A graphene patch that monitors and possibly treats diabetes

Diabetes is growing into a global public health crisis, one that places enormous economic burdens on many nations. Once thought of as a disease that typically strikes affluent adults, type 2 diabetes has quickly spread all over the world, indifferent to socioeconomic status or age.

Treatment of type 2 diabetes requires patients to control their blood sugar levels through a mix of dietary restrictions and medication. Unfortunately, following the progress of these efforts is not as easy as it sounds. Glucose-monitoring devices available on the market typically require the user to obtain a small blood sample that can be read to quantify the level of the sugar. A minimally or non-invasive alternative would probably help many patients stay on top of their health.

 

Register your team for Walkerz Against Diabetes

Pictured are the walk committee, from left, Eloy Cuevas, Watermill Express; Stacy Morgan Mora, Tamez and Ortegon Law Office; Nancy Garcia, Doctors Hospital at Renaissance and RGVDA Board Member; Alma Cortez, Walmart.; Melissa Martinez, Navy Army Community Credit Union. Not shown; AJ Garcia and Sofia Hernandez, Doctors Hospital at Renaissance.

Pictured are the walk committee, from left, Eloy Cuevas, Watermill Express; Stacy Morgan Mora, Tamez and Ortegon Law Office; Nancy Garcia, Doctors Hospital at Renaissance and RGVDA Board Member; Alma Cortez, Walmart.; Melissa Martinez, Navy Army Community Credit Union. Not shown; AJ Garcia and So…

Pictured are the walk committee, from left, Eloy Cuevas, Watermill Express; Stacy Morgan Mora, Tamez and Ortegon Law Office; Nancy Garcia, Doctors Hospital at Renaissance and RGVDA Board Member; Alma Cortez, Walmart.; Melissa Martinez, Navy Army Community Credit Union. Not shown; AJ Garcia and Sofia Hernandez, Doctors Hospital at Renaissance.



Posted: Sunday, March 27, 2016 3:00 pm

Register your team for Walkerz Against Diabetes

Special to the Monitor

The Monitor

The Rio Grande Valley Diabetes Association “Walkerz Against Diabetes” committee member are busy signing up teams of the upcoming 5k walk/run. This fun filled event will be held Saturday, April 30, at Edinburg Municipal Park in Edinburg.

Registration for the 5k walk/run begins at 7:30 a.m. Along with our awareness walk/run, the RGVDA is hosting health screenings, such as blood glucose check, foot screening, eye screening, as well as general diabetes information.

If you are interested in supporting the RGVDA and its cause we are in need of teams and/or individual walkers as well. Teams consist of 10 individuals or more, each team member or individual participate are asked to donate $25, with will include the official Walkerz Against Diabetes T-shirt. All proceeds will go to maintain the free services RGVDA offers for the residents of the Rio Grande Valley.

We encourage all walkers and runners to support the RGVDA while we promote the importance of physical activity as an essential part of a healthy lifestyle; whether it is to manage your diabetes or to prevent the onset of diabetes. If you are just starting an exercise regime or are an experienced runner we ask that you come out and show your support as well as bring awareness to a health epidemic that is growing in the Rio Grande Valley at unprecedented rates. One out of every four individuals has diabetes in the Rio Grande Valley, and many more are at risk. Exercise along with a healthy diet is vital in the prevention of Type 2 iabetes.

The RGVDA is a local non-profit organization, founded in 2006 by area professionals in order to bring awareness on this a growing health epidemic to one of the hardest hits areas in the country-Hidalgo County. All the funds generated by the RGVDA stay in the Rio Grande Valley to be used exclusively for educational purposes providing not only awareness but also, diabetic management classes, in school presentations, support groups among other services for adults and children.

The RGVDA would like to thank all its sponsors of Walkerz Against Diabetes; Walmart, Channel 5, Navy Army Community Credit Union, Rudy’s Country Store BBQ, Taco Palenque, Watermill Express.

For more information on Walkerz Against Diabetes or the RGVDA, call the RGVDA office at (956) 782-1900.

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Sunday, March 27, 2016 3:00 pm.

Atom-Thin Patch Could Help Control Diabetes–without Needles

A wearable, graphene-based patch could one day maintain healthy blood glucose levels in people by measuring the sugar in sweat and then delivering the necessary dose of a diabetes drug through the skin (Nat. Nanotech. 2016, DOI: 10.1038/nnano.2016.38).

The device takes scientists a step closer to the “coveted prize” in diabetes care: a noninvasive method to monitor and control blood glucose levels, writes Richard Guy of the University of Bath in a commentary about the new work.

Currently, most diabetic patients keep track of their blood glucose levels by pricking their fingers and testing a resulting droplet of blood. For people who must monitor their levels regularly, this can be a literal pain. “There are a lot of people who don’t like sticking things in their skin,” Guy says.

About 15 years ago, the Food Drug Administration approved a noninvasive glucose-monitoring device called the GlucoWatch Biographer. Patients wore it on their wrists, and it extracted glucose from interstitial fluid in the skin using a small current. It didn’t catch on, in part because it wasn’t user friendly, Guy tells CEN.

