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Woman cured of Type 1 diabetes in life-changing clinical trial

<p>Marlaina Goedel was diagnosed with Type 1 diabetes when she was just five-years-old, and not only was the disease controlling her, but it almost cost her life. </p> <p>"I've crashed my car into a brick building before having a diabetic attack while driving," Goedel recalled. </p> <p>Her condition was so extreme that she felt robbed of a normal childhood, telling the <em>Daily Mail </em>that she was in and out of hospital with  life-threatening diabetic ketoacidosis, which causes toxic chemicals to build up in the blood due to a lack of insulin.</p> <p>Now 30-years-old, the Illinois woman no longer needs daily insulin shots and can finally enjoy sugar again thanks to a pioneering stem cell therapy that has cured her of type 1 diabetes. </p> <p>Goedel was one of three Americans who have been cured of their type 1 diabetes thanks to the clinical trial involving an islet cell transplant. </p> <p>It is a one-off infusion that involved transplanting islet cells into her liver to help her body produce insulin on its own. </p> <p>After four weeks, she no longer needed to take insulin. </p> <p>"[My doctor] said, ‘Mark it on your calendar. Today is the day. Stop all insulin,'" Goedel said of the life-changing moment. </p> <p>"I just went quiet and finally said, ‘I’m here. I’m in shock. I’m going to need you to repeat that.’"</p> <p>The trial was being run at the University of Chicago Medicine Transplant Institute. </p> <p>While Islet cell transplants isn't a new procedure, the current anti-rejection medication used can be toxic to the transplanted cells, potentially making it less effective over time. </p> <p>The clinical trial that ran at the university tested out a new antibody called tegoprubart, which was given to Goedel and the two other patients. </p> <p>Tegoprubart is made from lab-made antibodies that trick the immune system into thinking the body made the cells on its own, preventing them from being rejected. </p> <p>The patients were then given islet cells from a deceased donor's pancreas, which were then infused into the patient's small blood vessels in their liver. Those cells then lodged into the blood vessels and started producing insulin. </p> <p>For Goedel the only side effect of the procedure was "feeling like I got punched in the ribs,"  with the procedure lasting just an hour. </p> <p>"The cure is out there," Goedel told the <em>Daily Mail. </em></p> <p>With her new lease on life, Goedel plans to go back to school and go horse riding without worrying about suffering an attack and causing an accident. </p> <p>"It took a while to get used to saying, 'I am cured. I am diabetes free.' It's been very freeing," she said.</p> <p>"No one should have to live with this disease. I know that now more than ever."</p> <p><em>Images: Good Morning America/ UChicago Medicine</em></p> <p> </p>

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For type 2 diabetes, focusing on when you eat – not what – can help control blood sugar

<p><em><a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Type 2 diabetes affects <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-common-is-diabetes/type-2-diabetes">1.2 million Australians</a> and accounts for <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">85-90%</a> of all diabetes cases. This chronic condition is characterised by high blood glucose (sugar) levels, which carry serious <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)30058-2/abstract">health</a> risks. <a href="https://www.nature.com/articles/nrendo.2017.151">Complications</a> include heart disease, kidney failure and vision problems.</p> <p>Diet is an important way people living with type 2 diabetes manage blood glucose, alongside exercise and medication. But while we know individualised, professional dietary advice improves blood glucose, it can be <a href="https://linkinghub.elsevier.com/retrieve/pii/S0168822717317588">complex</a> and is not always <a href="https://www.publish.csiro.au/py/PY13021">accessible</a>.</p> <p><a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">Our new study</a> looked at the impact of time-restricted eating – focusing on when you eat, rather than what or how much – on blood glucose levels.</p> <p>We found it had similar results to individualised advice from an accredited practising dietitian. But there were added benefits, because it was simple, achievable, easy to stick to – and motivated people to make other positive changes.</p> <h2>What is time-restricted eating?</h2> <p>Time-restricted eating, also known as <a href="https://www.annualreviews.org/content/journals/10.1146/annurev-nutr-082018-124320">the 16:8 diet</a>, became popular for weight loss around 2015. Studies have since shown it is also an <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2811116">effective way</a> for people with type 2 diabetes to manage blood glucose.</p> <p>Time-restricted eating involves limiting when you eat each day, rather than focusing on what you eat. You restrict eating to a window during daylight hours, for example between 11am and 7pm, and then fast for the remaining hours. This can sometimes naturally lead to also eating less.</p> <p>Giving your body a break from constantly digesting food in this way helps align eating with natural <a href="https://doi.org/10.1111/jne.12886">circadian rhythms</a>. This <a href="https://doi.org/10.1111/jnc.15246">can help</a> regulate metabolism and improve overall health.</p> <p>For people with type 2 diabetes, there may be specific benefits. They often have their <a href="https://doi.org/10.2337/dc12-2127">highest blood glucose</a> reading in the morning. Delaying breakfast to mid-morning means there is time for physical activity to occur to help reduce glucose levels and prepare the body for the first meal.</p> <h2>How we got here</h2> <p>We ran an <a href="https://www.mdpi.com/2072-6643/12/11/3228">initial study</a> in 2018 to see whether following time-restricted eating was achievable for people with type 2 diabetes. We found participants could easily stick to this eating pattern over four weeks, for an average of five days a week.</p> <p>Importantly, they also had improvements in blood glucose, spending less time with high levels. <a href="https://www.mdpi.com/2072-6643/12/2/505">Our previous research</a> suggests the reduced time between meals may play a role in how the hormone insulin is able to reduce glucose concentrations.</p> <p><a href="https://doi.org/10.1001/jamanetworkopen.2023.39337">Other studies</a> have confirmed these findings, which have <a href="https://doi.org/10.1186/s12986-021-00613-9">also shown</a> notable improvements in HbA1c. This is a <a href="https://www.ncbi.nlm.nih.gov/books/NBK304271/">marker</a> in the blood that represents concentrations of blood glucose over an average of three months. It is the <a href="https://journals.sagepub.com/doi/10.4137/BMI.S38440">primary clinical tool</a> used for diabetes.</p> <p>However, these studies provided intensive support to participants through weekly or fortnightly meetings with researchers.</p> <p>While we know this level of support <a href="https://www.nature.com/articles/0802295">increases</a> how likely people are to stick to the plan and improves outcomes, it is not readily available to everyday Australians living with type 2 diabetes.</p> <h2>What we did</h2> <p>In our <a href="https://www.sciencedirect.com/science/article/pii/S0168822724008039">new study</a>, we compared time-restricted eating directly with advice from an <a href="https://dietitiansaustralia.org.au/working-dietetics/standards-and-scope/role-accredited-practising-dietitian">accredited practising dietitian</a>, to test whether results were similar across six months.</p> <p>We recruited 52 people with type 2 diabetes who were currently managing their diabetes with up to two oral medications. There were 22 women and 30 men, aged between 35 and 65.</p> <p>Participants were randomly divided into two groups: diet and time-restricted eating. In both groups, participants received four consultations across the first four months. During the next two months they managed diet alone, without consultation, and we continued to measure the impact on blood glucose.</p> <p>In the diet group, consultations focused on changing their diet to control blood glucose, including improving diet quality (for example, eating more vegetables and limiting alcohol).</p> <p>In the time-restricted eating group, advice focused on how to limit eating to a nine-hour window between 10am and 7pm.</p> <p>Over six months, we measured each participant’s blood glucose levels every two months using the HbA1c test. Each fortnight, we also asked participants about their experience of making dietary changes (to what or when they ate).</p> <h2>What we found</h2> <p>We found time-restricted eating was as effective as the diet intervention.</p> <p>Both groups had reduced blood glucose levels, with the greatest improvements occurring after the first two months. Although it wasn’t an objective of the study, some participants in each group also lost weight (5-10kg).</p> <p>When surveyed, participants in the time-restricted eating group said they had adjusted well and were able to follow the restricted eating window. Many told us they had family support and enjoyed earlier mealtimes together. Some also found they slept better.</p> <p>After two months, people in the time-restricted group were looking for more dietary advice to further improve their health.</p> <p>Those in the diet group were less likely to stick to their plan. Despite similar health outcomes, time-restricted eating seems to be a simpler initial approach than making complex dietary changes.</p> <h2>Is time-restricted eating achievable?</h2> <p>The main barriers to following time-restricted eating are social occasions, caring for others and work schedules. These factors may prevent people eating within the window.</p> <p>However, there are many benefits. The message is simple, focusing on when to eat as the main diet change. This may make time-restricted eating more translatable to people from a wider variety of socio-cultural backgrounds, as the types of foods they eat don’t need to change, just the timing.</p> <p>Many people don’t have access to more individualised support from a dietitian, and receive nutrition advice from their GP. This makes time-restricted eating an alternative – and equally effective – strategy for people with type 2 diabetes.</p> <p>People should still try to stick to <a href="https://www.eatforhealth.gov.au/guidelines/guidelines">dietary guidelines</a> and prioritise vegetables, fruit, wholegrains, lean meat and healthy fats.</p> <p>But our study showed time-restricted eating may also serve as stepping stone for people with type 2 diabetes to take control of their health, as people became more interested in making diet and other positive changes.</p> <p>Time-restricted eating might not be appropriate for everyone, especially people on medications which don’t recommend fasting. Before trying this dietary change, it’s best speak to the healthcare professional who helps you manage diabetes.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241472/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/evelyn-parr-441878">Evelyn Parr</a>, Research Fellow in Exercise Metabolism and Nutrition, Mary MacKillop Institute for Health Research, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a> and <a href="https://theconversation.com/profiles/brooke-devlin-2237174">Brooke Devlin</a>, Lecturer in Nutrition and Dietetics, School of Human Movement and Nutrition Sciences, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/for-type-2-diabetes-focusing-on-when-you-eat-not-what-can-help-control-blood-sugar-241472">original article</a>.</em></p>

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What is type 1.5 diabetes? It’s a bit like type 1 and a bit like type 2 – but it’s often misdiagnosed

