your diabetes cure

Diabetes is widely recognized

2008-09-18T06:09:00.000-07:00

What is diabetes?

Diabetes is a disorder of metabolism—the way our bodies use digested food for growth and energy. Most of the food we eat is broken down into glucose, the form of sugar in the blood. Glucose is the main source of fuel for the body.

After digestion, glucose passes into the bloodstream, where it is used by cells for growth and energy. For glucose to get into cells, insulin must be present. Insulin is a hormone produced by the pancreas, a large gland behind the stomach.

When we eat, the pancreas automatically produces the right amount of insulin to move glucose from blood into our cells. In people with diabetes, however, the pancreas either produces little or no insulin, or the cells do not respond appropriately to the insulin that is produced. Glucose builds up in the blood, overflows into the urine, and passes out of the body in the urine. Thus, the body loses its main source of fuel even though the blood contains large amounts of glucose.

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What are the types of diabetes?

The three main types of diabetes are

type 1 diabetes
type 2 diabetes
gestational diabetes

Type 1 Diabetes

Type 1 diabetes is an autoimmune disease. An autoimmune disease results when the body’s system for fighting infection (the immune system) turns against a part of the body. In diabetes, the immune system attacks and destroys the insulin-producing beta cells in the pancreas. The pancreas then produces little or no insulin. A person who has type 1 diabetes must take insulin daily to live.

At present, scientists do not know exactly what causes the body’s immune system to attack the beta cells, but they believe that autoimmune, genetic, and environmental factors, possibly viruses, are involved. Type 1 diabetes accounts for about 5 to 10 percent of diagnosed diabetes in the United States. It develops most often in children and young adults but can appear at any age.

Symptoms of type 1 diabetes usually develop over a short period, although beta cell destruction can begin years earlier. Symptoms may include increased thirst and urination, constant hunger, weight loss, blurred vision, and extreme fatigue. If not diagnosed and treated with insulin, a person with type 1 diabetes can lapse into a life-threatening diabetic coma, also known as diabetic ketoacidosis.

Type 2 Diabetes

The most common form of diabetes is type 2 diabetes. About 90 to 95 percent of people with diabetes have type 2. This form of diabetes is most often associated with older age, obesity, family history of diabetes, previous history of gestational diabetes, physical inactivity, and certain ethnicities. About 80 percent of people with type 2 diabetes are overweight.

Type 2 diabetes is increasingly being diagnosed in children and adolescents. However, nationally representative data on prevalence of type 2 diabetes in youth are not available.

When type 2 diabetes is diagnosed, the pancreas is usually producing enough insulin, but for unknown reasons the body cannot use the insulin effectively, a condition called insulin resistance. After several years, insulin production decreases. The result is the same as for type 1 diabetes—glucose builds up in the blood and the body cannot make efficient use of its main source of fuel.

The symptoms of type 2 diabetes develop gradually. Their onset is not as sudden as in type 1 diabetes. Symptoms may include fatigue, frequent urination, increased thirst and hunger, weight loss, blurred vision, and slow healing of wounds or sores. Some people have no symptoms.

Gestational Diabetes

Some women develop gestational diabetes late in pregnancy. Although this form of diabetes usually disappears after the birth of the baby, women who have had gestational diabetes have a 20 to 50 percent chance of developing type 2 diabetes within 5 to 10 years. Maintaining a reasonable body weight and being physically active may help prevent development of type 2 diabetes.

About 3 to 8 percent of pregnant women in the United States develop gestational diabetes. As with type 2 diabetes, gestational diabetes occurs more often in some ethnic groups and among women with a family history of diabetes. Gestational diabetes is caused by the hormones of pregnancy or a shortage of insulin. Women with gestational diabetes may not experience any symptoms.

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How is diabetes diagnosed?

The fasting blood glucose test is the preferred test for diagnosing diabetes in children and nonpregnant adults. It is most reliable when done in the morning. However, a diagnosis of diabetes can be made based on any of the following test results, confirmed by retesting on a different day:

A blood glucose level of 126 milligrams per deciliter (mg/dL) or more after an 8-hour fast. This test is called the fasting blood glucose test.
A blood glucose level of 200 mg/dL or more 2 hours after drinking a beverage containing 75 grams of glucose dissolved in water. This test is called the oral glucose tolerance test (OGTT).
A random (taken at any time of day) blood glucose level of 200 mg/dL or more, along with the presence of diabetes symptoms.

Gestational diabetes is diagnosed based on blood glucose levels measured during the OGTT. Glucose levels are normally lower during pregnancy, so the cutoff levels for diagnosis of diabetes in pregnancy are lower. Blood glucose levels are measured before a woman drinks a beverage containing glucose. Then levels are checked 1, 2, and 3 hours afterward. If a woman has two blood glucose levels meeting or exceeding any of the following numbers, she has gestational diabetes: a fasting blood glucose level of 95 mg/dL, a 1-hour level of 180 mg/dL, a 2-hour level of 155 mg/dL, or a 3-hour level of 140 mg/dL.

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What is pre-diabetes?

People with pre-diabetes have blood glucose levels that are higher than normal but not high enough for a diagnosis of diabetes. This condition raises the risk of developing type 2 diabetes, heart disease, and stroke.

Pre-diabetes is also called impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it. Some people have both IFG and IGT.

IFG is a condition in which the blood glucose level is high (100 to 125 mg/dL) after an overnight fast, but is not high enough to be classified as diabetes. (The former definition of IFG was 110 mg/dL to 125 mg/dL.)
IGT is a condition in which the blood glucose level is high (140 to 199 mg/dL) after a 2-hour oral glucose tolerance test, but is not high enough to be classified as diabetes.

Pre-diabetes is becoming more common in the United States, according to new estimates provided by the U.S. Department of Health and Human Services. About 40 percent of U.S. adults ages 40 to 74—or 41 million people—had pre-diabetes in 2000. New data suggest that at least 54 million U.S. adults had pre-diabetes in 2002. Many people with pre-diabetes go on to develop type 2 diabetes within 10 years.

The good news is that if you have pre-diabetes, you can do a lot to prevent or delay diabetes. Studies have clearly shown that you can lower your risk of developing diabetes by losing 5 to 7 percent of your body weight through diet and increased physical activity. A major study of more than 3,000 people with IGT, a form of pre-diabetes, found that diet and exercise resulting in a 5 to 7 percent weight loss—about 10 to 14 pounds in a person who weighs 200 pounds—lowered the incidence of type 2 diabetes by nearly 60 percent. Study participants lost weight by cutting fat and calories in their diet and by exercising (most chose walking) at least 30 minutes a day, 5 days a week.

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What are the scope and impact of diabetes?

Diabetes is widely recognized as one of the leading causes of death and disability in the United States. In 2002, it was the sixth leading cause of death. However, diabetes is likely to be underreported as the underlying cause of death on death certificates. About 65 percent of deaths among those with diabetes are attributed to heart disease and stroke.

Diabetes is associated with long-term complications that affect almost every part of the body. The disease often leads to blindness, heart and blood vessel disease, stroke, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy, and birth defects are more common in babies born to women with diabetes.

In 2002, diabetes cost the United States $132 billion. Indirect costs, including disability payments, time lost from work, and premature death, totaled $40 billion; direct medical costs for diabetes care, including hospitalizations, medical care, and treatment supplies, totaled $92 billion.

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2008-07-30T11:53:00.001-07:00

Walking for 45 minutes helps to control diabetes

2008-07-27T23:19:00.001-07:00

People with diabetes can limit the impact of the condition simply by walking for an extra 45 minutes a day, according to scientists who found exercise helped to keep blood sugar levels in check.

Scientists at Newcastle University studied people with late-onset, or type 2, diabetes. They found that walking improved their bodies' ability to store sugar and burn fat, which after a few weeks reduced the effects of diabetes.

And here is the rest of it.

In Britain, more than 2.3 million people have diabetes. Around 90% of them have the type 2 form, which is linked to obesity and a sedentary lifestyle. If left untreated it can lead to blood vessel damage that triggers heart disease, strokes, and can require patients to have limbs amputated.

"This gives people an immediate way to help control diabetes without any additional drugs. It's a simple message," said Michael Trenell, whose study appears in the journal Diabetes Care today. Trenell's team used MRI scanners to measure how efficiently 20 volunteers, 10 of whom had type 2 diabetes, burned energy in their leg muscles before and after taking part in the eight-week trial.

Each volunteer was given a pedometer and asked to walk more than 10,000 steps a day. On average, people take around 6,000 steps during their daily routine.

The scans revealed that by being more active, diabetics burned 20% more fat and were able to store more sugar in their muscles.

Muscles are the biggest storage depots for sugar in the body, but when they fail to absorb enough, sugar levels stay abnormally high in the bloodstream, causing damage to veins, arteries and organs.

"People often find the thought of going to the gym quite daunting, but we've found that nearly everyone with diabetes is able to become more active through walking. Many people got off the bus a few stops earlier," said Trenell.

Iain Frame at Diabetes UK said the study proved that "even gentle physical activity is vital in managing type 2 diabetes".

Diabetes Experts Recommend New Therapy for Diabetes

2008-07-27T02:18:00.001-07:00

For the first time, a consensus of diabetes and metabolic disorder experts have recommended a comprehensive treatment regimen for patients with pre-diabetes. The recommendations call for specific guidelines on both lifestyle, and pharmaceutical intervention where appropriate. The recommendations are made in a Consensus Statement released this morning by the American Association of Clinical Endocrinologists (AACE).
Pre-diabetes is a condition defined by elevated fasting glucose levels or impaired glucose tolerance. According to the Centers for Disease Control (CDC), more than 56 million Americans currently have the condition, which leaves patients at risk, not only for developing type 2 diabetes, but also for cardiovascular complications. This is an extension of the effort to recognize and treat type 2 diabetes earlier and more aggressively.
However, at this time, there are no pharmacologic therapies that have been approved by the FDA for prevention of the conversion of pre-diabetes to diabetes. That's why the expert panel has recommended a two-pronged approach to treating pre-diabetes. The first is intensive lifestyle management to prevent the progression to type 2 diabetes.
"As individuals and as a society, we need to address those forces which are creating the epidemic of obesity, diabetes, and pre-diabetes," said Yehuda Handlesman MD, FACP, FACE, Treasurer of AACE and Medical Director of the Metabolic Institute of America. "We understand the difficulties in implementing solutions, but as an association of endocrinologists we are committed to supporting community and national efforts in every way we can."
The recommendation calls for patients to adhere to the guidelines set forth in the Diabetes Prevention Program, established by the United States government.
"Although lifestyle can clearly modify the progression of patients towards overt diabetes, it may not be sufficient," said Alan J. Garber, MD, PhD, FACE, Professor of Medicine, Baylor College of Medicine, Houston, and Chairman of the Consensus Conference. "Medications may well be required, particularly in high risk groups."
The second approach is to prevent the development of cardiovascular complications, and to help those patients where lifestyle modifications have been insufficient to modify cardiovascular risk factors. This requires cardiovascular risk reduction medications for abnormal blood pressure and cholesterol independent of glucose control medications.
"The data show that there is a spectrum of severity, with the most severely affected approaching the risks of people with diagnosed type 2 diabetes," said Daniel Einhorn, MD, FACP, FACE, Vice President of AACE and Medical Director of the Scripps Whittier Institute for Diabetes in La Jolla, CA. "In these highest risk individuals, who represent a minority, pharmacologic strategies may be appropriate if intensive lifestyle therapies fail. Regardless, all individuals at risk for diabetes should be aware of the level of their risk factors and be prepared to take action."
While the number of people with pre-diabetes in the United States exceeds 56 million, most patients with the condition have not been diagnosed. People are considered high risk if they have near diabetic levels of blood glucose, hypertension, or abnormal lipid profiles. These patients should consider working with their doctor to monitor their status.
The preliminary publication of the Consensus Statement is available at media.aace.com. The final document will be published later this year in Endocrine Practice, the Journal of the American Association of Clinical Endocrinologists.

