Wellness

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WEDNESDAY, May 16, 2018 -- Millions of U.S. seniors can now take part in a Medicare program designed to prevent prediabetes from progressing to type 2 diabetes.

Almost half of Americans 65 and older have prediabetes, and many don't know it. In addition to an increased risk of type 2 diabetes, prediabetes puts people at risk of heart disease and stroke, according to the American Association of Diabetes Educators.

"Medicare has expanded its coverage to include diabetes prevention, and that's really great news," said Angela Forfia, senior manager of prevention for the American Association of Diabetes Educators.

Prediabetes means blood sugar levels are elevated, but not as high as in type 2 diabetes. Weight loss and increased physical activity can help ward off a type 2 diagnosis.

"Seniors are a very high-risk group for type 2 diabetes," Forfia said. But they're also much more likely than younger people to be successful at preventing diabetes, she added.

Taking action is key. "If you wait even a year, prediabetes can become diabetes," Forfia said.

The Medicare Diabetes Prevention Program is based on a year-long national diabetes prevention program started by the U.S. Centers for Disease Control and Prevention.

Private insurers often cover the CDC's diabetes prevention program because it's been shown to reduce the risk of type 2 diabetes by 58 percent overall. In people over 60, the program reduces risk of type 2 diabetes by 71 percent, according to the diabetes educators' group.

The new program includes at least 16 intensive "core" sessions of a CDC-approved curriculum. Those 16 sessions occur over six months in a classroom-style setting. Participants receive education on long-term dietary changes, increased physical activity, and behavior-change strategies for weight control, according to the U.S. Centers for Medicare and Medicaid Services.

After the core sessions are done, less intensive follow-up meetings are held monthly to help reinforce the new healthy behaviors.

The main program goal is to lose at least 5 percent of body weight. The program also aims to get people exercising at least 150 minutes a week, Forfia added.

But program coordinators work with program participants to "set realistic, achievable goals," Forfia said.

Overall, the program includes 24 hours of instruction. "It's really just a full day of commitment, and the program can have a tremendous impact on your life," she noted.

This is welcome news, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.

"Treating prediabetes is better than treating diabetes. The CDC's diabetes prevention program has been very successful, but we don't always have enough referrals to the program," Zonszein said.

"Primary care physicians need to know this is a tremendous opportunity to help their patients with prediabetes," he added.

So, who's eligible for the new program? First, you must be enrolled in Medicare Part B. Other requirements include:

• A body mass index (BMI) of at least 25, or at least 23 if Asian. (BMI is a rough measure of body fat using height and weight measurements. A BMI of 25 or higher is considered overweight.)
• An abnormal blood sugar level within 12 months of the first core session. Blood sugar can be measured in one of three ways: An A1C test that doesn't have to be done fasting (5.7 to 6.4 percent is prediabetes); a fasting blood test (110 to 125 milligrams per deciliter is prediabetes); or a 2-hour fasting glucose tolerance test (140 to 199 mg/dL is prediabetes).
• No previous diagnosis of type 1 or type 2 diabetes.
• No end-stage kidney disease.

Although the reimbursement for services became available in April, Forfia said it will likely take programs time to get started. In the meantime, she said the CDC's diabetes prevention program may offer classes in your area. Talk with your doctor to see if you need diabetes prevention services. Your physician may also be able to help you enroll.

More information

Learn more about the Medicare Diabetes Prevention Program from the U.S. Centers for Medicare and Medicaid Services.

Copyright © 2018 HealthDay. All rights reserved.

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The US Food and Drug Administration (FDA) has given permission for a dual-hormone artificial pancreas, dubbed the bionic pancreas, to be used in the homes of people with type 1 diabetes.

It is thought the pioneering iLet device could revolutionise diabetes treatment as it mimics the way a pancreas works, delivering insulin, glucagon or a combination. However, in the trial which has been given approval, the device will deliver just insulin.

The iLet has been developed by Edward Damiano, PhD, president of Boston-based Beta Bionics, who is aiming to have the device fully approved by official bodies in the foreseeable future. He introduced it to the world in 2015, calling it a "bridge to a cure" for type 1 diabetes.

The FDA has now given the go ahead for home-use clinical studies. Children aged 6-17 and adults with type 1 diabetes will be recruited via Massachusetts General Hospital, Stanford University and the University of Colorado.

The study will use Novo Nordisk's recently approved fast-acting insulin aspart, marketed as Fiasp, as well as insulin lispro (Humalog) and conventional insulin aspart (NovoRapid/NovoLog) in both adults and children. Fiasp is the newest insulin in the group of rapid-acting analogue insulin and has been shown to be quicker-acting than Humalog or NovoRapid.

Edward R. Damiano, founder and CEO of Beta Bionics and a professor of biomedical engineering at Boston University, said: "The design of this ambitious insulin-only bionic pancreas study builds on the foundation of previous studies we have conducted with our clinical collaborators testing our bionic pancreas algorithms with previous investigational platforms."

The previous studies Dr Damiano is referring to include a 2017 study where the bionic pancreas showed glucagon infusion to be successful in preventing hypos, and another later that year where the device reduced diabetes-related distress.

Dr Damiano added: "This trial is exciting, not only because it represents the first time we will be able to test our bionic pancreas algorithms with our proprietary iLet platform ... and not only because it will draw upon those who use [multiple daily injection] therapy in equal number to those who use insulin pumps for their clinical care, but also because we will be breaking new ground by being the first group to test autonomous insulin delivery using Fiasp."

Beta Bionics hopes to enter pivotal trials with its final design in 2019 and anticipates the iLet to launch in 2020.

