Ada Releases Standards Of Medical Care For Patients With Diabetes
Diabetes requires continuing medical care and patient self-management to prevent acute complications and to reduce the risk of long-term complications. Diabetes care is complex and requires that many issues—not only glycemic control—be managed. To address these issues, the American Diabetes Association (ADA) published a position statement containing evidence-based recommendations for diabetes care, treatment goals, and tools to evaluate the quality of care. The full statement, “Standards of Medical Care in Diabetes—2006,” was published in the January 2006 supplement to Diabetes Care. Screening Type 2 diabetes usually is not diagnosed until complications develop, and approximately one third of all persons with diabetes may be undiagnosed. Screening to detect prediabetes should be considered in persons 45 years and older, particularly in persons with a body mass index (BMI) of at least 25 kg per m2. Screening also should be considered in persons who are younger than 45 years if they are overweight and have an additional risk factor (Table 1). Screening for prediabetes and diabetes should be performed in high-risk, asymptomatic children (Table 2) and adults. If test results are normal, repeat testing should be performed at three-year intervals in adults and at two-year intervals in children. TABLE 1 Testing should be considered in all persons 45 years and older, particularly in persons with a BMI of 25 kg per m2 or greater. If test results are normal, testing should be repeated at three-year intervals. Testing should be considered in younger persons and performed more frequently in persons with a BMI of 25 kg per m2 or greater who have additional risk factors, such as those who: Are habitually physically inactive Are members of a high-risk ethnic population (e.g. Continue reading >>
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Cholesterol, Triglycerides And Your Health
Cholesterol, triglycerides and your health Lowering your blood cholesterol levels by modifying your lifestyle and eating habits will dramatically reduce your risk of cardiovascular disease including having a fatal or disabling heart attack or stroke Approximately half of adult Australians have a total blood cholesterol level higher than what is recommended safe! This makes high blood cholesterol a major health concern in Australia. Cholesterol and triglycerides are separate types of 'lipids' (a building block of cells in the body) that circulate in your blood. Cholesterol is produced naturally by the liver and is used to build and maintain cells. Triglycerides store unused calories and provide your body with energy. LDL (low-density lipoprotein) cholesterol is called the 'bad' cholesterol because: It can help form plaques and contribute to atherosclerosis. Higher levels reflect an increased risk of cardiovascular disease. HDL (high-density lipoprotein) cholesterol is called the 'good' cholesterol because: It helps to remove excess cholesterol from plaques and thus slow plaque growth. Lower levels reflect a higher risk of diabetes and cardiovascular disease. The liver returns the cholesterol it cannot use to our bloodstream. An excess of cholesterol in our bloodstream can cause fatty deposits ('plaques') to form in our arteries. This is a process that occurs over time called atherosclerosis. These deposits cause the arteries to narrow and can eventually block them completely, leading to a heart attack or stroke. Any excess calories from foods that are not needed for quick energy are turned into triglycerides and stored in fat cells to be used later. Eating more calories than you burn could result in high triglycerides. High levels of cholesterol and triglycerides alone, Continue reading >>
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Cholesterol Levels In Children And Adolescents
The American Academy of Pediatrics (AAP) recommends all children between 9 and 11 years old are screened for high blood cholesterol levels due to the growing epidemic of obesity in children. In addition, the AAP recommends cholesterol testing for the following groups of children: Those whose parents or grandparents have had heart attacks or have been diagnosed with blocked arteries or disease affecting the blood vessels, such as stroke, at age 55 or earlier in men, or 65 or earlier in women Those whose parents or grandparents have total blood cholesterol levels of 240 mg/dL or higher Those whose family health background is not known (eg, many adopted children), or those who have characteristics associated with heart disease, such as high blood pressure, diabetes, smoking, or