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This site is an archive of our Well Written Blog posts until April 2020. For the most up-to-date content visit NWIJournal.com.

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Type 2 Diabetes: The King of the Non-Communicable Diseases?

Posted By Colin Bullen, Tuesday, February 18, 2020

Type 2 Diabetes: The King of the Non-Communicable Diseases?

Wreaking Havoc with your Health

Type 2 diabetes occurs when the body doesn't produce enough insulin to function properly, or the body's cells doesn’t react to insulin. This means glucose stays in the blood rather than being used as fuel for energy. The body stores the excess in little bundles called glycogen in the liver and muscles, which partly explains why type 2 diabetes is often associated with obesity. 

Diabetes is diagnosed when fasting glucose levels reach 126mg/dL, but risk increases once people reach 100 mg/dL, at which point they are classified as ‘prediabetic’. The way the body processes glucose is important to understand because high levels of glucose in the blood over extended periods can cause significant health problems, notably with eyes, the heart and nerves.   

 

The King of the Non-Communicable Diseases

Type 2 diabetes might justifiably be regarded the king of the non-communicable diseases – the class of diseases most affected by the behaviors we practice on a day-to-day basis. In 1990, the percentage of Americans diagnosed with diabetes (type 1 and type 2) was 2.5% of the population. By 2015, this had risen to 7.4%, a nearly threefold increase driven entirely by type 2. Given that undiagnosed diabetes is common, current estimates predict that around 9.4% of the population (30 million Americans) has diabetes, 90-95% of whom have type 2. 

This dramatic spike in prevalence has resulted in some rather alarming predictions of future prognosis, with publications in some reputable journals suggesting that the current prevalence figures could double, or even triple, by 2050 - 2060.  In contrast, more recent publications suggest that prevalence and new diagnoses of diabetes have started to stabilize, as seen in the illustration below. Whether prevalence of diabetes increases or stabilizes, diabetes has a negative impact on a large part of the population, including serious health consequences.

To improve diagnostic accuracy and provide more useful information to sufferers, classic diagnostic tests, like the fasting plasma glucose (FPG) and AIC tests (whic measures average blood sugar for the previous two to three months), are being replaced by continuous monitoring devices like the Freestyle Libre. This type of glucose monitoring is useful for patients wanting to monitor their glucose levels on an ongoing basis, to help preempt and avoid hypoglycemic shock episodes.

 

Making the Change:  Controlling Type 2 Diabetes Through Behavior Change

Type 2 diabetes is caused by a combination of lifestyle and genetic factors – some cultures are more susceptible than others. Given that genetics are not changing rapidly, we can be confident that the increase in type 2 diabetes is almost entirely caused by our behaviors. Equivalently, it can also be controlled through behavior change. The Behavioral Research and Applied Technology Laboratory research suggests that a wide range of behavioral changes can reduce blood sugar levels and hence reduce the prevalence of diagnosed diabetes significantly. 

  • Exercise and reduced sedentary behavior (less sitting) both demonstrate 30% reductions in blood sugar levels, and diabetes prevalence. 
  • Practicing mindfulness has been shown to reduce blood sugar and diabetes by around 15%, while getting a good night sleep (around 7-8 hours) increases improvement in symptoms around 10%.
  • The research on healthy eating is patchy, which is partly due to the difficulty of setting up reliable experiments on eating habits and diets, as well as having to rely on people's ability to stick to prescribed dietary regimes. However, we have seen strong empirical evidence supporting the impact of the ketogenic diet, for instance, in controlling blood sugar levels in diabetic and prediabetic populations.

Compared to other lifestyle habits, exercise and movement have the largest impact on blood sugar levels and hence diabetes prevalence. At least one study notes that exercise benefits are best achieved through strength rather than cardio workouts, and most reveal a benefit from combinations of cardio and strength, so if you are increasing your exercise to reduce blood sugar, weights should be included in your workout. Two minutes of activity every 20 minutes reduces sedentary behavior, which in turn improves glycemic control. Although physicians recommend that exercise should still be combined with drug therapy, clinical trials confirm that exercise has the potential to be at least as effective at controlling blood sugar as medicines – and with pleasant rather than unpleasant side effects. 

Reducing the Cost and Suffering

Diabetes is a costly disease, both in terms of the medical cost and in terms of the human suffering. Organizations looking to change the health risk profile of their employee populations would do well to address this risk. Based on US population data, it’s likely that more than 60% of the diabetic population are not exercising. If the finding is that prevalence can be reduced by 30% through exercise, this would suggest that a reduction of at least 2% in diabetes prevalence is achievable in a typical US population just through changing exercise behavior. We believe that a comprehensive healthy behavior change program will have an even greater impact. 

Setting up a change-ready environment that allows employees to adopt healthier behaviors regarding exercise, healthy eating, mindfulness, and sleep hygiene will result in significant improvements in an organization’s health risk profile. The cost and productivity benefits will manifest over time and can be accurately predicted. Any organization looking to evaluate the impact of investing in these changes or wanting to understand more about how to create healthy and change-ready cultures should contact Change Craft on hello@changecraft.consulting.


