Diabetes Fast Facts

Here’s a look at diabetes, a disease that affects millions of people around the world. Diabetes is characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both. The disease can lead to serious complications such as blindness, kidney damage, cardiovascular disease, limb amputations and premature death.

Facts

People with diabetes or certain other underlying medical conditions are more likely to become severely ill if infected with Covid-19, according to the CDC. Worldwide, the number of people living with the potentially fatal disease has quadrupled since 1980, to around 422 million, according to the World Health Organization (WHO).

37.3 million people in the United States have diabetes, about 11.3% of the population. 8.5 million (23%) of adults with diabetes are undiagnosed. Diabetes was the eighth leading cause of death in the United States in 2020, according to provisional data from the National Vital Statistics System.

There are several types of diabetes: Type 1, Type 2 and gestational diabetes. Prediabetes occurs when blood glucose levels are higher than normal but not yet high enough to be diagnosed as diabetes. Before developing Type 2 diabetes, people almost always have prediabetes. Research has shown that some long-term damage to the body may occur during prediabetes.

Type 1 diabetes develops when the body’s immune system destroys pancreatic beta cells, the only cells in the body that make insulin. This form of diabetes usually strikes children and young adults. Only 5-10% of people with diabetes have Type 1. Risk factors for Type 1 diabetes may be autoimmune, genetic or environmental. There is no known way to prevent Type 1 diabetes.

Type 2 diabetes occurs when the body does not produce enough insulin or the cells do not use insulin properly. Type 2 diabetes is the most common form of diabetes and in adults, it accounts for about 90% to 95% of all diagnosed cases of diabetes. It is associated with older age, obesity, family history, physical inactivity and race/ethnicity.

It is more common in African Americans, Latino Americans, American Indians, Asian Americans, Native Hawaiians and other Pacific Islanders. Type 2 diabetes in children and adolescents, although still rare, is being diagnosed more frequently.

Gestational diabetes is a form of glucose intolerance diagnosed during pregnancy. It affects about 4% of all pregnant women. A diagnosis of gestational diabetes doesn’t mean that a woman had diabetes before she conceived, or that she will have diabetes after giving birth.

Other types of diabetes result from genetic conditions, surgery, medications, infections and other illnesses. Such types of diabetes account for 1% to 5% of all diagnosed cases.

Possible Symptoms

Frequent urination
Excessive thirst
Unexplained weight loss
Extreme hunger
Sudden changes in vision
Numbness in hands or feet
Tiredness
Dry skin
Slow healing wounds
Frequent infections

Complications

Adults with diabetes have heart disease death rates about two to four times higher than adults without diabetes. The risk for stroke is two to four times higher among people with diabetes. People with diabetes are at high risk for high blood pressure.

Diabetes is the leading cause of new cases of blindness among adults aged 20-74 years. Diabetes is the leading cause of kidney failure. Between 60% and 70% of people with diabetes have mild to severe forms of nervous system damage or neuropathy.

US Diabetes Statistics

1.4 million new cases are diagnosed every year in the United States.

In 2019, about 96 million people aged 18 or older had prediabetes.

About 286,000 people under 20 years old have diabetes.

$327 billion – Cost to treat diabetes in the US in 2017.

Timeline

1921 – Insulin is discovered by Drs. Frederick Banting and Charles Best.

November 16, 2012 – The CDC releases a report showing that 18 states had a 100% or more increase in the prevalence of diabetes from 1995 to 2010. Forty-two states saw an increase of at least 50%.

January 17, 2014 – For the first time, US surgeon general’s report on the health consequences of smoking includes data that indicates smoking can cause diabetes, as well as erectile dysfunction, rheumatoid arthritis, macular degeneration, ectopic pregnancies and impaired immune function. Smokers have a 30% to 40% increased risk of developing Type 2 diabetes compared with nonsmokers.

May 4, 2015 – A study published in the Journal of Clinical Investigation detects a possible connection between diabetes and Alzheimer’s disease.

September 28, 2016 – The Food and Drug Administration approves a so-called artificial pancreas. The first-of-its-kind device, the size of a cell phone, monitors and treats patients with type 1 diabetes, also known as juvenile diabetes.

September 28, 2017 – The FDA approves the “first-ever continuous blood sugar monitoring device” that doesn’t require patients to prick their fingers for blood samples.

December 2, 2019 – An estimated 18% of adolescents ages 12 to 18 and 24% of young adults ages 19 to 34 in the United States have prediabetes, according to a JAMA Pediatrics study covering 2005-2016.

