Diabetes Daily Joins Everyday Health to Expand Our Reach

On behalf of the Diabetes Daily team, I am excited to share that we are joining the Everyday Health family of websites!

Since 2005, our mission at Diabetes Daily has been to help people with diabetes live healthy, happy, and hope-filled lives. Going forward, we will have far more resources to continue serving our community and helping people thrive.

So what is going to change?

Diabetes Daily will continue to serve our community as an independent website. Our blog, social channels, forum, and newsletter will stay the same. Our core team of contributors will remain in place. I continue to lead the team as the Executive Editor, Ross Wollen as our Senior Writer, and Julie De Vos as our Community Manager. All three of us have diabetes: we live and breathe the condition. We will continue to connect with other great writers, partners, experts and influencers in the field, and do whatever we can to serve this community.

Everyday Health is investing in Diabetes Daily because they love the quality of our content and, even more importantly, they respect the vibrancy of our community of readers: you. There are no plans to radically change our mission or our style. In fact, they are investing more resources into our team, our technology, and our future!

This website will be in great company. Everyday Health Group is already home to many of the world’s most trusted health websites. If you’ve visited EverydayHealth.com, BabyCenter.com, MedPageToday.com or WhatToExpect.com, you have already experienced their outstanding work.

Thanks to you, Diabetes Daily has grown since 2005 and now supports nearly 1 million members across our site, community and social platforms — and this is only the beginning.  Joining the growing Everyday Health family will expand our reach, improve our technology, and help us dramatically advance our mission of helping everyone affected by diabetes.

You can read more on the official announcement.

Source: diabetesdaily.com

We Asked an Immunologist Your Questions About COVID-19 Vaccine Safety

This content originally appeared on Beyond Type 1. Republished with permission.

By Lala Jackson

August 2021 is starting to feel like March 2020 – the COVID-19 delta and other emerging variants are more dangerous than the original virus, but what does that mean? Cases are rising rapidly, are we safe? Do we need to wear masks or not? Vaccines work, but do they for everyone?

To get some clarity, we spoke with Bernard Khor, MD, PhD, of the Benaroya Research Institute at Virginia Mason in Seattle, Washington. Dr. Khor’s laboratory is trying to find new ways to treat autoimmune diseases, specifically for people living with Down Syndrome as they are more likely to develop autoimmune diseases like type 1 diabetes. Because he spends so much time researching immune responses, we published his interview on whether type 1 diabetes means a person is immunocompromised and wanted to talk with him more about COVID-19 vaccine safety for people with type 1 diabetes.

Beyond Type 1: Are people with type 1 diabetes more likely to get COVID-19?

Dr. Khor: People who have autoimmune diseases aren’t necessarily immunocompromised; instead we can think of it as having a dysregulated immune system. That’s what causes the immune system to attack its own body. It does not necessarily mean that they don’t respond appropriately against infections.

What we do know is that, if they catch it, people with type 1 diabetes are more susceptible to worse outcomes from COVID. If it were my child or loved one living with type 1 diabetes, I would do everything I could to mitigate that risk.

What about the delta variant? How did we get here?

The delta variant and other variants we’re seeing start to develop are worse for everyone. These mutations happen because the virus has had time to persist and improve itself. If we were able to completely contain it, if everyone got the vaccines right now, we could stop this pattern by giving it nowhere to hide. But if the coronavirus is hiding in 30 to 40 percent of the population, it will come back and come back worse again and again. It’s just a matter of time.

That’s the thing about a virus – it’s not a one time threat. It’s an ongoing, adaptable threat. It’s a virus that mutates. It’s trying to survive. It can change and adapt to circumstances. There’s another variant coming out from Peru that’s getting more powerful – it’s affecting younger people, it’s leading to more rapid hospitalization, it’s a worse disease.

I cannot overstate how much COVID-19 needs to be respected. The writing on the wall was very clear from the beginning. We have seen outbreaks of diseases before and we have seen pandemics before. They are all agents that need to be respected immensely.

Other forms of coronavirus – SARS, MERS – were incredibly bad. In both cases we basically escaped worse outcomes because we got lucky; transmission rates of those viruses weren’t as high as COVID. Now we have COVID. We started off unlucky, and if we don’t respect it, it will get worse. It can cause death, it can cause disability, it can cause horrible outcomes. We’ve seen nursing homes decimated, it’s devastating.

We as scientists can make the best thing we possibly can, but it doesn’t matter if no one uses it. I see this as our generation’s World War event. We’re lucky that many of us are inside, that we have Netflix and ways to work from home. But the societal impact is every bit as serious.

Are people with type 1 diabetes more likely to have a particularly bad reaction to the vaccine?

All the data points to no. You’ll rarely hear a scientist say never—1 in millions is not never—but all the studies to date say no, and we can have confidence in that because there’s been a lot of post-marketing assessment of these vaccines. We have a lot of people who have taken the vaccines already worldwide to see how it’s working.

And that’s what we look at—the remarkably low rate of adverse reactions that are reported and tracked, versus the highly measurable rates of severe illness or death, or of long-term disability from long haul COVID.

What about the fear that vaccines in general can lead to new or more autoimmune issues? Can you explain the risk?

It’s a terrible thing to come down or have your child come down with a severe life-long illness. Type 1 diabetes is so diabolically difficult, and it’ll be different for different people. It’s a slog. So of course we want to know why it happens. Especially when you’re trying to find that important of an answer, our minds are programmed to look for patterns, but when you look from a single case, you’re only able to make the pattern from the single situation. Huge studies have uniformly debunked the idea that vaccinations commonly cause autoimmune issues.

That’s the benefit of our system – it’s very transparent. When there are adverse effects, we know about them. There are rare occurrences that have been seen; an example was a batch of flu vaccines in the 1970s, where several people came down with a rare autoimmune disorder called Guillain-Barré syndrome (GBS). Even in that instance, the risk of getting GBS was ten times less than the risk of death from flu. The cost benefit ratio is not even close.

Editor’s Note: There have been 100 reports of GBS among people who received the Johnson & Johnson vaccine, from approximately 12.5 million doses administered. Each year in the United States, an estimated 3,000 to 6,000 people develop GBS. Most people fully recover from the disorder. Whenever health issues like these do arise from vaccines, the FDA requires revisions to the information provided to vaccine recipients and healthcare providers so that they know about potential risks. No similar pattern has been identified with the Moderna and Pfizer-BioNTech COVID-19 vaccines.

How can we trust vaccines that only have emergency use authorization (EUA) And are not fully approved?

Editor’s Note: Since this interview was published on August 10, 2021, the FDA has granted the Pfizer and BioNTech COVID-19 vaccine full approval for ages 16 and up, with the EUA still in effect for ages 12-15 and booster doses for immunocompromised individuals. 

