Beat it

Beat it

Diabetes complications declining, says federal study


By Ana B. Ibarra

Despite diabetes having reached epidemic proportions in recent years, complications related to the disease are on the decline, according to a new federal study.
Data released by the Center for Disease Control and Prevention shows some complications triggered by diabetes have plummeted substantially in the past two decades among U.S. adults.
For the new study, the CDC monitored diabetes-related complication rates from 1990 to 2010 for diabetics age 20 or older.
Rates of heart attacks, strokes, lower limb amputations, end-stage kidney failure and deaths due to high blood sugar have all dropped.
According to the report, cardiovascular complications and deaths from high blood sugar decreased by more than 60 percent each. The rates of both strokes and lower extremity amputations declined by about half, and rates for end-stage kidney failure fell by about 30 percent.
“These findings show that we have come a long way in preventing complications and improving quality of life for people with diabetes,” said Edward Gregg, lead author of the study. “While the declines in complications are good news, they are still high and will stay with us unless we can make substantial progress in preventing type 2 diabetes.”
Although complications have declined, the number of adults reporting diabetes during this time frame has tripled. The CDC estimates that nearly 26 million Americans have diabetes, and an additional 79 million are at risk of developing the disease. The center also reports that diabetes and its complications account for $176 billion in total medical costs each year.
From 2010 to 2012, Merced County recorded an average of 55 deaths a year due to diabetes. Merced County is ranked No. 51 of the state’s 58 counties for diabetes-related mortality, with No. 1 Amador County having the fewest diabetes-related deaths and No. 58 San Bernardino County having the most deaths on the list compiled by the California Department of Public Health. .
Janon Pittz, a diabetes educator at the Center for Diabetes in Merced, said the decline in diabetes-related health problems can be attributed to an increase in access to care, new technology, improved medication and a boost in community education.
Pittz, who has been a certified diabetes educator for 10 years, said the Central Valley tends to have a high incidence of diabetes because of demographics. “We probably have a higher rate because of of our diverse population,” she said. “We have Hmong and Native American communities and a large Hispanic population who all have a higher prevalence of diabetes.”
Merced County offers a variety of programs to help residents control and prevent diabetes, Pittz said.
Among the resources available is diabetes education classes at the Mercy Education Outpatient Center, 2740 M St.
Lillian Sanchez, a community health educator and an instructor for the classes, said education is key in combating the disease. During the classes, residents learn how to test their blood sugar at home and how to reduce complications.
The biggest concern among those who take the classes is nutrition-related, according to Sanchez.
“The biggest area of frustration for patients is food and meal planning” she said. “They usually have a hard time grocery shopping and selecting foods that they can eat.”
Diabetes classes are offered Tuesdays from 3 to 4 p.m. at the Mercy Education Outpatient Center. Call the Mercy Education Center at (209) 564-4384 for more information.





