World Diabetes Day 2018: Lifestyle changes that may help reduce the risk of diabetes

November 14 marks World Diabetes Day 2018, part of Diabetes Awareness Month, which aims to raise awareness of the condition and encourage those who may be at risk to be tested.

With many studies focusing on the lifestyle factors that are associated with diabetes, here we round up some of the recent research which suggests changes we can make to lower our risk of the disease.


Try to take time for yourself

Canadian research which followed 7,065 workers between the ages of 35 and 74 for a period of 12 years found that women who work 45 or more hours a week have a 63 percent higher risk of developing diabetes than women who work between 35 and 40 hours, although no association was found between working hours and diabetes in men. The researchers suggested that women might work longer hours in part due to household chores and family responsibilities, which could prompt a chronic stress response in the body, increasing the risk of hormonal abnormalities and insulin resistance, and that reducing the amount of working hours might help curb the risk of the disease.

Get the optimal amount of sleep

Korean researchers have found that sleeping too much or too little are both linked with an increased risk of developing metabolic syndrome, a group of conditions including elevated waist circumference, high triglyceride levels, low levels of good cholesterol, high blood pressure and high fasting blood sugar. The large-scale study looked at 133,608 participants aged 40 to 69 years, finding that compared to those who slept six to seven hours per day, men who slept less than six hours and men and women who slept more than 10 hours were more likely to develop metabolic syndrome, which can increase the risk of diabetes.

Get some exercise

A European study found that even in children, physical exercise can reduce the accumulation of risk factors of type 2 diabetes and cardiovascular disease, possibly lowering the risk of young people developing the conditions later in life. However, children who increased their sedentary behavior showed an increase in the accumulation of risk factors. In addition, United States researchers found earlier this year that women who had a high level of fitness pre-pregnancy had a 21 percent lower risk of developing gestational diabetes than women with a lower level of fitness.

Quit smoking

A large-scale study which looked at 512,891 Chinese adults aged 30 to 79 years found that regular smokers have a 15 to 30 percent higher risk of developing diabetes compared with those who have never smoked. Smoking more cigarettes each day, starting smoking at a younger age, and smoking and being obese were also linked to an even greater risk of developing the condition.

Give your social life a boost


According to Dutch researchers, a good social life could help lower the risk of developing type 2 diabetes and pre-diabetes. Social isolation is already known to be associated with type 2 diabetes, with the new study also finding that a lack of participation in clubs or other social groups increased the risk of pre-diabetes in women and the risk of type 2 diabetes in both men and women, while having more friends, and more friends who lived close by, helped reduce the risk of the condition. JB

source: lifestyle.inquirer.net

Boy who went viral after Foo Fighters performance uses newfound fame to help sick friend

The 10-year-old boy who went viral after his performance of a Metallica song with the Foo Fighters in Kansas City is now using his fame to raise money for his friend suffering from a rare disease.

In a Facebook post last Oct. 15 shared by his mom, Jennifer Dlugolecki, Collier is seen in several videos thanking all of his new followers.

He then begins to talk about his friend, Bo, who has a rare disease causing him to suffer from Type 1 diabetes, epilepsy, growth hormone deficiency and other chronic diseases.

Collier is asking his new followers to donate to Bo’s GoFundMe page to help raise money for his medical costs.

Collier had previously raised money for Bo with a lemonade stand fundraiser. As of writing, the post has over 200 shares on Facebook. JB

source: lifestyle.inquirer.net

Aspirin disappoints for avoiding first heart attack, stroke

Taking a low-dose aspirin every day has long been known to cut the chances of another heart attack, stroke or other heart problem in people who already have had one, but the risks don’t outweigh the benefits for most other folks, major new research finds.

Although it’s been used for more than a century, aspirin’s value in many situations is still unclear. The latest studies are some of the largest and longest to test this pennies-a-day blood thinner in people who don’t yet have heart disease or a blood vessel-related problem.


One found that aspirin did not help prevent first strokes or heart attacks in people at moderate risk for one because they had several health threats such as smoking, high blood pressure or high cholesterol.

Another tested aspirin in people with diabetes, who are more likely to develop or die from heart problems, and found that the modest benefit it gave was offset by a greater risk of serious bleeding.

Aspirin did not help prevent cancer as had been hoped.


And fish oil supplements, also tested in the study of people with diabetes, failed to help.

“There’s been a lot of uncertainty among doctors around the world about prescribing aspirin” beyond those for whom it’s now recommended, said one study leader, Dr. Jane Armitage of the University of Oxford in England. “If you’re healthy, it’s probably not worth taking it.”

The research was discussed Sunday at the European Society of Cardiology meeting in Munich. The aspirin studies used 100 milligrams a day, more than the 81-milligram pills commonly sold in the United States but still considered low dose. Adult strength is 325 milligrams.

WHO’S REALLY AT RISK?

A Boston-led study gave aspirin or dummy pills to 12,546 people who were thought to have a moderate risk of suffering a heart attack or stroke within a decade because of other health issues.

After five years, 4 percent of each group had suffered a heart problem — far fewer than expected, suggesting these people were actually at low risk, not moderate. Other medicines they were taking to lower blood pressure and cholesterol may have cut their heart risk so much that aspirin had little chance of helping more, said the study leader, Dr. J. Michael Gaziano of Brigham and Women’s Hospital.