May 15, 2022 – In its biannual Diabetes Report Card, the CDC notes a decrease in newly diagnosed cases of diabetes after almost two decades of continual increases. In 2019, the number of newly diagnosed US adults decreased from a high of 9.3 per 1,000 in 2009 to 5.9 per 1,000 adults.

By:

Source: Diabetes Fast Facts – CNN

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What Happens to Your Body When You Don’t Get Enough Sleep?

We’ve all been there before: You promise yourself just a few more minutes—and suddenly, it’s 2 a.m. and you’re still wide awake. Perhaps you’re binging a new favorite Netflix series or fretting over a morning meeting— whatever the root cause, you’re tossing and turning in bed all night, instead of getting the shut-eye you so desperately need.

What most of us don’t understand, however, is what really happens to our bodies when we don’t achieve that optimal level of sleep, which for most adults clocks in between seven and eight hours. Ahead, we asked a few doctors to explain how are bodies react to too-little sleep—and their answers might surprise you.

It becomes more difficult to focus on mental and physical tasks.

According to Dr. Jan K. Carney, MD, MPH, the Associate Dean for Public Health & Health Policy, and Professor of Medicine at Larner College of Medicine at the University of Vermont and the National Institutes of Health, sleep is essential for health at every age. “When we don’t get enough sleep, it is harder to stay alert, focus on school or work, and react quickly when driving,” Dr. Carney says.

Your memory and mood suffers—and your appetite increases.

Sleep physician Dr. Abhinav Singh, MD, FAASM, the Medical Director of the Indiana Sleep Center, and Sleep Foundation Medical Review Panel member, says that, believe it or not, losing precious hours of sleep and drinking excessive amounts of alcohol have similar physical consequences. “Sleep loss is linked to memory impairment, poor mood, increased appetite (think obesity and diabetes), and reduced reflexes,” he says. “Increased reaction time and some studies have compared it to being worse than being intoxicated with alcohol.”

Long-term sleep shortage could lead to chronic physical and mental health concerns.

While Dr. Carney says the short-term risks of sleep loss are things we’re all familiar with—feeling drowsy and having trouble concentrating—the real risk is what a compounded lack of sleep can do over time. “Longer-term sleep shortage is associated with increased risks for chronic health conditions such as high blood pressure, heart disease, obesity, stroke, and depression.”

You can’t make up for lost sleep.

Unfortunately, you can’t “catch up” on sleep—once those hours are gone, they’re gone for good. “It is best to develop and keep regular sleep habits over the long term,” shares Dr. Carney, adding that you also can’t “learn to live” with less sleep. “The best way to ensure both adequate sleep and high-quality sleep is to develop good sleep habits.”

This means implementing a routine with a consistent bedtime and wake time each day—even on weekends. “Regular exercise helps, as does avoiding caffeine or alcohol near bedtime,” Carney says. “Our environment is essential—we need a calm, quiet, dark, and cool location where we sleep regularly.”

By:

Source: What Happens to Your Body When You Don’t Get Enough Sleep?

How Much Sleep Do You Need?

These guidelines serve as a rule-of-thumb for how much sleep children and adults need while acknowledging that the ideal amount of sleep can vary from person to person.

For that reason, the guidelines list a range of hours for each age group. The recommendations also acknowledge that, for some people with unique circumstances, there’s some wiggle room on either side of the range for “acceptable,” though still not optimal, amount of sleep.

Deciding how much sleep you need means considering your overall health, daily activities, and typical sleep patterns. Some questions that you help assess your individual sleep needs include:

  • Are you productive, healthy, and happy on seven hours of sleep? Or have you noticed that you require more hours of sleep to get into high gear?
  • Do you have coexisting health issues? Are you at higher risk for any disease?
  • Do you have a high level of daily energy expenditure? Do you frequently play sports or work in a labor-intensive job?
  • Do your daily activities require alertness to do them safely? Do you drive every day and/or operate heavy machinery? Do you ever feel sleepy when doing these activities?
  • Are you experiencing or do you have a history of sleeping problems?
  • Do you depend on caffeine to get you through the day?
  • When you have an open schedule, do you sleep more than you do on a typical workday?

Start with the above-mentioned recommendations and then use your answers to these questions to home in on your optimal amount of sleep.

How Were the Recommendations Created?

To create these recommended sleep times, an expert panel of 18 people was convened from different fields of science and medicine. The members of the panel reviewed hundreds of validated research studies about sleep duration and key health outcomes like cardiovascular disease, depression, pain, and diabetes.

