StemCell Therapy

By Arlene Karidis By Arlene Karidis April 7 at 2:05 PM

Nearly four times as many Americans may die of diabetes as indicated on death certificates, a rate that would bump the disease up from the seventh-leading cause of death to No. 3, according to estimates in a recent study.

Researchers and advocates say that more-precise figures are important as they strengthen the argument that more should be done to prevent and treat diabetes, which affects the way sugar is metabolized in the body.

We argue diabetes is responsible for 12 percent of deaths in the U.S., rather than 3.3 percent that death certificates indicate, lead study author Andrew Stokes of the Boston University School of Public Health said in an interview.

About 29 million Americans have diabetes, according to the Centers for Disease Control and Prevention. There are two forms of the disease: Type 1, in which the pancreas makes insufficient insulin, and the more common Type 2, in which the body has difficulty producing and using insulin.

Using findings from two large national surveys, the study looked mainly at A1C levels (average blood sugar over two to three months) and patient-reported diabetes. In the latest study, researchers compared death rates of diabetics who had participated in these surveys to information on their death certificates.

The authors also found that diabetics had a 90 percent higher mortality rate over a five-year period than nondiabetics. This held true when controlling for age, smoking, race and other factors.

[Women with diabetes are especially prone to developing heart disease]

These findings point to an urgent need for strategies to prevent diabetes in the general population. For those already affected, they highlight the importance of timely diagnosis and aggressive management to prevent complications, such as coronary heart disease, stroke and lower-extremity amputations, Stokes said.

We hope a fuller understanding of the burden of disease associated with diabetes will influence public authorities in their messaging, funding and policy decisions, such as taxation of sugar-sweetened beverages and use of subsidies to make healthy foods more accessible, he said.

When they embarked on the study, the investigators were curious about two findings from earlier research. The first was a higher obesity rate and shorter life expectancy among Americans than Europeans. (The researchers already knew that obesity and diabetes were related.) The second revelation was a rise in deaths by any cause among middle-aged white Americans.

We tried to piece together causes of mortality in the U.S., looking closer at diabetes, which we knew was underreported, Stokes said.

Mortality rates attributed to diabetes are imprecise largely because death results from both immediate and underlying causes, and not every one of them gets recorded. For example, cardiovascular disease might be recorded as the cause of a persons death even though that disease may have been caused by diabetes.

Further challenging the task of identifying cause of death is that diabetics have a long history of problems before serious complications occur.

When diabetes started 10 to 30 or more years before a patient died, the disease may not be in the forefront of the attending physician at time of death, explains Catherine Cowie, an epidemiologist at the National Institute of Diabetes and Digestive and Kidney Diseases. And there are no clear guidelines about which conditions should be cited as cause of death.

Detailed electronic medical records may help pinpoint the primary cause. But still, its hard [to get the full picture] in this day and age when health care for diabetics is divided between different practitioners, she said.

She advises patients to report their diabetes to all their health providers, whether they are having complications at the time or not.

Weve been trying to promote healthy lifestyle to prevent diabetes and complications for a long time. This includes paying attention to the ABCs, which are to bring down A1C, blood pressure and cholesterol. But I think this [study] is new evidence that its important to focus on these things. Its more data to show what diabetes can lead to, Cowie says.

In 2016, diabetes accounted for about $1.04 billion in National Institutes of Health funding, compared with about $5.65 billion spent on cancer research. Having a better gauge on the mortality figures could have an effect on research dollars, said Matt Petersen, managing director of medical information for the American Diabetes Association.

But the true death rate means only so much.

Whats most important is why it is and what we can do about it. The goal of research is prevention and, if possible, cure. Short of uncovering a cure, key is figuring out how do we best treat it and reduce complications, Petersen said.

For Type 2 diabetes, new drugs that work in combination and in different ways to address differing patient cases have rolled out in just the past two years. Healthy lifestyle choices can also affect outcomes.

So I think the public should hear [that] yes, diabetes can be deadly, but that we have the ability to reduce the chance for this disease, Petersen says. And for those who have diabetes, we can treat it well and reduce the risk for debilitating and deadly complications.

[Why treating diabetes keeps getting more expensive]

[The man who knows more about death than anyone else]

[The scary reason why doctors say kids need HPV vaccinations]

[New research identifies a sea of despair among white, working-class Americans]

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Diabetes is even deadlier than we thought, study suggests - The ... - Washington Post

For the last five years, our grandson, Tyler Kane Ochs (TKO), along with his family and friends, have participated in the annual Step Out Walk to Stop Diabetes that is held each spring at Keeneland Race Track in Lexington. It is a big event that draws over 2,000 participants from central and eastern Kentucky to join the battle to fight and call attention to this terrible, always debilitating, and far-to-frequently cause of death.

This year the walk, as well as a 5K race, will take place on the morning of June 3 from 8:30 until its over. Anyone and everyone is welcome to join. You can register at the site that morning but you need to be there at 8:30, no later than 9, if you want to enter the race on trails through Keenelands lush woods.

Long-term readers of Points East already know that I drum up cash sponsorship for our team from you around this time every spring. If youre a new reader, welcome aboard.

Diabetes is the seventh, most-listed, on death certificates, cause of death in our country. However, it is most likely the root cause of a host of other killers such as heart disease, strokes, kidney failure, liver disease, blood poisoning and hemorrhages, to name a few, that are listed as the cause of death without mentioning diabetes.

For example, even though neither of them have done me in so far, I have had two strokes that the doctors tell me were probably related to my diabetes. The jury is still out on whether my intimate association with Mr. Parkinson was brought on by erratic blood sugar imbalances. The point is, that if either of the strokes had proven to be fatal, my diabetes would not have been listed as a cause of death even though it would, most likely, have been the root cause. Thanks to diabetes, Ive undergone five eye surgeries since 2015 and I am already in need of another round. Diabetes is one of, if not the most absolute, leading causes of blindness and is, by far, the leading cause of lower extremity amputations among adults. I could go on and on, but I think you get the picture.

The truth of the matter is that, other than visual impairment, I am not much bothered with the disease on a daily basis as long as I take my metformin, orally, twice a day, try to eat responsibly and get as much exercise as possible.

Our adult son, Christopher, is not so lucky. He has to have two daily injections of insulin. Chris has had so many life-threatening diabetes episodes that we have lost count. Hes had two already this year that involved Loretta and me uttering terrorized prayers that the ambulance get here fast enough to save his life. So, comparing what I endure, diabetes-wise, to what Chris and Tyler put up with is sorta like comparing a bee sting to a rattlesnake bite.

Our 8-year- old Grandson, Tyler, has to wear an insulin pump, and he has to monitor every bite of food or drink, other than water, that he ingests. Tyler can and does count every carbohydrate that goes into his mouth and does up to half a dozen blood tests every day. The insulin pump is strapped to his lower abdomen and attached to a needle injected into his belly and he has to wear it 24-7. The needle location has to be changed every three days. While he has not yet mastered the science of changing the needle by himself, he has been doing his own blood tests and carb counts since he was age three. Tyler was already a math whiz, two years before he started kindergarten.

The pump is far less painful than having three or more insulin shots every day and the dosage regulation is also much more precise. But the thing that most amazes me is that TKO does not allow the contraption or the disease to slow him down or prevent him from doing anything he wants to do. I can tell you, for sure that his parents and grandparents cringe and hold their breath every time he slides into second base or home plate but our worry doesnt prevent him from doing so. Apparently, little league baseball players have a deep-seeded, inherent need to slide into bases, even when theres not the slightest chance that the fielders might try to throw them out. Tyler would rather play baseball than eat ice cream and thats a good thing because an ice cream cone could kill him.

Tyler would also be the first person to tell you that we dont participate in the Step Out Walk, hoping for some imminent miracle that would enable him to live without an insulin pump and such a severely restricted diet. And even though we dont totally rule out that remote possibility of a miracle cure, our focus is on kids, like TKO, who are not yet born and we firmly believe that that the American Diabetes Association will eventually provide medical science with the financial resources to fund the research and development to stop diabetes.

By helping sponsor Team TKO in the Step Out Walk-Run you can join our battle, or wed love to have you join us at Keeneland a couple hours after the sun comes up on June 3. There will be tons (literally) of free, healthy food and drinks and we usually have at least one diabetic professional athlete from the NFL or NBA make a speech and sign autographs. Convenient Parking is never a problem.

Ive lost track of the total number of my readers who have helped sponsor Team TKO and me over the last five years, but they number in the hundreds and your total contributions over those years is well over 15 thousand dollars.

If you would like to help sponsor us this year, the easiest way is to go online to stepout.diabetes.org and click on donate at the top of the page, then click on donate to a runner/walker and type in Ike Adams. That will take you to Team TKOs page. I will try to update our progress on a daily basis should you want to check the website to see how we are doing. But please do make sure that you go to the trouble of designating your pledge to me, otherwise we wont know you made it and you will not receive one of Tylers autographed photo thank you notes later this summer.

