Type 1 Diabetes: Molecule Identified to Regenerate Insulin-Producing Cells

A neurotransmitter by the name of GABA, known to reduce brain activity, could induce the regeneration of insulin-producing cells, researchers in France have found. The breakthrough, confirmed in mice and partially validated in humans, brings new hope to patients suffering from type 1 diabetes, explains the French National Institute of Health and Medical Research, INSERM (Institut national de la santé et de la recherce médicale).



This latest research, published in the journal Cell, could hold particular significance for patients suffering from type 1 diabetes.

This form of the disease accounts for 5% to 10% of all diabetes cases. Although with no symptoms for a relatively long time, the disease often manifests during childhood or adolescence, when 80% to 90% of insulin-producing cells in the pancreas (beta cells) have already been destroyed due to an autoimmune reaction.

The main aim of the research was to regenerate these cells, "as current treatments are not always sufficient in preventing (serious) complications," explains INSERM.

The team of researchers discovered that this effect could be induced "with no genetic modification, using GABA, a neurotransmitter that is naturally present in the body and also available as a dietary supplement."

Previously, only a genetic modification of cells that resemble the beta cells, called glucagon-secreting alpha cells, was able to increase the number of insulin-producing cells.

GABA is the main inhibitory neurotransmitter of the central nervous system. Unlike dopamine or adrenaline, it doesn"t have a stimulating effect. In the body, GABA is synthesized from an amino acid called glutamic acid. Dietary sources of glutamic acid include cod, soybeans, almonds, cheese (Parmesan, Gouda, Edam, Gruyère) and veal.

The role of GABA was first observed in mice.

"In mice, GABA induces the continuous, yet controlled, regeneration of pancreatic alpha cells and their transformation into insulin-producing beta cells. The regenerated cells are functional and can cure chemically-induced diabetes multiple times," said the researchers.

In humans, the scientists found that the number of glucagon-producing alpha cells was reduced by 37% and the number of insulin-producing cells increased by 24% in pancreatic islets treated with GABA.

"These results are truly encouraging for a putative application in humans. Accordingly, a pilot clinical trial will soon be initiated to determine whether GABA may effectively help patients with type 1 diabetes," the researchers conclude.

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Diabetes Tops List of Costliest Diseases in US

Diabetes leads a list of just 20 diseases and conditions that account for more than half of all spending on healthcare in the United States, according to a new comprehensive financial analysis.

U.S. spending on diabetes diagnosis and treatment totaled $101 billion in 2013, and has grown 36 times faster than spending on heart disease, the country"s No. 1 cause of death, researchers reported.



"After adjusting for inflation, we see that every year the U.S. is spending 6 percent more than we spent the year before on diabetes," said lead researcher Joseph Dieleman, assistant professor at the University of Washington Institute for Health Metrics and Evaluation.

"That"s really a remarkable growth rate, notably faster than the economy is growing or health care spending as a whole," he said.

The annual rate of growth in healthcare spending between 1996 and 2013 has been 3.5 percent on average, Dieleman noted.

"Spending on diabetes grew twice as fast as all conditions combined" during that 18-year period, he said.

The study findings were published in the Dec. 27 issue of the Journal of the American Medical Association.

Americans spent $2.1 trillion in 2013 on diagnosis and treatment of health problems, which amounts to more than 17 percent of the total U.S. economy, the researchers concluded from their analysis of federal data.

"That is a staggering, almost unimaginable amount," Dr. Ezekiel Emanuel wrote in an editorial accompanying the new study. Emanuel is chair of medical ethics and health policy at the University of Pennsylvania.

"Indeed, this level of spending makes the U.S. health care system the fifth largest economy in the world, behind only the U.S., Chinese, Japanese and German national economies," Emanuel pointed out.

Dieleman and his colleagues broke down the $2.1 trillion spent in 2013 across 155 different health conditions, to see which diseases were drawing in the most dollars.

The top 10 most costly health expenses in 2013, according to the analysis, were:

• Diabetes -- $101.4 billion.


• Ischemic heart disease -- $88.1 billion.


• Low back and neck pain -- $87.6 billion.


• High blood pressure -- $83.9 billion.


• Injuries from falls -- $76.3 billion.


• Depression -- $71.1 billion.


• Dental care -- $66.4 billion.


• Vision and hearing problems -- $59 billion.


• Skin-related problems -- $55.7 billion.


• Pregnancy and postpartum care -- $55.6 billion.

"There are things on that list that, when we think of healthcare, they"re not necessarily the things the average American would think of," Dieleman said.

The first five conditions alone comprised 18 percent of all personal health care spending and totaled $437 billion in 2013, the researchers noted.

Cancer did not make the list because the researchers split the category into all different types of cancers, such as breast cancer and colon cancer, Dieleman said. All combined, cancer care cost about $115 billion, the study found.

However, Dieleman added that this study only looked at total dollars spent on health care, and not whether the dollars were spent wisely. A follow-up report coming out in a few months will connect the money to risk factors that cause illness.

"I think of this study as providing a landscape," he said. "It tells you where to start digging deeper. For example, it tells you we"re spending notably more on diabetes, and now we can think about why that is."

Of the money spent on diabetes care in 2013, more than 57 percent went to medications and 23.5 percent went to outpatient care, the study authors reported.

"We know in diabetes most of the growth was in pharmaceuticals," Dieleman said.

But that doesn"t necessarily mean money for medications is ill-spent, he added.

"I think people are quick to point at pharma, but if medications are preventing trips to the clinic, that"s not necessarily a bad thing," Dieleman said. "Spending on treatment of high cholesterol is almost exclusively pharma, and that"s probably a good thing."

On the other hand, billions are being spent on low back and neck pain, and 70 percent of that spending is for working-age people younger than 65, Dieleman said.

"When I talk with medical doctors about this, there"s some cynicism about the effectiveness of the spending on low back and neck pain," he said. "Low back and neck pain is certainly one of those places where we"re spending a lot, and it encourages us to look closer and evaluate what we are getting out of that spending."

Emanuel agreed in his editorial.

"Rates of pain-associated health problems are actually increasing, rather than decreasing, and few people would rate the U.S. performance on these conditions as exemplary," he wrote.

"Patients who want pain relief often undergo surgery, even when rest, physical therapy and nonsurgical interventions would be equally effective," Emanuel said.

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Metformin Still Best Drug for Type 2 Diabetes

Newly updated guidelines reaffirm that metformin is the first-line drug for people with type 2 diabetes, and that several other medications -- including newer ones -- can be added if needed.



The recommendations come from the American College of Physicians (ACP). The American Academy of Family Physicians endorsed the new guidelines. The ACP updated the guidelines because of new research into diabetes drugs, and the U.S. Food and Drug Administration approval of new diabetes drugs.

"Metformin, unless contraindicated, is an effective treatment strategy because it has better effectiveness, is associated with fewer adverse effects, and is cheaper than most other oral medications," ACP president Dr. Nitin Damle said in a college news release.

"The escalating rates of obesity in the U.S. are increasing the incidence and prevalence of diabetes substantially. Metformin has the added benefit of being associated with weight loss," Damle said.

The ACP recommends that if a patient needs to take a second drug by mouth to lower blood sugar levels, physicians should look at adding a sulfonylurea, thiazolidinedione, SGLT-2 inhibitor, or a DPP-4 inhibitor.

Examples of sulfonylurea drugs include glyburide (Diabeta, Glucovance, Micronase), glimepiride, glipizide (Glucotrol) and tolbutamide. Thiazolidinedione drugs include pioglitazone (Actos) and rosiglitazone (Avandia).

SGLT-2 inhibitors include canagliflozin (Invokana), empagliflozin (Jardiance) and dapagliflozin (Farxiga). DPP-4 inhibitors include sitagliptin (Janumet, Januvia) or linagliptin (Jentadueto, Tradjenta). Brand names for metformin include Glumetza, Glucophage, and Fortamet.

"Adding a second medication to metformin may provide additional benefits," Damle said.

