Causes Of Death In Young Australians With Type 1 Diabetes: A Review Of Coronial Postmortem Examinations
Summary Objective: To determine the causes of death in Australians with type 1 diabetes mellitus who died aged 40 years or younger. Design and setting: Retrospective review of autopsy reports at the Department of Forensic Medicine, Sydney, New South Wales, 1 January 1994 – 31 December 2006. Main outcome measure: Causes of mortality in people with type 1 diabetes aged ≤ 40 years. Results: Of the 26 682 autopsy reports, 1914 were for individuals with diabetes (type 1, 400; type 2, 1514). Cardiovascular disease accounted for 51% of deaths (169/333) in people with type 1 diabetes aged > 40 years, versus 13% among those aged ≤ 40 years (9/67; P = 0.001). Acute complications of diabetes (27%; 18/67), unnatural deaths (28%; 19/67), and sudden unexpected deaths (22%; 15/67) were the predominant causes of death in young individuals with diabetes. Sudden unexpected death was more common in those with type 1 diabetes compared with a sex-matched control population in the same age range (22% v 5%; χ2 P < 0.001). Of the sudden unexpected deaths, 10 people were found dead in an undisturbed bed with no cause of death found at autopsy (“dead-in-bed” syndrome; mean age [SD], 30.2 [9.4] years; males : females = 4 :1). Conclusions: In deceased young people with type 1 diabetes examined by the Coroner, acute diabetic complications, unnatural causes, and sudden unexpected deaths were the predominant causes of death. The relatively high frequency of sudden unexpected deaths, such as dead-in-bed syndrome, requires further investigation. Continue reading >>
Mortality Trends In Type 1 Diabetes
The Allegheny County (Pennsylvania) Registry 1965–1999 Abstract OBJECTIVES—To investigate long-term mortality and its temporal trends as of 1 January 1999 among the 1,075 patients with type 1 diabetes (onset age <18 years, diagnosed between 1965 and 1979) who comprise the Allegheny County population-based registry. RESEARCH DESIGN AND METHODS—Overall, sex- and race-specific mortality rates per person-year of follow-up were determined. Standardized mortality ratios were also calculated. Survival analyses and Cox proportional hazard model were also used. Temporal trends were examined by dividing the cohort into three groups by year of diagnosis (1965–1969, 1970–1974, and 1975–1979). RESULTS—Living status of 972 cases was ascertained as of January 1, 1999 (ascertainment rate 90.4%). The mean duration of diabetes was 25.2 ± 5.8 (SD) years. Overall, 170 deaths were observed. The crude mortality rate was 627 per 100,000 person-years (95% CI 532–728) and standardized mortality ratio was 519 (440–602). Life-analyses by the Kaplan-Meier method indicated cumulative survival rates of 98.0% at 10 years, 92.1% at 20 years, and 79.6% at 30 years duration of diabetes. There was a significant improvement in the survival rate between the cohort diagnosed during 1965–1969 and that diagnosed during 1975–1979 by the log-rank test (P = 0.03). Mortality was higher in African-Americans than in Caucasians, but there were no differences seen by sex. The improvement in recent years was seen in both ethnic groups and sexes. CONCLUSIONS—An improvement in long-term survival was observed in the more recently diagnosed cohort. This improvement is consistent with the introduction of HbA1 testing, home blood glucose monitoring, and improved blood pressure therapy in the 1980s. Continue reading >>
Myocardial Infarction Risk Among Type 1 Diabetes Patients Equal For Both Sexes
Home Heart Health Myocardial Infarction Risk among Type 1 Diabetes Patients Equal for Both Sexes Myocardial Infarction Risk among Type 1 Diabetes Patients Equal for Both Sexes Myocardial infarction, more commonly known as heart failure, is one of the risks faced by people suffering from type 1 diabetes. This is because type 1 diabetes affects the coronary blood vessels, often causing them to constrict. This is known as coronary artery disease. It was earlier believed that men were more affected than women by coronary artery disease. However, a new study shows that women are at as much risk as men. Researchers at Gothenburg University in Sweden studied patients with type 1 diabetes who had done a coronary angiography from the year 2001 to 2013. There were approximately 2,800 people who were subjects of the study, 42 percent of which were women who were suffering from diabetes for approximately 35 years. Researchers found that only 20 percent of the women had normal coronary arteries and the rest had developed complications. Another 20 percent of the women had one constricted artery while 50 percent had more than one. The findings of the study were a positive indication according to researcher Viveca Ritsinger, as after 35 years of having diabetes, one would expect more patients to suffer from coronary artery disease. She explained that this was probably because Swedish doctors continuously monitor their patientsmost patients could maintain normal blood sugar levels after developing the condition. In addition, various other factors of cardiovascular disease risk were also monitored. Researchers conducted a seven-year follow-up study using the same patient group. The key findings are as follows: Women who did not have type 1 diabetes had a lower risk of mortality compared Continue reading >>
