Pain Reliever Lowers Blood Sugar in Type 2 Diabetics, Study Says

But side effects of aspirin-like drug warrant further study

By Serena Gordon

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- An aspirin-like drug appears to lower blood sugar in people with type 2 diabetes, according to new research.

A study of the drug -- the prescription pain reliever salsalate -- also found it reduced inflammation associated with type 2 diabetes. But it produced unwelcome side effects that could limit its potential as a diabetes treatment.

"This trial is a test of possibly the oldest drug in Western use, and, because it's so old, there are no clinical trials on it," said study senior author Dr. Steven Shoelson, a professor of medicine at Harvard Medical School in Boston.

"This trial was for a full year and showed that salsalate does lower blood glucose," said Shoelson, who is also the associate research director at the Joslin Diabetes Center in Boston.

The study, published in the July 2 issue of the Annals of Internal Medicine, included 286 people between 18 and 75 years old with type 2 diabetes. Type 2 diabetes occurs when the body no longer produces enough of the hormone insulin to convert carbohydrates from food into fuel for the body.

At the start of the study, the participants' average A1C levels -- a measure of blood sugar levels over several months -- were between 7 and 9.5 percent. The American Diabetes Association generally recommends a level of below 7 percent for adults.

The study volunteers were randomly assigned to 48 weeks of salsalate at a dose of 3.5 grams per day, or to an inactive placebo pill. No other changes were made to current diabetes, blood pressure or cholesterol medications during the first six months of the trial, the researchers noted.

Over 48 weeks, people taking the medication saw their A1C levels drop by 0.37 percent compared to placebo.

Shoelson said that people who have metabolic syndrome -- a group of risk factors (including type 2 diabetes) for cardiovascular disease -- often have higher than normal white blood cell counts, suggesting inflammation. In this study, people on salsalate saw a drop in their white blood cell counts, but Shoelson noted that they were "always well within the normal range."

Improvements were seen in several areas among those taking the drug, including: fasting blood sugar; uric acid, which is a chemical associated with gout; and levels of triglyceride, a type of blood fat. Levels of adiponectin -- a substance related to decreased insulin resistance -- and hematocrit, a measure of red blood cells, also improved for people taking salsalate.

Not all of the changes linked to the drug were beneficial, however. The medication appeared to cause a slight weight gain -- less than 3 pounds compared to those taking the placebo. Many type 2 diabetes medications have weight gain as a side effect, Shoelson said.

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Tracking sugar intake?

Hi Buddies! I just switched from another nutrition tracker because this one (Calorie Count) tracks your vitamins and minerals, as well as the regular stuff like calories and fats. Awesome! But one area I know I need to improve in is how much sugar I consume since I love to bake! Does anyone know if/how/where to track sugar in Calorie Count? Any insight would be much appreciated! Thanks!

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Low Blood Sugar May Raise Dementia Risk in Diabetics: Study

Overly aggressive glucose control might backfire in older patients, findings suggest

By Steven Reinberg

HealthDay Reporter

MONDAY, June 10 (HealthDay News) -- Low blood sugar in older adults with type 2 diabetes may increase their risk of dementia, a new study suggests.

While it's important for diabetics to control blood sugar levels, that control "shouldn't be so aggressive that you get hypoglycemia," said study author Dr. Kristine Yaffe, a professor of psychiatry, neurology and epidemiology at the University of California, San Francisco.

The study of nearly 800 people, published online June 10 in JAMA Internal Medicine, found that people with episodes of significant hypoglycemia -- low blood sugar -- had twice the chance of developing dementia, Yaffe said. Conversely, "if you had dementia you were also at a greater risk of getting hypoglycemic, compared with people with diabetes who didn't have dementia," she said.

People with type 2 diabetes, by far the most common form of the disease, either don't make or don't properly use the hormone insulin. Without insulin, which the body needs to convert food into fuel, blood sugar rises to dangerously high levels. Over time, this leads to serious health problems, which is why diabetes treatment focuses on lowering blood sugar. But sometimes blood sugar drops to abnormally low levels, which is known as hypoglycemia.

Exactly why hypoglycemia may increase the risk for dementia isn't known, Yaffe said. Hypoglycemia may reduce the brain's supply of sugar to a point that causes some brain damage, Yaffe said. "That's the most likely explanation," she added.

Moreover, someone with diabetes who has thinking and memory problems is at particularly high risk of developing hypoglycemia, she said, possibly because they can't manage their medications well or perhaps because the brain isn't able to monitor sugar levels.

Whether preventing diabetes in the first place reduces the risk for dementia isn't clear, although it's a "very hot area" of research, Yaffe said.

