Top Tips: Type 2 Diabetes

Top tips: type 2 diabetes

Dr Kevin Fernando provides top tips on diagnosing and managing type 2 diabetes and identifying people at high risk
identifying people at risk of developing type 2 diabetes and gestational diabetes
tailoring the HbA1c target to the individual
structured education programmes and educational resources that can help patients to self-manage their diabetes.
The State of the nation 2016 (England)time to take control of diabetes report from Diabetes UK warns that 5 million people in England are at high risk of developing type 2 diabetes mellitus (T2DM).1 High-quality evidence from several international diabetes prevention studies shows that early lifestyle intervention can reduce both long-term progression to T2DM,2 and long-term incidence of cardiovascular and all-cause mortality.3 Based on the evidence from five large-scale and tightly controlled randomised trials,3 the NHS Diabetes Prevention Programme46 was launched during 2016 to provide individualised lifestyle support for those at high risk of T2DM.
1 Identify people who are at high risk of T2DM on your practice register
NICE Public Health Guideline (PHG) 38 Type 2 diabetes: prevention in people at high risk recommends the use of a risk-assessment tool such as the QDiabetes-2016 risk calculator to identify patients at high risk of T2DM.7,8 The tool calculates an individuals 10-year risk of developing diabetes; in general, 10% or above is considered high risk.7
NICE PHG38 provides a useful flowchart (see Figure 1, below) outlining recommended interventions for patients at various levels of risk of T2DM:8
if low/medi Continue reading

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Resistance Training for Diabetes Prevention and Therapy: Experimental Findings and Molecular Mechanisms

Resistance Training for Diabetes Prevention and Therapy: Experimental Findings and Molecular Mechanisms
1Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, A-6060 Hall in Tirol, Eduard Wallnoefer-Zentrum 1, Austria
2Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
1Institute for Nutritional Sciences and Physiology, University for Health Sciences, Medical Informatics and Technology, A-6060 Hall in Tirol, Eduard Wallnoefer-Zentrum 1, Austria
2Department of Internal Medicine, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA
Received 2013 Oct 31; Accepted 2013 Dec 9.
Copyright 2013 B. Strasser and D. Pesta.
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
This article has been cited by other articles in PMC.
Type 2 diabetes mellitus (T2D) is characterized by insulin resistance, impaired glycogen synthesis, lipid accumulation, and impaired mitochondrial function. Exercise training has received increasing recognition as a cornerstone in the prevention and treatment of T2D. Emerging research suggests that resistance training (RT) has the power to combat metabolic dysfunction in patients with T2D and seems to be an effective measure to improve overall metabolic health and reduce metabolic risk factors in diabetic patients. However, there is limited Continue reading

Surgical cure for type 2 diabetes by foregut or hindgut operations: a myth or reality? A systematic review

, Volume 31, Issue1 , pp 2537 | Cite as
Surgical cure for type 2 diabetes by foregut or hindgut operations: a myth or reality? A systematic review
Bariatric surgery results in remission of type 2 diabetes mellitus in a significant proportion of patients. Animal research has proposed the foregut and hindgut hypotheses as possible mechanisms of remission of T2DM independent of weight loss. These hypotheses have formed the basis of investigational procedures designed to treat T2DM in non-obese (in addition to obese) patients. The aim of this study was to review the procedures that utilise the foregut and hindgut hypotheses to treat T2DM in humans.
A systematic review was conducted to identify the investigational procedures performed in humans that are based on the foregut and hindgut hypotheses and then to assess their outcomes.
Twenty-four studies reported novel procedures to treat T2DM in humans; only ten utilised glycated haemoglobin A1c (HbA1c) in their definition of remission. Reported remission rates were 2040% for duodenaljejunal bypass (DJB), 7393% for duodenaljejunal bypass with sleeve gastrectomy (DJB-SG), 62.5100% for duodenaljejunal bypass sleeve (DJBS) and 4795.7% for ileal interposition with sleeve gastrectomy (II-SG). When using a predetermined level of HbA1c to define remission, the remission rates were lower (27, 63, 0 and 65%) for DJB, DJB-SG, DJBS and II-SG.
The outcomes of the foregut- and hindgut-based procedures are not better than the outcomes of just one of their components, namely sleeve gastrectomy. The complexity of these procedures in additio Continue reading

Lack of Sleep May Raise Child's Type 2 Diabetes Risk: Study

Lack of Sleep May Raise Child's Type 2 Diabetes Risk: Study
It found link -- but no proof -- between less slumber and risk factors for blood sugar disease
TUESDAY, Aug. 15, 2017 (HealthDay News) -- Children who get too little sleep may be more likely to have risk factors for type 2 diabetes, new research suggests.
The study of more than 4,500 British kids found a link between kids' sleep habits and certain diabetes "risk markers." Children who slept fewer hours each night tended to be a bit heavier and to show more insulin resistance.
Insulin is a hormone that regulates blood sugar levels. When the body starts to become resistant to insulin, that can be a precursor to type 2 diabetes.
So, the findings raise the possibility that childhood sleep habits could affect the odds of diabetes -- or other health conditions -- later in life, said researcher Christopher Owen.
"We believe that these small differences [in diabetes risk markers] early in life could plausibly persist," said Owen, a professor of epidemiology at St. George's, University of London.
Past studies, he noted, have found that diabetes risk can "track" from early life to adulthood.
However, the new findings do not prove that a lack of sleep causes kids' diabetes risk to rise, said Dr. Nicole Glaser.
Glaser, a pediatrician and professor at the University of California, Davis, cowrote an editorial published online with the study in the Aug. 15 issue of Pediatrics.
In it, she points out that there could be other explanations for the link between kids' sleep and diabetes risk markers: For example, it might Continue reading

What it's like to raise a child with type 1 diabetes

Do What You Think You Cant: What its like to raise a child with type 1 diabetes
As part of a new series on the challenges of parenting, Im thrilled to bring a guest post to Foodlets today, written by Leigh Fickling. AKA, the human pancreas. Here is her story.
Almost five years ago, I joined a club that I never signed up for.
A club I had no interest in and had very little knowledge of in the first place. A club that forces you to do math problems in your head all day and all night. That causes you to become an expert in ordering supplies and carefully rationing those supplies until you can get your next order. This club changes its rules for membership almost every day. It beeps with alerts and requires a steady stream of batteries and charging cords. Theres no vacation, no age restrictions yet it has worldwide membership. This club simultaneously creates feelings of loneliness and togetherness. It makes you cry and ache with such profound sadness that you arent sure that you can make it another day.
But, you have to. You have to do what you think that you cant do.
In 2013, my three year old daughter was diagnosed with Type 1 diabetes and our lives were forever changed. I joined the club that no one wants to joinparents of children with diabetes.
In 2013, my three year old daughter was diagnosed with Type 1 diabetes.
Before I go on, lets get some things straight.
I am not a medical professional and I dont play one on TV. I am a higher education administrator and spend most of my days helping people with disabilities access employment or educational experiences bot Continue reading