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Re: Diabetes news for spring 2019

Bell Pepper Poppers




• Nonstick cooking spray
• mini sweet peppers
• turkey bacon (diced)
2 slice
• onion(s) (diced)
1/2 cup
• cream cheese (fat-free, room temperature)
4 oz
• soft goat cheese (room temperature)
2 oz
• red pepper flakes (crushed)
1/4 tsp
• whole wheat bread (toasted)
1 slice
• garlic (minced)
1 clove
• Parmesan cheese (grated)
1 tbsp



• Preheat the oven to 375° F. Coat a baking sheet with cooking spray. Set aside.

• Slice each pepper in half lengthwise then scoop out any seeds and membrane.

• Add bacon to a non-stick sauté pan with cooking spray over medium heat and cook until crisp. Drain on a paper towel and set aside.

• Add onions to the pan used to cook the bacon and add more cooking spray if needed. Cook the onions, stirring occasionally until clear. Set aside to cool.

• In a small bowl, mix the cream cheese and goat cheese. Add the bacon, onions and red pepper flakes. Stir to combine.

• Grind toasted bread in a food processor with the garlic and parmesan cheese. Set aside in a small bowl.

• Spoon the cheese mixture into each pepper half (1 Tsp. of mixture per popper), and then press the cheese side of the popper into the whole wheat breadcrumb mixture. Lay on the prepared baking sheet breadcrumb side up and spray each on lightly with cooking spray.

• Bake the poppers for about 20 minutes or until the peppers have softened and the breadcrumbs are golden brown.


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Re: Diabetes news for spring 2019

I just listend to a Dr from the BBC ,share this very tip, so I am going to use it







WHITE bread is often feared by those on a diet because of its high Glycaemic Index (GI), which can make your sugar and insulin levels spike, leaving you tired and hungry.

But studies have found that the GI is LOWER in white bread that’s been frozen then defrosted - so how does that work?

The GI is LOWER in white bread that’s been frozen Toasting frozen white bread reduces the effect it has on your blood sugar level

The glycaemic index (GI) is a rating system for foods containing carbohydrates.

It shows how quickly each food affects your blood sugar (glucose) level when that food is eaten on its own.

The exciting news is that researchers have found that if you freeze white bread, then defrost and eat it, its GI is 31 per cent lower.

This is because the starch molecules in bread take on a different structure as a result of freezing, defrosting and toasting it.

Essentially, the process makes it more difficult for the enzymes to break the starch down into sugar.

Better still, if you toast the frozen bread (instead of eating it cold once it’s defrosted) the GI reduces even more, resulting in the bread having a 39 per cent lower GI than its fresh equivalent.

Tests are yet to be carried out on brown bread - so it's not yet known whether freezing then toasting it will have similar effects on its GI.

A fresh white loaf of bread has a 31% higher GI than a frozen loaf Defrosted and toasted bread isn’t better for everyone, though

Nutritionist Fiona Hunter told the Mirror that those with common tummy problems like bloating and IBS could find freezing then toasting bread makes their symptoms WORSE.

She explained: “Baking bread softens the wheat starch...when you cool it again it hardens and becomes ‘resistant starch’.

“This can be harder to digest for some people and can lead to bloating and gas, which are symptoms of irritable bowel syndrome.

“If you do have bloating and other IBS symptoms, try to avoid freezing your bread and see if it makes any difference.”


Freezing then defrosting and toasting a loaf of white bread will reduce the effects it has on your blood sugar levels

Ultimately, unless you suffer from IBS, the next time you crave a white loaf you should try the freezing then toasting trick.

You can then enjoy white bread safe in the knowledge it’s better for your blood sugar levels than a fresh slice would be.

Not only that, freezing bread is extremely convenient for those who don’t get through a whole loaf at once.

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Re: Diabetes news for spring 2019

@cherry... fascinating about freezing the white bread. I just had blood work for Celiac yesterday and I am hoping that it comes back negative. My endo thinks I have it but I am not so sure. I love bread so I am going to try it today and see if it makes a difference. Thanks for the tip!

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Re: Diabetes news for spring 2019

Diabetes patients who use Express Scripts could soon see out-of-pocket insulin costs max out at $25 a month, but industry analysts and advocates aren’t satisfied with the new plan.


The new patient assurance program places a $25 cap on the cost of a 30-day supply of insulin for “eligible people with diabetes in participating plans.”

