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HIV And Diabetes

HIV and Diabetes

HIV and Diabetes

Diabetes is a disease in which levels of blood glucose (also called blood sugar) are too high. Glucose comes from the breakdown of the foods we eat and is our main source of energy. There are two main types of diabetes: type 1 diabetes and type 2 diabetes.
Use of some HIV medicines may increase blood glucose levels and lead to type 2 diabetes. Other risk factors for type 2 diabetes include a family history of diabetes, being overweight, and lack of physical activity.
People with HIV should have their blood glucose levels checked before they start taking HIV medicines. People with higher-than-normal glucose levels may need to avoid taking some HIV medicines and use other HIV medicines instead.
Blood glucose testing is also important after starting HIV medicines. If testing shows high glucose levels, a change in HIV medicines may be necessary.
Type 2 diabetes can often be controlled with a healthy diet and regular exercise. A healthy diet includes vegetables, fruits, beans, whole grains, and lean meats and is low in processed foods high in sugar and salt. Regular exercise means being active for 30 minutes on most days of the week. Sometimes, in addition to a healthy diet and regular physical activity, some people may need to take medicines to control type 2 diabetes. Continue reading

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Are Older Adults Being Overtreated for Diabetes?

Are Older Adults Being Overtreated for Diabetes?

Older patients are not the same as younger patients. You’d think this was obvious, yet doctors often use a one-size-fits-all approach to prescribing treatment that can put their older patients at risk.
The latest example of this: another study showing that patients 65 or older with diabetes may be overtreated by doctors who too aggressively try to control blood sugar levels, regardless of their patients’ other health problems.
The new study, by Yale researchers, analyzed a decade of data on 1,288 diabetes patients age 65-plus, from a federal health survey. Although the patients ranged from being relatively healthy to being in poor health with multiple problems, there was little difference in the proportion given insulin and sulfonylurea drugs to tamp down their blood sugar to the same low level.
This can put older patients at risk for hypoglycemia — a dangerous reaction to low blood sugar that can cause confusion, rapid heartbeat, vision problems and loss of consciousness, according to lead study author Kasia Lipska, M.D., assistant professor of endocrinology at the Yale School of Medicine.
There’s also little evidence that aggressively lowering blood sugars in older people to the standard target — hemoglobin A1C below 7 percent — provides any benefit, “and it could, in fact, cause greater harm,” she said in a statement.
“Our study suggests that we have a one-size-fits-all approach despite questionable benefits and known risks. We have been potentially over-treating a substantial proportion of the population,” Lipska said. The study was published Jan. 12 Continue reading

Diabetes in numbers: the worrying statistics

Diabetes in numbers: the worrying statistics

OVER THE PAST thousand years of medical progress, the human race has seen a slow but steady increase in human longevity. Although the occasional plague, famine or war will lead to a mortality peak in a generation, by and large each new wave of humanity is healthier than the last. But it seems that this encouraging trend is about to change.
A study published in 2015 revealed that middle-aged white Americans are dying at younger ages than their parents for the first time in decades, and as with all trends, where the US leads, the UK and Europe are certain to follow soon after. In fact, there are many similar studies suggesting that today’s children may go on to lead shorter lives than their parents.
To explain these trends, experts have looked at two main factors – firstly “deaths of despair” such as opioid overdoses, suicides and complications from long-term alcohol abuse. In 2015, 52 000 Americans died of drug overdoses alone, more than those who died per annum of HIV/AIDS during the epidemic’s peak years in the mid 90s. Almost half of these deaths were due to opioid-based drugs, such as heroin or the much stronger synthetic opioid fentanyl. Secondly, a more recent study has linked diabetes to the increase in American mortality. Whilst in 1958 only 0.93 per cent of the US population was diagnosed diabetic, now 7.02 per cent (nearly 30 million people) of the country live with the disease. The number has grown three-fold since the early 1990s, rising with the ever-increasing obesity rates.
Approximately 368 million people on Earth were living with the disease in 201 Continue reading

Decoding the diabetic diet

Decoding the diabetic diet

A focus on carb- and portion-control should be top priority, but that doesn't mean the occasional treat is out of the question
A crucial tool in controlling diabetes is being vigilant about what you put in your mouth. But, some experts say, you don't have to be a slave to the glycemic index or banish cake and ice cream forever.
The primary goal for diabetics is to regulate their blood glucose (sugar) levels because they can't rely on their bodies to naturally produce enough insulin, the hormone that shuttles glucose from the bloodstream into cells. With Type 1 diabetes, the pancreas stops making insulin, while with Type 2, the pancreas progressively makes less and less insulin or the body has difficulty using it (known as insulin resistance).
Left uncontrolled, diabetes can lead to long-term organ damage, resulting sometimes in heart disease, stroke, vision loss, kidney failure, foot amputation or death, studies show.
Anyone with diabetes should meet with a dietitian to formulate a meal plan tailored to their particular needs, experts say. But there are some general best practices.
Carbohydrate-rich foods, which break down into glucose during digestion, are of principal concern in a diabetic's diet. Those who use mealtime insulin injections — usually Type 1 diabetics and some Type 2 diabetics — typically have to count the grams of carbohydrates they eat at each meal so that they can give themselves the appropriate insulin dose.
But carbs are not the enemy or the only factor.
"What matters most is how much people eat," said certified diabetes educator Marion Franz, a Min Continue reading

Pancreatic cancer and diabetes – a cellular case of chicken and egg

Pancreatic cancer and diabetes – a cellular case of chicken and egg

We’ve all heard the age-old question about the chicken and the egg.
Well scientists studying the link between diabetes (a condition where the amount of glucose in your blood is too high because the body cannot use it properly) and pancreatic cancer are facing a similar conundrum. It seems there’s a link between the two conditions, but it’s not clear which one comes first.
While the majority of people with diabetes will never develop pancreatic cancer, the question of whether diabetes could be a cause or a consequence of pancreatic cancer is an important one.
Answering this could help scientists better understand the biology of these two conditions, and might help spot people at higher risk of pancreatic cancer.
So, as it’s pancreatic cancer awareness month, we’ve dug into the evidence to see what is known about these links, and which questions remain unanswered.
We know there’s a link
Doctors first started exploring the possibility of a link between diabetes and pancreatic cancer in the 1940s and 1950s.
Several reports had come out saying that patients with pancreatic cancer were more likely to also have diabetes than other people. This has been shown for type 2 diabetes as well as type 1 and young onset diabetes.
Since then, many studies have shown a link between the two conditions. Overall, it seems that people with diabetes are around twice as likely to be diagnosed with pancreatic cancer than the general population.
And this makes sense, given that diabetes and pancreatic cancer are diseases that both affect the pancreas.
The next big question is: how does t Continue reading

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