One percent of aspirin takers had stomach or intestinal bleeding, mostly mild— twice as many as those on dummy pills. Aspirin users also had more nosebleeds, indigestion, reflux or belly pain.

Bayer sponsored the study, and many researchers consult for the aspirin maker. Results were published by the journal Lancet.

ASPIRIN FOR PEOPLE WITH DIABETES?

People with diabetes have a higher risk of heart problems and strokes from a blood clot, but also a higher risk of bleeding. Guidelines vary on which of them should consider aspirin.

Oxford researchers randomly assigned 15,480 adults with Type 1 or 2 diabetes but otherwise in good health and with no history of heart problems to take either aspirin, 1 gram of fish oil, both substances, or dummy pills every day.


After seven and a half years, there were fewer heart problems among aspirin users but more cases of serious bleeding, so they largely traded one risk for another.

FISH OIL RESULTS

The same study also tested omega-3 fatty acids, the good oils found in salmon, tuna and other fish. Supplement takers fared no better than those given dummy capsules — 9 percent of each group suffered a heart problem.

“We feel very confident that there doesn’t seem to be a role for fish oil supplements for preventing heart disease,” said study leader Dr. Louise Bowman of the University of Oxford.

The British Heart Foundation was the study’s main sponsor.  Bayer and Mylan provided aspirin and fish oil, respectively. Results were published by the New England Journal of Medicine.

Other studies are testing different amounts and prescription versions of fish oil, “but I can’t tell people go spend your money on it; we think it’s probably better to eat fish,” said Dr. Holly Andersen, a heart disease prevention specialist at New York-Presbyterian/Weill Cornell who was not involved in the study.

The new research doesn’t alter guidelines on aspirin or fish oil, said Dr. Nieca Goldberg, a cardiologist at NYU Langone Medical Center and an American Heart Association spokeswoman. They recommend fish oil only for certain heart failure patients and say it’s reasonable to consider for people who have already suffered a heart attack. /cbb

source: technology.inquirer.net

Diabetes, obesity behind 800K cancers worldwide – study

Nearly six percent of new cancers diagnosed worldwide in 2012 – some 800,000 cases – were caused by diabetes and excess weight, according to a study published on Tuesday.

Among the 12 types of cancer examined, the percentage of cases chalked up to these factors was as high as a third, researchers reported in The Lancet Diabetes & Endocrinology, a leading medical journal.

Cancers stemming from diabetes and obesity combined was almost twice as common among women as men, the study also found.

And of the two cancer-causing agents, being overweight or obese – above 25 on the body-mass index, or BMI – was responsible for twice as many cancers as diabetes.

The conditions, in reality, are often found together, as obesity is itself a leading risk factor for diabetes.

“While obesity has been associated with cancer for some time, the link between diabetes and cancer has only been established quite recently,” said lead author Jonathan Pearson-Stuttard, a clinical research fellow at Imperial College London’s Faculty of Medicine.

“Our study shows that diabetes – either on its own or combined with being overweight – is responsible for hundreds of thousands of cancer cases each year across the world,” he also said.

A surge in both conditions over the last four decades has made the tally significantly worse, the study showed.

The global increase in diabetes between 1980 and 2002 accounted for a quarter of the 800,000 cases, while the obesity epidemic over the same period resulted in an additional 30 percent of cases.

On current trends, the share of cancers attributable to the two conditions is seen to increase by 30 percent for women and 20 percent for men in less than 20 years, the researchers warned.

“In the past, smoking was by far the major risk factor for cancer, but now healthcare professionals should also be aware that patients who have diabetes or are overweight also have an increased risk,” Pearson-Stuttard, said.

For men, obesity and diabetes accounted for a more than 40 percent of liver cancers while for women they were responsible for a third of uterine cancers, and nearly as many cases of breast cancer.

The threshold for obesity is a BMI of 30. BMI is one’s weight in kilos divided by one’s height (in centimeters) squared.

Persons with a BMI of 25 to 29.9 are considered to be overweight.               /kga

source: lifestyle.inquirer.net

Gluten-free diet increases risk of type 2 diabetes, says study

In response to the trend for gluten-free products, the American Heart Association (AHA) announced on Thursday a research, based on 30 years of surveys, that establishes a link between gluten-free diets and a higher risk of type 2 diabetes.

To date, no scientific studies have demonstrated any health benefits that accrue from a gluten-free diet for the vast majority of people who do not suffer from Celiac disease (which affects one percent of the population in the United States) or gluten intolerance.

Using data from three long-term studies that monitored 200,000 people over 30 years, researchers from Harvard University evaluated the impact of a gluten-free diet on the health of subjects with no medical diagnosis of gluten intolerance.

Their findings, which have now been made public by the AHA, are unequivocal. People who regularly consume gluten (an average of 5.8 to 7.1 grams per day) have a lower risk of developing type 2 diabetes. Bread, pizza, pasta, cereal, pretzels and even muffins were among respondents’ most commonly listed sources of gluten.

At the same time, the researchers noted that those who sought to avoid gluten consumed less cereal fiber, which is known to reduce the risk of diabetes.