<p><em><a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>While you’re likely familiar with type 1 and type 2 diabetes, you’ve probably heard less about type 1.5 diabetes.</p> <p>Also known as latent autoimmune diabetes in adults (LADA), type 1.5 diabetes has features of <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">both type 1 and type 2 diabetes</a>.</p> <p>More people became aware of this condition after <a href="https://www.imdb.com/name/nm0004726/">Lance Bass</a>, best known for his role in the iconic American pop band NSYNC, <a href="https://www.foxnews.com/health/pop-singer-lance-bass-type-1-5-diabetes-know-disease">recently revealed</a> he has it.</p> <p>So, what is type 1.5 diabetes? And how is it diagnosed and treated?</p> <h2>There are several types of diabetes</h2> <p>Diabetes mellitus is a group of conditions that arise when the levels of glucose (sugar) in our blood are higher than normal. There are actually <a href="https://diabetesjournals.org/care/article/37/Supplement_1/S81/37753/Diagnosis-and-Classification-of-Diabetes-Mellitus">more than ten types</a> of diabetes, but the <a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(23)01301-6/fulltext">most common</a> are type 1 and type 2.</p> <p>Type 1 diabetes is an <a href="https://diabetesjournals.org/care/article/44/11/2589/138492/The-Management-of-Type-1-Diabetes-in-Adults-A">autoimmune condition</a> where the body’s immune system attacks and destroys the cells in the pancreas that make the hormone insulin. This leads to very little or no insulin production.</p> <p>Insulin is important for moving glucose from the blood into our cells to be used for energy, which is why people with type 1 diabetes need <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6995794/">insulin medication daily</a>. Type 1 diabetes usually <a href="https://www.nature.com/articles/s41390-024-03107-5">appears</a> in children or young adults.</p> <p>Type 2 diabetes is not an autoimmune condition. Rather, it happens when the body’s cells become resistant to insulin over time, and the pancreas is no longer able to make enough insulin to <a href="https://diabetesjournals.org/care/article/47/Supplement_1/S20/153954/2-Diagnosis-and-Classification-of-Diabetes">overcome this resistance</a>. Unlike type 1 diabetes, people with type 2 diabetes still produce some insulin.</p> <p>Type 2 is more common in adults but is <a href="https://www.sciencedirect.com/science/article/abs/pii/S1871402121002733">increasingly</a> seen in children and young people. Management <a href="https://www.racgp.org.au/getattachment/41fee8dc-7f97-4f87-9d90-b7af337af778/Management-of-type-2-diabetes-A-handbook-for-general-practice.aspx">can include</a> behavioural changes such as nutrition and physical activity, as well as oral medications and insulin therapy.</p> <h2>How does type 1.5 diabetes differ from types 1 and 2?</h2> <p>Like type 1 diabetes, type 1.5 occurs when the immune system attacks the pancreas cells that make insulin. But people with type 1.5 often don’t need insulin <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">immediately</a> because their condition develops more slowly. Most people with type 1.5 diabetes will need to use insulin within <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5111528/">five years</a> of diagnosis, while those with type 1 typically require it from diagnosis.</p> <p>Type 1.5 diabetes is usually diagnosed in people <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">over 30</a>, likely due to the slow progressing nature of the condition. This is older than the typical age for type 1 diabetes but younger than the usual diagnosis age for type 2.</p> <p>Type 1.5 diabetes shares <a href="https://www.nature.com/articles/nrendo.2017.99">genetic and autoimmune risk factors</a> with type 1 diabetes such as specific gene variants. However, evidence has also shown it may be influenced by lifestyle factors such as <a href="https://pubmed.ncbi.nlm.nih.gov/29589073/">obesity</a> and <a href="https://www.frontiersin.org/journals/physiology/articles/10.3389/fphys.2019.00320/full">physical inactivity</a> which are more commonly associated with type 2 diabetes.</p> <h2>What are the symptoms, and how is it treated?</h2> <p>The symptoms of type 1.5 diabetes are highly variable between people. Some have no symptoms at all. But generally, people may experience the following <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a>:</p> <ul> <li>increased thirst</li> <li>frequent urination</li> <li>fatigue</li> <li>blurred vision</li> <li>unintentional weight loss.</li> </ul> <p>Typically, type 1.5 diabetes is <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">initially treated</a> with oral medications to keep blood glucose levels in normal range. Depending on their glucose control and the medication they are using, people with type 1.5 diabetes may need to monitor their blood glucose levels regularly throughout the day.</p> <p>When average blood glucose levels increase beyond normal range even with oral medications, treatment may progress to insulin. However, there are <a href="https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2022.959011/full">no universally accepted</a> management or treatment strategies for type 1.5 diabetes.</p> <h2>Type 1.5 diabetes is often misdiagnosed</h2> <p>Lance Bass said he was initially diagnosed with <a href="https://www.healthline.com/health-news/lance-bass-misdiagnosed-diabetes">type 2 diabetes</a>, but later learned he actually has type 1.5 diabetes. This is <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">not entirely uncommon</a>. Estimates suggest type 1.5 diabetes is misdiagnosed as type 2 diabetes <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">5–10% of the time</a>.</p> <p>There are a few possible reasons for this.</p> <p>First, accurately diagnosing type 1.5 diabetes, and distinguishing it from other types of diabetes, requires special <a href="https://journals.lww.com/jaanp/abstract/2009/03000/latent_autoimmune_diabetes_of_adulthood__lada___an.4.aspx">antibody tests</a> (a type of blood test) to detect autoimmune markers. Not all health-care professionals necessarily order these tests routinely, either due to cost concerns or because they may not consider them.</p> <p>Second, type 1.5 diabetes is commonly found in adults, so doctors might wrongly assume a person has developed type 2 diabetes, which is more common in this age group (whereas type 1 diabetes usually affects children and young adults).</p> <p>Third, people with <a href="https://diabetesjournals.org/diabetes/article/69/10/2037/16062/Management-of-Latent-Autoimmune-Diabetes-in-Adults">type 1.5 diabetes</a> often initially make enough insulin in the body to manage their blood glucose levels without needing to start insulin medication. This can make their condition appear like type 2 diabetes, where people also produce some insulin.</p> <p>Finally, because type 1.5 diabetes has <a href="https://www.ncbi.nlm.nih.gov/books/NBK557897/">symptoms</a> that are similar to type 2 diabetes, it may initially be treated as type 2.</p> <h2>We’re still learning about type 1.5</h2> <p>Compared with type 1 and type 2 diabetes, there has been much less research on how common type 1.5 diabetes is, especially in <a href="https://www.sciencedirect.com/science/article/abs/pii/S1043276018301292">non-European populations</a>. In 2023, it was estimated type 1.5 diabetes represented <a href="https://pubmed.ncbi.nlm.nih.gov/37428296/">8.9%</a> of all diabetes cases, which is similar to type 1. However, we need more research to get accurate numbers.</p> <p>Overall, there has been a limited awareness of type 1.5 diabetes and <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10683931/">unclear diagnostic criteria</a> which have slowed down our understanding of this condition.</p> <p>A misdiagnosis can be stressful and confusing. For people with type 1.5 diabetes, being misdiagnosed with type 2 diabetes might mean they don’t get the insulin they need in a timely manner. This can lead to worsening health and a greater likelihood of complications down the road.</p> <p>Getting the right diagnosis helps people receive the most appropriate treatment, save money, and reduce <a href="https://diabetesjournals.org/diabetes/article/73/Supplement_1/55-OR/155112/55-OR-Diabetes-Distress-among-Persons-Living-with">diabetes distress</a>. If you’re experiencing symptoms you think may indicate diabetes, or feel unsure about a diagnosis you’ve already received, monitor your symptoms and chat with your doctor.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237041/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/emily-burch-438717">Emily Burch</a>, Accredited Practising Dietitian and Lecturer, <a href="https://theconversation.com/institutions/southern-cross-university-1160">Southern Cross University</a> and <a href="https://theconversation.com/profiles/lauren-ball-14718">Lauren Ball</a>, Professor of Community Health and Wellbeing, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-is-type-1-5-diabetes-its-a-bit-like-type-1-and-a-bit-like-type-2-but-its-often-misdiagnosed-237041">original article</a>.</em></p>

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Does eating ham, bacon and beef really increase your risk of developing type 2 diabetes?

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p>That lunchtime staple, the humble ham sandwich, has come in for a bashing in the press recently. According to <a href="https://www.theguardian.com/society/article/2024/aug/20/two-slices-of-ham-a-day-can-raise-type-2-diabetes-risk-by-15-research-suggests">many</a> <a href="https://www.dailymail.co.uk/health/article-13761253/Eating-ham-daily-linked-increase-risk-diabetes.html">reports</a>, eating two slices of ham a day can increase your risk of developing type 2 diabetes.</p> <p>But what’s the science behind these headlines?</p> <p>The research offers a more complex picture. <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00179-7/fulltext">A new study</a> from the University of Cambridge highlighted an association between developing type 2 diabetes and eating processed meat like ham and bacon, and red meat such as beef and lamb.</p> <p>This led to headlines suggesting the risk was mainly linked to <a href="https://www.telegraph.co.uk/news/2024/08/21/ham-sandwich-processed-meat-fresh-risk-link-type-2-diabetes/">ham sandwiches</a>. This seems to have come from the <a href="https://www.cam.ac.uk/research/news/red-and-processed-meat-consumption-associated-with-higher-type-2-diabetes-risk">press release</a>, which used ham as the example to quantify the amount of processed meat associated with a 15% increased risk of developing type 2 diabetes over ten years.</p> <p>The research found that this risk was linked to eating an extra 50g of processed meat every day, which happens to equate to two slices of ham. A useful example thus appears to have been taken up by the media as the main cause, perhaps ignoring some of the key messages coming from the study.</p> <p>So, can processed and red meat really increase your risk of developing type 2 diabetes?</p> <p>The <a href="https://www.diabetes.org.uk/diabetes-the-basics/types-of-diabetes/type-2/diabetes-risk-factors">biggest risk factors</a> linked to developing type 2 diabetes are being over 40, having family members with type 2 diabetes, being of South Asian or African descent, or having a higher body weight – and especially a larger waist.</p> <figure><iframe src="https://www.youtube.com/embed/EsOBcx2bJqU?wmode=transparent&amp;start=0" width="440" height="260" frameborder="0" allowfullscreen="allowfullscreen"></iframe></figure> <p>The Cambridge study used data from nearly 2 million people from 31 studies. Participants were followed for an average of ten years. During this time, around one in 20 people developed type 2 diabetes.</p> <p>The research suggested that a 10% increase in the probability of developing type 2 diabetes was associated with every 100g of additional red meat eaten daily. Eating half as much extra processed meat every day was linked to an even greater increased risk of developing the disease.</p> <p>This is not the <a href="https://ajcn.nutrition.org/article/S0002-9165(23)66119-2/abstract">first time</a> that both processed and red meats have been linked with an increased risk of developing type 2 diabetes. However, the key strength of the Cambridge study was that it tried to control for many of the other factors linked to the disease, including smoking, having a higher body weight, dietary intake and exercise.</p> <p>However, the size of the increased risk is modest, considering few people included in the study ate 50g or more processed meat per day – meaning moderate ham consumption is likely to have <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9908545/">no meaningful effect</a> on your risk.</p> <h2>What’s the link?</h2> <p>Processed meat has been linked to increased risk of type 2 diabetes because of its nitrate and salt content – additives that are used to cure many processed meats.</p> <p>Nitrates and salt in processed meats have also <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6893523/">been linked to</a> an increased risk of developing colon cancer. In fact, the World Health Organization classifies the additives as <a href="https://www.who.int/news-room/questions-and-answers/item/cancer-carcinogenicity-of-the-consumption-of-red-meat-and-processed-meat">group 1 carcinogens</a>, which means they can cause a range of cancers.</p> <p>The mechanism linking processed meat to cancer seems to be similar to how it might be linked to type 2 diabetes. During digestion, processed meat produces <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6294997/">N-nitroso chemicals</a>, which can damage cells. This can lead to inflammation and affects how insulin, the hormone that controls blood glucose (sugar), works. This in turn can lead to <a href="https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance">insulin resistance</a>, when cells in your muscles, fat and liver don’t respond well to insulin and can’t easily take up glucose from your blood.</p> <p>Red meat, meanwhile, is <a href="https://www.healthline.com/nutrition/healthy-iron-rich-foods">rich in iron</a>. Research suggests that people with <a href="https://www.diabetes.org.uk/diabetes-the-basics/related-conditions/haemochromatosis-diabetes#:%7E:text=So%20a%20rise%20of%20iron,GP%20as%20soon%20as%20possible.">high levels of iron</a> are more likely to develop type 2 diabetes. However, <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8744124/#:%7E:text=The%20WHO%20has%20recognised%20iron,being%20affected%20with%20this%20condition.">low levels of iron</a> are more of a health concern for the general population.</p> <p>Another potential link regarding red meat could be the way it is cooked.</p> <p><a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5521980/">Previous studies</a> have suggested that charred meat, cooked over an open flame or at high temperature, is also linked to an increased risk of developing <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5911789/">type 2 diabetes</a>. Charring meat leads to formation of toxic chemicals such as <a href="https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/heterocyclic-amine#:%7E:text=Heterocyclic%20amines%20are%20aromatic%20compounds,of%20reactions%20called%20Maillard%20reactions.">heterocyclic aromatic amines</a> and harmful compounds like <a href="https://www.healthline.com/nutrition/advanced-glycation-end-products">advanced glycation end products</a>, both of which have been linked to <a href="https://pubmed.ncbi.nlm.nih.gov/21709297/">insulin resistance and type 2 diabetes</a>.</p> <h2>Bye-bye barbecues and bacon butties?</h2> <p>The key message is reduction, rather than avoidance. The UK government nutritional recommendations offer sound advice: limit your combined intake of red and processed meat to no more than <a href="https://www.nhs.uk/live-well/eat-well/food-types/meat-nutrition/#:%7E:text=Red%20meat%20and%20processed%20meat&amp;text=If%20you%20currently%20eat%20more,%2C%20veal%2C%20venison%20and%20goat.">an average of 70g per day</a>.</p> <p>But these guidelines also suggest that red meat can be a valuable source of iron. So, if you decide to stop eating red meat, you should eat alternative sources of iron such as beans, lentils, dark green vegetables and fortified cereals.</p> <p>This needs to be done as part of a carefully planned diet. Non-meat sources of iron are more difficult for our bodies to absorb so should be eaten with a source of vitamin C, found in green vegetables and citrus fruit.</p> <p>The best advice to reduce your risk of developing type 2 diabetes is to maintain a healthy weight – consider losing weight if you have a higher body weight – and be as physically active as possible.</p> <p>A healthy diet should be based on plenty of vegetables, fruit, beans, peas, lentils, nuts and seeds, along with some wholegrain foods, some dairy products, fish and white meat (or vegetarian alternatives) – plus moderate amounts of red meat and minimal processed meat. This will help reduce your risk of type 2 diabetes, <a href="https://www.bhf.org.uk/informationsupport/support/healthy-living/healthy-eating">heart disease</a>, and <a href="https://www.cancerresearchuk.org/about-cancer/causes-of-cancer/diet-and-cancer/does-having-a-healthy-diet-reduce-my-risk-of-cancer">many cancers</a> – as well being more <a href="https://www.bda.uk.com/static/539e2268-7991-4d24-b9ee867c1b2808fc/a1283104-a0dd-476b-bda723452ae93870/one%20blue%20dot%20reference%20guide.pdf">environmentally sustainable</a>.</p> <p>But if you have a penchant for ham sandwiches, rest assured you can continue to indulge as an occasional treat. It’s your overall lifestyle and diet that really matter for your health and risk of developing type 2 diabetes.<!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/237346/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/duane-mellor-136502">Duane Mellor</a>, Visiting Academic, Aston Medical School, <a href="https://theconversation.com/institutions/aston-university-1107">Aston University</a></em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/does-eating-ham-bacon-and-beef-really-increase-your-risk-of-developing-type-2-diabetes-237346">original article</a>.</em></p> </div>