If you would rather make a paper contribution, simply mail a check made payable to American Diabetes Association, with Team TKO on the memo line. Send it to my home address and Tyler and I will turn it in on Step Out Day: Ike Adams, 249 Charlie Brown Road, Paint Lick, KY 40461.

Reach longtime Enterprise columnist Ike Adams at [emailprotected] or on Facebook or 249 Charlie Brown Road, Paint Lick, KY 40461.

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Team TKO ready to fight diabetes again - The Harlan Daily Enterprise

Dr. Tonatiuh Barrientos Gutierrez, an epidemiologist in Mexico City, jogs near his home in the southern part of the capital. He says it's hard to run on the city's streets. Meghan Dhaliwal/for NPR hide caption

Dr. Tonatiuh Barrientos Gutierrez, an epidemiologist in Mexico City, jogs near his home in the southern part of the capital. He says it's hard to run on the city's streets.

Let's say you'd like to go for a run in Mexico City.

Dr. Tonatiuh Barrientos, an epidemiologist with Mexico's National Institute of Public Health, thinks that's a good idea in theory. An expert on diabetes, he'd like to see more people in the Mexican capital get out and exercise to combat the disease.

But as a runner himself, he knows that Mexico City isn't an easy place to jog. In a metropolis of 22 million, there are only a handful of parks where people can run.

"Look, this is a fairly crowded street. It's a pretty noisy street. It's polluted," Barrientos says walking through the Tlalpan neighborhood that lies between his office and his home. "Now just imagine trying to convince yourself to get out there and run."

Runners in the wooded park of Viveros in Coyoacan, Mexico City. Mexico City has few runner-friendly spaces. The altitude discourages exertion and the air quality is often so bad some runners wear face masks. Yet health officials urge people to exercise more. Meghan Dhaliwal/for NPR hide caption

Runners in the wooded park of Viveros in Coyoacan, Mexico City. Mexico City has few runner-friendly spaces. The altitude discourages exertion and the air quality is often so bad some runners wear face masks. Yet health officials urge people to exercise more.

It's a tough sell. "I mean the only place for you to really run is on the sidewalk. You can't run on the street because you'll probably get run over," he says.

The sidewalk is an uneven mix of broken cement slabs and cobblestones. Street vendors have set up little tables and carts to sell everything from electrical supplies to fried pork cracklings.

There are so many people that it's hard to even walk at a fast clip.

And if you do manage to find a stretch of sidewalk, the elevation in Mexico City combined with the smog and the chances of getting mugged make running a hard thing to get excited about.

"There are a lot of obstacles," Barrientos says as he dodges his way past low-hanging awnings. "And you need to deal with that if you wanted to try to run here."

Professionally, Barrientos has tracked the slow, steady rise in Type 2 diabetes in Mexico. Roughly 14 million Mexicans are now living with diabetes nearly triple the number who had the disease in 1990.

Barrientos says for too long health officials considered it the responsibility of patients to change their diet and exercise routines. They either did it or didn't. He says now it's become clear that addressing one of Mexico's biggest health crises requires changes at a much higher level and includes lobbying for healthier public spaces where people can easily get out and exercise.

Exercise equipment, often placed in public parks like this one in the Tlalpan area of Mexico City, encourages residents to be more active. Meghan Dhaliwal/for NPR hide caption

Exercise equipment, often placed in public parks like this one in the Tlalpan area of Mexico City, encourages residents to be more active.

"How do we change the world so that making healthy decisions is a lot easier than it is right now?" he asks.

Diabetes has mushroomed as Mexicans' lifestyles have changed dramatically over the last 40 years. Several generations ago diabetes was almost unheard of in Mexico. Now it's the leading cause of death, according to the World Health Organization. Mexicans with indigenous ancestry have a genetic predisposition for the condition that makes them even more likely to develop it than Caucasians. But a key driver of Type 2 diabetes in Mexico and globally is still a person's diet.

Barrientos says current projections show that by 2030, 17 percent of all Mexican adults will have diabetes.

"And that of course opens a lot of questions about sustainability," he says. "Can you really sustain a public health system with 17 percent of your population being diabetic? Especially if you are not prepared to control that diabetes."

Some epidemiologists predict that by 2050, half the adults in the country could suffer from diabetes in their lifetime.

Diabetes can be reversed with weight-loss surgery in some cases. Uncontrolled, the metabolic disorder can have grave health consequences. It can lead to blindness, nerve damage, kidney failure and, in some cases, foot amputations.

Barrientos and others are now saying the focus of diabetes prevention in Mexico needs to shift away from shaming individuals to looking at new government policies to tackle this mounting health crisis.

"With tobacco we faced the same thing for many, many years. We were trying to encourage people to quit: Because if you don't quit you're going to die!" he says. "The only time that we started to see real change was when we said, 'We are going to change the rules of the game.' The more expensive it is the less you're going to be willing to spend your precious money on something that isn't good for you."

A variety of fried snacks and soft drinks are for sale in Mexico City's Centro Historico neighborhood. Meghan Dhaliwal/for NPR hide caption

In an effort to reduce soda consumption, the government in 2014 imposed a 1 peso per liter tax on sugar sweetened beverages, the equivalent of about 10 U.S. cents on a standard 2 liter bottle.

At the time Mexico was the leading per capita consumer of soda in the world. In regulatory filings in 2015, Coca-Cola said that the annual consumption of its beverages in Mexico was more than 600 8-ounce servings per person per year. That means that, on average, every Mexican was drinking nearly two glasses of Coke beverages every day. And that doesn't even count the amount of Pepsi or other brands of soda being consumed.

Alejandro Calvillo, the head of a consumer group called El Poder del Consumidor, says soda is making Mexicans sick.

Walking just outside his office in Mexico City, he points out little shops selling Coke and junk food on just about every block. In fact, the red Coca-Cola logo has become a symbol that declares snack shop.

"Coke in Mexico has more than 1.5 million places that sell Coke," Calvillo says. "The presence of these products is everywhere." Calvillo was one of the advocates behind the 2014 soda tax, although he would have liked the tax to have been even higher. A higher tax, he argues, would have pushed down consumption even more and given the government more resources to combat the lifestyle that's linked to diabetes. In indigenous communities in Chiapas, he says, parents put Coke in baby bottles for their infants "and the government isn't doing anything. It's crazy."

Like Barrientos, he says that if Mexico is going to successfully combat diabetes, the rules of the game need to change.

His efforts to get the soda tax increased even more, however, have so far been unsuccessful.

But Jorge Terrazas, the head of ANPRAC, the carbonated beverages trade association in Mexico City, says soda is unfairly blamed for Mexico's extremely high rates of obesity and diabetes.

"There's not conclusive scientific evidence demonstrating the relation between the intake of soft drinks with overweight," he tells NPR.

The average Mexican's daily intake of calories far exceeds the World Health Organization recommendation of 2,000, and Terrazas says the majority of those calories are coming from things other than soda.

But anti-soda campaigners says sugar is a big part of the problem. They say calling for solutions that rely on individuals alone to change their lifestyles won't solve Mexico's diabetes crisis.

Barrientos, the epidemiologist and runner, says the solution is going to require major changes to the way Mexicans live, eat and exercise.

Visit link:
Diabetes In Mexico: A Challenge To Improve Diet And Exercise - NPR - NPR

Anais Martinez is on the hunt in Mexico City's Merced Market, a sprawling covered bazaar brimming with delicacies. "So this is the deep-fried tamale!" she says with delight, as if she'd just found a fine mushroom specimen deep in a forest.

The prized tamales are wrapped in corn husks and piled next to a bubbling cauldron of oil.

"It's just like a corn dough patty mixed with lard, put in a corn husk or banana leaf, steamed and then deep fried," says Martinez of this traditional Mexican breakfast. "And then after you fry it, you can put it inside a bun and make a torta [sandwich] out of it. So it's just like carbs and carbs and fat and fat. But it's actually really good."

And it only costs 10 pesos roughly 50 cents.

Martinez is a designer in Mexico City. She studied gastronomy here and now moonlights for a company called Eat Mexico giving street food tours.

Deeper in the market there's an area packed with taco stalls. Customers stand at the counters or sit on wobbly plastic stools. The young cooks fry, flip and chop various meats into tortillas. They pound strips of flank steak out on wooden cutting boards. Piles of red chorizo sausage simmer in shallow pools of oil. Yellow slabs of tripe hang from meat hooks.

We've just come to one of Martinez's favorite taco stands. Its specialty is pork tacos served with french fried potatoes piled on top.

"The pork is really thinly sliced, rubbed with chiles and spices and then they fry it," Martinez says as the meat sizzles on a long steel griddle in front of her. "Also, really good."

Rich, fatty street food like this is available all over Mexico at bus stops, at schools and on street corners. And it's affordable to the masses. A heaping plate of Martinez's favorite pork tacos costs less than a dollar.

