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The FDA has approved Wegovy, an anti-obesity drug, for reducing cardiovascular risk in adults with overweight or obesity and established cardiovascular disease. The label expansion now allows for the once-weekly injection of semaglutide 2.4 mg to be used to reduce risks for major adverse cardiovascular events (MACEs). These events include cardiovascular death, nonfatal heart attack, or nonfatal stroke. The drug should be used in combination with a reduced-calorie diet and increased physical activity. This approval makes Wegovy the first weight loss medication to also help prevent life-threatening cardiovascular events in adults with cardiovascular disease and either obesity or overweight, according to the FDA with type 2 diabetes.

Several clinical trials, including the SUSTAIN and PIONEER trials, have demonstrated that semaglutide can reduce the risk of major adverse cardiovascular events (MACE) in people with type 2 diabetes who are at high risk for cardiovascular disease. These trials have shown a reduction in the risk of cardiovascular events such as heart attack, stroke, and cardiovascular death in participants treated with semaglutide compared to those treated with a placebo or other diabetes medications.

The exact mechanisms by which semaglutide reduces cardiovascular risk are not fully understood, but it is believed to be related to its effects on blood sugar control, body weight, blood pressure, and other metabolic factors. Additionally, semaglutide may have direct effects on the cardiovascular system, such as reducing inflammation and improving vascular function. Overall, the cardiovascular benefits of semaglutide make it an important treatment option for individuals with type 2 diabetes who are at high risk for cardiovascular disease. However, as with any medication, it’s essential to discuss the potential risks and benefits with your healthcare provider to determine if semaglutide is the right choice for you.

This patient population has a higher risk of cardiovascular death, heart attack, and stroke. Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health, he added. The approval was based on results from the 3-year SELECT trial, which randomly assigned 17,604 patients with cardiovascular disease and body mass index 27 to weekly semaglutide or placebo. None of the patients had diabetes, although two-thirds met prediabetes criteria. The incidence of MACEs was reduced by 20% with the drug. The label will also reflect the risk reduction of 15% for cardiovascular death and 19% for death from any cause. Participants also lost a mean of 9.4% of body weight over the first 2 years with semaglutide vs 0.88% with placebo.

Adverse events leading to discontinuation of treatment occurred in 16.6% in the semaglutide group, mostly gastrointestinal effects, and in 8.2% in the placebo group. The maker of the weight loss medication, Novo Nordisk, has also filed for a label expansion in the European Union, with a decision expected in 2024. 

Wegovy is now the first weight loss medication to also be approved to help prevent life-threatening cardiovascular events in adults with cardiovascular disease and either obesity or overweight, This patient population has a higher risk of cardiovascular death, heart attack, and stroke. Providing a treatment option that is proven to lower this cardiovascular risk is a major advance for public health.

Semaglutide is a glucagon-like peptide-1 (GLP-1) receptor antagonist, a class of medications that has gathered much media attention as of late.1 The FDA said that semaglutide should not be used in combination with other medication containing semaglutide or other GLP-1 receptor agonists.
The approval was based on efficacy and safety in the multicentered, placebo-controlled, double-blind SELECT (NCT03574597) trial, which had over 17,600 individuals in the cohort. Treatment was randomized between semaglutide or the placebo, with both groups receiving standard-of-care treatment, including management of blood pressure and cholesterol, and healthy lifestyle counseling, including diet and physical activity, according to the FDA. Investigators of the study found that semaglutide significantly reduced the risk of major adverse cardiovascular events (MACE) such as CVD death, heart attack, and stroke, which occurred in 6.5% of individuals in the semaglutide group compared with 8% of those in the placebo group.

The FDA approved Wegovy (semaglutide) for a new use: reducing the risk of cardiovascular (CV) death, heart attack, and stroke in adults with both cardiovascular disease (CVD) and overweight or obesity. Wegovy is the first weight-loss medication approved for this specific purpose. It should be used alongside a reduced-calorie diet and increased physical activity.

REFERENCES:

https://www.medscape.com/viewarticle/fda-approves-semaglutide-cardiovascular-risk-reduction-2024a10004ix?src=&form=fpf
https://www.dicardiology.com/content/fda-approves-wegovy-cardiovascular-risk-reduction-adults-known-heart-disease-and-overweight
https://www.pharmacytimes.com/view/fda-approves-semaglutide-for-new-indication-involving-cardiovascular-disease

Medications that have been suggested by doctors worldwide are available here
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Ozempic (semaglutide) is a medication primarily used to treat type 2 diabetes. Recent studies have suggested that it may have potential benefits beyond glycemic control, including possible effects on kidney disease progression. Some research indicates that Ozempic may slow the progression of kidney disease in people with type 2 diabetes, though more studies are needed to confirm these findings and understand the mechanisms involved. It’s always essential for individuals to discuss potential treatment options and their implications with their healthcare providers.

Type 2 diabetes is a condition that results from the body no longer responding to insulin, the hormone that controls blood glucose levels. People with type 2 diabetes are at high risk of developing chronic kidney disease. Semaglutide sold under the brand name Ozempic is a drug that, in conjunction with diet and exercise, improves blood glucose (sugar) control in people with diabetes. Now, trial results show that semaglutide may also reduce the progression of kidney disease.

