Category Archives: Diabetes

As a person gains weight even a few pounds the body can have more difficulty regulating blood sugar levels via insulin. The result: a condition called insulin resistance, in which the pancreas has to pump out more and more insulin in an effort to move sugar from the blood and into the cells. Insulin resistance is at the heart of most type 2 diabetes cases.Insulin whether made by the body or taken as a medication promotes fat storage and weight gain. So, gaining weight can force the body to make more insulin, which causes more weight gain, and on and on. But even modest weight loss 5 to 10 percent of ones body weight can lead to huge improvements, Hamdy observes. His own research has shown that a 7 percent loss can improve insulin sensitivity by approximately 57 percent.

The more dehydrated you are, the more concentrated the sugars in your blood become, like a prune versus a juicy plum, says Jessica Crandall Snyder, a certified diabetes care and education specialist in Denver. AstudyinDiabetes Carefollowed subjects for nine years. Those who drank less than a half liter of water per day had a higher risk of developing elevated blood sugar levels compared with those who drank more. Water, herbal tea and milk all count. Coffee lovers should limit their intake to three cups a day; caffeine is dehydrating.

Exercise snacking means spreading short bouts of activity throughout the day even just a 10- to 15-minute walk after dinner. Research suggests that these bite-size bits of activity can help control blood sugar better than one longer workout.

But make sure youre doing various types of exercise, including strength training. Adults naturally lose 8 percent of their muscle mass every 10 years between ages 40 and 70, and diabetes doubles that, Hamdy points out. Try spending 10 minutes a day building strength by using weights, resistance bands or body-weight moves; 10 minutes doing aerobic activity such as fast walking, swimming, jogging or tennis; and 10 minutes stretching, which improves joint movement and reduces chances of injury. Walking as much as possible throughout the day matters, too. A 2018studyin theBritish Journal of General Practicelinked 10,000 steps a day with improved diabetes control.

Protein is important for maintaining muscle and stimulating several hormones that contribute to blood sugar regulation. Focus on fish, white-meat chicken, plant-based sources (beans, nuts and tofu) and lean cuts of beef, and make sure youre eating protein at breakfast and lunch as well as at dinner.

People with diabetes, obesity or both are at increased risk for severe illness and death from COVID-19. And emerging research suggests that COVID can worsen diabetes by causing damage to the pancreas and system-wide inflammation that increases insulin resistance.

Because vaccination leads to milder COVID, if infected, it should indirectly result in less COVID impact for preexisting diabetes, says Nitin Kapoor, M.D., a professor of endocrinology at Christian Medical College in Vellore, India. Also, his research is among several studies that link COVID to new cases of diabetes.

After hearing You have type 2 for the first time, people often go to extremes, drastically limiting carbs (with diets such as keto) or trying to live without sugar. But too few carbs can result in fatigue, nutritional deficiencies and dangerously low blood sugar. Avoid the trap of focusing on sugars and instead read labels for Total Carbohydrate; this term incorporates sugars (both naturally occurring and added) as well as other types of carbs, says Crandall Snyder. Women should aim for 30 to 45 grams of total carbs per meal; men, 60 to 75.

Because proper nutrition is so important after a diabetes diagnosis, she advises consulting with a registered dietitian (RD) or certified diabetes care and education specialist (CDCES) to get your eating plan on the right track. (Medicare covers three hours of nutritional counseling if youve been diagnosed with diabetes, and 10 hours of diabetes self-management education.)

Its common for people who are trying to control their diabetes to feel like failures if they cant get off their medications, says Phyllisa Deroze, a global diabetes patient advocate and diabetes lifestyle blogger. A year after my diagnosis, I was managing with just diet and exercise. There was a big Woo-hoo! with every medication I dropped, she notes. But her health care provider explained that medications could still play an occasional role in her life and, indeed, Deroze ended up needing insulin while she was pregnant. Insulin gets a bad rap, but it helps many people, she says.

Science journalist Leslie Goldman holds a masters degree in public health.

