Monthly Archives: March 2017

By Serena Gordon

HealthDay Reporter

TUESDAY, March 21, 2017 (HealthDay News) -- The effects of climate change are far-reaching, but new research suggests a surprising linkage to a warming Earth -- more cases of type 2 diabetes.

For every 1 degree Celsius (1.8 degrees Fahrenheit) rise in environmental temperature, the researchers calculated that there would be an increase of more than 100,000 new cases of type 2 diabetes in the United States alone.

Why?

The study authors explained that during cold spells -- at least a few cold days in a row -- so-called brown fat is activated. Brown fat is different from white fat. When activated, it leads to an improvement in the body's sensitivity to insulin, a hormone that helps usher sugar from foods into cells for energy.

"The function of brown fat tissue is to burn fat to generate heat, which is important to prevent a drop in body temperature during cold exposure," explained lead researcher Lisanne Blauw. She's a Ph.D. student at Leiden University Medical Center in the Netherlands.

"Therefore, we hypothesize that brown fat plays a role in the mechanism underlying the association between outdoor temperature and diabetes: in warmer climates, brown fat is less activated, which may causally lead to insulin resistance and diabetes," she said.

Before you start packing for colder climes, it's important to note that this study cannot prove a direct cause-and-effect relationship between warmer temperatures and the development of type 2 diabetes.

Still, Blauw said, "On the basis of our 'brown fat hypothesis,' we believe that at least part of the association can be causally explained by brown fat activity."

The prevalence of type 2 diabetes is rising rapidly across the world. In 2015, about 415 million people worldwide had the disease, the researchers said. By 2040, that number is expected to be as high as 642 million.

In people with pre-diabetes and type 2 diabetes, the body doesn't use insulin properly. These people are said to be insulin-resistant. In those with pre-diabetes, the body can still keep up with demand by producing more and more insulin. But, eventually, the body can't keep pace and it doesn't make enough insulin to keep blood sugar levels from rising. This is when type 2 diabetes develops.

A recent study reported that people with type 2 diabetes exposed to moderate cold for 10 days showed improved insulin resistance, which means they're using insulin more efficiently. This may have occurred due to an increase in brown fat activity. Other past research showed that brown fat is most active in the winter, when temperatures are coldest, the study authors noted.

For the new study, investigators used information from adults in 50 U.S. states, along with Guam, Puerto Rico and the U.S. Virgin Islands. The data covered from 1996 to 2009.

People told researchers if a doctor had ever diagnosed them with type 1 or type 2 diabetes. Approximately 91 percent of diabetes in high income countries is type 2.

The study team also looked at data from the World Health Organization on fasting blood sugar levels and obesity rates for 190 countries.

"In this study, we showed that an increase in outdoor temperature is related to an increase in new diabetes cases in the U.S.," Blauw said.

Although the researchers didn't have information on diabetes diagnoses globally, they did see signs that people were more insulin-resistant in warmer areas.

"People need to realize that global warming may have serious implications for our health, as we showed in this study that more persons get diabetes in years that the mean outdoor temperature is higher," Blauw said.

But not everyone is ready to sound the alarm bell just yet.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said, "This is an interesting article, and a challenging concept."

But, Zonszein explained, "diabetes is a very complex disease and it's unlikely to come down to one factor, such as brown [fat]."

In addition, the database the researchers relied on used self-reported cases of diabetes, which can overestimate or underestimate diabetes rates, he pointed out.

The role of brown fat in people isn't yet clear, Zonszein said. Humans don't seem to have a lot of it, though it's very common in rodents.

The study was published online March 20 in BMJ Open Diabetes Research & Care.

WebMD News from HealthDay

SOURCES: Lisanne Blauw, B.Sc., Ph.D. student, Leiden University Medical Center, the Netherlands; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; March 20, 2017, BMJ Open Diabetes Research & Care, online

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A Warming Planet Might Mean More Diabetes - WebMD

The Will County Health Department will hold a Diabetes Alert Day education event on March 28, 2017 from 10am to 2pm at the Will County Community Health Center. Stop by and take the Diabetes Risk Test and learn how to reduce your risk of Diabetes. Free blood sugar testing will be available.

According to the Center for Disease Control, 8.5% of Will County residents have diabetes, which is over 57-thousand people. One out of every 11 people have diabetes. Diabetes Alert Day is an ideal time to learn the facts and protect yourself against a growing epidemic.

