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Archive for the ‘Diabetes’ Category

COVID Deaths High When Hospitalized With Diabetes – WebMD

Friday, February 19th, 2021

By Ernie Mundell and Robert Preidt HealthDay Reporters

THURSDAY, Feb. 18, 2021 (HealthDay News) -- Diabetes is a big risk factor for a severe bout of COVID-19, and a new European study bears that out: It finds that 1 in every 5 hospitalized COVID-19 patients with diabetes die within 28 days of admission.

One U.S. expert wasn't surprised by that grim finding.

"Diabetic patients are clearly in a very high-risk category and should be among the first groups of people to get the vaccine," advised Dr. Mangala Narasimhan, who directs critical care services at Northwell Health in New Hyde Park, N.Y. She also advises people with diabetes to make sure they are taking control of their blood sugar levels and avoiding any complications of the disease.

Such steps "seem to really make a difference in terms of survival from COVID infection," said Narasimhan, who wasn't involved in the new study.

The research was led by Bertrand Cariou and Samy Hadjadj, diabetologists at University Hospital Nantes in France. In May of last year they had released preliminary findings that showed that 10% of COVID-19 patients with diabetes died within seven days of hospital admission.

The newer, updated results are from a larger number of patients -- close to 2,800 -- treated for COVID-19 at 68 hospitals across France. Their mean age was 70, nearly two-thirds were men, and many were overweight. About 40% were also experiencing various forms of complications from their diabetes.

During the 28 days after their admission to a hospital, 21% of patients died, the French team reported Feb. 17 in the journal Diabetologia.

Of those patients who survived at least one month, 50% were discharged from the hospital with a median stay of nine days; 12% were still hospitalized at day 28, and 17% had been transferred from their first hospital to another facility.

Younger age, routine diabetes therapy using the drug metformin, and having had symptoms longer prior to hospital admission were key factors associated with a higher likelihood of being discharged from the hospital, the researchers said.

Patients who regularly took insulin -- possibly indicating more advanced diabetes -- had a 44% higher risk of death than those who didn't take insulin, the investigators said. Long-term blood sugar control wasn't associated with patient outcomes, but a higher level of blood sugar at the time of hospital admission was a strong predictor of death and of a lower chance of discharge.

Dr. Barbara Keber directs family medicine at Glen Cove Hospital in Glen Cove, N.Y. Reading over the findings, she said they show "diabetes is clearly a significant risk factor for both need for ICU/ventilator care in the hospital as well as for death" within a month of admission.

Keber said it "makes sense" that people with complications from poorly controlled diabetes are at higher risk, since this creates a "pro-inflammatory state" that is similar to that seen in advanced COVID-19.

But Keber also cautioned that death rates may have improved for COVID-19 patients, including those with diabetes, over the past year.

"This study was done in the first wave of the pandemic, and many of the current treatment regimens and medications that were tried in the early phase have been found to not be beneficial and other treatment regimens have taken their place," she noted.

For example, "the current use of steroids for treatment may play a role in the [improved] prognosis of patients overall and especially for those with diabetes," Keber said.

More information

The American Diabetes Association has more on COVID-19.

SOURCES: Mangala Narasimhan, DO, director, critical care services, Northwell Health, New Hyde Park, N.Y.; Barbara Keber, MD, chair, family medicine, Glen Cove Hospital, Glen Cove, N.Y.; Diabetologia, news release, Feb. 17, 2021

WebMD News from HealthDay


COVID Deaths High When Hospitalized With Diabetes - WebMD


Diabetic Retinopathy Stages: The 4 Stages and What to Do – Healthline

Friday, February 19th, 2021

Diabetic retinopathy is an eye disease that affects people living with diabetes. It develops when high blood sugar damages the tiny blood vessels in the retina. This causes a variety of symptoms like blurry vision and vision loss.

This progressive disease may lead to irreversible vision loss, so its important to have regular eye exams. A doctor can then diagnose the condition early and slow its progression.

Glucose, or blood sugar, is a main source of energy yet too much circulating in the blood can be harmful to the body.

Typically, the pancreas releases the hormone insulin, which helps cells absorb glucose for energy. In the case of diabetes, though, the body doesnt make enough insulin or doesnt use it properly. This causes glucose to accumulate in the blood.

Consistent levels of high blood sugar can affect different parts of the body, including the eyes.

Diabetic retinopathy doesnt only weaken or damage the blood vessels in the eye. It can also cause the development of new abnormal blood vessels in the retina.

Diabetic retinopathy is a progressive eye disease classified by two types and four stages.

The two types are nonproliferative and proliferative. Nonproliferative refers to early stages of the disease, while proliferative is an advanced form of the disease.

This is the earliest stage of diabetic retinopathy, characterized by tiny areas of swelling in the blood vessels of the retina. These areas of swelling are known as micro aneurysms.

Small amounts of fluid can leak into the retina at the stage, triggering swelling of the macula. This is an area near the center of the retina.

Increased swelling of tiny blood vessels starts to interfere with blood flow to the retina, preventing proper nourishment. This causes an accumulation of blood and other fluids in the macula.

A larger section of blood vessels in the retina become blocked, causing a significant decrease in blood flow to this area. At this point, the body receives signals to start growing new blood vessels in the retina.

This is an advanced stage of the disease, in which new blood vessels form in the retina. Since these blood vessels are often fragile, theres a higher risk of fluid leakage. This triggers different vision problems such as blurriness, reduced field of vision, and even blindness.

Diabetic retinopathy doesnt usually cause symptoms during the nonproliferative stages, so its possible to have it and not know it. This is because blood vessels dont always leak in these stages.

Many people dont have symptoms until the disease progresses to proliferative diabetic retinopathy.

However, an eye examination by an eye care specialist or ophthalmologist can detect diabetic retinopathy in its earlier stages, before symptoms become apparent.

Symptoms of proliferative diabetic retinopathy include:

Be mindful, too, that diabetic retinopathy symptoms usually affect both eyes at the same time.

To diagnose diabetic retinopathy, your doctor may complete a comprehensive eye examination. This involves measuring:

Your doctor will likely also dilate your eye to examine your optic nerve and retina using special eye drops.

Doctors can also diagnose diabetic retinopathy with fluorescein angiography, which checks for abnormal blood vessel growth or leakage.

Theyll inject a yellow dye into a vein in your arm, allowing the dye to travel through your blood vessels. A special camera takes images of the dye as it travels through the blood vessels in your retina.

Diabetic retinopathy may lead to irreversible vision loss, but it is treatable. Treatment starts with managing blood sugar and diabetes. This includes taking diabetes medication as directed, watching your diet, and increasing physical activity.

Keeping blood sugar within a healthy range can slow the progression of vision loss.

Other treatments will depend on the stage or extent of the disease. If caught very early before damage to the retina occurs blood sugar management might be the only necessary treatment. Your doctor will continue to monitor your eyes, though, to ensure the disease doesnt progress.

If youre in a nonproliferative stage but experience some eye damage, treatment options might include:

Preventing diabetic retinopathy starts with managing blood sugar.

This involves managing diabetes with medication, balanced eating habits, and regular physical activity. You should also monitor your blood sugar on a regular basis and speak with your doctor if your levels are difficult to manage.

A healthy diet consists of:

Diabetes management may also involve other changes. This can include managing your blood pressure and cholesterol and avoiding tobacco.

Diabetic retinopathy isnt the only complication of diabetes. Blood sugar levels outside of a healthy range can cause other long-term issues, such as:

It may also lead to other conditions involving significant vision loss or blindness, such as:

If you have diabetes, make an appointment to see an eye care specialist such as an ophthalmologist at least once a year, or as often as your doctor recommends.

You should also see your doctor if your glucose level remains high despite medication and other changes, or if you notice any changes in vision, even if they are subtle.

Diabetic retinopathy is a potentially serious eye disease that can result in permanent distorted vision or loss of vision. Any changes in vision, such as blurriness, poor night vision, and an increase of eye floaters, should prompt a trip to the eye doctor.

Speak with your eye care specialist to diagnose any possible eye conditions. Although diabetic retinopathy isnt reversible, it is treatable.

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Diabetic Retinopathy Stages: The 4 Stages and What to Do - Healthline


Diabetic Feet: Issues, Treatment, and Prevention – Healthline

Friday, February 19th, 2021

Managing diabetes and keeping your blood sugar within a healthy range doesnt only protect against heart attacks and stroke, it can also keep your feet healthy.

Diabetes is a condition where the body doesnt produce enough insulin or use insulin properly, causing sugar levels in the blood to rise above normal. Uncontrolled high blood sugar can reduce blood flow in your feet, leading to serious complications.

Paying attention to your foot healthwhich includes recognizing early signs of problemsand maintaining a healthy blood sugar lowers the risk for complications.

Prolonged high blood sugar can gradually damage your blood vessels, restricting blood flow to your organs and other parts of your body. Lack of blood flow can lead to heart disease, stroke, kidney problems, and even vision problems.

Blood vessel damage also affects blood flow to your feet, causing a number of foot health issues.

According to the Centers for Disease Control and Prevention (CDC), about half of people living with diabetes will develop some kind of diabetic neuropathy or nerve damage. This damage can occur anywhere in the body, but usually affects the nerves in the feet and the legs.

Nerve damage can cause a tingling sensation and pain in your feet. As your condition worsens, you might lose all feeling in your feet. This is when diabetic neuropathy becomes dangerous.

Pain is a warning that something isnt right in the body. It can alert you to cuts, sores, and blisters on your feet. But if you have diabetic neuropathy and lose feeling in your feet, a cut or blister could go unnoticed for an extended length of time. If you dont receive prompt treatment for these types of injuries, you could develop an infection.

Diabetic neuropathy can lead to other complications. Reduced blood flow to your feet means that sores or infections might not heal as easily. Infections that dont heal can progress to gangrene, which is death of tissue due to lack of blood flow.

If gangrene starts to affect other parts of your body, your doctor might have to amputate a toe, foot, or leg to stop its spread.

Diabetes can also cause a circulation disorder known as peripheral vascular disease. This cardiovascular disease results from limited blood flow to the legs and feet. A blockage or narrowing of blood vessels also restricts blood flow.