I think it’s incredible that we have a vaccine ready as quickly as we did – that has been due to immense collaborative work from the entire global scientific community. That work happened because of the immense threat and impact of COVID-19.

In this case, scientists worked hard, building upon decades of existing research to make this thing work. In a sense, we also got lucky. We are so fortunate that these vaccines work as well as they do. We built this nice big shiny thing, now we have to walk on in. Because scientists can build the best possible solution and it means nothing if people don’t use it.

Lack of full approval—which we know is coming soon—is due to the fact that the FDA has a rigid and bureaucratic approval process. It’s not wrong. But it makes it very slow even once the medicine and science has been proven, as is the case with the COVID-19 vaccines we offer in the US.

But no corners have been cut—the data has been reviewed, the process has been transparent. Everyone understands the need for post-marketing surveillance, ongoing data from the vaccines as they are administered. No expense has been spared for that.

How do we know that people who take the COVID-19 vaccine won’t face health issues from it in twenty years?

I cannot think of a scientific mechanism to be worried about that. I do know that COVID is here and is a very real risk, right now. We fear the unknown; the fear of the known has become hard to remind people of. After more than a year, we’ve gotten used to the bear that’s in the house. We can get worried about how we’re dealing with the bear, or we can go ahead and get the bear out of the house.

We heard discussion a few weeks ago about the psychology of choosing to take the COVID-19 vaccine; that to humans, it’s scarier to face making a choice and something bad happening, like taking the vaccine and getting sick from it, and less scary if something bad happens to you passively, like getting COVID-19 when you are going about your daily life trying to be careful. It feels like less responsibility. What are your thoughts on this?

Choosing not to do something is as much a choice as doing something. It’s about the risk of not doing it, not taking the vaccine.

You can always be nervous about some infinitesimal risk of doing something, but there’s a true risk of not doing something in this particular case. And the risk is not just what might happen to you if you get COVID, it’s the risk of all the people you might pass COVID to, including grandparents and children.

Because it’s not a question of if you will be exposed to COVID-19, it’s a question of when.

Source: diabetesdaily.com

Remission, Not Reversal: Experts Agree to Define Ultimate Type 2 Diabetes Success

Type 2 diabetes can be considered “in remission” if patients can maintain non-diabetic blood glucose levels (<6.5% A1c) for 3 months without medication, according to an international panel of experts.

On August 30, the American Diabetes Association joined the Endocrine Society, the European Association for the Study of Diabetes, and Diabetes UK in co-authoring a consensus statement on “the definition and interpretation of remission in type 2 diabetes.” Here’s a press release, and here’s the full statement.

Remission is Becoming More Common

Type 2 diabetes remission has always been rare – a 2014 survey concluded that fewer than 2% of adults with diabetes experienced any level of remission without bariatric surgery – but in recent years, it has become more common.

The increasing prevalence of diabetes reversal owes partially to the rise in bariatric surgery, but is also likely due to the proliferation of new weight loss and diabetes management techniques. Although diabetes rates continue to rise unabated throughout the world, experience and understanding of the disease have led to superior treatment strategies, allowing a minority of patients to return their blood glucose levels to non-diabetic levels.

Now there are even companies, such as Virta Health, that have based their entire business strategy on the belief that diabetes “reversal” is within the reach of millions of adults with the condition.

With so much attention paid to diabetes remission, the world’s major diabetes authorities decided that the phenomenon of diabetes remission or reversal needed to be properly addressed, named, and described. The consensus statement should help guide study of the phenomenon, and give doctors and patients a framework for understanding just what remission really means.

What’s in a Name?

The experts seem to have given very careful consideration to what word doctors should use to refer to the achievement of regaining non-diabetic blood sugar levels. Many in the diabetes world use words like “reverse” or “correct” or even “cure” to refer to this phenomenon, each of which has its own implications. To speak of a “cure,” for example, is to imply that the disease has left and will never return; in the case of a patient that needs to keep up with dramatic lifestyle adjustments to keep their blood sugar at non-diabetic levels, this is a plainly inaccurate label. “Reversal” and “resolved” likewise suggest similar shades of meaning.

The panel decided,

that diabetes remission is the most appropriate term. It strikes an appropriate balance, noting that diabetes may not always be active and progressive yet implying that a notable improvement may not be permanent.

The term also accounts for the fact that while patients with diabetes may have achieved normal glycemic levels, they may still suffer from insulin resistance and/or deficiency, factors that may mean that they need to continue keeping a careful watch on their blood sugar management.

An earlier statement from the American Diabetes Association on type 2 remission categorized patients into different types of remission – partial, complete, and prolonged. These categories have been discarded as unhelpful.

Diagnosing Remission

Type 2 diabetes remission is now defined “as a return of HbA1c  to < 6.5% (<48 mmol/mol) that occurs spontaneously or following an intervention and that persists for at least 3 months” without the use of insulin or glucose-lowering medications. (The statement also allows for some other manners of diagnosing remission, such as using fasting blood glucose, in cases where HbA1c may be unreliable.)

The 3- month time parameter helps weed out both fluke A1c results and the lingering effect of medication, which can last for months after it’s been discontinued. Lifestyle interventions (changes to diet and exercise) and surgery (especially gastric bypass) can precipitate diabetes remission.

At the moment, the experts advise that patients in remission should have their A1c, as well as any potential diabetic complications, checked annually.

By definition, patients with type 1 diabetes cannot achieve remission (except under perhaps under unique and extraordinary circumstances), given their lifelong reliance on exogenous insulin

How to Achieve Remission

The most reliable way of creating type 2 diabetes remission is through bariatric surgery: nearly half of the patients in a Swedish cohort experienced lasting remission.

Bariatric surgery, however, is a very intense and expensive operation, and it comes with its own risks and complications; most patients with type 2 diabetes will not be considered good candidates. For the rest, weight loss, however it may be achieved, appears to be the best path to remission. Experts additionally debate the efficacy of specialized eating patterns, such as low-carbohydrate diets and therapeutic fasting.

Remission may not be a realistic goal for everyone, and researchers don’t yet have a solid understanding of why some patients are better able to reset their metabolic health than others.

We have an entire article on diabetes remission – originally published using terminology that is now officially out of step with mainstream practice: What You Need to Know About Reversing Type 2 Diabetes.

Going Forward

There’s an awful lot we still don’t know about remission. To date, diabetes remission has not attracted much attention from researchers, possibly because it was considered such a rarity. But with that changing, the diabetes authorities behind the consensus statement recognized a need to guide the questions of researchers.