Diabetes | Pay attention to diabetes warning signs


By Bob Potter

I’m lucky. I don’t have diabetes. And I want to keep it that way.
Probably through a combination of good genes, a moderately healthy lifestyle and diet, and pure luck, I have so far avoided this disease that is afflicting more and more Americans of all ages.
But I, too, have to pay attention.
I was only vaguely aware of diabetes until a few years ago. I knew of a few children who had Type-1, formerly called juvenile diabetes. And I was remotely aware of adult-onset diabetes, or Type-2. But I didn’t really understand the impact diabetes has.
It turns out that the modern lifestyle we all enjoy has stacked the deck against our health and in favor of Type-2 diabetes. Years spent carrying extra weight, eating fast and processed food, and sitting in cars and in front of TVs and computers are having major effects. Almost 26 million Americans have diabetes today, millions more are considered pre-diabetic, and it is estimated that 30 to 40 percent of the children born today will develop Type-2 diabetes in their lifetimes. One in five older than 65 now has it. It is everywhere.
Even those who seemingly don’t fit the “diabetes profile,” who are not overweight or inactive, are not safe because of factors they inherited.
All of this means that — slender or heavy, active or sedentary — we all need to be aware of the possibility of becoming diabetic and need to do everything we can to avoid this mark of modern living.
Much information is available about how to live with diabetes, and indeed, you can live a full and productive life with diabetes by making the necessary lifestyle changes. But a far better strategy is to avoid getting diabetes in the first place. Here are several things each of us can do to help keep diabetes away from our door:
• Know your numbers. The Mount Nittany Physician Group recommends that everyone know their body mass index, blood pressure, blood glucose, cholesterol and kidney function numbers. Insist that your health provider gives you these tests and explains the results. These numbers can give you a heads up about your current and future health. If you heed the warning signs early enough, some basic lifestyle and dietary changes may be all you need to do.
• Watch your weight. A high body mass index number is a warning.
• Watch your waist. That spare tire around your middle is a huge diabetes danger sign.
• Watch your diet. Fast and processed foods from burger joints and chain restaurants are loaded with salt, sugar and fat. Each can lead to problems if eaten in excess. Start by eliminating sugary drinks such as sodas and fruit beverages. Eat more whole fruits and vegetables. Cook your own food. Sound diet-ary advice is readily available.
• Exercise more. Walk, run, swim, bike, go to the gym, climb mountains — do something. Find what you like and just do it. One generally accepted goal is to take 10,000 steps each day. Think you are that active? Just buy an inexpensive pedometer and you’ll probably see how far short of that mark you fall. If your job involves sitting, you’ll never reach 10,000 steps unless you seek exercise.
We all know people with diabetes. Talk to them and listen to their diabetes stories. Listen to what they are doing (or not doing) to stay as healthy as possible. Learn from them to help yourself avoid diabetes, and encourage them in their diabetes fight. Do it for them — and for you.
Few who have diabetes suddenly “caught it.” It is almost always the result of many years of not knowing or ignoring the warning signs.
There are endless temptations out there that can lead to diabetes, but most of us have a choice: We can endure the lifestyle limitations, expense and pain of dealing with diabetes — or we can do everything humanly possible to keep from getting it in the first place.
This is the health battle of our lives, and we are all in it.




Hoops for Health, Fighting Obesity and Type-2 Diabetes


Jermaine Collier, Program Manager of S.A. Mobile Fitness, a program of United Charitable Programs (UCP), is striving to make a healthier tomorrow for our nation’s children by teaching kids the positive outcome of an interactive healthy lifestyle.
San Antonio, TX, April 25, 2014 --(PR.com)-- With over half of the population in San Antonio, TX being obese, fitness advocates and health experts like Jermaine Collier, Program Manager of S.A. Mobile Fitness, want to put an end to this epidemic.
Collier’s program, S.A. Mobile Fitness, will be hosting Hoops for Health, a two-day fitness event on May 2nd and 3rd. The event will feature a three-on-three basketball tournament for youth ages 10 to 18, a shooting competition, a dunk competition and more.
Professional players and coaches will be in attendance to speak about the importance of work ethics in sports and in life to be successful. There will also be physicians on site to speak about the dangers of a sedentary lifestyle, obesity and type-2 diabetes.
“I think that the presence of professional players and coaches will inspire and give guidance to the you that want to go to the next level on how physically fit they have to be successful in basketball,” said Collier. “My objective is to fight obesity and to provide a safe, fun, and non-discriminating environment where youth and adults can exercise, build relationships, gain nutritional information, and learn strategies to live an overall healthy lifestyle.”
During the Hoops for Health event, Collier hopes to raise $5,000. The funds raised will go towards S.A. Mobile Fitness events throughout the year. Hoops for Health will be held at Lou Hamilton Community Center located at 10700 Nacogdoches Rd, San Antonio, TX 78217. There is $25 registration fee. To register, please visit their website at http://www.jcultimatetraining.com/Sponsorship-and-Donations.html.
Through S.A. Mobile Fitness, Collier aims to conduct fitness clinics that raise awareness of the harm of poor physical fitness with a special focus on preventing obesity and Type 2 Diabetes. All donations to S.A. Mobile Fitness are tax-deductible.
Collier is an expert in fitness and sports with a bachelor’s degree in Sports and Exercise Science from Greensboro College located in North Carolina. He also has six years of professional experience as a physical trainer and is committed to daily physical activity himself.
S.A. Mobile Fitness is sponsored by UCP, a 501(c)(3) nonprofit fiscal sponsor of active charitable programs. Through UCP, Collier is able to focus solely on his program’s charitable mission, rather than on the administrative burdens that an independent nonprofit can have. For more information about S.A. Mobile Fitness, please visit their website at www.JCUltimateTraining.com.
UCP's mission is to empower people to help others by fiscally sponsoring targeted charitable programs that effect positive change through charitable, educational, scientific, or religious actions worldwide. UCP programs vary in size, budget and scope, but all share the desire to make a difference in the lives of others. For more information about UCP and fiscal sponsorship, please visit www.UnitedCharitablePrograms.org.





