Don't lose your feet! A report from the BBC shows that there is an increase in the number of amputations through diabetes type 2. It is so important to keep on top of your diabetes and to get your blood sugar and cholesterol under control. If you don't then you are at best self mutilating or at worst committing very slow suicide.

It seems that just a few cups of tea or coffee a day can help stave off diabetes.

This is from the BBC
Tea and coffee drinkers have a lower risk of developing type 2 diabetes, a large body of evidence shows.
And the protection may not be down to caffeine since decaf coffee has the greatest effect, say researchers in Archives of Internal Medicine.
They looked at 18 separate studies involving nearly 500,000 people.
This analysis revealed that people who drink three or four cups of coffee or tea a day cut their risk by a fifth or more, say researchers.
The same amount of decaffeinated coffee had an even bigger effect, lowering risk by a third.
Type 2 diabetes usually starts after the age of 40 and develops when the body can still make some insulin, but not enough, or when the insulin that is produced does not work properly. Type 2 diabetes is treated with a healthy diet and increased physical activity. In addition to this, medication and/or insulin is often required.
The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus
The study authors
If the findings prove true, doctors may well start advising people to put the kettle on as well as take more exercise and watch their weight, say the researchers.
When the authors combined and analysed the data, they found that each additional cup of coffee consumed in a day cut diabetes risk by 7%.
Lead researcher Dr Rachel Huxley, from the University of Sydney in Australia, said because of the finding with decaffeinated coffee, the link is unlikely to be solely related to caffeine.
Instead, other compounds in coffee and tea - including magnesium and antioxidants known as lignans or chlorogenic acids - may be involved.
Special brew
"The identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial."
Dr Victoria King, of Diabetes UK, said: "Without full information about what other factors may be influencing the type 2 diabetes risk of the studies' participants - such as their physical activity levels and diet - as well as what the active ingredient in tea or coffee appears to be, we cannot be sure what, if anything, this observed effect is down to.
"What we can be sure of is that the development of type 2 diabetes is strongly linked to lifestyle, which means that many cases could be prevented by keeping active and eating a healthy balanced diet that is low in fat, salt and sugar with plenty of fruit and vegetables."




This press release is an announcement from the Archives of Internal Medicine


CHICAGO - Individuals who drink more coffee (regular or decaffeinated) or tea appear to have a lower risk of developing type 2 diabetes, according to an analysis of previous studies reported in the December 14/28 issue of Archives of Internal Medicine. A previously published meta-analysis suggested drinking more coffee may be linked with a reduced risk, but the amount of available information has more than doubled since.
By the year 2025, approximately 380 million individuals worldwide will be affected by type 2 diabetes, according to background information in the article. "Despite considerable research attention, the role of specific dietary and lifestyle factors remains uncertain, although obesity and physical inactivity have consistently been reported to raise the risk of diabetes mellitus," the authors write.
Rachel Huxley, D.Phil, of The George Institute for International Health, University of Sydney, Australia, and colleagues identified 18 studies involving 457,922 participants and assessing the association between coffee consumption and diabetes risk published between 1966 and 2009. Six studies involving 225,516 individuals also included information about decaffeinated coffee, whereas seven studies with 286,701 participants reported on tea consumption.
When the authors combined and analyzed the data, they found that each additional cup of coffee consumed in a day was associated with a 7 percent reduction in the excess risk of diabetes. Individuals who drank three to four cups per day had an approximately 25 percent lower risk than those who drank between zero and two cups per day.
In addition, in the studies that assessed decaffeinated coffee consumption, those who drank more than three to four cups per day had about a one-third lower risk of diabetes than those who drank none. Those who drank more than three to four cups of tea had a one-fifth lower risk than those who drank no tea.
"That the apparent protective effect of tea and coffee consumption appears to be independent of a number of potential confounding variables raises the possibility of direct biological effects," the authors write. Because of the association between decaffeinated coffee and diabetes risk, the association is unlikely to be solely related to caffeine. Other compounds in coffee and tea-including magnesium, antioxidants known as lignans or chlorogenic acids-may be involved, the authors note.
"If such beneficial effects were observed in interventional trials to be real, the implications for the millions of individuals who have diabetes mellitus, or who are at future risk of developing it, would be substantial," they conclude. "For example, the identification of the active components of these beverages would open up new therapeutic pathways for the primary prevention of diabetes mellitus. It could also be envisaged that we will advise our patients most at risk for diabetes mellitus to increase their consumption of tea and coffee in addition to increasing their levels of physical activity and weight loss."

