Latest news with #DiabetesCare
Medscape
2 days ago
- Health
- Medscape
ADA Issues New MASLD Guidelines
A new consensus report from the American Diabetes Association (ADA) provides a practice-oriented framework for screening and managing metabolic dysfunction–associated steatotic liver disease (MASLD) in people with diabetes and prediabetes. Published online on May 28, 2025, in Diabetes Care, the report is a comprehensive update to the recommendations the ADA released in 2023. It is intended for clinicians treating patients with diabetes — primarily type 2 diabetes (T2D) — but also type 1 diabetes with obesity and prediabetes. Topics covered include the rationale for the recent change in terminology, epidemiology, fibrosis risk stratification, monitoring, treatment, and referral guidance, with interprofessional team management emphasized throughout. 'This will provide primary care doctors and anyone taking care of people with diabetes the tools to diagnose [MASLD] early and guide therapy…to prevent cirrhosis, and refer to the hepatologist as needed for additional therapy and monitoring,' lead author Kenneth Cusi, MD, professor of medicine at the Division of Endocrinology, Diabetes & Metabolism in the Department of Medicine at the University of Florida, Gainesville, Florida, told Medscape Medical News . The guidelines recommend that clinicians routinely screen people with T2D or prediabetes for MASLD. 'We explain that the liver should be incorporated into our management in the same way we do for chronic kidney disease, eye disease, and nerve disease as an end-organ damage that is particularly affected by diabetes,' Cusi said. In the United States, at least 70% of people with T2D have MASLD, about half of whom have the more progressive form termed metabolic dysfunction–associated steatohepatitis (MASH). About 1 in 5 with T2D have advanced liver fibrosis. The presence of MASH increases the risks for complications including cirrhosis, hepatocellular carcinoma, and overall mortality, according to the new consensus report. Liver disease has not been a focus of diabetes management until recently, Cusi noted. 'We didn't think about it. The epidemic of obesity, and with that, of diabetes, is driving this liver disease. The obesity epidemic has had a big worsening since the 1990s, so this damage in the past 20 or 30 years is just now becoming evident in the liver.' Terminology Change: Highlighting Insulin Resistance, Reducing Stigma The document reviews the current nomenclature for SLD, which was officially changed in 2023 to remove the words 'fatty' and 'alcoholic.' Now, MASLD is defined as the presence of SLD with at least one metabolic risk factor such as obesity, hypertension, prediabetes, high triglycerides, low high-density lipoprotein cholesterol, or T2D, with minimal or no alcohol consumption (< 20 g/d for women; < 30 g/d for men). The term 'MetALD' is used for those with MASLD who also have increased alcohol consumption (20-50 g/d for women; 30-60 g/day for men). Steatosis in the setting of alcohol consumption above those levels is termed 'alcohol-associated liver disease (ALD).' The term MASH is defined as steatohepatitis with at least one metabolic risk factor and minimal alcohol consumption. 'At-risk MASH' refers to steatohepatitis with clinically significant fibrosis (stage F2 or higher). Diagnosis: Staged Screening for Fibrosis The document recommends routine screening of people with T2D, prediabetes, and/or obesity with cardiovascular risk factors, with the goal of identifying those with high-risk MASH. Intervention is then aimed at preventing fibrosis progression and cirrhosis. A graphic diagnostic algorithm advises initial use of the noninvasive Fibrosis-4 (FIB-4) tool, which risk stratifies based on age, liver enzymes, and platelet count. 'The FIB-4 is composed of very simple things that are already in the electronic medical record of all patients. We also discuss the role of electronic medical records to improve implementation,' Cusi said. Those with a FIB-4 < 1.3 have a low risk for future cirrhosis and can be managed in primary or team care with optimized lifestyle and repeated FIB-4 every 1-2 years. If the FIB-4 is > 2.67, direct referral to a liver specialist is advised. If FIB-4 is between 1.3 and 2.67, a second risk-stratification test is recommended. Ideally, this would be a liver stiffness measurement (LSM), most commonly with transient elastography. If that is unavailable, an alternative is the noninvasive enhanced liver fibrosis (ELF) test. If the LSM is < 8.0 kPa or ELF is < 7.7, the fibrosis risk is low and routine management can continue with repeat testing in 1-2 years. But if higher, hepatology referral is recommended. Treatment: Lifestyle, Plus Old and New Drugs The report details lifestyle modification for MASLD, including nutrition plans; physical activity; behavioral health; and the role of diabetes self-management, education and support. The role of obesity treatment in people with MASLD, both metabolic surgery and pharmacotherapy, is also discussed at length. No current pharmacologic treatments have been approved for MASLD, but both semaglutide and tirzepatide have demonstrated benefit in treating MASH and are approved for treating T2D, obesity, and other related comorbidities. A thyroid hormone receptor beta agonist, resmetirom, was approved in early 2024 for the treatment of MASH with fibrosis stages F2 and F3, but is extremely expensive at about $50,000 a year, Cusi noted. An older, generic glucose-lowering drug, pioglitazone, has also shown benefit in reducing fibrosis and may be a lower-cost alternative. The document also includes a section on alcohol intake, which complicates the MASLD picture, Cusi noted. 'We think that this is going to help doctors to consider alcohol, which is often overlooked and under-reported. If patients have moderate fibrosis, they should completely quit alcohol.' Cusi has received research support (to his institution) from Boehringer Ingelheim, Echosens, Inventiva, Labcorp, and Perspectum, and has served as a consultant for Aligos Therapeutics, Arrowhead, AstraZeneca, 89bio, Bristol-Myers Squibb, Boehringer Ingelheim, Eli Lilly, GlaxoSmithKline, Novo Nordisk, ProSciento, Sagimet Biosciences, Siemens USA, Zealand Pharma, and Terns Pharmaceuticals.