All that cheap food in a country where incomes are rising is contributing to Mexico's massive diabetes epidemic.

Diabetes is now the leading cause of death in Mexico according to the World Health Organization. The disease takes an estimated 80,000 lives each year. Nearly 14 percent of adults in this country of 120 million suffer from the disease one of the highest rates of diabetes in the world. And it's all happened over the last few decades.

For roughly $2 a day, people in Mexico can now afford a diet heavy in carbohydrates, sugar and fat that delivers way more calories than the WHO's recommended daily intake of 2,000. A study in 2015 showed Mexico to be the leading consumer of junk food in Latin America, consuming 450 pounds of ultraprocessed foods and sugary beverages per person each year.

Until just recently Mexico was the largest per capita consumer of soda in the world, chugging down 36 gallons of sugary drinks per person per year. That dubious distinction now falls to Argentina, with the U.S. and Chile not far behind.

Excessive body fat is one of the main contributors to the onset of Type 2 diabetes. And obesity rates have been climbing steadily in Mexico. It's now one of the world's most overweight countries, coming in just behind the United States.

Mexican health officials are well aware of the crisis. Late last year, the health minister declared diabetes and obesity to be public health emergencies the first time they'd made such a declaration that wasn't targeting an infectious disease.

"Diabetes is one of the biggest problems in the health system in Mexico," says Dr. Carlos Aguilar Salinas at the National Institute of Medical Sciences and Nutrition in Mexico City. "It's the first cause of death. It's the first cause of disability. It's the main cost for the health system."

Treating a patient with a severe case of diabetes in Mexico, he says, can cost upward of $40,000 a year. But the bigger problem, Aguilar says, is that the Mexican health system isn't prepared to treat the sheer number of diabetes patients with serious medical complications who show up in its clinics every day.

"The Mexican health system is very efficient to treat infectious disease," he says. But chronic disorders like diabetes, which require lifelong attention and medical monitoring, call for a different skill set from doctors. And Mexico's health system is still adjusting to this shift toward treating chronic disease.

Recognizing how daunting it is to treat diabetes, Mexican officials are trying to prevent it in the next generation. In 2014 the country slapped a controversial 5 cents per liter tax on soda. New rules bar advertisements for high calorie junk food aimed at children. Public service announcements encourage people to exercise more. And there's a major push to restrict the sale of soda and junk food in schools.

The head of the World Health Organization's office in Mexico, Dr. Gerry Eijkemans, says diabetes is a huge challenge to health care systems throughout Latin America.

"Diabetes used to be a disease of the rich," she says. "In Western Europe and the U.S., it was really the people who had the money who were obese, and now it's actually the opposite."

This is forcing already overstretched public health systems in Latin America to devote more resources to this complex disease.

"In order to prevent an infectious disease, you reduce the mosquitoes and basically you're done," Eijkemans says. "Not that it's easy, but it's much easier than changing a lifestyle, changing the way a society is basically organized [to encourage] people to consume unhealthy food with lots of fat and sugar."

An article earlier this year in the medical journal The Lancet warned: "Rising levels of increasingly severe obesity mean that, worldwide, populations are on the brink of a catastrophic epidemic of diabetes."

In Latin America, Mexico isn't on the brink of that epidemic, it's already there.

See more here:
Pork Tacos Topped With Fries: Fuel For Mexico's Diabetes Epidemic - WAER

Newser

A New Warning About Gestational Diabetes Newser "Women with small weight gains within the healthy BMI range doubled their risk of gestational diabetes compared to women whose weight remained stable," says researcher Akilew Adane, with "small" being defined as a gain of 1.5% to 2.5% of body weight a ...

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A New Warning About Gestational Diabetes - Newser

Angela Loucks remembers Dec. 11, 2011, as a day that would change her daughters life forever.

When the doctor at Peninsula Childrens Clinic told her Chloe, then 4-years-old, had Type 1 diabetes and was insulin dependent, Loucks broke down in tears.

Chloe took the news a little better than her mom.

She leaned over and put her hand on me and told me itd be OK, Loucks said.

And it has been OK for the Loucks family, they say.

At first, Loucks said she thought Chloes symptoms of extreme thirst and hunger were part of growing up but the diagnosis that their daughter now had a chronic condition was a culture shock. In time, lifestyle changes came and the Loucks family including dad Larry and sister Emily began to make healthier food choices in support of Chloe.

Being diabetic hasnt taken away her childhood either. Chloe still rides her bike, jumps on the trampoline, goes to birthday parties and trick or treats on Halloween. Treats are just eaten in moderation.

Its just a way of life for her now, Loucks said.

I dont really know anything different, Chloe said.

On and off

Traveling for care is a way of life for many young diabetics, too a functional reality for many local diabetics. The Olympic Peninsula has been without an endocrinologist, a doctor specializing in hormonal imbalances in the endocrine system, for more than a year.

Dr. Josh Jones, chief physician officer for Olympic Medical Physicians, said his group is not recruiting a new endocrinologist for a number reasons, but mainly because of their rarity.

Its difficult to have a solo, lone doctor of any kind of specialty of any kind of coverage, Jones said. There was plenty of need. We werent able to create a program and the clinical infrastructure around the endocrinologist.

Chloe and her family travel to Seattle Childrens every three-four months to see an endocrinologist while others travel to Swedish Pediatrics or Mary Bridge Childrens in Tacoma.

Dr. Jeff Weller, a pediatrician at Peninsula Childrens Clinic, said bringing in a pediatric endocrinologist is even more rare.

Its nearly impossible to have sub-specialists in a rural area, Weller said. All sub-specialists work at a tertiary care center like Mary Bridge.

To offer a local option, Seattle Childrens sends a team including a pediatric endocrinologist to Peninsula Childrens Clinic one day every three months to meet with children with diabetes.

Weller said that interval matches routine appointment schedules in bigger areas.

Waiting

Casey Vass of Sequim has five children and her youngest Kylus, 2, has been a diabetic for about a year. They met with Seattle Childrens endocrinology team in late February in Port Angeles, but Vass said there was such a backlog of patients they waited for more than four hours.

Vass said its easier for her family to travel to Seattle Childrens than wait that long again.

I want him to be monitored and know were doing what we need to be doing, she said.

I cant see putting my family through this every four months.

Shes traveled to Seattle for various diabetes education classes and appointments and since February shes called the clinic twice about filling a prescription and advice on dealing with the stomach flu.

Hes growing so fast that were adjusting his (insulin) numbers every time we go in, she said.

Time is the hardest part of managing her sons diabetes, Vass said.

Its so time-consuming, she said. Its all day with all the food and medical and insurance stuff.

Options

Sadie Crowe of Port Angeles has similar struggles with diabetes on the peninsula.

Crowe, 38, grew up a Type 1 diabetic in Sequim and her daughter Roslyn, 7, has lived with the autoimmune disease for four-plus years, too.

When Roslyn was diagnosed, we really considered whether we should stay here, Crowe said.

They dont provide the level of care we need for Type 1 diabetes here.

Both mother and daughter wear insulin pumps and Roslyn sees a doctor at Mary Bridge Childrens every three months.

It would be life changing for us if we didnt have to drive to Tacoma for care, she said.

Roslyn sees local physicians for immunizations, colds and other basic care but Crowe said when a diabetic is sick you get a little sicker.

Well call the endocrinologist sometimes because if we cant get the diabetes under control, then we cant stop the virus, she said.

On average, Roslyn has traveled about once a year to Tacoma for Mary Bridges pediatric intensive care unit, Crowe said.

Care

The total number of diabetics, Type 1 or 2, isnt known on the Olympic Peninsula, but the Juvenile Diabetes Research Foundation estimates there are more than 1.25 million Americans with Type 1 diabetes.

The Centers for Disease Control and Prevention estimates about 26 million Americans have diabetes.

Type 2 diabetes, usually diagnosed in adults, is a metabolic disorder where a person can still produce insulin but cannot use it as well.

Vickie Everrett, supervisor of nutrition counseling and a diabetes educator for Olympic Medical Center, said they see and treat diabetes as an epidemic.

We want to change the mindset of people, she said.

Through her programming, she sees about 600 people annually for diabetes education with about 30 of those Type 1.

It isnt just, Youve got to lose weight and move more, Everrett said. Its really sitting down with them and talking with them about how they fix food, what kind of food access they have and what are their physical abilities in order to get their best medical care.

Some of the things they cover includes diabetes self-management and self-training, counseling services, and they offer a monthly support group from 6:30-7:30 p.m. the fourth Tuesday of each month at Olympic Memorial Hospital.

Everrett said she typically doesnt work with children under 18 and that patients are usually referred by primary care physicians for diabetes assistance.

Weller said when juvenile diabetics are diagnosed they are sent to a tertiary center like Seattle Childrens to be stabilized and work with a diabetes educator.

