More than ever, Americans with diabetes are meeting three goals vital for control of their disease, a new study finds. And that could lower their risk for diabetes-related complications such as heart disease, stroke, kidney disease, blindness and amputations.
According to the study results, the number of Americans with diabetes who now meet or exceed goals for the three “ABCs” ― which stand for A1C, blood pressure and cholesterol ― increased from about 2 percent in 1988 to nearly 19 percent in 2010. A1C is a measure of blood glucose, or sugar, over two to three months.
Experts recommend that people with diabetes aim for an A1C of less than 7 percent; a blood pressure reading under 130/80 mmHg; and an LDL cholesterol reading of less than 100 mg/dL. (LDL is considered the “bad” cholesterol.)
Researchers from the National Institutes of Health and the Centers for Disease Control and Prevention analyzed data gathered by the National Health and Nutrition Examination Surveys from 1988 to 1994 and from 1999 to 2010. NHANES is a federal program of studies that regularly assesses the health and nutritional status of Americans.
The investigators found that 53 percent of Americans met A1C goals from 2007 to 2010, compared with 43 percent from 1988 to 1994. Fifty one percent of people with diabetes met blood pressure goals, up from 33 percent. And 56 percent met cholesterol goals, up from 10 percent.
The researchers attributed the improvement in LDL cholesterol to a dramatic increase in statin use. Some 51.4 percent of adults with diabetes take the cholesterol-lowering drugs, compared with 4.2 percent from 1988 to 1994, according to the study.
Several factors may be driving the improvement in diabetes control, according to the researchers. Among them: new and improved medications; rising concerns about the obesity and diabetes epidemics in the U.S.; and more attention being placed on healthy behaviors.
Despite the heartening news, not everyone who has diabetes is doing a good job of controlling it. Nearly half of Americans with diabetes did not meet each ABC goal, the researchers wrote.
People 75 or older were more likely to have controlled their A1C than were adults ages 20 to 49. And non-Hispanic whites and non-Hispanic blacks were more likely than Mexican Americans to have an A1C of less than 7 percent.
Blood pressure goals were more likely to be reached by younger people than by older people; by non-Hispanic whites than by non-Hispanic blacks; and by people who had graduated from college than by people who had graduated only from high school.
Finally, older people were more successful at lowering LDL cholesterol than younger people. So were non-Hispanic whites, people who had at least a high school diploma, and men.
“Our data also show that there is much room for improvement,” the researchers wrote. “As the U.S. population ages and diabetes prevalence increases, it becomes increasingly urgent to find ways to overcome barriers to good diabetes management and deliver affordable, quality care so those with diabetes can live a longer and healthier life without serious diabetes complications.”
Pass it on: More Americans are controlling their diabetes, but there’s room for improvement.
State government to provide treatment for 24-day-old infant born with Neonatal Diabetes Mellitus, a rare condition occurring in 1 in every two lakh live births in the country
The State government has offered to provide help for life-long, if necessary, in the treatment of a 24-day-old infant, who was born with Neonatal Diabetes Mellitus (NDM), a rare condition and estimated to be occurring in 1 in every two lakh live births in the country.
The male baby was born in a private hospital on January 28 in Karimnagar where the paediatrician detected high blood sugar levels. The baby was then referred to another private hospital here for about 10 days before being admitted to Niloufer Hospital.
Lok Ayukta of Andhra Pradesh, Justice B. Subhashan Reddy, took up the case suo motu last week and directed the government to provide necessary treatment to the baby born to poor parents hailing from Mallapur village in Karimnagar district. He had observed that it was the fittest case for the government to intervene and said that the child should not be allowed to die simply because his parents could not afford treatment.
Head of Department and Professor of Neonatology at Niloufer Hospital, Dr. Hima Bindu Singh, said the baby was being closely monitored and insulin was being given intermittently either subcutaneously or intravenously. She said that to know if it was a transient or permanent NDM, blood samples were sent by air to Mohan Diabetes Centre at Chennai on Tuesday for molecular genetic testing and the report was expected in two months.
The baby would be kept at the hospital for the coming weeks and the family members would be trained in the meantime on how to monitor the condition and give insulin. The baby would be discharged only after the family members were confident of taking care of him. Endocrinologist, Dr. Jayanti Ramesh said NDM was caused by genetic mutation. He said in case it was temporary phenomenon, the child would recover in the coming months but it could recur again in adulthood.