Dietitian takes diabetes head-on with food


For years, nutrition coach Susie Fricker has been touting the benefits of a veggie-rich diet through countless classes at local libraries and health care facilities. Participants in the class have repeatedly asked Fricker to expand her curriculum to include classes on warding off diabetes, so Fricker is obliging.
She will kick off her new “Food for Life: Diabetes Initiative” classes with a free introductory presentation from 1 to 3 p.m. Saturday at Cocoa Beach Public Library, 550 N. Brevard Ave.
“We’ll be discussing the prevention of diabetes through a plant-based diet,” she said.
“We want to offer options. There are some people who are happy to be on diabetes meds the rest of their lives, but there are a lot of people who aren’t happy with that.”
The class is based on Physicians’ Committee for Responsible Medicine Diabetes Initiative materials. Fricker’s cancer-fighting classes are also based on the PCRM’s curriculum. Sponsored by Healthy Planet of Brevard, the class will serve as a “taste test” for the four-week sessions Fricker plans to offer later in the year.
Fricker’s goal with the class is to offer options through an entertaining — and tasty — program. As she does with the cancer-fighting classes, Fricker will prepare specifically designed healthy recipes and offer samplings to the crowd.
At the core of Fricker’s new classes is Dr. Neal Barnard’s “Program for Reversing Diabetes.” If the name Barnard seems familiar, you might have caught the good doctor speaking on the connection between disease and food in the many health-related specials PBS carts out during pledge weeks.
The “Food for Life” series of classes was designed by physicians, nurses and registered dietitians. The format features information on how certain foods and nutrients work to promote health and cooking demonstrations and samplings of simple, nutritious recipes. The introductory session includes a 30-minute video from Barnard.
The program is aimed at individuals who have diabetes and would like to wean themselves from medications, as well as for individuals who just want to ward off the disease.
“Diabetes is a hot topic these days, right up there with cancer,” Fricker said.
“Everybody knows someone with diabetes or cancer. Turning things around is not rocket science. Some people think that going to a plant-based diet is too drastic, but I tell them that what is really drastic is taking meds for the rest of their lives.”
Signing up for classes
Registration for Susie Fricker’s Cocoa Beach workshop is not required. To contact Fricker about additional class sessions, call 321-652-0563. For details, see fflclasses.org.



For Diabetics, Health Risks Fall Sharply

By SABRINA TAVERNISE and DENISE GRADYAPRIL 

Federal researchers on Wednesday reported the first broad national picture of progress against some of the most devastating complications of diabetes, which affects millions of Americans, finding that rates of heart attacks, strokes, kidney failure and amputations fell sharply over the past two decades.

The biggest declines were in the rates of heart attacks and deaths from high blood sugar, which dropped by more than 60 percent from 1990 to 2010, the period studied. While researchers had had patchy indications that outcomes were improving for diabetic patients in recent years, the study, published in The New England Journal of Medicine, documents startling gains.

“This is the first really credible, reliable data that demonstrates that all of the efforts at reducing risk have paid off,” said Dr. David M. Nathan, director of the Diabetes Center at Massachusetts General Hospital, who was not involved in the study. “Given that diabetes is the chronic epidemic of this millennium, this is a very important finding.”