Morbidity And Mortality In Diabetic Patients On Peritoneal Dialysis. Twenty-five Years Of Experience At A Single Centre
Tab. 2. Causes of Hospitalisation and PD Discontinuation in Diabetic and Non-Diabetic Patients Aims: To describe PD outcomes over 25 years in a single centre, comparing hospitalisation rate, technique withdrawal, and survival between diabetic (DM) and non-diabetic (NonDM) patients. Differences between type 1 (DM1) and type 2 (DM2) diabetics were also analysed. Patients and methods: One hundred and eighteen DM patients (52 year old average, 74 men, 44 female) and 117 Non-DM (53 year old average, 64 men, 53 female), with at least 2 months on PD, 2520 (2-109) and 29.427 (2-159) months respectively, were included. Diabetics were divided in 66 DM1 and 52 DM2. The survival and hospitalisation study was also analysed in two different time periods: before 1992 (1981-1992) and after 1992 (1993-2005). Results: 93% Non-DM and 75% DM were self-sufficient to manage the PD technique (P<.001) as well as 65% of 44 blind patients. 28% of Non-DM and 15% of DM received a renal allograft (P<.001). There was no difference in transfer to haemodialysis. 18.6% of DM and 4.3% of Non-DM patients presented >4 comorbid factors on starting PD (P<.001). Hospitalisation (admissions/year) was higher in DM than in Non-DM patients (3.4 vs 1.8, P<.01) and also hospitalisation length (46 vs 22 days/year, P=.01), without differences between DM1 and DM2. Admissions due to cardiovascular events, infections, technical problems and peritonitis were more frequent in DM2 than in Non-DM and DM1 patients (P<.05). However, DM2patients admitted to hospital for peritonitis did not spend more days in hospital than Non-DM or DM1 patients. Mortality was 48% in DM and 22% in Non-DM (P<.001). Survival adjusted for comorbidity was higher in Non-DM (P<.001). Cerebrovascular disease was the highest risk factor for mortality Continue reading >>
Time Trends In Mortality In Patients With Type 1 Diabetes: Nationwide Population Based Cohort Study
Abstract Objective To examine short and long term time trends in mortality among patients with early onset (age 0-14 years) and late onset (15-29 years) type 1 diabetes and causes of deaths over time. Design Population based nationwide cohort study. Setting Finland. Participants All Finnish patients diagnosed as having type 1 diabetes below age 30 years between 1970 and 1999 (n=17 306). Main outcome measures Crude mortality, standardised mortality ratios, time trends, and cumulative mortality. Results A total of 1338 deaths occurred during 370 733 person years of follow-up, giving an all cause mortality rate of 361/100 000 person years. The standardised mortality ratio was 3.6 in the early onset cohort and 2.8 in the late onset cohort. Women had higher standardised mortality ratios than did men in both cohorts (5.5 v 3.0 in the early onset cohort; 3.6 v 2.6 in the late onset cohort). The standardised mortality ratio at 20 years’ duration of diabetes in the early onset cohort decreased from 3.5 in the patients diagnosed in 1970-4 to 1.9 in those diagnosed in 1985-9. In contrast, the standardised mortality ratio in the late onset cohort increased from 1.4 in those diagnosed in 1970-4 to 2.9 in those diagnosed in 1985-9. Mortality due to chronic complications of diabetes decreased with time in the early onset cohort but not in the late onset cohort. Mortality due to alcohol related and drug related causes increased in the late onset cohort and accounted for 39% of the deaths during the first 20 years of diabetes. Accordingly, mortality due to acute diabetic complications increased significantly in the late onset cohort. Conclusion Survival of people with early onset type 1 diabetes has improved over time, whereas survival of people with late onset type 1 diabetes has det Continue reading >>
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
- Maternal obesity as a risk factor for early childhood type 1 diabetes: a nationwide, prospective, population-based case–control study
- Improved pregnancy outcomes in women with type 1 and type 2 diabetes but substantial clinic-to-clinic variations: a prospective nationwide study
Type 1 Diabetes Linked To Lower Life Expectancy
