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Advice To Walk After Meals Is More Effective For Lowering Postprandial Glycaemia In Type 2 Diabetes Mellitus Than Advice That Does Not Specify Timing: A Randomised Crossover Study

Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study

Advice to walk after meals is more effective for lowering postprandial glycaemia in type 2 diabetes mellitus than advice that does not specify timing: a randomised crossover study

Abstract
Regular physical activity is a cornerstone of diabetes management. We conducted a study to evaluate whether specifying the timing of walking in relation to meals enhances the benefits conferred by current physical activity guidelines.
A total of 41 adults with type 2 diabetes mellitus (mean ± SD age 60 ± 9.9 years; mean diabetes duration 10 years) participated in this randomised, crossover study. Randomisation was by a computer-generated protocol. For periods of 2 weeks, advice to walk 30 min each day was compared with advice to walk for 10 min after each main meal. Both sets of advice met current physical activity guidelines for people with type 2 diabetes mellitus. Physical activity was measured by accelerometry over the full intervention, and glycaemia was measured using continuous glucose monitoring in 5 min intervals over 7 days. The primary outcome of postprandial glycaemia was assessed during the 3 h after a meal by the incremental area under the blood glucose curve (iAUC).
The iAUC was significantly lower when participants walked after meals compared with on a single daily occasion (ratio of geometric means 0.88, 95% CI 0.78, 0.99). The improvement was particularly striking after the evening meal (0.78, 95% CI 0.67, 0.91) when the most carbohydrate was consumed and sedentary behaviours were highest. One participant died during the 30 day washout period between interventions, but participation in this study was not judged to contribute to this unfortunate event.
The benefits relating to physical activity following meals suggest that current guidelines shou Continue reading

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Beating type 2 diabetes into remission

Beating type 2 diabetes into remission

Recognising and accurately coding reversal of type 2 diabetes is key to improving outcomes and reducing healthcare costs, argue Louise McCombie and colleagues
Type 2 diabetes, generally perceived as progressive and incurable, now affects 5-10% of the population, about 3.2 million people in the UK.1 Until complications develop, most patients are managed entirely within primary care, with diabetes comprising a major part of general practice activity. About 10% of total UK NHS expenditure goes on treating diabetes, and international figures suggest that medical costs for people with diabetes are twofold to threefold greater than the average for age and sex matched people without diabetes.1
Application of current clinical guidelines to reduce glycated haemoglobin (HbA1c) levels and cardiovascular risks, primarily with drugs and generic lifestyle advice, has improved clinical outcomes, but many patients still develop vascular complications, and life expectancy remains up to six years shorter than in people without diabetes.2 The diagnosis carries important social and financial penalties for individuals, as well as poor health prospects.
Remission of diabetes (no longer having diabetes, at least for a period) is clearly attainable for some, possibly many, patients but is currently very rarely achieved or recorded. Greater awareness, documentation, and surveillance of remissions should improve health outcomes and reduce healthcare costs.
Changing management
In keeping with trends in most medical specialties, diabetes management is beginning to focus on reversible underlying diseas Continue reading

Is Type 2 diabetes reversible?

Is Type 2 diabetes reversible?

Katy Wiley began her struggle with Type 2 diabetes in 1990, when she was pregnant with her second child. The disease progressed, and at eight weeks she started insulin treatment, hoping that once her son was born, the diabetes would disappear. Instead, her condition steadily declined.
Vision problems and nerve damage, common complications of diabetes, began to appear. Her A1C blood glucose (sugar) levels were increasing, she was at least 50 pounds overweight and the medication metformin had been added to her daily therapy routine of insulin injection. That's when she read about a Type 2 diabetes study at Cleveland Clinic that was recruiting patients to participate in one of three arms of treatments to study the effectiveness of methods to treat and possibly reverse Type 2 diabetes.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that Type 2 diabetes usually begins with insulin resistance or the inability of the fat, muscle and liver cells to use the insulin produced in the pancreas to carry sugar into the body's cells to use for energy. At first, the pancreas will work harder to make extra insulin, but eventually it won't be able to keep making enough to maintain normal blood glucose levels, and glucose will build up in the blood instead of nourishing the cells. That's when diabetes Type 2 has developed and needs to be treated.
In the United States, according to the Centres for Disease Control, 29.1 million people - 9.3 per cent of the population - have diabetes (about one million Australians have been diagnosed with diabetes). About 95 per Continue reading

Type 2 Diabetes Remission With Intensive Treatment

Type 2 Diabetes Remission With Intensive Treatment

Theory proposed that type 2 diabetes can be reversed in the short term with medical approaches over bariatric surgeries.
Type 2 diabetes can be acquired over time when a person makes poor lifestyle choices with their diet and lives a sedentary lifestyle. Eventually, it progresses to a chronic state with additional complications, but it can be reversed with lifestyle approaches and a series of oral and injectable medications. According to the Society’s Endocrine Facts and Figures, one in 10 American adults has type 2 diabetes and either cannot produce enough insulin or their pancreas is not making insulin efficiently. Thus, resulting in an increase in blood sugar and keeping the cells from receiving energy. Ongoing studies have stressed treating type 2 diabetes by reversing the disease rather than controlling its progression by achieving normoglycemia.
Recent studies show that intensive medical treatment for two to four months, using oral medications, insulin and lifestyle therapies may help reverse type 2 diabetes. In an open-labeled, parallel, randomized pilot trial, a short-term intensive metabolic approach was conducted to target the fasting and postprandial normoglycemia and weight loss using a combination of pharmacological and lifestyle approaches to induce sustained diabetes remission. The objective of the study was to assess the feasibility, safety, and potential to induce remission of a short-term intensive metabolic strategy. All analyses were performed using the intention-to-treat principle. A chi-square test and two sample t-test was used to compare dichotomou Continue reading

Diabetes increase putting NHS future 'at stake'

Diabetes increase putting NHS future 'at stake'

INDYPULSE
Diabetes increase putting NHS future 'at stake'
Tackling diabetes is “fundamental” to the future of NHS as the number of adults with the condition nears four million, Public Health England has warned.
Around 3.8 million adults in England now have diabetes, with at least 940,000 of those undiagnosed, new figures have revealed.
About 90 per cent of the cases are Type 2 diabetes, which is linked to being overweight and obese and therefore largely preventable, PHE, who released the data, said.
The other 10 per cent are Type 1, which usually develops in childhood and is often inherited.
Diabetes can lead to serious health complications including limb amputation, kidney disease, stroke and heart attacks. Treating the disease and the complications arising from it costs the NHS around £10 billion annually.
John Newton, chief knowledge officer at PHE, said: "The number of people with diabetes has been steadily increasing and tackling it is fundamental to the sustainable future of the NHS.
"Diabetes can be an extremely serious disease for those that have it and treating it and its complications costs the NHS almost £10bn a year.
"Developing Type 2 diabetes is not an inevitable part of ageing. We have an opportunity through public health to reverse this trend and safeguard the health of the nation and the future of the NHS."
The new Diabetes Prevalence Model was launched ahead of PHE's conference at Warwick University. It shows that 9 per cent of people aged 45 to 54 have diabetes, but this rises to 23.8 per cent of those aged over 75.
Earlier this month, senior health Continue reading

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