A disease that breeds disease: why is type 2 diabetes linked to increased risk of cancer and dementia?



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Rachel Climie, Baker Heart and Diabetes Institute and Jonathan Shaw, Baker Heart and Diabetes Institute

In Australia, more than 1.1 million people currently have type 2 diabetes.

A host of potential complications associated with the disease mean a 45-year-old diagnosed with type 2 diabetes will live on average six years less than someone without type 2 diabetes.

This week we published a report bringing together the latest evidence on the health consequences of type 2 diabetes.

Aside from demonstrating the complications we know well – like the link between diabetes and heart disease risk – our report highlights some newer evidence that suggests type 2 diabetes is associated with an increased risk of cancer and dementia.




Read more:
How Australians Die: cause #5 – diabetes


Common complications of type 2 diabetes

Type 2 diabetes, which typically develops after the age of 40, is usually due to a combination of the pancreas failing to produce enough of the hormone insulin, and the cells in the body failing to adequately respond to insulin.

Since insulin is the key regulator of blood glucose (sugar), this causes a rise in the blood sugar levels.

Risk factors for developing type 2 diabetes include being overweight, being physically inactive, having a poor diet, high blood pressure and family history of type 2 diabetes.

Being overweight is a risk factor for type 2 diabetes – but not all people with type 2 diabetes are overweight.
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People with type 2 diabetes are about twice as likely to develop heart disease than people without type 2 diabetes.

While heart attacks, due to blockages in the coronary arteries, are perhaps the better recognised form of heart disease, heart failure, where the heart muscle is unable to pump enough blood around the body, is becoming more common, especially in people with type 2 diabetes.

This is due to a number of factors, including better treatment and prevention of heart attacks, which has allowed more people to survive long enough to develop heart failure.

People with type 2 diabetes are up to eight times more likely to develop heart failure compared to those without diabetes.




Read more:
Got pre-diabetes? Here’s five things to eat or avoid to prevent type 2 diabetes


Meanwhile, diabetes is the most common cause of kidney failure and vision loss in working age adults, and accounts for more than 50% of foot and leg amputations.

But beyond these common and familiar complications of diabetes, there’s mounting evidence to suggest type 2 diabetes increases the risk of other diseases.

Emerging complications of type 2 diabetes

People with type 2 diabetes are approximately two times more likely to develop pancreatic, endometrial and liver cancer, have a 30% higher chance of getting bowel cancer and a 20% increased risk of breast cancer.

Increased cancer risk is of particular concern for the growing number of people under 40 living with type 2 diabetes. In Australia, this group saw a significant increase in deaths from cancer between 2000 and 2011.

Dementia, too, is a recently recognised complication of type 2 diabetes. A meta-analysis involving data from two million people showed people with type 2 diabetes have a 60% greater risk of developing dementia compared to those without diabetes.




Read more:
Type 2 diabetes increasingly affects the young and slim; here’s what we should do about it


Why the increased risk?

It’s important to acknowledge the studies we looked at are observational and can’t tell us diabetes necessarily caused these conditions. But they do suggest having diabetes is associated with an increased risk.

The two leading theories for why cancer risk is increased in people with type 2 diabetes relate to glucose and insulin.

Many types of cancer cells use glucose as a key fuel, so the more glucose in the blood, potentially, the more rapidly cancer will grow.

Alternatively, insulin can promote the growth of cells. And since in the early stages of type 2 diabetes insulin levels are elevated, this might also promote the development of cancer.

It’s especially important people with diabetes take up cancer screening programs.
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There are several possible explanations for the link between diabetes and dementia. First, strokes are more common in people with type 2 diabetes, and both major and repeated mini-strokes can lead to dementia.

Second, diabetes affects the structure and function of the smallest blood vessels throughout the body (the capillaries), including in the brain. This may impair the delivery of nutrients to a person’s brain cells.

Third, high glucose levels and other metabolic disturbances associated with diabetes may, over time, directly affect the way certain types of brain cells function.