Read more:
7 Ways to Improve or Prevent Diabetes - AARP

In the past couple of years, you or someone you know has likely faced fear, uncertainty, illness, or another challenging emotion or event as the world continues to live through the COVID-19 pandemic.

One skill that may be helpful in facing situations like these is resilience.

Resilience is the ability to bounce back from adversity and stress. Resilience is a trait that we strive toward, rather than something we do or do not have, says Marisa Hilliard, PhD, associate professor at Baylor College of Medicine and Texas Childrens Hospital and founder of Baylors Resilience and Diabetes Behavioral Research Lab in Houston.

There are many ways to build resilience, and for people managing a health condition such as diabetes, healthy routines can play an important role in times of stress, says Howard B.A. Baum, MD, endocrinologist and associate professor of medicine at Vanderbilt University in Nashville, Tennessee.

Building resilience can result in positive health effects like doing well with diabetes outcomes, such as A1C goals, time in target blood glucose range, or quality of life despite all the challenges that life throws your way, says Dr. Hilliard.

Increasingly, researchers like Hilliard and Dr. Baum are identifying techniques and approaches to build resilience and to help people with diabetes live healthy and long lives.

RELATED: Is Stress the Source of Your Blood Sugar Swing?

Our studies try to identify the protective factors that people already have or can build to achieve better diabetes outcomes, says Hilliard.

For example, a study published in July 2018 in Diabetes Care, which Hilliard led, involved more than 470 adolescents ages 10 to 19 with type 1 diabetes and found that strengths in managing diabetes, such as confidence in care or support from others, were associated with resilience. This resilience was linked with positive diabetes outcomes, such as regular blood glucose checks, a lower A1C, and a higher quality of life.

Joyce Yi-Frazier, PhD, senior clinical research scientist at Seattle Childrens Hospital in Washington, was among the first to explicitly study the role of resilience in diabetes management. In a study published in 2008 in the British Journal of Health Psychology, she and her colleagues found a strong association between rising distress and worsening A1C among people with low or moderate resilience. Those with high resilience did not show the same associations between distress and A1C. The study examined 111 people with type 1 or type 2 diabetes.

Our research has shown that resilience and stress do impact diabetes management, quality of life, and A1C, says Dr. Yi-Frazier, who now also studies resilience in other diseases such as cancer.

Another study by Yi-Frazier, published in Stress Health, consisted of 145 participants with type 1 or type 2 diabetes and found that individuals with adaptive coping strategies had higher resilience than people with maladaptive coping approaches, such as denial or anger.

A smallstudy published in October 2020 in the International Journal of Behavioral Medicine enrolled 35 people with type 2 diabetes in a resilience-based education program that led to large increases in self-management behaviors and lower A1C readings after six months. Some of these same researchers are now leading a clinical trial that is funded by the National Institutes of Health to examine how resilience-specific diabetes education impacts the health outcomes of African Americans who are living with type 2 diabetes.

In Baums research, he has found that people with more routines for their diabetes management may be more resilient and adaptable, and thus have more favorable diabetes outcomes such as lower A1C. In astudy published in October 2020 inApplied Ergonomics,Baum and his colleagues at Vanderbilt University interviewed 50 people with type 1 or type 2 diabetes and found that storing everyday objects such as blood glucose meters or insulin in accessible places anchored diabetes management routines and encouraged adherence.

RELATED: Do You Have Type 2 Diabetes Burnout?

We have to be deliberate about our resilience, says Yi-Frazier. In other words, we need to spend the time to figure out how to shore up our resources that we need in times of stress.

Sometimes, these resources are psychosocial and sometimes they are physical, practical routines. And either can help people better manage diabetes, say Hilliard and Baum.

Baum recommends identifying techniques that you know help you remember everyday details in your diabetes management. This could mean setting an alarm on your phone when you take medications or moving your insulin to the kitchen, so you take it during mealtimes.

It's undeniable that diabetes can be challenging, and the disease is associated with burnout and depression. Yet positive affect and strategic thinking can help build resilience. Hilliard shares the following tips:

Focus on small achievable goals, such as walking a few days a week, rather than big goals that may be hard to achieve all at once.

