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Published: Fri, 17 Nov 2017 14:06:55 GMT

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Diabetes can raise cardiac death risk sevenfold, study finds

Wed, 15 Nov 2017 00:00:00 GMT

A new Danish study has found that young adults with diabetes may be seven times more likely to die from sudden cardiac death, compared to their peers without diabetes. Whilst this sounds worrying, sudden cardiac death is relatively rare and readers should not be overly anxious. Note also that risks of heart disease can be minimised by keeping blood glucose well controlled and following a healthy lifestyle. The study suggests that younger people with diabetes and abnormalities in their blood vessels caused by the chronic narrowing of arteries (atherosclerosis) may have an especially high risk of cardiac death. The findings, which were presented at the American Heart Association's annual Scientific Sessions, compared the death rates from several cardiovascular-related causes of people aged 35 or younger with and without diabetes. There were 14,295 deaths during the 10-year study and, among those who died, 471 (70 per cent) had type 1 diabetes and 198 (30 per cent) had type 2 diabetes. The researchers at Copenhagen University Hospital found that the death rate was higher among people with diabetes in almost every category. The study found that overall, compared to those without diabetes, young adults with diabetes were eight times more likely to die from any kind of heart disease, such as heart failure or atherosclerosis. The risk for sudden and non-sudden cardiac death increased sevenfold and ninefold, respectively, for individuals with diabetes. Researchers also found that people with diabetes had twice the risk of developing other serious diseases, like pulmonary disease, endocrine disease, malignancies, and infectious disease. The study is one of the first to look at causes of death and cause-specific death rates among children and young adults nationwide. The findings highlight the importance of cardiovascular risk factors management from an early age. Continuous monitoring of blood lipids and blood pressure, alongside tighter control of blood glucose, may be especially important to lower the risk of heart disease and comorbidities in youth with diabetes.

NHS-backed study to test Fitbit-like health trackers for diabetes prevention

Tue, 14 Nov 2017 00:00:00 GMT

Thousands of people will receive Fitbit-like health trackers free on the NHS as part of a one-year trial aimed at testing a combination of wearable devices and mobile apps to help keep at-risk patients from developing type 2 diabetes. Having access to wearable monitoring devices and mobile health tools makes it easier for people to track their physical activity levels, as well as other types of health data, and see how lifestyle changes impact their blood glucose levels. In the upcoming trial, more than 5,000 people will test apps, gadgets and wristbands similar to Fitbits, which will primarily track their activity levels. Other health metrics, such as sleep and eating habits, will also be digitally recorded throughout the study. The scheme will run in eight areas of the country and give people access to technology including the prediabetes wristbands Buddi Nujjer. The wearable monitors participants' sleep and activity automatically, and users can also keep track of how often they eat. A built-in app then provides feedback and delivers supportive messages, developed by Clinical Academic Groups (CAGs) of King's Healh Partners, to encourage a healthy balance of eating, sleeping, and exercise. The study participants will also be given additional educational resources and personal coaching sessions to help them sustain these lifestyle and behavioural changes. According to Simon Stevens, the CEO of NHS England, boosting the digital capability of the NHS with essential tools for healthy lifestyle change is the next logical step in diabetes prevention. "So much else in our lives is now about online social connection and support, and that now needs to be true too for the modern NHS. This (initiative) is the latest example of how the NHS is getting practical and serious about supporting people to stay healthy," Stevens told the Press Association. This trial is another step towards making care decisions more data driven and addressing barriers to successful behaviour change. Research shows that communicating personalised disease risks for behaviours like physical activity or diet doesn’t really help change behaviour in itself or has minor effects. Encouraging people to make lasting changes around their diet and their activity levels with adequate tools and digital coaching, as provided in this trial, could have a more significant impact on their health. If trials like this one go well, this move could lead to a significant expansion of self-care with more gadgets like the Buddi Nujjer commercialised and distributed across the NHS.

Office bullying may impact type 2 diabetes risk

Tue, 14 Nov 2017 00:00:00 GMT

Bullying and violence at work could increase the risk of developing type 2 diabetes, according to Scandinavian researchers. Men were reported to be 61 per cent more likely to develop type 2 diabetes when exposed to negative workplace behavior, while women had a 36 per cent increased risk. However, the findings observed only an association and there is no concrete evidence to say that exposure to office bullying causes type 2 diabetes. The study involved 45,905 men and women aged between 40 and 65 from across Sweden, Denmark and Finland. None of the participants had diabetes at the start of the research. A study team led by Dr Tianwei Xu, Department of Public Health and the University of Copenhagen, asked the participants to report any negative behaviour in the workplace from the previous 12 months. They discovered nine per cent of the people in the study had experienced some kind of office bullying across an 11-year period, while 12 per cent were exposed to workplace violence or threats of violence. After adjustment for variables such as alcohol consumption and mental health difficulties, being bullied at work was associated with a 46 per cent higher risk of type 2 diabetes - 61 per cent for men, 36 per cent for women. Although the findings show a link between workplace bullying and type 2 diabetes, researchers do not know exactly why one might trigger the other. One hypothesis is that stress might contribute to the diabetes diagnosis in some way. The authors wrote: "Being bullied is regarded as a severe social stressor that may activate the stress response and lead to a range of downstream biological processes that may contribute towards the risk of diabetes. "There is a moderate and robust association between workplace bullying, violence and the development of type 2 diabetes. As both bullying and violence or threats of violence are common in the workplace we suggest that prevention policies should be investigated as a possible means to reduce this risk." The findings appear online in the journal Diabetologia.