Chronic kidney disease affects one in three adults with diabetes. Both type 1 and type 2 diabetes increase the risk of chronic kidney disease if blood glucose (sugar) levels are not controlled. The resulting damage to blood vessels and nephrons in the kidneys means they cannot function effectively. As the early stages of kidney disease cause few or no symptoms, people with diabetes should manage their blood glucose, blood pressure, and cholesterol levels. They should also get regular checks from their doctor.
Semaglutide which is marketed as Ozempic, is one of a group of drugs called glucagon-like peptide-1 (GLP-1) receptor agonists. These mimic a hormone GLP-1 that makes the body produce more insulin, reduces appetite, and gives feelings of fullness.

The Food and Drug Administration (FDA) has approved Ozempic as a treatment for type 2 diabetes, in addition to diet and exercise. As well as helping control blood glucose, it may also reduce the risk of heart attack, stroke, or death in adults with type 2 diabetes and heart disease. One study has shown that it could also reduce inflammation, which may explain these other health effects.

Now, the manufacturer of Ozempic Novo Nordisk has announced headline results of their latest trial, suggesting that semaglutide can reduce the risk of kidney disease progression by 24% in people who have type 2 diabetes and chronic kidney disease. The detailed results of the FLOW trial will be presented at a scientific conference later this year. They have not yet appeared in a peer-reviewed journal. This is a very significant finding; over 500 million people have diabetes, and 30-40% have chronic kidney disease, and we need treatments to stop or reduce progression of the kidney disease as well as to reduce the burden of cardiovascular disease which is high in this population. People with [type 2 diabetes] and [chronic kidney disease] are at amplified risk for cardiovascular-related morbidity and mortality and progression to kidney failure. Treatment options capable of mitigating heart and kidney risk in this population are greatly needed, he told us.

Researchers on the FLOW trial recruited 3,533 people with type 2 diabetes and chronic kidney disease from 418 locations in 28 countries. They randomly allocated them to semaglutide or placebo. Participants self-administered both semaglutide and the visually identical placebo by weekly subcutaneous injection. Those in the semaglutide group started on a dose of 0.25 milligrams (mg) per week for 4 weeks, increasing the dose to 0.5 mg, then to 1 mg after 8 weeks and for the rest of the trial.

In addition, all participants received the maximum labeled or tolerated dose of a RAAS blocking agentTrusted Source unless contraindicated or not tolerated which helps control hypertension, acute myocardial infarctionTrusted Source (heart attack), chronic systolic heart failure, stroke, and diabetic renal disease. Participants had a mean age of 66.6 years, 69.7% were men and 65.7% were white. All participants had type 2 diabetes diagnosed, on average, 17.4 years before the start of the trial and chronic kidney disease. The trial was meant to run until the end of 2024 but was stopped early after it reached its primary endpoint. The endpoint is composed of kidney disease progression and cardiovascular and kidney death, and in particular progression to kidney failure and mortality of cardiovascular events. These are frequent in this population of [type 2 diabetes] with [chronic kidney disease], so that we can reduce this by 24% is important and meaningful for patients.

In the announcement, Novo Nordisk stated that the trial had achieved a statistically significant and superior reduction in kidney disease progression as well as cardiovascular and kidney death of 24% for people treated with semaglutide 1.0 mg compared to placebo. There needs to be repeated assessments with different samples of participants across the world. In the real world setting, people behave differently and have other conditions as well. So, we need more effectiveness trials [because] effectiveness trials find how well a medication works [unlike] efficacy trials that measure how well it works in RCT/lab studies. The recently released headline results are impressive, yet we await the presentation and publication of the complete trial results to fully understand the efficacy and safety outcomes of the trial.

Ozempic is not without side effects. While Ozempic (semaglutide) can be effective in managing type 2 diabetes, it’s important to be aware of potential side effects. Like many medications, Ozempic does carry the risk of side effects, some of which can be serious. It’s crucial for individuals to discuss these potential risks with their healthcare providers before starting the medication and to monitor for any adverse reactions while taking it.

REFERENCES:

https://www.medicalnewstoday.com/articles/ozempic-may-delay-kidney-disease-progression-latest-trial-results-show
https://www.healthline.com/health-news/ozempic-cuts-risk-of-kidney-disease-related-events-new-trial-shows
https://health.economictimes.indiatimes.com/news/pharma/pharma-industry/novo-nordisk-ozempic-trial-delays-progression-of-chronic-kidney-disease/108237567?utm_source=top_news&utm_medium=tagListing
https://www.reuters.com/business/healthcare-pharmaceuticals/novo-nordisk-ozempic-trial-delays-progression-chronic-kidney-disease-2024-03-05/

Medications that have been suggested by doctors worldwide are available here
https://mygenericpharmacy.com/index.php?cPath=1_22_846

Diabetes, more especially type 2 diabetes, is emerging as one of the 21st century’s most difficult medical issues. It is also anticipated that 380 million individuals globally will receive a diabetes diagnosis by 2025. Diabetes management and treatment are increasingly important because it is a risk factor for many other diseases and chronic health conditions, including stroke, kidney disease, cardiovascular disease, and blindness, to name a few. However, many people are thought to be in a precursor stage known as prediabetes before they go on to develop type 2 diabetes. People with this illness have blood sugar levels that are higher than normal but not high enough to be classified as type 2 diabetes. However, a significant risk factor for type 2 diabetes is prediabetes. The statistics of those who have prediabetes provide a clear picture when it comes to scaling this issue: more than one in three persons in the U.S. S. along with the U. K. have been identified as prediabetic. Therefore, if prediabetes is considered an early warning sign of type 2 diabetes, people can take  steps to reverse the course of this condition and it is possible to reverse this condition with significant lifestyle changes.

