Category Archives: Diabetes

A free weekly series of classes on diabetes education and prevention is beginning this week at the Marion Oaks Fitness and Recreation Center.

The Department of Health in Marion County (DOH-Marion), in partnership with the Marion County Hospital District, is offering the free classes at the fitness and recreation center, which is located at 280 Marion Oaks Lane in Ocala.

DOH-Marions Diabetes Empowerment and Education Program, or DEEP, runs for six weeks, beginning on Thursday, June 30, from 9:30 a.m. to 11:30 a.m. The classes will meet at that same time and location each Thursday through August 4.

DEEP is a series of classes that aims to help participants who have diabetes or are considered pre-diabetic to better understand their condition and self-care options.

The classes will cover such topics as understanding how diabetes affects the human body and how to monitor it. DEEP will also include instruction on the importance of meal planning, physical activity, and a balanced diet, as well as teaching participants how to identify and prevent diabetic complications.

AdventHealth Ocala staff will also be in attendance to provide free clinical screenings.

The classes are free, but space is limited. For more information, or to register, call 352-644-2624.

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Free diabetes education classes kick off this week at Marion Oaks Fitness and Recreation Center - Ocala News

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

Individuals with diabetes who experience COVID-19 are at increased risk for long COVID compared to individuals without diabetes, according to data from a literature review of seven studies.

Diabetes remains a risk factor for severe COVID-19, but whether it is a risk factor for postacute sequelae of COVID-19 (PASC), also known as long COVID, remains unclear, Jessica L. Harding, PhD, of Emory University, said in a late-breaking poster session at the annual scientific sessions of the American Diabetes Association.

Long COVID is generally defined as "sequelae that extend beyond the 4 weeks after initial infection" and may include a range of symptoms that affect multiple organs, Harding said. A study conducted in January of 2022 suggested that type 2 diabetes was one of several strong risk factors for long COVID, she noted.

Harding and colleagues reviewed data from seven studies published from Jan. 1, 2020, to Jan. 27, 2022, on the risk of PASC in people with and without diabetes. The studies included patients with a minimum of 4 weeks' follow-up after COVID-19 diagnosis. All seven studies had a longitudinal cohort design, and included adults from high-income countries, with study populations ranging from 104 to 4,182.

Across the studies, long COVID definitions varied, but included ongoing symptoms of fatigue, cough, and dyspnea, with follow-up periods of 4 weeks to 7 months.

Overall, three of the seven studies indicated that diabetes was a risk factor for long COVID (odds ratio [OR] greater than 4 for all) and four studies indicated that diabetes was not a risk factor for long COVID (OR, 0.5-2.2).

One of the three studies showing increased risk included 2,334 individuals hospitalized with COVID-19; of these about 5% had diabetes. The odds ratio for PASC for individuals with diabetes was 4.18. In another study of 209 persons with COVID-19, of whom 22% had diabetes, diabetes was significantly correlated with respiratory viral disease (meaning at least two respiratory symptoms). The third study showing an increased risk of long COVID in diabetes patients included 104 kidney transplant patients, of whom 20% had diabetes; the odds ratio for PASC was 4.42.

The findings were limited by several factors, including the relatively small number of studies and the heterogeneity of studies regarding definitions of long COVID, specific populations at risk, follow-up times, and risk adjustment, Harding noted.

More high-quality studies across multiple populations and settings are needed to determine if diabetes is indeed a risk factor for long COVID, she said.

In the meantime, "careful monitoring of people with diabetes for development of PASC may be advised," Harding concluded.

"Given the devastating impact of COVID on people with diabetes, it's important to know what data has been accumulated on long COVID for future research and discoveries in this area," Robert A. Gabbay, MD, chief science and medical officer for the American Diabetes Association, said in an interview. "The more information we have, the better we can understand the implications."

Gabbay said he was surprised by the current study findings. "We know very little on this subject, so yes, I am surprised to see just how significant the risk of long COVID for people with diabetes seems to be, but clearly, more research needs to be done to understand long COVID," he emphasized.

The take-home message for clinicians is the importance of screening patients for PASC; also "ask your patients if they had COVID, to better understand any symptoms they might have that could be related to PACS," he noted.

"It is crucial that we confirm these results and then look at risk factors in people with diabetes that might explain who is at highest risk and ultimately understand the causes and potential cure," Gabbay added.

The study was supported by the National Heart, Lung, and Blood Institute. Harding and Gabbay had no financial conflicts to disclose.

This article originally appeared on MDedge.com, part of the Medscape Professional Network.

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Diabetes Tied to Risk of Long COVID, Too - Medscape

Neuropathy was associated with masticatory (chewing) dysfunction independent of missing teeth or diabetes severity in a small study in Japan.

"We demonstrated that patients with type 2 diabetes who developed diabetic neuropathy had significantly reduced masticatory efficiency," Yuta Hamamoto, DDS, PhD, and colleagues report in a study published online in PLoS One.

The decreased chewing ability was independent of missing teeth or diabetes severity, Hamamoto, a clinical fellow in the Department of Periodontal Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Japan, clarified in an email to Medscape Medical News.

Their findings are important because "chewing well is essential for successful diet therapy and control of blood glucose level in patients with hyperglycemia," the researchers explain.

Successful diet therapy requires that a doctor and nutritionist pay attention to the patient's chewing ability. Dental intervention may also be required, Hamamoto said.

"We can restore their occlusal function by prosthetic and periodontal treatment," he said. "We can also examine the oral function and give patients rehabilitation to improve mastication."

Good glycemic control in type 2 diabetes delays the onset and progression of microvascular complications including nephropathy, neuropathy, and retinopathy, the researchers write.

At the same time, periodontitis is characterized by tooth mobility or loss leading to chewing dysfunction, and it is widely accepted that tooth loss is associated with diabetes.

Hamamoto and colleagues aimed to determine whether chewing ability was associated with microvascular complications of diabetes using a new test that quantifies chewing ability.

They enrolled 172 patients with type 2 diabetes who underwent educational hospitalization in the Department of Endocrinology and Diabetes Medicine, Hiroshima University Hospital from April 2016 to March 2020.

These patients had developed severe diabetes and were hospitalized to receive education about diabetes, nutrition, and therapy, including guidance about how to inject insulin, Hamamoto explained.

The patients provided blood and urine samples that were used to measure urine creatinine, serum urinary albumin excretion, and urine albumin-to-creatinine ratio to detect diabetic nephropathy.

Diabetic neuropathy was diagnosed as having two of the following: diabetic neuropathy symptoms, reduced Achilles tendon reflex, or decreased vibration sensation on the internal malleolus.

The patients had an eye exam to detect diabetic retinopathy.

They had a dental exam that included a count of moving (loose) teeth, missing teeth, and detection of periodontitis.

At baseline, the patients had a mean age of 61 and 58% were men. On average, they had had diabetes for 11 years, and their mean A1c was 10.3%.

Close to three quarters of the patients had diabetic neuropathy (71%) and a quarter had diabetic retinopathy (25%). About half had stage 1 chronic kidney disease (CKD) (53%) and fewer had stage 2 CKD (34%), stage 3 CKD (7%), or stage 4 CKD (6%); none had stage 5 CKD.

On average, the patients had 23 teeth and two moving teeth. None had dental implants and 46 patients had removable prostheses.

Chewing efficiency was measured using a chewing ability test (Gluco Sensor GS-II, GC Corporation, Tokyo, Japan). For this test, patients chewed 2 g of gummy jelly that contained about 100 mg of glucose for 20 seconds, then rinsed with 10 mL of water, and then spat the chewed jelly and water into a cup covered with a mesh. The sensor detected the amount of glucose in the filtrate, and the average of two tests was taken as a measure of chewing efficiency.