These “eligible people” would include about 700,000 patients in commercially insured plans across Cigna and Express Scripts, according to Express Scripts spokeswoman Jennifer Luddy.

Boston University public health professor Alan Sager called the plan a “baby step forward” but cautioned patients not to be fooled by drug makers.

“It’s a smoke screen behind which they plan to raise prices on everything else,” said Sager. “I think they hope to distract us the way a pickpocket does.”

Sager said that while patients should be grateful for some relief, the Express Scripts program is “a half-inch wide Band-Aid on a gaping wound.”

Legislation surrounding affordable drug costs has been ramping up in Massachusetts and across the country, which Sager said is making drug companies nervous.

“What the legislators are going to do is look as good as possible while angering the drug makers as little as possible,” said Sager.

Antroinette Worsham of Ohio, who founded T1 Diabetes Journey Inc. after losing her 22-year-old daughter Antavia Worsham to insulin rationing, said the $25 cap is just a “cover-up” used to make drug companies look good.


“The pharmaceutical companies are now in the news and they just don’t want to be out there, they don’t want their name to be brought up,” said Worsham.

She said many patients would be left out of the new program: “Anybody who needs a life-saving medication should be eligible.”

Luddy said the Cigna and Express Scripts patient assurance program is the result of “new opportunities we have as a combined organization to make health care simpler for our customers and members.”

The program will be activated by moving covered insulin products to a lower co-payment. For diabetes patients on insulin plans managed by Cigna and Express Scripts, the average out-of-pocket cost for insulin was $41.50 for a 30-day supply in 2018.

Tracey Brown, CEO, and Dr. William Cefalu, Chief Scientific Officer of the American Diabetes Association, said the ADA is pleased with the new plan.

“When insulin is affordable, people with diabetes are able to take the dose of insulin prescribed by their health care provider, and therefore they are less likely to ration or skip doses,” Brown and Cefalu said in a statement.

“No one should have to ration insulin or skip insulin doses due to high out-of-pocket costs. Insulin is not a luxury, it is a matter of life and death, every day for more than 7.4 million Americans with diabetes,” said Brown and Cefalu.

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Re: Diabetes news for spring 2019

All Forms of Physical Activity Count: Just Do Something, Anything 

As to what kind of exercise is necessary—both aerobic (activity that raises your heart rate) and strength training are important, says Tim Church, MD, PhD, an adjunct professor at Pennington Biomedical Research Center in Baton Rouge, Louisiana. Examples of basic muscle-strengthening exercises include squats, lunges, planks, and use of hand weights or resistance bands.

You’ll want to do both pulling exercises and pushing movements like presses. Or, opt for yoga or Tai chi to gain the same benefits. Muscle (strength) training is crucial, especially as people get older, he says.

“As you age, you lose as much as 3 to 5% of our muscle every year, starting at about 45 to 50 years so it’s important to preserve muscle strength through exercise,” Dr. Church says. “so that you are able to chase your grandchildren around, get up from a chair, and to be able to get dressed in the morning so we are talking quality of life health.”4

Doing a little muscle training doesn’t have to be time-consuming, Dr. Church says. All you need is 20 minutes, two to three times a week, to work all your large muscles. Often, he tells EndocrineWeb, “people don’t get motivated to move more until something happens to them or to one of their friends. Don’t postpone working your muscles. It’s not just about strength, it’s also  about preventing illness, which is far better than trying to recover from a fall or other disabling incident.”

“You want to be living the life you wish for at age 70,” he says. “The worst scenario is becoming the 70-year-old who is bedridden when you can be the Septuagenarian whose days are full of your favorite activities. Exercise is the thing that can help people maintain the quality of their lives.”

Even more reason to add strength training to your weekly routine—Exercise is a great way to help manage your blood sugar, says Dr. Church. “People forget that the muscle is a very important metabolic tissue. It plays a role in controlling blood sugar by storing blood sugar until it is needed and then releasing it. If your muscles aren’t doing what they should, then you will have a harder time controlling your blood sugar. And if you have prediabetes, without making any changes, you are on your way toward developing diabetes.”

And there’s another reason to include strength training. Your risk of heart attack or stroke decreases by up to 70%, particularly if you have type 2 diabetes, just by lifting weights at least once a week,5 according to Duck-Chul Lee, PhD, associate professor of kinesiology at Iowa State University in Ames, co-author of a study published the Journal of Clinical Endocrinology & Metabolism. In following 13,000 adults, they were able to confirm that resistance training reduces the likelihood that these individuals will develop heart disease and death.