The study has added weight to warnings from nutritionists worried by the excessively high glycemic index of processed gluten-free products that lack fiber and nutrients and may contain additives. And that is not to mention the risk posed by the “healthy” image of these products, which may lead some consumers to overindulge.

In the U.S., a 2014 Consumer Reports National Research Centre survey found that 63 percent of Americans believe that a gluten-free diet would improve their physical and mental health.

The Harvard University study findings were presented at the American Heart Association’s Epidemiology and Prevention/Lifestyle and Cardiometabolic Health 2017 Scientific Sessions in Portland, Oregon. JB

source: lifestyle.inquirer.net

‘Exercise prescriptions’ important for type 2 diabetes

Patients with type 2 diabetes should be given exercise “prescriptions” that specify the type, duration, intensity and frequency of workouts, adapted to the individual, according to a new review.

Although exercise improves blood sugar control, insulin sensitivity, blood pressure and cholesterol levels, most people with diabetes do not engage in regular exercise, the authors write.

“Exercise and physical activity can help to control type 2 diabetes,” said lead author Dr. Romeu Mendes of the Public Health Unit, ACES Douro I—Marao e Douro Norte in Vila Real, Portugal.

“There are many successful case-studies of patients who reversed metabolic dysfunction only with lifestyle strategies (exercise plus diet),” but the benefits disappear when healthy diet and regular exercise stop, he said.

“Diabetes is a chronic disease and must be managed for life,” Mendes said. “Regular exercise and a healthy nutritional pattern are the basis of the treatment.”

The researchers reviewed published recommendations or guidelines for exercise prescriptions for people with type 2 diabetes issued by international scientific organizations in the field of diabetology, endocrinology, cardiology, public health and sports medicine.

They included 11 publications from institutions like the European Association for the Study of Diabetes, American Diabetes Association, Francophone Diabetes Society and Swedish National Institute of Health.

“We were not aware that there were so many scientific organizations issuing specific recommendations for exercise prescription in this population,” Mendes told Reuters Health by email.

The guidelines agreed that people with type 2 diabetes should accumulate at least 150 minutes of moderate to vigorous aerobic exercise per week, spread over at least three days of the week, and also recommend resistance exercise at least twice weekly.

Aerobic exercise can include brisk walking, running, cycling, swimming or other activities, and resistance exercise should target large muscle groups with machines or free weights. Some institutions also recommend some flexibility training, Mendes and colleagues reported in the British Journal of Sports Medicine.

“The ultimate and most important variable for people is quality of life,” Mendes said, noting that exercise particularly improves health-related quality of life.

Exercise has indisputable life-saving benefits, but there is limited research on the benefits of exercise among people with diabetes, said Huseyin Naci, a health policy researcher at the London School of Economics who was not part of the new review.

“According to our previous research, there is a bias against testing exercise,” Naci told Reuters Health by email. “Medical research increasingly favors drug interventions over strategies to modify lifestyle.”

“The vast majority of patients with type 2 diabetes do not engage in regular exercise,” Mendes said. “This may be explained by insufficient awareness about the potential benefits of exercise and the lack of specific knowledge about current recommendations.”

Advising patients to increase their exercise levels is not enough, he said. Prescriptions should include specific information on the type, mode, duration, intensity and weekly frequency, and the exercise strategies must be adapted for each individual, based on other health conditions, contraindications and realistic personal goals.

“According to the US Centers for Disease Control and Prevention, roughly one third of doctors prescribe exercise in primary care,” Naci said. “This is promising, but more doctors should discuss and give brief advice to their patients about the benefits of exercise and refer patients with diabetes to structured exercise programs.” — Reuters

Marriage may be bad for your waistline – US study

Need another reason to blame weight gain on your marriage? When one spouse becomes obese, the other’s risk of obesity almost doubles, a US study suggests.

“Normal weight people whose spouses went from being normal weight to obese were more likely to become obese,” said Laura Cobb, who led the study as a researcher at Johns Hopkins University in Baltimore.

“This suggests that changes in one spouse are likely to also be reflected in the other spouse, likely because of similar changes in diet, physical activity or other behaviors that impact obesity,” Cobb said by email.

Plenty of research already links marriage and weight gain, and scientists have firmly established the connection between obesity and heart disease, diabetes, and certain cancers.

What the current study adds is a fresh take on how couples may gain weight in tandem, insight that might help shape more effective obesity prevention and treatment efforts targeting couples, Cobb and colleagues note in the American Journal of Epidemiology.

Researchers followed almost 4,000 couples for up to 25 years, starting between 1987 and 1989. After an initial exam, they had three follow-up visits roughly three years apart, followed by a fifth exam between 2011 and 2013.

At the start of the study, 23 percent of the men and 25 percent of the women were obese.

Non-obese men whose wives became obese between visits in the study were 78 percent more likely to become obese during that period than they would have been had their wives not gained so much weight, the study found.

Having a husband become obese was linked to an 89 percent increased risk of developing obesity for their wives.

Not many people who started out obese lost enough weight to be considered no longer obese, but when they did, their spouse was also more likely to become non-obese.

Shortcomings of the study include the long stretch of time that elapsed between the fourth and fifth exams and the large proportion of people who died or left the study before the final visit, the authors acknowledge.

