Diabetes And Influenza: A Dangerous Combination

Nov. 14, 2017 is World Diabetes Day, the world’s largest diabetes awareness campaign that aims to unite the global diabetes community to produce a powerful voice to highlight the realities and threats of dealing with this chronic medical condition.
Diabetes is a major threat to health globally.
In the U.S., diabetes rates have almost doubled in the past two decades, from 5.5 percent in 1994 to 9.3 percent in 2012. An estimated 30.3 million people, or 9.4 percent of the U.S. population, had diabetes in 2015. The CDC projects that one in three adults could have diabetes by 2050. More than one-quarter of seniors (ages 65 and older) has diabetes (25.9 percent, or 11 million seniors). In the European region, about 60 million people have diabetes, or about 10.3 percent of men and 9.6 percent of women aged 25 years and over. In Africa, the rate of diabetes remains low, but the number of people living with diabetes has dramatically increased from 4 million in 1980 to 25 million in 2014. More than 60 percent of those with diabetes live in Asia, with nearly half in China and India combined. The Asia Pacific region has 138 million people with diabetes, and the number may increase to 201 million by 2035.
The prevalence of diabetes is increasing mostly due to increases in obesity, unhealthy eating habits and decreased physical inactivity. Globally, diabetes kills about 3.4 million people annually. WHO projects that diabetes deaths will double between 2005 and 2030.
Diabetes itself is not a major problem unless the blood glucose is uncontrolled and either rises too high or drops too lo Continue reading

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Diabetes-Related Leg Cramps: How to Prevent and Treat

Being suddenly woken up by a painful knot in your calf—or frozen toes—isn't fun. Here's what diabetes has to do with it and what you do to stop the pain.
Perhaps you’ve been there—in the middle of a perfectly restful night of sleep you are abruptly woken up by an intense pain from a cramping muscle, typically in your foot or calf.
Although the exact cause of muscle cramps is still up for debate, they are frequently linked to poor flexibility and muscle fatigue. A smaller body of research also suggests that diabetes can increase your risk of experiencing leg cramps, potentially due to swings in blood sugar levels, certain medications, and long-term complications such as diabetic neuropathy (nerve damage).1,2 With or without diabetes, these cramps are characterized by the sudden, involuntary, and painful tightening (contraction) of a muscle. They occur most frequently in the evenings in the following muscle groups:
Calf muscles (back of the lower leg)
Hamstrings (back of the thigh)
Quadriceps (front of the thigh)
Cramps can also occur in the hands, feet, arms, neck, and abdomen
What causes these painful cramps and how can I prevent them?
“Although the exact cause of muscle cramps remains unknown, they are not inevitable,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE. While cramps may seemingly come on without warning, knowing the factors and situations that can cause muscle cramps can help you understand them, prevent them, and treat them. Here, some reasons for cramps and what you can do to avoid them:
Uncontrolled blood sugar levels. Glucose is required for mu Continue reading

Eat Carbs Last to Reduce After-Meal Blood Sugar Spikes?

Amazing but apparently true: Eating carbohydrates AFTER some protein, fat, or possibly fiber causes much lower after-meal blood sugar spikes than eating the carbs first.
Two small new studies from Cornell University in New York and the University of Pisa in Italy, respectively, showed the same thing. At Cornell, two groups of people with Type 2 diabetes ate the same meal: some bread, fruit juice, meat, and green salad. One group started with the bread and juice; the other with the meat and salad. A third group ate everything together as a sandwich.
At the beginning of the meal, and every 30 minutes thereafter for three hours, subjects had their glucose and insulin levels checked. The group that started with the bread had after-meal glucose spikes about 50% higher than the group that started with protein and vegetables. Those who ate everything together as a sandwich had about a 40% higher glucose spike than those who started with the protein and vegetables.
All three groups repeated the meals in different orders after a week and again a week later, said lead researcher Alpana Shukla, MD. In all groups, eating protein first led to much smaller glucose spikes, “comparable to what we see with diabetes medication.”
The Pisa study was longer-term and done “free-range,” not in a lab. Each group of people with Type 2 diabetes was given a meal plan and allowed to choose the specific foods they wanted, as long as the foods added up to the same number of calories. One group was told to eat their protein or fat food first, the other to eat their carbs first.
After four months, Continue reading

The Natural History of Type 2 Diabetes: Practical Points to Consider in Developing Prevention and Treatment Strategies

CLINICAL DIABETES
VOL. 18 NO. 2 Spring 2000
PRACTICAL POINTERS
Type 2 diabetes, previously referred to as adult-onset or non-insulin-dependent diabetes, progresses from an early asymptomatic stage with insulin resistance to mild postprandial hyperglycemia to frank diabetes requiring pharmacological intervention. Understanding this natural history of type 2 diabetes will guide primary care providers in formulating effective treatment regimens that reflect the pathological differences between these stages of the disease. The optimal medication regimen, when used in conjunction with dietary changes and exercise, will require modifications for each patient as the disease progresses.
The term impaired glucose tolerance (IGT) or pre-diabetes was first coined in 1979 by the World Health Organization and the National Diabetes Data Group to replace the terms borderline, chemical, and asymptomatic diabetes mellitus. In 1997, an expert committee of the American Diabetes Association recommended the following criteria for IGT: a normal fasting plasma glucose (<126 mg/dl) with a postprandial plasma glucose of >140 mg/dl but <200 mg/dl 2 h after a 75-g oral glucose challenge.1
This stage of mild postprandial hyperglycemia is an extremely useful marker of patients at risk for the eventual development of type 2 diabetes. Patients with IGT may benefit from timely patient education and perhaps even more aggressive forms of intervention, such as diet, exercise, or medication. An estimated 15.7 million Americans have type 2 diabetes, representing 5.9% of the population. Only two-thirds of those Continue reading

Diabetes and heart disease linked by genes, reveals Penn-led study

PHILADELPHIA -- Type 2 diabetes (T2D) has become a global epidemic affecting more than 380 million people worldwide; yet there are knowledge gaps in understanding the etiology of type-2 diabetes. T2D is also a significant risk factor for coronary heart disease (CHD), but the biological pathways that explain the connection have remained somewhat murky. Now, in a large analysis of genetic data, published on August 28, 2017 in Nature Genetics, a team, led by researchers in the Perelman School of Medicine at the University of Pennsylvania, has first looked into what causes T2D and second clarified how T2D and CHD - the two diseases that are the leading cause of global morbidity and mortality, are linked.
Examining genetic sequence information for more than 250,000 people, the researchers first uncovered 16 new diabetes genetic risk factors, and one new CHD genetic risk factor; hence providing novel insights about the mechanisms of the two diseases. They then showed that most of the sites on the genetic known to be associated with higher diabetes risk are also associated with higher CHD risk. For eight of these sites, the researchers were able to identify a specific gene variant that influences risk for both diseases. The shared genetic risk factors affect new biological pathways as well as targets of existing drugs, including icosapent ethyl and adipocyte fatty acid binding protein.
The findings add to the basic scientific understanding of both these major diseases and point to potential targets for future drugs.
"Identifying these gene variants linked to both type 2 diabetes a Continue reading