After studying the evidence, the panel used several rounds of voting and discussion to narrow down the ranges for the amount of sleep needed at different ages. In total, this process took over nine months to complete.

Other organizations, such as the American Academy of Sleep Medicine (AASM) and Sleep Research Society (SRS) have also published recommendations for the amount of sleep needed for adults2 and children3. In general, these organizations closely coincide in their findings as do similar organizations in Canada.4

Improve Your Sleep Today: Make Sleep a Priority

Once you have a nightly goal based on the hours of sleep that you need, it’s time to start planning for how to make that a reality.

Start by making sleep a priority in your schedule. This means budgeting for the hours you need so that work or social activities don’t trade off with sleep. While cutting sleep short may be tempting in the moment, it doesn’t pay off because sleep is essential to being at your best both mentally and physically.

Improving your sleep hygiene, which includes your bedroom setting and sleep-related habits, is an established way to get better rest. Examples of sleep hygiene improvements include:

If you’re a parent, many of the same tips apply to help children and teens get the recommended amount of sleep that they need for kids their age. Pointers for parents can help with teens, specifically, who face a number of unique sleep challenges.

Getting more sleep is a key part of the equation, but remember that it’s not just about sleep quantity. Quality sleep matters5, too, and it’s possible to get the hours that you need but not

feel refreshed because your sleep is fragmented or non-restorative. Fortunately, improving sleep hygiene often boosts both the quantity and quality of your sleep.

If you or a family member are experiencing symptoms such as significant sleepiness during the day, chronic snoring, leg cramps or tingling, difficulty breathing during sleep, chronic insomnia, or another symptom that is preventing you from sleeping well, you should consult your primary care doctor or find a sleep professional to determine the underlying cause.

You can try using our Sleep Diary or Sleep Log to track your sleep habits. This can provide insight about your sleep patterns and needs. It can also be helpful to bring with you to the doctor if you have ongoing sleep problems.

By: Eric Suni  – SleepFoundation

Restricting Calories Leads To Weight Loss, Not Necessarily The Window of Time You Eat Them In

1

Results of a new weight loss study were published this week, leading to headlines proclaiming intermittent fasting “isn’t a magic diet trick after all”.The researchers aimed to test whether adding a restriction on what time of day you were allowed to eat (or not) to the usual low calorie (or kilojoule) diet led to greater weight loss compared to just following a low calorie diet. They recruited 139 adults whose average weight was 88 kilograms and age 32 years.

The participants were randomised to follow either the low calorie diet that had reduced their usual daily energy intake by 25%, or the same low calorie diet with the addition of a time period during which they were allowed to eat in an eight-hour window between 8am and 4pm each day.This approach is called “time-restricted eating” or a “16-hour intermittent fast”. Both groups received support from health coaches to follow their diets for 12 months.

Results showed that after one year, people in both groups lost 7-10% of their baseline body weight. While the low calorie group lost an average of 6.3 kilograms, the low calorie plus time restricted eating group lost 8 kilograms. Although there was a 1.8 kilogram difference between the groups, it was not a statistically significant difference.

Participants in both groups also had better blood sugar and blood fat levels and improved insulin sensitivity, but again there was no significant differences between groups.

1. It wasn’t based in the US

Most intermittent fasting studies have been conducted in the United States. This trial was done in China and recruited people in Guangzhou, so it provides important data using a culturally sensitive, prescribed calorie restriction over 12 months.

2. It showed small extra time restrictions on eating don’t make much difference

In their normal lives, the participants in Guangzhou had a usual window for daily eating of about 10.5 hours. Studies in other populations, particularly the US, show about 90% of adults have an eating window of 12 hours, with only 10% of adults having an overnight fasting period greater than 12 hours.

For more than 50% of people in countries like the US, the overnight fast is less than nine hours, meaning they eat over a 15 hour time period each day. So in the current study, the time restriction on eating was only minor – at about two hours less per day than what’s usual for people in China. This would not have been too big a difference from usual.

The researchers also reported that in China, the biggest meal is usually eaten in the middle of the day, so that was not influenced by the time restriction. In countries where the evening meal is the biggest or people snack all evening, then time restriction may still be a beneficial way to reduce intake.

A 2020 review of 19 studies that used time-restricted intermittent fasting found it was an effective treatment for adults with obesity, leading to greater loss of body weight and body fat, with significantly lower systolic blood pressure and blood glucose.

3. It showed support is imperative

Both groups in this trial were given a lot of support to adhere to the kilojoule-restricted diet. They were provided with one meal replacement shake per day for the first six months, to make it easier to follow the kilojoule restriction and help improve adherence to the diet.