Everrett said theyve implemented a diabetes prevention program that starts again in August and is covered by Medicare in 2018 for patients who participated in the Center for Disease Controls diabetes program the past three years.

Possibile fixes

While options may be limited, physicians like Jones and Weller want to look for more collaboration.

We can leverage some of our electronic health records to help primary care care doctors provide better care especially around diabetes, Jones said.

Everrett agrees, saying there are a lot of people with diabetes and with early risk factors such as being overweight, a more sedentary lifestyle and those older than 60 who need enhanced support.

That defines a large part of our population, she said. But their providers have to refer them to the (diabetes education) service.

Even though diabetics may prefer to see a specialist, most local diabetes care is not provided by an endocrinologist, Jones said.

For the chronic ongoing care, their care will live in their primary care provider, he said.

Both types of diabetes can be managed by a primary care provider, Jones said, and in more complicated cases theyll consult a specialist.

Weller said tertiary centers are good about having phone access and Olympic Medical Center officials are looking to grow telemedicine offerings through secure, video-to-video in the future.

Peninsula Childrens Clinics recent partnering with Olympic Medical Physicians, also provides a lot of opportunities for growth and opportunity, Jones said, but there are no current plans regarding juvenile diabetes aside from current operations.

Hope

Traveling to Seattle Childrens takes a full day every three months for one of Chloes appointments, Loucks said.

But Chloe looks at the appointment as a fun trip, she says, and only dreads a scheduled arm poke for shots.

For me, whats more important is that she is comfortable and everything is a good fit rather than the cost of gas and traveling for a whole day, Loucks said.

After four-plus years of a strict diet, finger pricks and insulin injections through her pump, Chloe remains hopeful for a cure.

Once a year, she and her family make and sell baked goods at her great-grandmothers garage sale with proceeds benefiting diabetes research.

Im very hopeful, Chloe said.

For more information on Type 1 diabetes and juvenile diabetes, visit http://www.jdrf.org and for more on general diabetes research and information, visit http://www.diabetes.org.

For more information on Olympic Medical Centers Diabetes Prevention Program, call 417-7125.

Reach Matthew Nash at mnash@sequimgazette.com.

Diabetics like Chloe Loucks, left, continue to do everyday things like jump on a trampoline with her sister Emily but in the winter months its been hard to be active, she says. Sequim Gazette photo by Matthew Nash

Eating healthy food is an important part of controlling blood sugars for diabetics. For Chloe Loucks, right, she checks with her mom Angela most of the time before eating snacks like peanut butter crackers, applesauce and yogurt which can bring blood sugar levels up.

Chloe Loucks, left, stands with her family, dad Larry, mom Angela, and sister Emily, on March 8 at the Regional Outreach Luncheon Meeting for Clallam & Jefferson County at Sunland Golf & Country Club. Chloe and Larry spoke about how much Seattle Childrens Hospital has helped her with treatment. The guilds have helped more than 1,400 patients receive $1.2 million in uncompensated care. Sequim Gazette photo by Matthew Nash

Excerpt from:
Locals choose out of area diabetes services due to availability - Sequim Gazette

In Brief Scientists have used a new drug to reverse diabetes in mice. The drug inhibits the enzyme LMPTP, which contributes to the development of Type 2 diabetes by weakening the body's sensitivity to the hormone. Defining Diabetes

In the global community, the number of people with diabetes has been on the rise since1980, with 422 million people diagnosed by 2014.The U.S. alone has experienced a substantial rise in the incidence of diabetes, with the number of Americans diagnosed increasing from 5.5 million in 1980, to 22 million in 2014a more than 300percent increase in less than 40 years.

Ateam of researchers, led by Stephanie Stanford at the University of California, San Diego, is proposinga solutionin the form of a single pill that aims to restore insulin sensitivityin diabetic patients. Type 2 diabetes develops when the bodys response to insulin, the hormone responsible for regulating sugar in our blood, weakens.A number of genetic and lifestyle factors will influence whether or not someone developsthis type of diabetes in their lifetime.

Up until now, drugs were unable to restore the insulin signaling function in diabetic patients instead, theywork by filtering out excess glucosein the blood that comes as a result of the dysfunction. The drug produced by Stanfords team, on the other hand, hopes to restore function.

The drug inhibits an enzyme called low molecular weight protein tyrosine phosphatase (LMPTP), which is suspected to contribute to the reduction in cell sensitivity to insulin. With reduced LMPTP activity, the drug reenables insulin receptors on the surface of cells particularly those in the liver which in turn restores the cells ability to regulate excess sugar. When the body can once again regulate blood sugar levels, the condition of Type 2 diabetes is effectively reversed.

The researchers fed lab mice a high-fat diet that made them obese, which subsequently caused them to develop high blood glucose levels. The drug was given to themice on a daily basis and successfully restored insulin sensitivity withoutproducing any adverse side effects.

While the mouse trials results are exciting, the team must continue testing the drug for safety, sohuman clinical trials are still some time away. But Stanford is confident that the drug could lead to a new therapeutic strategy for treating type 2 diabetes,

While we have seen diabetes reversal in patients before,it has never been achieved through medication alone. So, if this drug is approved for use in humans it would be a truly revolutionary treatment.

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A New Drug May Be Able to Completely Reverse Diabetes - Futurism

A family sells pastries in Mexico City. As Mexicans' wages have risen, their average daily intake of calories has soared. Meghan Dhaliwal/for NPR hide caption

A family sells pastries in Mexico City. As Mexicans' wages have risen, their average daily intake of calories has soared.

Mario Alberto Maciel Tinajero looks like a fairly healthy 68-year-old. He has a few extra pounds on his chest but he's relatively fit. Yet he's suffered for the last 20 years from what he calls a "terrible" condition: diabetes.

"I've never gotten used to this disease," he says. Maciel runs a stall in the Languilla market in downtown Mexico City. This market is famous for its custom-made quinceaero dresses and hand-tailored suits.

Diabetes has come to dominate Maciel's life. It claimed the life of his mother. He has to take pills and injections every day to keep it under control.

"I've never gotten used to this disease," says Mario Alberto Maciel Tinajero, at his dress shop in the Lagunilla market. "Imagine not being able to eat a carnitas taco!" Meghan Dhaliwal/for NPR hide caption

"I've never gotten used to this disease," says Mario Alberto Maciel Tinajero, at his dress shop in the Lagunilla market. "Imagine not being able to eat a carnitas taco!"

And because of the disease he's supposed to eat a diet heavy in vegetables that he views as inconvenient and bland. "Imagine not being able to eat a carnitas taco!" he says with indignation. His doctors have told him to stop eating the steaming hot street food that's for sale all around the market tacos, tamales, quesadillas, fat sandwiches called tortas. His eyes light up when talks about the roast pork taquitos and simmering beef barbacoa that he's supposed to stay away from.

"A person who has to work 8 or 10 hours has to eat what's at hand, what's available," he says. "It's difficult to follow a diabetic diet. The truth is it's very difficult."

Diabetes is the leading cause of death in Mexico, according to the World Health Organization. The disease claims nearly 80,000 lives each year, and forecasters say the health problem is expected to get worse in the decades to come. By contrast, in the U.S. it's the sixth leading cause of death, with heart disease and cancer claiming 10 times more Americans each year than diabetes.

Rising rates of obesity combined with a genetic predisposition for Type 2 diabetes has caused a slow steady rise in the condition in Mexico over the last 40 years. Now roughly 14 percent of adults in this country of 120 million are living with what can be a devastating and even fatal health condition. Diabetes poses an increasing burden on the nation's hospitals and clinics. The surge in diabetes threatens the very stability of Mexico's public health care system, according to new reports.

For many people with diabetes in Mexico, like Maciel, managing the condition is a constant and significant challenge.

"I'd say I have it about 50 percent under control," he says, even though he was diagnosed two decades ago. "I take my medicine. I inject my insulin twice a day, in the morning and the night. I try to eat a proper diet as much as I can."

At times he says he can't afford his medications. And trying to cut down on the amount of sugar, salt and fat in his diet, as his doctors tell him he should, is easier said than done.

And Maciel's experience helps explain how Type 2 diabetes has become the leading cause of death in Mexico.

Type 2 diabetes is often considered a lifestyle disease because it's far more likely to develop in people who are overweight. Mexico has seen a rapid increase in obesity, with the number of people categorized as overweight and obese tripling over the last four decades.

The obesity problem is in part a side effect of Mexico's economic progress. As wages have risen, the average daily intake of calories has soared. In 2012 Mexico was the world's top per capita consumer of soda in the world guzzling 176 liters per person per year, according to the Mexican government. That's nearly 500 cans of soda for every man, woman and child. (Mexico was recently overtaken by Argentina, the U.S. and Chile.) Coca-Cola is practically the national drink in Mexico. Type 2 diabetes has skyrocketed as soda consumption has risen.

