 (5.53, 5.76), for 0–1 and >3 h/day respectively. For PA in non-obese men, the reduction associated with activity ≥1/week was negligible compared to a reference value of 5.20 HbA1c% for those less active; b Continue reading >>
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- A Sedentary Lifestyle and Diabetes
- Why High-Fat vs. Low-Fat Dairy May Be Better Suited for Those with Diabetes, Obesity, and Cardiovascular Disease
Abdominal Obesity Is Strongly Associated With Cardiovascular Disease And Its Risk Factors In Elderly And Very Elderly Community-dwelling Chinese
Obesity is usually considered to predispose to atherosclerotic cardiovascular disease (ASCVD) but milder degrees of obesity or overweight may be protective in some elderly populations. We examined the relationships between general and abdominal obesity indices with ASCVD and its risk factors in elderly (aged ≥65 years) Shanghai community residents Among the 3950 participants, 21.5% had ASCVD, 56.2% had body mass index (BMI) ≥24 kg/m2, 50.1% had high waist circumference (WC) and 77.1% had waist-to-height ratio (WHtR) ≥0.50. WHtR increased with age in both men and women whereas WC increased with age only in women and BMI decreased with age only in men. The optimal WHtR cut-off value to predict the risk of ASCVD determined by receiver operating characteristic analysis was WHtR ≥0.53 with a prevalence of 55.8%. Having abdominal obesity was significantly associated with prevalent ASCVD with WHtR ≥0.53 having a higher value for the odds ratio than high WC, whereas high BMI was not associated. All three indices predicted high glucose, triglycerides and hsCRP levels but only the WHtR ≥0.53 showed a significant association with physical activity. Abdominal obesity indices, but not BMI, predicted prevalent ASCVD and its risk factors in this elderly Chinese population. Cardiovascular disease (CVD) is the leading cause of death in most countries worldwide. Over the past 3 decades, the prevalence of the CVD risk factors hypertension and raised plasma cholesterol levels have declined in many high-income countries, but the prevalence of overweight and obesity continued to increase in both developed and developing countries1,2,3. Excess adiposity is associated with reduced physical activity and several chronic conditions including type 2 diabetes, hypertension, and dyslipid Continue reading >>
Obesity And Heart Disease
Obesity is a major public health problem. Obesity and overweight epidemic worldwide is also closely linked to the rise in the incidence of cardiovascular disorders. Cardiovascular disorders are one of the largest health problems in almost all of the developed and developing nations of the world. Cardiovascular disease kills more people than any other disease and account for the largest share in health expenditure. Risk factors associated with cardiovascular disease Some of the major risk factors associated with cardiovascular disease include:- tobacco smoking being physically inactive eating a diet high in saturated fats and low in unsaturated fats being overweight or obese having high blood cholesterol having a high blood pressure advancing age type 2 diabetes related complications of atherosclerosis or hardening of the arteries, high blood pressure and high cholesterol Overlap with obesity risk factors Many of these risk factors overlap considerably with those for obesity and overweight linking the two conditions. Obesity and atherosclerosis Atherosclerosis is the process that gradually hardens the walls of the arteries making them lose their elasticity and finally blocks them up or narrows them down to impair blood flow. The blockage is caused by fatty and fibre-like deposits. Atherosclerosis is the main underlying cause of cardiovascular disease. When it affects the heart, it may lead to coronary artery disease and heart attacks. When this affects the brain it causes strokes and when it affects the peripheral blood vessels, it leads to peripheral artery disease. A high body mass index is inexorably related to atherosclerosis. The association of atherosclerosis is strong with rising waist circumference, waist hip ratio and abdominal subcutaneous fat deposition as wel Continue reading >>
- Drug that lowers blood sugar to combat type 2 diabetes ‘also helps fight obesity and heart disease’
- High Fructose Corn Syrup (HFCS): A Substance That Cause Autism, Diabetes, Cancer, Liver Failure, Heart Disease, Obesity & Dementia is Now Hidden Under New Name
- Fight Off Heart Disease With These Five Heart-Healthy Foods
Diabetes, Heart Disease, And You