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New device could help GPs detect Alzheimer's in minutes

<p>GPs could soon be able to screen their patients for Alzheimer's Disease in a matter of minutes, using a handheld device the size of a credit card. </p> <p>The first-of-a-kind finger-prick blood test was developed by engineers at Melbourne's Monash University and it can detect the hallmark protein biomarkers of early Alzheimer's Disease within minutes. </p> <p>This could become an important tool for doctors in diagnosing patients before the symptoms progress. </p> <p>In Australia alone there are around 420,000 people living with dementia, with that number set to double by 2054. </p> <p>Associate Professor Sudha Mokkapati, from Monash Materials Science and Engineering, helped lead the development of the testing device.</p> <p>"Detecting very early disease in large populations could dramatically change the trajectory of this burdening disease for many patients, and shave millions off associated healthcare costs," Mokkapati said.</p> <p>"We've completed testing that shows the technology is highly advanced by design and capable of detecting ultra-low levels of several disease biomarkers in blood." </p> <p>The device also has the potential to remove the need for laboratory-based pathology tests, making diagnoses faster and cheaper. </p> <p>The university is currently seeking funding to complete the next stage - clinical validation, which will help bring the device one step closer to reality. </p> <p>"Most patients with neurodegenerative disease are typically diagnosed at advanced stages. Sadly, treatments targeting late-onset disease provide limited therapeutic benefit," Associate Professor Matthew Pase, at Monash's School of Psychological Sciences, said. </p> <p>"Earlier screening could change the outlook for many patients diagnosed with cognitive impairment, increasing the chance of halting or slowing symptom development and the rapid progression of the disease."</p> <p><em>Image: Monash University/ Nine</em></p> <p> </p>

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Ovarian cancer is hard to detect. Focusing on these 4 symptoms can help with diagnosis

<p><em><a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>Ovarian cancers are often found when they are already advanced and hard to treat.</p> <p>Researchers <a href="https://ascopubs.org/doi/10.1200/JCO.2010.32.2164">have long believed</a> this was because women first experienced symptoms when ovarian cancer was already well-established. Symptoms can also be <a href="https://cancer.org.au/cancer-information/causes-and-prevention/early-detection-and-screening/early-detection-of-ovarian-cancer">hard to identify</a> as they’re vague and similar to other conditions.</p> <p>But <a href="https://ijgc.bmj.com/content/early/2024/07/24/ijgc-2024-005371">a new study</a> shows promising signs ovarian cancer can be detected in its early stages. The study targeted women with four specific symptoms – bloating, abdominal pain, needing to pee frequently, and feeling full quickly – and put them on a fast track to see a specialist.</p> <p>As a result, even the most aggressive forms of ovarian cancer could be detected in their early stages.</p> <p>So what did the study find? And what could it mean for detecting – and treating – ovarian cancer more quickly?</p> <h2>Why is ovarian cancer hard to detect early?</h2> <p>Ovarian cancer <a href="https://pubmed.ncbi.nlm.nih.gov/24979449/">cannot be detected</a> via cervical cancer screening (which used to be called a pap smear) and pelvic exams <a href="https://pubmed.ncbi.nlm.nih.gov/24979449/">aren’t useful</a> as a screening test.</p> <p>Current <a href="https://www.canceraustralia.gov.au/cancer-types/gynaecological-cancers/clinicians-hub/ovarian-cancer-guidelines">Australian guidelines</a> recommend women get tested for ovarian cancer if they have symptoms for <a href="https://www.canceraustralia.gov.au/sites/default/files/publications/assessment-symptoms-may-be-ovarian-cancer-guide-gps/pdf/ocg_assessment_of_symptoms_gp_card_0.pdf">more than a month</a>. But many of the <a href="https://cancer.org.au/cancer-information/types-of-cancer/ovarian-cancer">symptoms</a> – such as tiredness, constipation and changes in menstruation – are vague and overlap with other common illnesses.</p> <p>This makes early detection a challenge. But it is crucial – a woman’s <a href="https://seer.cancer.gov/statfacts/html/ovary.html">chances of surviving ovarian cancer</a> are associated with how advanced the cancer is when she is diagnosed.</p> <p>If the cancer is still confined to the original site with no spread, the five-year survival rate is 92%. But over half of women diagnosed with ovarian cancer first present when the cancer has <a href="https://seer.cancer.gov/statfacts/html/ovary.html">already metastatised</a>, meaning it has spread to other parts of the body.</p> <p>If the cancer has spread to nearby lymph nodes, the survival rate is reduced to 72%. If the cancer has already metastasised and spread to distant sites at the time of diagnosis, the rate is only 31%.</p> <p>There are mixed findings on whether detecting ovarian cancer earlier leads to better survival rates. For example, a trial in the UK that screened more than 200,000 women <a href="https://pubmed.ncbi.nlm.nih.gov/37183782/">failed to reduce deaths</a>.</p> <p>That study screened the general public, rather than relying on self-reported symptoms. The new study suggests asking women to look for specific symptoms can lead to earlier diagnosis, meaning treatment can start more quickly.</p> <h2>What did the new study look at?</h2> <p>Between June 2015 and July 2022, the researchers recruited 2,596 women aged between 16 and 90 from 24 hospitals across the UK.</p> <p>They were asked to monitor for these four symptoms:</p> <ul> <li>persistent abdominal distension (women often refer to this as bloating)</li> <li>feeling full shortly after starting to eat and/or loss of appetite</li> <li>pelvic or abdominal pain (which can feel like indigestion)</li> <li>needing to urinate urgently or more often.</li> </ul> <p>Women who reported at least one of four symptoms persistently or frequently were put on a <a href="https://pubmed.ncbi.nlm.nih.gov/22479719/">fast-track pathway</a>. That means they were sent to see a gynaecologist within two weeks. The fast track pathway has been used in the UK since 2011, but is not specifically part of Australia’s guidelines.</p> <p>Some 1,741 participants were put on this fast track. First, they did a blood test that measured the cancer antigen 125 (CA125). If a woman’s CA125 level was abnormal, she was sent to do a internal vaginal ultrasound.</p> <h2>What did they find?</h2> <p>The study indicates this process is better at detecting ovarian cancer than general screening of people who don’t have symptoms. Some 12% of women on the fast-track pathway were diagnosed with some kind of ovarian cancer.</p> <p>A total of 6.8% of fast-tracked patients were diagnosed with high-grade serous ovarian cancer. It is the most aggressive form of cancer and responsible for 90% of ovarian cancer deaths.</p> <p>Out of those women with the most aggressive form, one in four were diagnosed when the cancer was still in its early stages. That is important because it allowed treatment of the most lethal cancer before it had spread significantly through the body.</p> <p>There were some promising signs in treating those with this aggressive form. The majority (95%) had surgery and three quarters (77%) had chemotherapy. Complete cytoreduction – meaning all of the cancer appears to have been removed – was achieved in six women out of ten (61%).</p> <p>It’s a promising sign that there may be ways to “catch” and target ovarian cancer before it is well-established in the body.</p> <h2>What does this mean for detection?</h2> <p>The study’s findings suggest this method of early testing and referral for the symptoms leads to earlier detection of ovarian cancer. This may also improve outcomes, although the study did not track survival rates.</p> <p>It also points to the importance of public awareness about symptoms.</p> <p>Clinicians should be able to recognise all of the ways ovarian cancer can present, including vague symptoms like general fatigue.</p> <p>But empowering members of the general public to recognise a narrower set of four symptoms can help trigger testing, detection and treatment of ovarian cancer earlier than we thought.</p> <p>This could also save GPs advising every woman who has general tiredness or constipation to undergo an ovarian cancer test, making testing and treatment more targeted and efficient.</p> <p>Many women remain <a href="https://www.google.com/url?q=https://pubmed.ncbi.nlm.nih.gov/24612526/&amp;sa=D&amp;source=docs&amp;ust=1723610085733806&amp;usg=AOvVaw3J5o5DwRFiDzFaQcD7VTQn">unaware of the symptoms</a> of ovarian cancer. This study shows recognising them may help early detection and treatment.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/236775/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, Australian Women and Girls' Health Research Centre, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/ovarian-cancer-is-hard-to-detect-focusing-on-these-4-symptoms-can-help-with-diagnosis-236775">original article</a>.</em></p>

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Shelley Duvall passes away at 75

<p>Shelley Duvall who starred in Stanley Kubrick's iconic horror film <em>The Shining</em> has passed away aged 75. </p> <p>Duvall died in her sleep on Thursday at her home in Bianco, Texas, after diabetes complications according to her friend and publicist Gary Springer. </p> <p>Her longtime partner, Dan Gilroy shared a heartbreaking statement. </p> <p>"My dear, sweet, wonderful life, partner, and friend left us last night," he said. </p> <p>"Too much suffering lately, now she's free. Fly away beautiful Shelley."</p> <p>Known for her thin physique, large expressive eyes and powerful performances, Duvall was remembered for her standout roles alongside Jack Nicholson in <em>The Shining</em> and Robin Williams in the comedy <em>Popeye</em>.</p> <p>She became Robert Altman's protégé after she was spotted by his staff members at a party in Houston, Texas in 1970, where she attended junior college, and Altman was preparing to film <em>Brewster McCloud</em> at the time.</p> <p>She also played memorable roles in some of his other films, including <em>Nashville</em> in 1975 and <em>3 Women</em> in 1977, which won her the Cannes Best Actress Award. </p> <p>"He offers me damn good roles," Duvall said about Altman for <em>The New York Times</em> in 1977.</p> <p>"None of them have been alike. He has a great confidence in me, and a trust and respect for me, and he doesn't put any restrictions on me or intimidate me, and I love him. I remember the first advice he ever gave me: 'Don't take yourself seriously.'"</p> <p>Despite <em>The Shining </em>being one of her greatest roles, filming it took an emotional toll on her, after having to be in hysterics during long days of filming, with one scene reportedly requiring 127 takes, </p> <p>By the 1990s she began retiring from acting and retreated from public life. </p> <p>"How would you feel if people were really nice, and then, suddenly, on a dime, they turn on you?" Duvall told the Times earlier this year.</p> <p>"You would never believe it unless it happens to you. That's why you get hurt, because you can't really believe it's true."</p> <p><em>Images: Soshellyduvall Instagram</em></p> <p> </p>

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Revolutionary diabetes detection via smartphone: A game-changer in healthcare

<p>In a groundbreaking advancement, scientists from <a href="https://www.klick.com/" target="_blank" rel="noopener">Klick Labs</a> have discovered a method that could revolutionise diabetes detection – using just a 10-second smartphone voice recording.</p> <p>No more travelling to clinics or waiting anxiously for blood test results. This new approach promises immediate, on-the-spot results, potentially transforming how we diagnose type 2 diabetes.</p> <p>The study, published in <a href="https://www.mcpdigitalhealth.org/article/S2949-7612(23)00073-1/fulltext" target="_blank" rel="noopener">Mayo Clinic Proceedings: Digital Health</a>, involved 267 participants, including 192 non-diabetic and 75 type 2 diabetic individuals. Each participant recorded a specific phrase on their smartphone multiple times a day over two weeks, resulting in 18,465 recordings.</p> <p>These recordings, lasting between six and 10 seconds each, were meticulously analysed for 14 acoustic features, such as pitch and intensity. Remarkably, these features exhibited consistent differences between diabetic and non-diabetic individuals, differences too subtle for the human ear but detectable by sophisticated signal processing software.</p> <p>Building on this discovery, the scientists developed an AI-based program to analyse the voice recordings alongside patient data like age, sex, height and weight. The results were impressive: the program accurately identified type 2 diabetes in women 89% of the time and in men 86% of the time.</p> <p>These figures are competitive with traditional methods, where fasting blood glucose tests show 85% accuracy and other methods, like glycated haemoglobin and oral glucose tolerance tests, range between 91% and 92%.</p> <p>"This technology has the potential to remove barriers entirely," said Jaycee Kaufman, a research scientist at Klick Labs and the study's lead author. Traditional diabetes detection methods can be time-consuming, costly and inconvenient, but voice technology could change all that, providing a faster, more accessible solution.</p> <p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Looking ahead, the team plans to conduct further tests on a larger, more diverse population to refine and validate this innovative approach. If successful, this could mark a significant leap forward in diabetes management and overall healthcare, making early detection simpler and more accessible than ever before.</span></p> <p>Stay tuned as this exciting development unfolds, potentially bringing us closer to a future where managing and detecting diabetes is as simple as speaking into your smartphone.</p> <p><em>Image: Shutterstock</em></p>

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Could not getting enough sleep increase your risk of type 2 diabetes?

