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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.</p> <p>Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>.</p> <p>More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it.</p> <p>So, what is type 1.5 diabetes? And how is it diagnosed and treated?</p> <h2>There are several types of diabetes</h2> <p>Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2.</p> <p>Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.</p> <p>Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults.</p> <p>Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.</p> <p>Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.</p> <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> <p>Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis.</p> <p>Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.</p> <p>Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes.</p> <h2>What are the symptoms, and how is it treated?</h2> <p>The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>:</p> <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> <p>Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.</p> <p>When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes.</p> <h2>Type 1.5 diabetes is often misdiagnosed</h2> <p>Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>.</p> <p>There are a few possible reasons for this.</p> <p>First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.</p> <p>Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).</p> <p>Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.</p> <p>Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2.</p> <h2>We’re still learning about type 1.5</h2> <p>Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.</p> <p>Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition.</p> <p>A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.</p> <p>Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>.</em></p> </div>

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Does eating ham, bacon and beef really increase your risk of developing type 2 diabetes?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>That lunchtime staple, the humble ham sandwich, has come in for a bashing in the press recently. According to <a href="https://www.theguardian.com/society/article/2024/aug/20/two-slices-of-ham-a-day-can-raise-type-2-diabetes-risk-by-15-research-suggests">many</a> <a href="https://www.dailymail.co.uk/health/article-13761253/Eating-ham-daily-linked-increase-risk-diabetes.html">reports</a>, eating two slices of ham a day can increase your risk of developing type 2 diabetes.</p> <p>But what’s the science behind these headlines?</p> <p>The research offers a more complex picture. <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext">A new study</a> from the University of Cambridge highlighted an association between developing type 2 diabetes and eating processed meat like ham and bacon, and red meat such as beef and lamb.</p> <p>This led to headlines suggesting the risk was mainly linked to <a href="https://www.telegraph.co.uk/news/2024/08/21/ham-sandwich-processed-meat-fresh-risk-link-type-2-diabetes/">ham sandwiches</a>. This seems to have come from the <a href="https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk">press release</a>, which used ham as the example to quantify the amount of processed meat associated with a 15% increased risk of developing type 2 diabetes over ten years.</p> <p>The research found that this risk was linked to eating an extra 50g of processed meat every day, which happens to equate to two slices of ham. A useful example thus appears to have been taken up by the media as the main cause, perhaps ignoring some of the key messages coming from the study.</p> <p>So, can processed and red meat really increase your risk of developing type 2 diabetes?</p> <p>The <a href="https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/diabetes-risk-factors">biggest risk factors</a> linked to developing type 2 diabetes are being over 40, having family members with type 2 diabetes, being of South Asian or African descent, or having a higher body weight – and especially a larger waist.</p> <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The Cambridge study used data from nearly 2 million people from 31 studies. Participants were followed for an average of ten years. During this time, around one in 20 people developed type 2 diabetes.</p> <p>The research suggested that a 10% increase in the probability of developing type 2 diabetes was associated with every 100g of additional red meat eaten daily. Eating half as much extra processed meat every day was linked to an even greater increased risk of developing the disease.</p> <p>This is not the <a href="https://ajcn.nutrition.org/article/S0002-9165(23)66119-2/abstract">first time</a> that both processed and red meats have been linked with an increased risk of developing type 2 diabetes. However, the key strength of the Cambridge study was that it tried to control for many of the other factors linked to the disease, including smoking, having a higher body weight, dietary intake and exercise.</p> <p>However, the size of the increased risk is modest, considering few people included in the study ate 50g or more processed meat per day – meaning moderate ham consumption is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908545/">no meaningful effect</a> on your risk.</p> <h2>What’s the link?</h2> <p>Processed meat has been linked to increased risk of type 2 diabetes because of its nitrate and salt content – additives that are used to cure many processed meats.</p> <p>Nitrates and salt in processed meats have also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893523/">been linked to</a> an increased risk of developing colon cancer. In fact, the World Health Organization classifies the additives as <a href="https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat">group 1 carcinogens</a>, which means they can cause a range of cancers.</p> <p>The mechanism linking processed meat to cancer seems to be similar to how it might be linked to type 2 diabetes. During digestion, processed meat produces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/">N-nitroso chemicals</a>, which can damage cells. This can lead to inflammation and affects how insulin, the hormone that controls blood glucose (sugar), works. This in turn can lead to <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance">insulin resistance</a>, when cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood.</p> <p>Red meat, meanwhile, is <a href="https://www.healthline.com/nutrition/healthy-iron-rich-foods">rich in iron</a>. Research suggests that people with <a href="https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes#:%7E:text=So%20a%20rise%20of%20iron,GP%20as%20soon%20as%20possible.">high levels of iron</a> are more likely to develop type 2 diabetes. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744124/#:%7E:text=The%20WHO%20has%20recognised%20iron,being%20affected%20with%20this%20condition.">low levels of iron</a> are more of a health concern for the general population.</p> <p>Another potential link regarding red meat could be the way it is cooked.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521980/">Previous studies</a> have suggested that charred meat, cooked over an open flame or at high temperature, is also linked to an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911789/">type 2 diabetes</a>. Charring meat leads to formation of toxic chemicals such as <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/heterocyclic-amine#:%7E:text=Heterocyclic%20amines%20are%20aromatic%20compounds,of%20reactions%20called%20Maillard%20reactions.">heterocyclic aromatic amines</a> and harmful compounds like <a href="https://www.healthline.com/nutrition/advanced-glycation-end-products">advanced glycation end products</a>, both of which have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/21709297/">insulin resistance and type 2 diabetes</a>.</p> <h2>Bye-bye barbecues and bacon butties?</h2> <p>The key message is reduction, rather than avoidance. The UK government nutritional recommendations offer sound advice: limit your combined intake of red and processed meat to no more than <a href="https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/#:%7E:text=Red%20meat%20and%20processed%20meat&amp;text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>.</p> <p>But these guidelines also suggest that red meat can be a valuable source of iron. So, if you decide to stop eating red meat, you should eat alternative sources of iron such as beans, lentils, dark green vegetables and fortified cereals.</p> <p>This needs to be done as part of a carefully planned diet. Non-meat sources of iron are more difficult for our bodies to absorb so should be eaten with a source of vitamin C, found in green vegetables and citrus fruit.</p> <p>The best advice to reduce your risk of developing type 2 diabetes is to maintain a healthy weight – consider losing weight if you have a higher body weight – and be as physically active as possible.</p> <p>A healthy diet should be based on plenty of vegetables, fruit, beans, peas, lentils, nuts and seeds, along with some wholegrain foods, some dairy products, fish and white meat (or vegetarian alternatives) – plus moderate amounts of red meat and minimal processed meat. This will help reduce your risk of type 2 diabetes, <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating">heart disease</a>, and <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/does-having-a-healthy-diet-reduce-my-risk-of-cancer">many cancers</a> – as well being more <a href="https://www.bda.uk.com/static/539e2268-7991-4d24-b9ee867c1b2808fc/a1283104-a0dd-476b-bda723452ae93870/one%20blue%20dot%20reference%20guide.pdf">environmentally sustainable</a>.</p> <p>But if you have a penchant for ham sandwiches, rest assured you can continue to indulge as an occasional treat. It’s your overall lifestyle and diet that really matter for your health and risk of developing type 2 diabetes.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237346/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Visiting Academic, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-eating-ham-bacon-and-beef-really-increase-your-risk-of-developing-type-2-diabetes-237346">original article</a>.</em></p> </div>

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Revolutionary diabetes detection via smartphone: A game-changer in healthcare

<p>In a groundbreaking advancement, scientists from <a href="https://www.klick.com/" target="_blank" rel="noopener">Klick Labs</a> have discovered a method that could revolutionise diabetes detection – using just a 10-second smartphone voice recording.</p> <p>No more travelling to clinics or waiting anxiously for blood test results. This new approach promises immediate, on-the-spot results, potentially transforming how we diagnose type 2 diabetes.</p> <p>The study, published in <a href="https://www.mcpdigitalhealth.org/article/S2949-7612(23)00073-1/fulltext" target="_blank" rel="noopener">Mayo Clinic Proceedings: Digital Health</a>, involved 267 participants, including 192 non-diabetic and 75 type 2 diabetic individuals. Each participant recorded a specific phrase on their smartphone multiple times a day over two weeks, resulting in 18,465 recordings.</p> <p>These recordings, lasting between six and 10 seconds each, were meticulously analysed for 14 acoustic features, such as pitch and intensity. Remarkably, these features exhibited consistent differences between diabetic and non-diabetic individuals, differences too subtle for the human ear but detectable by sophisticated signal processing software.</p> <p>Building on this discovery, the scientists developed an AI-based program to analyse the voice recordings alongside patient data like age, sex, height and weight. The results were impressive: the program accurately identified type 2 diabetes in women 89% of the time and in men 86% of the time.</p> <p>These figures are competitive with traditional methods, where fasting blood glucose tests show 85% accuracy and other methods, like glycated haemoglobin and oral glucose tolerance tests, range between 91% and 92%.</p> <p>"This technology has the potential to remove barriers entirely," said Jaycee Kaufman, a research scientist at Klick Labs and the study's lead author. Traditional diabetes detection methods can be time-consuming, costly and inconvenient, but voice technology could change all that, providing a faster, more accessible solution.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Looking ahead, the team plans to conduct further tests on a larger, more diverse population to refine and validate this innovative approach. If successful, this could mark a significant leap forward in diabetes management and overall healthcare, making early detection simpler and more accessible than ever before.</span></p> <p>Stay tuned as this exciting development unfolds, potentially bringing us closer to a future where managing and detecting diabetes is as simple as speaking into your smartphone.</p> <p><em>Image: Shutterstock</em></p>

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Could not getting enough sleep increase your risk of type 2 diabetes?