The Will County Health Department urges everyone to be aware of diabetes risk factors. Common risk factors for diabetes include: being overweight, being over 45 years old of age, having a family history of type 2 diabetes, not physically active, and having gestational diabetes or giving birth to a baby who weighed more than 9 pounds. Race and ethnicity are also factors.

The Will County Health Department is located at 1106 Neal Avenue in Joliet.

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Free Diabetes Testing At Will County Health Department - 1340 WJOL - 1340 WJOL

Conference to focus on diabetes issues Annanews Southern Seven Health Department, in collaboration with the Diabetes Today Resource Team, is planning to host a diabetes conference on Thursday evening, March 30. The conference is scheduled from 5 p.m. to 8 p.m. at Shawnee Community College near ...

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Conference to focus on diabetes issues - Annanews

A Philadelphia police officer is crediting a preventative health program with helping him make significant lifestyle changes.

For the last six months, Eric Scott has participated in Temple University Health Systems Diabetes Prevention Program.

The goal of the long-term program is to help people prevent or delay the onset of type 2 diabetes, which occurs when the body doesnt produce enough insulin to regulate blood glucose. Diabetes can increase the risk of heart attack, kidney failure, nerve damage or stroke.

The American Diabetes Association notes there are about 30 million Americans living with the condition, while 86 million have prediabetes. Prediabetes occurs when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes.

The free yearlong program, which is led by the Temple Center for Population Health, was launched back in 2014. Since its inception, 22 people have graduated from the program which is funded with a grant from the Center for Medicaid and Medicare Innovation and the Philadelphia Department of Public Health.

Scott was introduced to the Diabetes Prevention Program through Law Enforcement Health Benefits in October 2016.

I thought the program would be good and it has proven to be effective, he said.

Program participants meet once a week in small groups for the first six months and then monthly for the remainder of the program.

The sessions are led by trained lifestyle coaches who help participants learn new skills and achieve their goals. The goals include a 5 to 7 percent weight loss from their starting weight and increasing their physical activity level to at least 150 minutes per week. Participants are required to track their food intake and weight loss and submit information on a weekly basis.

The coaches guide the classes through a curriculum developed by the Centers for Disease Control and Prevention that focuses on modest weight loss and increasing physical activity. Temple is currently offering diabetes prevention classes at the hospital, Jeanes Hospital, Bright Hope Baptist Church, Zion Baptist Church, Mercy Neighborhood Ministries and La Forteleza.

The program is a group program and we are encouraged by the other participants who are there, Scott explained.

We sort of share our stories as to what are some of the ups and downs or highs or lows that we had faced during the week. We have wonderful facilitators who have been really helpful and resourceful.

Edoris Lomax, the program coordinator for Temples Diabetes Prevention Program, said the initiative has an important educational role.

It also plays a role in educating people in the community about diabetes but also what prediabetes is because many people havent heard of prediabetes and actually educating them on what diabetes is and the possibility that they can prevent becoming a diabetic just by virtue of making small lifestyle changes, said Lomax, who also facilitates some of the classes.

For Scott, tapping into the program is paying off. His A1c level, a measurement of the average blood sugar level, has been increasing during the last five years. Scotts A1c level has decreased and hes lost almost 20 pounds since he joined the program.

I feel more energetic, said the 56-year-old Pittsburgh native.

Im moving a lot better and Ive adopted the lifestyle thats what this is, its a lifestyle.

He cut back on unhealthy options such as fried foods, cakes, potato chips and soda and is more engaged in his health. He has learned about the importance of monitoring his sugar intake, counting calories and and reading food labels.

Scott has a history of hypertension and high cholesterol, two risk factors for the development of diabetes. He understands the importance of making healthy lifestyle changes to help prevent diabetes from developing.

I understand how cost effective it is to change your lifestyle earlier, versus later, Scott added. Financially its a lot better and your life expectancy is greater.

Scott is one of 22 clients who are midway through the program. Temple is now accepting new program enrollees.

The more people we have enrolled, the better outcomes we will have and the more lives we affect and thats our goal at the Center for Population Health to affect as many lives as possible with this free program, said Ronnie Whyte, director, Population Health, Temple Center for Population Health.

She said the program is open to those diagnosed with prediabetes or have risk factors such as high blood pressure, high cholesterol or a family history of diabetes.