It’s not unusual for married couples to forge common habits over time that influence their weight, said Ivanka Prichard, a weight loss researcher at Flinders University in Adelaide, Australia.

“Over time, similarities in diet, particularly any unhealthy aspects, may lead to weight changes,” Prichard, who wasn’t involved in the study, said by email. “There are also a range of pressures in life that could impact this such as having children, work, shared health knowledge, time or finances.”

Like unhealthy habits, though, positive lifestyle choices can also be contagious in a marriage, said Debra Umberson, director of the Population Research Center at the University of Texas at Austin.

“When married people get in shape or lose weight, it’s often because one spouse takes the lead and urges the other spouse along,” Umberson, who wasn’t involved in the study, said by email. “Even if the person not taking the lead is resistant, over time they will probably be influenced by the kinds of food and activities their spouse is involved with—especially if the person taking the lead is the one who purchases groceries or prepares meals.” — Reuters

Diabetics can avoid problems with attention to heart risks

Even if they haven't been diagnosed with heart disease, diabetics with classical heart-risk factors like smoking and elevated “bad” cholesterol are at heightened risk of serious heart-related “events” and death, according to a new study.

Among people with diabetes but not heart disease, researchers linked more than a third of cardiovascular “events”—such as heart attack and stroke—and 7 percent of deaths to inadequate control of heart risk factors.

That means those cardiac events and deaths might have been avoided with better control of the known risk factors, the study team writes in Diabetes Care.

“The take home message from this study is that adults with diabetes can reduce their risk of cardiovascular events, and patients should work together with their provider to set a care plan including goals and strategies to reduce modifiable risk factors,” said lead author Gabriela Vazquez-Benitez, a research investigator at HealthPartners Institute for Education and Research in Minneapolis, Minnesota.

“This can include regular care visits, screening, laboratory, weight, and blood pressure,” she told Reuter’s Health in an email.

The risk factors for cardiovascular problems in diabetes are well known and include high blood pressure, smoking and poor control of blood sugar. If more attention were paid to these risk factors, the rate of cardiovascular problems and death could be substantially reduced, the study team argues.

There are nearly 25 million Americans with diabetes and if current trends continue, more than one in three adults are projected to develop the disease.

Stroke and coronary heart disease are the major causes of complications, deaths and healthcare costs in adults with diabetes, they write.

The authors point out that medical advances have improved the health of people with diabetes, especially when it comes to cardiovascular problems. But for people with diabetes as a group, the burden of cardiovascular problems remains very high.

In their study, Vazquez-Benitez and her team analyzed data on nearly 860,000 adults with diabetes.

They looked at rates of major cardiovascular complications such as heart attacks and heart failure, as well as deaths from all causes, plus four risk factors: blood pressure, levels of LDL cholesterol, smoking and blood sugar levels over the months.

The authors emphasize that overall rates of major cardiovascular complications and deaths were “substantially higher” in people with diabetes who already had heart disease, compared to those without it.

But delaying diabetes complications is possible, Vazquez-Benitez said, not only for cardiovascular events but for problems like nerve damage and kidney disease.

“Although there is a genetic component of diabetes, there are modifiable risk factors that can reduce risk of heart attack, stroke and death,” said Deborah Greenwood, a registered nurse and president of the American Association of Diabetes Educators. Lowering blood sugar, LDL cholesterol and blood pressure, as well as quitting smoking can greatly reduce risk, she said.

All adults over 45 should be screened for diabetes so it can be diagnosed and treated early, said Greenwood, who was not involved in the study. For most people with so-called pre-diabetes, she pointed out, losing 5 to 7 percent of body weight and doing 150 minutes of physical activity per week could avert progression to full-blown diabetes.

She also emphasized the importance of participating in diabetes self-management education and partnering with a credentialed diabetes educator to change behaviors and improve modifiable risk factors. “A diabetes educator will work with you to develop a plan specifically tailored to your individual needs, preferences and lifestyle to ensure success,” Greenwood said. — Reuters

Certain diabetics more likely to benefit from blood pressure meds

People with type 2 diabetes who get treatment for high blood pressure live longer and have a lower risk of heart disease, according to a new review.

But to the researchers’ surprise, diabetics with only slightly high blood pressure - higher than the healthy range but not quite in the hypertension range - didn’t get as much benefit from treatment.

“Everything else being equal,” the patients with type 2 diabetes most likely to benefit from blood pressure lowering are those whose blood pressure is higher, said coauthor Professor Kazem Rahimi of The George Institute United Kingdom and The University of Oxford, in email to Reuters Health.

The review included 40 trials from 1966 to 2014 on blood pressure lowering treatments in more than 100,000 people with type 2 diabetes. The treatments included diuretics (sometimes called “water pills”), ACE inhibitors, and other drugs.

A healthy blood pressure reading is 120/80 millimeters (mm) of Mercury (Hg).

Readings above 120/80 but below 140/90 indicate “pre-hypertension.” Blood pressure above 140/90 mm Hg can be diagnosed as hypertension.

According to the new review, with every decrease of 10 mm Hg in the first number – the systolic blood pressure - the risk of dying during the study decreased by about 10 percent, and the risk of an acute heart problem, heart disease, stroke and diabetic retinopathy also went down.

