close
DIABETES

The latest reports on these 10 endocrine fields, no longer know OUT!

no thumb

PART 1 1 Fasting every other day to improve insulin resistance Overweight/obese people often have insulin resistance. Diets that are fasted every day and limit calorie intake may reduce the risk of diabetes in this population, but what is better or worse?still not clear.A recent study from the University of Illinois at Chicago in the United States concluded that dietary interventions that were fasted every other day were more effective in reducing insulin resistance in participants.The study included 43 participants with a BMI of at least 25 kg/m2, insulin resistance, 11 of whom were fasted every other day, 17 were restricted to calorie intake, and 15 were kept on their diet.In the 12-month study, participants who fasted every other day had to consume 125% of the calories needed in the first 6 months and reduced the intake to 25% the next day;The proportion of the last 6 months is 150% and 100%.Participants in the calorie-restricted diet limited calories to 75% of demand during the first 6 months; they limited calories to 100% of demand during the next 6 months.The results showed that participants who restricted calorie intake lost 6% of their body weight, while those who fasted every other day lost 8% of their body weight, both of which were thinner than those of regular diets, but the difference between the two wasNot obvious.The real benefit of fasting every other day was to improve insulin resistance in patients (p<0.05). Fasting insulin was reduced by 52% every other day, while the caloric intake group was only reduced by 14%. The reduction in insulin resistance was also significant.Differences (53% vs 17%, p<0.05).Researchers point out that participants who are fasting every other day have been trying to reach their own dietary intervention goals, so long-term sustainability and tolerability remain questionable.However, the plan for fasting every other day can reduce more weight while taking more calories, and the improvement of insulin resistance is more obvious. This is amazing.2 Diabetic patients need to adjust their ketogenic diet simultaneously. Diabetic patients may want to choose a ketogenic diet or a very low-carbohydrate diet that may reduce blood sugar, but there may also be an increase in urine output, leading to an increased risk of dehydration and hypoglycemia.Therefore, for diabetics, starting a ketogenic diet or other very low-carbohydrate diet requires simultaneous adjustment of the medication regimen to avoid a range of risks.At the ADA 2019 meeting, Diana Isaacs from the Cleveland Clinic Diabetes Center introduced some drug adjustment programs.First, some drugs should be used with caution. Isaacs recommends discontinuing the use of sulfonylureas, glibenclamides, and prandial insulin during diet interventions to avoid hypoglycemia, and patients on very low-carbohydrate diets do not need to use it.Alpha-glycosidase inhibitors; SGLT2 inhibitors can continue to be used with caution if ketoacidosis is not present; insulin and thiazolidinediones may increase body weight and should be considered for discontinuation; antihypertensive drugs with diuretic effects can be usedHalve.For insulin use, Isaacs believes that patients with type 2 diabetes should reduce basal insulin by 30%-50%, U-500 insulin by 50%, and replace short-acting/long-acting insulin products with basal insulin;Diabetes adjustments are much more complicated, requiring about 20% reduction in basal insulin and monitoring of blood ketones, which should be stopped immediately if symptoms of discomfort occur.In addition, for patients receiving a very low-carbohydrate diet, it may be necessary to improve hypoglycemia by ingesting some protein.At the same time, low intake of carbohydrates may cause constipation, which may improve the symptoms, but may lead to electrolyte imbalance.Therefore, these dietary intervention programs need to be carried out under strict medical supervision.A low-carbohydrate diet may be a healthy attempt with the right guidance.3 Does diabetes require dietary supplements?A 2012 study showed that 26.2% of people with diabetes in the United States use dietary supplements or alternative drugs.However, why do diabetics use these supplements?Are those supplements harmful but harmful?Professor Laura Shane-McWhorter from the University of Utah School of Pharmacy accepted the interview and made some suggestions.Professor Shane-McWhorter pointed out that 56.9% of the dietary supplements or alternative medicines used by the people are herbal medicines. Patients usually believe in the "effect" of these herbs, rather than prescription drugs. They think that these herbs are more "natural" and can have no side effects.Control your blood sugar even better than prescription drugs.However, these supplements are a waste of a little money, but if they are harmful to the body, it is really worth the loss.People with liver disease should avoid potentially hepatotoxic supplements such as cinnamon, while people with poor blood pressure control should avoid ginseng intake.The role of several popular supplements is also discussed in the dialogue: aloe vera may have the effect of lowering blood sugar, and its fiber may prevent the absorption of glucose and promote the growth of probiotics; bitter gourd may inhibit the rise of blood