The statement includes a laundry list of areas where future study is required, including:

  • How often patients in remission need to be re-evaluated
  • Whether or not patients in remission could still benefit from metformin and other drugs
  • Whether other metabolic parameters (such as cholesterol levels) need to be monitored
  • How long remission can be expected to last
  • What impact remission has on longterm health outcomes

Having finally named and described the phenomenon, the panel hopes to spur research into the reality of the condition so that it may be better understood.

 

Source: diabetesdaily.com

Back to School with Diabetes Amidst the COVID-19 Variants

This content originally appeared on Beyond Type 1. Republished with permission.

By Lala Jackson

This article was published on August 13, 2021. As of Monday, August 23, the FDA has granted the Pfizer and BioNTech COVID-19 vaccine full approval for ages 16 and up, with the Emergency Use Authorization (EUA) still in effect for ages 12-15 and for booster doses for immunocompromised individuals. Full approval for other COVID-19 vaccines currently under EUA is expected soon.

While hopes were high that we could head back to school for the 2021 school year as though we were closer to “normal,” the development of COVID-19 variants amidst low vaccination rates has thrown a wrench in plans. But when kids need to get back to in-person schooling for quality of life, quality of learning, and socialization, how can we best keep them safe?

To help answer this and other questions about going back to school safely, JDRF—in collaboration with American Diabetes Association and Sansum Diabetes Research Institute—hosted a conversation with doctors and experts from the CDC, ADA, and the Fairfax County Health Department (Virginia).

Moderator Dr. Kristin Castorino, senior research physician at Sansum Diabetes Research Institute, kicked off the event with the most pressing question—is it even safe for students and their teachers who have diabetes to return to in person schooling, particularly for those under 12 who cannot be vaccinated yet?

“I’d change the question from ‘is it safe?’ to ‘is it appropriate?’ and I think it is,” answered Dr. Fran Kaufman, pediatric endocrinologist and chief medical officer at Senseonics. “There aren’t known answers as things change… but we need to get our kids back to school, not only for learning but for socialization.”

Dr. Kaufman stressed that the best way to make school safe is for everyone who can get vaccinated to do so. Dr. Christa-Marie Singleton, MD, MPH, senior medical advisor at the CDC later elaborated, “Vaccines protect folks against serious symptoms, hospitalization, and death. The best way to protect ourselves, our families, and our youngest people is for the adults and kids over the age of 12 around them to get vaccinated.”

“We also know about the importance of masking,” continued Dr. Kaufman. “It’s important to follow the CDC’s recommendation that all children and adults should be masked in the indoor school environment.”

What About the Legal Rights of Kids With Diabetes?

Particularly as some states ban school districts from being able to require masks in indoor learning environments, what legal protections do kids with diabetes have to stay safe in school? Crystal Woodward, MPS, director of the ADA’s Safe at School campaign, stressed “the rights of students with diabetes do not go away during a pandemic. They have legal protections under federal and state laws. Those accommodations may look a little different, but they do not go away.”

Similarly to how the Americans with Disabilities Act protects people with diabetes in the workplace, section 504 of The Rehabilitation Act protects the education of children with disabilities like diabetes. This law allows children with diabetes and their families to create what are known as 504 plans, which clearly outline agreed upon accommodations for students with disabilities at school.

While parents cannot dictate the actions of other students, they can include directives for their own children to stay safer from COVID-19 in 504 Plans, like instructions that their student must always wear a mask or will need extra physical distance in a classroom setting.

“It’s imperative that [children with diabetes] have a section 504 plan,” Crystal explained. “Everyone needs to be clear on what accommodations will be provided and by whom, like the student having the ability to take an exam at an alternate time if blood glucose levels are out of range during the scheduled test time.” Ensuring the student also knows what is in their own 504 plan can help them feel more empowered and comfortable asking for what they need.

For distance learning, 504 plans can dictate that children with diabetes can take snack or meal breaks at times best for the student, or have an agreed upon communication method with the teacher if the student needs to take a break to attend to a low or high blood sugar.

“Bottom line: the rights of students do not go away,” Crystal reiterated. “Students with diabetes and their families should work with schools and everyone needs to understand their role and responsibilities, and the plan should be updated as needed. It’s always better to get it in writing. Put the 504 plan in place while everything is going well—you never know if a principal or a nurse or a teacher is going to be there throughout the year.” Panel members stressed that families who don’t speak English, particularly in public schools, have a legal right to translators who can help establish 504 plans.

Jacqueline McManemin, RN, BSN, certified diabetes education and care specialist (CDECS) and assistant nurse manager for the health services division of Fairfax County Health Department in Virginia, spoke about what they’re continuing to do in their school district (one of the 15 largest in the nation) to keep students safe. “Parents should expect to see much of the same precautions this year that were in place last year. Particularly when students are inside, they should be masked.”

School administrators across the country can work to make schools more safe for all children, particularly those with chronic illnesses like asthma and diabetes, by putting in protective measures like establishing two different health clinics—one for people exhibiting symptoms of COVID-19 or other communicable illnesses and a separate clinic for routine care and injury treatment.  Meals can be eaten outside as weather permits and student interaction in hallways can be minimized by teachers rotating between classrooms rather than groups of students switching classrooms every period. Protocol also needs to be clearly communicated with all staff and parents about what to do if a student starts showing symptoms of COVID-19 while at school.

Getting Kids Mentally Ready for in-Person School

Back to school doesn’t just mean a change of location, it’s a change in schedules, types of interaction and stimulation, and levels of distraction that can also impact diabetes care. Psychologist Cynthia E. Muñoz, PhD, MPH, assistant professor of clinical pediatrics at the University of Southern California’s Keck School of Medicine and president of healthcare and education for the American Diabetes Association, reminded the community that the impact of the pandemic on each individual has been unique and therefore approaches to regain a sense of normalcy must be unique too.

“For parents and guardians, be aware of how you’ve been impacted. Seek support, through family, through primary care, through a therapist. Find ways to talk about your fears or concerns,” encouraged Dr. Muñoz. She went on to suggest ways to get kids mentally and physically ready for school again.

“Now that schools are starting to open, it’s time to start looking at sleep schedules, screen time, and start shifting routines and schedules to get children ready for the new routine,” she noted. “Many people watch a lot of content on social media or television—not just kids, everyone—but it’s a passive interaction with others. Shifting to a more active form of communication with others can be another way to help people ease into the change of a lot more interaction than people have had in the last year or so.”

Helping Kids Who Feel Singled Out

Kids with diabetes often deal with feelings of being the odd kid out, having to visit the school nurse, having to deal with special routines. When COVID-19 is added, kids with diabetes may feel like they’re the only ones taking special precautions, which can be additionally isolating. How can parents help children dealing with these feelings?