Recognize when youve met a small goal and then build on that change to reach larger goals in your diabetes management.

Gratitude means acknowledging what youre grateful for and can involve expressing thanks. Practice this for yourself and others who help you manage diabetes. For example, be grateful in times that youve had a successful day, such as when youve met your diabetes management goals, or do it when youve had a challenging day such as stress at work and then you still fit in, say, exercise.

No one is going to do this for you, so its up to the person with diabetes to make this effort.

A mental health professional such as a social worker or psychologist trained to help people with diabetes is ideal. The American Diabetes Association has a searchable directoryof these specialists by area, and many offer telehealth.

Hilliard and Baum also point out that empathy and support, together from clinicians, caregivers, and people with diabetes themselves, are empowering.

Even during the pandemic and the growing mental health crisis in America, says Hilliard: Many people with diabetes have been able to show resilience and do well with their diabetes management despite the numerous stresses in our world.

RELATED: Tired All the Time? Diabetes Could Be to Blame

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How Resilience Can Help You Manage Type 2 Diabetes (and How to Build It) - Everyday Health

A database study of Veteran patients suggests that statin medications can raise the risk of diabetes progression. Based on the findings, the researchers say patients should be carefully observed when they start on statins.

Common statins are atorvastatin (sold as Lipitor), fluvastatin (Lescol XL), and pitavastatin (Livalo). More than 35 million Americans take the prescription drugs to help control cholesterol.

The study, published Oct. 4, 2021, in JAMA Internal Medicine, included more than 83,000 matched pairs of patients. Each pair consisted of a patient who started taking a statin at some point during the study period, and a similar comparison patient who initiated a non-statin drug namely, an H2 blocker or proton pump inhibitor. Those drugs treat stomach acid conditions and are known to not affect diabetes risk.

The study group was mostly men, ages 30 and older. All were diagnosed with diabetes at some point during the study period of 2003 to 2015. All were regular users of VA health care.

Diabetes progression occurred in about 56% of statin users, versus 48% of users of non-statin medications.

Furthermore, each individual component of diabetes progression new insulin initiation, increase in the number of glucose-lowering medication classes, incidence of five or more measurements with blood glucose greater than or equal to 200 milligrams per deciliter, or a new diagnosis of ketoacidosis or uncontrolled diabetes was significantly higher among statin users.

The study also found a dose-response relationship, with higher intensity of LDL-cholesterol lowering associated with greater diabetes progression.

Patients on high-intensity statins and who were otherwise healthy had the highest risk of diabetes progression, said lead author Dr. Ishak A. Mansi, of the University of Texas Southwestern Medical Center and the VA North Texas Health Care System.

The link between increased insulin resistance and statins, which help to lower cholesterol and prevent heart attacks, is well-documented. Its substantial enough, the Mayo Clinic has observed, that the Food and Drug Administration (FDA) has issued a warning on statin labels regarding blood glucose levels and diabetes.

A meta-analysis of 13 studies published by The Lancet in 2010, for example, revealed that statin therapy was associated with a 9% increased risk for incident diabetes.

But until recently, the clinical impact of statins metabolic effect in patients with diabetes wasnt widely known outside of academic circles, or discussed with patients.

Prior research has shown statins to be associated with increased insulin resistance, Mansi explains. But doctors do not routinely measure insulin resistance for their patients. Rather, it is done [in] research and academic circles only, not in everyday life. Our study took findings reported by academic studies of increased insulin resistance [linked] with statin use in research papers and translated it into everyday language of patients care that is, patients on statins may need to escalate their anti-diabetes therapy.

While no single study should change practice, this study should alert [guideline] writers and policymakers that more studies are needed, says Mansi.

Notably, the findings are particularly relevant to Veterans: More than 30 million Americans have diabetes, according to the Centers for Disease Control and Prevention (CDC), and about a quarter of VA patients have the disease, including some who may have developed it as a result of exposure to Agent Orange in Vietnam.