sugar in a variety of ways, butIt is not recommended to treat diabetes with bitter gourd because it is actually useless; cinnamon is associated with a decrease in fasting blood glucose or triglyceride levels, but it is not effective for improving HbA1c levels; flaxseed contains alpha-linolenic acid and lignans, although it is often desirableThis supplement can bring about weight loss, hypoglycemic effects, etc., but research has not proven useful; some studies have shown that chyle may help liver disease and improve blood sugar.Healthcare professionals should discuss with patients whether or not to use supplements, taking into account existing evidence, patient disease control goals, possible side effects, and drug interactions to make decisions.Professor Shane-McWhorter highlighted the patient's claim that the so-called supplement is not an FDA-approved drug but is considered only a food.4 What does “mindfulness diet” mean for people with diabetes?The recent saying of "righteousness and diet" is very rampant. What is this new diet plan?Can diabetics try it?What is the difference between this dietary intervention and the previous programs?To answer these questions, two “mindfulness diet” experts, Megrette Fletcher and Michelle May, interviewed us and introduced us to the concept of mindfulness diet and its help in diet control for people with diabetes.They pointed out that the righteous thought diet originated from righteous thoughts, and the so-called righteous thoughts were chosen to recognize the present without judgment.We can try it now, try to realize the body itself, just pay attention to the feeling of the body, if you feel uncomfortable, what changes can you make?For example, change your position, find something to drink or find a blanket?And the mindfulness diet is to let you take care of yourself by making you aware of your feelings.Dietary interventions sometimes limit people's intake of certain foods or certain nutrients, but this can be difficult to maintain and may even cause eating disorders.People with diabetes may feel guilty because they are unable to adhere to dietary interventions, or avoid eating interventions because they cannot persist.Our dietary interventions tend to focus more on digital changes, which prevent patients from paying attention to the bits and pieces of life that may affect blood sugar.The focus of the mindfulness diet is not to limit eating habits to the rules of the numbers, but to ask people to pay attention to their bodies.For example, when you find yourself eating too much, the mindfulness diet will make you aware of this and notice that you are eating too much for the "disc".When you eat a meal, you won't eat too much. You will even check your blood sugar and think about the effects of eating too much on your blood sugar.Experts advise people to ask themselves six questions when eating: Why do you want to eat?When do you want to eat?What do you like to eat?How do I eat?How much have I eaten?Where did my calorie intake go?By knowing your body, mindfulness diet can help diabetic patients to look at their eating habits from another angle. Instead of “catching” the various requirements of the diet, they learn to “listen” to the voice of their body and accept that they are always on the go.The need to manage diet and control blood sugar.5 Super-processed foods cause overeating and gaining weight, so don't eat too much!Low-carbohydrate diet, ketogenic diet, raw diet, high-protein diet, low-fat diet, botanical diet... There are many disputes between diet schemes, so it’s so busy that everyone is at a loss, but these very different diets have one thing in common.To avoid excessive intake of super processed foods.This "tacit understanding" has been supported by recent studies that lead to overeating and weight gain.The study from the National Institute of Diabetes, Digestive and Kidney Diseases included 20 well-stabilized adults who were randomized to receive super-processed or unprocessed diet for 2 weeks during the 28-day study period.exchange.During the study, participants were able to eat 3 meals a day plus snacks. The two diets were matched in terms of total, energy density, macronutrients, cellulose, sugar and salt levels, but the difference in calories between the two groups of foodsVery big.The results showed that participants received an average daily energy intake of 508 kcal (p = 0.0001) when receiving super processed foods.This phenomenon was associated with a large increase in intake of carbohydrates (280 kcal, p < 0.0001) and fat (230 kcal, p = 0.0004), but the intake of protein (-2 kcal, p = -.85) was not significant.Change.This New Year's energy intake level increased the participant's weight gain by 0.9 kg (p=0.0009) in the super processed food stage, with fat increased by 0.4 kg (p=0.0015); in the unprocessed diet stage, body weightInstead, it decreased by 0.9 kg (p = 0.007) and the fat was also reduced by 0.3 kg (p = 0.05).Dr. Kevin D. Hall, who participated in the study, pointed out that although it is difficult to directly extend the conclusions from research directly into real life, the intake of more super processed foods is indeed compared with the intake of unprocessed foods.Involved in more calories, the weight of the corresponding participants also increased.Limiting the intake of super processed foods may be one of the effective strategies