Babies

“Low birth weight is consistently associated with an increased risk of type 2 diabetes in adulthood,” Dr. Magnus Kaijser of the Karolinska Institute, Stockholm, Sweden, and colleagues write. Exactly how poor fetal growth and premature birth fit into the picture, however, was not known.

As reported in the journal Diabetes, the researchers identified a group of subjects born prematurely or with low birth weight at four delivery units in Sweden from 1925 through 1949. The development of diabetes in these groups was compared with that seen in a similar group of subjects who had normal birth weights and were born at full term.

A total of 6425 subjects were included in the study. Of these, 2931 were born prematurely (before the 37th week of pregnancy) and 2176 had a low birth weight (less than 5.5 pounds), but were born at full term.

An analysis of hospital databases indicated that 508 of the subjects were treated for diabetes during follow-up from 1987 to 2006.

The authors found that subjects who were born very prematurely (before the 32nd week of pregnancy) were 67 percent more likely to develop diabetes than those born at term.

Similarly, birth weights that were much lower than the average weight for a given point in pregnancy increased the odds of diabetes by 76 percent.

“We have found that the association between low birth weight and risk for diabetes seems to be (the result of) both poor fetal growth and preterm birth,” Kaijser and colleagues conclude.

Vegetables

When 13 diabetics doubled their fiber intake, the study participants began to excrete less calcium in their urine — a sign that their body’s calcium absorption had declined, the researchers observed.

Fiber is known to help lower cholesterol, improve blood sugar control and maintain bowel regularity; and adults are advised to get roughly 25 grams or more each day.

But these latest findings suggest that poorer calcium absorption may the trade-off, the researchers report in the journal Diabetes Care.

“Because more calcium equals better bone health, we recommend that people on high-fiber diets talk to their physician about increasing their dietary calcium as well, in order to get the most benefit from both,” senior researcher Dr. Abhimanyu Garg, of the University of Texas Southwestern Medical Center in Dallas, said in a written statement.

He added that it is important to consult a doctor or dietitian first because excessive calcium can cause kidney stones.

The findings are based on 13 middle-aged and older adults with type 2 diabetes who each consumed 50 grams of fiber per day for 6 weeks, followed by 24 grams per day over another 6-week period.

Garg’s team found that when participants were on the higher-fiber diet, their calcium excretion declined. Some studies, the researchers note, have suggested that dietary fiber binds with certain minerals, forming “complexes” that cannot be absorbed.

Garg suggested that people try foods that provide both fiber and calcium, such as spinach, broccoli, figs, papaya, beans and artichokes.

blood sugar monitor

The average American consumes more than a pound of refined sugar a week. It sounds unbelievable until you realize that sugar goes by more than 50 names and is an ingredient in virtually all processed foods, from your morning doughnut to the ketchup on your burger.

Eat it (along with excess fat and calories), sit around, and you’ll gain weight.

It’s the average American way of life, and it deserves a new warning label: Practicing this lifestyle could send another sugar — your blood sugar — into the danger zone.

Your body’s primary source of fuel, blood sugar plays a vital role in physical and mental well-being. But when it rises even slightly above normal — thanks to excess body fat, lack of exercise, and/or genetics — your health, your energy levels, and your weight-loss efforts are jeopardized.

Overlooked by doctors
High-normal blood sugar is anything but normal. Too high to be healthy yet too low to be called diabetes, high-normal blood sugar has long been overlooked by doctors and their patients alike. Yet an estimated 16 million Americans have it — including tens of thousands of children and teens.

High-normal blood sugar can lead to the following conditions:
Overweight
Syndrome X
Pregnancy diabetes
PCOS
Full-blown type 2 diabetes
Heart disease and stroke

It wasn’t until after I had been on immunosuppressants and blood pressure medicines following my renal transplant that I developed diabetes, so it can happen to anyone at anytime.

Pills

Despite low rates of heart attacks and related problems in testing, the Food and Drug Administration will still ask an outside panel to scrutinize the company’s safety data at a meeting Wednesday.

Bristol-Myers and partner AstraZeneca have asked the FDA to approve Onglyza to reduce blood sugar levels in patients with type 2 diabetes. The drug uses a chemical reaction similar to Merck’s Januvia and would compete against the blockbuster medication, which had sales of $1.4 billion last year.

The drug is part of a new wave of medications taking aim at the U.S. diabetes market, which has grown to more than $5 billion as the disease becomes more prevalent.

Analyst estimates of Onglyza’s market potential vary, given its similarity to a more established drug. Sales estimates range from $300 million per year to more than $1 billion.

Shares of New York-based Bristol-Myers climbed 36 cents, or 1.7 percent, to close at $21.02 Monday. U.S.-traded shares of London-based AstraZeneca rose $1.87, or 5.8 percent, to $34.25.