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Study links statin use with diabetes progression, points to need for further research - VAntage Point - VAntage Point Blog

ARLINGTON, Va., Dec. 8, 2021 /PRNewswire/ -- The American Diabetes Association (ADA), the nation's leading volunteer health organization, announced a new partnership with Dr. Comfort, to provide foot care resources on an ADA platform in a journey-driven experience for those living with diabetes and their caregivers.

Dr. Comfort is the national sponsor of Living with Diabetes: Foot Care & Amputation. The Foot Care & Amputation section of the platform leads each user to learn to care for their feet, understand foot conditions and complications, ways to stay physically active, and more. Individuals living with diabetes and their caregivers can access this platform by answering a few simple questions to help guide them on their journey to reach the tools, resources, and education they need for successful foot care.

Every four minutes in America, a limb is amputated due to diabetes. This statistic is even more shocking when you consider that amputation is almost completely preventable. Education and resources are vital for those living with diabetes and this partnership will help arm millions of people with the information they need to prevent foot care complications.

"The ADA is working hard to help the over 34 million Americans with diabetes deal with and overcome the unique health complications they face on a daily basis such as foot complications. Through this personalized diabetes journey experience, we hope to meet them where they are to deliver the resources and education they need to thrive," said Jacqueline Sebany, Chief Marketing and Digital Officer for the American Diabetes Association.

The journey was developed to deliver information to those living with diabetes based on self-identified need and interest, as well as where they are in their diabetesjourney.

About the American Diabetes AssociationThe American Diabetes Association (ADA) is the nation's leading voluntary health organization fighting to bend the curve on the diabetes epidemic and help people living with diabetes thrive. For 81 years the ADA has driven discovery and research to treat, manage, and prevent diabetes while working relentlessly for a cure. Through advocacy, program development, and education we aim to improve the quality of life for the nearly 122 million Americans living with diabetes or prediabetes. Diabetes has brought us together. What we do next will make us Connected for Life. To learn more or to get involved, visit us atdiabetes.orgor call 1-800-DIABETES (1-800-342-2383). Join the fight with us on Facebook (American Diabetes Association), Spanish Facebook (Asociacin Americana de la Diabetes),Twitter (@AmDiabetesAssn), andInstagram (@AmDiabetesAssn).

Contact: Daisy Diaz, 703-253-4807[emailprotected]

SOURCE American Diabetes Association

http://www.diabetes.org

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American Diabetes Association and Dr. Comfort Team Up to Give Millions Living with Diabetes Much-Needed Resources to Prevent Foot Complications -...

New research from a Swedish cohort study suggests patients with obesity and diabetes who undergo bariatric surgery could dramatically reduce their risk of cancer.

An analysis of data from the matched, prospective Swedish Obese Subjects (SOS) study, which included a median of 21 years of follow-up data, results indicated those who underwent bariatric surgery lowered their risk of cancer by 37%, but also suggest those achieving normal glucose control and diabetes remission reduced their risk of cancer by 60%.

The global epidemic of both obesity and diabetes leads to an increased risk of cancer, as well as an increased risk of premature death. It has been estimated that, over the next 10 to 15 years, obesity may cause more cancer cases than smoking in several countries. This is a clear illustration of how serious the condition is, said Magdalena Taube, PhD, associate professor of Molecular Medicine at Sahlgrenska Academy, University of Gothenburg, in a statement. Strategies are need to prevent this development, and our results can provide vital guidance for prevention of cancer in patients with obesity and type 2 diabetes.

With an interest in shrinking an apparent knowledge gap related to the effects of bariatric surgery on cancer risk among patients with both obesity and diabetes, the current study was designed Taube and colleagues from the University of Gothenburg to assess incidence of cancer among patients from the SOS study. A nonrandomized, parallel assignment study launched in 1987, the SOS study enrolled more than 4000 patients, who were followed from enrollment through 2005. Results of the study suggested bariatric surgery was associated with meaningful reductions in body weight and mortality among patients with severe obesity.