Sugar Substitutes Elevate a Bitter Debate

2008-07-25T22:42:00.001-07:00

People seem to take sweeteners personally — responding in angst, argument or even anger. How can a substitute for sugar (that has a measly 16 calories per teaspoon) create such an uproar? Enter the blog! At last a medium where dialogue can reign.

What triggered my interest in discussing this subject was a study by Swithers and Davidson in the February 2008 issue of "Behavioral Neuroscience."

We know that sweet taste from sugar is a powerful trigger that prompts the mind and body to eat and to process calories. However, when the researchers fed rats a food sweetened with a no calorie sweetener — food that was actually lower in total calories — the rats actually ate more food and gained more weight than rats given sugar sweetened food that was higher in total calories. In addition to eating more of the no-calorie sweetened food, the rats also adjusted their body processes to burn fewer calories — contributing to increased body weight and fat.

They discuss the potential implications of their findings: the increases in the numbers of Americans consuming products containing low/no calorie sweeteners from about 70 million in 1987 to about 160 million in 2000, and that low/no calorie sweeteners abound in a wide variety of foods (especially in the form of soft drinks). That the incidence of obesity has also increased dramatically during this period, from about 16 percent of the population to about 30 percent.

They also site a recent human study from the July 31, 2007, issue of "Circulation" that suggested that intake of one or more regular or diet soft drinks was associated with a greater than 50 percent incidence of metabolic syndrome (obesity, inches around the abdomen, higher fasting blood sugar and fat levels, and higher blood pressure).

Could it be that low/no-calorie sweeteners (and foods containing them) fake us into consuming and conserving more calories than if we simply eat the food that has the real (calorie-containing) sugar in it?

My take? Low/no calorie sweetened foods sometimes offer a lower calorie alternative to foods sweetened with sugar (check the label to make sure). There are studies that also show that low/no calorie sweetened foods are helpful for controlling weight. The rat study gave me pause though.

For me — I'll take sugar-sweetened items on special occasions and in moderation. We get ample "sugar" naturally from whole foods and don't need sweets every meal, every day. Safety of these low/no calorie sweeteners? I'm going to save this topic for another time.

Your take on low/no calorie sweeteners? Angst? Argument? Anger? I want to hear from you.

New Recommendations for Prediabetes

2008-07-25T03:50:00.001-07:00

If you're one of the estimated 57 million people in the U.S. with prediabetes, an expert medical committee has some advice for you.

The committee, assembled by the American College of Endocrinology and the American Association of Clinical Endocrinologists, has been meeting in Washington, D.C., for the last two days talking about prediabetes.

Here are their recommendations for dealing with prediabetes:

Don't blow it off. In prediabetes, blood sugar levels are above normal but not high enough to be classified as diabetes -- yet. But prediabetes isn't harmless; it makes diabetes (and its many complications) more likely. And it's a risk for your heart right now.

The bottom line: Prediabetes is an immediate risk and a shadow hanging over your future health. So get aggressive about dealing with it now. Don't wait until it gets worse.

Focus on lifestyle. "Lifestyle is the first way to go" in dealing with prediabetes, committee member Yehuda Handelsman, MD, FACP, FACE, medical director of the Metabolic Institute of America, said today at a news conference about the committee's prediabetes recommendations.

Here are the steps the committee wants you to take:

    * Lose 5% to 10% of your body weight -- for good.
    * Get 30-60 minutes of moderate-intensity physical activity at least five days per week.
    * Eat low-fat diet with adequate dietary fiber.
    * To lower blood pressure, cut back on sodium and don't drink too much alcohol.
    * Take aspirin, unless you have a medical reason not to (ask your doctor first).
    * Get your blood pressure and cholesterol down to the levels recommended for diabetes patients.

Take medication, if needed. If lifestyle isn't enough to reduce your risk of diabetes and heart disease, medications may help. But you'll still need to persist with the healthy lifestyle.

Don't get hung up on numbers. The blood sugar benchmarks for diagnosing diabetes are "somewhat arbitrary," says Alan Garber, MD, PhD, FACE, the committee's chairman and a professor at Baylor College of Medicine in Houston. If your blood sugar numbers are outside of the normal range, that's enough of a cue to take action.

The committee also called for further research to find out which prediabetes patients are at the highest risk, and to study drug treatment for prediabetes. The committee's work was sponsored by various drug companies.

Maternal Obesity Increases Diabetes Risk For Female Offspring

2008-07-24T02:44:00.001-07:00

Maternal obesity has been associated with diabetic complications in the resulting offspring, according to experiments in mice reported recently by researchers at the University of Louisville.
Obesity is presently a worldwide health issue, and it is commonly considered a risk factor for diabetes, cardiovascular disease, and stroke. When a pregnant woman is obese, her children can be affected by malformation, functional abnormalities, obesity, and type II diabetes. Since, presently, over 18% of American women are classified as obese, and between 18 and 38% of pregnant women meet this criteria, it is an important issue in maternal and child health in this country. However, very little is known about the mechanism of the link between maternal obesity and diabetic effects in offspring.
To investigate this association, Dr. Jianxiang Xu and Junying Han of the University of Louisville first established a viable animal model to function similarly to maternal diabetes might in humans. Female mice, genetically predisposed to obesity and further marked with a yellow coat color, were mated with normal mice, whose offspring could then be classified by coat color for this obesity gene. The obesity prone mice were obese between 6 and 8 weeks of age, but maintained normal blood glucose levels. Offspring from these and from normal crosses were then fed with normal food for up to 15 weeks, then fed with a high fat diet, and examined by sex, and the mother's obesity status. In this first portion of the study, the birth weight of offspring from obese mothers was 14% higher than in the control group.
When the offspring, at 50 weeks of age, were administered 2 mg glucose per kg body weight. This resulted in similar glucose levels in each group, but major differences in the serum insulin levels. Namely, in female offspring from obese mothers, there was a significant increase in serum insulin levels, while females from obese mothers and males showed no significant differences. This indicates that β cell function was impaired in the female offspring of obese mothers.
To confirm this link, a second experiment was performed. Pancreatic cells were isolated from 50 week old offspring to be tested in vitro for insulin excretion. Cells from mice with a normal diet showed normal secretion, but in the high fat diet, insulin secretion was sharply reduced in offspring from an obese mother, especially when exposed to a high glucose concentration. The measure of other enzymes related to glucose metabolism such as transketolase, GAPDH, and PFK in the cells of the 50 week old mice indicated a decrease in production by the β cells ranging from 31% to 70% for those born to an obese mother.
According to the researchers, this shows that obesity in pregnancy is a factor by itself to impaired glucose tolerance in offspring, which could contribute to the development of gestational diabetes in the mother and type II diabetes in the offspring. Additionally, since there are many mothers who are obese without displaying gestational diabetes, this obesity might be a greater factor in the health of their children than previously expected.

Natural Substitutes for Sugar

2008-07-22T23:37:00.001-07:00

Diabetes need to pay attention to the glycemic levels of the carbohydrates they eat and plan their meals around low glycemic foods. What is a glycemic level? It is an index of foods based on how each food item affects the blood sugar levels. Foods with a high glycemic level burn up fast in our bodies and raise our blood sugars levels too quickly. If a food item has a low glycemic level it moves slowly through our bodies, slowly but surely releasing glucose into our bloodstream. To explain it another way low glycemic foods keep the diabetic on an even keel with out extreme highs or lows in the blood sugar levels; which is much easier on the body and healthier.

Low glycemic foods also help diabetics (actually everyone) to lose weight, keep those mood swings down to a minimum, make us feel full and keep our energy levels balanced. Its okay to eat high glycemic foods, but do not eat a meal that is completely made up of high glycemic foods. Someone with diabetes needs to balance out the effects of eating high glycemic foods by including low glycemic foods in their meals. Not only do diabetics need to be careful of the glycemic index of their foods, but so do athletes and people who are hypoglycemic or on a diet.

To find the glycemic index level of most foods, go to http://www.glycemicindex.com/. Click on "GI Database" then type in the name of the food item you want to know more about in the search box. The scale is from 0-100, with 100 being the highest level (0-55 low ; 56-69 medium ; 70-100 high).

Below are several healthy choices for diabetics to use to sweeten their food. All are considered low glycemic foods and all are natural foods. Check for yourself how each affects your blood sugars. Test your blood sugar levels before the meal then two hours after. If your blood sugar levels are within your target range then you can use that particular sweetener.

Agave nectar or syrup is made from Blue Agave, a plant that looks like a cactus, but really is from the lily family. It looks a little bit like a soft brown version of honey, but it isn't as thick. Agave nectar is 25% sweeter than regular sugar, so you don't need as much to sweeten your food. I actually find that I only need about ½ a cup of agave for every cup of sugar. Besides being a healthy sugar substitute I have found that pure agave nectar is great as syrup for pancakes. Experiment with agave and find out what your taste buds want. Depending on the type of agave nectar you use the glycemic index is between 11 and 19.

Apple juice, unsweetened:

Apple juice is good for you and it makes excellent substitute for sugar, it also can be used as a substitute for wine in a recipe. When you are buying apple juice make sure it is unsweetened and does not have corn syrup. If your recipe is a little dry and needs to be a little sweeter, then apple juice would be a good substitute. You will need to experiment to figure out how much apple juice should be used. A little warning though, apple juice can produce high blood sugar levels for some diabetes. A good number of apples have a glycemic level of 40.