This condition can occur in anyone, but the risk is higher in people with diabetes, because blood vessel changes often prevent the smooth flow of blood. Plus, high blood sugar can thicken blood to the point where it doesnt flow easily.

Nerve damage from diabetes can also trigger a rare condition known as Charcot foot. This typically occurs when a person has an injury, such as a sprain or fracture, that goes unnoticed due to lack of sensation caused by peripheral neuropathy. As the person continues to walk on the injured foot, it causes trauma to the bone.

Deformity occurs when joints become dislocated and collapse. The arch of the foot will often collapse, too, causing a roundness on the bottom of feet.

Along with foot deformity, other signs of Charcot foot include swelling, and your feet might appear red and warm to the touch.

A round bottom on feet also raises the risk of sores due to friction. If you have diabetic neuropathy and lose feeling in your feet, an open sore can become infected. This puts you at risk for amputation.

Poor blood circulation and blood flow can slow the healing process of sores on your feet, putting you at risk for serious life-threatening complications.

Even if you havent lost feeling in your feet, bring the following symptoms to your doctors attention. Signs of feet issues include:

You can avoid serious diabetes complications by seeing your doctor and getting treatment early for conditions that affect your feet.

Unfortunately, theres no cure for diabetic neuropathy. But you can take steps to slow the progression of this disease. Your doctor will likely recommend pain medication to help alleviate nerve pain.

For mild nerve pain, you can take over-the-counter medications like acetaminophen or ibuprofen. For moderate or severe pain, prescription medications like anti-seizure drugs and antidepressants can help ease nerve pain and improve the quality of your life, too.

Maintaining a healthy weight and regular physical activity can also slow the progression of diabetic neuropathy.

If you develop peripheral vascular disease your doctor will also recommend treatment to slow disease progression and improve blood flow.

Regular exercise, eating a healthy, balanced diet, and losing weight can help improve blood flow, as does quitting smoking. Smoking restricts blood vessels.

Treatment might also involve medication to reduce blood clotting, lower your cholesterol, or reduce your blood pressure depending on the underlying cause of a blockage.

Good diabetes managementmedication, regular exercise, and a healthy dietcan also reduce symptoms of peripheral vascular disease.

In severe cases, you may need angioplasty for peripheral vascular disease. This is a surgical procedure to open up a blocked artery and restore blood flow.

Gangrene treatment involves antibiotics to kill bacteria and stop an infection, as well as surgery to remove damaged tissue. Treatment for Charcot foot involves preventing further deformity.

Wearing a cast to immobilize the foot and ankle can gradually strengthen these bones, as does wearing custom shoes or a brace. In severe cases, surgery can help correct a deformity.

One way to prevent foot issues with diabetes is to keep your blood sugar within a healthy range, so check your blood sugar on a regular basis. Also, take your diabetes medication as instructed. If youre unable to control your blood sugar, see your doctor.

Other tips to prevent foot issues include:

Not only should you take steps to keep your blood sugar within a healthy range, you should also take steps to keep your feet healthy. Heres how to protect your feet with diabetes:

Some diabetes foot complications are life-threatening, or they put you at risk for amputation. See a doctor if you have any concerns or notice unusual changes with your feet.

A seemingly minor issue like cracked skin on your feet, yellow toenails, athletes foot, or an ingrown nail can become a serious problem if left untreated. Also, see your doctor for any cuts or scrapes that dont heal to avoid an infection on your feet.

Although theres no cure for diabetes, a healthy diet, regular exercise, and taking your medication as instructed can lower your risk for complications.

Its very important to keep your feet healthy when you have diabetes. Check your feet daily for signs of injury or infection, and see your doctor right away if you notice any unusual symptoms.

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Diabetic Feet: Issues, Treatment, and Prevention - Healthline


Dialogue with the private sector on medicines and technologies for diabetes care, February 2021 – World Health Organization

Friday, February 19th, 2021

United Nations Secretary-General, Antnio Guterres, and World Health Organization (WHO) Director-General, Dr Tedros Adhanom Ghebreyesus, have announced that a Global Diabetes Compact will be launched on 14 April 2021 to mark the 100-year anniversary of the discovery of insulin for the treatment of diabetes. The centenary offers a window of opportunity for the global diabetes community to come together to reflect on addressing barriers to accessing insulin and associated health technology products. It is an opportune time to forge a common vision among all stakeholders to develop a multisectoral plan of action to address these barriers and ensure that no person living with diabetes goes untreated.

The WHO Department of Noncommunicable Diseases (NCD), in collaboration with the Division of Medicines and Health Products, is convening a series of biannual dialogues with the private sector to define meaningful and effective contributions to the implementation of national responses for the prevention, management and control of NCDs and the attainment of related Sustainable Development Goal (SDG) targets. The dialogues will focus on mobilizing commitments and contributions by the private sector toward national NCD responses to achieve SDG targets 3.4, 3.8 and 3b by improving access to and affordability of safe, effective and quality-assured medicines and health technology products.

Improving access to medicines and health technology products for the diagnosis, management and treatment of diabetes is multi-faceted and part of a broader challenge of ensuring access to health care. It requires a robust health system which includes good leadership and governance, adequate financing, access to information and evidence, quality service delivery, a strong health workforce, and equitable access to essential medicines and health technology products of assured quality, safety, efficacy and cost-effectiveness. Effective interventions will require enhanced collaboration and commitment for greater impact at country-level. The first dialogue in the series, which is being held on 23-24 February 2021, will focus on improving access to human insulin and associated health technology products for diabetes as part of the Global Diabetes Compact. Subsequent dialogues will focus on other NCDs, such as cardiovascular disease, cancer, lung diseases, oral health, rehabilitation, sensory impairments and disability.

This first dialogue aims to encourage inputs, commitments, and contributions from the pharmaceutical and health technology product industries to support WHOs activities to improve access to medicines and health technology products for diabetes, including for the 14 April 2021 launch of the Global Diabetes Compact.

A summary report of this meeting will be available on this website after the meeting.

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Dialogue with the private sector on medicines and technologies for diabetes care, February 2021 - World Health Organization


Connecting the Dots on Diabetes: My Mission to Address the Root Cause of Diabetes – Healthline

Friday, February 19th, 2021

Welcome to Connecting the Dots on Diabetes, a series by Sydney Williams of Hiking My Feelings chronicling the organizations mission to hike 1 million miles for diabetes awareness in 2021.

Throughout the series, Sydney, who received a diagnosis of type 2 diabetes in 2017, will interview diabetes advocates, community organizers, policy makers, and patients to answer the question: Is there a relationship between trauma and diabetes? If so, if we treat the trauma, can we more effectively treat diabetes?

When I was first diagnosed with type 2 diabetes, I had a lot of questions. What is happening inside my body? What can I eat? Will I be on medications for the rest of my life?

There are a ton of resources available to answer these questions, but I wanted to take my health into my own hands and be my own best advocate.

In the wake of this diagnosis, I came to a shocking realization: I didnt really know myself.

Sure, I had been existing in this body on this planet for 32 years when I got the call that changed my life, but who was I really? What did I believe? What had I internalized from society, my parents, my coaches, and other people in my life?

How had that informed my life choices, circumstances, and overall outlook on what life should be? I realized I was living the life I thought I should be living, not one of my own design.

Ive said it before and Ill say it again, diabetes is the best thing that ever happened to me.

Just 9 months before my diagnosis, I started backpacking.

It was December 2016, and this was the next chapter of my healing journey. I had no idea how my life would unfold when I went on that trip, but it undeniably changed my life on a cellular level.

When I got home, I was sore for 3 weeks. I couldnt walk right and my feet were healing from an onslaught of blisters from ill-fitting shoes and a lack of physical preparation. Yet, at the same time, I felt a deep love for the body I had been occupying for the 31 years prior to that hike.

I didnt know how my life would change or who would help me get to where I wanted to go, but for the first time, I was clear on what I wanted and why. I wanted to be fit, to get healthy. Not a new goal for me in January, but this time it was different.

I fell in love with backpacking on that trip. I fell in love with how my body felt in the wilderness, the healing power of nature, and how refreshed and clearheaded I felt when it was all said and done.

Despite the blisters and aches and pains, I came home a new woman and I wanted to honor that new woman with every step I took for the rest of my life.

I wanted to be able to hike as much as possible and enjoy the experience. If there was any way I could do more hiking and backpacking and not have my body get in the way of the miles I wanted to do per day, or how many days I could be out in the backcountry in a row, I wanted to explore that.

So I did.

I picked up paddleboarding during the summer of 2017 and declared to myself that I was a multi-sport athlete. When it was too hot to hike, Id be on the water. When it was too cold to paddle, Id be in the mountains.

For all of my life, I never called myself an athlete because I figured if I wasnt going to the Olympics and winning gold medals, then who am I? In that moment, I squashed that old story and wrote a new one: Im an athlete. Time to live like one.

After a summer full of paddleboarding, I was diagnosed with type 2 diabetes. As it got cooler and paddleboarding wasnt as appealing, I started walking every day around my neighborhood, eventually graduating to local hiking trails.

Slowly but surely, my life started to change before my eyes.

On my walks and hikes, I didnt listen to music, podcasts, or audiobooks. My phone stayed in my pocket. I was able to hear my inner voice.

Intense physical activity brought up lots of painful memories. When my body started getting tired, my brain told me wild stories about how Im too fat and too out of shape to be out here.

I didnt like how I was talking to myself and I remembered my first backpacking trip, where I learned how to be my own best friend.

Instead of running away from difficult feelings and memories, or numbing them with alcohol or ice cream, I listened.

When I started to peel back the layers of the life I had built for myself, I gained context and insights about the life events that led to the behaviors that contributed to my diagnosis.

I repeated that 2016 backpacking trip in June 2018, 10 months into my journey managing diabetes, and once again, my life was changed.

Without all the distractions of life, I was able to connect the dots between trauma I had experienced earlier in my life (a sexual assault in college) and how, when I didnt get help, I started coping by eating and drinking my feelings.

After more than a decade of neglecting my health, I was diagnosed with type 2 diabetes.

When I cut out the harmful behaviors and started hiking and tending to my mental health, my A1C improved, and my daily readings were in the healthy zone.