Colin BullenColin Bullen is the founder and director of Change Craft, a global business established to help organisations execute effective and successful wellbeing change. In business, he’s the technician, evaluator, and strategist. A true road-less-traveled devotee, he qualified as an actuary in 1992 in the UK before spending 13 years in South Africa where he met Chicago-based business partner Hanlie van Wyk. During this time, he has steadily broadened his métier into health, well-being, leadership, strategy, assessment, and data.

Colin has a deep passion for helping companies find their human touch, whilst accelerating their performance and focusing their vision. Colin is also one of the creators of the behavioral research database that is BRATLAB and has been a driving force behind early successes in Change Craft. 


Tags:  Change Craft  Diabetes  Disease  Health  type 2 diabetes 

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Wellness Trends - June 2019

Posted By NWI, Wednesday, June 26, 2019
Updated: Thursday, June 20, 2019

Social & Emotional Wellness Are Critical Factors to Success


Social Determinants of Health Definitions 

We hear a lot more these days about social determinants of health (SDOH), but what are they? The World Health Organization provides a definition of SDOH.  

Further, the Centers for Disease Control and Prevention provides additional definitions that should be considered in addition to SDOH. 

 

Transamerica Health Care Studies

Special thanks to Hector De La Torre of the Transamerica Center for Health Studies for providing this insightful data 

Wellness TrendsTransamerica Center for Health Studies® (TCHS) – a division of the Transamerica Institute® – is focused on empowering consumers and employers to achieve the best value and protection from their health coverage. TCHS engages with the American public through national surveys, its website, research findings and consumer guidance. 

 

Grocery Store Bills Can Determine Diabetes Rates by Neighborhood

Dietary habits are notoriously difficult to monitor. Now data scientists have analyzed sales figures from London’s biggest grocer to link eating patterns with local rates of high blood pressure, high cholesterol, and high blood sugar.  Read more at MIT Technology Review


Tags:  Diabetes  Emotional Wellness  Health Care  Healthcare  SDOH  Social Determinants of Health  Social Wellness  Trends  Wellness Trends 

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Want to Avoid Diabetes? Eat at Home.

Posted By NWI, Monday, July 11, 2016

New materials made available by the Public Libraries of Science (PLOS) indicate that eating food prepared at home significantly reduces your risk of developing diabetes.

 

Research by Qi Sun, from the Harvard T.H. Chan School of Public Health, indicates that a diet of food prepared outside the home, specifically fast food, is high in energy but low in nutrients. This type of diet has a tendency to cause weight gain, which in turn correlates with increased risk of type-2 diabetes.

 

Sun and colleagues’ findings indicate that people who eat 5-7 evening meals at home have an average of 15% lower chance of developing type-2 Diabetes as compared to people who eat 2 or less evening meals at home.

 

Sun’s research also indicated that the tendency to eat more meals at home is itself a trait of people who tend to have lifestyles that trend toward better diets and more exercise – both mitigating factors in the risk of type-2 diabetes.

 

To read the full article from PLOS, click here.


Tags:  Diabetes  Diet  Health  Health Care  Nutrition  Wellness 

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Advancements in Type 2 Diabetes Treatment

Posted By NWI, Saturday, November 1, 2014
Updated: Monday, October 20, 2014

November is American Diabetes Month (sponsored by the American Diabetes Association; see www.diabetes.org for more information). In recognition of this month, Wellness News You Can Use is reporting on a recent important advancement in diabetes research.

Researchers at Lund University in Sweden are testing a treatment for type 2 diabetes which targets the disease mechanism itself, not just the symptoms. The result of this research would be a more personalized approach to diabetes treatment. Details of the treatment were released in a press release October 14, 2014.

By using an individual patient’s genetic risk profile, this treatment is able to restore the individual’s capacity to secrete insulin. The treatment is undergoing additional testing.

While this treatment news is exciting for individuals who have type 2 diabetes, it is also important to focus on ways to prevent getting type 2 diabetes and on management strategies.

The following is from the American Diabetes Association.

Things you can do to lower your risk of contracting type 2 diabetes:

  • Maintain a healthy weight.
  •  Eat a well-balanced diet of fruits and vegetables.
  •  Incorporate exercise into your daily routine.
  • Have your blood pressure and cholesterol levels checked and work with your medical provider to maintain healthy levels of both.
  • If you smoke, quit.

If you have been diagnosed with type 2 diabetes, the following six steps are critical in the management of the disease:

  • Work with your doctor to plan a diet that supports healthy diabetes maintenance.
  • Get physically active.
  • Take medicine (if your doctor prescribes it).
  • Check your blood glucose (if your doctor recommends it).
  • Go to all of your check-up appointments

 

Source: Tang, Y., Axelsson, A.S., Spegel, P., Andersson, L.E., Mulder, H., Groop, L.C., Renstrom, E., Rosengren, A.H. Genotype-based treatment of type 2 diabetes with an  2A-adrenergic receptor antagonist. Science Translational Medicine, 2014; 6 (257): 257ra139 DOI: 10.1126/scitranslmed.3009934

Tags:  Diabetes  November 2014  Physical  Research 

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Does this Neighborhood Make me Look Fat?

