Diabetic Live

Those Most Prone to Gestational Diabetes: According to PR Newswire, “More than 10 percent of women of Chinese and Korean heritage may be at risk for developing diabetes during pregnancy.”

Kaiser Permanente conducted the study funded by the American Diabetes Association (ADA). The full report can be found in the December issue of the Ethnicity and Disease journal.

The report states, “Pacific Islanders, Filipinos, Puerto Ricans, and Samoans are also at higher-than-average risk – while Caucasian, Native-American, and African-American women have a lower-than-average risk.” The study followed 16,000 women in the state of Hawaii due to the high diversity of ethnicities in that Pacific island state.

To be clear the type of diabetes discussed in this report is gestational diabetes (GDM) that can, “lead to serious pregnancy and birthing complications, including early delivery and C-sections. It can also increase the child’s risk of developing obesity later in life.”

The reason this study has become important is because it is the first time multiple specific ethnicities were broken down in an effort to identify risk associations.

The PR Newswire reports states, “Researchers divided Asians into five ethnic sub-groups and found some striking differences: Korean and Chinese women have the greatest risk of developing GDM. Filipinos are next, but Japanese and Vietnamese women have the same risk as the rest of the population. Among three groups of Pacific Islanders, Samoans and other Pacific Islanders (including women from Fiji and Tahiti) have a higher-than-average risk, while women classified as Native Hawaiians are at average risk. Caucasian, Native-American, and African-American women have the lowest risk for developing GDM.”

Kathryn Pedula, MS, a researcher at the Kaiser Permanente Center for Health Research explains why her company views this as a landmark discovery, “All pregnant women and their caregivers need to be educated about gestational diabetes, but it is especially important for women in these ethnic groups at higher risk.”

The 16,000 + participants in the study were women who delivered babies through Kaiser Permanente Hawaii. Some women had more than one child during the study so the report actually reflects more than 22,000 births from 1995-2003.

Winston F. Wong, MD, MS is a medical director of Kaiser Permanente’s Community Benefit Disparities Improvement and Quality Initiatives. He told PR Newswire, “While we cannot eliminate the increased risk of prenatal diabetes among our Korean and Chinese patients, we use this kind of research to alert and empower our health care professionals and physicians to reduce disparities and achieve the best possible outcomes for our patients and their children.”

As part of this multi-year study mothers-to-be were, “screened for gestational diabetes between 24-28 weeks of pregnancy. If they have GDM, they are treated as part of routine care. More than 20 percent of women in the study had elevated glucose levels.”

MayoClinic.com describes Gestational Diabetes as, “Gestational diabetes is a type of diabetes that occurs only during pregnancy. Like other forms of diabetes, gestational diabetes affects the way your body uses sugar (glucose) — your body’s main source of fuel. Gestational diabetes can cause high blood sugar levels that are unlikely to cause problems for you, but can threaten the health of your unborn baby.

“Any pregnancy complication is concerning, but there’s good news. You can manage gestational diabetes by eating healthy foods, exercising regularly and, if necessary, taking medication. Taking good care of yourself can help ensure a healthy pregnancy for you and a healthy start for your baby.”

Record Breaking Cyclist Tackles Diabetes: He’s won more awards than most cyclists will ever see. He survived testicular cancer and has evoked passion in many who want to see an end to cancer. Lance Armstrong is a much-celebrated figure, but at the moment he’s not thinking about the 2010 tour de France – he’s thinking about diabetes.

Armstrong became impassioned with sports when he started as a swimmer back in Texas as a boy. He would later advance to triathlons and then on to cycling. Many sports organizations have named him sportsman of the year and he has defied the odds in overcoming health difficulties that has resulted in the death of many.

In 2004 he started the Lance Armstrong Foundation. A yellow rubberized bracelet that read “Livestrong” was a key to raising funds for the organization. Millions of bands have sold and Armstrong uses his cycling as a way to raise awareness for the needs of cancer patients. More than 70 million of these wristbands have been sold at $1 per band. The money raised has gone to cancer research.

