Posts tagged ‘type 2 diabetes’
People prescribed anti-depressants should be aware they could be at increased risk of type 2 diabetes, say UK researchers.
The University of Southampton team looked at available medical studies and found evidence the two were linked.
But there was no proof that one necessarily caused the other.
It may be that people taking anti-depressants put on weight which, in turn, increases their diabetes risk, the team told Diabetes Care journal.
Or the drugs themselves may interfere with blood sugar control.
These findings fall short of being strong evidence that taking anti-depressants directly increases risk of type 2 diabetes”
Dr Matthew Hobbs of Diabetes UK
Their analysis of 22 studies involving thousands of patients on anti-depressants could not single out any class of drug or type of person as high risk.
Prof Richard Holt and colleagues say more research is needed to investigate what factors lie behind the findings.
And they say doctors should keep a closer check for early warning signs of diabetes in patients who have been prescribed these drugs.
With 46 million anti-depressant prescriptions a year in the UK, this potential increased risk is worrying, they say.
Prof Holt said: “Some of this may be coincidence but there’s a signal that people who are being treated with anti-depressants then have an increased risk of going on to develop diabetes.
“We need to think about screening and look at means to reduce that risk.”
Diabetes is easy to diagnose with a blood test, and Prof Holt says this ought to be part of a doctor’s consultation.
“Diabetes is potentially preventable by changing your diet and being more physically active.
“Physical activity is also good for your mental health so there’s a double reason to be thinking about lifestyle changes.”
Around three million people in the UK are thought to have diabetes, with most cases being type 2.
Dr Matthew Hobbs of Diabetes UK, said: “These findings fall short of being strong evidence that taking anti-depressants directly increases risk of type 2 diabetes. In this review, even the studies that did suggest a link showed only a small effect and just because two things tend to occur together, it doesn’t necessarily mean that one is causing the other.
“But what is clear is that some anti-depressants lead to weight gain and that putting on weight increases risk of type 2 diabetes. Anyone who is currently taking, or considering taking, anti-depressants and is concerned about this should discuss their concerns with their GP.”
Not the best thing to do after a day sitting at your desk
Sitting for long periods increases the risk of diabetes, heart disease and death, researchers suggest.
The scientists from Leicester and Loughborough Universities say harm is done even if people also exercise.
The study, published in Diabetologia, analysed 18 existing studies involving almost 800,000 people.
Diabetes UK said anyone who spent a lot of time sitting or lying down would “obviously benefit” from moving more.
The researchers say the opportunities for sedentary behaviour in modern society such as watching TV, sitting in a car or using a computer are “ubiquitous”.
Of course, in modern society many people head to the gym for a burst of exercise to redress the balance.
But the research team, led by Dr Emma Wilmot from the Diabetes Group at the University of Leicester, says while going to the gym or pool after work is better than heading straight for the sofa, spending a long time sitting down remains bad for you.
Each of the studies they assessed used different measures – for example more or less than 14 hours a week watching TV, or self-reported sitting time of less than three hours a day to more than eight.
The researchers say this means it is not possible to give an absolute limit for how much sedentary time is bad for you.
But Dr Emma Wilmot, who led the study, said it was clear that those who sat the most had a higher risk of diabetes, heart disease and death than those who sat the least.
We can have standing meetings, we can walk during the lunch break, and we can look to reduce TV viewing in the evenings by seeking out less sedentary behaviours”
Prof Stuart Biddle, Loughborough University
She said: “If a worker sits at their desk all day then goes to the gym, while their colleague heads home to watch TV, then the gym-goer will have better health outcomes.
“But there is still a health risk because of the amount of sitting they do.
“Comparatively, the risk for a waiter who is on their feet all day is going to be a lot lower.”
She added: “People convince themselves they are living a healthy lifestyle, doing their 30 minutes of exercise a day.
“But they need to think about the other 23.5 hours.”
The strongest associations in the analysis were between prolonged sitting and diabetes.
There is evidence that being sedentary negatively affects glucose levels and increases insulin resistance – but scientists do not yet know how.