Posted By NWI, Tuesday, July 1, 2014
Updated: Wednesday, June 18, 2014
WalkableResearch released in June from the American Diabetes Association showed that individuals who live in neighborhoods that are conducive to walking (think walking trails or city neighborhoods with resources like grocery stores within walking distance) experience a lower rate of obesity and diabetes.

The more we rely on (or have to rely on) our cars, the more unhealthy we are.

The study done over a 10-year period by a team of Canadian scientists pointed out that an individual’s environment could be secretly working against their overall health. Specifically, the studies found that people living in neighborhoods with greater walkability saw on average a 13 percent lower development of diabetes incidence over 10 years than those that were less walkable. Overweight and obesity, as well, was lowest in the most walkable neighborhoods and fell by 9 percent over 10 years, whereas it rose 13 percent in neighborhoods with the least walkability during that time, according to the research.

What can you do about it? Short of moving, look for every opportunity to get up and walk (park farther away, walk your dog, find a nearby nature trail, etc.). If you are moving, you might consider the neighborhood as well as its walkable resources. Instead of letting your environment determine your physical activity, be determined to move as much as you can.

For more information visit the American Diabetes Association: http://www.diabetes.org/newsroom/press-releases/2014/do-walkable-neighborhoods-reduce-obesity-and-diabetes.html#sthash.VY2LQdjb.dpuf

Tags:  Diabetes  Environment  July 2014  Physical  Social  Weight 

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Diabetes Does Not Discriminate in Women: New Study

Posted By NWI, Monday, September 30, 2013

Woman DiabetesWhile black and Hispanic women tend to have higher rates of diabetes, a new study finds that the rate at which women die of diabetes-related diseases such as cardiovascular disease and cancer does not favor one race over another.

The study, released by the University of Massachusetts School of Medicine (September 2013), specifically looked at postmenopausal women. Yunsheng Ma, MD, PhD, MPH, associate professor of medicine and the lead author of the study, concluded that the way to reduce high diabetes-related death rates among all postmenopausal women would be to focus on prevention. While many drugs are available to treat diabetes, the impact of those drugs on aging women is still unknown…making prevention the best route.

Overall, the research acknowledges that diabetes rates vary by race (27.1 percent for blacks, 20.8 percent for Hispanics, 15.9 percent for Asians and 11.7 percent for whites). However, diabetes has an "amplifying” effect on other chronic illnesses regardless of race.

Current research suggests that 80 to 90 percent of diabetes cases may be preventable by lifestyle modifications, such as being physically active, maintaining a healthy weight, and having a healthful diet.

University of Massachusetts Medical School (2013, September 17). New insight into reducing racial, ethnic disparities in diabetes.

Tags:  Diabetes  October 2013  Physical  Social 

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Mobile Phone Technology Helps Patients to Manage Diabetes: New Study. (August 2011)

Posted By National Wellness Institute, Monday, August 1, 2011
Updated: Thursday, December 27, 2012

Ongoing research from the University of Maryland (UM) School of Medicine has found that an interactive computer software program appears to be effective in helping patients manage their Type 2 diabetes using their mobile phones. The study is being published in the September issue of the journal Diabetes Care.

The study, one of the first to scientifically examine mobile health technology, found that a key measure of blood sugar control– the amount of hemoglobin A1c in a person's blood – was lowered by an average of 1.9 percent over a period of one year in patients using the mobile health software. The findings support the further exploration of mobile health approaches to manage many chronic conditions, including diabetes.

The study indicates that using mobile phones, the Internet and other mobile communications technology to keep patients healthy may have broad applications to help patients and their physicians manage many health conditions. The U.S. Food & Drug Administration just last month released draft guidance on how it intends to regulate the field.

The yearlong study enrolled 163 patients with the help of 39 primary care doctors in Baltimore County, Baltimore City, Montgomery County and Anne Arundel County. Patients were divided into four groups based on the research assignment of their physician. Three patient groups received mobile phones loaded with the diabetes management software and the fourth group served as a control group. All patients in the study received a free blood glucose meter and testing supplies.

The software examined in the research provided real-time feedback on patients' blood sugar levels, displayed medication regimens and served as a "virtual coach." A patient's blood sugar test results were sent wirelessly from a blood glucose monitor to the mobile phone. If the level was too low or too high, the software on the phone prompted the person to take steps to correct it. The system also analyzed blood sugar levels and other patient information and sent computer-generated logbooks and suggested treatment plans to the patients' primary care doctor.

For more information on the research cited in this story visit: University of Maryland Medical Center

Tags:  August 2011  Diabetes  Diet  Nutrition  Physical 

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