TUESDAY, May 15, 2018 (HealthDay News) — Millions of U.S. seniors can now take part in a Medicare program designed to prevent prediabetes from progressing to type 2 diabetes.
Almost half of Americans 65 and older have prediabetes, and many don’t know it. In addition to an increased risk of type 2 diabetes, prediabetes puts people at risk of heart disease and stroke, according to the American Association of Diabetes Educators.
“Medicare has expanded its coverage to include diabetes prevention, and that’s really great news,” said Angela Forfia, senior manager of prevention for the American Association of Diabetes Educators.
Prediabetes means blood sugar levels are elevated, but not as high as in type 2 diabetes. Weight loss and increased physical activity can help ward off a type 2 diagnosis.
“Seniors are a very high-risk group for type 2 diabetes,” Forfia said. But they’re also much more likely than younger people to be successful at preventing diabetes, she added.
Taking action is key. “If you wait even a year, prediabetes can become diabetes,” Forfia said.
The Medicare Diabetes Prevention Program is based on a year-long national diabetes prevention program started by the U.S. Centers for Disease Control and Prevention.
Private insurers often cover the CDC’s diabetes prevention program because it’s been shown to reduce the risk of type 2 diabetes by 58 percent overall. In people over 60, the program reduces risk of type 2 diabetes by 71 percent, according to the diabetes educators’ group.
The new program includes at least 16 intensive “core” sessions of a CDC-approved curriculum. Those 16 sessions occur over six months in a classroom-style setting. Participants receive education on long-term dietary changes, increased physical activity, and behavior-change strategies for weight control, according to the U.S. Centers for Medicare and Medicaid Services.
After the core sessions are done, less intensive follow-up meetings are held monthly to help reinforce the new healthy behaviors.
The main program goal is to lose at least 5 percent of body weight. The program also aims to get people exercising at least 150 minutes a week, Forfia added.
But program coordinators work with program participants to “set realistic, achievable goals,” Forfia said.
Overall, the program includes 24 hours of instruction. “It’s really just a full day of commitment, and the program can have a tremendous impact on your life,” she noted.
This is welcome news, said Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.
“Treating prediabetes is better than treating diabetes. The CDC’s diabetes prevention program has been very successful, but we don’t always have enough referrals to the program,” Zonszein said.
“Primary care physicians need to know this is a tremendous opportunity to help their patients with prediabetes,” he added.
So, who’s eligible for the new program? First, you must be enrolled in Medicare Part B. Other requirements include:
- A body mass index (BMI) of at least 25, or at least 23 if Asian. (BMI is a rough measure of body fat using height and weight measurements. A BMI of 25 or higher is considered overweight.)
- An abnormal blood sugar level within 12 months of the first core session. Blood sugar can be measured in one of three ways: An A1C test that doesn’t have to be done fasting (5.7 to 6.4 percent is prediabetes); a fasting blood test (110 to 125 milligrams per deciliter is prediabetes); or a 2-hour fasting glucose tolerance test (140 to 199 mg/dL is prediabetes).
- No previous diagnosis of type 1 or type 2 diabetes.
- No end-stage kidney disease.
Although the reimbursement for services became available in April, Forfia said it will likely take programs time to get started. In the meantime, she said the CDC’s diabetes prevention program may offer classes in your area. Talk with your doctor to see if you need diabetes prevention services. Your physician may also be able to help you enroll.
Learn more about the Medicare Diabetes Prevention Program from the U.S. Centers for Medicare and Medicaid Services.
MONDAY, May 7, 2018 (HealthDay News) — Diabetes has become a worldwide epidemic, but you can protect yourself with a healthier diet. And the same type of diet can help you manage diabetes if you already have it.
According to experts at Boston’s Joslin Diabetes Center and the Harvard School of Public Health, specific foods that help reduce your risk include green leafy vegetables, oat cereal, yogurt and dairy products, grapes, apples, blueberries and walnuts. Surprisingly, coffee and decaf java are also on the list.
Though weight loss for people who are overweight is often suggested, the researchers also found that even without weight loss, changing to a healthier diet helps stave off diabetes.
The quality of your fats and carbs matters more than the quantity. That means making choices like whole grains instead of refined ones, while limiting processed carbs in general and choosing fish and chicken in place of red and processed meats. Also, choose plant-based fats rather than animal fats, which also promotes heart health. And aim to add other fruits, vegetables, legumes and nuts, while limiting alcohol and skipping sugary drinks and foods.