obesity For children in these categories, their first cholesterol test should be after 2 years but no later than 10 years of age. A child may have high cholesterol for a variety of reasons such as obesity, diabetes, liver disease, kidney disease, or an underactive thyroid. If an initial test shows high cholesterol, your pediatrician will check your child’s blood again at least 2 weeks later to confirm the results. If it is still high, the doctor will also determine if your child has an underlying condition. A recent government report indicated that there is good evidence that children with cholesterol problems become adults with high cholesterol. So it is important to monitor the cholesterol of children who may have an increased risk of elevated cholesterol. Source Adapted from Nutrition: What Every Parent Needs to Know (Copyright © American Academy of Pediatrics 2011) The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatri Continue reading >>
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Diabetes, Cholesterol, Bp: Normal Is No Longer Normal
Pre-diabetes On 10 June 2014 there were global headlines about a ‘condition’ called pre-diabetes. From the Mail telling us that “A third of adults have ‘borderline’ diabetes – but most don’t know: Rising tide of obesity means number who have ‘pre-diabetes‘ has trebled since 2006″ to the Huffington Post proclaiming “Most People In England Have Borderline Diabetes, New Study Reveals“. One third was never most people when I did proportions, but anyway. Here is the summary of the study and findings from a journal web site and here is the original (full) article. A quick review of the article should have made the media far more challenging, instead of just taking the press release headlines: 1) The study used data already gathered for Health Survey England (HSE), which started in 1991. The number of adults involved in the HSE, from whom blood samples were taken, was 7,455 in 2003; 6,347 in 2006 and 1,951 in 2009. I can’t find the numbers for 2011, but they are likely to be small if the trajectory continues. There are over 40 million adults in England. Using 2009 as a guide, projections on this concept of ‘pre-diabetes’ have been made based on 0.0048% of the population. I can’t get my head around such numbers. 2) People were diagnosed with pre-diabetes if they had glycated haemoglobin (an indicator of blood sugar levels) between 5.7% and 6.4%. This is the US guideline for ‘pre-diabetes’. The UK guideline is 6.0-6.4%. This would have over-predicted the idea of having a pre-condition. 3) The introduction to the full article in the BMJ is worth a read. The introduction notes that England set up a scheme to offer people aged between 40 and 74 a health check to try to pick up blood glucose concerns (and other things). Then it admits that “the Continue reading >>
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The Dangers Of High Cholesterol And Diabetes
Scientists are finding evidence that diabetes itself wreaks havoc with cholesterol, significantly increasing the likelihood of a heart attack or stroke even higher. The close ties between these two risk factors mean that if you are diabetic, you have to be extremely vigilant about controlling your cholesterol. Link Between Insulin and Cholesterol Researchers are still figuring out exactly how diabetes changes cholesterol levels at the microscopic cellular level. They do know that high levels of insulin in the blood tend to adversely affect the number of cholesterol particles in the blood. High insulin levels act to raise the amount of LDL-cholesterol (the "bad cholesterol") that tends to form plaques in arteries and lower the number of HDL cholesterol particles ("good cholesterol") that help to clear out dangerous plaques before they break off to cause a heart attack or stroke. Diabetes also tends to cause higher levels of triglycerides, another type of fat circulating in the blood. Similarly, high cholesterol can also be a predictor of diabetes; elevated cholesterol levels are often seen in people with insulin resistance, even before they have developed full-blown diabetes. When LDL levels start to climb, experts recommend paying close attention to blood sugar control and starting a diet and exercise regimen to help stave off diabetes and cardiovascular disease. This is especially important if you have a family history of heart disease. For people with Type 1 diabetes, controlling blood sugar can make a big difference. Good blood sugar control is related to near-normal cholesterol levels, similar to those seen in people without diabetes. But people with poorly controlled Type 1 diabetes have increased triglyceride levels and lower HDL levels, which contribute to the de Continue reading >>