Diabetes, especially type 2 diabetes, has a horrible stigma around it. A common trope is that we made unhealthy choices and brought it on ourselves.

While I did make some unhealthy choices, the trauma of the sexual assault is what informed those choices. For some people with diabetes, lifestyle plays no role.

We could all stand to have a bit more empathy and compassion for folks who have diabetes. Every experience with diabetes is personal.

In the wake of my diagnosis and subsequent love for hiking, I founded a nonprofit organization called Hiking My Feelings. We started in 2018, and since then weve hosted more than 200 events around the United States introducing people to the healing power of nature.

My work explores how trauma manifests in our minds and bodies, and how the outdoors can help us heal. The question were looking to explore in 2021 is a big one:

Is trauma a root cause of diabetes? If so, if we address the trauma, can we manage diabetes more effectively?

The inspiration for addressing this question came as a result of my own journey navigating type 2 diabetes. Once I faced the trauma head-on and addressed my mental health, my physical health followed closely behind.

According to 2018 data from the Centers for Disease Control and Prevention (CDC) on the prevalence of diagnosed diabetes in America, some of the most disturbing statistics come to light when breaking the prevalence down by race:

If you look at these groups and think about issues like poverty, access to healthcare, education, food deserts (and food swamps), the pay gaps in America, and the historical trauma experienced by these communities colonization, racism, slavery, oppression, systemic issues then its even more evident that trauma could be a root cause of diabetes.

In this column, you can look forward to interviews with the people who are working to make the world a better place by means of diabetes awareness and education, learn about hiking and walking for mental and physical health, and hear from the community leaders, organizations and brands who are helping increase accessibility of recreation opportunities in marginalized communities.

This year, we are on a mission to hike 1 million miles for diabetes awareness and were taking our work on the road through our Take a Hike, Diabetes tour.

Obviously, we cant hike 1 million miles in a year by ourselves, so were counting on our community and all of the friends we havent met yet to help us meet and exceed our goal.

Were just getting started, and its never too late to join us. Healing happens one step at a time.

Sydney Williams is an adventure athlete and author based in San Diego. Her work explores how trauma manifests in our minds and bodies and how the outdoors can help us heal. Sydney is the founder of Hiking My Feelings, a nonprofit organization on a mission to improve community health by creating opportunities for people to experience the healing power of nature. Join the Hiking My Feelings Family, and follow along on YouTube and Instagram.

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Connecting the Dots on Diabetes: My Mission to Address the Root Cause of Diabetes - Healthline


Studies: Lilly’s Tirzepatide Reduces A1C and Weight in Type 2 Diabetes Patients – BioSpace

Friday, February 19th, 2021

Jonathan Weiss/Shutterstock

In Phase III studies, Eli Lillys tirzepatide led to significant A1C and body weight reductions from baseline in adults with type 2 diabetes.

This morning, Indianapolis-based Eli Lilly said tirzepatide, a once-weekly dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist, hit the mark in both the Phase III SURPASS-3 and SURPASS-5 Phase III clinical trials after 52 weeks and 40 weeks, respectively.

In the 52-week SURPASS-3 study, the longest in the program to date, the highest dose of tirzepatide reduced A1C by 2.37% and body weight by 28.4 pounds, a 13.9% reduction. Study participants were insulin-nave and had a mean duration of diabetes of 8.4 years, a baseline A1C of 8.17% and a baseline weight of 94.3 kg, 207 pounds.

Results showed that all three tirzepatide doses (5 mg, 10 mg and 15 mg) led to superior A1C and body weight reductions compared to titrated insulin degludec. Lilly noted that 92.6% of participants on tirzepatide achieved an A1C of less than 7%, which is the American Diabetes Association's recommended target for people with diabetes. Additionally, up to 48.4% of participants treated with tirzepatide achieved an A1C of less than 5.7Z%.

In the SURPASS-5 study, tirzepatide reduced A1C by 2.59% and body weight by 10.9 kg, an 11.6% change. Study participants had a mean duration of diabetes of 13.3 years, a baseline A1C of 8.31%, a baseline weight of 95.2 kg, about 210 pounds, and a baseline insulin glargine dose of 37.6 units per day. All three doses of tirzepatide demonstrated superior A1C reductions and weight reductions from baseline compared to placebo.

Across the three doses, up to 97.4% of participants on tirzepatide achieved an A1C of less than 7%. Also, 62.4% of participants treated with the highest dose of tirzepatide achieved an A1C of less than 5.7%.

Mike Mason, president of Lilly Diabetes, hailed the results demonstrated by tirzepatide in the two studies.

Tirzepatide delivered impressive A1C and body weight reductions in both studies and continued to achieve consistent efficacy and safety results in people living with type 2 diabetes, regardless of how long they have had the condition," Mason said in a statement. Significantly lowering A1C levels and weight are high priorities throughout the type 2 diabetes treatment journey, and the results we have seen from three SURPASS studies to date fuel our belief in tirzepatide's ability to meet those needs.

There are approximately 34 million people in the United States and about 463 million people in the world who have a form of diabetes. Type 2 diabetes is the most common type internationally, accounting for an estimated 90% to 95% of all diabetes cases inthe United Statesalone

Tirzepatide integrates the actions of both incretins into a single novel molecule. GIP is a hormone that may complement the effects of GLP-1 receptor agonists. Eli Lilly said the integration of both incretins represents a new class of medicines being studied for the treatment of type 2 diabetes. In preclinical models, GIP has been shown to decrease food intake and increase energy expenditure therefore resulting in weight reductions, and when combined with a GLP-1 receptor agonist, may result in greater effects on glucose and body weight.

Tirzepatide is in Phase III development for blood glucose management in adults with type 2 diabetes and for chronic weight management. It is also being studied as a potential treatment for non-alcoholic steatohepatitis (NASH).

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Studies: Lilly's Tirzepatide Reduces A1C and Weight in Type 2 Diabetes Patients - BioSpace


Obesity Pegged as Diabetes Cause in Almost Half of US Cases – Medscape

Friday, February 19th, 2021

Dr Natalie A. Cameron

Roughly 40% of all US cases of incident diabetes during 2013-2016 were directly attributable to obesity, a finding that further solidifies the major etiologic role for obesity in the current American diabetes epidemic.

Researchers used data from a diverse cohort of 4200 American adults in the MESA study during 2000-2017 to calculate a relative risk for developing diabetes of 2.7 in people with obesity compared with similar participants without obesity.

They then applied this relative risk estimate to obesity prevalence rates during serial iterations of NHANES, the recurring US-wide survey of vital statistics in a representative cross-sectional population.

Their calculations showed that, during 2013-2016, 41% of US adults who developed new onset diabetes did so because of obesity, after adjusting for potential confounders.

This "population attributable fraction," or disease burden attributable to obesity, varied somewhat by sex, and by racial and ethnic subgrouping. Obesity was linked with the highest attributable rate among non-Hispanic White women, a rate of 53%, and with the lowest rate among non-Hispanic Black men, with an attributable fraction of 30%, Natalie A. Cameron, MD, and colleagues report in their study, published online February 10 in the Journal of the American Heart Association.

"Our study highlights the meaningful impact that reducing obesity could have on type 2 diabetes prevention in the United States. Decreasing obesity needs to be a priority," said Cameron, of the McGaw Medical Center of Northwestern University in Chicago, Illinois, in a statement issued by the American Heart Association.

"Public health efforts that support healthy lifestyles, such as increasing access to nutritious foods, promoting physical activity, and developing community programs to prevent obesity, could substantially reduce new cases of type 2 diabetes," she added.

MESA (Multi-Ethnic Study of Atherosclerosis) enrolled adults 45-84 years old and free from clinical cardiovascular disease at six US sites during 2000-2002, and then followed them with four additional examinations through 2017.

For the current study, researchers narrowed the cohort down to 4200 participants who were 45-79 years old and free from diabetes at entry, and also restricted this subgroup to participants classified as non-Hispanic White (54% of the cohort), non-Hispanic Black (33%), or Mexican American (13%). At entry, 34% of the cohort had obesity, with a body mass index of at least 30 kg/m2.

During a median follow-up of just over 9 years, 12% of the cohort developed incident diabetes. After adjusting for possible confounders, a hazard ratio model showed an overall 2.7-fold higher rate of incident diabetes among people with obesity compared to those without.

The researchers then applied this hazard ratio to obesity prevalence statistics from NHANES (National Health and Nutrition Examination Survey) during the same time period, with data from the biennial NHANES project collapsed into four time strata: 2001-2004, 2005-2008, 2009-2012, and 2013-2016. They again limited their analysis to NHANES data collected from people 45-79 years old who self-reported categorization as non-Hispanic White, non-Hispanic Black, or Mexican American.

During the period from 2001-2004 to 2013-2016, overall obesity prevalence tallied by NHANES data rose from 34% to 41%. Among people with type 2 diabetes during 2013-2016, obesity prevalence was 65%.

To calculate the population attributable fractionresearchers combined the MESA and NHANES estimates and adjusted for potential confounders and foundthat, overall, in 41% of people with incident diabetes during 2013-2016, the disease was attributable to obesity.

J Am Heart Assoc. 2021;10:e018799. Full text

The study received no commercial funding, and none of the authors had disclosures.

For more diabetes and endocrinology news, follow us on Twitter and Facebook. Follow Medscape on Facebook, Twitter, Instagram, and YouTube.

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Obesity Pegged as Diabetes Cause in Almost Half of US Cases - Medscape


Timing of exercise impacts men with Type 2 diabetes – Harvard Gazette

Friday, February 19th, 2021

Numerous studies have demonstrated the role of physical activity in improving heart health for patients with Type 2 diabetes. But whether exercising at a certain time of the day promised an added health bonus for this population was still largely unknown.

New research published inDiabetes Care reports a correlation between the timing of moderate-to-vigorous physical activity and cardiovascular fitness and health risks for individuals who have Type 2 diabetes and obesity or overweight.

The research team fromBrigham and Womens Hospitaland Joslin Diabetes Center investigators, along with collaborators found that, in its study of 2,035 people, men who performed physical activity in the morning had the highest risks of developing coronary heart disease (CHD), independent of the amount and intensity of weekly physical activity. Men most active midday had lower cardiorespiratory fitness levels. In women, the investigators did not find an association between specific activity timing and CHD risk or cardiorespiratory fitness.