Karimnagar DM HO, Dr. K. Nageshwar Rao said the parents of the baby were assured that government would reimburse the expenditure incurred on the treatment of the baby so far. He said even if insulin was required for life-long, it was possible for the government to provide. “After discharge, my health assistants would regularly follow-up at Mallapur village,” he added.
Ask nutritionist Dr Ramesh Bijlani. 25 years of research makes him the man to go to for answers on how to eat right
While researchers across the world bring you grim new data about how modern-day eaters are doomed to suffer ill How To Exercise Horse In The Heat .com/topic/health”>health, a gentleman in Delhi, who has spent a quarter of a century researching nutrition, says it’s lucky if you are Indian. Eating a healthy diet is simple for us, claims Dr Ramesh Bijlani, because a traditional desi meal meets most nutritional requirements, if current research findings are anything to go by. Moderation, not monasticsm, is key. “Intolerable dos and don’ts about foods are impressive, but not desirable,” says the expert, who is out with his latest book, Eating Wisely and Well
Bijlani takes on four questions most of us are itching to get answered:
Why do you compare carbohydrates with Cinderella?
About 70 per cent of the energy content of an Indian diet comes from carbohydrates. Yet, they are often looked down on, as if they are a necessary evil. Affluent Indians often declare with an air of superiority, ‘I eat no carbs’, little realising that if that’s the case, they are following a poor diet. The science of nutrition can safely assert that if 70 per cent of one’s energy comes from carbohydrates, it is an indicator of a healthy diet. Dietary carbohydrates can either contain starches (complex carbohydrates) or sugars (simple carbohydrates). The principal sources of starch are cereals, pulses, potatoes and bananas.
Cereals and pulses are a package deal. They provide not only carbohydrates but protein, too, a small quantity (but an important type) of fat, some vitamins, minerals and so on. So, eating cereals and pulses automatically ensures a supply of several other nutrients, which the body needs. In contrast, sugar is 100 per cent carbohydrate. For once, such purity is not desirable; it is better to consume carbohydrates ‘contaminated’ with protein, fat, vitamins and minerals.
New studies throw up contradicting data each day. How does one figure how much water to drink?
We need just enough water to balance loss through urine and sweat. The water requirement of an adult may vary from one to five litres a day. There are two indicators to how much water to drink — thirst, and the colour of urine. If we depend only on thirst, we might drink just enough water, but just enough is not good enough; a little more is always better. The colour of urine can guide us towards that. If we drink enough water to ensure that the urine is colourless, not yellow, the water intake is just right.
Dilute urine prevents kidney stones and infection. Stones are born as tiny crystals, and this crystallisation is less likely to occur if the urine is diluted. Germs also need food material to grow on, and therefore, grow more easily in concentrated urine.
Why is re-using heated oil a bad idea?
Heating changes the oil physically and chemically. Physically, the viscosity of the oil is altered. Chemically, it may acquire carcinogenic substances. This is more likely if the oil also contains suspended food particles, which may get burnt during cooking to produce carcinogens. That’s why oil left over after frying should not be used repeatedly. Oil left over after one cycle of frying should be used by adding to a vegetable or dal. Among the commonly used vegetable oils, the one that stands heat best is coconut oil.
What’s the hype over antioxidants?
Drawing energy from food involves a process similar to burning wood. Wood burns with the help of oxygen. The process involved in the release of energy is called oxidation. Oxidation has an unpleasant by-product — highly reactive chemical entities (called free radicals, or reactive oxygen species) that can cause damage to the cells in the body. To prevent this damage, we have two antioxidant mechanisms. One is in-built, and the other is sourced from diet. A few examples of non-traditional nutrients with antioxidant activity are resveratrol and flavonoids in grapes and tea; lycopene in tomatoes and watermelons; lutein in carrots, corn, and yellow fruits; and allyl sulphides in onion and garlic.
Best time to have water
1. Water dilutes the digestive juices. So, drinking water during meals weakens digestion. If you must, make sure it’s no more than one glass. But it also helps rinse the mouth between morsels, letting you enjoy the unmixed taste of each dish.