Room for improvement

Despite well-established recommendations for the management of type 2 diabetes, such as guidelines for medication use, healthy diet and regular physical activity, there remains a significant gap between the evidence and what happens in practice.

A study from the US showed only one in four patients with type 2 diabetes met all the recommended targets for healthy levels of glucose, cholesterol and blood pressure.

Australian data has shown having diabetes is associated with 14% increased likelihood of discontinuing cholesterol medication after one year.

In our report, we showed increasing the use of a range of effective medications would prevent many hundreds of people with diabetes developing heart disease, strokes and kidney failure each year.




Read more:
Unscrambling the egg: how research works out what really leads to an increased disease risk


With the burden of diabetes complications in our community casting such a large shadow in terms of death rates, disability and impact on the health system, we need greater education and support for people with living diabetes, as well as health professionals treating the condition.

For people with type 2 diabetes, close monitoring for other diseases such as cancer through screening programs is particularly important.

And alongside managing their blood sugar levels, it’s essential Australians with type 2 diabetes are supported to keep risk factors for complications, such as blood pressure and cholesterol, at healthy levels.

A healthy diet and regular physical activity is a good place to start.The Conversation

Rachel Climie, Exercise Physiologist and Research Fellow, Baker Heart and Diabetes Institute and Jonathan Shaw, Deputy Director, Baker Heart and Diabetes Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Had gestational diabetes? Here are 5 things to help lower your future risk of type 2 diabetes



For women who have had gestational diabetes, maintaining a healthy diet can help lower the risk of developing type 2 diabetes later on.
From shutterstock.com

Clare Collins, University of Newcastle; Hannah Brown, University of Newcastle, and Megan Rollo, University of Newcastle

Gestational diabetes is a specific type of diabetes that occurs in pregnancy.

Once you’ve had gestational diabetes, your risk of having it again in your next pregnancy is higher. So too is your lifetime chance of developing type 2 diabetes and heart disease.

The good news is taking steps such as adopting a healthier diet and being more active will lower those risks, while improving health and well-being for you and your family.




Read more:
Gestational diabetes in the mother increases Type 1 and Type 2 diabetes risks for the whole family


What is gestational diabetes?

Gestational diabetes affects about one in seven to eight pregnant women in Australia.
Women are screened for gestational diabetes at around 24 to 28 weeks gestation using a glucose tolerance test. Gestational diabetes is diagnosed when blood glucose levels, also called blood sugar levels, are higher than the normal range.

Screening is designed to ensure women with gestational diabetes receive treatment as early as possible to minimise health risks for both the mother and the baby. Risks include having a baby born weighing more than four kilograms, and the need to have a caesarean section. Management of gestational diabetes includes close monitoring of blood glucose levels, a healthy diet, and being physically active.

The risk of developing type 2 diabetes increases markedly in the first five years following gestational diabetes, with risk plateauing after ten years. Women who have had gestational diabetes have more than seven times the risk of developing type 2 diabetes in the future than women who haven’t had the condition.

Type 2 diabetes

If type 2 diabetes goes undiagnosed, the impact on your health can be high – especially if it’s not detected until complications arise.

Early signs and symptoms of type 2 diabetes include extreme thirst, frequent urination, blurred vision, frequent infections and feeling tired and lethargic.

Doing regular exercise can lessen the risk of developing type 2 diabetes.
From shutterstock.com

Long-term complications include an increased risk of heart disease and stroke, damage to nerves (especially those in the fingers and toes), damage to the small blood vessels in the kidneys, leading to kidney disease, and damage to blood vessels in the eyes, leading to diabetes-related eye disease (called diabetic retinopathy).

If you’ve ever been diagnosed with gestational diabetes, here are five things you can do to lower your risk of developing type 2 diabetes.

1. Monitor your diabetes risk

Although gestational diabetes is a well-known risk factor for type 2 diabetes, some women have not been informed of the increased risk. This means they may not be aware of the recommendations to help prevent type 2 diabetes.

All women diagnosed with gestational diabetes should have a 75g oral glucose tolerance test at 6–12 weeks after giving birth. This is to check how their body responds to a spike in blood sugar after they’ve had the baby, and to develop a better picture of their likelihood of developing type 2 diabetes.