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936"><em>University of Technology Sydney</em></a></em></p> <p>Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.</p> <p>So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.</p> <h2>The study</h2> <p>Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.</p> <p>The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.</p> <p>As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.</p> <p>Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.</p> <p>The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.</p> <p>One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.</p> <p>Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.</p> <h2>Why might short sleep increase diabetes risk?</h2> <p>In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.</p> <p>We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.</p> <p>Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>.</p> <p>This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.</p> <p>These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.</p> <p>While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.</p> <p>Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.</p> <p>The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>.</p> <h2>Good sleep, healthy diet</h2> <p>Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.</p> <p>Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.</p> <p>While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health.</p> <p>The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk.</p> <p>In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.</em></p> </div>

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12 signs that you’re borderline diabetic

<p><strong>Do you have diabetes?</strong></p> <p>If you are a borderline diabetic, it means you have prediabetes. Your blood sugar levels are higher than normal, but not enough to be diagnosed with full-blown type 2 diabetes. Maybe you’ve noticed that you’re losing weight or more tired than normal. Or perhaps you’re thirsty or have vision issues. Here’s a look at some of the more common signs that you could be a borderline diabetic.</p> <p><strong>You’re really thirsty and are peeing a lot</strong></p> <p>“Prediabetes is caused when the body is unable to efficiently process blood sugars,” says endocrinologist Dr Jason Ng. “This happens over time as the body builds up resistance to insulin, the hormone that helps the body control blood sugars.” As you become insulin resistant, the body has to produce more insulin to keep blood sugars at a good level.</p> <p>Eventually it can’t keep up, so blood sugars rise. Prediabetes may take you by surprise, as there often aren’t symptoms – though there are a few subtle cues you can look out for. “A patient may feel slightly more thirsty and have to urinate more over time as well as the sugars increase in their body,” Dr Ng says.</p> <p><strong>You're exhausted </strong></p> <p>Borderline diabetes could be one of the medical reasons you’re tired all the time. If you’re one of the 2 million Australians who have prediabetes, according to Diabetes Australia you may notice you’re not feeling up to your normal activity level. “Patients may feel more tired or sluggish,” Dr Ng says. Blood sugar fluctuations can cause fatigue; plus, other factors that often appear with blood sugar problems could be the culprit, such as depression or obesity, according to a study published in 2012 in Diabetes Educator.</p> <p>Physical activity is recommended by the American Diabetes Association to help with prediabetes symptoms, but ironically people with the condition may be too tired to exercise. If that’s the case, see your doctor. “Most of prediabetes is diagnosed by lab work at a doctor’s office,” Dr Ng says. With prediabetes, “fasting sugar is between 100 to 125 mg/dl or a random blood sugar between 140 to 200 mg/dl.”</p> <p><strong>You’re losing weight</strong></p> <p>Among the silent diabetes signs you might be missing is weight loss. Although we associate blood sugar problems with being overweight, once you start becoming borderline diabetic you may actually drop kilos. If you’re going to the bathroom more frequently, you’re excreting extra sugar and losing more kilojoules. Diabetes may also keep sugar in your food from reaching your cells.</p> <p>This might leave you “feeling hungry all the time,” says Dr Deena Adimoolam, assistant professor of medicine, endocrinology, diabetes and bone disease. So if you’re eating more than usual and still losing weight, talk to your doctor.</p> <p><strong>You have blurred vision </strong></p> <p>One of the clear signs you have high blood sugar is actually not seeing clearly. Dr Adimoolam says that blurred vision is a sign that you’re borderline prediabetic. Why? Diabetic eye disease occurs when high blood sugar causes damage to the blood vessels in the eye, which can leak and swell, leading to vision changes. According to the National Eye Institute, one type of eye damage, diabetic retinopathy, is the leading cause of vision loss among people with diabetes and the leading cause of blindness among adults.</p> <p>A study by The Diabetes Prevention Program (DPP) found that 8 per cent of prediabetic participants had diabetic retinopathy. It can be addressed if caught early, so bring up blurry vision to your doctor as soon as you notice it.</p> <p><strong>You have dark areas on your skin</strong></p> <p>One body changes that could signal a bigger problem that you are borderline prediabetic are dark patches on your skin called acanthosis nigricans (AN). The condition usually appears in elbows, armpits, knees, or on the neck, has a velvety texture, and likely occurs because excess insulin causes a rapid growth of cells. It’s also more common in people with obesity – another risk factor for prediabetes.</p> <p>But a study published in the Annals of Family Medicine showed that although patients with AN tend to have multiple risk factors for diabetes, AN itself may also be an independent risk factor for the disease. Because of this, AN’s presence may help doctors detect prediabetes sooner.</p> <p><strong>You have PCOS</strong></p> <p>Polycystic ovary syndrome (PCOS) is a disorder where a woman’s hormones are unbalanced. Studies like one published in the Journal of Clinical Endocrinology and Metabolism in 2017, have shown that PCOS is a risk factor for diabetes.</p> <p>It’s not known exactly how they are linked, but researchers are looking into the connection between PCOS and insulin. High levels of insulin may contribute to increased production of male hormones called androgens, which is a symptom of PCOS. PCOS is also associated with being overweight, as is prediabetes – but studies have shown that even average-weight women with PCOS are at increased risk of high blood sugar.</p> <p>Also, women with PCOS may be more likely to have gestational diabetes (diabetes while pregnant; more on that later), which also can lead to an increased risk of type 2 diabetes. If you are diagnosed with PCOS, your reproductive endocrinologist may test your glucose level to make sure you’re not borderline prediabetic.</p> <p><strong>You don't get good sleep </strong></p> <p>“When you don’t get enough sleep, less insulin is released in the body,” says Dr Richard Shane, behavioural sleep therapist. “Sleep deprivation can cause insulin-producing cells to fail to use the insulin efficiently or to stop functioning. Your body also secretes more stress hormones, which interfere with insulin’s ability to be effective.”</p> <p>In one study, duration and quality of sleep was shown to be associated with prediabetes. Another factor could be that we tend to crave kilojoules and junk food for energy when we’re tired – plus, we don’t feel like exercising. This can lead to inactivity and weight gain, other risk factors for prediabetes.</p> <p><strong>You have a family history of diabetes</strong></p> <p>Among the medical facts you should know is your family’s health history. “There can be a genetic cause for the development of type 2 diabetes due to certain gene mutations,” Dr Adimoolam says. “Some people may have a genetic predisposition to developing type 2 diabetes due to presence of certain genes than have been passed down from one generation to the next.” One study in Diabetologia found that a family history of diabetes increased the risk for prediabetes by 26 per cent.</p> <p>The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that you’re more likely to develop diabetes if you have a family history of the disease. In addition, “Some data suggests that the risk of type 2 diabetes is five times higher in those with diabetes on both the maternal and paternal sides of the family,” Dr Adimoolam says.</p> <p><strong>You're of a certain age </strong></p> <p>There are many reasons why you’ll age better than your parents, including that you know age itself is a risk factor for certain conditions – so you’ll take measures to prevent them. Unfortunately, prediabetes is more likely in older people. “The higher your age, the greater risk for development of diabetes,” Dr Adimoolam says. “This might be related to increased body fat with age, which increases one’s risk for type 2 diabetes.”</p> <p>In addition, Dr Ng says that high blood pressure and high cholesterol are also risk factors for prediabetes. These are all common conditions as we age, and are also associated with metabolic syndrome, a cluster of disorders that can lead to heart disease and stroke.</p> <p><strong>You had gestational diabetes</strong></p> <p>Having had gestational diabetes in the past also puts you at risk for prediabetes now, according to research, including a study in BMC Pregnancy and Childbirth. “Once you have been diagnosed with any form of diabetes, like gestational diabetes, you are at an increased risk for developing this again over time, especially with weight gain,” Dr Adimoolam says.</p> <p>According to the American Diabetes Association, doctors don’t know exactly why gestational diabetes develops, but it could be that pregnancy hormones affect how the body uses insulin. The NIDDK suggests women who’ve had gestational diabetes have their blood glucose tested every three years.</p> <p><strong>You're overweight </strong></p> <p>You can potentially reverse type 2 diabetes if you lose weight – and the same goes for if you are borderline diabetic. “By and large, obesity is the main cause of insulin resistance, as certain fat cells are known to cause and intensify insulin resistance over time,” Dr Ng says. And it’s not just how much you weigh, but where your weight is located on your body. “Waist size is typically proportional to centralised, or abdominal, obesity,” Dr Adimoolam says.</p> <p>“The more centralised abdominal fat, the higher one’s insulin resistance, and the greater the increased risk for the development of type 2 diabetes.” Genetics may also play a role here, as certain body types with more abdominal fat (“apple-shaped”) can run in families and certain ethnic groups, she says.</p> <p><strong>You have an unhealthy lifestyle </strong></p> <p>Whether you are borderline prediabetic or not, there are many science-based reasons to start working out. “Lack of exercise may promote weight gain, which is a risk factor for type 2 diabetes,” Dr Adimoolam says. A study from Johns Hopkins published in the Journal of General Internal Medicineshowed that people with prediabetes who dropped 10 per cent of their body weight dramatically reduced their risk of diabetes – but every little bit helps.</p> <p>Dr Ng suggests losing even 5 to 7 per cent of your body weight, quitting smoking, and adopting a borderline diabetic diet. “Interventions that typically reduce weight include increased exercise, especially aerobic exercise, 150 minutes or more per week, and eating a balanced, low-fat diet that is not heavy on carbs,” he says. “Prediabetes is often thought of as a ‘warning sign,’ which is why lifestyle intervention is so important.”</p> <p>Ultimately, the message is that prediabetes is not irreversible. “Prediabetes is the stage before one develops type 2 diabetes, and in most cases is preventable,” Dr Adimoolam says. “You may not need medications to treat prediabetes if you are able to change your lifestyle, with the goal for treatment focusing on diet changes and exercise.”</p> <p><em>Image credits: Getty Images </em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/diabetes/12-signs-that-youre-borderline-diabetic?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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These 10 smart grocery swaps can help reverse diabetes