HealthDay Reporter today lose more than a decade of life to the chronic disease, despite improved treatment of both diabetes and its complications, a new Scottish study reports. Men with type 1 diabetes lose about 11 years of life expectancy compared to men without the disease. And, women with type 1 diabetes have their lives cut short by about 13 years, according to a report published in the Jan. 6 issue of the Journal of the American Medical Association. The findings "provide a more up-to-date quantification of how much type 1 diabetes cuts your life span now, in our contemporary era," said senior author Dr. Helen Colhoun, a clinical professor in the diabetes epidemiology unit of the University of Dundee School of Medicine in Scotland. Diabetes' impact on heart health appeared to be the largest single cause of lost years, according to the study. But, the researchers also found that type 1 diabetics younger than 50 are dying in large numbers from conditions caused by issues in management of the disease -- diabetic coma caused by critically low blood sugar, and ketoacidosis caused by a lack of insulin in the body. "These conditions really reflect the day-to-day challenge that people with type 1 diabetes continue to face, how to get the right amount of insulin delivered at the right time to deal with your blood sugar levels," Colhoun said. A second study, also in JAMA, suggested that some of these early deaths might be avoided with intensive blood sugar management. In that paper, researchers reduced patients' overall risk of premature death by about a third, compared with diabetics receiving standard care, by conducting multiple blood glucose tests throughout the day and constantly adjusting insulin levels to hit very specific blood sugar levels. "Across the board, indiv Continue reading >>
Kidney Disease And Increased Mortality Risk In Type 2 Diabetes
Abstract Type 2 diabetes associates with increased risk of mortality, but how kidney disease contributes to this mortality risk among individuals with type 2 diabetes is not completely understood. Here, we examined 10-year cumulative mortality by diabetes and kidney disease status for 15,046 participants in the Third National Health and Nutrition Examination Survey (NHANES III) by linking baseline data from NHANES III with the National Death Index. Kidney disease, defined as urinary albumin/creatinine ratio ≥30 mg/g and/or estimated GFR ≤60 ml/min per 1.73 m2, was present in 9.4% and 42.3% of individuals without and with type 2 diabetes, respectively. Among people without diabetes or kidney disease (reference group), 10-year cumulative all-cause mortality was 7.7% (95% confidence interval [95% CI], 7.0%–8.3%), standardized to population age, sex, and race. Among individuals with diabetes but without kidney disease, standardized mortality was 11.5% (95% CI, 7.9%–15.2%), representing an absolute risk difference with the reference group of 3.9% (95% CI, 0.1%–7.7%), adjusted for demographics, and 3.4% (95% CI, −0.3% to 7.0%) when further adjusted for smoking, BP, and cholesterol. Among individuals with both diabetes and kidney disease, standardized mortality was 31.1% (95% CI, 24.7%–37.5%), representing an absolute risk difference with the reference group of 23.4% (95% CI, 17.0%–29.9%), adjusted for demographics, and 23.4% (95% CI, 17.2%–29.6%) when further adjusted. We observed similar patterns for cardiovascular and noncardiovascular mortality. In conclusion, those with kidney disease predominantly account for the increased mortality observed in type 2 diabetes. Continue reading >>
Diabetes Death Rates Among Youths Aged ≤19 Years — United States, 1968–2009
Persons using assistive technology might not be able to fully access information in this file. For assistance, please send e-mail to: [email protected]. Type 508 Accommodation and the title of the report in the subject line of e-mail. Weekly Although diabetes mellitus most often is diagnosed in adulthood, it remains one of the most common serious chronic diseases of childhood (1). Youths with diabetes are at risk for diabetes-related mortality because of acute complications that can result from the condition (2), including diabetic ketoacidosis and hypoglycemia (3). In the United States in 2010, an estimated 215,000 persons aged ≤19 years had diagnosed diabetes (3). Medical care for diabetes has improved considerably in recent decades, leading to improved survival rates. However, recent trends in diabetes death rates among youths aged <10 years and 10–19 years in the United States have not been reported. To assess these trends, CDC analyzed data from the National Vital Statistics System for deaths in the United States with diabetes listed as the underlying cause during 1968–2009. This report highlights the results of that analysis, which found that diabetes-related mortality decreased 61%, from an annual rate of 2.69 per million for the period 1968–1969 to a rate of 1.05 per million in 2008–2009. The percentage decrease was greater among youths aged <10 years (78%) than among youths aged 10–19 years (52%). These findings demonstrate improvements in diabetes mortality among youths but also indicate a need for continued improvement in diabetes diagnosis and care. To produce stable estimates, annual diabetes death rates among youths aged ≤19 years in the United States were calculated from National Vital Statistics System data for 2-year or 3-year periods from 196 Continue reading >>