The general message for our patient population remains that you should exercise whenever you can as regular exercise provides significant benefits for health, said corresponding authorJingyi Qian of theDivision of Sleep and Circadian Disordersat the Brigham and an instructor of medicine at Harvard Medical School. But researchers studying the effects of physical activity should take into account timing as an additional consideration so that we can give better recommendations to the general public about how time of day may affect the relationship between exercise and cardiovascular health.

The researchers analyzed baseline data from the Look AHEAD (Action for Health in Diabetes)study, a multi-site, randomized clinical investigation that began in 2001 and monitored the health of more than 5,000 individuals with Type 2 diabetes and overweight or obesity. Among them, over 2,000 individuals had objectively measured physical activity at baseline.

The study population was very well characterized at baseline, with detailed metabolic and physical activity measurements, which was an advantage of using this dataset for our work, said corresponding author Roeland Middelbeek of the Joslin Diabetes Center, who is a co-investigator of the Look AHEAD study.

For theDiabetes Carearticle, the researchers reviewed data from hip-mounted accelerometers that participants wore for one week at the beginning of the Look AHEAD study. The researchers tracked the clock-time of daily moderate-to-vigorous activity, including labor-intensive work that extends beyond more traditionally defined forms of exercise. To assess the participants risk level of experiencing CHD over the next four years, the researchers used the well-known, sex-specificFramingham risk score algorithm.

Sex-specific physiological differences may help explain the more prominent correlations seen in males, who tend to be at risk of CHD earlier in life. However, the researchers note that other factors could also be at play. It remains unclear why time-specific activity may be associated with different levels of health and fitness.

The researchers also could not account for participants varying circadian rhythms: whereas a jog at 6 p.m. for one participant may be evening exercise, another participant prone to waking later in the day may, biologically, consider it to be afternoon, regardless of how the clock-time of the activity was recorded in the study.

Interest in the interaction between physical activity and the circadian system is still just emerging, Qian said. We formed a methodology for quantifying and characterizing participants based on the clock-time of their physical activity, which allows researchers to carry out other studies on other cohorts.

Beyond further integrating circadian biology with exercise physiology, the researchers are also excited to use longitudinal data to investigate how exercise timing relates to cardiovascular health outcomes, particularly among diabetes patients more vulnerable to cardiovascular events.

Other contributors to the research include Michael P. Walkup, Shyh-Huei Chen, Peter H. Brubaker, Dale S. Bond, Phyllis A. Richey, John M. Jakicic, Kun Hu, Frank A.J.L. Scheer, and the Look AHEAD Research Group.

Funding was provided by the National Institutes of Health. National Heart, Lung, and Blood Institute (K99HL148500). The Look AHEAD trial was supported by the Department of Health and Human Services through the following cooperative agreements from the National Institutes of Health (DK57136, DK57149, DK56990, DK57177, DK57171, DK57151, DK57182, DK57131, DK57002, DK57078, DK57154, DK57178, DK57219, DK57008, DK57135, and DK56992). The Indian Health Service (I.H.S.) provided personnel, medical oversight, and use of facilities.

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Timing of exercise impacts men with Type 2 diabetes - Harvard Gazette


Obesity and diabetes drug could be on the way – DW (English)

Friday, February 19th, 2021

To understand the new findings, one has to take ina bit of basic research.The focus here is on two messenger substances that researchers at Helmholtz Zentrum Mnchen, the German Center for Diabetes Research (DZD), ETH Zurich and Indiana Universityfeel show particular promise. These substances aregastric inhibitory polypeptide (GIP) and glucagon-like peptide-1 (GLP-1).

GIP and GLP-1 are produced in the digestive tract and play vitalroles in regulating body weight and food intake. A study on their effects now published in the journal Cell Metabolism provides pointersfor developing drugs to treat obesity and type 2 diabetes.

GIP acts on receptors of the central nervous system located in the brain, stimulatingthe release of insulin and loweringblood glucose levels. But how exactly this works has not been clear until now.

First author Qian Zhang and her team had two different types of mice at their disposal for their experiment: normal wild-type mice and specially bred mice that lacked the GIP receptors in the brain. The researchers injected both typeswith GIP.

Mice naturally have GIP receptors, but for the trial, scientists used specially bred mice without them

It was found that body weight and food intake decreasedin the wild-type mice, indicatingthat the hormone has an effect on appetite regulation. In contrast, food intake remained the same in the special laboratory mice lacking the GIP receptor. Their body weight decreased only minimally.

The researchers also looked at the mice's brain activity. "After administration of GIP, increased neuronal activity was evidentin the area of the hypothalamus associated with the control of appetite ," says Christian Wolfrum of ETH Zurich.

As far as the treatment of type 2 diabetesgoes, it isGLP-1 that plays an important role. It enhances the glucose-dependent release of insulin from the cells of the pancreas. Diabetics do not produce enough insulin themselves and have to inject it regularly.The problem is that GLP-1 is broken down again very quickly in the body and has to be constantly produced again. A solution to this problem has been available since 2005: a drug called Exenatide from AstraZeneca.

This contains an active ingredient derived from the saliva of the North American Gila monster, a venomous lizard.Itacts in a similar wayto GLP-1but is not broken down as quickly by the body.

The active ingredient is therefore an "agonist." This means that it mimics the action of a hormone at a receptor and stimulates the receptor in the same way.

A similar approach usingGLP-1 and GIP agonists had already been taken by researchers at Helmholtz Zentrum Mnchen together with colleagues from Indiana University. They had combined two hormones in a single molecule that acts on and stimulates both GIP and GLP-1 receptors.

This dual agonist simultaneously lowers weight and improves blood glucose levels. The researcherspublished their research in Science Translational Medicine in 2013.

The compound has now already entered a phase III clinical trial. It has been shown that the combination drug reduces body weight more than just one molecule does when acting at the GLP-1 receptor.

In the more recent mouse trial, it became clear, however,that the drug had no effect in mice lacking the GIP receptor in the brain. "Our work shows for the first time that the GLP-1/GIP dual agonist requires the GIP receptor in the brain to reduce body weight and food intake," saidTimo Mller, last author of the new study and head of the Institute for Diabetes and Obesity (IDO) at Helmholtz Zentrum Mnchen.

His next goal is now to find further active substances to improve GIP receptor signalingbecause these appear to be the central mechanism for treating both conditions.

Sugar is converted to fat in the body about two to five times more quickly than starches. In other words, when we consume sugar, were feeding our fat cells. The fructose in sugar is also metabolized by the liver, which can contribute to fatty liver disease. That can promote insulin resistance and lead to Type 2 diabetes with a lifelong impact on your health.

In small amounts, sugar promotes the release of serotonin, a hormone that boosts mood. But too much sugar can promote depression and anxiety. Sudden shifts in blood sugar levels can also lead to irritability, anxiety and mood swings.

We already know that sugar has a variety of health effects, but it also affects the skin. Thats in part due to glycation, the process whereby sugar molecules bind to collagen fibers. As a result, the collagen fibers lose their natural elasticity. Excess sugar also damages microcirculation, which slows cell turnover. That can promote the development of wrinkles, make you look older than your age.

The microflora of your gut promote digestion and protect your digestive system from harmful bacteria. Consuming too much sugar gets your gut microflora out of whack. Fungi and parasites love sugar. An excess of the Candida albicans yeast can lead to a host of annoying health symptoms. And sugar also contributes to constipation, diarrhea and gas.

In overweight people, the brain responds to sugar by releasing dopamine, in much the same way that it responds to alcohol or other addictive substances. Test it yourself: avoid all sugary foods and beverages for ten days. If you start to get headachy and irritable after a day or two, and start craving sugar, then you could be suffering from sugar withdrawal.

People who consume excess sugar are more likely to engage in aggressive behavior. Children with ADHD are also affected by sugar. For these children, too much sugar affects concentration and promotes hyperactivity. Thats why its a good idea for children to avoid eating sugar during school hours.

Excessive sugar consumption makes it harder for the immune system to ward off disease. After consuming sugar, the immune systems ability to kill germs is reduced by up to 40 percent. Sugar also saps the bodys store of vitamin C, which white blood cells need to fight off viruses and bacteria. Sugar also promotes the inflammatory response, and even minor inflammation can trigger numerous diseases.

Studies have shown that excess sugar consumption increases the risk of developing Alzheimers disease. A 2013 study showed that insulin resistance and high blood sugar values both of which are common in diabetes are associated with a higher risk of neurodegenerative diseases such as Alzheimers.

Cancer cells need sugar to proliferate. An international research team headed by Lewis Cantley of Harvard Medical School is researching how sugar might contribute to the growth of malignant cells. He believes that refined sugar may be what causes cancer cells to develop into tumors. Hes still testing that hypothesis but recommends that even slender people consume as little sugar as possible.

Excess sugar consumption may have a negative impact on memory. According to a study carried out by Berlins Charit University Hospital, people with high blood sugar levels have a smaller hippocampus the part of the brain thats key to long term memory. In the study, people with high blood sugar also performed more poorly on tests of memory than those with low blood sugar levels.

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Obesity and diabetes drug could be on the way - DW (English)


Diabetes Burnout: What It Is and How to Handle It – WebMD

Friday, February 19th, 2021

Two weeks ago, I tore the meniscus of my right inner knee as I got off my stationary exercise bike. The pain of the injury didnt show up until a few mornings later -- getting out of bed, I set my foot onto the floor and immediately raised a yelp of misery.

At the orthopedist office, the doctor drained fluid from the knee and injected cortisone with the largest needle I had ever seen. Thankfully, the injection worked, and after a few days of ice and rest, I was cleared to return to my regular activities.

But I didnt. Instead of returning to my daily exercise routine, I stayed put as my bike and weights gathered dust. I didnt take walks outside; I didnt hit my yoga mat.

It wasnt only exercise I abandoned: I didnt take my blood sugars. I stood in the kitchen and -- ignoring years of "clean eating" -- downed six homemade chocolate chip cookie bars. I pushed the scale into the closet and avoided mirrors.

I had hit the wall when it came to my diabetes care. I was officially burned out.