2. Drinking water before a meal fills up the tummy, making sure you eat less. This might help you lose weight.
3. Consuming water after a meal serves as a partial mouthwash, helping keep the teeth healthy.
English: Dagwinkel foodstores fresh fruits vegetables (Photo credit: Wikipedia)
Selecting beneficial sources of carbs can allow you to effectively control your blood sugar and help you lose weight. Consuming a diet rich in healthier types of carbohydrates can also help you to reduce your risk of developing cancer, diabetes and coronary artery disease.
As part of a healthy diet or any reasonable plan to lose weight, it is vital to understand the importance of the glycemic index (GI). The glycemic index measures how much a specific food elevates your blood sugar or glucose.
The glycemic index describes the effect of a specific amount of a food on blood sugar compared with the same amount of pure glucose or sugar. For example, a food with a glycemic index of 20 boosts blood sugar only 20% as much as pure glucose. One with a GI of 90 acts essentially as pure sugar.
People with diabetes understand that when they consume carbohydrates, their blood sugar goes up. The total amount of carbs you eat at a meal or in a snack essentially determines how high your blood sugar elevates.
However, the specific food itself also plays a role. As an example, a serving of white rice has nearly the same effect as eating pure table sugar—a rapid, high spike in blood sugar. By contrast, a serving of lentils or beans has a slower and more gradual effect on rise in blood sugar.
Foods with a high glycemic index result in a quick spike in insulin and blood glucose, while low glycemic foods have a slower and smaller effect on the rise in your blood sugar with a lower spike in insulin.
The net effect of eating lower glycemic foods is a more gradual rise in blood sugar and a lower insulin spike, ultimately making you feel full for a longer period of time, preventing surges in hunger and appetite.
It is important to select foods with a low glycemic index, as opposed to those with a high glycemic index. You can mix in other foods with a moderate glycemic index in moderation as part of a balanced diet.
Glycemic Index Chart:
Low glycemic index (GI of 55 or less): beans, most fruits and vegetables, pasta, nuts, minimally processed grains, low-fat dairy foods.
Moderate glycemic index (GI 56 to 69):, corn, white and sweet potatoes couscous, white rice, Cream of Wheat and Mini Wheats.
High glycemic index (GI of 70 or higher): White bread, bagels, croissants, rice cakes, most crackers, cakes, doughnuts, most pre-packaged breakfast cereals.
Six Food Substitutions for Lowering Glycemic Index
- Eat brown rice instead of white rice.
- Eat bran cereal/flakes instead of cornflakes.
- Eat whole wheat pasta or bulgur instead of a baked potato.
- Eat whole grain bread instead of white bread.
- Eat steel cut oats instead of instant oatmeal.
- Eat green peas or leafy vegetables instead of corn.
MUMBAI: Diabetic men are twice as likely to suffer from DNA damage to sperms than healthy individuals, an ongoing study by Jaslok Hospital and Research Centre has revealed. The study also showed that diabetes significantly reduced sperm count and affected the movement and appearance of sperm.
Doctors said the findings are worrying, especially when India has emerged as the diabetes capital of the world. Also, with diabetes affecting more and more young people in the country, the study has sent alarm bells ringing.
The study found that diabetic men were nearly three times more likely to suffer from sperm apoptosis— self-destruction of a cell due to break-up of the DNA—than healthy individuals.
Fragmented or broken DNA may not only lead to fertility issues but also higher miscarriage rates in couples.
Dr Firuza Parikh, director of the Jaslok Hospital’s IVF and genetics centre, said the findings were in conjunction with global observations that diabetes could contribute to changing the morphology or the look of sperm. The study showed that in diabetic men, 92% sperm looked abnormal whereas only 11% healthy donors showed abnormality.
Diabetic men also fared poorly in sperm count and motility—the agility of a sperm to fertilize an egg. In diabetic men, sperm motility hovered around 22% while it was more than double in case of those who did not suffer from the disease. Sperm count in diabetic men was found to be less than half of that of healthy individuals.
The study, initiated about three years ago by the Pedder Road hospital’s assisted reproduction and genetics department, compared the sperm quality in 120 diabetic and non-diabetic men in the 24-45 age group. Smokers were excluded to avoid any interference in the findings.
Dr Arundhati Athalye and Dr Meenal Khandeparkar, the main investigators, said the study underlined the need to perform routine DNA fragmentation testing in every diabetic patient seeking infertility treatment as that could be the underlying cause.
Dr Prochi Madon, head of genetics, pointed out that early diagnosis was the key to beat diabetes and associated health problems. “The diabetic men chosen for the study had come to the clinic seeking treatment for infertility.”