IDF launches new Diabetes Atlas to mark World Diabetes Day

Tue, 14 Nov 2017 00:00:00 GMT

To mark World Diabetes Day, the International Diabetes Federation (IDF) has reiterated the need for urgent action in reducing worldwide diabetes rates. Data published in the eighth edition of the IDF Diabetes Atlas, launched in Brussels, reveals that 425 million adults worldwide are currently living with diabetes. Ninety per cent of cases are believed to be type 2 diabetes. Particularly, the IDF highlighted the disproportionate impact of diabetes on women. Over 200 million women live with diabetes, and millions face barriers in accessing effective care, diagnosis and treatment. This year's World Diabetes Day theme is 'Women and diabetes - our right to a healthy future', and combating these barriers is a pressing mission for the IDF. IDF President Dr. Shaukat Sadikot said: "Women and girls are key agents in the adoption of healthy lifestyles to prevent the further rise of diabetes and so it is important that they are given affordable and equitable access to the medicines, technologies, education and information they require to achieve […] healthy behaviours. "IDF is calling for all nations affected by the diabetes pandemic to work towards the full implementation of the commitments that have been made. We have both the knowledge and the expertise to create a brighter future for generations to come." Over 700 million are estimated to be affected by diabetes by 2045, while more than 350 million adults are at high risk of developing type 2 diabetes. "There is urgency for more collective, multi-sectoral action to improve diabetes outcomes and reduce the global burden of diabetes. If we do not act in time to prevent type 2 diabetes and improve management of all types of diabetes, we place the livelihood of future generations at risk," added Dr. Nam Cho, IDF President-Elect and Chair of the IDF Diabetes Atlas committee. Editor's note: While these worldwide rates of diabetes are undeniable alarming, an exceptional amount of good is being done through people with diabetes eating a healthy low-carb diet and getting regular exercise. People who join our award-winning Low Carb Program, which was launched on World Diabetes Day in 2015, are losing weight, improving their blood sugar levels, reducing their dependency on medication and even putting their type 2 diabetes into remission. Greater awareness of the benefits of cutting out starchy carbohydrates and processed food is pivotal in fighting the diabetes epidemic and essential towards creating the brighter future the IDF is calling for.

Study reveals how calorie restriction can help lower blood glucose in the short term

Mon, 13 Nov 2017 00:00:00 GMT

A new study describes how short-term calorie restriction can lead to better blood glucose control and lipid levels, in rats. Previous human studies reported that many people with type 2 diabetes are able to reverse their diabetes after bariatric surgery, which significantly restricts calorie intake, and that this reversal seems uncoupled from weight loss. In this new study, researchers at Yale University School of Medicine tried to understand the mechanisms by which calorie restriction may help reverse type 2 diabetes. To that end, the research team placed one of two groups of rats with type 2 diabetes on a very low-calorie diet (VLCD) for three days. The diet reduced their calorie intake by a quarter and was made up of 51 per cent carbs, 39 per cent fat and 10 per cent protein. Using a novel approach for tracking liver metabolites, known as PINTA, researchers monitored the levels of substrates involved in processes linked to increased glucose production and insulin resistance in the liver. The results revealed that, although the body weight of rats on the VLCD did not change, the low-calorie diet lowered their blood glucose levels by about 75 mg/dL (4.2 mmol/L) and led to a 50 per cent decrease in their insulin levels on average. According to the researchers, this decrease in blood glucose was attributable to a 30 per cent reduction in glucose production by the liver, that insulin did a better job at suppressing because of diverse insulin-sensitising effects of the VLCD. The calorie restriction led to a decrease in the rate of conversion of amino acids into glucose (gluconeogenesis) and in the breakdown of glycogen to glucose (glycogenolysis), taking place in the liver. There were also favourable changes to lipids. The VLCD reduced liver and blood triglyceride levels as well as a precursor to triglycerides, known as diacylglycerol, whose accumulation in the liver has been linked to insulin resistance. These improvements contributed to reducing liver fat content, improving hepatic insulin sensitivity, and to lowering activation of processes associated with non-alcoholic fatty liver disease (NAFLD). Overall, this study shows that the insulin-sensitising effects of short-term caloric restriction seem to be confined to the liver, where the VLCD acts to decrease glucose production and fat content. The next step for the researchers will be to confirm whether the findings can all be replicated in people with type 2 diabetes undergoing either bariatric surgery or consuming VLCDs. The findings were published in the journal Cell Metabolism.