Chewing efficiency was significantly associated with duration of diabetes (P = .049), number of remaining teeth (P < 0001), number of moving teeth (P = .007), and having diabetic neuropathy (P < .0001).

Age, body mass index, A1c, periodontal inflammatory surface area, sex, and current smoking were not significantly associated with chewing ability.

After adjusting for multiple variables, diabetic neuropathy was significantly associated with lower chewing efficiency (P = .007), as was having fewer than 20 teeth (P .0001).

However, "unexpectedly," neither diabetic retinopathy nor diabetic nephropathy correlated with masticatory efficiency, the researchers write.

"These results imply that diabetic neuropathy could be the cause of the resultant masticatory disorder in diabetes patients," they conclude.

They propose two biological mechanisms to explain this. Diabetic neuropathy may cause loss of muscle involved in chewing, or it may cause trigeminal nerve palsy (lack of nerve function) in muscles involved in chewing.

However, unlike previous studies, the current study did not find that periodontitis was associated with chewing ability. Therefore, more research is needed.

Two researchers were supported by the Grants-in-Aid for Scientific Research (KAKENHI) program. The authors have reported no competing financial disclosures.

PLoS One. Published online June 6, 2022. Article

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Diabetic Neuropathy Associated With Chewing Difficulty - Medscape

Since early 2021, the Beta Cell Foundation has collected data on vaccine adverse events from 528 patients with type 1 diabetes by using an online database for analysis.

The analysis showed that some patients with type 1 diabetes experienced elevated (or disturbed) blood glucose levels after vaccination with COVID vaccines:

What is the link between type 1 diabetes, COVID, and the vaccines?

Late at night on May 31, 2022, hundreds of parents from 26 provinces and central government directly controlled municipalities across China sent out an online plea for help: more than 600 children had developed type 1 diabetes after receiving the Chinese-manufactured vaccines. Some parents said that their families had no history of diabetes for three generations. Is there a correlation between the vaccines and these childhood diabetes cases?

In addition, we have received a report of adverse diabetes events after vaccination in mainland China, and the 211 cases in the report had quite detailed information. We analyzed the association between these 211 cases of diabetes and the vaccines received by the patients, by using the same principles as in our previous analysis of the over 800 leukemia cases, with a conservative approach.

The patients in these adverse events were predominantly male, with a median age of 12 years old. This is very similar to the age of prevalence of type 1 diabetes, which is more prevalent in children aged 10 to 14.

Among patients who were injected with one brand of vaccines, the vaccines produced by Sinovac Life Sciences Co., Ltd accounted for 29 percent, the highest proportion, followed by Beijing Institute of Biological Products Co., Ltd., Changchun Institute of Biological Products Co., Ltd., and Chengdu Institute of Biological Products Co., Ltd. These proportions match with the overall proportions of COVID-19 vaccines used in mainland China.

Type 1 diabetes was the main type of diabetes that occurred in these patients, accounting for 96 percent. The remainder are other types of diabetes, such as type 2 diabetes. Under normal circumstances, type 1 diabetes accounts for less than 5 percent of the total cases. Type 1 diabetes is hereditary and usually occurs in children or adolescents, whose parents or siblings also have type 1 diabetes, while type 2 diabetes is more common in adults.

Seventy-two percent of all diabetes patients developed symptoms or were diagnosed at a median of 66 days, or 2 months, after the second dose of the COVID-19 vaccines.

Overall, the association between the onset of diabetes and the second dose is very strong in terms of timing. Moreover, among these 211 patients, no one had a family history of diabetes, which is a consistent pattern that warrants alarm.

The pancreas is an important organ that produces insulin, which is a hormone that binds to the insulin receptors on the cells. It helps glucose enter the cells, so that it can be used by the cells.

When glucose remains in the bloodstream and is unable to enter the cells, it causes high levels of blood glucose. And type 1 diabetes is caused by a significant deficiency of insulin, which prevents blood glucose from being used effectively by the cells and thus causes blood glucose to rise.

The reason for this inability to produce enough insulin is usually damage to the pancreatic islet cells caused by autoimmune or viral problems.

In the case of type 2 diabetes, the bodys insulin secretion is normal, but the cells are not sensitive to insulin, and blood glucose is retained outside the cells and cannot be used effectively, causing hyperglycemia.

Then, is it possible that diabetes is related to COVID-19 infection? Studies have shown that there is indeed a connection between the SARS-COV-2 virus and diabetes.

In 2021, a study jointly published in the journal Cell Metabolism by Stanford University, the University of California, San Francisco, and the University of Basel, Switzerland, showed that the SARS-COV-2 virus can directly infect pancreatic islet cells and induce their apoptosis (cell death), thus reducing the insulin level. This is fully consistent with the pathogenesis of type 1 diabetes mellitus.

In March 2022, the authoritative medical journal The Lancet published a large-scale clinical study of 1 million participants, which found that patients with long COVID had a 40 percent increased risk of developing diabetes. More than 99 percent of diagnoses of diabetes in the studys cohort relate to type 2 diabetes.

We know that the pathogenesis of type 1 diabetes is mainly the autoimmune attack on pancreatic islet cells, resulting in insulin deficiency.

The COVID-19 vaccines manufactured in China are mainly inactivated vaccines. The quality of these vaccines is difficult to control, and there may be activated virus particles left in the vaccines. And even a small amount of viruses entering the human body can replicate themselves, thus affecting the bodys immune system.

In addition, all COVID vaccines, no matter what type they are, contain spike proteins, and numerous basic and clinical case studies have found that spike proteins can:

Are there other vaccines, besides the COVID-19 vaccines, that could be associated with diabetes?

Some of the ingredients contained in the COVID-19 vaccines can induce chronic inflammation, damage cellular mitochondria, and cause autoimmune phenomena, all of which can damage pancreatic islet cells and cause diabetes.

In fact, there may be other factors besides this. A private pediatric practice in Portland, Oregon, conducted a decade-spanning retrospective pediatric clinical analysis focusing on the long-term health status of multiple vaccine recipients.

They reviewed all medical records for children born between June 1, 2008 and January 27, 2019. The average numbers of medical office visits were compared between the vaccinated and unvaccinated groups. Among all the children, 2,763 had received 1 to 40 vaccines, and 561 didnt receive any vaccine.

The study found significant differences in the numbers of medical office visits for asthma, allergic rhinitis, respiratory infection, and anemia over a decade between the two groups of children.

Of particular note, all 561 of the unvaccinated patients in the study did not have ADHD, while 5.3 percent of the vaccinated children had ADHD.

From this study, we can indeed observe that vaccinated children are more prone to immune disorders such as chronic inflammation, allergies, and even autoimmune disorders.

The study was published in the International Journal of Environmental Research and Public Health, but it has been withdrawn for reasons that werent made public. In general, it is unusual for a medical paper to be withdrawn without any clear reason.

Based on the current basic and clinical evidence, children with a family history of diabetes and adult diabetics should really calculate their risks associated with vaccination. If they have already received the COVID-19 vaccines, it is important to minimize the damage caused by them. So what can be done to prevent the possible risks?

Due to the poor drug therapy compliance of some patients, the limited access to conventional hypoglycemic drugs for a large population, and the inevitable side effects and drug resistance of conventional pharmaceuticals, people have been looking for effective natural foods, such as natural fruits and vegetables and herbs, to lower their blood sugar. Holistic therapies, including regular exercise, low-sugar and low-carbohydrate diets, adequate sleep and stress control, can be beneficial for type 1 diabetes and even type 2 diabetes.

Therefore, our recommended foods include ginseng, bitter gourd, and berberine. These bitter-tasting foods can be consumed more often, and there is a scientific reason behind it.

Bitter melon is a medicinal plant of the gourd family. Scientists have found that its many components, including saponins, polysaccharides, triterpenoids, proteins, vitamins, minerals, flavonoids, ascorbic acid, and steroids, all have health benefits for the human body.