Time to Talk Yourself Into Moving Even A Little

Whatever your motivating factor, by adding strength training into your weekly routine, in the same way as you brush your teeth daily, you will anticipate doing it regularly, says Dr. Church. There are tons of exercise programs available online and in apps to help you find something that will fit your interest and comfort level.

For many, waking up in the morning and getting your exercise done is a sure way to establish a positive start to the day. For others, walking at lunch and again after dinner works best. And some people find have the regular rhythm of going to yoga, a local adult education class, or the gym when both convenience and affordable does the trick.

Since there are a wide variety of programs, you’ll see the best results if you are able to work with someone who can create an exercise routine for you. Just one session with a personal trainer at the local gym can be enough to get your own your way. “You‘ll want a program tailored to your personal needs,” says Dr. Church.

You can get your aerobic and strength training exercises in smaller increments? The most significant change in the new physical activity guidelines aims to make meeting daily goals much easier to meet.1 There’s no longer a time-limiting requirement to being active. So even if you have just five minutes to walk, or do one weight-lifting exercise, it counts!  

Age Better: More Reasons to Expand Your Physical Activity 

For adults, the recommendations for cardio-based exercise (that boosts your heart rate) remain the same: 150 to 300 minutes per week of moderate-intensity exercise, or 75 to 150 minutes of vigorous aerobic activity. What’s new is the need for everyone to add muscle-strengthening activities two to three days per week.1

For older adults,1 the goal stresses “multicomponent physical activity that incorporates balance exercises with aerobic and muscle-strengthening activities,” says Dr. Church. Since the risk of bone fractures increases with age, maintaining good balance means reducing your risk of falls. So when you walk, include a few hills rather than just traversing a flat route, or put the treadmill on an incline to get the same good benefit.

Any effort to move more will up your chances of aging well. After all, inactivity causes 10% of the premature mortality in the United States,1 according to the Department of Health and Human Services. And one in five adults has metabolic syndrome, meaning they have at least three risk factors: excess abdominal fat, high total blood cholesterol, low high-density lipoprotein (“good”) cholesterol, high blood pressure, and elevated blood glucose levels.6

More Reasons for Women Reaching Menopause, Children to Move More 

One group of adults who can benefit significantly from increased physical activity are women in the menopausal transition because of an increased risk for metabolic syndrome, which predisposes them to both heart disease and type 2 diabetes.6

“We found that greater physical activity was associated with recovery from metabolic syndrome,” Jennifer S. Lee, MD, PhD, associate professor of medicine at Stanford University Medical Center in Palo Alto, California, who was the lead author of the study. “The evidence suggests that women who are at risk for metabolic syndrome may be able to recover from it by upping their level of physical activity.”6

These risks can be reduced simply by exercising more (and eating fewer calories),3 writes Dr. Duck-Chul Lee.

“Since we didn’t assign women to do more physical activity but rather we observed them over time and saw an association between more physical activity and a reduction in the risks for metabolic syndrome, our study results are not definitive because the design was observational, not interventional,” Dr. Jennifer Lee tells EndocrineWeb.

“Physical activity levels in this country typically decrease with age as diabetes and obesity increase. However, it is not clear yet if people are less active leading to the development of these diseases or they become less active after these conditions develop so more research is required,”3 says Dr. Duck-Chul Lee. “We know that a lack of time is one of the major reasons that women and others don’t exercise.”   

“Although it is not yet clear precisely how exercise impacts menopause in women, it is clear that they should participate in some physical activity, including resistance exercise since they are more susceptible to osteoporosis and cardiovascular diseases after menopause,”6 Dr. Jennifer Lee says.

In pre-school aged children (3- to 5-year-olds), the physical activity guidelines indicate a need for them to be physically active throughout the day, with a target of three hours of activity daily. Children and teenagers (6 to 17 years) should engage in an at least one hour or more of moderate to vigorous physical activity daily.1


In the United States, low levels of adherence to the guidelines for physical activity mean that close to $117 billion in annual healthcare costs are “directly attributable” to not meeting the guidelines,1 Dr. Giroir says, and this represents a “threat to our national security, because obesity disqualifies nearly one-third of American youth aged 17 to 24 years for military service.”