Dr Wilmot said the study’s message could help those at high risk of diabetes, such as obese people or those of South Asian ethnic origin, because it was an easy lifestyle change to make.
Prof Stuart Biddle, of Loughborough University, who also worked on the study, said: “There are many ways we can reduce our sitting time, such as breaking up long periods at the computer at work by placing our laptop on a filing cabinet.
“We can have standing meetings, we can walk during the lunch break, and we can look to reduce TV viewing in the evenings by seeking out less sedentary behaviours.”
Dr Matthew Hobbs, head of research at Diabetes UK, said people should not be discouraged from exercising.
He added: “What is clear is that anyone who spends lots of time sitting or lying down would benefit from replacing some of that time by standing or walking.
“Aside from any direct effect reducing the amount of time you spend sitting down may have, getting more physical activity is a great way of helping maintain a healthy weight, which is the best way of minimising your risk of Type 2 diabetes.”
Cheese lovers could be 12 percent less likely to develop type 2 diabetes, research finds. But that doesn’t necessarily mean you can eat cheese with abandon.
WEDNESDAY, July 25, 2012 — People with an elevated diabetes risk are often told to avoid high-fat foods, such as cheese, but a new study published in the American Journal of Clinical Nutrition suggests that a diet rich in cheese might actually prevent the disease from developing.
The reason? Cheese’s particular brand of fat and fermentation process, researchers in the Netherlands concluded. A study of more than 300,000 people across eight European countries indicated that total dairy consumption was not associated with diabetes risk. But cheese and other fermented dairy products, such as yogurt and thick, fermented milk were inversely associated with type 2 diabetes.
Out of all the dairy products, cheese was found to lower risk the most. Researchers say that though results are promising, more research needs to be done to determine a link between fermented dairy and diabetes risk.
Fat and Your Diabetes-Prevention Diet
Because numerous studies have found high-fat diets to be associated with diabetes risk and inflammation in the body, which is linked to a host of other chronic diseases, this research does not give you a free pass to go cheese-crazy.
“Diabetes puts people at increased risk for heart disease, which is why it’s important to watch your fat intake,” says Dara Gurau, RD at Sunnybrook Health Sciences Center in Toronto. “Cheese and dairy products are higher in saturated fat, so it’s best to choose lower fat varieties of these foods such as skim milk, fat-free yogurt, low-fat cottage cheese, and hard cheeses with less than 16 percent milk fat.”
To cut your diabetes risk, Gurau also suggests avoiding the trans fats found in margarine, fried foods, and any foods that list hydrogenated oil as an ingredient. For healthy fat sources, add more olive and canola oils, nuts, seeds, avocados, and olives to your diet, Gurau suggests. She also recommends adding two to three servings of fatty fish, such as mackerol or salmon, to your diet per week. The omega-3 fatty acids found in such fish are essential for skin, heart, and brain health, and may also lessen diabetes risk.
Type 2 diabetes is threatening a new group of people: seemingly fit women.
By Sushma Subramanian, Photography By Tom Schierlitz
Stephanie Yi, 29, had a body most women would kill for. She never had to work hard to maintain her long-limbed, flat-bellied frame—weekend hikes near her northern California home and lots of spinach salads did the trick. She could easily afford to indulge her sweet tooth with the occasional buttery, sugary snack. At 5’7″ and 120 pounds, she had, she figured, hit the good-genes jackpot.
But everything changed two years ago, when a crippling fatigue left her sidelined from college classes. Listless, she dragged herself to a doctor, who suspected a thyroid imbalance. A blood test and a few days later, she received the alarming results: Her thyroid was fine; her blood sugar levels were not. She was prediabetic and on the cusp of developing type 2.
Stephanie was stunned. Of course, she’d heard diabetes was a health crisis. (At last count, 26 million Americans had the disease, according to the Centers for Disease Control and Prevention.) But weren’t type 2 diabetics fat, sedentary, and on junk-food-and-soda diets? Stephanie hadn’t been to a drive-through in ages; she didn’t touch meat. Yet, somehow, she’d gotten an illness most slim women dodge.