Cholesterol Metabolism In Type 1 Diabetes
Little information is available on cholesterol absorption and synthesis in human type 1 diabetes. We studied these variables using serum cholesterol precursor sterol ratios to cholesterol as surrogate markers of cholesterol synthesis and those of cholestanol and plant sterols to reflect cholesterol absorption in seven type 1 diabetic subjects and in five age- and body weight–matched control subjects. Total and lipoprotein cholesterol levels were similar, but triglycerides in intermediate-density lipoprotein (IDL) and LDL were higher in type 1 diabetic than in control subjects. Most of the marker sterols were transported by LDL and HDL in both groups. The percentage of esterified cholesterol was lower in triglyceride-rich lipoproteins in diabetic patients than in control subjects. The ratios of the absorption marker sterols in serum were higher, and those of the synthesis markers were lower in type 1 diabetic than in control subjects. The increased cholestanol ratios were seen in all lipoproteins, and those of free and total plant sterols were mainly in LDL, whereas the decreased free and total synthesis markers were mainly in all lipoproteins. In conclusion, high absorption and low synthesis marker sterols seem to characterize human type 1 diabetes. These findings could be related to low expression of ABC G/5 G/8 genes, resulting in high absorption of cholesterol and sterols in general and low synthesis of cholesterol compared with type 2 diabetes. Patients with type 2 diabetes frequently have dyslipidemia and altered metabolism of triglyceride-rich lipoproteins. In addition, cholesterol metabolism is changed, such that cholesterol absorption efficiency and serum plant sterols, reflecting cholesterol absorption (1), are low (2,3) and serum cholesterol precursor sterol Continue reading >>
Cholesterol Screening Tests And Diabetes
Reviewed by Minesh Khatri, MD on October 14, 2017 When you have diabetes, you're more likely to get heart disease. Because of that, you need to have your cholesterol levels and triglycerides (a type of blood fat) checked at least once a year. A simple blood test is all you need. It also helps to know as much as you can about cholesterol and the steps you can take to keep your levels where they should be. The golden rule: Keep your bad LDL cholesterol level down and your good HDL level up. Your body actually needs some cholesterol. But many people have too much of the bad kind and not enough of the good. Over time, that can lead to a buildup called plaque in your arteries, leaving less space for blood to flow. Blocked heart vessels can cause chest pain, a heart attack, or a stroke. The "good" HDL cholesterol helps your body get rid of the "bad" LDL. The higher your HDL level, the better. Another type of blood fat, called triglycerides, also makes heart disease more likely, although its not the same as cholesterol. You want to keep your triglyceride levels low. Diet.Saturated fat in the foods you eat raises your bad cholesterol level. Weight.Extra pounds increase your cholesterol and your chance of getting heart disease. Exercise.Get it regularly, since that can lower "bad" cholesterol and bring up the "good." Genes.They influence how much cholesterol your body makes. High levels can run in families. Other causes.Certain medications and medical conditions can raise your levels. High triglycerides could come from diabetes or thyroid problems. It can help to lose extra weight and avoid foods that are high in calories. What Should My Total Cholesterol Level Be? A blood test is all you need to find out what your cholesterol level is. Your doctor may recommend that you fast f Continue reading >>
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Know Your Numbers For A Healthy Heart
Many people get the shock of their lives when they discover unexpectedly that their coronary arteries are blocked. Especially if they're fit and active, the surprise is even bigger. Doctors often discover that patients are a walking timebomb; and that they have been suffering, albeit silently, from high cholesterol and blocked arteries (artherosclerosis) long before heart disease is diagnosed. Sometimes artherosclerosis can be so severe, and the risk for heart attack so immense, that the patient has to undergo coronary artery bypass surgery as an emergency measure. But the news is not all bad: most recover from the surgery, and with cholesterol-lowering drugs, daily exercise, a low-fat eating plan, and regular check-ups, their