Scientists have also specifically studied the hypoglycemic effects of various bitter melon concentrates:

A study published in the journal Phytomedicine showed that bitter melon saponins can induce cells to produce more insulin.

Bitter melon can also enhance cellular sensitivity to insulin and reduce metabolic syndrome.

An animal study published in the Journal of Medicinal Food in 2011 showed that bitter melon seeds can increase the sensitivity of peripheral cells to insulin, thereby reducing the symptoms associated with metabolic syndrome, which can be effective against type 2 diabetes.

Overall, bitter melon is beneficial for both type 1 and type 2 diabetes because it:

A study published in Nutrition Journal in 2015 found that bitter melon has a moderate hypoglycemic effect compared to a glucose-lowering drug called glibenclamide.

Although bitter melon is not as effective as glibenclamide in lowering blood sugar, it can be more effective in improving cardiovascular risk factors associated with diabetes. Triglyceride and total cholesterol levels were significantly lower in people who received bitter melon doses, whereas blood lipids rose in those who took glibenclamide instead.

Diabetes is not simply a blood sugar symptom, but essentially a metabolic disorder. The nutrients in bitter melon can act on multiple levels, as they not only focus on lowering blood sugar, but can also lower blood lipids and help with weight loss. If the entire bodys internal environment is adjusted, and the state of metabolic syndrome is reversed, blood sugar will naturally slowly drop, which is the treatment of the fundamental cause of the disease rather than simply managing symptoms.

Oral hypoglycemic drugs may have a better effect on lowering blood sugar, but they cannot solve the root cause of the disease.

The treatment of the disease should also focus on the big picture, in order to solve the root cause of the disease.

Views expressed in this article are the opinions of the author and do not necessarily reflect the views of The Epoch Times. Epoch Health welcomes professional discussion and friendly debate. To submit an opinion piece, please follow these guidelines and submit through our form here.

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VaccinesNot Just COVID ShotsLinked to Type 1 Diabetes Because of Damage to These Types of Cells - The Epoch Times

WHIPPANY, N.J.--(BUSINESS WIRE)--Bayers KERENDIA (finerenone) was recognized by the American Diabetes Association (ADA) Standards of Medical Care in Diabetes2022 with a new grade A recommendation* for improving cardiovascular (CV) outcomes and reducing the risk of chronic kidney disease (CKD) progression in patients with CKD associated with type 2 diabetes (T2D).1

KERENDIA was approved in the United States based on the results of FIDELIO-DKD, to reduce the risk of sustained eGFR decline, end-stage kidney disease, CV death, nonfatal myocardial infarction and hospitalization for heart failure in adult patients with CKD associated with T2D.4 The KERENDIA label contains a Warning and Precaution that KERENDIA can cause hyperkalemia.4 For more information, see Important Safety Information and the FIDELIO-DKD study results below.

The addendum, titled Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes2022, was updated based on evidence from the FIDELIO-DKD and FIGARO-DKD Phase III studies as well as the FIDELITY prespecified pooled analysis,1 which comprise the largest cardiorenal outcomes program to investigate the occurrence of fatal and nonfatal CV events and progression of kidney disease in patients with CKD associated with T2D in more than 13,000 patients. The program investigated the impact of finerenone in adults with CKD associated with T2D across a range of disease severity (CKD stages 1-4).2

The Standards of Medical Care in Diabetes2022 were first released in December 2021 and included a grade A recommendation for KERENDIA in a new section emphasizing the importance of chronic kidney disease and risk management.

At the ADAs 82nd Scientific Sessions on June 6, and aligned with the ADA interim update, the ADA and Kidney Disease: Improving Global Outcomes (KDIGO) orally presented a joint consensus statement on the management of CKD and diabetes, recommending the use of finerenone for patients with T2D, an estimated glomerular filtration rate (eGFR) of 25 mL/min/1.73 m2, normal serum potassium concentration and albuminuria (albumin-to-creatinine ratio [ACR] 30 mg/g) despite maximum tolerated dose of renin-angiotensin-system (RAS) inhibitor.3 In the coming months, both the consensus statement and the final KDIGO update are expected to be published.

Managing patients with chronic kidney disease and type 2 diabetes requires a multidisciplinary care team that works together to control the disease while working to reduce the risk of cardiovascular events and slow kidney disease progression, said Professor George Bakris, M.D., University of Chicago Medicine and principal investigator of FIDELIO-DKD. The ADA and KDIGOtwo highly respected clinical bodiesaligned on an oral joint consensus statement at the ADA scientific sessions supporting KERENDIA as a pillar of established therapy to improve cardiovascular and renal outcomes for patients with chronic kidney disease associated with type 2 diabetes.3

The joint statement orally presented at the ADA scientific sessions from two prestigious professional organizations provide additional clinical information for health care providers to consider when looking for treatment options in the ongoing management of their patients with chronic kidney disease associated with type 2 diabetes, said Sameer Bansilal, M.D., M.S., FACC, Vice President, Cardiovascular, U.S. Medical Affairs at Bayer. At Bayer, we are committed to continuing our long history of researching and providing treatments to fight cardiovascular and kidney diseases.

About the ADA Standards of Medical Care in Diabetes2022 Update

The new grade A recommendation reads: For patients with type 2 diabetes and chronic kidney disease treated with maximum tolerated doses of ACE inhibitors or angiotensin receptor blockers, addition of finerenone should be considered to improve cardiovascular outcomes and reduce the risk of chronic kidney disease progression. A1 Additionally, the Lifestyle and Pharmacological Intervention subsection now includes the following statement: Patients with type 2 diabetes and chronic kidney disease should be considered for treatment with finerenone to reduce cardiovascular outcomes and the risk of chronic kidney disease progression.1

The December 2021 update included the following grade A recommendation for KERENDIA for CKD associated with T2D in section 11: In patients with chronic kidney disease who are at increased risk for cardiovascular events or chronic kidney disease progression or are unable to use a sodium-glucose cotransporter 2 inhibitor, a nonsteroidal mineralocorticoid receptor antagonist (finerenone) is recommended to reduce chronic kidney disease progression and cardiovascular events (Table 9.2). A5 The section was also updated to include evidence from the Phase III trial FIGARO-DKD and the prespecified pooled analysis FIDELITY, in addition to evidence from the Phase III trial FIDELIO-DKD.6

*Recommendations with an A rating, the ADA's highest recommendation, are based on large, well-designed clinical trials or well-done meta-analyses that have the best chance of improving outcomes. Generally, these recommendations have the best chance of improving outcomes when applied to the population to which they are appropriate.7

About KERENDIA (finerenone)

INDICATION:

IMPORTANT SAFETY INFORMATION

CONTRAINDICATIONS:

WARNINGS AND PRECAUTIONS:

Measure serum potassium periodically during treatment with KERENDIA and adjust dose accordingly. More frequent monitoring may be necessary for patients at risk for hyperkalemia, including those on concomitant medications that impair potassium excretion or increase serum potassium4

MOST COMMON ADVERSE REACTIONS:

DRUG INTERACTIONS:

USE IN SPECIFIC POPULATIONS:

Please read the Prescribing Information for KERENDIA.