If you find it more helpful to follow a set plan, there are many healthful diets that can be tailored to your personal tastes and calorie needs.
Diet Starting Points:
- Mediterranean diet.
- Low-glycemic index diet.
- Moderately low carbohydrate diet.
- Vegetarian diet.
Keep in mind that it’s never too late to use diet to your advantage, even if you already have diabetes. People enrolled in Joslin’s “Why WAIT” program, which includes a low-carb diet and regular exercise, not only lost weight and maintained it, but were also able to cut their diabetes medications by more than half.
Click here to learn more about the Joslin “Why WAIT” program and other ways to prevent or manage diabetes through lifestyle changes.
THURSDAY, April 12, 2018 (HealthDay News) — Artificial intelligence software that can detect diabetes-related damage to the retina — called diabetic retinopathy — has been approved by the U.S. Food and Drug Administration.
The IDx-DR program analyzes images of a patient’s retinas taken with a special camera. The digital images are uploaded to a cloud server on which IDx-DR software is installed.
The software provides one of two results — “more than mild diabetic retinopathy detected: refer to an eye care professional” or “negative for more than mild diabetic retinopathy; rescreen in 12 months.”
If diabetic retinopthay is detected, patients should see an eye care provider for further evaluation and possible treatment as soon as possible, the FDA said.
This is the first approved software that provides a screening decision without the need for a health care provider to interpret the image or results, which means it can be used by health care providers who don’t typically provide eye care.
Diabetic retinopathy is the most common cause of vision loss among the more than 30 million Americans with diabetes and the leading cause of vision impairment and blindness among working-age adults, according to the FDA.
“Early detection of retinopathy is an important part of managing care for the millions of people with diabetes, yet many patients with diabetes are not adequately screened for diabetic retinopathy since about 50 percent of them do not see their eye doctor on a yearly basis,” said Dr. Malvina Eydelman, director of the FDA’s Division of Ophthalmic, and Ear, Nose and Throat Devices.
“Today’s decision permits the marketing of a novel artificial intelligence technology that can be used in a primary care doctor’s office,” Eydelman added in an agency news release.
The FDA said its approval of the software was based on a clinical study of retinal images from 900 patients. IDx-DR correctly identified more than mild diabetic retinopathy 87.4 percent of the time and correctly identified patients who did not have more than mild diabetic retinopathy 89.5 percent of the time.
The software should not be used to screen for diabetic retinopathy in patients who’ve had laser treatment, surgery or injection in the eye or have any of the following conditions: persistent vision loss, blurred vision, floaters, previously diagnosed macular edema, severe non-proliferative retinopathy, proliferative retinopathy, radiation retinopathy or retinal vein occlusion, according to the FDA.
The agency also said the software should not be used in pregnant women with diabetes because diabetic retinopathy can progress rapidly during pregnancy and the software is not intended to evaluate rapidly progressive diabetic retinopathy.
The software is made by IDX LLC.
The U.S. National Eye Institute has more on diabetic eye disease.
THURSDAY, April 5, 2018 (HealthDay News) — If an overweight child slims down before puberty, the risk of type 2 diabetes seems to slide away with the lost pounds.
Later weight loss also lowers the risk of type 2 diabetes in adulthood, just not as much, new research reports.
“The sooner we can get children to a healthy weight and lifestyle, the better off they’ll be,” said nutritionist Samantha Heller from NYU Langone Health System in New York City. Heller wasn’t involved in the current study, but reviewed its findings.
Nearly one-quarter of the world’s children are overweight or obese, the researchers pointed out in the study.
The study’s lead author, Lise Bjerregaard, said it’s known that being overweight in childhood and early adulthood is linked to a higher risk of type 2 diabetes later in life. The researchers wanted to know if diabetes risk would change if overweight kids lost weight.
“We studied the associations between different combinations of weight status in childhood, adolescence and early adulthood, and later development of type 2 diabetes,” said Bjerregaard. She is a postdoctoral research fellow at Bispebjerg and Frederiksberg Hospital in Denmark.
The study included data from almost 63,000 men living in Denmark. Each had their weight and height measured at ages 7 and 13 years, and again in early adulthood (between 17 and 26 years old).