heart disease is now controlled. Many others are not as fortunate. Heart disease claims more than 12 million lives around the world each year, and South Africa has a very high rate: every eight minutes another South African has a heart attack. Every fourth one is fatal. Are you (unwittingly) heading for a heart attack? According to the Heart and Stroke Foundation of South Africa, the six main “health checks” that every South African should consider are: blood pressure, blood cholesterol levels, BMI, presence of diabetes, whether you smoke or not, and your physical activity level High blood pressure, raised cholesterol and diabetes can develop without any symptoms, and are often only diagnosed after causing substantial damage to your health. For good heart health, don’t smoke. Eat wisely: limit your intake of saturated fat and trans fatty acids, and eat at least five portions of fruit and vegetables daily. According to US Surgeon General recommendations, 30 minutes of exercise that increases the heart rate, every day of the week, would preven Continue reading >>
Cholesterol & Diabetes
Most adults with type 1 or type 2 diabetes are at high risk for cardiovascular diseases such as heart attack and stroke. People with diabetes have an increased risk of these diseases even if their low-density lipoprotein, or LDL ("bad") cholesterol, is “normal.” They have an even higher risk if their LDL-cholesterol is elevated. Definitions Cardiovascular disease: Damage to the heart and blood vessels. One cause is narrowing of the blood vessels due to fat deposits on the vessel walls, which limits blood flow. Cholesterol: A fat substance that is naturally present in your blood and cells. There are two main types of cholesterol: LDL and HDL. LDL (low-density lipoprotein): Often called “bad” cholesterol because higher levels of LDL can increase the risk of cardiovascular disease. HDL (high-density lipoprotein): Often called “good” cholesterol because higher levels of HDL can reduce the risk of cardiovascular disease. Triglyceride: A form of fat that the body makes from sugar, alcohol or other food sources. Have you had your cholesterol tested lately? Adults with diabetes should have their cholesterol tested yearly or as indicated by your health-care provider. More frequent testing may be necessary for people taking cholesterol medications. Always discuss your cholesterol results with your doctor and other members of your health-care team. Have you been told that you have high cholesterol? High cholesterol usually refers to high LDL (“bad”) cholesterol. The main goal is to lower LDL-cholesterol. Check with your health-care provider to find out if you should be on medication to accomplish this. Weight management, healthy eating and regular physical activity will also help you reach this goal. Diabetes management requires good blood glucose (sugar), blood pr Continue reading >>
Diabetes And High Cholesterol 101
Cholesterol is a type of fat found in the blood. Everyone has it, but people with diabetes are more likely to have unhealthy levels of LDL, which can cause narrowing or blocking of the blood vessels. This blockage, when severe, keeps blood from reaching some areas of the heart, increasing your risk for a heart attack or stroke. There are two types of cholesterol in the blood: HDL and LDL. LDL levels should be kept low to help protect your heart. By contrast, HDL is a healthy fat that helps clear fatty deposits from your blood vessels and protect your heart. Try thinking "L should be low, H is healthy" to help you remember the difference between the two types. Triglycerides are another type of fat in your blood that can add to your risk of a heart attack or stroke at high levels, similar to the effect of high cholesterol. Know the Numbers What are the low and high levels of cholesterol for those with diabetes? According to the American Diabetes Association (ADA), most adults with diabetes should aim for an LDL level of less than 100 mg/dl. The ADA-recommended HDL levels are greater than 40 mg/dl for men with diabetes and greater than 50 mg/dl for women with diabetes. The ADA recommends that both men and women with diabetes aim for triglyceride levels less than 150 mg/dl. What's mg/dl? It stands for milligrams of cholesterol per deciliter of blood -- the standard unit of measure for cholesterol and triglycerides. Everyone, including people with diabetes, needs some cholesterol in their blood to help build healthy cells. However, there are no symptoms to alert you if your LDL is too high or your HDL is too low. A blood test at your doctor's office is the only way to know. As a result, it is especially important to have your cholesterol checked regularly (at least yearly) i Continue reading >>