Applesauce, unsweetened:

We use homemade applesauce at our house. Just peel, wash, then slice the apples, put them in a pot and cook on low heat. Do not add water, there is enough water already between the natural water in the apples and the water you used to wash the apples. This is all you do if you want to use it as a sweetener, but if you want a great homemade applesauce add cinnamon to the pot - it depends on your taste buds how much. Once the apples are cooked, use a potato masher for chunky applesauce or a mixer for smooth applesauce. We make up our applesauce then freeze it so it's ready when we need it.
Applesauce is not only a healthy sugar substitute but you can use it as an oil/shortening substitute, which is a good way to cut down on the fat in a recipe. It depends on what type of apples you use on the glycemic level, but it will probably be in the 40s. For some reason mashing apples give it a higher glycemic level.

Bananas:

Mashed bananas are a good sugar substitute; use one cup of mashed bananas for one cup of sugar. A couple of warnings: bananas have a strong flavor and will affect the taste of the recipe; and this is another substitute that a diabetic needs to be careful of, because it can raise your blood sugar levels too high. Test yourself before eating a recipe using bananas and a couple of hours later to see how it affects you. The glycemic level is 51.

Stevia:

Stevia is made from the leaves of a plant from South America called stevia rebaudiana; it is a member of the daisy family of flowers. It is much sweeter than sugar, some say as much as 300 times. Substitute 1 teaspoon of liquid stevia or 1 ½ to 2 tablespoons for every cup of sugar the recipe lists. That's not a typo, 1 teaspoon versus one sugar; stevia is that much sweeter. Be careful not to use too much stevia, if you use too much it has an awful bitter taste. Stevia is a good substitute for sugar, but you must understand that you do not need to use much of it otherwise you will ruin your recipe. Note: Stevia is only sold as a dietary supplement in the United States because the FDA has banned the use of stevia as a sugar substitute. Stevia's glycemic level is 0.

Diabetes Could Be A Hidden Condition For Heart Disease Patients

2008-07-22T00:05:00.001-07:00

Researchers at the University of Warwick have discovered diabetes could be a hidden condition for some patients with coronary heart disease.
In a study led by Dr Saverio Stranges, Associate Professor of Cardiovascular Epidemiology at Warwick Medical School, the team looked at levels of oxidative stress in the body (a toxic effect which causes cell damage).
They found high levels of oxidative stress in people with coronary heart disease, previously thought to be a marker of the heart condition, could instead indicate a condition of glucose abnormality, such as overt type 2 diabetes.

The research team took blood samples to contrast oxidative stress levels in people with coronary heart disease, people with type 2 diabetes and healthy control subjects. Previous studies have shown people with type 2 diabetes and people with coronary heart disease have high levels of oxidative stress.
Dr Stranges' team expected to produce similar results, but they found that those stress levels were low in people with coronary heart disease but without type 2 diabetes. Further investigation showed people from this group with high levels also had overt type 2 diabetes.
The research used data taken from the Western New York Health Study. This was a case-control study of myocardial infarction and cardiovascular risk factors among residents of Erie and Niagara Counties, New York.
Dr Stranges said: "The results were intriguing. We expected to find high levels of oxidative stress in people with a clinical heart condition, such as myocardial infarction, and people with diabetes. As we thought, the levels were high for diabetics, but there were some discrepancies for people with heart disease.
"Our findings suggest the observed associations of increased oxidative stress in individuals with heart disease may be dependent on underlying abnormalities in glucose metabolism."

Potential New Therapies For Diabetes-Induced Vascular Disease

2008-07-21T02:44:00.000-07:00

New findings from Bristol scientists could lead to future treatments to prevent lower limb amputations in diabetes - which currently affect 100 people a week in the UK (source Diabetes UK).

The research from the University of Bristol is published online in Circulation Research and was funded by the British Heart Foundation (BHF) and the European Vascular Genomic Network of Excellence (EVGN).

Diabetes can have serious complications like gangrene and skin ulcers due to a restriction of blood supply to and healing capacity of the affected areas and this causes the dysfunction of cells lining the blood vessels. Legs and feet are often severely affected, and, after blood supply is obstructed or injury, the tissue seems to be unable to heal itself by growing new blood vessels making the situation much worse. If gangrenous wounds fail to heal amputation may be the only option.

Dr Costanza Emanueli, BHF Reader at Bristol University and colleagues at the Bristol Heart Institute have previously found that a group of growth factors - known as neurotrophins - play a role in the vascular system. Growth factors act on two completely different types of cellular receptors. One type, trk, mediates positive actions, such as survival and growing new blood vessels and the other, p75NTR, has not been comprehensively characterised.

In healthy blood vessels, the cells that line the blood vessels do not possess the p75NTR receptor, and the development of new blood vessels and healing of the obstructed blood supply and wounds is rapid. However, diabetes causes the cells lining the blood vessels to produce the p75NTR receptor, and prevents the growth of new blood vessels necessary for blood supply and healing of damaged tissue.

Dr Emanueli's group found that if they put the receptor gene into healthy blood vessel cells, the cells became dysfunctional. Equally, injecting the gene into healthy muscle and then restricting blood supply caused impaired healing following the injury identical to that seen in diabetes.

The final proof was to inhibit the p75NTR receptor in diabetic mice before restricting the blood supply to one of their "limbs". The researchers found that p75NTR inhibition enabled the limb to recover from the restricted blood flow and be well supplied with blood.

p75NTR acts by depressing the cell's normal signalling mechanisms that are necessary to stimulate the growth of new blood vessels. In its absence, this process proceeds normally.

Dr Emanueli said: "Our findings demonstrate the importance of understanding the individual factors responsible for such diabetes-induced complications. The data reveal that by suppressing the action of one particular gene, we can improve recovery of tissues following inadequate blood flow, and this opens up new avenues for its use to combat diabetes-induced vascular disease."

Fruit juice linked to a modest rise in diabetes risk

2008-07-19T00:02:00.001-07:00

We may have trusted the faithful fruit juice which promises good health and offers great refreshment at the same time. But now as per a new research, fruit juice has been tied to modest rise in Diabetes. The fruit juice which stood by us for so long and promised good health and nutrients seem to pave way for diabetes risk to enter.
The research observed that having an additional three servings of whole fruit daily or one more serving of spinach, kale or similar leafy green vegetable was tied to a lower risk of developing diabetes which was found over an 18-year period among 71,346 women enrolled in the Health Study. However the research also found that there was only a very low risk of raise in diabetes risk, so we can heave a sigh of relief.
Dr. Lydia A. Bazzano of Tulane University School of Public Health and Tropical Medicine, New Orleans and her colleagues looked carefully at the data on the diets of Health Study participants which noticed that 4 529 of participants developed type 2 diabetes while being followed. The women were divided into groups on the basis of fruit, vegetable and fruit juice consumption.
It was noticed that an increase of three servings a day of whole fruit was linked with an 18 percent lower risk of type 2 diabetes, whereas a single additional serving of leafy green vegetables decreased the risk by 9 percent.
Dr Lydia A. Bazzano, commented This is not going to prevent it if you have many risk factors and you're overweight, but it's a prevention strategy.
The reason suspected for the risk in diabetes due to fruit juice is due to the higher levels of sugar in the juice and leafy vegetables did not face the risk of sugar, thus they reduced the risk of diabetes. The Health center researchers also concluded that the high sugar load in fruit juice in the liquid form can be rapidly absorbed and thus increases the risk of Diabetes. However the diabetes risk still awaits if a person is overweight or follows an unhealthy diet and lifestyle.

Diabetes Diet Food

2008-07-17T22:11:00.001-07:00

Below is the table of the foods the diabetic should take. These foods are different from each other depending upon the calories they contain, so they should be taken accordingly. There should be three to five servings of vegetables, two to three servings of milk, and two to four servings of fruits in your daily diet. You can take meat, poultry, and nuts two times in a day. Grains, breads, and rice can be taken with 6 to 11 servings daily.

Vegetables

Fruits

Proteins

Milk with very low fat

Fats

Starches

Each contains 25 calories

Each contains 60calories

Each contains 75 calories

Each contains 90 calories

Each contains 45 calories

Each Contains 80 Calories

Carrots, Broccoli, Zucchini, Cabbage

If cooked then take ½ cup

Else take

1 cup

Small Banana or Apple

1 Cup Strawberries

1 orange

1 Egg

1 Ounce beef, Pork chop, Mozzarella cheese

2 Ounces Fish fillet, Shellfish or Fat free cheese

¾ Cup plain non fat or low fat

1 Cup Milk, fat-free or very-very low fat

1Teaspoon of butter or vegetable oil

1 Slice of Bacon

2 Tablespoons of cream cheese

1/8 Avocado

1 Slice of whole wheat or white bread

2 Slices of low calorie bread

½ Hamburger bun or English muffin

¾ Cup Cold cereal

Here is a recommendation of the diet menu you can follow daily.

A typical Breakfast

Glass of freshly squeezed orange
Large bowl of cereal with fat free milk
Toast with minimal margarine & preserves
Tea/Coffee (of fat free milk)

Typical Snack

Fruit(any of the above mentioned)
Low fat yogurts
Whole Wheat Sandwiches
Cereal

A typical Lunch

Large whole wheat sandwich with lean meat and large salad with low fat dressing
Low fat yogurt

A typical Dinner

4oz Lean chicken with 2 medium potatoes and two helpings vegetables
Chopped fruit topped with low fat ice-cream

Diabetes Diet Food Exchange List

Food group	You can have...	Or exchange it for...
Fruit (Each serving contains about 15 grams carbohydrates)	1 small or medium piece of fresh fruit	1/2 cup fruit juice, or canned or chopped fruit
Vegetable (Each serving contains about 5 grams carbohydrates)	1 cup raw vegetables	1/2 cup cooked vegetables or vegetable juice
Starch (Each serving contains about 15 grams carbohydrates)	1 slice or ounce bread	1/2 cup pasta, cereal, starchy vegetable
Sugar, honey, molasses	1 teaspoon	4 grams carbohydrates
Milk (does not include cream, yogurt or cheese)	1 cup milk	12 grams carbohydrates and 8 grams protein
Meat	1 ounce meat, fish, poultry, cheese or yogurt	1/2 cup dried beans
Fat (includes nuts, seeds and small amounts of bacon & peanut butter)	1 teaspoon oil, butter or margarine	5 grams fat

Not All Sweeteners the Same for Managing Type 2 Diabetes

2008-07-17T01:27:00.001-07:00

A recent research shows that when it comes to managing Type 2 diabetes, all sweeteners may not be the same. Some sweeteners, including date sugar and less refined, dark brown sugars, showed potential for managing Type 2 diabetes and related complications. The research was conducted by Kalidas Shetty of the University of Massachusetts Amherst and Lena Galvez Ranilla of the University of San Paolo, Brazil.