<p><strong>Diagnosis diabetes</strong></p> <p>It can feel daunting to be faced with the need to make a major lifestyle change. You enjoy food, and you should. At Reader’s Digest, we like to think nature designed nutrition to taste delicious so it can be a source of pleasure in your day that’s fun to look forward to.</p> <p>If you’ve been diagnosed with diabetes or pre-diabetes, this diagnosis doesn’t have to take over your whole identity and all the things that bring you joy. There are ways to adapt some of your favourite foods so you can still have them!</p> <p>Registered dietitian Jackie Newgent lists interesting meal swaps you can make so that classic dishes can be healthier, while still plenty pleasurable.</p> <p>With some wisdom and dedication, it can be possible to turn your condition around and feel great for good.</p> <p><strong>Pair starchy with non-starchy veggies</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one kilo potatoes</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> 500g kilo potatoes plus 500g cauliflower</p> <p>This mashed potato hack keeps your total carbs in check without forgoing flavour. Whip equal parts boiled potatoes together with roasted or boiled cauliflower.</p> <p>The results of this dynamic duo may help you better manage your blood glucose, since they’re carb-friendlier than a huge bowl of mashed potatoes alone: 100 grams of cooked potatoes without skin provides 22 grams of total carbohydrates, versus 13 grams total carbohydrate in the 100 gram combination of cooked potatoes and cauliflower.</p> <p><strong>Pick fruit you can chew</strong></p> <div> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one litre apple juice</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one bag of apples</p> <p>Enjoy whole fruit rather than just the juice whenever possible to get all the fibre of the naturally sweet fruit with its edible peel…plus chewing satisfaction. One medium apple contains 4.4 grams of fibre while a 200ml glass or juice box of 100-percent apple juice has 0.4 grams of fibre.</p> <p>The soluble fibre in apples can help slow down absorption of sugars. Polyphenols in apples may have powerful antioxidant properties.</p> <p><strong>Grill a better burger</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> 500g 85% lean ground beef patties</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> 500g ground chicken breast</p> <p>Gram for gram, chicken breast has significantly less saturated fat than the marbly beef of classic burgers. Specifically, an 85g cooked 85% lean ground beef patty has five grams of saturated fat compared to 0.6 grams of saturated fat for a cooked patty made from 85g of chicken breast meat.</p> <p>Keeping saturated fat intake low is especially important when you have diabetes to help keep your heart healthy. Pro-tip: make chicken burgers juicier and tastier by combining ground chicken breast with a little plain yogurt, rolled oats, and herbs and spices before cooking.</p> <p><strong>Look for live cultures in the dairy section</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one container regular cottage cheese</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one container plain low-fat Greek yogurt or cultured cottage cheese</p> <p>Probiotics are “good” bacteria that help keep your gut healthy. For people with type 2 diabetes, research published in Advances in Nutrition suggested that probiotics may also have glucose-lowering potential. So, pop products with live active cultures (probiotics) into your cart while strolling by the dairy aisle. Choose plain low-fat Greek yogurt or cultured cottage cheese.</p> <p>Be sure to read the nutrition labels, since probiotics aren’t in all dairy foods. And, for the lower-sodium pick, stick with yogurt.</p> <p><strong>Choose healthier-sized grain portions </strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> 1/2 dozen bakery-style plain bagels</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one package of wholegrain English muffins</p> <p>Swapping wholegrain in place of refined grain products helps kick up fibre and other plant nutrients. Studies suggests this is linked to lower risk of type 2 diabetes. Also, opting for healthier-sized varieties, such as wholegrain English muffins rather than big bakery-style plain bagels helps cut kilojoules (and carbs) – not enjoyment – while promoting a healthier weight. In fact, you’ll slash over 1000 kilojoules by enjoying a whole-wheat English muffin instead of that oversized 140g bagel.</p> <p><strong>Get your munchies with benefits </strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one bag of potato chips</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one jar or bulk-bin container of roasted peanuts</p> <p>It’s a no-brainer: a small handful of nuts is a better bet than potato chips. Peanuts, for instance, offer a triple whammy of dietary fibre, plant protein and healthy fat, which can boost satiety. Greater satisfaction means a greater chance you’ll keep mealtime portions right-sized.</p> <p>When peanuts or other nuts are eaten along with carb-rich foods, they can help slow down the blood sugar response. Plus, a Mediterranean study found that higher nut consumption may be associated with better metabolic status.</p> <p><strong>Dress a salad smartly </strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one bottle of fat-free salad dressing</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one small bottle olive oil plus one small bottle balsamic or red wine vinegar</p> <p>Some bottled salad dressings can trick you. For instance, “fat-free” salad dressing may be loaded with added sugars. (For reference: four grams of sugar is equal to one teaspoon.)</p> <p>So, read salad dressing labels carefully for sneaky ingredients, especially excess salt (over 250 milligrams of sodium per two-tablespoon serving) or added sugars (more than five grams added sugars per two-tablespoon serving). Better yet, keep it simple and make your own vinaigrette using 2-3 parts oil to 1 part vinegar.</p> <p><strong>Select less salty soup</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one can/carton of vegetable- or bean-based soup</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one can/carton of low-sodium vegetable- or bean-based soup</p> <p>When compared to people without diabetes, sodium levels were higher in patients with type 2 diabetes, based on a meta-analysis published in European Journal of Nutrition. Curbing sodium intake is beneficial for people with diabetes since too much may increase your risk for high blood pressure.</p> <p>So, slurp up soup that’s low in sodium. And kick up flavour with a splash of cider vinegar, grated citrus zest, herbs, spices, or a dash of hot sauce.</p> <p><strong>Go for "naked" fish</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> Breaded fish sticks</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> Frozen salmon fillets</p> <p>Cut salmon into large cubes, season, and grill on skewers. Or make fish sticks by simply cutting into skinny fillets, season and roast. Why? Research published in Diabetes Care finds that eating oily fish may be associated with a lower risk of type 2 diabetes. Non-oily fish, like the whitefish in fish sticks, didn’t show this link.</p> <p>Salmon is an oily fish and a major source of omega-3 fatty acids, a heart-friendly fat. Plus: when you make your own salmon skewers or sticks, you won’t have extra carbs from breading.</p> <p><strong>Do dip with a punch of protein</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one container of sour cream &amp; onion dip</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one container of pulse-based dip, like hummus</p> <p>Wise snacking can be helpful for managing blood glucose. It can also be delicious. Dunk veggies or wholegrain pita wedges into pulse-based dip, like hummus, black bean dip, or lentil dip.</p> <p>Check this out: one-quarter cup (that’s 60 grams) of onion dip has 870 kiljoules, five grams of saturated fat, 1.2 grams of protein, and 0.1 grams of fibre, while one-quarter cup hummus has 590 kilojoules, 1.5 grams of saturated fat, 4.7 grams of protein, and 3.3 grams of fibre. Hummus clearly wins!</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/diabetes/reverse-diabetes-10-smart-grocery-swaps?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p> </div> <div class="slide-image" style="font-family: inherit; font-size: 16px; font-style: inherit; box-sizing: border-box; border: 0px; margin: 0px; outline: 0px; padding: 0px; vertical-align: baseline;"> </div>

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1 in 6 women are diagnosed with gestational diabetes. But this diagnosis may not benefit them or their babies

<p><em><a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>When Sophie was pregnant with her first baby, she had an <a href="https://www.ncbi.nlm.nih.gov/books/NBK279331/#:%7E:text=Oral%20glucose%20tolerance%20tests%20(OGTT,enough%20by%20the%20body's%20cells.)">oral glucose tolerance</a> blood test. A few days later, the hospital phoned telling her she had gestational diabetes.</p> <p>Despite having only a slightly raised glucose (blood sugar) level, Sophie describes being diagnosed as affecting her pregnancy tremendously. She tested her blood glucose levels four times a day, kept food diaries and had extra appointments with doctors and dietitians.</p> <p>She was advised to have an induction because of the risk of having a large baby. At 39 weeks her son was born, weighing a very average 3.5kg. But he was separated from Sophie for four hours so his glucose levels could be monitored.</p> <p>Sophie is not alone. About <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">one in six</a> pregnant women in Australia are now diagnosed with gestational diabetes.</p> <p>That was not always so. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827530/">New criteria</a> were developed in 2010 which dropped an initial screening test and lowered the diagnostic set-points. Gestational diabetes diagnoses have since <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">more than doubled</a>.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=388&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=388&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=388&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=487&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=487&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=487&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">Gestational diabetes rates more than doubled after the threshold changed.</span> <span class="attribution"><span class="source">AIHW</span>, <span class="license">Author provided</span></span></figcaption></figure> <p>But <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">recent</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33704936/">studies</a> cast doubt on the ways we diagnose and manage gestational diabetes, especially for women like Sophie with only mildly elevated glucose. Here’s what’s wrong with gestational diabetes screening.</p> <h2>The glucose test is unreliable</h2> <p>The test used to diagnose gestational diabetes – the oral glucose tolerance test – has poor reproducibility. This means subsequent tests may give a different result.</p> <p>In a <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2214956">recent Australian trial</a> of earlier testing in pregnancy, one-third of the women initially classified as having gestational diabetes (but neither told nor treated) did not have gestational diabetes when retested later in pregnancy. That is a problem.</p> <p>Usually when a test has poor reproducibility – for example, blood pressure or cholesterol – we repeat the test to confirm before making a diagnosis.</p> <p>Much of the increase in the incidence of gestational diabetes after the introduction of new diagnostic criteria was due to the switch from using two tests to only using a single test for diagnosis.</p> <h2>The thresholds are too low</h2> <p>Despite little evidence of benefit for either women or babies, the current Australian criteria diagnose women with only mildly abnormal results as having “gestational diabetes”.</p> <p>Recent studies have shown this doesn’t benefit women and may cause harms. A <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">New Zealand trial</a> of more than 4,000 women randomly assigned women to be assessed based on the current Australian thresholds or to higher threshold levels (similar to the pre-2010 criteria).</p> <p>The trial found no additional benefit from using the current low threshold levels, with overall no difference in the proportion of infants born large for gestational age.</p> <p>However, the trial found several harms, including more neonatal hypoglycaemia (low blood sugar in newborns), induction of labour, use of diabetic medications including insulin injections, and use of health services.</p> <p>The study authors also looked at the subgroup of women who were diagnosed with glucose levels between the higher and lower thresholds. In this subgroup, there was some reduction in large babies, and in shoulder problems at delivery.</p> <p>But there was also an increase in small babies. This is of concern because being small for gestational age can also have consequences for babies, including long-term health consequences.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=349&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=349&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=349&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=438&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=438&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=438&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="attribution"><span class="source">NEJM</span>, <span class="license">Author provided</span></span></figcaption></figure> <h2>Testing too early</h2> <p>Some centres have begun testing women at higher risk of gestational diabetes earlier in the pregnancy (between 12 and 20 weeks).</p> <p>However, a <a href="https://pubmed.ncbi.nlm.nih.gov/37144983/">recent trial</a> showed no clear benefit compared with testing at the usual 24–28 weeks: possibly fewer large babies, but again matched by more small babies.</p> <p>There was a reduction in transient “respiratory distress” – needing extra oxygen for a few hours – but not in serious clinical events.</p> <h2>Impact on women with gestational diabetes</h2> <p>For women diagnosed using the higher glucose thresholds, dietary advice, glucose monitoring and, where necessary, insulin therapy has been shown to reduce complications during delivery and the post-natal period.</p> <p>However, current models of care can also cause harm. Women with gestational diabetes are often denied their preferred model of care – for example, midwifery continuity of carer. In rural areas, they may have to transfer to a larger hospital, requiring longer travel to antenatal visits and moving to a larger centre for their birth – away from their families and support networks for several weeks.</p> <p>Women say the diagnosis often dominates their antenatal care and their whole <a href="https://pubmed.ncbi.nlm.nih.gov/32028931/">experience of pregnancy</a>, reducing time for other issues or concerns.</p> <p>Women from culturally and linguistically diverse communities <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03981-5">find it difficult</a> to reconcile the advice given about diet and exercise with their own cultural practices and beliefs about pregnancy.</p> <p>Some women with gestational diabetes <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-2745-1">become</a> extremely anxious about their eating and undertake extensive calorie restrictions or disordered eating habits.</p> <h2>Time to reassess the advice</h2> <p>Recent evidence from both randomised controlled trials and from qualitative studies with women diagnosed with gestational diabetes suggest we need to reassess how we currently diagnose and manage gestational diabetes, particularly for women with only slightly elevated levels.</p> <p>It is time for a review to consider all the problems described above. This review should include the views of all those impacted by these decisions: women in childbearing years, and the GPs, dietitians, diabetes educators, midwives and obstetricians who care for them.</p> <p><em>This article was co-authored by maternity services consumer advocate Leah Hardiman.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205919/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/1-in-6-women-are-diagnosed-with-gestational-diabetes-but-this-diagnosis-may-not-benefit-them-or-their-babies-205919">original article</a>.</em></p>

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COVID-19 infection linked to a higher risk of diabetes