Diabetes is a common disease that is on the rise in America. Having diabetes raises your risk for developing other dangerous conditions, especially heart disease and stroke. November is National Diabetes Month, a time to raise awareness about preventing and managing diabetes and protecting yourself from its complications. Diabetes is a serious condition that happens when your body can’t make enough of a hormone called insulin or can’t properly use the insulin it has. Insulin helps your body digest sugars that come from what you eat and drink. Without enough insulin, sugar builds up in your blood. Over time, that sugar buildup damages your nerves, blood vessels, heart, and kidneys. More than 29 million Americans have diabetes, or about 1 of every 11 people. 1 About 8 million of them don’t know they have diabetes. Another 86 million—more than 1 in 3 Americans older than 20 years—have prediabetes, a condition in which a person’s blood sugar is high, but not yet high enough to trigger diabetes.2 Most people with diabetes have type 2 diabetes. Adults with type 2 diabetes are about twice as likely to die from heart disease as adults who do not have diabetes.3 Surprising Facts About Diabetes Women with diabetes have a 40% greater risk of developing heart disease and a 25% greater risk of stroke than men with diabetes do.5 Experts aren’t sure why the risk is so much greater in women with diabetes than in men with diabetes. Women’s biology may play a role: Women usually have more body fat, which can put them at greater risk for heart disease and stroke. If you are a woman with diabetes, you can take steps to control your condition and improve your chances for avoiding heart disease and stroke (see below). Almost 7 in 10 people with diabetes over age 65 will die o Continue reading >>
Cardiovascular Disease & Diabetes
The following statistics speak loud and clear that there is a strong correlation between cardiovascular disease (CVD) and diabetes. At least 68 percent of people age 65 or olderwith diabetes die from some form of heart disease; and 16% die of stroke. Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes. The American Heart Association considers diabetes to be one of theseven major controllable risk factors for cardiovascular disease. Why are people with diabetes at increased risk for CVD? Diabetes is treatable, but even when glucose levels are under control it greatly increases the risk of heart disease and stroke. That's because people with diabetes, particularly type 2 diabetes,may have the following conditions that contribute to their risk for developing cardiovascular disease. High blood pressure has long been recognized as a major risk factor for cardiovascular disease. Studies report a positive association between hypertension and insulin resistance. When patients have both hypertension and diabetes, which is a common combination, their risk for cardiovascular disease doubles. Abnormal cholesterol and high triglycerides Patients with diabetes often have unhealthy cholesterol levels including high LDL ("bad") cholesterol, low HDL ("good") cholesterol, and high triglycerides. This triad of poor lipid counts often occurs in patients with premature coronary heart disease. It is also characteristic of a lipid disorder associated with insulin resistance called atherogenic dyslipidemia, or diabetic dyslipidemia in those patients with diabetes. Learn more about cholesterol abnormalities as they relate to diabetes. Obesity is a major risk factor for cardiovascular disease and has been strongly associated with insulin Continue reading >>
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
- Diabetes and cardiovascular disease: A deadly duo
Your Weight And Heart Disease
How does my weight affect my health? Research shows that being overweight or obese can: raise your blood cholesterol levels increase your blood pressure increase your risk of developing Type 2 diabetes. Because these are risk factors for coronary heart disease, your weight can have a big impact on your long-term health. Even if you don't have any of these conditions, it's important to keep to a healthy weight so you don't develop them in future. What can I do to keep my heart healthy? The good news is that if you’re overweight or obese, you can reduce your risk of coronary heart disease by reaching and keeping to a healthy weight. Continue reading >>
The 10 Biggest Risk Factors For Heart Disease