"However, the increased cost may not always support the added benefit, particularly for the more expensive, newer medications. ACP recommends that clinicians and patients discuss the benefits, adverse effects, and costs of additional medications," he added.

An estimated 29 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention.

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Diabetes it affects Almost 10 Years From Lifespan

Type 2 diabetes reduces lifespan by almost a decade, says a new study published in JAMA. The study, which included more than 512,000 Chinese adults, found that those who were diagnosed with the metabolic disease in middle age lost, on average, nine years of life when compared to people who didn"t have the disease.



Participants were recruited between 2004 and 2008 and were followed until 2014. Of the group, 6 percent had diabetes (4 percent lived in rural areas while 8 percent lived in urban areas).

Researchers found that those with diabetes had twice the risk of dying during the follow-up period, and the increase was higher in rural areas than in urban areas.

Diabetes was associated with increased mortality from ischemic heart disease, stroke, chronic kidney disease, chronic liver disease, infection, and cancer of the liver, pancreas and breast.

The risk of dying from complications of diabetes (diabetic ketoacidosis or coma) was much greater in rural areas than in urban areas, and was much higher than in high-income countries.

The University of Oxford researchers estimated that the 25-year probability of death would be 69 percent among those diagnosed with diabetes at age 50 years compared with 38 percent among otherwise similar individuals without diabetes. The loss of life equaled about nine years of life —10 years in rural areas and eight years in urban areas.

More than 29 million Americans have diabetes, and it"s the seventh leading cause of death, according to the American Diabetes Association. More than a quarter of Americans age 65 and older have diabetes.

Numerous studies have shown that losing weight and following a healthy diet will reduce the risk of developing Type 2 diabetes. A March 2016 study from Britain"s Newcastle University found that losing 10 percent of body weight slashed the risk of Type 2 diabetes by up to 90 percent.

The study, which was published in Diabetes Care, found that undergoing a crash diet (800 calories) for eight weeks stopped diabetes in its tracks. If patients maintained their weight loss, they remained free of the condition. Even patients who had been diagnosed with diabetes for 10 years were able to reverse the disease.

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Diabetes During Pregnancy Hikes Depression Risk

Gestational diabetes and a previous bout of depression can increase a first-time mother"s risk of postpartum depression, a new study suggests.



The analysis of data from more than 700,000 women in Sweden showed that gestational diabetes (developing diabetes during pregnancy) alone raised the risk for postpartum depression.

However, that risk rose even more if a woman had previously been diagnosed with depression.

"Most practitioners think of these as two isolated and very different conditions, but we now understand gestational diabetes and postpartum depression should be considered together," said study lead author Michael Silverman. He"s an assistant professor of psychiatry at the Icahn School of Medicine at Mount Sinai in New York City.

"While having diabetes increases [postpartum depression] risk for all women, for those women who have had a past depressive episode, having diabetes during pregnancy makes it 70 percent more likely that they will develop [postpartum depression]," Silverman said in a school news release.

The researchers said they also identified other risk factors for postpartum depression.

Among women with a history of depression, diabetes before pregnancy and giving birth prematurely at 32 to 36 weeks (full-term delivery is 39 to 40 weeks) increased the risk, the researchers said.

Also, among women with no history of depression, giving birth at a young age, having an instrument-assisted or cesarean delivery, and giving birth before 32 weeks increased the risk.

The study was published online Jan. 18 in the journal Depression and Anxiety.

"The reason a doctor asks if you smoke is because they know you are 20 times more likely to get cancer if you do. We believe ob-gyns should now do the same for depression history," Silverman said. "With this information, we can now intervene early, before the mother gives birth."

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Language Barriers Cited in Poorer Diabetes Care

Hispanic-American Type 2 diabetes patients who lack proficiency in English may end up with poorer care, a new study finds.

Specifically, these patients were found to be much less likely than non-Hispanic patients to take newly prescribed diabetes medications as directed, the researchers said.



The study "suggests that more needs to be done to improve adherence to newly prescribed medications among Latino patients at all levels of English proficiency," wrote a team led by Dr. Alicia Fernandez, of the University of California, San Francisco.

 A diabetes specialist who reviewed the study wasn"t surprised by the results.The research "further validates what many clinicians already know: Patients who do not understand English tend to do worse with management of chronic disease," said Dr. Maria Pena. She is an endocrinologist who directs the Center for Weight Management at Lenox Hill Hospital in New York City.

According to background information in the study, more than 3.1 million Hispanics in the United States have diabetes and must take medication every day.

For the research, Fernandez"s team tracked data from nearly 31,000 insured patients in California.

The study found that more than 60 percent of Spanish-speaking Hispanic patients did not take newly prescribed diabetes drugs as directed. That"s compared to about 52 percent of English-speaking Hispanics, and 37.5 percent of white patients, the researchers said.

"Our study among insured patients suggests that more needs to be done to improve adherence to newly prescribed medications among Latino patients at all levels of English proficiency," Fernandez and her co-authors wrote.

The study was published Jan. 23 in JAMA Internal Medicine.

Another study in the same issue of the journal was led by Melissa Parker of Kaiser Permanente in Oakland, Calif. Her team found that blood sugar control could improve for Hispanic type 2 diabetes patients with limited English skills -- but only when they switched from a primary care doctor who only spoke English to a doctor who primarily spoke Spanish to his or her patients.

Pena called diabetes treatment a "complex" issue that requires clear understanding between doctor and patient, if it is to succeed.

She said that "in some cases, treatment may require frequent checking of finger sticks to monitor sugar levels, injecting medications such as insulin, and knowing how to calculate the amount of insulin necessary based on the amount of carbs consumed."

And while the new studies focused on Spanish-speaking patients with type 2 diabetes, Pena believes the results probably hold true for "any disease that requires long-term monitoring and follow-up."

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High-Tech Sugar Monitors Boost Diabetes Care

A continuous glucose monitor helps people with Type 1 diabetes who need insulin shots every day manage their blood sugar levels safely, two new studies suggest.

Also known as a CGM, the device constantly measures and reports a person"s blood sugar levels. It does this via a thin wire sensor that"s inserted underneath the skin, a transmitter worn on top of the skin, and a receiver (or smartphone) to gather the information.



"Few treatment options exist in the type 1 diabetes field. CGM is a treatment option that [people] should test if they have the option," said Dr. Marcus Lind, lead researcher on one of the studies. He"s the chief physician of diabetology at Uddevalla Hospital in Sweden.

People with Type 1 diabetes don"t make enough insulin -- a hormone the body needs to use the carbohydrates in food for fuel. Because of this, people with Type 1 rely on insulin injections or insulin delivered through a tiny catheter inserted under the skin and then attached to an insulin pump worn outside the body. People with Type 1 diabetes using shots may need five or six insulin injections daily.

In people with Type 2 diabetes, the body is no longer able to use insulin properly. Most (95 percent) of diabetes cases involve the type 2 form of the disease. Sometimes, people with type 2 diabetes also need to use insulin injections.

However, using insulin is a difficult balancing act -- too much or too little can cause problems, even life-threatening ones.

Aaron Kowalski is vice president of research for JDRF (formerly the Juvenile Diabetes Research Foundation). He noted, "Insulin is a dangerous but necessary drug for people with Type 1 diabetes. These studies provide additional support for CGMs, which have been getting better and better. There"s no doubt that someone on insulin will benefit from these devices."

When blood sugar levels go out of range -- either too high or too low -- a CGM"s receiver sends an alarm, alerting the person with diabetes (or a parent for babies and children with diabetes) to the problem.

This is important because when blood sugar levels drop too low, people with diabetes can become disoriented, and if levels drop even further, they may pass out. Blood sugar levels that are too high and left untreated over time can cause complications such as kidney troubles, eye problems and heart disease.

Both studies used the Dexcom G4 CGM, and were funded by the manufacturer, Dexcom Inc. All participants used insulin shots to manage their Type 1 diabetes.

The study led by Lind included 161 people with Type 1 diabetes at 15 diabetes clinics in Sweden. Their average age was 44. The patients were randomly assigned to one of two groups.

