Two-year results from a community intervention designed to reduce the incidence of Type 2 diabetes show marked reductions in rates of insulin resistance and glucose metabolism disorders, especially among those with highest participation.

“Prevalence of Type 2 diabetes mellitus appears to be increasing unabated, particularly so amongst indigenous people who have been exposed to relatively rapid acculturation,” say Kirsten Coppell (University of Otago, Dunedin, New Zealand) and team.

The Ngati and Healthy project is an ongoing community intervention set up in a rural, largely Maori population in New Zealand north of Gisborne. The intervention was designed to reduce diabetes risk by encouraging weight loss in the overweight and obese, increased physical activity, increased intake of whole grain cereal, vegetables, and fruit, and reduced intake of energy dense foods with high fat and sugar content.

In this study, the researchers report results from the initial baseline (n=286) and 2-year (n=235) surveys from the project. The surveys involved an oral glucose tolerance test, measurement of fasting insulin and lipids, measurement of anthropometric characteristics, and collection of dietary and demographic data.

Writing in the journal Diabetes Research and Clinical Practice, the researchers report that overall insulin resistance had declined significantly from 35.5% at baseline to 25.4% at 2 years. Prevalence of Type 2 diabetes also decreased from 12.6% to 10.6% across the whole group.

This was largely due to the dramatic reduction in insulin resistance from 38.2% to 25.6% in women aged 25??”49 years. Reductions in insulin resistance among women aged 50 years and older, men aged 25??”49 years, and men aged 50 years and older were also present, but non-significant.

In women aged 25??”49 years, the proportion of individuals meeting the minimum recommended exercise level and consuming wholemeal or wholegrain bread in preference to white bread increased significantly by 15.20% and 23.20%, respectively, over the 2 years.

In comparison, older women did not significantly increase their consumption of wholemeal bread (1.98% increase), but 16.03% more met the minimum recommended exercise level in 2006 than in 2003.

Neither older nor younger men had significant changes in exercise level, but consumption of wholemeal bread did increase by 20.37% in the younger group and 10.27% in the older group of men over the study period.

The largest reductions in weight, body mass index, and triglycerides were also seen in the group of younger women, although they were not statistically significant.

“Our demonstration of a significant decrease in insulin resistance prevalence and associated changes in lifestyle in a group who most actively participated in the healthy lifestyle intervention suggests that it is possible to stem the tide of the diabetes epidemic in an indigenous population in the long term,” conclude Coppell et al.

“Challenges for the future include the requirement of sustaining the momentum in the long term, to further engage men of all ages and to enhance the structural component of the strategy.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

We have often heard doctors advising diabetics to ensure that blood glucose levels are normal. In other words it is very important to maintain acceptable blood glucose levels. The concentration of blood sugar in a mammal’s blood is the blood glucose level, which is usually expected to be in a reference range between 4mmol/L and 6mmol/L. Levels higher than that range are a cause of concern and need medication as per doctor’s advice. Failure to maintain normal levels leads to hyperglycemia (higher level) or hypoglycemia (lower level). Acceptable blood sugar levels cannot be specific values, and your doctor would be the best person to answer what is safe for you depending upon your health status.

Normal values of blood glucose level

The blood glucose level varies at different times of the day. In most humans you would normally find the levels within a range of 80mg/dL to 110mg/dl i.e. 3.9 to 6.0mmol/L. The level goes up temporarily shortly after eating up to maybe 140mg/dL. The level is on a lower side in the early morning before you have your first meal.

Blood sugar tests and their normally acceptable blood glucose levels

* Fasting blood sugar test: The fasting blood sugar test is conducted after you fast for at least eight hours. The normal range for this test is 70 to 100mg/dL or 3.9 to 5.6mmol/L.

* Random blood sugar test: This test is conducted to measure blood sugar at any point in time of the day. Though there is no specific level defined, the sugar level should not be acceptable if higher than 200mg/dL i.e. 11.1mmol/L.

* Oral glucose tolerance test: This test measures the response of your body to sugar intake. First the fasting blood sugar level is measured. Then you are given a sugary solution and your blood sugar level is measured after 1 hour and then after 2 hours after you have the solution. This test is often used to screen pregnant women for gestational diabetes. The normal sugar level for this test is lower than 141mg/dL i.e. 7.8mmol/L.

