The Diabetes Epidemic + Analysis Bites

Hiya there, Dr Jedha right here and thanks for tuning into episode 43. Over the previous couple of months I’ve been gathering collectively some headlines, highlights, analysis bites and bits to share so at this time we’ll be masking a combination mash of matters from world diabetes statistics and world well being group warnings to analysis bites about metformin timing, excessive cortisol and excessive blood sugar, emulsifiers, flavonoids, meals, wholesome diets, together with the environment and BPA in plastic bottles and cautions about browsing the wild west internet.

First, let’s dig into some sobering statistics. 

Globally we’re dealing with main main well being points, and particularly, current headlines throughout the globe have emphasised the worldwide diabetes epidemic continues to develop uncontrolled. 

The FDA commissioner publicly acknowledged america is failing diabetes. Within the US there are roughly 34 million residing with kind 2 diabetes, 98 million residing with prediabetes, and eight.7 million folks undiagnosed.

The UK famous an 18% rise in circumstances of prediabetes in only one 12 months, putting folks at excessive threat of kind 2 diabetes, 21% improve in kind 2 diabetes, at the very least 1.2 million undiagnosed. Within the UK, there are roughly 4 million residing with kind 2 diabetes, over 3.6 million prediabetes. 

Australia revealed alarming statistics, with charges of kind 2 diabetes tripling over the previous three many years and at the very least half one million undiagnosed circumstances. In Australia there are roughly 1.3 million residing with kind 2 diabetes, 2 million prediabetes.

In Canada stats are sitting round 3.2 million with kind 2 diabetes, 6 million with prediabetes, one other million extra undiagnosed, with a 26% improve in circumstances anticipated within the subsequent decade.

Most annoying is the elevated charges we’re seeing in youthful folks – and we’re primarily speaking about kind 2 diabetes, as that is the most typical kind. 

Within the UK, there’s been a 25% improve within the variety of folks underneath 40 with prediabetes, and a 40% rise in kind 2 diabetes diagnoses in youthful folks. In Australia, the previous decade has seen a 44% improve in folks between 21-39 years and 17% rise in these underneath 21 years!! Within the US we’ve seen a rise of half one million identified circumstances in 18-44 12 months olds, and an estimated few hundred thousand extra undiagnosed. The tendencies in kind 2 diabetes in youngsters and adolescents from 10 to 19 years is rising. 

To say we’ve a problem is de facto an understatement.

What’s attention-grabbing about this, and that is the place I wish to ask in your assist: So the attention-grabbing factor is the share of individuals assembly targets for A1c ranges underneath 7%, together with normalizing blood stress and ldl cholesterol is just sitting at 11.1%. Out of all of the thousands and thousands of individuals residing with diabetes, it is a small share. We actually want your assist in spreading the phrase about us, about DMP, in regards to the T2Diet Program, about Sort 2 Diabetes Discuss, as a result of the stuff we do helps folks obtain these targets and we have to assist extra folks do that. I’m proud to say we’re a part of the answer and may make a huge impact on folks’s lives. So please, share a hyperlink to our web site on social media, advocate our web site or our podcast to household, buddies or colleagues and in the event you’re a daily listener of the podcast, please depart a score on Apple, Spotify or the place you hearken to the podcast, as a result of this all actually helps us attain extra folks and the extra folks we are able to attain, the extra lives we are able to affect and alter for the higher. And I thanks prematurely for doing that. 

As I stated, to say we’ve a problem is de facto an understatement. It is a world diabetes epidemic and one of many main points is our weight-reduction plan and diet high quality. Extra importantly although, is 2 issues: 

One, there was widespread misinformation about weight-reduction plan and diet and what the suitable kind of consuming plan to alter diabetes well being. Sadly this contains info that has come out of diabetes organizations for many years. That is horrible as we all know folks flip to locations just like the American Diabetes Affiliation, Diabetes Canada or Diabetes Australia to get info and so they suppose it’s the perfect info. After all, why wouldn’t you suppose that as these organizations are supposedly the governing our bodies of diabetes within the nation. As well as, their info is free, which is interesting. However that doesn’t imply it’s correct or based mostly on the perfect analysis. 

The second problem is there simply isn’t sufficient help obtainable. There’s not sufficient workforce capability to fulfill the demand. With 34 million folks residing with kind 2 diabetes within the US, there are lower than 5000 endocrinologists – who are supposed to be specialists on this space. This lack of workforce capability is widespread, with restricted well being professionals throughout all areas, diabetes educators, physicians, dietitians, amongst others. And it’s a problem that’s world as nicely. 

That’s the place our on-line diet applications and providers are serving to to shut the hole. We will attain folks irrespective of the place they’re, present the continued training and help folks want, and also you get pleasure from accessing that help anytime, wherever. As I stated, I’m very pleased with the truth that we’ve been supporting folks to attain higher well being for over a decade and we are going to clearly proceed to do this. 