The researchers also collected information on whether or not type 2 diabetes was diagnosed when these same men were between 30 and 60 years old.
If kids who were overweight at 7 years old lost weight before age 13, their risk of developing type 2 diabetes in adulthood dropped to the same level as someone who had never been overweight, the findings showed.
And when an overweight child lost weight before adulthood (but not before puberty), the odds of developing type 2 diabetes in adulthood were nearly 50 percent higher than someone who had always been at a normal weight.
However, they were significantly less likely to develop type 2 diabetes than someone who stayed overweight from childhood into early adulthood, the researchers said. Someone who stayed overweight throughout childhood and early adulthood had more than four times higher odds of developing type 2 diabetes as an adult than someone who’d always been a normal weight.
Youngsters who were slim at age 7, but gained excess weight by early adulthood also increased their risk of type 2 diabetes, the investigators found.
The researchers noted that although the exact risk levels might vary, they expect that different populations — say, people in another country — would likely see a similar reduction in the risk of adult type 2 diabetes with earlier weight loss.
Heller explained that when someone loses weight, they become less insulin resistant and the body’s metabolism works more efficiently.
“The body becomes more efficient at burning fat, and there’s less inflammation,” she said.
Endocrinologist Dr. Andrea Dunaif, from the Icahn School of Medicine at Mount Sinai in New York City, also reviewed the study’s findings.
“These findings suggest that the adverse effects of childhood overweight can be reversed by normalizing weight prior to puberty,” she said. “In contrast, the adverse effects of overweight on diabetes risk at puberty and older are only partially reversible.”
Dunaif added that these findings suggest that weight-loss interventions should target overweight children before puberty, and then emphasize weight maintenance.
Heller said parents can help their children by acting as role models.
“Model healthy eating. It’s hard when you’re tired after a day of work not to go to the drive-thru or to throw in a frozen pizza, but the long-term consequences aren’t worth it. If kids get used to fast-food and junk foods and soda that are highly palatable, that’s setting them up for a very difficult life of trying to make healthier choices later on,” Heller explained.
“Eat healthier, engage in physical activity, get them outside playing. Make these changes now, and maybe you can save them from diabetes later,” she advised.
The study was published in the April 5 issue of the New England Journal of Medicine.
For tips on preventing childhood obesity, visit the Academy of Nutrition and Dietetics.
TUESDAY, Dec. 19, 2017 (HealthDay News) — You probably lean on your friends in tough times. Now, new research suggests your pals might even help you prevent one very big health problem — type 2 diabetes.
In a study of nearly 3,000 middle-aged to elderly people in the Netherlands, researchers found that people who had social networks of 10 to 12 people were less likely to develop type 2 diabetes than people with only seven to eight close friends.
Each drop in a social network member was tied to a 5 percent to 12 percent higher risk of diabetes, the study found.
The investigators also found that men living alone were more likely to have type 2 diabetes, while living alone didn’t seem to affect a woman’s risk of having the blood sugar disease.
“A larger network size may have an important impact on an individual’s lifestyle,” said the study’s lead author, Stephanie Brinkhues. She’s a doctoral candidate at Maastricht University in the Netherlands.
“A larger network also means more access to social support when it is needed, more contacts outside the house, and therefore being more socially active. The larger social network may help people to improve their lifestyle, eat more healthy and be more physically active,” she said.
Those are important steps for preventing type 2 diabetes, which is linked to sedentary behavior and being overweight.
As to why men living alone might not do as well, the study’s senior author, Miranda Schram, suggested several possibilities.
“Potentially, men living alone may not take care of themselves as much as women in this situation,” said Schram, an associate professor at Maastricht University.
“They may have more unhealthy lifestyles, for instance, eating less fresh vegetables and fruit, being less physically active and, in general, health may be less an issue for them, compared to women living alone,” she added.
Schram’s advice to anyone at high risk of type 2 diabetes? Consider making new friends, volunteering or joining special-interest groups.
Both authors noted that this study wasn’t designed to prove a cause-and-effect relationship. However, other research has also found a link between type 2 diabetes and living alone or with less social support, which suggests that these factors might contribute to type 2 diabetes, they said.
But at least one doctor thinks that if isolation or social networks play some role in type 2 diabetes, it’s a small role.
Dr. Joel Zonszein is director of the Clinical Diabetes Center at Montefiore Medical Center in New York City.