Bionic pancreas shown to boost satisfaction and reduce worry in type 1 diabetes care

Mon, 13 Nov 2017 00:00:00 GMT

Adults with type 1 diabetes experienced less distress and greater treatment satisfaction when using a bionic pancreas, according to new research. A bionic pancreas is an exciting ongoing development within type 1 diabetes research. The device is capable of automatically controlling blood glucose levels through two insulin pumps which deliver and insulin and glucagon, essentially mimicking a healthy pancreas. The US study investigated the psychosocial impact of a bionic pancreas to see how patients fared using the device in a real-world outpatient setting. Thirty-nine adults with type 1 diabetes were recruited, all of whom spent 11 days using the device or their usual care return, before swapping over for another 11 days. Psychological questionnaires were administered before the study, at the end of the first 11 days and at the end of the study. Using the bionic pancreas resulted in fewer episodes of hypoglycemia, less food concerns and reduced diabetes-related distress. Patients worried less about their blood glucose levels and were generally more satisfied with this treatment. A few concerns were raised, however, particularly the burden of carrying the technology and the inconvenience of changing the glucagon supply every day. "These results suggest that BP may provide significant improvements in the personal experience of managing diabetes, along with better clinical outcomes," said the researchers. "Overall, participants report substantial psychosocial benefits accruing from the BP relative to their usual method of diabetes care. "Participants also reported a number of burdens associated with the system. Future versions of the BP device should be designed with the goal of addressing these concerns, and studies with larger, more diverse samples, and with more technology-naive participants are needed." US company Beta Bionics hopes to have an insulin-only approved version of their bionic pancreas, the iLet, in 2018. The study results were published in the journal Diabetes Technology and Therapeutics.

JDRF announces commitment to aid open-protocol artificial pancreas development

Mon, 13 Nov 2017 00:00:00 GMT

JDRF has announced plans to support the development of artificial pancreas technology by helping to put in place financial, regulatory and legal frameworks. Research into artificial pancreas systems is continually evolving and clinical trials are ongoing. Later this year an insulin-only version of the iLet, commonly known as a bionic pancreas, is expected to be submitted to the US Food and Drug Administration (FDA). But a tech-savvy community of people tired of waiting for device approval are building their own artificial pancreas devices as part of the #WeAreNotWaiting movement. JDRF says it now wants to "fuel innovation" to support the thriving community behind open-loop artificial pancreas systems such as Nightscout and OpenAPS, which use open protocol to reverse engineer continuous glucose monitors (CGMs) and insulin pumps to deliver insulin based on blood glucose readings. As part of a new initiative, JDRF will award grants to projects supporting this movement, and help the approval process and lobby manufacturers to ensure secure and safe connections with devices through Bluetooth. JDRF Chief Mission Officer Dr Aaron Kowalski said: "JDRF is firmly committed to ensuring people with diabetes have access to tools that improve their lives as we drive towards a cure. "Automated insulin delivery systems are already benefiting people with type 1 diabetes, and open-protocol innovation is providing additional solutions. JDRF will explore means to ensure innovation continues at a rapid pace and that we tap the best people from diverse fields to support progress in this area." A spokesman for JDRF added that the new initiative would "explore ways to overcome potential challenges in the use and adoption of open-protocol systems", adding "JDRF believes that both proprietary and open-protocol development pathways can fuel innovation that improves outcomes and reduces the burden of T1D". Editor's note: The people behind the #WeAreNotWaiting movement have strong understanding of diabetes and engineering. Making changes to your insulin pump or CGM is not recommended, and doing this could invalidate product warranties.