<p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936"><em>University of Technology Sydney</em></a></em></p> <p>Not getting enough sleep is a common affliction in the modern age. If you don’t always get as many hours of shut-eye as you’d like, perhaps you were concerned by news of a <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">recent study</a> that found people who sleep less than six hours a night are at higher risk of type 2 diabetes.</p> <p>So what can we make of these findings? It turns out the relationship between sleep and diabetes is complex.</p> <h2>The study</h2> <p>Researchers analysed data from the <a href="https://www.ukbiobank.ac.uk/">UK Biobank</a>, a large biomedical database which serves as a global resource for health and medical research. They looked at information from 247,867 adults, following their health outcomes for more than a decade.</p> <p>The researchers wanted to understand the associations between sleep duration and type 2 diabetes, and whether a healthy diet reduced the effects of short sleep on diabetes risk.</p> <p>As part of their involvement in the UK Biobank, participants had been asked roughly how much sleep they get in 24 hours. Seven to eight hours was the average and considered normal sleep. Short sleep duration was broken up into three categories: mild (six hours), moderate (five hours) and extreme (three to four hours). The researchers analysed sleep data alongside information about people’s diets.</p> <p>Some 3.2% of participants were diagnosed with type 2 diabetes during the follow-up period. Although healthy eating habits were associated with a lower overall risk of diabetes, when people ate healthily but slept less than six hours a day, their risk of type 2 diabetes increased compared to people in the normal sleep category.</p> <p>The researchers found sleep duration of five hours was linked with a 16% higher risk of developing type 2 diabetes, while the risk for people who slept three to four hours was 41% higher, compared to people who slept seven to eight hours.</p> <p>One limitation is the study defined a healthy diet based on the number of servings of fruit, vegetables, red meat and fish a person consumed over a day or a week. In doing so, it didn’t consider how dietary patterns such as time-restricted eating or the Mediterranean diet may modify the risk of diabetes among those who slept less.</p> <p>Also, information on participants’ sleep quantity and diet was only captured at recruitment and may have changed over the course of the study. The authors acknowledge these limitations.</p> <h2>Why might short sleep increase diabetes risk?</h2> <p>In people with <a href="https://www.diabetesaustralia.com.au/about-diabetes/type-2-diabetes/">type 2 diabetes</a>, the body becomes resistant to the effects of a hormone called insulin, and slowly loses the capacity to produce enough of it in the pancreas. Insulin is important because it regulates glucose (sugar) in our blood that comes from the food we eat by helping move it to cells throughout the body.</p> <p>We don’t know the precise reasons why people who sleep less may be at higher risk of type 2 diabetes. But <a href="https://doi.org/10.7759/cureus.23501">previous research</a> has shown sleep-deprived people often have increased <a href="https://doi.org/10.1186/1476-511X-9-125">inflammatory markers</a> and <a href="https://doi.org/10.1007/s00125-015-3500-4">free fatty acids</a> in their blood, which <a href="https://doi.org/10.1007/s11892-018-1055-8">impair insulin sensitivity</a>, leading to <a href="https://doi.org/10.7759/cureus.23501">insulin resistance</a>. This means the body struggles to use insulin properly to regulate blood glucose levels, and therefore increases the risk of type 2 diabetes.</p> <p>Further, people who don’t sleep enough, as well as people who sleep in irregular patterns (such as shift workers), experience disruptions to their body’s natural rhythm, known as the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995632/">circadian rhythm</a>.</p> <p>This can interfere with the release of hormones like <a href="https://doi.org/10.1210/edrv.18.5.0317">cortisol, glucagon and growth hormones</a>. These hormones are released through the day to meet the body’s changing energy needs, and normally keep blood glucose levels nicely balanced. If they’re compromised, this may reduce the body’s ability to handle glucose as the day progresses.</p> <p>These factors, and <a href="https://www.science.org/doi/10.1126/sciadv.aar8590">others</a>, may contribute to the increased risk of type 2 diabetes seen among people sleeping less than six hours.</p> <p>While this study primarily focused on people who sleep eight hours or less, it’s possible longer sleepers may also face an increased risk of type 2 diabetes.</p> <p>Research has previously shown a U-shaped correlation between sleep duration and type 2 diabetes risk. A <a href="https://doi.org/10.2337/dc14-2073">review</a> of multiple studies found getting between seven to eight hours of sleep daily was associated with the lowest risk. When people got less than seven hours sleep, or more than eight hours, the risk began to increase.</p> <p>The reason sleeping longer is associated with increased risk of type 2 diabetes may be linked to <a href="https://doi.org/10.2337/dc15-0186">weight gain</a>, which is also correlated with longer sleep. Likewise, people who don’t sleep enough are more likely to be <a href="https://doi.org/10.1016/j.sleh.2017.07.013">overweight or obese</a>.</p> <h2>Good sleep, healthy diet</h2> <p>Getting enough sleep is an important part of a healthy lifestyle and may reduce the risk of type 2 diabetes.</p> <p>Based on this study and other evidence, it seems that when it comes to diabetes risk, seven to eight hours of sleep may be the sweet spot. However, other factors could influence the relationship between sleep duration and diabetes risk, such as individual differences in sleep quality and lifestyle.</p> <p>While this study’s findings question whether a healthy diet can mitigate the effects of a lack of sleep on diabetes risk, a wide range of evidence points to the benefits of <a href="https://www.who.int/initiatives/behealthy/healthy-diet">healthy eating</a> for overall health.</p> <p>The <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2815684">authors of the study</a> acknowledge it’s not always possible to get enough sleep, and suggest doing <a href="https://pubmed.ncbi.nlm.nih.gov/33137489/">high-intensity interval exercise</a> during the day may offset some of the potential effects of short sleep on diabetes risk.</p> <p>In fact, exercise <a href="https://doi.org/10.1016/j.jshs.2023.03.001">at any intensity</a> can improve blood glucose levels.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/225179/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/giuliana-murfet-1517219">Giuliana Murfet</a>, Casual Academic, Faculty of Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a> and <a href="https://theconversation.com/profiles/shanshan-lin-1005236">ShanShan Lin</a>, Senior Lecturer, School of Public Health, <a href="https://theconversation.com/institutions/university-of-technology-sydney-936">University of Technology Sydney</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-not-getting-enough-sleep-increase-your-risk-of-type-2-diabetes-225179">original article</a>.</em></p>

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12 signs that you’re borderline diabetic

<p><strong>Do you have diabetes?</strong></p> <p>If you are a borderline diabetic, it means you have prediabetes. Your blood sugar levels are higher than normal, but not enough to be diagnosed with full-blown type 2 diabetes. Maybe you’ve noticed that you’re losing weight or more tired than normal. Or perhaps you’re thirsty or have vision issues. Here’s a look at some of the more common signs that you could be a borderline diabetic.</p> <p><strong>You’re really thirsty and are peeing a lot</strong></p> <p>“Prediabetes is caused when the body is unable to efficiently process blood sugars,” says endocrinologist Dr Jason Ng. “This happens over time as the body builds up resistance to insulin, the hormone that helps the body control blood sugars.” As you become insulin resistant, the body has to produce more insulin to keep blood sugars at a good level.</p> <p>Eventually it can’t keep up, so blood sugars rise. Prediabetes may take you by surprise, as there often aren’t symptoms – though there are a few subtle cues you can look out for. “A patient may feel slightly more thirsty and have to urinate more over time as well as the sugars increase in their body,” Dr Ng says.</p> <p><strong>You're exhausted </strong></p> <p>Borderline diabetes could be one of the medical reasons you’re tired all the time. If you’re one of the 2 million Australians who have prediabetes, according to Diabetes Australia you may notice you’re not feeling up to your normal activity level. “Patients may feel more tired or sluggish,” Dr Ng says. Blood sugar fluctuations can cause fatigue; plus, other factors that often appear with blood sugar problems could be the culprit, such as depression or obesity, according to a study published in 2012 in Diabetes Educator.</p> <p>Physical activity is recommended by the American Diabetes Association to help with prediabetes symptoms, but ironically people with the condition may be too tired to exercise. If that’s the case, see your doctor. “Most of prediabetes is diagnosed by lab work at a doctor’s office,” Dr Ng says. With prediabetes, “fasting sugar is between 100 to 125 mg/dl or a random blood sugar between 140 to 200 mg/dl.”</p> <p><strong>You’re losing weight</strong></p> <p>Among the silent diabetes signs you might be missing is weight loss. Although we associate blood sugar problems with being overweight, once you start becoming borderline diabetic you may actually drop kilos. If you’re going to the bathroom more frequently, you’re excreting extra sugar and losing more kilojoules. Diabetes may also keep sugar in your food from reaching your cells.</p> <p>This might leave you “feeling hungry all the time,” says Dr Deena Adimoolam, assistant professor of medicine, endocrinology, diabetes and bone disease. So if you’re eating more than usual and still losing weight, talk to your doctor.</p> <p><strong>You have blurred vision </strong></p> <p>One of the clear signs you have high blood sugar is actually not seeing clearly. Dr Adimoolam says that blurred vision is a sign that you’re borderline prediabetic. Why? Diabetic eye disease occurs when high blood sugar causes damage to the blood vessels in the eye, which can leak and swell, leading to vision changes. According to the National Eye Institute, one type of eye damage, diabetic retinopathy, is the leading cause of vision loss among people with diabetes and the leading cause of blindness among adults.</p> <p>A study by The Diabetes Prevention Program (DPP) found that 8 per cent of prediabetic participants had diabetic retinopathy. It can be addressed if caught early, so bring up blurry vision to your doctor as soon as you notice it.</p> <p><strong>You have dark areas on your skin</strong></p> <p>One body changes that could signal a bigger problem that you are borderline prediabetic are dark patches on your skin called acanthosis nigricans (AN). The condition usually appears in elbows, armpits, knees, or on the neck, has a velvety texture, and likely occurs because excess insulin causes a rapid growth of cells. It’s also more common in people with obesity – another risk factor for prediabetes.</p> <p>But a study published in the Annals of Family Medicine showed that although patients with AN tend to have multiple risk factors for diabetes, AN itself may also be an independent risk factor for the disease. Because of this, AN’s presence may help doctors detect prediabetes sooner.</p> <p><strong>You have PCOS</strong></p> <p>Polycystic ovary syndrome (PCOS) is a disorder where a woman’s hormones are unbalanced. Studies like one published in the Journal of Clinical Endocrinology and Metabolism in 2017, have shown that PCOS is a risk factor for diabetes.</p> <p>It’s not known exactly how they are linked, but researchers are looking into the connection between PCOS and insulin. High levels of insulin may contribute to increased production of male hormones called androgens, which is a symptom of PCOS. PCOS is also associated with being overweight, as is prediabetes – but studies have shown that even average-weight women with PCOS are at increased risk of high blood sugar.</p> <p>Also, women with PCOS may be more likely to have gestational diabetes (diabetes while pregnant; more on that later), which also can lead to an increased risk of type 2 diabetes. If you are diagnosed with PCOS, your reproductive endocrinologist may test your glucose level to make sure you’re not borderline prediabetic.</p> <p><strong>You don't get good sleep </strong></p> <p>“When you don’t get enough sleep, less insulin is released in the body,” says Dr Richard Shane, behavioural sleep therapist. “Sleep deprivation can cause insulin-producing cells to fail to use the insulin efficiently or to stop functioning. Your body also secretes more stress hormones, which interfere with insulin’s ability to be effective.”</p> <p>In one study, duration and quality of sleep was shown to be associated with prediabetes. Another factor could be that we tend to crave kilojoules and junk food for energy when we’re tired – plus, we don’t feel like exercising. This can lead to inactivity and weight gain, other risk factors for prediabetes.</p> <p><strong>You have a family history of diabetes</strong></p> <p>Among the medical facts you should know is your family’s health history. “There can be a genetic cause for the development of type 2 diabetes due to certain gene mutations,” Dr Adimoolam says. “Some people may have a genetic predisposition to developing type 2 diabetes due to presence of certain genes than have been passed down from one generation to the next.” One study in Diabetologia found that a family history of diabetes increased the risk for prediabetes by 26 per cent.</p> <p>The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) says that you’re more likely to develop diabetes if you have a family history of the disease. In addition, “Some data suggests that the risk of type 2 diabetes is five times higher in those with diabetes on both the maternal and paternal sides of the family,” Dr Adimoolam says.</p> <p><strong>You're of a certain age </strong></p> <p>There are many reasons why you’ll age better than your parents, including that you know age itself is a risk factor for certain conditions – so you’ll take measures to prevent them. Unfortunately, prediabetes is more likely in older people. “The higher your age, the greater risk for development of diabetes,” Dr Adimoolam says. “This might be related to increased body fat with age, which increases one’s risk for type 2 diabetes.”</p> <p>In addition, Dr Ng says that high blood pressure and high cholesterol are also risk factors for prediabetes. These are all common conditions as we age, and are also associated with metabolic syndrome, a cluster of disorders that can lead to heart disease and stroke.</p> <p><strong>You had gestational diabetes</strong></p> <p>Having had gestational diabetes in the past also puts you at risk for prediabetes now, according to research, including a study in BMC Pregnancy and Childbirth. “Once you have been diagnosed with any form of diabetes, like gestational diabetes, you are at an increased risk for developing this again over time, especially with weight gain,” Dr Adimoolam says.</p> <p>According to the American Diabetes Association, doctors don’t know exactly why gestational diabetes develops, but it could be that pregnancy hormones affect how the body uses insulin. The NIDDK suggests women who’ve had gestational diabetes have their blood glucose tested every three years.</p> <p><strong>You're overweight </strong></p> <p>You can potentially reverse type 2 diabetes if you lose weight – and the same goes for if you are borderline diabetic. “By and large, obesity is the main cause of insulin resistance, as certain fat cells are known to cause and intensify insulin resistance over time,” Dr Ng says. And it’s not just how much you weigh, but where your weight is located on your body. “Waist size is typically proportional to centralised, or abdominal, obesity,” Dr Adimoolam says.</p> <p>“The more centralised abdominal fat, the higher one’s insulin resistance, and the greater the increased risk for the development of type 2 diabetes.” Genetics may also play a role here, as certain body types with more abdominal fat (“apple-shaped”) can run in families and certain ethnic groups, she says.</p> <p><strong>You have an unhealthy lifestyle </strong></p> <p>Whether you are borderline prediabetic or not, there are many science-based reasons to start working out. “Lack of exercise may promote weight gain, which is a risk factor for type 2 diabetes,” Dr Adimoolam says. A study from Johns Hopkins published in the Journal of General Internal Medicineshowed that people with prediabetes who dropped 10 per cent of their body weight dramatically reduced their risk of diabetes – but every little bit helps.</p> <p>Dr Ng suggests losing even 5 to 7 per cent of your body weight, quitting smoking, and adopting a borderline diabetic diet. “Interventions that typically reduce weight include increased exercise, especially aerobic exercise, 150 minutes or more per week, and eating a balanced, low-fat diet that is not heavy on carbs,” he says. “Prediabetes is often thought of as a ‘warning sign,’ which is why lifestyle intervention is so important.”</p> <p>Ultimately, the message is that prediabetes is not irreversible. “Prediabetes is the stage before one develops type 2 diabetes, and in most cases is preventable,” Dr Adimoolam says. “You may not need medications to treat prediabetes if you are able to change your lifestyle, with the goal for treatment focusing on diet changes and exercise.”</p> <p><em>Image credits: Getty Images </em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/diabetes/12-signs-that-youre-borderline-diabetic?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p>

