Differential Weight Loss Effects On Type 2 Diabetes Remission Among Adults

Differential Weight Loss Effects on Type 2 Diabetes Remission Among Adults

An analysis of nationally representative survey-based data finds that 5.2% of adults with type 2 diabetes were in remission, without bariatric surgery, at the end of the second year.
INTRODUCTION: Little is known about the variation in the effect of nonsurgical weight loss among obese and nonobese individuals on the incidence of type 2 diabetes (T2D) remission.
METHODS: Using data from a nationally representative healthcare survey, we analyzed the differential effect of weight loss on the relationship between obesity and the incidence of T2D remission over the span of 1 year among 3755 adults. Anyone who reported having T2D in the first year, but not in the subsequent year, was considered to be in remission. Changes in a person’s weight were measured as change in the body mass index. Data gathered between 2009 and 2013 were analyzed in 2016.
RESULTS: The incidence of self-reported remission was 5.22% (P <.001). Among obese individuals (BMI≥30), those who experiences a 3% drop in weight, at minimum, were 2.1 percentage points more likely to report remission than those who lost less than 3% bodyweight (P <.05). Comparing all individuals who lost more than 3% of their weight with those who lost less than 3% of their weight, obese individuals were 3.7 percentage points more likely than nonobese individuals to report being in remission (P <.05). Furthermore, after accounting for demographic and clinical information, we found that T2D remission was negatively associated with the duration of a T2D diagnosis and diabetes medication type, and was positively associated with being Continue reading

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NIHR Signal Type 2 diabetes is becoming more common in children

The number of children being diagnosed with both type 1 and type 2 diabetes is rising, but new cases of type 2 diabetes, the form associated with being overweight, has risen five-fold in about five years. New analysis in this NIHR-supported study suggest that type 2 diabetes now accounts for up to a third of diabetes diagnoses in children.
Amongst 100,000 school age children about six new cases of type 2 diabetes a year could be expected in the 1990s. This increased to about 33 new cases per year by the end of the next decade (2009 to 2013). Data was taken from the UK Clinical Practice Research Datalink, a primary care database of electronic health records.
Children who are obese have about a four times greater risk of developing type 2 diabetes compared with those of a normal weight. Having type 2 diabetes brings an increased risk of other complications and healthcare problems for individuals and is associated with extra resource use and costs for society.
NICE has produced guidance about preventing type 2 diabetes, but it appears that more needs to be done to promote healthier lifestyles to children and their families. Continue reading

You Told Glu: The Connection between Stress and Diabetes Burnout

Everyone experiences stress from time to time. This is normal and healthy—many scientists consider stress to be physiologically adaptive, when it occurs in moderation. However, coping with a chronic disease, such as type 1 diabetes, requires constant management. Diabetes-related stress can become overwhelming and harmful. Stress can also make it more difficult to manage fluctuations in blood glucose. In fact, being stressed around the time of a meal can actually increase insulin needs, resulting in heightened blood glucose levels.
Different types of stressors can make blood glucose levels swing wildly. Anything that results in increased sympathetic nervous system activity (heightened heart rate and physical arousal) and increased adrenal activity (hormones such as cortisol being released into the bloodstream) can result in in large spikes in blood glucose.
The Glu community discussed different situations that affected their own glucose levels in some interesting comments in our questions of the day. Some of the top things that have an effect on BG were:
Interpersonal stress
“Getting in a fight with my husband makes me go high, must be that fight or flight response.”
Performance anxiety
“Work stress, in my experience, has been difficult, as I tend to sacrifice my health in order to keep up with expectations at work.”
Sudden startling experiences
“My BG is affected by feelings of fear or being shocked or startled—it shoots up for hours and just hangs there.”
Major life changes, like having a baby
“The only time in my life I have ever forgotten an injection ( Continue reading

Diabetes Prevention in Older Adults

Today's Dietitian
Vol. 19, No. 4, P. 30
With the introduction of the Medicare Diabetes Prevention Program, dietitians will have even more ammunition to help prevent this costly disease.
The number of people in the United States aged 65 and older is estimated to reach more than 98 million by 2060,1 and as this aging population continues to grow, there will be more cases of type 2 diabetes. The Centers for Disease Control and Prevention (CDC) projects that the number of older individuals with diabetes will double or even triple by 2050, affecting one in three adults older than 65.2 In addition, more Medicare dollars are spent on beneficiaries with diabetes.3 The good news is type 2 diabetes can be prevented or delayed with appropriate lifestyle changes.
This article discusses the prevalence of diabetes and prediabetes in older adults, associated diabetes complications, the Diabetes Prevention Program (DPP) and Medicare DPP (MDPP), and strategies for nutrition professionals counseling older adults on diabetes prevention.
Diabetes Prevalence
According to CDC projections, even if diabetes rates level off, the aging population will change the face of diabetes, and the incidence of diabetes will continue to grow. In fact, it's projected to double in the next 20 years.4
Diabetes is a costly disease—personally and economically. Older adults with diabetes experience diabetes complications such as lower-extremity amputation, myocardial infarction, visual impairment, and end-stage renal disease at rates higher than any age group.4 Those aged 75 and older are twice as likely to visit Continue reading

Dairy, Diabetes, and Your Heart

My wife’s grandfather passed away two weeks ago. At 94, he'd lived an amazing life. He grew up in a family that owned large areas of land near Farmington, New Mexico, and Durango, Colorado. He served as a pilot in World War II, married a wonderful woman, and had seven children. His wife died in her late fifties of ovarian cancer, and he lived another 40 years alone as a widower.
He worked hard his entire life and continued to farm and ranch into his nineties. His legacy is left through his family, and through the many people he touched with small acts of kindness. He was a loving man of few words, but when we spoke, the words he chose were always uplifting.
He lived his long, active life on a diet rich in meat and dairy products, which we’re often advised to avoid for heart health.
The first few years I knew him, I think my wife’s grandfather had whole milk and a steak for at least two of his daily meals. You'd think that such a diet could be harmful, but he remained independent in his home, still working, until a stroke suddenly took his life.
When I see patients in the clinic, one of the first things they mention when we discuss diet is that they intend to cut out all dairy products. Because nutritional guidelines often recommend a low-fat diet, most people believe this means they should consume less dairy fat.
But is this a good idea? Are milk, cheese, butter, and other dairy products really harmful to your health, and should you avoid them? Personal experience and new clinical research sheds light on this question.
The Facts on Dairy Products and Your Health
First Continue reading