The first group was given CGM for 26 weeks, and then conventional therapy for 26 weeks, with a period of no monitoring for 17 weeks in between. The other group did this in reverse and started with conventional therapy. Conventional therapy is self-monitoring of blood sugar levels.

The second study was led by Dr. Roy Beck, executive director of the Jaeb Center for Health Research in Tampa, Fla. This study included 158 patients. Their average age was 48. They were treated at 24 endocrinology practices across the country.

These volunteers were randomly given 24 weeks of CGM therapy or conventional therapy.

In both studies, blood sugar levels improved in both groups of patients. HbA1C levels dropped for those using CGMs. HbA1C is often called A1C for short. This test measures an average blood sugar level over the past two to three months. The results are expressed as a percentage. The American Diabetes Association goal for adults with diabetes is to get below 7 percent.

In Beck"s study, there was a mean drop of 0.6 percent more in A1C for the CGM group versus the control group. In Lind"s research, the decrease was about 0.4 percent more in those on CGMs than the control group. Both study authors said these drops were meaningful for patients.

Lind"s group also saw a drop in severe low blood sugar (hypoglycemia) in people on a CGM.

"The satisfaction in our study was extremely high. CGMs have gotten smaller and more accurate. The benefits are greater and the hassles are less. It"s worth it to carry around another device," Beck said.

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Stem Cell Byproduct May Protect Against Glaucoma

A byproduct of stem cells may hold the key for one day protecting against glaucoma, a leading cause of blindness in the United States.

That"s the determination of a new study by researchers at the National Eye Institute (NEI), part of the National Institutes of Health, which showed stem cell secretions, called exosomes, seemed to protect the retina in the eyes of rats.



Since stem cells can morph into any type of cell in the body, they have long been thought to hold promise for failing eyesight due to glaucoma and other degenerative eye diseases, which are more common in people with diabetes. But stem cells are prone to immune rejection and unwanted cell growth, making them a difficult candidate for productive study.

Exosomes, on the other hand, do not have these limitations. Once thought to be the waste disposal system of cells, exosomes are packed with proteins lipids and gene-regulating RNA — which can send signals to protect cells in the retina. And since exosomes are not hindered by rejection and unwanted cell growth, researchers were excited to test them on the retina.

Exosomes were injected weekly into the vitreous fluid of the test rats. The vitreous fluid is a clear gel located between the lens of the eye and the retina. The exosomes were first tagged by fluorescent material to allow tracking as they moved into the retina. After induced injury to the retina, those treated with stem cell exosomes lost only about 30 percent of their retinal ganglion cells, the cells responsible for proper retina functioning — essential for eyesight— compared to the 90 percent loss of the untreated test subjects.

Researches determined this was the work of the messenger RNA — which can interfere or silence gene expression. They said that since they do not know the exact pathway of the protective exosomes, more research is crucial.

"We need to know which particular microRNA — there are more than 2,000 different microRNA molecules — are delivered into the retinal ganglion cells and what proteins or signaling pathways are being targeted upon arrival," said Stanislav Tomarev, a principal investigator at NEI. "We also need to attempt to target exosomes to specific sets of neurons and other cell types or groups of cells."

Tomarev said he and other team members want to test their results with other known beneficial therapies in order to find the optimal therapeutic effect. It may be a combination of exosomes and traditional therapy that will work best to combat glaucoma and other degenerative diseases of the eyes.

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US Deaths Higher Than Previous Estimates

The number of Americans who die from diabetes is much higher than previously believed, according to a new study.

The research, based on federal government data, found that diabetes causes 12 percent of deaths in the United States. That makes it the third-leading cause of death after heart disease and cancer, researchers said.



"Another way of saying that is, if diabetes were eliminated as a disease process, the number of deaths would decline by 12 percent," said study author Samuel Preston, a sociology professor at the University of Pennsylvania.

"There has been only one similar, earlier research effort, and it was based on data from the 1980s and early "90s. It showed deaths attributable to diabetes amounted to roughly 4 percent of total deaths," he said in a university news release.

Data for the new study came from the U.S. National Health Interview Survey (NHIS) and the U.S. National Health and Nutrition Examination Survey (NHANES). Both are conducted annually, which gives researchers more current figures.

From this, the researchers found that Americans with diabetes have about a 90 percent higher death rate than those without diabetes. They noted that diabetes as the "underlying cause of death" had been significantly underreported in the United States.

"There is only one underlying cause of death on a death certificate," Preston said. But, "diabetes is not listed as frequently as it is involved in the death of individuals."

Study co-author Andrew Stokes is a demographer at Boston University. He said: "When we monitor trends in the health of populations and we look at the mortality statistics, some major threats to U.S. mortality and life expectancy stand out, like drug and alcohol poisonings and suicide. Diabetes didn"t."

The study was published in the journal PLOS One.

The number of Americans with diabetes rose nearly 300 percent between 1980 and 2014, from 5.5 million in 1980 to almost 22 million, according to U.S. Centers for Disease Control and Prevention data.

"American life expectancy has been growing at a very slow rate for the past decade or so, even decreasing slightly in 2015," Preston said.

"It hasn"t yet been established statistically, but it"s fairly likely that obesity and diabetes together are an important factor in this slowdown," Preston added. "We believe that these estimates will prove useful in helping to more precisely identify their roles."

Stokes said, "What our results point to is the need for strategies at the population level to combat the epidemics of obesity and diabetes. We need something on a population scale because it"s a major issue. It"s not an issue that"s confined to certain subsets of the population."

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Sitting Not Linked to Diabetes

Being a couch potato may not be a deadly as you think, say British and Australian researchers who ruled out sitting as a direct cause of diabetes. Their findings cast doubt on the popular saying that "sitting is the new smoking," and say their study indicates that several complex factors determine whether sitting is harmful to health.



"Sitting has attracted a lot of publicity in recent years for being as dangerous as smoking and for being harmful regardless of how physically active people are," said lead author Emmanuel Stamatakis of the University of Sydney. "However, this is one of the very few long-term studies to investigate whether there is a link between sitting behaviors and risk of development of diabetes."

Stamatakis and colleagues from the University of Exeter, University College London, and Victoria University, Australia, analyzed responses from a long-term health study of London-based office workers who were initially free of diabetes and major cardiovascular disease.

The participants, who were middle-aged and older office workers based in London, were asked in 1998 to detail the time they spent sitting, including at work and commuting as well as their leisure time and watching television.

Researchers then examined their blood glucose levels until the end of 2011 to determine how many had developed diabetes during the 13-year follow-up, taking into consideration several factors including obesity, physical activity, and alcohol and smoking habits.

They found little evidence for a link between sitting and diabetes, and these weak associations were limited to TV sitting time.

"Importantly, our research was among the first long-term studies to distinguish between various types of sitting behaviors — not just TV sitting, which is used in the majority of existing studies," said Stamatakis. "But TV time and sitting time are practically uncorrelated so we have very good reasons to believe that the health risks attributed to TV in the past are due to other factors, such as poorer mental health, snacking and exposure to unhealthy foods advertising," he said.

"Many previous studies also rarely acknowledge how higher BMI at the outset of the study increases the participant"s risk of developing diabetes, which could compromise study results.

"Another reason for our results could be that these London-based workers were protected by the large amounts of walking they reported, which was nearly 45 minutes per day on average. With most white-collar workers forced to spend many hours each day in front of a computer not moving, this amount of physical activity may be an absolute necessity to maintain good health."

More than 29 million Americans have diabetes, and it"s the seventh leading cause of death, according to the American Diabetes Association. More than a quarter of Americans age 65 and older have diabetes.

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Sickle Cell Trait Skews Common Diabetes Test

A genetic trait that affects red blood cells and is fairly common among African Americans and Hispanic Americans can cause an important blood sugar test to miss signs of diabetes, researchers say.

The test known as hemoglobin A1c (HbA1c) estimates long-term blood sugar levels by measuring the amount of glucose sticking to red blood cells, but blood cells from people with sickle cell trait don"t live as long, so they have less time to collect glucose.