- Incidence of End-Stage Renal Disease Attributed to Diabetes Among Persons with Diagnosed Diabetes United States and Puerto Rico, 20002014
- Disparities in Diabetes Deaths Among Children and Adolescents United States, 20002014
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Diabetes Life Expectancy
Tweet After diabetes diagnosis, many type 1 and type 2 diabetics worry about their life expectancy. Death is never a pleasant subject but it's human nature to want to know 'how long can I expect to live'. There is no hard and fast answer to the question of ‘how long can I expect to live’ as a number of factors influence one’s life expectancy. How soon diabetes was diagnosed, the progress of diabetic complications and whether one has other existing conditions will all contribute to one’s life expectancy - regardless of whether the person in question has type 1 or type 2 diabetes. How long can people with diabetes expect to live? Diabetes UK estimates in its report, Diabetes in the UK 2010: Key Statistics on Diabetes[5], that the life expectancy of someone with type 2 diabetes is likely to be reduced, as a result of the condition, by up to 10 years. People with type 1 diabetes have traditionally lived shorter lives, with life expectancy having been quoted as being reduced by over 20 years. However, improvement in diabetes care in recent decades indicates that people with type 1 diabetes are now living significantly longer. Results of a 30 year study by the University of Pittsburgh, published in 2012, noted that people with type 1 diabetes born after 1965 had a life expectancy of 69 years.[76] How does diabetic life expectancy compare with people in general? The Office for National Statistics estimates life expectancy amongst new births to be: 77 years for males 81 years for females. Amongst those who are currently 65 years old, the average man can expect to live until 83 years old and the average woman to live until 85 years old. What causes a shorter life expectancy in diabetics? Higher blood sugars over a period of time allow diabetic complications to set in, su Continue reading >>
Gender Disparities In Mortality In Patients With Type 1 Diabetes
Editor's Note: Commentary based on Huxley RR, Peters SAE, Mishra GD, Woodward M. Risk of all-cause mortality and vascular events in women versus men with type 1 diabetes: a systematic review and meta-analysis. Lancet Diabetes Endocrinol 2015;3:198-206. Background It is known that type 1 diabetes leads to premature death. Type 1 diabetes, unlike other autoimmune diseases, affects both males and females equally. Although women generally have lower mortality than men, Huxley et al. examined mortality rates for those with type 1 diabetes to see if this gender protection extends to mortality in those with type 1 diabetes. Prior studies have shown that women often have inadequate control of diabetes compared to men. Although some small studies have shown that women with type 1 diabetes have higher mortality, this paper was the first meta-analysis to quantify sex differences in all-cause as well as cause-specific events and mortality in those with type 1 diabetes. Methods A meta-analysis of studies was performed that reported sex-specific standardized mortality ratio (SMR) or hazard ratios associated with type 1 diabetes for either all-cause mortality or various other outcomes. This analysis examined within-sex excess mortality due to type 1 diabetes. A random effects meta-analysis with inverse variance weighting was performed to obtain sex-specific pooled SMRs for all-cause mortality, or mortality from cardiovascular (CVD) disease, renal disease, cancer, accident or suicide, as well incident coronary heart disease (CHD) and stroke. Subgroup analyses were done by baseline year of data collection, by region, by duration of study follow-up, by age of study participants, type of study design, and by quality of study. Results Data from 214,114 individuals with type 1 diabetes from Continue reading >>
Hypoglycemia In Children With Type 1 Diabetes: Unawareness Is A Concrete Risk