What is diabetes burnout? Its when the emotional toll of taking care of your disease becomes overwhelming and, for whatever reason, you give up. In my case, my knee injury was the final straw that sent me over the edge; but the truth is, but there had been so much else leading up to it. The long pandemic months that kept us mostly inside, unable to visit family or friends. The death of my sisters mother-in-law earlier that week (a lovely, warm woman who dealt with her own late-in-life diabetes by permitting herself two -- exactly two -- Raisinets a night). The frustrating inability of my husband or myself to schedule a COVID-19 vaccine in our state despite our eligibility. The 21-degree weather with more snow and ice headed our way; the very notion that my beloved Bruce Springsteen had sold out and narrated an ad for the Super Bowl. The masks. The handwashing.


There are many, many reasons for diabetes burnout. For some, it arrives when you get a complication even though youve done your best to take care of your disease. Or when despite every effort, the scale refuses to budge. Or high-sugar readings never drop. And it can take many forms: You might refuse to go to your doctor. Or stop monitoring your food. Or "forget" to renew your medications.

Most of us experience diabetes burnout at some point. No matter the cause, the signs and symptoms are the same: Youre sick of being sick, and you cant take it anymore.

For a week, that was me. So how did I deal? I made myself some rules:

1. No beating myself up. I gave myself the right to be sick of my disease.

2. I acknowledged that it couldnt last forever. As delicious as it was to pretend that I didnt have to care for my diabetes, I knew it couldnt last. I decided to call my time away from diabetes a vacation. Since I couldnt take a vacation during the pandemic, I reasoned, a short escape from diabetes might be the best Id get.

3. There were limits. I didnt down sleeves of Oreos or gallons of ice cream, but I did let loose: making spaghetti for dinner one night (white pasta!) and adding a glass of wine or two (or three). I exercised if I felt like it, but I didnt push myself to get a certain number of cardio minutes. If I felt like stopping, I did.

4. Medications were non-negotiable. I continued to take my medications (some habits survive burnout), but I ignored my sugar readings. (I really didnt want to know.)

5. I reached out for support. I talked to a friend about what I was going through and let her remind me of how careful I normally was, and how, maybe, I had needed to take a break to power through.

At the weeks end, I had put on a few pounds. When I got back to testing my sugars, my first reading wasnt great -- but it wasnt horrific either. I dumped the cookie bars and went food shopping for new items that were healthy, low carb, and a little off the beaten track: Japanese eggplant, portobello sliders, low-carb tortillas, a bottle of oyster sauce -- to regain my interest in healthy food.

Lets be clear: Burnout sucks, and it can hurt your health. Diabetes care is best when it's consistent and ongoing. If you find yourself experiencing diabetes burnout, contact your doctor or diabetes educator. They can help you get back on track by reminding you of your earlier progress or setting you up with a regular support group. In these difficult days, we need all the help we can get.

WebMD Blog

Ilene Raymond Rush is an award winning health and science freelance writer. Based on her own experiences with type 2 diabetes, she brings a personal take and a reporters eye to examine the best and newest methods of treating and controlling the disease.

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Diabetes Burnout: What It Is and How to Handle It - WebMD


Extension system to offer diabetes education program this spring – Moulton Advertiser

Friday, February 19th, 2021

A diabetes education program, offered virtually by the Alabama Cooperative Extension System, will begin next in March, according to an announcement from the Lawrence County Extension Office.

The Diabetes Empowerment Education Program (DEEP) will be offered in six 30-minute to hour-long sessions online, beginning March 24.

"Let's have a DEEP conversation about managing your diabetes," Regional Agent Elaine Softly, who will lead the program, said.

About 610,458 Alabamians live with diabetes, notes Softley. Every year, an estimated 31,000 state residents are diagnosed with diabetes.

She added that diabetes and prediabetes cost an estimated $5.4 billion in Alabama each year, and serious complications from the conditions include heart disease, stroke, amputation, end-stage kidney disease, blindness and even death.

Softley's series will cover topics: Understanding the Human Body, Understanding Risk Factors for Diabetes, Monitoring Your Body, Being Physically Active, Planning Meals, Identifying and Preventing Complications, Learning about Medications & Medical Care, and Living with Diabetes: Mobilizing Your Family and Friends.

For those without access to reliable internet service, other program participation options may be available, according to Extension Coordinator Donna Shanklin.

"The program can be delivered face-to-face to established groups, such as a quilt group, church members, or book clubs, as long as they are following COVID-19 guidelines," Shanklin said. "Just give the office a call to see if Softley can fit you into her schedule. If you do not have access to the internet, we can offer the use of our facilities for a limited number of people following COVID-19 guidelines."

Online sessions will take place at noon on March 24, March 31, April 7, April 14, April 21 and April 28.

Questions may be directed to Elaine Softley by calling 256-324-2851, or by emailing The Lawrence County Extension Office, located on Alabama 157 in Moulton, may be reached by calling 256-974-2464.

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Extension system to offer diabetes education program this spring - Moulton Advertiser


How are the CDC, North Carolina treating Type 1 diabetes in the vaccine rollout? – PolitiFact

Friday, February 19th, 2021

A billboard in Johnston County suggests North Carolina Gov. Roy Cooper is shortchanging people with type 1 diabetes.

A WRAL viewer emailed a photo of the billboard on U.S. Highway 301 to PolitiFact. It says:

"Gov Roy Cooper does not consider Type 1 diabetes an under lying health issue! Think about that!"

The billboard does not show who paid for it. Warren Stancil, the president of the billboard company, InterState Outdoor Inc., said he doesnt know the buyers identity.

"This was an anonymous person who bought the ad space. All I know is whats in the message," Stancil said in an email. The ad went up around Jan. 22, he said.

Given the timing of the message in the midst of a vaccine rollout, were assuming for the purposes of this check that the messenger is likely referring to where diabetics fall in North Carolinas inoculation schedule.

The billboards message touches on a controversial subject. To date, the U.S. Centers for Disease Control and Prevention does not consider both types of diabetes to carry the same level of risk for COVID-19 complications. In North Carolina, meanwhile, the health department has grouped Type 1 and Type 2 diabetes together and people with either condition qualify for covid vaccines in Group 4, ahead of the general population.

Type 1 diabetes and COVID-19

The CDCs webpage about how the virus affects people with medical conditions says people with Type 2 diabetes are at increased risk, while people with Type 1 diabetes "might" be at increased risk.

Under current CDC recommendations, people with Type 1 diabetes would be vaccinated with the general population.

Advocacy groups such as the American Diabetes Association and JDRF (formerly known as the Juvenile Diabetes Research Foundation) are lobbying the CDC to place higher priority on people with Type 1 diabetes.

A study published in December found that Type 1 diabetes "independently increases the adverse impacts of COVID-19," while another recent study found that Black COVID-19 patients were more likely to develop a serious complication of Type 1 diabetes than white patients.

Still, JDRF spokeswoman Cynthia Rice said that, as a result of the CDCs recommendations, "many states" havent prioritized people with Type 1 diabetes. So the American Diabetes Association has been contacting governors and state agencies across the country, spokeswoman Daisy Diaz told PolitiFact.

Type 1 diabetes and North Carolina

In North Carolina, the health department currently considers both types of diabetes to be "chronic conditions." Where does that put diabetics in North Carolinas vaccine rollout?

Lets say someone has diabetes but isnt over age 65, doesnt work in an essential industry and doesnt meet any other criteria for moving up North Carolinas vaccine priority list.

That person would be in Group 4 of the states five groups:

Group 1: Healthcare workers, long-term care staff and residents

Group 2: Older adults

Group 3: Frontline essential workers

Group 4: Adults at increased risk of severe illness

Group 5: Everyone else

Asked about North Carolinas plan, Rice said: "That is the policy we are seeking around the country, with Type 1 included with other disease that increase risk of severe illness from COVID."

Possible confusion

While people with both types of diabetes are prioritized in North Carolina, old versions of the health departments website may have given people the wrong impression.

Take for example the departments FAQ page about COVID-19 vaccines. Under the "getting vaccinated" section, the department lists chronic conditions that make someone a higher priority for vaccination.

The page currently lists both types of diabetes as chronic conditions.

However, according to an internet archive, the page excluded Type 1 diabetes from its list of chronic conditions as recently as Feb. 12. The webpage quoted CDC guidance, mentioning only Type 2 diabetes as a chronic condition.

That exclusion may be why some media outlets have mentioned only Type 2 diabetes when reporting on North Carolinas rollout.

North Carolina has tried to follow most CDC recommendations, said SarahLewis Peel, a spokeswoman for the health department. However, Peel said, North Carolina has always intended to prioritize all diabetics for vaccines.

People with both types of diabetes have been prioritized together since the state released its guidance for Group 4 on Jan. 25, she said.

Our ruling

The billboard says "Cooper does not consider Type 1 diabetes an (underlying) health issue!"

North Carolinas vaccine rollout prioritizes people with type 1 diabetes ahead of the general population. So its clear that Cooper, to some degree, considers the disease to be an underlying health issue.

We rate this claim False.

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How are the CDC, North Carolina treating Type 1 diabetes in the vaccine rollout? - PolitiFact


Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study – DocWire…

Friday, February 19th, 2021

This article was originally published here

Diabetologia. 2021 Feb 17. doi: 10.1007/s00125-020-05351-w. Online ahead of print.


AIMS/HYPOTHESIS: This is an update of the results from the previous report of the CORONADO (Coronavirus SARS-CoV-2 and Diabetes Outcomes) study, which aims to describe the outcomes and prognostic factors in patients with diabetes hospitalised for coronavirus disease-2019 (COVID-19).

METHODS: The CORONADO initiative is a French nationwide multicentre study of patients with diabetes hospitalised for COVID-19 with a 28-day follow-up. The patients were screened after hospital admission from 10 March to 10 April 2020. We mainly focused on hospital discharge and death within 28 days.

