Unusual Type 2 Diabetes Symptoms Not to Ignore

Approximately 463 million people globally are living with type 2 diabetes and by 2045, this is supposed to rise to 700 million. Type 2 diabetes is largely caused by insulin resistance (IR) while the cause of IR can range from any number of genetic deficiencies to environmental causes. It’s important to look at both of these factors when considering a type 2 diagnosis.

Symptoms may be similar to those of type 1 diabetes but are often less pronounced since the condition progresses gradually over time. A startling statistic is that 1 out of 2 people will be misdiagnosed, leaving them susceptible to years of elevated blood sugars and the risk of complications that come along with the disease before being properly diagnosed and treated.

It is more important than ever to know the signs of type 2 diabetes so that a person can properly educate themselves in order to make better choices to improve their blood sugars and overall health. Routine blood tests at your yearly physical should help determine if you are experiencing issues that need medical attention.

Many of us are aware of the common symptoms associated with type 2 diabetes. But since it may take years before a correct diagnosis, many say they were unable to detect the slow changes to their health. It is important to pay attention to these signs especially if you are at an increased risk for type 2 diabetes.

Common Symptoms of Type 2 Diabetes

Some common symptoms to look out for are:

  • Increased thirst and frequent urination. As sugar build-ups up in your blood, it forces your body to try to flush it out through increased urination.
  • Increased hunger. Because your body is not absorbing sugar properly, it thinks it needs more creating you to become hungrier than normal.
  • Weight loss. As your body can’t utilize sugar, it turns to muscle and fat for fuel, which can result in significant weight loss.
  • Fatigue. Your body loses access to sugar which has been your main source of energy, therefore, leaving you feeling exhausted.
  • Blurred vision. High blood sugars can cause swelling of your lens and damage blood vessels which can create vision issues.
  • Slow to heal sores. High blood sugar can make your immune system not function as well as normally, causes wounds to heal more slowly.
blurred vision diabetes sign

Blurred vision is a classic symptom of type 2 diabetes. Photo credit: Adobe Stock

Unusual Symptoms of Type 2 Diabetes

While many will have classic symptoms leading up to a type 2 diagnosis, some people have rare and unusual symptoms that occur. Here are some of the less common symptoms to look out for, as being vigilant can help add years to your life.

  • Dark patches of skin. This condition is known as acanthosis nigricans (AN) and seems to occur mostly around the neck area or other areas where there are creases of skin such as the armpit or groin area. It is more common for people with darker skin and is a result of skin cells reproducing too quickly because of the excess of insulin in the blood.
  • Yeast infections and jock itch. High levels of sugar in your blood can cause an overgrowth of yeast in the genital area, resulting in a fungal infection. Other fungal infections such as bladder infections and skin infections can also be indicators of diabetes.
  • Itchy, bumpy, discolored skin. Eruptive xanthomatosis is a condition that can occur in people with poorly-managed blood sugars who have very high triglycerides and high cholesterol. It creates itchy, yellowish-colored bumps on the backs of the appendages and buttocks when blood sugars are elevated for a long period of time.
  • Sexual dysfunction. This is seen mostly among men with type 2 diabetes who frequently have high blood sugars. Elevated blood sugar levels can lead to nerve and blood vessel damage making it harder to achieve an erection. Women can also experience sexual issues related to high blood sugars, including arousal problems and less lubrication.
  • Lightheadedness. We often assume that when we feel this way it must be because we are hungry or fatigued but this can also be a result of diabetes. Dizziness will often be a sign of low blood sugar, but long bouts of high blood sugar will lead to dehydration, affecting sodium and electrolyte levels, resulting in cognitive changes.
  • Lack of sleep. There are quite a  few reasons a looming type 2 diagnosis could cause you issues when it comes to getting sleep. If you have undetected high blood sugars, you are likely to get up a few times to urinate disrupting your rest. Additionally, being obese isn’t only a risk factor for diabetes, it increases your risk of sleep apnea as well. If you notice your sleep patterns are changing, it is important to talk to your doctor.

It isn’t always easy or possible to be attuned to all the changes in your health but being aware of the symptoms, both common and uncommon, can help you to detect any issues if they arise. The good news is that once a proper diagnosis is given, you can take control of your health and normalize your blood sugars which will make many of these symptoms disappear. Acting fast is key to ensuring no long term complications.

If you were diagnosed with type 2 diabetes, what symptoms did you have? And if you haven’t been diagnosed, but have reason to think you may, what symptoms are you experiencing? Share and comment below!

