Africa: Does Nigeria Have The Most People With Diabetes In Sub-Saharan Africa?

Africa: Does Nigeria Have the Most People With Diabetes in Sub-Saharan Africa?

A top drug firm executive said Nigeria registers the most new cases of diabetes in the region and that 5 million people in the country are living with the disease. Do the claims get a clean bill of health?
Diabetes is a growing concern for Nigeria, a drug multinational executive said ahead of a recent summit on the chronic disease in Lagos.
"About three years ago South Africa and Ethiopia tended to have more diabetes than Nigeria," said Dr Philip Ikeme, the medical director of the Nigeria, Ghana and eastern African arm of pharmaceutical giant Sanofi. Among Sanofi's products are the insulin shots used to manage diabetes.
"Now Nigeria has the highest incidence of diabetes in sub-Saharan Africa." (Note: Incidence refers to the number of new cases in a given period, say a month or a year, while prevalence is the total number of people in a population with a disease in a specific time period.)
"In terms of actual numbers we are looking at five million people whom we know have diabetes," Ikeme said, adding that the actual number was "much more".
Does the data support Ikeme's claim?
We examined the numbers.
What is diabetes?
Diabetes is a chronic disease caused by the body's inability to produce required amounts of insulin - the hormone that regulates blood sugar - or to efficiently use the insulin it produces, according to the World Health Organisation. These are called type 1 and type 2 diabetes respectively.
In 2015, it was the 6th leading cause of death in lower and middle income countries. WHO notes that over the past decade, the prevalence of diabetes has risen faster in low Continue reading

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Can I Drink Alcohol If I Have Type 2 Diabetes?

Studies have shown that moderate alcohol consumption may have favorable effects, such as raising good cholesterol (HDL) and lowering the risk of cardiovascular disease.
Some studies suggest that moderate alcohol consumption may even reduce the risk of developing type 2 diabetes. The most important rule is to keep consumption moderate. The American Heart Association defines moderate alcohol consumption as one drink per day for women and two drinks per day for men.
One alcoholic beverage is measured as a 12-ounce beer, 5-ounce glass of wine, or 1.5-ounce distilled spirits (vodka, whiskey, gin, etc.).
On the other hand, excessive alcohol consumption or binge drinking, defined as more than five alcoholic beverages in a two-hour time span for men and four for women, can increase the risk of heart disease, type 2 diabetes, and metabolic syndrome. Excessive consumption can also make glucose control a challenge by increasing weight and insulin resistance.
If you do decide to drink alcohol, some options are better than others. In addition, if you have diabetes there are certain considerations you must take in order to stay safe. Alcohol consumption can result in increased insulin production, which can lower blood sugars. The American Diabetes Association recommends that persons with diabetes be educated on the recognition and management of delayed hypoglycemia (low blood sugar) when drinking alcohol, especially if those persons are using insulin or other medications that can cause blood sugars to drop.
What types of alcohol should I avoid and what should I choose instead:It’s wise Continue reading

Review of the Medtronic 630G Insulin Pump

I am going to break with tradition and state my recommendation at the outset I love the Medtronic 630G. However, please read the entire story because it is worth knowing my full experience with the pump. Because like with most things there are both good and some not so good parts to owning a new piece of technology.
Getting started
When the 630G arrived, there were all kinds of warnings about leaving the pump alone until you call the local trainer. So I immediately picked it up and started messing with it. I also called my local representative and explained that I had my new pump, but due to insurance issues, I could not start the sensor for another month. The trainer suggested I proceed with pump only training and then tag on sensor training when I received it. So a few days after receiving the pump I was in class.
The day of training went very well. The trainer gets a high five for adapting the class to the learner’s level. She made sure it was valuable for me (I have used Medtronic pumps for 17 years) and my wife who seldom if ever touches my pump.
About 30 days later insurance released my sensors, so we took the sensor training in the same place with a different trainer. The sensor trainer was incredibly good. Since I relate everything to the Dexcom experience, she again took me where I was and helped me develop insights about how my new sensor and pump work together.
Wearing the pump
I love the color screen. The operation of the pump is easy and straightforward if you are familiar with prior Medtronic pumps. But and this is a big “but” there are some new features Continue reading

ACOG Releases Updated Guidance on Gestational Diabetes

SUMMARY:
ACOG has released updated guidance on gestational diabetes (GDM), which has become increasingly prevalent worldwide. Highlights and changes from the previous practice bulletin include the following:
Fetal Monitoring
Screening for GDM – One or Two Step?
ACOG (based on NIH consensus panel findings) still supports the ‘2 step’ approach (24 – 28 week 1 hour venous glucose measurement following 50g oral glucose solution), followed by a 3 hour oral glucose tolerance test (OGTT) if positive
Note: While the diagnosis of GDM is based on 2 abnormal values on the 3 hour OGTT, ACOG states, due to known adverse events, one abnormal value may be sufficient to make the diagnosis
1 step approach (75 g OGTT) on all women will increase the diagnosis of GDM but sufficient prospective studies demonstrating improved outcomes still lacking
ACOG does acknowledge that some centers may opt for ‘1 step’ if warranted based on their population
Who Should be Screened Early?
ACOG has adopted the NIDDK / ADA guidance on screening for diabetes and prediabetes which takes in to account not only previous pregnancy history but also risk factors associated with type 2 diabetes. Screen early in pregnancy if:
Patient is overweight with BMI of 25 (23 in Asian Americans), and one of the following:
Physical inactivity
Known impaired glucose metabolism
Previous pregnancy history of:
GDM
Macrosomia (≥ 4000 g)
Stillbirth
Hypertension (140/90 mm Hg or being treated for hypertension)
HDL cholesterol ≤ 35 mg/dl (0.90 mmol/L)
Fasting triglyceride ≥ 250 mg/dL (2.82 mmol/L)
PCOS, acanthosis nigri Continue reading

Study suggests link between A1 beta-casein and Type 1 diabetes

RESEARCH: Type 1 diabetes, an autoimmune disease in which the body attacks its own insulin-producing cells, is on the rise globally.
Early evidence of an association between Type 1 diabetes and a protein in cow milk, known as A1 beta-casein, was published in 2003. However, the notion that the statistically strong association could be causal has remained controversial.
As part of a seven-person team, we have reviewed the overall evidence that links A1 beta-casein to type 1 diabetes. Our research brings forward new ways of looking at that evidence.
Different types of diabetes
Type 1 diabetes is the form of diabetes that often manifests during childhood. The key change is an inability of the pancreas to produce insulin, which is essential for transporting glucose across internal cell membranes.
There is common confusion between Type 1 and the much more common Type 2 diabetes. Type 1 diabetes is an autoimmune disease. This means that the immune system attacks the body's own cells. Insulin-producing cells in the pancreas are then destroyed by "friendly fire".
READ MORE:
* A1 or A2 milk? Where's the research?
* What the 'milk devil' could do
* What does A2 milk have to offer?
There is no accepted lifestyle change that will prevent or cure Type 1 diabetes and daily insulin injections are required throughout life.
In contrast, people who develop Type 2 diabetes still produce some insulin, but the liver and muscles become resistant to insulin's ability to move glucose out of the blood and into the tissues. Type 2 diabetes is primarily a disease of middle-aged and older people and is Continue reading