No one can fault Armstrong for his passion for cancer research. After all the cause was very personal. His passion propelled the cause and raised awareness. However, at the dawn of a new decade Armstrong is adding a new cause to his health awareness plate.

According to BusinessWire.com, “LIVESTRONG.COM, an online destination for health, fitness and lifestyle-related information… announced the launch of MyPlate D, a free online nutrition tracking tool designed to empower people with diabetes to take control of their disease and to help those who are at risk make healthier choices. LIVESTRONG.COM began testing this new tool in conjunction with National Diabetes Month and is now releasing it to a wider audience to raise awareness of the disease. According to the American Diabetes Association, 23.6 million adults and children in the United States — nearly 8 percent of the population — have diabetes.”

Lance Armstrong is quoted as saying, “LIVESTRONG.COM was created to help consumers take action and reduce their risks for diseases and illness by making small, positive changes in their daily lives. MyPlate D was really just the next step in developing an all-encompassing and cohesive resource for risk reduction.”

BusinessWire.com describes the new service by saying, “MyPlate D includes comprehensive nutrition information which enables users to track calories, fat, protein and carbohydrates for more than 625,000 food items. The tool also allows users to view their overall nutrition, as well as in-depth data about specific foods to balance their nutritional intake with daily activities and exercise.”

Armstrong has been very active in developing online tools and using social media to enhance his position on health related issues and the MyPlate D program is an expansion of the belief that many people are getting information online so, by extension, this program has the potential to reaching out to many who might not attend a local class on a particular subject or may be too embarrassed to ask questions about diabetes.

The new service will also have a community function by allowing users to interact with each other while utilizing tools that can help them reach and maintain personal health objectives. Francine R. Kaufman, M.D. and LIVESTRONG.COM expert said, “We designed MyPlate D to give users the tools to make better choices, and immediately see how changes in diet impact their overall health.”

Diabetic Benefits in Coffee and Tea: Do you consider coffee drinking to be a vice that you might need to give up in order to maintain optimum health? Maybe the vice is actually a source of improved health and diabetes avoidance? New evidence seems to support the claim.

According to EndocrineToday.com, “Drinking three to four cups of tea and regular or decaffeinated coffee per day was associated with a 5% to 10% lower risk for diabetes, according to a new meta-analysis published in the Archives of Internal Medicine.”

Research seemed to indicate it isn’t necessarily the caffeine that helps either. Those who participated in the study could drink either caffeinated or decaffeinated version of coffee and as long as they drank more than three cups a day they experienced about a 25% reduction in the likelihood of diabetes development. The results were very similar for those who enjoyed drinking tea.

The key seems to be the total volume of product consumed. The benefits decrease when fewer than 3 cups are consumed in a day.

And just so you don’t think this is a small study, consider this…

“Researchers pooled data on 18 studies during 1966 and 2009 including 457,922 participants that examined the association between coffee consumption and risk for diabetes. Six studies included 225,516 participants and assessed the association with decaffeinated coffee; seven studies included 286,701 participants and assessed the association with tea consumption.”

To add counterbalance to the report EndocrineToday.com also quoted Lars Rydén, MD PhD. “Coffee helps, but other things are even more important. Those who are overweight should reduce their body weight by 5% to 10% and include physical activity such as a brisk walk for 30 minutes a day. Then those people who are at risk of developing diabetes will reduce this risk by 40% to 50%. It is interesting to consider why a beverage like coffee has a beneficial effect. It is obviously not the caffeine, as decaffeinated coffee has the same efficiency as caffeinated coffee. Coffee may contain antioxidants but the studies have not measured the number of chemicals in the blood which is important.”

In other words an individual should not automatically conclude that the consumption of coffee or tea would be the only thing they are required to do in order to avoid the development of diabetes. We all need to be conscious of the need to make wise choices in what we eat and to add physical challenges to our daily list of things to do.

Another word of caution comes from Dr Victoria King, of Diabetes UK who told the BBC, “Without full information about what other factors may be influencing the type 2 diabetes risk of the studies’ participants – such as their physical activity levels and diet – as well as what the active ingredient in tea or coffee appears to be, we cannot be sure what, if anything, this observed effect is down to,” according to RedOrbit.com.