Transferring on with the remainder of at this time’s episode I’ve some analysis I’ve been gathering, attention-grabbing new analysis I’ve learn that I wished to share with you. 

The very first thing we’re masking is the perfect time to take metformin. 

Metformin is likely one of the mostly prescribed medicines for managing each kind 2 diabetes and prediabetes. A frequent query I get is, ‘When is the perfect time to take metformin? Ought to it’s earlier than, with, or after meals?’ Historically, to attenuate gastrointestinal misery, it’s typically really helpful to take metformin with meals.

Nonetheless, new analysis means that the optimum time would possibly truly be 30-60 minutes earlier than meals. The examine discovered that taking metformin earlier than meals led to better reductions in glucose ranges and elevated blood ranges of GLP-1. Now, you could be pondering, ‘Isn’t GLP-1 the identify of a brand new remedy? Truly, GLP-1 stands for glucagon-like peptide-1, which is a hormone naturally produced within the physique. It helps regulate blood sugar ranges and urge for food. Some diabetes medicines, like these you might need heard of, Ozempic or Wogovy for instance, mimic this hormone to assist handle blood sugar extra successfully.

So, by taking metformin earlier than meals, you could be enhancing your physique’s pure GLP-1 ranges, main to raised blood sugar management. 

Talking of the favored medication Ozempic or Wogovy. Across the globe there was surging demand for these and with that comes one other main problem – counterfeit medication! The World Well being Group issued a world vital warning about this counterfeit drug problem, with some medication discovered to be falsely claiming to comprise semaglutide, the energetic ingredient in diabetes drug Ozempic and weight-loss remedy Wegovy. In accordance with WHO, counterfeit variations have been present in Brazil, the UK, and the US. The Australian Authorities additionally issued warnings about harmful compounded replicas being distributed to sufferers. Clearly, that is of excessive concern and one thing I wished to focus on that you just pay attention to in the event you do take these medicines. 

One other attention-grabbing little analysis chunk was a brand new examine about how excessive ranges of cortisol might improve issues or make it troublesome to manage blood sugar. It’s new knowledge so we actually want extra analysis to actually set up this however primarily when you have been struggling to get your blood sugar ranges underneath management it might be attributable to excessive cortisol. Cortisol is our stress hormone and when that is excessive it elevates blood sugar ranges. The researchers screened 1000 folks and located 24% of them had excessive cortisol and much more attention-grabbing was that those that have been taking a number of medicines for hypertension had greater charges of excessive cortisol. They don’t know whether or not that is stress associated or attributable to alterations in organs, for instance, some folks had abnormalities within the adrenal gland. That is the gland that produces cortisol. As I stated, that is very early knowledge so will probably be attention-grabbing to see if this evolves as extra analysis is completed. 

There was a examine highlighting the possibly detrimental results of widespread food components by way of threat of growing kind 2 diabetes. There’s not an excessive amount of analysis round particular components so I all the time discover this analysis attention-grabbing. 

Widespread emulsifiers with doubtlessly detrimental results included tripotassium phosphate, guar gum, xanthan gum, sodium citrate, gum arabic, and carrageenans. These would possibly sound acquainted as you’ve most likely seen them on meals labels of widespread meals like breads, muffins, biscuits, yogurt, ice cream, chocolate bars, margarines, ready-to-eat meals and plenty of different processed meals.  As I stated, the analysis highlighted that components might contribute to elevated threat of growing kind 2 diabetes. 

For this reason we’ve such a give attention to encouraging nutrient-dense, high quality diets. Nutrient-dense diets, wealthy in greens, fiber, protein, and wholesome fat, present nutritional vitamins, minerals, and important vitamins which are foundational for sustaining steady blood sugar ranges, decreasing mobile irritation and optimizing metabolism. By specializing in consuming high-quality meals, we are able to keep away from the pitfalls of ultra-processed meals, to assist mitigate metabolic disturbances and scale back threat of diabetes. And naturally, to deal with diabetes extra successfully too. All the time attempt to give attention to consuming complete, unprocessed meals.

After all it’s logical and is smart {that a} wholesome consuming plan helps higher well being. It’s actually been proven in ample analysis to help improved blood sugar, weight reduction, and decreased medicines. However simply to substantiate this, a examine checked out nearly 1600 males between 51-81 years with out diabetes. And naturally a wholesome consuming plan was related to decrease blood glucose and higher insulin sensitivity, and this was no matter whether or not an individual had a genetic threat of kind 2 diabetes. The wholesome consuming half isn’t actually new. It’s simply extra analysis to substantiate the very fact. I assume the attention-grabbing factor was that even with the next genetic threat, you might have some management of the outcomes and specializing in a wholesome consuming plan is essential. Within the examine the unhealthy diets have been Excessive in fried potatoes or French fries; hamburgers; pizza; refined pasta or rice; candy pastries; sweet; savory pies and pastries; savory snacks; ice cream or puddings; French roll, baguette, or different white bread; candy cookies, biscuits; and so forth. As we are able to see, we’re speaking about plenty of refined and processed meals that’s loaded with added sugar and excessive in carbohydrates. Nutrient poor meals. 