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American Diabetes Association® Issues Critical Updates to the 2019 Standards of Medical Care in Diabetes Contact

Michelle Kirkwood

Arlington, Virginia
March 27, 2019

Today, the American Diabetes Association® (ADA) issued important updates to the 2019 Standards of Medical Care in Diabetes (Standards of Care), in annotations as the Living Standards of Care, focused on improving cardiovascular and renal health in people with diabetes. The updates were informed by newly published research and crafted and approved by the ADA’s Professional Practice Committee, which is responsible for producing the annual Standards of Care. The Living Standards of Care are available immediately online at Diabetes Care.

Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality for individuals with diabetes, and heart disease is the cause of one in four deaths in the U.S. Diabetes is the leading cause of chronic kidney disease, and approximately one out of four adults with diabetes has kidney disease. Recently published research indicated an urgent need to update the 2019 Standards of Care to ensure optimal treatment recommendations for people with cardiovascular disease and diabetes, and for those with chronic kidney disease and diabetes. The March 27 Living Standards of Care updates are:

  • Section 10 was updated based on the outcome of Reduction of Cardiovascular Events with Icosapent Ethyl–Intervention Trial (REDUCE-IT), which determined the addition of icosapent ethyl to statin therapy for patients with high triglyceride levels reduced cardiovascular events. The Standards of Care now include a recommendation that icosapent ethyl be considered for patients with diabetes and atherosclerotic cardiovascular disease (ASCVD) or other cardiac risk factors on a statin with controlled LDL-C, but with elevated triglycerides (135-499) to reduce cardiovascular risk.
  • Sections 9, 10, and 11 have been revised based on findings from The Dapagliflozin Effect on Cardiovascular Events-Thrombosis in Myocardial Infarction 58 (DECLARE-TIMI 58) Trial, in which dapagliflozin treatment showed a reduction of hospitalization for heart failure and a reduction in progression of chronic kidney disease (CKD).
  • Based on a revision to the prescribing information for dapagliflozin, for patients with diabetes and CKD, the approved use per estimated glomerular filtration rate (eGFR) has been revised from ≥60 mL/min/1.73 m2 to ≥45 mL/min/1.73 m2 in Section 11 of the Standards of Care.

“New research can lead to improved patient outcomes and quality of life, and the American Diabetes Association is proud to continue to provide the most current evidence-based guidelines for people living with diabetes. These Living Standards of Care updates via the online annotations to our yearly Standards of Care enable us to translate and communicate significant research findings that will empower health professionals to provide optimal care for millions of Americans living with diabetes,” said the ADA’s Chief Scientific, Medical and Mission Officer William T. Cefalu, MD.

The Standards of Care provide the latest in comprehensive, evidence-based recommendations for the diagnosis and treatment of children and adults with type 1, type 2 or gestational diabetes; strategies to improve the prevention or delay of type 2 diabetes; and therapeutic approaches that reduce complications and positively affect health outcomes. Beginning in 2018, the ADA updates and revises the online version of the Standards of Care throughout the year, with annotations for new evidence or regulatory changes that merit immediate incorporation. The online version of the Standards of Care will include any research updates or policy changes that are approved throughout 2019.

Updates to the Standards of Care are established and revised by the ADA’s Professional Practice Committee (PPC). The committee is a multidisciplinary team of 14 leading U.S. experts in the field of diabetes care and includes physicians, diabetes educators, registered dietitians and others whose experience includes adult and pediatric endocrinology, epidemiology, public health, lipid research, hypertension, preconception planning and pregnancy care. For the 2019 Standards of Care, two designated representatives from the American College of Cardiology (ACC) reviewed, provided feedback and endorsed the recommendations for cardiovascular disease and risk management on behalf of the ACC. The PPC performs an extensive, global clinical diabetes literature search each year for the annual Standards of Care update, supplemented with input from ADA leaders and staff and the medical community at-large. Members of the PPC must disclose potential conflicts of interest with industry and/or relevant organizations; these disclosures are available on page S184 of the 2019 Standards of Care.

The complete, annotated Standards of Care, which includes updates made today, can be accessed online on Diabetes Care. The Abridged Standards of Medical Care in Diabetes have also been updated and can be accessed online on Clinical Diabetes.