Lowering blood pressure appeared to carry the most benefit for people whose initial systolic readings were higher than 140 mm Hg, the authors write in JAMA.

“The study calls for more individualized treatment decisions when it comes to controlling blood pressure in people with type 2 diabetes, in particular for diabetics with lower baseline blood pressure levels,” Rahimi said.

Blood pressure medications did decrease the risk of other problems like stroke, diabetic eye disease and excess protein in the urine, even for people with relatively lower blood pressures, he said.

But diuretics can cause an increase in blood sugar for people with diabetes. Other side effects of blood pressure medications include impotence, potassium deficiency, skin rash or kidney damage.

One in 10 Americans has diabetes today, most often type 2, the adult-onset kind, according to the Centers for Disease Control and Prevention. Two out of three people with diabetes have high blood pressure or take medication to lower it, according to the American Diabetes Association.

“People with a blood pressure of 140 or higher are likely to enjoy the greatest benefit from blood pressure lowering, and for most, the benefits of taking blood pressure medication are likely to outweigh the potential side effects,” Rahimi said. “In people with systolic blood pressure below 140 mm Hg, treatment recommendation requires more careful assessment of the patient’s likely absolute net benefit.”

Based on one U.S. trial in 2010, blood pressure goals have been relaxed for people with diabetes, which may have been an overreaction, according to Dr. Bryan Williams of University College London, who wrote an accompanying editorial in the journal.

Before that trial, most guidelines recommended that people with diabetes keep their blood pressure below 130/80 mm Hg. Afterward, some guidelines were relaxed to 140/90 mm Hg.

Rahimi’s study “shows that the current BP goals are not low enough to optimally reduce the risk of stroke, for example,” Williams told Reuters Health by email.

“Certainly BP should be lowered to below 140/90 mm Hg and I would suggest it would be appropriate to go lower than 130/80 if the patient will tolerate it and this is more likely to be tolerated better in younger people,” he said.

“There is no magical threshold above which blood pressure suddenly becomes harmful and below which it becomes benign,” Williams said. “The thresholds are designed to simplify trials and guidance but in reality the risk relationship is continuous with no obvious threshold.” — Reuters

Post-traumatic stress doubles diabetes risk in women

MIAMI - Women who suffer from post-traumatic stress are almost twice as likely to develop type 2 diabetes as women not affected by the disorder known as PTSD, a US study said Wednesday.

The research in the journal JAMA Psychiatry was led by public health scientists at Columbia University and Harvard University, and provides the "strongest evidence to date of a causal relationship between PTSD and type 2 diabetes," the journal said in a statement.

The data was based on surveys given to nearly 50,000 US women from 1989 to 2011.

Researchers found that about half the increased risk for diabetes was attributable to the use of antidepressants (34 percent) and overeating, as measured by elevated body mass index (14 percent).

But the other half of the heightened risk could not be explained, and researchers ruled out potential links to smoking, diet, alcohol intake or exercise.

The study also found that the more symptoms of PTSD a woman had, the higher her risk of developing type 2 diabetes.

About one in nine women experience PTSD at some point, which is twice the rate among men, according to background information in the article.

"Not only is PTSD devastating to mental health, but it affects physical health too, raising risk for cardiovascular disease, diabetes, and obesity," said senior author Karestan Koenen, professor in the Department of Epidemiology at the Mailman School at Columbia University.

Researchers urged healthcare professionals to be on the lookout for signs of diabetes in women who have endured traumatic events.

"As fewer than half of Americans with PTSD receive treatment, our study adds urgency to the effort to improve access to mental health care to address factors that contribute to diabetes and other chronic diseases," said first author Andrea Roberts, research associate in the Department of Social and Behavioral Sciences at Harvard School of Public Health. — Agence France-Presse

source: gmanetwork.com

Study asks whether artificial sweeteners may drive diabetes

LONDON - Scientists studying the effects of artificial sweeteners in mice and humans say they have found that eating them may increase the risk of developing glucose intolerance, a risk factor for diabetes.

In work that raises questions over whether artificial sweeteners—widely seen as "healthier" than sugars—should be reassessed, the researchers said the substances altered the balance of microbes in the gut linked to susceptibility to metabolic diseases like diabetes.

"In our studies we found that artificial sweeteners may drive, or contribute to... an exaggerated elevation in blood glucose levels—the very same condition that we often aim to prevent by consuming them," said Eran Elinav of the Weizmann Institute of Science in Israel, who co-led the work.

Calorie-free artificial sweeteners are widely used in foods and drinks such as diet fizzy drinks or sodas and sugar-free yoghurts and desserts and are recommended for weight loss and for treatment or prevention of diabetes.

Nutrition and metabolism experts who were not involved in Elinav's studies said the results were intriguing, but were mainly focused on mice, were very preliminary and should not trigger changes in recommendations on so-called non-caloric artificial sweeteners (NAS).

"This research raises caution that NAS may not represent the 'innocent magic bullet' they were intended to be to help with the obesity and diabetes epidemics, but it does not yet provide sufficient evidence to alter public health and clinical practice," said Nita Forouhi, programme leader at the Medical Research Council's epidemiology unit at Cambridge University.