They also received dietary counselling from trained health coaches for the 12 months of the trial. They received dietary information booklets that included advice on portion size and sample menus. They were encouraged to weigh foods to improve their accuracy in reporting kilojoule intakes and were required to keep a daily log with photographs of foods eaten and the time, using the study app.

They also received follow-up calls or app messages twice a week and met with the health coach individually every two weeks for the first six months. In the second six months, they continued to fill out their dietary records for three days per week and received weekly follow-up telephone calls and app messages and met with a health coach monthly. They also attended monthly health-education sessions.

This was a lot of support and is very important. Receiving long-term support to achieve health behaviour changes typically achieves a weight loss of 3–5% of body weight, which significantly lowers risk of weight-related health conditions, including a 50% lower risk of developing type 2 diabetes over eight years.

4. Even with good adherence, individual weight loss varies

Individual weight loss responses were very variable, even though adherence was high in this trial.

About 84% of participants adhered to the prescribed daily calorie targets and time restricted eating period. Weight loss at 12 months varied from 7.8 to 4.7 kilograms in the low calorie only group, and 9.6 to 6.4 kilograms in the low calorie plus time-restricted eating group.

As we have seen many times previously, this study confirms there is no one best diet for weight loss. It also shows small decreases in the window of time you’re eating probably won’t make a difference to weight loss.

By:

Laureate Professor in Nutrition and Dietetics, University of Newcastle

.
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Fourth Shot Protects Against Severe Omicron Outcomes; COVID May Increase Risk of Rare Eye Blood Clots

The following is a summary of some recent studies on COVID-19. They include research that warrants further study to corroborate the findings and that has yet to be certified by peer review.

Fourth vaccine dose protects vs Omicron for at least a month

A fourth dose of the COVID-19 vaccine from Pfizer and BioNTech provided significant added protection against severe disease, hospitalization and death for at least a month in older individuals, according to a study conducted when the Omicron variant was dominant.

The estimated effectiveness of the fourth dose during days 7 to 30 after it was administered compared with a third dose given at least fourth months earlier was 45% against infection, 55% for symptomatic disease, 68% for hospitalization, 62% for severe disease and 74% for death, the research team reported on Wednesday in The New England Journal of Medicine.

The study compared 182,122 individuals aged 60 and older who received a fourth dose and 182,122 very similar people who had received a third dose but not a fourth.

“The results of our real-world study suggest that a fourth vaccine dose is, at least initially, effective against the Omicron variant,” the researchers said. “Additional follow-up will allow further assessment of the protection provided by the fourth dose over time.”

A recently published study that looked only at rates of breakthrough infections and serious illness after the fourth dose found that efficacy waned quickly versus infection but held steady versus severe illness.

COVID-19 may increase risk for rare eye clots. Patients with COVID-19 may have an increased risk of rare vision-threatening blood clots in the eye for months afterward, new findings suggest.

Because SARS-CoV-2 infections increase the risk of blood vessel obstructions at other sites in the body, researchers studied nearly half a million COVID-19 patients to see whether they would develop clots in the veins or arteries of the retina, the nerve tissue at the back of the eye that receives images and sends them to the brain.

Over the next six months, 65 patients had a retinal vein occlusion. While that number is low, it reflects a statistically significant 54% increase compared with pre-COVID infection rates, according to a report published on Thursday in JAMA Ophthalmology.

Retinal artery clots were 35% more common after COVID-19 than before, but that difference might have been due to chance. The clots most often occurred in patients with other conditions that increased their risk of blood vessel problems, such as diabetes, high blood pressure, and high cholesterol.

By: Nancy Lapid

Source: Fourth shot protects against severe Omicron outcomes; COVID may increase risk of rare eye blood clots

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Critics:

By: Mary Van Beusekom

Compared with a third vaccine dose, a fourth dose of the Pfizer/BioNTech COVID-19 vaccine lowered the risk of infection, symptomatic infection, hospitalization, severe illness, and death 52% to 76%—depending on the measure—amid the Omicron surge among older adults.

Protection against infection waned, however, after 5 weeks, but not protection against severe COVID-19. The findings were published yesterday in the New England Journal of Medicine.

Seven to 30 days after the fourth COVID-19 dose, vaccine effectiveness (VE) relative to the third dose was estimated at 45% against infection (95% confidence interval [CI], 44% to 47%), 55% against symptomatic illness (95% CI, 53% to 58%), 68% against COVID-19 hospitalization (95% CI, 59% to 74%), 62% against severe disease (95% CI, 50% to 74%), and 74% against death (95% CI, 50% to 90%).