But the findings do suggest that patients' mental status needs to be considered in the management of diabetes, Yaffe said.

Other experts agreed.

"This does raise concern about low blood sugar causing future problems with dementia and dementia causing problems with low blood sugar," said Dr. Stuart Weinerman, an endocrinologist at North Shore-LIJ in Great Neck, N.Y.

Weinerman isn't convinced that the association between hypoglycemia and dementia is cause-and-effect, however. "This is not a definitive study. It raises questions, but it doesn't answer them," he added.

But hypoglycemia is a serious problem for diabetics, Weinerman said. "Sooner or later, everyone is going to have some hypoglycemia," he said.

Episodes of hypoglycemia increase with age, perhaps because of changes in kidney function and drug metabolism, according to an accompanying journal commentary.

Anyone taking drugs that lower blood sugar should be aware of the signs of hypoglycemia, and be prepared to deal with it, Weinerman said. Symptoms can include confusion, jitteriness, fainting, heart palpitations and blurred vision.

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Countries With More Sugar in Food Supply Have More Diabetes

By Serena Gordon

HealthDay Reporter

WEDNESDAY, Feb. 27 (HealthDay News) -- It's a common belief that type 2 diabetes is caused by eating too much sugar. While it's not nearly that simple, a new study bolsters the connection between the disorder and sugar consumption.

The study found that even when researchers factored obesity out, an association still remained between the amount of sugar in the food supply and a country's rate of diabetes.

"The old mantra that 'a calorie is a calorie' is probably naive," said study lead author Dr. Sanjay Basu, an assistant professor of medicine at Stanford University. "Some calories may be more metabolically harmful than others, and sugar calories appear to have remarkably potent properties that make us concerned about their long-term metabolic effects. This study also suggests that obesity alone may not be the only issue in [the development of] diabetes."

Results of the study are published Feb. 27 in the journal PLoS One.

The prevalence of diabetes in the world has more than doubled over the last 30 years, according to study background information. That means nearly one in 10 adults in the world has diabetes, and most of those have type 2 diabetes. (The less-common type 1 diabetes is an autoimmune disease that's not related to food intake.)

Although the development of type 2 diabetes is associated with obesity and sedentary lifestyles, not everyone with type 2 diabetes is overweight, according to the American Diabetes Association. A genetic susceptibility to the disease is also believed to play a role.

Previous research has suggested that obesity isn't the only driver in the development of type 2 disease, and some studies have pinpointed excessive sugar intake, particularly sugars added to processed foods.

To get an idea of whether sugar plays an independent role in type 2 diabetes, Basu and his colleagues reviewed data from the United Nations Food and Agricultural Organization on the availability of foods in 175 countries. They also obtained data on the prevalence of diabetes in adults from the International Diabetes Federation.

Using statistical methods to tease out certain factors, such as obesity, the researchers found that the availability of sugar in the diet was linked to diabetes. For every additional 150 calories of sugar -- about the amount in a 12-ounce can of sweetened soda -- that were available per person daily, the prevalence of diabetes rose 1 percent in the population.

And, this rise was independent of obesity, physical activity and other factors that might contribute to the development of type 2 diabetes, the investigators found.

But, when the researchers looked at 150 additional calories per person a day from other sources, they found only a 0.1 percent rise in the rate of diabetes.

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FDA Should Work to Cut Sugar Levels in Sodas, Experts Say

Title: FDA Should Work to Cut Sugar Levels in Sodas, Experts Say
Category: Health News
Created: 2/13/2013 12:35:00 PM
Last Editorial Review: 2/14/2013 12:00:00 AM

View the original article here

Exercises to Lower Your Blood Sugar

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Reviewed By Laura J. Martin, MD

It’s never too late to reap the benefits of exercise, whether you’re 45 or 105. First of all, it simply makes you feel good to move. By becoming more active, you can also lower your blood sugar to keep diabetes under control.

“You don’t need to run a marathon to get results,” says Dawn Sherr, RD, of the American Association of Diabetes Educators. “Walking, swimming, and playing with the grandkids are all great ways to get exercise.”

Follow these four steps to get started.

Step 1: Make a Plan

If you're just starting, ask your doctor which exercise is right for you. Ask if you need to adjust your diabetes medicine before you hit the trail or the pool.

Next, think about what you'll enjoy most. You’re more likely to stick with activities you like. Here are a few suggestions:

Walk outdoors or indoors on a track or in a mall Take a dance class Bicycle outdoors or ride a stationary bike indoors Swim or try water aerobics Stretch Try yoga or tai chi Play tennis Take aerobics or another fitness class Do housework, yard chores, or gardening Try resistance training with light weights or elastic bands

If more than one of these appeals to you, go for them! In fact, combining cardio, like walking or swimming, with stretching or balance moves gives you a better workout. Any way you move will help lower your blood sugar.