On our May podcast, “In Conversation: Can diet and exercise help reverse prediabetes?” Dr. Thomas Barber, an associate clinical professor at Warwick Medical School and consultant endocrinologist at University Hospitals Coventry and Warwickshire, joined Dr. Hilary Guite and me. Additionally, Healthline Media and Medical News Today Managing Editor Angela Chao shared her personal story of reversing her diagnosis of prediabetes and the lifestyle changes she made to maintain it. In Angela’s instance, few medical professionals would have thought that her blood sugar levels were concerning. She is not thin, young, and energetic like most people with prediabetes or those at risk of getting diabetes. She did, however, admit that at the time she led a fairly sedentary lifestyle. She said that because my readings were so low on the spectrum, I don’t even think my primary care physician at the time talked to me about it beyond providing the range and the diagnosis. She did, however, add that some doctors and her medical friends seemed concerned about the changes to the cutoff point for readings that qualified as prediabetes.

According to Dr. Barber, the diagnosis of diabetes and prediabetes was previously made using fasting glucose readings or a conventional glucose tolerance test. In this test, participants were given 75 grams of a sugar-filled beverage, and their blood sugar levels were monitored for the following two hours. Additionally, the definition of prediabetes is constantly changing and may vary from nation to nation. Definitions vary amongst societies and prestigious organizations. According to Dr. Barber, the first thing to really keep in mind is that there is a continuum involved when discussing diabetes or prediabetes. Should we choose the U. S. along with the U. K. For instance, there are variations in the thresholds and units of measurement applied when diagnosing prediabetes. As you point out, there are various units, which makes it a little confusing. However, in essence, in the U. K. for glucose, we use millimoles per liter, and in the U.S. S. milligrams per deciliter, to be exact. We typically use millimoles per mole in clinical settings now, and we have for a while, according to Dr. Barber. He went on, “I think that further complicating matters is the hemoglobin A1C, which has two different percentage units, one that we have historically used and the other that is now replaced by millimoles per mole.

According to Dr. Barber, glucose is a continuous variable rather than a discrete measure. He clarified that while everyone can agree on what is elevated and what is normal, there are kind of disagreements about everything in between. The World Health Organization approved hemoglobin A1C as a test for diabetes a few years ago. While additional glucose readings can be useful, Dr. Barber stated that medical professionals do primarily rely on A1C in current clinical practice. With regard to prediabetes in the U.S. K. this is predicated on an A1C of 39 to 47 mmol per mol; according to him, 39 is equal to an A1C of 5 points 7 percent. Anything that raises the hemoglobin A1C level above 48 millimoles per mole, or 6.5% of the baseline, is considered diabetes by definition. According to him, in order to diagnose type 2 diabetes, we should ideally have at least two of those readings that are elevated. When Angela was diagnosed, her A1C was 5 points8 percent, and anything above 5 points7 was considered prediabetes. Dr. Barber reminded us that, in the United States, Angela’s readings would not have been regarded as prediabetes and that, in recent years, the diagnostic criteria for diabetes have gradually decreased. K. at the time, since the values were extremely near to normal and not quite below the cut-off.

Usually, prediabetes shows no symptoms at all. On the other hand, some people may occasionally have frequent thirst, wake up in the middle of the night to urinate, experience blood sugar spikes, or have energy crashes. Prediabetes is frequently asymptomatic, so many people who are diagnosed with it may have had it for months or even years. Furthermore, it can easily go unreported unless people are tested for it, according to Dr. Barber. In describing her personal experience, Angela said, “I definitely didn’t have a wide range of symptoms.”. On the other hand, I was definitely already drinking water on a regular basis. I therefore found it difficult to determine whether anything was changing. Low blood sugar, particularly if she went for prolonged periods without eating, was something she did notice prior to the diagnosis. Over the years, she said, there has been a consistent pattern of significant fluctuations in her blood sugar levels, which she could feel physically. She can, however, fast trouble-free for more than 16 hours now because of certain lifestyle adjustments. Sugar surges and falls may be considered preemptive indicators of diabetes.

According to Dr. Dot Barber, prediabetes is a general term that can refer to either elevated fasting glucose or elevated postprandial glucose. Dr. Dot Barber stated that fluctuations in blood sugar levels, or glycemia, were often observed in the context of insulin resistance. Glucose levels tend to rise a little higher than they should, he explained, because the beta cells can’t produce enough insulin, for example, or the insulin isn’t as effective after a meal. He explained that without careful monitoring of blood sugar levels throughout the day, people might not physically notice these changes. “I guess the difference really is that most of the time, in the context of prediabetes, we’re not aware of this,” he said. It makes perfect sense that as you lead a healthier lifestyle, lose weight, and reverse prediabetes, your blood sugar levels will stabilize. He mentioned Angela’s description of the changes she saw and said that the insulin becomes more effective and can handle the fluctuations in glycemia better.