For information about enrolling call (215) 707-7247.

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Temple's diabetes prevention program has positive impact - The Philadelphia Tribune

LEXINGTON Treating diabetes is a passion for staff at Plum Creek Medical Group.

Two staff members at the clinic, physician assistant Melissa Hall and registered nurse/care coordinator Tatiana Varona manage a customized 16-week class for patients living with diabetes.

"We really saw the need in our community and in our patients to promote and teach a healthier lifestyle. Our lifestyle plays a major role in our overall health and the development and progression of chronic disease. We hope that through this program we can help our patients, and our community, live healthier and more fulfilled lives," Hall said.

Both Hall and Varona have a passion for helping people reach their goals in regards to weight and health.

They noted that diabetes and obesity are a problem nationwide. The most recent data available shows that in 2012, more than a third of adults and about 17 percent of children nationwide are obese. About 30-35 percent of Nebraskans are obese as well, according to national data.

Obesity is related to many chronic health conditions including diabetes, high blood pressure and heart disease.

In 2012 more than 29 million Americans had diabetes and each year another 1.4 million Americans are diagnosed. As of 2012, 86 million Americans had pre-diabetes.

Studies show that lifestyle changes, including dietary changes and increasing physical activity, can prevent the progression of pre-diabetes to diabetes. Diabetes is more common in American Indians, African Americans and Hispanics.

"Our primary goal with this program is to prevent the progression from pre-diabetes to diabetes, or help patients better control their diabetes and high blood pressure with diet and exercise, when able. Weight loss is just another benefit of changing your lifestyle," Hall said.

The group meets weekly for 16 weeks, then monthly for the remainder of the year, for a total of 24 meetings.

The diabetes support group meetings consist of private weigh-ins and discussion on topics revolving around nutrition. They teach logging food consumed, physical activity, stress management and a multitude of other, more specific topics. Each meeting is about an hour, however with group discussion, they tend to last a bit longer, Hall said.

Hall said PCMG recommends continued regular interval follow-up with a medical provider, to continue to evaluate any chronic medical conditions.

Two key components to the class that have been crucial in helping participants who have had great results are: tracking food intake by consistently logging and increasing physical activity.

The initial goal of the diabetes group, Hall said, is to decrease the risk of developing diabetes or better manage current health conditions.

Hall said participants with the diabetes group have not only implemented healthier lifes styles but are also achieving big goals.

"We have had participants that have lost quite a bit of weight (over 50 lbs.) and continue to keep it off. We have had participants decrease the amount of medication that they take for diabetes and high blood pressure. Some have actually completely gotten off multiple medications," she said.

"But the ultimate goal, is to help those in our community live a healthier lifestyle, so they dont need to rely on medications as much, to help them reach their full health potential, and feel better," Hall said.

For more information on the diabetes class or to register, call Melissa Hall at Plum Creek Medical Group at 308-324-6386.

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Plum Creek Medical Group offers personalized classes for those living with diabetes - Lexington Clipper Herald

March 21, 2017 by Dimitris Bertsimas, The Conversation Tools of diabetes treatment almost always include improved diet and regular exercise. Credit: http://www.shutterstock.com

When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons.

Type 2 diabetes runs in my family. My grandfather died of complications related to the condition. My mother was diagnosed with the disease when I was 10 years old, and my Aunt Zacharoula suffered from it. I myself am pre-diabetic.

As a teen, I remember being struck by the fact that my mother and her sister received different treatments from their respective doctors. My mother never took insulin, a hormone that regulates blood sugar levels; instead, she ate a limited diet and took other oral drugs. Aunt Zacharoula, on the other hand, took several injections of insulin each day.

Though they had the same heritage, the same parental DNA and the same disease, their medical trajectories diverged. My mother died in 2009 at the age of 75 and my aunt died the same year at the age of 78, but over the course of her life dealt with many more serious side effects.

When they were diagnosed back in the 1970s, there were no data to show which medicine was most effective for a specific patient population.

Today, 29 million Americans are living with diabetes. And now, in an emerging era of precision medicine, things are different.

Increased access to troves of genomic information and the rising use of electronic medical records, combined with new methods of machine learning, allow researchers to process large amounts data. This is accelerating efforts to understand genetic differences within diseases including diabetes and to develop treatments for them. The scientist in me feels a powerful desire to take part.