For the new patch, the researchers, led by Dae-Hyeong Kim of Seoul National University, decided to detect glucose in sweat because previous studies had shown that levels of the sugar in perspiration match those in blood. Other groups have also developed devices that can analyze biomolecules in sweat (CEN, Feb. 1, 2016, page 11).

The new device uses layers of the fluoropolymer Nafion to absorb sweat and carry it toward the device’s sensors, which are built on modified graphene. The team doped the graphene with gold atoms and functionalized it with electrochemically active materials to enable reactions needed to detect glucose.

In the patch’s glucose sensors, the enzyme glucose oxidase reacts with the sugar and produces hydrogen peroxide, which, through an electrochemical reaction, extracts current from the doped graphene. This produces an electrical signal proportional to the amount of glucose present. The patch also contains pH and temperature sensors that help ensure that the glucose sensor’s signals accurately reflect the sugar’s concentration in sweat.

When two healthy volunteers wore the patch, the measured glucose levels—including spikes after meals—matched those from a commercial glucose meter. To monitor the levels, the patch sent its sensor signals to a device that analyzed them and then wirelessly relayed the data to a smartphone.

The drug delivery half of the patch consists of an array of 1-mm-tall polymer microneedles that pierce the skin. Each needle is made from a mixture of the diabetes drug metformin and a dissolvable polymer, polyvinyl pyrrolidone. And the needles are coated with a layer of tridecanoic acid. A gold and graphene mesh sits on top of the needle array and serves as a heater that can melt the coatings. Once the tridecanoic acid melts, the needle dissolves in the skin and releases its drug payload.

When researchers applied just the drug-delivery component to the stomachs of diabetic mice, they could deliver enough metformin to lower the animal’s elevated blood glucose levels by more than 50% in 6 hours.

Guy thinks the sensor portion of the patch is closer to real-world use than the drug-delivery component. To make the drug-delivery system practical, he says, the researchers must make the microneedle array as small as possible. That means they must find a drug that’s effective at low doses.

As for the glucose-detection half of the device, Guy wonders how often a user would have to calibrate the sensors to ensure accurate readings.

Still, he calls the patch an impressive proof of concept.

This article is reproduced with permission from Chemical Engineering News (© American Chemical Society). The article was first published on March 24, 2016.

Dr. Phil on Type 2 diabetes: I should have talked about it before

Dr. Phil McGraw is known for doling out advice on mental health on his talk show, but now the daytime host is also focusing on physical health with his new campaign about managing Type 2 diabetes.

Though the TV personality has struggled with Type 2 diabetes for more than two decades, he only recently decided to open up and talk in-depth about his personal experience living with the disease.

Why did you decide to partner with AstraZeneca to talk about Type 2 diabetes?

This is a real passion project for me. We’re talking about Type 2 diabetes and that was something I was diagnosed with over 25 years ago, and so I’ve been managing this disease for a long, long time. This is one of those diseases that has a real stigma to it because people judge that population as being lazy and out of shape and not taking care of themselves. When you talk to that population, they struggle with feeling judged, so I welcome the opportunity to deal with all of that.

Tell me about how it’s been for you to live with Type 2 diabetes.

A lot of people didn’t know what was going on with me. There are 28 million people in America that are diagnosed with Type 2 diabetes and another 86 million that are estimated to be at risk. That number is probably way low. I was one of those people that didn’t know I had it.

When I went to the doctor, it was because I was really having trouble losing weight no matter what I did, and I was having huge fluctuations in energy. They said you have Type 2 diabetes and your blood sugar is really out of control. I was not at all happy to be told I had a disease, but on the other hand, I was glad to finally have an answer.

What is the project you’re working on to raise awareness about Type 2 diabetes?

AstraZeneca was really interested in working with me to talk about dealing with how to manage diabetes because I deal with the psychological aspects of it. The disease is not curable and it’s not going away, so I’m going to focus on what now? What do you do with it now? They were completely willing and interested to say, “Let’s be responsible corporate citizens and help people understand how to manage this,” so we did this really exciting campaign called the On It campaign. It lives on OnItMovement.com, and I have put together six steps that I think cut across managing the disease for all Type 2 diabetes.

The six steps are very doable. You don’t have to be rich or have every resource at your fingertips. The first is what I talked about before: Move forward and get past the shame and judgment about Type 2 diabetes because it’s not your fault. Get educated and understand what this disease is all about. There’s lots more info on the website.

You’re known for covering health on your show. Why did you wait until now to talk more openly about your struggle with diabetes?

I’ve talked about it before, but I never focused on it. Frankly, I should have. I never put together and organized a plan or call to action for people. I should have. I just wasn’t putting enough emphasis on it, but I am now and I’m glad that I am.

You have an app, Doctor on Demand. How do people use it?