<p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">A Canadian study looking at more than 600,000 people has found a higher rate of new diabetes diagnoses in those who’d been infected with </span><a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://cosmosmagazine.com/health/covid/" target="_blank" rel="noreferrer noopener">COVID-19</a><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">.</span></p> <div class="copy"> <p>The study, which is <a href="https://doi.org/10.1001/jamanetworkopen.2023.8866" target="_blank" rel="noreferrer noopener">published</a> in <em>JAMA Network Open</em>, suggests that COVID may be responsible for a 3% to 5% excess burden of diabetes at the population level.</p> <p>The Canadian researchers drew on data from the British Columbia COVID-19 Cohort: a study that collected the health records of people tested for SARS-CoV-2 in the province from January 2020 to December 2021.</p> <p>From this cohort, 125,987 people tested positive to COVID-19. The researchers matched each of these people with four unexposed people of the same age, sex, and test date.</p> <p>This gave them a sample of 629,935 people, a fifth of whom had been infected with SARS-CoV-2.</p> <p>They then went looking for incident diabetes – that is, a new diagnosis – more than 30 days after the COVID test.</p> <p>The COVID-positive group had a rate of 672.2 new diabetes diagnoses per 100,000 people, significantly higher than the control group’s rate of 508.7 new diagnoses per 100,000.</p> <p>This translates to roughly 3-5% extra diabetes cases at a population level, according to the researchers’ analysis.</p> <p>“Our overall results were consistent with several other studies finding higher risk of incident diabetes after SARS-CoV-2 infection; however, the increase in risk was lower in our analysis compared with other studies,” they write in their paper.</p> <p>They suggest a few differences in study populations for this discrepancy.</p> <p>It’s not yet clear <em>why</em> there’s a link between COVID infection and diabetes.</p> <p>In their paper, the researchers point out that SARS-CoV-2 has been shown to attack pancreatic cells which are involved with insulin production. Low-grade inflammation from COVID could also play a role. But these processes are still poorly understood.</p> <p>“Our study highlights the importance of health agencies and clinicians being aware of the potential long-term consequences of COVID-19 and monitoring people after COVID-19 infection for new-onset diabetes for timely diagnosis and treatment,” conclude the researchers.</p> </div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/covid/diabetes-covid-link/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian.</em></p> <p><em>Images: Getty</em></p> </div>

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Naturally combat the onset of diabetes

<p dir="ltr">Pre-diabetes is the period before diabetes is officially diagnosed. Progressing from pre-diabetes to diabetes is not imminent. There are plenty of ways you can get on top of it to reduce the risk of diabetes. </p> <p dir="ltr" role="presentation"><strong>1. Cut out sugar and refined carbohydrates </strong></p> <p dir="ltr">Eating foods high in refined carbs and sugar increases blood sugar and insulin levels, which could lead to diabetes over time. Examples of these foods are white bread, potatoes and various breakfast cereals. Limit sugar and choose complex carbs like veggies, oatmeal and whole grains.</p> <p dir="ltr"><strong>2. Quit smoking</strong></p> <p dir="ltr">If you’re a current smoker, cut it out! Smoking can contribute to insulin resistance which can lead to type 2 diabetes. Quitting smoking has been shown to reduce the risk of developing type 2 diabetes over time.</p> <p dir="ltr"><strong>3. Portion control</strong></p> <p dir="ltr">Avoid large portions as they can contribute to the increase of insulin and blood sugar levels. Eating too much at one time can lead to higher blood sugar and insulin levels in pre-diabetics.</p> <p dir="ltr"><strong>4. Exercise</strong></p> <p dir="ltr">Aim for at least 30 minutes of exercise a day. You don’t have to strain yourself, you can take a walk, go swimming or dance around the house, but make sure you stay on top of it and practise these activities at least five days a week. </p> <p dir="ltr"><strong>5. Drink more water</strong></p> <p dir="ltr">Drinking water over other beverages may help control blood sugar and insulin levels. Drinking primarily water will stop you from over consuming beverages that are high in sugar and preservatives, in turn reducing the risk of diabetes.</p> <p dir="ltr"><strong>6. Eat more fibre</strong></p> <p dir="ltr">Getting an adequate amount of fibre is beneficial for gut health and weight management. Having a good source of fibre at each meal can help prevent spikes in blood sugar and insulin levels. </p> <p dir="ltr"><em>Image credit: Shutterstock</em></p>

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The best and worst drinks for people with diabetes

<p><span style="color: #444444; font-family: Raleway, sans-serif, 'Helvetica Neue', Helvetica, Arial; font-size: 16px; background-color: #ffffff;">Choosing the right drinks for people with diabetes is as important as choosing the right foods, and it isn’t always simple. Is coffee helpful or harmful to insulin resistance? Does zero-calorie diet soda affect your blood sugar? Some studies may only add to the confusion. We reviewed the research and then asked three top registered dietitians, who are also certified diabetes educators, what they tell their clients about seven everyday drinks for people with diabetes. Here’s what to know before you sip.</span></p> <h4><span style="color: #444444; font-family: Raleway, sans-serif, Helvetica Neue, Helvetica, Arial;">Drink more: Water</span></h4> <p>Drinking enough water has so many health benefits. But could downing a few glasses of H2O help control your blood sugar? A study in the journal Diabetes Care suggests so: The researchers found that people who drank 475ml (two cups’ worth) or less of water a day were about 30 percent more likely to have high blood sugar than those who drank more than that daily. The connection seems to be a hormone called vasopressin, which helps the body regulate hydration. Vasopressin levels increase when a person is dehydrated, which prompts the liver to produce more blood sugar.</p> <p><strong>How much:</strong> Experts recommend six to nine 250ml glasses of water per day for women and slightly more for men. You’ll get some of this precious fluid from fruit and vegetables and other fluids, but not all of it. “If you’re not in the water habit, have a glass before each meal,” recommends registered dietitian Constance Brown-Riggs, a certified diabetes educator. “After a few weeks, add a glass at meals too.” If you’re already meeting your water targets, there’s no need to push it further.</p> <h4>Drink more: Milk</h4> <p>Moo juice isn’t just a kids’ drink – it’s one of the best drinks for people with diabetes, too. It provides the calcium, magnesium, potassium and vitamin D your body needs for many essential functions. “Low-fat or fat-free milk is a great beverage for people with diabetes,” Brown-Riggs says. Drinking more milk can also help prevent strokes (a concern for many people with diabetes) by 7 percent, according to research from the <em>Journal of the American Heart Association</em>. Bonus: The researchers also found that eating cheese produced the same effect. If you’re lactose intolerant or allergic to dairy, eating plenty of dark green vegetables can help you obtain the calcium and other electrolytes you need.</p> <p><strong>How much: </strong>Experts recommend eating two to three daily servings of dairy products, including low-fat or fat-free milk. Milk does contain carbohydrates so remember to factor in 12 grams of carbohydrate for every 250ml glass. “Drink milk with a meal so your body can handle the natural rise in blood sugar that happens when we eat carbohydrates,” says registered dietitian Angela Ginn, a certified diabetes educator.</p> <h4>Drink more: Tea</h4> <p>No kilojoules, big flavour, and a boatload of antioxidants have made tea – particularly green and black – trendy for health reasons, especially when it comes to drinks for people with diabetes. Sipping more than three cups of tea a day could lower the risk for developing diabetes, other researchers found. Tea may also help reduce your risk of stroke and heart disease. The exception to these diabetic drinks: sweetened, bottled iced teas, which have tons of added sugar.</p> <p><strong>How much:</strong> Three to four cups of tea are OK for most people; just be sure the caffeine doesn’t keep you awake at night. More is fine if you opt for decaf. And watch what you add: Avoid sugar and full-fat milk and cream.</p> <h4>Drink carefully: Coffee</h4> <p>A 2018 systematic review and meta-analysis in Nutrition Reviews found that coffee drinkers are at lower risk for developing type 2 diabetes. (A compound in coffee called chlorogenic acid seems to slow absorption of glucose into the bloodstream.) But other research indicates that for people who already have diabetes, coffee may raise blood sugar or make the body work harder to process it. Bottom line: It comes down to how coffee affects your individual blood sugar. What many people with diabetes add to their coffee may be the real issue. “Sugar, sweetened creamers, and high-fat milk and half-and-half can raise your blood sugar and your weight,” Brown-Riggs says.</p> <p><strong>How much:</strong> Experts say sipping two to three cups a day is probably fine, but if you’re having a tough time controlling your blood sugar, it may be worth cutting out coffee to see if it makes a difference. “Everyone’s blood sugar response to foods is unique and individual,” Ginn says.</p> <h4>Drink carefully: Diet soft drink</h4> <p>Are fizzy, zero-calorie drinks a brilliant choice for people concerned about diabetes, or could they do more harm than good? One 2018 study in Current Developments in Nutrition looked at over 2,000 people and found that those who drank diet soft drink every day increased their chances of developing diabetes, leading researchers to conclude that diet soda itself could be a risk factor. The news may be even worse for diabetics drinking zero-calorie sodas. Researchers in Australia looked at 600 patients with diabetes and found that drinking more than four cans of diet soft drink a week doubled their chances of developing proliferative diabetic retinopathy, an eye disease that’s a complication of diabetes.</p> <p><strong>How much:</strong> If you have a soft drink habit, it’s probably OK to sip one zero-calorie drink a day instead of a sugary version, but given the research, it’s best to wean yourself off. Make sure to also drink healthy drinks for people with diabetes like water and tea. Resist the temptation to see diet soft drink as a “magic eraser” allowing you to indulge in foods like chips, dips, sweets, fries, and burgers. People who enjoyed their diet soft drink as part of a healthy diet had lower risk of high blood sugar and high cholesterol than those who ate fried and sugary foods in one study in the <em>American Journal of Clinical Nutrition.</em></p> <h4><span style="color: #444444; font-family: Raleway, sans-serif, Helvetica Neue, Helvetica, Arial;">Drink less: Soft drink and sugary drinks</span></h4> <p>With upwards of 10 teaspoons of sugar in every 375ml can or bottle, sweet drinks can send your blood sugar soaring – and boost your risk for weight gain, high blood pressure, stroke and heart disease. One sugary drink a day can add 630 empty kilojoules and about 40 to 50 grams of blood-sugar-raising carbohydrates to your diet, all of which can cause you to pack on belly fat and increase inflammation and insulin resistance – boosting the risk for diabetes and heart disease. Bottom line: Soda and sugary fruit drinks are some of the worst drinks for people with diabetes.</p> <p>“If you have diabetes, cutting out soda and other sugar-sweetened drinks is one of the most powerful ways to control blood sugar, lose weight, and improve your health,” says Ginn. “Switching to healthier drinks can save hundreds of calories and a lot of carbohydrates. It’s often one of my first goals when I work with someone newly diagnosed with diabetes.”</p> <p><strong>How much: </strong>None, ideally. Think of soft drink as you would a decadent dessert that you might indulge a taste of once in a blue moon. If you have a soda habit, cut back by drinking a smaller size for a week or two, or mixing half regular soda with half diet soda or soda water to reduce your kilojoule and carb intake. Aim to go sugar-free: Water and soda water (including zero-calorie fruit-flavoured types) are ideal, and diet soft drink is an option for diabetic drinks but don’t exceed one a day.</p> <h4>Drink less: Fruit juice</h4> <p>Your mum served up OJ every day with breakfast, and you grew to love it. The labels display tempting photos of colourful fruit. But are juices healthy diabetic drinks for blood sugar and weight control? A regular juice habit is associated with an increased risk of type 2 diabetes, according to a study published in Diabetes Care. In terms of nutrition, a piece of real fruit is a better deal (and science is backing that people with diabetes can, and should, eat fruit). A 125ml serving of 100 percent orange juice has 247 kilojoules, 13.6 grams carbohydrates, and no fibre; compare that to a small fresh orange, which has 188 kilojoules, 11 grams carbohydrates, and 2 grams of blood-sugar-controlling fibre. That said, people with diabetes can indulge in a little 100 percent fruit juice once in a while, says registered dietitian Dawn Menning, a certified diabetes educator. “They should just know the amount of juice they are consuming and factor the number of carbohydrates into their eating plan,” she says.</p> <p><strong>How much: </strong>Juice lovers, eat fruit or switch to a low-sodium veggie juice, which is much lower in calories and carbohydrates than fruit juice. If you’re really craving juice, try a 125ml serving with a meal. Test your blood sugar afterward, and then repeat with the same meal for the next three or four days. If your blood sugar doesn’t rise more than 35 to 50 points, a little juice could be fine.</p> <p><em>Image: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.com.au/healthsmart/diabetes/the-best-and-worst-drinks-for-people-with-diabetes" target="_blank" rel="noopener">Reader's Digest</a>.</em></p>

