Just Read: Alzheimers Disease Is Type 3 DiabetesEvidence Reviewed

Ted Eytan, MD ( @tedeytan ) December 29, 2017
At Low Carb San Diego, I first heard the term Type III Diabetes, which, it turns out is new to the 21st Century, but not to this decade, as this paper was published in 2008 and references use of the term as early as 2005. The term is intriguing and opens the mind to a potential mechanism for dementia progression, and maybe prevention.
The dementia review, which appears very complete (and with a very respected team of experts, some of whom I have the pleasure to know), covers the determinants of dementia using the best data available.
It also introduces (to me) the concept of cognitive reserve, because it has been shown that people who do not have dementia while they are alive have damaged brains when they are examined in death.
Interestingly to me, this single concept is similar to insulin resistance, because its known that a person can have normal glucose control (or glucose control reserve) at the same time their insulin system is struggling.
In the review, diet/nutrition approaches for prevention treatment are briefly discussed, as well as the potential relationship to insulin resistance in the brain, but Diabetes Type III is not mentioned specifically & this paper isnt referenced.
With that in mind, and after asking Georgia and the study author on Twitter for comment on this, I decided to review this paper, written by a team at Brown University, to get grounded:
Cognitive impairment is associated with disorders in brain glucose metabolism
People with diabetes or related metabolic syndromes are at much higher risk Continue reading

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Diabetes monitors are getting closer to their iPhone moment

Diabetes monitors are getting closer to their iPhone moment
As regulators approve glucose-monitoring systems, the market potential is huge
Weight loss was found to help patients with type 2 diabetes go into remission. Getty Images
Diabetes devices may be having their iPhone moment.
For decades, the daily routine of diabetics involved painful needles, finger-pricking lancets and imprecise glucose meters. Now, manufacturers have begun incorporating the slick and consumer-friendly designs of Silicon Valley, linking to phones and other tech devices.
This is a crossroads for diabetes technology, said Raj Denhoy, an analyst at Jefferies in New York.
September marked a breakthrough in the US, as regulators approved the first glucose-monitoring system that doesnt need a blood sample, Abbott Laboratories FreeStyle Libre. The new devices do away with fingerpricks, changing an unpleasant, several-times-a-day routine into quiet monitoring in the background through a sensor worn on the back of the upper arm.
Other companies have been left behind. Johnson & Johnson is closing its insulin-pump unit after failing to keep up with Medtronic Plc. DexCom, the current leader in glucose-monitoring systems, lost a third of its market value on Sept. 28 after Abbotts Libre got approval.
On DexComs earnings conference call Wednesday executives, peppered with questions about the Libre, said the company hopes to introduce its own fingerprick-free device before the end of 2018. The comments about next-generation monitors helped assuage investors concerns about DexComs prospects, sending the s Continue reading

Managing Type 2 Diabetes: A Team-BasedApproach

Managing Type 2 Diabetes: A Team-Based Approach Top
Help patients with type 2 diabetes achieve their glycemic goals.
Managing Type 2 Diabetes: A Team-BasedApproach
Marie T. Brown, MD, FACP Rush University, American Medical Association
Katherine A. Kirley, MD, MS American Medical Association
Christine Sinsky, MD, FACP American Medical Association
How will this module help me improve glycemic control and prevent complications in my patients with type 2 diabetes?
Outlines six steps for developing an efficient team-based approach to managing diabetes
Provides answers to common questions about diabetes management for patients with type 2 diabetes
Provides examples from other practices on how they are helping patients achieve their glycemic goals
Increasing administrative responsibilitiesdue to regulatory pressures and evolving payment and care delivery modelsreduce the amount of time physicians spend delivering direct patient care. Diabetes is a complex illness that requires a lot of effort to manage, by both patients and their care teams. This module explains a team-based approach to helping improve glycemic control and prevent complications in patients with type 2 diabetes. Included in this module are ways to evaluate the impact of poor glycemic control on your practice, recommended interventions to pilot with your team, guidance on how to optimize medications, and methods on how best to engage patients in their treatmentplan.
Managing Type 2 Diabetes a team based approach
At the end of this activity, participants will be able to:
At the end of this activity, l Continue reading

Pain Point for People with IBS and Diabetes

10-20 percent of people in the U.S. have IBS and about 10 percent have diabetes. So its a good bet that some of you have both! And even those without a diagnosis of diabetes or pre-diabetes may be concerned about managing blood sugar levels to help with mood or fatigue. Diets for these conditions both revolve around the types and amounts of carbohydrates you consume. The pain point? Some of the best strategies for managing diabetes increase symptoms for people with IBS. Sometimes people who work very hard at improving their diets for diabetes run into big trouble with abdominal and bowel symptoms when they do so. But all is not lost. You can learn to manage both conditions, thanks to other strategies for the two that mesh very nicely.
Meat, fish, seafood, poultry, eggs, and oils dont contain any carbs at all, so they arent really part of this discussion. All other foods do contain carbs. Some of them occur naturally in foods, such as lactose in milk, or starch in potatoes. Fibers in foods such as nuts, whole grains and vegetables are technically considered carbs too. Sweeteners that may be added to prepared foods are sources of carbs. Some of these carbs are FODMAPS. Others are not.
Here are some important pointers for people with diabetes or pre-diabetes, and things to consider for those who are also limiting their FODMAP intake.
There are many good low-FODMAP sources of fiber that people with diabetes can eat. Delicious lower-FODMAP hummus starts with canned, drained chick peas, which are lower in FODMAPs than those used to make commercial hummus. Scroll down to try Continue reading

Headlines from the 2017 ADA Scientific Sessions

Headlines from the 2017 ADA Scientific Sessions
The American Diabetes Association (ADA) recently wrapped up the 78th Scientific Sessions its annual conference for presenting new research in the diabetes field in San Diego. Here is a sampling of studies presented at the meeting:
The popular oral diabetes drug metformin may provide some protection against atherosclerosis (hardening of the arteries) in people with Type 1 diabetes but does not appear to benefit blood sugar control, according to results from the Reducing with Metformin Vascular Adverse Lesions (REMOVAL) trial. A total of 428 people age 40 and over with Type 1 diabetes and at increased cardiovascular risk were randomly assigned to receive either 1,000 milligrams of metformin twice daily or placebo (inactive treatment) for the course of the three-year trial.
The medicine did not significantly reduce carotid artery intima-media thickness, a marker of atherosclerosis, and although it did significantly reduce HbA1c (a measure of glucose control over the previous 23 months), this was only for the first three months of the study. However, metformin did decrease body weight and LDL (bad) cholesterol, indicating that it may have benefits for people with Type 1 diabetes.
The trial changes the way we think about metformin. The guidelines suggest you can add it in obese Type 1 diabetes patients to reduce glucose, but we didnt see much evidence of glucose reduction beyond three months, noted lead investigator John R. Petrie, MD, PhD. Obviously, dont use it for glucose lowering. But consider using it for reducing weig Continue reading