for preventing and treating obesity.PART 2 6 Ingesting saturated fat promotes fatty liver production, and unsaturated fatty acids are healthier!Fatty liver is not something you can think of, you have to eat saturated fat.A recent study from Uppsala University in Sweden pointed out that polyunsaturated fatty acids in excessive intake of plants do not seem to cause fat accumulation in the liver, but saturated fats are different. Even if the intake is the same, saturated fat can still be greatlyIncreases the accumulation of fat in the liver, leading to the production of fatty liver.The study included 60 participants who were heavily or obese. During the 12-week study period, participants were randomized to receive muffins made from refined sunflower oil rich in plant-derived unsaturated fatty acids or saturated.Muffins made from fat refined palm oil for a total of 8 weeks, during which the weight increased by 3%; the following 4 weeks received a low calorie diet of 800kcal per day.The results showed that the weight gains of the two groups were similar (2.31 vs 2.01 kg, p=0.05), but the fat content of the liver in the participants who consumed palm oil muffins increased by a staggering 53%, but the sunflower oil muffins were eaten.Participants did not increase or decrease the fat in the liver, which was reduced by an average of 2%. The difference between the two groups was significant (p=0.001).The results of the study showed that the weight gains of the two groups were similar, but the plant-derived polyunsaturated fatty acids did not increase the fat in the liver, and did not have any adverse effects on liver enzyme levels and blood lipids.Ulf Riserus, an associate professor of clinical nutrition and metabolism who is over-intake in the study, points out that learning to choose the right fat in the diet helps prevent non-alcoholic fatty liver.The accumulation of fat in the liver increases the starting point of many liver diseases, and is also closely related to dyslipidemia and type 2 diabetes. Diet will be one of the important means to prevent and treat fatty liver and type 2 diabetes.Researchers are currently expanding their research to include the benefits of polyunsaturated fatty acids for fatty liver and type 2 diabetes.7 Vitamin D supplementation improves insulin sensitivity, beta cell function, and turns over?Vitamin D is a controversial master. The D2d study released at the ADA 2019 conference just announced that vitamin D is not effective in preventing diabetes. Immediately, there is a study of biting a bit, indicating that in patients with high-risk or newly diagnosed type 2 diabetes.Supplementation of vitamin D for 6 months can delay the metabolic deterioration process in this population.The study from the University of Quebec Laval Medical Center in Canada included 96 newly diagnosed patients with type 2 diabetes or who were considered to be at high risk for diabetes based on waist circumference and insulin resistance, taking 5000 IU of vitamin D daily during the study period.Or placebo.Baseline serum vitamin D levels were not higher than 55 mmol/L for all participants.After 6 months of supplementation, the M value of participants' response to peripheral insulin sensitivity increased from 3.97 mg/kg/min at baseline to 4.88 mg/kg/min, whereas the M value of participants in the placebo group was not significant.Changes in vitamin D significantly improved participants' peripheral insulin sensitivity (p=0.009).In those with pre-diabetes and type 2 diabetes, M values ​​increased and the progression of diabetes slowed.In contrast, participants who took placebo had almost no change in M ​​values.However, the researchers found no significant difference in M ​​values ​​between vitamin D and placebo in participants without pre-diabetes or type 2 diabetes.Therefore, vitamin D is still unable to prevent the occurrence of type 2 diabetes, but it may delay its progress.The study also found that vitamin D supplementation can mainly improve participants' peripheral insulin sensitivity, while also protecting β-cell function.As a highly controversial supplement, the relationship between vitamin D and diabetes has never been clear, and all factors may affect the results of the study, want to really affirm or deny the role of vitamin D in controlling the risk of reducing diabetes,More research may still be needed.8 Plant-based diet, obese people, insulin sensitivity, β-cell function, you can do vitamin D, eat more green vegetables!In addition to the role of vitamin D in improving insulin sensitivity and beta cell function, recent studies have found that plant-based diets may have similar effects.In fact, the botanical diet has been shown to reduce the risk of type 2 diabetes and is expected to be used to treat type 2 diabetes.The study from the American Association of Physicians and Medicines included data from 75 overweight/obese participants, 38 of whom required a low-fat, vegan diet consisting of vegetables, grains, beans, and fruits.The remaining 37-meter participants did not make any changes.Women are allowed to drink 1 serving a day and men can drink 2 servings.The study lasted for 16 weeks, and the researchers compared the changes in metabolic parameters of the participants before and after the intervention.The results showed that the vegetarian group participants had a significant increase in insulin