"In the middle of the 1970s and especially after the '80s, the prevalence of diabetes exploded," says Dr. Carlos Aguilar Salinas, the vice head of the endocrine department at Mexico's National Institute of Medical Sciences and Nutrition in Mexico City.

"Diabetes is now one of the biggest problems in the health system in Mexico," he says. It's the first cause of death. It's the first cause of disability. It's the first cause of early retirement. It's the main cost for the health system."

Diabetes costs the Mexican health care system billions of dollars each year.

The disease can lead to serious eye problems including blindness, nerve damage that requires amputations and kidney failure, among other issues.

Mexico's public health care system attempts to manage the huge number of people with diabetes by trying to get them to manage their blood sugar levels, alter their diet and exercise more.

But there diabetes is typically a lifelong condition. Once someone is diagnosed, the goal is to get the disease under control and keep it from getting worse.

Just around the corner from where Mario Alberto Marciel Tinajero has his dress-making shop, Dr. Rosa Estrella Calvillo Gomez runs a one-room medical clinic in the Languilla market.

Dr. Estrella Gomez says her patients don't want to accept that they have a disease for which there is no cure. "Tell me anything but don't tell me I'm a diabetic," they say to her. Meghan Dhaliwal/for NPR hide caption

Dr. Estrella Gomez says her patients don't want to accept that they have a disease for which there is no cure. "Tell me anything but don't tell me I'm a diabetic," they say to her.

The free clinic was set up by the local government. People can come in for any kind of health problem. But Calvillo says roughly half her patients are coming for complications with diabetes.

"Diabetics don't just come in with high blood sugar," Calvillo says sitting behind a desk overflowing with promotional drug samples that she gets from pharmaceutical representatives. "It's about controlling multiple health problems at once," she says, and most of her patients with diabetes don't have the disease under control.

"The problem that I have here first, is the denial and second, the cost of the medication."

Patients don't want to accept that they have a disease for which there is no cure. "Tell me anything but don't tell me that I'm a diabetic,'" she says they tell her. She melodramatically puts her hands over her eyes and shakes her head. "They deny it."

Also, diabetes isn't an easy condition to manage. The public health system treats severe complications like nerve damage or blindness, although dialysis and kidney transplants are not available. For the daily management of diabetes, patients are largely on their own.

Easy access to rich foods, such as those sold at this bakery in a Mexico City Metro station, contributes to Mexico's high rates of obesity and diabetes. Meghan Dhaliwal/for NPR hide caption

Calvillo says a diabetic can easily spend $150 a month out of pocket on insulin injections, blood sugar test strips and medications for hypertension and other complications.

"To get excellent control of diabetes costs a lot of money," she says, "It costs as much as renting an apartment."

Mario Alberto Maciel Tinajero is one of the doctor's patients. He says coping with the disease is a real struggle, and many people with diabetes are desperate.

"The most dangerous thing for diabetics is to fall into the hands of charlatans, swindlers who offer miracle products," he says.

As diabetes took its final toll on his mother, he watched as she spent thousands of pesos on useless he thinks possibly even toxic herbs and injections. After both her feet had been amputated and doctors were only offering palliative care, salesmen came along offering "magical" injections, alleging that they'd give her relief.

"With the promise of a cure, you can be left in the street with nothing," he says. "Absolutely nothing."

Maciel is grateful to have Dr. Calvillo to help him grapple with the condition.

"If this clinic didn't exist," he says, "I would be dead."

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How Diabetes Got To Be The No. 1 Killer In Mexico - NPR

Newser

Researchers Developing Contact Lens to Help People With Diabetes Newser (Newser) People with diabetes can monitor their blood glucose levels continuously by using electrodes implanted under their skin, but that method can be painful and can even lead to infections. Researchers think they have a more elegant solution: a ... Researchers develop contact lens that tells people with diabetes ...The Independent Contact lens could help people with diabetes and identify other medical conditionsDiabetes.co.uk BIONIC contact lens could be breakthrough for patients with diabetes - and THIS is whyExpress.co.uk all 11 news articles »

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Researchers Developing Contact Lens to Help People With Diabetes - Newser

Somerset County Health Department...

SOMERSET COUNTY, Md. - According to the Centers for Disease Control and Prevention, more than 25 million people through out the U-S have diabetes and one local county is hoping to bring those numbers down through a new campaign.

Drivers on Route 13 nearEden may notice a new billboard, as Somerset County Health Department is using this as one tool to showcase their new campaign called "Know Your Numbers".

This campaign is to more awareness on the key indicators that would put a person at risk for prediabetes, which could leave to Type 2 Diabetes.

Community Health Educator at the Somerset CountyHealth Department, Crystal Bell tells 47 ABC that Type 2 Diabetes is the most common form of diabetes.

We are told Type 2 Diabetes is rising and it's an epidemic, which is why the state of Maryland has launched this initiative to try to prevent it.

The health department says many individuals do not understand the risks of being prediabetic.

A PRMC nutrition and diabetes coordinator, Susan Cottongim, tells us there are three numbers to notice for those risks.

One includes the A1C testing, which is a reflection of blood sugar for a 3-month period.

A1C numbers between the range of 5.7 and 6.4 can indicate that you are in a prediabetic state.

As for the other two numbers to look at is high blood pressure and cholesterol.

Somerset County Health Department is hoping that through their new campaign, they can help residents identify those risks.

Bell states, "A primary risk factor is being overweight, not being physically active when you're over the age of 45, the metabolism slows down a little, so we say if you're over the age of 45 definitely your risk factors will increase."

The Health Department warns residents if you do not control it in it's prediabetic state, getting Type 2 Diabetes can lead to even bigger issues, such as blindness, heart disease, and kidney disease.

And because of those measures, Somerset County Health Department is hoping to make a difference through providing program.

One program is the free Diabetes Prevention Program.

This program is a year long and they meet once a month.

We are told they have already seen about 40 participants.

The program tries to help those that need to lose weight as well as those just pushing for a healthier lifestyle.

In order to help yourprediabeticstate controlling your intake is key.

For example, for your beverage choices, drinking less drinks with sugar. Food wise, portion control is a major factor by focusing on food groups such as fruits and vegetables.

If you click here, they even offer free resources, education, as well as a prediabetes risk assessment test.

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Somerset County Health Department creates new campaign to prevent Type 2 Diabetes - WMDT

Hindustan Times

Urine metabolites may help predict which obese teens will develop diabetes Science Daily Researchers have discovered a unique metabolic "signature" in the urine of diabetic, obese black teenagers that they say may become a way to predict the development of type 2 diabetes in people at risk. They will present their results Tuesday at the ... Avoid night shifts if you have diabetes. Late hours make condition harder to controlHindustan Times all 5 news articles »

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Urine metabolites may help predict which obese teens will develop diabetes - Science Daily

WYDaily.com is your source for free news and information in Williamsburg, James City & York Counties.

Healthier lifestyles, including regular exercise and better eating habits are all goals most diabetes patients are striving for.

Kendra Robinson, a certified diabetes educator at Old Towne, believes these goals, plus learning from each other in a group setting is essential in managing the disease.

At Old Towne Medical Center, group medical visits are an option for patients with Type 2 diabetes a program that has been successful for the past eight years.

Robinson follows 400 diabetes patients, and said those who do group visitswhich include four to five patientshave better outcomes than those who are seen individually by doctors.

These patients tend to follow through more than patients we are seeing one on one, Robinson said.

During group visits, doctors and nurses give patients information about medications and nutrition, but the patients learn how to manage the disease from each other, Robinson added.

Ultimately, diabetes is a disease that is self-managed, Robinson said. Lifestyle modification is the number one treatment.

Type 2 diabetes, distinct from type 1 diabeteswhich is caused by genetic mutations or virusesoften develops from lifestyle factors, namely obesity.

March 28th marked the American Diabetes Association (ADA)s nation-wide Alert Day, in which it invites all Americans to take a diabetes risk test on its web site: http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/?loc=alertday

According to the ADA, the biggest risk factor for diabetes is becoming overweight by overeating.

Not surprisingly, dietary changes are the biggest obstacle diabetics need to overcome, Robinson added. Access to healthy food is a challenge. Changing age-old eating habits is very difficult.

With that in mind, Old Towne also offers cooking classes and grocery store tours for diabetes patients.

During the classes, they make healthy meals, and then send everyone home with a bag of groceries and healthy recipes. They also go to the grocery stores where patients are most likely to shop.

We teach them how to get the most bang for buck; read a food label; use a coupon, Robinson said.

Its a big hit because at the end of the tour, everyone gets a little gift card to buy some things they learned about on the tour that they never tried before.

This spring Old Towne plans to launch an eat out program, which will target older men who are either widowed or single and tend to eat out a lot.

The idea is to go to the restaurants where they regularly eat and help them select healthy food items.

Old Towne also has a medications assistance program that provides diabetes medications for free, Robinson said, and the Sentara Williamsburg Regional Medical Center provides discounted rates for diabetes-related testing.

