Diabetes Archive

When diet and exercise are not enough for a person with diabetes to manage their blood sugar, one or more medications may be needed. Adding a second medication can offer additional benefits beyond blood sugar control, but the benefits and risks of these newer classes of drugs must be weighed for each person.

On call

Q. My blood pressure stays low. Sometimes it drops so low, it causes dizziness and weakness. What causes this?

A. Of the possible causes of low blood pressure, two are at the top of my list. First, I would review your medications. Drugs prescribed to treat high blood pressure and heart disease are the ones that most often cause this side effect. Reducing the dose with your doctor's approval may be all you need.

Drinking no more than four or five 8-ounce cups of coffee per day—equal to about 400 milligrams of caffeine—helps people get the drink's health benefits with a lower risk of caffeine side effects like anxiety and nervousness.

News briefs

A modest uptick in the amount of fruit and vegetables you eat can help ward off type 2 diabetes, according to a study published online July 8, 2020, by The BMJ. From a much larger study involving some 340,000 people from eight European countries, scientists selected 9,754 participants who were newly diagnosed with diabetes over a decade. Researchers compared the fruit and vegetable intakes of these people to those of about 13,000 participants who remained diabetes-free during the study period. Researchers also measured blood levels of seven key plant-derived nutrients, including vitamin C and brightly colored antioxidant pigments called carotenoids. People with the highest intakes of fruit and vegetables and the highest blood levels of the plant-derived nutrients were 25% to 50% less likely to get diabetes during the study period, compared with those who ate the least of these food groups or had the lowest nutrient levels. Even better, it didn't take a whole lot of extra green, red, yellow, and orange on the plate to make a dent in diabetes risk. The equivalent of only two-thirds of a medium apple or just over one-third of a cup of mixed fruit each day offered protection.

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In the journals

Not only can regular leg stretching help reduce cramps and muscle strains, it also may be another way to protect against heart disease and stroke. A study published online July 1, 2020, by The Journal of Physiology found that performing simple leg stretches can help improve blood flow throughout the body.

Researchers split 39 healthy people into two groups. One group didn't do any stretching. The other group performed four types of leg stretches five times a week for 12 weeks. The stretches focused on the hip, knee, and ankle. Each stretch was done for 45 seconds with a 15-second recovery. Afterward, the researchers found that the arteries in the lower legs of the stretching group had better blood flow and less stiffness. The stretching group also had lower blood pressure at the end of the study compared with their initial readings.

News briefs

Eating a diet high in foods tied to inflammation — such as processed meat, sweets, and refined grains — is associated with many health problems, including an increased risk for colon cancer, heart disease, stroke, or diabetes. A Harvard study published online May 7, 2020, by Gastroenterology found another potential risk: Crohn's disease, a condition characterized by areas of inflammation throughout the large and small intestines. Researchers evaluated 30 years' worth of self-reported diet information from more than 208,000 men and women. Diets were scored based on foods that promote inflammation. Compared with people who had the lowest inflammatory diet scores, people with the highest scores had a 51% higher risk for developing Crohn's disease. The risk for Crohn's doubled among people who went from a low- to a high-inflammatory diet during the study. The study is observational and doesn't prove that an inflammatory diet causes Crohn's disease. But with so many other risks associated with foods that promote inflammation, it's important to eat as many foods that fight inflammation as possible. In other words, focus on whole, unprocessed foods with no added sugar — such as vegetables, fruits, whole grains, legumes (beans, lentils), fish, poultry, nuts, seeds, a little bit of low-fat dairy, and olive oil.

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News briefs

First it was certain blood pressure and heartburn drugs; now some medications used to treat type 2 diabetes are being recalled because of cancer concerns. The FDA warned in late May and early June 2020 that some lots of extended-release metformin may contain unacceptable levels of N-nitrosodimethylamine (NDMA), a possible cancer-causing chemical. At least five manufacturers are now issuing voluntary recalls of the medications. But if you take extended-release metformin, don't just stop on your own. Not all extended-release metformin products are affected by the voluntary recalls, and stopping any medication that controls blood sugar can be very dangerous. The FDA advises that you check in with your doctor or pharmacist. Ask if your medication is affected by the recall; if so, ask if you should switch to another version of the drug.

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Are artificial sweeteners benign or a threat to your long-term health? A recent study adds a new element to the debate.

Artificial sweeteners seem to offer a tantalizing free pass to dessert. These low- or no-calorie additives taste like sugar, but your body can't absorb them the same way it does natural sugars. You get the taste without the calories, which should mean that you can eat them guilt-free. Right?

Over the years, experts have increasingly questioned whether artificial sweeteners are too good to be true. Are they really your ticket to a ­low-calorie treat — or will you wind up getting your just desserts for trying to outsmart Mother Nature?

The latest recommendations focus on newer medications, lifestyle changes, and procedures.

If you have heart disease, following a healthy diet and getting regular exercise should be a top priority. Both habits can help you reach and stay at a healthy weight and lower your blood pressure and cholesterol level. Chances are you'll also need to take medications to further improve those common heart-related risk factors. But if you also have diabetes, you may need even more aggressive treatment, according to new advice from the American Heart Association.

The recommendations, published May 12, 2020, in the journal Circulation, detail the latest evidence about treatments for people with both heart disease and diabetes. Diabetes, which affects about one in 10 adults, doubles the odds of having a heart attack or stroke (see "Why is diabetes hard on your heart?").

Many lifestyle factors can influence the development of atrial fibrillation, and doctors now better understand the importance of these factors in treating afib. Those who are at risk of developing afib can take action to improve their health, and in some cases they may be able to reduce their symptoms.