Keys to Long Term Success and Preventing Complications

Contrary to popular belief, you can live a long, healthy life with type 2 diabetes, without developing complications. In its 2010 report, Diabetes UK found that someone with type 2 diabetes is likely to have a reduced life expectancy by up to 10 years, and someone living with type 1 diabetes is likely to have a reduced life expectancy by up to 20 years.

However, with advanced technologies and therapies, people are living longer and healthier than ever. Results from the University of Pittsburgh after a 30-year longitudinal study found that people with type 1 diabetes born after 1965 had a life expectancy of 69 years — longer than any study had ever previously found.

In part four of our four-part series on living well with type 2 diabetes, we will dive into the keys to long term success managing your condition, and how to prevent complications over the long term.

What Causes Complications?

It’s important to know what causes complications in people with type 2 diabetes. Not everyone living with diabetes will develop complications, but the occurrence of chronic hyperglycemia, or high blood sugar, can lead to heart disease, kidney failure, nerve damage, and retinopathy (the most common complications of diabetes). It’s important to keep your blood sugars in range as much as possible to help prevent the onset of these complications.

Keys to Long Term Success

A number of factors have been shown to help slow the progression of (or completely prevent) complications in people with diabetes:

  • Keep HbA1c in range – Studies have shown that keeping your HbA1c lower than 7% can prevent the onset of complications, and closely monitoring your blood sugar (testing regularly) can help tighten your control. Talk with your doctor about the ideal number of times she would like you to test per day, and make sure you always test before and after meals.
  • Take your medications as prescribed – Some people think that insulin is “bad” or they just don’t like the thought of taking a pill every day. You’re prescribed your medicine for a reason, and you should follow all doctors’ orders to take them as prescribed. Rationing or skipping doses can quickly lead to complications or even premature death.
  • Follow a sensible diet – You don’t need to go completely paleo or keto to have better blood sugars, but speaking with your doctor or seeing a nutritionist can help you develop an eating plan that will work for you that you can sustain. Be sure to include plenty of fresh vegetables, protein, and water. Eating similar foods, eating a low carbohydrate lunch (of 20 grams or fewer) and limiting meals at restaurants has also been shown to help improve blood sugar management in people with diabetes.
  • ExerciseExercise is one of the most important things you can do to prevent complications. Not only does it lower blood sugars, but it gets the heart working and the blood pumping, increasing circulation and strengthening your whole cardiovascular system. Exercise boosts your immune system, and increases serotonin in the brain, making you feel good and helping to prevent the onset of depression. According to our Thrivable Insights study, people with type 2 diabetes who have an HbA1c <6.5% are more likely (20% vs 8%) to exercise 4-6 times per week than people living with type 2 diabetes who have an HbA1c of 8% or higher.
  • Surround yourself with support – Diabetes is a marathon, not a sprint, and the journey can be lonely at times. A study from the University Hospital in Denmark found that loneliness may actually cause premature death by damaging the blood vessels of the heart, which can be compounded with a diagnosis of diabetes. Long term success with your diabetes care is much more likely if you surround yourself with supportive family and friends, or if you can find a community who will understand. Sharing your thoughts, worries, and feelings will help lighten your load, and you may just learn a thing or two that you didn’t previously know about diabetes and how to better care for yourself!

Have you had diabetes for a long time, and are thriving without complications? What are some of the best strategies you’ve employed to achieve success? Share this post and comment below!

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”!

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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.

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

Source: diabetesdaily.com

Diabetes Eye Screenings: Why They Are Important and Challenging

This content originally appeared on diaTribe. Republished with permission.

By Renza Scibilia and Chris ‘Grumpy Pumper’ Aldred

Regular eye screenings are important for people with diabetes. Learn more about diabetes-related retinopathy screenings from diabetes advocates Renza and Grumpy

What Causes Diabetes-Related Retinopathy?

Diabetes-related retinopathy occurs when many years of high blood sugar levels cause damage to blood vessels in the eye. This damage triggers your body to make more blood vessels – but these new vessels are fragile and easily damaged, which can result in bleeding or scarring in the eye that worsens vision. Fortunately, there are medications available that can improve symptoms. For more background on diabetes-related retinopathy, see here.

There is more to developing a diabetes-related eye condition than just A1C. Time in range also plays a role, as seen by recent research – diaTribe will be updating readers on this in the coming months!  Blood pressure also plays an important role in our risk, as can rapid fluctuations in glucose levels. Family history of eye conditions, such as glaucoma and age-related macular degeneration (AMD), may increase the risk of diabetes-related eye issues, so knowing and sharing your family history is important when discussing your eyes at screening appointments.

The importance of eye screenings

In diaTribe’s past interview with ophthalmologist (eye doctor) Dr. Ivan Suñer of Memorial Hospital of Tampa, we learned that people with retinopathy often have no noticeable symptoms until they are at high risk for losing their vision. Early detection of diabetes-related retinopathy is crucial to prevent vision loss. Thus, his number one piece of advice was to see a doctor regularly for eye screenings. The American Diabetes Association (ADA) recommends that people with diabetes get a comprehensive eye exam every two years if there is no evidence of retinopathy. For those with retinopathy, the ADA recommends an eye exam every year.