Rates of obesity and diabetes are reaching epidemic proportions worldwide, and advice to cut down on sugar intake as part of a more healthy diet is often accompanied by recommendations to replace sugary drinks with "diet" or "light" versions that use artificial sweeteners instead.

Elinav's team conducted a series of experiments in both mice and humans, repeating them several times to check their results. They used three common artificial sweeteners—saccharin, sucralose or aspartame.

They found that mice whose drinking water was supplemented with glucose and a sweetener developed marked glucose intolerance compared with mice drinking water alone, or water with just sugar in it. The artificial sweeteners exert this effect by altering the balance of gut microbes, they said.

Findings inconclusive for humans

Moving on to human studies, the researchers analyzed around 400 people and found that the gut bacteria in those who consumed artificial sweeteners was significantly different from those who did not. They also found NAS eaters had "markers" for diabetes, including raised blood sugar levels and glucose intolerance.

The scientists then put seven volunteers who did not normally consume artificial sweeteners on controlled 7-day diet of high NAS intake, and found that after only four days their blood glucose levels were up and the composition of their gut bacteria had also changed, mirroring the results in mice.

"These results indicate that non-caloric artificial sweeteners may exacerbate, rather than prevent, metabolic disorders such as glucose intolerance and diabetes," the team wrote in their study in the journal Nature on Wednesday.

Naveed Sattar, a professor of metabolic medicine at the University of Glasgow who had no direct involvement with Elinav's research, said the finding in the mice experiments was interesting "but we have to remember two important things":

"Animal data for many experiments do not show the same effect in humans, which can sometimes be quite the opposite," and "current epidemiological data in humans do not support a meaningful link between diet drinks and risk for diabetes, whereas sugar rich beverages do appear to be associated with higher diabetes risk."

"So, these findings would not make me choose sugary drinks over diet drinks," he said. —Reuters

Demanding, low-control jobs linked to type 2 diabetes

NEW YORK – Even without classic risk factors for type 2 diabetes, people with high-stress, low-control jobs were over 60 percent more likely to develop the disease than unstressed workers in a new German study.

The findings add to substantial evidence that job strain represents a serious health risk on its own, researchers say.

“What we first suspected was that job strain might be related to lifestyle variables - that people who are under high job strain would smoke or maybe eat unhealthy food more, but this was not the case,” said lead study author Karl-Heinz Ladwig, of the Technical University in Munich.

“For me this was the most exciting thing, to find out that these things might not responsible for this unique effect,” he said.

Past research dating back decades has established that jobs with a combination of high demands and low control over how the work is done offer a formula for high worker stress.

That particular kind of job strain has long been linked to heart disease and death. The underlying cause is generally thought to be a mixture of physical wear-and-tear from the chronic stress itself and unhealthy coping behaviors like smoking, drinking and overeating.

A few studies in more recent years have connected this form of worker stress to diabetes, although sometimes the effect was seen only in women or was largely linked to coping behaviors.

To explore the connection further, Ladwig’s team followed more than 5,000 men and women in Germany for over 12 years.

None of the participants had diabetes at the beginning of the study, when each answered a well-established questionnaire to measure job strain. It included 11 questions, some of which focused on job demands, such as having to work fast, hard, under time pressure or with conflicting demands, or having excessive amounts of work.

Other questions were meant to assess the person’s level of job control, including their level of responsibility and competence for the job and ability to make decisions in their current position.

Based on the answers, participants were subdivided into groups: low job strain, high job strain, passive and active.

Participants with demanding jobs who had control over how their work got done, or those with undemanding jobs, were considered to have “low job strain.” Those with high job demands and low control over their work were considered to have “high job strain.”

Apart from job demands, people in jobs that afforded some control were considered “active” and those without control were categorized as “passive.”

Almost 300 cases of type 2 diabetes developed during the follow-up period, and the largest proportion of these, almost 7 percent, came from the high job-strain group, the study team reports in the journal Psychosomatic Medicine.

The passive or active categories contributed the next largest number of cases, followed by the low job strain group, with 4 percent.

The researchers calculated that the high job strain participants had a 63 percent higher chance of developing diabetes than the low job strain group.

The results held after the team accounted for age, sex, family history of diabetes and weight. The difference did shrink somewhat when researchers factored in socioeconomic status and physical intensity of work, but remained significant.

In general, the participants with high job strain were more often female, physically inactive, smoked and had low education levels. But none of these variables made a difference in the diabetes risk based on job strain.

That suggests the stress itself is causing the effect, Ladwig and his team speculate, and the likely culprit is the stress hormone cortisol, which can alter the way the body regulates blood sugar.

“The rising prevalence of type 2 diabetes is a worldwide concern and this study is investigating the role of job strain in this growing epidemic,” said Mikaela von Bonsdorff, a gerontology researcher at the University of Jyväskylä in Finland, who was not involved in the study.

The American Diabetes Association says that by 2050, one in every three Americans will have diabetes

Von Bonsdorff cautions that although the authors found high job strain might increase the risk of type 2 diabetes, it is evident that other factors such as, socioeconomic position and unhealthy living habits may be playing a role.

Loretta Platts, a researcher at Kings College London who also was not involved in the study, said, “It is also possible that the real influence of stressful work on type 2 diabetes might be even larger than is suggested by the results found in this study.”