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Age, not weight, should be the big decider in whether to screen for diabetes

<p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Because it’s possible to be diabetic or prediabetic without any symptoms, and early diagnoses lead to better health outcomes, lots of countries have screening programs for diabetes.</span></p> <div class="copy"> <p>In the US, overweight or obese people between 35 and 70 are recommended to regularly get diabetes tests.</p> <p>But <a href="https://www.ajpmonline.org/article/S0749-3797(23)00006-5/fulltext" target="_blank" rel="noreferrer noopener">new research</a> in the <em>American Journal of Preventative Medicine</em> has called this into question, suggesting that screening based purely on age will catch the greatest proportion of diabetic and prediabetic people.</p> <p>“It might sound counterintuitive because we think of being overweight or obese as the primary cause of diabetes,” says lead author Dr Matthew O’Brien, an associate professor of medicine at Northwestern University Feinberg School of Medicine, US.</p> <p>“But if we make decisions about diabetes testing based on weight, we will miss some people from racial and ethnic minority groups who are developing prediabetes and diabetes at lower weights.”</p> <p>The researchers examined data from all the 2021 diabetes screenings recommended by the US Preventive Services Task Force. Based on this data, they recommend screening every US adult aged between 35 and 70.</p> <p>“All major racial and ethnic minority groups develop diabetes at lower weights than white adults, and it’s most pronounced for Asian Americans,” says O’Brien.</p> <p>Roughly half of US adults have Type 2 diabetes or prediabetes, and 81% of adults with prediabetes don’t know they have it. Diagnoses are delayed in ethnic minorities, compared to white people.</p> <p>“Diabetes is a condition in which unacceptable racial and ethnic disparities persist,” says O’Brien.</p> <p>“That’s why we need a screening approach that maximises equity. If we can find everyone earlier, it helps us reduce these disparities and the bad outcomes that follow.”</p> <p>The researchers also found that it might be beneficial for members of some ethnic minorities to receive earlier screening, but they don’t formally recommend it.</p> <p>“It’s imperative that we identify a screening approach that is equitable across the entire US population,” says O’Brien.</p> <p>“Our findings illustrate that screening all adults aged 35 to 70 years, regardless of weight or body mass index, performs equitably across all racial and ethnic groups.”</p> <p>This age cut-off also makes it much simpler for clinicians to decide whether someone should get a diabetes test.</p> <p>“There are many ways to nudge patients and providers to complete this testing, which should be the focus of future research,” says O’Brien.</p> <p>In Australia, diabetes tests are recommended based on a <a href="https://www.healthdirect.gov.au/diabetes-screening-tests" target="_blank" rel="noreferrer noopener">range of risk factors</a>, including age, waist measurement, ethnicity, physical activity and family history. Diabetes Australia has a <a href="https://www.diabetesaustralia.com.au/risk-calculator/" target="_blank" rel="noreferrer noopener">risk calculator</a> with which you can determine your own risk.</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=240911&amp;title=Age%2C+not+weight%2C+should+be+the+big+decider+in+whether+to+screen+for+diabetes" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/diabetes-tests-screening-age-weight/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by <a href="https://cosmosmagazine.com/contributor/ellen-phiddian">Ellen Phiddian</a>. </em></p> <p><em>Images: Shutterstock</em></p> </div>

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Type 1 diabetes sufferers in for price hike

<p>Those suffering from Type 1 diabetes will be hit with a steep hike in prescription costs when a life-changing insulin is removed from the Pharmaceutical Benefits Scheme (PBS) in April 2023.</p> <p>Local Member for Fairfax Ted O’Brien and Shadow Minister for Health and Aged Care Senator Anne Ruston have revealed 15,000 Australian families will be affected when the drug Fiasp becomes less accessible from April 1.</p> <p>Fiasp is a mealtime insulin that is designed to improve blood sugar control in diabetes sufferers at a faster rate than alternative diabetes medications.</p> <p>Mr O’Brien said he was made aware of the issue by the mother of a young high school student on the Sunshine Coast “whose quality of life will now be at risk from the government’s decision”.</p> <p>“Freya Goldston is a 14-year-old, high-performing student in my electorate who will tell anybody about the remarkable impact that this medicine has had on her life,” Mr O’Brien said.</p> <p>“Freya’s family will have her prescription go from around $7 to more than $280 at a time when households are already under serious financial pressure.</p> <p>“The Labor Government needs to provide an immediate solution to support the 15,000 families who will otherwise need to start making decisions about what household expenses they can cut back on to afford this life-changing medicine.”</p> <p>Mr O’Brien shared the former Coalition Government listed Fiasp on the PBS in 2019 to ensure accessible prices to the fast-acting insulin for diabetes patients.</p> <p>“But now, without any consultation or support for the patients impacted, the government’s decision to suddenly remove Fiasp from the PBS is sending the price soaring,” he said.</p> <p>A spokesperson for Health Minister Mark Butler said his office was alerted of the drug manufacturer Novo Nordisk removing Fiasp from the PBS on February 22 2023.</p> <p>“The minister’s office is now working with the department and Novo Nordisk,” the spokesperson said.</p> <p>“We understand the decision by Novo Nordisk to remove Fiasp from the PBS has been concerning for many Australians living with diabetes and their families.”</p> <p>The spokesperson did not comment on whether there was consultation or support for impacted diabetics when Mr Butler was approached about the removal of Fiasp.</p> <p>Nearly 28,000 people have signed a petition online created by Belinda Moore called “Save Fiasp from falling off the PBS”.</p> <p>“The Australian diabetes community will keep advocating until we witness no evidence of inequitable access to diabetes services, clinicians, technology and therapies.”</p> <p>Ms Ruston also said he was disappointed in the government's decision as Australians are already suffering from a cost-of-living crisis, and the removal of Fiasp from the PBS will affect thousands of Australians.</p> <p>“The government must urgently guarantee that they will provide sufficient support to ensure the viability of affordable diabetes medications in Australia,” Ms Ruston said.</p> <p><em>Image credit: Shutterstock</em></p>

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Police reveal Elizabeth Struhs' tragic last days

<p>Elizabeth Struhs' parents have faced court over the alleged murder of their daughter, after they withheld vital medication in the belief God would save their eight-year-old child. </p> <p>Elizabeth was a diabetic, and it has been alleged that her parents, Kerrie and Jason, refused to administer her life-saving insulin that she required daily. </p> <p>In January this year, police allege her parents, along with 12 others from the family's religious sect, intentionally stopped Elizabeth's medication which led to a near week-long, painful death.</p> <p>"They believe that every other religion is second and wrong," Elizabeth's older sister, Jayde Struhs, told <a href="https://9now.nine.com.au/a-current-affair/elizabeth-struhs-death-queensland-police-reveal-allegations-diabetic-girl-left-to-die/a3b06e00-3077-4fcd-8479-8302dd00c91b" target="_blank" rel="noopener"><em>A Current Affair</em></a> earlier this year.</p> <p>Kerrie and Jason Struhs, along with members of the Stevens and Schoenfisch families, are accused of being part of a cult-like church in Toowoomba, referring to themselves as The Saints.</p> <p>The court heard that the group believe solely in the healing power of God and reject any medical intervention. </p> <p>As such, 14 members of the group, including Elizabeth's parents, are being charged with her murder. </p> <p>All 14 of the accused have rejected any legal assistance and are representing themselves through the trial. </p> <p>Elizabeth's father Jason was the first to front court for a committal hearing, with police prosecutor Sergeant Alister Windsor telling the court, "Mr Struhs had the requisite knowledge to know that the withholding of diabetic treatment would result in pain and suffering to Elizabeth".</p> <p>It is alleged Elizabeth's insulin was stopped on January 3rd, before she died on January 7th.</p> <p>"Mr Struhs intentionally withheld the insulin," Windsor said.</p> <p>More than 100 statements from witnesses, CCTV, police body camera vision and medical reports form the brief of evidence, detailing how the group allegedly prayed over Elizabeth rather than seek help.</p> <p>Magistrate Clare Kelly had the task of looking through it all, to decide if Mr Struhs would stand trial.</p> <p>Kelly told the court last Tuesday: "The statement by Mr Struhs goes into a significant level of detail about his thought processes and ultimately the basis for the decision he took to stop providing the life-saving medication to Elizabeth."</p> <p>"It is contended that Mr Struhs failed to provide the insulin to Elizabeth, he clearly knew that it was probable death would result from him ceasing to administer insulin to Elizabeth."</p> <p>While Jason was the first to show any emotion in court over his daughter's death, his wife Kerrie sat emotionless in a separate hearing, as the court heard she actively supported and encouraged the cessation of Elizabeth's insulin.</p> <p>Magistrate Kay Philipson told the court, "The defendant's own statement goes into detail about her involvement in the religious group."</p> <p>"She goes into detail about not wanting to be part of the medications given to Elizabeth."</p> <p>Fellow members of The Saints Andrea Stevens and her mother Loretta Stevens also fronted court facing murder charges, as the court heard they allegedly aided Elizabeth's parents in stopping the insulin, showing reckless indifference to human life.</p> <p>All will now face trial for murder.</p> <p><em>Image credits: A Current Affair</em></p>

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Is just 4.5 kg of weight loss really going to help stop type 2 diabetes?