About Diabetes Care®
Diabetes Care, a monthly journal of the American Diabetes Association (ADA), is the highest-ranked, peer-reviewed journal in the field of diabetes treatment and prevention. Dedicated to increasing knowledge, stimulating research and promoting better health care for people with diabetes, the journal publishes original articles on human studies in clinical care, education and nutrition; epidemiology, health services and psychosocial research; emerging treatments and technologies; and pathophysiology and complications. Diabetes Care also publishes the ADA’s recommendations and statements, clinically relevant review articles, editorials and commentaries. Topics covered are of interest to clinically oriented physicians, researchers, epidemiologists, psychologists, diabetes educators and other health care professionals. 

About the American Diabetes Association
Approximately every 21 seconds, someone in the United States is diagnosed with diabetes. Nearly half of the American adult population has diabetes or prediabetes, and more than 30 million adults and children are living with the disease. The American Diabetes Association (ADA) is the nation’s leading voluntary health organization on a mission to prevent and cure diabetes, as well as improve the lives of all people affected by the disease. For nearly 80 years, the ADA has driven discovery by funding research to treat, manage and prevent all types of diabetes, while working relentlessly for a cure. Magnifying the urgency of this epidemic, the ADA works to safeguard policies and programs that protect people with the illness, those at risk of developing diabetes and the health care professionals who serve them by initiating programs, advocacy and education efforts that can lead to improved health outcomes and quality of life.


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Re: Diabetes news for spring 2019

High blood sugar, or hyperglycemia, can affect those with type 1 and 2 diabetes as well as prediabetes. It can happen when you eat something with too much sugar or too many simple carbs, forget to take your insulin, or even when you’re sick or stressed.

Whatever the reason, everyone can agree the signs and symptoms of high blood sugar are no fun. According to the American Diabetes Association, indications that your blood sugar is too high include extreme thirst, a frequent need to urinate, and exhaustion. And if left untreated, high blood sugar can quickly develop into a life-threatening condition called ketoacidosis. Yikes!

Here’s the thing—everyone’s diabetes care plan is different, but one thing we can all benefit from is eating a healthy breakfast that keeps our blood sugar stable throughout the day. While, unfortunately, there aren’t any miracle foods that can replace insulin, here are six easy ways to stabilize your blood sugar with breakfast.

Choose Complex Carbs

Greg DuPree
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Greg DuPree


This probably goes without saying, but foods like refined cereals and glazed donuts can make your blood sugar skyrocket. But that doesn’t mean you have to avoid carbs entirely at breakfast—just make sure to opt for whole-grains like steel-cut oats, muffins made with whole-wheat flour, or maybe a sweet potato stuffed with scrambled eggs and black beans. The complex carbs in whole grains, beans, and starchy veggies are full of fiber, which takes longer to digest and affects your blood sugar more slowly, according to the ADA.

View Recipe: Overnight Oats With Kiwi and Coconut Flakes

Don't Exercise Before Breakfast

Molly Cranna for TIME
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Molly Cranna for TIME


Exercise is an important part of blood sugar management, and when done regularly it can help improve insulin sensitivity and lower your A1C levels. How exercise affects your blood sugar depends on how long you’re active, and varies from person to person. But generally exercise will lower your blood sugar and make your body more sensitive to insulin for up to 24 hours after a workout, according to the ADA.

If you tend to work out in the morning, it’s important to test your blood sugar levels before and after your workout to see how your body responds. If your blood sugar tends to quickly drop off after a workout, it’s smart to have breakfast before you head to the gym to keep you fueled and your blood sugar steady.

Opt for the Right Kind of Fat
Caitlin Bensel
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Caitlin Bensel


People with diabetes are more at risk for high cholesterol. According to the American Heart Association, “Diabetes tends to lower ‘good’ cholesterol levels and raise triglyceride and ‘bad’ cholesterol levels, which increases the risk for heart disease and stroke.”

Eating monounsaturated (or “heart-healthy” fats) such as avocado, olive oil, or fatty fish can help lower bad LDL cholesterol. And if you’re prediabetic, it can actually reduce your risk of developing diabetes.

Carolyn Williams, PhD, RD, in her article 10 Foods Diabetics Should Eat Daily, says “Some research suggests [healthy fats] may also improve glucose usage by cells, thanks to their anti-inflammatory effects.” So go ahead and make some avo toast for breakfast—it’s good for your heart!

View Recipe: Smoked Salmon Breakfast Casserole

Prioritize Fiber

Photo: Katherine Flynn
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Photo: Katherine Flynn


Almost everyone could use more fiber in their diets (in fact, nearly 95% of Americans don't get enough), but those with diabetes should be prioritizing it even more. Even though fiber is a type of carbohydrate, it doesn’t raise your blood sugar levels. In fact, according to a study published in the New England Journal of Medicine, people who ate as much as 50g of fiber a day (way more than the recommended average of 20-35g a day) had much better control of their blood glucose.