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These 10 smart grocery swaps can help reverse diabetes

<p><strong>Diagnosis diabetes</strong></p> <p>It can feel daunting to be faced with the need to make a major lifestyle change. You enjoy food, and you should. At Reader’s Digest, we like to think nature designed nutrition to taste delicious so it can be a source of pleasure in your day that’s fun to look forward to.</p> <p>If you’ve been diagnosed with diabetes or pre-diabetes, this diagnosis doesn’t have to take over your whole identity and all the things that bring you joy. There are ways to adapt some of your favourite foods so you can still have them!</p> <p>Registered dietitian Jackie Newgent lists interesting meal swaps you can make so that classic dishes can be healthier, while still plenty pleasurable.</p> <p>With some wisdom and dedication, it can be possible to turn your condition around and feel great for good.</p> <p><strong>Pair starchy with non-starchy veggies</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one kilo potatoes</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> 500g kilo potatoes plus 500g cauliflower</p> <p>This mashed potato hack keeps your total carbs in check without forgoing flavour. Whip equal parts boiled potatoes together with roasted or boiled cauliflower. </p> <p>The results of this dynamic duo may help you better manage your blood glucose, since they’re carb-friendlier than a huge bowl of mashed potatoes alone: 100 grams of cooked potatoes without skin provides 22 grams of total carbohydrates, versus 13 grams total carbohydrate in the 100 gram combination of cooked potatoes and cauliflower.</p> <p><strong>Pick fruit you can chew</strong></p> <div> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one litre apple juice</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one bag of apples</p> <p>Enjoy whole fruit rather than just the juice whenever possible to get all the fibre of the naturally sweet fruit with its edible peel…plus chewing satisfaction. One medium apple contains 4.4 grams of fibre while a 200ml glass or juice box of 100-percent apple juice has 0.4 grams of fibre. </p> <p>The soluble fibre in apples can help slow down absorption of sugars. Polyphenols in apples may have powerful antioxidant properties.</p> <p><strong>Grill a better burger</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> 500g 85% lean ground beef patties</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> 500g ground chicken breast</p> <p>Gram for gram, chicken breast has significantly less saturated fat than the marbly beef of classic burgers. Specifically, an 85g cooked 85% lean ground beef patty has five grams of saturated fat compared to 0.6 grams of saturated fat for a cooked patty made from 85g of chicken breast meat.</p> <p>Keeping saturated fat intake low is especially important when you have diabetes to help keep your heart healthy. Pro-tip: make chicken burgers juicier and tastier by combining ground chicken breast with a little plain yogurt, rolled oats, and herbs and spices before cooking.</p> <p><strong>Look for live cultures in the dairy section</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one container regular cottage cheese</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one container plain low-fat Greek yogurt or cultured cottage cheese</p> <p>Probiotics are “good” bacteria that help keep your gut healthy. For people with type 2 diabetes, research published in Advances in Nutrition suggested that probiotics may also have glucose-lowering potential. So, pop products with live active cultures (probiotics) into your cart while strolling by the dairy aisle. Choose plain low-fat Greek yogurt or cultured cottage cheese.</p> <p>Be sure to read the nutrition labels, since probiotics aren’t in all dairy foods. And, for the lower-sodium pick, stick with yogurt.</p> <p><strong>Choose healthier-sized grain portions </strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> 1/2 dozen bakery-style plain bagels</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one package of wholegrain English muffins</p> <p>Swapping wholegrain in place of refined grain products helps kick up fibre and other plant nutrients. Studies suggests this is linked to lower risk of type 2 diabetes. Also, opting for healthier-sized varieties, such as wholegrain English muffins rather than big bakery-style plain bagels helps cut kilojoules (and carbs) – not enjoyment – while promoting a healthier weight. In fact, you’ll slash over 1000 kilojoules by enjoying a whole-wheat English muffin instead of that oversized 140g bagel.</p> <p><strong>Get your munchies with benefits </strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one bag of potato chips</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one jar or bulk-bin container of roasted peanuts</p> <p>It’s a no-brainer: a small handful of nuts is a better bet than potato chips. Peanuts, for instance, offer a triple whammy of dietary fibre, plant protein and healthy fat, which can boost satiety. Greater satisfaction means a greater chance you’ll keep mealtime portions right-sized.</p> <p>When peanuts or other nuts are eaten along with carb-rich foods, they can help slow down the blood sugar response. Plus, a Mediterranean study found that higher nut consumption may be associated with better metabolic status.</p> <p><strong>Dress a salad smartly </strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one bottle of fat-free salad dressing</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one small bottle olive oil plus one small bottle balsamic or red wine vinegar</p> <p>Some bottled salad dressings can trick you. For instance, “fat-free” salad dressing may be loaded with added sugars. (For reference: four grams of sugar is equal to one teaspoon.)</p> <p>So, read salad dressing labels carefully for sneaky ingredients, especially excess salt (over 250 milligrams of sodium per two-tablespoon serving) or added sugars (more than five grams added sugars per two-tablespoon serving). Better yet, keep it simple and make your own vinaigrette using 2-3 parts oil to 1 part vinegar.</p> <p><strong>Select less salty soup</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one can/carton of vegetable- or bean-based soup</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one can/carton of low-sodium vegetable- or bean-based soup</p> <p>When compared to people without diabetes, sodium levels were higher in patients with type 2 diabetes, based on a meta-analysis published in European Journal of Nutrition. Curbing sodium intake is beneficial for people with diabetes since too much may increase your risk for high blood pressure.</p> <p>So, slurp up soup that’s low in sodium. And kick up flavour with a splash of cider vinegar, grated citrus zest, herbs, spices, or a dash of hot sauce.</p> <p><strong>Go for "naked" fish</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> Breaded fish sticks</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> Frozen salmon fillets</p> <p>Cut salmon into large cubes, season, and grill on skewers. Or make fish sticks by simply cutting into skinny fillets, season and roast. Why? Research published in Diabetes Care finds that eating oily fish may be associated with a lower risk of type 2 diabetes. Non-oily fish, like the whitefish in fish sticks, didn’t show this link.</p> <p>Salmon is an oily fish and a major source of omega-3 fatty acids, a heart-friendly fat. Plus: when you make your own salmon skewers or sticks, you won’t have extra carbs from breading.</p> <p><strong>Do dip with a punch of protein</strong></p> <p><span style="text-decoration: underline;"><em>Instead of:</em></span> one container of sour cream &amp; onion dip</p> <p><span style="text-decoration: underline;"><em>Buy:</em></span> one container of pulse-based dip, like hummus</p> <p>Wise snacking can be helpful for managing blood glucose. It can also be delicious. Dunk veggies or wholegrain pita wedges into pulse-based dip, like hummus, black bean dip, or lentil dip. </p> <p>Check this out: one-quarter cup (that’s 60 grams) of onion dip has 870 kiljoules, five grams of saturated fat, 1.2 grams of protein, and 0.1 grams of fibre, while one-quarter cup hummus has 590 kilojoules, 1.5 grams of saturated fat, 4.7 grams of protein, and 3.3 grams of fibre. Hummus clearly wins!</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/diabetes/reverse-diabetes-10-smart-grocery-swaps?pages=1" target="_blank" rel="noopener">Reader's Digest</a>. </em></p> </div>

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1 in 6 women are diagnosed with gestational diabetes. But this diagnosis may not benefit them or their babies