* A1C test (glycated hemoglobin): This test is used to gauge how well you are managing your diabetes. This test is used to measure your average blood sugar for the past two to three months. It shows what percentage of hemoglobin is sugar coated (glycated). The acceptable level for non diabetics is 4 to 6 percent. For the diabetics the normal acceptable level is lower than 7 percent. Doctors may recommend it to be 6% during pregnancy. The level more than 7 may indicate a change to your diabetes treatment plan.

It is very important to know the higher values as well. There can be different reasons for higher levels other than diabetes, like severe stress, heart attack, stroke, medicines like corticosteroids or excess production of growth hormone. Doctors may advice you to take different tests to find if you have diabetes. Usually the criteria is fasting blood glucose level of 126 mg/dL i.e. 7.0mmol/L or higher, for oral glucose tolerance test of 200 mg/dL i.e. 11.1mmol/L and other symptoms of diabetes like frequent urination, unexplained weight loss and increase in appetite, fatigue etc.

The acceptable blood glucose levels may vary depending upon your diabetes and other health conditions. Your doctor would be the best person to express the most acceptable levels. Ensure that you regularly test your sugar level and take due care, medication, exercises, and diet control to keep it within the acceptable range.

Drink lots of water because it is calorie free and helps to flush away the toxins. Flavored water, an excellent healthy drink for diabetics! Did you know that flavored carbonated water has no calories, sugar, body, sweetener, color or preservatives? Read more about flavored and carbonated water at carbonatedseltzerwater

Advanced Diabetes Treatment Centers are locally owned and operated centers which provide individualized treatment for those diabetics whose diabetes has gotten out of control.

These centers offer a state of the art therapy for persons with both Type-1 and Type-2 diabetes which in most cases have developed complications. These centers offer intense therapy known as Metabolic Activation Therapy or MAT. With this therapy, a diabetic visits one of these clinics once a week where intravenously insulin is delivered in a series of ten doses over a one-hour period. After an hours rest, this process is repeated two more times. This steady, measured insulin to the liver is much more effective than other treatments.

This MAT therapy stabilizes or decreases kidney dysfunction as well as improves cardiac function, wound healing, digestion and neuropathy. These are all some of the most common life threatening complications of diabetes. This therapy is currently the only therapy that exists which has been proven to arrest and in some cases reverse common complications of diabetes.

MAT is indicated when blood glucose levels have gotten out of control with frequent hospital stays because of diabetic ketoacidosis or severe hypoglycemic problems with hypoglycemic unawareness. MAT is also indicated with diabetics whose renal function has continued to decline despite oral hypoglycemic agent and insulin therapy with blood pressure control.

Other indications for MAT are in cases of non-gangrenous, non-healing ulcers on the leg which are not complicated by osteomyelitis and are not responding to other therapy. It is also indicated in cases with severe neuropathy.

Diabetes is a disease with many complications when the blood glucose levels, diet and other forms of treatment have gotten out of control. It is these extreme complications that make this disease so difficult to live with and is such a threat to a patient’s life and well-being.

In the eyes of diabetics, an eye disease called diabetic retinopathy can develop which can lead to bad vision and even blindness. This is because of narrowing of the blood vessels in the back of the eyes which get weak and can lead to blood and fluid leaking into the retina from these weakened blood vessels. The retina is the part of the eye that sends visual images to the brain.

The kidneys are affected by diabetes because of the damage that can be done to the small blood vessels which are needed to filter the blood. This will show up as excess protein in the urine. Often if not treated, so much protein is lost that water from the blood moves into body tissues and causes swelling. Diabetes also causes damage to nerves in parts of the body. The nerves in the bladder can be affected making it difficult to urinate. This can also cause damage to the kidneys. Also because of the high level of sugar, there are problems with frequent kidney infections. All of these problems can damage the kidneys and even damage the kidneys so badly that they fail to function.

Drink lots of water because it is calorie free and helps to flush away the toxins. Did you know that flavored carbonated water has no calories, sugar, body, sweetener, color or preservatives? The taste is fantastic, extremely refreshing and gives diabetics a great drink without any carbohydrates. Read more about carbonated water at carbonatedseltzerwater.

Diabetics have the most problems with their feet. This is because of nerve damage in the feet and the narrowing of blood vessels in the legs. These two problems can cause a tiny cut to become extremely infected and lead to gangrene of the foot. Gangrene can lead to amputation of the foot or leg.