Study links impaired glucose metabolism in the brain to Alzheimers disease

Fri, 10 Nov 2017 00:00:00 GMT

A new study shows connections between disruptions in brain glucose metabolism and early Alzheimer's disease symptoms. Research increasingly suggests that Alzheimer's disease and type 2 diabetes may stem from the same metabolic dysregulation, as they share common roots such as problems with insulin and glucose metabolism. In this study, researchers at the National Institute on Aging (NIA) performed autopsies on Alzheimer's patients involved in the decades-long Baltimore Longitudinal Study of Aging (BLSA). They analysed brain tissue samples from three groups of participants: those with visible Alzheimer's symptoms and tangles and amyloid plaques in their brain, those who lacked symptoms but had plaques and tangles, and a control group without Alzheimer's disease. Glucose metabolism and brain glucose levels were measured in different areas of the brain including some that are more vulnerable to Alzheimer's, such as the frontal and temporal cortex. There were abnormalities in the mechanism of glucose breakdown (glycolysis) in the brains of people affected with Alzheimer's, and this poorer ability of the brain to process glucose affected the course of the disease. Researchers found that lower rates of glycolysis and subsequent higher brain glucose levels correlated to an increased formation of beta amyloid plaques and neurofibrillary tangles, in those with the disease. According to researchers, reductions in brain glycolysis may be linked to the development of Alzheimer's symptoms, like memory problems and declining cognitive abilities. In addition to this, researchers saw a decreased activity of certain enzymes controlling glycolysis, and lower levels of glucose transporters GLUT3, in brains with Alzheimer's disease compared to normal brains. The research team also checked blood glucose levels in study participants years before they died and found that greater increases in blood glucose levels were associated with greater brain glucose levels at death. Further research is however needed to determine whether these abnormalities in brain glucose metabolism are definitively connected with the severity of symptoms of Alzheimer's or disease progression speed. The findings were published in the journal Alzheimer's and Dementia.

Doctor plans epic running challenge for World Diabetes Day

Fri, 10 Nov 2017 00:00:00 GMT

A doctor is set to run across Cardiff visiting as many GP surgeries as he can in support of World Diabetes Day. Dr Sam Rice (pictured), a consultant endocrinologist, will begin his epic challenge at the Diabetes UK Cymru office at 8am on Tuesday 14 November before heading to GP practices all over the city. Each surgery he visits will receive information about a series of films Dr Rice has developed for staff to pass onto their patients. The day afterwards Dr Rice plans to run to the Welsh Government to ensure MPs are aware of how widespread type 2 diabetes has become across the country. Dr Rice said: "I live in Wales and work with people living with diabetes. One in four of us now either has or are at risk of type 2 diabetes and over 40 per cent of our kids over 12 are either overweight or obese and it is these kids who will most likely go on to get type 2 diabetes in the future. "Diabetes is often a really hard thing to live with that can be associated with some devastating complications. I want to try and do something to raise the awareness of this and to hopefully get people in Wales to think differently about how they live and look after themselves and their families." Dr Rice currently has no idea how far he will end up running, but he is hoping to raise at least £675. A series of challenges, activities and awareness campaigns will take place on World Diabetes Day, a global event run by the International Diabetes Federation (IDF). This year's theme is women with diabetes. Keep checking our Facebook and Twitter pages ahead of World Diabetes Day to see what we've got in store. On World Diabetes Day in 2015 we launched our award-winning Low Carb Program. To get further involved with Diabetes Awareness Month you can upload selfie pictures and your diabetes stories as part of our #FacesOfDiabetes and #BlueNovember campaigns to encourage everyone to talk more openly about their condition. Picture: South Wales Guardian

Eating more antioxidant-rich food could reduce type 2 diabetes risk

Fri, 10 Nov 2017 00:00:00 GMT

Regular consumption of antioxidant-rich foods such as tea, walnuts and blueberries can help to lower the risk of type 2 diabetes, researchers say. A French study published in the journal Diabetologia has reported that women with higher antioxidant scores had a 27 per cent reduced risk of type 2 diabetes compared to those with the lowest scores. Scientists analysed total antioxidant capacity in 64,223 women between 1993 and 2008 to see whether overall diet was associated with type 2 diabetes risk. At the beginning of the study the participants completed a dietary questionnaire, which included information on more than 200 food items. This enabled researchers to assess the 'total dietary antioxidant capacity' for each participant. None of the women had diabetes before the study began. A total of 1,751 women developed type 2 diabetes during the 15-year follow-up period. When the associations between antioxidant score and diabetes risk were analysed, the risk was diminished with increased antioxidant consumption. "This link persists after taking into account all the other principal diabetes risk factors: smoking, education level, hypertension, high cholesterol levels, family history of diabetes and, above all, BMI, the most important factor," said first author Francesca Romana Mancini, who is part of the French National Institute of Health and Medical Research. The foods and drink that contributed most to a higher dietary antioxidant score were fruits and vegetables, tea and red wine (in moderation), while coffee was excluded from the analysis because it has already been linked to reduced type 2 diabetes risk. The research builds on existing studies that have shown certain antioxidants such as vitamins C and E can reduce type 2 diabetes risk, but the mechanisms behind this action are unclear. Mancini said: "We know that these molecules counterbalance the effect of free radicals, which are damaging to cells, but there are likely to be more specific actions in addition to this, for example an effect on the sensitivity of cells to insulin. This will need to be confirmed in future studies." Increasing your antioxidant score can be achieved through eating a variety of low-carb foods such as strawberries, hazelnuts and vegetables. For more information visit our award-winning Low Carb Program.