When lead author Mary Elizabeth Lacy from Brown University School of Public Health in Providence, Rhode Island, and her colleagues used standard HbA1c cutoffs to screen for diabetes, “we identified 40 percent fewer cases of prediabetes and 48 percent fewer cases of diabetes in individuals with sickle cell trait than in those without sickle cell trait,” she told Reuters Health by email.

Sickle cell disease is a serious condition that occurs when a person has two copies of a defective gene responsible for making part of the hemoglobin molecule in red blood cells. Hemoglobin allows the cells to carry oxygen to the tissues that need it, but in people with two copies of the faulty gene, blood cells can turn sickle-shaped, causing painful crises and even death.

People with only one copy of the defective gene are said to have sickle cell trait, and most have no symptoms of sickle cell disease. The gene is most common among people with ancestry in sub-Saharan Africa, Central America and South America, Saudi Arabia, India, Turkey, Greece and Italy.

The U.S. Centers for Disease Control and Prevention estimates that 1 in 13 African American babies are born with sickle cell trait.

In their study of 4,620 African Americans, including 367 with sickle cell trait, Lacy’s team found that HbA1c levels were 0.3 percent lower in those with the trait than in those without it, even though they had similar blood sugar levels.

While 0.3 percent may seem small, Lacy said, “a difference of 0.3 percentage points in HbA1c could be the difference between being identified as high-risk (and being targeted for more frequent monitoring as well as additional diabetes prevention efforts) or not, or receiving a diagnosis of diabetes or not.”

Among individuals with no history of diabetes and not taking diabetes medications, testing blood sugar directly detected pre-diabetic elevated blood sugar levels or full-fledged diabetes in equal numbers of people, regardless of whether they had sickle cell trait, the researchers report in JAMA.

But if HbA1c was used instead of blood sugar testing, pre-diabetic elevated blood sugar would be diagnosed in about 29 percent of those with sickle cell trait compared to 49 percent of those without the trait. Similarly, the HbA1c test would identify diabetes in about 4 percent of those with sickle cell trait and about 7 percent of those without the trait.

The results of HbA1c testing need to be interpreted with caution in patients with sickle cell trait, Lacy concludes. “These findings were based on one method of HbA1c measurement. While it is approved for use in those with sickle cell trait, we are unable to say whether our findings are due to assay interference or a biological phenomenon in those with sickle cell trait.”

Doctors should consider using a glucose tolerance test if they suspect diabetes in people with SCT whose HbA1c is close to the cutoff level, said Dr. Anthony J. Bleyer from Wake Forest School of Medicine in Winston-Salem, North Carolina, who coauthored a related editorial.

“I think there needs to be more research in this area. The HbA1c is a really important test that we use all the time. We need to make sure it is accurate for individuals of all races and ethnicities,” Bleyer said by email.

“Approximately 10 percent of African American patients have sickle cell trait. It is prudent to test African American patients for hemoglobinopathy (sickle cell trait) before relying on HbA1c for diagnosis diabetes/prediabetes and before using HbA1c to monitor blood sugar control,” Dr. Kristina Behan from the University of West Florida in Pensacola, who was not involved in the study, said by email.

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New Breakthrough Treatment Combats Diabetic Kidney Disease

In a spectacular breakthrough, an international scientific team has developed a drug to prevent progression of the most common cause of kidney failure, diabetic kidney disease.

Type 2 diabetes is one of the world’s fastest-growing chronic diseases. The World Health Organization estimates it affects a whopping 420 million people globally — almost quadrupling in less than 40 years. As diabetes has become more common — now striking one in eight Americans — so has diabetic kidney disease.



Diabetic kidney disease (DKD), often fatal, is a long-term complication of diabetes. Researchers call it the most common cause of renal failure, affecting as many as one-third of people with Type 2 diabetes. Few treatment options exist to prevent progressive loss of renal function in victims of this cruel condition.

But the new drug, called 2H10, could be a game-changer in treating DKD. It was developed in a collaboration stretching back a decade between Sweden’s Karolinska Institutet (one of Europe’s leading medical universities) and Uppsala University along with Australia’s biggest biotechnical company, CSL.

Research team leader Dr. Ulf Eriksson, a professor at the Karolinska Institutet, says the work challenges a widely accepted belief in medical circles “that diabetic kidney disease is simply the result of chronic elevated blood glucose.”

Instead, the scientists developed a novel approach, targeting transportation of lipids — or fatty acids — from the blood into the body’s tissues using 2H10.

A report of on the team’s work appears this month in the peer-reviewed journal Cell Metabolism.

The drug, a monoclonal antibody, blocks signaling of a protein known as VEGF-B (Vascular Endothelial Growth Factor B), which governs the transportation and storage of lipids in body tissue. CSL has developed a version of 2H10 called CSL346 suitable for use in humans.

According to immunologist Dr. Andrew Nash, a member of the team and CSL’s senior vice-president of research, the breakthrough “addresses an important area of unmet medical need.”

Nash, who oversees CSL’s research laboratories in Melbourne, Australia, adds the research “could lead to an entirely new approach to the treatment of Type 2 diabetes.”

The new therapy works extremely well in laboratory conditions and tests on mice. Large-scale human trials, using the CSL346 version, will be conducted in Australia later this year. Doctors expect the treatment to be available in three to five years.

The key aim of the research was to devise a way to stop diabetes progressing into potentially deadly diabetic kidney disease.

The disease occurs when the kidney’s network of capillaries becomes scarred and less efficient in carrying out their task of filtering blood to purify it.

But 2H10 prevents fatty acids from accumulating in kidneys and damaging the vital blood vessels.

“With diabetes, the small blood vessels in the body are injured. When blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly,” notes National Kidney Foundation. “Your body will retain more water and salt than it should, which can result in weight gain and ankle-swelling. You may have protein in your urine. Also, waste materials build up in your blood.

“Diabetes also may cause nerve damage. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine with a high sugar level.

The foundation also notes that end-stage kidney failure occurs when the kidneys are no longer able to function and dialysis or transplantation is needed.

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Too Much Screen Time Raises Kids" Diabetes Risk

Kids who get too much screen time may be more likely to have risk factors that increase their chances of type 2 diabetes, new research says.



Watching television, playing video games or sitting in front of a computer or other device for more than three hours each day was linked to more body fat and insulin resistance. Those factors mean the body is less able to keep blood sugar levels under control, the British researchers said.

They said limiting children"s screen time could be necessary to prevent health issues later on.

"Our findings suggest that reducing screen time may be beneficial in reducing type 2 diabetes risk factors, in both boys and girls and in different ethnic groups from an early age," wrote the study authors, led by Claire Nightingale, from St. George"s University of London.

"This is particularly relevant, given rising levels of type 2 diabetes, the early emergence of type 2 diabetes risk, and recent trends suggesting that screen time-related activities are increasing in childhood and may pattern screen-related behaviors in later life," the researchers said.

Previous research has shown that adults who spend excessive amounts of time in front of a TV or computer are at greater risk for weight gain and type 2 diabetes, Nightingale"s group explained.

Since young people are increasingly using devices such as tablets and smartphones, the study authors investigated if this risk also applied to children.

The study included health information on nearly 4,500 children between 9 and 10 years old. The youngsters were from three cities in the United Kingdom -- Birmingham, Leicester and London.

The children"s cholesterol, insulin resistance, fasting blood sugar levels, markers of inflammation, blood pressure and body fat were measured. The kids were also asked to detail their daily use of televisions, computers, video games and other devices.

About 4 percent of the children never watched TV or used an electronic device. Slightly more than one-third reported getting less than one hour of screen time each day. Of the remaining children, 28 percent spent up to two hours in front of a screen, 13 percent got up to three hours and 18 percent spent more than three hours each day sitting in front of a television or electronic device.

Excessive screen time was far more common among boys than girls. Children of African or Caribbean descent were also more likely to spend three or more hours in front of a screen than white or Asian children, the researchers reported.

The researchers found that total body fat among the kids increased along with their screen time. Specific indicators of body fat -- such as skin fold thickness and fat mass -- were all higher among the kids who got more than three hours of screen time each day than those who got just one hour or less.