“I like to approach this question around the concept of support, building layers of support around the student,” Dr. Muñoz explained. “One level should be ensuring that someone at the school should know that the child has diabetes and knows what kind of support they need. Another category is who could know [the student has diabetes], but doesn’t necessarily have to, like friends. For the student with diabetes, getting support from a friend or classmate they trust could go a long way. If the student feels like they’re going to be the only one wearing a mask, they can ask a friend to wear it with them.”

“I think it’s important for adults to be sensitive to this,” Dr. Muñoz continued. “Saying “everyone has something different” might minimize how a student feels. Acknowledging their feelings and taking the time to ask them what will help goes a long way.”

To get advice from other parents and guardians or to help your student with diabetes find other kids who understand, be sure to join the Beyond Type 1 community.

Learn more about the JDRF – Beyond Type 1 Alliance here.

You Can Watch the Entire Conversation Here:

Source: diabetesdaily.com

Here’s Why the CDC Updated their Mask Recommendations (Again)

This content originally appeared on Beyond Type 1. Republished with permission.

By Lala Jackson

On Tuesday, July 26, 2021, the Centers for Disease Control (CDC) in the United States issued new masking recommendations amidst increased rates and much more dangerous variants of COVID-19 in the US. There are two big and related reasons why:

  1. Masks are the most effective way to slow the spread of COVID-19, no matter your vaccination status. This is particularly important in places with high transmission rates; you can check your county’s rate here.
  2. We are in a fourth surge of COVID-19 in the United States, with hospitalization rates surging to higher than when the pandemic began. This is due to the more contagious and more dangerous delta variant of COVID-19.

Who Needs to Be Wearing a Mask and When?

Everyone, particularly when you’re in indoor public spaces (because you’re breathing in other people’s air, and they’re breathing in yours).

If you’re vaccinated, this is primarily to do your part to protect others. Breakthrough cases, (where a vaccinated person gets the COVID-19 disease) are rare, but vaccinated people can still carry the coronavirus to others without having any symptoms. Luckily, vaccinations still make a massive difference – people who are vaccinated are less likely to carry coronavirus and are extremely unlikely to experience any severe symptoms from the disease.

If you’re not vaccinated, this is to protect yourself and others, as you can carry high levels of COVID-19 to others even if you don’t get sick yourself. However, even if you’re an otherwise healthy person, it’s important to keep in mind just how much more dangerous the new variants of COVID-19 are.

These variants will continue to develop rapidly until almost everyone is vaccinated—because they have so many hosts in which to thrive—and they are more contagious than the original COVID-19 variant. This is due to how viruses mutate (all viruses do this; it’s why we have new flu vaccines every year to address new variants of the flu). And because so many people are still unvaccinated, the virus has lots of places to thrive and change, making it more contagious and more dangerous.

Why Do Vaccinated People Need to Wear a Mask in Indoor Public Spaces?

The delta variant can live in small amounts in people who are vaccinated, so even with no symptoms of COVID-19 ourselves, vaccinated folks can still pass the virus to other people.

This is particularly dangerous for the elderly or ill who have already been vaccinated but cannot afford to take on the high viral load of the delta variant and for children who are not yet eligible to be vaccinated.

To combat high transmission rates, several cities have already instituted mask mandates again, like Washington, D.C., Savannah, GA, and St. Louis, MO.

What Can We Do to Protect Ourselves and Others From the New Variants?

Getting vaccinated against COVID-19 and continuing to wear masks in indoor public spaces are the most impactful things we can each do to protect ourselves and others. Doing so right now matters, as we do not want to give the novel coronavirus more time to continue mutating beyond what we know how to prevent and treat. We have the tools to stop the current COVID-19 variations but they mean nothing unless we all use them now.

What if I’m Too Healthy to Get COVID-19?

Particularly if you have diabetes, you pay so much attention to your health, and you already do so much to make sure your system is healthy and strong. But think about this – hospitals are getting overwhelmed by COVID patients again, which means they cannot provide care for anyone else who needs it. Check out this statement from the Chief Medical Officer of Our Lady of the Lake Hospital in Louisiana.

Even if you don’t get COVID-19, can you absolutely guarantee that you won’t have a diabetes issue that needs medical help? That you won’t get in an accident where you need the emergency room? What if you just get the normal flu and you need IV-fluids, but there aren’t enough medical professionals to help you because they’re all dealing with COVID patients?

COVID-19 is a disruptor to our entire medical system. Protecting yourselves and others against it by getting the vaccine is the best way to ensure that you and your loved ones will be able to get the care they need, when they need it.

When Will This End?

When the vast majority of people are vaccinated against COVID-19, giving the virus no more places to hide and mutate into stronger and more dangerous versions.

Do your part. Get vaccinated. If you’re hesitant about them or want to learn more about their safety, read this piece clarifying a few myths about the vaccines, or this piece explaining how mRNA vaccines work.

For more information on the COVID-19 vaccines for kids, read this.

Source: diabetesdaily.com

Diabetes Community Survey Shows Drug Costs Still Ranks Highest Access Concern

This content originally appeared on Beyond Type 1. Republished with permission.

By Beyond Type 1 Team

In early 2021, Beyond Type 1’s advocacy division surveyed almost two thousand people living with or caring for someone with diabetes to determine key healthcare access issues faced by members of the Beyond Type 1 community throughout 2020. While other surveys on access have been conducted within the diabetes community, it was important to Beyond Type 1 to hear directly from the community they serve on issues faced, both throughout the COVID-19 pandemic and generally.

The survey follows ongoing advocacy work from Beyond Type 1 addressing the rising cost of insulin and other healthcare access issues such as implicit bias and equitable technology access, Medicare and Medicaid access, drug pricing and rebate reform, and more.

The survey ran in English and Spanish, was anonymous, and included survey respondents both within and outside of the United States. The survey was run independently by Beyond Type 1 and specific methodology can be found at the bottom of this article.

Key Learnings

Access + Cost

A majority of respondents (56%) ranked access to affordable insulin and diabetes drugs as their most important access issue. This aligns with data reported from studies such as the 2018 Yale report showing that one in four insulin-dependent people ration insulin due to cost, while also nodding toward the high cost of other diabetes medications like SGLT2 inhibitors and GLP-1 receptor agonists.

Almost half of respondents (40%) ranked access to diabetes supplies as the second most important access issue (8.5% of respondents ranked access to supplies as their most important access issue), while nearly the same amount of respondents (36%) ranked access to affordable healthcare coverage as their third most important access issue. Just 6% of respondents ranked access to new therapies that cure, treat, or prevent diabetes as their top access issue (75% of respondents ranked it as their least important access issue).

Health Insurance

In the United States, 66.4% of respondents indicated they used employer-based health insurance to access healthcare in 2020. This is slightly higher than the 2019 U.S. population health insurance coverage data provided by the Current Population Survey Annual and Social Economic Supplement (CPS ASEC) and the American Community Survey (ACS), which calculated 55.4%.