For the current study, investigators included 701 patients with obesity and diabetes from the original SOS study. This cohort included 393 patients who underwent bariatric surgery and 308 who received conventional treatment. The median follow-up of this cohort was 21.3 (IQR, 17.6-24.8) years with a maximum follow-up of 30.7 years. Overall, 17% (n=68) of the bariatric surgery group developed cancer and 24% (n=74) of the conventional treatment group developed cancer.

Upon analysis, results indicated the incidence rate of first-time cancer was 9.1 (95% CI, 7.2-11.5) per 1000 person-years among patients with obesity and diabetes who underwent bariatric surgery compared to 14.1 (95% CI, 11.2-17.7) per 1000 person-years in those who received conventional treatment (aHR, 0.63 [95% CI, 0.44-0.89]; P=.008). Investigators pointed out surgery was associated with a reduction in cancer incidence among women (aHR, 0.58 [95% CI, 0.38-0.90]; P, but sex-treatment interaction was nonsignificant (P=.630). Further analysis suggested those who achieved diabetes remission at the 10-year follow-up suggested these patients experienced an even greater reduction in cancer incidence (aHR, 0.40 [95% CI, 0.22-0.75]; P=.003).

What we see is that, among patients with type 2 diabetes, many cancer cases are preventable. These results are an important contribution that enhances our understanding of the connection between glucose control and cancer prevention, added Kajsa Sjholm, PhD, associate professor of Molecular Medicine at Sahlgrenska Academy, University of Gothenburg, in the aforementioned statement.

This study, Association of Bariatric Surgery With Cancer Incidence in Patients With Obesity and Diabetes: Long-Term Results From the Swedish Obese Subjects Study, was published in Diabetes Care.

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Bariatric Surgery Associated with Lower Cancer Risk in Obesity and Diabetes - Endocrinology Network

Scientists have found that venom from the cone snail helps to stabilise blood sugar levels, which could pave the way for the development of new fast-acting drug options for people with diabetes.

Researchers from the University of New Hampshire examined the variants of the toxic insulin-like venom known as Con-Ins which is used by the cone snail to paralyse its prey.

Associate professor of chemical engineering, Harish Vashisth, said: Diabetes is rising at an alarming rate and its become increasingly important to find new alternatives for developing effective and budget-friendly drugs for patients suffering with the disease.

Our work found that the modelled Con-Ins variants, or analogues, bind even better to receptors in the body than the human hormone and may work faster which could make them a favourable option for stabilising blood sugar levels and a potential for new therapeutics.

The venom from the snail induces a hypoglycaemic reaction that lowers blood sugar levels. Researchers examined the venoms peptide sequence and used computer simulations of each Con-Ins variant complex with human insulin receptor to test their stability.

Lead author and postdoctoral research associate Biswajit Gorai said: While more studies are needed, our research shows that despite the shorter peptide sequences, the cone snail venom could be a viable substitute and we are hopeful it will motivate future designs for new fast-acting drug options.

The study has been published in Proteins: Structure, Function, and Bioinformatics.

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Snail venom could offer new way of treating people with diabetes - Diabetes.co.uk

Global Anti-biofilm Wound Dressing Market: Overview

The rise in the occurrence of chronic illnesses such as diabetes and cancer throughout the world is driving expansion of the global anti-biofilm wound dressing market. Non-communicable illnesses are becoming more prevalent due to various factors such as smoking, alcohol usage, antibiotic resistance, and unhealthy and sedentary lifestyles.

Healthcare facilities, such as hospitals, have been overburdened as a result of the COVID-19 pandemic, with many Covid positive individuals; as a result, several nations have postponed elective surgeries as well as other healthcare operations indefinitely. Patients with acute and persistent wounds must thus be treated either at outpatient clinics or at home. As a result, demand for wound care products at home, like anti-biofilm wound dressing, has risen. In addition to that, as the elderly population is at a higher risk of infection and is unable to attend a healthcare facility, the need for home healthcare is growing. Furthermore, many people have turned to online therapy for help with their health problems. These factors are likely to drive growth of the global anti-biofilm wound dressing market in the near future.