In a recent seminar at Jaslok Hospital, Dr Craig Niederberger, head of urology at the University of Illinois in Chicago, stressed that in addition to sperm function tests, it was important to thoroughly evaluate men suffering from infertility. He said the link between low testosterone, male infertility and the risk of prostatic cancer later in life was already established.
But it is not all bad news for young men with diabetes. Parikh said some couples grappling with infertility managed to conceive naturally after working on ways to de-stress. “Lifestyle modification or simple things like taking a vacation have worked for many.”
The United Nations has been drawing attention in recent years to the growing burden of non-communicable diseases, which have been adding to morbidity and premature deaths in most countries. In a declaration issued at a high-level meeting in 2011, the U.N. argued that low and middle income countries should actively pursue public health policies that will reduce the incidence of NCDs arising from diabetes, hypertension, high cholesterol, and a high body mass index. One of the countries that is at the epicentre of these health concerns is India, due mainly to weak public health policies and changing lifestyles. As The Lancet points out in recent commentary, much of the burden of non-communicable diseases is linked to the consumption of tobacco, alcohol, and ultra-processed food and drink (which are energy dense but nutrient poor). The public health community now unanimously accepts the link between these and a higher burden of NCDs. Neglect of chronic diseases by India has, according to the World Health Organisation, cost the country $9 billion in 2005 due to premature deaths caused by heart disease, stroke and diabetes. Over a 10-year period, the losses are projected to rise to a colossal aggregate of $237 billion.
While tobacco and alcohol are receiving close scrutiny as key factors influencing disease burdens, including cancer, the role of ultra-processed packaged food is not getting the attention it deserves. The makers of all forms of packaged food see India as a gigantic emerging market — and source of profit growth. Moreover, advanced markets are saturated. It is here that regulation of unhealthy food holds the key. The primary goal should be to use taxation, labelling and awareness creation to make high-energy, low nutrition foods unattractive to the consumer. There is a deplorable trend among food manufacturers to push less harmful packaged food as being actually ‘healthy’. This travesty must be reversed through determined policy intervention, and consumption of wholesome, fresh meals high in vegetable and fruit content must be encouraged. It is relevant to point out here that the biscuit industry has been lobbying in India to displace fresh-cooked food in the school noon meal programme, with its own packaged products, drawing sharp criticism from nutritionists and development experts. Packaged meals high in calories, sugar and salt are no substitute for fresh food and actually cause harm. They can only add to the risk of death by cardiovascular disease, estimated to be about five million by 2020. By contrast, a dramatic decline in death due to infectious diseases is projected. The agenda for social and political action is clear.
Saudi Gazette report
TAIF — The city of Taif has set a Guinness record for testing the highest number of people for diabetes on Wednesday.
Taif University carried out 9,736 tests within eight hours, breaking the previous record held by India, which tested 7,024 people in one day.
By achieving this record, Taif University also secured the title of being the first Saudi university or educational organization to enter Guinness Book of World records.
Cheers and celebrations broke out when the results were announced by a representative of the Guinness Book of World Records Wednesday night at Taif’s Heart Mall.
Students of Taif University’s Medical College were deployed at 14 different locations to perform the tests.
These locations included malls, schools and the university itself.
Dr. Abdulhameed Sarwah from the university’s faculty of medicine was one of the doctors present at the testing locations.
He told Saudi Gazette: “This type of events have many benefits, besides setting the record.
“Our main objective was to benefit the public; they were able to know their blood sugar level as well as their weights in comparison with their heights.
“If there was any abnormality discovered, this allowed them to take good precautionary steps based on our advice before it was too late.”
“We know that one of the main causes of diabetes is obesity due to the type of our diet and lack of exercise.”
Osaid Al-Sulaimani was supervising four health teams at Taif’s Heart Mall.
He said: “The response of the public was great; it was above our expectations.
“We received a huge number of people, both men and women.
“Our objective was to reach 8,000 people and we easily managed to exceed that.”
Rasheed Talal, a fifth year student at the university’s College of Pharmacy, was one of the volunteers.
He said: “Our job was to create public awareness and educate people.
“We only did initial tests; if the sugar level was found to be really high we asked them to perform further tests at a hospital.
“A large number of people are unaware that they have diabetes, including children.
“Sometimes, they discover this when it is too late.