Source: diabetesdaily.com

Debate: Can Technology Eliminate Hypoglycemia? (ADA 2020)

Advances in diabetes technology have brought forth a lot of new and valuable tools to people living with diabetes. From continuous glucose monitors (CGMs), to insulin pumps, to integrated systems that can automatically adjust insulin delivery based on CGM reading to safeguard against hypoglycemia, diabetes tech is rapidly evolving. For all insulin users, low blood glucose is of particular concern; too much insulin on board can quickly result in an emergency situation, if not promptly addressed.

At the American Diabetes Association (ADA) 80th Scientific Sessions, experts debated the following important question:

Can technology alone solve the problem of hypoglycemia in diabetes?

Dr. Richard M Bergenstal, MD from the International Diabetes Center at Park Nicollet argued “for”, while Dr. Emma G. Wilmot, MD from the University Hospitals of Derby and Burton present her case “against” this notion. Here is the synopsis from this exciting debate. Notably, both presenters disclosed numerous relationships with technology companies and pharmaceutical companies.

Yes, Technology Alone Can Solve the Issue of Hypoglycemia

Dr. Bergenstal began by defining four specific “problems” of hypoglycemia:

  1. “Dangerous levels and ripple effects of hypoglycemia”—low blood glucose levels can cause mental turmoil and may prevent patients from striving for optimal glycemia
  2. Defining hypoglycemia
  3. Detecting hypoglycemia
  4. Preventing hypoglycemia

We have been pretty unsuccessful at preventing hypoglycemia; that is, until technology was introduced,” he stated.

Strikingly, the presenter mentioned that after over 20 years of improvements to the average a1C levels, they are now increasing across the board. Dr. Bergenstal attributed this largely to people’s fear of hypoglycemia. He also mentioned a recent paper that indicates that, sadly, we are also experiencing a “resurgence in diabetes-related complications.”

Next, the presenter addressed the importance of consistently defining hypoglycemia. He explained that the official definitions of hypoglycemia (as defined for clinical trials reporting) have been evolving in recent years, now often defined by levels.

Then, the speaker moved forward to discuss that CGM technology was critical to the most thorough detection of hypoglycemia, noting that self-monitoring of blood glucose (SMBG, or finger-sticks) did not present the whole picture of blood glucose trends, making it more likely that low blood glucose could go unnoticed. Moreover, he argued that the accuracy of today’s CGM devices are on par with many blood glucose meters.

As far as the capability of technology in preventing hypoglycemia, Dr. Bergestal presented data from a very large international study showing that CGM use resulted in a tremendous decrease in both hyperglycemia and hypoglycemia, across a large patient population, across the board. He also presented data from several other studies that demonstrated the benefits of CGM technology as related to the incidence of hypoglycemia.

Next, he also addressed the role of “smart insulin pumps” that communicate with CGMs in helping to further reduce hypoglycemia. Strikingly, the results from one study using an “automated basal/hybrid closed loop system (closed loop at all times with meal-time manual assist bolusing)” resulted in a 100% reduction in hypoglycemia. The presenter also showed some case reports that suggested more technology (CGM + Pump vs. CGM + MDI) may yield better glycemic management. Furthermore, he touched upon several other advancements, ranging from faster-acting insulin formulations on the market and in development to smart insulin pens, and their relevance in improving outcomes (see below).

Dr. Bergenstal had this to say in conclusion:

“Technology can address [all four problems of hypoglycemia]… We’re going now from just good clinical care, to really ethics and just morality, I think. This journal of HealthCare Ethics Committee Forum, they looked at and postulated that continuous glucose monitoring is really a matter of justice. I know that sounds a little extreme, but if it can do what I’m showing you it can do, and people are struggling every day, maybe they really do have a right to use this technology… I think we better rely on technology to prevent the highs and the lows of diabetes.”  

No, Technology Alone Cannot Solve the Issue of Hypoglycemia

Dr. Emma Wilmot began by sharing that she loves diabetes technology, and that it plays an important role in reducing hypoglycemia. “However, technology ALONE can solve the problem of hypoglycemia? If only it were that simple,” she stated.

The speaker went on to present data showing that despite CGM use, as many as 25% of users are still experiencing severe hypoglycemia. She argued that “structured education” in diabetes management plays a more central role in reducing hypoglycemia, pointing to numerous research studies showing significantly improved outcomes following a formal diabetes education program.

Moreover, Dr. Wilmot commented on the role of hypoglycemia unawareness, and how reducing the incidence of low blood glucose levels via educational programs, also helped to mitigate hypoglycemia unawareness, in turn likely reducing severe hypoglycemia even more.   In contrast, she stated that there is no research to show that technology use can help to mitigate hypoglycemia unawareness. Furthermore, the presenter discussed several studies that showed “no additional benefit” of technology use (CGM and/or insulin pumps).