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This study from Transparency Market Research (TMR) provides a complete insight of the global anti-biofilm wound dressing market. It provides well-researched data on a variety of market aspects in order to provide useful business input for profit generation.

Global Anti-biofilm Wound Dressing Market: Notable Developments

ConvaTec Group Plc (Conva Tec) declared the official launch of an innovative product called "ConvaMax" in January 2020. Diabetic foot ulcers, pressure ulcers, leg ulcers, and dehisced surgical wounds are all treated with this new medication. Additionally, the product is available in non-adhesive forms as well, allowing total freedom in integrating compression bands or an extra main dressing to support care regimen.

The noted players that are operational in the global anti-biofilm wound dressing market are Coloplast A/S, Smith & Nephew PLC., ConvaTec Group plc., The 3M Company, Mlnlycke Health Care AB, and Urgo Medical.

Global Anti-biofilm Wound Dressing Market: Key Trends

Below-mentioned market trends and opportunities mark the global anti-biofilm wound dressing market:

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High Prevalence of Diabetes to Drive Growth of the Market in Near Future

Diabetic foot ulcers affect around 2% to 10% of diabetics, according to studies done by B. Braun Melsungen AG in 2018. Furthermore, according to the American College of Physicians, the number of new cases every year for diabetic foot ulcers is about 6.3 % in 2017, and the incidence rate of foot ulcers in diabetic individuals in their lifetime ranges from 19% to 34%. Because anti-biofilm wound dressing solutions are highly suggested for treating chronic wounds, market growth is expected to observe high growth rate..

The majority of surgical wounds following cancer surgery are big and deep, generating exudates that must be managed on a daily basis. Anti-biofilm wound dressings, such as iodine and silver-based wound dressings, aid in wound management and infection prevention. As a result, the growing prevalence of chronic illnesses is projected to enhance product demand, thereby pushing global anti-biofilm wound dressing market.

The market is expected to be driven by an increase in the number of road accidents, trauma events, and burns throughout the world. According to the World Health Organization (WHO), around 1,000,000 individuals in India suffering from serious or moderate burns each year.

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Global Anti-biofilm Wound Dressing Market: Geographical Analysis

North America dominated the market with a substantial share of the global anti-biofilm wound dressing market and is expected to dominate the market in the near future. Some of the reasons predicted to drive the market include existence of many major competitors in the area, an increase in the number of sports injuries, and a rise in the number of traffic accidents. Furthermore, the existence of a well-developed healthcare infrastructure as well as advantageous reimbursement policies is projected to drive market expansion during the forecast period.

Asia Pacific is expected to expand at the rapid growth rate during the forecast period. The presence of emerging nations such as China, India, and Japan in the Asia Pacific region is expected to boost market expansion.

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Anti-biofilm Wound Dressing Market: High Prevalence of Diabetes to Drive Growth of the Market in Near Future - BioSpace

Treating patients who have early breast cancer with metformin a drug used to treat and control high blood sugar levels in patients with diabetes after their initial cancer treatments did not improve invasive disease-free survival (IDFS) or overall survival (OS), regardless of estrogen or progesterone receptor (PR) status.

The results came from the phase 3 CCTG MA.32 trial, which was presented at the 2021 San Antonio Breast Cancer Symposium.

The primary analysis showed that outcomes in patients with estrogen receptor (ER)positive and PR-positive disease was similar between two groups, where patients received either metformin or a placebo.

Metformin does not improve IDFS, OS, or other breast cancer outcomes in moderate/high risk estrogen receptor (ER)/PR-positive or ER/PR-negative breast cancer patients and should not be used as breast cancer treatment in those groups, said Dr. Pamela J. Goodwin, lead study author and professor of medicine at the University of Toronto, during the presentation.

The research team attempted to determine if treatment with metformin could induce better tumor responses based on the association of obesity with poor breast cancer outcomes and the drugs ability to promote weight loss and lower insulin levels.