<p>A new study has found that losing just 4.5 kg of weight could be the difference between getting type 2 diabetes and not.</p> <p>That’s the headline on some of the publicity surrounding the research, except like all these studies, it’s significantly more complicated than that. So, let’s talk about it.</p> <p>The study looked at around 100,000 nurses and other health professionals from a few different US cohort studies that started in the late 1980s.</p> <p>The team looked at up to 10 years of weight changes and tracked the participants for 24 years to see if they developed type 2 diabetes.</p> <p>They also looked at the way that those who lost more than 4.5 kg, dieted. They split them into seven categories – low-calorie diet; exercise; low-calorie diet plus exercise; fasting; commercial weight loss program; diet pills; and a combination of fasting, commercial and diet pills.</p> <p>When the team looked at the original results, they found something surprising: In the overall population, those who lost more than 4.5 kilograms had a higher risk of being diagnosed with type 2 diabetes than those that didn’t diet or try and lose weight.</p> <p>This was particularly striking for those that lost the weight due to limiting calories, diet pills, fasting, or weight loss programs.</p> <p>The researchers then split the data into BMI categories – those who were ‘normal’ weight or underweight, those who were overweight and those who were obese.</p> <p>The findings of a higher risk of type 2 diabetes after trying to lose weight broadly held in both the ‘underweight’ and ‘normal’ as well as the ‘overweight’ categories.</p> <p>“We were a bit surprised when we first saw the positive associations of weight loss attempts with faster weight gain and higher type 2 diabetes risk among lean individuals,” says Qi Sun, a nutrition researcher at the TH Chan Harvard School of Public Health.</p> <p>As you can see in this figure below, the risk of type 2 diabetes only reduced a little – significantly less than the increased risk of type 2 diabetes if you lost over 4.5 kilograms while at a normal BMI.</p> <p><img src="https://oversixtydev.blob.core.windows.net/media/2022/10/figures.jpg" alt="" width="1280" height="720" /></p> <p>As noted in the paper, the vast majority of people try and diet at some point or another – in 2013 to 2016 almost half of US adults reported trying to lose weight.</p> <p>But almost everyone either doesn’t succeed or puts all the weight back on, normally within a few months.</p> <p>This study backs that up. After 10 years, those who tried to lose weight (known as the weight loss strategies group) gained more weight than those that hadn’t.</p> <p>“Participants who lost 4.5+ kg were likely to gain more weight and have higher risk of type 2 diabetes than those who did not attempt to lose weight,” the team writes in their paper.</p> <p>“By 10 years of follow-up, all weight loss strategy groups were associated with more weight gain than the reference group (ranging from 1.7% for exercise to 6.6% for fasting, commercial weight loss program and pills).”</p> <p>It’s important to note here that exercise and eating well is not bad for you. Exercise has been shown time and time again to help us live longer, and eating more fruits and vegetables and less processed food is better for us.</p> <p>However, this study is a good reminder that just losing weight – particularly in ways like weight loss pills, calorie restriction and weight loss programs are not a silver bullet for keeping us healthy.</p> <p>In fact, depending on who you are, it seems it might make it worse.</p> <p>The conclusion from the study is worth reading in full:</p> <p>In conclusion, in individuals with obesity, losing 4.5+ kg of body weight intentionally was associated with less weight gain and lower T2D risk, regardless of the methods used to achieve the weight loss. However, for individuals who were lean, losing 4.5+ kg was not associated with these health benefits. Of all WLSs, exercise was optimal for long-term weight control and T2D prevention. Our data support current guidelines for body weight management, such as that issued by the Obesity Society, which recommend a weight loss of 5% to 10% of baseline weight for individuals who are overweight or obese and exercise of 200 to 300 minutes per week to maintain the weight loss.</p> <p><strong>This article originally appeared on <a href="https://cosmosmagazine.com/health/diabetes-type-2-weight-loss-4-5-diet-pills-exercise/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Jacinta Bowler.</strong></p> <p><em>Image: Shutterstock</em></p>

Body

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The bittersweet story of diabetes

<p>You probably know someone in your life with <a href="https://www.who.int/news-room/fact-sheets/detail/diabetes" target="_blank" rel="noreferrer noopener">diabetes</a> – a chronic disease that effects about 422 million people worldwide and each year directly causes 1.5 million deaths. Worryingly, both of these statistics have been rising steadily over the last few decades and diabetes has been recognised as the world’s <a href="https://www.diabetesaustralia.com.au/about-diabetes/diabetes-globally/#:~:text=Diabetes%20is%20recognised%20as%20the,caused%201.5%20million%20deaths%20globally." target="_blank" rel="noreferrer noopener">fastest growing chronic condition</a>. Characterised by elevated levels of blood glucose (sugar), diabetes can also lead to serious damage to the heart, blood vessels, eyes, kidneys, and nerves over time.</p> <p>Insulin is a hormone which, among other functions, is released into the bloodstream when we eat to help regulate blood glucose levels, which may rise dangerously high or drop too low if we lack insulin.</p> <p>There are two types of diabetes: type 1 is caused by an autoimmune disorder where the body attacks cells in the pancreas that produce insulin, markedly reducing or shutting down insulin production. Type 2 diabetes – the most common type – usually develops in adults when the body becomes resistant to insulin and gradually loses the ability to produce it.</p> <p>While people with type 2 diabetes may be able to slow or even stop the progression of the condition through changes to their diet and physical activity, there is currently no cure for type 1.</p> <p><em>Bittersweet</em>, a documentary selected for the <a href="https://scinema.org.au/" target="_blank" rel="noreferrer noopener">SCINEMA International Science Film Festival</a> in 2018, follows the personal stories of young people living with diabetes and their daily struggle to manage this lifelong disease.</p> <figure class="wp-block-embed is-type-video is-provider-youtube wp-block-embed-youtube wp-embed-aspect-16-9 wp-has-aspect-ratio"> <div class="wp-block-embed__wrapper"> <div class="entry-content-asset"> <div class="embed-wrapper"> <div class="inner"><iframe title="Bittersweet - The Rise Of Diabetes (Trailer)" src="https://www.youtube.com/embed/E3zMT_Te_Ys?feature=oembed" width="500" height="281" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div> </div> </div> </div> </figure> <p>You can watch <em>Bittersweet</em> in full <a href="https://australiascience.tv/vod/bittersweet/" target="_blank" rel="noreferrer noopener">here</a>.</p> <p>Read on for some recent diabetes research you may have missed.</p> <p><strong>Marine snail inspires fast-acting injectable insulin</strong></p> <p>Insulin is an essential medicine for diabetics, but for some marine predators it’s the ultimate weapon. Some ocean dwelling cone snails have an insulin in their venom that can drop the blood sugar of fish prey so swiftly that they’re paralysed and defenseless. This fast-acting venom inspired scientists to design new fast-acting human insulins based on its structure.</p> <p>Human insulin is normally produced and stored in the pancreas until it’s needed. The individual molecules come together to link first into pairs and then into groups of six, which allows insulin to be stored efficiently.</p> <div class="newsletter-box"> <div id="wpcf7-f6-p185498-o1" class="wpcf7" dir="ltr" lang="en-US" role="form"> <form class="wpcf7-form mailchimp-ext-0.5.56 spai-bg-prepared init" action="/health/body-and-mind/diabetes-prevent-treat/#wpcf7-f6-p185498-o1" method="post" novalidate="novalidate" data-status="init"> <p style="display: none !important;"><span class="wpcf7-form-control-wrap referer-page"><input class="wpcf7-form-control wpcf7-text referer-page spai-bg-prepared" name="referer-page" type="hidden" value="https://cosmosmagazine.com/health/" data-value="https://cosmosmagazine.com/health/" aria-invalid="false" /></span></p> <p><!-- Chimpmail extension by Renzo Johnson --></form> </div> </div> <p>But this property of insulin isn’t helpful for diabetics who rely on insulin injections. This is because until the clusters separate, the molecules are prevented from making their way from the injection site to the bloodstream. This creates a delay that can make it difficult for people with diabetes to keep their blood glucose within the optimal range, increasing the risk of complications.</p> <p>But the cone snail’s venomous insulins don’t form these clusters at all, and that’s what makes them so fast acting. Since researchers <a href="https://www.pnas.org/doi/abs/10.1073/pnas.1423857112" target="_blank" rel="noreferrer noopener">first discovered</a> this phenomenon in the cone snail species <em>Conus geographus</em>, new insulins that form fewer clusters than natural human insulin have become available to patients. And although they still form pairs, they do separate more easily in the body.</p> <p>Now, a research team have developed a new hybrid insulin that doesn’t form any of these clusters, using parts of the structure of a new insulin-like molecule found in the cone snail <em>Conus kinoshitai</em>. This new molecule still has the ability to bind to the human insulin receptor (which is key to insulin’s regulation of glucose) and the researchers hope that it, as well as the original <a href="https://cosmosmagazine.com/health/insulin-may-benefit-from-working-at-a-snails-pace/" target="_blank" rel="noreferrer noopener"><em>Conus geographus</em>-inspired insulin</a>, hold promise as potential diabetes therapeutics.</p> <p>The <a href="https://www.nature.com/articles/s41589-022-00981-0" target="_blank" rel="noreferrer noopener">study</a> was published in <em>Nature Chemical Biology</em>.</p> <p><strong>Why yogurt lowers the risk of developing type 2 diabetes</strong></p> <p>Scientists have known for years that eating yogurt is associated with a <a href="https://academic.oup.com/ajcn/article/98/4/1066/4577090?login=true" target="_blank" rel="noreferrer noopener">reduced risk of type 2 diabetes</a>, but until now the reason why this occurs has been a mystery. Now, <a href="https://www.nature.com/articles/s41467-022-29005-0" target="_blank" rel="noreferrer noopener">new research</a> has found that this protection could come partly from a specific product of metabolism (a metabolite) – called branched chain hydroxy acids (BCHA) – from lactic bacteria in yogurt.</p> <p>“BCHA are found in fermented dairy products and are particularly abundant in yogurt,” says co-lead author Dr Hana Koutnikova, of Danone Nutricia Research in the Netherlands. “Our body produces BCHA naturally, but weight gain seems to affect the process.”</p> <p>Researchers studied the effects of eating yogurt on mice that were fed a rich diet in sugars and fats, with one group being given the equivalent of two daily servings of yogurt in humans and the other not. This was carried out over 12 weeks, after which the researchers found the yogurt fed group had better control of blood glucose levels, insulin resistance, and liver function.</p> <p>By analysing all of the metabolites present in the mice’s blood and livers they measured changes in BCHA levels and found that while levels of BCHA were reduced in obese and insulin-resistant mice, these levels were partially maintained when also consuming yogurt.</p> <p>They then went on to show that BCHA improves the action of insulin on the metabolism of glucose in liver and muscle cells, increasing their glucose intake.</p> <p>The researchers suggest that the next step could be to determine whether dietary intake of BCHA can offset the decrease associated with weight gain and help restore normal metabolic function in obese and insulin resistant people.</p> <p><!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --></p> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=185498&amp;title=The+bittersweet+story+of+diabetes" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></p> <p><!-- End of tracking content syndication --></p> <div id="contributors"> <p><em><a href="https://cosmosmagazine.com/health/body-and-mind/diabetes-prevent-treat/" target="_blank" rel="noopener">This article</a> was originally published on <a href="https://cosmosmagazine.com" target="_blank" rel="noopener">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/imma-perfetto">Imma Perfetto</a>. Imma Perfetto is a science writer at Cosmos. She has a Bachelor of Science with Honours in Science Communication from the University of Adelaide.</em></p> <p><em>Image: Getty Images</em></p> </div>