Obesity, having a high body mass index, and being overweight are some of the most well-known risk factors for type 2 diabetes. Additionally, as we age, our vulnerability increases. And the reason for that is that as we age, the beta cells and insulin’s receptors can no longer function as well, and insulin itself becomes slightly less effective. Accordingly, as we age, our chance of having prediabetes and diabetes rises, according to Dr. Barber. Dr. Barber added that eating a diet heavy in high-glycemic foods and sugary drinks, as well as stress, can all raise risk. Conversely, he asserted that a diet low in simple carbohydrates and high in fiber can delay the onset of dysglycemia. Genetics and ethnic origin are other factors to consider. Dr. Dot Barber presented the results of a recent study she and her colleagues carried out in the U. K. which revealed that, at a BMI of 23.9%, individuals of South Asian ethnicity had the same risk of developing diabetes as did white people at 30.

In contrast, Angela’s risk was increased by her family history. My mother, a retired medical doctor, had warned me since I was a teenager about the slight family history of type 2 diabetes on my father’s side. She also mentioned that everyone on that side of the family was thin and had no weight problems. Dr. According to Barber, diabetes is frequently attributed to lifestyle decisions, but many people are unaware that it is a hereditary disorder. According to him, patients with a strong family history may not always exhibit the characteristics of type 2 diabetes, such as being middle-aged, male, obese, and having a large abdomen. That’s the idea that most people with type 2 diabetes have of the typical person. And, he added, as you say, Angela doesn’t conform to any of those stereotypes of what that entails. Dr. Barber also emphasized that having a genetic predisposition to diabetes at birth can result in dysglycemia even in the absence of those other factors. More than 40 genes and gene mutations have been found to increase your risk of developing type 2 diabetes. Additionally, he stated that even though each effect is relatively weak on its own, adding them all together can have a cumulative effect. Through a combination of intermittent fasting, a balanced diet with an increased amount of lower-glycemic index foods and complex carbohydrates, and a sig, Angela was able to reverse her diabetes.

She advised against strict dieting, keto, and quick, drastic changes that aren’t long-term. Dr. Barber acknowledged that while this approach obviously worked for Angela, not many people would be able to make such drastic life changes and may find it challenging. According to Dr. Barber, there is evidence to suggest that intensive lifestyle treatments that prioritize diet, physical activity, weight loss, and other related factors can effectively prevent or postpone the onset of type 2 diabetes. In my opinion, it serves as a kind of early warning system that indicates when a person needs to make a lifestyle change. He added that it must be beneficial if it inspires or motivates people to alter their way of life.

REFERENCES:

https://www.medicalnewstoday.com/articles/in-conversation-can-diet-and-exercise-reverse-prediabetes?utm_source=ReadNext
https://www.hopkinsmedicine.org/health/wellness-and-prevention/prediabetes-diet
https://www.healthline.com/health/diabetes/how-to-reverse-prediabetes-naturally
https://www.healthcentral.com/condition/type-2-diabetes/how-can-you-reverse-prediabetes
https://www.breathewellbeing.in/blog/reverse-your-prediabetes-with-the-best-diet-and-exercise/

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According to research, adults with chronic conditions can exercise more effectively when they participate in aquatic high-intensity interval training (AHIIT). They observed that AHIIT had an effect comparable to that of land-based training (LBHIIT) and that it might be a useful and safe substitute for those with long-term medical conditions who are unable to engage in land-based exercise. Although there is conflicting data regarding the physiological benefits of exercising in the water, experts agree that it can help reduce joint strain and enable individuals to perform movements that they may not be able to on dry land. For those with long-term medical conditions who find land-based training too challenging, researchers have a message. Come on in. The water is clear. Currently available in the BMJ Open Sport and Exercise Medicine journal. According to the study, adults with chronic conditions like diabetes and arthritis can exercise more effectively when they participate in high-intensity interval training (AHIIT), which is conducted in water. Additionally, the researchers claim that AHIIT has an effect comparable to that of land-based training (LBHIIT) and that it could be a beneficial and safe substitute for LBHIIT for those with long-term medical conditions. Dr. Sports medicine expert Mark Slabaugh of Mercy Medical Center in Baltimore told Medical News Today that exercising in the water has obvious advantages for those with chronic pain, arthritis, and tendinitis.

Salbaugh, who was not involved in the study, said, “This study gives us as clinicians even more options for patients who are interested in cross training and doing HIIT workouts but can not due to joint pain.”. “I advise my patients to begin with these brief AHIIT sessions and work their way up to longer swimming sessions, as swimming is a sport that can be continued well into old age. The study team examined 18 trials to compare the effects of AHIIT and LBHIIT on participants’ ability to exercise (as determined by oxygen consumption, walking tests, and other physical fitness assessments). Additionally, they contrasted AHIIT with a control group that did not exercise and moderate-intensity exercise in water (AMICT). Using the widely accepted GRADE system, the researchers evaluated the degree of certainty in the evidence. They examined 868 participants with a variety of illnesses, including multiple sclerosis, back pain, arthritis, type 2 diabetes, and chronic lung disease (COPD), with 74% of the participants being female. A few individuals were dealing with multiple chronic illnesses. Standardized mean differences (SMD) were used in the study to represent group differences. A small effect was indicated by an SMD of 0.2-0.49, a moderate effect by 0.5-0.79, and a large effect by 0.8 or more.

