Weight gain during the first 3 years after quitting smoking may increase the risk for Type 2 diabetes, suggest US researchers.

“The message is: Don’t even start to smoke,” commented lead author Hsin-Chieh Yeh from Johns Hopkins University School of Medicine in Baltimore, Maryland.

“If you smoke, give it up. That’s the right thing to do. But people have to also watch their weight,” she added.

The team assessed the change in risk for Type 2 diabetes before, immediately after, and 3 or more years after quitting smoking in 10,892 participants of the ARIC (Atherosclerosis Risk in Communities) Study who did not have diabetes at baseline between 1987 and 1989.

Smoking status was assessed by interview at baseline and at follow-up, and the participants were followed up for up to 17 years. Overall, there were 4900 never-smokers and 5992 smokers who had smoked for 0??”30 years at baseline.

Over the study period, 1254 participants developed Type 2 diabetes. The researchers found that, overall, individuals who smoked had a 42% higher relative risk for developing Type 2 diabetes than those who never smoked.

However, the risk for Type 2 diabetes among smokers increased further immediately after they quit smoking and for up to 3 years afterwards, before decreasing gradually.

More specifically, compared with those who had never smoked, the relative risk for developing Type 2 diabetes for former smokers, new quitters, and continuing smokers increased by 22%, 73%, and 31%, respectively.

Yeh and colleagues found that the highest increase in relative risk for Type 2 diabetes of 91% occurred in the first 3 years after quitting. After this time, the risk for Type 2 diabetes gradually fell to 0% by 12 years after smoking cessation.

Of note, after adjusting for change in weight the increased risk for diabetes was significantly weakened and those at highest risk for diabetes after quitting gained more than 4 kg in the 3 years after quitting.

“Smokers who quit should receive advice about avoiding weight gain and about diabetes prevention and early detection,” conclude the authors in the Annals of Internal Medicine.

“Such countermeasures might include lifestyle counseling and aggressive weight management, use of nicotine replacement therapy ??” which seems to blunt weight gain related to quitting ??” and more frequent checking of blood glucose as a means of early detection.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Free abstract

Do you know that diabetes is a creepy silent killer which can happen to anyone of any age group? Therefore, it is important that you know what are the symptoms of diabetes so as to prevent it from torturing and ruining you for the rest of your life. In the States, there are ample medical help within reach, however, due to ignorance of the tell tale signs, as many as 17 million people contracted diabetes without knowing the symptoms.

You can prevent diabetes, and it is extremely crucial to find out early and not miss the golden treatment period. Some symptoms of diabetes which you can look out for include excessive thirst, blurry vision, frequent urination, fatigue and sudden weight loss. It is important to know the symptoms early and be vigilant when it comes to health matters.

Some of these symptoms of diabetes are a result of the excessive glucose in your blood. As there are inadequate insulin in your body to remove the glucose,, you will tend to feel thirsty and want to drink more water to quench your thirst. This is a vicious cycle which causes you to visit the toilet more often.

It is important to recognize the signs and symptoms of diabetes early so that you are able to seek professional care as early as possible so that you can prevent any further diabetic complications. Some complications include eye disease, kidney disease and nerve disease which can be deadly. Find out how you can prevent diabetes and live healthily today.

Learning how to cope with type 2 diabetes certainly takes time and patience. And when it comes to an eating plan, no doubt you have questions, and naturally you want these questions answered. One thing which is good for you to know is this: stop dieting… it doesn’t work, it actually works against you.

When you diet you force yourself to stop listening to your “natural hunger” cues. And therefore you do not hear your “comfortable” cues neither. Often we react to feeling deprived by overeating so it makes sense to say you need to stop dieting and start listening to your body telling you when you are hungry. Now this can be a little tricky for people with type 2 diabetes as the condition itself alters how you would normally respond. Due to insulin resistance, the increased level of natural insulin floating around in your bloodstream tells you you are hungry, even shortly after eating a reasonable sized meal.