Of the remaining third of respondents:

  • 8.1% received 2020 health coverage through Medicaid
  • 7.7% through Healthcare.gov / State Marketplace
  • 5.8% through Medicare
  • 5% reported no insurance coverage in 2020,
  • and 4.6% indicated ‘other’, which could include either a combination of coverage options, catastrophic care plans, COBRA, and/or other temporary plans

While two-thirds of respondents reporting employer-based health insurance could be seen as a positive—that access to healthcare is the norm rather than the exception—40.4% of respondents indicated they incur a deductible of more than $1500 per person for their insurance coverage. This indicates that over a third of respondents are covered by High-Deductible Healthcare Plans (HDHPs), a rising trend across American healthcare that, for those with chronic health needs, creates excessive financial burden.

HDHPs create a scenario in which a person often must pay full price for medications or supplies until the healthcare plan’s deductible is met, creating a significant out-of-pocket cost at the start of every calendar year. For people living with chronic conditions such as diabetes, this economic burden can create avoidance of healthcare treatment, unaffordability of life-essential medications, and inability to purchase or utilize supplies needed.

Out of Pocket Costs

Survey respondents reported excessive out of pocket expenses not only for medications, but for diabetes supplies (such as insulin pump or glucose monitoring supplies).

  • 55% of respondents stated they have paid more than $100 out-of-pocket in any month for any diabetes medication
  • 64% of respondents paid more than $100 out-of-pocket in any month for diabetes supplies

Global Issues

While the American healthcare system often creates an undue financial burden for people living with diabetes, access abroad remains a major issue as well.

  • 55% of respondents could not get supplies
  • 18.3% of respondents had run out of medications or rationed due to cost
  • 23% of respondents made a decision between bills and diabetes supplies

The Impact of COVID-19

Of course, the COVID-19 pandemic exacerbated healthcare issues across the globe. For those living with diabetes or caring for individuals with diabetes,

  • 30.7% of respondents did not see a healthcare professional or have lab work completed in 2020 due to fear of contracting COVID-19
  • 38.4% of respondents experienced mental health issues related to the COVID-19 pandemic
  • 7.8% of respondents experienced employment discrimination due to COVID-19 in relation to diabetes during 2020

The Bottom Line

Living with diabetes creates a major financial burden for many—the added medical cost of living with diabetes in the United States has been estimated at an average of $9,071 annually per individual—and the financial decisions that many are forced into making create short- and long-term consequences. Among survey respondents:

  • 21.6% ran out of medications or rationed due to cost
  • 15.0% skipped specialist visits or other healthcare to pay for diabetes care or supplies
  • 16.8% did not see a medical professional due to cost
  • 14.1% “borrowed” insulin or other diabetes supplies because of cost
  • 20.1% utilized a copay card for any diabetes medication
  • 22.8% made a decision between bills and diabetes supplies

These survey responses will continue to shape ongoing work being done by Beyond Type 1 ensuring everyone impacted by diabetes — type 1, type 2, and beyond — has a right to the best care possible for their unique situation. To learn more about Beyond Type 1’s advocacy work and to lend your voice to legislative actions, click here.

Details on Methodology

The Beyond Type 1 Diabetes Experiences Survey was created on Formsite, a secure platform for processing and hosting sensitive survey data in both English and Spanish versions. Both versions were identical in ranking questions, response offers, and language. The survey was logic mapped to offer additional questions for those who identified as individuals living outside the United States.

Questions were created by employees of Beyond Type 1 living with diabetes, with careful attention paid to plain, inclusive language in demographic self-identification inquiries.

The Beyond Type 1 Diabetes Experiences Survey was shared online through different avenues from mid-January to mid-February in English and mid-January to mid-March in Spanish through the Beyond Type 1 website (English and Spanish), the Beyond Type 2 website (English and Spanish), a targeted email from Beyond Type 1, and both organic and paid posts on Twitter, Facebook, and Instagram. There was no paper version available to print out; it was online responses only.

Respondents self-identified as people living with diabetes or caring for an individual living with diabetes.

The survey was completely voluntary; no one was paid to provide responses. All responses were mandatory for a survey to be deemed complete. If an individual did not click submit at the bottom of the survey, no results were recorded. A statement before the beginning explained that the survey results were anonymized, and only aggregate data and key learnings would be shared publicly.

1924 individuals fully completed the survey, with 1850 identifying as living in the United States.

Noted Limitations

The sample size of 1924 individuals is a small section of the global diabetes population, although larger than many similar surveys in the space. Additionally, respondents cannot be assumed as indicative of all people living with diabetes – 93% of respondents lived with or were caretakers of someone with type 1 diabetes, 91% lived in the United States, 85% were white, and 83% were female. Just 3.2% were 65+. All respondents had access to the internet and were either already following or in some way connected to Beyond Type 1 channels.

Source: diabetesdaily.com

Debate at the ADA: Should Athletes with Diabetes Go Low-Carb, or High-Carb?

By Maria Muccioli and Ross Wollen

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Do you need carbohydrates to optimize athletic performance? Or can athletes with diabetes do even better when they fuel their bodies with protein and fat?

By now it’s clear that the low-carb approach to diabetes has largely gained clinical acceptance, for people with both type 2 and type 1 diabetes (T1D). But some questions remain about when carbohydrate restriction is and isn’t appropriate.

One of those big questions: athletics. It’s long been conventional wisdom that athletes – whether elite professionals or weekend warriors – absolutely need carbs to fuel performance. But when you’ve got diabetes, “carb loading” the night before a big race is a tricky proposition.

At this year’s ADA Scientific Sessions, two experts went head-to-head in a debate on “Carbohydrate Intake and Its Impact on Athletics and Health.”

Read on to hear what happened – and who, in our opinion, won the debate.

The Case for a High-Carb Diet

In his presentation titled “High/Normal Carbohydrate Intake Optimizes Performance and Glycemia,” James P. Morton, PhD argued in favor of a normal-to-high carbohydrate approach for athletic performance and blood glucose management. Morton is a professor of exercise metabolism at Liverpool John Moores University.

Morton focused his talk on the importance of fueling high-energy expenditure for elite athletes, such as those on multi-week bicycle races. He presented some data showing that people who consumed a high-carb load were able to exercise for longer periods of time than those who consumed a placebo solution. Morton pointed out that for professionals, even tiny differences can make the difference between victory and defeat.

As an example, Morton presented a case study of Tour de France winner Chris Froome. In 2018, Froome made a very dramatic comeback on the 19th day of a multi-week cycling race. He ate an incredible amount of carbohydrates that day and the day previous, which Morton believes contributed significantly to his victory.