It’s a telemedicine app. It’s something that allows you to use your smartphone, laptop or desktop to get information with a board-certified physician, usually with the wait time of under 45 seconds. You don’t have to sit in a waiting room where everybody’s sick — if you weren’t sick, you’ll get sick before you leave — and it’s been an amazing, disruptive force in medicine. It’s a highly efficient way to get healthcare and I suspect the more you accessible you make healthcare, the more you’ll see a dent in these 86 million people who are at risk for diabetes.

Phife Dawg’s Death a Reminder to Take Diabetes Seriously




The death at 45 of Malik “Phife Dawg” Taylor of A Tribe Called Quest shines a glaring spotlight on blacks’ vulnerability to diabetes, the condition he battled for decades, and which ultimately claimed his life.

African American adults are “80 percent more likely” than white adults to have been diagnosed with diabetes, according to the US Department of Health and Human Services, which also found in 2013 that African Americans were twice as likely as to die from the disease.

Black celebrities reported to have the condition include Blackish star Anthony Anderson; singer, Patti LaBelle; actress Sherri Shepherd; former American Idol judge Randy Jackson; Queen of Soul Aretha Franklin; Grammy winner Chaka Khan; entrepreneur Damon Dash; NBA legend Dominique Wilkins; and actress and former Miss America Vanessa Williams. Eating healthy, getting fit, taking proper medications, tracking glucose levels, and getting a twice yearly A1c test to track glucose levels over time are believed to be among the best ways to control the disease.

Taylor made his long-running battle with Type 2 diabetes public in the 1993 song “Oh My God,” rapping, “When’s the last time you heard a funky diabetic?” His condition was aggravated, by an uncontrolled sweet tooth, he admitted in Beats, Rhymes and Life, a 2011 documentary about the history of Tribe, where Taylor said: “Like straight-up drugs. I’m just addicted to sugar.”

Unchecked, diabetes can lead to dire health outcomes, including blindness, limb amputation, and kidney failure. The disease was a primary cause of kidney failure in 44 percent of new cases in 2011, with blacks suffering from kidney failure at a rate three times higher than whites.

Taylor’s condition worsened to the point that he received a kidney transplant from his wife in 2008, while still in his 30s. An All Hip Hop article from that year reported that Taylor was first diagnosed with diabetes in 1990, and went on dialysis in 2000, during which time he had difficulty performing and dropped considerable weight.

It’s a strain on me as far as going where I want to go, doing what I want to do,” he told Diabetes Forecast. “When I was on dialysis the first time, my stepson was playing basketball [and] I couldn’t practice with him. I wanted to go out and run with him and things of that nature, but I didn’t feel good.”

Though his prospects appeared to look up with the new kidney, four years later he was reportedly back on the waiting list for yet another one, and then on March 22 he succumbed to complications from diabetes.

RELATED: Cedric the Entertainer ‘Steps On Up’ for Diabetes Campaign

Taylor initially formed A Tribe Called Quest with high school classmate Q-Tip in 1985. The group later grew with the addition of Jarobi White and Ali Shaheed Muhammad, releasing five albums together between 1990 and 1998, and in 2015 reissuing their debut, People’s Instinctive Travels And The Paths Of Rhythm to mark its 25th anniversary. They also reunited on The Tonight Show With Jimmy Fallon to perform that album’s chart topping single, “Can I Kick It?”


Diabetes affects how your body uses blood sugar, a source of fuel for the cells in muscles, tissues and the brain. People with diabetes have a glut of glucose in their blood. Type 1 is considered to be a more severe form of the disease, where the person is dependent upon insulin to control it. It’s sometimes called “juvenile” diabetes, because it typically develops during childhood or teen years. The most common form, Type 2, is non-insulin dependent diabetes, and usually develops after 35. While those who have it are able to produce some of their own insulin, it’s usually not enough. Often, Type 2 occurs in people who are overweight and/or sedentary. There’s also prediabetes, where blood sugar is high, but hasn’t yet developed into type 2 diabetes, and gestational diabetes, which can occur during a pregnancy.


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HHS Says Diabetes Prevention Program Will Save Medicare Money

There's been considerable debate as to whether identifying people with prediabetes could have health benefits.i

There’s been considerable debate as to whether identifying people with prediabetes could have health benefits.

iStockphoto


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There's been considerable debate as to whether identifying people with prediabetes could have health benefits.

There’s been considerable debate as to whether identifying people with prediabetes could have health benefits.

iStockphoto

A diabetes prevention program being tested by the YMCA of the USA has proven successful at reducing the risk of developing the disease, according to the Department of Health and Human Services.

So the Obama administration wants Medicare to pay for the services for beneficiaries at high risk of developing diabetes.

The program “improves health care quality while reducing health care costs,” HHS Secretary Sylvia Burwell said at a press conference at the Anthony Bowen YMCA branch in Washington, D.C., on Wednesday. “We found that the enrollees lost about 5 percent of their body weight, enough to substantially cut their risk of the disease.”

One of every three Medicare dollars is spent on patients with diabetes, according to HHS, and the prevention effort saved Medicare about $2,650 per participant over 15 months. That’s more than the cost of the preventive program.