Looking at insulin: one of the factors important in weight loss is of course to watch the glycemic index of the carbohydrates you eat. Eating low-GI carbs ensures a low blood sugar response and a lower amount of insulin being required to help lower your blood sugar levels.

Looking at what you drink: Be careful of what you are drinking. As well as your body not being really satisfied by fluids, watch out for the calories/kilojoules content of that beverage. Many drinks, including fruit drinks, spike your blood sugar level and in turn that affects your natural insulin response as well.

There is a lot of “talk” on the internet about coffee being good for diabetics, so lets look at some facts about coffee and see what you think:

Coffee facts include:

• coffee is caffeinated… caffeine stimulates insulin production. With type 2 diabetes, your body is in a state of insulin resistance, where your cells don’t respond to insulin. This results in your pancreas producing insulin at a much higher rate than normal. So do you need a caffeinated beverage? Probably not
• coffee is addictive. Ever try to kick the coffee habit? You’re in store for a humongous headache if you stop it cold
• coffee will charge you up for the day. Coffee sends a message to your adrenal glands that there is a survival situation happening. This can then result in in your body being more acidic than alkaline… in an alkaline state your body heals
• drinking more than four cups of coffee a day can lead to brittle bones
• coffee stimulates your appetite… not what many type 2 diabetics need

Coffee may taste good, but many health practitioners report that coffee is a beverage you need to avoid as it does stimulate your appetite.

With type 2 diabetes, you want to know what is possible. And the answer is to use your eating plan, supplements and exercise patterns to reverse it. You can do it, just like thousands of others have.

Foods reverse diabetes is becoming a well-known fact and by adding the right foods to your daily diet you can easily achieve the ultimate goal in reversing diabetes. It may sound hard at first, but it does get easier as your routine becomes a habit, the most important thing to remember is that it is a good habit to have, because this is what will allow you to get back to living a normal life once more.

By introducing certain foods into your diet, you will not only feel good but also be in total control of your diabetes. By adding more raw foods into your diet you will definitely increase your weight loss and achieve remarkable results.

A raw food diet is an excellent example of what foods reverse diabetes. Some of these include chopped vegetables, salads, fresh fruit which are all rich in fibre and do not include any added fat and are low GI. It is important to note that there are two sources of fat in a diet and they are animal products and vegetable oils, so by eliminating meat, dairy products and eggs from your diet you are not including cholesterol in your diet as these sources are the only foods that contain cholesterol. This is a tremendous benefit for diabetics as one of the problems faced is having high cholesterol.

Some of the other foods included in the raw food diet are seeds, nuts, legumes and sprouted grains. Eliminating animal products is very important as it is free of animal protein, which is what harms the kidneys and as you know protecting your kidneys is the key goal being a diabetic. Make sure that the protein that you include in your diet comes from plant products only.

The following four food groups is a nutritional guide that can assist you with planning your diet and show you what foods reverse diabetes:

* Vegetables - Cauliflower, broccoli, sweet potato, spinach, green beans, artichokes, squash and kale

* Fruits - Berries (all the berry family), peaches, pears, apples, grapes, bananas, kiwifruit, and oranges

* Whole Grains - Oats, brown rice, whole grain pasta, couscous, barley, millet, bran cereal, rye or pumpernickel bread and bulgur wheat

* Pulses - Baked beans, soya beans, kidney beans, chickpeas, lentils, split peas, low-fat soya products, and peas

Remember to always choose low GI foods when making your selections, keep vegetable oils to a minimum, avoid all animal products and only choose foods that come from plant sources. By applying these rules and knowing what foods reverse diabetes to your diet you will see amazing results and if done correctly, you will even be able to eliminate your medications for good.

Wide shoes are a must for many diabetics, not only for comfort but also for the individual’s health. Diabetes is a condition where sugar accumulates in the person’s blood, unable to get into the cells where it is used for energy. Whether this is because the person’s pancreas no longer produces insulin (type 1 diabetes) or because the person has become resistant to insulin (type 2 diabetes), over time high blood glucose can result in a number of complications, including poor circulation.