How do carbs fuel performance? The primary explanation centers around the availability of glycogen (branched glucose molecules) in the liver and muscle. The higher the glycogen levels, the more glucose is readily available to power activity.  Morton also presented evidence that those who eat high-carb delay the point at which they begin burning fat for energy, and claimed that delaying this crossover point was important for top performance in endurance athletes.

In addition, Morton cited personal testimonies from some elite endurance athletes, such as audio of interviews from his podcast, claiming that support of high-carb for athletic performance is “unanimous.”

Unfortunately, little of this presentation had much to do with the unique challenges of athletes with diabetes. And for that matter, its focus on truly elite professionals may be of limited relevance to even the most avid part-time athletes. Morton has never worked directly with athletes with type 1 diabetes, but referred to the opinions of his “friend and colleague” Sam Scott, PhD, a researcher at Novo Nordisk. Scott has plenty of firsthand experience with high-performing diabetic athletes: he works with Novo Nordisk’s inspiring all-diabetes pro cycling team.

Morton invited the audience to read Scott’s recent publication concerning type 1 diabetes, carbohydrate intake, and athletic performance. In that paper, Scott concludes that low-carb diets “represent an effective strategy to improve glycaemic control and metabolic health in people with T1D,” but that their effect on athletic performance is basically unknown:

Despite low carbohydrate training being one of the most widely debated topics amongst athletes, coaches and sport scientists, there is very little published research specific to athletes with T1D.

Some evidence suggests that people with type 1 diabetes might especially benefit from “train low” strategies – basically, limiting carbohydrate intake during regular training, and increasing carb consumption for competitions. Beyond that, however, there simply isn’t enough evidence to make concrete claims.

Leaning on his experience with non-diabetic athletes, Morton concluded:

Regardless of whether you have normal glycemic responses or you have type 1 diabetes, the principle of ensuring high carbohydrate availability should always be upheld, because carbohydrate will certainly make you go faster.

The Case for a Low-Carb Diet

In his presentation titled “Low Carbohydrate Intake Optimizes Performance and Glycemia”, Dominic D’Agostino, PhD argued that because low-carbohydrate diets are optimal for blood glucose control, they are therefore also optimal for athletic performance.

D’Agostino, a molecular pharmacologist, is something of a minor rock star in the keto community. He’s a frequent guest on podcasts and Youtube shows, and has a fair personal understanding of keto athletic achievement: he’s an impressive powerlifter to boot.

D’Agostino started by acknowledging that we do not really know the best level of carb intake for athletes. But in his telling, practices even among the elite are far from unanimous, with athletes experimenting with a variety of strategies, ranging broadly from carb restriction to carb loading.

Many athletes choose a low-carb diet because they like the way that it feels – some claim, for example, that keto results in more consistent energy throughout competition, making them much less likely to “bonk” or hit the wall. But for people with diabetes, the primary point in favor of a low-carb diet is the degree to which it optimizes glucose control.

A very low-carb or ketogenic diet doesn’t just steady blood sugar – it also appears to result in some measure of “hypoglycemic resilience”. This isn’t a small matter for diabetic athletes. Hypoglycemia during exercise or competition won’t just ruin athletic performance: it can be very dangerous.

Not only does ketosis protect against hypoglycemia, he explained, but recent research also shows additional benefits of ketosis, such as reduction of oxidative stress. D’Agostino also noted that increased fat utilization can lead to “glycogen sparing”, and that a low-carb diet does not cause glycogen depletion in the muscle. These features may confer additional athletic advantages.

Photo by Adobe Stock

While Morton’s presentation was largely founded on the assumption that athletes with diabetes are fundamentally like athletes without diabetes, D’Agostino emphasized a different principle:

Normal glycemia is optimal for health, performance and recovery.

Of course, normal blood glucose levels are very difficult to achieve for people with type 1 diabetes, especially during exercise. But the low-carb diet has been validated as perhaps the best method of doing so.

D’Agostino explained that his own thoughts on the subject were formed partially by the experience of his former Ph.D. student, Andrew Koutnik, who lives with type 1 diabetes. Initially, D’Agostino believed that type 1 diabetes was “the one condition that I thought you would want to stay away from low-carbohydrate nutrition,” but Koutnik’s success first convinced him otherwise.

I reached out to Koutnik, now a research scientist at Florida Institute for Human and Machine Cognition.

He stressed that most studies comparing high- and low-carb athletic results show mixed or neutral results; when there is a difference, the difference “is often of little meaningful impact to most individuals engaging in physical activity.”

Dr. Koutnik argues that any nutritional program that doesn’t consider glycemic control is missing the most important factor: “Very few will debate that poor health leads to poor performance. Additionally, few will debate that normoglycemia is likely to lead to better performance than hyper- or hypoglycemia.” Therefore, for the T1D athlete, performance is a “consequence” of health.

Who Won the Debate?

Here are our thoughts:

At a diabetes conference, the focus should remain on diabetes. Although Morton presented some evidence to support the performance benefits of high-carbohydrate intake in elite athletes without diabetes, it’s a mistake to assume that the same benefits would occur in athletes with diabetes, or that they wouldn’t be counterbalanced by the known downsides of high-carb consumption. Glycemic management is a huge issue during exercise, and both low and high blood sugars can have dramatic effects on performance.

exercise woman

Photo by Andrew Tanglao (Unsplash)

Most of Morton’s talk also focused on elite endurance athletes. But what we learn from the best athletes on the planet may not be very useful for the rest of us.

In our opinion, D’Agostino showed a better understanding of the balancing act that athletes with diabetes (especially type 1 diabetes) need to perform.

Even if we accept that carb loading can provide a perceptible boost to serious athletes, we have to acknowledge that those carbs (and any accompanying insulin) also make it more likely for the athlete to experience hypo- or hyperglycemia, which can instantly ruin any sports outing. And the more predictable and stable your blood sugar, the more confident you can be, and the less mental space you’ll have to waste on monitoring and micromanaging glycemic changes. And if a ketogenic diet really does provide some protection against hypoglycemia, that’s just even more reason to choose a very low carb diet.

If you’re actually an elite athlete, maybe carbohydrates can help push you to the peak of performance. But maybe not – the scientific evidence is not overwhelming. For the rest of us, blood sugar control remains of paramount importance. It seems to me that a low-carbohydrate diet is more likely to deliver confident performances and strong athletic results.

What are your thoughts on this debate?

Source: diabetesdaily.com

Technology is Great, but Most Kids with Diabetes Still Need More Help (ADA 2021)

Recent decades have brought incredible advances in diabetes technology, but children and teens are still struggling to meet recommended glycemic targets.