This financial help is significant because diabetes can be an expensive disease to manage. At Old Towne 76 percent of patients are uninsureda number that is rising, according to Janis C.L. MacQueston, Old Towne Director of Development.

The patient population also tends to be fairly transient. Of the 400 diabetes patients that Robinson follows, between 250 and 300 come regularly, meaning every three to six months.

For those who stick around for a while, control is pretty good, Robinson said.

But the attrition rate is high, and they constantly get new patientsespecially young adults who were obese in childhood and carried that into adulthood, she continued.

According to the Virginia Atlas of Community Health, six percent of the population over age 19 in Williamsburg has type 2 diabetes, and 25 percent of the population between the ages of 14 and 19. In James City County, ten percent of the adult population has diabetes, and 37 percent of teenagers.

Many patients test for diabetesat one of Old Townes free walk-in clinicswhen they already have tell-tale signs of the disease, like blurry vision or frequent sweating, Robinson said.

We check their blood sugar, and its off the charts, she added.

Another program in Williamsburg at the Peninsula YMCA called the Diabetes Prevention Program tries to help people before they even get to that point. It enrolls people with prediabetes, which can morph into diabetes, usually within five years, if left untreated.

The program is nationwide, has beenimplemented in 252 YMCAs throughout the U.S., and follows CDC guidelines, saidMichael Bennett, the regional director of operations and chronic diseases at the Peninsula YMCA.

Bennett said theyve enrolled 32 people locally.

So far weve had really good stories, he said. The facilitator gives them tools, and the participants help each other out. They become a support system for each other.

The goal is for people to lose five to seven percent of their body weight, and engage in 150 minutes of physical activity each week.

Michael Maguire, age 71, did the same prevention program at the Victory Family YMCA in Yorktown. He was pre-diabetic before doing the course.

Unfortunately, I inherited the family susceptibility to diabetes, and I was headed to full-fledged type 2 [diabetes], Maguire said.

He weighed a little over 200 pounds at the beginning of the course, which he started in December, 2015. A year later, he was down to 182and his A1C was below the pre-diabetic range.

Achieving these numbers has meant eating fewer sweets and carbs. Once he found himself in the middle of a heavy meal, actually opting for a salad instead.

For most people, it took forty to fifty years to develop the lifestyle of diabetes. You cant undo that in forty or fifty days, but you can in forty to fifty weeks, he said, adding that the program is slow-paced and very supportive.

The Williamsburg Health Foundation gave the YMCA a $45,000 grant to sign up 75 new people by the end of the year, Bennett said.

Were trying to encourage people to nip it in the bud, he said.

For more information on the YMCA program, people can call 757-342-5338, or visit the YMCA web site: http://www.peninsulaymca.org/diabetes/.

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Group medical visits key with managing diabetes | Williamsburg ... - Williamsburg Yorktown Daily

Special to the Journal

Hinghams Ryan Enright was diagnosed with a unique form of diabetes, known as latent autoimmune diabetes in adults (LADA), in 2010 and this year, Enright will be running his 20th Boston Marathon for Joslin Diabetes Center, where he receives his diabetes care from Dr. Elena Toschi.

Since being diagnosed six years ago, the 44-year-old has learned how to manage and cope with his diabetes with the help of the doctors, educators and staff at Joslin, which is especially important for a seasoned marathoner.

Enright is running 40-50 miles each week in preparation for his 25th marathon, doing his long runs on the weekends in Hingham and logging miles along the Charles River during the week. He wears a continuous glucose monitor (CGM) to monitor his blood sugar levels as he runs, and has had to experiment with the settings to ensure he does not go high or low as his distances increase.

My hope is that the funds I raise will benefit Joslin and their team of researchers in their battle to find a cure, said Enright. This is a very specialyear for me given that it will be my 20th consecutive Boston Marathon and I am so grateful that I have the resources at Joslin who make it possible for me to make that left on Boylston Street and cross the finish line. Running on Team Joslin for the second year in a row has allowed me to elevate the awareness of this great organization and educate people on what diabetes is all about, and how it can be prevented and treated. I credit the education, passion and mission of Joslin for helping me not miss a step on my way to Boston number 20.

Ryans goal is to raise $10,000 for Joslins High Hopes Fund. For more information or to donate, visit Ryans CrowdRise page: https://www.crowdrise.com/JoslinDiabetesCenterBoston2017/fundraiser/ryanenright.

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Hingham man running 20th consecutive marathon despite diabetes - Wicked Local Hingham

PortCityDaily.com is your source for free news and information in the Wilmington area.

Donna Livingston has a sweet tooth. Cookies, soft drinks, sweet tea. She likes her sugar.

Livingston, age 59, had never thought about the consequences of her cravings until she retired in 2011 from her career as a high school math teacher at New Hanover High School in Wilmington.

Over the next few years, she noted a rise in her health insurance premiums. To bring them back down, her health insurance company said that she would need to have a health assessmentwhich included an A1C reading, the average of three months of blood sugar levels.

Her A1C was 5.6, which is borderline normal. A blood sugar of 5.7 is considered pre-diabetes, and 6.5 is diabetes. But Livingston was overweight160 pounds on her 54 frame. She had other worrisome health measures. So, the state lumped her in the pre-diabetic category.

It kind of scared me that I was at risk for diabetes, Livingston said, recalling that her maternal grandfather had the disease, but neither of her parents had it.

What Livingston learned about diabetes, she didnt like.

It can affect a lot of organs. You can get amputations because of it, she said. You can be on meds for the rest of your life.

Livingston didnt want to go down that path, so she consulted a nutritionist, and later saw an ad in the paper for a diabetes prevention course at the YMCA, and signed up.

The YMCA course is part of a nation-wide CDC effort to curb the diabetes epidemic in the U.S. According to the American Diabetes Association, in 2012 nearly 10 percent of the population had diabetes, or 29.1 million people. Another 86 million Americans had pre-diabetesan increase of 79 percent from 2010.

March was national diabetes awareness month, and last Tuesday was diabetes alert day, in which the ADA invites all potentially at-risk Americans to take its online assessment, which can be taken at any time: http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/?loc=alertday

The CDC diabetes prevention program, which is active at YMCAs in 47 states, has enrolled more than 50,000 people. At the Wilmington YMCA, over 130 people enrolled in the first year-long program, which started in October, 2015.

Our goal is really to help people get in front of (diabetes), said Marjorie Lanier, the diabetes prevention program coordinator at the Wilmington YMCA. (The program has) been replicated over and over again. There is a lot of evidence that people enrolled in program can cut their risk in half.

The course is group-based, with no more than 15 people in any one group. They meet weekly for classes, and are also required to do 150 minutes of exercise per week.

The power in that is that the groups are all in the same boat, working toward similar goals, Lanier said. That peer support is really powerful.

The next courses begin in May, and more information is at the YMCA website:https://www.wilmingtonfamilyymca.org/programs/diabetes-prevention-program/

Livingston, who finished the program in February, agreed that sharing ideas with her classmates was one of the most useful parts of the program. Most importantly, she learned how to control portions and make better food choices, like cutting out fried food and limiting pasta.

Ive never been a diet person, but this is a program that you can live with. Youre eating regular food, Livingston said.

She eats more salads, fruit and veggies, and if she has a sweetlike cherry dump cake (one of her favorites)shell just have one piece, and then share it at church.

Eating like this, Livingston has stuck to a 1,200-calorie diet, and she ended up losing about 45 pounds, at one point weighing just 116 pounds. That far exceeded the programs own five-to-seven percent weight loss goal for participants.

Livingston felt too thin, so she added nuts and some other healthy fats to her diet, and is now back up to her ideal weight of 125-130 pounds.

Many counties in the South comprise what the CDC considers the diabetes belt. Although New Hanover is not among the 29 North Carolina counties in that categorynor are Pender and Brunswickthe rate of diabetes in this area is significant.

According to the North Carolina Public Health Department, 12.1 percent of the population in Pender County is diabetic, 11 percent in Brunswick, and 8.4 percent in New Hanover County.

In nearby Columbus County, which is considered part of the diabetes belt, 16 percent of the population has diabetes.

Susan Mintz, a registered nurse and certified nurse educator at the New Hanover County Health Department, blames the incidence of diabetes primarily on a culture of poor food choices.

Cheap, fast food is just way too plentiful. Weve kind of lost a connection with trying to eat well. Weve lost what is a normal amount of food to eat, Mintz said. Were just not exercising. Were spending too much time on computers. The populations getting older.

Mintz runs a call line out of the health department for newly diagnosed diabetes patients (910-798-6775), as well as a support group for people with diabetes and pre-diabetes, as well as their caretakers.

Still in the South, its the female that cooks, Mintz said. Were all brought up in a certain culture, eating certain foods.

Weaning people from their beloved sweet tea and fried chicken can be tough, she added.