While more calls are made for additional studies it is theorized that perhaps the, “magnesium, lignans, or antioxidants,” in the coffee and tea may account for the reduction in diabetes risk.

While physicians are encouraging their patients to exercise, eat right and lose some weight those same doctors may also now be less inclined to restrict their patients from drinking coffee and/or tea.

When Obesity Doesn’t Always Mean Diabetes: It’s well documented that obesity and diabetes go hand in hand. However a chance encounter with a gene not previously linked to diabetes may have researchers reconsidering what they know, how they apply that knowledge and what it may ultimately mean to overweight patients.

ScienceDaily.com reports, “The chance discovery of a genetic mutation that makes mice enormously fat but protects them from diabetes has given researchers at Boston University School of Medicine, USA, new insights into the cellular mechanisms that link obesity to Type 2 diabetes. Dr Gerald Denis and his colleagues report their findings in the current issue of The Biochemical Journal.”

The gene is known as Brd2 and, “In mice where there had been a single, genetic change in the Brd2 gene, fortuitously reducing its expression, the mice became severely obese — but did not go on to develop Type 2 diabetes. This result was very surprising because in both ‘mice and men’, chronic obesity commonly leads to Type 2 diabetes, with its life-threatening consequences, including heart disease, kidney and nerve damage, osteoporosis, blindness and circulation problems in the feet that can require amputation.”

You need to understand that the ‘fat’ mice would have been comparable to a man weighing 600 pounds. According to ScienceDaily.com the overweight mice, “Exercised at the same levels as normal mice and, in comparison, lived for a surprisingly long time.”

This same report indicates, “There is an urgent need for a much deeper biological understanding of the forces that link obesity and diabetes, in order to design new drugs and therapies for treatment.”

There are some individuals who are obese, yet do not develop diabetes. It is believed that an individual can be overweight and non-diabetic with a correctly functioning metabolism. It is when the metabolism slows down that diabetes can develop. Dr Denis is quoted by ScienceDaily.com as saying, “Studies have shown that these individuals have a reduced ‘inflammatory profile’. Inflammation caused by normal immune cells called macrophages leads to insulin resistance and Type 2 diabetes — this inflammation is typically seen in connection with obesity but it is the inflammation that is a trigger for diabetes, not the obesity itself. The mechanisms that explain this protection from diabetes are not well understood.”

In describing what may be happening in the body of the individual Dr. Denis said, “Much like these protected obese humans, the Brd2-deficient mice have reduced inflammation of fat and never develop failure of the beta cells in the pancreas that is associated with Type 2 diabetes.”

The research on Brd2 was at least partially funded by the National Institutes of Health and Dr Denis was quick to point out, “The strong influence of Brd2 levels on insulin production and action suggest that Brd2 is likely to be a promising target for diabetes treatment, but also imply that overactive Brd2 might cause diabetes. The ways in which Brd2 affects the immune system may also play a part in Type 1 diabetes, further studies to determine this are needed.”

These finding are reported in concert with other studies that are looking to genetic manipulation to turn off genetic triggers that can result in diabetes. Obviously this type of research is not taken lightly and needs additional findings to confirm the true value of the information that may be best described as preliminary.

Dental Diabetes Detection: Does it make sense to offer diabetic screenings in a dental office? New research tends to suggest that under specific circumstances it does.

According to ScienceDaily.com, “An overwhelming majority of people who have periodontal (gum) disease are also at high risk for diabetes and should be screened for diabetes, a New York University nursing-dental research team has found. The researchers also determined that half of those at risk had seen a dentist in the previous year, concluded that dentists should consider offering diabetes screenings in their offices, and described practical approaches to conducting diabetes screenings in dental offices.”

Data was examined from 2,923 adult dental patients over a two-year period. These patients “had not been diagnosed with diabetes.”

Dr. Shiela Strauss is an Associate Professor of Nursing and Co-Director of the Statistics and Data Management Core for NYU’s Colleges of Dentistry and Nursing. Strauss led the study conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention.

