Mild anemia is commonly found in patients with Type 2 diabetes and is associated with micro- and macroangiopathies, Japanese researchers report.

The team from Edogawa Hospital in Tokyo says that it is therefore important to carry out extensive examinations for these complications as well as evaluating the causes of anemia when mild anemia is found in patients with Type 2 diabetes.

Anemia is recognized as a risk factor for cardiovascular events and diabetic retinopathy, but Hiroyuki Ito and colleagues say no study has yet investigated whether mild anemia, which does not require iron or erythropoiesis stimulating agent supplements, is associated with diabetic complications.

To investigate further, they compared 1189 patients with Type 2 diabetes mellitus at their institution with 211 healthy individuals (controls).

Overall, 33% of the patients with diabetes had anemia, defined as a hemoglobin level of less than 13.5 g/dl in men or 12.0 g/dl in women, 25% had grade 1 anemia, with a hemoglobin level of ?11.0 g/dl, and 8% had grade 2 anemia, with hemoglobin of <11.0 g/dl.

Anemia was significantly more common in men and women with diabetes, at 37% and 27%, than in controls, at 17% and 16%, respectively. Grade 1 anemia was observed in just 15% of controls.

The prevalence of anemia in patients with diabetes increased with the progression of the stage of diabetic nephropathy and chronic kidney disease.

Both grade 1 and grade 2 anemia were significantly associated with all diabetic micro- and macroangiopathies assessed in unadjusted analysis, except for grade 2 anemia and cerebrovascular disease.

Grade 1 anemia remained significantly associated with diabetic retinopathy, coronary heart disease, and peripheral arterial disease after adjusting for several potential confounders, with corresponding odds ratios of 2.13, 1.82, and 2.18.

Reporting in the Journal of Diabetes Investigation, the authors conclude that “it is important to carry out intensive examinations for the detection of diabetic micro- and macroangiopathies, in addition to the evaluation of treating some of the easily correctable causes of anemia”.

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

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Patients with Type 2 diabetes have an increased risk for relatively poor cognition if they experienced prediabetes hypertension 16 years earlier, research suggests.

When examining the relation between diabetes-associated cognitive function and metabolic and vascular risk factors it is important to consider that levels of certain risk factors may change over time.

Longitudinal studies that compare the risk factor profile over time between patients with good and poor cognitive functioning are therefore important.

These data have recently been provided by Esther van den Berg (University Medical Center Utrecht, The Netherlands) and co-workers in an analysis of 16-year data from the population-based Hoorn study, which examined glucose metabolism and vascular disease in Dutch men and women aged 50 “74 years.

The current analysis includes those individuals who did not have Type 2 diabetes when the study was initiated in 1989, but who had developed the disease by the 2000 “2001 examination.

Of these participants, 64 agreed to attend a further examination in 2005 “2007 and underwent an extensive neuropsychologic examination covering six cognitive domains (abstract reasoning, memory, information processing speed, attention and executive functions, visuoconstruction and language).

Patients were divided into tertiles according to a sum score for performance across cognitive domains, and the domain score for information-processing speed. Individuals in the lowest tertile were considered to have relatively poor cognition, and individuals in the highest tertile relatively good cognition.

The time course of vascular risk factors from 1989 to 2005 “2007 was compared between the tertiles adjusting for age, gender, and estimated IQ.

Reporting in the journal Diabetes/Metabolism Research and Reviews, the authors found that patients with relatively poor cognition had a 14 “18 mmHg higher systolic blood pressure in 1989 than patients with good cognition; levels of vascular risk factors were similar between cognitive function tertiles at the 2005 “2007 examination.

Interestingly, patients with relatively poor cognition did not have higher glycated hemoglobin levels at any point during the study, and had similar lipid profiles and body weight compared with Type 2 diabetes patients with good cognition. However, the authors note that the duration of Type 2 diabetes was relatively short, and the patients’ glucose levels were well-controlled.