Soluble fiber—found in plant-based foods such as whole-grain oats, beans, raspberries, apples, oranges, and sweet potatoes—is particularly beneficial for people with diabetes. One study even found that regularly consuming fiber-rich foods adds good bacteria to your gut microbiome and can actually help lower your A1C levels over time.

View Recipe: Apple Pie Energy Bites

Don’t Avoid Fruit (But Skip the Smoothie)

Photo: Johnny Autry
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Photo: Johnny Autry


If you have diabetes, don't be afraid to eat fruit. I recently spoke to Jill Weisenberger, MS, RDN, CDE, author of Diabetes Weight Loss-Week by Week, for an article on fruit and diabetes and she told me, “Sugar in fruit doesn’t have to translate into high blood sugar levels. In fact, a piece of fruit about the size of a tennis ball provides only about 15 grams of carbohydrates—about the same as a cup of milk, a slice of whole wheat bread, 1/3 cup of brown rice, or a tablespoon of sugar.” Research also shows eating blueberries daily may actually help reduce your type 2 diabetes risk and improve insulin sensitivity and glucose tolerance.

One caveat to the fruit rule: Opt for whole fruit over juices or smoothies. An 8-oz. glass of orange juice has twice as much the sugar and only a quarter of the fiber as a medium orange. Fruit can be high in sugar, and without the fiber to slow absorption, a smoothie or glass of juice can make your blood sugar spike.

Still set on having your morning glass of OJ? Try some eggs or avocado to offset it. Meghann Moore, RD, CDE, MPH, told Diabetes Forecast, “When drinking juice, it may be a good idea to pair it with a meal that contains protein and fat. A combination of food and juice will digest more slowly and may not raise your blood sugar as quickly or as much as the juice alone.”

View Recipe: Blueberry-Oatmeal Muffins

Sprinkle on the Cinnamon

Iain Bagwell
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Iain Bagwell


Need another reason to love this sweet and comforting spice? Research has shown that cinnamon may increase insulin sensitivity and therefore help reduce blood sugar. Bonus: This powerful little spice may also help reduce bad cholesterol levels. So go ahead and sprinkle some into your coffee grounds before brewing, or shake some on top of your oatmeal.

View Recipe: Cinnamon Roll Muffins

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Not just lung diseases, air pollution leads to diabetes deaths too: Report


Sunitha Rao R | TNN | Updated: Apr 5, 2019, 07:48 IST


BENGALURU: Air pollution causes not only breathing ailments but also diabetes deaths, according to the recently released State of Global Air 2019 report, put together by US-based researchers.

As per the report, exposure to fine particulate matter (PM 2.5) was the third leading risk factor for Type 2 diabetes deaths in 2017, after high blood sugar and excessive body weight.


According to the World Health Organisation, air pollution — both ambient and indoor — kills millions every year. While its link to pulmonary diseases is well-established, that it can be fatal for diabetics is alarming and a major cause of concern for patients, who are already at a heightened risk of heart and kidney disorders and stroke. Infamous as the world's diabetes capital, India faces the twin challenges of mitigating the disease's burden and combating air pollution. While policy interventions by the government and transition to renewable energy will go a long way in bettering air quality, citizens can do their bit by ditching private vehicles and wearing masks.

The same year, Type 2 diabetes accounted for over one million deaths and 57 million DALYs (disability adjusted life years). The burden has increased by 175% and 141% respectively since 1990. While the diabetes rate has gone up in all countries, the largest burden is found in China and India, shows the study.

Doctors say once fine particulate matter enters the human blood stream, it leads to inflammation in veins and gradually reduces the quality and quantity of insulin production.

However, doctors in Bengaluru say it’s tough to convince patients about the correlation between air pollution and diabetes. “Evidence will come only after air quality is improved. This can be better proven when we live amid clean air, with fresh diabetes cases gradually reducing,” said Dr Mohan Badgandi, consultant endocrinologist, Manipal Hospitals.

According to Dr Badgandi, chemical air pollution — especially nitrogen dioxide and sulphur dioxide components — causes certain changes in body metabolism. “They lead to vascular endothelium damage, causing harm to blood vessels and inflammation. There is a biological link between air pollution, diabetes and diabetes deaths,” he explained.

