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Blood pressure drugs may raise heart attack risk for diabetes patients



While patients with systolic pressure above 140 saw health benefits, those with pressure at or below 140 saw potential risks go up.
By Stephen Feller  

Previous studies have shown more aggressive treatment of blood pressure is beneficial for most patients, however a new study from Sweden shows diabetes patients face greater health risk with the tougher approach. Photo by Rido/Shutterstock
UMEA, Sweden, Feb. 25 (UPI) -- Although many with diabetes have high blood pressure, and it is important for these patients to keep blood pressure under control, a new study suggests aggressive treatment may increase risk for heart attack.
Researchers in Sweden found in a large study that diabetic patients with systolic blood pressure lower than 140 before treatment with antihypertensive drugs had a higher chance for heart attack.
More than 70 million people in the United States have high blood pressure, considered a systolic pressure above 140 and diastolic pressure above 90. Recommendations for controlling blood pressure have long aimed for 140, howeverrecent research found more aggressive treatment -- setting a goal for systolic pressure of 120 -- can significantly lower the risk of cardiovascular events and death.
Health benefits have been seen when aiming for an even lower blood pressure, but diabetic patients face other health concerns that complicate such strong treatment goals.
"In practice, it is important to remember that undertreatment of high blood pressure is a bigger problem than overtreatment," Mattias Brunström, a doctoral student at Umeå University, said in a press release. "Many treatment guidelines, both Swedish and international, will be redrawn in the next few years. It has been discussed to recommend even lower blood pressure levels for people with diabetes -- maybe as low as 130. We are hoping that our study, which shows potential risks of such aggressive blood pressure lowering treatment, will come to influence these guidelines."
For the study, published in the British Medical Journal, researchers reviewed 49 trials including 73,738 participants, most of whom had type 2 diabetes, to find the effects of varying levels of blood pressure treatment.
For patients with systolic pressure above 150, aggressive blood pressure treatment lowered the risk of any type of death, death from a cardiovascular event, heart attack, and kidney discharge. With a baseline systolic pressure between 140 and 150, treatment also was seen to reduce death, heart attack, and heart failure.
Patients with systolic pressure lower than 140, however, saw an increased risk of heart attack, a cardiovascular event leading to death, or any cause of death.
"Our study shows that intensive blood pressure lowering treatment using antihypertensive drugs may be harmful for people with diabetes and a systolic blood pressure less than 140 mm Hg," Brunström said. "At the same time, it is important to remember that blood pressure lowering treatment is crucial for the majority of people with diabetes whose blood pressure measures above 140."


Blood pressure drugs may raise heart attack risk for diabetes patients


While patients with systolic pressure above 140 saw health benefits, those with pressure at or below 140 saw potential risks go up.

By Stephen Feller  

Previous studies have shown more aggressive treatment of blood pressure is beneficial for most patients, however a new study from Sweden shows diabetes patients face greater health risk with the tougher approach. Photo by Rido/Shutterstock
UMEA, Sweden, Feb. 25 (UPI) -- Although many with diabetes have high blood pressure, and it is important for these patients to keep blood pressure under control, a new study suggests aggressive treatment may increase risk for heart attack.
Researchers in Sweden found in a large study that diabetic patients with systolic blood pressure lower than 140 before treatment with antihypertensive drugs had a higher chance for heart attack.
More than 70 million people in the United States have high blood pressure, considered a systolic pressure above 140 and diastolic pressure above 90. Recommendations for controlling blood pressure have long aimed for 140, howeverrecent research found more aggressive treatment -- setting a goal for systolic pressure of 120 -- can significantly lower the risk of cardiovascular events and death.
Health benefits have been seen when aiming for an even lower blood pressure, but diabetic patients face other health concerns that complicate such strong treatment goals.
"In practice, it is important to remember that undertreatment of high blood pressure is a bigger problem than overtreatment," Mattias Brunström, a doctoral student at Umeå University, said in a press release. "Many treatment guidelines, both Swedish and international, will be redrawn in the next few years. It has been discussed to recommend even lower blood pressure levels for people with diabetes -- maybe as low as 130. We are hoping that our study, which shows potential risks of such aggressive blood pressure lowering treatment, will come to influence these guidelines."
For the study, published in the British Medical Journal, researchers reviewed 49 trials including 73,738 participants, most of whom had type 2 diabetes, to find the effects of varying levels of blood pressure treatment.
For patients with systolic pressure above 150, aggressive blood pressure treatment lowered the risk of any type of death, death from a cardiovascular event, heart attack, and kidney discharge. With a baseline systolic pressure between 140 and 150, treatment also was seen to reduce death, heart attack, and heart failure.
Patients with systolic pressure lower than 140, however, saw an increased risk of heart attack, a cardiovascular event leading to death, or any cause of death.