Using big data to optimize treatment

My students and I have developed a data-driven algorithm for personalized diabetes management that we believe has the potential to improve the health of the millions of Americans living with the illness.

It works like this: The algorithm mines patient and drug data, finds what is most relevant to a particular patient based on his or her medical history and then makes a recommendation on whether another treatment or medicine would be more effective. Human expertise provides a critical third piece of the puzzle.

After all, it is the doctors who have the education, skills and relationships with patients who make informed judgments about potential courses of treatment.

We conducted our research through a partnership with Boston Medical Center, the largest safety net hospital in New England that provides care for people of lower income and uninsured people. And we used a data set that involved the electronic medical records from 1999 to 2014 of about 11,000 patients who were anonymous to us.

These patients had three or more glucose level tests on record, a prescription for at least one blood glucose regulation drug, and no recorded diagnosis of type 1 diabetes, which usually begins in childhood. We also had access to each patient's demographic data, as well their height, weight, body mass index, and prescription drug history.

Next, we developed an algorithm to mark precisely when each line of therapy ended and the next one began, according to when the combination of drugs prescribed to the patients changed in the electronic medical record data. All told, the algorithm considered 13 possible drug regimens.

For each patient, the algorithm processed the menu of available treatment options. This included the patient's current treatment, as well as the treatment of his or her 30 "nearest neighbors" in terms of the similarity of their demographic and medical history to predict potential effects of each drug regimen. The algorithm assumed the patient would inherit the average outcome of his or her nearest neighbors.

If the algorithm spotted substantial potential for improvement, it offered a change in treatment; if not, the algorithm suggested the patient remain on his or her existing regimen. In two-thirds of the patient sample, the algorithm did not propose a change.

The patients who did receive new treatments as a result of the algorithm saw dramatic results. When the system's suggestion was different from the standard of care, an average beneficial change in the hemoglobin of 0.44 percent at each doctor's visit was observed, compared to historical data. This is a meaningful, medically material improvement.

Based on the success of our study, we are organizing a clinical trial with Massachusetts General Hospital. We believe our algorithm could be applicable to other diseases, including cancer, Alzheimer's, and cardiovascular disease.

It is professionally satisfying and personally gratifying to work on a breakthrough project like this one. By reading a person's medical history, we are able to tailor specific treatments to specific patients and provide them with more effective therapeutic and preventive strategies. Our goal is to give everyone the greatest possible opportunity for a healthier life.

Best of all, I know my mom would be proud.

Explore further: Data-driven algorithm yields notable improvements in HbA1c

This article was originally published on The Conversation. Read the original article.

(HealthDay)A data-driven algorithm for personalized diabetes care can yield substantial improvements in hemoglobin A1c (HbA1c), according to a study published online Dec. 5 in Diabetes Care.

The American Diabetes Association (ADA) recommends metformin as the first-line treatment for type 2 diabetes. Metformin monotherapy should be initiated at the time of diagnosis for most patients unless there are contraindications. ...

(HealthDay)Data from electronic health records (EHRs) can be used to detect more cases of diabetes than claim codes alone and can be used to accurately distinguish between type 1 and type 2 diabetes, according to a study ...

(HealthDay)An algorithm has been developed to help physicians navigate medical treatment for obesity care, according to a report published by the American Society of Bariatric Physicians (ASBP).

It may be possible to assess the risk of developing dementia by analyzing information gathered during routine visits to the family doctor, according to research published in the open access journal BMC Medicine.

How do mammals keep two biologically crucial metabolites in balance during times when they are feeding, sleeping, and fasting? The answer may require rewriting some textbooks.

Daily screen time of three or more hours is linked to several risk factors associated with the development of diabetes in children, finds research published online in the Archives of Disease in Childhood.

Jason Dyck has long believed in the beneficial properties of resveratrola powerful antioxidant produced by some plants to protect against environmental stresses. The professor of pediatrics at the University of Alberta ...

The age at which girls start menstruating could flag a later risk of diabetes during pregnancy, according to a University of Queensland study

Short bursts of high-intensity exercise could help people with non-alcoholic fatty liver disease reduce their risk of type 2 diabetes.

A diet designed to imitate the effects of fasting appears to reverse diabetes by reprogramming cells, a new USC-led study shows.

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Using math to develop an algorithm to treat diabetes - Medical Xpress