Screen time was also linked to the kids" levels of leptin -- a hormone that"s involved in appetite control and insulin resistance, the researchers said. This was true regardless of other factors that could affect the kids" type 2 diabetes risk factors, such as household income, puberty stage and level of physical activity.

The authors noted their findings don"t prove a cause-and-effect relationship, but they could have important implications for public health as more children are routinely using electronic devices.

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Newer Type 2 Diabetes Drugs Protect Heart

A newer class of type 2 diabetes drugs significantly cut the risk of death and hospitalization for heart failure compared with other medicines for the disease, according to data released on Sunday from a so-called real world study sponsored by AstraZeneca.



The drugs, known as SGLT-2 inhibitors, work by removing blood sugar via the urine and include Astra"s Farxiga, Jardiance from Eli Lilly and Co and Boehringer Ingelheim, and Invokana from Johnson & Johnson.

Jardiance caused a stir in 2015, when a clinical trial conducted to reassure it does not cause heart problems instead showed it reduced the combined risk of hospitalization for heart failure or death from heart failure by 39 percent in high risk patients. The heart benefit has since been incorporated into Jardiance"s label.

AstraZeneca is conducting its own large clinical trials to determine the heart effect of Farxiga with results expected in 2019.

But the latest data presented by Dr. Mikhail Kosiborod at the American College of Cardiology scientific meeting in Washington appears to indicate that heart protection is not limited to Jardiance.

"The fact that the results are remarkably consistent from country to country regardless of which compound predominates, that certainly seems to suggest that it"s a class effect," said Kosiborod, a cardiologist from Saint Luke"s Mid America Heart Institute in Kansas City. He noted that most Americans in the data were taking Invokana, while Farxiga was dominant in Europe.

The study, which analyzed data from more than 300,000 type 2 diabetes patients collected from six countries, found the SGLT-2 drugs slashed the combined risk of hospitalization for heart failure and death from any cause by 46 percent.

The data was obtained from real-world sources, such as medical records, claims databases and national registers.

Most patients were taking Farxiga or Invokana with less than 10 percent on Jardiance. The comparator medicines included a wide variety of diabetes treatments, including metformin, DPP-4 inhibitors, such as Merck & Co"s Januvia, and insulin, among others.

The vast majority of patients had no history of heart disease. But heart disease is the number one killer of people with diabetes, and mounting evidence of heart protective qualities of SGLT-2 drugs could lead to greater use.

"This class has a real potential of improving patient outcomes," Kosiborod said.

Given the observational nature of the study the possibility of unmeasured confounding factors exists, researchers noted.

More than 400 million people worldwide have diabetes, of whom at least 90 percent have type 2.

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Moving After Meals Cuts Heart Risks for Diabetics

People with type 2 diabetes who sit all day have a riskier blood fat mixture than those who move around or exercise periodically throughout the day, according to researchers in Australia.

“We have previously shown that interrupting prolonged sitting with light intensity activity after meals reduces risk factors for heart disease and diabetes, such as elevated blood sugars and high blood pressure,” said lead author Dr. Megan S. Grace from Baker Heart and Diabetes Institute and Monash University in Melbourne.



Past research has also shown that patients with type 2 diabetes have an altered blood fat profile that contributes to inflammation and insulin resistance and that exercise can improve this profile.

“What we found interesting about this study was that breaking up sitting also reduces levels of lipids (fats) in the bloodstream that are associated with risk for type 2 diabetes and its complications,” Grace said by email. “Our study showed that breaks which include either simple resistance exercise or light walking were generally equally beneficial in reducing blood lipids.”

Researchers looked at blood lipid profiles in 21 overweight or obese adults with type 2 diabetes under three different conditions: sitting throughout the day (rising only to use the bathroom); breaking up sitting by light walking for three minutes every 30 minutes; and breaking up sitting by doing light exercise like squats and knee raises for three minutes every 30 minutes.

During sitting, and especially after meals, the lipid profile reflected an inflammatory state that also lacked the antioxidants needed to fight inflammation, according to the results in the Journal of Clinical Endocrinology and Metabolism.

Both light walking and light exercise changed this profile into one that was less inflammatory and had a greater capacity for fighting inflammation. Light exercise also improved fat-burning capacity.

“Our current findings reinforce the message that avoiding prolonged periods of sitting, and finding ways to increase activity across the day, is beneficial for health,” Grace said. “In line with the recent American Diabetes Association Position Statement, we recommend interrupting sitting every 30 minutes with a few minutes of light intensity activity, in addition to regularly taking part in a structured exercise program.”

Her best advice: “Stand up, sit less, and move more - particularly after meals.”

"The results are novel and important because they identified new mechanisms to explain why sitting time has been linked with poor health,” said Dr. Sarah Kozey-Keadle from California Polytechnic State University in San Luis Obispo, who has studied ways to reduce sitting time and increase physical activity.

“Although not directly addressed in this report, the most important message related to physical activity is that exercise can prevent the onset of type 2 diabetes and prevent complications for those who already have type 2 diabetes,” she told Reuters Health by email.

“The second message is that there are health benefits for replacing and breaking up sitting time with activities that are not considered exercise, such as standing and lower intensity activities of daily living, especially for people who are currently less active,” Kozey-Keadle said.

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Medicinal Diet Counters Onset of Type 1 Diabetes

Researchers at Australia"s Monash University found — for the first time — that a healthy diet high in short-chain fatty acids (SCFAs) protects against Type 1 diabetes



Type 1 diabetes is an autoimmune disease that occurs when immune cells called autoreactive T cells attack and destroy the cells that produce insulin, the hormone that regulates blood sugar levels. About 1.25 million American adults and children have the condition which used to be called juvenile diabetes.

The specialized diet uses starches containing insoluble fibers — found in many foods including fruit and vegetables — that resist digestion and pass through to the colon or large bowel where they are broken down by microbiota (gut bacteria).

The process of fermentation produces acetate and butyrate which, when combined, provided complete protection against Type 1 diabetes.

"The Western diet affects our gut microbiota and the production of these short-chain fatty acids," said researcher Dr. Eliana Mariño.

"Our research found that eating a diet which encourages the gut bacteria that produce high levels of acetate or butyrate improves the integrity of the gut lining, which reduces pro-inflammatory factors and promotes immune tolerance," Mariño said.

"We found this had an enormous impact on the development of Type 1 diabetes," she said.

According to Professor Charles Mackay, who initiated the research, the study shows how non-pharmaceutical approaches, including special diets and gut bacteria, could treat or prevent autoimmune diseases such as Type 1 diabetes.

"The findings illustrate the dawn of a new era in treating human disease with medicinal foods," he said.

"The materials we used are something you can digest that is comprised of natural products —  resistant starches are a normal part of our diet.

"The diets we used are highly efficient at releasing beneficial metabolites. I would describe them as an extreme superfood," he said.

The researchers are expanding their research to investigate diet"s effect on obesity and other inflammatory diseases including cardiovascular disease, Type 2 diabetes, asthma, food allergies, and inflammatory bowel disease.

The findings were published in the journal Nature Immunology.

A 2015 study published in Gut found that eating a typical Mediterranean diet, which is high in foods rich in fiber, such as fruits and vegetables, increased the amount of short-chain fatty acids in the gut. SCFAs have been linked to many health benefits, including a reduced risk of inflammatory diseases, diabetes, and cardiovascular disease.

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Insulin Shots as Effective as Pumps

Adults with type 1 diabetes may be able to manage their blood sugar levels just as well with multiple daily insulin injections as they can with continuous insulin pumps, a recent study suggests.

In type 1 diabetes, a lifelong condition, the pancreas produces little or no insulin, a hormone needed to allow blood sugar to enter cells and produce energy. People with the condition usually have to test their own blood sugar level throughout the day and inject insulin to manage it; otherwise they risk complications like heart disease and kidney damage.



Some previous research has suggested pumps may help patients get better blood sugar control than they can achieve by giving themselves multiple daily insulin injections. But patients tend to get more intensive training on managing their blood sugar with pumps than they do with injections, so some doctors have questioned whether better patient education might be the reason pumps get better results.