About Finerenone Phase III Clinical Trials Program

Having randomized more than 13,000 patients with CKD associated with T2D around the world, the Phase III program with finerenone in CKD associated with T2D comprises two studies, evaluating the effect of finerenone versus placebo on top of standard of care (SoC) on both renal and CV outcomes.2

The FIDELIO-DKD (FInerenone in reducing kiDnEy faiLure and dIsease prOgression in Diabetic Kidney Disease) study was a randomized, double-blind, placebo-controlled, multicenter study in adult patients with CKD associated with T2D, defined as either having an uACR of 30 to 300 mg/g, eGFR 25 to 60 mL/min/1.73 m2 and diabetic retinopathy, or as having an uACR of 300 mg/g and an eGFR of 25 to 75 mL/min/1.73 m2.4,8 The trial excluded patients with known significant nondiabetic kidney disease and a clinical diagnosis of chronic heart failure with reduced ejection fraction and persistent symptoms (NYHA class II to IV).4 All patients were to have a serum potassium 4.8 mEq/L at screening and be receiving standard of care background therapy, including a maximum tolerated labeled dose of an angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB).4 A total of 5,674 patients were randomized to receive finerenone (N=2,833) or placebo (N=2,841) and were followed for a median of 2.6 years.4 The mean age of the study population was 66 years, and 70% of patients were male.6 The trial population was 63% white, 25% Asian, and 5% Black.4

Finerenone reduced the incidence of the primary composite endpoint of a sustained decline in eGFR of 40%, kidney failure, or renal death (HR 0.82 [95% CI, 0.73-0.93; P=0.001]).4 The treatment effect reflected a reduction in a sustained decline in eGFR of 40% and progression to kidney failure.6 There were few renal deaths during the trial.4

Finerenone also reduced the incidence of the composite endpoint of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke or hospitalization for heart failure (HR 0.86 [95% CI, 0.75-0.99; P=0.034]).4 The treatment effect reflected a reduction in cardiovascular death, nonfatal myocardial infarction and hospitalization for heart failure.4

The most frequently reported adverse reaction was hyperkalemia (18.3% KERENDIA vs. 9% placebo).4 Hospitalization due to hyperkalemia for the KERENDIA group was 1.4% versus 0.3% in the placebo group.4 Hyperkalemia led to permanent discontinuation of treatment in 2.3% of patients receiving KERENDIA versus 0.9% of patients receiving placebo.4

FIGARO-DKD (FInerenone in reducinG cArdiovascular moRtality and mOrbidity in Diabetic Kidney Disease), a randomized, double-blind, placebo-controlled trial, randomly assigned 7,352 participants to finerenone (N=3686) or placebo (N=3666) on top of standard of care, including a maximum tolerated labeled dose of ACEis or ARBs.9 Patients had UACR 30<300 mg/g and eGFR 2590 mL/min/1.73m2 or UACR 3005000 mg/g and eGFR 60 mL/min/1.73m2.9 This data is under review with the FDA.

KERENDIA significantly reduced the risk of the composite primary endpoint of time to first occurrence of CV death or nonfatal CV events (myocardial infarction, stroke or heart failure hospitalization) by 13% (relative risk reduction, HR 0.87 [95% CI, 0.76-0.98; P=0.0264]) over a median duration of follow-up of 3.4 years when added to maximum tolerated labeled dose of ACEi or ARB in adults with CKD associated with T2D.9 The reduction in the CV composite outcome was primarily driven by hospitalization due to heart failure.9

The incidence of the secondary endpoint, a composite of time to kidney failure, a sustained decrease of eGFR 40% from baseline over a period of at least four weeks, or renal death, was lower with finerenone than with placebo, affecting 350 (9.5%) and 395 (10.8%) patients, respectively.8 However, the difference was not statistically significant (HR 0.87 [95% CI, 0.76-1.01]) over a median duration of follow-up of 3.4 years.9

Overall, hyperkalemia-related adverse events occurred more often in patients receiving finerenone compared with placebo (10.8% and 5.3%, respectively).9 Hospitalization due to hyperkalemia for the finerenone group was 0.6% versus 0.1% in the placebo group, and there was no hyperkalemia-related death in either treatment group. Treatment was discontinued due to hyperkalemia in 1.2% of patients treated with finerenone compared to 0.4% in the placebo group.9

Bayer also initiated the FINEARTS-HF study, a multicenter, randomized, double-blind, placebo-controlled Phase III study that will investigate finerenone compared to placebo in more than 5,500 symptomatic heart failure patients (NYHA class II-IV) with a left ventricular ejection fraction of 40%.10 The primary objective of the study is to demonstrate superiority of finerenone over placebo in reducing the rate of the composite endpoint of cardiovascular death and total (first and recurrent) heart failure events (defined as hospitalizations for heart failure or urgent heart failure visits).10

About Chronic Kidney Disease Associated With Type 2 Diabetes

Patients with CKD associated with T2D are three times more likely to die from a CV-related cause than those with T2D alone.11 CKD is a serious and progressive condition that is generally underrecognized.12 CKD is a frequent complication arising from T2D and is also an independent risk factor of CV disease.13-15 Approximately 40% of all patients with T2D develop CKD.15 Despite guideline-directed therapies, patients with CKD associated with T2D remain at high risk of CKD progression and CV events.13,14,16,17 T2D is the leading cause of end-stage kidney disease, which requires dialysis or a kidney transplant to stay alive.18-20

About Bayers Commitment in Cardiovascular and Kidney Diseases

Bayer is an innovation leader in the area of cardiovascular diseases, with a long-standing commitment to delivering science for a better life by advancing a portfolio of innovative treatments. The heart and the kidneys are closely linked in health and disease, and Bayer is working in a wide range of therapeutic areas on new treatment approaches for cardiovascular and kidney diseases with high unmet medical needs. The cardiology franchise at Bayer already includes a number of products and several other compounds in various stages of preclinical and clinical development. Together, these products reflect the companys approach to research, which prioritizes targets and pathways with the potential to impact the way that cardiovascular diseases are treated.

About Bayer

Bayer is a global enterprise with core competencies in the life science fields of health care and nutrition. Its products and services are designed to help people and the planet thrive by supporting efforts to master the major challenges presented by a growing and aging global population. Bayer is committed to drive sustainable development and generate a positive impact with its businesses. At the same time, the Group aims to increase its earning power and create value through innovation and growth. The Bayer brand stands for trust, reliability and quality throughout the world. In fiscal 2021, the Group employed around 100,000 people and had sales of 44.1 billion euros. R&D expenses before special items amounted to 5.3 billion euros. For more information, go to http://www.bayer.com.

Find more information at http://www.pharma.bayer.com Our online press service is just a click away: http://www.bayer.us/en/newsroom Follow us on Facebook: http://www.facebook.com/pharma.bayer Follow us on Twitter: https://twitter.com/BayerUS

Forward-Looking Statements

This release may contain forward-looking statements based on current assumptions and forecasts made by Bayer management. Various known and unknown risks, uncertainties and other factors could lead to material differences between the actual future results, financial situation, development or performance of the company and the estimates given here. These factors include those discussed in Bayers public reports which are available on the Bayer website at http://www.bayer.com. The company assumes no liability whatsoever to update these forward-looking statements or to conform them to future events or developments.

References:

COR-KER-US-0018-2

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Bayer's KERENDIA (finerenone) Receives New Recommendations From American Diabetes Association for Improving Cardiovascular Outcomes and Managing...

MANILA, Philippines President Ferdinand Marcos Jr. wants to bring rice prices down to just P20 per kilo.

With immense funding, he can, especially now that he has assumed the position of agriculture chief.But this comes at a cost, which would sideline other agricultural products and have immense implications for public health.

Heres some of the reasons why his low target price is terrible economics.

Neighboring Southeast Asian countries, like Vietnam and Thailand, have something that the Philippines doesnt have: land suitable for growing rice.

In a discussion paper published by the Food and Agriculture Organization, economist David Dawe said that countries that are able to export are situated on the Southeast Asian mainland, while the Philippines, as well as fellow rice importers Malaysia and Indonesia, are islands or peninsulas.

The answer is that the countries on the mainland have dominant river deltas that provide ample water and flat land (important for easier control of that water). Such an environment is particularly suitable for cultivating rice, which, unlike wheat and maize, has a semi-aquatic ancestry and is thus particularly sensitive to water shortages, Dawe said.

Dawe added that these river systems also allow for lower-cost transportation of rice over medium and long distances and effectively facilitate exports.