Have diabetes and fed up with people who don't have diabetes 'sticking their oar in' whether in a kind meaning way or not? Yeah, so was Dr Polonsky and he came up with some diabetes etiquette which I am happy to share with you. Feel free to share with your non diabetic friends :)

Here are Dr. Polonsky's 10 etiquette tips for people without diabetes, written from the perspective of someone with diabetes:

• 1 - DON'T offer unsolicited advice about my eating or other aspects of diabetes. You may mean well, but giving advice about someone's personal habits, especially when it is not requested, isn't very nice. Besides, many of the popularly held beliefs about diabetes ("you should just stop eating sugar") are out of date or just plain wrong.
• 2 - DO realize and appreciate that diabetes is hard work. Diabetes management is a full-time job that I didn't apply for, didn't want, and can't quit. It involves thinking about what, when, and how much I eat, while also factoring in exercise, medication, stress, blood sugar monitoring, and so much more - each and every day.
• 3 - DON'T tell me horror stories about your grandmother or other people with diabetes you have heard about. Diabetes is scary enough, and stories like these are not reassuring! Besides, we now know that with good management, odds are good you can live a long, healthy, and happy life with diabetes.
• 4 - DO offer to join me in making healthy lifestyle changes. Not having to be alone with efforts to change, like starting an exercise program, is one of the most powerful ways that you can be helpful. After all, healthy lifestyle changes can benefit everyone!
• 5 - DON'T look so horrified when I check my blood sugars or give myself an injection. It is not a lot of fun for me either. Checking blood sugars and taking medications are things I must do to manage diabetes well. If I have to hide while I do so, it makes it much harder for me.
• 6 - DO ask how you might be helpful. If you want to be supportive, there may be lots of little things I would probably appreciate your help with. However, what I really need may be very different than what you think I need, so please ask first.
• 7 - DON'T offer thoughtless reassurances. When you first learn about my diabetes, you may want to reassure me by saying things like, "Hey, it could be worse; you could have cancer!" This won't make me feel better. And the implicit message seems to be that diabetes is no big deal. However, diabetes (like cancer) IS a big deal.
• 8 - DO be supportive of my efforts for self-care. Help me set up an environment for success by supporting healthy food choices. Please honor my decision to decline a particular food, even when you really want me to try it. You are most helpful when you are not being a source of unnecessary temptation.
• 9 - DON'T peek at or comment on my blood glucose numbers without asking me first. These numbers are private unless I choose to share them. It is normal to have numbers that are sometimes too low or too high. Your unsolicited comments about these numbers can add to the disappointment, frustration, and anger I already feel.
• 10 - DO offer your love and encouragement. As I work hard to manage diabetes successfully, sometimes just knowing that you care can be very helpful and motivating.

Understanding Blood Glucose levels


So you are newly diagnosed as a diabetic and you know that you have to monitor your blood sugar levels, and you know this because the Doctor told you that.

But what you don’t know is what it actually means. This should help.


Blood sugar concentration, (or in reality glucose level), refers to the amount of glucose present in your blood. Normally the blood glucose level is maintained at a reference range between about 3.6 and 5.8 mM (mmol/l). It is tightly regulated as a part of metabolic homeostasis.

WTF? Exactly what does that mean?

metabolic homeostasis basically means keeping (or regulating) the internal systems so as to keep a stable condition.

Mmol/L is the standard unit of measurement and refers to micro moles per litre and you don’t need to understand the chemistry but in case you want to know:

SCIENCE BIT:
Average normal blood glucose levels in humans are about 5mM (mmol/l) this is because the molecular weight of glucose, C6H12O6, is about 180 g/mol). The total amount of glucose normally in circulating human blood is about 3.3 to 7g – because an average human contains about 5 litres of blood. (That is just over a gallon in old money). Glucose levels vary a little during the day, rising after meals for an hour or two by a few grams and are usually lowest in the morning, before the first meal of the day (unless you are a secret midnight snacker).


So, what is this GLUCOSE stuff? Well it is carried by the bloodstream from the intestines or liver to body cells, it is the primary source of energy for body's cells, fats and oils (ie, lipids) being primarily a compact energy store, kind of like a battery. It really doesn’t mean that you should stop eating sugar, it means that you need to better control the type of food that you eat. But that is a separate story.

Failure to maintain blood glucose in the normal range leads to conditions of persistently high (hyperglycemia) or low (hypoglycemia) blood sugar. And that means that your body is not maintaining metabolic homeostasis.

A diabetic fails to maintain metabolic homeostasis and normally is hyperglycaemic and has very high glucose levels and this is often characterised by a constant thirst, with the resultant frequent trips to the loo.

Earlier on in treatment, a diabetic may also start to suffer hypoglycaemic attacks. This is often because the medication has not returned the body to stability and may well be over compensating.

So, at first, you really need to monitor your blood glucose levels, and map it against the food that you eat. That way you can see the effects of what you eat and the medication that you take.

As Alexandr would say ‘Simples’

More on the drug scare - a good explanation I thought

A group of drugs commonly used for diabetes carry an increased risk of heart problems and death when compared with a different type of diabetes drug, researchers have found.

Their study found that people taking drugs called sulphonylureas are more likely to have heart attacks, heart failure or die, compared to people taking another popular diabetes drug called metformin. Doctors should choose metformin when treating people with diabetes, unless they can't take it or it doesn't work for them, say the researchers.

What do we know already?