One of the symptoms of poor circulation is a loss of sensation in the extremities, usually starting in the feet. What this means is that many diabetics can’t feel it when their shoes pinch, cause blisters, or even sometimes if they happen to stub their toe and break it. As a result, many doctors recommend that their diabetic patients wear wide shoes to help prevent these kinds of problems.

The reason why doctors want their diabetic patients to be careful about injuring their feet is that poor blood circulation also means that their feet won’t heal as quickly as other parts of their body, and sometimes not at all. The lack of adequate circulation doesn’t just numb the nerves; it also disables the body’s defenses against infection. As a result, even a small injury such as a blister or a broken toe can end up turning into a serious, life-threatening condition that may result in the toe, foot, or even the entire leg needing to be amputated.

To prevent this serious complication of diabetes, it is extremely important for a diabetic to take extremely good care of their feet. There are several things that doctors recommend their diabetic patients do. First of all, it is important to wear comfortable, wide shoes to minimize how much their footwear rubs or pinches their feet. Also, diabetics should always break in new shoes slowly, starting with an hour and wearing them a little longer each day, so that they don’t hurt your feet if they are stiff.

In addition, it is important for a diabetic to inspect their feet every day for sores, blisters, ingrown toenails, and other injuries, no matter how minor. The reason you need to inspect your feet is because you might not feel the injury when it happens, and without a visual inspect it could get much worse before you notice. Also, if you have poor circulation it can also very quickly turn into something much more serious if left unmonitored and untreated. If your feet are numb, be sure you visit the doctor for any injuries, even if it seems like nothing more than an ingrown toenail, and be very careful to wear comfortable shoes that won’t hurt your feet even worse.

Finally, it is important to maintain as good control of your blood glucose as possible to prevent a loss of circulation to your feet. Poor circulation generally comes from chronically high blood sugars, so checking your blood sugar often will help you and your doctor adjust your treatment regimen to control your sugars as tightly as possible. Tighter control means fewer complications, and combined with comfortable shoes, can mean an almost nonexistent chance of encountering complications that affect your feet.

As you can see, as a diabetic there is a lot riding on how well you take care of your feet. Serious infections and perhaps even amputation can result if you don’t protect your feet from getting hurt, and closely monitor any injuries that do happen. Comfortable, wide shoes that don’t pinch or rub are therefore a crucial part of caring for your feet as a diabetic.

High exposure to bisphenol A (BPA), a chemical used in plastic food containers, is associated with increased risk for coronary heart disease (CHD) and diabetes, confirm study results.

David Melzer (University of Exeter, UK) and co-investigators previously discovered the link between BPA exposure and CHD and diabetes in a smaller study, as reported by MedWire News.

“This is only the second analysis of BPA in a large human population sample. It has allowed us to largely confirm our original analysis and exclude the possibility that our original findings were a statistical ‘blip’,” said Melzer.

The researchers assessed links between BPA exposure, measured from urinary concentrations of BPA, and diagnoses of myocardial infarction, CHD, angina, diabetes and elevated serum liver enzyme levels.

The study cohort comprised 2948 adults aged 18 “74 years who participated in the National Health and Nutrition Examination Survey (NHANES) 2003 “2004 (n=1455) and 2005 “2006 (n=1493) and who were representative of the general US population.

The mean level of urinary BPA was lower in 2005 “2006 than 2003 “2004 at 1.79 versus 2.49 ng/ml.

A per z-score increase in urinary BPA increased the relative risk for CHD by 33% and 42% in the 2005 “2006 cohort and 2003 “2006 pooled cohort, respectively.

A similar increase in urinary BPA did not significantly increase the relative risk for diabetes in 2005 “2006. However, in the 2003 “2006 pooled cohort a per z-score increase in BPA amplified the relative risk for diabetes by 24%.

Of note, the team found no significant association between BPA levels and gamma glutamyl transferase concentrations, but in the pooled cohort associations with alkaline phosphatase and lactate dehydrogenase were significant.

“We now need to investigate what causes these health risk associations in more detail and to clarify whether they are caused by BPA itself or by some other factor linked to BPA exposure,” commented study author Tamara Galloway (University of Exeter).