The program was developed with an $11.8 million innovation grant under the Affordable Care Act and piloted at YMCA centers across the country. The goal was to work with people with prediabetes, which is characterized by risk factors including higher-than-normal blood sugar, obesity and a sedentary lifestyle, to prevent the condition from progressing to full-on diabetes.

Participants met with a lifestyle coach each week and learned about diabetes risks, healthy eating and the value of increased exercise. The YMCA says the 42,000 participants in 45 states lost an average of 5.5 percent of their body weight after one year.

It’s the first program to meet requirements under the Affordable Care Act to gain Medicare coverage, HHS says, including undergoing an independent audit to confirm that it’s effective and saves money. HHS will propose rules this summer that would allow Medicare to pay for the preventive services.

“Expanding Medicare coverage for these evidence-based programs is a significant step toward lowering the burden of chronic disease in a way that improves lives and reduces Medicare spending,” said Lisel Loy, director of the prevention initiative at the Bipartisan Policy Center.

Burwell says she hopes employers and insurance companies will also offer the program to their workers and customers.

Skin patch shows promise for pain-free diabetes testing

An experimental device might one day literally take the pain out of managing diabetes, Korean researchers say.

The new invention uses a patch to monitor blood sugar levels via sweat, and delivers the diabetes drug metformin through the skin with microneedles.

“Diabetics are reluctant to monitor their blood glucose levels because of the painful blood-gathering process,” said study author Hyunjae Lee, from Seoul National University in the Republic of Korea. “We highly focused on a noninvasive monitoring and therapy system for diabetics.”

The findings were published online March 21 in the journal Nature Nanotechnology. The study team was led by Dae-Hyeong Kim, at Seoul National University. Funding for the study was provided by the Institute for Basic Science in the Republic of Korea.

Currently, people with diabetes have two options for monitoring blood sugar (glucose) levels, said Richard Guy, who wrote an accompanying editorial in the journal. He’s a professor of pharmaceutical sciences at the University of Bath in the United Kingdom.

One option is a blood glucose meter that requires a finger stick to draw out a drop of blood for testing. The other option is continuous glucose monitoring, which requires that a sensor be placed underneath the skin and worn constantly. Both of these options are invasive and can be painful.

Previously, a less invasive product called GlucoWatch pulled fluid through the skin to the device to measure blood sugar levels. However, that device was never commercially successful and was taken off the market, Guy said.

The Korean research team used a substance called graphene to develop a thin, flexible patch. Graphene conducts electricity, and can be transparent, soft and very thin, the researchers explained.

The patch also contains a variety of sensors that detect humidity, sweat glucose levels, pH and temperature, the researchers said. In addition, the patch contains heat-sensitive microneedles.

The patch uses sweat to determine “sweat glucose,” which can be used to figure out blood glucose levels. Lee said the accuracy of the sweat glucose sensor is similar to that of home blood glucose meters in the United States.

Guy pointed out that someone who sweats a lot might pose a challenge for the patch.

But the researchers said they’ve already taken this into consideration. “We integrated a humidity sensor in the diabetes patch to check how much sweat is generated. So the person who perspires heavily wouldn’t affect the sensing,” said Tae Kyu Choi, another study author from Seoul National University.

Likewise, Choi said, the researchers accounted for someone who perspires very lightly.

The researchers tested the glucose-sensing ability of the patch in two humans and found the device was able to accurately measure blood sugar levels.

In the current version of the patch, the researchers used microneedles to deliver the diabetes drug metformin to mice. Over six hours, the drug — delivered through the skin — was able to drop blood sugar levels from 400 milligrams per deciliter to 120 milligrams per deciliter, the researchers said. For someone without diabetes, a normal blood sugar level taken randomly would generally be under 125 milligrams per deciliter, according to the U.S. National Library of Medicine.

Insulin — the hormone necessary to lower blood sugar for people with type 1 diabetes — wasn’t used because it’s a protein that would be difficult to deliver through microneedles because it’s large, and it would be vulnerable to the heating process that allows the drug to be delivered through the skin, the study authors explained.

But, Guy said he expects that should this system go forward in development, other drugs that can lower blood sugar more effectively might be considered. “I think metformin was chosen as an example of a drug used in diabetics for the illustration of proof-of-concept,” he said.

The researchers said they believe the device could be used by either type 1 or type 2 diabetics.

However, Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said the cost of the device might make it very impractical for people with type 2 diabetes. And, he said, people with type 2 diabetes don’t have to know what their blood sugar levels are as often as people with type 1 diabetes.

“They have proved the concept — that a sweat patch can do the monitoring and can deliver a drug transdermally [through the skin]. Trying to do something like this noninvasively really is the holy grail of diabetes. So, there may be a future for this, but there are many barriers to be overcome,” Zonszein said.

The researchers said their next step is to improve the long-term stability and accuracy of the blood glucose sensor. Lee and Choi estimated it would be at least five years before they could solve any remaining obstacles and commercialize the device.

“The promise of a transdermal, minimally invasive glucose monitoring device is coming closer to fruition. I’d hope we’d see a new effort to bring a skin-based monitoring device for glucose to the market in the next few years,” Guy said. “In contrast, such as system combined with drug delivery is, in my opinion, much further away.”