Thus, in terms of achieving rice self-sufficiency, island countries have a natural disadvantage. Less of their land is suited to growing rice and, as a result, they cannot compete at the margin with the mainland rice exporters, he said.

Land for rice harvest in the Philippines is relatively small at 4.8 million hectares, according to data from the Department of Agriculture.

Thailand and Vietnam have around 10.5 million hectares and 7.5 million hectares for rice production, respectively.

Data from the Philippines Rice Research Institute (PhilRice) said that farmers in Nueva Ecija, the Philippines rice granary, is able to produce a kilo of rice for P12.41.

Vietnam can produce the same amount of rice for just P6.53, and Thailand at P8.85.

A typical Filipino rice farmer will usually sell rice at a farmgate price of around P17 to P19 per kilo. Transport costs and other expenses to take the rice to the palengkes or supermarkets would double the price of rice to P34 to P38 per kilo.

The chart below by PhilRice shows the breakdown of expenses per kilo of rice produced:

Meanwhile, rice from Vietnam and Thailand can cost around just P23 to P27, prior to slapping of tariffs upon entry to the Philippines.

Data from the Philippine Statistics Authority (PSA) showed that well-milled rice retails at around P37 to P41 per kilo.

Other than competition, the Philippines also faces a climate change crisis.

Based on Fitchs Climate Change Physical Risk Exposure Heatmap rankings, the Philippines ranked fourth in terms of risks arising from floods and storms. The Philippines trailed Mozambique, Vietnam, and Bangladesh.

Climate change caused P506.1 billion (around $10 billion) in losses and damage to the Philippines over the past decade, according to the Department of Finance.

Meanwhile, rapid urbanization also poses a challenge to the rice sector. PhilRice noted that it led 45.3% of the population to move in urban areas, effectively resulting in changes in the demand pattern for rice.

With geography, climate change, and other global market forces in play, what can Marcos do to bring down prices?

More imports? According to Geny Lapina, a faculty member of the Department of Agricultural and Applied Economics of the University of the Philippines-Los Baos, importing more rice wont bring rice prices all the way down to P20 per kilo.

Lapina explained that imported rice would arrive in Philippine ports at around P24 per kilo. Add in the tariffs and other costs, and it would reach stores at around P33 per kilo.

Removing the tariffs would also place farmers at a disadvantage, as the Rice Competitiveness Enhancement Fund or RCEF which supports farmers programs rely on tariffs.

If you remove the tariff, where will we get the funds for RCEF? So youre really balancing these things. Our reality is that [the P20 per kilo] is not going to happen. We can dream it, Lapina said.

Lapina added that the Philippines faces more headwinds now, as the peso weakens to a 16-year low against the US dollar. This means higher import costs.

Subsidies for farmers? If Marcos decides to lower prices by buying rice from farmers at higher rates and then selling it at a lower price, this would lead to a fiscal problem.

Cenon Elca, faculty of UPLBs Department of Agricultural and Applied Economics, said that this could cost the government as much as P200 billion.

If you buy at P20 to support farmers and sell at P10 at the farmgate, the net effect is a capital outlay of around P200 billion just to support that P20 retail price of rice, Elca said.

Elca added that this amount is over 10 times RCEPs P18-billion fund.

If you pour in money, you can make it happen. But hearing from the statement of Finance Secretary Benjamin Diokno, he favors fiscal discipline, as our debt-to-GDP (gross domestic product) is now at 63%, Lapina said. (READ: A Staple Problem? History of rice crisis in the Philippines)

As Marcos aims to bring rice prices down, this might mean that other crops and agricultural products may be further sidelined.

Currently, rice has the biggest budgetary support at P15.5 billion, followed by fisheries (P3 billion), high value crops (P1.6 billion), corn (P1.5 billion), livestock (P1.1 billion), and organic agriculture (P665 million).

You are channeling towards rice only. For agricultural development, thats not the direction we see in our research. The direction is diversification, thats good for biodiversity, Lapina said.

Its very difficult to focus on rice alone even from a government investment perspective; you dont want to put all your eggs in one basket, Lapina added.

Lapina and Elca also warned that lower rice prices would encourage Filipinos to consume more rice.

There are Filipinos now who are shifting away from rice and are concentrating more on consuming protein and vegetables. But if they see rice prices go down, they might go back to a cereal-based diet and thats not good, it could imply higher incidence of diabetes, Elca said.

The chart below shows that Filipinos may consume as much as 15.88 million tons of rice by 2030.

PSA data showed that deaths due to diabetes mellitus ranked fourth in 2020 at 37,265, after heart diseases (99,680), cancer (62,289), and cerebrovascular diseases (59,736).

In the Philippines, 1 in 14 Filipino adults lives with diabetes, according to the International Diabetes Foundation.

Experts said that the pandemic likely increased the chances of adults developing diabetes due to reduced physical activity and obesity.

While the numbers would show that it would be impossible for Marcos to bring prices down to his desired level, he can at least pick up on the gains of the past administrations and follow the rice industry road map.

The roadmap details the 57 provinces that have the potential to produce rice at the lowest production cost of P8 to P10 per kilo, considering the geographic location and other challenges. (READ: Dutertes agri chief to Marcos: Use PPP to build irrigation systems, hike DA budget)

It also details which rice-producing areas cannot compete with imports, and farmers would have to transition out of rice farming. Rappler.com

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Debt and diabetes: The cost of Marcos' P20/kilo rice aspiration - Rappler

To help cover the rising cost of insulin for people whose insurance doesn't include it or the 28 million Americans without insurance Walmart offers the first-ever private brand analog insulin at a low cost.

The offering includes analog insulin vials retailing for $72.88 and FlexPens retailing for $85.88, according to Walmart in a press release highlighting its low-cost insulin on Wednesday.

An insulin-dependent diabetic could go through one vial anywhere from one week to a few months, according to the American Diabetes Association.

Through a partnership with insulin manufacturer Novo Nordisk, Walmart is selling the insulin products under a private label called ReliOn that saves customers up to 75% off the cash price of branded analog insulin.

This translates to a savings of up to $101 per branded vial or $251 per package of branded FlexPens, according to Walmart in the release.

The ReliOn private label of Novolog injection analog insulin in vials and FlexPens, as well as ReliOn NovoLog Mix 70/30,are available at Walmart and Sams Club pharmacies nationwide to anyone with a prescription, regardless of their insurance status.

"We know many people with diabetes struggle to manage the financial burden of this condition, and we are focused on helping by providing affordable solutions," Cheryl Pegus, executive vice president for Walmart Health & Wellness, said in a statement. "We also know this is a condition that disproportionately impacts underserved populations. With ReliOn NovoLoginsulin, were adding a high-quality medication for diabetes to the already affordable ReliOn line of products and continuing our commitment to improve access and lowering cost of care."

For many with diabetes, their health depends on having reliable access to insulin. Insulin helps control blood sugar levels and prevent complications that diabetes causes.

And, people living in rural America are 17% more likely to be diagnosed with diabetes than those in urban areas.

The rising price of insulin a diabetes drug thats been around 100 years has been well documented and widely criticized.

Solutions, though, have been elusive.

"While drug pricing in the United States is complicated and involves many stakeholders, the publics need for life-saving medications like insulin at predictable and more affordable prices should drive all of us to do more and do better," Walmart stated in the release.

National drug spending jumped 7.7% in 2021, growing to $576.9 billion, according to a study released in April 2022 by the American Society of Health-System Pharmacists.

The average cash price for insulin in the U.S. in late 2021 had risen more than 40% compared to early 2014. Due to the rising cost, one in four people with type 1 or type 2 diabetes in the U.S. resorted to rationing their insulin because of the high cost, according to researchers for the Yale School of Medicine.