UPI
5 days ago
- Health
- UPI
Diabetes, high blood pressure combo puts more Americans at risk
A study shows that a combination of diabetes/high blood pressure threatens more American lives. Adobe stock/HealthDay Twice as many Americans now face the increased risk of death that comes from having both high blood pressure and type 2 diabetes, a new study reports. About 12% of the U.S. population had high blood pressure and type 2 diabetes at the same time in 2018, up from 6% in 1999, researchers reported recently in the journal Diabetes Care. Having both conditions more than doubled the risk of dying from any cause and tripled the risk of death from heart disease, compared to those without either condition, researchers found. "Even having co-existing prediabetes and elevated blood pressure was associated with up to 19% higher mortality risk, compared to having neither or either of these risk states," said senior researcher Nour Makarem, an assistant professor of epidemiology at Columbia University's Mailman School of Public Health. "This suggests that the increase in risk of dying commences before levels of blood glucose and blood pressure progress to Type 2 diabetes and hypertension," she said in a news release. For the study, researchers analyzed data for nearly 49,000 adults who participated in the U.S. National Health and Nutrition Examination Survey between 1999 and 2018. Conducted by the National Center for Health Statistics, the survey includes health exams and lab tests to check the health of participants. "A striking finding is that the burden of co-existing hypertension and type 2 diabetes nearly doubled over the study period," Makarem said. "Overall, about two-thirds of participants with diabetes also had hypertension, and about a quarter of adults with hypertension had concurrent diabetes." About a third of people with both high blood pressure and type 2 diabetes died during a median follow-up of about nine years, researchers found. (Median means half died sooner, half later.) By comparison, 20% of those with only type 2 diabetes and 22% of those with only high blood pressure died. Just 6% of people with neither chronic health problem died. Overall, the study concluded that: Compared to having high blood pressure only, having both conditions increased risk of premature death from any cause by 66% and heart-related death by 54%. Compared to having type 2 diabetes only, having both increased risk of premature death by 25% and more than doubled the risk of heart-related death. "This underscores the urgent need for public health strategies to effectively prevent and manage these conditions and reverse these adverse trends," Makarem said. More information The American Diabetes Association has more on diabetes and high blood pressure. Copyright © 2025 HealthDay. All rights reserved.