“The risks associated with exposure to BPA may be small, but they are relevant to very large numbers of people. This information is important since it provides a great opportunity for intervention to reduce the risks.”

The results of this study are published in the journal PLoS ONE.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Bisphenol A exposure linked with metabolic disorders

Study results show that recommendations to screen patients prescribed second generation antipsychotics (SGAs) for high blood glucose and cholesterol are largely being ignored by physicians.

In 2003, the US Food and Drug Administration (FDA) required a warning about increased diabetes risk to be added to the labeling of SGAs or atypical antipsychotics and for clinicians to be sent letters warning them of the risk.

Subsequent to this, the American Diabetes Association and American Psychiatric Association suggested that all patients prescribed to receive SGAs should have glucose and lipid testing before commencing therapy.

“The side effects that can be caused by these new types of antipsychotic medications, some of which were first approved in the 1990s, are not trivial,” said study author Daniel Hartung from Oregon State University College of Pharmacy in Portland, USA.

“Increases in blood sugar, cholesterol and body weight can lead to diabetes in some cases, and this patient group already has a problem with diabetes that’s almost twice that of the general population.”

Elaine Morrato (University of Colorado Denver, Aurora, USA) and colleagues assessed the trends for lipid and glucose testing on prescription of SGAs in a cohort of 109,451 individuals who began taking SGAs between January 1st, 2002 and December 31st, 2005.

A control cohort of 203,527 individuals who began taking albuterol, but not antipsychotic medication, were used for comparison purposes.

The team found that initial testing rates for glucose and lipids were low, at 27% and 10%, respectively, for patients starting SGA treatment.

Over the 4-year period between 2002 and 2005, there was no increase in glucose testing and only a marginally significant increase in lipid testing of 1.7% in these patients.

“The existing baseline screening and ongoing monitoring of glucose and lipid levels in these patients was already pretty low, and the FDA warning really had no impact in changing that,” commented Hartung.

He added: “Part of the problem may be that simply sending doctors a letter about these issues, which come up every now and then with medications, is just not getting the job done.

“With this group of medications, at least, it clearly wasn’t effective, and it does raise questions about whether new approaches are needed. Part of the problem may also be people moving from one doctor to another, and inaccurate assumptions about testing being made.”

The results of this study are published in the Archives of General Psychiatry.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

Free abstract

An estimated 40.9 million people in India are known to suffer from diabetes according to the International Diabetes Federation. Also, it has been predicted that by 2030, every fifth diabetic in the world will be an Indian. These are some of the important facts that should be kept in mind to prevent the condition.

Diabetes develops earlier in Indians in comparison to the Western population. This could have something to do with factors in their lifestyle that increase the risk for this condition.

Diabetes mellitus is a metabolic disorder characterized by high blood sugar. There are two types of diabetes, type 1 and type 2. Type 1 is mostly seen in children (juvenile diabetes) while type 2 usually develops in adults.

The main cause of diabetes is the diminished production of insulin by the pancreas and also the development of resistance towards the action of insulin.

Factors like genetics (positive family history), obesity, hormonal conditions such as PCOD (polycystic ovarian disorder), high cholesterol levels, and most importantly, improper eating habits, stress and anxiety coupled with addictions such as excessive smoking, contribute to the development of the condition.

Simple lifestyle changes can cut the risk of diabetes.

Signs and symptoms: Some of the common symptoms that indicate diabetes are increased thirst or hunger pangs, frequent urge to urinate, unexplained weight loss or gain.

Once you get diabetes it cannot be cured but diabetes can be managed with lifestyle modifications and requisite medications or insulin intake through injections or pumps (as advised by the doctor). Once diabetes is controlled and managed, one can lead a normal, healthy life.

Prevention and management of diabetes is possible with regular exercise such as brisk walk and control and modification in diet.