The number of Americans with diabetes more than tripled over the period of the study and is now nearly 26 million. Nearly all the increase came from Type 2 diabetes, which is often related to obesity and is the more common form of the disease. An additional 79 million Americans have pre-diabetes, which means they are at high risk of developing the disease.
Researchers from the Centers for Disease Control and Prevention, who wrote the study, estimate that diabetes and its complications account for about $176 billion in medical costs every year. The study measured outcomes for both Type 1 and Type 2.

Researchers said the declines were the fruit of years of efforts to improve the health of patients with Type 2 diabetes. Doctors are much better now at controlling the risk factors that can lead to complications — for example, using medications to control blood sugar, cholesterol and blood pressure — health experts said. What is more, a widespread push to educate patients has improved how they look after themselves. And a major effort among health care providers to track the progress of diabetes patients and help steer the ones who are getting off track has started to have an effect. 

“These results are very impressive,” said Dr. K. M. Venkat Narayan, professor of medicine and epidemiology at Emory University, who specializes in diabetes and was not involved in the study. “There is strong evidence that we’re implementing better care for patients with diabetes. Awareness has increased tremendously, and there’s been a great deal of emphasis on coordinated care in health care settings.”

Edward W. Gregg, a senior epidemiologist at the Centers for Disease Control and Prevention and the lead author of the study, said researchers used four federal data sets — the National Health Interview Survey, the National Hospital Discharge Survey, the United States Renal Data System, and Vital Statistics — over a 20-year period to give a comprehensive picture of diabetes outcomes.

Dr. Gregg said the study relied on large sample sizes, including hundreds of thousands of diabetics who had heart attacks, and thousands who died from high blood sugar.
“This is the first time we’ve put the full spectrum together over a long period of time,” Dr. Gregg said. He pointed out that heart attacks, which used to be the most common complication by far, had dropped down to the level of stroke, which also fell.
“We were a bit surprised by the magnitude of the decrease in heart attack and stroke,” he said.
Beyond the declines in the rates of heart attacks and deaths from high blood sugar, the study found that the rates of strokes and lower extremity amputations — including upper and lower legs, ankles, feet, and toes — fell by about half. Rates for end-stage kidney failure dropped by about 30 percent. The study did not measure blindness, another critical diabetes complication.

Dr. Gregg cautioned, however, that the number of Americans with diabetes continued to rise. “We have to find a way to replicate these successes, to transfer that knowledge into preventing the disease to begin with,” he said.

The declines in rates of complications began around 1995 and continued gradually, but steadily, over time, the data show. What drove the outcomes varied by the complication, Dr. Gregg said. Improved blood sugar control has made a difference, especially in reducing the rate of amputations and end-stage kidney disease. Declines in smoking and the rising use of statins to lower cholesterol and of other medications to control blood pressure contributed to the declines in heart attacks and strokes.

Six factors that can help cure diabetes



Sunday, April 06, 2014 by: Sandeep Godiyal
Tags: diabetes, natural cures, beta cells

(NaturalNews) Type I diabetes, though similar to Type II diabetes, is also very different in a crucial way. While Type II diabetes involves the body's inability to utilize its own insulin properly, Type I diabetes occurs when the body cannot make enough natural insulin on its own. This happens when the beta cells that lie within the pancreas are not able to produce a sufficient amount of insulin.
A few of the known triggers for Type I diabetes include chemical exposure, incompatible choice in foods, bacterial infections, autoimmune issues and viral infections, to name just a few of the factors that could cause the diseases. Over the years, there have been a number of studies whose results have appeared in reputable medical journals that point to the effectiveness of certain elements when it comes to providing a cure for Type I diabetes. These foods and compounds all share one exciting characteristic: their potential to provide beta cell regeneration. A few of the compounds that have been shown to help cure Type I diabetes follows:
Corn Silk
A study in 2009 found that the vitamins, proteins, carbohydrates, flavanoids and other compounds that make up corn silk stimulated the regeneration of beta cells while also reducing blood sugar in rats with Type I diabetes.
Avocado
Avocado seed extract is responsible for the reduction of blood sugar in diabetic rats. This result was noted in a study performed in 2007 in which the pancreatic islet cells showed a protective and restorative improvements.
Honey
A human study has shown its positive effects of honey on curing Type I diabetes. A study conducted in 2010 gives promise to the effects of long-term consumption of honey when it comes to the regeneration of beta cells as indicated by the levels of fasting C-peptide.
Stevia
A substance whose properties compared favorably with glibenclamide, a popular medication often prescribed to people with Type I diabetes, stevia has been shown to provide revitalization to beta cells that have been damaged. This, and other findings, were recorded in a 2011 study on humans.
Nigella Sativa
Also widely known as black seed, this plant can lead to a partial regeneration of beta cells, according to an animal study completed in 2003. During a human study, undertaken in 2010, diabetics who consumed 1 gram of black seed for a period of up to 12 weeks showed a wide range of benefits. This includes an increase in the function of beta cells.
Chard
During a 2000 study, when diabetic rats were fed chard extract, their injured beta cells began to recover.