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Plant based diets could prevent type 2 diabetes

<p>Eating a diet high in plant foods with little or no red meat has been linked to a lower risk of type 2 diabetes in the most comprehensive scrutiny of this connection so far.</p> <p>This protective effect is even stronger for diets high in healthier plant foods such as fruits, vegetables, whole grains, legumes and nuts.</p> <p>Diabetes has been called “the fastest growing health crisis of our time”. At the same time, plant-based diets are gaining popularity.</p> <p><span style="font-family: inherit;">Therefore, the researchers thought it was important to quantify their link with diabetes risk, says first author Frank Qian from the Harvard TH Chan School of Public Health, US – especially given the large variation in these diets. </span></p> <p><span style="font-family: inherit;">The analysis, </span>published<span style="font-family: inherit;"> in the </span>Journal of the American Medical Association<span style="font-family: inherit;">, included nine studies with more than 300,000 participants – of whom 23,544 had type 2 diabetes – over two to 28 years of follow-up. </span></p> <p><span style="font-family: inherit;">In the primary evaluation, Qian and co-authors focussed on an overall higher intake of plant-based foods along with little or no animal-based foods. Therefore, this included vegetarian or vegan dietary patterns.</span></p> <p>They found that people with the highest adherence to predominantly plant-based diets had a 23% reduced risk of type 2 diabetes compared to those with the lowest consumption of plant foods.</p> <p>But these dietary patterns didn’t exclude plant-derived foods that have been linked to higher diabetes risk, such as sugar and refined carbohydrates.</p> <p><span style="font-family: inherit;">When narrowing the analysis to four studies that defined a plant-based diet as the healthy whole food options, they found a 30% lower risk of type 2 diabetes.</span></p> <p>While it must be noted that the studies are observational, most, if not all, adjusted for well-known risk factors, including body mass index (BMI), gender, smoking status and family history of diabetes, among other potentially confounding variables.</p> <p>Several factors could explain the associations, the authors say.</p> <p>Plant-based diets typically include healthy plant foods packed with nutrients, polyphenols and fibre, which can improve insulin sensitivity, lower blood pressure, reduce inflammation and help maintain a healthy weight.</p> <p><span style="font-family: inherit;">All of these can lower the risk of type 2 diabetes. Conversely, eating red and processed meat has been linked to higher risk.</span></p> <p><span style="font-family: inherit;">Because the studies controlled for BMI, and excess weight and type 2 diabetes are a deadly duo, the authors suggest the associations they found could underestimate the actual degree of protection conferred by the diets.</span></p> <p><span style="font-family: inherit;">“Overall,” says senior author Qi Sun, “these data highlight the importance of adhering to plant-based diets to achieve or maintain good health.” </span></p> <!-- Start of tracking content syndication. Please do not remove this section as it allows us to keep track of republished articles --> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=26041&amp;title=Plant-based+diets+could+prevent+type+2+diabetes" alt="" width="1" height="1" /></p> <!-- End of tracking content syndication --> <div id="contributors"> <p><a href="https://cosmosmagazine.com/health/nutrition/plant-based-diets-could-prevent-type-2-diabetes/">This article</a> was originally published on <a href="https://cosmosmagazine.com">Cosmos Magazine</a> and was written by <a href="https://cosmosmagazine.com/contributor/natalie-parletta">Natalie Parletta</a>.</p> </div>

Food & Wine

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The 10 best superfoods for diabetics

<p><em>Image: Shutterstock</em></p> <p>1. Dark Chocolate</p> <p>Chocolate is rich in flavonoids, and research shows that these nutrients reduce insulin resistance, improve insulin sensitivity, drop insulin levels and fasting blood glucose, and blunt cravings. But not all chocolate is created equal.</p> <p>In a 2008 study from the University of Copenhagen, people who ate dark chocolate reported that they felt less like eating sweet, salty or fatty foods compared to volunteers given milk chocolate, with its lower levels of beneficial flavonoids (and, often, more sugar and fat, too).</p> <p>Dark chocolate also cut the amount of pizza that volunteers consumed later in the same day, by 15 per cent.</p> <p>The flavonoids in chocolate have also been shown to lower stroke risk, calm blood pressure and reduce your risk for a heart attack by 2 per cent over five years.</p> <p>Another benefit of dark chocolate is its ability to<span> </span>boost cognitive performance.</p> <p>2. Broccoli </p> <p>Broccoli is an anti-diabetes superhero.</p> <p>As with other cruciferous vegies, like kale and cauliflower, it contains a compound called sulforaphane, which triggers several anti-inflammatory processes that improve blood sugar control and protect blood vessels from the cardiovascular damage that’s often a consequence of diabetes.</p> <p>(Heart disease is the leading cause of death for people with diabetes, so this protection could be a lifesaver.)</p> <p>Sulforaphane also helps flip on the body’s natural detox mechanisms, coaxing enzymes to turn dangerous cancer-causing chemicals into more innocent forms that the body can easily release.</p> <p>A diet packed full of<span> </span>lots of vegies is the best way to go for overall good health.</p> <p><strong>3. Blueberries</strong></p> <p>Blueberries really stand out.</p> <p>They are a good source of<span> </span>fibre: both insoluble fibre (which “flushes” fat out of your system) and soluble fibre (which slows down the emptying of your stomach, and improves blood sugar control).</p> <p>In a study by the United States Department of Agriculture, people who consumed 2.5 cups of wild blueberry juice per day for 12 weeks lowered their blood glucose levels, lifted depression and improved their memories.</p> <p>Researchers credit these results to anthocyanins in the berries, a natural chemical that shrinks fat cells and also stimulates the release of adiponectin, a hormone that regulates blood glucose levels, among other things.</p> <p>Increasing adiponectin levels can help keep blood sugar low and increase our sensitivity to insulin.</p> <p><strong>4. Steel Cut Oats</strong></p> <p>You may not think of porridge as a superfood, but it can help reduce the risk of developing type 2 diabetes.</p> <p>Oats contain high amounts of magnesium, which helps the body use glucose and secrete insulin properly.</p> <p>An eight-year trial showed a 19 per cent decrease in type 2 diabetes’ risk in women with a magnesium-rich diet, and a 31 per cent decreased risk in women who regularly ate whole grains.</p> <p>Steel-cut oats are just as easy to cook as quick-cooking porridge, but when grains are left whole they are filled with the fibre, nutrients and bound antioxidants that challenge digestion in a good way, allowing blood sugar to remain more stable.<span> </span>You should aim for 25-35 grams per day.</p> <p><strong>5. Fish </strong></p> <p>Fish is a slimming star: rich in protein, it will help to keep you satisfied; but also, fish contains a special type of fat that helps cool inflammation.</p> <p>Thousands of studies show that people with the highest blood levels of omega-3 fatty acids have less body-wide inflammation, the very inflammation that leads to and worsens diabetes and weight problems.</p> <p>A fish-rich diet can also reduce your risk of developing health problems, especially stroke, as a result of your diabetes.</p> <p>People who ate baked, broiled or steamed fish reduced their odds for a stroke by 3 per cent, as reported in a 2010 Emory University study.</p> <p>(However, fried fish – such as fast-food fish sandwiches, fish sticks and fried seafood of any type – increased risk.)</p> <p><strong>6. Olive Oil </strong></p> <p>Following a Mediterranean-style diet rich in olive oil helps reduce the risk of type 2 diabetes by as much as 50 per cent compared to a diet low in fat, according to a recent Spanish study.</p> <p>Independently, researchers at Technical University of Munich (TUM) and the University of Vienna found that olive oil improved satiety the most when compared to lard, butter and canola oil.</p> <p>In addition to being a standout source of health-promoting monounsaturated fats, olive oil is also rich in antioxidant nutrients that protect cells from damage, and prevents the development of heart disease.</p> <p>While it may seem counterintuitive, monounsaturated fats such as olive oil, walnuts and salmon, can help you manage how much you eat.<span> </span>Try these other tips for controlling weight.</p> <p><strong>7. Psyllium Husk</strong></p> <p>This fibre supplement,<span> </span>long used for constipation relief, is proven to help people with diabetes control blood sugar better.</p> <p>A 2010 review from the University of California, San Diego, published in the Annals of Pharmacotherapy, confirms this benefit.</p> <p>People who took psyllium before a meal saw their post-meal blood sugar levels rise 2 per cent less than those who didn’t use the supplement.</p> <p>One caution: the researchers recommend waiting at least four hours after taking psyllium before taking medications, because psyllium can decrease their absorption.</p> <p><strong>8. Cannellini Beans</strong></p> <p>Packed with protein and cholesterol-lowering soluble fibre, legumes such as tender white cannellini beans are slow to raise blood sugar.</p> <p>As part of a 2012 University of Toronto study, 121 people with type 2 diabetes followed a healthy diet containing a daily cup of beans or whole grains.</p> <p>After three months, the bean group saw their A1c levels – a check of average blood sugar levels – fall nearly twice as much as the whole-grain group.</p> <p>As a low-GI food, cannellini beans are great for lowering blood glucose levels.<span> </span>Here are some ways to make the switch to a low-GI diet.</p> <p><strong>9. Spinach </strong></p> <p>Spinach is one of many leafy greens that have been shown to drop the risk of developing diabetes; collards are another great choice.</p> <p>People who consume more than one serving a day of spinach and other leafy greens slashed their risk by 14 per cent, compared to people who ate less than half a serving daily, found one British study.</p> <p>This green is particularly rich in vitamin K, along with several minerals including magnesium, folate, phosphorus, potassium and zinc.</p> <p>It’s also a good source of the plant chemicals lutein and zeaxanthin, and various flavonoids.</p> <p>Although spinach is technically a rich source of calcium, another nutrient in spinach called oxalic acid prevents much of that calcium from being absorbed, but you can blanch spinach (boil it for just one minute) to reduce this chemical.</p> <p>Spinach and other leafy greens you have to hand<span> </span>make an excellent soup<span> </span>for the warmer or cooler months.</p> <p><strong>10. Sweet Potatoes </strong></p> <p>One analysis found that sweet potatoes reduce HbA1c measures between 0.30 and 0.57 per cent, and fasting blood glucose by 10 to 15 points.</p> <p>Sweet potato also contains anthocyanins, which are the natural pigments that give the sweet potato its deep orange colour and the antioxidants believed to have anti-inflammatory, antiviral and antimicrobial qualities.</p> <p>Sweet potatoes are also rich in soluble fibre, which helps to regulate the glucose released into the bloodstream.</p> <p><em>Written by <span>Erin Palinkski-Wade</span>. This article first appeared in </em><a href="https://www.readersdigest.com.au/healthsmart/beauty/21-amazing-health-and-beauty-benefits-of-olive-oil"><em>Reader’s Digest</em>.</a><em><span> </span>For more of what you love from the world’s best-loved magazine, </em><a href="http://readersdigest.innovations.com.au/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA87V"><em>here’s our best subscription offer. </em></a></p>

Caring

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5 superfoods for diabetes you didn’t know about