“Depending on their origin and grade of refining, many sweeteners contained significant amounts of antioxidants, which have the potential to control diabetes-linked high blood pressure and heart disease,” says Shetty, who adds that these were in vitro laboratory studies performed outside of living organisms. “Several types of sweeteners also showed an interesting potential to inhibit the action of a key enzyme related to Type 2 diabetes, which is also the target of drugs used to treat this condition.”

Additional members of the research team include food scientist Young-In Kwon of UMass Amherst and Maria Ines Genovese and Franco Maria Lajolo of the University of San Paulo, Brazil. Results were published in the most recent issue of the Journal of Medicinal Food.”

The team started by collecting an exhaustive array of sweeteners, everything from the complete line offered by Domino, to unprocessed, dark brown sugars from Mauritius and Peru. Pure maple syrup, corn syrup-based sweeteners, “natural” sugar products like sucanat and sugars from Asia, India, South America and China rounded out the list.

Extracts of the sweeteners were first analyzed to determine their total content of a group of antioxidants known as phenolic compounds, the same plant chemicals that give red wine and tea their heart-healthy benefits. Testing showed that when it comes to sugar, darker is definitely better. Dark brown sugars contained up to 4,741 micrograms of phenolic compounds per gram, compared to 18 micrograms per gram for white sugar. The highest antioxidant levels were found in the darkest sugars.

Further testing showed that these phenolic compounds had significant antioxidant properties, scavenging harmful free radicals that can damage the delicate machinery of cells. According to Shetty, high blood sugar levels in diabetics can cause the overproduction of these free radicals, contributing to high blood pressure and accelerating the development of heart disease.

Date sugar produced in the United States and dark brown sugars from Peru and Mauritius packed the biggest punch, racking up the highest antioxidant levels and scavenging an impressive 82 to 88 percent of free radicals in laboratory in vitro tests.

Sweeteners were then tested for their ability to inhibit the activity of alpha-glucosidase, an enzyme that moderates blood glucose levels by controlling the passage of sugars from the small intestine. “Diabetes is characterized by a rapid rise in blood glucose levels after meals,” says Shetty. “Inhibiting alpha-glucosidase, which is the target of several drugs used to treat diabetes, can help prevent this spike.”

Most sweeteners derived from sugar cane inhibited alpha-glucosidase action by 26 to 50 percent, including the dark brown sugars and natural sugar products from evaporated cane juice. Date sugar inhibited the enzyme by 75 percent.

Surprisingly, several sweeteners based on corn syrup inhibited alpha-glucosidase levels by 77 to 81 percent, although they contained low levels of phenolic compounds. “This level of inhibition could be due to sugar polymers known as oligosaccharides that are not completely broken down, mimicking the action of certain drugs that inhibit alpha-glucosidase,” says Shetty. “This investigation is continuing.”

Date sugar and sweeteners based on corn syrup also inhibited an enzyme that plays a role in high blood pressure, a common complication of diabetes. According to Shetty, the reason for this is not clear based on current studies.

“Replacing sugars in processed foods and beverages with low calorie and noncaloric sweeteners is one long term strategy for Type 2 diabetics,” says Shetty. “But these results indicate that a strategic choice of dietary sweeteners, especially less refined sugars close to the original nature of the ingredients found in whole plants, also has potential in managing Type 2 diabetes and related complications. This provides a strong rationale for further animal and clinical studies for better diet design.”

Only Diet can’t Control Type 2 Diabetes

2008-07-16T03:28:00.001-07:00

Despite strong evidence that type 2 diabetes can be prevented or at least delayed by a combination of lifestyle changes and good dietary advice, a team of Cochrane Researchers found that there is no indication whether dietary advice alone can prevent the disease.

Type 2 diabetes is very common and the number of people affected is increasing. The disease is linked to obesity, with 80% of individuals who develop the disease being obese. Therefore as the incidence of obesity rises around the world, so too does the incidence of type 2 diabetes. The World Health Organization (WHO) estimates that more than 180 million people worldwide have diabetes. It claims that this number is likely to more than double by 2030.*

When a team of Cochrane Researchers set out to see if dietary advice alone could help a person with type 2 diabetes, they were only able to identify two trials that together involved just 358 people.

"Considering the importance of this disorder, we were disappointed to find such a small amount of relevant data," says lead researcher Lucie Nield, who works in Centre for Food, Physical Activity & Obesity, University of Teesside, Middlesbrough.

The two studies did, however, indicate that dietary advice alone could play an important role. One study randomly assigned people to either a control group or a dietary advice group. After six years 67.7% of people in the control group had diabetes, compared with only 43.8% in the advice group. This was a 33% reduction. In another study 12 months of dietary advice led to significant reductions in many diabetes related factors, such as insulin resistance, fasting C-peptide, fasting proinsulin, fasting blood glucose, fasting triglycerides, and fasting cholesterol and PAI-1.

"These two studies give grounds for believing that dietary advice alone could play an important role in reducing type 2 diabetes, but we do need more well-designed, long-term studies before we can work out the best advice to give," says Nield.

Cut Risk of Type 2 Diabetes

2008-07-14T23:55:00.001-07:00

More than 23 million Americans have diabetes, and up to a quarter of those do not even know they have it. A new report found that children are at greater risk of developing the disease.

ABC News' medical contributor Dr. Marie Savard appeared on "Good Morning America" today to share five tips on reducing you and your family's risk for type 2 diabetes

1. Determine if You are at Risk

Find out your family history. If there is diabetes in your family, then you are at greater risk. If you had pregnancy gestation diabetes, you are at risk. If you are African-American or Hispanic, you are at greater risk.

Check on blood sugar level. Your blood sugar should be under 100; 100 to 126 is prediabetic, which means you are well on your way to trouble, but diabetes is still preventable at this stage.

2. Rule of 100s

Blood sugar under 100. As previously mentioned, check your blood sugar level, and if it is higher than 100, you are on your way to trouble.

LDL Cholesterol under 100. This is the bad kind of cholesterol. As opposed to HDL, the "good" kind of cholesterol, high levels of LDL can put you at serious risk for diabetes.

Mean blood pressure under 100. The average of two blood pressure tests ought to be under 100. It will tell you where you stand and how much you need to work at lowering your numbers by changing your lifestyle.

3. Exercise

Walk 30 minutes every day. The No. 1 way to cut down your risk of diabetes, or to manage the disease if you already have it, is to exercise. Several studies say that exercise can lower your risk of diabetes by nearly 60 percent and as much as 70 percent in the elderly.

Lose 2 inches from the waist. You need to lose weight to get the effects. So get out a pedometer and your tape measure and start taking 10,000 steps a day. That's about 30 minutes of walking and you can do it in increments of 2,000 steps. The benefit is cumulative, even if you stop and start.

4. Eat High Fiber Foods and Healthy Fats

Eat more fruits and vegetables. Diet is another big lifestyle change that has a major impact on preventing diabetes.

Olive oil and Omega 3 fish oil are the right kind of fat. Fish such as salmon or tuna are good for you. You can even take supplements if you cannot get enough fish.

Drink a touch of alcohol. This may surprise some people, but a little bit of red wine can improve insulin activity.

5. Avoid Artificial Sweeteners

A good, in-depth study has found that just one can of diet soda a day can increase your risk of becoming prediabetic. The study suggested that the sweet taste of the artificial sweeteners may actually confuse the brain and cause us to gain weight.

High Level of Fetuin-A -protein Linked to Increased Diabetes Risk

2008-07-14T00:57:00.001-07:00

A new study has shown that having a higher than normal level of fetuin-A, a protein produced in the liver and secreted into the blood stream, is linked to an increased risk of developing diabetes.

"Type 2 diabetes mellitus has become a global epidemic and the increased prevalence of obesity is a major contributing factor. However, diabetes does not develop in all obese individuals and there is a strong genetic contribution to risk," the authors said.

"Despite significant recent advances, mechanisms responsible for individual differences in clinical phenotype remain largely unknown," they added.

Previous studies have found a link between higher fetuin-A levels and insulin resistance, but the association with incident type 2 diabetes mellitus is unknown.

To examine whether higher fetuin-A levels are associated with the occurrence of diabetes in older persons, Joachim H. Ix, M.D., M.A.S., of the University of California, San Diego, and San Diego Veterans Affairs Healthcare System, and colleagues conducted a study.

It included 406 persons (age 70 to 79 years) without diabetes at the start of the study, and who had fetuin-A levels measured at baseline, and had six years of follow-up.

Diabetes developed in 135 participants (10.1 cases/1,000 person-years [the number of individuals in the study times the number of years of follow-up per person]).

Analysis indicated a graded increase in the incidence of diabetes with increased fetuin-A levels.

The third of the group with the highest levels had more than twice the incidence rate compared with the lowest third (13.3 vs. 6.5 cases/1,000 person-years).

The link was independent of physical activity, inflammatory biomarkers, and other commonly available measures of insulin resistance and was irrespective of sex, race, and obesity status.

The association was moderately weakened by adjustment for visceral adiposity - fat accumulation around the abdomen.

"Future studies should evaluate whether the results may generalize to middle-aged individuals in whom the [diabetes] incidence rate is highest. If confirmed in future studies, fetuin-A may ultimately prove useful as a target for therapeutics, and its study may provide novel insights to glucose metabolism in humans,"

Useful Tips for Purchasing Diabetes Glucose Monitor Kit

2008-07-13T02:38:00.001-07:00

Whether you are a type 1 or type 2 diabetic, you need to have a regular and constant monitor to find the state of your health. Though most of the diabetic patients understand the importance of testing blood glucose level frequently, many of them are confused about selecting the right kind of meter.

When for the first time they are dictated with blood sugar, they rush to the nearest chemist and take home their glucose monitor kit without considering how effective it can be for them. But, now that research and studies are constantly being upgraded, glucose meters have got new forms and shapes. Whether you are purchasing your diabetes glucose monitor kit for the first time or you are less delighted with the one that you have and trying to get a new one, you have to consider various aspects of the home medical device.

A dependable Glucose meter:

While purchasing your diabetic glucose monitor kit you need to take care of two major aspects. The most expensive one is not surely the best one. There are many good quality strips available at a reasonable price. Hence, you must select the one that is affordable for you. Besides, select the one that has got the maximum features meeting your requirements. A standard diabetic glucose monitor kit is one that displays a striking balance between its cost and features.

Testing Strips:

Testing strips are unique for each testing meter. You may be thinking of the reason behind it. But more than that, it is important to find that which strip will go fine with your diabetes glucose monitor kit. Some models take comparably cheaper strips than other. After selecting the strip to buy take a 30 day test supply on hand. There is no reason why you should take over-the-counter and make it remain in your cupboard for ever.