The consequences of skipping or reducing insulin treatments can put a diabetic's life at risk. Complications include an increased likelihood of blindness, amputations, heart attack and kidney failure, according to the U.S. Centers for Disease Control and Prevention.

The rising cost of insulin has prompted lawmakers, including Congress, to call for price caps and for pharmaceutical companies to find ways to drop the cost for patients.

Walmart stated it was "encouraged" to see lawmakers at the federal and state levels recognize the need to make insulin more affordable.

In his State of the Union address on March 1, 2022, President Joe Biden called for a nationwide $35 cap on insulin copayments for those enrolled in private health plans or Medicare.

The U.S. House approved a bill in February 2022 that does just that. The bill caps cost-sharing under private health insurance for a month's supply of selected insulin products at $35 or 25% of a plan's negotiated price (after any price concessions), whichever is less, beginning in 2023.

Michigan U.S. Rep. Dan Kildee, D Flint, said the rising cost of insulin and other drugs is proving to be a financial burden on patients.

"As a father of a Type 1 diabetic, I have seen firsthand how the high price of prescription drugs like insulin can harm patients and harm families," Kildee, one of the bill's sponsors, said on the House floor before the vote. "When my daughter turned 26 and got her own health insurance, there were months where she spent a third of her take-home pay because shes diabetic on staying alive."

Kildee urges the U.S. Senate to pass the bill in a June 21 Tweet.

"No one should ever be forced to ration their insulin," Kildee wrote. "My bill to cap the cost of insulin at $35 per month passed the House. Americans cant afford to wait any longer. The Senate must act now and help lower the cost of this necessary lifesaving medication."

Additionally, the Senate is pursuing a bipartisan agreement on a similar measure.

Unwilling to wait for federal action, 16 states across the country, starting with Colorado in 2019, enacted caps on insulin co-pays, ranging from $25 to $100 a month for consumers with commercial health insurance.

Eight more states are considering similar legislation, including Michigan.

On Feb. 24, 2021, Michigan State Rep. Sara Cambensy, D Marquette, introduced a bill that would cap out-of-pocket insulin costs at $50 a month.

A copay cap provides some consumer relief, but Cambensy acknowledged it wouldnt "get to the root bottom" where manufacturers set prices. Three drug companies dominate the production of insulin.

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Walmart sells low-price insulin to uninsured as more patients with diabetes struggle to pay for drug - Midland Daily News

Proceeds support Miami Valley Hospital patients at the Bull Family Diabetes Center.

DAYTON, Ohio (July 5, 2022) The Valley Classic, Miami Valley Hospital Foundations annual golf tournament in support of patient programs at Miami Valley Hospital, will tee off July 25, 2022, at NCR Country Club in Kettering.

The Valley Classic is one of the areas longest running and most successful charity golf outings. This event has raised more than $4 million to support numerous patient programs and projects at Miami Valley Hospital. Proceeds from this years tournament will benefit diabetes patient education through the Bull Family Diabetes Center.

Educators at the Bull Family Diabetes Center help patients better manage their disease, said Jenny Lewis, CFRE, system vice president of philanthropy at Premier Health. This tournament has served our hospitals patients and their families for more than three decades and would not be possible without the extraordinary support of our sponsors, players, donors, and volunteers who have made this tournament such a huge success.

The tournament format is a four-player scramble. Brunch is available prior to a shotgun start. Player registration is $375 per player or $1,500 per foursome. The entry fee includes brunch, greens fee, cart, driving range, refreshments on the course, gifts, prizes, a silent auction, and cocktails and dinner for each player and their guest that evening at the golf course.

This tournament is so special in helping our community and diabetic patients, said John Bull, chairman of the 2022 Valley Classic Steering Committee. We encourage men and women, no matter their golf skillset, to join us in raising funds for this wonderful service.

Gold Level sponsors Cisco and CDW lead nearly 40 sponsors and in-kind donors for this years event. Tournament proceeds support the work of the Certified Diabetes Educators who provide education for inpatients and outpatients.

Based at the Bull Family Diabetes Center, the diabetes educators completed 1,148 inpatient visits in 2021. In addition, the Miami Valley Hospital Foundation helps fund outpatient diabetes education for individuals who are uninsured or underinsured. Funds raised by The Valley Classic helps sustain these vital educational programs that enhance the lives of diabetic patients throughout our region.

To register, for sponsorship information, or to find out more about the Valley Classic, please contact the Foundation at (937) 208-2700, or visit the Miami Valley Hospital Foundation website by clicking here.

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The Valley Classic Tees Off for 33rd Annual Golf Tournament - Premier Health

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Diabetes is a chronic disease that has reached epidemic proportions among adults and children worldwide (1).

Uncontrolled diabetes has many serious consequences, including heart disease, kidney disease, blindness, and other complications.

Prediabetes has also been linked to these conditions (2).

Importantly, eating certain foods can raise your blood sugar and insulin levels and promote inflammation, which may increase your risk of disease.

This article lists 11 foods and drinks that people with diabetes or prediabetes should avoid.

Carbs, protein, and fat are the macronutrients that provide your body with energy.

Among them, carbs have the greatest effect on your blood sugar by far. This is because theyre broken down into sugar, or glucose, and absorbed into your bloodstream.

Carbs include starches, sugar, and fiber. However, fiber isnt digested and instead absorbed by your body in the same way other carbs are, so it doesnt raise your blood sugar.

Subtracting fiber from the total carbs in a portion of food will give you its digestible or net carb content. For instance, if a cup of mixed vegetables contains 10 grams of carbs and 4 grams of fiber, its net carb count is 6 grams.

When people with diabetes consume too many carbs at a time, their blood sugar levels can rise to dangerously high levels.

Over time, high levels can damage your bodys nerves and blood vessels, which may set the stage for heart disease, kidney disease, and other serious health conditions.

Maintaining a low carb intake can help prevent blood sugar spikes and greatly reduce the risk of diabetes complications.

Therefore, its important to avoid the foods and drinks listed below.

Sugary beverages are the worst drink choice for someone with diabetes.

First, theyre very high in carbs, with a 12-ounce (354-mL) can of cola providing 38.5 grams (3).

The same amount of sweetened iced tea and lemonade each contain almost 45 grams of carbs exclusively from sugar (4, 5).

In addition, these drinks are loaded with fructose, which is strongly linked to insulin resistance and diabetes. Indeed, studies suggest that consuming sugar-sweetened beverages may increase the risk of diabetes-related conditions like fatty liver disease (6, 7, 8).

Whats more, the high fructose levels in sugary drinks may lead to metabolic changes that promote belly fat and potentially harmful cholesterol and triglyceride levels.

In separate studies in adults with overweight and obesity, consuming 25% of calories from high fructose beverages on a weight-maintaining diet led to increased insulin resistance and belly fat, lower metabolic rate, and worse heart health markers (9, 10).

To help control blood sugar levels and prevent disease risk, consume water, club soda, or unsweetened iced tea instead of sugary beverages.

Sodas and sweet drinks are high in carbs, which increase blood sugar. Also, their high fructose content has been linked to insulin resistance and an increased risk of obesity, fatty liver, and other diseases.

Artificial trans fats are extremely unhealthy.

Theyre created by adding hydrogen to unsaturated fatty acids to make them more stable.

Trans fats are found in margarines, peanut butter, spreads, creamers, and frozen dinners. Furthermore, food manufacturers often add them to crackers, muffins, and other baked goods to help extend a products shelf life.

Although trans fats dont directly raise blood sugar levels, theyve been linked to increased inflammation, insulin resistance, and belly fat, as well as lower levels of HDL (good) cholesterol and impaired arterial function (11, 12, 13, 14, 15, 16).

While more research is needed to gain a clearer understanding of the relationship between trans fats and insulin resistance, the links mentioned above are especially concerning for people with diabetes, as theyre at an increased risk of heart disease.