To focus on once more the significance of nutrient dense meals having a number of well being advantages, a UK Biobank examine highlighted that flavonoid-rich meals might help scale back the chance of kind 2 diabetes. The inhabitants examine, involving over 113,000 members, revealed {that a} greater consumption of flavonoid-rich meals—equivalent to tea, berries, and different meals—was related to a 26% decrease threat of growing T2D.

Key findings included:

• Ingesting tea (black and inexperienced): with a 21% decrease T2D threat with 4 servings/day
• Consuming berries: with 15% decrease T2D threat with 1 serving/day

So actually contemplate together with tea and berries in your every day routine. Most pure meals will present many well being advantages as a result of compounds they comprise – the flavonoids and polyphenols for instance, which is why we encourage nutrient dense meals. 

Onto one other subject. For those who’ve by no means heard of bisphenol A, or BPA—it’s a chemical discovered in lots of plastic water bottles and meals containers. For a very long time, the proof linking BPA to well being points has been observational. This implies it confirmed an affiliation however couldn’t show that BPA was the direct trigger of those well being issues. Nonetheless, a groundbreaking new examine has offered direct proof that BPA can scale back insulin sensitivity, doubtlessly rising the chance of kind 2 diabetes. The examine discovered that even ranges of BPA at the moment thought-about secure by the Environmental Safety Company can impair insulin response. This implies that we would must rethink our publicity to BPA and go for options like stainless-steel or glass bottles. Definitely along with your ingesting water it’s good to take heed to this and use stainless-steel or get BPA free plastic. This concern over BPA is a part of a broader consciousness about environmental contaminants and their potential long-term well being results. Latest analysis has additionally proven that microplastics, which might infiltrate human cells, would possibly pose severe well being dangers, being discovered all over the place from our lungs to our reproductive organs. There’s ongoing analysis in these areas nevertheless it does spotlight the truth that our fashionable setting performs a job in our general well being as nicely. 

The very last thing I wished to cowl at this time was the loopy inaccurate stuff I come throughout when looking the wild west internet. These things actually frustrates me as a result of it offers folks completely fallacious recommendation and in doing so goes to maintain folks from getting higher outcomes with their well being. As an example, I got here throughout an article titled: ‘Finest Weight-reduction plan Plans for Individuals with Diabetes, Reviewed by Consultants’. After I see headlines like that I all the time suppose: okay, right here we go. The article kicks off by selling the Diabetes Plate Technique, which is a technique the American Diabetes Affiliation makes use of, which permits collection of meals decisions and One-fourth of your plate might be carbohydrate meals like complete grain rice, quinoa, and starchy greens equivalent to potatoes and butternut squash, or 3 decisions which is round 45 grams of carbs. Now, that’s so much. Additional down the article the nurse/diabetes educator recommends folks eat 30-60 grams of carbohydrates per meal. Granted, not all the article was unhealthy, however the carbohydrate suggestions are out of line. At 60 grams per meal an individual with any sort of diabetes will battle to decrease blood sugar and A1c, shed pounds and scale back meds, so it’s simply not sound recommendation. Sadly I noticed this identical recommendation lately on the Australian Nationwide Diabetes Service Scheme web site. The carbohydrate course they supply and their carbohydrate counting and fast guidelines recommends 30-45 grams carbs per meal for girls and 45-60 grams of carbs per meal for males. One of these info is outdated and even dangerous to folks, in order I stated, it makes me a bit annoyed. In any case, I wished to notice this for you at this time, to maintain a watch out throughout the wild west internet as a result of it’s extra widespread than to not come throughout inaccurate info. And on the subject of implementing that recommendation into your life, it could actually do you extra hurt than good. Simply hold your sheriff detective hat on as you browse the wild west internet, okay. 

Properly, that’s all from me at this time. I hope you’ve loved at this time’s episode, quantity 43. As I pressured in the beginning, with the rising charges of diabetes, we actually want your assist in spreading the phrase about us, about DMP, in regards to the T2Diet Program, about Sort 2 Diabetes Discuss, as a result of the stuff we do helps folks obtain these targets and we have to assist extra folks do that. Please share a hyperlink to our web site on social media, advocate our web site or our podcast to household, buddies or colleagues and in the event you’re a daily listener of the podcast, please depart a score on Apple, Spotify or the place you hearken to the podcast, as a result of this all actually helps us attain extra folks and the extra folks we are able to attain, the extra lives we are able to affect and alter for the higher. 

Thanks prematurely for doing that. 

Take care till subsequent week.

Dr Jedha, over and out.