Stay Healthy | Living With Diabetes | Diabetes | Cdc
To receive email updates about this page, enter your email address: Its very important for you to take your diabetes medicines exactly as directed. Not taking medications correctly may lower the level of glucose and cause the insulin your body to go up. The medicines then become less effective when taken. Some people report not feeling well as a reason for stopping their medication or not taking it as prescribed. Tell your doctor if your medicines are making you sick. He or she may be able to help you deal with side effects so you can feel better. Dont just stop taking your medicines, because your health depends on it. This section provides information about staying healthy with your diabetes. What routine medical examinations and tests are needed for people with diabetes? Measure your blood pressure at every visit. Check your feet for sores at every visit, and give a thorough foot exam at least once a year. Give you a hemoglobin A1C test at least twice a year to determine what your average blood glucose level was for the past 2 to 3 months. Test your urine and blood to check your kidney function at least once a year. Test your blood lipids (fats)total cholesterol; LDL, or low-density lipoprotein (bad cholesterol); HDL, or high-density lipoprotein (good cholesterol); and triglycerides at least once a year. You should also get a dental checkup twice a year, a dilated eye exam once a year, an annual flu shot, and a pneumonia shot. For more information, see Tests and Goals for Each Visit and Tests and Goals for Each Year from the Center for Disease Control and Preventions (CDC) publication, Take Charge of Your Diabetes. How does maintaining healthy blood glucose levels help people with diabetes stay healthy? Research studies in the United States and other countries have s Continue reading >>
What Is High Cholesterol?
High cholesterol is a condition that occurs when levels of cholesterol in your blood are elevated enough to cause health problems such as heart disease. Heart disease is the leading cause of death in the United States, according to the American Heart Association. High cholesterol — sometimes known as hypercholesterolemia — is painless and doesn't cause any symptoms. What Is Cholesterol? Cholesterol is a dense, fatty substance found in every cell of your body. Produced by your liver, cholesterol is essential to many life-sustaining functions. It helps your body make hormones and vitamin D, and it's also found in compounds — such as bile — that your body creates to help you digest food. Cholesterol circulates throughout your bloodstream in little bundles called lipoproteins. The interior of these bundles is composed of fat, while proteins form the exterior walls. Types of Cholesterol There are two main categories of cholesterol in the blood: Low-density lipoproteins (LDL) Considered cholesterol's "bad" form, LDL enables cholesterol to create deposits (plaque) that build up and harden on the walls of blood vessels. When this happens in the coronary arteries (the arteries that serve your heart), it reduces your heart's supply of oxygen-rich blood. Narrowed, stiffened coronary arteries cause the disease atherosclerosis, commonly called "hardening of the arteries." This is a serious condition that can cause heart attacks, strokes, and even death. These plaques can also form on the arteries that supply blood to your brain, abdomen, arms, and legs, leading to a higher risk of stroke, intestinal damage, and peripheral arterial disease. High-density lipoproteins (HDL) HDL is the "good" kind of cholesterol, because it helps reduce LDL levels. The role of HDL is to transpor Continue reading >>
Cholesterol
People with diabetes generally have similar total cholesterol levels and similar rates of the 'good' (HDL) cholesterol as the general population. However, people with diabetes, on average, have higher levels of 'bad' (LDL) cholesterol and higher levels of triglycerides than people without diabetes. This is because diabetes can upset the balance between 'good' (HDL) and 'bad' (LDL) cholesterol levels in a number of ways. People with diabetes tend to have 'bad' cholesterol particles that stick to arteries and damage their walls more easily. High levels of glucose in the blood can result in 'bad' cholesterol staying in the blood stream for longer People with diabetes tend to have low HDL and high triglyceride (another blood fat) levels, both of which boost the risk of heart and artery disease. This means that people with diabetes are at