“Patients with poor cognition had a higher systolic blood pressure than patients with good cognition over 16 years before. This suggests that diabetes-associated cognitive decline is related to the cumulative effects of long-term exposure to hypertension, even in pre-diabetes stages,” conclude the authors.

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

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Due to Modern lifestyle, we are isolated from “The Nature” to the chemicals in the name of science. That is why, modern day diseases are increasing steeply; one among them is “Diabetes”.

Reasons for the steep increase in people with diabetics

• Isolating ourselves from nature,
• eating to much of fast foods, bakery items and ready to eat packed foods,
• due to increase in machines, there is no or very low physical activities and
• becoming over weight and/or obese.

Valuable suggestion to avoid diabetes

• Plan to reduce body weight, reducing body weight can reduce body fat too, thus limits the risk factor of diabetes or supports effective treatment.
• Increase physical activity, which help to burns extra calories and thus supports to lower blood glucose level.
• Say no thanks for excess fat and sugar.
• Slowly include and increase soluble fibers in the diet.
• Add some diabetes natural herbs in the daily life, for detail information with scientific proof on the effectiveness of treatment visit “resource”

Diabetes herbal remedies

Due to increased cost and side effects of modern medicines, people with diabetics start searching for an effective alternative with;
• Less or no side effect,
• Better blood glucose level control,
• Cheaper cost and effective treatment
• Having other additional health benefits.

Natural herbs can fulfill almost all of the above expectations. It can effectively control blood glucose or sugar, also it can nourish pancreas, liver, kidney, heart and eye; these organs responsible for the cause of high blood glucose or affected by the long run of diabetes. Yes herbs can be supportive in both for the treatment and to limit or eliminate diabetes complications.

Results from an influenza surveillance project in Canada show that patients with diabetes who become infected with the pandemic influenza A (H1N1) virus are at significantly greater risk for hospitalization and intensive care unit (ICU) admission than those without diabetes.

Diabetes is thought to be a risk factor for more severe flu infection, but attempts to quantify such increased risk have revealed differing results.

Robert Allard (University of Montreal) and colleagues reported outcomes of their study of 162 patients, aged 28.6 years on average, who were hospitalized with polymerase chain reaction-confirmed pandemic H1N1 infection. Of these, 22 (14%) had diabetes - nine had Type 1 and 13 had Type 2.

The number of patients with diabetes was significantly higher than the 7.1 cases that would be expected from population rates, and the team found that the presence of either type of diabetes increased the risk for hospitalization with pandemic H1N1 infection around three fold compared with not having diabetes.

In addition, 32.3% (n=10) of the 31 patients with pandemic H1N1 infection who required admission to the ICU after hospital admission were diabetic.

The researchers calculated that diabetics had a significant 4.29-fold increased risk for ICU admission with pandemic H1N1 infection following adjustment for age and presence of cardiovascular disease compared with nondiabetics. The degree of risk was not significantly different between those with Type 1 and Type 2 diabetes.

The percentage of hospitalized patients with diabetes in this study was similar to that of previous studies in which 11-21% of hospitalized patients with pandemic H1N1 infection were reported to be diabetic.

“Our results corroborated the impression that persons with diabetes who contract pandemic H1N1 are more likely than others to be hospitalized or to require ICU care,” add Allard and team in the journal Diabetes Care.

“As previously reported for infection-related mortality in diabetic patients, ICU risk was independent of the presence of coexisting heart disease.”

The authors conclude: “Risk estimates for seasonal influenza could strengthen the basis for recommendations that persons with diabetes be regularly immunized against influenza.”

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

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Patients with diabetes who are hospitalized for myocardial infarction (MI) have reduced long-term survival compared with nondiabetics hospitalized for MI, report researchers.

Diabetes is a known risk factor for increased post-MI mortality, say Thomas Kümler (Rigshopitalet University Hospital, Blegdamsvej, Copenhagen, Denmark) and colleagues.

“As a result, it is important to know whether diabetes as an important risk factor does not deteriorate over time, even when cardiovascular disease is established,” they add.