As long as we can keep the education going, I think that can help. Its one of those things where you cant quit.

The support group meets on the first Friday of every month from 10 a.m.-11 a.m. at the New HanoverCounty Senior Center on Shipyard Boulevard.

diabetes, dieting, health, sugar

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Prevention is key to remaining outside the South's 'Diabetes Belt' - Port City Daily

When University of Nebraska-Lincoln undergrad Ethan Cismoski began browsing fraternities to join, Delta Tau Deltas philanthropic partner immediately caught his attention.

The national fraternity has a partnership with the Juvenile Diabetes Research Foundation, a nonprofit organization funding research to find a cure for Type 1 Diabetes a disease Cismoski was diagnosed with he was 16.

Once he was diagnosed, Cismoski, the current philanthropy chair of the Lincoln fraternity, had to learn how to adjust to accommodate for the disease. This includes checking blood sugar about six times each day and injecting insulin after every meal.

Learning about it was pretty hard, he said. Its such a big lifestyle change everyones heard of diabetes, but nobody really knows what happens or what the people go through.

On Sunday morning, Delta Tau Delta hosted an event to help change this. The Lincoln fraternity chapter teamed up with the College Diabetes Network-Lincoln student organization to raise awareness for Type 1 Diabetes through its first annual JDRF Walk.

The walk looped across campus, leading them from the Nebraska Union, through Memorial Stadium and back. While the walk was free, $15 donations gave participants a T-shirt. All proceeds went to the Lincoln JDRF chapter.

Haley Schepers, president and founder of College Diabetes Network-Lincoln,said she was happy the organization and fraternity were able to pair up to host the event.

Its good to show that the Greek community is more than just Greek life, she said. Its good to have them support us and be able to work with them as a Greek life, university life combination, which doesnt happen very often.

Justin Hicklin, the external vice president of the fraternity chapter, said the walk had raised about $1,200 as of Sunday morning, but this years event focused more on raising awareness rather than money.

(We want people to be) aware of what diabetics go through on a daily basis, Hicklin said. I think its just cool that people are here and show that they care.

Schepers said she hopes increased awareness can lead to a change across campus.

We want to create a community of support for Type 1 Diabetics on campus, she said. Theres different things for Type 1 Diabetics (that can change), like having the carbs at the dining halls that helps make their lives easier on campus.

Cismoski agreed that raised awareness is important he could even see misinformation about the disease at Sunday's walk. Event organizers offered free coffee and donuts, and Cismoski overheard people asking if diabetic people could eat the food.

Diabetes is pretty popular, but no one really knows how it works, he said. We can eat the same stuff you do, we just need an extra step.

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UNL diabetes walk raises Type 1 awareness - Lincoln Journal Star

Type 2 diabetes is a serious health concern in the United States and across the globe. New research shows that a high consumption of legumes significantly reduces the risk of developing the disease.

The legume family consists of plants such as alfalfa, clover, peas, peanuts, soybeans, chickpeas, lentils, and various types of beans.

As a food group, they are believed to be particularly nutritious and healthful. One of the reasons for this is that they contain a high level of B vitamins, which help the body to make energy and regulate its metabolism.

Additionally, legumes are high in fiber and contain minerals such as calcium, magnesium, and potassium. They also comprise a variety of so-called phytochemicals - bioactive compounds that further improve the body's metabolism and have been suggested to protect against heart disease and diabetes.

Finally, legumes are also considered to be a "low glycemic index food," which means that blood sugar levels increase very slowly after they are consumed.

To make people aware of the many health benefits of legumes, the year 2016 has been declared the International Year of Pulses by the Food and Agriculture Organization of the United Nations. Pulses are a subgroup of legumes.

Because of their various health benefits, it has been suggested that legumes protect against the onset of type 2 diabetes - a serious illness that affects around 29 million people in the U.S. and more than 400 million adults worldwide. However, little research has been carried out to test this hypothesis.

Therefore, researchers from the Unit of Human Nutrition at the Universitat Rovira i Virgili in Tarragona, Spain, together with other investigators from the Prevencin con Dieta Mediterrnea (PREDIMED) study, set out to investigate the association between legume consumption and the risk of developing type 2 diabetes in people at an increased risk of cardiovascular disease.

The study also analyzes the effects of substituting legumes with other foods rich in proteins and carbohydrates, and the findings were published in the journal Clinical Nutrition.

The team investigated 3,349 participants in the PREDIMED study who did not have type 2 diabetes at the beginning of the study. The researchers collected information on their diets at the start of the study and every year throughout the median follow-up period of 4.3 years.

Individuals with a lower cumulative consumption of legumes had approximately 1.5 weekly servings of 60 grams of raw legumes, or 12.73 grams per day. A higher legume consumption was defined as 28.75 daily grams of legumes, or the equivalent of 3.35 servings per week.

Using Cox regression models, the researchers analyzed the association between the incidence of type 2 diabetes and the average consumption of legumes such as lentils, chickpeas, dry beans, and fresh peas.

Overall, during the follow-up period, the team identified 266 new cases of type 2 diabetes.

The study revealed that those with a higher intake of legumes were 35 percent less likely to develop type 2 diabetes than their counterparts who consumed a smaller amount of legumes. Of all the legumes studied, lentils had the strongest association with a low risk of type 2 diabetes.

In fact, individuals with a high consumption of lentils (defined as almost one weekly serving) were 33 percent less likely to develop diabetes compared with their low-consumption counterparts - that is, the participants who had less than half a serving per week.

Additionally, the researchers found that replacing half a serving per day of legumes with an equivalent portion of protein- and carbohydrate-rich foods including bread, eggs, rice, or potatoes also correlated with a reduced risk of diabetes.

The authors conclude that:

"A frequent consumption of legumes, particularly lentils, in the context of a Mediterranean diet, may provide benefits on type 2 diabetes prevention in older adults at high cardiovascular risk."

Learn how a healthful vegetarian diet could substantially reduce type 2 diabetes risk.

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Legumes may lower risk of type 2 diabetes - Medical News Today - Medical News Today

Gabe Kirsch helps lead the Bulls to back-to-back national titles Courtesy of Gabe Kirsch |

Senior hockey player Gabe Kirsch takes a shot. Kirsch plays for the UB hockey club team despite being diagnosed with type-1 diabetes.

Can I get a whiskey coke, Gabe Kirsch says at the bar.

Kirsch, a senior hockey player and biomedical science major, inputs the amount of carbs in his whiskey coke into his insulin pump. From there, his insulin pump does all the work, ensuring his blood sugar levels remain steady.

Kirsch has type-1 diabetes. One misstep in his diet could lead to irregularities in his body.

However, Kirsch does not let this disease stop him from doing what he loves, which is to play hockey. Hes part of the UB club hockey team, which has won back-to-back Division III club hockey national titles the first UB team to win back to back.

The issue I have is, what happens in your body physiologically is when you start to play hockey, you have adrenaline hormones and what those do is they mobilize your bodys glucose storage for energy, Kirsch said. So, for a person like me who doesnt have the insulin to counteract, a lot of times Ill have elevated blood glucose cells during a game.

Type-1 diabetes is typically diagnosed in children and was originally called juvenile diabetes. Only about 5 percent of people with diabetes have type-1, according to the American Diabetes Association. Those with type-1 diabetes suffer from a lack of insulin production. Insulin helps the body to absorb glucose, or sugars.

For every two grams of carbs, Kirsch needs to pump insulin into his body. Every diabetic has a different ratio of carbs to insulin and if not done properly, it can affect everyday tasks, or even sleep.

Sometimes your sleep would get interrupted, lets say you eat a late time snack, you give yourself too much insulin and then you start to feel hypoglycemic symptoms while youre sleeping, Kirsch said. So, you have to get up and go eat some carbs.

Kirsch must always keep an insulin pen on him. His close friends and roommates all know how to use the pen in case of an emergency. Luckily, Kirsch has never had to use the pen.

Kirschs friends know how difficult it was for the hockey player to adjust, but admire his determination to overcome the disease and continue playing.

It doesnt really affect him, he still goes to school and plays hockey and does all the same things that he did before, said Kelly Yazwinski, a longtime friend and senior occupational therapy major. Hes good at hiding it but he loves to talk about it a lot. We make fun of him for it, we rip on him because he always talks about it.

Kirsch found out he had diabetes his senior year of high school after his hockey season was finished. The following season, at his former school Mercyhurst College, Kirsch sat out due to the disease. He was still adjusting to the daily work that goes into staying healthy and maintaining the right glucose balance.

Jennifer Kirsch, his mother, worried he might not have been ready to start playing again.

Even for him, he was a little worried about it as well because it was such a new process, Jennifer said. The testing, the eating and counting carbs and all that. I think he just wanted to get a handle on it first before he played a sport.

Jennifer received a phone call from Kirschs pediatrician one day while her son was in school, taking an exam. After testing Kirschs blood at a regular appointment, the results came back and revealed he had type-1 diabetes.