There are almost a quarter-million young people in the US with diabetes (more than 75% with type 1 diabetes), according to the American Diabetes Association. For youth especially, early detection and optimal management are of utmost importance; with many decades of life ahead, keeping blood glucose levels in check today can help reduce unpleasant (and deadly) diabetic complications decades down the road. Prudent diabetes management also has immediate benefits and can have a huge impact on quality of life.

What’s the scope of the problem, and what can be done about it? Scientists at the American Diabetes Association (ADA) 81st virtual Scientific Sessions relayed the striking results of several studies on the state of things today for kids and teens with diabetes. Here are some of the most notable findings.

Youth A1c’s Are Not Improving

It has long been the case, unfortunately, that the majority of pediatric diabetes patients routinely do not meet their treatment goals, most often assessed via quarterly A1c testing. A team of researchers across the US reported on recent trends in recently diagnosed youth, as part of the SEARCH for Diabetes in Youth initiative. The major conclusion?

HbA1c levels remained stable but higher than recommended across discrete cohorts of SEARCH youth with type 1 diabetes duration ≤ 30 months, particularly among non-white youth.

In fact, the average A1c levels among young people with diabetes remain quite high; despite rapid advancement in technology use and newer insulin formulations, the report shows no significant change between average A1c levels between 2002 and 2016. The average A1c held steady at about 7.9%.

How Much is Technology Helping?

Now, for some better news. It appears that early use of continuous glucose monitoring (CGM) technology is associated with lower A1c levels. As reported by Dr. Priya Prahalad of Stanford Children’s Health, newly-diagnosed youth (2018-2020) who were offered CGM initiation early on had markedly lower A1c levels than those from a previous cohort that did not initiate CGM therapy.

Unfortunately, while the A1c differences between the two groups were significantly different at 6, 9, and 12 months after diagnosis, the average A1c level was still at or above 7%, for a considerable proportion of study participants. These results underscore the value of CGM use in improving diabetes management in young people, but also demonstrate the need for more effective management strategies in this group.

Trouble at School

A report from Dr. Christine March and her team at the University of Pittsburgh illustrated the unique challenges that children face on school days vs. weekends. In this study, CGM data from hundreds of children with diabetes were analyzed to assess trends in blood glucose levels (specifically, the time-in-range, TIR metric) across hours of the day and night, as well as on weekdays vs. weekends. The main result?

For weekday school hours, median TIR (70-180 mg/dL) was 52.4%; only 34 (15%) of youth met a TIR goal of >70%… Weekday and weekend CGM metrics were clinically similar, though TIR was statistically higher and time high/very high (>180 mg/dL) lower on weekends… Notably, TIR early in the school day was nearly half of TIR during similar weekend hours, perhaps relating to sleep/meal schedules.

Moreover, the team looked at various attributes, like insulin pump use, duration since diabetes diagnosis, and A1c level to see if there was a connection with the time-in-range metric. They report that younger age, shorter diabetes duration, and lower A1c levels were associated with more TIR during school hours. Interestingly, insulin pump use appeared to have no effect in this study.

Technology and Diabetes Distress

Several researchers posited that youths with diabetes and their caregivers have very different perceptions regarding the emotional impact of advanced diabetes technology.

Can Tech Reduce Family Conflict?

One study presented this week sought to determine whether the use of diabetes technology devices improved “family conflict” in teens with type 1 diabetes. In this evaluation of 60 participants, researchers found lower A1c levels in those using closed-loop technology. The technology also led to a significant increase in caregivers reporting lower levels of family conflict surrounding diabetes management. Perhaps surprisingly, the teenagers themselves did not seem to think that family conflict had been reduced by the closed-loop pumps.

Does Tech Alleviate Diabetes Worries, or Exacerbate Them?

A second study suggested that advanced technology use may actually provoke anxiety in children.

Dr. Fatemah Abdulhussein and colleagues from UCSF evaluated whether the use of advanced insulin delivery systems alleviated worry and fear of low blood glucose levels among patients and caregivers. The major findings?

Longer duration of diabetes, duration of pump use, and duration of CGM use were all associated with higher mean worry scores [among children, but not their caregivers].

That’s the cruel paradox of childhood diabetes in a nutshell: the longer a child has had diabetes, the more stress it causes. And superior management tools may only add to the emotional burden, rather than alleviate it.

Management Success Still Leads to Peace of Mind

The UCSF researchers also looked at diabetes treatment satisfaction scores and found that the only variable in the study that was associated with a lower treatment satisfaction score was higher GMI (glucose management indicator). They conclude,

These data suggest that despite recent advancements in diabetes technology, FOH [fear of hypoglycemia] and diabetes treatment satisfaction still remain significant concerns and need to be addressed in clinical contexts.

smartphone to detect depression and loneliness

Photo credit: Adobe Stock

Parents Experience Diabetes Distress, Too.

A lot of burden falls on the diabetes caregiver, too, and understandably so.

A team of researchers based in Washington, DC and Nashville, TN looked at “parental reports of diabetes distress [DD], diabetes-related family conflict, quality of life” along with patient A1c levels. A key finding that that higher A1c levels in young people were associated with a higher incidence of parental diabetes distress, related family conflict, and quality of life. Notably, female caregivers were more likely to experience distress than male caregivers. Researchers summarize,

Importantly, parental DD is related to children’s glycemic control, suggesting that increased psychological support for parents with teens with DD is warranted.

The Takeaways

A1c levels remain steady at about 7.9% for young people with diabetes in the US, still considerably higher than what is recommended by major health organizations. Some research shows that CGM utilization and the use of closed-loop insulin pumps can help improve diabetes management. Of course, cost and access also remain barriers for many when it comes to technology access.

Sadly, even with the use of advanced technology, it appears that patients and caregivers alike experience a considerable amount of distress in dealing with the demanding nature of diabetes management. Perhaps patients and families would benefit from increased emotional support as much as improved access to diabetes technology.

Importantly, A1c levels stood out in several studies as important determinants in patient and caregiver treatment satisfaction, as well as distress levels. Glycemic control should remain a paramount goal, not just for short- and long-term health, but also for emotional wellbeing. Helping youth with diabetes achieve or exceed recommended targets is likely to help lessen the mental burden of diabetes management and improve quality of life and family dynamics in the long term.

Source: diabetesdaily.com

Do Low-Carbohydrate, High-Protein Diets Offer an Advantage? (ADA 2021)

We already know that low-carb diets can be great for glucose control and diabetes management. The evidence is clear: patients with both type 2 diabetes and type 1 diabetes can benefit from the low-carbohydrate approach.

But as the diet has gained acceptance, some specialists have begun to look more carefully at the details and other consequences of the low-carb approach. Does the amount of protein matter? Can carbohydrate restriction have negative effects on lipid profiles, cognition, or mental health parameters?