<p>These superfood are the best to incorporate in your diabetes diet.</p> <p><strong>Dark chocolate </strong></p> <p>Chocolate is rich in flavonoids, and research shows that these nutrients reduce insulin resistance, improve insulin sensitivity, drop insulin levels and fasting blood glucose, and blunt cravings. But not all chocolate is created equal.</p> <p>In a 2008 study from the University of Copenhagen, people who ate dark chocolate reported that they felt less like eating sweet, salty or fatty foods compared to volunteers given milk chocolate, with its lower levels of beneficial flavonoids (and, often, more sugar and fat, too).</p> <p>Dark chocolate also cut the amount of pizza that volunteers consumed later in the same day, by 15 per cent.</p> <p>The flavonoids in chocolate have also been shown to lower stroke risk, calm blood pressure and reduce your risk for a heart attack by 2 per cent over five years.</p> <p><strong>Broccoli </strong></p> <p>Broccoli is an anti-diabetes superhero.</p> <p>As with other cruciferous vegies, like kale and cauliflower, it contains a compound called sulforaphane, which triggers several anti-inflammatory processes that improve blood sugar control and protect blood vessels from the cardiovascular damage that’s often a consequence of diabetes.</p> <p>(Heart disease is the leading cause of death for people with diabetes, so this protection could be a lifesaver.)</p> <p>Sulforaphane also helps flip on the body’s natural detox mechanisms, coaxing enzymes to turn dangerous cancer-causing chemicals into more innocent forms that the body can easily release.</p> <p><strong>Blueberries </strong></p> <p>Blueberries really stand out.</p> <p>They are a good source of fibre: both insoluble fibre (which “flushes” fat out of your system) and soluble fibre (which slows down the emptying of your stomach, and improves blood sugar control).</p> <p>In a study by the United States Department of Agriculture, people who consumed 2.5 cups of wild blueberry juice per day for 12 weeks lowered their blood glucose levels, lifted depression and improved their memories.</p> <p>Researchers credit these results to anthocyanins in the berries, a natural chemical that shrinks fat cells and also stimulates the release of adiponectin, a hormone that regulates blood glucose levels, among other things.</p> <p>Increasing adiponectin levels can help keep blood sugar low and increase our sensitivity to insulin.</p> <p><strong>Steel-cut oats</strong></p> <p>You may not think of porridge as a superfood, but it can help reduce the risk of developing type 2 diabetes.</p> <p>Oats contain high amounts of magnesium, which helps the body use glucose and secrete insulin properly.</p> <p>An eight-year trial showed a 19 per cent decrease in type 2 diabetes’ risk in women with a magnesium-rich diet, and a 31 per cent decreased risk in women who regularly ate whole grains.</p> <p>Steel-cut oats are just as easy to cook as quick-cooking porridge, but when grains are left whole they are filled with the fibre, nutrients and bound antioxidants that challenge digestion in a good way, allowing blood sugar to remain more stable. You should aim for 25-35 grams per day.</p> <p><strong>Fish </strong></p> <p><strong> </strong>Fish is a slimming star: rich in protein, it will help to keep you satisfied; but also, fish contains a special type of fat that helps cool inflammation.</p> <p>Thousands of studies show that people with the highest blood levels of omega-3 fatty acids have less body-wide inflammation, the very inflammation that leads to and worsens diabetes and weight problems.</p> <p>A fish-rich diet can also reduce your risk of developing health problems, especially stroke, as a result of your diabetes.</p> <p>People who ate baked, broiled or steamed fish reduced their odds for a stroke by 3 per cent, as reported in a 2010 Emory University study.</p> <p>(However, fried fish – such as fast-food fish sandwiches, fish sticks and fried seafood of any type – increased risk.)</p> <p><em>Written by Erin Palinkski-Wade. This article first appeared in <a href="https://www.readersdigest.com.au/healthsmart/diabetes/15-best-superfoods-diabetics">Reader’s Digest.</a> For more of what you love from the world’s best-loved magazine, <a href="http://readersdigest.innovations.com.au/c/readersdigestemailsubscribe?utm_source=over60&amp;utm_medium=articles&amp;utm_campaign=RDSUB&amp;keycode=WRA93V">here’s our best subscription offer.</a></em></p> <p><img style="width: 100px !important; height: 100px !important;" src="https://oversixtydev.blob.core.windows.net/media/7820640/1.png" alt="" data-udi="umb://media/f30947086c8e47b89cb076eb5bb9b3e2" /></p>

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New ‘smart’ insulin could revolutionise Type 1 diabetes treatment

<p><span style="font-weight: 400;">For the 15 in every 100,000 people with Type 1 diabetes, living with the condition often involves balancing diet, exercise, and insulin therapy to keep blood sugar levels in a normal range.</span></p> <p><span style="font-weight: 400;">Though there are a plethora of solutions being developed to help those with diabetes live more easily, a new approach has focused on insulin itself.</span></p> <p><span style="font-weight: 400;">Dr Michael Weiss, a biochemist from the School of Medicine at Indiana University, has worked with colleagues to tweak the structure of insulin so it responds to the presence of a simple sugar molecule.</span></p> <p><img style="width: 500px; height:231px;" src="https://oversixtydev.blob.core.windows.net/media/7843122/image-for-release_weiss_pnas.jpg" alt="" data-udi="umb://media/411d3753b46448bb978e1922daac8560" /></p> <p><em><span style="font-weight: 400;">Image: IU School of Medicine</span></em></p> <p><span style="font-weight: 400;">The researchers have utilised a feature already built into insulin’s structure - a “hinge” that enables the molecule to function when open and keeps it stable while closed.</span></p> <p><strong>What the study found</strong></p> <p><span style="font-weight: 400;">The experiments performed by Dr Weiss and his team used the carbohydrate fructose to manipulate insulin, so that it would only be ‘switched on’ by the presence of a certain amount of sugar, causing it to activate a sample of cells derived from the liver.</span></p> <p><span style="font-weight: 400;">Though the experiments were more confirmation that the concept would be viable than an actual treatment, it would theoretically work for an insulin shaped to activate in the presence of glucose.</span></p> <p><strong>Why it matters</strong></p> <p><span style="font-weight: 400;">Weiss envisions a future where people don’t have to worry about their blood sugar falling too low (hypoglycemia) or too high (hyperglycemia), which can result in symptoms such as delirium, convulsions, blindness, or strokes.</span></p> <p><span style="font-weight: 400;">“The promise of this kind of ‘smart’ insulin is that it would transform diabetes care, so people wouldn’t have to worry anymore,” Weiss </span><a rel="noopener" href="https://medicine.iu.edu/news/2021/07/Synthetic-hinge-could-hold-key-to-revolutionary-smart-insulin-therapy" target="_blank"><span style="font-weight: 400;">said</span></a><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">“With our invention, we envision that when the blood sugar goes too low, the hinge would close,” he explained.</span></p> <p><span style="font-weight: 400;">Though a lot needs to happen before this invention is incorporated into treatments, it could help affected individuals be able to manage their sugar levels and improve their quality of life.</span></p> <p><span style="font-weight: 400;">This research was published in </span><em><a rel="noopener" href="https://www.pnas.org/content/118/30/e2103518118" target="_blank"><span style="font-weight: 400;">PNAS</span></a></em><span style="font-weight: 400;">.</span></p> <p><em><span style="font-weight: 400;">Image: IU School of Medicine, Getty</span></em></p>

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New diabetes test could make blood-testing obsolete

<p><span style="font-weight: 400;">A new diabetes test could soon make the finger-prick testing of blood glucose obsolete.</span></p> <p><span style="font-weight: 400;">Aussie researchers from the University of Newcastle have developed the “world-first, pain-free diabetes test” from 20 years of research by a team led by Professor Paul Dastoor.</span></p> <p><span style="font-weight: 400;">“What we’ve done is to develop a way of creating biosensors, that we can print using reel-to-reel printing equipment,” Professor Dastoor said.</span></p> <p><span style="font-weight: 400;">The “lickable” test works using a plastic strip coating in a natural enzyme that interacts with saliva and produces an electrical current.</span></p> <p><span style="font-weight: 400;">This current can then be detected and measured to determine glucose levels with high accuracy, with the results able to be delivered via a smartphone app.</span></p> <p><span style="font-weight: 400;">“We’re able to test and have sensitivities at the concentration levels that glucose is in your saliva,” Professor Dastoor said.</span></p> <p><span style="font-weight: 400;">“And, so, we don’t need to test blood, we will now be able to use saliva to test for glucose.”</span></p> <p><span style="font-weight: 400;">Elaine Staunton, who was diagnosed with type 2 diabetes in her 30s, is overjoyed that the finger-prick tests could soon be replaced.</span></p> <p><span style="font-weight: 400;">“That would be marvellous if we could get that, especially for children,” Ms Staunton told </span><a rel="noopener" href="https://www.abc.net.au/radio/newcastle/programs/mornings/stigma-of-living-with-diabetes/13441428" target="_blank"><span style="font-weight: 400;">ABC Newcastle</span></a><span style="font-weight: 400;">.</span></p> <p><span style="font-weight: 400;">While the diagnosis didn’t come as a surprise to her, what did was the stigma associated with the condition.</span></p> <p><span style="font-weight: 400;">At a work function, Ms Staunton was victimised for needing to monitor her blood glucose levels, which are controlled by insulin injections.</span></p> <p><span style="font-weight: 400;">“I’ve always been taught to do my insulin when my meal’s in front of me,” Ms Staunton said.</span></p> <p><span style="font-weight: 400;">“I was hauled over the coals after the luncheon and told I wasn’t to inject myself in public and, if I had to do it, I had to do it in the toilet.</span></p> <p><span style="font-weight: 400;">“I was absolutely devastated. I cried all the way home and made the decision on the way home that I couldn’t go back there.”</span></p> <p><span style="font-weight: 400;">Now in her 50s, Ms Staunton said anything that would reduce the need to draw blood up to four times a day would be a welcome relief.</span></p> <p><span style="font-weight: 400;">“That’s a big thing, no blood,” she said.</span></p> <p><span style="font-weight: 400;">Professor Dastoor said the new tests would have positive health outcomes.</span><span style="font-weight: 400;"><br /></span><span style="font-weight: 400;">“That’s huge because … having to test your blood puts people off doing their testing, and that then leads to poor health outcomes,” he said.</span></p> <p><span style="font-weight: 400;">The inspiration for the test came from Professor Dastoor’s wife, who would help young children monitor their glucose levels during the day as a primary school teacher.</span></p> <p><span style="font-weight: 400;">“It’s a heartbreaking scenario, where the lunch bell rings and everyone runs to the playground bar an unfortunate few, who stay back to surrender their finger for blood testing at every meal time,” he said.</span></p> <p><span style="font-weight: 400;">“Our vision was to create a world where no one needs to bleed in order to eat.”</span></p> <p><span style="font-weight: 400;">The technology will be rolled out on a commercial scale, with the Australian government announcing $6.3 million in funding to build a manufacturing facility for the tests in the Hunter by the end of 2023.</span></p> <p><em><span style="font-weight: 400;">Image: University of Newcastle, Elaine Staunton</span></em></p>

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