Reading Logbook:

Now the meters are available with memory of keeping few hundred readings. But it is always better to keep a written logbook of your own that you can take with you to the doctor the next time you visit. It should store not only the readings of your blood glucose record, but also the date, time and the circumstances that led to the fluctuation in the record.

A lancing device and lancets:

Every diabetes glucose monitor kit is available with a lancing device and lancets. It is the most indispensable part of the whole kit as it pokes the skin to bleed for the test. Survey says, most people use and reuse the same lancet before changing it. But every time you should use fresh lancet for best result, less pain and hygiene.

There are some other things that you need to consider. Pick up a disposal container for the sharps like lancets and needles. Once the container is filled up it can be disposed off at a safe place. It is also essential to take blood contaminated materials such as swabs, tissues and test strips.

Type 2 diabetic patients are open to various side effects if they are not controlling their abnormal sugar level. The simple device of diabetes glucose monitor kit can inform you about your glucose level and you can decide on your intake of insulin. In case you are not satisfied with your idea of finding the right kind of device for you, search engine websites is the answer to all. You can search and gather complete information about it. Also you should consult your physician about the strips and the kind of glucose monitor kit that you should use.

Diabetes And Male Infertility are Linked

2008-07-11T17:24:00.001-07:00

Diabetes in men has a direct effect on fertility, a scientist told the 24th annual conference of the European Society of Human Reproduction and Embryology. Dr. Con Mallidis from Queen's University, Belfast, UK, said that, despite the prevailing view that it had little effect on male reproductive function, the Belfast group had shown that diabetes caused DNA damage in sperm.

The increase in the numbers of diabetics diagnosed at a young age has coincided with worldwide concerns over male fertility, he told the conference. "But this is not simply a coincidence," he said. "We have shown for the first time that diabetes adversely influences male fertility at a molecular level."

The scientists studied semen samples from men with diabetes who were receiving insulin therapy. On initial routine microscopic examination the semen samples appeared normal, apart from a slight decrease in volume.

"But when we looked for DNA damage, we saw a very different picture," said Dr. Mallidis, adding that this is not part of a routine semen analysis. "Sperm RNA was significantly altered, and many of the changes we observed are in RNA transcripts involved in DNA repair. And comparison with a database of men of proven fertility confirmed our findings. Diabetics have a significant decrease in their ability to repair sperm DNA, and once this is damaged it cannot be restored."

Transcription is the synthesis of RNA under the direction of DNA, and is the first step towards gene expression, where the information from the gene becomes a product such as a protein translating the genetic information into a cellular function. If there are errors in transcription, there will also be errors in the function of the gene. "We were particularly interested to see a fourteen-fold decrease in the expression of a protein called ornithine decarboxylase, which is responsible for the production of spermine and spermidine, compounds responsible for cell growth that help stabilise the structure of DNA. We also found that spermatogenesis 20, a factor unique to the testis and whose function remains unknown, was greatly increased. Taken together, these factors indicate clearly that having diabetes has a direct influence on the health of semen."

Sperm DNA quality is known to be associated with decreased embryo quality, low embryo implantation rates, higher miscarriage rates, and some serious childhood diseases, in particular some childhood cancers. Over the years possible causes for sperm DNA fragmentation have been suggested but to date the exact mechanism for the damage remains unknown, say the scientists.

"We found a class of compounds known as advanced glycation end products (AGEs) in the male reproductive tract. These are formed as the result of glycation (the addition of sugar)," said Dr. Mallidis, "and accumulate during normal ageing. They are dependent on life style - diet, smoking etc - and in many diabetic complications are centrally implicated in DNA damage. We believe that they play a similar role in the male reproductive system."

The scientists intend to follow up their work by trying to determine how AGEs cause and contribute to DNA damage. They believe that they may have uncovered a new role for AGEs, and that their influence goes far beyond diabetes and its complications.

"We must now try to develop strategies to protect sperm, and to diminish the accumulation of AGEs," said Dr. Mallidis. Such strategies could involve changes in diet, disrupting a step in the formation of AGEs, or increasing the body's protection against AGEs, possibly through the use of dietary supplements.

"Finally, there is spermatogenesis 20. What does it do, how does it do it, under what circumstances and why? Why is it so greatly increased in diabetics? We need to find answers to all these questions," said Dr. Mallidis.

Restricting Insulin Doses Increases Mortality Risk

2008-07-10T17:54:00.000-07:00

A new study led by researchers at the Joslin Diabetes Center has found that women with type 1 diabetes who reported taking less insulin than prescribed had a three-fold increased risk of death and higher rates of disease complications than those who did not skip needed insulin shots. The new research appears in the March issue of Diabetes Care.

The study highlights the dangers of insulin restriction and concludes that mortality associated with the behavior appears to occur in the context of eating disorder symptoms often exhibited in women with diabetes – sometimes referred to as “diabulimia” in the media.

This 11-year follow-up study of 234 women is one of the first to show an increased risk of mortality as well as higher rates of kidney and foot problems in those who restricted their insulin intake. In addition, the average age of death was younger for those involved in insulin restriction: 45 years of age as compared to 58 years for those who did not restrict.Thirty percent of the subjects reported restricting their insulin intake at the study’s outset. Frequency of the behavior appears to influence mortality risk. Insulin-restricting women who died had reported more frequent insulin restriction and reported more eating disorder symptoms at the study’s outset than those insulin-restrictors who were still living at study’s end.

Eating disorder symptoms include extreme concern for body weight and shape, judging self worth according to a thin body ideal, restrictive eating patterns, binge eating and other methods of purging calories, such as vomiting.

“This is an incredibly important women’s health issue in the area of diabetes,” said lead author Ann E. Goebel-Fabbri, Ph.D., psychologist and investigator in the Section on Behavioral and Mental Health at Joslin Diabetes Center and instructor at Harvard Medical School. “The average age of death was significantly younger in the insulin-restricting group,” said Goebel-Fabbri. “This behavior emerged as a significant risk factor for mortality.”

Type 1 diabetes is the autoimmune form of the disease, in which the body is no longer able to produce insulin, a hormone which allows the body to utilize and store calories for energy. Current treatment guidelines for type 1 diabetes aim at achieving near normal blood glucose ranges by taking multiple daily doses of insulin. This study’s findings strongly suggest that insulin restriction and related eating disorder behaviors may be unique barriers to achieving optimal diabetes management, Goebel-Fabbri said.

“Women with this behavior need specialized treatment by someone who understands the connection between eating disorders and diabetes,” she said. “We know that current type 1 diabetes treatment is especially good at preventing complications and preserving longevity. The biggest frustration is knowing that these women, by virtue of their eating disorders, are unable to utilize that lifesaving set of tools.”

Goebel-Fabbri noted that other studies have shown that women with diabetes are nearly 2.5 times more likely to develop an eating disorder than women without diabetes. Warning signs include: unexplained elevations in A1c levels; repeated problems with diabetic ketoacidosis (DKA), which can be fatal; extreme concerns about weight and body shape; change in eating patterns; unusual pattern of intense exercise (sometimes associated with frequent hypoglycemia); and ammenorrhea (skipping monthly menstrual cycles).

“Raising awareness of the impact of insulin restriction among clinicians who treat type 1 diabetes is extremely important so that they can make appropriate assessments and referrals to mental health professionals who are experienced in the treatment of people with diabetes,” said study co-author Katie Weinger, Ed.D., R.N., investigator in the Section on Behavioral and Mental Health at Joslin Diabetes Center and assistant professor of Psychiatry at Harvard Medical School.

Diabetes Recipe-Vegetable Chili

2008-07-09T21:43:00.001-07:00

"This is a great dish that takes no time at all. It can be made without the meat and it still tastes great. Great for potlucks! When dished out, add sour cream to thicken and add hot pepper sauce for zip!"

PREP TIME
15 Min

COOK TIME
30 Min

READY IN
45 Min

INGREDIENTS (Nutrition)

    * 1 pound cubed turkey breast
    * 1 cup minced onion
    * 1 tablespoon minced garlic
    * 2 teaspoons chili powder
    * 1/2 teaspoon ground cumin
    * 1/8 teaspoon ground cinnamon
    * 1 (14.5 ounce) can peeled and diced tomatoes
    * 1 (14 ounce) can chicken broth
    * 1 (15 ounce) can kidney beans
    * 1 (15 ounce) can pinto beans
    * 1 (10 ounce) package frozen corn kernels

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DIRECTIONS

1. In a large pot over medium heat, cook turkey until browned. Stir in onions, cover and cook 5 minutes.
2. Stir in garlic, chili powder, cumin and cinnamon and cook until fragrant, about a minute. Pour in tomatoes and bring to a boil. Stir in broth, kidney beans, pinto beans and corn and bring to a boil again. Then reduce heat and simmer 10 minutes, or until thoroughly heated.

Vitamins block post-meal grogginess in diabetics

2008-07-08T23:29:00.001-07:00

Fatty meals may cloud the brains of people with type 2 diabetes, but antioxidant vitamins can help clear the fog, Canadian researchers demonstrated in a study they conducted.

The findings suggest, the researchers say, that memory impairment after heavy meals in type 2 diabetics is related to oxidative damage.

The findings shouldn't be interpreted to mean that people can avoid the harmful consequences of fatty foods and "bad carbs" by popping vitamin pills, Dr. Carol Greenwood of the University of Toronto, who was involved in the study, told Reuters Health.

In the study, Greenwood and colleague Michael Herman Chui had 16 men and women with type 2 diabetes who were 50 and older eat three different meals at three separate weekly sessions: a Danish, cheddar cheese and yogurt with whipped cream; water only; or the same meal plus 1000 milligrams of vitamin C and 800 international units of vitamin E.

They found that people performed worse on tests of verbal recall and working memory 105 minutes after eating the high fat meal. But when they took vitamins with the meal, they did just as well on the tests as they did after drinking water.

The cognitive effects observed in the study were subtle, but large enough to impair performance, Greenwood said in an interview. "It kind of makes the 50-year-old brain more like the 75-year-old brain," she explained. And these effects could accumulate to cause lasting damage, according to the researcher.

Greenwood said studies are planned using brain imaging to look at what exactly happens in the brain of diabetes patients after a heavy meal.

Diet 'helps prevent diabetes'

2008-07-08T00:32:00.001-07:00

Sticking to a diet which includes fruit, vegetables, fibre and healthier fats could protect against type two diabetes, a study suggests. More than 14,000 Spanish volunteers were quizzed about eating habits, then checked over four years to see who developed the condition.