Regulators have begun demanding more rigorous safety testing of diabetes drugs since a 2007 analysis suggested GlaxoSmithKline’s blockbuster pill Avandia could increase heart risks.

Under guidelines issued last year, FDA requires companies to test diabetes drugs on more high-risk patients, including the elderly, to detect potential heart problems. Detecting heart risks connected with diabetes drugs is challenging because patients with the disease are already at risk of heart problems.

Because Bristol-Myers and AstraZeneca conducted their studies before the guidelines were released, their testing “was not designed to prospectively measure cardiovascular risk,” agency reviewers noted. As a result the FDA said there is “insufficient information” to determine if some heart problems were related to the drug, according to briefing documents posted online.

Easy Vegetarian Lasagna

Easy Vegetarian Lasagna
(makes 6 servings)

olive oil cooking spray
3 cloves garlic, minced
1 small onion, 4 ounces (120 g), chopped
1 28-ounce (793 g) crushed tomatoes
1 1/2 teaspoons (7.5ml) dried basil
1 teaspoon (5 ml ) fennel, crushed
1 teaspoon (5 ml ) dried orange rind*
1/8 teaspoon (0.6 ml) crushed red pepper flakes
1 15-ounce (425 g) container low fat ricotta cheese
1/2 pound zucchini (240 g), grated and squeezed of excess liquid
2 small carrots, 4 ounces (120 g ), grated
1/2 cup (120 ml) egg substitute
1 cup (120 g) shredded skim milk mozzarella cheese, plus 1/4 cup (30 g) for garnish (optional)
2 tablespoons (15 g) grated Romano cheese, plus 1 teaspoon (2.5 g) for garnish (optional)
6 oven-ready lasagna noodles

Preheat the oven to 350°F (180°C), Gas Mark 4.
Spray a non-stick covered pot with cooking spray. Add the onion and garlic and cook over medium heat until the onion is transparent, about 5 minutes. Add the tomatoes, basil, fennel, orange rind, and red pepper flakes. Bring to a slow simmer, cover and cook while you ready the rest of the ingredients.
Place the ricotta in a large bowl. Fold in the grated zucchini and carrots. Stir in the egg substitute, grated mozzarella and finally the Romano cheese. Set aside.
Prepare an 8-inch (20 cm) oven-proof square pan by spreading 3 to 4 tablespoons of the tomato sauce on the bottom. Place 2 lasagna noodles on the bottom. Spread with 1/3 of the cheese and vegetable mixture and top with 1/3 of tomato sauce. Repeat making 3 layers, ending with tomato sauce. Top with reserved mozzarella and Romano.
Cover the lasagna with aluminum foil which you tent a bit to make sure it does not touch the cheese on top. Make sure to crimp around the edges of the pan. Bake for 1 hour, uncovering the last 10 minutes.
Remove from oven and allow to set for 10 minutes before cutting.
Per serving: 260 calories (26% calories from fat), 19 g protein, 7 g total fat (4.2 g saturated fat), 29 g carbohydrate, 4 g dietary fiber, 30 mg cholesterol, 426 mg sodium
Diabetic exchanges: 2 lean protein (meat), 2 vegetable

Blood Sugar Monitor

The frequency at which you should monitor your blood glucose will depend on how you plan to use the information. People who take multiple daily doses of insulin or use insulin pumps need to monitor at least 3 or 4 times daily to stay safe and to adjust insulin doses for high or low glucose levels. Those not on insulin but who are in the process of having their medications adjusted should monitor often enough to guide the medication adjustments, usually 2 or 3 times a day. If you’re on medications that can cause hypoglycemia, like sulfonylureas, you should have a working blood glucose meter and test strips on hand so you can conduct a blood glucose check if you feel low, if you’re planning to engage in physical activity, or if you have to miss or delay a meal.

Even if you’re not on a medication that can cause hypoglycemia, and have achieved your glucose control targets, it may be a good idea to perform spot checks of your glucose at least a few times a week for your own information.

chocolate and wine

From webmd: American adults say that getting a chronic disease would be worse than getting a divorce or losing a job, yet they knowingly engage in behavior that can lead to diabetes.

A new survey, commissioned by the American Diabetes Association and conducted by Harris Interactive, shows that 52% of people rank the possibility of developing a chronic disease as worse than a whole host of other potential problems, such as losing a job, getting a divorce, or accumulating sizable debt. The study also shows that most adults are aware of risky behaviors that can lead to diabetes, but many cling to those behaviors anyway.

Sixty-six percent of adults say avoiding doctor visits is risky, but 50% do it anyway. Similarly, 70% of adults say that maintaining an unhealthy weight is risky, yet 46% of people admit that they are doing so.