The 10 Biggest Risk Factors for Heart Disease The 10 Biggest Risk Factors for Heart Disease 1120 747 Romanhood Romanhood The world can be a scary place. Killer storms, terrorist attacks, and disease are front page news practically everyday. It can make you scared to step foot outside. But shocking truth is that despite all the terrible things happening around the world, the biggest risk to your life is right there in the room with you. Heart disease remains the leading cause of death in the United Statesfor men and womenkilling about 600,000 people each year. Thats roughly 1 in 4 total deaths, or more than all cancer deaths combined. Men have a higher risk of heart disease than women until the age of 75 The good news is that many of the factors that lead to heart disease are avoidable, and other factors are treatable with easy to get, inexpensive medications and a few simple lifestyle changes. Heart health is a scary thing to think about, but theres a heck of a lot more you can do for your heart than the next superstorm. Get to know the 10 biggest risk factors that contribute to heart disease so you can prevent falling victim to the real biggest killer in the US. Heart Disease: Non-modifiable Risk Factors Lets start with the bad news first: Theres nothing you can do about three of the biggest risk factors for heart disease. Your age, family history, and even your gender are all strong risk factors for heart disease. Thats the bad news. The good news is that knowing how these risk factors affect you can help you and your doctor reduce their impact. In fact, it might even bemore important to address existing conditions like high cholesterol and blood pressure as you age and if you have a strong family history of heart disease. Good heart health starts with awareness. Her Continue reading >>
Obesity: Effects On Cardiovascular Disease And Its Diagnosis
Obesity: Effects on Cardiovascular Disease and its Diagnosis Department of Cardiology (BM, AK, JC), State University of New York Upstate Medical University, Syracuse Department of Internal Medicine (LF), State University of New York Upstate Medical University, Syracuse Corresponding author: Boban Mathew, MD, MRCP, DM, Department of Cardiology, SUNY Upstate Medical University, 750 East Adam Street, Syracuse, NY 13210 (E-mail:bmathew6{at}yahoo.com) The higher prevalence of cardiovascular disease in obese individuals is indirectly mediated, to a large extent, by the increased frequency of various well known risk factors like hypertension, diabetes, and dyslipidemia, either individually or as part of the metabolic syndrome. However, there are several ways in which obesity directly affects the cardiovascular system; these will be discussed in detail. We also focus on various challenges posed by obesity in the performance and interpretation of cardiac investigations and how they can be addressed. The incidence of obesity started growing to epidemic proportions in the 1980s. Currently more than 30% of the US population is obese (body mass index [BMI] 30) and nearly two thirds are overweight (BMI between 25 and 29.9). These figures are expected to rise further if the current trend continues 13 (see Table 1 4 ). There are 2 distinct genetic mechanisms involved in obesity. One is caused by the infrequent presence of certain genes, which produce rare syndromes associated with significant obesity. However, obesity is much more commonly mediated by the presence of other susceptibility genes. More than 41 such genetic sites have been identified and in their presence obesity will develop only if there is a favorable environment. 5 ,6 These genes control different processes, such as r Continue reading >>
- Why High-Fat vs. Low-Fat Dairy May Be Better Suited for Those with Diabetes, Obesity, and Cardiovascular Disease
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
The Medical Risks Of Obesity
1Division of Endocrinology, Diabetes and Nutrition, St. Luke's-Roosevelt Hospital Center, Columbia University, New York, NY Correspondence: Xavier Pi-Sunyer, MD, Division of Endocrinology, Diabetes, and Nutrition, St. Luke's-Roosevelt Hospital Center, 1111 Amsterdam Avenue, Room 1020, New York, NY 10025. Tel: 212-523-4161 Fax: 212-523-4830 [email protected] The publisher's final edited version of this article is available at Postgrad Med See other articles in PMC that cite the published article. Obesity is at epidemic proportions in the United States and in other developed and developing countries. The prevalence of obesity is increasing not only in adults, but especially among children and adolescents. In the United States in 2003 to 2004, 17.1% of children and adolescents were overweight, and 32.2% of adults were obese. Obesity is a significant risk factor for and contributor to increased morbidity and mortality, most importantly from cardiovascular disease (CVD) and diabetes, but also from cancer and chronic diseases, including osteoarthritis, liver and kidney disease, sleep apnea, and depression. The prevalence of obesity has increased steadily over the past 5 decades, and obesity may have a significant impact on quality-adjusted life years. Obesity is also strongly associated with an increased risk of all-cause mortality as well as cardiovascular and cancer mortality. Despite the substantial effects of obesity, weight loss can result in a significant reduction in risk for the majority of these comorbid conditions. Those comorbidities most closely linked to obesity must be identified to increase awareness of potential adverse outcomes. This will allow health care professionals to identify and implement appropriate interventions to reduce patient risk and mortality. Continue reading >>