Here’s the difference between pre-diabetes, Type 1 and Type 2

The American Diabetes Association estimates that almost 30 million Americans are diabetic, while an additional 86 million are considered pre-diabetic, and the incidence continues to increase at alarming rates. If you’ve been diagnosed with pre-diabetes, your blood sugar levels are higher than normal, but not quite high enough for you to be considered diabetic. When an individual has pre-diabetes, it also means they are beginning to develop insulin resistance. Insulin resistance slows the flow of glucose to the cells, causing a back-up of sugar in the blood. If you are diagnosed with pre-diabetes and you don’t begin making important lifestyle changes, you could develop Type 2 diabetes. Fortunately, pre-diabetes can be delayed or even reversed by making lifestyle changes. Regular physical activity and weight loss are some of the best things you can do to prevent the onset of diabetes.

Only five percent of diabetes in the United States is considered Type 1, where the body makes very little or no insulin. Insulin is the hormone needed to move glucose from the blood into the body cells to provide energy. Type 1 diabetes is treated by adding insulin back into the body either through injections or an insulin pump. Regularly checking your blood sugar level and being conscious of what you are eating are important practices for managing type 1 diabetes. In terms of diet, this means avoiding sweets, eating low fat and controlling portion sizes, especially carbohydrates.

Approximately 90 percent of diabetes diagnosed in the United States is Type 2, which is when your body does not make enough insulin and becomes insulin-resistant. Type 2 diabetes commonly presents itself without symptoms; however, high blood sugar symptoms can include frequent urination, unusual thirst, extreme tiredness, blurry vision, extreme hunger and wounds that are slow to heal. While diabetes cannot be cured, Type 2 diabetes can be successfully controlled with diet, exercise, weight loss, and medications possibly insulin injections.

Cone Health and the Lifestyle Center at Alamance Regional Medical Center have a network of endocrinologists, diabetes educators, nurses and dietitians that are dedicated to educating the community about diabetes and how they can take steps to prevent the disease.

Spokesperson Background:

Hilda Cook is a registered nurse and certified diabetes educator at Cone Health Alamance Regional’s Lifestyle Center.  She earned her diploma in nursing through Davis Hospital in 1971. Hilda has been taking care of diabetes patients since 2000 and is an insulin pump trainer.

Lifestyle changes are key to California’s diabetes crisis

Even for those who have worked decades to fight the spread of diabetes in the United States, last week’s news was something of a stunner.

In California, more than half of all adults – 55 percent – are considered diabetic or prediabetic, according to a UCLA Center for Health Policy Research study released this month. Even more worrisome, those afflicted are getting younger, with roughly one in three adults ages 18 to 39 considered prediabetic – a danger zone that means they’re at major risk of developing life-threatening Type 2 diabetes.

“This is the iceberg,” said Ann Albright, director of diabetes programming at the Centers for Disease Control and Prevention in Atlanta. Albright made her comments while in Sacramento last week for a statewide conference on prediabetes that drew about 140 doctors, researchers and government and public health officials.

By 2020, Albright said, experts predict that one in five U.S. adults will have diabetes, double the current number. “That trajectory is frightening,” she told the audience. “They are walking toward the cliff’s edge.”

The frustration, said researchers, is that most people actually have a choice when it comes to diabetes. Unlike many diseases, Type 2 diabetes is largely preventable. Decades of clinical studies have shown “lifestyle changes” – primarily shedding some weight and getting more exercise – are extremely effective in preventing or delaying the onset of Type 2 diabetes.

And yet so many Americans seem unable or unwilling to adjust their habits. Why?

Deborah Greenwood, program director for Sutter Health’s diabetes education network, is among the experts who point to a culture saturated with cheap, processed foods, whether in vending machines, fast-food outlets or grocery aisles.

“The environment doesn’t make it easy to make choices around physical activity and food, when you’re faced with so many high-calorie, high-carbohydrate, inexpensive options,” said Greenwood, a past president of the American Association of Diabetes Educators.

Even for those who want to make changes, she said, it can be extremely tough to break habits ingrained since childhood.

“The way we live and eat is a habit, and you can’t break a habit in a short period of time,” Greenwood said. “The research shows it takes about six months for some behavior changes to become a new habit.”

In some cases, those habits are seemingly hard-wired into us. “As mammals, we are programmed to like sugar, fat and salt in every possible way,” said Harold Goldstein, executive director of the California Center for Public Health Advocacy, which co-sponsored the UCLA study and hosted the Sacramento conference.

Surrounded by super-sized, sugary options at every turn, “for us to say ‘No’ to those time and time again is against our basic nature,” Goldstein said.

55 Percent of California adults considered diabetic or prediabetic, according to UCLA study

Unlike Type 1 diabetes, which is typically genetic and not considered preventable, Type 2 diabetes can generally be avoided with an improved diet and increased physical activity. It tends to hit older adults and is more prevalent in certain ethnic groups, including African Americans, Latinos and Pacific Islanders.