Artificial trans fats have been outlawed in most countries, and in 2018 the Food and Drug Administration (FDA) banned the use of partially hydrogenated oil the major source of artificial trans fat in the food supply in most processed foods (17).

This doesnt mean that all foods in the United States are now free of artificial trans fats. Manufacturers arent required to list trans fats on the nutrition facts labels if a product contains under 0.5 grams of trans fat per serving (18).

Its best to avoid any product that contains the words partially hydrogenated in its ingredient list.

Trans fats are unsaturated fats that have been chemically altered to increase their stability. Theyve been linked to inflammation, insulin resistance, increased belly fat, and heart disease.

White bread, rice, and pasta are high carb, processed foods.

Eating bread, bagels, and other refined-flour foods has been shown to significantly increase blood sugar levels in people with type 1 and type 2 diabetes (19, 20).

This response isnt exclusive to products made with refined white flour. In one study, gluten-free pastas were also shown to raise blood sugar, with rice-based types having the greatest effect (21).

Another study found that high carb foods not only raised blood sugar but also decreased brain function in people with type 2 diabetes and mental deficits (22).

These processed foods contain little fiber. Fiber helps slow the absorption of sugar into the bloodstream.

In other research, replacing these low fiber foods with high fiber foods was shown to significantly reduce blood sugar levels in people with diabetes. Moreover, people with diabetes experienced reductions in cholesterol.

Increased fiber consumption also improved gut microbiota, which may have led to improved insulin resistance (23).

White bread, pasta, and rice are high in carbs yet low in fiber. This combination can result in high blood sugar levels. Alternatively, choosing high-fiber, whole foods may help reduce blood sugar response.

Plain yogurt can be a good option for people with diabetes. However, fruit-flavored varieties are a very different story.

Flavored yogurts are typically made from nonfat or low fat milk and loaded with carbs and sugar.

In fact, a 1-cup (245-gram) serving of fruit-flavored yogurt may contain almost 31 grams of sugar, meaning nearly 61% of its calories come from sugar (24).

Many people consider frozen yogurt to be a healthy alternative to ice cream. However, it can contain just as much or even more sugar than ice cream (25, 26).

Rather than choosing high sugar yogurts that can spike your blood sugar and insulin, opt for plain, whole milk yogurt that contains no sugar and may be beneficial for your appetite, weight control, and gut health (27, 28).

Fruit-flavored yogurts are usually low in fat but high in sugar, which can lead to higher blood sugar and insulin levels. Plain, whole milk yogurt is a better choice for diabetes control and overall health.

Eating cereal can be one of the worst ways to start your day if you have diabetes.

Despite the health claims on their boxes, most cereals are highly processed and contain far more carbs than many people realize.

In addition, they provide very little protein, a nutrient that can help you feel full and satisfied while keeping your blood sugar levels stable during the day (29).

Even some healthy breakfast cereals arent good choices for those with diabetes.

For instance, just a 1/2-cup serving (about 56 grams) of granola contains 44 grams of carbs, while Grape Nuts contain 47 grams. Whats more, each provides no more than 7 grams of protein per serving (30, 31).

To keep blood sugar and hunger under control, skip most cereals and choose a protein-based low carb breakfast instead.

Many breakfast cereals are high in carbs but low in protein. A high protein, low carb breakfast is the best option for diabetes and appetite control.

Coffee has been linked to several health benefits, including a reduced risk of diabetes (32).

However, flavored coffee drinks should be viewed as a liquid dessert rather than a healthy beverage.

Studies have shown your brain doesnt process liquid and solid foods similarly. When you drink calories, you dont compensate by eating less later, potentially leading to weight gain (33, 34).

Flavored coffee drinks are also loaded with carbs.

For instance, a 16-ounce (473-mL) Caramel Frappuccino from Starbucks contains 57 grams of carbs, and the same size of the Blonde Vanilla Latte contains 30 grams of carbs (35, 36).

To keep your blood sugar under control and prevent weight gain, choose plain coffee or espresso with a tablespoon of heavy cream or half-and-half.

Flavored coffee drinks are very high in liquid carbs, which can raise blood sugar levels and fail to satisfy your hunger.

People with diabetes often try to minimize their intake of white table sugar, as well as treats like candy, cookies, and pie.

However, other forms of sugar can also cause blood sugar spikes. These include brown sugar and natural sugars such as honey, agave nectar, and maple syrup.

Although these sweeteners arent highly processed, they contain at least as many carbs as white sugar. In fact, most contain even more.

Below are the carb counts of a 1-tablespoon serving of popular sweeteners:

In one study, people with prediabetes experienced similar increases in blood sugar, insulin, and inflammatory markers regardless of whether they consumed 1.7 ounces (50 grams) of white sugar or honey (41).

Your best strategy is to avoid all forms of sugar and use natural low carb sweeteners instead.

Honey, agave nectar, and maple syrup arent as processed as white table sugar, but they may have similar effects on blood sugar, insulin, and inflammatory markers.

Fruit is a great source of several important vitamins and minerals, including vitamin C and potassium.

When fruit is dried, the process results in a loss of water that leads to even higher concentrations of these nutrients.

Unfortunately, its sugar content becomes more concentrated as well.

One cup (151 grams) of grapes contains 27.3 grams of carbs, including 1.4 grams of fiber. By contrast, 1 cup (145 grams) of raisins contains 115 grams of carbs, 5.4 of which come from fiber (42, 43).

Therefore, raisins contain more than four times as many carbs as grapes do. Other types of dried fruit are similarly higher in carbs than their fresh counterparts.

If you have diabetes, you dont have to give up fruit altogether. Sticking to low sugar fruits, such as fresh berries or a small apple, can provide health benefits while keeping your blood sugar in the target range.

Dried fruits become more concentrated in sugar and may contain more than four times as many carbs as fresh fruits do. Avoid dried fruit and choose fruits low in sugar for optimal blood sugar control.

Pretzels, crackers, and other packaged foods arent good snack choices.

Theyre typically made with refined flour and provide few nutrients, although they have plenty of fast-digesting carbs that can rapidly raise blood sugar.

Here are the carb counts for a 1-ounce (28-gram) serving of some popular snacks:

In fact, some of these foods may contain even more carbs than stated on their nutrition label. One study found that snack foods provide 7.7% more carbs, on average, than the label states (47).

If you get hungry in between meals, its better to eat nuts or a few low carb vegetables with an ounce of cheese.

Packaged snacks are typically highly processed foods made from refined flour, which can quickly raise your blood sugar levels.

Although fruit juice is often considered a healthy beverage, its effects on blood sugar are similar to those of sodas and other sugary drinks.

This goes for unsweetened 100% fruit juice, as well as types that contain added sugar. In some cases, fruit juice is even higher in sugar and carbs than soda.

For example, 8 ounces (250 mL) of soda and apple juice contain 22 and 24 grams of sugar, respectively. An equivalent serving of grape juice provides 35 grams of sugar (48, 49, 50).

Similarly to sugar-sweetened beverages, fruit juice is loaded with fructose. Fructose drives insulin resistance, obesity, and heart disease (51).

A much better alternative is to enjoy water with a wedge of lemon, which provides less than 1 gram of carbs and is virtually calorie-free (52).

Fruit juices contain at least as much sugar as sodas. Their high fructose content can worsen insulin resistance, promote weight gain, and increase the risk of heart disease.

French fries are a food you may want to steer clear of, especially if you have diabetes.

Potatoes themselves are relatively high in carbs. One medium potato contains 34.8 grams of carbs, 2.4 of which come from fiber (53).

However, once theyve been peeled and fried in vegetable oil, potatoes may do more than spike your blood sugar.

Deep-frying foods has been shown to produce high amounts of toxic compounds, such as advanced glycation end products (AGEs) and aldehydes. These compounds may promote inflammation and increase the risk of disease (54, 55).