a higher risk of: Heart disease, including heart attack and stroke Circulation problems which can lead to damage to hands, feet and legs Improving Blood Cholesterol There is strong evidence to suggest that lifestyle changes, like eating a healthy diet and doing regular physical activity, can significantly improve the blood cholesterol levels of people with diabetes. In Australia, eating less saturated fat is one of the most practical ways to lower cholesterol. Low cholesterol or cholesterol free foods may be useful for some people, but check that they also low in saturated fat. You should focus on eating less saturated fat rather than eating less cholesterol, because saturated fats more often effect on blood cholesterol levels and many of the foods that are high in saturated fat are also high in cholesterol anyway. If a food does make a low cholesterol claim, check the amount of saturated fat in the nutrition panel. For oils, margarines and Continue reading >>
Original Article Blood Glucose And Cholesterol Levels In Adult Population Of Bangladesh: Results From Steps 2006 Survey
Abstract A nationally representative survey was carried out to determine the distribution of blood glucose and cholesterol in adult population of Bangladesh in the absence of existing data. The study adopted a multistage and geographically clustered sampling technique of households. A total of 2610 individuals (1444 men and 1166 women) aged 25–64 years were selected from rural and urban areas. Capillary blood glucose and total cholesterol levels were measured using an overnight fasting state. The mean age of the participants was 41 years [standard deviation (SD), 11 years]. Half of them (49%) were from urban areas. Half of them (51%) had primary or higher education. Mean glucose was 74 mg/dL (SD 23 mg/dL). Men had higher mean glucose levels (79 mg/dL) than women (67 mg/dL). Age-standardized prevalence of diabetes (blood glucose level ≥126 mg/dL and/or use of anti-diabetic medication) was 5.5%. In men, it was almost two-and-half times (7.6%) compared with women (2.8%). It was also double in urban areas (7.8%) compared with rural areas (3.4%). Mean cholesterol level among all participants was 167 mg/dL (SD 26 mg/dL). Men and women had almost similar levels (169 mg/dL versus 166 mg/dL, respectively). Prevalence of high cholesterol level (≥240 mg/dL) was very low (1.3%) in both men (2.2%) and women (0.5%). However, the prevalence of borderline high cholesterol was substantial (5.8%) in this sample. The prevalence of high hypercholesterolemia is low, whereas there is a high prevalence of borderline high cholesterol and diabetes in the adult population of Bangladesh. This warrants population-based interventions to tackle this problem. Continue reading >>
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Cholesterol And Diabetes
The ADA's revised treatment guidelines contain many updates, but one of the most significant is a push for statin therapy across-the-board. It's a serious effort to stop cardiovascular disease, one of the prime causes of death for people with diabetes. Diabetes greatly increases the risk of developing cardiovascular disease (CVD). Since high cholesterol levels also increase CVD risk, it's important to keep cholesterol levels under control if you have diabetes. Cholesterol consists of three main components: high-density cholesterol (HDL, good cholesterol), low-density cholesterol (LDL, bad cholesterol), and triglycerides. According to the new American Diabetes Association (ADA) guidelines, high LDL cholesterol is a common problem for people with diabetes. Also referred to as dyslipidemia, this condition greatly increases the risk of developing CVD.1 Cholesterol Numbers for People with Diabetes It's important to know your cholesterol numbers. If you don't have prexisting CVD, your numbers should be: total cholesterol: < 200 mg/dL total triglycerides: < 200 mg/dL HDL cholesterol (the "good" cholesterol): > 45 mg/dL LDL cholesterol (the "bad" cholesterol): <130 mg/dL If you have CVD already, your numbers should be: total cholesterol: < 200 mg/dL total triglycerides: < 200 mg/dL HDL cholesterol: > 35 mg/dL LDL cholesterol: < 100 mg/dL Current Guidelines: New Focus on Statins The ADA now recommends that all people with diabetes take the cholesterol lowering drugs—statins—in addition to lifestyle therapy (meal planning changes and exercise) to reduce the likelihood of developing heart disease (eg, heart attack and stroke).2 "Statins are the drugs of choice for LDL cholesterol lowering and cardioprotection," the ADA stated. Patients with diabetes should either be prescribed Continue reading >>