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It can be a good idea to bring your spouse to a GP medical examination if you are obese. Because Danish researchers from the Departments of Public Health at the University of Copenhagen and Aarhus University have in a new study found a connection between the BMI of one spouse and the other spouse's risk of developing type 2 diabetes.

'We have discovered that you can predict a person's risk of developing type 2 diabetes based on his or her partner's BMI. This means that you can tell whether a person has a heightened risk or not on the basis of the partner's BMI', says Postdoc Jannie Nielsen, who is the first author of the study, which has been published in the scientific journal Diabetologia.

The three researchers have examined data from 3,649 men and 3,478 women from the English Longitudinal Study of Ageing in the UK. In the UK, it is estimated that five million Britons have a high risk of developing diabetes.

On a global scale, 422 million adults have diabetes according to WHO. And it is estimated 1,5 million deaths are caused by the disease.

Difference Between Men and Women

From other studies the researchers knew that spouses are often similar in terms of body weight, among other things because people often marry someone similar to themselves and often share dietary and exercise habits when living together.

Therefore, the researchers also examined whether the heightened risk of developing type 2 diabetes of an obese woman, for example, was merely a result of her own body weight. Here the researchers found a difference between the two sexes.

'If we adjusted for the women's own weight, they did not have a heightened risk of developing type 2 diabetes as a result of their husband's BMI. But even when we adjusted for the weight in men, they had a heightened risk', says Jannie Nielsen.

A man, whose wife had a BMI of 30 kg/m2, had a 21-per cent higher risk of developing diabetes than men whose wives had a BMI of 25 kg/m2 -- regardless of the man's own BMI.

The researchers have not examined why only the men still had a heightened risk after own weight adjustment. They do have a theory, though, which involves who is in charge of the household.

'We believe it is because women generally decide what we eat at home. That is, women have greater influence on their spouse's dietary habits than men do', Jannie Nielsen explains and refers, among other things, to a US study, which showed that women more often than men are responsible for doing the household's cooking and shopping.

Early Detection Is Vital

Diabetes can cause complications and serious sequelae such as damage to the heart, kidneys and eyes. According to the Danish Diabetes Association, 35 per cent experience complications by the time they are diagnosed with diabetes. Therefore, early detection is vital.

'The earlier a disease is detected, the higher the potential for successful prevention and treatment. We know that type 2 diabetes can be prevented or postponed, reducing the number of years that patients have to live with the disease. Just as related complications can be postponed through early detection', says Jannie Nielsen.

If type 2 diabetes is detected at an early stage, medical treatment can be postponed, and instead the patient can begin with lifestyle changes such as eating a healthy diet and doing more physical exercise.

Based on the study, Jannie Nielsen believes that early detection of type 2 diabetes can be improved if we change our approach to the disease.

'Our approach to type 2 diabetes should not focus on the individual, but instead on, for example, the entire household. If a woman has a heightened risk, there is a strong probability that it is shared by her husband'.

'We know that men are less inclined to go to the doctor. So if a woman comes to her GP with risk factors for type 2 diabetes, the GP should therefore perhaps ask her to bring her husband next time', says Jannie Nielsen.

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Below is 5 top tips for livng with daibetes

5 TOP TIPS FOR LIVING POSITIVELY WITH DIABETES

In February of 2018, family therapist Ilene Vinikoor, one of the founding members of the DRI Foundation’s PEP Squad (Parents Empowering Parents), marked her 50th year of living with type 1 diabetes. She explained, “In 1968, there were no glucose meters, insulin pumps or continuous glucose monitors. I didn’t know my blood sugar until I went to my doctor every 6 months. Wow, have things changed!”

Living with diabetes hasn’t been easy for her, but she always keeps a positive attitude. Here are a few tips from Ilene:

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An oral type 1 diabetes drug that can be taken alongside insulin is set to be reviewed by the US Food and Drug Administration (FDA).

Sotagliflozin (marketed as Zynquista), made by pharmaceutical companies Sanofi and Lexicon, is a dual SGLT1 and SGLT2 inhibitor. This means this one tablet has two different functions.

The SGLT1 inhibitor part of the drug works by delaying the process of glucose being absorbed by the intestines, which helps avoid the blood sugar spike after a meal. The SGLT2 inhibitor part helps the kidneys work better at excreting the excess sugar in the blood.

Zynquista has undergone several clinical trials and results have shown people who took the drug achieved better HbA1c levelswithout increasing the risk of severe hypoglycemia.

One issue that the FDA will need to consider is the risk of diabetic ketoacidosis (DKA). DKA is a serious condition that requires emergency hospitalisation and can in some cases be fatal. In one trial of sotagliflozin, 3% of participants on the drug developed DKA compared with just 0.6% in the group that took a placebo.

The drugmakers have now asked the FDA to look at the findings with a view to making it available to members of the public.

Zynquista has also showed to help people lose weight and, on average, trial participants lost 2.98 kg compared to those with type 1 diabetes who had not been prescribed the medication.

The drug has been developed in response to the growing levels of people with type 1 diabetes developing serious hypoglycemia.

The news comes in the same week that Diabetes.co.uk has unveiled it will soon be launching its Type 1 Program, which aims to help people with type 1 diabetes achieve better blood sugar control with less fear of hypoglycemia.

You can be among the first to take part by registering your interest at type1program.com

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This link is from the CDC ( center for disease control) with Joan Lunden. It has many topics about living with diabetes. There is no way I could bring it over here, but it is a safe link

https://www.cdc.gov/diabetestv/index.html