Kümler and team report results from a study of 6676 consecutive patients who had MI between May 1990 and August 1992, and who were screened for entry into the TRACE (Trandolapril Cardiac Evaluation) study. Of the participants, 719 had diabetes and 5949 did not.

The researchers found that mortality at 10 and 15 years post-MI in patients with diabetes was 82.7% and 91.1%, respectively, compared with a corresponding 60.2% and 72.9% in patients without diabetes; a statistically significant difference.

The researchers also carried out Landmark analysis, which showed that diabetes continued to have a significant prognostic effect throughout the duration of follow-up.

During the whole period of follow-up, individuals with diabetes were 1.47 times more likely to die than those without diabetes.

Writing in the journal Cardiovascular Diabetology, Kümler et al conclude: “This is a plausible result from a biological point of view as diabetes is a progressive and chronic disease.”

They add: “The presence of diabetes identifies MI patients at high-risk, who are candidates for continued aggressive medical therapy.”

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

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“Is there a Natural Way To Stop Diabetes?”

Many people are asking this question every day. According to the statistics, 23,6 million people in the United States (almost 8% of the population) suffer from this disease. And the bad news is that a large percentage of them doesn’t even know it. In fact, it is estimated that there are at least 5,7 million cases of undiagnosed diabetes in the country. Unfortunately, many people underestimate the severity of this disease. The truth it is the seventh leading cause of death on the U.S. and it kills more people than breast cancer and AIDS combined. The main reason why this happens is that 80 percent of sufferers develop cardiovascular diseases sooner or later.

If you are suffering with this condition I’m sure you are wondering why this has happened to you. A major risk factor is being overweight. Almost 9 out of 10 people with type 2 diabetes are overweight, so losing these extra pounds can help you lower you blood sugar and also your risk of developing heart disease. It would be a very good idea to eat less fat. You should also limit your carbohydrate intake. This nutrient affects your blood sugar levels more than any other, so you should count the grams of carbohydrates you eat every day and also spread your carbohydrate intake throughout the day by eating small and regular meals.

Most sufferers believe that eating too much sugar causes diabetes, but the matter is more complicated. It’s not only about sugar. Consuming too many calories, whether from sugar or from fat is what causes the most problems. There are no forbidden foods. You can even eat sweets or chocolate in small quantities and as a part of a healthy meal plan.

Also according to the American Diabetes Association, physical activity is a must if you want to control this condition. It is advised to exercise for at least 30-60 minutes per day.

Even small changes to your lifestyle can have remarkable results!

Adult onset diabetes, also known as Type 2 diabetes, is normally diagnosed in adults over the age of 45. However, it can begin at any age, and the increase of Type 2 diabetes in children has alarmed many health care officials. Unlike juvenile onset diabetes, Type 2 diabetes seldom requires insulin injections. Instead, it is normally managed through a program of diet, exercise, and, if needed, oral medications.

Diabetes currently has no cure. When the pancreas fails to produce enough insulin to maintain blood sugar levels, or when the body cannot utilize it properly, diabetes can occur. Insulin is needed for the body to take glucose (sugar) from the bloodstream and store it in cells. If the glucose remains in the bloodstream, it can cause damage to major organs. In addition, the body is unable to utilize the glucose as a source of energy.

Some diabetics may have no symptoms whatsoever, while many fail to recognize their symptoms as warning signs of diabetes. These warning signs include weight loss and numbness or burning of the extremities. Excessive thirst or hunger, blurred vision, and waking up to urinate (and going more often during the day) may also signal the onset of diabetes.

Complications from diabetes may include kidney failure and nerve damage, particularly in the feet and legs. In addition, diabetes increases the patient’s risk for stroke, heart attack, and atherosclerosis. There is also some evidence that it may also be a contributing factor in some forms of dementia.

Being overweight is one risk factor for developing Type 2 diabetes. Patients with the condition, or those who are borderline, should try to reduce their body weight. Exercise is not only beneficial to weight loss, but increased cardiovascular activity also helps to control blood sugar levels.