For the current study, researchers set out to answer this question. They offered 260 adults with type 1 diabetes the same education on how to manage their blood sugar, also known as blood glucose, and then randomly assigned participants to use pumps or daily injections.

"What the trial shows fairly unequivocally is that education/training can produce considerable benefit, although it leaves many patients still a long way from current glucose targets," said lead study investigator Dr. Simon Heller, a diabetes researcher at the University of Sheffield in the UK.

To compare pumps to injections, researchers examined average blood sugar levels over the course of several months by measuring changes to the hemoglobin molecule in red blood cells. The hemoglobin A1c test measures the percentage of hemoglobin that is coated with sugar, with readings of 6.5 percent or above signaling diabetes.

At the start of the study, participants had average A1c readings of 9.1 percent, indicating poorly controlled blood sugar with an increased risk of serious complications.

After two years of follow-up, most patients still had poorly controlled blood sugar. People using the pumps achieved average A1c reductions of 0.85 percentage points, compared with 0.42 percentage points with multiple daily injections, researchers report in the BMJ.

Once researchers accounted for other factors that can influence blood sugar such as age, sex and treatment center, the difference in A1c for pump versus injection patients was too small to rule out the possibility that it was due to chance.

There are many different types of pumps and injection devices on the market, and one limitation of the study is that researchers didn"t examine how specific design features might influence how well patients succeeded in managing their blood sugar, the authors note.

It"s also possible that the effort to give pump and injection patients the same level of education may have skewed the results because in real life, patients might get more education when they start using pumps than they would for injections, said Dr. Roman Hovorka, director of research at the University of Cambridge Metabolic Research Laboratories in the UK.

Pumps also have a technological advantage that wasn"t addressed in the study, Hovorka, who wasn"t involved in the research, said by email. These devices can collect data on insulin delivery and blood sugar levels and transmit that information to clinicians, enabling doctors to adjust treatment based on the results.

But because pumps are much more expensive than injections, it doesn"t make sense to use them unless they have a proven advantage for blood sugar control, said Dr. Edwin Gale, emeritus professor of diabetes at the University of Bristol in the UK.

In the UK, pumps cost about 2,500 pounds ($3,116.25) a year plus an additional 1,500 pounds ($1,869.75) for batteries and other supplies, researchers note.

"I think the take-home message for patients is that pumps won"t do the job for you," Gale said by email. "They are not for everyone, and many people can do just as well on multiple injections."

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Diabetes Continues Its Relentless Rise

Two new studies on diabetes deliver good and bad news, but the overall message is that the blood sugar disease remains a formidable public health burden.

The first study looked at the incidence of type 1 and type 2 diabetes in U.S. children, and uncovered this troubling trend: From 2002 to 2012, the rates for both types of diabetes increased, especially among racial and ethnic minorities.



But a bit of hope was offered up in the second study: Swedish researchers reported a drop in the incidence of heart disease and stroke in adults with both types of diabetes.

"These studies highlight our concerns about the increasing prevalence of diabetes. Every 23 seconds, another person is diagnosed with diabetes [in the United States]," said Dr. William Cefalu, chief scientific, medical and mission officer for the American Diabetes Association (ADA).

Cefalu added that the Swedish study was encouraging and shows that things are "trending in the right direction. Because of research in diabetes, we"ve been able to improve the lives of millions of people with diabetes around the world, but the disease is still increasing worldwide. We still have a lot of work to do."

In the United States, approximately 29 million people have diabetes, according to the ADA. The vast majority of those have type 2 diabetes. About 1.3 million people have type 1 diabetes.

In people with type 2 diabetes, the body doesn"t use insulin properly. This is called insulin resistance. Insulin is a hormone that helps usher sugar from foods into the body"s cells to be used as fuel. When someone has type 2 diabetes, this process doesn"t work well and blood sugar levels rise. Obesity is the main risk factor for type 2 diabetes, though it"s not the only factor involved in the disease.

Type 1 diabetes is an autoimmune disease. The body"s immune system mistakenly attacks the insulin-producing cells in the pancreas. This leaves someone with type 1 diabetes with little to no insulin. To stay alive, someone with type 1 diabetes must replace that insulin through injections.

"The specific genes and environmental/behavioral factors that cause type 2 diabetes are different than those that cause type 1 diabetes," explained Elizabeth Mayer-Davis, the author of the study on diabetes incidence in children.

Mayer-Davis and colleagues found that type 1 diabetes was increasing 1.8 percent a year. The increase was significantly larger for Hispanic children, at 4.2 percent a year. That compared with 1.2 percent for white children, the findings showed.

The factors underlying the increase aren"t entirely clear, she said.

Although far fewer children have type 2 diabetes, the disease is increasing faster than type 1. Between 2002 and 2012, the rate of type 2 diabetes increased 4.8 percent a year. The annual increase in type 2 diabetes in black children was 6.3 percent. For Asian/Pacific Islanders, the yearly increase was 8.5 percent, and for Native Americans, it was almost 9 percent, the investigators found.

"The increase in incidence of type 2 diabetes is likely related primarily to the increases in overweight and obesity in youth, although this is not the only reason," said Mayer-Davis. She"s a professor of nutrition and medicine at the University of North Carolina, Chapel Hill.

The second study looked at all of the people registered in a Swedish National Database from 1998 through 2012, and followed their health through 2014. The database has nearly 37,000 people with type 1 diabetes and more than 457,000 with type 2 diabetes. These patients were compared to similar people without diabetes (the "control" group).

The researchers saw roughly a 40 percent greater reduction in heart disease and stroke in people with type 1 diabetes compared to the matched controls. In people with type 2 diabetes, there was roughly a 20 percent greater drop in heart disease and stroke compared to the control group, the study showed.

When it came to deaths during the study period, people with type 1 diabetes had similar reductions in the number of deaths compared to controls. People with type 2, however, had smaller reductions in deaths versus the control group, the researchers found.



Even with these improvements, people with either type of diabetes still have much higher overall rates of premature death and heart disease than the control groups, the study authors noted.

"We believe the changes observed in our study most likely reflect a combination of advances in clinical care for patients with diabetes," said study author Dr. Aidin Rawshani. He is from the Institute of Medicine at the University of Gothenberg in Sweden.

"Perhaps the most important is improved management of cardiovascular risk factors," he said. These risk factors include high blood pressure, abnormal cholesterol, signs of early kidney damage and poor blood sugar control. He said treatment with high blood pressure medications and cholesterol-lowering drugs likely contributed to the improvement.

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Red Wine Compound Boosts Cardio Health in Diabetics

Supplements of the potent antioxidant resveratrol may reduce artery stiffness in people with Type 2 diabetes, according to a new study that may explain how the compound in red wine boosts cardiovascular health.

The research, presented this week at the American Heart Association"s 2017 Scientific Sessions in Minneapolis, suggests the compound may help boost the cardiovascular health in diabetics and others.



"This adds to emerging evidence that there may be interventions that may reverse the blood vessel abnormalities that occur with aging and are more pronounced in people with Type 2 diabetes and obesity," said the new study’s senior author, Dr. Naomi M. Hamburg, of the Boston University School of Medicine.

The researchers recruited 57 obese, middle-aged patients with Type 2 diabetes. Nearly two-thirds of the participants were African-American and slightly more than half were women.

The body"s largest artery, the aorta, becomes stiffer with age and illness, increasing the risk of heart attacks and strokes. To measure aortic stiffness, the researchers performed a test called the carotid-femoral pulse wave velocity (CFPWV) after patients consumed daily doses of 100 mg/day of resveratrol for two weeks followed by 300 mg/day of resveratrol for two weeks.

They performed the test again after patients underwent comparable placebo dosing for a total of four weeks.

Researchers also assessed the ability of the participants’ blood vessels to relax and expand as needed to accommodate changes in blood flow, an important indicator of healthy blood vessel function.

Overall, the researchers found that resveratrol was associated with a trend toward reduced aortic stiffness.