According to ScienceDaily.com, “Using guidelines established by the American Diabetes Association, Dr. Strauss determined that 93 percent of subjects who had periodontal disease, compared to 63 percent of those without the disease, were considered to be at high risk for diabetes and should be screened for diabetes. The guidelines recommend diabetes screening for people at least 45 years of age with a body mass index (a comparative measure of weight and height) of 25 or more, as well as for those under 45 years of age with a BMI of 25 or more who also have at least one additional diabetes risk factor. In Dr. Strauss’s study, two of those additional risk factors — high blood pressure and a first-degree relative (a parent or sibling) with diabetes — were reported in a significantly greater number of subjects with periodontal disease than in subjects without the disease. Dr. Strauss’s findings, published today in the online edition of the Journal of Public Health Dentistry, add to a growing body of evidence linking periodontal infections to an increased risk for diabetes.”

The reason Strauss suggests using the dental office to conduct diabetic screenings is that many patients will visit the dentist when they will not routinely visit their family doctor, “Three in five reported a dental visit in the past two years; half in the past year; and a third in the past six months,” she said. These statistics seem to suggest a helpful health link between early diagnosis of diabetes and dental visits.

Strauss commented, “The issue of undiagnosed diabetes is especially critical because early treatment and secondary prevention efforts may help to prevent or delay the long-term complications of diabetes that are responsible for reduced quality of life and increased levels of mortality among these patients. Thus, there is a critical need to increase opportunities for diabetes screening and early diabetes detection.”

While it has been suggested dentists might use a standard glucose meter to test blood sugar samples in patients there are others who believe a gum tissue blood sample could be viewed as standard procedure among patients who don’t generally expect a finger prick in a dental office.

We have yet to see if dental offices will become a first line defense for diabetes detection, but the idea does appear to have merit. If a routine dental visit can help identify what is believed to be a large number of undiagnosed cases there may be room for improved quality of life by starting intervention therapies earlier.

A Partnership to Save Beta Cells: What would it be like for those who may be prone to the development of Type 1 diabetes to encounter a solution that stops beta cells from being destroyed? A newly announced partnership hopes to answer that question.

According to PRNewswire.com, “The Juvenile Diabetes Research Foundation, a leader in setting the agenda for diabetes research worldwide, said that it will begin working with The Johnson & Johnson Corporate Office of Science and Technology, and its affiliates, to speed the development of drug targets and pathways to promote the survival and function of insulin-producing cells in people who have diabetes. The program will look to fund research at academic centers around the world that could eventually lead to novel drug targets and industry collaborations for the treatment of type 1 diabetes.”

It may not be possible to completely stop the development of type 1 diabetes, but the long-term consequences could be diminished if insulin-producing cells can be spared from damage following an initial attack, “The joint program will solicit grant proposals from academia and medical research foundations for one- or two-year research projects. The research will focus on agents and compounds that safely promote survival and function of beta cells – the cells within the pancreas that produce insulin, and that are lost in the immune attack that causes type 1 diabetes. Preserving or maintaining beta cell mass and activity in people with type 1 diabetes can reduce insulin requirements, make controlling the disease easier and more effective, and lower the risk of both short- and long-term complications of the disease,” according to the PRNewswire report.

The release further quotes Alan J. Lewis, Ph.D., President and Chief Executive Officer of the Juvenile Diabetes Research Foundation, “This program will clearly help accelerate the translation of basic research into therapies useful in the treatment of diabetes. By creating this novel incubator program to support early stage research with a company known for first-class research and significant experience in the commercialization of products, we believe we can increase the number of viable drug targets identified and fundamentally change the pace of diabetes research.”

In type 1 diabetes the problem always originals with damaged cells that effectively destroy the ability of the pancreas to produce needed insulin. If therapies can be developed that result in salvaging remaining cells this would be a huge plus to type 1 diabetics. It could also be argued that if this partnership is successful it may be possible to develop therapies that not only preserve remaining cells, but also prevent damage before it starts.