Indeed, several studies have linked frequently consuming french fries and other fried foods to heart disease and cancer (56, 57, 58, 59).

If you dont want to avoid potatoes altogether, eating a small serving of sweet potatoes is your best option.

In addition to being high in carbs that raise blood sugar levels, french fries are fried in unhealthy oils that may promote inflammation and increase the risk of heart disease and cancer.

Knowing which foods to avoid when you have diabetes can sometimes seem tough. However, following a few guidelines can make it easier.

Your main goals should include staying away from unhealthy fats, liquid sugars, processed grains, and other foods that contain refined carbs.

Avoiding foods that increase your blood sugar levels and drive insulin resistance can help keep you healthy and reduce your risk of future diabetes complications.

It might likewise help to reach out to others for support. Healthlines free app, T2D Healthline, connects you with people living with type 2 diabetes. Ask diet-related questions and seek advice from others who get it. Download the app for iPhone or Android.

Read this article in Spanish.

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11 Foods and Drinks to Avoid with Diabetes - Healthline

Researchers have recently successfully treated Type 1 diabetes by transplanting insulin-producing pancreas cells into the patient.

University of Missouri scientists are partnering with Harvard and Georgia Tech to create a new diabetes treatment that involves transplanting insulin-producing pancreatic cells

Type 1 diabetes is estimated to affect around 1.8 million Americans. Although type 1 diabetes often develops in childhood or adolescence, it can occur in adulthood.

Despite active research, type 1 diabetes has no cure. Treatment methods include taking insulin, monitoring your diet, managing blood sugar levels, and exercising regularly. Scientists have also recently discovered a new treatment method that holds promise.

A group of researchers from the University of Missouri, Georgia Institute of Technology, and Harvard University has proved the successful use of a novel Type 1 diabetes treatment in a large animal model in a new study published in Science Advances on May 13th. Their method includes transferring insulin-producing pancreas cells, known as pancreatic islets, from a donor to a recipient without the need for long-term immunosuppressive medicines.

According to Haval Shirwan, a professor of child health and molecular microbiology and immunology at the MU School of Medicine and one of the studys primary authors, people with Type 1 diabetes immune system may malfunction, leading it to target itself.

The immune system is a tightly controlled defense mechanism that ensures the well-being of individuals in an environment full of infections, Shirwan said. Type 1 diabetes develops when the immune system misidentifies the insulin-producing cells in the pancreas as infections and destroys them. Normally, once a perceived danger or threat is eliminated, the immune systems command-and-control mechanism kicks in to eliminate any rogue cells. However, if this mechanism fails, diseases such as Type 1 diabetes can manifest.

Diabetes impairs the bodys ability to produce or utilize insulin, a hormone that aids in the regulation of blood sugar metabolism. People with Type 1 diabetes are unable to manage their blood sugar levels because they do not produce insulin. This lack of control may result in life-threatening problems including heart disease, kidney damage, and vision loss.

Shirwan and Esma Yolcu, a professor of child health and molecular microbiology and immunology at the MU School of Medicine, have spent the last two decades targeting an apoptosis mechanism that prevents rogue immune cells from causing diabetes or rejection of transplanted pancreatic islets by attaching a molecule called FasL to the islets surface.

A type of apoptosis occurs when a molecule called FasL interacts with another molecule called Fas on rogue immune cells, and it causes them to die, said Yolcu, one of the studys first authors. Therefore, our team pioneered a technology that enabled the production of a novel form of FasL and its presentation on transplanted pancreatic islet cells or microgels to prevent being rejected by rogue cells. Following insulin-producing pancreatic islet cell transplantation, rogue cells mobilize to the graft for destruction but are eliminated by FasL engaging Fas on their surface.

Haval Shirwan and Esma Yolcu work in their lab at the Roy Blunt NextGen Precision Health building. Credit: University of Missouri

One advantage of this new method is the opportunity to potentially forgo a lifetime of taking immunosuppressive drugs, which counteract the immune systems ability to seek and destroy a foreign object when introduced into the body, such as an organ, or in this case, cell, transplant.

The major problem with immunosuppressive drugs is that they are not specific, so they can have a lot of adverse effects, such as high instances of developing cancer, Shirwan said. So, using our technology, we found a way that we can modulate or train the immune system to accept, and not reject, these transplanted cells.

Their method utilizes technology included in a U.S. patent filed by the University of Louisville and Georgia Tech and has since been licensed by a commercial company with plans to pursue FDA approval for human testing. To develop the commercial product, the MU researchers collaborated with Andres Garca and the team at Georgia Tech to attach FasL to the surface of microgels with proof of efficacy in a small animal model. Then, they joined with Jim Markmann and Ji Lei from Harvard to assess the efficacy of the FasL-microgel technology in a large animal model, which is published in this study.

Haval Shirwan looks at a sample through a microscope in his lab at the Roy Blunt NextGen Precision Health building. Credit: University of Missouri

This study represents a significant milestone in the process of bench-to-bedside research, or how laboratory results are directly incorporated into use by patients in order to help treat different diseases and disorders, a hallmark of MUs most ambitious research initiative, the NextGen Precision Health initiative.

Highlighting the promise of personalized health care and the impact of large-scale interdisciplinary collaboration, the NextGen Precision Health initiative is bringing together innovators like Shirwan and Yolcu from across MU and the UM Systems three other research universities in pursuit of life-changing precision health advancements. Its a collaborative effort to leverage the research strengths of MU toward a better future for the health of Missourians and beyond. The Roy Blunt NextGen Precision Health building at MU anchors the overall initiative and expands collaboration between researchers, clinicians, and industry partners in the state-of-the-art research facility.

I think by being at the right institution with access to a great facility like the Roy Blunt NextGen Precision Health building, will allow us to build on our existing findings and take the necessary steps to further our research, and make the necessary improvements, faster, Yolcu said.

Haval Shirwan and Esma Yolcu. Credit: University of Missouri

Shirwan and Yolcu, who joined the faculty at MU in the spring of 2020, are part of the first group of researchers to begin working in the NextGen Precision Health building, and after working at MU for nearly two years they are now among the first researchers from NextGen to have a research paper accepted and published in a high-impact, peer-reviewed academic journal.

Reference: FasL microgels induce immune acceptance of islet allografts in nonhuman primates by Ji Lei, Mara M. Coronel, Esma S. Yolcu, Hongping Deng, Orlando Grimany-Nuno, Michael D. Hunckler, Vahap Ulker, Zhihong Yang, Kang M. Lee, Alexander Zhang, Hao Luo, Cole W. Peters, Zhongliang Zou, Tao Chen, Zhenjuan Wang, Colleen S. McCoy, Ivy A. Rosales, James F. Markmann, Haval Shirwan and Andrs J. Garca, 13 May 2022, Science Advances.DOI: 10.1126/sciadv.abm9881

Funding was provided by grants from the Juvenile Diabetes Research Foundation (2-SRA-2016-271-S-B) and the National Institutes of Health (U01 AI132817) as well as a Juvenile Diabetes Research Foundation Post-Doctoral Fellowship and a National Science Foundation Graduate Research Fellowship. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

The studys authors would also like to acknowledge Jessica Weaver, Lisa Kojima, Haley Tector, Kevin Deng, Rudy Matheson, and Nikolaos Serifis for their technical contributions.

Potential conflicts of interest are also noted. Three of the studys authors, Garca, Shirwan, and Yolcu, are inventors on a U.S. patent application filed by the University of Louisville and the Georgia Tech Research Corporation (16/492441, filed Feb. 13, 2020). In addition, Garca and Shirwan are co-founders of iTolerance, and Garca, Shirwan, and Markmann serve on the scientific advisory board for iTolerance.

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Harvard Scientists Have Developed a Revolutionary New Treatment for Diabetes - SciTechDaily