RESULTS: We included 2796 participants: 63.7% men, mean age 69.7 13.2 years, median BMI (25th-75th percentile) 28.4 (25.0-32.4) kg/m2. Microvascular and macrovascular diabetic complications were found in 44.2% and 38.6% of participants, respectively. Within 28 days, 1404 (50.2%; 95% CI 48.3%, 52.1%) were discharged from hospital with a median duration of hospital stay of 9 (5-14) days, while 577 participants died (20.6%; 95% CI 19.2%, 22.2%). In multivariable models, younger age, routine metformin therapy and longer symptom duration on admission were positively associated with discharge. History of microvascular complications, anticoagulant routine therapy, dyspnoea on admission, and higher aspartate aminotransferase, white cell count and C-reactive protein levels were associated with a reduced chance of discharge. Factors associated with death within 28 days mirrored those associated with discharge, and also included routine treatment by insulin and statin as deleterious factors.

CONCLUSIONS/INTERPRETATION: In patients with diabetes hospitalised for COVID-19, we established prognostic factors for hospital discharge and death that could help clinicians in this pandemic period.

TRIAL REGISTRATION: identifier: NCT04324736.

PMID:33599800 | DOI:10.1007/s00125-020-05351-w

Predictors of hospital discharge and mortality in patients with diabetes and COVID-19: updated results from the nationwide CORONADO study - DocWire...


Diabetes Product Supply Is This the Calm Before Storm Brexit? – Medscape

Friday, February 19th, 2021

Patients' worries about supplies of insulin, as well as other diabetes medications and devices due to Brexit have not, so far, been born out in reality, but the long-term situation remains uncertain as cross-border movement of goods is set to rise, according to experts.

In particular, Northern Ireland puts a fine point on these concerns with difficulties already apparent at border crossings.

Experts also warn patients against stockpiling medicines and related goods, which would in itself create product shortages not directly related to Brexit border issues.

"In some areas the cure is worse than the disease," cautioned Mark Dayan, MSc, Brexit programme lead at the Nuffield Trust.

At only 7 weeks after the end of Brexit transitional arrangements, it is reasonable to assume that the first few weeks are a relatively artificial reflection of the longer-term status quo around the bidirectional trade between the UK and EU.

Concerns around the supply of devices and medicines including insulin are very real to those whose lives depend on it, but in reality, how valid are they?

Back in 2018 when Brexit negotiations were in full-flow, the scene was set when senior officials expressed concerns around insulin supply. Sir Michael Rawlins, who was chair of the Medicines and Healthcare products Regulatory Agency (MHRA) at the time, told the Pharmaceutical Journal that: "We make no insulin in the UK. We import every drop of it. You can't transport insulin around ordinarily because it must be temperature-controlled."

Then a study of tweets posted in 2019 by people with diabetes reflected that these concerns were rife among patients too. At this point the outcome of Brexit 'no deal' or 'deal' negotiations were unknown.

Recently published in JMIR Diabetes on 27 January, the study investigated patients' views around lots of disease-related issues, but of note, the tweets around diabetes product supplies were particularly poignant.

Insulin supply is a key concern for dependent patients because a lack of the replacement hormone can be fatal. The study found that 9% of tweets featured real worries among diabetes patients relating to insulin availability, whatever the outcome of Brexit negotiations.

Tweets emphasised the desperation and fear of some patients. One wrote: "INSULIN - for most of you it is just a medical term, but it is a lifesaver for me and other type 1 diabetics. Do I buy a big fridge to stockpile to make sure I can live while you #brexiters apply for your new blue passport?"

Another wrote: "Diabetics are not sure if their life-saving insulin will run out.So many medications CANNOT BE STOCKPILED!It's a DEATH THREAT from the government and violates our human right to life. #NotoDeathbyBrexit #DyingforBrexit."

Su Golder, PhD, from the University of York led the Twitter study. "UK-based patients with type 1 diabetes were all very worried and scared about supply," she told Medscape UK in an interview. "We don't know if these concerns were real, but the opinion expressed does show how vulnerable these people feel.

"Because insulin is a life-saving drug that needs storing in the fridge, it can't really be stockpiled," she adds.

Nikki Joule, policy manager at Diabetes UK, lends support but also contextualises these concerns. "The worry is understandable, particularly around insulin because people depend upon it for their lives," she said, but added that, "I think much of the concern expressed by people with diabetes is really anxiety and hasn't been borne out by reality, so far at least, and certainly not above and beyond normal short-term shortages that happen, Brexit or not."

Diabetes UK says it has supported Government calls to suppliers of insulin and other diabetes medicines too, asking them to keep 6 weeks of stockin the UK. "Contingency plans comprised alternative routes into the country, extra stock being held on UK soil, and the Department of Health and Social Care (DHSC) ensured those levels of stock with both medications and device companies," said Nikki Joule.

"In fact, we were aware that some companies had threetimes more stock than a 6-week supply, and so far, to our knowledge at Diabetes UK, supply routes seem to be operating well," she added.

The DHSC was always concerned about insulin given how essential it is for people with type 1 diabetes and others who are dependent on insulin, said Ms Joule, and this concern was not only due to the risk of 'no deal' but also for potential disruption due to restrictions or supply issues around COVID-19. "The same actions and contingency plans around supply would need to be taken whether issues were related to Brexit or COVID."

She also noted that stock problems are unlikely for many diabetes medicines such as metformin or gliclazide, because they are made by a large range of companies in the UK.

The default 'no deal' scenario never came to pass, and the EU-UK Trade and Cooperation Agreement was signed on December 24, 2020.

In an interview with Medscape UK, Mr Dayan explained some of the new processes and challenges underpinning the movement of medicines and devices, including those for diabetes, across borders between the European Union (EU) and UK.

Essentially, concerns prevail around customs and regulatory processes, including medicines' safety alert systems.

Since January 1, 2021, customs processes around the logging of import and exports declarations, as well as new permits and details have been required by hauliers to enable movement between countries.

In terms of diabetes-related products moving into the UK from the EU, the border checks and customs declarations required by UK authorities facilitate a smoother flow of goods into the UK than vice versa.

"Right now, things are relatively under control," said Mr Dayan, adding that companies have some concerns, but this does not seem to have led to more shortages than normal. He pointed out that this reflected several years of work by the DHSC and companies in trying to negotiate the best way forward.

To minimise any difficulties associated with Brexit, the UK has provided various grace periods for products entering the UK from the EU, explains Mr Dayan. "For example, deferral on customs forms for 6 months at the UK border, and a 2-year grace period for regulatory issues. Most relevant are the border-to border easement measures, so the UK is accepting batch testing certificates until 2023."

Some arrangements are more mutually beneficial than others and facilitate trade. "The trade and cooperation agreement that came out on Christmas Eve contains mutual recognition for Good Manufacturing Practice (GMP) for medicines, and EU inspection certificates are still accepted here in the UK," Mr Dayan highlights.

"Unfortunately, many of the easements applied by the UK are not reciprocated by the EU," he pointed out.The safety of medicines databases does raise some concerns, Mr Dayan says. When it left the single market, the UK also left behind its right to submit or receive safety alerts and data from the EU systems for pharmacovigilance (EudraVigilance) or devices (EudaMed). "The danger is that we are, as a result, less well informed about emerging or potential problems with drugs and devices on the market," says Mr Dayan.

Alone, the UK has a smaller population to report safety issues than the EU, and safety issues become more visible with higher patient numbers. However, he points out that reporting systems in the EU and US should mean any safety issues or anomalies are visible but the UK will not necessarily have direct access to these databases. "I'm not overly optimistic about this changing. I'd like to have seen more on this in the trade agreement."

The complex situation in Northern Ireland, which is subject to the Northern Ireland protocol (to overcome the need for a border between the Republic of Ireland, which is still part of the EU, and Northern Ireland, which is no longer part of the EU, there is an arrangement whereby there is effectively a border check down the Irish Sea) is challenging and promises to continue to be so.

"The situation around regulatory switch overs in Northern Ireland is making it far more difficult for companies to move medicines from the mainland,"Mr Dayanremarks.

This will remain a live issue, with Cabinet Office Minister, Michael Gove, recently requesting an extension to the existing grace period beyond April.Mr Dayanhighlights that this reflects genuine concerns around the situation there. "For medicines, Northern Ireland has effectively stayed in the EU, and the movement of medicines from the UK [mainland] faces similar hurdles as shipping them anywhere on the continent. This is certainly an area where there is more risk."

The UK is only 7 weeks into Brexit and many companies gave January a wide berth, avoiding the borders for fear of confusion and delays. As a result, cross-border controls have run relatively smoothly to date. The next few months might paint a different picture with volumes of trade at borders picking up.

With all of the UK's insulin imported from the EU, concerns are not without foundation. Supplies are all sourced from EU-based manufacturing and distribution centres, with the main providers being Sanofi (France), Novo Nordisk (Denmark), and Lilly (various EU locations).

But Mr Dayan explained that despite all the UK's insulin supply being imported, insulin supply from the large pharma companies is less risky than medicines made by smaller firms. "These companies might be less capable of dealing with Brexit-related changes around operating across different markets," he said.

On January 1, when the transition period ended, many companies responded to the anticipated pressures and extra administrative needs of Brexit by avoiding the border altogether. "However, at some point this will recover, and as trade volumes increase it might get more difficult. We need to start thinking about the longer-term, for example, around the introduction of new products and long-term cost implications," he cautions.

People building their own personal stockpiles of medicines is the greatest concern stressed by both Mr Dayan and Ms Joule, and more widely. "It isn't a good idea for patients to stockpile because that will create shortages. If people start stockpiling generally then it could apply to other types of medicines and be a greater problem than the effect of Brexit itself," Mr Dayan says.

Most devices, notably continuous glucose monitors (CGM) and goods such as testing strips and sensors, are largely made and supplied by the EU. Exceptionally, the Abbott FreeStyle Libre is made in the UK, and digital interventions likeLow Carb Programare also produced in the UK.

Supply of testing strips or sensors for CGMs might be more challenging than medications, especially ones that need frequent changes such as sensors that require replacement every 7 days.

In early January, people reported a problem obtaining sensors for a Medtronic pump, Ms Joule said, explaining that it actually turned out the delay was with the delivery firm and related to documentation rather than anything to do with the company directly. "This has been resolved now," she says.