"Our study shows that intensive blood pressure lowering treatment using antihypertensive drugs may be harmful for people with diabetes and a systolic blood pressure less than 140 mm Hg," Brunström said. "At the same time, it is important to remember that blood pressure lowering treatment is crucial for the majority of people with diabetes whose blood pressure measures above 140."

A Do-It-Yourself Revolution in Diabetes Care



By PETER ANDREY SMITH

John Costik, right, and his son Evan reflected on an iPad’s screen. An app on the device displays Evan’s blood sugar levels in real time. CreditBrendan Bannon for The New York Times
John Costik got the call at the office in 2012. It was his wife, Laura, with terrible news: Their 4-year-old son, Evan, was headed into the emergency room.
His blood sugar reading was sky high, about 535 mg/dl, and doctors had discovered he had Type 1 diabetes. The first three days in the hospital were a blur during which the Costiks, engineers in Rochester, received a crash course in managing the basics of diabetes care.
For starters, they were told to log their son’s numbers on paper forms. It was their first hint that diabetes management did not occupy a place on technology’s bleeding edge. The methods for guesstimating carbohydrate intake also seemed imprecise, Mr. Costik found, and the process generated a lot of wasted data.
“The last thing you want to do is find some form and fill it out,” he said. “You’re really just emotionally trying to cope with it, and that data in that book isn’t necessarily useful to the people with diabetes.”
Several months later, Mr. Costik fitted his son with a Dexcom G4 continuous glucose monitor. A hair-thin sensor under Evan’s skin recorded an exact blood sugar reading at five-minute intervals, 24 hours a day.
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But all that data left with Evan every morning when he headed off to day care. Mr. Costik wanted something better: continuous access to his son’s glucose readings.
So he examined the device’s software code and wrote a simple program that transmitted the monitoring data to an online spreadsheet he could view on a Web browser, Android mobile phone or, eventually, his Pebble smartwatch.
 “I wanted our lives to be simple,” Mr. Costik said, “and I wanted Evan to live a long time, and diabetes to be a nuisance, not a huge struggle.”
Mr. Costik shared a photograph of his simple hack on Twitter — and discovered a legion of parents who were eager to tailor off-the-shelf devices into homemade solutions. Together, they have set in motion a remarkable, egalitarian push for improved technology to manage diabetes care, rarely seen in the top-down world of medical devices.
In 2014, the last year for which data is available, the Centers for Disease Control and Prevention estimated that 29 million adults were living with diabetes. Of these, 5 to 10 percent had Type 1, which develops when the body’s immune system destroys pancreatic beta cells.
Now, as consumer gadgets weave themselves ever more tightly into everyday life, patients and their families are finding homespun solutions to problems medical-device manufacturers originally did not address. Industry executives say the pace of user-driven innovation was one reason the Food and Drug Administration recently reclassified remote glucose-monitoring devices, hastening approval for new models by big companies like Dexcom and Medtronics.
James Wedding, a civil engineer who lives outside Dallas, saw Mr. Costik’s Twitter post and used his code to set up a remote monitor system for his daughter, Carson, who is now 12.
We asked parents of children with Type 1 diabetes to share their stories about the educational obstacles they have encountered and the steps they took to overcome them.
“Once I got all the pieces together, I remember crying — not quite in sadness, just in utter amazement — the first time I could see her numbers displayed on my computer screen and she was on the other side of the house,” Mr. Wedding said.
 “It is such a change in your relationship when the first question out of your mouth when you talk to your son, your daughter, your spouse, your brother, whatever, is no longer, ‘Hey, what’s your number?’ It’s ‘How was math class? How was work? What are you up to today?’”
Lane Desborough, an engineer in California, got in touch with Mr. Costik after seeing his tweet, ultimately creating an open-source system based in part on Mr. Costik’s code. It allows anyone to hack existing glucose monitors so they transmit readings to the cloud, where they can be read by patients and caregivers.