From that point, women who have had gestational diabetes should continue to have regular testing to see whether type 2 diabetes has developed.

Talk to your GP about how to best monitor diabetes risk factors. Diabetes Australia recommends a blood glucose test every one to three years.

2. Aim to eat healthily

Dietary patterns that include vegetables and fruit, whole grains, fish and foods rich in fibre and monounsaturated fats are associated with a lower risk of developing type 2 diabetes.

In more than 4,400 women with prior gestational diabetes, those who had healthier eating patterns, assessed using diet quality scoring tools, had a 40-57% lower risk of developing type 2 diabetes compared with women with the lowest diet quality scores.




Read more:
Are you at risk of being diagnosed with gestational diabetes? It depends on where you live


Glycaemic index (GI) ranks carbohydrate-containing foods according to their effect on blood glucose levels. The lower the GI, the slower the rise in blood sugar levels after eating. Research suggests that a higher GI diet, and consuming lots of high GI foods (glycaemic load), is associated with a higher risk of developing type 2 diabetes, while a lower GI diet may lower the risk of type 2 diabetes.

Take our Healthy Eating Quiz to check how healthy your diet is and receive personal feedback and suggestions on how to boost your score.

3. Be as active as possible

Increasing your physical activity level can help lower your risk of developing type 2 diabetes.

Engaging in 150 minutes of moderate-intensity exercise per week, such as walking for 30 minutes on five days a week; or accumulating 75 minutes of vigorous-intensity physical activity a week by swimming, running, tennis, cycling, or aerobics, is associated with a 45% lower risk of developing type 2 diabetes after having had gestational diabetes. Importantly, both walking and jogging produced a similar lower risk of type 2 diabetes.

In contrast, prolonged time spent watching TV was associated with a higher risk of type 2 diabetes in women with a history of gestational diabetes.

Strength training is also important. A large study of 35,754 healthy women found those who engaged in any type strength training, such as pilates, resistance exercise or weights, had a 30% lower rate of developing type 2 diabetes compared to women who did not do any type of strength training.

Women who did both strength training and aerobic activity had an even lower risk of developing either type 2 diabetes or heart disease.

Breastfeeding has been shown to reduce the risk of type 2 diabetes, even in mums who haven’t had gestational diabetes.
From shutterstock.com

4. Breastfeed for as long as you can

Research shows breastfeeding for longer than three months reduces the risk of developing type 2 diabetes by about 46% in women who have had gestational diabetes. It is thought that breastfeeding leads to improved glucose and fat metabolism.

The Nurses Health Study followed more than 150,000 women over 16 years. It found that for every additional year of breastfeeding, the risk of developing type 2 diabetes was reduced by 14-15% – even in mothers who had not been diagnosed with gestational diabetes.

Organisations such as the Australian Breastfeeding Association and lactation consultants offer support to help all women, including those who have had gestational diabetes, to breastfeed their infants for as long as they choose.




Read more:
Want to breastfeed? These five things will make it easier


5. Keep an eye on your weight

Weight gain is a known risk factor for developing type 2 diabetes. In a study of 666 Hispanic women with previous gestational diabetes, a weight gain of 4.5kg during 2.2 years follow-up increased their risk of developing type 2 diabetes by 1.54 times.

Another study saw 1,695 women with previous gestational diabetes followed up between eight to 18 years after their diagnosis. This research found that for each 5kg of weight gained, the risk of developing type 2 diabetes increased by 27%.

Aiming to modify your eating habits and being as active as you can will help with weight management and lower the risk of developing type 2 diabetes. Within interventions that support people to adopt a healthy lifestyle, one review found every extra kilogram lost by participants was associated with 43% lower odds of developing type 2 diabetes.




Read more:
Health Check: what’s the best diet for weight loss?


The Conversation


Clare Collins, Professor in Nutrition and Dietetics, University of Newcastle; Hannah Brown, PhD Candidate Nutrition and Dietetics, University of Newcastle, and Megan Rollo, Postdoctoral Research Fellow, Nutrition & Dietetics, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Plinky Prompt: What Non Profit Organizations Do You Support? Would You Ever Start Your Own?