Hindustan Times
24-05-2025
- Health
- Hindustan Times
Fitness coach suggests 6 strategies to reverse diabetes naturally: Lose visceral fat to 7 hours of sleep
Type 2 diabetes is a chronic disease that onsets when the body cannot use insulin correctly and sugar builds up in the blood. While there are several treatments available, you can also aid your medications by using natural methods to reverse it. Also Read | Nutritionist says make these 5 food swaps to prevent or reverse diabetes: 'Swap fruits first in the morning with…' On May 23, fitness coach Alwyn took to his Instagram page, Fitness by Alwyn, to share 6 things one can do to reverse type 2 diabetes naturally. 'More than 90 million Indians have diabetes or prediabetes. But here's the good news: Type 2 diabetes is not a life sentence. In many cases, it can be reversed. Let's break down the science-backed strategy to do it,' he wrote. Alwyn suggested 6 things that you can start doing right away: A post shared by Fitnessbyalwyn (@fitnessbyalwyn) According to the fitness coach, research shows that losing 10-15 kg led to diabetes remission in 86 percent of participants. 'Visceral fat (especially around the liver and pancreas) drives insulin resistance,' he explained and suggested focusing on fat loss, not just blood sugar control. Do this: • Calorie deficit through real food • High-protein meals (1.5 to 2g/kg body weight) • 30-45 mins of exercise daily (strength + walking) 'Forget crash diets. Aim for a low glycemic load (GL) diet,' he explained. Here is a list of low GI foods, which Alwyn had suggested in a previous post. Low-GL meals reduce post-meal glucose spikes and improve HbA1c. Eat more: • Non-starchy veggies (palak, bhindi, broccoli) • Low-GL fruits (apple, berries, orange) • Protein-rich foods (eggs, dals, tofu, fish, paneer) • Good fats (nuts, seeds, avocado, ghee) Limit: • White rice, maida, sugar • Fruit juices and sugary drinks • Processed snacks and sweets 'Just 15 minutes of walking post-meal significantly reduces blood sugar spikes (Diabetes Care, 2013),' Alwyn cited a study. He suggested: Move every day: • 8,000–10,000 steps • Resistance training 3x/week • 10–15 min walk after lunch and dinner According to the fitness coach, 'chronic stress = high cortisol = more insulin resistance'. Additionally, poor sleep means poor glucose control. Aim for: • 7–8 hours of sleep • Evening wind-down routine • Stress reducers: breathwork, meditation, journaling, time outdoors The fitness coach suggested tracking these three factors weekly: • Fasting blood glucose (<100 mg/dL) • HbA1c (<5.7%) • Waist circumference (↓ belly fat = ↑ insulin sensitivity) Bonus: Use a CGM (Continuous Glucose Monitor) to identify sugar-spiking foods. Alwyn warned that before taking aids, one should always consult their doctor and suggested consuming: • Berberine: natural Metformin-like effect • Cinnamon: may improve insulin sensitivity • Vitamin D, magnesium, omega-3s to support metabolic health Per the fitness coach, signs of reversal include: • Fasting glucose <100 mg/dL • HbA1c <5.7% • No meds, stable sugars, high energy Note to readers: This article is for informational purposes only and not a substitute for professional medical advice. Always seek the advice of your doctor with any questions about a medical condition.
Yahoo
12-05-2025
- Health
- Yahoo
5 Key Causes of Type 2 Diabetes—and Simple Tips to Reduce Your Risk
Understanding what causes type 2 diabetes is crucial. The chronic condition occurs when your body doesn't produce enough insulin or use it efficiently, leading to a buildup of glucose in the bloodstream. Over time, high blood sugar levels can cause serious health problems, including an increased risk of heart disease, stroke, kidney disease, nerve damage and eye disease. Here, the biggest risk factors and steps you can take to stay healthy. Unlike type 1 diabetes, which is an autoimmune disorder, type 2 diabetes (T2D) is typically caused by a combination of age, genetics and lifestyle. Of course, you can't control your age or your family history. But other risk factors are preventable, and a few simple lifestyle changes can help you ward off T2D. Here's what to watch for: A study in Diabetes Care found that certain ultra-processed foods—such as refined breads, sauces, condiments, processed meats, sweetened beverages and ready-to-eat dishes—increase the risk of developing type 2 diabetes. To reduce your risk: Cut back on processed foods with high saturated fat or sugar. 'Adopt an eating pattern focused on more plant-based or pescatarian foods,' says William Hsu, MD, Head of Diabetes Regression and Remission Program and Chief Medical Officer, L-Nutra. Dr. Hsu also recommends increasing fiber intake while reducing refined carbohydrates. If you need an easy swap to get started, try replacing juice with whole fruit. 'High-calorie beverages can add significant sugar intake and calories and contribute to insulin resistance,' says Rachel Pessah-Pollack MD, FACE, an endocrinologist and Clinical Professor of Medicine at NYU Grossman School of Medicine. 'If patients are looking to have orange juice or apple juice, I encourage them to have the fruit instead.' A review of 45 studies published in the Public Library of Science showed a close link between lack of physical activity and type 2 diabetes. A sedentary lifestyle can lead to reduced blood flow and a buildup of visceral fat, both of which are risk factors for type 2 diabetes. 