High-Salt Diets Could Double Risk of Heart Woes for Diabetics

By Dennis Thompson
HealthDay ReporterLatest Diabetes NewsCoaching May Help Diabetics Battle DepressionThe 'Bear' Facts on Obesity and DiabetesFast-Slow Walking May Be Better for DiabetesPoor People With Diabetes More Likely to Lose LimbDoctor's Visits for Young Adults With Diabetes UpWant More News? Sign Up for MedicineNet Newsletters!
TUESDAY, July 22, 2014 (HealthDay News) -- A diet loaded with salt is associated with double the risk of heart attack or stroke in people with type 2 diabetes. The risk skyrockets even higher among those whose diabetes isn't well-managed, a new Japanese study reports.
The study found that people with diabetes who consumed an average of 5.9 grams of sodium daily had double the risk of developing heart disease than those who consumed, on average, 2.8 grams of sodium daily. In addition, heart disease risk jumped nearly 10-fold for people with poorly managed type 2 diabetes and a diet with excess salt.
However, it's important to note that this study only found an association between salt intake and increased heart disease; the study wasn't designed to prove that the increased salt intake actually caused heart disease.
Still, experts believe it's important to limit salt in the diet.
"The findings are very important from a public health point of view," said Dr. Prakash Deedwania, chief of cardiology for the Veterans Administration Central California Health Care System and a professor at the University of California, San Francisco School of Medicine.
"Everyone's focused on controlling glucose

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Fast-Slow Walking May Be Better for Diabetes

By Peter Russell
WebMD Health News
Reviewed by Keith Barnard, MD
Aug. 5, 2014 -- Periods of power walking mixed with strolling at a more leisurely pace may be a more effective way for people with diabetes to control their blood sugar levels, rather than walking at a constant speed, according to a small study.
Exercise helps people with type 2 diabetes control their blood sugar levels. Although high-intensity exercise offers the prospect of better control, doctors often warn against that approach, due to the risk of injury and the likelihood someone will not stay with it.
Researchers at the University of Copenhagen previously highlighted the value of interval-walking training, where the intensity of the training alternates. Their latest study analyzes how this technique helps patients.
Training Program
People with type 2 diabetes were randomly put in 3 groups. Twelve were put into a program of interval-walking training (IWT), another 12 were assigned to a group using a constant walking approach (CWT), and the rest formed a baseline group.
Training consisted of five 1-hour sessions each week for 4 months. The researchers gave the groups precise instructions about their exercise regime, although the training was unsupervised.
A device was used to measure blood sugar levels and insulin production in each of the volunteers at the start and end of the study period.
The Results
The researchers found improved blood sugar control only among those who had mixed power walking with slower walking. This was probably caused by an increase in insulin sensitivity (or, in general, how well your body uses insulin), they write.
"Whether these beneficial effects of IWT continue and result in better health outcomes in the long term must be determined in order to justify the clinical

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The 'Bear' Facts on Obesity and Diabetes

TUESDAY, Aug. 5, 2014 (HealthDay News) -- The ways grizzly bears deal with hibernation and fluctuating weight might offer valuable new clues to human obesity and diabetes, new research suggests.
The study authors note that the tissues of obese people with type 2 diabetes become dangerously insensitive to insulin, the hormone that helps control the level of sugar in the blood.
However, unlike people, insulin levels in grizzly bears do not change, the researchers found. Instead, the bears' cells seem to be able to control their ability to respond to insulin.
In fact, in the fall -- when grizzly bears are most obese -- they are also the most sensitive to insulin, says a team led by Dr. Kevin Corbit, of the drug maker Amgen, Inc.
According to Corbit's group, this happens because the activity of a key protein found in fat cells, called PTEN, is shut down.
In fact, weeks into hibernation, grizzly bears develop a "natural" state of diabetes that is cured when they wake up in the spring, according to the study, which is published Aug. 5 in the journal Cell Metabolism.
During hibernation, grizzly bears also store the fuel their bodies need to survive the winter in fat tissue. In other obese animals however, fat builds up in the liver and muscles, Corbit's team pointed out.
The bear findings are "in contrast to the common notion that obesity leads to diabetes in humans," Corbit said in a journal news release. In fact, the finding suggests that obesity and diabetes "may exist naturally on opposite ends of the metabolic spectrum," he said.
Corbit stressed that these findings have yet to be borne out in humans. However, "we believe that these and other data do support a more comprehensive and perhaps holistic approach to caring for patients with diabetes and/or obesity," he said.
His team believes that the mechanisms that lead to obesity in some people -- such as lower levels of PTEN -- might also protect them from diabetes. On the other hand, what leads other people to develop diabetes might also protect them from becoming obese.
"This more sophisticated understanding of the relationship between diabetes and obesity should enable researchers not only to develop therapies targeting these mechanisms, but also to identify the appropriate patients to whom these therapies should be targeted," Corbit said.
-- Mary Elizabeth Dallas

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More information May help to fight against Diabetes