The incidence of type 1 diabetes (T1D) is increasing rapidly, especially in younger age groups. The data from Western European Diabetes Mellitus Centers suggest an annual rate increase of 3–4% in children and adolescents1. The latest worldwide estimates show 415 million of patients with diabetes overall, that would become 642 million around 2040; there are 86,000 new cases a year of T1D among children and 542,000 patients worldwide2. The incidence varies approximately 400-fold between nations, with wide variations among regions of the same state. For example, the incidence of T1D in Italy is significantly different from the observed rate in Sardinia3 (epidemiologic data in 2011: 45/100,000 new cases per year between 0 and 14 years of age), that has a trend of increase second only to Finland2,4. International consensus and guidelines have underlined the relevance of multiple dose insulin therapy to obtain a near physiological glycosylated hemoglobin (HbA1c) that may prevent or slow the progression of chronic complications of T1D5. The Diabetes Control and Complications Trial (DCCT) has demonstrated that intensive therapy delays microvascular complications in adolescents and adults and euglycemia has a great impact on the management of diabetes in the young6. However, a stricter control of glycemic values also increases the risk of severe hypoglycemia7. Severe hypoglycemia is one of the most dangerous acute complications during insulin treatment in patients with T1D. Hypoglycemia is defined as an abnormally low plasma glucose concentration that may expose the individual to potential harm8. Metabolic impairment is a basic aspect in diabetes and may have severe outcomes on multiple physiologic pathways; glycemic control has a relevant role in this metabolic change and it Continue reading >>
Glycemic Control And Excess Mortality In Type 1 Diabetes
The excess risk of death from any cause and of death from cardiovascular causes is unknown among patients with type 1 diabetes and various levels of glycemic control. We conducted a registry-based observational study to determine the excess risk of death according to the level of glycemic control in a Swedish population of patients with diabetes. We included in our study patients with type 1 diabetes registered in the Swedish National Diabetes Register after January 1, 1998. For each patient, five controls were randomly selected from the general population and matched according to age, sex, and county. Patients and controls were followed until December 31, 2011, through the Swedish Register for Cause-Specific Mortality. The mean age of the patients with diabetes and the controls at baseline was 35.8 and 35.7 years, respectively, and 45.1% of the participants in each group were women. The mean follow-up in the diabetes and control groups was 8.0 and 8.3 years, respectively. Overall, 2701 of 33,915 patients with diabetes (8.0%) died, as compared with 4835 of 169,249 controls (2.9%) (adjusted hazard ratio, 3.52; 95% confidence interval [CI], 3.06 to 4.04); the corresponding rates of death from cardiovascular causes were 2.7% and 0.9% (adjusted hazard ratio, 4.60; 95% CI, 3.47 to 6.10). The multivariable-adjusted hazard ratios for death from any cause according to the glycated hemoglobin level for patients with diabetes as compared with controls were 2.36 (95% CI, 1.97 to 2.83) for a glycated hemoglobin level of 6.9% or lower (≤52 mmol per mole), 2.38 (95% CI, 2.02 to 2.80) for a level of 7.0 to 7.8% (53 to 62 mmol per mole), 3.11 (95% CI, 2.66 to 3.62) for a level of 7.9 to 8.7% (63 to 72 mmol per mole), 3.65 (95% CI, 3.11 to 4.30) for a level of 8.8 to 9.6% (73 to 82 mm Continue reading >>
- Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators
- The effect of a low-carbohydrate, ketogenic diet versus a low-glycemic index diet on glycemic control in type 2 diabetes mellitus
- Mortality and Cardiovascular Disease in Type 1 and Type 2 Diabetes
Mortality Rates For Type 1 Diabetes Patients Still Too High
Despite major advances in the treatment of type 1 diabetes over the past 30 years, type 1 men are living approximately 11 fewer years than their non-diabetic peers. For women, the years lost is even higher at 13…. Scottish researchers examined data from a prospective cohort of patients in Scotland with type 1 diabetes who were aged 20 years or older from 2008 through 2010 and were in a nationwide register (n=24,691 contributing 67,712 person-years and 1,043 deaths). Life expectancy at an attained age of 20 years was an additional 46.2 years among men with type 1 diabetes and 57.3 years among men without it, an estimated loss in life expectancy with diabetes of 11.1 years (95% CI, 10.1-12.1). Life expectancy from age 20 years was an additional 48.1 years among women with type 1 diabetes and 61.0 years among women without it, an estimated loss with diabetes of 12.9 years (95% CI, 