Here we describe three new study reports just released at the American Diabetes Association (ADA) 81st virtual Scientific Sessions that address some of these topics.

Higher-Protein Diet, Inflammation and Type 2 Diabetes Remission

Many studies have shown that weight loss and improved blood glucose levels can be achieved with a variety of dietary approaches, but does increasing the protein and lowering carbs offer even more advantages for those with diabetes?

Frankie Stenz, MS, PhD, and Associate Professor of Medicine Endocrinology, and her team at the University of Tennessee evaluated the effects of a high-carb (55% CHO and 15% protein) vs. a high-protein (30% protein and 40% CHO) diet in adults with type 2 diabetes for 6 months. They report that the higher-protein approach significantly reduced inflammatory markers (several important cytokines measured in the blood), as compared to the higher-carb group. Inflammation markers are important parameters, especially for those with diabetes, as inflammation is closely linked to insulin resistance. Also, while weight loss was similar between the two groups, those adhering to the higher-protein diet had a significant increase in lean body mass as well as a decrease in fat mass as compared to the higher-carb group.

Moreover, while improved glucose tolerance and and insulin sensitivity occurred in both groups to some degree, diabetes remission occurred in only 16% in the high-carb group, as compared to a striking 100% in the higher-protein group. Remission was defined by the study authors as a lowering of A1c to <6.5%, along with fasting glucose levels of <126 mg/dL and not exceeding 140 mg/dL at two hours post-meal. The researchers conclude,

The HP [High Protein] diet demonstrated improvement in glucose tolerance and insulin sensitivity with 100% remission… and a significant decrease in inflammatory cytokines.

Photo credit: iStock

Lower-Carb, Higher-Protein Diets and Lipid Levels

Effects on blood lipid levels when eating lower-carb (and by extension higher protein and fat) are often a point of controversy, especially when it comes to people with diabetes, who are already at higher risk for heart disease. Heart disease is complex and multifactorial; however, many researchers agree that both blood glucose parameters and lipid profiles can play a significant role. Previous research has produced some mixed results regarding how different diets can affect lipid profiles, with many studies showing improvements in lipid parameters when eating lower-carb.

Most recently, an international team of experts from Denmark and Texas released the results of a new study that evaluated how lower-carb, higher-protein diets affect weight loss and blood lipid profiles in adults with type 2 diabetes. Over a period of six weeks, 72 patients were assigned to a lower-carb, higher-protein diet (30% CHO and 30% protein) vs. a “conventional” eating approach (50% CHO and 17% protein). When weight loss and blood lipid profiles were examined between the groups, the findings demonstrated that while both groups achieved similar levels of weight loss, those in the lower-carb, higher-protein group achieved more of a decrease in their triglyceride and LDL-cholesterol levels, along with a greater increase in HDL-cholesterol levels. Also, they determined that the triglyceride levels in the liver were significantly reduced in this group, as compared to those eating higher-carb. The team concluded that,

Carbohydrate restriction adds to the positive effect of weight loss in T2D patients by inducing greater improvements in atherogenic lipid profile, maybe facilitated by a reduction in intrahepatic fat.

Carbohydrate Restriction, Quality of Life and Cognitive Performance

Do low-carbohydrate eating patterns have effects on cognitive function and mental health?

Nicole J. Jensen and a team from Copenhagen University in Denmark just announced the results of a randomized trial that examined quality of life parameters and cognitive function among “72 adults with type 2 diabetes and overweight and obesity” as a function of diet. One group was assigned to a lower-carb, higher-protein diet (30% CHO and 30% protein) and another to a higher-carb diet (50% CHO and 17% protein) for six weeks. Next, the team looked at weight loss along with mental health parameters and cognitive performance scores between the two groups. While both groups achieved similar weight loss, the study authors reported additional mental health and cognitive benefits in the lower-carb, higher-protein group. They conclude,

Weight loss improves physical health independently of diet composition, and carbohydrate restriction may further benefit mental health, without adversely affecting overall cognition.

Summary

Altogether, these new studies highlight that while weight loss and improvement of blood glucose levels is achievable using various dietary approaches, lower-carb and higher-protein diets appear to confer additional benefits. Namely, lowering carbs and increasing protein consumption can lower inflammation, improve lipid parameters, increase lean muscle mass and fat loss, and further improve glucose levels in adults with type 2 diabetes, as opposed to a more conventional dietary approach. Moreover, a lower-carb, higher protein diet may confer additional mental health benefits and does not negatively affect cognitive performance.

Source: diabetesdaily.com

There’s a Diabetes TV Channel Now

Ready or not, here it comes what must be the world’s first television channel dedicated totally to diabetes.

Myabetic Diabetes TV is up and running – you can find it today on Apple TV, Roku, and all other major streaming platforms. You can also watch directly on the Myabetic website.

You might be surprised at the wealth and diversity of content that the channel already has: over 60 original episodes, most of which are under 15 minutes long.

The flagship show is Real Talk, a talk show with a roundtable format that addresses specific diabetes topics. There are multiple panels (“Women with Diabetes,” “Parents of Children with Diabetes”); each has recorded at least a handful of episodes on different topics of interest.

There’s also plenty of lifestyle content:

· Three cooking shows, featuring the successful food bloggers of T’ara Talks Food and The Hangry Woman and the guys from the plant-based Mastering Diabetes program.

· Three exercise shows, each hosted by a professional trainer with diabetes.

· Ever wondered how to DJ with diabetes? Wonder no more. That’s one of the handful of practical videos the channel has produced.

· There’s even a crafting program named “Glucose and Glue Sticks.” Now you too can create your own DIY diabetes supply box.

Most surprising of all, perhaps, are the multiple spoof videos, including “The Bachelor with Diabetes” and a western, “The Ballad of the Diabetic Desperado.” These are short videos with high production values and a very, very corny sense of humor with clear viral potential. There’s also a cartoon for kids, “Chasing Unicorns.”

Myabetic Diabetes TV can get silly, but it can also get serious: two documentaries explore the experiences of people living with type 1 diabetes in Uganda and in an Iraqi refugee camp.

The new channel is the project of Myabetic, a diabetes lifestyle brand best known for its stylish bags, wallets, and travel cases, all designed to hold your glucose management paraphernalia and look good doing it.

“Myabetic Diabetes TV debuts beautifully produced films and TV shows that are unlike anything you’ve seen in diabetes,” said Myabetic founder Kyrra Richards. “By showcasing diverse perspectives and sharing authentic and relatable stories, we hope that people living with diabetes and their loved ones watch Myabetic Diabetes TV and feel less alone.”

The channel is sponsored by Tandem, and is free for all to watch. All of the regular shows have produced at least a few episodes already. Why not give it a shot?

Source: diabetesdaily.com

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