Martin Fitchet, M.D., Therapeutic Area Head, Cardiovascular and Metabolism for Johnson & Johnson Pharmaceutical Research and Development, L.L.C was also quoted in the PRNewswire release, “Beta cell survival is a critical research focus to advance the understanding of the natural history of diabetes, and importantly, where to intervene to slow or arrest the progression of this disease. Establishing this alliance with The Juvenile Diabetes Research Foundation is a part of our commitment to access external innovation to drive discovery and development of new therapies for the patients who most need them.”

The partnership is designed to fast track ideas and initiatives that can accelerate the dynamics of diabetes research in a critical area that attempt to get at the root of the most prevalent problem in type 1 diabetes and provide substantial assistance in an arena that has previously been closed to medical intervention.

A New Way to Test for Prediabetes: Screening for new diabetes cases has always been a challenge because testing isn’t mandatory and current testing is very specific in how it is administered. However, a test not currently used for diagnosing diabetes may be added as a less restrictive way to check for the presence of the disease.

The American Diabetes Association (ADA) recently recommended using the A1C test as a way to identify those who are diabetic and prediabetic.

According to WebMD, “Patients do not need to fast before the test is given, and it is far less likely to identify clinically irrelevant fluctuations in blood sugar because it measures average blood glucose levels over several months.”

This is important because no special preparation for the test is required and can be administered during any routine visit to the doctor if the physician feels it is warranted.

John Buse, MD, PhD, ADA president for medicine and science told WebMD, “We now know that early diagnosis and treatment can have a huge impact on outcomes by preventing the complications commonly seen when diabetes is not well controlled. Our hope is that people with early or prediabetes who might otherwise not be tested would have the A1C test.”

While the A1C test has been available for more than three decades it has taken some time for the test to be considered a reliable test for diabetes detection.

WebMD suggests diabetic testing for the following…

• Any adult who is overweight or obese (BMI of 25 or greater) with one or more additional risk factor for diabetes including: having a family history of the disease, belonging to a high-risk ethnic group (African-American, Latino, Native American, Asian-American), having high blood pressure or a history of gestational diabetes.
• Anyone who is age 45 or older, regardless of risk factors. (Source: WebMD)

When A1C levels are above 6.5 an individual is diagnosed as diabetic. Anything reading between 5.7 and 6.4 is considered pre-diabetic. A healthy patient should have an A1C level of around 5.

While the A1C test is not to be used as a replacement for current tests Buse believes the addition of this test could help identify millions of prediabetics who have not had any traditional tests. Buse told WebMD, “I’m thinking of an overweight guy who is 40 years old who doesn’t see the doctor unless he strains his back or is sick.”

If an individual who is overweight could reduced their overall weight by 5-10% most risk factors for diabetes are reduced by as much as 60% according to the report.

This goal is achieved through lifestyle alterations and adding physical exercise to your daily routine. The ADA would like to see insurance companies help by paying for programs for those diagnosed as prediabetic. No word on if that will happen, but the pressure is on for a greater awareness and diagnoses of prediabetes – and then removing the obstacles that stand in the way of good health.

The potential of a test that identifies those most at risk for developing diabetes is important because early detection can allow choices to be made that could prevent the disease from further development.

If you overweight and are 45 years of age or older this might be a great test to help you get on track with long-term health objectives.

Couch Potatoes Run the Risk of Death: Shocking research from Australia indicates that people who spend too much time in front of the TV often find themselves at pronounced risk of death or critical health care issues.

According to WiredPRNews.com, “A recent study suggests that too much time in front the television can be bad for the health of individuals; regardless of whether they are overweight or at a healthy weight. As reported by Reuters, Australian researchers found that hours spent sitting in front of a television daily can increase risks of death from heart complications and other health conditions.”

This sedentary lifestyle can result in obesity, which can it turn develop into diabetes. Study leader David Dunstan, of the Baker Heart and Diabetes Institute, is quoted in the report as remarking, “A lot of the normal activities of daily living that involved standing up and moving the muscles in the body have been converted to sitting… For many people, on a daily basis, they simply shift from one chair to another – from the chair in the car to the chair in the office to the chair in front of the television,” according to WiredPRNews.com.