Eating a balanced, healthy diet is an important part of the treatment plan. Consistency is important, and eating around the same times each day is recommended. Also, meals should include the same types of food in the same proportions.

A proper diabetic diet does not need to be costly. Some of the best foods for those with diabetes are also some of the least expensive. These include beans, oatmeal, and barley. Tomatoes and citrus fruits are recommended, as are leafy green vegetables, such as spinach. Dairy products such as milk and yogurt are good choices, but only if the fat free versions are chosen. Sugars should be eaten sparingly, and with prior planning by the reduction of other carbohydrates in the same meal.

Controlling diabetes involves a partnership between the patient and his or her physician. By making the lifestyle changes needed, the symptoms can be controlled and potential complications avoided.

Type 2 diabetes, once exclusive to adults, is now appearing in children in rapidly increasing numbers. This increase runs parallel to the rising rate of childhood obesity.

Poor nutrition from processed foods and take-away, plus such low rates of exercise leads right to metabolic problems for more and more children.

Frightening Statistics!

As recently as ten years ago, if a child received a type 2 diabetes diagnosis it would be written up in a medical journal. Today at least one third of the cases of diabetes diagnosed in juveniles is type 2 diabetes! The average age is thirteen and a half, but type 2 has been found in children as young as four years.

It is also estimated that 4 per cent of adolescents, between the age of thirteen to nineteen have undiagnosed metabolic issues which is connected to type 2 diabetes.

Bigger Than You Think!

“Diabetes is not a little bit of a problem. It’s a huge problem for the people who have it,” says Dr Francine Kaufman, MD, a pediatric endocrinologist from L.A. These days her clinic is filled with children with type 2 diabetes.

What You Need to Know:

Many parents miss the obvious single risk factor… obesity, especially around the child’s middle where an “apple-shaped” figure is obvious. In other words, fat around the belly and waist.

Mostly kids with type 2 diabetes are overweight, in fact, roughly 90 per cent are. During puberty, insulin secretion increases and insulin sensitivity decreases by approximately 30 per cent.

What You Can See:

• a darkened, velvety and thickened skin area in the folds of skin in the armpit, groin and neck area. Known as acanthosis nigricans; the cause is still not really known but it seems to be related to insulin resistance. These areas may cause itching
• unusual thirst and excessive urination and urination during the night. This is how the child’s body copes with getting rid of excess sugar. Usually children who have been playing outside on a hot day get thirsty… they drink to replace fluids they have lost… they don’t urinate more than usual. And usually they don’t urinate during the night-time
• a child with undiagnosed diabetes can have unusual hunger with no weight gain. Normally a child who eats a lot of food puts on weight!
• unnatural fatigue is another sign… muscle and body cells are not able to use sugar that is eaten for energy, so the child is often tired
• frequent infections and sores that take longer than normal to heal
• blurred vision may be something you child mentions to you… this happens because the blood sugar level is high and affects their eye lens. The blurriness improves when the blood sugar level lowers

Do you know studies have shown children who spend large amounts of time watching TV:

• do not do any physical activity, and
• eat many sugary foods that are advertised during children’s TV programs at the rate of approximately twelve food advertisements per hour

One study in California showed by reducing TV watching time to eight hours per week helped kids to control their weight, compared to kids who did not change their TV watching habits.

Do you know that excess body fat is the one really important risk factor in developing type 2 diabetes? Obesity is the one thing you can control. You can see it and you can feel it happening from the first weeks. You know if your clothes are becoming too tight, or if you have to move your belt up one more notch! From there you move onto a larger size in clothes. There is your early warning sign.

Yes, we do have an aging population which could explain the increase in type 2 diabetes and it is more common in the over 50 age group. The truth is 90% of this group have gained a significant amount of weight since their early twenties. Nowadays more younger people are being diagnosed due to obesity; we now have overweight children and adolescents being diagnosed.

When we think of losing weight, the word diet springs to mind. It almost means deprivation to us, why not think of a healthy eating plan instead?