Bioc3600 Obesity, Diabetes And Cardiovascular Disease
Here are about 220 papers that I consulted when preparing these lectures. There is is no need to read them all, this list is mainly for the use of teaching staff who are maintaining this website. There should be links to all the papers that are mentioned on the slides. They are provided so that people can follow up ideas that they find interesting, and also to illuminate areas where I was particularly obscure. The links from the authors' names (or sometimes from the DOI) will often take you to the abstract, at which point you can opt to either read the full text HTML report, or alternatively download the PDF version. Abramson & Wright (2007) Are lipid-lowering guidelines evidence-based? The Lancet 369, 168169. Adams et al (2006) Overweight, Obesity, and Mortality in a Large Prospective Cohort of Persons 50 to 71 Years Old. N Engl J Med 355, 763778. Adan et al (2008) Anti-obesity drugs and neural circuits of feeding. Trends in Pharmacological Sciences 29, 208-217. Ahmed (2005) Advanced glycation endproducts role in pathology of diabetic complications. Diabetes Research and Clinical Practice 67, 3-21. Ait-Oufella et al (2009) Cytokine network and T cell immunity in atherosclerosis. Semin Immunopathol 31, 2333. Andrews et al (2008) UCP2 mediates ghrelins action on NPY / AgRP neurons by lowering free radicals. Nature 454, 846851. Aragones et al (2008) Oxygen Sensors at the Crossroad of Metabolism. Cell Metabolism 9, 1122. Ashall et al (2009) Pulsatile Stimulation Determines Timing and Specificity of NF-B-Dependent Transcription. Science 324, 242246. Ashcroft (2006) K-ATP channels and insulin secretion: a key role in health and disease. Biochem. Soc. Trans. 34, 243-246. Avruch et al (2009) Amino acid regulation of TOR complex 1. Am J Physiol Endocrinol Metab 296, 592602. Ba Continue reading >>
- Why High-Fat vs. Low-Fat Dairy May Be Better Suited for Those with Diabetes, Obesity, and Cardiovascular Disease
- American Diabetes Association® Releases 2018 Standards of Medical Care in Diabetes, with Notable New Recommendations for People with Cardiovascular Disease and Diabetes
- Conjoint Associations of Gestational Diabetes and Hypertension With Diabetes, Hypertension, and Cardiovascular Disease in Parents: A Retrospective Cohort Study
Why Does Obesity Increase The Risk For Cardiovascular Disease?
Abstract Insulin resistance and inflammation are recognized as important links between obesity and cardiovascular disease (CVD). Plasma free fatty acids (FFA), either released from the abnormally enlarged adipose tissue or as part of the excessive nutrient intake, produce insulin resistance and inflammation. Both insulin resistance and inflammation are tightly linked to several independent CVD risk factors such as type 2 diabetes (T2DM), hypertension, dyslipidemia and disorders of blood coagulation. Several hypotheses have been proposed to explain how increased plasma FFA levels can cause insulin resistance including a) the lipid metabolite hypothesis, b) the inflammation hypothesis, c) the hyperinsulinemia hypothesis and d) the endoplasmic reticulum (ER) stress hypothesis. The latter does not require presence of elevated plasma FFA levels and thus provides a mechanism to explain the development of insulin resistance and inflammation in all obese individuals, i.e., those with and without elevated plasma FFA levels. Hyperinsulinemia per se has been suspected to cause CVD based on epidemiologic studies which have associated chronic hyperinsulinemia with CVD without, however, establishing a cause and effect relationship. There are, however, newer results which support the hypothesis that chronic hyperinsulinemia per se can promote the development of CVD. For instance, hyperinsulinemia can activate triglyceride formation, several matrix metalloproteinases (MMP), and the tissue factor pathway of blood coagulation, all of which are known to be associated with CVD, even in the presence of "metabolic insulin resistance". Continue reading >>
- Why High-Fat vs. Low-Fat Dairy May Be Better Suited for Those with Diabetes, Obesity, and Cardiovascular Disease
- Poor sleep can increase risk of heart disease, Type 2 diabetes, stroke and more here is why a good nights rest is great for your health
- Lowering Cardiovascular Disease Risk for Patients With Diabetes