How It Works

When you do moderate exercise, like walking, that makes your heart beat a little faster and breathe a little harder. Your muscles use more glucose, the sugar in your blood stream.  Over time, this can lower your blood sugar levels. It also makes the insulin in your body work better. You'll get these benefits for hours after your walk or workout.

Just remember you don’t have to overdo it. Strenuous exercise can sometimes increase blood sugar temporarily after you stop exercising.  Very intense exercise can cause the body to make more stress hormones which can lead to an increase in blood sugar.

Step 2: Set a Schedule

The best time to exercise may be after a meal. Ask your doctor what time of day is best for you. Take the dog for a walk after breakfast and dinner. Or schedule a yoga class or a round of tennis after lunch.

To stay motivated, ask a friend or family member to come along, or join a class. You won't skip an outing when other people are counting on you!  Company can make it more fun, too.

Step 3: Get Ready Wear well-fitting, comfortable shoes and cotton socks that don't rub. The right footwear can prevent blisters that could become serious infections for some people with diabetes. Check your blood sugar before a brisk walk or workout. If it's below 100, check with your doctor to see if you need to eat a snack first. Carry a snack or glucose tablets in case your blood sugar gets low. Drink plenty of water before, during and after your workout. Always wear your diabetes ID necklace or bracelet while you’re exercising.

 

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Reviewed By Laura J. Martin, MD

What you eat -- and when you eat it -- can affect your blood sugar levels. These food tips, in addition to following your doctor’s advice, can help keep your blood sugar levels in check.

Make One Change at a Time

"When you’ve spent a lifetime developing eating habits, you can't just flip a switch and change them overnight," says Dee Sandquist, MS, RD, a spokeswoman for the Academy of Nutrition and Dietetics. Instead, Sandquist suggests starting with one change and working from there.

Don’t Skip Meals

For good blood sugar control, space your meals about four to six hours apart. Eating meals at around the same time each day may also help keep your blood sugar steady.

Spacing carbohydrates evenly throughout the day helps keep your blood sugar level.

Skipping meals isn't a good idea when you have diabetes. This is true even if you're planning on going to a party or event. Don't skip meals to "save" your calories for later. Instead, eat your other meals at the regular time. When you get to the party, try to eat the same amount of carbohydrates you would at a meal. It's fine to have a treat, just don’t go overboard.

Carbs: Cut Portion Size

You don’t need to cut all carbs -- such as breads, pasta, potatoes, and rice. Take a look at how much you’re eating. To keep your energy steady, you probably just need to eat a little less. Instead of your usual serving size, try having two-thirds the amount. Do this for every meal and snack.

Try cutting back your carb portions for a few weeks. You may notice that your blood sugar levels are lower, and you may even drop a few pounds.

Balance Your Plate

Counting carbs and calories or calculating the glycemic index of foods can be complicated! Here’s a simple trick that may help you to start eating better. The "plate method" helps you eat the right mix and amounts of different food groups -- carbs, proteins, and healthy fats. Eating the right mix can help you keep your blood sugar in check and keep your energy steady.

Here's how it works:

Start with a 9- or 10-inch plate. Fill 1/2 of your plate with non-starchy vegetables such as salad, greens, broccoli, green beans, or beets. Fill1/4 of your plate with protein food: lean meat, fish, tofu, eggs, cheese, or poultry. Fill 1/4 of your plate with a starchy food, such as bread, rice, potatoes, or pasta. On the side, add a serving of fruit. Also have a cup of non-fat or low-fat milk, low-fat yogurt, or a roll.

This still works if you want to cut portions. It’s a visual to help you remember that even if you eat less, half of the food you eat should be vegetables. Think of meat and starchy foods as side dishes.

Fine-Tune Your Diet

Gradually, you can start to make other healthy changes once you have one or two under your belt. For example, slowly adjust your diet to swap in healthier food choices.

Instead of mashed potatoes with butter and cream, try a plain baked potato with a little cottage cheese. Or have fish or lean poultry instead of cuts of red meat with lots of fat.

Watching what you eat is one part of living better with diabetes.  Be sure to still follow your doctor’s advice to control your blood sugar levels.

View Article Source

SOURCES:

American Diabetes Association: "Create Your Plate."

Cleveland Clinic: "Nutrition Basics for People with Diabetes," "Diabetes and the Foods You Eat."

Dee Sandquist, MS, RD, spokeswoman for the Academy of Nutrition and Dietetics.

 

 

Reviewed by Laura J. Martin, MD on January 22, 2013

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