The above list is just the beginning of the many natural elements and compounds that show great promise in relieving Type I diabetes. This can lead to a better quality of life for those people who have the disease.




Diabetes costliest among non-specialty Rx



A snapshot of 2013 prescriptions by the PBM Express Scripts shows that diabetes medications trounce all others in terms of annual patient spend on traditional medications, followed by drugs for high cholesterol, hypertension and heart disease.
Further, diabetes was among the top-10 most expensive traditional medications whose use went up between 2012 and 2013, rising 14%, whereas spend per patient for cholesterol and blood pressure/heart disease fell.
Express Scripts research indicates that diabetes medication expenses are only going to increase, and predicts the spend will continue to grow between 10% and 13% every year through 2016.
The PBM found that use of traditional medications, such as diabetes therapies, rose 0.5% between 2012 and 2013. Use and cost, however, are two different metrics, and although use of traditional medication inched up a half-percentage point, higher prices pushed spending up almost 5%. This is not a surprise for investors: drug companies noted throughout the year that higher prices supported their balance sheets, even when volumes fell.
Use of specialty medications—which includes drugs like the lauded, or condemned, hepatitis C medication Sovaldi —rose 2.5% between 2012 and 2013, and the spend jumped 14%, while accounting for almost 28% of total drug outlay. Express Scripts said brands had a significant impact in overall drug costs in both the traditional and specialty drug categories.
Despite Sovaldi's reknown, it was not a leading specialty class based on spend. Instead, the top three most expensive specialty medication classes were for inflammatory conditions, multiple sclerosis and cancer.
While specialty may sound like an off-to-the-side category, Express Scripts notes that specialty drugs comprised the majority of the FDA's 2013 approvals for the third year in a row, vs. 33% of FDA approvals in 2008. Among last year's big names: Roche's Kadcyla, Roche's Gazyva and Pharmacyclics/Janssen's Imbruvica.




