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Early Glycemic Control And Magnitude Of HbA1c Reduction Predict Cardiovascular Events And Mortality: Population-Based Cohort Study Of 24,752 Metformin Initiators

Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators

Early Glycemic Control and Magnitude of HbA1c Reduction Predict Cardiovascular Events and Mortality: Population-Based Cohort Study of 24,752 Metformin Initiators

OBJECTIVE We investigated the association of early achieved HbA1c level and magnitude of HbA1c reduction with subsequent risk of cardiovascular events or death in patients with type 2 diabetes who initiate metformin.
RESEARCH DESIGN AND METHODS This was a population-based cohort study including all metformin initiators with HbA1c tests in Northern Denmark, 2000–2012. Six months after metformin initiation, we classified patients by HbA1c achieved (<6.5% or higher) and by magnitude of HbA1c change from the pretreatment baseline. We used Cox regression to examine subsequent rates of acute myocardial infarction, stroke, or death, controlling for baseline HbA1c and other confounding factors.
RESULTS We included 24,752 metformin initiators (median age 62.5 years, 55% males) with a median follow-up of 2.6 years. The risk of a combined outcome event gradually increased with rising levels of HbA1c achieved compared with a target HbA1c of <6.5%: adjusted hazard ratio (HR) 1.18 (95% CI 1.07–1.30) for 6.5–6.99%, HR 1.23 (1.09–1.40) for 7.0–7.49%, HR 1.34 (1.14–1.57) for 7.5–7.99%, and HR 1.59 (1.37–1.84) for ≥8%. Results were consistent for individual outcome events and robust by age-group and other patient characteristics. A large absolute HbA1c reduction from baseline also predicted outcome: adjusted HR 0.80 (0.65–0.97) for Δ = −4, HR 0.98 (0.80–1.20) for Δ = −3, HR 0.92 (0.78–1.08) for Δ = −2, and HR 0.99 (0.89–1.10) for Δ = −1 compared with no HbA1c change (Δ = 0).
CONCLUSIONS A large initial HbA1c reduction and achievement of low HbA1c levels Continue reading

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Avocado and Diabetes: Benefits, Risks, and More

Avocado and Diabetes: Benefits, Risks, and More


Avocados are growing in popularity. The creamy green fruit is packed with vitamins, nutrients, and heart-healthy fats . While they are high in fat, its the good kind of fat that benefits people with type 2 diabetes .
If you have type 2 diabetes, adding avocado to your diet may help you lose weight, lower cholesterol, and increase insulin sensitivity. Read on to learn more about the benefits of avocados for people with diabetes.
Benefits of avocadofor people with type 2 diabetes
Avocados are low in carbohydrates, which means they have little effect on blood sugar levels. A recent study published in Nutrition Journal evaluated the effects of adding half an avocado to the standard lunch of healthy, overweight people. They discovered that avocados do not significantly impact blood sugar levels.
Part of what makes avocados a good choice for people with diabetes is that, although they are low in carbs, they are high in fiber. Many other high-fiber foods may still spike blood sugar levels.
One half of a small avocado, which is the standard amount people eat, contains about 5.9 grams of carbohydrate and 4.6 grams of fiber.
According to the National Academies , the minimum recommended daily fiber intake for adults is:
A 2012 review published in the Journal of the American Board of Family Medicine looked at the results of 15 studies involving fiber supplements (around 40 grams of fiber) for people with type 2 diabetes. They found that fiber supplements for type 2 diabetes can reduce fasting blood sugar levels and A1c levels .
You dont need to take supplements to achieve the Continue reading