<p><em><a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p>When Sophie was pregnant with her first baby, she had an <a href="https://www.ncbi.nlm.nih.gov/books/NBK279331/#:%7E:text=Oral%20glucose%20tolerance%20tests%20(OGTT,enough%20by%20the%20body's%20cells.)">oral glucose tolerance</a> blood test. A few days later, the hospital phoned telling her she had gestational diabetes.</p> <p>Despite having only a slightly raised glucose (blood sugar) level, Sophie describes being diagnosed as affecting her pregnancy tremendously. She tested her blood glucose levels four times a day, kept food diaries and had extra appointments with doctors and dietitians.</p> <p>She was advised to have an induction because of the risk of having a large baby. At 39 weeks her son was born, weighing a very average 3.5kg. But he was separated from Sophie for four hours so his glucose levels could be monitored.</p> <p>Sophie is not alone. About <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">one in six</a> pregnant women in Australia are now diagnosed with gestational diabetes.</p> <p>That was not always so. <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2827530/">New criteria</a> were developed in 2010 which dropped an initial screening test and lowered the diagnostic set-points. Gestational diabetes diagnoses have since <a href="https://www.aihw.gov.au/reports/diabetes/diabetes/contents/how-many-australians-have-diabetes/gestational-diabetes">more than doubled</a>.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=388&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=388&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=388&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=487&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=487&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/536691/original/file-20230710-23-v8weyw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=487&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="caption">Gestational diabetes rates more than doubled after the threshold changed.</span> <span class="attribution"><span class="source">AIHW</span>, <span class="license">Author provided</span></span></figcaption></figure> <p>But <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">recent</a> <a href="https://pubmed.ncbi.nlm.nih.gov/33704936/">studies</a> cast doubt on the ways we diagnose and manage gestational diabetes, especially for women like Sophie with only mildly elevated glucose. Here’s what’s wrong with gestational diabetes screening.</p> <h2>The glucose test is unreliable</h2> <p>The test used to diagnose gestational diabetes – the oral glucose tolerance test – has poor reproducibility. This means subsequent tests may give a different result.</p> <p>In a <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2214956">recent Australian trial</a> of earlier testing in pregnancy, one-third of the women initially classified as having gestational diabetes (but neither told nor treated) did not have gestational diabetes when retested later in pregnancy. That is a problem.</p> <p>Usually when a test has poor reproducibility – for example, blood pressure or cholesterol – we repeat the test to confirm before making a diagnosis.</p> <p>Much of the increase in the incidence of gestational diabetes after the introduction of new diagnostic criteria was due to the switch from using two tests to only using a single test for diagnosis.</p> <h2>The thresholds are too low</h2> <p>Despite little evidence of benefit for either women or babies, the current Australian criteria diagnose women with only mildly abnormal results as having “gestational diabetes”.</p> <p>Recent studies have shown this doesn’t benefit women and may cause harms. A <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa2204091">New Zealand trial</a> of more than 4,000 women randomly assigned women to be assessed based on the current Australian thresholds or to higher threshold levels (similar to the pre-2010 criteria).</p> <p>The trial found no additional benefit from using the current low threshold levels, with overall no difference in the proportion of infants born large for gestational age.</p> <p>However, the trial found several harms, including more neonatal hypoglycaemia (low blood sugar in newborns), induction of labour, use of diabetic medications including insulin injections, and use of health services.</p> <p>The study authors also looked at the subgroup of women who were diagnosed with glucose levels between the higher and lower thresholds. In this subgroup, there was some reduction in large babies, and in shoulder problems at delivery.</p> <p>But there was also an increase in small babies. This is of concern because being small for gestational age can also have consequences for babies, including long-term health consequences.</p> <figure class="align-center "><img src="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=600&amp;h=349&amp;fit=crop&amp;dpr=1 600w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=600&amp;h=349&amp;fit=crop&amp;dpr=2 1200w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=600&amp;h=349&amp;fit=crop&amp;dpr=3 1800w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=45&amp;auto=format&amp;w=754&amp;h=438&amp;fit=crop&amp;dpr=1 754w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=30&amp;auto=format&amp;w=754&amp;h=438&amp;fit=crop&amp;dpr=2 1508w, https://images.theconversation.com/files/540643/original/file-20230802-29-1dw2rw.png?ixlib=rb-1.1.0&amp;q=15&amp;auto=format&amp;w=754&amp;h=438&amp;fit=crop&amp;dpr=3 2262w" alt="" /><figcaption><span class="attribution"><span class="source">NEJM</span>, <span class="license">Author provided</span></span></figcaption></figure> <h2>Testing too early</h2> <p>Some centres have begun testing women at higher risk of gestational diabetes earlier in the pregnancy (between 12 and 20 weeks).</p> <p>However, a <a href="https://pubmed.ncbi.nlm.nih.gov/37144983/">recent trial</a> showed no clear benefit compared with testing at the usual 24–28 weeks: possibly fewer large babies, but again matched by more small babies.</p> <p>There was a reduction in transient “respiratory distress” – needing extra oxygen for a few hours – but not in serious clinical events.</p> <h2>Impact on women with gestational diabetes</h2> <p>For women diagnosed using the higher glucose thresholds, dietary advice, glucose monitoring and, where necessary, insulin therapy has been shown to reduce complications during delivery and the post-natal period.</p> <p>However, current models of care can also cause harm. Women with gestational diabetes are often denied their preferred model of care – for example, midwifery continuity of carer. In rural areas, they may have to transfer to a larger hospital, requiring longer travel to antenatal visits and moving to a larger centre for their birth – away from their families and support networks for several weeks.</p> <p>Women say the diagnosis often dominates their antenatal care and their whole <a href="https://pubmed.ncbi.nlm.nih.gov/32028931/">experience of pregnancy</a>, reducing time for other issues or concerns.</p> <p>Women from culturally and linguistically diverse communities <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-021-03981-5">find it difficult</a> to reconcile the advice given about diet and exercise with their own cultural practices and beliefs about pregnancy.</p> <p>Some women with gestational diabetes <a href="https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-020-2745-1">become</a> extremely anxious about their eating and undertake extensive calorie restrictions or disordered eating habits.</p> <h2>Time to reassess the advice</h2> <p>Recent evidence from both randomised controlled trials and from qualitative studies with women diagnosed with gestational diabetes suggest we need to reassess how we currently diagnose and manage gestational diabetes, particularly for women with only slightly elevated levels.</p> <p>It is time for a review to consider all the problems described above. This review should include the views of all those impacted by these decisions: women in childbearing years, and the GPs, dietitians, diabetes educators, midwives and obstetricians who care for them.</p> <p><em>This article was co-authored by maternity services consumer advocate Leah Hardiman.</em><!-- Below is The Conversation's page counter tag. Please DO NOT REMOVE. --><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/205919/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /><!-- End of code. If you don't see any code above, please get new code from the Advanced tab after you click the republish button. The page counter does not collect any personal data. More info: https://theconversation.com/republishing-guidelines --></p> <p><em><a href="https://theconversation.com/profiles/paul-glasziou-13533">Paul Glasziou</a>, Professor of Medicine, <a href="https://theconversation.com/institutions/bond-university-863">Bond University</a> and <a href="https://theconversation.com/profiles/jenny-doust-12412">Jenny Doust</a>, Clinical Professorial Research Fellow, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a></em></p> <p><em>Image credits: Getty Images</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/1-in-6-women-are-diagnosed-with-gestational-diabetes-but-this-diagnosis-may-not-benefit-them-or-their-babies-205919">original article</a>.</em></p>

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COVID-19 infection linked to a higher risk of diabetes

<p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">A Canadian study looking at more than 600,000 people has found a higher rate of new diabetes diagnoses in those who’d been infected with </span><a style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;" href="https://cosmosmagazine.com/health/covid/" target="_blank" rel="noreferrer noopener">COVID-19</a><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">.</span></p> <div class="copy"> <p>The study, which is <a href="https://doi.org/10.1001/jamanetworkopen.2023.8866" target="_blank" rel="noreferrer noopener">published</a> in <em>JAMA Network Open</em>, suggests that COVID may be responsible for a 3% to 5% excess burden of diabetes at the population level.</p> <p>The Canadian researchers drew on data from the British Columbia COVID-19 Cohort: a study that collected the health records of people tested for SARS-CoV-2 in the province from January 2020 to December 2021.</p> <p>From this cohort, 125,987 people tested positive to COVID-19. The researchers matched each of these people with four unexposed people of the same age, sex, and test date.</p> <p>This gave them a sample of 629,935 people, a fifth of whom had been infected with SARS-CoV-2.</p> <p>They then went looking for incident diabetes – that is, a new diagnosis – more than 30 days after the COVID test.</p> <p>The COVID-positive group had a rate of 672.2 new diabetes diagnoses per 100,000 people, significantly higher than the control group’s rate of 508.7 new diagnoses per 100,000.</p> <p>This translates to roughly 3-5% extra diabetes cases at a population level, according to the researchers’ analysis.</p> <p>“Our overall results were consistent with several other studies finding higher risk of incident diabetes after SARS-CoV-2 infection; however, the increase in risk was lower in our analysis compared with other studies,” they write in their paper.</p> <p>They suggest a few differences in study populations for this discrepancy.</p> <p>It’s not yet clear <em>why</em> there’s a link between COVID infection and diabetes.</p> <p>In their paper, the researchers point out that SARS-CoV-2 has been shown to attack pancreatic cells which are involved with insulin production. Low-grade inflammation from COVID could also play a role. But these processes are still poorly understood.</p> <p>“Our study highlights the importance of health agencies and clinicians being aware of the potential long-term consequences of COVID-19 and monitoring people after COVID-19 infection for new-onset diabetes for timely diagnosis and treatment,” conclude the researchers.</p> </div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/covid/diabetes-covid-link/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by Ellen Phiddian.</em></p> <p><em>Images: Getty</em></p> </div>

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Naturally combat the onset of diabetes

<p dir="ltr">Pre-diabetes is the period before diabetes is officially diagnosed. Progressing from pre-diabetes to diabetes is not imminent. There are plenty of ways you can get on top of it to reduce the risk of diabetes. </p> <p dir="ltr" role="presentation"><strong>1. Cut out sugar and refined carbohydrates </strong></p> <p dir="ltr">Eating foods high in refined carbs and sugar increases blood sugar and insulin levels, which could lead to diabetes over time. Examples of these foods are white bread, potatoes and various breakfast cereals. Limit sugar and choose complex carbs like veggies, oatmeal and whole grains.</p> <p dir="ltr"><strong>2. Quit smoking</strong></p> <p dir="ltr">If you’re a current smoker, cut it out! Smoking can contribute to insulin resistance which can lead to type 2 diabetes. Quitting smoking has been shown to reduce the risk of developing type 2 diabetes over time.</p> <p dir="ltr"><strong>3. Portion control</strong></p> <p dir="ltr">Avoid large portions as they can contribute to the increase of insulin and blood sugar levels. Eating too much at one time can lead to higher blood sugar and insulin levels in pre-diabetics.</p> <p dir="ltr"><strong>4. Exercise</strong></p> <p dir="ltr">Aim for at least 30 minutes of exercise a day. You don’t have to strain yourself, you can take a walk, go swimming or dance around the house, but make sure you stay on top of it and practise these activities at least five days a week. </p> <p dir="ltr"><strong>5. Drink more water</strong></p> <p dir="ltr">Drinking water over other beverages may help control blood sugar and insulin levels. Drinking primarily water will stop you from over consuming beverages that are high in sugar and preservatives, in turn reducing the risk of diabetes.</p> <p dir="ltr"><strong>6. Eat more fibre</strong></p> <p dir="ltr">Getting an adequate amount of fibre is beneficial for gut health and weight management. Having a good source of fibre at each meal can help prevent spikes in blood sugar and insulin levels. </p> <p dir="ltr"><em>Image credit: Shutterstock</em></p>

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The best and worst drinks for people with diabetes