The results pointed to an 83% lower risk for those who followed the diet, the British Medical Journal reported.

But UK experts said the study was not conclusive.

People living in Crete, southern Italy and Greece provided the inspiration for the so-called Mediterranean diet.

Their traditional lifestyle involved not only regular exercise, but also plenty of fish, fruit and vegetables, usually cooked in olive oil, and washed down with the occasional glass of red wine.

Studies have suggested that modern diets based on this ideal could improve heart health.

The idea that it could also reduce the risk of diabetes is a logical step - olive oil is already known to improve blood sugar control and lower blood pressure.

The 14,000 men and women, of varying ages, were all scored on their own recollection of which elements of the Mediterranean diet they followed in day-to-day life, and split into three groups, depending on the level of their adherence to the diet.

As well as gaining a point for eating key ingredients fish, fruit and olive oil, they got one for cutting back on animal fats and keeping to a moderate alcohol intake.

The highest group had managed seven or more points, while the bottom group had less than three points.

The researchers then waited to see who developed diabetes over the next four years, and found that the average risk for those in the highest group was 83% lower than for those in the lowest group.

Those in the middle had a 59% fall in the risk of diabetes.

Too young

However, the average age of those taking part was around 40 years old - under the normal age for type II diabetes to strike, and the study authors conceded that the relatively low numbers of new cases of the condition over their four-year period made the results harder to rely on.

They called for bigger and longer-term studies to test the diet.

Dr Iain Frame from Diabetes UK said another weakness was the questionnaire format, which relied on volunteers' honesty and memory to give accurate results.

He said: "Although it is interesting that the researchers conclude that a Mediterranean diet could provide protection against Type II diabetes, more robust research is needed before we can draw any firm conclusions about this claim.

"A fundamental link between being overweight and developing Type 2 diabetes has already been proven.

"Diabetes UK advises people to follow a healthy diet low in fat, sugar and salt with plenty of fruit and vegetables, and to take regular physical activity to reduce the risk of developing the condition."

Gaining Body Fat May Be Good For Those With Type 1 Diabetes

2008-07-06T23:31:00.001-07:00

Gaining body fat may be a good thing, at least for people with type 1 diabetes, say researchers at the University of Pittsburgh Graduate School of Public Health. Their study, being presented at the 68th Scientific Sessions of the American Diabetes Association in San Francisco, followed 655 patients with type 1 diabetes for 20 years and found that patients who gained weight over time were less likely to die.
The findings are based on participants in the Pittsburgh Epidemiology of Diabetes Complications Study, a long-term prospective study of childhood onset type 1 diabetes, which began in 1986. Participants in the study, an average age of 28 when entering the study and 44 at its completion, were diagnosed with type 1 diabetes between 1950 and 1980. Researchers measured patients' body mass index (BMI) and waist circumference and assessed BMI every two years during the study period. Over the course of the study, 147 deaths occurred.
Results showed that patients whose BMI increased the most during the study (2 to 11 points or about 10 to 55 pounds) were one-third less likely to die than those who had smaller increases in BMI, indicating that weight gain may protect people with type 1 diabetes from premature death.
"Although weight gain in adulthood is typically associated with increased mortality, this may not be the case for those with type 1 diabetes," said Trevor Orchard, M.D., professor of epidemiology at the University of Pittsburgh Graduate School of Public Health. "Gaining a reasonable amount of weight may be a sign patients are getting enough insulin and appropriately controlling their disease, which may partly explain why those who gained weight over time had lower mortality rates," said Dr. Orchard, who also is professor of medicine and pediatrics at the University of Pittsburgh School of Medicine.
Dr. Orchard and colleagues also looked at BMI ranges and mortality and found no difference in mortality between those with a BMI in the overweight range (BMI 25 to 30) and the normal range (BMI 20 to 25). Conversely, they found that having a BMI in the underweight (BMI less than 20) or obese range (BMI 30 and greater) was a strong predictor of mortality. When researchers controlled for waist circumference, a commonly cited reason for general fat mortality, patients with a BMI in the underweight range were at greatest risk for death, while those with a BMI in the overweight or obese ranges had a decreased risk of mortality compared to patients with a normal BMI.
"These results are not a firm recommendation to people with type 1 diabetes to put on weight, but it does raise the possibility that weight recommendations in type 1 diabetes may be somewhat different than those for the general population, and emphasizes the complex relationship between body fat and mortality in diabetes," added Baqiyyah Conway, M.P.H., lead author of the abstract.
Previously known as juvenile diabetes, type 1 diabetes is usually diagnosed in children and young adults. In type 1 diabetes, the pancreas produces little or no insulin to properly control blood sugar levels. It is typically treated with insulin replacement therapy. As many as 3 million Americans have type 1 diabetes.

How Exercise Affects Diabetes

2008-07-06T02:46:00.001-07:00

Exercise helps control blood glucose levels, increases energy levels, improves heart health, and promotes emotional well-being. Barring other medical complications, the majority of people with type 1 and type 2 diabetes can participate in, and benefit from, at least 30 to 60 minutes of physical activity most days of the week. Always consult your healthcare team before starting a new exercise program.

Type 1 Diabetes

Exercise has many positive health benefits, including short-term blood glucose control, and is recommended for most people with type 1 diabetes.

Because exercise typically has a blood glucose lowering effect, people with type 1 diabetes need to pay particular attention to their blood glucose levels before, during, and after exercise. They should also take certain measures to prevent blood sugar emergencies.

It’s important to note that although exercise generally has a blood glucose lowering effect, for some people with type 1 diabetes an intensive workout can actually cause hyperglycemia, or high blood sugars, particularly if blood glucose levels were high prior to the workout. Monitoring blood glucose levels before and after working out and logging your glycemic response to different physical activities are important tools for safe exercise with type 1 diabetes.

Type 2 Diabetes

Leading a sedentary (or inactive) lifestyle is one of the major risk factors for developing type 2 diabetes, and the high incidence of obesity and overweight among people with type 2 is also highly correlated with inactivity. Starting a workout program can lower body mass and consequently decrease the insulin resistance of type 2 diabetes; studies have shown that people with type 2 diabetes who exercise regularly have better A1c profiles than those who don’t. Along with medical nutrition therapy, exercise is one of the first lines of defense in type 2 diabetes control.

In addition, exercise is a key tool in preventing one of the leading complications of type 2 diabetes—cardiovascular disease. Studies have shown that regular activity lowers triglyceride levels and blood pressure.

Diabetic Diet Dos and Don’ts

2008-07-06T02:35:00.001-07:00

Diabetic Diet Dos

For breakfast, take cholesterol-lowering oatmeal

Have nuts rich in mono unsaturated fat, such as pecans, walnuts, and almonds

Eat pasta, stews and leafy salads along with beans-- kidney beans, chick peas, and dry beans, navy beans and peas which can reduce LDL "bad"; cholesterol

Fat free milk, yogurt, and cheese to be taken

Eggs whites to be included

White meat chicken and Fish and shellfish (not battered) are good

Increase intake of dry beans and peas

Have at least 20 to 25 grams of raw onion daily

Add wheat bran to your wheat flour (50% wheat flour + 50% wheat bran). This helps increase fiber in your diet

You can also add flaxseed and methi seeds into the wheat flour

Increase fiber intake in the form of raw fruits, vegetables, whole cereals etc

Intake of cinnamon, garlic, onion, karela( bitter gaurd), guar beans is known to considerably reduce blood glucose level

Diabetic Diet Don'ts

Don't fry foods instead bake, broil, poach or saute in nonstick pans. Steam or microwave vegetables. Buy tuna packed in water, not oil

Eat less high-fat red meat and more low-fat turkey and fish. Avoid organ meats

Limit the use of condiments such as ketchup, mustard and salad dress ion--they're high in salt and can be high in sugar, too

Rinse processed foods in water and, wherever possible, choose fresh foods over canned

Limit your salt (sodium content)

Read labels carefully. Soy sauce, brine and MSG, for example, contain a lot of sodium

Don't select ready to eat and junk foods items available to you

Don't smoke and stop alcohol consumption

Don't skip meals and medicine times

What does diabetes have to do with heart disease?

2008-07-06T02:28:00.001-07:00

People with diabetes are more likely to get heart disease. When you have diabetes, your blood sugar level is often much higher than it should be. Too much sugar in the blood can cause damage to many parts of the body, including blood vessels. Some lifestyle habits may also raise the risk of heart disease. Here are some things you can do to lower your risk:

1. Keep your blood sugar level under control.
Keeping your blood sugar level under control will lower your risk of heart disease. Many people with diabetes check their blood sugar level every day to make sure that their medicines and diet and exercise are working to keep blood sugar in a normal range.

By exercising often and eating a healthy diet, many people with type 2 diabetes (the kind of diabetes you're not born with) can keep their blood sugar level nearly normal. Some people have to take medicines to control their blood sugar level.

2. Lose weight--and keep it off.
Diabetes, being overweight and heart disease often go together. Losing weight helps a lot of health problems. For example, if you have been told that your blood pressure is too high, losing weight can bring it down. If your blood sugar level has been hard to control, losing weight can help.

Weight loss is important if you have a lot of extra weight around your waist and tummy. People who have "spare-tire" or fat around their waist are more at risk for heart disease than people who have extra weight around the hips or thighs.

You don't have to lose a huge amount to lower your risk for heart disease. Losing even 10 pounds can help.

3. Lower your cholesterol level.
Cholesterol is in many fats and oils, but it is not a fat. It is a part of many important body substances (like hormones) and body structures (including the brain and nerves). But, too much cholesterol in your blood can clog your arteries.

You've probably heard about "good" and "bad" cholesterol. Bad cholesterol or LDL cholesterol, which stands for low-density lipoprotein, can clog your arteries and lead to heart disease. Good cholesterol or HDL cholesterol, which stands for high-density lipoprotein, carries unneeded cholesterol away from body tissues, so it lowers your risk of heart disease.

If your doctor says your cholesterol level is too high, what can you do about it? It helps to lose weight and eat a healthy diet. Your diet should limit the amount of fatty and cholesterol-rich foods you eat.

There are many cookbooks available that contain low-fat, heart-healthy recipes and meal suggestions. If you need help figuring out how to change your diet, your doctor might refer you to a dietitian. A dietitian has special training in planning healthy diets.

If diet alone doesn't lower your cholesterol , medicines can help do that. You and your doctor can talk about these medicines. The medicine that is best for you depends on your special needs and medical condition.

4. Increase your physical activity.
Along with diet, exercise is very important for people with diabetes. Diet and exercise work together to help your body work properly. If you have changed your diet to lose weight, exercising can help you lose weight faster.