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I don’t have any non profit organizations that I support on a regular basis. I do support various non profit organizations from time to time, but it tends to be a bit all over the shop.

I have supported such environmental organizations as Bush Heritage Australia and WWF, among others. I have also supported Compassion and other similar organizations from time to time, such as when the appeal went out for assistance during the tsunami crisis on Boxing Day a few years ago.

I do have an interest, should I have access to any money, to start a foundation-type organization for diabetes research and support. The reason for this interest is that a dear friend died a few years ago who suffered badly from diabetes.

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Plinky Prompt: What I'd Do With a Million Dollars


‘Diabetes causes amputations’, warns poster

I do have something of a plan for when (or rather if) I have a million dollars. I would like to start a diabetes foundation in memory of a friend who died. My friend had diabetes and this would be a great way to remember her I think.

Obviously, there would be other things I would do with some of the money, but the establishment of a foundation would be very important to me.

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Plinky Prompt: If You Had Unlimited Resources What Would You Create?


I would create a Diabetes Research Foundation. Why would I do this? Because I would like to do something in memory of my friend Rebecca who had diabetes.

ERITREA: THIRD CHRISTIAN THIS YEAR DIES IN MILITARY PRISON


LOS ANGELES, July 27 (Compass Direct News) – Another Christian imprisoned for his faith in Eritrea has died from authorities denying him medical treatment, according to a Christian support organization.

Sources told Netherlands-based Open Doors that Yemane Kahasay Andom, 43, died Thursday (July 23) at Mitire Military Confinement Center.

A member of the Kale-Hiwot church in Mendefera, Andom was said to be secretly buried in the camp.

Weakened by continuous torture, Andom was suffering from a severe case of malaria, Open Doors reported in a statement today.

“He was allegedly further weakened by continuous physical torture and solitary confinement in an underground cell the two weeks prior to his death for his refusal to sign a recantation form,” the organization said. “It is not clear what the contents of the recantation form were, but most Christians interpret the signing of such a form as the denouncement of their faith in Christ.”

Andom is the third known Christian to die this year at the Mitire camp, located in northeastern Eritrea. Mogos Hagos Kiflom, 37, was said to have died from torture at the same center in early January. On Jan. 16, Mehari Gebreneguse Asgedom, 42, died in solitary confinement at the Mitire camp from torture and complications from diabetes, according to Open Doors.

It was not immediately known whether Andom was married or how many family members survive him. He had spent the past 18 months at the Mitire camp.

Last October Open Doors learned of the death of another Christian, Teklesenbet Gebreab Kiflom, 36, who died while imprisoned for his faith at the Wi’a Military Confinement Center. He was reported to have died after prison commanders refused to give him medical attention for malaria.

In June 2008, 37-year-old Azib Simon died from untreated malaria as well. Weakened by torture, sources told Compass, Simon contracted malaria only a week before she died.

With the death of Andom last week, the number of Christians who have died while imprisoned for their faith in Eritrea now total nine. Along with the two Christians who died in January and Kiflom and Azib last year, Nigisti Haile, 33, tied from torture on Sept. 5, 2007; Magos Solomon Semere, 30, died from torture and pneumonia at Adi-Nefase Confinement Center, outside Assab, in February 2007; Immanuel Andegergesh, 23, died in Adi-Quala Confinement Center in October 2006 from torture and dehydration; and also at the Adi-Qaula center, Kibrom Firemichel, 30, died from torture and dehydration also in October 2006.

More than 2,800 Christians remain imprisoned for their faith in Eritrea, according to Open Doors.

The Eritrean government in May 2002 outlawed all religious groups except Islam and the Orthodox, Catholic and Lutheran churches. The government of President Isaias Afwerki has stepped up its campaign against churches it has outlawed, once again earning it a spot on the U.S. Department of State’s latest list of worst violators of religious freedom.