Untreated, Type 2 can lead to a host of life-threatening complications, including blindness, heart and kidney disease and lower limb amputations.

Maria Ibarra knows that reality. Six years ago, at age 35, she was diagnosed with diabetes, a disease that has rippled through her family with devastating consequences. Her youngest brother is blind, and her aunt had a lower leg amputated, both as a result of diabetes. Other family members have had major health complications related to the disease.

Ibarra started taking medication but initially didn’t pay too much attention to her diagnosis. When her blood glucose levels crept higher, her doctor recommended a six-week series of classes that offered instruction on nutrition, blood-glucose monitoring, physical activity and one-on-one counseling. Eventually, she joined a Sutter Health study that required her to check her blood-sugar levels before and after meals. It was a shocker.

“When I first started (daily monitoring at meals), my glucose was 189. I could not believe it. That was the first time I was genuinely scared,” said Ibarra, who lives in Citrus Heights with her two teenage daughters.

That’s when she started making changes and paying attention to what she ate. She noted that when she ate a flour tortilla, her sugar would skyrocket. “When I changed it to a corn tortilla or (flatbreads) made of whole wheat, I noticed my sugars were much more controlled. … It wasn’t until I started testing that I learned how food affected my glucose numbers. I realized that what I ate really mattered.”

Slowly and tentatively, she also started to get more physically active. “I won’t lie. When I started, I struggled to walk for 10 minutes,” she said. Gradually, she stretched her time and distance, and eventually signed up for – and finished – a 5K walk.

“Change is one of the hardest things to do when it’s not how you were raised,” Ibarra said. “I’m Mexican, and in my culture … exercise wasn’t something we did.”

Today, exercise and healthy eating are ingrained in her daily routine. She walks during her lunch break at her job as a medical records specialist. She adds black beans as protein to her taco salad, rather than preparing them as a heavy side dish. On weekends, she and her daughters wash, chop and bag fresh fruits and vegetables for grab-and-go lunches at school or work. Instead of high-sugar specialty coffee drinks, she takes her coffee plain with a sugar-free creamer.

Ibarra said the changes were hard but also empowering. “I wanted to be an example to my daughters. I may have diabetes, but it doesn’t stop me from living a healthy life.”

As mammals, we are programmed to like sugar, fat and salt in every possible way. … For us to say ‘No’ to those time and time again is against our basic nature.

Harold Goldstein, executive director, California Center for Public Health Advocacy

For years now, the CDC and National Institutes of Health have touted “lifestyle change” programs clinically proven to help prevent the onset of diabetes.

Albright, who runs a CDC division focused on translating research into practice, said there are more than 800 organizations, 50 commercial health plans and numerous states that offer programs recognized by the CDC under the National Diabetes Prevention Program.

“We would love for California to come on board as well,” she said.

According to a 2015 state auditor’s report, California ranks last in the nation in per capita funding for diabetes prevention. The state spent 3 cents per person in 2012 – and that’s only federal dollars, since California does not allocate state funds for diabetes prevention, the auditor’s report noted.

The auditor chided the state for its lagging efforts, calling diabetes a “growing epidemic” that costs California an estimated $27.5 billion a year in health-related costs. The state Department of Public Health “has not been able to expand its diabetes prevention activities to many of the counties … that have a high prevalence of diabetes,” the report noted.

That lack of state effort frustrates those on the front lines of the fight.

“California is putting zero dollars into diabetes prevention. If we’re not pissed off, there’s a problem,” said Tom Boyer, government affairs director for Novo Nordisk, a health care company that provides diabetes care, speaking at last week’s conference. “Government is not stepping up to do its job.”

Goldstein, of the California Center for Public Health Advocacy, said it’s time the state invested in the problem. “The tsunami of diabetes is on its way. It’s time to act.”

He and others have called for more blood screening, expanded insurance coverage of diabetes prevention programs, and more state and local policies to reduce consumption of sugary drinks, including a soda tax. Goldstein also sees the need for a statewide prediabetes education campaign, akin to the anti-tobacco campaign of the 1990s that led to dramatic drops in smoking and lung cancer deaths.

The state Department of Public Health defended its efforts, saying in an emailed response that it is using “appropriate and available federal funding to implement programs that address strategies reducing the burden of prediabetes and diabetes.”

Many health professionals are hopeful that the alarming headlines and continuing research will result in more funding, as well as prod more people into healthy habits.

Greenwood, who has worked on diabetes issues for nearly 40 years, said she senses a shift in awareness and a willingness to increase prevention efforts, partly because federal reimbursements under Medicare now are based in part on healthy outcomes, rather than solely on volume of patient visits.

The stakes are huge, she said, especially with prediabetes trending younger.

“When I think of the data on younger adults, that scares me so much. How long you live with diabetes increases your risk of complications. If you can get diabetes at 18, you’re going to be at risk of having heart disease at 28.”

Preventing diabetes

Check your score Go to the CDC’s site, DoIHavePrediabetes.org, and take the risk test. If you score high, ask your doctor about a blood test to determine if you are diabetic or have prediabetes.