In a subset of 23 patients with high arterial stiffness at the start of the study, they found that the 300 mg dose of resveratrol reduced aortic stiffness by 9.1 percent and that the 100 mg dose reduced it by 4.8 percent. For those receiving a placebo, aortic stiffness actually increased.

Animal studies have shown that resveratrol activates a gene called SIRT 1 which counters the effects of obesity, delays the development of chronic diseases, and promotes longevity.

To see if a similar process occurs in humans, the researchers took a sample of the inner lining of blood vessels from seven participants and examined the tissue for SIRT1 activity. Although they detected increased SIRT1 activity after resveratrol supplementation, the difference was not statistically significant.

"We found that resveratrol also activates the longevity gene SIRT1 in humans, and this may be a potential mechanism for the supplements to reduce aortic stiffness,” said lead study author Dr. Ji-Yao Ella Zhang, Ph.D., also of the Boston University.

“However, the changes in this small and short-term study are not proof. Studies with longer treatment are needed to test the effects of a daily resveratrol supplement on vascular function."

Resveratrol belongs to a group of compounds called polyphenols that help protect the body against damage caused by free radicals.

Small amounts of resveratrol are naturally found in red wine, peanuts, berries, and the skin of red grapes. For example, a glass or red wine may contain 1-2 milligrams. Supplements of resveratrol – including those used in clinical studies – usually contain hundreds of times that amount of resveratrol.

Preliminary research – most of it conducted in animals or cell cultures – suggests that resveratrol may protect against:

Alzheimer’s disease, by protecting nerve cells and preventing the buildup of plaque.

Cancer, by preventing the metastasis (spread) of tumors and promoting the apoptosis (death) of cancer cells.

Diabetes, by reducing the risk of insulin resistance, a condition in which cells fail to respond normally to the hormone insulin, which often leads to elevated blood sugar.

Heart disease, by reducing inflammation, blood levels of LDL “bad” cholesterol, and the “stickiness” of platelets that can clump together and form clots. .

In line with previous research linking resveratrol with anti-aging effects, a recent study of rhesus monkeys shows that that compound can help counteract the adverse effects of high fat and high-sugar diet on muscle cells.

A growing number of human studies also suggests significant health benefits. For example, a recent clinical study of Alzheimer’s disease patients shows that resveratrol restores blood-brain barrier integrity, which helps prevent inflammatory molecules from entering the brain.

Another recent clinical study shows that resveratrol can help correct hormone imbalances in women with polycystic ovary syndrome (PCOS), a leading cause of infertility.

So far, researchers have not linked resveratrol to any serious side effects. But some experts believe that high daily doses (1,000 mg or more) may:

Increase the risk of bleeding, especially when taken in conjunction with blood thinners such as warfarin (Coumadin) and NSAIDs such as aspirin and ibuprofen.

Interfere with the metabolism of some commonly prescribed drugs, including statins for heart disease and benzodiazepines for anxiety.

Experts agree that more research is needed to establish resveratrol’s safety, efficacy, and optimal dosages.

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Diet Rich in Plant Proteins May Prevent Diabetes

A plant-based high-protein diet may reduce the risk of developing Type 2 diabetes, according to a new study by researchers at the University of Eastern Finland. That"s good news for the more than 29 million people in the United States who are affected by the disease.



The new research, published in the British Journal of Nutrition, joins a growing body of evidence that suggests too much animal protein, as well as carbs, contributes to diabetes.

Jyrki Virtanen, a certified clinical nutritionist and researcher on the study, found that high plant protein intake decreased the risk of developing Type 2 diabetes by 35 percent.

Conversely, the study found individuals who followed diets that included high levels of all types of meat, including processed and unprocessed red meat and white meat, had an increased risk of developing Type 2 diabetes.

Plants that are high in protein include lentils, quinoia, nuts, (almonds, walnuts, cashews, and pistachios), seeds (chia, sunflower, sesame, and pumpkin), beans, and legumes.

The researchers caution that it may be other compounds found in meat other than protein that up the risk of developing diabetes.

Male study participants who ingested the highest amount of plant protein were more than one-third less likely to develop Type 2 diabetes than men who ate the lowest amount of plant protein.

Virtanen and his team estimate that replacing just 5 grams of animal protein with a plant protein a day may cut the risk of diabetes by 18 percent.

Virtanen says the link may be explained by the effect of plant protein on blood glucose levels. Study participants who consumed more plant protein had lower blood glucose levels. Researchers also discovered that a higher intake of egg protein also lowered the risk of type 2 diabetes.

Marc Ramirez, a Texas native, says he reversed his Type 2 diabetes with a plant-based diet.

“I now follow three basic guidelines: I eat no animal products, I eat low-fat foods, and I avoid high-glycemic [sugary] foods,” Ramirez says.

Ramirez says that he was off all of his medications in less than two months and has been medicine-free for over three years. He says he now weighs 207 pounds and is now no longer considered diabetic.

For those already diagnosed with Type 2 diabetes, regular physical activity, healthy eating, and taking medications to lower blood glucose levels are all imperative for overall health, experts say.

According to the National Institute of Diabetes and Digestive and Kidney Diseases, healthy eating should focus on a variety of food groups.

Experts recommend:

• Non-starchy vegetables should be about half of your plate, while grains or another starch on one fourth of the plate. The remaining quarter of your plate should be lean meat (such as poultry) or plant protein.


• Be aware that, if you have diabetes, various food types can affect your blood sugar levels. High-carb and sugary foods can cause your blood sugar to spike.


• Keep in mind the impact of sweetened beverages. You should avoid or limit drinks that are full of sugar or high fructose corn syrup, as they will cause your blood sugar to rise quickly.


• It’s also important to coordinate your meals and medications. Too little food may result in dangerously low blood sugar, or hypoglycemia. Too much food may cause blood sugar levels to climb too high and cause hyperglycemia.


• Regular physical activity is also an important part in managing diabetes. When you exercise, your muscles use sugar for energy. Regular exercise also helps your body use insulin more effectively and lower your blood sugar levels. Remember to check your blood sugar level before, during and after exercise, especially if you take insulin. Drink plenty of water and keep a small snack with you while exercising.

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Could a Natural Sweetener Help Control Blood Sugar?

Stevia isn’t just a sweet substitute for those on a sugar-free or low-calorie diet. The plant-based sweetener helps control blood sugar, according to a recent study published in Nature Communications—above and beyond what you’d expect from cutting back on sugar. The way stevia works could make it an ally in the fight against diabetes. (For other blood sugar tamers, see 10 of the best herbs and supplements for diabetes.)

Researchers at the University of Leuven in Belgium monitored mice for two weeks while giving them stevia in their drinking water. In particular, the researchers were interested in a protein called TRPM5 that is stimulated by stevia: TRPM5 is essential for taste perception, but it’s also involved in the release of insulin—the hormone that helps control blood sugar.

Sure enough, when the mice got stevia, TRPM5 activity increased and the mice produced more insulin. Study author Rudi Vennekens, a biochemist, said in ScienceDaily that the mice actually gained “protection against diabetes.” (Don’t miss this go-to guide on superfoods for diabetics.)

To test the findings, Vennekens and colleagues gave the sweetener to mice who lack the protein. “Stevia did not have this protective effect on mice without TRPM5,” said Vennekens. “This indicates that the protection is due to the TRPM5 stimulation.”

The next step for researchers is figuring out whether the sweetener has the same effect in humans. While the results will be a few years coming, if you decide you want to give the sweetener a try, make sure you’re getting the real thing. “Many commercial stevia products are highly purified extracts and are not always as healthy as some of their ‘natural’ labels would lead you to believe,” writes nutritionist Jo Lewin in BBC Good Food. “Like with other sugar alternatives, it is the extraction and processing methods that change the properties of the whole leaf into something quite different.”

Lewin also warns that the intensely sweet additives can drive up your desire for sweet-tasting foods and drinks—so use caution. “The long term effects of sweeteners are still unknown,” she says, “and there is a clear need for further experimentation with respect to the metabolic processes involved.”