<p><span style="color: #444444; font-family: Raleway, sans-serif, 'Helvetica Neue', Helvetica, Arial; font-size: 16px; background-color: #ffffff;">Choosing the right drinks for people with diabetes is as important as choosing the right foods, and it isn’t always simple. Is coffee helpful or harmful to insulin resistance? Does zero-calorie diet soda affect your blood sugar? Some studies may only add to the confusion. We reviewed the research and then asked three top registered dietitians, who are also certified diabetes educators, what they tell their clients about seven everyday drinks for people with diabetes. Here’s what to know before you sip.</span></p> <h4><span style="color: #444444; font-family: Raleway, sans-serif, Helvetica Neue, Helvetica, Arial;">Drink more: Water</span></h4> <p>Drinking enough water has so many health benefits. But could downing a few glasses of H2O help control your blood sugar? A study in the journal Diabetes Care suggests so: The researchers found that people who drank 475ml (two cups’ worth) or less of water a day were about 30 percent more likely to have high blood sugar than those who drank more than that daily. The connection seems to be a hormone called vasopressin, which helps the body regulate hydration. Vasopressin levels increase when a person is dehydrated, which prompts the liver to produce more blood sugar.</p> <p><strong>How much:</strong> Experts recommend six to nine 250ml glasses of water per day for women and slightly more for men. You’ll get some of this precious fluid from fruit and vegetables and other fluids, but not all of it. “If you’re not in the water habit, have a glass before each meal,” recommends registered dietitian Constance Brown-Riggs, a certified diabetes educator. “After a few weeks, add a glass at meals too.” If you’re already meeting your water targets, there’s no need to push it further.</p> <h4>Drink more: Milk</h4> <p>Moo juice isn’t just a kids’ drink – it’s one of the best drinks for people with diabetes, too. It provides the calcium, magnesium, potassium and vitamin D your body needs for many essential functions. “Low-fat or fat-free milk is a great beverage for people with diabetes,” Brown-Riggs says. Drinking more milk can also help prevent strokes (a concern for many people with diabetes) by 7 percent, according to research from the <em>Journal of the American Heart Association</em>. Bonus: The researchers also found that eating cheese produced the same effect. If you’re lactose intolerant or allergic to dairy, eating plenty of dark green vegetables can help you obtain the calcium and other electrolytes you need.</p> <p><strong>How much: </strong>Experts recommend eating two to three daily servings of dairy products, including low-fat or fat-free milk. Milk does contain carbohydrates so remember to factor in 12 grams of carbohydrate for every 250ml glass. “Drink milk with a meal so your body can handle the natural rise in blood sugar that happens when we eat carbohydrates,” says registered dietitian Angela Ginn, a certified diabetes educator.</p> <h4>Drink more: Tea</h4> <p>No kilojoules, big flavour, and a boatload of antioxidants have made tea – particularly green and black – trendy for health reasons, especially when it comes to drinks for people with diabetes. Sipping more than three cups of tea a day could lower the risk for developing diabetes, other researchers found. Tea may also help reduce your risk of stroke and heart disease. The exception to these diabetic drinks: sweetened, bottled iced teas, which have tons of added sugar.</p> <p><strong>How much:</strong> Three to four cups of tea are OK for most people; just be sure the caffeine doesn’t keep you awake at night. More is fine if you opt for decaf. And watch what you add: Avoid sugar and full-fat milk and cream.</p> <h4>Drink carefully: Coffee</h4> <p>A 2018 systematic review and meta-analysis in Nutrition Reviews found that coffee drinkers are at lower risk for developing type 2 diabetes. (A compound in coffee called chlorogenic acid seems to slow absorption of glucose into the bloodstream.) But other research indicates that for people who already have diabetes, coffee may raise blood sugar or make the body work harder to process it. Bottom line: It comes down to how coffee affects your individual blood sugar. What many people with diabetes add to their coffee may be the real issue. “Sugar, sweetened creamers, and high-fat milk and half-and-half can raise your blood sugar and your weight,” Brown-Riggs says.</p> <p><strong>How much:</strong> Experts say sipping two to three cups a day is probably fine, but if you’re having a tough time controlling your blood sugar, it may be worth cutting out coffee to see if it makes a difference. “Everyone’s blood sugar response to foods is unique and individual,” Ginn says.</p> <h4>Drink carefully: Diet soft drink</h4> <p>Are fizzy, zero-calorie drinks a brilliant choice for people concerned about diabetes, or could they do more harm than good? One 2018 study in Current Developments in Nutrition looked at over 2,000 people and found that those who drank diet soft drink every day increased their chances of developing diabetes, leading researchers to conclude that diet soda itself could be a risk factor. The news may be even worse for diabetics drinking zero-calorie sodas. Researchers in Australia looked at 600 patients with diabetes and found that drinking more than four cans of diet soft drink a week doubled their chances of developing proliferative diabetic retinopathy, an eye disease that’s a complication of diabetes.</p> <p><strong>How much:</strong> If you have a soft drink habit, it’s probably OK to sip one zero-calorie drink a day instead of a sugary version, but given the research, it’s best to wean yourself off. Make sure to also drink healthy drinks for people with diabetes like water and tea. Resist the temptation to see diet soft drink as a “magic eraser” allowing you to indulge in foods like chips, dips, sweets, fries, and burgers. People who enjoyed their diet soft drink as part of a healthy diet had lower risk of high blood sugar and high cholesterol than those who ate fried and sugary foods in one study in the <em>American Journal of Clinical Nutrition.</em></p> <h4><span style="color: #444444; font-family: Raleway, sans-serif, Helvetica Neue, Helvetica, Arial;">Drink less: Soft drink and sugary drinks</span></h4> <p>With upwards of 10 teaspoons of sugar in every 375ml can or bottle, sweet drinks can send your blood sugar soaring – and boost your risk for weight gain, high blood pressure, stroke and heart disease. One sugary drink a day can add 630 empty kilojoules and about 40 to 50 grams of blood-sugar-raising carbohydrates to your diet, all of which can cause you to pack on belly fat and increase inflammation and insulin resistance – boosting the risk for diabetes and heart disease. Bottom line: Soda and sugary fruit drinks are some of the worst drinks for people with diabetes.</p> <p>“If you have diabetes, cutting out soda and other sugar-sweetened drinks is one of the most powerful ways to control blood sugar, lose weight, and improve your health,” says Ginn. “Switching to healthier drinks can save hundreds of calories and a lot of carbohydrates. It’s often one of my first goals when I work with someone newly diagnosed with diabetes.”</p> <p><strong>How much: </strong>None, ideally. Think of soft drink as you would a decadent dessert that you might indulge a taste of once in a blue moon. If you have a soda habit, cut back by drinking a smaller size for a week or two, or mixing half regular soda with half diet soda or soda water to reduce your kilojoule and carb intake. Aim to go sugar-free: Water and soda water (including zero-calorie fruit-flavoured types) are ideal, and diet soft drink is an option for diabetic drinks but don’t exceed one a day.</p> <h4>Drink less: Fruit juice</h4> <p>Your mum served up OJ every day with breakfast, and you grew to love it. The labels display tempting photos of colourful fruit. But are juices healthy diabetic drinks for blood sugar and weight control? A regular juice habit is associated with an increased risk of type 2 diabetes, according to a study published in Diabetes Care. In terms of nutrition, a piece of real fruit is a better deal (and science is backing that people with diabetes can, and should, eat fruit). A 125ml serving of 100 percent orange juice has 247 kilojoules, 13.6 grams carbohydrates, and no fibre; compare that to a small fresh orange, which has 188 kilojoules, 11 grams carbohydrates, and 2 grams of blood-sugar-controlling fibre. That said, people with diabetes can indulge in a little 100 percent fruit juice once in a while, says registered dietitian Dawn Menning, a certified diabetes educator. “They should just know the amount of juice they are consuming and factor the number of carbohydrates into their eating plan,” she says.</p> <p><strong>How much: </strong>Juice lovers, eat fruit or switch to a low-sodium veggie juice, which is much lower in calories and carbohydrates than fruit juice. If you’re really craving juice, try a 125ml serving with a meal. Test your blood sugar afterward, and then repeat with the same meal for the next three or four days. If your blood sugar doesn’t rise more than 35 to 50 points, a little juice could be fine.</p> <p><em>Image: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://www.readersdigest.co.nz/healthsmart/diabetes/the-best-and-worst-drinks-for-people-with-diabetes" target="_blank" rel="noopener">Reader's Digest</a>.</em></p>

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Age, not weight, should be the big decider in whether to screen for diabetes

<p><span style="font-family: -apple-system, BlinkMacSystemFont, 'Segoe UI', Roboto, Oxygen, Ubuntu, Cantarell, 'Open Sans', 'Helvetica Neue', sans-serif;">Because it’s possible to be diabetic or prediabetic without any symptoms, and early diagnoses lead to better health outcomes, lots of countries have screening programs for diabetes.</span></p> <div class="copy"> <p>In the US, overweight or obese people between 35 and 70 are recommended to regularly get diabetes tests.</p> <p>But <a href="https://www.ajpmonline.org/article/S0749-3797(23)00006-5/fulltext" target="_blank" rel="noreferrer noopener">new research</a> in the <em>American Journal of Preventative Medicine</em> has called this into question, suggesting that screening based purely on age will catch the greatest proportion of diabetic and prediabetic people.</p> <p>“It might sound counterintuitive because we think of being overweight or obese as the primary cause of diabetes,” says lead author Dr Matthew O’Brien, an associate professor of medicine at Northwestern University Feinberg School of Medicine, US.</p> <p>“But if we make decisions about diabetes testing based on weight, we will miss some people from racial and ethnic minority groups who are developing prediabetes and diabetes at lower weights.”</p> <p>The researchers examined data from all the 2021 diabetes screenings recommended by the US Preventive Services Task Force. Based on this data, they recommend screening every US adult aged between 35 and 70.</p> <p>“All major racial and ethnic minority groups develop diabetes at lower weights than white adults, and it’s most pronounced for Asian Americans,” says O’Brien.</p> <p>Roughly half of US adults have Type 2 diabetes or prediabetes, and 81% of adults with prediabetes don’t know they have it. Diagnoses are delayed in ethnic minorities, compared to white people.</p> <p>“Diabetes is a condition in which unacceptable racial and ethnic disparities persist,” says O’Brien.</p> <p>“That’s why we need a screening approach that maximises equity. If we can find everyone earlier, it helps us reduce these disparities and the bad outcomes that follow.”</p> <p>The researchers also found that it might be beneficial for members of some ethnic minorities to receive earlier screening, but they don’t formally recommend it.</p> <p>“It’s imperative that we identify a screening approach that is equitable across the entire US population,” says O’Brien.</p> <p>“Our findings illustrate that screening all adults aged 35 to 70 years, regardless of weight or body mass index, performs equitably across all racial and ethnic groups.”</p> <p>This age cut-off also makes it much simpler for clinicians to decide whether someone should get a diabetes test.</p> <p>“There are many ways to nudge patients and providers to complete this testing, which should be the focus of future research,” says O’Brien.</p> <p>In Australia, diabetes tests are recommended based on a <a href="https://www.healthdirect.gov.au/diabetes-screening-tests" target="_blank" rel="noreferrer noopener">range of risk factors</a>, including age, waist measurement, ethnicity, physical activity and family history. Diabetes Australia has a <a href="https://www.diabetesaustralia.com.au/risk-calculator/" target="_blank" rel="noreferrer noopener">risk calculator</a> with which you can determine your own risk.</p> <p><img id="cosmos-post-tracker" style="opacity: 0; height: 1px!important; width: 1px!important; border: 0!important; position: absolute!important; z-index: -1!important;" src="https://syndication.cosmosmagazine.com/?id=240911&amp;title=Age%2C+not+weight%2C+should+be+the+big+decider+in+whether+to+screen+for+diabetes" width="1" height="1" data-spai-target="src" data-spai-orig="" data-spai-exclude="nocdn" /></div> <div id="contributors"> <p><em>This article was originally published on <a href="https://cosmosmagazine.com/health/diabetes-tests-screening-age-weight/" target="_blank" rel="noopener">cosmosmagazine.com</a> and was written by <a href="https://cosmosmagazine.com/contributor/ellen-phiddian">Ellen Phiddian</a>. </em></p> <p><em>Images: Shutterstock</em></p> </div>

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Lie detection tests have worked the same way for 3,000 years – and they’re still hopelessly inaccurate