“Once the toxic chemicals in the air enter the blood barrier, the body treats them as foreign elements, leading to inflammation. This causes insulin resistance and also reduces insulin production. Air pollution and diabetes are interlinked,” said Dr Rahul Patil, consultant cardiologist, head, project Premature Coronary Artery Disease (PCAD), Sri Jayadeva Institute of Cardiovascular Sciences and Research, who is researching the effects of air pollution on human health.

Although genetic and environmental factors play a major role in development of diabetes, other endocrine disruptors like PM 2.5 may play a pivotal role in younger individuals being afflicted in recent years, said Dr S Satish Kumar, endocrinologist and chairman of Ameya Healthcare. “Though the exact mechanism is yet to be found, research suggests inflammatory markers increase in the body leading to immune activation, which in turn increases insulin resistance. Central nervous system inflammation may also play a role,” he explained.

Dr Satish said those exposed to PM 2.5 on a long-term basis were found to have higher blood glucose levels, blood sugar attached to haemoglobin, LDL cholesterol (bad cholesterol), common fat like triglycerides, low HDL cholesterol (good cholesterol), factors which lead to increased cardiovascular deaths.


Foul air killed 5 million people in 2017


As per the report, long-term exposure to outdoor and indoor air pollution contributed to nearly 5 million deaths from stroke, diabetes, heart attack, lung cancer and chronic lung disease in 2017. South Asian countries — Bangladesh, India, Nepal and Pakistan — formed the most polluted region in the world, with over 1.5 million air-pollution related deaths.


Who conducted study?


The State of Global Air 2019 annual report and accompanying interactive website have been put together by the Health Effects Institute in coordination with the Institute of Health Metrics and Evaluation (IHME) at the University of Washington, University of British Columbia and University of Texas-Austin.
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Wikipedia Commons

Approximately one-third of type 1 patients have markers for another autoimmune disease at diagnosis. One of these diseases is thyroid disease.

Thyroid disease is common in the general population, but it is especially common in type 1 women with more than 20% having the disease.  Many people with type 2, in particular middle-aged women, are also susceptible to a non-immune-based form of thyroid disease.

The thyroid, a small, butterfly-shaped gland that wraps around your windpipe, has a highly important job. As the largest gland in the endocrine system, it regulates hormones and ensures growth, metabolism and development all occur at “normal” rates.

When the thyroid gland is out of synch, its regulative functions are thrown off. The hormonal imbalance can result in either hyperthyroidism or hypothyroidism.

Hyperthyroidism is caused by the thyroid gland producing too much thyroid hormone.  It may be caused by Graves disease (an autoimmune disease in which the body’s own cells attack the thyroid gland), one or more thyroid nodules, ingesting too much iodine, inflammation of the thyroid gland or taking too much thyroid medication.

Symptoms include:

  • Sweating
  • Weight loss
  • Diarrhea
  • Distraction
  • Menstrual changes in women
  • Rapid heart rate
  • Thick skin on the knees, elbows, and shins

When you have hyperthyroidism your metabolism quickens, and medicines such as insulin are metabolized faster. Your blood glucose level may appear higher than usual because the insulin or oral medications do not remain in the body long enough to control it.  In addition, the symptoms of hyperthyroidism may mimic those of hypoglycemia.  It is important always to check your blood sugar before eating extra carbohydrate.

Hypothyroidism is caused by thyroid gland producing too little thyroid hormone.  The most common form of hypothyroidism is an disease called Hashimoto’s thyroiditis.  Symptoms include:

  • Fatigue
  • Lethargy
  • Depression
  • Constipation
  • Weight gain
  • Low blood pressure
  • Slow pulse
  • Intolerance to cold

Hypothyroidism causes your metabolism to slow and the medications you take, including insulin, stay active longer than they normally would.  You may find that your blood glucose levels are lower than they are normally, and you may experience hypoglycemia or low blood sugar.  Until the condition is treated it may be necessary to reduce your dose of insulin or oral medication to prevent low blood glucose.

It’s important to have your thyroid levels checked annually with a simple a blood test. The test will indicate whether you have an over-active or under-active thyroid, depending on the level of hormones in your blood. Your doctor can take it from there and put you on a proper course of medication, to get your hormones under control without affecting greatly your diabetes.