Diabetes Tied to Higher Risk of Pancreatic Cancer in Study




FRIDAY, April 4, 2014 (HealthDay News) -- People with diabetes have double the risk of pancreatic cancer compared to people who don't have diabetes, according to a new analysis of 88 previous studies.
Diabetes has been considered a risk factor for pancreatic cancer, but what's not clear is which condition comes first. This new analysis suggests that at least for some people, pancreatic cancer might be responsible for diabetes.
Experts note, however, that the overall risk for pancreatic cancer remains low among people with diabetes.
"Our study demonstrated that there is an overall two-fold increased risk of pancreatic cancer in patients with diabetes mellitus," said Dr. Mehrdad Nikfarjam, a senior lecturer and transplant surgeon at the University of Melbourne, in Australia.
Diabetes mellitus includes type 1 and type 2 diabetes.
"The study also demonstrates that diabetes mellitus itself may be an early indicator of the development of pancreatic cancer in certain cases," Nikfarjam said. "Patients with diabetes mellitus that were analyzed had a seven-fold increased risk of being diagnosed with pancreatic cancer within the first year of being diagnosed with diabetes."
"Studies have demonstrated that pancreatic cancer can produce certain substances that influence the way the body handles insulin and blood sugar, resulting in diabetes," he said. "In some patients with pancreatic cancer and diabetes, the diabetes actually improves once the cancer is removed."
But Nikfarjam also said there is a plausible biological connection for diabetes to influence the growth of pancreatic cancer, too.
"It is thought that the chemical changes that occur in the body with type 2 diabetes can promote the growth of pancreas cells and also result in damage that leads to the development of pancreatic cancer," he said. "Type 1 diabetes is similarly thought to be a risk factor, but to a lesser extent."
Although the review found an association between diabetes and risk of pancreatic cancer, it did not prove that either disease causes the other.
A U.S. expert said the review results are not unexpected.
"The conclusions from this meta-analysis are very consistent with those drawn at a [U.S. National Institutes of Health] workshop on the subject," said Dr. Robert Ratner, chief scientific and medical officer at the American Diabetes Association.
"Clearly, there is a relationship between diabetes and pancreatic carcinoma, and it could go in either direction," he said. "Pancreatic cancer might cause diabetes or diabetes might cause pancreatic cancer."
Ratner added that the overall risk of pancreatic cancer is quite low, so this isn't something that should worry most people with diabetes.
Nikfarjam agreed. "The risk of developing pancreatic cancer overall remains very low, even in long-standing diabetic patients," he said. "These patients should not be alarmed. It is even possible that good blood sugar control may lessen the risks."
A major problem with pancreatic cancer, however, is that it's often diagnosed at a very late stage. Overall five-year survival rates are less than 1 percent, and many patients diagnosed with late-stage pancreatic cancer don't survive more than four to six months after the diagnosis, according to background information included in the study.
Although the current review of past studies found an overall two-fold increased risk of pancreatic cancer in people with diabetes, that risk was highest soon after diagnosis. Within the first year after diagnosis, the risk of pancreatic cancer was nearly seven times higher than for someone without diabetes.
Although the risk stays elevated for a long time, after 10 years the risk of pancreatic cancer for someone with diabetes is just 36 percent higher than for someone without diabetes.
This suggests a window of opportunity for diagnosing pancreatic cancer earlier than it is currently. Detection methods for pancreatic cancer may include CT scans, PET scans and endoscopy, according to the American Cancer Society. Testing for pancreatic cancer is often expensive.
"It would not be feasible to screen all people with diabetes," Nikfarjam said. "Patients over the age of 55 without significant risk factors for diabetes who develop diabetes out of the blue appear to be a potentially good initial screening target."
Ratner agreed that it wouldn't make sense to screen everyone newly diagnosed with diabetes for pancreatic cancer because so few would have it.
"There are circumstances where it might make sense. Someone with a family history of pancreatic cancer or a history of chronic pancreatitis or someone who smokes already has an increased risk of pancreatic cancer," Ratner said.
"If the onset of diabetes is associated with a loss of appetite and weight loss, that's not the typical onset of type 2 diabetes," he said. "Type 2 usually causes hunger and isn't associated with a loss of weight. If someone's risk is higher and the onset of diabetes isn't typical, that's someone who may warrant more substantive investigation."
Results of the study were published online recently in the journal Annals of Surgical Oncology.