A Growing Threat
The CDC estimates that one in nine adults has diabetes and, if current trends continue, one in three will be diabetic by the year 2050. For decades, typical type 2 patients were close to what Stephanie pictured: heavy and inactive. They were also older, often receiving a diagnosis in middle age or beyond. But while such type 2 cases continue to skyrocket, there has been a disturbing increase in a much younger set.
The number of diabetes-related hospitalizations among people in their thirties has doubled in the past decade, with women 1.3 times more likely to be admitted than men. Perhaps even more troubling is the enormous number of people age 20 or older with prediabetes: 65 million, up from 57 million in 2007.
Suddenly, a condition that can take half a lifetime to develop has become a young person’s problem. Even more surprising, about 15 percent of people with type 2 diabetes aren’t overweight, according to the National Institutes of Health. They’re not feasting on ice cream and cheeseburgers. But their average-weight bodies are hiding a dark secret.
Skinny-Fat and Stressed Out
Molecular imaging expert Jimmy Bell, M.D., studies a condition he calls TOFI—thin outside, fat inside. Nearly undetectable from a person’s appearance, TOFI happens when fat that would normally build up under your skin (hello, thunder thighs!) gloms onto your abdominal organs instead. This visceral fat is way worse than any muffin-top chub—it can cause inflammatory substances to affect your liver and pancreas, and lower your insulin sensitivity, putting you at risk for type 2. “With TOFI, you might look slim,” says Bell, “but your insides are behaving as if you are obese.”
A big skinny-fat risk factor? Neglecting exercise and regulating weight through food choices alone, a behavior plenty of young women in our diet-obsessed, desk-strapped culture are prone to. Turns out, breaking a sweat is key in lowering blood sugar, because even moderate exercise causes muscles to suck up glucose at 20 times the normal rate (regular workouts are also the only way to shed visceral fat).
That’s a fact Corinne Waigand, 30, wishes she had known. In college, she regularly skipped breakfast and pounded Mountain Dew in lieu of lunch to keep her wired for class. After school, she’d indulge all of her cravings—cookies, cake, pasta, chips—before sometimes heading out to parties with friends. She rarely exercised, though she did go on the occasional low-sugar kick; one year, she gave up soda for Lent and dropped 10 pounds (she gained it all back). At 5’10” and 165 pounds, she was never overweight, let alone obese, but her behavior caused huge troughs and peaks in her insulin production.
Corinne was diagnosed with type 2 diabetes two years ago. Like Stephanie, she was shocked. “I didn’t fit the physical description of someone with type 2,” she says. “Sure, I had some bad eating habits, but it never showed on my body.”
Many young women also unwittingly engage in a second big TOFI and diabetes risk: yo-yo dieting. “Each time you lose weight through dieting, you also lose muscle,” explains Betul Hatipoglu, M.D., an endocrinologist at the Cleveland Clinic. “And each time you regain that weight, you gain only fat.” In other words, yo-yo dieters lose the muscle mass that would help them burn visceral fat and control blood sugar—a type 2 double whammy.
Layered on top of these risks is another familiar culprit: daily stress. When your mind is taxed, your body produces the stress hormone cortisol to give you a jolt of energy. Problem is, cortisol also temporarily elevates blood sugar—a diabetes danger if you’re tense all the time. Plus, scientists have found that too much cortisol can also mess with fat storage and lead to a spike in visceral blubber among stressed-out, normal-weight women. That’s right—chronic stress contributes to making you skinny-fat.
Stephanie Yi didn’t yo-yo diet and wasn’t super stressed. Sure, she had that sweet tooth, but don’t lots of fit women? After her prediabetes diagnosis, she called her father. He reminded her that his father had died from a heart attack related to diabetes when Stephanie was very young. She was likely the victim of yet another type 2 risk: genetic predisposition.
Scientists are still working out the specifics, but lean young people might be at a bigger risk of developing type 2 if one of their also-lean relatives was diagnosed, according to the Joslin Diabetes Center at Harvard Medical School. (If both her parents have type 2, a woman has a 50 percent chance of getting it herself; if both of her parents and a sibling have it, her risk increases fourfold.) Why? It’s possible that normal-weight type 2 patients inherited a specific set of genes that affects the way their body handles even a bit of excess fat.