Fourteen to 30 days after the fourth dose, VE was 52% (95% CI, 49% to 54%) against infection, 61% (95% CI, 58% to 64%) against symptomatic illness, 72% (95% CI, 63% to 79%) against hospitalization, 64% (95% CI, 48% to 77%) against severe disease, and 76% (95% CI, 48% to 91%) against death.

In the fourth week after the fourth dose, the adjusted infection rate was lower by a factor of 2.0 (95% CI, 1.9 to 2.1) than that in the three-dose group and lower by a factor of 1.8 (95% CI, 1.7 to 1.9) than that among controls.

The difference in absolute risk for COVID-19 hospitalization 7 to 30 days after a fourth vaccine dose, relative to a third, was 180.1 per 100,000 people (95% CI, 142.8 to 211.9), while it was 68.8 cases per 100,000 (95% CI, 48.5 to 91.9) for severe disease. A sensitivity analyses of VE against infection had similar results as those in the primary analysis.

Starting in the fifth week after the fourth dose, the rate ratio (RR) for infection began to fall. The adjusted rate of infection in the eighth week after the fourth dose was comparable to that of internal controls. The RR for the three-dose group relative to the four-dose group was 1.1, while the rate ratio for the internal control group, compared with the four-dose groups, was 1.0.

The RRs comparing controls with fourth-dose recipients were larger and lasted longer for severe disease. In the fourth week after the fourth dose, the adjusted rate of severe disease was lower by a factor of 3.5 than in three-dose recipients and a factor of 2.3 than in internal controls.

The adjusted rate of severe illness in the fourth week after the fourth dose was 1.6 cases per 100,000 person-days, compared with 5.5 cases per 100,000 in three-dose recipients and 3.6 cases per 100,000 in internal controls. The adjusted rate differences were 3.9 fewer cases per 100,000 person-days and 2.1 fewer cases per 100,000 than the three-dose group and internal controls, respectively.

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Shortness of Breath Could Signal Heart Attack With Worst Survival Rate Study

Shortness of breath may be a sign of heart attack and lead to less survival than those with typical symptoms of chest pain, according to a study.

The researchers from Braga Hospital in Portugal, showed that just 76 per cent of heart attack patients with dyspnoea or fatigue as their main symptom are alive at one year compared to 94 per cent of those with chest pain as the predominant feature.

“Patients presenting with shortness of breath or fatigue had a worse prognosis than those with chest pain. They were less likely to be alive one year after their heart attack and also less likely to stay out of hospital for heart problems during that 12-month period,” said Dr. Paulo Medeiros from the Hospital.

“Dyspnoea and extreme tiredness were more common heart attack symptoms in women, older people and patients with other conditions such as high blood pressure, diabetes, kidney disease and lung disease,” Medeiros added.

Chest pain is the hallmark presentation of myocardial infarction but other complaints such as shortness of breath, upper abdominal or neck pain, or transient loss of consciousness (blackouts) may be the reason to attend the emergency department.

The study focused on non-ST-elevation myocardial infarction (NSTEMI), a type of heart attack in which an artery supplying blood to the heart becomes partially blocked.

The study included 4,726 patients aged 18 years and older admitted with NSTEMI between October 2010 and September 2019.

Patients were divided into three groups according to their main symptom at presentation. Chest pain was the most common presenting symptom (4,313 patients; 91 per cent), followed by dyspnoea/fatigue (332 patients; 7 per cent) and syncope (81 patients; 2 per cent). Syncope is a temporary loss of consciousness caused by a fall in blood pressure.

Patients with dyspnoea/fatigue were significantly older than those in the other two groups, with an average age of 75 years compared with 68 years in the chest pain group and 74 years in the syncope group.

Those with dyspnoea/fatigue were also more commonly women (42 per cent) compared to patients with chest pain as the main symptom (29 per cent women) or syncope (37 per cent women).

Compared to the other two groups, patients with dyspnoea/fatigue as their main symptom were more likely to also have high blood pressure, diabetes, chronic kidney disease and chronic obstructive pulmonary disease (COPD).

“This study highlights the need to consider a diagnosis of myocardial infarction even when the primary complaint is not chest pain. In addition to the classic heart attack symptom of chest pain, pressure, or heaviness radiating to one or both arms, the neck or jaw, people should seek urgent medical help if they experience prolonged shortness of breath,” Medeiros said.

Source: Shortness of breath could signal heart attack with worst survival rate Study

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