Read more: Obesity Linked With Higher Distress in Breast and Prostate Cancers

Patients were eligible for the study if they had a diagnosis of invasive breast cancer within one year and negative margins following surgery. Tumors had to be staged as T1c to T3 meaning tumors could range from 2 cm to more than 5 cm and N0 to N3 (cancer in no lymph nodes to 10-plus lymph nodes), with T1cN0 requiring additional adverse features. All patients must have received standard breast cancer therapy and could not have diabetes.

The primary analysis was in patients with ER/PRpositive breast cancer, with 1,268 patients in the metformin group and 1,265 in the placebo group. They had median ages of 52 and 53 years, respectively, and 62.1% and 60.2% were postmenopausal.

A total of 52.5% and 54.2%, respectively, had T2 tumor stage, and most disease was grade 2 or grade 3. Additionally, 16.5% and 17.4% had HER2-positive disease, with 97% receiving Herceptin (trastuzumab).

Invasive disease-free survival (IDFS) occurred in 18.5% and 18.3% of patients receiving metformin and placebo, respectively. Rates of distant, local/regional and tumors in the opposite breast from diagnosis as well as new primary cancer were similar between groups.

In total, 131 patients (10.3%) in the metformin group died, compared with 119 (9.9%) in the placebo group. Causes of death among those who received metformin were breast cancer (7.8%), other primary malignancies (1.2%) and cardiovascular disease (0.3%) among other factors (1%), with similar rates in the placebo group.

A total of 21.7% of patients in the metformin group experienced grade 3 (severe) or worse side effects, compared with 18.7% in the placebo group. These side effects included nausea, vomiting, bloating and diarrhea.

Results among patients with ER/PR-negative breast cancer showed that futility or treatment without any benefit for the patient was established at 29.5 months of follow-up with 172 IDFS events. At the 96-month follow-up, there were 245 IDFS events in 1,116 patients, with no benefit noted with metformin.

The exploratory analysis looked at patients who had human epidermal growth factor receptor 2 (HER2)-positive breast cancer. Interestingly, patients who had at least one C allele a type of genetic variation had a higher pathologic complete response rate with metformin than those who had no allele. Goodwin said any presence of a C allele is associated with a metformin benefit on glucose control in diabetes.

A total of 620 patients with HER2-positive cancer were analyzed, with 99.4% receiving chemotherapy and 96.5% receiving Herceptin (trastuzumab).

When looking at the entire HER2-positive population, patients who received metformin had fewer IDFS events than those who were administered placebo. There were also fewer patient deaths with metformin.

Exploratory analyses in HER2-positive breast cancer suggested a beneficial effect of metformin on IDFS and OS, notably in patients with at least one C allele of the rs11212617 snp. These observations should be replicated in future research, concluded Goodwin.

A version of this article was originally published on Cancer Network as, Metformin Does Not Improve Outcomes in Early Hormone ReceptorPositive or Negative Breast Cancer.

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Medication Used to Treat Diabetes Fails to Improve Breast Cancer Outcomes - Curetoday.com

Posted: Dec 6, 2021 / 10:00 AM CST / Updated: Dec 2, 2021 / 09:42 AM CST

(Baptist Health) Many people put off healthcare during the COVID-19 pandemicincluding care for diabetes. Among adults under 30 with diabetes, nearly 9 in 10 delayed care during the pandemic, according to theCenters for Disease Control and Prevention(CDC). More than 60% of people ages 30 to 59 with diabetes did the same.

If you have diabetes, you probably know that managing your condition is important for your long-term health. But in the era of COVID-19, diabetes care is more important than ever. People with diabetes are more likely to have serious complications from COVID-19. According to theAmerican Diabetes Association, controlling your condition may lower that risk.

If you delayed diabetes care during the pandemic, getting back on track doesnt have to be stressful. Start with these four steps, based on advice from CDC.

Keep up with daily care.Eating well and getting exercise every week can help keep diabetes in check. And make sure to take any medications your doctor has prescribed.

Schedule regular checkups.See your doctor at least once every six months. If youve been finding it harder to manage your diabetes during the pandemic, go every three months. Get a checkup for your mouth too: See your dentist at least once a year.