<p>Popular culture is fascinated with the ability to detect liars. Lie detector tests are a staple of police dramas, and TV shows such as Poker Face feature “human polygraphs” who detect deception by picking up tell-tale signs in people’s behaviour.</p> <p>Records of attempts to detect lies, whether by technical means or by skilled observers, go back at least 3,000 years. Forensic science lie detection techniques have become <a href="https://onlinelibrary.wiley.com/doi/10.1111/j.1541-1338.2005.00166.x">increasingly popular</a> since the invention of the polygraph early in the 20th century, with the latest methods involving advanced brain imaging.</p> <p>Proponents of lie detection technology sometimes <a href="https://www.press.umich.edu/3091709/lying_brain">make grandiose claims</a>, such as a <a href="https://doi.org/10.1007/s11896-022-09566-y">recent paper</a> that said “with the help of forensic science and its new techniques, crimes can be easily solved”.</p> <p>Despite these claims, an infallible lie detection method has yet to be found. In fact, most lie detection methods don’t detect lies at all – instead, they register the physiological or behaviour signs of stress or fear.</p> <h2>From dry rice to red-hot irons</h2> <p>The <a href="https://journals.sagepub.com/doi/10.1177/1529100610390861">earliest recorded lie detection method</a> was used in China, around 1000 BC. It involved suspects placing rice in their mouths then spitting it out: wet rice indicated innocence, while dry rice meant guilty.</p> <p>In India, around 900 BC, <a href="http://scholarlycommons.law.northwestern.edu/cgi/viewcontent.cgi?article=2844&amp;context=jclc">one method</a> used to detect poisoners was observations of shaking. In ancient Greece a rapid pulse rate was taken to indicate deceit.</p> <p>The Middle Ages saw barbaric forms of lie detection used in Europe, such as the red-hot iron method which involved suspected criminals placing their tongue, often multiple times, on a red-hot iron. Here, a burnt tongue indicated guilt.</p> <h2>What the polygraph measures</h2> <p>Historical lie detection methods were based in superstition or religion. However, in the early 20th century a purportedly scientific, objective, lie detection machine was invented: the polygraph.</p> <p>The <a href="https://www.ojp.gov/pdffiles1/nij/grants/228091.pdf">polygraph measures</a> a person’s respiration, heart rate, blood pressure, and skin conductance (sweating) during questioning.</p> <p>Usually a “control question” about a crime is asked, such as “Did you do it?” The person’s response to the control question is then compared to responses to neutral or less provocative questions. Heightened reactions to direct crime questions are taken to indicate guilt on the test.</p> <h2>The overconfidence of law enforcers</h2> <p>Some law enforcement experts claim they don’t even need a polygraph. They can detect lies simply by observing the behaviour of a suspect during questioning.</p> <p>Worldwide research shows that law enforcers are often <a href="https://doi.org/10.5093/apj2022a4">confident they can detect lying</a>. Many assume a suspect’s nonverbal behaviour reveals deceit.</p> <p>A <a href="https://www.emerald.com/insight/content/doi/10.1108/14636641111134314/full/html">2011 study with Queensland police</a> revealed many officers were confident they could detect lying. Most favoured a focus on nonverbal behaviour even over available evidence.</p> <p>However, <a href="https://link.springer.com/chapter/10.1007/978-3-319-96334-1_3">research shows</a> that law enforcers, despite their confidence, are often not very good at detecting lying.</p> <p>Law enforcement officers are not alone in thinking they can spot a liar. <a href="https://journals.sagepub.com/doi/10.1177/0022022105282295">Global studies</a> have found that people around the world believe lying is accompanied by specific nonverbal behaviours such as gaze aversion and nervousness.</p> <h2>What’s really being tested</h2> <p>Many historical and current lie detection methods seem underpinned by the plausible idea that liars will be nervous and display observable physical reactions.</p> <p>These might be shaking (such as in the ancient Indian test for poisoners, and the nonverbal behaviour method used by some investigators), a dry mouth (the rice-chewing test and the hot-iron method), increased pulse rate (the ancient Greek method and the modern polygraph), or overall heightened physiological reactions (the polygraph).</p> <p>However, there are two major problems with using behaviour based on fear or stress to detect lying.</p> <p>The first problem: how does one distinguish fearful innocents from fearful guilty people? It is likely that an innocent person accused of a crime will be fearful or anxious, while a guilty suspect may not be.</p> <p>This is borne out with the polygraph’s <a href="https://nap.nationalacademies.org/read/10420/chapter/10#218">high false-positive rate</a>, meaning innocent people are deemed guilty. Similarly, some police have assumed that <a href="https://cqu-primo.hosted.exlibrisgroup.com/permalink/f/1rb43gr/TN_cdi_informaworld_taylorfrancisbooks_9781843926337">innocent, nervous suspects were guilty</a> based on inaccurate interpretations of behavioural observations.</p> <p>The second major problem with lie detection methods based on nervous behaviour is there is <a href="https://journals.copmadrid.org/apj/art/apj2019a9">no evidence</a> that specific nonverbal behaviours reliably accompany deception.</p> <h2>Miscarriages of justice</h2> <p>Despite what we know about the inaccuracy of polygraph tests, they haven’t gone away.</p> <p>In the US, they are still used in some police interrogations and <a href="https://www.wired.com/story/inside-polygraph-job-screening-black-mirror/">high-security job interviews</a>. In the UK, lie detector tests are used for <a href="https://www.gov.uk/government/publications/domestic-abuse-bill-2020-factsheets/mandatory-polygraph-tests-factsheet">some sex offenders on probation</a>. And in China, the use of polygraphs in law enforcement may <a href="https://www.sciencedirect.com/science/article/abs/pii/S0031938414005964?via%3Dihub">even be increasing</a>.</p> <p>Australia has been less enthusiastic in adopting lie-detection machines. In New South Wales, the use of lie-detector findings was barred from court in 1983, and an attempt to present polygraph evidence to a court in Western Australia in 2003 <a href="https://www.tandfonline.com/doi/abs/10.1375/pplt.2004.11.2.359">also failed</a>.</p> <p>Many historical and current lie detection methods emulate each other and are based on the same assumptions. Often the <a href="https://muse.jhu.edu/book/13865">only difference</a> is the which part of the body or physical reaction they focus on.</p> <p>Using fallible lie detection methods <a href="https://journals.copmadrid.org/apj/art/apj2022a4">contributes to wrongful convictions</a> and miscarriages of justice.</p> <p>Therefore, it is important that criminal-justice practitioners are educated about fallacious lie detection methods, and any new technique grounded in fear or stress-based reactions should be rejected.</p> <p>Despite outward appearances of technological advancement, over many millennia little has changed. Fearful innocents remain vulnerable to wrongful assumptions of guilt, which is good news for the fearless guilty.</p> <p><em>This article originally appeared on <a href="https://theconversation.com/lie-detection-tests-have-worked-the-same-way-for-3-000-years-and-theyre-still-hopelessly-inaccurate-200741" target="_blank" rel="noopener">The Conversation</a>.</em></p> <p><em>Images: Getty</em></p>

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Can ideology-detecting algorithms catch online extremism before it takes hold?

<p>Ideology has always been a critical element in understanding how we view the world, form opinions and make political decisions. </p> <p>However, the internet has revolutionised the way opinions and ideologies spread, leading to new forms of online radicalisation. Far-right ideologies, which advocate for ultra-nationalism, racism and opposition to immigration and multiculturalism, have proliferated on social platforms.</p> <p>These ideologies have strong links with violence and terrorism. In recent years, <a href="https://www.asio.gov.au/sites/default/files/2022-02/ASIO_Annual_Report_2020-21.pdf">as much as 40%</a> of the caseload of the Australian Security Intelligence Organisation (ASIO) was related to far-right extremism. This has <a href="https://www.abc.net.au/news/2023-02-13/right-wing-terror-threat-declines-says-asio/101965964">declined</a>, though, with the easing of COVID restrictions.</p> <p>Detecting online radicalisation early could help prevent far-right ideology-motivated (and potentially violent) activity. To this end, we have developed a <a href="https://arxiv.org/abs/2208.04097">completely automatic system</a> that can determine the ideology of social media users based on what they do online.</p> <h2>How it works</h2> <p>Our proposed pipeline is based on detecting the signals of ideology from people’s online behaviour. </p> <p>There is no way to directly observe a person’s ideology. However, researchers can observe “ideological proxies” such as the use of political hashtags, retweeting politicians and following political parties.</p> <p>But using ideological proxies requires a lot of work: you need experts to understand and label the relationships between proxies and ideology. This can be expensive and time-consuming. </p> <p>What’s more, online behaviour and contexts change between countries and social platforms. They also shift rapidly over time. This means even more work to keep your ideological proxies up to date and relevant.</p> <h2>You are what you post</h2> <p>Our pipeline simplifies this process and makes it automatic. It has two main components: a “media proxy”, which determines ideology via links to media, and an “inference architecture”, which helps us determine the ideology of people who don’t post links to media.</p> <p>The media proxy measures the ideological leaning of an account by tracking which media sites it posts links to. Posting links to Fox News would indicate someone is more likely to lean right, for example, while linking to the Guardian indicates a leftward tendency. </p> <p>To categorise the media sites users link to, we took the left-right ratings for a wide range of news sites from two datasets (though many are available). One was <a href="https://reutersinstitute.politics.ox.ac.uk/our-research/digital-news-report-2018">based on a Reuters survey</a> and the other curated by experts at <a href="https://www.allsides.com/media-bias/ratings">Allsides.com</a>. </p> <p>This works well for people who post links to media sites. However, most people don’t do that very often. So what do we do about them?</p> <p>That’s where the inference architecture comes in. In our pipeline, we determine how ideologically similar people are to one another with three measures: the kind of language they use, the hashtags they use, and the other users whose content they reshare.</p> <p>Measuring similarity in hashtags and resharing is relatively straightforward, but such signals are not always available. Language use is the key: it is always present, and a known indicator of people’s latent psychological states. </p> <p>Using machine-learning techniques we found that people with different ideologies use different kinds of language. </p> <p>Right-leaning individuals tend to use moral language relating to vice (for example, harm, cheating, betrayal, subversion and degradation), as opposed to virtue (care, fairness, loyalty, authority and sanctity), more than left-leaning individuals. Far-right individuals use grievance language (involving violence, hate and paranoia) significantly more than moderates. </p> <p>By detecting these signals of ideology, our pipeline can identify and understand the psychological and social characteristics of extreme individuals and communities.</p> <h2>What’s next?</h2> <p>The ideology detection pipeline could be a crucial tool for understanding the spread of far-right ideologies and preventing violence and terrorism. By detecting signals of ideology from user behaviour online, the pipeline serves as an early warning systems for extreme ideology-motivated activity. It can provide law enforcement with methods to flag users for investigation and intervene before radicalisation takes hold.</p> <p><em>Image credits: Getty Images</em></p> <p><em>This article originally appeared on <a href="https://theconversation.com/can-ideology-detecting-algorithms-catch-online-extremism-before-it-takes-hold-200629" target="_blank" rel="noopener">The Conversation</a>. </em></p>

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Detective steals thousands from elderly woman

<p>An elderly woman who was scammed out of $30,000 in an online scam has once again been stolen from, after the police officer helping her recover the money stole her bank details. </p> <p>In May 2021, 74-year-old Sonia was robbed by fraudsters pretending to be NBN workers after they convinced her to transfer the hefty five-figure sum.</p> <p>After discovering it was a scam, Sonia then reported the crime to NSW Police, who sent a detective to her home to investigate.</p> <p>The officer was supposed to be helping Sonia recover her stolen money, but instead tried to use her credit card and banking details and purchase almost $20,000 worth of goods.</p> <p>The police officer fronted Liverpool Local Court on Wednesday where his barrister tried to explain his client's behaviour saying he had gone "off the rails" and fallen into a depression due to the nature of his work.</p> <p>In June 2021, the detective, who cannot be named, attended Sonia's home several times to investigate what happened, often wearing his full police uniform.  </p> <p>To gain her sympathy, he said he had a brain aneurysm and had not yet told his girlfriend or work. </p> <p>According to police documents tendered to the court, Sonia trusted him and he told her she "reminded him of his own grandmother", the <a href="https://www.dailytelegraph.com.au/truecrimeaustralia/police-courts-nsw/detective-investigating-30k-fraud-on-74yo-woman-steals-her-credit-card-for-16k-shopping-spree/news-story/1823067b8a55dc184f1278ce6a933b69" target="_blank" rel="nofollow noopener">Daily Telegraph</a> reported.</p> <p>When he asked to see her online banking details, credit cards and passwords, Sonia gave them to him willingly, assuming they were needed for his ­investigation.</p> <p>The detective tried to buy close to $20,000 worth of items from JB Hi Fi, Big W and Myer, including iPhones, GoPro cameras and Apple Watches.</p> <p>Thankfully for Sonia, none of the attempted purchases went through, as they were all rejected by Sonia's bank as suspicious activity.</p> <p>When Sonia was notified of the attempted transactions, she immediately suspected the detective who had been supposed to be helping her. </p> <p>In court this week, the now former detective pleaded guilty to stealing Sonia's bank details, and will will face Downing Centre District Court in Sydney on May 12th when he will be sentenced.</p> <p>More than 18 months after the events, Sonia is still very troubled by what happened and blames herself.  </p> <p>"I can't switch off a feeling that I was stupid in the first place ... I trusted this guy and then he did that," she said.</p> <p><em>Image credits: Getty Images</em></p>

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