'When we move, cells need glucose for fuel,' explains Sulagna Misra, MD, BCMAS, founding physician at Misra Wellness. 'Without exercise, glucose uptake by the cells is limited. Glucose is then turned into fat and stored as fuel for later.' To reduce your risk: Set an alarm for movement breaks. 'Take a stretch break or a walk break every two hours while you are sitting,' Dr. Misra says. 'Even small things like taking the stairs or parking farther away than normal are collective things that add up!' What else can help? 'Simple things like standing while on a call, stretching during TV time or taking a five-minute dance break,' says Maria Teresa Anton, MD, Endocrinologist & Educator at Pritikin Longevity Center. And while you may prefer to grab a seat after meals, finding time for movement is a better bet. 'Take short walks after meals to help control blood sugar levels,' suggests Dr. Hsu. Also smart: Cut back on TV time when you can. A study in Frontiers in Endocrinology found that TV time in particular was closely associated with diabetes risk, much more than time spent in front of the computer or behind the wheel of your car. Your type 2 diabetes 'risk increases particularly after age 45 or post-menopause, when hormonal changes can make the body more resistant to insulin,' Dr. Hsu explains 'As estrogen levels drop, insulin sensitivity can too,' adds Dr. Anton. To reduce your risk: 'Strength training, protein-packed meals and mindful stress management can all help counteract the effects of aging on blood sugar levels,' explains Dr. Anton. Dr. Hsu recommends focusing on eating habits that slow the aging process at the cellular level. 'Focus on cellular rejuvenation strategies that have been shown to reduce biological age, including as little as three cycles of periodic five-day fasting-mimicking diet cycles per year,' he says. 'Sleep is when we 'rest and digest,'' Dr. Misra says. If you're not getting enough restful sleep each night, it can throw off your hormone balance, including the stress hormone cortisol and the hormones that help regulate your appetite. According to a review in Cureus, poor sleep habits can also trigger an inflammatory response, which is linked to increased insulin resistance and a greater risk of developing type 2 diabetes. To reduce your risk: Simple changes to your sleep habits can make it easier to keep your hormones in check and help prevent insulin resistance. Dr. Misra recommends making the following changes to your bedtime routine: Avoid food and alcohol at least three to four hours before bed. Power down your devices at least two hours before bed. The blue light from screens can increase alertness and interfere with your circadian rhythm. Keep your room as dark and quiet as you can. Keep a writing pad and pencil next to your bed to jot down any persistent anxious or intrusive thoughts that keep you from dozing off. If you're still having trouble sleeping, talk to your doctor. 'There are a lot of issues that cause poor sleep, from mattress or pillow type to obesity to respiratory issues,' Dr. Misra says. Type 2 diabetes typically develops over the course of a few years. Over time, insulin resistance can lead to prediabetes, a condition in which your fasting blood glucose levels are elevated, but not high enough to meet the criteria for a diabetes diagnosis. Left unmanaged, prediabetes can eventually develop into full-blown type 2 diabetes. 'Nearly 98 million Americans are classified as prediabetic, with blood glucose levels higher than normal but below diabetic thresholds)—and 80% of them don't even know it,' says Dr. Hsu. Early signs of prediabetes may include: Slightly elevated blood glucose levels Metabolic markers like increased visceral fat Increased thirst, fatigue or frequent urination Skin changes like patches of darker skin (acanthosis nigricans) To reduce your risk: Stay up-to-date on testing. 'Detecting prediabetes early can reduce your risk of progression to type 2 diabetes,' Dr. Pessah-Pollack says. Common blood tests that can help you spot prediabetes include: Fasting blood sugar. This measures the amount of glucose in your blood after eight hours without food. A reading between 100-125 mg/dL may indicate prediabetes. A1c. This measures how much glucose binds to hemoglobin in your red blood cells, which can reflect your average blood glucose levels over the past three months. A reading between 5.7-6.4 percent may indicate prediabetes. If you have any risk factors for type 2 diabetes, including obesity, physical inactivity, a history of gestational diabetes or a family history of the condition, ask your doctor about getting tested at least once a year and work on adopting healthier habits. Keep scrolling for more diabetes stories! What Is Type 3 Diabetes? Doctors Explain How Insulin Resistance May Increase Alzheimer's Risk 'Parks and Rec' Retta Opens up About Her Type 2 Diabetes and Keeping Blood Sugar in Check (EXCLUSIVE) High Morning Blood Sugar, or 'Dawn Phenomenon,' Can Wreck Sleep and Metabolism—Here's How to Fix It This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.