When I went into the school [to pick him up] I was crying and he said to me Mom it is going to be OK. He was rock solid and I dont think the whole thing really hit him and I was a wreck and didnt handle it well at all but he was rock solid, Jennifer said.

Kirsch remembers the situation vividly. He had a feeling something was wrong with his body. He lost 10 pounds in a matter of a couple months and never realized it until his boss at his job said something to him.

Kirsch was in the hospital for four days. Doctors and nurses taught him what he needed to do to maintain his health with the disease.

That remorse for myself kind of transitioned quickly because I was in the pediatric unit and so I had all these other little kids that were maybe 10 years old that had also got diagnosed, Kirsch said. It was kind of eye opening in a way and I didnt feel as bad for myself I started feeling bad for these kids that didnt understand why every time they had to do something so normal such as eating, they had to take a shot.

Four years after his diagnosis, Kirsch hardly notices the wire that comes out of his shirt, connecting his insulin to his body. Regular checks have become routine and the hockey player has a great sense of what he can and cannot eat or drink.

As for his diabetes on the ice, his teammates dont take notice of it either.

His diabetes does not affect his gameplay at all, you could not tell he was diagnosed with it, said Danny Edmonds, a teammate and roommate. He was a heavy contributor to our team with his leadership as well as points.

Kirsch has been able to still do what he loves while never letting diabetes control his life.

Its definitely a controllable thing. Kirsch said. The first month or so there is a adjustment phase. You need to learn how to count carbs efficiently and recognize what your body is telling you.

Jeremy Torres is a sports staff writer and can be reached at sports@ubspectrum.com

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Diabetic UB hockey player looks to maintain lifestyle - University at Buffalo The Spectrum

(Reuters Health) Diabetes can lead to blindness, but children and teens with diabetes may not receive recommended eye exams in the years following their diagnosis, a U.S. study suggests.

Researchers found that just 65 percent of youth with type 1 diabetes and 42 percent of those with type 2 diabetes had vision-loss screening within six years of their diabetes diagnosis.

More youth now than ever are being diagnosed with diabetes. By 2050, the prevalence with type 1 will triple and the prevalence with type 2 will quadruple, with the greatest increase in minority populations, said lead study author Dr. Sophia Wang of the University of Michigan Medical School in Ann Arbor.

The American Academy of Ophthalmology recommends screening for diabetic retinopathy five years after an initial diabetes diagnosis for youth with type 1 diabetes while the American Diabetes Association and the American Academy of Pediatrics recommend screening within three to five years. For kids with type 2 diabetes, screening is recommended at diagnosis.

Diabetic retinopathy is a complication of diabetes that may not have symptoms in early stages but can progress to vision loss. The damage to the retina of the eye results from damage to tiny blood vessels that affects other parts of the body as well.

About half of people with retinopathy develop diabetic macular edema, a fluid build-up in the retina, or glaucoma.

Diabetic retinopathy is the number one cause of vision loss in ages 20-74, so screening is an important component of diabetes care, Wang told Reuters Health by email.

To see how many kids with diabetes are getting the recommended screening, Wang and colleagues analyzed data from a national managed care network, which included more than 5,400 youth under age 21 with type 1 diabetes and 7,200 with type 2 diabetes.

Overall, researchers found that about 4,000 kids, or 31 percent, had an eye exam.

Those with type 1 diabetes were more likely to have had an eye exam compared with those who had type 2 diabetes, the study team reports in JAMA Ophthalmology . White and Asian youth were more likely to have had exams than black and Latino youth. Those with a higher household net worth were also more likely to receive an eye exam compared with those in lower-income households.

Despite the fact that all the youth in our study possessed health insurance, we found disparities by race and family affluence, suggesting that they may be particularly at risk, Wang said.

In the study, 11 percent of black children and teens and 18 percent of Latino youth were less likely to undergo an eye exam compared to white kids. Younger patients were also less likely to receive an exam than older ones.

We must educate adolescents and caregivers on the importance of screening to improve care coordination between different medical specialists such as pediatricians, endocrinologists, ophthalmologists and optometrists, said study author Dr. Joshua Stein of the University of Michigan Kellogg Eye Center in Ann Arbor.

More research is needed on new technologies which might render ophthalmic screening more accessible, such as retinal photography performed in primary care physicians clinics, he told Reuters Health by email.

Diabetic retinopathy is considered the most common microvascular complication of diabetes and is projected to grow at an alarming rate, said Dr. Seema Garg of the University of North Carolina at Chapel Hill, who wrote a commentary accompanying the study.

Visual impairment is detrimental to patients personal independence, economic productivity, employment and overall quality of life, she told Reuters Health by email. The opportunity costs of a lifetime of blindness are enormous.

Socioeconomics, geographical barriers, delayed referrals from primary care doctors, language barriers and cultural barriers also play a part in the screening gap. Retina screening via telemedicine could help address the issue, especially for racial minorities and economically disadvantaged youth, Garg writes in the commentary.

Telemedicine is an emerging strategy for improving screening with remote expert interpretation, she writes. Telemedicine is effective in reaching underserved populations in remote, rural or urban settings where patients may be at risk for more advanced disease.

SOURCE: bit.ly/2nAJHv1 and bit.ly/2nQkjn2 JAMA Ophthalmology, online March 23, 2017.

A federal judge in Delaware on Friday struck down key patents held by Acorda Therapeutics Inc related to its multiple sclerosis drug Ampyra, causing the stock to tumble 24 percent before trading was halted.

YANGON Myanmar is training up hundreds of midwives in an effort to reduce the number of women who die in childbirth, one of many social policy reforms launched by the country as it emerges from decades of military rule.

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Youth with diabetes need vision loss screening | Reuters - Reuters

REIDSVILLE Since Fall 2015, the Cone Health Nutrition and Diabetes Management Center in Reidsville has been tackling diabetes head on as the first clinic of its kind in Rockingham County.

We provide education to patients that have diabetes and other medical problems, said Penny Crumpton, registered dietician and certified diabetes educator with the center. Our goal is to try to help provide knowledge and education to those who need assistance in helping improve their diabetes and reducing the complications that we know diabetes can cause.

According to Crumpton, diabetes is a serious issue in Rockingham County.

The rates of diabetes are extremely high in Rockingham County so the need is very great in terms of reaching out to those who are most in need, Crumpton said. While we educate patients with diabetes, we also try to reach out and address the epidemic of pre-diabetes that certainly puts patients at high risk for developing diabetes down the road.

Uncontrolled diabetes can lead to long time and irreversible problems, including damage to the eyes and kidneys, cardiovascular complications and peripheral vascular disease.

In the year and a half since the center opened, Crumpton and Gebre Nida, the centers endocrinologist, have been working with patients to help address those problems.

At the office, patients can come for one-on-one counseling sessions to discuss their situation or guests can attend free community education classes at 9 a.m. on the first and third Monday of the month at Annie Penn Hospital.

Yet with diabetes a prevalent problem in the area, Crumpton and Nida are pushing for awareness through the diabetes task force. This task force unites local health care providers and other community stakeholders around making a change.

Were working through the diabetes task force to try to increase the public awareness of the rates of diabetes and getting the resources more visible to the community and being able to connect patients with resources, Crumpton said.

For Norbert Hector, the center has already made a difference in his life after visiting the center for the first time in February.

According to Hector, he was diagnosed with diabetes about 20 years ago and has been on insulin for about 11 years.

About two months ago, my readings became very erratic, and so I called (my primary care provider) and tried to do some self-adjusting and really messed it up, he said.

His doctor referred him to Nida at the Cone Health Nutrition and Diabetes Management Center in Reidsville.

As a diabetic, I had been concerned about it, Hector said. I know its a progressive disease, and Ive watched other diabetics including my brother get progressively worse and my brother eventually died.

By following the directions given to him by Nida and Crumpton and with the support of his wife, Hector has already seen improvements in his condition.

I feel a lot more optimistic now than I did two months ago, he said.

As the center creates more stories like Hectors and the practice builds, they will consider adding another endocrinologist and diabetes educator to widen the centers impact and reach the growing population affected by diabetes.

For more information about the Cone Health Nutrition and Diabetes Management Center in Reidsville, call 336-951-6070 or visit the center at 1107 S. Main St., Reidsville.

You have nothing to lose and whole lot to gain, Hector said. Give it a shot.

Contact JustynMelrose at (336) 349 -4331, ext. 6140 and follow@jljmelrose on Twitter.

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Cone Health clinic fights diabetes in Rockingham County - Greensboro News & Record

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Diabetes: Kids and Type 1 Diabetes myfox8.com The incidence of type 1 diabetes, previously known as juvenile diabetes, has been steadily rising in the United States. Type 1 diabetes is an auto-immune disease in which the body is destroying the cells in the pancreas that make insulin, and is often ...

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Diabetes: Kids and Type 1 Diabetes - myfox8.com