Technology is not for all,” Dr. Wilmot noted, citing issues like various technical problems, alarm fatigue, and site skin reactions. Strikingly, according to data from T1 Exchange, “41% had stopped using CGM in the past year.” Similarly, she noted, “30% of youth discontinued the hybrid closed-loop system”. Access and affordability is another paramount issue, she noted.

Rebuttals

While Dr. Bergenstal remarked that he understood and appreciated the role of patient education programs, he noted in his rebuttal, that the glycemic outcomes are not optimal in these patient populations, stating he believes technology can give us better control, reducing both hypo- and hyperglycemia.

Dr. Wilmot concurred that the levels of glycemia currently being achieve are “nowhere near good enough” and also agreed that several established educational programs are now incorporating technology education as well. However, she maintained that technology alone was not the sole solution.

Dr. Bergestal concurred with this, but also stated that technology is “outpacing everything else we’ve thrown at hypoglycemia so far.”

Conclusions

While most will agree that technology use can help to reduce hypoglycemia, whether it can be altogether (or even mostly) overcome with technology use alone remains a point of debate. Undoubtedly, the role of education in diabetes management plays a pivotal role. There is no “set-it-and-forget-it” in diabetes management today, not quite yet, anyway, and certainly not across the board for patients. Perhaps, as smart technology evolves further and becomes more mainstream, it may eventually overtake patient education in importance when it comes to preventing adverse events.

What are your thoughts on this subject?

Source: diabetesdaily.com

Are People with Diabetes Immunocompromised?

What does it mean to be immunocompromised?

Simply put, the term “immunocompromised” means that the person’s immune system is not functioning properly to fight off infections. This could be due to a number of reasons, including underlying health conditions, or specific medications that the person is taking.

For example, patients who are HIV-positive are considered immunocompromised. This is because HIV invades the T cells (a type of white blood cell), which are a major component of our immune system. When functioning normally, T cells help to effectively clear various infections. Because HIV affects the T cells, the immune system of these patients may not respond as effectively, and they may struggle with complications from infections that most healthy people would easily recover from.

Similarly, some classes of medications can directly inhibit immune system responses. For instance, patients who are taking anti-rejection medications following an organ or tissue transplant are considered immunocompromised. This is also the case for patients who take immunosuppressive agents for other reasons, including for the treatment of certain autoimmune conditions and cancers.

Also, because immune system function is underdeveloped in very young children and declining in the very elderly, one may consider that the very young and the very old might be considered immunocompromised to a degree (because the immune system is not functioning quite as efficiently as it does in a healthy adult).

So, what about diabetes? Could diabetes, on its own, affect our immune system function to such a degree that would be considered “immunocompromised”? Are people with diabetes, by definition of just having the condition, immunocompromised?

It is known that high blood glucose levels can negatively affect immune system function, likely doing so through several mechanisms. High blood glucose levels are linked to negative clinical outcomes in the context of infections. The importance of maintaining optimal blood glucose management, and especially during infection and in the hospital setting, has been described in the scientific literature.

It is also well-established that patients with diabetes who achieve the recommended A1c levels have a markedly lowered risk for developing infections or complications from infections as compared to those with higher A1cs. You can read more about the connection between blood glucose levels and health complications here.

One expert commentary published in the Canadian Medical Association Journal explains,

“The evidence indicates that an immunocompromised state occurs only in the context of poor glycemic control with severe complications such as diabetic ketoacidosis or in adults with vasculopathy and peripheral neuropathy.”

There is some debate concerning the pathophysiology of both type 1 and type 2 diabetes as related to aberrant inflammatory responses and what this could mean for responses to certain infections. However, this is a complex and multifactorial topic, of which much remains to be elucidated at this time, and we cannot generalize based on theoretical and/or poorly characterized physiological processes in this patient population.

What is well-established, is that for patients who are able to maintain optimal glycemic management, and in the absence of other factors (such as related complications, a medication that may suppress immune system function), diabetes, on its own, does not make the patient automatically immunocompromised. However, for patients who frequently experience very high blood glucose levels and certain associated complications, immune system function can be negatively affected. This subset of patients might be considered “immunocompromised” due to the frequency and severity of hyperglycemia as compared to those with more optimal glycemic management and/or other complicating factors.

Also, it’s important to remember that when talking about an entire population of people with diabetes, on average, these patients are more likely to be immunocompromised. In addition to (generally) having higher than normal blood glucose levels for a considerable proportion of time, many people with diabetes are more likely to also have other health conditions that may negatively affect their immune system function. One example, in particular for patients with type 2 diabetes, is obesity, which is known to negatively impact immune function.

In summary, to accurately determine whether a patient with diabetes is “immunocompromised”, we must consider their overall health, including other health conditions, the medications that they use, as well as their age and glycemic management. Simply having diabetes does not, on its own, necessarily mean that the patient is immunocompromised, although as a group, this patient population is more likely to have immune system function issues.