Mr. Desborough called the project Nightscout. The Nightscout group on Facebook, known as CGM in the Cloud, provides free tech support for users trying to improve on monitoring devices.
About two dozen users have even started a project called Open APS, in which they are pairing insulin pumps with glucose monitors in an effort to create an open-source artificial pancreas system. These wearable devices, which automate insulin delivery, are being tested in academic settings, but these early adopters are not waiting for the results of those continuing clinical trials.
Mr. Costik now works at the Center for Clinical Innovation at the University of Rochester, where he works to improve management options for all patients; Mr. Desborough is now the chief engineer atBigfoot Biomedical, a start-up in Palo Alto, Calif., that plans to create an artificial pancreas.
More recently, the home tinkering projects have buoyed a patient-led initiative to make generic insulin. Anthony Di Franco, a founder of the biotech hacker space Counter Culture Labs in Oakland, Calif., has had diabetes for 10 years. Mr. Di Franco saw what parents with diabetic children were doing with glucose monitoring devices and wondered why, even with insurance coverage, a three-month supply of insulin often totaled hundreds of dollars.
“I was frustrated with the situation,” he said.
With available laboratory tools, and a wealth of available academic literature, he set out to learn whether insulin could be home-brewed on a small scale. After some research, Mr. Di Franco realized, “We can do it, and we can do it now. All of the tools already exist.”
Last year, the Open Insulin Project raised $16,656 in one of the more ambitious efforts to radically transform diabetes care. So far, the small team of researchers has inserted the genes that make proinsulin (the form of insulin produced by the human body) into E. coli bacteria and began culturing the organism on a larger scale.
The intent is not to make insulin at home, or on an industrial scale. Any drug that is injected comes with substantial risks and would face considerable regulatory scrutiny. Rather, the hackers hope to be able to demonstrate the technological feasibility. Within a year or two, Mr. Di Franco said he envisions handing off the protocols and any intellectual property to a generics manufacturer.
“One thing that would make me happy,” he said, “is that if more people who needed insulin got ahold of it by whatever means necessary.”
Dr. Jeremy A. Greene, a physician and historian at Johns Hopkins University, who recently wrote in The New England Journal of Medicine about the lack of generic insulin, said patients with diabetes had a long history of tinkering with existing technology, even in ways that were not officially sanctioned.
Dr. Greene argues that while manufacturers in insulin are making innovations — the newest forms of insulin are substantial improvements over earlier products — they stop producing the older forms once they lose patent protection. Patients and their insurers pay a high price for patented insulin or go without.
Biohackers are attempting to resurrect an older product to address the lack of generic insulin, Dr. Greene said.
“I don’t think that we should be surprised that a population of technologically savvy patients, whose lives are dependent on access to a supply of a biological agent, should be interested in taking means of production into their own hands, especially at time when insulin prices have risen at unpredictably alarming rates.”


This Simple Trick Boosts Vitamin D in Diabetics




By Nick Tate   
A simple change in diet could boost vitamin D levels in Type 2 diabetics, according to new research from Iowa State University.
The findings, published in the Journal of Agricultural and Food Chemistry, are significant because diabetics have trouble retaining vitamin D, which is important for bone health and protecting against cancer and other diseases.
The Iowa State researchers found diabetic rats fed an egg-based diet had higher concentrations of the form of vitamin D known as 25-hydroxyvitamin D-3, as well as improved blood glucose levels. They also gained less weight over the course of the study than those who did not eat the egg-based diet.
"Eggs are the richest source of 25-hydroxyvitamin D-3 in the diet, and there isn't any conversion required to make it into the blood. If you take it in a supplement or food fortified with vitamin D, it has to be converted to that form," said Matthew Rowling, an associate professor of food science and human nutrition.