If you have type 2 diabetes, it means you have too much glucose in your blood. This can damage your blood vessels, causing heart attacks and strokes, as well as damage to smaller blood vessels in your kidneys, feet, and eyes. Some people with type 2 diabetes control their blood glucose through diet and exercise, but most people need diabetes medicines.

The most commonly used drugs are metformin (brand name Glucophage), and a group of medicines called sulphonylureas. Sulphonyureas include the medicines chlorpropamide, glimepiride (Amaryl), glipizide (Glibenese, Minodiab), tolbutamide, glibenclamide (Daonil, Euglucon), and gliclazide (Diamicron).

Another group called glitazones (also known as thiazolidinediones) are also used. There are two types: rosiglitazone (Avandia) and pioglitazone (Actos).

These medicines all help keep your blood glucose under control, although they work in different ways.

Lately, there's been concern that some of these drugs might increase your chances of having a heart attack or getting heart failure (where the heart can't pump blood efficiently). It's hard to pick up these problems in the clinical studies that are done before drugs are licensed, because they may take a long time to happen, and you need to test very large groups of people to pick up these sorts of differences in risk.

This new study looked at the risks of having a heart attack, getting heart failure, or dying for any reason while taking one or more of the commonly used diabetes drugs. The researchers used figures from a big database of prescribing information, cross-checked with patient records. They compared each type of drug with metformin, because metformin is a well-established diabetes drug that tends to be used first for people with diabetes.

What does the new study say?

The study found that people were more likely to die of any cause, or to get heart failure, while taking a sulphonylurea drug, compared with while taking metformin. They were also more likely to have a heart attack, although this link was not as strong.

It's hard to say exactly how big the difference is. That's because the researchers analysed the results in different ways. Using one set of calculations, the researchers said sulphonylureas were linked to a 60 percent increased risk of death, while using another set, the increased risk was 24 percent.

Of the two glitazone drugs, pioglitazone seemed to be better than rosiglitazone, although the researchers say they need to see more studies to be sure of this. People were less likely to die of any cause while taking pioglitazone, compared with while taking rosiglitazone or metformin. Neither pioglitazone nor rosiglitazone was linked to more deaths or heart attacks than metformin, although rosiglitazone was linked to an increased chance of heart failure. Doctors are already warned not to prescribe rosiglitazone for people at risk of heart failure.

It's important to remember that the study didn't compare the drugs with no treatment. So, it didn't say that people were more likely to die while taking sulphonylureas compared with taking nothing at all. The study may simply show that metformin works better than sulphonylureas.

How reliable are the findings?

The good points of this study are that it covered a lot of people (more than 90,000) over an average of 7 years each. Because of the way the data was recorded, we can compare the risks and benefits of treatments as they're actually prescribed, taking account of the fact that people tend to take more than one drug, or move from one drug to another over time.

However, this makes it harder to account for all the different factors that could affect the results. For example, people might only take sulphonylurea drugs after they'd tried metformin, and it hadn't worked well enough for them, or because they have kidney disease (people with kidney disease can't take metformin). That might mean that people who took sulphonylureas were sicker than people who took metformin, so more likely to die of any cause.

Also, the study relies on all the information on the databases being correctly entered at the time. Because this was a 'real world' study, rather than set up by researchers from the start, there's likely to be more human error in terms of recording data than in a clinical trial.

Where does the study come from?

The study was done by a team of researchers based at Imperial College in London, UK. It was published in the BMJ (British Medical Journal). The study was not directly funded by anyone, although some of the researchers received grants from various research programmes.

What does this mean for me?

If you are taking a sulphonylurea drug, the results of the study might sound alarming. But they may be less alarming than they sound. The study doesn't show that these drugs are actively doing you harm. If they reduce your glucose levels, they protect you against potential problems with your eyes, nerve endings, and feet, as well as treating symptoms such as thirst and tiredness.

What the study shows is that they may not be reducing your overall risk of having a heart attack, heart failure, or dying for any other reason, compared with metformin. Previous studies have shown that metformin seems to reduce the chances of having a heart attack or dying in people with diabetes, especially if you're overweight.

Doctors in the UK are advised to prescribe metformin first for patients with diabetes, although they are told to consider a sulphonylurea in some groups of patients. According to national guidelines, sulphonylureas work faster, so may be used when a quick treatment is needed, and may also be more suitable for patients who are not overweight.

What should I do now?

All diabetes medicines protect against the problems you get from having too much glucose in your blood. It's important not to stop taking medicines without talking to your doctor first.

If you have diabetes and you haven't been treated with metformin before, it may be worth discussing this with your doctor, especially if you're overweight.

A new diabetic drug scare - sulphonylurea increases the risk of heart disease. Well, hello!!! Diabetes increases the risk of heart disease and of losing eyesight and amputation and stroke. The bloody disease is far worse than the cure.

Mind you, quite please I am not taking it at the moment I am on Metformin and Vildagliptin, how long before they say that vildagliptin causes problems and withdraw that?

There is a story in the NHS here, and it has links to the daily telegraph and Daily Mirror stories.