How to Have a Diabetes-Friendly Thanksgiving Day for the Whole Family

How to Have a Diabetes-Friendly Thanksgiving Day for the Whole Family


How to Have a Diabetes-Friendly Thanksgiving Day for the Whole Family
For most Americans, November is the time for turkey, football, and pumpkin spice everything. But its also National Diabetes Month , a time to spread awareness about the disease, which, in 2015, affected over 30 million people in the U.S.
While there are a few different kinds of diabetes , all involve a problem with the bodys ability to produce or use insulin well. Insulin is a hormone produced by the pancreas that helps the bodys cells use glucose (sugar) for energy. When theres not enoughor anyinsulin available, glucose stays in the blood and can cause serious health problems. No matter the form diabetes takes, experts agree that food and lifestyle factors are essential for helping to maintain overall health.
Its important to find a lifestyle that can help improve the lipid [cholesterol] profile, blood pressure, and blood sugar, says Malcolm Thaler, MD, a New York-based physician . All of these goals can help be managed by a lifestyle that incorporates weight loss, healthy nutrition, and exercise.
If youre thinking, Wait a minute! Those sound like great goals for almost anyone, then youre right. Theres no such thing as a diabetic diet, says Tracy Morris, an accredited dietetic professional and nutrition curriculum designer at Fitbit. But luckily, a diabetes-friendly meal is one thats good for everyone!
And a diabetes-friendly Thanksgiving is possible, even if the thought of subjecting traditional relatives to nutritious dishes and light exercise seems daunting. Here are four simple ways to make th Continue reading

The 30-minute op that can save diabetes patients from losing a leg - so why aren't more patients being offered this?

The 30-minute op that can save diabetes patients from losing a leg - so why aren't more patients being offered this?

Last year, Graham Baker was facing the prospect of losing his left leg below the knee, a complication of his type 2 diabetes.
Poorly controlled blood sugar levels had encouraged the arteries in his left calf to fur up, and this was obstructing the blood flow so much that the tissues and bones in his lower leg were being starved of blood and oxygen.
‘I had a scan to monitor the blood flow in my left leg and was told that without surgical intervention, I would likely lose the lower part of my leg — my years of poor diabetes management had basically blocked up the main artery,’ says 52-year-old Graham, a carer from High Wycombe, Bucks.
But specialists said they could save the leg — and it could be done under local anaesthetic in less than an hour.
It involved a newly refined procedure that clears the artery of blockages. Graham — who is married to Beryl, 53 — had the procedure, called endovascular revascularisation, at the John Radcliffe Hospital in Oxford last September and his leg was saved.
There are many people in the same position who could also benefit from the procedure, but don’t.
In fact, new figures reveal that one person a day needlessly loses their foot or leg because this simple procedure isn’t more widely available.
Blockages in the blood vessels in the legs (known as peripheral arterial disease) is common, but people with diabetes are particularly prone. This is because nitric oxide, a gas we all produce that helps keep blood vessels healthy, becomes less effective in the presence of repeatedly high blood sugar — as can occur in diabetes.
As a Continue reading

Boy’s illness motivates family to fight diabetes

Boy’s illness motivates family to fight diabetes

It was Christmas 2009 and the Schapler family – Peggy, Rick, Tylee and Davis – was in full-blown holiday mode.
The tree was up, the presents were wrapped, the house was decked and the family was ready for a trip to the Polar Express. Davis, then 2 years old, had a cold, so Peggy decided to take him to the pediatrician prior to the trip.
The doctor’s visit was also an opportunity for Peggy to discuss other health concerns she had noticed in Davis in recent weeks.
Davis was showing signs of increased urination, irritability and excessive thirst; all of which are signs and symptoms of type 1 diabetes (T1D). Davis’ doctor tested his blood sugar three different times with the meter reading HI, which meant his blood sugar was well over 500; the average range is between 80-120.
The doctor immediately sent the family to Phoenix Children’s Hospital. It was at that moment, the journey to turn T1D into “type none” began for the Schapler family.
Peggy will often tell people that T1D picked the wrong family because she has made it her mission to raise funds and increase awareness of T1D ever since that life changing day in 2009.
“T1D changed our lives forever. It is our new norm. Davis and our entire family have T1D,” Peggy said.
Peggy realized right away the lack of public awareness around the signs, symptoms and treatment of T1D.
Friends and family members thought it was a short-term illness, not a lifelong illness.
T1D typically shows up in children and young adults and it’s a disease they do not outgrow and will not go away. It accounts for 5-10 percent of all pe Continue reading

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