11.7-14.1). Even among those with type 1 diabetes with an estimated glomerular filtration rate of 90 mL/min/1.73 m2 or higher, life expectancy was reduced (49.0 years in men, 53.1 years in women) giving an estimated loss from age 20 years of 8.3 years (95% CI, 6.5-10.1) for men and 7.9 years (95% CI, 5.5-10.3) for women. Overall, the largest percentage of the estimated loss in life expectancy was related to ischemic heart disease (36% in men, 31% in women) but death from diabetic coma or ketoacidosis was associated with the largest percentage of the estimated loss occurring before age 50 years (29.4% in men, 21.7% in women). The researchers concluded that, “Estimated life expectancy for patients with type 1 diabetes in Scotland based on data from 2008 through 2010 indicated an estimated loss of life expectancy at age 20 years of approximately 11 years for men and 13 years for women compared w Continue reading >>
Joslin Researchers On Type 1 Mortality: There’s Still More To Be Done
Since the advent of insulin in the 1920s, deaths from type 1 diabetes have steadily decreased. In the decades since, innovations and technologies have prolonged patients’ lives even longer, and with far fewer complications from the disease. But that doesn’t mean our work is done. Joslin physicians Lori Laffel, M.D., M.P.H., Chief of Clinical Programs for Children, Adolescents and Young Adults at Joslin Diabetes Center, Senior Investigator in the Section on Genetics and Epidemiology and Professor of Pediatrics at Harvard Medical School, and Michelle Katz, M.D., M.P.H., Associate Director of the Pediatric, Adolescent and Young Adult Section at Joslin Diabetes Center and Instructor of Medicine at Harvard Medical School, recently co-authored an editorial in the January issue of the Journal of the American Medical Association. In response to two studies also published in the January issue, Drs. Laffel and Katz aimed to comment on the current trends of type 1 mortality, its historical context, and what still needs to be done to prolong the lives of type 1 patients. To fully realize the potential benefits for persons with type 1 diabetes from the information presented in these papers, Dr. Katz and Dr. Laffel focus on recommendations for achieving life-long glycemic control. Their editorial identifies special areas of concern, particularly during the transition from pediatric care into adult care, and suggests outreach efforts to make sure these patients don’t fall too far behind in their self-care “These papers are very important and we were pleased to write an editorial framing the studies within the context of management of type 1 diabetes in the 21st century, both locally and globally,” says Dr. Laffel. The first paper was a follow up study to the landmark Diabete Continue reading >>
5 Common Type 1 Diabetes Complications
3 0 Type 1 diabetes carries with it a much higher risk of developing some associated serious health problems. While in the past, getting diabetes-related health complications was almost a certainty, with modern blood glucose monitoring, control, and treatment, the risks have decreased significantly. Even a few decades ago, life expectancy for people with diabetes was regularly considered to be 10 years shorter than for people without the disorder. In 2012, however, a large-scale study found that life-expectancy was now only about 6 years less than average. For comparison, a lifetime of smoking will reduce life expectancy by 10 years. So what are the diabetes complications that you need to be looking out for? Largely, they fall into either cardiovascular or neuropathic categories. To make diabetes complications even more complicated, they tend to affect people of different sexes and different ethnicities differently. One more wild card is that recent studies have found that some people with Type 1 diabetes actually never develop most of the complications associated with diabetes. The good news is that with proper blood glucose control and a healthy lifestyle, the risks for developing Type 1 diabetes complications are drastically reduced. Some studies have actually found that careful monitoring and management can reduce the chances of developing any of these by as much as 50%. Still, everyone with Type 1 diabetes should keep a careful eye out for the five most common diabetes complications. Diabetic Ketoacidosis Diabetic Ketoacidosis (or DKA), is a condition caused by severe hyperglycemia (high blood sugar) which causes rapid fat breakdown in the body. As the fat breaks down, they release fatty acids which are then converted into chemicals called ketones, which are highly Continue reading >>
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- Type 2 diabetes, once considered a disease for adults, is increasingly common in tweens and teens
