Diabetes
Impacts of Substance use/abuse on Diabetes
The outreach coordinator, Leah Dupre at www.DrugAbuse.com recently made me aware of a good resource that advances awareness and understanding of the impacts of substance use on diabetes.
Dr. Karen Vieira, PhD MSM has created “a comprehensive resource on the implications, contraindications and the latest research regarding substance abuse and diabetes.”
The link below will take you to, “..a comprehensive 6,000 word research piece, and it is the product of our shared desire to help prevent and treat harms associated with diabetes and substance abuse. It includes easily-understood graphic elements, 31 supporting citations of landmark research and authority sources (seen at the bottom) and answers for the most common questions regarding diabetes, alcohol and every major drug of abuse.”
http://drugabuse.com/guides/substance-abuse-and-diabetes/
You can navigate numerous topics by placing the cursor over the “Skip to Section” button.
The comprehensive nature of this resource affirms the interrelated nature of all of the body’s physiological systems with the progression and consequences of having any kind of diabetes diagnosis.
What we put into our bodies truly affects our whole being.
Cortisol- Its Role in Stress, Inflammation, and Indications for Diet Therapy
Lifestyle change leads to improvement in Diabetes, Depression
When the status quo in one’s state of health is unacceptable, change is a welcome thing. Identifying and making change happen can experienced as problematic. Physical movement of any type is some form of physical change, if only in ending in a different state than when/where one started. Lifestyle change can be a tall order for most of us, however one may confidently begin with baby steps that cannot be denied, such as going for a walk, or making a conscious choice of whatever type.
Here is a study abstract that associates lifestyle change with improved outcomes for those with diabetes and depression diagnoses. Click on the URL below to gain access to the full text of this report.
http://www.physiciansbriefing.com/Article.asp?AID=688407
Intensive Lifestyle Changes Lead to Lasting Improvement in T2DM
Reduction in incidence of mild or greater depression symptoms; improved physical function
MONDAY, June 2, 2014 (HealthDay News) — For obese/overweight adults with type 2 diabetes, an intensive lifestyle intervention (ILI) is associated with a reduced risk of incident depression and with better physical function, according to a study published in the June issue of Diabetes Care.
Thomas A. Wadden, Ph.D., from the University of Pennsylvania in Philadelphia, and colleagues compared the effects of an ILI with a diabetes support and education (DSE) control intervention on long-term changes in depression symptoms, antidepressant medication use, and health-related quality of life. Participants included 5,145 overweight/obese individuals with type 2 diabetes who were followed for a median of 9.6 years. They administered the Beck Depression Inventory (BDI) at baseline, annually at years one to four, and at year eight.
The researchers found that, compared with DSE, ILI correlated with a significant reduction in the incidence of mild or greater depression symptoms (BDI scores ≥10; hazard ratio, 0.85; P= 0.0145). Both groups experienced a worsening of Medical Outcome Study Short Form 36 (SF-36) physical component summary scores over time, but throughout the first eight years the ILI participants reported better physical function than DSE participants (all P values < 0.01). No significant between-group differences were seen in the proportion of participants who used antidepressant medications or in SF-36 mental component summary scores.
“These findings should be considered when evaluating the potential benefits of ILIs,” the authors write.
Several authors disclosed financial ties to the pharmaceutical and weight loss industries.
Higher levels of Inflammation link Diabetes and Depression
Sleep Apnea association with Diabetes Risk
Is it the Bean?
In our stressed out hyper-driven world of rising global incidence of diabetes, it is always good news to discover evidence that inescapable habits (also known as “well established neural circuits”) can be helpful!
In this case researchers studied over a million coffee drinkers and concluded: “This study provides strong evidence that regular consumption of coffee is beneficial for prevention of diabetes.”
Those who consumed one cup daily demonstrated the best preventative effect with gradual decrease in benefit as the number of cups increases.
Affirmation of the Taoist proverb:
“Everything in moderation, Nothing in excess” (with the possible exception of moderation……)
This article was downloaded from an open source: http://www.medscape.com/viewarticle/819816
Coffee, Even Decaf, Linked to Lower Type 2 Diabetes Risk
January 28, 2014
Coffee consumption is strongly associated with a reduced risk for type 2 diabetes, regardless of whether the coffee is caffeinated or not, according to a new meta-analysis of 28 prospective studies, published in the February issue of Diabetes Care.
“Compared with no coffee consumption…6 cups/day of coffee was associated with a 33% lower risk of type 2 diabetes,” the authors write, adding, “Caffeinated coffee and decaffeinated coffee consumption were both associated with a lower risk of type 2 diabetes.”
Drinking coffee has been well-established in previous meta-analyses as being associated with a reduced risk for type 2 diabetes; however, the new review was needed to account for more recent trials evaluating the benefits of caffeinated vs decaffeinated coffee, the authors explain.
“We found that a 1-cup/day increment of regular coffee was associated with a 9% reduction in diabetes, and 1 cup/day of decaf was associated with 6% reduction in diabetes, but the difference in risk reduction between the 2 types of coffee was not statistically different,” said senior author Frank B. Hu, MD, PhD, a professor of nutrition and epidemiology with the Harvard School of Public Health in Boston, Massachusetts.
“This study provides strong evidence that regular consumption of coffee is beneficial for prevention of diabetes,” Dr. Hu told Medscape Medical News. “For individuals who already drink coffee, they may enjoy this and other potential health benefits, and for those who are sensitive to the effects of caffeine, decaf may confer similar benefits.”
Robust Findings
The 28 studies in the analysis included 1,109,272 participants, and all had the outcome of risk for type 2 diabetes; there were 45,335 cases of diabetes, with follow-up ranging from 10 months to 20 years.