According to the study, AHIIT had a minor positive impact when compared to AMICT (SMD 0.45) and a moderately positive impact when compared to no exercise (SMD 0.78). Furthermore, there was no discernible difference in the exercise capacity between LBHIIT and AHIIT. Compared to LBHIIT, fewer adverse events were reported with AHIIT. The range of 84 percent to 100 percent was the adherence rate for AHIIT. Physical therapist Sydnee Corbin is also the clinic director of SporTherapy in Texas, where therapy is conducted in a swimming pool. Water-based therapy, according to Corbin, who was not involved in the study, helps people with conditions like osteoarthritis, balance issues, sensory processing disorders, generalized weakness/deconditioning, and post-operative patients by offloading joints while increasing resistance. According to Corbin, “the pool is a great opportunity to provide resistance and sensory feedback—a unique property that is difficult to replicate on land.”. Reaching a patient population that would otherwise be sedentary or inactive can be greatly facilitated by an aquatic setting. “.

According to Corbin, individuals who suffer from osteoarthritis, persistent low back pain, or other long-term medical conditions might not be able to fully engage in LBHIIT and reap the full benefits of HIIT. “By introducing AHIIT, we can decrease further health risks to those populations and be more inclusive to them,” the speaker stated. In addition to offloading joints, the aquatic environment gives users’ systems sensory input that might otherwise be sensitized due to chronic pain, constant resistance from the water, and, if done in a heated pool, the ability to relax otherwise painful muscles and joints. “Mr. Medical News Today was informed by William Ashford, an orthopedic surgeon at AICA Orthopedics in Atlanta who was not involved in the study, that AHIIT presents a highly effective treatment modality, especially for individuals with musculoskeletal conditions like chronic back pain and arthritis. According to Ashford, the buoyancy of the water minimizes joint stress and offers a natural resistance, enabling people to engage in exercises that would be too painful or impractical on land. Additionally, Ashford noted that the cardiovascular benefits of HIIT are well-established, and applying this knowledge to an aquatic setting appears to enhance these benefits for some populations. According to Ashford, maintaining an exercise routine is essential to managing chronic illnesses.

Water exercise has its limitations as well. “Although beneficial for numerous individuals, it may not be appropriate for all patients, particularly those with specific chronic lung conditions, as the water pressure may cause difficulties in breathing,” stated Ashford. Also, some patients may find it difficult to get to the right facilities. Having said that, Ashford recommended further study to find strategies for expanding the reach of water-based therapy. “AHIIT is a highly effective, flexible, and patient-centered method for treating a range of chronic illnesses,” the speaker stated. The benefits of HIIT are combined with the special qualities of water to create a synergistic effect that can be especially helpful for patients who have trouble with land-based exercises. “.

REFERENCES:

https://www.diabetes.org.uk/guide-to-diabetes/managing-your-diabetes/exercise/swimming-diabetes
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3347725/
https://www.swimming.org/justswim/diabetes-and-swimming/
https://www.medicalnewstoday.com/articles/how-high-intensity-water-exercise-can-help-people-with-diabetes-and-other-conditions

For diabetics medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=77_95

According to recent studies, insulin does not lose its efficacy even when kept out of the refrigerator for several months. Insulin can be maintained at room temperature, according to guidelines already in place, but the new information provides further detail on acceptable temperature ranges. Insulin must be kept out of direct sunlight and kept at or above 25°C (77°F) or below freezing for optimal effects. For those with type 1 diabetes who are unable to consistently refrigerate their insulin, new research reveals that insulin can be kept at room temperature for months and still maintain its efficacy.

In a recent review, the Cochrane Collaboration examined the effects of various temperatures on insulin and discovered that unopened containers of some human insulin types could be kept at 77°F, or 25°C, for up to six months without significantly losing potency. The information affects both individuals without refrigerators and those whose refrigerators may not be dependable. Richter points out that some refrigerator pockets truly get too cold below freezingwhich reduces the effectiveness of any insulin that may be kept there.

It is possible to maintain the efficacy of insulin if it is not refrigerated and is stored outside. Richter advises avoiding direct sunlight and letting it grow too hot or too chilly. Insulin that hasn’t been opened should normally be stored in refrigerators at 4°C (39°F), whereas insulin that is being used should be left at room temperature. Richter noted that the new data from our research indicated that insulin could be administered for longer periods of time and at greater temperatures without significantly reducing activity in those living in challenging settings.

According to him, the results have raised new issues that might be the subject of further investigation, such as examining the impacts of both motion and temperature. According to him, “people who use insulin pumps, for instance, wear them close to their bodies, which causes a higher temperature, and they’re more or less continuously moving.” We also seek information on how people who live in cold climates keep their insulin from freezing. Individuals with type 1 diabetes are well aware of the urgent necessity of insulin. Insulin is a dependable and efficient treatment for type 1 diabetes since it lowers blood glucose in those whose systems are unable to manage glucose on their own.