Know risk factors The biggest risk factors for diabetes: Age (typically 45 and older), being overweight, having a sedentary lifestyle, and having family members with diabetes. Certain ethnic groups – African Americans, American Indians, Hispanics and Pacific Islanders – are more likely to develop diabetes.

Lose weight Dropping just 5-7 percent of your body weight can slow or even reverse prediabetes. For someone who weighs 200 pounds, that’s 10-15 pounds.

Eat healthier Emphasize dark/orange greens, whole grains, fresh fruits and vegetables; avoid sodas and packaged foods. You can still eat foods you love, but in smaller portions or less fatty versions.

Find a program There are lots of diabetes prevention programs, some offered by YMCAs, others online, some through health insurers or community organizations. Check with your doctor, employer or health plan to see if they offer “lifestyle change” programs, typically a yearlong program of weekly and monthly sessions on eating, cooking and physical activity. The CDC’s National Diabetes Prevention Program lets you search by city and state.

Source: Centers for Disease Control and Prevention

Sugar tax – will it unintentionally penalise diabetics?

Photo of Yvette with bottles of LucozadeImage copyright
Chris Loukes

Image caption

Yvette Loukes has type 1 diabetes and carries Lucozade with her everywhere she goes in case her blood sugar levels drop

Parents of teenagers with type 1 diabetes say George Osborne’s plan to raise the cost of sugary drinks will have an unintentional impact on their families.

On Wednesday the chancellor unveiled plans to tax soft drinks manufacturers who put large amounts of sugar in their products.

But people with type 1 diabetes say sugary drinks like Lucozade are a necessity and not a luxury that should be taxed.

‘We spend a fair amount of money on sport drinks’

Chris Loukas from Urmston in Trafford, Greater Manchester, says his teenage daughter Yvette is sporty, fit and healthy. She manages her type 1 diabetes with energy drinks that contain sugar .

Image copyright
James Lester

“Yvette was diagnosed at the age of four. As a family, we spend a fair amount of money on Lucozade energy and sport drinks. Not all kids who regularly consume expensive sugary drinks are lazy, overweight slobs,” Chris says.

“My daughter is very fit, she plays football and has played sport at high levels for the last 10 years.”

‘This sugar tax is just another kick in the teeth’

Supporters of the sugar tax, including Jamie Oliver, believe it will help tackle child obesity.

But Chris says it’s unfair and could end up putting an unnecessary burden on the NHS.

“People with coeliac disease can get prescriptions for gluten-free foods. Parents strapped for cash might ask to get Lucozade on prescription in the future.

“I am willing to pay for the Lucozade my daughter drinks but this sugar tax is just another kick in the teeth and I’m concerned it will put pressure on our already-stretched NHS.”

Image copyright
James Lester

Image caption

Yvette wants to play football professionally one day and is determined that her condition will not hold her back

Yvette, 17, plays for Manchester United under-17s ladies football team, who have reached their first-ever FA Youth Cup final where they face Arsenal next month.

‘I feel faint, like I am going to collapse. It’s scary’

She always has a bottle of Lucozade to hand in case her blood sugar levels drop, something that happens a few times a week.

The family say they have begun stocking up on the glucose drink before the sugar tax takes effect from 2018 .

“If I don’t drink Lucozade I feel faint, like I am going to collapse. It’s scary,” Yvette says.

“I love playing football, I want to play the sport professionally one day and I wont let my diabetes hold me back.

“My hero is Sir Steve Redgrave because he also has diabetes but he hasn’t let it affect him.

“He is a great inspiration to me.”

Image copyright
Chris Loukes

Image caption

Yvette Loukes: “I had this picture taken with my hero Sir Steve Redgrave a few years ago”

Sugar tax exemption card

Chris says the family are doing all they can to maximise Yvette’s performance on the pitch and he has a suggestion for Chancellor George Osborne to consider.

“Maybe the Government should consider providing type 1 diabetics, whose condition is seldom caused by poor lifestyle choices, some sort of sugary drink tax exemption card.

“Type 1 sufferers who play sport like my daughter, at the very highest level, at least must be worthy of such consideration.”

Diabetes: type 1 vs type 2

  • Diabetes is a condition where the body cannot regulate blood sugar levels, because of problems with the hormone insulin
  • In type 1 diabetes, the body is unable to produce any insulin
  • In type 2 diabetes, not enough insulin is produced or the insulin that is made by the body doesn’t work properly

Living with type 1 diabetes

Diabetes explained

Chris Askew, CEO of Diabetes UK, said “We fully understand that some people are very concerned about the sugar tax announcement.

“We know that people living with type 1 diabetes, which is not linked to lifestyle and cannot be prevented, use sugar-sweetened drinks to treat low blood glucose levels and some people with type 2 diabetes also rely on high sugar products in the management of their diabetes.

“This is why the measure should be introduced in a way that doesn’t adversely impact on the way people manage their condition.”

‘Keeping my son alive got a lot more expensive’

The Loukes family’s concerns are not isolated. Kate Stephen’s son has type 1 diabetes.

