Diabetes is blinding young population

Beware of rising blood sugar level, it may not only force you to give up sweets but can also make you blind. India, which already has the dubious distinction of being the diabetic capital of the world, is now witnessing a larger number of patients reporting vision-loss at an early age.
According to a recent study, nearly 18 per cent of urban working population is falling prey to retinopathy. Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in working age group. Dr Rajiv Raman, director, vitreoretinal services at Choithram Nethralaya and also the principal investigator of this study, says, "With diabetes hitting working population aged 35 and above, more and more numbers are reporting with retinopathy. Out of 100 patients with diabetes, 18-20 are diagnosed with mild to severe retinopathy."
He attributes the rising trend of retinopathy to changing lifestyle, eating habits of young population, hypertension and diabetes being reported at early age. The study was conducted on nearly 6,000 people based on socio-economic criteria.
The study used multi-stage random sampling method. The measures included were age- and gender-adjusted prevalence of diabetes and diabetic retinopathy, and correlation of prevalence with history-based risk factors. The results found that the prevalence of diabetic retinopathy in general population was 3.5 per cent. The prevalence of diabetic retinopathy in the population with diabetes mellitus was 18.0 per cent. The duration of diabetes is the strongest predictor for diabetic retinopathy. The study also found that if the age of onset of diabetes is less than 30 years then chances of developing severe retinopathy are five times higher. The disease is more common in men.
Dr Raman said, "We found an interesting fact that though diabetes has rural/ urban difference and difference in rich or poor, diabetic retinopathy does not. Once a person has diabetes, irrespective of socio-economic difference or geographic difference, he has similar chances of getting retinopathy."
According to the World Health Organization ( WHO), India will become one of the major hubs of diabetic population during the next two decades; the number of cases of adult-onset diabetes mellitus will grow to nearly 80 million in 2030. According to doctors working in the field of diabetes in city, out of 100 cases 15-20 are found to have the problem of vision-loss or retinopathy.
Dr P G Raman, senior diabetologist, says, "The problem is becoming more common these days. There are several cases where the problem is still unknown. I recommend my patients to get an eye check-up if there is vision-loss rather than changing spectacles."
Earlier news reports say India is also home to the largest number of the blind in the world. The problem of retinopathy persists but only limited data are available on the prevalence of diabetic retinopathy in the general population. As the awareness regarding the disease is low, people usually report at a stage when severe damage is already done.
Reasons:
The possible reasons for the rising trend of diabetic retinopathy are acculturation, changing lifestyles, changing food habits and more sedentary lifestyle.
Symptoms and detection:
Often there are no symptoms in the early stages of the disease, nor is there any pain. Be sure to have a comprehensive dilated eye exam at least once a year. Blurred vision may occur when the macula-the part of the retina that provides sharp central vision-swells from leaking fluid.
Treatment and measures:
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of the disease, people with diabetes should control their levels of blood sugar, blood pressure and cholesterol. Proliferate retinopathy is treated with laser surgery. This procedure is called scatter laser treatment.

A Drug To Treat Diabetes Before It Begins

A new study shows that people who are high risk of developing Type 2 diabetes may be able to prevent the disease by taking pioglitazone (sold as Actos), a common drug for diabetes treatment. But experts say that doesn't mean everyone with high blood sugar levels should be taking the medication.
Diabetes often progresses from a condition of impaired insulin sensitivity to the full-blown disease. Doctors have long been eager to find medications or lifestyle changes that can slow this progression or stop it altogether. While 21 million Americans suffer from Type 2 diabetes, nearly four times as many have high blood sugar levels that put them at risk of developing the disease.
Now researchers led by Dr. Ralph DeFronzo at the Texas Diabetes Institute and University of Texas Health Science Center report in the New England Journal of Medicine that pioglitazone can be an effective tool in helping high-risk patients control their blood sugar and stop the onset of diabetes.
The drug helps diabetes patients become more sensitive to their body's insulin; in Type 2 diabetes, the amount of insulin patients make isn't sufficient to break down the sugar they consume in their diet.
Among more than 600 people with elevated blood sugar levels and at least one additional risk factor for diabetes — including a family history of diabetes, being overweight, high cholesterol levels or hypertension — 2% of those taking pioglitazone developed diabetes, compared with 7.6% of those in the placebo group, during the study's more than two year follow-up, amounting to a 72% reduction in risk for those taking pioglitazone. In addition, more of the volunteers who took pioglitazone were able to restore their glucose tolerance to normal levels than those who were on placebo.
The reduction in diabetes risk seen in the new study was greater than that of other interventions that doctors currently use to help people with pre-diabetes avoid the disease. Another drug used to treat diabetes and control blood sugar, metformin, can lower risk by 31%; other medications in pioglitazone's class have lowered risk by up to 62%; and lifestyle modifications such as diet and exercise have also reduced risk by 58%.
Still, as encouraging as the results are, the study's authors caution that the data shouldn't be a license to prescribe pioglitazone to everyone at high risk of developing diabetes. The drug belongs to the same class of anti-diabetes medications as rosiglitazone, or Avandia, which the Food and Drug Administration put on restricted use last fall after evidence that it increased patients' risk of heart attack and stroke.
Pioglitazone has not been associated with such risks, but participants in the study who took the medication gained more weight than those taking placebo. While the gain was small, becoming overweight remains a strong risk factor for developing diabetes.
That's why diabetes doctors continue to reserve drug-based treatments of pre-diabetes only for only those patients who have tried and failed to control their escalating blood sugar with non-pharmaceutical methods, such as diet and exercise. It may take longer and may not result in as dramatic a benefit as medications, but lifestyle options, experts say, are safer and potentially longer lasting.