Blood glucose levels dropped nearly 50 percent for diabetic rats on an egg-based diet, compared to those fed a standard diet. Concentrations of the vitamin were 148 percent higher for the egg-fed group and plasma triglyceride concentrations — a risk factor for cardiovascular disease — dropped 52 percent.

Paleo diet touted as better for diabetics could cause rapid weight gain, research finds



The World Today
By Rachael Brown

Researchers who set out to prove the benefits of the Paleo diet have instead discovered it could cause significant and rapid weight gain.
The study by Melbourne University researchers, took two groups of overweight mice with pre-diabetes symptoms. One group was put on the low-carb, high-fat Paleo diet, and the other on their normal diet
The scientists found that mice on the Paleo diet gained 15 per cent of their body weight, in only eight weeks.
The findings, published in Nature's Nutrition and Diabetes journal have reignited the debate between scientists and celebrity chefs over the controversial diet.
The increasingly popular Paleo (or "caveman") diet has been touted as a way to lose weight and even reverse or better manage conditions like diabetes, irritable bowel syndrome, and multiple sclerosis.
But University of Melbourne diabetes researcher Associate Professor Sof Andrikopoulos said the results of his study were a cautionary tale about fad diets.
Professor Andrikopoulos began research to find out whether the Paleo diet could benefit patients with diabetes or pre-diabetes.
Mice were used for the study due to their genetic, biological, and behavioural characteristics which closely resemble that of humans.
Professor Andrikopoulos said he expected some weight loss, but was instead surprised by the extent of weight gain.

"The fat mice became even fatter and their glucose control became even worse," Professor Andrikopoulos said.
He said, comparing this to a person, it would mean an 80-kilogram man would soon hit 92 kilograms on the scales.
"The Paleo diet may not necessarily be good for everybody. My advice is that if you're concerned about weight and your health, go and seek professional advice, go and speak to your GP, go and speak to your dietician, your nutritionist, and get tailored individualised advice," Professor Andrikopoulos said.
Controversial Paleo advocate Pete Evans defends the diet
Last year one of the Paleo diet's biggest promoters, celebrity chef Pete Evans, was widely criticised after releasing a cookbook that recommended feeding infants bone broth as baby formula.

What is the Paleo or Stone Age diet?
•           The Paleo diet is based on the idea that we should eat what we did when humans were hunter gatherers.
•           Foods included are lean meat, vegetables, fruit, eggs, and seafood. Those on a Paleo diet are encouraged to exclude grains, legumes, dairy products, refined sugar, salt and processed foods.
•           Although the Paleolithic or Stone Age diet first appeared in the 1970s, it has received renewed interest over the past few years.
•           It is claimed the diet reduces body weight and helps prevent conditions such as diabetes, high blood cholesterol, stroke, osteoporosis and inflammatory disease.
•           Most dietitians don't recommend the diet because it encourages high meat consumption, which has been linked to an increased risk of bowel cancer, and because it encourages people to cut out whole food groups (grains and dairy).
Source: ABC Health and Wellbeing