secretion levels after eating (p < 0.001) compared with the control participants who did not make any changes, while the HOMA-IR level of insulin resistance was significantly decreased, HOMA-IR levels.There was a significant positive correlation between changes in BMI and visceral fat content.Dr. Hana Kahleova, director of clinical research at the study, noted that this study demonstrated that a 16-week plant-based diet improved participants' beta-cell function.In the early stages of pre-diabetes or type 2 diabetes, it may be possible to preserve or even reverse the function of beta cells by using a plant-based diet.Researchers hope to have relevant dietary interventions early in the diabetes process to achieve better results.Of course, researchers don't expect everyone to accept plant-based dietary interventions, but for patients who want to try, the open mind and tried mindset of this approach may change their diabetes progression and even turn around completely.The beginning of the patient's diabetes.9 Polyunsaturated fatty acids fail to prevent diabetes Polyunsaturated fatty acids (PUFAs) include omega-3, omega-6 and omega-9 fatty acids, such as eicosapentaenoic acid and docosahexaenoic acid commonly found in fish.Flaxseed oil from plants, α-linolenic acid, linoleic acid, etc. in rapeseed oil.Many guidelines recommend reducing saturated fat intake and increasing polyunsaturated fat intake to prevent type 2 diabetes, but recent studies published in the BMJ suggest that intake of more polyunsaturated fatty acids does not seem to reduce type 2 diabetes.Risk of illness.This meta-analysis systematically evaluated 83 randomized early-onset trials to assess the relationship between the intake of omega-3, omega-6 and total polyunsaturated fatty acids and the risk of type 2 diabetes.All studies lasted for more than 24 weeks and recorded the participants' blood glucose, insulin, HbA1c, insulin resistance, and diabetes.It was found that long-chain omega-3 intake did not affect the occurrence of type 2 diabetes, and there was no significant change in the levels of HbA1c, insulin resistance, fasting insulin, and fasting blood glucose, but the daily intake of long-chain omega-3 fatty acids.More than 4.4g may be associated with an increased risk of type 2 diabetes.People have been worried about the negative impact of long-chain omega-3 intake on the risk of type 2 diabetes, and the results of this study have dispelled doubts.No significant results were found in the study of omega-6 unsaturated fatty acids, and there was no effect on the appearance of diabetes, insulin resistance, HbA1c and fasting blood glucose levels.Eating fish oil may not prevent diabetes, but it does not increase the risk of diabetes.Studies have shown that there is no evidence that long-chain omega-3, alpha-linolenic acid, omega-6 or total unsaturated fatty acid intake has an impact on blood sugar and diabetes risk, so there is no reason to encourage people to supplement long-chain omega-3 fatty acids.Prevent or treat diabetes.If long-chain omega-3 fatty acids need to be replenished to lower triglyceride levels, the daily intake should not exceed 4.4g to avoid an increased risk of type 2 diabetes.10 Breastmilk eats much, children are not afraid of fat. Children born to mothers with gestational diabetes are more likely to become obese. What can be done?In fact, the solution is on the chest of the mothers!As long as you want to give your baby more breast milk, it can effectively reduce the risk of obesity in the future.According to a study from the University of Texas at Austin, the risk of obesity in breastfed children can be reduced by 44% compared to those who are not breastfed!The study included data on mother and child in Los Angeles, 3707, of which 13% had gestational diabetes and 27% were exclusively breastfed for at least 6 months, but 23% also consumed more than 3 servings per day.Sugar sweet drink.When the researchers investigated, the average age of the children was 3 years old, 19% of whom were overweight or obese.. It was found that for children with gestational diabetes mothers, if they were able to adhere to simple breastfeeding, their overall risk of obesity was reduced by 44%.For children ages 1-5, the relative risk can be reduced by 61% (HR 0.39, 95% CI 0.30-0.49), and for children aged 2-5 years, the risk can be reduced by 60% (0.40, 0.28-0.58).However, the results of this series require children not to consume too much sugary sweet drinks, otherwise the risk of obesity will rise again. If the child consumes less than one sugary sweet drink per day, then it can also be breastfed.Benefit from.The study also found that children who did not have gestational diabetes mothers were breast-feeding, and they were not too fat, whether or not they had sugary sweet drinks.The researchers pointed out that all mothers should urge them to insist on simple breastfeeding and limit their intake of excessive sugary sweet drinks.For mothers without gestational diabetes, breastfeeding can keep their children from the risk of obesity caused by sugary sweet drinks, and for mothers who have had gestational diabetes, their children should be breastfed.To reduce the associated risk of obesity.To lose weight, grab the first bite from the doll! , please do not reprint without the authorization of the copyright owner.

ouyangshaoxia

The author ouyangshaoxia