It is imperative for physicians to inform their patients about the warning signs and symptoms of hypoglycemia reactions. For this reason, he said, it’s imperative that you constantly remind your patients that they must eat in order for their bodies to absorb glucose and that they should always carry a glucose tablet. Dr. Romain mentioned that he treats patients from a low-income community, which can make it difficult for them to get insulin.

For the patient, it might be quite difficult, especially if they don’t have insurance. I make an effort to learn about my patients’ daily lives because many people are unaware of the seriousness of type 1 diabetes. He stated that it is important to consider the potential for serious problems. Knowing what foods to eat and how much exercise is necessary since diabetes, whether type 1 or not, can induce myocardial infarction, which is the main cause of death for diabetics. Dr. Romain continued, “It all comes down to teaching the patient how critical it is to get the illness under control so we can avoid those consequences from developing.

REFERENCES:

https://www.cochrane.org/news/human-insulin-less-temperature-sensitive-previously-thought
https://www.healthline.com/health-news/safe-insulin-storage-room-temperature
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD015385.pub2/full

For diabetes medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?cPath=77_95

The higher risk of death linked to a sedentary lifestyle can be eliminated with about 22 minutes of moderate to intense physical activity every day, according to a recent study. People’s risk of dying reduces more the more they exercise. The results of the study demonstrate that regular exercise can be done in one sitting or in smaller bursts during the day. Contrary to popular belief, a recent study indicates that much less exercise can lower a person’s risk of death. The study discovers that a sedentary lifestyle can lower one’s chance of dying young by as much as 22 minutes per day of moderate to vigorous physical activity (MVPA).

Naturally, the benefits of exercise are dose-dependent, meaning that, up to a certain degree, the more activity, the lower the risk of mortality. 11,989 participants in multiple fitness-tracker studies—the Swedish Healthy Aging Initiative, the Norwegian National Physical Activity Survey, the Norwegian Tromso Study, and the U.S. National Health and Nutrition Examination Survey—were monitored by the study’s authors. Every participant in the studies, who was at least fifty years old, gave the researchers information about their height, weight, sex, education, alcohol and smoking habits, and history of diabetes, heart disease, or cancer. 6,042 people sat for 10.5 hours or more every day, compared to 5,943 participants who sat for less than that amount. The purpose of the study was to evaluate the impact of physical activity and inactive time on mortality risk as determined by death registries. If an individual does not exercise for more than 22 minutes per day, sitting for more than 12 hours per day is linked to a 38% higher risk of death than sitting for 8 hours.

A minimum of 75 minutes of intense activity, 150–300 minutes of moderate–to–vigorous exercise per week, or a combination of both is advised by the World Health Organization (WHO).

The first author of the study, Dr. Edvard H. Sagelv of UiT The Arctic University of Norway in Tromso, stated: “There is some disagreement in the research community regarding the dangers of prolonged periods of inactivity. Sedentary time is not that harmful when compared to not exercising, in my opinion. He continued, “Yet prior research suggests that prolonged periods of inactivity are elevating the likelihood of illness and untimely demise.”

“Our legs and core muscles will weaken if we’re not using them, which will make it harder for us to walk a little distance, which will decrease our desire to be active,” she continued. Additionally, this raises the possibility of falling, which increases our risk of injuries that further discourage us from engaging in physical activity. “Keep in mind that the heart is a muscle,” Dr. Zaslow advised. She pointed out that the cardiac muscle weakens with less activity, making physical activity much more difficult as the heart must be reconditioned. According to Dr. Zaslow, cardiometabolic illness has been linked to sedentary lifestyles.

Dr. Melody Ding, who was not involved in the study, stated that although the study is focused on older adults, physical activity is known to give a range of advantages, including mental health, cardiometabolic profiles, and cognitive functioning. Dr. Ding stated, “There are good reasons to be active throughout your lifespan.” Dr. Zaslow made the point that exercise is necessary for even young children to develop and strengthen their muscles since it prepares them for a lifetime of physical activity. Furthermore, physical activity is linked to improved mental health, including a decrease in anxiety and depression. This is still another significant advantage, according to Dr. Zaslow, considering the highly publicized mental health issue among youth.

She said that exercise helps people sleep better as well, making it easier to fall asleep and stay asleep longer. “We are aware that injury rates are lower when we get better sleep. Thus, research indicates that children who get more than eight hours of sleep have 50% fewer injuries. “I consider exercise and exercising consistently to be like an upward spiral,” Dr. Zaslow remarked. Dr. Sagelv emphasized that the study’s 22 minutes of daily physical exercise equates to the 150 minutes that the WHO recommends. According to our research, people who engage in moderate-to-intense physical exercise for longer than 22 minutes a day do not have a higher risk of dying from being inactive for longer. This runs counter to the WHO’s guideline, according to him, to deal with high sedentary time that cannot be avoided by consuming more than 150–300 minutes of MVPA each week.