“We tried to make the people as comfortable as possible, so that it was easy for them to get in touch with us.”
Diabetes is a lifestyle disease that can easily be avoided by changing certain daily habits.
Over 25 percent of the Saudi Arabian adult population suffers from this disease and this figure is expected to double by 2030.
According to the World Health Organization (WHO) Saudi Arabia has the second highest rate of diabetes in Middle East and the seventh highest in the world.
There are culturally appropriate ways to prevent obesity among Latino children, according to a new collection of studies from Salud America! Those might involve guided grocery store trips, menu labeling at restaurants, community gardens, and video-game-based exercise programs, they write in the American Journal of Preventive Medicine.
In the United States, Latinos are currently the most populous and fastest-growing ethnic minority. About 44 percent of Latino boys and 38 percent of Latino girls are either overweight or obese, compared with an average rate of 31 percent. Children who are overweight or obese are more likely to remain so later in life, which can put them at greater risk for long-term health conditions, such as high blood pressure, type 2 diabetes, and some forms of cancer.
The supplement presents studies that sought effective approaches for preventing and controlling obesity among Latino children. The studies represent work conducted in eleven states and a variety of participants, research methodologies, and outcomes.
Salud America! is a national network of advocates, policymakers and researchers that seeks environmental and policy solutions to Latino childhood obesity. The special supplement highlights 19 papers, including three commentaries by a range of political and medical leaders, such as San Antonio Mayor Julián Castro and Harvey V. Fineberg, President of the Institute of Medicine. Each paper considers the context of Latino culture, health conditions, and/or policies in places where Latino children and families live, work, learn, play, and pray.
Within the Latino community, studies concluded that:
- Owners of small, independent restaurants can improve access to healthy menu options and continue to publish calorie information on their menus
- Tending community gardens or attending nutrition and cooking workshops improved or maintained children’s body mass indices and increased the presence of fruits and vegetables in the home
- Capitalizing on the interconnectedness of one’s faith and health, religious communities can serve as conduits for obesity prevention programs that offer faith-oriented cooking classes, health education, and physical activity opportunities
- A child’s participation in an afterschool fitness program can increase the likelihood of subsequent fitness over a two-year period
- Barriers related to transportation, language, and school communication can negatively affect families’ physical activity
- Policy development and environmental change are possible to stimulate physical activity, based on a study administered within the United States – Mexico border colonias
Within schools, a team of investigators concluded that using active video games can increase cardiorespiratory endurance and math scores over time among Latino students.
Within the Latino family, studies focused on the effectiveness of a variety of interventions:
- An intervention involving nutrition education about food selection and a guided trip to the grocery store resulted in a decrease in the total number of calories per dollar spent, challenging the common perception that purchasing healthy foods costs more money
- A summertime intervention of parental training and guidance to support healthy lifestyle choices among mothers, combined with a program of exercise, nutrition education, and behavioral counseling for their daughters, produced a significant reduction in the percentage of body fat and waist circumference for the girls
- Among migrant workers, parents were not as concerned about overweight children as they were obese children, indicating the need for more community education and prevention programs
“This supplement is the culmination of several years of diligence, passion, and hard work in identifying and examining the most promising policy-relevant strategies to reduce and prevent obesity among Latino children,” say supplement editors Amelie G. Ramirez, DrPH, MPH, director of Salud America! and the Institute for Health Promotion Research at The University of Texas Health Science Center at San Antonio, and Guadalupe X. Ayala, PhD, MPH, of the Division of Health Promotion and Behavioral Sciences in the Graduate School of Public Health at San Diego State University. “In addition to fueling new research findings, Salud America! helped to increase the skills and experience of researchers working in the field, and further expand the national Salud America! research network. The ranks of those working to reverse the country’s obesity epidemic are getting stronger each day.”
In his commentary, George R. Flores, MD, MPH, asserts, “Research represented in the Salud America! supplement is noteworthy because it represents good science and new information about a population and problem that deserve much greater attention, was produced with a minimum of resources, and provided opportunities for professional growth to a number of early career scientists. For its foresight and support of Salud America!, The Robert Wood Johnson Foundation merits acclaim.”
Citation: Addressing Latino Childhood Obesity Through Research and Policy: Findings from the Salud America! Experience, American Journal of Preventive Medicine, Volume 44, Issue 3, Supplement 3 (2013)