The relative risk for type 2 diabetes with coffee consumption, compared with no or rare consumption, ranged from 0.92 for 1 cup per day, 0.85 for 2 cups, 0.79 for 3 cups, 0.75 for 4 cups, 0.71 for 5 cups, and 0.67 for 6 cups.
Meanwhile, the relative risk for diabetes associated with 1 cup of caffeinated coffee per day (compared to no or rare coffee consumption) was 0.91 compared with 0.94 for 1 cup of decaffeinated coffee per day ( P = .17).
The findings were consistent for men as well as women, and while coffee-brewing methods were not assessed in the studies, the inclusion of diverse populations likely covered a wide array of methods, the authors note.
“Most coffee is likely to be filtered coffee, and the results from studies conducted in various populations, including US, European, and Asian, were similar, indicating consistency of the results despite potentially different preparation and processing methods,” they observe.
And while none of the studies assessed levels of sugar and dairy added to coffee, the amounts are “likely to be small compared with other food sources,” they add.
While this meta-analysis does provide “strong evidence” that higher consumption of coffee is associated with a significantly lower risk for diabetes, “longer-term randomized controlled trials are needed to establish causality and to elucidate the underlying mechanisms,” they conclude.
Coffee Just a Small Part of the Diabetes Equation
One possible explanation for the reduced risk for diabetes with coffee consumption could be the role of chlorogenic acid, a phenolic compound and a major component of coffee, Dr. Hu said.
“Chlorogenic acid has been shown to improve insulin sensitivity and reduce blood sugar absorption,” he told Medscape Medical News.
“Compounds in coffee also include antioxidant polyphenols, minerals such as magnesium and chromium, [and] vitamins; however, it is impossible to tease out the effects of individual compounds, because they don’t exist in isolation in coffee and they may have synergistic effects.”
He stressed also that coffee consumption remains a small piece of the picture.
“Coffee is only one of many dietary and lifestyle factors that can contribute to diabetes prevention. Clearly, maintaining a healthy weight through diet and exercise is the most important way to reduce risk of diabetes. For those who drink coffee regularly, they should enjoy it, but they still need to watch their weight and be physically active.”
The research received funding from the National Institutes of Health. The authors have reported no relevant financial relationships.
Diabetes Care . 2013; 37:569-586. Abstract
Diabetes and Depression Combination Raises Heart Attack Risk
This article presents evidence that links a measure of experienced state of well-being generated in the mid-brain (depression) with a metabolic condition (diabetes) and the risk of myocardial infarction (heart attack. All three systems are fed by the vagus (ninth cranial) nerve and can be regulated by mindfulness practices.
It was downloaded from open source: http://www.medpagetoday.com/MeetingCoverage/EASDCardio/41896
Diabetes and Depression Combo Hikes MI Risk
Published: Sep 26, 2013 | Updated: Sep 27, 2013
BARCELONA — Individuals who have both diabetes and depression have an increased likelihood of having a myocardial infarction (MI), a large Swedish study affirmed.
The odds of having an MI compared with individuals without either condition were greatest among those ages 45 to 64, with the strongest association seen in women (OR 7.1, 95% CI 6.1-8.2), according to Karin Rådholm, of Linköping University in Sweden.
The corresponding odds ratio for men in that age group was 2.8 (95% CI 2.5-3.2), Rådholm reported at the European Association for the Study of Diabetes meeting here.
The chances of having an MI were also elevated — but to a lesser extent — in men and women who had either diabetes or depression, but not both.
Previous studies have shown an association between diabetes and depression, and a study published last year showed that treating both conditions simultaneously in the primary care setting was associated with improved glycemic control. Patients with both conditions have been shown to have an increased cardiovascular risk.
Rådholm and colleagues explored the link between diabetes, depression, and MI using data on 3,738,524 individuals ages 45 to 84 from Swedish national registries of prescription drug use, hospitalizations, and deaths. The analysis excluded those who had had an MI before the beginning of the study period.
Prescriptions for medications for diabetes and depression were used as surrogates for the conditions themselves.
The researchers divided the patients into four groups, which could be shuffled each of the 3 years of the study, based on drug use:
- Neither type of medication
- Anti-diabetics only
- Antidepressants only
- Both types of drugs
During the 3-year follow-up, 1.2% of the participants had a first MI. Of those, 37% were fatal.
In the older half of the cohort (ages 65 to 84), all three of the drug groups carried an increased likelihood of having an MI, with odds ratios ranging from just over 1.0 to about 3.0 compared with non-users. The greatest odds were observed in those taking both types of medication and in women versus men.
The findings were similar in the younger half of the cohort (ages 45 to 64), with odds ratios ranging from just over 1.0 to about 7.0. The results were not changed by adjustment for the use of anti-hypertensives.
The findings were not surprising, according to Ewan Pearson, PhD, MBBChir, of the University of Dundee in Scotland. “It’s a very nice, large study that establishes the fact that people with diabetes and people with depression have higher rates of cardiovascular events,” said Pearson, who co-chaired the session at which Rådholm presented the results.
What is noteworthy is the large sample size used in the analysis, he said.
“A study of 3.7 million is incredible,” he said. “It just shows the utility of these massive population resources that Sweden has access to.”
Rådholm acknowledged that the study was limited by the lack of information on the indications for use of antidepressants, noting, for example, that tricyclics can be used for neuralgias and other conditions. The analysis also lacked information on important confounders, such as smoking, lipid levels, and lifestyle.
Rådholm did not report any conflicts of interest.
