Diabetes Archive

People at high risk of heart disease get the most benefit from these costly drugs.

If you're a woman with diabetes, your risk of developing heart disease is four times that of a woman without diabetes. That means protecting your heart health should be a top priority. It starts with adopting heart-healthy lifestyle changes. But if you have a history of heart attack or stroke or are high risk for other reasons, your doctor may suggest a diabetes medication with extra benefits.

Women and their doctors can choose from a crop of new drugs that may reduce diabetes-related heart risks. "Today we're starting to try to customize or personalize an individual's preventive medicine. We take certain subgroups of patients — such as those with a past history of stroke, heart attack, or heart failure — and steer them toward specific drugs based on new data," says Dr. David Nathan, director of the Diabetes Center and Clinical Research Center at Massachusetts General Hospital and professor of medicine at Harvard Medical School.

Research we're watching

While eating more foods rich in omega-3 fatty acids may lower the risk of heart attack, that doesn't seem to reduce the risk of developing diabetes, according to a study published Aug. 24 in The BMJ. Prompted by past findings that this type of healthy fat might reduce diabetes risk and improve blood sugar (glucose) control, researchers decided to look further into the issue. They reviewed 83 randomized trials involving more than 120,000 people, both with and without diabetes. Each trial went on for six months or longer. These trials looked at whether increasing consumption of omega-3 fats (derived from fish or plants), omega-6 fats (such as those in soybean or corn oil), or total polyunsaturated fats could help lower blood glucose or reduce the risk of developing diabetes. They found that increasing the amount of omega-3, omega-6, or total polyunsaturated fats in the diet over an average study period of nearly three years didn't seem to have any effect on glucose metabolism or diabetes risk. It didn't matter whether the additional healthy fats came from supplements, enriched foods, or foods that were naturally rich in these fats.

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Ask the doctors

Q. My doctor recently told me I have prediabetes. Is this condition reversible?

A. Yes, it is possible to reverse prediabetes. Prediabetes is a condition that affects millions of Americans. The CDC estimates that as many as one in every three American adults has the condition, which is defined as having blood sugar that is elevated, but not high enough to meet the threshold for diabetes. Left untreated, prediabetes can progress to diabetes, a condition in which your body is not able to absorb glucose for energy properly, causing blood sugar to rise. If it's not managed properly, diabetes can lead to a number of health problems, from heart attack and stroke to blindness, kidney problems, and infections, among others. But making some lifestyle changes can reduce the risk that your prediabetes will develop into diabetes.

Technology may help to provide more supportive, efficient, and effective care for diabetes, a leading contributor to heart disease.

About one of every 11 adults in this country has diabetes — a chronic, costly condition that's closely connected to heart disease. Lifestyle changes that encourage eating healthy foods, exercising, and losing weight are the cornerstone of managing both problems. But making those changes can often feel overwhelming and frustrating, especially for people with diabetes. They also need to keep tabs on their blood sugar levels, which are influenced by what and when they eat and exercise.

And getting effective support for managing diabetes with lifestyle changes isn't easy. "The current system for managing diabetes is broken," says Dr. Osama Hamdy, medical director of the Obesity Clinical Program at Harvard-affiliated Joslin Diabetes Center. For starters, there aren't nearly enough endocrinologists for the millions of people with diabetes in this country. Appointments with these specialists are often too short and too infrequent for people to make meaningful progress, he explains.

Trying to make up for not getting enough sleep during the week by sleeping longer on weekends has been found to have negative effects such as weight gain, expending less energy, and increased calorie intake during evenings.

A recent 15-year follow-up to the Veterans Affairs Diabetes Trial found that short-term intensive blood sugar control did not lead to significant reduction of risk of cardiovascular events in the long term.

From 1990 to 2010, there was a significant decrease in diabetes-related complications, but since then the trend has reversed and complications are on the rise among young adults. This may be due to the changing profile of those who develop type 2 diabetes, or may be due to other factors.

News briefs

We already know that a diet rich in red meat is linked to many health problems, such as heart disease, type 2 diabetes, and colorectal cancer. Now a Harvard-led study published online June 12, 2019, by BMJ suggests that boosting your red meat intake increases your risk for early death. Scientists analyzed questionnaire answers about health and diet provided by more than 81,000 healthy men and women between 1986 and 2010. In particular, researchers looked at whether changes in red meat consumption during an eight-year period of the study affected the risk of death eight years later. The findings: An increase of just half a serving of processed red meat per day was associated with a 13% higher risk for dying young from any cause; an additional half-serving of unprocessed red meat increased the risk by 9%. On the flip side, decreasing total red meat consumption and increasing the consumption of nuts, fish, poultry without skin, dairy, eggs, whole grains, or vegetables was tied to a lower risk of death. The takeaway: Try to curb your appetite for red and processed meats like bacon, salami, and hot dogs. Eat more poultry, fish, or plant-based proteins (like beans, lentils, nuts, and seeds), along with the other components of a healthy diet.

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Sweet drinks go down easy, but they may be hard on your heart. Aside from plain water, the healthiest choices are unsweetened tea, coffee, and flavored waters.

When you want to quench your thirst with something a little more exciting than plain old water, there are a dizzying array of choices these days. However, many of the beverages in supermarkets and convenience store aisles are loaded with added sugar. Even many of those that sound healthy (such as 100% fruit juice and vitamin-enhanced water) contain as much sugar as regular sodas.

Yes, the sugar in fruit juice is naturally occurring, as opposed to the processed sugar (usually high-fructose corn syrup) found in many carbonated and noncarbonated drinks such as sodas, vitamin water, and the like. But people should still be mindful about consuming too much fruit juice, says Vasanti Malik, a nutrition researcher at the Harvard T.H. Chan School of Public Health.