It doesn’t seem to have an upper limit at which it stops being beneficial to health. The risk decrease does however, seem to level off at the higher ends, roughly 60–120 minutes per day, especially for people who are extremely sedentary.” It’s also not necessary for people to engage in 22 minutes of action all at once every day, as per Dr. Zaslow and earlier studies. Taking ten or fifteen minutes here and there to engage in “exercise snacking” may be a more manageable task for individuals with hectic schedules. It’s crucial to keep in mind that, from the standpoint of public health, performing any MVPA is preferable to performing none at all. Dr. Ding stated that it is better to exert a little bit more effort even if one is unable to meet the goal.

REFERENCES:

https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/exercising-just-for-20-25-minutes-can-prevent-death-risk-due-to-prolonged-sitting/articleshow/104784810.cms?from=mdr
https://www.medicalnewstoday.com/articles/daily-20-25-mins-of-physical-activity-may-offset-death-risk-from-prolonged-sitting
https://www.bmj.com/company/newsroom/daily-20-25-mins-of-physical-activity-may-offset-death-risk-from-prolonged-sitting/

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Prior to developing into type 2 diabetes, prediabetes raises the risk of heart attack, kidney, eye, and other cancers. There isn’t a recognized pharmacological therapy for prediabetes at the moment. Researchers at the German Center for Diabetes Research (DZD) have now demonstrated the mechanisms by which prediabetes can be put into remission, or a condition in which blood glucose levels return to normal. The DZD multicenter trial further demonstrates that long-term improvement in renal and vascular function is linked to long-term protection against type 2 diabetes and prediabetes remission. The researchers write in The Lancet diabetic & Endocrinology that it’s interesting because the underlying mechanisms are distinct from those in type 2 diabetic remission.

People with type 2 diabetes are more likely to experience heart attacks, renal problems, strokes, and death. Up until a few years ago, type 2 diabetes was believed to be untreatable. We now understand that significant weight loss can significantly reduce the risk of type 2 diabetes in a large number of people. The majority of people often develop type 2 diabetes once more within a few years, therefore this remission rarely lasts. Due to their higher risk of developing type 2 diabetes as well as issues with the heart, kidneys, and eyes, among other things, people with prediabetes may need to know this.

But what triggers the remission of prediabetes? In order to answer this query, researchers from the Department of Diabetology, Endocrinology, and Nephrology at the University Hospital of Tübingen and the Institute of Diabetes Research and Metabolic Diseases (IDM) at Helmholtz Munich performed a post-hoc analysis on participants with prediabetes from the Prediabetes Lifestyle Intervention Study (PLIS).

In a one-year lifestyle intervention involving a balanced diet and more exercise, 1,105 people with prediabetes participated in this randomized-controlled multicenter trial run by the DZD. The 298 participants who had lost at least 5% of their body weight as a result of the intervention were next evaluated by the researchers. Participants who had responded were those whose fasting, 2-hour, and HbA1c levels had returned to normal after a year, indicating that they had entered remission. Non-responders were people who lost weight but still had prediabetes and did not go into remission.

Contrary to what the researchers had hypothesized, there was no difference in relative weight loss between responders and non-responders, indicating that it was not weight loss that separated those who entered remission from those who did not. Individuals who were able to attain remission, as opposed to non-responders, showed a noticeable improvement in insulin sensitivity. In essence, they were better able to increase their sensitivity to the hormone insulin, which decreases blood glucose levels, than those who did not respond. The amount of insulin secreted did not change in either group, though. This distinction is important since type 2 diabetes remission mostly rely on increased insulin secretion.

The researchers compared the two groups in order to pinpoint the reason behind responders’ elevated insulin sensitivity. Despite reducing the same amount of body weight, the responders had reduced their abdomen fat more than the non-responders. The intestines are encircled by visceral abdominal fat, which is situated inside the abdominal cavity. An inflammatory response in adipose tissue is partly responsible for its effect on insulin sensitivity.

In fact, those subjects who achieved remission also had lower blood levels of inflammatory proteins. “Since the responders showed a reduction in abdominal fat in particular, it will be important in the future to identify the factors that promote the loss of this fat depot,” says Arvid Sandforth, one of the two primary authors. Surprisingly, the reduction of liver fat, which is a significant risk factor for the onset of diabetes, did not differ between the two groups. Even two years after the conclusion of the lifestyle intervention, the chance of acquiring type 2 diabetes was reduced by 73% in those who achieved remission. Additionally, they displayed fewer indicators of renal injury and improved blood vessel health.

To delay the emergence of type 2 diabetes, prediabetes is currently treated with weight loss and lifestyle changes, but without glucose-based objectives to direct the treatment process. The new analysis from the DZD closes this gap: Remission should be the new therapeutic goal for persons with prediabetes, according to the newly available evidence. According to co-first author Prof. Dr. Reiner Jumpertz-von Schwartzenberg, this could alter treatment strategies and reduce the risk of complications for our patients.The study found that remission in prediabetes is defined as a fasting blood glucose level of less than 100 mg/dl (5.6 mmol/l), a 2-hour glucose level of less than 140 mg/dl (7.8 mmol/l), and a HbA1c level of less than 5.7 percent. When body weight is decreased and waist circumference shrinks by at least 4 cm in women and 7 cm in men, the likelihood of remission rises. According to researchers, these characteristics can now be applied as biomarkers.