Incarcerated Christians from throughout Eritrea have been transferred to the Mitire prison. In April Open Doors learned that 27 Christian prisoners held at police stations in the Eritrean capital of Asmara had been transferred to the Mitire military camp for further punishment.

They included a pastor identified only as Oqbamichel of the Kale-Hiwot Church, pastor Habtom Twelde of the Full Gospel Church, a pastor identified only as Jorjo of the Full Gospel Church, two members of the Church of the Living God identified only as Tesfagaber and Hanibal, Berhane Araia of the Full Gospel Church and Michel Aymote of the Philadelphia Church.

On April 17, according to the organization, 70 Christians were released from the Mitire military facility, including 11 women imprisoned for six months for allegedly failing to complete their required 18 months of military service. The Christians said that authorities simply told them to go home and that they had no idea why they had been released. They had been originally arrested in Asmara, Dekemhare, Keren, Massawa and Mendefera and transported to Mitire for punishment.

Eritrean officials have routinely denied that religious oppression exists in the country, saying the government is only enforcing laws against unregistered churches.

The government has denied all efforts by independent Protestant churches to register, and people caught worshipping outside the four recognized religious institutions, even in private homes, suffer arrest, torture and severe pressure to deny their faith. The Eritrean Orthodox Church and its flourishing renewal movement have also been subject to government raids.

Reliable statistics are not available, but the U.S. Department of State estimates that 50 percent of Eritrea’s population is Sunni Muslim, 30 percent is Orthodox Christian, and 13 percent is Roman Catholic. Protestants and Seventh-day Adventists, along with Jehovah’s Witnesses, Buddhists, Hindus, and Baha’is make up less than 5 percent of the population.

Report from Compass Direct News 

CHINA: BOOKSTORE OWNER SENTENCED TO THREE YEARS IN PRISON


Shi Weihan also fined nearly $22,000; ‘illegal business’ printed Bibles for free distribution.

 

LOS ANGELES, June 10

(Compass Direct News) – A Beijing court today found Christian bookstore owner Shi Weihan guilty of “illegal business operation” and sentenced him to three years in prison and a 150,000 yuan (US$21,975) fine.

Sources said Shi’s store operated legally and sold only books for which he had obtained government permission, and that his Holy Spirit Trading Co. printed Bibles and Christian literature without authorization but only for free distribution to local house churches.

The 38-year-old Shi had been released on Jan. 4, 2008 due to insufficient evidence for the same vague charge of “illegal business operation,” but he was arrested again two month later, on March 19, and held virtually incommunicado. Contrary to Chinese law, authorities have denied all but a few visits from his lawyer and family, held him without charges for most of his time in jail, and initially withheld medication for his diabetes.

The court ruling appears to have allowed time that Shi has spent in jail to count toward his sentence, a source said, as his prison term was described as running from Nov. 28, 2007, when he was initially arrested, to Nov. 27, 2010.

Others in a printing company who stood trial with Shi appeared to have received similar sentences. A written judgment is expected within 15 days to allow time for an appeal to be filed, said Ray Sharpe, a friend of Shi.

“Absent an appeal, it is also possible that Shi could be allowed a sort of medical parole, due to his diabetic condition,” Sharpe said. “Hopefully, he could then be allowed to stay in a hospital under a sort of house arrest.”

He said that Shi did not yet know whether he would appeal, adding that the process could take up to a year.

Friends and business acquaintances of Shi have described him as a model citizen of China, saying that he has inspired them to love China by his patriotism and love for his homeland. They said he is known for selfless sacrifice on behalf of poor and disenfranchised rural Christians and minority children.

For much of his incarceration, Shi’s wife Zhang Jing and their two daughters, 12-year-old Shi Jia and 8-year-old Shi En Mei, have not known where he was being held. The family has been under nearly continual surveillance, limiting their ability to make contact with people who could assist them.

Sources said Zhang has worried about her husband’s condition and that she has taken on leadership duties at their church, where Public Security Bureau officials have intimidated the congregation with regular visits. Some members have left the church because of the intimidation, sources said, and Zhang is said to have suffered anxiety and stress that have led to depression.