And because thyroid disease is common in type 1 if you experience any of the above symptoms it is important to inform your health care provider so you can receive the proper treatment for both diseases.

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Re: Diabetes news for spring 2019

otein Released from Fat Following Exercise Improves Glucose Tolerance, and Health

Another Reason to Exercise!

BOSTON – (February 11, 2019) – It’s well-known that exercise improves health, but understanding how it makes you healthier on a molecular level is the question researchers at Joslin Diabetes Center are answering.

Laurie J. Goodyear, PhD, Section Head and Senior Investigator at Joslin Diabetes Center, and Professor of Medicine at Harvard Medical School

After performing experiments in both humans and mice, the researchers found that exercise training causes dramatic changes to fat. Additionally, they discovered that this “trained” fat releases factors into the bloodstream that can have positive effects on health. The study was published online February 11, 2019, in Nature Metabolism. 

It’s known that fat cells secrete proteins called adipokines, and that many adipokines increase with obesity, having harmful effects on metabolism and health.

“In contrast to the negative effects of many adipokines, our study identified transforming growth factor beta 2 (TGF-beta 2) as an adipokine released from adipose tissue (fat) in response to exercise that actually improves glucose tolerance,” says Laurie J. Goodyear, PhD, Head of Joslin’s Section on Integrative Physiology and Metabolism and study co-author.

Not only did exercise-stimulated TGF-beta 2 improve glucose tolerance, treating obese mice with TGF beta 2 lowered blood lipid levels and improved many other aspects of metabolism.

“The fact that a single protein has such important and dramatic effects was quite impressive,” says Goodyear, Professor of Medicine at Harvard Medical School.

Two years ago, the international research team first demonstrated that adipose tissue offers beneficial metabolic effects in response to exercise.

“Our hypothesis was that exercise is changing the fat, and as a result of that change, the fat releases these beneficial proteins into the bloodstream,” says Goodyear. “Before this discovery, we always just focused on the positive effects of muscle.”

Building on this insight, Joslin researchers sought to identify the adipokines released from fat in exercise. To do so, they ran a series of molecular experiments in both humans and mice. They identified levels of adipokines in men before and after a cycle of exercise. They also  studied exercising mice.

Their analysis identified TGF beta 2 as one of the proteins upregulated in exercise in humans and mice. Additional investigation confirmed that levels of this one adipokine actually increased in the fat tissue as well as in the bloodstream with exercise, in both cases.

To find out if the protein promoted beneficial metabolic effects, they treated the mice with TGF beta 2. The experiment showed a number of positive metabolic effects in the mice, including improved glucose tolerance and increased fatty acid uptake.

Next, they fed the mice a high fat diet, causing the animals to develop diabetes. To know if TGF beta 2 was actually responsible for the metabolic effects, they treated the diabetic mice with TGF beta 2. This reversed the negative metabolic effects of the high fat diet, similar to what happens with exercise.

“Our results are important because it’s really the first demonstration of an exercise-released adipokine that can have beneficial metabolic effects on the body,” says Goodyear. 

Another significant finding was that lactic acid, which is released during exercise, serves as an integral part of the process. Lactate is released by the muscles during exercise then travels to the fat where it triggers the release of TGF beta 2. 

“This research really revolutionizes the way we think about exercise, and the many metabolic effects of exercise. And, importantly, that fat is actually playing an important role in the way exercise works,” says Goodyear.

These findings suggest that TGF beta 2 may be a potential therapy for treatment of high blood sugar, and eventually a potential therapy for type 2 diabetes. Long-term studies will be needed to determine the safety of TGF beta 2 treatment.

Other study authors include Hirokazu Takahashi Christiano R. R. Alves , Kristin I. Stanford, Roeland J. W. Middelbeek, Pasquale Nigro, Rebecca E. Ryan, Ruidan Xue, Masaji Sakaguchi, Matthew D. Lynes, Kawai So, Joram D. Mu, Min-Young Lee, Estelle Balan, Hui Pan, Jonathan M. Dreyfuss, Michael F. Hirshman, Mohamad Azhar, Jarna C. Hannukainen, Pirjo Nuutila , Kari K. Kalliokoski , Søren Nielsen, Bente K. Pedersen, C. Ronald Kahn and Yu-Hua Tseng.

Journal reference: Takahashi et al. TGF-B2 is an Exercise-Induced Adipokine that Regulates Glucose and Fatty Acid Metabolism. Nature Metabolism, February 11, 2019.