But today, Evans stood by the diet that has given him over 1 million Facebook followers and healthy cookbook sales.
"I put my hand on my heart and say 100 per cent that the Paleo way, as we promote it, is 100 per cent healthy for people with type 2 diabetes," Evans told The World Today.
Evans denied accusations he was promoting a diet with little or no scientific evidence and said this latest research would not temper his promotion of the diet.
"I work with Dr Lynda Frassetto from the University of San Francisco. If you want to see the research, have a look at the research she did two years ago comparing the Paleo diet to the American Diabetes Association diet, the Paleo diet came out on top," he said.
The study Peter Evans refers to is one Dr Lynda Frassetto was co-author of, conducted at the University of California, concluding "even short-term consumption of a Paleolithic-type diet improved glucose control and lipid profiles in people with type 2 diabetes compared with a conventional diet containing moderate salt intake, low-fat dairy, whole grains and legumes."
Also in Australia, Adelaide researchers in collaboration with the CSIRO have developed what they describe as "a diet and exercise that reduces the burden of type 2 diabetes, and has reduced participants' medication levels by an average of 40%. The diet incorporates an eating pattern that is very low in carbohydrates and higher in protein and unsaturated fats.
Peter Evans added "The first question I'd ask is: 'Why are they testing mice on a diet that isn't their natural diet in the first place?'."
But Professor Andrikopoulos insisted: "We do know that mice and men share genes and share the same physiology, all of the advances in the medical field that we have and we enjoy have been tested first in animal models."
Although he did concede that every body was different.
"I don't think you can make a blanket statement that it's going to beneficial for everybody and I think people's circumstances, their living style, their exercise regime differs, their genetic makeup is different," he said.
"For example, Pete Evans is a thin guy who exercises daily and he has the time to go out and source organic stuff.
"Now if you're a family person, you've got two kids, a full time job that's not in the diet industry and you're doing pick-ups and drop-offs at school, doing sports runs on the weekend, you don't have time to do what Pete Evans does — to go to the organic market, to pick the right foods, I don't think you can blanket statement everybody."
Professor Andrikopoulos added that his research was independent as it was internally funded by the University of Melbourne.
"I am employed, in essence, by the National Health and Medical Research Council via the University of Melbourne. There is no conflict, unlike him [Pete Evans], there is no conflict, I've got no cookbook," he said.



Reduce Risk Of Diabetes with These 7 Exceptional Foods


Diabetes is a very common disease in the world today. With more people becoming over weight, diabetes and heart disease are often quick to follow.

Bad dieting is a common cause of diabetes, convenience food and busy schedules make it too easy for people to fall into a trap of bad habits. By watching your food intake, you will be able to remain healthy and greatly reduce the risk of diabetes.
Here are 7 foods that can help to combat diabetes.

GUAVA
This exotic fruit has many reasons that make it a great food for fighting diabetes. A study revealed that consuming guava without the skin can reduce sugar absorption in the blood stream. Guava is also high in vitamin C which can reduce the damage of cells linked with diabetes.

BEEF
Less hunger means less insulin spikes and red meat such as beef is great for combating diabetes. One should choose lean cuts such as fillet, sirloin or rump. Protein will keep you fuller for longer and fight off unwanted cravings for unhealthy foods.
AVOCADO
The green creamy, rich and rare food does not damage your digestive tract. Avocado is full of monounsaturated fat and is slow digesting, keeping blood sugar from spiking too much after meals. The good fat in avocado can even help reverse the effects of insulin resistance and stop any risks of diabetes.

PEANUT BUTTER
Monounsaturated fats contained in peanut butter are also a healthy support for your metabolism. A recent study revealed that peanut butter can stave off people’s appetite for 2 hours longer; compared to a high carb, low fibre snack.

APPLES
Remember, an apple a day may keep the doctor away. They are low in calories but high in fibre, and can stop hunger and insulin spikes between meals. Apples also lessen bad cholesterol and stop erratic spiking of the blood sugar in us.

FISH
A well-known problem for diabetic people is the risk of heart disease. Eating one portion of fish a week can reduce your chance of heart disease by 40%! Fish contains healthy fats that have a positive effect in the body proving that not all fats are bad for you! The omega fatty acids help reduce inflammation in the body, along with diabetic symptoms like insulin resistance.

DARK GREEN VEGETABLES
Broccoli, spinach, kale are wondrous vegetables known as super foods and will often make most top ten lists. They are packed full of anti-oxidants and enough Vitamin C for your whole day in just one serving. These vegetables also have good amounts of chromium which regulates safe blood sugar in your veins and arteries.