For example, some women can house ample junk in their trunk without serious health consequences—their pancreas functions as a genius locksmith that distributes insulin keys to open the doors that let cells store sugar. But other women, like Stephanie, might have a much lower threshold for excess food or fat. Certain DNA might hinder their pancreatic function; no matter how many keys are passed out, none work.
Sugar gets locked out of cells and floods the bloodstream, damaging organs like the liver and heart, says endocrinologist Nicola Abate, M.D., of the University of Texas.
While the only test for “type 2 DNA” involves a long, hard look at a family tree, researchers know that certain people might be at a higher risk. Asian Americans, for instance, are more likely than white Americans to develop type 2, even though just 9 percent of the former group are obese, compared with 32 percent of the latter, according to the National Diabetes Fact Sheet. It appears, says Abate, that Asian Americans are genetically predisposed to be extra sensitive to extra calories.
Stamping Out Prediabetes
Some doctors, such as leading diabetes expert Richard Bernstein, M.D., believe that many of the slim women diagnosed with type 2 don’t actually have that disease. Rather, they could have an undiagnosed case of type 1.
“The definitions of type 1 and type 2 are too vague,” he says. “Many adults show symptoms of both.” After all, the signs—extreme thirst, blurred vision, high blood sugar—can be similar, according to the National Institutes of Health. So it’s important to get tested for both types (the typical type 2 screen does not look for the autoantibodies that come with type 1). “Most doctors don’t test for diabetes unless their patient is obese,” says Abate. But they should; symptoms might not show up until the disease is well under way. Ask your doctor to check you every five years.
Your best bet, of course, is preventing type 2 symptoms altogether. Even if you have type 2–prone DNA, the disease is almost entirely preventable if you make smart lifestyle choices or catch prediabetes early. “While type 2 can never be reversed, prediabetes can,” says Abate. The problem is that about 93 percent of prediabetics don’t even know they’re sick.
Besides being tested, a crucial antidiabetes move is to eat healthy foods—not just foods that seem healthy, says Bell. Women can up their TOFI risk by downing too much junk food in disguise—all too easy with sugar lurking in “health foods” such as low-fat salad dressings, breakfast cereals, and vitamin drinks. Such fare is often packed with high-fructose corn syrup, which the body converts into visceral fat. Eat as little added sugar as possible each day and stick with low-glycemic-index carbs and unprocessed foods like fruits, veggies, and whole grains.
Since cutting out her guilty pleasures, Stephanie has watched her blood sugar levels drop. She has also said good-bye to carb-heavy white bread and embraced exercise nearly every day of the week. (Studies show that just 30 minutes of brisk walking a day can cut people’s odds of developing type 2 by 58 percent—even people who are already prediabetic—according to the NIH.) “I know my body better now,” says Stephanie. “Making these small changes has made me healthier.” The last time she checked, her blood sugar was close to normal.
by Lee Gui Ping Amanda
SINGAPORE – A new drug to treat adults with type 2 diabetes mellitus was launched by Boehringer Ingelheim and Eli Lily alliance today.
The Health Science Authority has approved Trajenta as a monotherapy, or to be used in combination in patients whose condition is cannot be adequately controlled by diet and exercise alone, irrespective of their renal and liver function.
Patients with type 2 diabetes – a common form of diabetes – do not produce enough insulin for the body’s needs or the body cannot use the insulin adequately.
The drug, to be taken orally, is the only diabetes treatment approved as one dose strength once daily for adult patients.
“Trajenta is the first DPP-4 (dipeptidyl peptidase-4 ) inhibitor available at one dose for all patients. Trajenta offers the benefits of the DPP-4 inhibitor class with good efficacy, tolerability, weight neutrality and low risk of hypoglycaemia as well as the additional advantage of no requirement for dose adjustment irrespective of their patients’ renal function,” said Professor Anthony Barnett, Emeritus Professor of Medicine from the University of Birmingham, UK.
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