“The investigators could only measure work stress at one time-point, and it is likely to be the cumulative impact of work stress over individuals’ whole working lives which may affect their chances of developing type 2 diabetes, not necessarily stress happening at any specific time-point,” she said.

“People are very engaged in their job situation and they have no distance from it and I think that we should get into a balanced life situation where working is one part which is important but not the only important thing in the world,” said Ladwig. — Reuters

TVs, cars, computers linked to obesity in poor nations

WASHINGTON - In low-income countries, people with cars, televisions and computers at home are far more likely to be obese than people with no such conveniences, researchers said Monday.

Eating more, sitting still and missing out on exercise by driving are all likely reasons why people with these modern-day luxuries could be gaining weight and putting themselves at risk for diabetes, researchers said.

The findings in the Canadian Medical Journal suggest extra caution is needed to prevent health dangers in nations that are adopting a Western lifestyle.

"With increasing uptake of modern-day conveniences -- TVs, cars, computers -- low and middle income countries could see the same obesity and diabetes rates as in high income countries that are the result of too much sitting, less physical activity and increased consumption of calories," said lead author Scott Lear of Simon Fraser University.

"This can lead to potentially devastating societal health care consequences in these countries."

The same relationship did not exist in developed nations, suggesting the harmful effects of these devices on health are already reflected in the high obesity and diabetes rates.

The study included nearly 154,000 adults from 17 countries across the income spectrum, from the United States, Canada and Sweden to China, Iran, India, Bangladesh and Pakistan.

Televisions were the most common electronic device in developing countries -- 78 percent of households had one -- followed by 34 percent that owned a computer and 32 percent with a car.

Just four percent of people in low-income countries had all three, compared to 83 percent of people in high-income countries.

Those that did have electronics were fatter and less active than those that did not.

People with all three were almost a third less active, sat 20 percent more of the time and had a nine-centimeter (3.5 inches) increase in waist circumference, compared to those that owned none of the devices.

The obesity prevalence in developing countries rose from 3.4 percent among those that owned no devices to 14.5 percent for those that owned all three.

In Canada, about 25 percent of the population is obese and in the United States, about 35 percent of people are obese.

"Our findings emphasize the importance of limiting the amount of time spent using household devices, reducing sedentary behavior and encouraging physical activity in the prevention of obesity and diabetes," said the study.  — Agence France-Presse

source: gmanetwork.com

Many with diabetes unaware of vision loss – US researchers

NEW YORK - Less than half of people with diabetes-related eye disease in the US have been told about it, which means they're also missing out on treatment that could save their sight, researchers say.

In US surveys of adults with diabetic macular edema—a condition that can ultimately lead to blindness—just 45 percent of respondents said they had been informed by their doctor that diabetes had affected their eyes. Nearly 30 percent already had vision loss in the affected eye.

It's important to catch the signs of diabetic macular edema (DME) early because it can be treated, Dr. Neil M. Bressler said. He led the study at the Wilmer Eye Institute of Johns Hopkins University School of Medicine and Hospital in Baltimore.

Diabetes commonly causes DME, which is a thickening of the eye's retina. That change can be detected in an eye exam that includes dilation of the pupils. Left untreated, DME is likely to cause progressive vision loss.

Degeneration of the retina in people with diabetes, known as diabetic retinopathy—which is often caused by DME—is the leading cause of blindness in the US, Bressler and his colleagues write in the journal JAMA Opthalmology.

Many U.S. medical authorities recommend annual eye checks for diabetics to monitor early signs of vision problems, but many people with diabetes do not get the proper type or frequency of eye care.

The survey data Bressler's team used included patient questionnaires and physical examinations, so people with vision loss could be identified even if they themselves were unaware of the changes in their sight.

The researchers considered a subset of 800 people from the survey who reported having diabetes, which affects 25.8 million people in the U.S., according to the Centers for Disease Control and Prevention.

Of the 800 self-reported diabetics, the physical exam confirmed that 238 had diabetic retinopathy without DME and 48 had DME.

Some 60 percent of those with DME said they had undergone an eye exam with pupil dilation within the past year. But only 45 percent said their doctor told them about the changes in their eyes.

Physician and patient behavior seem not to have changed in recent years, despite wonderful new achievements in potential treatments for diabetic eye problems, Dr. Lee Jampol told Reuters Health.

A professor of ophthalmology who studies diabetes and vision at Northwestern University in Chicago, Jampol was not involved with the new estimate.

"This study is very important as it shows that many diabetics are not aware of potential or actual real risk to their eyesight from diabetic retinopathy," Jampol said.

Physicians and patients need to be more aware of the vision risks involved in diabetes and insist on yearly visits to the ophthalmologist, he said.

Treatment for DMA "typically involves injections of biologics into the middle cavity of the eye that in most cases cause resolution of the swelling with prevention of vision loss in about 90 to 95 percent of cases, and improvement in vision in about 50 percent of cases when the edema involves the center of the retina and is causing vision impairment," Bressler said.

Patients tend to need about nine injections in the first year with a couple of additional shots over the next two years, and may require laser surgery as well, which can cause the price to vary quite a bit, he said.