High diabetes rate linked to ethnic backgrounds, poor walkability



The diabetes rates in the suburban GTA region of Peel are among the highest in Ontario due to ethnic background of its residents and lack of walkability, researchers at Toronto’s St. Michael’s Hospital say.
The region, which is comprised of Caledon, Brampton and Mississauga, is “characterized by wide streets and high-traffic intersections – neither of which are conducive to walking,” the researchers found.
Using data from the Institute for Clinical Evaluative Sciences and Statistics Canada, Peel Public Health also found that the region has a large population of residents from South Asia and the Caribbean, who are more genetically susceptible to developing diabetes than people of European descent.
•          
“We found that diabetes rates were highest in neighbourhoods that discourage walking and in neighbourhoods where more of the residents come from world regions that have high levels of diabetes,” Dr. Gillian Booth, an endocrinologist and researcher St. Michael’s Hospital, said in a statement on Monday.
One in 10 adults in Peel has diabetes and researchers predict that by 2025, one in six will have the disease.
Overall, the number of people in Ontario living with diabetes has been increasing over the years, with 1.2 million people diagnosed with the chronic disease in 2010.
To determine where diabetes is most common, Peel Public Health partnered with researchers at St. Michael’s Centre for Research on Inner City Health and developed an “atlas” of region, mapping rates of the disease across the community.
“Peel certainly lights up on a map of Ontario diabetes rates,” said Dr. Rick Glazier, researcher at St. Michael’s Hospital. “When we looked at the region in more detail, we found that some neighbourhoods, particularly those in Brampton, had noticeably higher rates.”
The 233-page diabetes atlas contains maps and data comparing the rates of diabetes against certain risk factors including:
•           Obesity
•           Income level
•           Ethnic background
•           Physical inactivity
•           Unhealthy diet
Peel Public Health and the region’s planning department are now collaborating to “influence built environment policies and processes.”
“The diabetes atlas is a useful reference to help us grow in a way that is healthy, economically viable and sustainable,” said Arvin Prasad, director of integrated planning at the Region of Peel.




Diabetes expenses have decreased, but are still high


BY KATHRYN DOYLE

 (Reuters Health) - Out-of-pocket expenses for diabetes treatment have gone down for many U.S. patients over the past decade, according to a new study. But nearly a quarter of people with diabetes still face high expenses.
In particular, "(out-of-pocket) expenses declined in the people with public insurance and in people with low income between 2001 and 2011," mostly because prescription drug costs went down, Rui Li told Reuters Health by email.
Li led the study at the Division of Diabetes Translation, part of the National Center for Chronic Disease Prevention and Health Promotion at the Centers for Disease Control and Prevention in Atlanta, Georgia.
The researchers examined data from ten years of a nationwide medical expenditure study. They defined people with high out-of-pocket expenses as those spending more than 10 percent of their family income on health care.
In 2001 and 2002, 28 percent of adults under age 65 with diabetes faced a high expense burden, which decreased to 23 percent by 2011, according to results published in Diabetes Care.
The dip was biggest for people with public insurance like Medicare or Medicaid: 43 percent of them had burdensome out-of-pocket expenses in 2001 and 2002, compared to 21 percent in 2011.
For people with private insurance, the proportion under high expense burden increased slightly over the course of the study.
The average person with diabetes accounted for more than half of the total out-of-pocket medical expenses of his or her family.
On the whole, expenses went down mostly because prescription drug spending went down, the authors write.
Over the last decade, Medicaid has made cheaper generic drugs more attractive to patients and prescribers, partly by limiting the amount of brand-name drugs that can be prescribed at one time.
"Any move to lowering expenses is great, but as the authors point out, there are some changes in the way the data was reported just around the time they show the major changes, so there still needs to be some caution with interpretation," said Dr. Robert J. Rushakoff, a diabetes researcher at the University of California, San Francisco.
Rushakoff was not involved with the study.
It's also possible that out-of-pocket expenses have gone down because people stopped being able to afford them at all, he told Reuters Health in an email.
High out-of-pocket costs for diabetes patients are a problem outside the U.S. as well, Li said.
"A study of 35 low and middle income countries found that persons with diabetes experienced differentially higher out-of-pocket medical spending, particularly among individuals with high levels of spending, and a greater chance of incurring catastrophic medical spending compared with otherwise similar individuals without diabetes," Li said.
Although older medications are now inexpensive, lab tests, medical follow-up and supplies remain costly, Rushakoff said.
Generic prescription medications can be filled for as little as $4 per month at Walmart or similar stores, he said. Test strips are a bigger expense, but people who are not on insulin don't need to use as many, and insurance generally covers them.
The Affordable Care Act may help continue to bring expenses down, in that more people will have insurance, Rushakoff said.

For patients, the best way to keep expenses down is to use generic medications or look into discount cards which are available for many newer medications and reduce the co-pay, he said. They can also make sure the test strips they select are covered by their insurance plan

Diabetes Mellitus Due to Food Additives and Pollution?