Who has benefited from fad diets? So many of us are dieting, riding a roller coaster of dieting and obsession, feeling deprived, binging then feeling guilty, then back to strict dieting and obsession. Jenny Craig, Atkins, Weight Watchers and South Beach are all fad diets that people usually give away after a short time. Research has revealed people who diet usually gain the lost weight back plus more pounds/kilograms.

Low-fat foods are readily available. Although fat may have been reduced in these foods, often calories/kilojoules are not. And they are usually too extreme in the carbohydrate (glycemic) load.

The main goal of weight loss is to lose body fat, not muscle. Water loss is fast and temporary and is regained very quickly. The formula for long-term weight loss is simple:

• Eat Less … reduce your energy intake. Take in less calories/kilojoules by eating more leafy vegetables and less fats, alcohol, starches, protein foods and refined carbohydrates
• Move More … increase your energy output. Spend more time with physical activity

You don’t need to cut anything out of your diet completely but the proportions are important:

• 30 per cent of your calories/kilojoules should come from lean protein
• 40 per cent from carbohydrates. Select foods with low-GI levels to try to keep the blood glucose response as low as possible
• this leaves 30 per cent from fats. And includes fat in the protein food, oil used in cooking, cream in your coffee, milk and margarine
• unsaturated fats come from olive oil, vegetable sources and fatty fish. They do not raise your cholesterol level
• saturated fats come from animal sources, eg. fat in steak, chicken, bacon, butter and cream. Less than one third of the daily fat intake should come from saturated fats. They have a tendency to promote coronary artery disease and you don’t want that.

An initial realistic goal if you are overweight, is to aim for a 5 to 10 per cent loss of your total body weight. This will help lower you blood sugar levels and give you better control of your type 2 diabetes.

Arterial stiffness is linked to both glycated hemoglobin (HbA1c) and duration of diabetes in patients with concomitant hypertension, highlighting the importance of early glycemic control for prevention of atherosclerotic disease in patients with Type 2 diabetes.

In people with diabetes, increased arterial stiffness is a strong risk factor for early mortality and is exacerbated by hypertension. To evaluate the associations between these risk factors, Yuhong Chen (Ruijin Hospital, Shanghai, China) and co-workers recruited 1000 patients with Type 2 diabetes with or without hypertension between 2005 and 2007.

Brachial-ankle pulse wave velocity (Ba-PWV) was used as a non-invasive measure of arterial stiffness. Duration of Type 2 diabetes was confirmed by clinical records and a detailed medical examination was performed.

To investigate the correlation between arterial stiffness and glycemic control, patients with diabetes and hypertension were divided into three subgroups based on HbA1c levels: less than 6.5%, 6.5% to less than 7.0%, and greater than 7.0%. All patients with diabetes were also divided into subgroups in terms of duration of diabetes: less than 5 years, 5 to 10 years, and greater than 10 years.

Ba-PWV was significantly higher in the 562 patients with diabetes and hypertension (1779 cm/s) than in the 438 patients without hypertension (1691 cm/s), despite similar levels of glycemic control.

Arterial stiffness correlated positively with HbA1c in patients with diabetes and hypertension, but not in patients without hypertension. In patients with hypertension, Ba-PWV was significantly higher in those with HbA1c levels of at least 7.0% compared with those who had HbA1c levels of less than 6.5%, leading the authors to suggest that arterial stiffness was associated with glycemic control.

Arterial stiffness was associated with HbA1c in all three divisions of diabetes duration in hypertensive patients, and increased progressively with increasing duration of diabetes. In patients without hypertension, arterial stiffness was only associated with a diabetes duration of greater than 10 years.

The authors suggest that hypertension is an additive risk factor for arterial stiffness in patients with diabetes causing earlier and faster development of atherosclerosis.

“Ba-PWV positively correlates with HbA1c and duration of diabetes in subjects with diabetes and hypertension, suggesting the importance of early glycemic control in the prevention of arterial stiffness and vascular complications,” they conclude.

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

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