However, Lewin does agree that pure stevia is a healthier choice than sugar because it doesn’t add calories, raise blood sugar or insulin levels, or cause cavities. And if it helps your body tame blood sugar, even better. (Here are 21 science-backed ways to prevent diabetes.)

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Ten Things Every Diabetic Should Know About Hypoglycemia!

Hypoglycemia is a state of low blood sugar levels... it"s always best to do a finger stick to find out the actual blood sugar level but signs of hypoglycemia include:

• lack of coordination


• wild mood swings uncharacteristic of the individual


• memory loss


• salivation


• teeth-grinding and


• convulsions

Many type 2 diabetics experience hypoglycemia from time to time because their medications increase the production of insulin whether their body needs it or not.



Although hypoglycemia is unlikely to result in death, it is still quite dangerous. The risk of accidents increases exponentially when diabetics have low blood sugars and then drive or operate equipment.

Here are ten tips to help you know you are hypoglycemic:

1. Almost every incident of hypoglycemia makes the diabetic feel hunger, but not every incidence of hunger is caused by hypoglycemia. The sensation of hunger results whenever cells are deprived of glucose. This can occur when there isn"t enough sugar in your circulation, that is as a result of hypoglycemia. It can also result when there isn"t enough insulin in your circulation to deliver the glucose to your cells, resulting in hyperglycemia.

2. Whenever your pulse is racing 1/3 faster than normal and you have not exercised in the last 2 to 3 hours, it"s safe to assume you are experiencing hypoglycemia. Most people find it easiest to take a pulse at the carotid artery on the side of the neck. Of course, you need to know your normal resting pulse to know what is a fast pulse rate for you.

3. Blurred vision, or double vision, often indicates hypoglycemia. Blurred vision with dry skin, breath that smells like nail polish remover, and dark urine, however, indicates extremely high blood sugars and dehydration.

4. In men who ordinarily experience morning erections, the absence of an erection indicates overnight hypoglycemia. Blood sugars get too low during the night, but then spike upward just before the person gets up.

5. Another common symptom of hypoglycemia is nystagmus. If you are the person taking care of a diabetic, ask him or her to look from side to side while holding their head still. If the eyes seem to "jump" from place to place, there may be hypoglycemia. If you are the diabetic, stare at the second hand of a clock or watch. If the second hand seems to "jump" from position to position, you may be experiencing hypoglycemia.

6. A high-fat meal oddly enough, can result in low blood sugar... this is because your stomach then takes longer to empty food into your intestines.

7. Excessive use of aspirin also can trigger hypoglycemia. Taking too much liver paralyzes the mechanism by which the liver releases glucose.

8. Having a cocktail or a drink before a meal can significantly lower blood sugars. Sometimes excessive drinking with a meal likewise prevents the normal release of sugars from the liver.

9. A sudden change from cold weather to warm weather often precipitates hypoglycemia.

10. Fatalities caused by hypoglycemia itself are very, very rare. This is because cells have several fail-safe mechanisms that allow them to survive low blood sugars and because permanent cell damage requires alteration, not only of blood sugar levels but also of levels of potassium, magnesium, and protein. Insulin is not an efficient method of suicide.

The remedy for low blood sugars, as you probably would have guessed, is sugar. However, most diabetics need very little sugar to get their blood sugars back to normal. As little as 15 grams, about 1/2 oz, of sugar is enough for most diabetics to get back to normal blood sugar levels. Even when a type 2 diabetic wants to eat everything in the refrigerator... and they usually do... just a small amount of sugar equivalent to half a sugar-sweetened soft drink, a small piece of fruit, or preferably a tube of glucose, is enough to prevent blood sugar problems.

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2 Super foods that reduce blood sugar level

If you are here to read this article it means that you had a wake up call from your blood sugar levels. Probably your doctor has told you that diabetes sunset has to happen soon or latter as you have a genetic disposition of this kind of ailment.



The simplest solution mostly prescribed by the endocrinologists is that you must now grab the syringe of insulin in your hand and baby sit you sugar levels. However I have news that can simply turn your joy into ecstasy. The addition of these 3 super foods helps in lowering the blood sugar level and turns your readings to normal blood sugar range.

It is famous that most types of grains are healthy for diabetics. The oats come top in the list. A good idea is to visit the whole food market. There you could find many bins of different types of granola. One must read carefully the labels on the different bins and look carefully at their sugar content. Some whole food may contain as low as 3 or 4 gm of sugar at the same time there would be some mouth watering granolas with even 20 gm of sugars. Your inners levels of high blood sugar may tempt you to buy the one that has 20gm sugar. However it is good to control the urge and select the one that contains around 8 gm or even les than this.

Breakfast must be planned in a way that it lowers the level of blood sugar. It is good to give a nice rest to the blood sugar levels from donuts, pancakes, croissants, hot pockets, biscuits and other sugar laden foods. This good head start of the day will help you to achieve normal blood sugar levels throughout the day.

Here is a nice breakfast idea for you.

2 handfuls of granola with a half cup low fat yogurt and c cup low fat milk makes a nice breakfast. Now you can add different flavored granola in different days. This combination of breakfast is fully loaded with fiber and fortified with healthy fats.

The next super food is Sweet Potato.

It is difficult to believe but it is true that the word that the word sweet brings a lot of joy as well as health benefits. Such foods enable you to satisfy your sweet tooth. Sweet potato is one such food that helps in bringing the blood sugar level down. It enables the body cells to better respond towards the hormone insulin. This better movement helps in facilitating the movement of sugar from the bloodstream in the cells. The beta carotene content of sweet potato brings the reversal of insulin resistance. Sweet potato also contains a good amount of vitamin B6. This vitamin content brings about the resistance towards heart related ailments.

Next in the list of super foods are nuts. Again never rely on the nuts that come in tin packaging as you do not know the source of oil they use.

Click here to find out 3 Proven Steps to Reverse Type-2 Diabetes 

You can eat pizza with type 2 diabetes

When you are diagnosed with type 2 diabetes, you must come to grips with the fact that you are going to have to alter some of your habits and your lifestyle. It is a serious illness that must be attended to if you want to live a long and active life. The good news is that you can easily manage diabetes through your diet and exercise routine.



Type 2 Diabetes is a disorder that displays an unhealthy and uneven level of sugar in your blood. This often comes about through diet choices that have been made. You can manage your Diabetes through diet and exercise, but that does not always mean that that is the only thing that you need to manage it. In fact, in some cases you will need medication to maintain healthy blood sugar levels.

That being said, you cannot depend on medications to maintain your health and well-being. You must be sure to adjust your diet so that it is rich in the foods that you need. When you are looking at your diet, you may come up with some simple questions about everyday foods that you really enjoy. You may wonder; can you eat pizza with Type 2 Diabetes?

Deciding what to eat is always a challenge, especially with Diabetes. However, pizza is definitely one of those foods that everyone loves and craves. The question is, can you have it as part of your diet and still be able to maintain your health? Well, yes, you can, but you need to understand some of the nutritional content of pizza to figure out how to incorporate it into your new and healthier lifestyle.

Pizza does have healthy elements on it like cheese, and vegetables. However, the foundation of a pizza is crust, and crust is bread. Bread is not a bad thing when it is used in normal does.

However, bread is full of carbohydrates, and typically, pizza dough is built with simple carbohydrates, which are essential sugars. It is precisely these carbohydrates that can cause you problems in the first place. These are the types of carbohydrates that are essentially sugars, and those are the sugars that can affect the levels in your blood leading to diabetes. Knowing that is important so that you do not overindulge in the types of food that might drive your blood sugar levels up. It"s also important to note that another key component of pizza is tomato sauce. Though it is not unhealthy, it is full of sugars.

So does that mean that you cannot eat pizza if you have Type 2 Diabetes? No, not at all. What it means is that you need to be cautious about how much pizza you eat. You most certainly can have a few slices every once in a while. What you cannot do is sit down to a medium thin crust all on your own and devour it in one sitting. Though it will take discipline, it is within your reach without having to sacrifice one of your favorite foods!

Click here to find out 3 Proven Steps to Reverse Type-2 Diabetes