REFERENCES:

https://www.medicalnewstoday.com/articles/reducing-abdominal-fat-may-help-reverse-prediabetes
https://www.news-medical.net/news/20230927/Loss-of-abdominal-fat-may-be-key-to-reversing-prediabetes.aspx
https://www.verywellhealth.com/weight-loss-reverse-type-2-diabetes-6670449

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Type 2 diabetes develops when the body is unable to control blood sugar levels, typically because insulin, the hormone that regulates blood glucose, is no longer being properly reacted to by the body. Type 2 diabetes can cause high blood pressure, cardiovascular illness, nerve damage, eyesight loss, and kidney damage if it is not well managed.

The greatest strategy to prevent type 2 diabetes and, in conjunction with medicine, to manage its symptoms is through lifestyle changes. Doctors advise regular exercise, maintaining a healthy body mass index, and following a heart-healthy diet that includes lots of fresh vegetables, whole grains, protein, and heart-healthy fats.

Type 2 diabetes, whose incidence is rising globally, is a serious health concern.

Type 2 diabetes is closely linked to aging, being overweight, and obesity. It is largely brought on by bad diets and lifestyles.

Changes in lifestyle, such as more exercise and a healthy diet, can lower the risk of type 2 diabetes.

A recent study also suggests that frequent tea consumption may help to control blood sugar levels and lower the risk of diabetes.

An observational study from China now reveals that those who frequently consume tea, especially dark tea, may lower their insulin resistance and improve their blood glucose levels, which lowers the risk of type 2 diabetes.

Regular tea drinkers have better blood glucose control

The study included 562 men and 1,361 women, aged 20 to 80, from eight Chinese provinces. A total of 1,135 of them had normal blood sugar levels, 436 of them had diabetes, 352 had prediabetes.

1,000 of the 1,923 participants regularly drank tea. They drank a variety of teas: 300 said they drank green tea, 125 said they drank black tea, 521 said they drank dark tea, and 54 said they drank other kinds. Everyone drank their tea devoid of milk and sugar.

The morning spot urine glucose-to-creatine ratio (UGCR), a measure of the excretion of glucose in the urine, was used by the researchers to investigate for any correlation between the frequency and type of tea drinking and excretion of glucose in the urine. In addition, they assessed insulin resistance and noted any glycemic abnormalities (such as past or present type 2 diabetes, usage of anti-diabetic drugs, or an abnormal 75g oral glucose tolerance test).

They discovered that daily tea drinkers had less insulin resistance and excreted more glucose in their urine. In comparison to people who never drank tea, they also had a 28% lower risk of type 2 diabetes and a 28% lower risk of prediabetes.

Greater advantages of dark tea

People who consumed dark tea, a particular variety of tea that contains a fermentation process involving microbes, were more susceptible to the effects.

Dark teas include Ripen Pu-erh tea, Qingzhuan brick tea, Kangzhuan brick tea, and Liubao tea.

Black tea versus fermented tea for diabetes

The authors concur that because this research was observational, it cannot conclusively show that tea consumption enhances blood sugar regulation. But Dr. Wu did offer an explanation for why it might have this effect:

“These findings suggest that the actions of bioactive compounds in dark tea may directly or indirectly modulate glucose excretion in the kidneys, an effect, to some extent, mimicking that of sodium-glucose co-transporter-2 (SGLT2), a new anti-diabetic drug class that is not only effective at preventing and treating type 2 diabetes but also has a substantial protective effects on the heart and kidneys.”

Dr. Wu informed MNT that the research team is preparing additional investigations:

Our team is conducting a double-blind, randomized experiment to examine the therapeutic benefits of routine drinking of microbial fermented tea vs. black tea on glycemic management in individuals with type 2 diabetes, with results expected in 2024.

As Dr. Inogong stated to MNT, “It would be interesting to see if these results could be reproduced in larger populations around the world, and if the association still holds, to then study any potential mechanisms by which dark tea impacts glucose regulation.” This could be a helpful step to try and confirm their findings. “[Dark tea] would be a wonderful natural supplement to consider in a treatment plan for those at risk for or who have established type 2 diabetes, if a mechanism is discovered.” Dr. Sue Inonog.

More proof of the health advantages of tea

Tea has long been believed to be healthy, and now scientific study is beginning to support those beliefs. Black and green tea contain polyphenols, which have been demonstrated to have anti-aging effects, cardiovascular advantages, and may even help prevent some cancers. According to the most recent study, reducing the risk of diabetes could be added to that list. Unless you consume excessive amounts, there is little evidence that drinking tea is harmful to your health. According to the current study, consuming a cup of tea each day may help keep blood glucose levels within a healthy range.

REFERENCES:

https://www.medicalnewstoday.com/articles/could-drinking-tea-every-day-reduce-type-2-diabetes-risk
https://www.everydayhealth.com/type-2-diabetes/drinking-tea-tied-to-lower-risk-of-type-2-diabetes/
https://www.thenationalnews.com/health/2023/10/02/drinking-dark-tea-every-day-may-reduce-risk-of-type-2-diabetes/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2669862/

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