You and your doctor can plan exercises that will work for you and be safe. You don't need a gym or expensive equipment to get good exercise. Brisk walking is great exercise. Climbing stairs instead of taking an elevator is another good thing to do.

Like eating a healthy diet, exercise will also help keep your blood sugar level normal and can lower your risk of heart disease.

5. Control your blood pressure.
People with diabetes often have high blood pressure too. High blood pressure is a big risk factor for stroke. It also increases your risk for heart disease and kidney disease.

The same lifestyle changes that control blood sugar levels and lower your risk of heart disease may also keep your blood pressure at safe levels. Weight loss and exercise are important. The more weight you lose, the more you lower your blood pressure. It is also important not to drink very much alcohol.

If your blood pressure doesn't come down enough with diet and exercise, your doctor might have you take medicines that will help.

6. If you smoke, stop smoking.
Smoking is bad for everyone but it's even worse for people with diabetes because it damages the blood vessels. If you have diabetes and you also smoke, you double your risk of getting heart disease. Worse still, if you keep smoking while you try to reduce other risks (like losing extra weight), you won't be able to exercise as much and you probably won't lose the weight you need to.

Remember:
Diabetes and heart disease are related. Diabetes, being overweight and having high blood pressure are related. Diet and exercise are good ways to control your blood sugar level, lower your blood pressure and cut your risk of getting heart disease. When diet and exercise don't help enough, medicines can help control blood sugar levels, lower cholesterol levels and control blood pressure. You can do a lot to help by your own efforts.

All about Insulin

2008-07-06T00:29:00.001-07:00

Insulin is a natural hormone made by the pancreas that controls the level of the sugar glucose in the blood. Insulin is synthesized in humans and other mammals within the beta cells (B-cells) of the islets of Langerhans in the pancreas. Insulin is derived from
proinsulin by cleavage of the C-peptide structure at the dipeptides Arg-Arg and Lys-Arg. Insulin is composed of an A chain of 21 amino acids and a B chain of 30 amino acids, the chains being held together by two disulfide bonds. Insulin is available from bovine (beef), porcine (pork), and recombinant (human) sources. Beef insulin differs from human insulin in two amino acid residues, and pork insulin in one residue. Fish insulin is also close enough to human insulin to be effective. In humans, insulin has a molecular weight of 5734. Regular (rapid onset, short-acting) and NPH (slower onset, longer duration) human insulin are the most commonly-used preparations.

Insulin plays a major part in the uptake of glucose by the cells of the body. It stimulates the formation of glycogen in the muscles and in the liver, while suppressing gluconeogenesis by the liver. When glucose enters our blood, the pancreas should automatically produce the right amount of insulin to move glucose into our cells. People with type 1 diabetes produce no insulin. People with type 2 diabetes do not always produce enough insulin. Glucose is normally the only sugar found in the blood. Blood glucose concentrations are kept within a relatively narrow range by such factors as hepatic and renal uptake and release, glucose removal by peripheral tissues, hormone influences on uptake and release, and intestinal absorption. Digestion causes carbohydrates to break down into glucose. After digestion, glucose is carried in the blood and goes to body cells where it is used for energy or stored. Insulin helps the body utilize blood glucose (blood sugar) by binding with receptors on cells like a key would fit into a lock. Once the key insulin- has unlocked the door, the glucose can pass from the blood into the cell. Inside the cell, glucose is either used for energy or stored for future use in the form of glycogen in liver or muscle cells.
Actions and functions of insulin
Insulin acts to promote the cellular uptake of blood glucose and, therefore, to lower the blood glucose concentration. The major function of insulin is to counter the concerted action of a number of hyperglycemia-generating hormones and to maintain low blood glucose levels. Insulin stimulates lipogenesis, diminishes lipolysis, and increases amino acid transport into cells. Insulin also
modulates transcription, altering the cell content of numerous mRNAs. It stimulates growth, DNA synthesis, and cell replication, effects that it holds in common with the insulin-like growth factors (IGFs) and relaxin. Insulin acts to reduce extracellular (including blood plasma) levels of glucose by interacting in some way yet unknown with various cell membranes.

Insulin induces its effects by binding to specific tyrosine kinase receptors in the plasma membrane of its target cells. Insulin stimulates the synthesis of glycogen by triggering a pathway that dephosphorylates glycogen synthase. The dephosphorylation activates the synthase. This also leads to the dephosphorylation of phosphorylase kinase, an enzyme needed in the breakdown of glucose. In adipose (fatty) tissue it facilitates the cellular uptake of glucose and its subsequent conversion to fatty acids, and it inhibits the breakdown of fatty acids to simpler compounds. In muscle insulin facilitates the transport of glucose into cells and in addition stimulates its conversion to glycogen. Insulin also increases protein synthesis in muscle. In the liver, insulin facilitates glucose catabolism and its conversion to glycogen and inhibits its synthesis from simpler compounds.

Insulin is used medically in some forms of diabetes mellitus. Patients with Type 1 diabetes mellitus depend on exogenous insulin (injected subcutaneously) for their survival because of an absolute deficiency of the hormone; patients with Type 2 diabetes mellitus have either relatively low insulin production or insulin resistance, and occasionally require insulin administration if other medications are inadequate in controlling blood glucose levels. Insulin forces storage of glucose in liver (and muscle) cells in the form of glycogen, lowered levels of insulin cause liver cells to convert glycogen to glucose and excrete it into the blood. This is the clinical action of insulin which is useful in reducing high blood glucose levels in diabetes.
Insulin resistance syndrome

Insulin resistance syndrome, or Syndrome X, is a condition where muscle cells have lost insulin sensitivity to the point that glucose no longer enters them. This causes more insulin to be released by the pancreas, resulting in an excess amount of insulin circulating in the blood and often a craving for more food. Insulin resistance is a decreased ability to use insulin to transport glucose into the body’s cells where it is needed for energy production. Insulin resistance can be linked to diabetes, hypertension, dyslipidemia, cardiovascular disease and other abnormalities. These abnormalities constitute the insulin resistance syndrome. Insulin resistance syndrome is caused by elevated insulin levels due to high blood pressure, high triglycerides and low HDL, excessive fat tissue in the abdominal region or a family history of diabetes. Insulin resistance occurs when the normal amount of insulin secreted by the pancreas is not able to unlock the door to cells. To maintain a normal blood glucose, the pancreas secretes additional insulin. In some cases (about 1/3 of the people with insulin resistance), when the body cells resist or do not respond to even high levels of insulin, glucose builds up in the blood resulting in high blood glucose or type 2 diabetes. Even people with diabetes who take oral medication or require insulin injections to control their blood glucose levels can have higher than normal blood insulin levels due to insulin resistance.
Insulin and diabetes mellitus

Diabetes is a disease that occurs when the body is either unable to produce insulin or to use it properly. Diabetes mellitus is characterized by varying or persistent hyperglycemia (elevated blood sugar levels), especially after eating. All types of diabetes mellitus share similar symptoms and complications at advanced stages. Hyperglycemia itself can lead to dehydration and ketoacidosis. The most important forms of diabetes are due to decreased production of insulin (diabetes mellitus type 1), or decreased sensitivity of body tissues to insulin (diabetes mellitus type 2, the more common form). Type I, which is genetic, is caused by an autoimmune response of the white blood cells to destroy the beta cells of the pancreas. The only treatment available for this type of diabetes is insulin injections. Type II diabetes is much more common and does not require the injection of insulin. It is usually caused by too high an insulin concentration in the blood stream. This is caused by the target cells' hyporesponsiveness to insulin. Type 1 diabetes most often manifests in childhood (hence also called juvenile onset diabetes) and is the result of an autoimmune destruction of the b-cells of the pancreas. Non-insulin-dependent diabetes mellitus (NIDDM or type 2 diabetes) is characterized by persistent hyperglycemia but rarely leads to ketoacidosis. Type 2 diabetes generally manifests after age 40 and therefore has the obselete name of adult onset-type diabetes. Type 2 diabetes can result from genetics defects that cause both insulin resistance and insulin deficiency.

Diabetes and Herbal Remedies

2008-07-06T00:09:00.001-07:00

Using herbal remedies and plant derivatives to help in the treatment of diabetes should certainly not be discounted. Although numerous ‘miracle herbal cure’ companies exist, and champion the ability of herbal compounds to supplement insulin as a treatment; these should not be taken at face value without thorough research and consultation with experts. That is not to say that some of the following herbs do not have properties that some diabetics will find beneficial. The herbs and plant derivatives listed below have largely been employed traditionally by native people in the treatment of diabetes, in the areas in which they grow. Many suffer from an inadequate knowledge base.

Allium

Allium sativum is more commonly known as garlic, and is thought to offer antioxidant properties and micro-circulatory effects. Although few studies have directly linked allium with insulin and glucose levels, results have been positive. Allium may cause a reduction in blood glucose, increase secretion and slow the degradation of insulin. Limited data is available however, and further trials are needed.

Aloe vera

Aloe Vera is a widely known household plant originating from arid countries and resembling the cactus. Grown across the globe, aloe is used as an after-sun lotion, to treat burns and to promote wound healing. It is well-regarded as a ‘healing herb.’ In some parts of the world, dried aloe vera sap and gel (taken from the inner portions of the leaves) are used traditionally to treat diabetes. Aloe vera may be able to lower fasting blood glucose levels as well as HbA1c.

Bauhinia forficata and Myrcia uniflora

Bauhinia forficata grows in South America, and is used in Brazilian herbal cures. This plant has been referred to as ‘vegetable insulin.’ Myrcia uniflora is also widely employed in South America. Studies utilising the herbs as tea infusions suggest that their hypoglycaemic effects are overrated.

Coccinia indica

Coccinia indica is also known as the ‘ivy gourd’ and grows wild across the Indian subcontinent. Traditionally employed in ayurverdic remedies, the herb has been found to contain insulin-mimetic properties (i.e; it mimics the function of insulin.) Significant changes in glycaemic control have been reported in studies involving coccinia indica, and experts believe that it should be studied further.

Ficus carica

Ficus carica, or fig-leaf, is well known as a diabetic remedy in Spain and South-western Europe, but its active component is unknown. Some studies on animals suggest that fig-leaf facilitates glucose uptake. The efficacy of the plant is, however, still yet to be validated in the treatment of diabetes.

Ginseng

Ginseng is a collective name for a variety of different plant species. In some studies utilising American ginseng, decreases in fasting blood glucose were reported. Varieties include Korean ginseng, Siberian ginseng, American ginseng and Japanese ginseng. In some fields the plant, particularly the panax species, are hailed as ‘cure-all.’ As is the case with many of the herbs employed around the world in the treatment of diabetics, further long-term studies are needed to verify the efficacy of ginseng.