Mental health coaching may help diabetes patients with depression and with lowering their blood sugar levels, a new study suggests.
Many people with diabetes suffer depression, which can interfere with their ability to manage their diabetes through monitoring blood sugar levels, being active, eating healthy and taking their medications, the researchers noted.
This study included diabetes patients in a rural, low-income area of central North Carolina. Nearly 16 percent of people in this area have diabetes, compared with 10 percent of people nationally. Thirty percent of these diabetes patients have depression and 65 percent are poor, the study authors wrote.
Researchers referred 182 patients with newly diagnosed type 2 diabetes and depression to a diabetes educator and also to a mental health coach, who helped them find ways to deal with the stresses and challenges in their lives. They had an average of three visits with the mental health coach.
After three months, the patients' anxiety and depression scores fell by an average of 49 percent, and their A1C levels (a test that determines average blood sugar levels over several months) dropped from an average of 8.8 percent to 7.7 percent. Diabetes patients typically try to get their A1C levels below 7 percent.
The study was presented Wednesday at the annual meeting of the American Association of Diabetes Educators, in Orlando, Fla. Research presented at meetings is considered preliminary until published in a peer-reviewed medical journal.
"The program was to be piloted for a two-year period but has been so powerful

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Fasting and Diabetes (Ramadan)

In some of the culture fasting is very important .Hindus usually fast many times of the year .Every month and some of the sects have fasting every week .Some of the  Christians sects  also believe in fasting, while Sikhs do not believe in Fasting   In Muslims  Fasting during the holy month of Ramadan is an important spiritual practice. Specially for Diabetes patient it becomes more important because this fasting period can be up to 40 days and some time up to 18 hours one have to fast  When you have diabetes, you may be wondering how fasting will affect your diabetes.  There is lots of unauthenticated information about fasting and Ramadan.   This post  is published to provide extra information  about some facts and myths about fasting for diabetes patients 

I know many people with diabetes who fast and don’t have a problem.  Is it okay for me?

It is true, many people with diabetes can fast safely, but each person is different.   Part of the decision you will make with your doctor has to do with the kind of diabetes medicine you take.   It is important to schedule an appointment  2-3 months before fasting  specially  Ramadan to discuss how fasting might affect your diabetes.  Your doctor or healthcare provider may suggest a change in your medication plan. Once a week fasting might need more attention as this breaks up patient routine ,so should contact doctor before fasting 

What can happen during fasting 

These are the major risks:

• Low blood glucose (or hypoglycemia) – The risk of blood glucose levels going too low is highest in people taking insulin or certain diabetes pills. Limit physical activity during fasting hours and be more active after sunset.  Talk with your healthcare provider to find out if your medicine puts you at risk for low blood glucose and discuss how to prevent it. 

• High blood glucose (or hyperglycemia) – While low blood glucose levels may happen during the day, after the fast is broken, there is a greater risk to overeat.  Watch out for eating too many sweets and keep the portion sizes moderate.   Even though Ramadan is known as a time of fasting – it is not uncommon for people to gain weight during this month, as in some families, every evening meal is a celebration. 

• Dehydration – This is especially a problem during the longer and hotter summer days.  Aim to drink sugar free and caffeine free drinks frequently throughout the evening and before dawn. 

I was told to not check my blood glucose during the day as it will break the fast. Is that true?

Checking blood glucose will not break a fast!    It is important to monitor blood glucose levels especially to identify a low glucose level.  A fast will have to be ended if glucose levels fall too low 4

How is low blood glucose treated?

If glucose levels do fall below 4, take 15 grams of carbohydrate in the form of one of these:  4 glucose tablets, 6 oz regular soda, 4 oz fruit juice or 1 tube glucose gel.  Wait 15 minutes and recheck again.  Follow with a snack if the evening meal is not for more than an hour.  

Do I stop taking medicine during Fasting 

No.  You continue taking your diabetes medicine, but you will take it at different times.  Your dose may also change.    This is one reason why it is very important to talk with your healthcare provider several months before Ramadan so you can plan ahead for how your diabetes medicines may need to change.

How do I plan my meals since I’m only eating twice a day?

After fasting meal or Dinner  should contain a balance of whole grain sources of starchy carbohydrates as well as some protein and fat to help slow the digestion and help the feeling of fullness last as long as possible into the day.   Healthy breakfast options good for the hot summer fasting days specially in Ramadan  include: 

• Whole grain cereal, low-fat milk, cottage cheese with sliced peaches topped with toasted almonds

• Plain Greek Yogurt flavored with blueberries and cinnamon, whole wheat toast with nut butter.

• Foul (a hearty middle eastern breakfast dish made of lentils or fava beans), small serving of sliced fruit

• Whole wheat roti (unleavened bread) and egg fish  (a southeast Asian dish)

Traditionally the fast is broken (Iftar) after sunset and begins with the eating of dates and drinking water.  Limit dates to 1-2 each evening.  Drink plenty of water and sugar free beverages though out the evening, but avoid caffeine beverages as they can be dehydrating. 

Usually when devotees break fast or end fast they end up eating too much .Specially in Ramadan  the iftar meal is a celebration time, aim to not overeat.  Discuss a plan with your dietitian.  Keep sensible portions in mind and follow the same guidelines for healthy eating that you do the rest of the year with an emphasis on whole grains, lean sources of meat, fish and poultry, small amounts of heart healthy fats and limit added sugars.