Many people with or without type 2 diabetes, have misconceptions about nutritional supplements. You may think you eat a balanced diet but in truth not too many people even come close to eating a healthy diet. Our lifestyle these days leaves little desire to prepare meals at home, eating out is no longer a luxury, it is something many do each and every day. Guess what, many restaurant meals are obtained from fast food outlets and processed foods are used… these would be lacking in important nutrients.

Another belief is that supplements do nothing beyond making expensive urine. It is true the B and C vitamins are water-soluble vitamins which means they are not meant to be stored by your body… they need to be replaced every day. They are meant to saturate your metabolic system… in order to saturate your system, some of the dosage may show up in your urine. Even when the urinary excretion threshold has been reached, water-soluble vitamins continue to benefit your body. This also occurs with prescription medications.

Vitamin B12 is one of these water-soluble vitamins… it helps:

• carbohydrate, fat and protein metabolism
• iron function better in your body
• maintain your central nervous system
• with folate activity
• with calcium absorption
• increase your energy
• with the formation and regeneration of red blood cells

How is vitamin B12 obtained:

• through diet simply by eating chicken, salmon and tuna, eggs and milk
• if you are a vegetarian, it will be difficult for you to get enough vitamin B12 but it can be found in vegetarian burger patties that are fortified with B12

In a recent study of forty-six people with type 2 diabetes taking metformin or phenformin or both, 30 per cent of these volunteers were found to have malabsorption of vitamin B12. This means their body was not absorbing the vitamin properly. This deficiency continued even after their medications were stopped.

Deficiency symptoms of vitamin B12 include:

• soreness and weakness in your arms and legs
• slow reflexes and sensory perception
• stammering
• difficulty walking, jerking of your limbs,
• nervousness
• nerve inflammation
• mood disorders
• mental slowness, memory loss
• unpleasant body odor

It’s easy for your health care provider to monitor your vitamin B12 levels… this is done by a blood test. If your levels are low, vitamin B12 can be delivered by injection, sublingually (under your tongue), or there is a new patch that delivers this vitamin to your body. It is also included in many multivitamin supplements.

Besides being helpful for people with type 2 diabetes taking metformin, vitamin B12 has been found to aid in the reduction of the risk of cardiovascular disease and, in conjunction with vitamin B6, is important for the prevention of diabetic neuropathy… it is essential for healthy nerve function.

Diabetic neuropathy is a family of nerve disorders caused by poorly controlled blood sugar levels for extended periods of time. Up to sixty per cent of people with type 1 or type 2 diabetes are affected by neuropathy or nerve damage. The likelihood of nerve damage occurring increases with the length of time you have diabetes.

As well as constantly high blood sugar levels, neuropathy is made worse by:

• the diabetic’s age… nerve damage is more common in people over 40
• the diabetic’s height… neuropathy is more common in taller people, as they have longer nerve fibers to damage
• alcohol… even small amounts of alcohol can make nerve damage worse

Various disorders of your nervous system are broken down into:

1. Loss of sensation… sensory nerves which detect cold, pain and heat are damaged

2. Loss of motor nerves… motor nerves carrying impulses to your muscles to control movement are damaged

3. Loss of autonomic nerves, or automatic nerves… we can’t control these ones. They take care of your heart rate, movement of food through your digestive system, and more. Automatic functions are dependant on the autonomic nerves and damage depends on the the location of the nerve. Problems with autonomic nerves could lead to:

• sexual dysfunction: occurs in 50 per cent of males with type 1 or type 2 diabetes, and 30 per cent of females with diabetes. Males are unable to sustain an erection and females have problems with lubricating the vagina for intercourse
• bladder issues: come about by you being unable to recognise bladder fullness. Urine is not eliminated and this leads to urinary tract infections
• sweating problem:especially in your feet. Then your body tries to compensate for lack of sweating in your feet by causing excessive sweating of your face and body
• abnormalities of your pupil: your pupils set the amount of light allowed to enter. Due to the neuropathy the pupil is small and will not open up in a dark room

Because of the large number of nerves in your body, you can run into all sorts of problems. But none of them ever need bother you. The key point to remember is prevention or early detection is much better than trying to fix diabetic neuropathy or diabetic nerve damage.