Gymnema sylvestre

Gymnema sylvestre is also employed in traditional ayurverdic medicine. The plant grows in the tropical forests of southern and central India, and has been linked with significant blood glucose lowering. Some studies in animals have even reported regeneration of islet cells and an increase in beta-cell function.

Momordica charantia

Momordica Charantia goes under a variety of names and is native to some areas of Asia, India, Africa and South America. Marketed as charantia, it is also known as karela or karolla and bitter melon. The herb may be prepared in a variety of different ways, and may be able to help diabetics with insulin secretion, glucose oxidation and other processes. Acute effects on blood glucose levels have also been reported.

Ocimum sanctum

Ocimum sanctum is an herb employed in traditional ayurverdic practises, and is commonly known as holy basil. A controlled clinical trial showed a positive effect on postprandial and fasting glucose, and experts predict that the herb could enhance the functioning of beta cells, and facilitate the insulin secretion process.

Opuntia streptacantha

Opuntia streptacantha (nopal) is commonly known as the prickly-pear cactus in the arid regions where it grows. Inhabitants of the Mexican desert have traditionally employed the plant in glucose control. Intestinal glucose uptake may be affected by some properties of the plant, and animal studies have found significant decreases in postprandial glucose and HbA1c. Once again, to validate the prickly-pear cactus as an effective means of aiding diabetic patients, long-term clinical trials are needed.

Silibum marianum

Silibum marianum is also known as milk thistle, and is a member of the aster family. Silymarin contains high concentrations of flavinoids and antioxidants, some of which may have a beneficial effect on insulin resistance. The role of milk thistle in glycaemic control is little understood.

Trigonella foenum graecum

Trigonella foenum graecum is known as fenugreek and is widely grown in India, North Africa, and parts of the Mediterranean. It is also a part of Ayurverdic treatment, and is used extensively in cooking. Of the few non-controlled trials that have been carried out on type 2 diabetics, most report improved glycaemic control. Further study is certainly warranted.

Further herbs that have been studied, and may have positive effects for diabetic patients include berberine, Cinnamomym tamala, curry, Eugenia jambolana, gingko, Phyllanthus amarus, Pterocarpus marsupium, Solanum torvum, and Vinca rosea.

Vitamins block post-meal grogginess in diabetics

2008-07-04T22:12:00.001-07:00

Fatty meals may cloud the brains of people with type 2 diabetes, but antioxidant vitamins can help clear the fog, Canadian researchers demonstrated in a study they conducted.

The findings suggest, the researchers say, that memory impairment after heavy meals in type 2 diabetics is related to oxidative damage.

Greenwood said studies are planned using brain imaging to look at what exactly happens in the brain of diabetes patients after a heavy meal.

Through New Findings Cure of Diabetes Now Possible

2008-07-03T21:50:00.001-07:00

Processes that can shed light on the release of the blood sugar-lowering hormone insulin and thus act as a potential target for developing improved diabetes treatment are being detailed by a new study.

Cyclic AMP (cAMP) is a universal messenger molecule that plays a vital role in the release of insulin from the beta cells in the pancreas and production of cAMP explains how certain hormones can amplify insulin secretion.

The team led by Anders Tengholms at Uppsala University has developed methods that can help in measuring both the secretion of insulin and the cAMP concentration in individual beta cells.

The discovery was based on the development of image analysis methods that make possible the detailed study of events immediately inside the plasma membrane of the insulin-secreting cells.

The results show that ATP, the energy-rich molecule that is produced when glucose is metabolized, causes an increase in cAMP concentration right at the cell membrane where the release of insulin takes place.

This increase varies rhythmically and coincides with similarly regular variations in another stimulant messenger, the calcium ion, resulting in pulsatile secretion of insulin.

Tengholm said that optimal glucose-induced insulin secretion requires that the varying cAMP and calcium signals are coordinated in time.

The new study helps in understanding the cellular mechanisms that underlie the pulsatile release of insulin in healthy individuals.

The connection between metabolism and cAMP is not only important for the secretion of insulin; it also plays a role in gene regulation, cell growth, and cell survival.

The observations thereby pave the way for understanding of the disturbed beta cell function in type 2 diabetes and for the development of new drugs for the disease.

Diabetes: Underrated, Insidious and Deadly

2008-07-02T23:59:00.001-07:00

In a set of recent focus groups, participants were asked to rank the severity of various health problems, including cancer, heart disease and diabetes.On a scale of 1 to 10, cancer and heart disease consistently ranked as 9s and 10s. But diabetes scored only 4s and 5s.

“The general consensus seems to be, ‘There’s medication,’ ‘Look how good people look with diabetes’ or ‘I’ve never heard of anybody dying of diabetes,’ ” said Larry Hausner, chief executive of the American Diabetes Association, which held the focus groups. “There was so little understanding about everything that dealt with diabetes.”

But diabetes is anything but minor. It wreaks havoc on the entire body, affecting everything from hearing and vision to sexual function, mental health and sleep. It is the leading cause of blindness, amputations and kidney failure, and it can triple the risk for heart attack and stroke.

“It is a disease that does have the ability to eat you alive,” said Dr. John B. Buse, a professor at the University of North Carolina School of Medicine who is the diabetes association’s president for medicine and science. “It can be just awful — it’s almost unimaginable how bad it can be.”

Diabetes results when the body cannot use blood sugar as energy, either because it has too little insulin or because it cannot use insulin. Type 2 diabetes, which accounts for 90 to 95 percent of cases, typically develops later in life and is associated with obesity and lack of exercise. Type 1 diabetes, which is often diagnosed in children, occurs when the immune system mistakenly destroys cells that make the insulin.

The disconnect between perception and reality is particularly worrisome at a time when national diabetes rates are surging. Just last week, the Centers for Disease Control and Prevention announced that the number of Americans with diabetes had grown to about 24 million, or 8 percent of the population. Almost 25 percent of those aged 60 and older had diabetes in 2007. And the C.D.C. estimates that 57 million people have abnormal blood sugar levels that qualify as pre-diabetes.

To be sure, diabetes is treatable, and an array of new medications and monitoring tools have dramatically improved the quality of care. But keeping the illness in check requires constant vigilance and expensive care, along with lifestyle changes like losing weight, exercising regularly and watching your carbohydrates.

Dr. Buse says patients who are focused on their disease and who have access to regular medical care have a good chance of living out a normal life span without developing a diabetes-related disability.

But some patients say they are too busy to take better care of themselves, and many low-income patients can’t afford regular care. Even people with health insurance struggle to keep up with the co-payments for frequent doctor visits and multiple medications.

And to make matters worse, diabetes is associated with numerous other health problems. Last week, for example, The Journal of the American Medical Association reported that people with depression were at higher risk for Type 2 diabetes, and vice versa.

That is not surprising: according to data published last year in the journal Diabetes Care, depression tends to interfere with a patient’s self-care, which requires glucose monitoring, medications, dietary changes and exercise.

Ultimately, diabetes can take a toll from head to toe. In the brain, it raises the risk not only for depression but also for sleep problems and stroke. It endangers vision and dental health. This month, The Annals of Internal Medicine is reporting that the disease more than doubles the risk of hearing loss.

Moving down the body, diabetes can lead to liver and kidney disease, along with serious gastrointestinal complications like paralysis of the stomach and loss of bowel control. Last year the journal Diabetes Care reported that in a sample of nearly 3,000 patients with diabetes, 70 percent had nonalcohol fatty liver disease.

Poor circulation and a loss of feeling in the extremities, called neuropathy, can lead to severe ulcers and infections; each year in the United States, there are about 86,000 diabetes-related amputations.

Diabetes can also take a toll on relationships. By some estimates, 50 percent to 80 percent of men with diabetes suffer from erectile dysfunction. Experts say women with diabetes often lose their libidos or suffer from vaginal dryness.

The challenge for doctors is to convince patients that diabetes is a major health threat. For years, the message from the American Diabetes Association has been one of reassurance that the disease is treatable. Now, beginning in 2009, the association plans to reframe its message to better communicate the seriousness of the disease.

“Our communication strategy is going to be that diabetes has deadly consequences, and that the A.D.A. is here to change the future of diabetes,” said Mr. Hausner, a former executive with the Leukemia and Lymphoma Society who came to the association 10 months ago. “It’s the word ‘deadly’ that was the potentially controversial word for the organization. In the past, people said, ‘We don’t want to get anybody scared.’ ”

The new strategy is not a scare tactic, he added. Prevention and hope will still be part of the message.

“It’s not that we don’t want people to have hope,” he said. “We want people to understand this is serious.”

Better Diabetes Control In Children

2008-07-02T22:30:00.001-07:00

A study by researchers at the Joslin Diabetes Center has shown that adherence to prescribed dietary recommendations is associated with better glucose control in children with type 1 diabetes.

"In recent years, diabetes management has been focused around new medications and technologies," said Lori Laffel, M.D., senior author of the paper, which is published in the July issue of Diabetes Care. "In this study, we were encouraged to identify the unique importance of diet on blood sugar control in children and teens with type 1 diabetes."

Laffel is Chief of Joslin Diabetes Center's Pediatric, Adolescent and Young Adult Section and an Investigator in the Joslin Section on Genetics and Epidemiology.

The study surveyed the parents of 119 children and teens ages 9-14 years and asked how closely they followed prescribed dietary behaviors, such as estimating carbohydrate intake, matching the child's insulin dose to carbohydrate intake and the quality of the diet itself, in terms of intake of sweets and fats.

Subjects who most closely adhered to the dietary recommendations had lower A1C levels - a measurement of average blood glucose deemed the best way to estimate overall glucose control. Lower A1C levels mean better glucose control.

Children who adhered closely or fairly closely to the prescribed dietary recommendations showed an A1C level of up to almost a full point lower than those who were least adherent. Those who adhered the least had an average A1C of 9 percent, while those who adhered more closely to the recommendations had an average A1C between 8.1 and 8.4 percent, depending on their level of adherence.

The A1C difference of between 0.6 and 0.9 is considered significant, according to Sanjeev Mehta, M.D., lead author and a Joslin staff physician and research associate, who noted that lowering A1C scores is associated with a significant reduction in risk of diabetes-related complications.

"By achieving target A1C levels, the long-term risk of complications can be reduced by 50 to 75 percent," he said. "For every point you lower your A1C score, the risk is reduced further."

Mehta said the study's demonstration that dietary behaviors are directly associated with glycemic control provides families with another avenue through which they can optimize their children's diabetes management. He noted that this study highlights the importance of dietary adherence in achieving optimal glucose control in the era where more youth with type 1 diabetes are using new technologies, such as insulin pumps and rapid acting insulin.

"The relative importance of dietary behaviors in diabetes management had not been investigated in this current era," he said.