Read more: http://healthland.time.com/2011/03/25/a-drug-to-treat-diabetes-before-it-begins/#ixzz1Yyfxx3Lq

5 Ways to Avoid Diabetes — Without Medications

New research suggests that when it comes to lowering your risk of diabetes, the more changes you make to your diet and lifestyle, the better.
Led by Jared Reis at the National Heart, Lung and Blood Institute, scientists report in the Annals of Internal Medicine that people can lower their risk of developing diabetes by as much as 80% if they adhere to a combination of lifestyle changes: exercising more, not drinking as much alcohol, quitting smoking, avoiding obesity and eating high-fiber, low-fat foods.
Although the advice sounds familiar, the new study is the first to demonstrate the effect of combining all the recommendations together. Previous studies have shown that losing weight or eating healthier can independently help reduce the risk of diabetes, but this study is the first to show the potential cumulative benefits of making multiple lifestyle changes.
The study involved more than 207,000 men and women aged 50 to 71 who were enrolled in the National Institutes of Health (NIH)–AARP Diet and Health Study. The participants were all healthy and free of heart disease, cancer and diabetes at the start of the study in 1995-96. When they joined, the volunteers filled out questionnaires about their lifestyle and diet, including what they ate, how much they weighed, how physically active they were, and whether they smoked or drank alcohol. The researchers tracked them for nearly a decade to see who developed diabetes.

VIDEO: Competing in the Olympics with Type-1 Diabetes

Reis and his team then divided the volunteers into low- and high-risk groups, depending on their responses to the lifestyle questions. People included in the low-risk diet group, for example, were those who ate foods with a low glycemic index (that is, foods that don't cause a sharp a spike in blood glucose levels, which can impair the body's ability to break down the sugar with insulin), more unsaturated as opposed to saturated fats, higher fiber and lower trans fats.
Women in the low-risk alcohol group drank no more than one alcoholic beverage a day; men drank no more than two. The low-risk physical activity group got at least 20 minutes of exercise three or more times a week. People whose BMI fell into normal ranges were considered low risk in terms of weight.
Each low-risk lifestyle habit was associated with a reduction in diabetes risk. Among men, those who were normal weight had a 70% lower risk of developing diabetes over 10, compared to those were overweight or obese. For women, the reduction in risk was 78%.

For men, the next most influential factors were not smoking and exercising regularly: non-smokers had a 24% lower risk of diabetes than current smokers or those who quit less than 10 years ago, and men who reported being physically active enjoyed a similar reduction in diabetes risk, compared with more sedentary men.
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For women, avoiding overindulgence in alcohol was an important factor in reducing diabetes risk: those who drank just one glass or less a day had a 37% lower risk, compared with women who drank more. And being physically active also helped women avoid diabetes; those who exercise regularly were 23% less likely to develop the disease than those who didn't.
What was more intriguing was how much the participants were able to lower their diabetes risk when they combined many of these healthy lifestyle habits. A man who ate a high-fiber, low-saturated fat diet and exercised regularly, for example, had a 28% lower risk of diabetes than his counterpart who ate less healthily and spent more time on the couch. If that man was also a non-smoker, his risk of diabetes dropped by 32%; if he also cut back on his alcohol, his risk fell by 39%. If he maintained a normal weight on top of everything, his overall risk of developing diabetes was 72% lower than his peers who adhered to none of the healthy lifestyle behaviors.
The numbers were even more impressive for women, who, by combining all five lifestyle factors, were able to lower their risk of developing diabetes by 84%.
While there are effective medications to treat diabetes, it's encouraging news that standard lifestyle modifications such as losing weight, eating right, exercising, quitting smoking and drinking in moderation can significantly lower the risk of the disease. Not everything, it seems, needs to be treated with a pill.


Read more: http://healthland.time.com/2011/09/07/5-ways-to-avoid-diabetes-without-medications/#ixzz1Yyb4oxaZ