Wednesday, May 29, 2019

The Importance of Physical Activity in Controlling Blood Glucose

Type 2 diabetes has been a dangerous chronic illness in the US for a number of years. And now, prediabetes is gaining attention because treating prediabetes can delay or avoid type 2 diabetes. Approximately 30 million US residents have type 2 diabetes, and more than 84 million US residents have prediabetes. A healthy diet and physical activity are seen as the tools to use in the fight against type 2 diabetes and prediabetes. And one study has suggested that a too-low level of physical activity is likely to lead to type 2 diabetes.

Investigators at McMaster University in Ontario, Canada looked at the effects of walking 1,000 steps or less a day for two weeks. The investigator focused, specifically, on overweight, elderly individuals, and found that the “sudden inactivity [of walking less than 1000 steps a day] caused blood sugar to spike in the pre-diabetic adults, and it stayed high even after people returned to normal levels of activity.”

It was reasoned that the limited physical activity meant that the body didn’t use as much of the glucose as it might have with more activity. And as glucose stays in the blood, more insulin is created to remove the glucose. Eventually, tissues become less sensitive to insulin, making it more difficult for insulin to remove the glucose from the blood.

The above study demonstrates the importance of physical activity. Some experts recommend 10,000 steps each day. Others argue that the number is less than 10,000 steps. However, based on the above study, the number of steps is probably at least a thousand.

Physical activity is needed to help regulate blood glucose. Physical activity, along with diet and lifestyle change, is an important tool in the fight against prediabetes and type 2 diabetes. And clinicians should always make physical activity a part of any type 2 diabetes and prediabetes treatment plan.

Saturday, May 25, 2019

Biomarkers Can Predict Type 2 Diabetes Two Decades Before the Diagnosis

For some time, diabetes has been a dangerous chronic illness in the US. And the disease has received a lot of attention. In recent years, prediabetes has also received a great deal of attention. Prediabetes has been given attention because it is often the forerunner of type 2 diabetes. Approximately 30 million Americans have type 2 diabetes, and over 84 million Americans have prediabetes. But luckily, there are biomarkers that can predict type 2 diabetes as much as two decades before a person is diagnosed with the disease. And there are proven lifestyle changes and medications that can help one delay or avoid type 2 diabetes.

In a Japanese study, 27,392 adults who did not have diabetes were studied. They were looked at between the years of 2005 and 2016. At the start of the study, blood glucose and weight were measured. During the 11 year period, 1067 of the subjects developed type 2 diabetes. The researchers concluded that since “the vast majority of people with type 2 diabetes go through the stage of prediabetes, [the researchers'] findings suggest that elevated metabolic markers for diabetes are detectable more than 20 years before its diagnosis.”

Another study, done in Sweden, also demonstrated that risk factors for type 2 diabetes exist up to 20 years before one is diagnosed with the disease. The study followed 296,439 individuals who were nondiabetic for 20 years. During that time about 10% of the study subjects received a diagnosis of type 2 diabetes. In looking at the biomarkers, BMI, triglycerides, and fasting glucose, it was revealed that those persons who had these biomarkers at higher than normal levels were at a higher risk of type 2 diabetes, about 20 years later.

Fortunately, intensive lifestyle intervention (ILI) and medication can help avoid or prevent type 2 diabetes after one is diagnosed with prediabetes. In one study where 422 adults in Southern California were examined, it was found that ILI or ILI in combination with medications can help individuals avoid type 2 diabetes. The researchers concluded that “after an average follow-up period of almost 3 years, the annual rate of transitioning to full diabetes was 4.1% among people who received only lifestyle therapy, and 1.7% in patients on two diabetes drugs.”

Further, “none of the patients on three diabetes drugs develop diabetes.” Patients in the study who received prescriptions for two medications were on metformin and another diabetes medication. And patients on three medications were on metformin and pioglitazone and another diabetes medication, including exenatide and liraglutide.

So clinicians should be aware that predicting diabetes is possible. And delaying or avoiding type 2 diabetes is also possible. Knowing this can help clinicians better treat patients who are at high risk of type 2 diabetes.

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