Catch up on tests.Make sure you have an A1C test at least every six months. And ask your doctor what other tests you may need. These may include eye or foot exams, a cholesterol check, or a kidney test.

Get vaccinated.The COVID-19 vaccines are safe and effective. Theyre the best way to avoid serious illness from COVID-19. If youre already vaccinated,get your booster shot.

Take charge of your health

Staying on top of diabetes care can help you stay well during the pandemic and in the yearsand decadesto come. Get more help to live well with diabetes in ourDiabetestopic center.

Excerpt from:
Diabetes care and COVID-19 - KARK

Results of a cross-sectional study fond diabetic kidney disease (DKD) was associated with retinal changes in patients with type 2 diabetes (T2D).

Early neurovascular retinal damage was seen among patients with type 2 diabetes (T2D), while changes were more significant in patients with diabetic kidney disease(DKD), according to results of a cross-sectional study. Findings were published in International Journal of Retinal and Vitreous.

Diabetic retinopathy (DR) constitutes the leading cause of vision loss among patients with diabetes, and duration of the disease, chronic hyperglycemia, and hypertension can all increase the risk of DR.

The microvascular complications of diabetes affect the eyes and kidneys and are associated with different risk factors such as diabetes duration and blood pressure and lipid control, researchers explained.

Furthermore, previous research has suggested a strong association between DR and diabetic renal neurodegeneration (DRN) and similar molecular pathways appear to be involved in the development of DKD and retinal microvascular injury, they added.

To detect structural and vascular retinal changes in patients with T2D without or without DKD, the researchers used swept-source optical coherence tomography (OCT) and OCT angiography (OCTA) to assess the eyes of patients presenting to a hospital in southern Brazil.

All participants presented to the public teaching hospital between July 2018 and July 2019 and were older than 45 years. A control group was made up of healthy, age-matched volunteers with no prior or current history of diabetes or kidney disease. Controls also could not present any ophthalmologic condition that could interfere on images evaluation as opacities and spherical equivalent outside3 diopters, the authors said.

The Chronic Kidney Disease Epidemiology Collaboration equation was used to calculate estimated glomerular filtration rate (eGFR), and all examinations were carried out in the morning. Each participant also underwent a complete ophthalmologic examination.

Of 129 patients with T2D, 258 eyes were included: 128 of 64 individuals with mild or no DKD and 130 eyes of 65 patients with DKD. Seventy-four eyes of 37 controls were also included in analyses. Sixteen eyes of patients with T2D were excluded for potentially confounding factors.

Analyses revealed:

Overall, results showed significant thinning of the inner retina of T2D patients, especially the GCL+/++layer and RNFL; enlargement of the foveal avascular zone (both superficial and deep plexus); and lower capillarity in the superficial retinal plexus compared with controls, the authors wrote. They added these findings suggest neurovascular changes are an ongoing component of DR that may precede clinically moderate to severe microvascular changes.

Results are also in accordance with prior descriptions of microcirculatory impairment in the vasculature of diabetic eyes prior to severe indicators of DR, the researchers explained. Data also point to a possible link between signs of DKD and microvascular foveal changes that suggest a higher risk for more severe DR.

The cross-sectional design of the study and its limited sample, composed mainly of White women, mark limitations to the analysis. Future longitudinal studies are warranted to better elucidate the relationship between early retinal neurovascular changes and risk of kidney disease or if DKD can drive worse retinal prognoses.

However, data did show DKD was associated with inner retinal and superficial plexus vascular changes in T2D patients with mild or no DR, suggesting an association of eye and early kidney changes, the authors concluded.

Reference

da Silva MO, do Carmo Chaves AEC, Gobbato GC, et al. Early neurovascular retinal changes detected by swept-source OCT in type 2 diabetes and association with diabetic kidney disease. Int J Retina Vitreous. Published online December 5, 2021. doi:10.1186/s40942-021-00347-z

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Experts Examine the Association Between Retinal Damage, DKD Presence in Patients With T2D - AJMC.com Managed Markets Network