Their two daughters have been ostracized at school for being the children of a prisoner, sources said.

Shi has lost more than 44 pounds since his second incarceration, they said, dropping to less than 130 pounds. The sources added that he has suffered from blisters because of unsanitary conditions in prison, as well as tinnitus that at times causes his ears to ring so loudly that he cannot sleep.

Chinese officials claim that the Nanjing Amity Printing Co. (Amity Press), the only government-approved Bible publisher, produces enough Bibles to meet the needs of the Chinese church, which various religious freedom organizations dispute. The groups complain that Amity prints a large share of its Bibles for export, and those sold domestically are not available to many Christians.

Report from Compass Direct News

ERITREA: CHRISTIAN DEATHS MOUNT IN PRISONS


Three more believers die in military confinement centers in past four months.

LOS ANGELES, January 21 (Compass Direct News) – Three Christians incarcerated in military prisons for their faith have died in the past four months in Eritrea, including the death on Friday (Jan. 16) of a 42-year-old man in solitary confinement, according to a Christian support organization.

Sources told Open Doors that Mehari Gebreneguse Asgedom died at the Mitire Military Confinement center from torture and complications from diabetes. Asgedom was a member of the Church of the Living God in Mendefera.

His death followed the revelation this month of another death in the same prison. Mogos Hagos Kiflom, 37, was said to have died as a result of torture he endured for refusing to recant his faith, according to Open Doors, but the exact date of his death was unknown. A member of Rhema Church, Kiflom is survived by his wife, child and mother.

Incarcerated Christians from throughout Eritrea have been transferred to the Mitire prison in the country’s northeast. In 2002 the Eritrean regime outlawed religious activity except that of the Orthodox, Catholic, Lutheran or Muslim religions.

In October Open Doors learned of the death of Teklesenbet Gebreab Kiflom, 36, who died while imprisoned for his faith at the Wi’a Military Confinement center. He was reported to have died after prison commanders refused to give him medical attention for malaria.

In June 2008, 37-year-old Azib Simon died from untreated malaria as well. Weakened by torture, sources told Compass, Simon contracted malaria only a week before she died.

Together with the deaths this month, the confirmed number of Christians who have died while imprisoned for their faith in Eritrea now totals eight.

 

Mass Arrests

At the same time, the government of President Isaias Afwerki has stepped up its campaign against churches it has outlawed, earning it a spot on the U.S. Department of State’s list of worst violators of religious freedom.

The government arrested 15 members of the Kale-Hiwot Church in Keren on Jan. 11, and before Christmas at least 49 leaders of unregistered churches in Asmara were rounded up over two weeks, Open Doors reported. Last November, 34 members of the Kale-Hiwot Church in Dekemhare were arrested.

Those arrested included members of the Church of the Living God, Medhaniel Alem Revival Group and the Philadelphia, Kale-Hiwot, Rhema, Full Gospel and Salvation by Christ churches, according to Open Doors. The church leaders’ names appeared on a government list of 180 people who were taken from their homes and work places.

In the November sweep, authorities arrested 65 members of the Kale-Hiwot Church in the towns of Barentu and Dekemhare, including 17 women. In Keren and Mendefera, 25 members of the Full Gospel Church were arrested, and 20 Christians belonging to the Church of the Living God in Mendefera and Adi-Kuala were arrested.

Church leaders in Eritrea told Open Doors that by mid-December, a total of 2,891 Christians, including 101 women, had been incarcerated for their faith.

On June 8, 2008 Compass learned that eight Christians held at the Adi-Quala prison were taken to medical emergency facilities as a result of torture by military personnel at the camp. Eritrean officials have routinely denied religious oppression exists in the country, saying the government is only enforcing laws against unregistered churches.

The government has denied all efforts by independent Protestant churches to register, and people caught worshipping outside the four recognized religious institutions, even in private homes, suffer arrest, torture and severe pressure to deny their faith. The Eritrean Orthodox Church and its flourishing renewal movement has also been subject to government raids.  

Report from Compass Direct News