Source: diabetesdaily.com

Research Trends with Dr. Maria: Cholesterol Benefits & More

Dr. Maria Muccioli holds degrees in Biochemistry and Molecular and Cell Biology and has over 10 years of research experience in the immunology field. She is currently a professor of biology at Stratford University and a science writer at Diabetes Daily. Dr. Maria has been living well with type 1 diabetes since 2008 and is passionate about diabetes research and outreach.

In this recurring article series, Dr. Maria will present some snapshots of recent diabetes research, and especially interesting studies than may fly under the mainstream media radar. Check out our first-ever installment of “Research Trends with Dr. Maria”!

***

Allergen in Diabetes Tech Adhesives

Diabetes technologies, like insulin pumps and continuous glucose monitors, are steadily gaining popularity, especially among patients with type 1 diabetes. While the technological advances have shown considerable benefit in improving patient outcomes and quality of life, one common issue is the unfavorable reactions to adhesives. A recent study published in Diabetes Technology & Therapeutics identified that a common culprit of these allergic reactions to adhesives may be a chemical called colophonium, a commonly-used adhesive, which was shown to be an allergen in over 40% of patients in the small study. Read more about the study and the use of this adhesive in medical products here.

Bariatric Surgery May Worsen Retinopathy

Retinopathy (eye disease) is a common complication of diabetes, and can be serious, leading to severe visual impairment and even blindness, especially when left untreated. A recent study published in Acta Ophthalmologica has uncovered a potential link between patients who undergo weight loss surgery and worsening retinopathy. Researchers adjusted for confounding variables, including glycemic control (A1c) and found that those who underwent bariatric surgery experienced worse retinopathy outcomes. Although the sample size was small, the data showed a significant worsening of eye disease in those who underwent surgery as compared to controls. Learn more about the study and outcomes here.

Super Healthy Probiotic Fermented Food Sources

Photo credit: Adobe Stock

Benefits of Probiotics for Type 2 Diabetes

The relevance of the gut microbiome in various health conditions, including diabetes, is gaining more and more attention. A recently published meta-analysis in The Journal of Translational Medicine discusses what we currently know about the effects of probiotic supplementation in patients with type 2 diabetes. Excitingly, probiotics can improve insulin resistance and even lower A1c! Learn more about exactly what the clinical trials have shown here.

Herbal Therapies Gaining Attention

With most modern medicines derived from plant compounds, it is not surprising that more research is being geared toward examining the effects of various herbal remedies on blood glucose levels and insulin sensitivity. A recent review published in The World Journal of Current Medical and Pharmaceutical Research summarizes the effects of some medicinal plants with potential anti-diabetic properties. Learn more about what is known about commons herbs and how they may be beneficial for glycemic control here.

Low HDL Cholesterol Linked to Beta Cell Decline

Research has previously suggested that higher HDL cholesterol levels may be protective of beta-cell function. A longitudinal study recently published in Diabetes Metabolism Research and Reviews indicated that patients with lower levels of HDL cholesterol were more likely to experience beta cell deterioration and develop type 2 diabetes than those with higher HDL cholesterol levels. Learn more about this study here.

***

Please share your thoughts with us and stay tuned for more recent research updates!

Source: diabetesdaily.com

Joslin Diabetes Center: A Global Leader in Research and Care

Learn about the mission and diabetes advocacy efforts of the Joslin Diabetes Center. Check out this summary to learn more about who they are, what they do, and more.
Source: diabetesdaily.com

Low-Carb Legend Dr. Bernstein Explains Why Normal Blood Sugar Is Critical

Dr. Richard K. Bernstein has lived with type 1 diabetes since age 11. At nearly 85 years old he remains busy treating people with diabetes, which he has done since 1983. Did you know Dr. Bernstein invented blood sugar self-monitoring and the use of a basal-bolus insulin dosing? Dr. Bernstein not only lives with and […]
Source: diabetesdaily.com

A Dose of Dr. E: Evidence-Based Hope

This content originally appeared on TCOYD: Taking Control of Your Diabetes. Republished with permission.Some people may feel doomed about having diabetes. In fact, a feeling of hopelessness is not uncommon when it comes to experiencing  diabetes distress. What can be done to help? Check out this short video by Dr. Steve Edelman.
Source: diabetesdaily.com

National Kidney Month

March is National Kidney Month. The kidneys serve an important role in filtering and balancing fluids in our bodies. Over time, high blood sugar can cause damage to this system. Although many of us are acutely aware of the link between diabetes and kidney issues such as nephropathy and Chronic Kidney Disease (CKD), there is […]
Source: diabetesdaily.com

Search

+