“To stop my son going into a hypoglycaemic coma, he uses Lucozade to bring his blood glucose levels up,” she says.

“The sugar tax will mean keeping my son alive just got a lot more expensive. We need to stop blaming the drinks.”

Lindsey Houghton’s 11-year-old son also has the condition.

“If his blood sugars fall too low we have to treat it with drinks like Lucozade. We use this as it’s the fastest way for a body to absorb sugar,” she says.

“Maybe we could use Coca-Cola instead, oh that’s right that’s going to be taxed too.”

Sugar tax – will it unintentionally penalise diabetics?

Photo of Yvette with bottles of LucozadeImage copyright
Chris Loukes

Image caption

Yvette Loukes has type 1 diabetes and carries Lucozade with her everywhere she goes in case her blood sugar levels drop

Parents of teenagers with type 1 diabetes say George Osborne’s plan to raise the cost of sugary drinks will have an unintentional impact on their families.

On Wednesday the chancellor unveiled plans to tax soft drinks manufacturers who put large amounts of sugar in their products.

But people with type 1 diabetes say sugary drinks like Lucozade are a necessity and not a luxury that should be taxed.

‘We spend a fair amount of money on sport drinks’

Chris Loukas from Urmston in Trafford, Greater Manchester, says his teenage daughter Yvette is sporty, fit and healthy. She manages her type 1 diabetes with energy drinks that contain sugar .

Image copyright
James Lester

“Yvette was diagnosed at the age of four. As a family, we spend a fair amount of money on Lucozade energy and sport drinks. Not all kids who regularly consume expensive sugary drinks are lazy, overweight slobs,” Chris says.

“My daughter is very fit, she plays football and has played sport at high levels for the last 10 years.”

‘This sugar tax is just another kick in the teeth’

Supporters of the sugar tax, including Jamie Oliver, believe it will help tackle child obesity.

But Chris says it’s unfair and could end up putting an unnecessary burden on the NHS.

“People with coeliac disease can get prescriptions for gluten-free foods. Parents strapped for cash might ask to get Lucozade on prescription in the future.

“I am willing to pay for the Lucozade my daughter drinks but this sugar tax is just another kick in the teeth and I’m concerned it will put pressure on our already-stretched NHS.”

Image copyright
James Lester

Image caption

Yvette wants to play football professionally one day and is determined that her condition will not hold her back

Yvette, 17, plays for Manchester United under-17s ladies football team, who have reached their first-ever FA Youth Cup final where they face Arsenal next month.

‘I feel faint, like I am going to collapse. It’s scary’

She always has a bottle of Lucozade to hand in case her blood sugar levels drop, something that happens a few times a week.

The family say they have begun stocking up on the glucose drink before the sugar tax takes effect from 2018 .

“If I don’t drink Lucozade I feel faint, like I am going to collapse. It’s scary,” Yvette says.

“I love playing football, I want to play the sport professionally one day and I wont let my diabetes hold me back.

“My hero is Sir Steve Redgrave because he also has diabetes but he hasn’t let it affect him.

“He is a great inspiration to me.”

Image copyright
Chris Loukes

Image caption

Yvette Loukes: “I had this picture taken with my hero Sir Steve Redgrave a few years ago”

Sugar tax exemption card

Chris says the family are doing all they can to maximise Yvette’s performance on the pitch and he has a suggestion for Chancellor George Osborne to consider.

“Maybe the Government should consider providing type 1 diabetics, whose condition is seldom caused by poor lifestyle choices, some sort of sugary drink tax exemption card.

“Type 1 sufferers who play sport like my daughter, at the very highest level, at least must be worthy of such consideration.”

Diabetes: type 1 vs type 2

  • Diabetes is a condition where the body cannot regulate blood sugar levels, because of problems with the hormone insulin
  • In type 1 diabetes, the body is unable to produce any insulin
  • In type 2 diabetes, not enough insulin is produced or the insulin that is made by the body doesn’t work properly

Living with type 1 diabetes

Diabetes explained

Chris Askew, CEO of Diabetes UK, said “We fully understand that some people are very concerned about the sugar tax announcement.

“We know that people living with type 1 diabetes, which is not linked to lifestyle and cannot be prevented, use sugar-sweetened drinks to treat low blood glucose levels and some people with type 2 diabetes also rely on high sugar products in the management of their diabetes.

“This is why the measure should be introduced in a way that doesn’t adversely impact on the way people manage their condition.”

‘Keeping my son alive got a lot more expensive’

The Loukes family’s concerns are not isolated. Kate Stephen’s son has type 1 diabetes.

“To stop my son going into a hypoglycaemic coma, he uses Lucozade to bring his blood glucose levels up,” she says.

“The sugar tax will mean keeping my son alive just got a lot more expensive. We need to stop blaming the drinks.”

Lindsey Houghton’s 11-year-old son also has the condition.

“If his blood sugars fall too low we have to treat it with drinks like Lucozade. We use this as it’s the fastest way for a body to absorb sugar,” she says.

“Maybe we could use Coca-Cola instead, oh that’s right that’s going to be taxed too.”