Added by Lara Stielow

The most commonly noted causes for the rise in diabetes mellitus are obesity and overeating but could food additives and pollution contribute? Type 2 diabetes accounts for 90-95% of all diabetes cases. In 2000, 171 million people worldwide had diabetes and that is expected to increase to 366 million by 2030. This epidemic has received a lot of attention but the fact remains that there is zero evidence that diabetes mellitus results from overeating and a sedentary lifestyle.
The problem with this disease, and many others, is that the mechanisms involved are so complex that approaches to managing the rise are more treatment-based than prevention-based.  The current model explaining type 2 diabetes assumes, without true evidence, that insulin resistance precedes elevated insulin levels. Hyperinsulinemia is thought to be the body’s compensatory response to insulin resistance but there is no understood mechanism by which such resistance triggers secretion.
In 2012, a meta-analysis published by the American Diabetes Association proposed that food additives may trigger type 2 diabetes. The study takes a critical view of the current disease model and the commonly blamed culprits: obesity, overeating, and an inactive lifestyle. Though the authors are of the opinion that hypersecretion of insulin is the catalyst of insulin resistance they conclude that there are likely many factors which could contribute.
One realistic environmental trigger for diabetes cited in the ADA analysis is BPA (bisphenol A).  BPA has been found to impair β-cell function, which is the pancreatic cell responsible for producing, storing, and releasing insulin. BPA has been shown in animal studies to have this effect in fetal, neonatal, and perinatal periods as well as adulthood.
A Lancet study, done in 1981, examined one inconsistency in an annual trend of initial diabetes diagnosis. The results suggest that the ingestion of a nitrogenous preservative while pregnant can contribute to diabetes in the offspring. This study specifically examined ketosis-prone diabetes, a particularly severe and more deadly form of diabetes. Although this was observed in type 1 diabetes an impairment of  β-cell function is common to both forms of diabetes suggesting that the potential involvement of food additives and pollution is worthy of further investigation.
Multiple epidemiological studies suggest that pollution might play a causative role in the development of type 2 diabetes. These studies have found consistent correlations between exposures to pollutants and diabetes mellitus. Living in a county in which a toxic waste dump is located increases the risk of developing diabetes, as does contact with certain organic pollutants and specific factories.

While most medical professionals and researchers believe that obesity, a sedentary lifestyle, and genetic risk factors are the main culprits of diabetes mellitus, those factors themselves have not been scientifically proven to cause type 2 diabetes. Increasing research is examining the possibility that an interplay of traditionally accepted “causes” of diabetes with environmental factors, such as chemical exposure, are at the root of diabetes mellitus. When the mechanism of disease onset is fully understood the doors will open to finding an effective (non-exacerbating) treatment and possibly even a cure.

The Key To Fighting Obesity Might Be Found In...Chocolate?

 JUSTIN SEDOR

The good news about chocolate just keeps pouring in. It's no secret that dark chocolate is full of antioxidants and other compounds that help boost brain function and mood as well as contribute to heart health. Scientists are even exploring ways to get the beneficial molecules found naturally in the cacao plant into a more concentrated form that can be taken orally, via a pill.

As scientists learn more about this magical substance, though, the headlines are getting even more exciting. New research on specific antioxidant compounds in chocolate suggest that your favorite dessert could be used to fight obesity and diabetes.

In a recent lab study, scientists fed mice a variety of different diets with different levels of fat and sugar. They tested the effects of several combinations of cocoa flavanols on the rodents and found that one set of compounds, called oligomeric procyanidins (or PCs), had a significant weight-control effect when given to mice on a high-fat diet. The PCs were also shown to help the mice regulate their blood glucose levels, indicating that they might be useful as a treatment for diabetes. Of course, further research is needed to get an idea of the effects of the compound on humans.


Although it's not quite an "eat chocolate to lose weight" situation, we kind of love that one of our favorite "indulgences" might provide a key weapon for fighting obesity and diabetes. Pretty sweet, no?