"Everyone with diabetes should be referred to an appropriate health care provider who can evaluate the retina for DME or diabetic retinopathy, even in the absence of symptoms, periodically, so that complications which can be treated to prevent vision impairment and blindness can be done," Bressler said. — Reuters

source: gmanetwork.com

Too little sleep linked to heart disease risk

NEW YORK - In a large US study, people who tended to get less than six hours of sleep nightly were more likely to have high blood pressure, high cholesterol, diabetes, and to be obese.

The research is the first to look at differences in risk between racial and ethnic groups, and also finds the strongest effect among Black and Hispanic Americans.

"This is important, since racial minorities are generally at increased risk of cardiovascular disease, diabetes and obesity," Michael A. Grandner said. "And if they also tend to have more sleep difficulties, that could be making things worse."

Grandner led the study at the Center for Sleep and Circadian Neurobiology at the University of Pennsylvania in Philadelphia.

Using nationwide survey data from 2008, researchers divided results from more than 5,000 respondents representing the US population into three groups. Very short sleepers got less than five hours per night, short sleepers got between five and six hours and long sleepers got more than nine hours.

Very short and short sleep were both linked to poor health, Grandner's team reports in the journal Sleep Medicine.

Very short sleepers were twice as likely to have high blood pressure and high cholesterol, compared to people who slept around seven to eight hours. Very short sleepers were also 75 percent more likely to have diabetes and 50 percent more likely to be obese.

Short sleepers were about 20 percent more likely than normal sleepers to report high blood pressure and obesity.

Blacks were most likely to report sleeping less than five hours and very short sleep was most strongly linked to obesity among Blacks.

Short sleep was strongly linked to high blood pressure among Blacks, Whites and non-Mexican Hispanics, while people of Asian descent had the strongest link between short sleep and high cholesterol.

Long sleepers did not appear to experience any negative health effects once researchers adjusted for other factors.

There is no consensus on what the ideal minimum amount of sleep should be for good health, Kristen L. Knutson said.

Knutson studies sleep and heart health in different populations at the University of Chicago Department of Medicine. She was not involved in the new study.

There's no set number for sleep, in part "because there is likely to be some variability in how much sleep different people need," Knutson said. "Still, the majority of large studies have found that people who say they sleep between seven and eight hours are the healthiest."

Recommendations vary by age, with younger people generally needing more sleep than older people.

"Like most aspects of health, too little is bad for you and too much is also likely bad for you," Grandner said.

"It is hard to say that short sleep is worse than long—it's just that we currently have a better idea of why short sleep is detrimental to health," he said.

Quantity of sleep isn't the only important factor though, Grandner said. Insomnia, sleep apnea and waking frequently during the night may be related to heart disease, diabetes and obesity, he said.

"These data do suggest that short sleep, whatever the cause, is associated with important negative health outcomes," Knutson said.

Sleep and health are likely linked in a two-way relationship, Grandner said. Less sleep may negatively impact health, and certain health conditions like obesity might make sleep more difficult.

"Lack of sleep limits your body's ability to keep itself healthy, increasing risk for disease, which puts stress on the body, making sleep harder," he said. "It is likely a cycle like this." — Reuters

source: gmanetwork.com

'Smart' nanoparticles may replace injections for diabetes treatment

In the near future, diabetics may no longer have to suffer multiple injections of insulin daily. Injections may be reduced to just once per week, and instead if insulin being fired into the bloodstream, nanoparticles may take its place, according to Time.

Scientists at North Carolina State University, the University of North Carolina at Chapel Hill, the Massachusetts Institute of Technology and Children Hospital Boston are behind the research that may change the lives of an estimated 366 million people worldwide suffering from diabetes.

“We’ve created a ‘smart’ system that is injected into the body and responds to changes in blood sugar by releasing insulin, effectively controlling blood-sugar levels,” said biomedical engineering assistant professor Dr. Zhen Gu of North Caroline State University. “We’ve tested the technology in mice, and one injection was able to maintain blood sugar levels in the normal range for up to 10 days.”

Diabetes is a metabolic condition in which the sufferer has increased levels of glucose, or “blood sugar”. Glucose is important because it release energy the body requires to function properly. Insulin is the hormone responsible for bringing this energy to the body’s cellular network. Problems arise when not enough insulin is produced, leading to an unhealthy buildup of blood sugar. Symptoms can include frequent urination as well as increased thirst and hunger.

If left untreated, diabetes can lead to death. Diabetics therefore have to closely observe their blood sugar levels daily, as well as inject themselves with insulin several times a day. This has proven as much of a hassle as it is painful to sufferers of the disease.

The proposed new treatment involves introducing nanopartciles, each containing insulin and special enzymes modified to detect glucose, into the bloodstream. The enzymes will circulate throughout the body, immediately converting the glucose they come into contact with into insulin. The enzymes are “fully biocompatible and dissolve in the body,” according to the researchers.

“This technology effectively creates a ‘closed-loop’ system that mimics the activity of the pancreas in a healthy person, releasing insulin in response to glucose level changes,” said Gu. “This has the potential to improve the health and quality of life of diabetes patients.”

The research was recently published in the science journal ACS Nano. The scientists are keen to commence human testing. — TJD, GMA News

source: gmanetwork.com