Yahoo
13-03-2025
- Health
- Yahoo
Eating Food in This Order Can Have Similar Benefits to Ozempic
By now, you likely know which foods and drinks can help prevent Type 2 diabetes—but did you know that the order in which you eat them can make a big difference in improving blood sugar and boosting your GLP-1 production (and weight loss!), too? Well, now you do. Or at least you will if you keep reading. 🩺 SIGN UP for tips to stay healthy & fit with the top moves, clean eats, health trends & more delivered right to your inbox twice a week 💊 But first, some backstory: I first learned about the food order phenomeon from French microbiologist Jessie Inchauspé (who you might know as @glucosegoddess on Instagram). The author of several books and cookbooks on the theme of stabilizing blood sugar, most of which I own and have read front to back (I recommend The Glucose Goddess Method), she's known for sharing easy-to-DIY blood sugar hacks for her readers and followers to implement in everyday life. One of the most popular? Eating food in a specific order, which wasn't her idea alone: Several studies conducted over the past decade have found that the sequence in which you eat your foods can impact your blood sugar, insulin, and GLP-1 levels and production. This exciting, because that's also what GLP-1 medications like Ozempic and Wegovy do. Parade aims to feature only the best products and services. If you buy something via one of our links, we may earn a commission. Related: Published in the journal Diabetes Care, a 2015 study had 16 individuals with Type 2 diabetes eat the same meal for three days—but in different orders each time. For the first day, they had carbohydrates first, followed by proteins and vegetables. On the second day, they ate protein and vegetables first, consuming carbs afterwards. For the the last meal of the study, they ate three elements—carbs, protein, and vegetables—altogether. After measuring glucose, insulin and other related hormonal responses, the study found that participants who ate carbs last produced higher levels of GLP-1 and lower levels of insulin while demonstrating a 53% over all reduction in blood sugar levels after eating as compared to eating carbs first. Multiple studies have since replicated these findings—published in BMJ Open Diabetes Research & Care and Nutrients, respectively—but the most most recent was published in Diabetes Care in February 2025. Led by yet another group of researchers at Weill Cornell Medicine, they found that the carbs-last approach was associated with 44% lower sugar peaks compared with eating carbs first. Ending with carbs last helped stabilize participants' glucose levels, reducing glycemic variability by 16.5%, and even aided in unintentional weight loss: Participants lost an average of 4.3 pounds in 12 days despite not making changes to their caloric intake. TL;DR? Eat your fiber-rich veggies and proteins first—so start with a salad with chicken or tofu, for example—then eat your carbs (rice, pasta, potatoes, bread). Your blood sugar, insulin and GLP-1 levels will thank you. Related: As for why or how food order could possibly have this effect? Basically, fiber-rich vegetables take longer to digest, which forms a protective "barrier" in your stomach. This slows the breakdown and absorption of carbohydrates, preventing blood sugar spikes and crashes and therefore increasing GLP-1. (This is also why increasing fiber is often recommended for blood sugar control. Fiber is great for it!) Alternatively, when you eat carbs first, your body quickly converts them into glucose, resulting in a surge of insulin to manage the sugar rush. Eating protein and fiber first reduces the need for that huge insulin response, making blood sugar more stable over time. The less blood sugar spikes you have means more sustained levels of GLP-1. I know this is probably confusing, but basically, fiber likes to go first in the gut. Related: You don't need to have Type 2 diabetes to reap the benefits of this food sequence: One of the aforementioned studies saw a 40% reduction in post-meal blood sugar peaks when eating carbs first as compared to last in people with prediabetes. This means they had high blood sugar, but not high enough to be considered Type 2 diabetes. Translation? Yes, the benefits seem to apply whether or not you're diabetic. So go eat that salad (first)! Related: As for why this matters? This information provides a simple, practical and most importantly, sustainable solution for everyday blood sugar control that almost anyone can follow. Plus, there's no medication required. "We're always looking for ways to help people with diabetes lower their blood sugar," said , who served as the 2015 study's senior author and principal investigator. "We rely on medicine, but diet is an important part of this process, too. Unfortunately, we've found that it's difficult to get people to change their eating habits." Also the Sanford I. Weill Professor of Metabolic Research at Weill-Cornell Medical College and director the Comprehensive Weight Control Center (both at the time of the study and in present day), Dr. Aronne continued: "Carbohydrates raise blood sugar, but if you tell someone not to eat them—or to drastically cut back—it's hard for them to comply. This study points to an easier way that patients might lower their blood sugar and insulin levels." Thus, rather than telling people to completely cut out one type of food, they can simply modify how they're eating it—and hopefully get some Ozempic-like perks while they're at it. Up Next:"Carbohydrate-last meal pattern lowers postprandial glucose and insulin excursions in type 2 diabetes." BMJ open diabetes research & care. "A Randomized Controlled Pilot Study of the Food Order Behavioral Intervention in Prediabetes." Nutrients. "Carbohydrates-Last Food Order Improves Time in Range and Reduces Glycemic Variability." Diabetes care. Dr. Louis J. Aronne, MD, FACP, Sanford I. Weill Professor of Metabolic Research at Weill-Cornell Medical College and director the Comprehensive Weight Control Center "Food order has significant impact on glucose and insulin levels." Weill Cornell Medicine.