The average television viewing time in America is 5 hours a day. This exceeds the amount researchers felt was acceptable. In fact the study shows that watching more than 4 hours of television each day can result in an 80% greater chance of death by cardiovascular disease and a 46% greater chance of death through other means.

What Causes Death in Watching TV?

You may be surprised to know that weight isn’t always a contributing factor in those who watch TV and struggle with disease. The real culprit seems to be in the act of sitting still for long periods of time. It appears that even those who spend up to an hour each day in exercise can face similar problems if they spend significant amounts of time in activities in which they remain still.

These activities could be reading a book, checking out the web, in a car commuting from one place to another or at a desk in an office.

Our bodies are designed to be used. When we sit without any movement we can cause our bodies to experience problems they weren’t made to handle.

So, is TV Watching Out?

Not necessarily. You might try a stationary bike while watching TV or fold clothes or perform other household chores that still allow you to watch your favorite show. Some individuals might experience better health by not using the remote to change the television or perhaps to use commercial breaks to walk around the house until the show comes back on.

The real key here is to pay attention to how much time you spend sitting still. In school academic activity is broken up by physical movement. The same should be true in the life of a family. Limit the amount of time a child spends playing video games. Transfer some of the time you might spend in watching TV to an evening walk or time on a treadmill.

If you work in an office take the time to walk a report to a colleague or to find time to locate office supplies you need rather than using the intercom to ask for it to be brought to your office. Find ways to get and stay mobile. Your long-term health is more important than what’s new on television tonight.

A Compelling Reason to Never Start Smoking: What if I were to tell you that people who stop smoking are 70% more likely to develop diabetes? I suppose that depends on whether you’ve only considered smoking and this convinces you not to – or if you are a smoker and have considered stopping.

It’s a new year and many individuals are doing their best to kick a habit that does damage to the lungs and often shortens life expectancy, but new information has many struggling with how to make wise decisions.

A new study followed 10,000 people who did not have diabetes when the study began. What researchers discovered was that a significant portion of those who quit smoking for health reasons were also prone to the development of diabetes.

The common thread in these findings was that of weight gain. Patients who quit smoking often substituted their craving for nicotine with a craving for something else. This was usually fulfilled in eating comfort foods. Essentially the weight gain from these coping mechanisms resulted in conditions in which diabetes could develop.

There is good news in this story. According to Guardian.co.uk the diabetes risk spiked in the first three year. “It then slowly reduced, over about 10 years, down to the level of risk of someone who never smoked,” the report indicated.

What if weight gain was not a problem? Well according to that same report, “The risk of diabetes from stopping smoking was almost cancelled out when they took account of the amount of weight people gained. So a smoker who didn’t gain weight after stopping might have little or no increased risk of diabetes.”

This works to confirm the long-standing research that indicates excess weight is often a profound contributor to diabetes.

According to Guardian.co.uk, “The study was done by researchers at universities in the US (Johns Hopkins University School of Medicine) and in Brazil. It was published in a journal called the Annals of Internal Medicine. The study was funded by grants from the National Heart, Lung, and Blood Institute and National Institute of Diabetes and Digestive and Kidney Diseases in the US.”

To be clear this report is in no way suggesting that people who smoke should continue smoking. The health risks make stopping not only reasonable, but also responsible. The overriding consensus seems to be that those who stop smoking should also be very aware of potential weight gain and work with their health care provider to maintain the weight while they break the chains of cigarette addiction.

Perhaps critical to this story is the idea that the best defense is a proactive offense. As diabetic rates continue to rise to unprecedented levels it may make more sense that ever to encourage young people to refrain from smoking in the first place. If a young person can really grasp the notion that the smoke damages the lungs and increases risk for heart attack and stroke they might think about not smoking. If they also understand that by trying to quit smoking once they start the end result could be diabetes they may rightfully conclude that it is a waste of time to pick up the habit.

Like almost everything in life it all comes down to choices. Some you can make early and can affect you for a lifetime. Others are made later and may provide more challenging circumstances to deal with.