Mr Dayan identifies that a key issue for devices is the validity of the manufacturer's CE mark. For UK firms wishing to export their devices to the EU, they would have needed to switch their CE (ConformitEuropenne) mark to an EU regulator prior to January 1, he said. "A UK regulator would not now be able to grant them a CE mark for export to the EU. These firms also have to work through many new customs and border checks for export to the EU that do not reflect the grace period that the UK is applying."

In theory, there is a UK equivalent of the CE mark known as theUKCA(UK Conformity Assessed) marking, which came into effect on January 1, 2021. It is a novel UK product marking that is used for goods being placed on the market in Great Britain (England, Wales, and Scotland). It is not yet widely used in practice. "It covers most goods which previously required theCE marking," says Mr Dayan. However, he adds, there is a grace period until mid-2023 when the UK will still accept EU-granted CE markings.

At the completion of the grace period, new devices made in the EU will need to obtain a UKCA marking as well as an EU CE mark. "This has the potential to increase costs at many steps," Mr Dayan points out.

Costs are predicted to increase once the grace period has passed and new checks, and a higher volume of checks, will need to be implemented.

Various studies have tried to work out the costs of having a free trade agreement versus being in the single market. One studyshowed a significant 5% increase in costs. "Given the NHS spends around 20 billion annually on medicines, that would require an extra one billion pounds," says Mr Dayan.

However, many medicine prices are resistant to price fluctuations due to a set drug price tariff, and a voluntary scheme that caps medicine costs, he explains."Companies are more likely to decide it is unprofitable to supply the UK anymore."

But insulin is unlikely to be affected, he stressed. "Lack of supply due to cost is unlikely to be an issue for insulin, which is a bulk product the UK is very willing to pay for."

However, for higher profit margin items, or at the other extreme, generic medicines where the profit margin is very low, firms might stop supply and this could lead to shortages, he adds. This happens quite regularly despite Brexit, he explained, and has happened more frequently since the EU referendum, probably due to the fall in the value of the Great British pound, which makes some products less profitable."For generic products, we would probably just pay more for them."

But the biggest concern will not be for medicines already on the market, but for new ones, said Mr Dayan. "The UK might be a lower priority market for new products. This tends to happen with smaller markets compared with the EU or US large markets."

Firms might not invest time and resource in a market that has lower returns. However, noted Mr Dayan, size might not be the only consideration. "I suspect the UK will try to use its regulatory system to remain an attractive place to introduce new medicines," he asserts.

"The MHRA granted approval to the COVID-19 vaccines quickly and the UK might be able to offer accelerated routes as an incentive."

Diabetes Product Supply Is This the Calm Before Storm Brexit? - Medscape


Diabetes monitoring without the needle – Axios

Sunday, February 14th, 2021

A European company is pioneering a bloodless way for people with diabetes to monitor their glucose levels.

Why it matters: More than 5% of the global population is affected by diabetes, and the number is set to keep rising. A more seamless monitoring system would make it easier for people with diabetes to manage their conditions and avoid disastrous health outcomes.

How it works: DiaMonTech is developing machines that use lasers and an optical lens to read glucose levels through the skin photothermally.

Background: People with diabetes suffer from problems managing blood sugar levels that stem from their inability or inefficiency of their bodies to produce the glucose-regulating hormone insulin.

What to watch: DiaMonTech has developed a lab-based version of its system that has been certified for medical use in clinics in Europe, and is working on a hand-held device for personal use that Lubinski believes could be ready by 2022.

Read more here:
Diabetes monitoring without the needle - Axios


People aged 40 with type 2 diabetes have increased coronavirus death risk, study finds – Yahoo News

Sunday, February 14th, 2021

National Review

President Bidens flurry of executive orders has now extended to housing policy and to a pledge to reverse the Trump administrations approach to fair housing. Specifically, that would mean reversing the Trump reversal of an Obama-era rule known as Affirmatively Furthering Fair Housing designed to introduce affordable (read subsidized) housing into higher-income, suburban zip codes. To justify a return to this controversial policy, President Biden rehearsed a long litany of federal housing-policy sins. Hes right about many of those but wrong about his approach to redress. More subsidized housing, in the tragic public-housing tradition, will only spur division and do little to help minority groups in their quest for upward mobility. It is incontrovertible, as President Biden stated in his executive order, that during the 20th century, Federal, State, and local governments systematically implemented racially discriminatory housing policies that contributed to segregated neighborhoods and inhibited equal opportunity and the chance to build wealth for Black, Latino, Asian American and Pacific Islander, and Native American families, and other underserved communities. Most significantly, the Federal Housing Authority would not insure mortgages for blacks in white neighborhoods, and racial covenants deed restrictions against blacks (and Jews, by the way) were the norm into the 1950s. Urban freeways ploughed through low-income, often (though not exclusively) minority, neighborhoods, displacing thousands. Today, we are left with the Cross Bronx Expressway and the Chrysler Freeway. Even this apology is, however, selective. African Americans, particularly, suffered the tragedy of a (still) favorite progressive program: public housing. A key history here is underappreciated. Historically black neighborhoods Central Harlem, Detroits Black Bottom, Chicagos Bronzeville, Desoto-Carr in St. Louis were denigrated as slums, even though they were home to large numbers of residential property owners and hundreds of black-owned businesses. When they were cleared to make way for public housing, they were replaced by high-rise hells in which ownership asset accumulation was by definition impossible. The social fabric of self-help, civil society, and upward mobility was ripped apart. Blacks have always been, and remain, disproportionately represented in public and otherwise subsidized housing, often trapped into long-term dependency by counterproductive policies: When their income rises, so does rent. Compensating for this dual history of outright racism and harmful progressivism must not mean a new generation of housing sins. But Affirmatively Furthering Fair Housing, should it be restored, is just that. Federal pressure through the leverage of local aid programs to force the introduction of subsidized rental housing for low-income tenants has long been a guarantee of resistance by lower-middle class residents, white and black, justifiably concerned that households who have not strived and saved to make it to their neighborhoods will pose problems. Concentrations of housing-voucher tenants, dispersed by the demolition of some public-housing projects, have already spread dysfunction and poor maintenance including into apartment buildings in Warrensville Heights, the Ohio hometown of Marcia Fudge, the incoming secretary of the U.S. Department of Housing and Urban Development. Racial integration and fair housing remain goals for which America must strive. But that means understanding how neighborhoods work. Americans, black and white, self-select to live in areas in which they share the socioeconomic characteristics of their neighbors. Some liberals might not like that but those are their personal choices, as well. When minority-group members share the economic and educational backgrounds of new neighbors, the odds of intolerance are vastly decreased. Thats why fair housing should mean nondiscrimination not subsidized new developments. Instead, Biden is doubling down on the example set by the Obama administration in Westchester County, which was forced to spend $60 million to subsidize 874 housing units in a county in which racial and ethnic minorities are already well represented. That means that current black and Hispanic homeowners, who have bought their homes through striving and saving, will have to see their county taxes used to subsidize others to the tune of $68,000 per home. The exclusionary suburbs wont be pried open by confrontation. There will be endless lawsuits. Instead, HUD, if its to have any useful role, must try to use such tools as model zoning (suggestions, not mandates) to convince local planning boards to permit the market to build naturally occurring affordable housing small homes, including small multifamilies, on small lots. Historically, thats how the American working class was able to afford homes. An administration truly interested in correcting the housing-policy sins of the past would not overlook the existing problems of public and subsidized housing. Heres a bold idea: sell off public-housing projects on high-value real estate (see the Brooklyn waterfront) and provide cash compensation to its residents. They should be able to move where they like or just put the money aside. Theres a lot about our housing past to correct. Doubling down on previous sins is not the way to start.

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People aged 40 with type 2 diabetes have increased coronavirus death risk, study finds - Yahoo News


In New London, agencies using education to combat diabetes –

Sunday, February 14th, 2021

New London Since Nydia Rodriguez met Wanda Santiago about a year ago, thecity resident has lost 20 pounds and gotten her Type 2 diabetes under control. That's because Santiago, Lawrence + Memorial Hospital's bilingual diabetes educator, has taught Rodriguez, a former nurse from Puerto Rico, about portion control, sugar substitutes and how to cut back on bread and pasta.

Santiago, who was also a nurse in Puerto Rico, has even connected Rodriguez with food banks that offer fresh fruit and vegetables.

"I talk to her almost every day," Rodriguez, 64, said in Spanish, with her daughter Yolanda Mejias translating. "If I need anything, I'll call her."

L+M hired Santiago in 2019 as part of a concerted effort by the hospital, city, local doctors, diabetes educators and the Ledge Light Health District to improve the health of residents with diabetes. The need is urgent in the city, where 12% of adults have diabetes, compared to 9.7% statewide and 11% in the greater New London area. A 2019 report found that in greater New London, 25% of African Americans and 23% of people over 65 have diabetes. Forty-six percent of Latinos are obese, putting them at risk for Type 2 diabetes.

Diabetes and other illnesses exact a heavy toll in New London's poorest neighborhoods, where census data show the average life expectancy is 69 years old. In nearby Stonington, it's 86.

Dr. Mae Whelan, an endocrinologist at the Northeast Medical Group Diabetes and Endocrine Center in New London, said her patients face food insecurity, few safe places to exercise, language barriers and limited access to transportation. Their problems have worsened during the COVID-19 pandemic.

Ledge Light, the New London Senior Center, the hospital and Whelan's practice all offer diabetes education, including by phone during the pandemic.

"This is the hardest chronic disease to manage because they have to know so much about it," Whelan said. "They have to understand what blood sugar is, when to do a finger stick, when to take their medicine and how to take it."

Mirroring a national trend, diabetes among Connecticut adults has risen from 6.9% in 2009 to 9.7% in 2018, according to the state Department of Public Health. Cindy Kozak, the coordinator of DPH's Diabetes Prevention and Control Program, said the state is working to reduce that rate but it's a challenge.

"Diabetes is a very expensive disease, both economically as well as in personal pain and suffering, so there are efforts to really bend that curve,'' she said.

The state spends $153,000 on a free Live Well with Diabetes program in many communities, among other efforts to curb diabetes. Connecticut residents also are taught by certified diabetes care and education specialists around the state at diabetes education centers. These programs are proven to lower the A1C, a three-month measurement of blood sugar control, Kozak said.