Given the importance of eye screenings, Renza and Grumpy – within a few days of each other – both recently tweeted about our upcoming eye screening checks. (Renza has annual visits to her private ophthalmologist as suggested by Australian guidelines; Grumps receives a screening every three to four months to monitor some damage in his left eye.)

Both of us (Renza and Grumpy) are fortunate that we live in countries with national eye screening programs for people with diabetes. (Australia’s program was launched just this year; the UK program has been around for a number of years now.)

In Australia, KeepSight operates as a “recall and reminder” system. People with diabetes register with the program and are sent prompts to make appointments. The frequency of these reminders is individually tailored, determined by how frequently screening checks are required.

In the UK, the Diabetic Eye Screening Program (time for a rename and some #LanguageMatters attention!) is overseen by the National Health Service (NHS). Screening appointments are made for people with diabetes, and follow up letters are sent with the results.

National screening programs work because they offer a coordinated and consistent approach that has the potential to reach a wide number of people. In an ideal world, they capture all people living with diabetes, ensuring screening occurs at the right time, changes to the eyes are identified early, and appropriate treatment is started immediately.

When implemented properly, the results of screening programs can be staggering. Before the UK program was established, diabetes-related eye conditions were the leading cause of preventable blindness in the UK. That is no longer the case.

The challenges of eye screenings

Not many people with diabetes look forward to their eye screenings. And many of us will look for any excuse to put off making or going to our screening appointment. There are a number of reasons for that.

While it may be one of the least invasive checks on our screening list, it can be one of the most disruptive. If pupil dilating drops are required, the rest of the day is often a write-off. Even when the blurred vision goes, we are often left feeling tired or with a headache from the bright light and eye strain caused by the drops.

On top of organizing time off work or school for ourselves, we may need to involve a friend or family member to take us to the appointment. All of these things can make coordination of our appointment difficult and become a reason that we postpone or cancel.

But logistics are only one reason we may decide to put off our appointment. Many of us are anxious about results from screening checks. Diabetes-related complications are often presented to us in such a scary and threatening way that we are frightened to organize and attend appointments. (Renza recently wrote this piece, “Why Scare Tactics Don’t Work in Diabetes” for diaTribe about how her introduction to diabetes-related complications when she was diagnosed with diabetes scared her so much that she was simply unable to face the thought of diabetes screenings.)

And those of us who have missed an appointment or two, or have never been screened before, become worried that we will be “told off” when we do eventually gather the courage to attend.

What works and how can we do better?

  • Making the process of actually having a diabetes eye check as easy and smooth as possible will always mean more uptake. Bringing screening to the people, rather than expecting people to travel long distances, will reduce a significant barrier to keeping up-to-date with screening checks. There are a number of different initiatives that are working toward making screening checks more convenient.
  • Pharmacies are being used in some areas to provide initial screening checks (using a retinal scanning camera), with any necessary follow-up being conducted by specialist eye health care professionals. This works well because it means the initial screening check – which will pick up any changes – is done somewhere convenient and familiar, and without the need for dilating drops. Hopefully this will reduce some of the nervousness people may feel about going to a clinic or hospital setting.
  • Coordinated reminder systems are great! Anything that helps ease the weight of “diabetes administration” is welcome to help with the daily tasks demanded by diabetes.
  • Counselling around the visit would also be helpful for some!

Having any sort of diabetes-related complications screening is never just about the process of attending and completing the screening. Just the thought of, and planning for, the appointment can be distressing for people, especially for those who have had complications presented to them in a scary or threatening manner. Offering counselling before and/or after screening is a great idea to help address some of those anxieties, and provide people with practical tips for coping.

Screening checks are part of the process of managing diabetes-related complications

We’d urge healthcare professionals to acknowledge just how difficult it can be for someone to simply show up for a screening appointment, and commend those that do. A little word of understanding can go a very long way!

As ever, peer support can be hugely beneficial. Whether it be sharing stories about how people manage to navigate anxieties and nervousness about eye screening checks, or how people have dealt with a diagnosis, speaking with others who have walked a similar path can be useful and can help reduce the isolation many people feel.

And finally, most people with diabetes do know the importance of regular complications screening, and that early detection and treatment will likely result in better outcomes. (In Grumps’ case, this early detection has meant that the issues have not progressed for several years and that, to date, no treatments have been required.) But that is not enough. We need to follow messages and campaigns that highlight the importance of screening with advice on how to make the process easier and more comfortable for people with diabetes, while recognizing how difficult it can be. Humanizing the experience of screening, and giving results and follow- up, is all an important part of the story.

Source: diabetesdaily.com

Type 2 Diabetes Remission: What Is It and How Can It Be Done?

This content originally appeared on diaTribe. Republished with permission.By Emma Ryan and Jimmy McDermott Learn about three ways that may put type 2 diabetes into remission: low-carbohydrate diets, low-calorie diets, and bariatric surgery Type 2 diabetes is traditionally described as a progressive disease – without major lifestyle changes, A1C levels will gradually increase over time, […]
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

How to Reduce Urinary Complications of Type 1 Diabetes

This content originally appeared on Integrated Diabetes Services. Republished with permission.Frequency, Impact and Prevention of Urologic Complications of Type 1 Diabetes There are some very widely talked about and avoided complications of type 1 diabetes (T1D) such as retinopathy, neuropathy, nephropathy and cardiovascular disease. However, there are other complications that get relatively little notice but […]
Source: diabetesdaily.com

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