Of the people who report they are extremely or very likely to develop diabetes, 83% know that being overweight or obese is a risk factor. Yet within this group, 67% say they still follow a poor diet and 62% say they maintain an unhealthy weight.

“We know Americans view activities like bungee jumping as especially risky and so they avoid them,” Richard M. Bergenstal, president elect of medicine and science of the American Diabetes Association, says in a written statement. “However, these same people are gambling daily by ignoring risk factors for a life-altering disease like diabetes and doing nothing about it.”

The survey was conducted in February and March and included 2, 516 U.S. residents, all at least 18 years old.

The survey was funded by the WellPoint Foundation, a nonprofit wholly funded by WellPoint Inc.

Dash Diet

There are a variety of weight loss therapies ranging from nutrition therapy (low-calorie diets and increasing physical activity) to behavior therapy, drugs, and surgery. But for the long run, it’s burning the calories you eat that counts.

Recently, at the direction of NIH, the U.S. Department of Agriculture (USDA) completed a study on popular diets and found the diets that reduce calories result in weight loss. If you don’t exercise, eating approximately 1,400-1,500 calories a day is recommended, no matter which foods you eat. It is also appears that the easiest way to control calories is by cutting back on how much fat you eat.

Most people who succeed at weight loss and keep it off eat a diet with 20-30% of their calories from fat. This is significantly less fat than is in the average American diet, which is more than 36% calories from fat. What you need to understand is that you don’t follow a diet for 8 days, 8 weeks, or 8 months.

Your new eating habits are the basis of your everyday food choices for the rest of your life. Healthy meal plans are high in vegetables, fruits, and other carbohydrates such as whole grains and low-fat dairy products. This is a moderate-fat, low-calorie way of eating that stops weight gain, leads to weight loss, and keeps it off. It is fast, convenient, and inexpensive.

For an overall eating plan, consider the DASH eating plan. “DASH” stands for “Dietary Approaches to Stop Hypertension,” a clinical study that tested the effects of nutrients in food on blood pressure. Study results indicated that elevated blood pressures were reduced by an eating plan that emphasizes fruits, vegetables, and lowfat dairy foods and is low in saturated fat, total fat, and cholesterol. The DASH eating plan includes whole grains, poultry, fish, and nuts and has reduced amounts of fats, red meats, sweets, and sugared beverages.

A second clinical study, called “DASH-Sodium,” looked at the effect of a reduced dietary sodium intake on blood pressure as people followed either the DASH eating plan or a typical American diet. Results showed that reducing dietary sodium lowered blood pressure for both the DASH eating plan and the typical American diet. The biggest blood pressure-lowering benefits were for those eating the DASH eating plan at the lowest sodium level (1,500 milligrams per day).

The DASH-Sodium study shows the importance of lowering sodium intake whatever your diet. But for a true winning combination, follow the DASH eating plan and lower your intake of salt and sodium.

Earth

How you prepare depends on where you’re going and for how long. Two weeks backpacking through Europe takes different planning than a week at the beach. Will you be crossing time zones? What kind of food will you eat and when? Will you be more active or less active than usual?

Getting Ready

Before a long trip, have a medical exam to make sure your diabetes is in good control. Schedule the exam with enough time to work on your control before you depart. Get immunization shots — if you need them — at least one month before you leave. If the shots make you sick, you’ll have time to recover before your trip.

Before any trip, get two papers from your doctor: a letter and a prescription. The letter should explain what you need to do for your diabetes, such as take diabetes pills or insulin shots. It should list insulin, syringes, and any other medications or devices you use. The letter should also list any allergies you have or any foods or medications to which you are sensitive.

The prescription should be for insulin or diabetes pills. You should have more than enough insulin and syringes or pills to last through the trip. But the prescription may help in case of emergency. In the United States, prescription rules may vary from state to state.

The prescription laws may be very different in other countries. If you’re going out of the country, write for a list of International Diabetes Federation groups. Write to: IDF, 1 rue Defaeqz, B-1000, Belgium (www.idf.org).

You may want to get a list of English-speaking foreign doctors from the International Association for Medical Assistance to Travelers (IAMAT), 1623 Military Road, #279, Niagara Falls, NY 14304 (www.iamat.org). IAMAT can be reached at 716-754 4883. If an emergency occurs while you’re traveling and you don’t have such a list, contact the American Consulate, American Express, or local medical schools for a list of doctors.

No matter where you go, wear a medical ID bracelet or necklace that shows you have diabetes. If you’re leaving the country, also learn how to say “I have diabetes” and “sugar or orange juice, please” in the language or languages of the countries you’ll visit.