"I ask doctors if diabetes education were a pill, would you prescribe it?" she said. "There are no side effects, and it's a real benefit."

A dangerous disease

Diabetes is the seventh leading cause of death in the U.S. and the main cause of kidney failure, lower-limb amputations and adult blindness. Most people with diabetes have Type 2, in which the body doesn't use insulin well. Five to 10% have Type 1, in which the body stops making insulin. Our bodies need insulin to get glucose from the bloodstream into the cells of the body.

While growing up in Detroit, Reona Dyess saw her great-grandmother struggle with diabetes.

"The terminology that I heard in my family is 'I've got sugar,'" said Dyess, who is Black. When Dyess, a New London City Council member, was diagnosed with Type 2 diabetes a dozen years ago, it hit her hard. "I hated that it happened, and I was in denial at first," she said.

Now 56, Dyess requires two insulin shots a day. She said the diabetes classes in New London have helped her be more mindful about what she eats. She said she was thrilled last year when the state legislature passed a $25 a month cap on insulin for those on state-regulated health insurance. When the law takes effect next year, it will also cap the cost of diabetes supplies at $100 a month.

Gretchen Edstrom, the education coordinator in Whelan's practice, said some patients ration their insulin and medications because they can't afford them. Some of the medications that work best at controlling blood sugar cost $900 or more a month, she said.

"They say, 'I knew I was running low on the medication, so I was only taking half my dose,'" Edstrom said. "It's very short-sighted to not take these life-saving drugs."

Dyess said she switched to cheaper but less effective over-the-counter insulin from Walmart during a year when she had no health insurance.

Emphasizing healthy food

When the pandemic shut down a mobile food pantry last spring, the city, Ledge Light, L+M and FRESH New London, an organization dedicated to food security and community-based agriculture,launched a Friday food delivery program feeding 170 families. They distribute 6,000 pounds of food a week, including 1,600 pounds of fresh fruit and vegetables, said Esther Pendola, L+M's community health project coordinator.

"We try to give them healthy options,'' she said. "I think one of the hard things with having diabetes is that it's expensive to eat that way."

As executive director of The Drop-In Learning Center of New London, Dyess has her students grow tomatoes that they bring home. She said the classes, food banks, farmers markets and community gardens throughout New London make a difference for people with diabetes.

"I see us going in a better direction," she said.

This story was reported under a partnership with the Conn. Health I-Team (, a nonprofit news organization focused on health reporting.

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In New London, agencies using education to combat diabetes -


Diabetes? This Suji Idli And Tomato Chutney Breakfast Combo Is Meant Just For You! – NDTV Food

Sunday, February 14th, 2021


Diabetes is emerging to be one of the most prevalent disorders of the modern world. It is a condition that is marked by fluctuating blood sugar levels and occurs when there is a lack of insulin produced in the body, or when the body is unable to respond to the insulin produced. Diabetes is of many types, like Type 1, Type 2, Gestational. There's also a condition called prediabetes that is becoming a very common phenomenon among youngsters today. Unfortunately, there is no known cure for diabetes, hence all you can do is to manage its symptoms through proper diet and lifestyle. Lack of timely intervention could lead to blindness, kidney failure and massive weight fluctuations.

(Also Read:Diabetes Diet: 5 Whole Grain Desi Flat Bread Recipes For Diabetics)

Diabetics should avoid consumption of refined flourPhoto Credit: iStock

While diabetics must plan their diet with caution, they should be extra careful of what they have for breakfast. Since that is the first meal of the day after about eight hours of slumber, you cannot nosh on anything that comes in front of your eyes. Eating foods of refined flour, refined cereals, processed food could lead to blood sugar spikes; this is why you should look for options that could balance your glycaemic load. Options may seem limited, but there are still enough ideas you can toy with. Take, for instance, suji or semolina - a healthy alternative to maida - may prove beneficial, only if it is consumed in moderation. Ms Jyoti Bhatt, Senior Dietician from Jaslok Hospital & Research Centre explains, "Rava is a coarse flour made from durum wheat, a hard type of wheat. Semolina is a great source of many minerals and fibre - nutrients that may help improving blood sugar levels and reduce your risk of type 2 diabetes."

(Also Read:Diabetes Diet: Neem Tea May Help Manage Blood Sugar Levels - Recipe Inside)

Suji is also known as semolina


Suji Idli and Tomato Chutney Recipe

Suji (also known as rava or semolina) is fairly versatile. You can use it to make upma, dosa, halwa and idli. Yes, you heard us. Traditional rice batter replaced with a suji one. This healthy variant of idli also comes with the goodness of carrots, giving your idlis a more wholesome and healthy upgrade. You can pair these spongy idlis with tangy and spicy tomato chutney. Here is the recipe link of both suji idli and tomato chutney.Try making it at home and let us know how you liked it in the comments below.

(This content including advice provides generic information only. It is in no way a substitute for qualified medical opinion. Always consult a specialist or your own doctor for more information. NDTV does not claim responsibility for this information.)

About Sushmita SenguptaSharing a strong penchant for food, Sushmita loves all things good, cheesy and greasy. Her other favourite pastime activities other than discussing food includes, reading, watching movies and binge-watching TV shows.

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Diabetes? This Suji Idli And Tomato Chutney Breakfast Combo Is Meant Just For You! - NDTV Food


Diabetes Health Type 1 &2: Not Only is Today a Day for Love- but It is Also a Day for Forgiveness – Diabetes Health

Sunday, February 14th, 2021

I have always felt that Valentines is a day to say, I love you, to my friends and family, I deliver this message with a text, a quick face-time chat, email, or snail mail-whatever medium I know the recipients use to communicate.

The clichd Valentines dinner, gifts, flowers, chocolate, and jewelry are fine, but do we need to buy something? Isnt unconditional love the best gift we can deliver one another? What if Valentines Day were a day for forgiving? Can you imagine hundreds of thousands of people putting their egos aside despite something done or said to them in the past that created a wall they never anticipated could come down?

Compound the ability to forgive year after year. I can confidently say that there certainly would be more love between everyone. As we forgive others for not doing or saying the right thing, we permit our friends and family to love themselves. Letting go of the past, of attachment to memories of moments that hurt us, is what heals the heart. Our pool of Valentines love becomes much more profound.

I wish you a day of love and forgiveness. Even if reaching out seems hard. Say who you forgive out loud to yourself and make it a mantra until you dare to call the loved one that has left you with a sore heart.

Diabetes Health Type 1 &2: Not Only is Today a Day for Love- but It is Also a Day for Forgiveness - Diabetes Health


Empagliflozin Treatment in HFrEF With Comorbid Diabetes/Prediabetes – The Cardiology Advisor

Sunday, February 14th, 2021

Patients with heart failure with reduced ejection fraction (HFrEF) who were diabetic or prediabetic had reduced left ventricular (LV) volumes following therapy with empagliflozin, according to study results published in Circulation.

In this multicenter randomized, double-blind, placebo-controlled trial ( Identifier: NCT03485092), 105 patients (mean age, 68.711.1 years; 73.3% men) with HFrEF and type 2 diabetes or prediabetes were recruited between 2018 and 2020 at 15 hospitals in Scotland. Patients were randomly assigned at a 1:1 ratio to receive empagliflozin (10 mg daily; n=52) or placebo (n=53) for 36 weeks. Patients were assessed during 6 visits during which they underwent cardiovascular magnetic resonance imaging, standard laboratory analyses, and were examined for cardiovascular health.

In this cohort, 77.1% of participants had New York Heart Association (NYHA) functional class II, 49.5% had been previously hospitalized for HF, and 78.1% had type 2 diabetes mellitus.

At baseline, average LV end-systolic volume index (LVESVi) was 80.837.2 ml/m2 and 76.729.3 mL/m2 among patients receiving empagliflozin and placebo, respectively. At 36 weeks, LVESVi was reduced by 7.911.8 mL/m2 in the empagliflozin group compared with a 1.5 mL/m2 reduction in the placebo group (adjusted between-group difference, -6.0; 95% CI, -10.8 to -1.2 mL/m2; P =.015).

The mean reduction in LV end-diastolic volume index was greater in the empagliflozin vs placebo group (empagliflozin: baseline, 114.737.0 mL/m2; week 36, 105.737.6 mL/m2; placebo: baseline, 111.429.2 mL/m2; week 36, 110.928.3 mL/m2; adjusted between-group difference, -8.2; 95% CI, -13.7 to -2.6 mL/m2; P =.004).

No difference for LV global longitudinal strain was observed (adjusted between-group difference, 0.35%; 95% CI, -0.25% to 0.95%; P =.25).

Patients receiving empagliflozin vs placebo had greater reductions in: uric acid (adjusted between-group difference, -66.2 umol/L; 95% CI, -91.9 to -40.5 umol/L; P <.0001), hematocrit (adjusted between-group difference, 0.027 L/L; 95% CI, 0.015-0.038 L/L; P <.0001), galectin-3 (adjusted between-group difference, 1.94 ng/mL; 95% CI, 0.41-3.47 ng/mL; P =.013), and N-terminal pro-B-type natriuretic peptide (adjusted between-group difference, -28%; 95% CI, -47% to -2%; P =.038).

Safety outcomes were comparable between the 2 groups, however, deaths occurred in 2 participants treated with empagliflozin (due to pancreatic cancer and cardiogenic shock).

These findings may not be generalizable to a more frail population, as patients with atrial fibrillation, cardiac devices, or NYHA functional class IV were excluded from this study.

[T]reatment with the SGLT2 inhibitor empagliflozin led to favorable reverse LV remodeling in patients with HFrEF and type 2 diabetes or prediabetes, concluded the study authors. This finding may, at least in part, explain the beneficial effect of SGLT2 inhibitors on clinical outcomes in HFrEF.

Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.


Lee M M Y, Brooksbank K J M, Wetherall K, et al. Effect of Empagliflozin on Left Ventricular Volumes in Patients with Type 2 Diabetes, or Prediabetes, and Heart Failure with Reduced Ejection Fraction (SUGAR-DM-HF). [published online November 13, 2020] Circulation. doi:10.1161/CIRCULATIONAHA.120.052186

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Empagliflozin Treatment in HFrEF With Comorbid Diabetes/Prediabetes - The Cardiology Advisor


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