“This was a very large and very impressive study, but there are still a lot of problems with the study,” he said.
One issue is with the design of the study itself. It only looks at one moment in time, and doesn’t account for changes that might have occurred in people’s lives.
Zonszein said there are so many other factors that can contribute to diabetes, it’s difficult to tease out the effect each one has, if any. The study authors did try to control for such factors, but it’s hard to account for all of them. Zonszein said more research is needed to see if these findings can be replicated.
In the meantime, he won’t be recommending extra social gatherings to his patients. “I don’t think having more friends or being less isolated will slow down the progression of diabetes,” he concluded.
However, the study authors stressed that people should be encouraged to expand their social network. Doing so could have additional health benefits, they said.
Study participants ranged in age from 40 to 75, with an average age of 60. About half were female, and 29 percent had type 2 diabetes.
The study was published online Dec. 18 in BMC Public Health.
Learn more about preventing type 2 diabetes from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.
TUESDAY, Oct. 24, 2017 (HealthDay News) — Cholesterol-lowering medications known as statins may lower your risk of heart disease, but also might boost the odds you’ll develop type 2 diabetes, new research suggests.
“In a group of people at high risk of type 2 diabetes, statins do seem to increase the risk of developing diabetes by about 30 percent,” said the study’s lead author, Dr. Jill Crandall. She’s a professor of medicine and director of the diabetes clinical trials unit at Albert Einstein College of Medicine in New York City.
But, she added, that doesn’t mean anyone should give up on statins.
“The benefits of statins in terms of cardiovascular risk are so strong and so well established that our recommendation isn’t that people should stop taking statins, but people should be monitored for the development of diabetes while on a statin,” she explained.
At least one other diabetes expert agreed that statins are still beneficial for those at risk of heart trouble.
Dr. Daniel Donovan Jr. is professor of medicine and director of clinical research at the Icahn School of Medicine at Mount Sinai Diabetes, Obesity and Metabolism Institute in New York City.
“We still need to give statins when LDL (bad) cholesterol isn’t under control. A statin intervention can lower the risk of a cardiovascular event by 40 percent, and it’s possible the diabetes may have been destined to happen,” he said.
The new study is an analysis of data collected from another ongoing study. More than 3,200 adults were recruited from 27 diabetes centers across the United States for the study.
The research goal was to prevent the progression of type 2 diabetes in people with a high risk of the disease, Crandall said. All of the study participants were overweight or obese. They also all showed signs that they weren’t metabolizing sugar properly at the start of the study, but not poorly enough to be diagnosed with type 2 diabetes.
Study volunteers were randomly chosen to get treatment with lifestyle changes that would lead to modest weight loss, the drug metformin or a placebo pill.
At the end of the intervention, they were asked to participate in the 10-year follow-up program. They had their blood sugar levels measured twice a year, and their statin use was tracked, too.
At the start of the follow-up period, 4 percent of participants were taking statins. At the end, about one-third were.
Simvastatin (Zocor) and atorvastatin (Lipitor) were the most commonly used statins.
The study was an observational study, so it couldn’t show a cause and effect relationship.
However, Crandall said the researchers measured levels of insulin secretion and insulin resistance. Insulin is a hormone that helps the body usher the sugar from foods into the body’s cells to be used as fuel.
Crandall said insulin secretion goes down when people take statins. Less insulin would lead to higher blood sugar levels. She said there was no indication that statins affected insulin resistance.
Donovan added that the study provides important information. “But I don’t think the message is stop statins,” he said. “Most people are probably developing heart disease before diabetes, and it’s important to treat the risk factors you can.”
Though they weren’t included in this study, people who already have type 2 diabetes should be closely monitored for increases in blood sugar when they start taking a statin, Crandall said. “The evidence so far is rather limited, but there have certainly been anecdotal reports of blood sugar being higher when someone starts statins,” she said.
She also suggested that blood sugar levels likely aren’t as much of a concern for those without diabetes or risk factors for diabetes when starting a statin. Besides excess weight, those risks include older age, high blood pressure and a family history of diabetes.
Crandall added that there are many people 50 and over with prediabetes who don’t know it, so it could be an issue for them.
Findings from the study were published online Oct. 23 in BMJ Open Diabetes Research & Care.
Learn more about the link between type 2 diabetes and statins from the American Heart Association journal Circulation.