Dr. Tina Ardon, a Mayo Clinic family medicine physician, says preventing Type 2 diabetes symptoms from developing starts with diet and exercise.

Watch: The Mayo Clinic Minute

Journalists: Broadcast-quality video pkg (1:04) is in the downloads at the end of the post. Please courtesy: "Mayo Clinic News Network." Read the script.

Your body processes sugar (glucose) into fuel from the foods you eat. But when the body can’t process the sugar and it builds up in the bloodstream, the reason might be a chronic disease — Type 2 diabetes.

"Symptoms like losing weight without a good reason, waking up at night to use the bathroom frequently, feeling fatigued, feeling not like yourself, those are all clues that there's something else going on," says Dr. Ardon.

Regular exercise and a diet rich in vegetables, fruits and lean proteins in place of processed foods that are high in fat and sugar can reduce the risk of Type 2 diabetes.

"Make sure we're exposing them to healthy foods so they can develop those healthy habits over a lifetime," says Dr. Ardon.

Young people who develop diabetes are at a higher risk of heart attacks, strokes, vision problems, and nervous system and kidney function issues.

"Seeing your primary care physician regularly can also be a really important tool that gives us a chance to catch things early, either on your bloodwork or your vital signs or with your weight," says Dr. Ardon. "We can provide some interventions and sometimes even some medications to help prevent the progression of Type 2 diabetes."

The post Mayo Clinic Minute: Prevention is key to reducing Type 2 diabetes in kids appeared first on Mayo Clinic News Network.

November is National Diabetes Month, a time to assess your risk for diabetes and your options if you're diagnosed with the illness.

A diabetes diagnosis means the body cannot regulate blood sugar due to inadequate insulin production from the pancreas — a long, flat gland that sits behind the stomach in the upper abdomen. The results for a patient with diabetes can be vision loss, and nerve and damage to other organs, unless blood sugar is controlled using medication or the patient undergoes a pancreas transplant.

"A pancreas transplant is the only cure for diabetes. It does not control diabetes. It cures diabetes," says Dr. Tambi Jarmi, a transplantation medicine physician at Mayo Clinic. "I find myself having a hard time convincing a diabetic patient after they receive the pancreas transplant that they are cured ― they're not diabetic. They don't believe it."

Watch: Dr. Jarmi shares the impact pancreas transplantation has on patients who are diabetic.

Journalists: Broadcast-quality video sound bites with Dr. Jarmi are in the downloads at the end of this post. Please courtesy: "Tambi Jarmi, M.D. / Transplant / Mayo Clinic"

Pancreas transplants are sourced from a deceased donor, and the organ to be transplanted must match the blood type of the recipient. Patients are not matched based on gender or race. With the replaced function of the pancreas and natural ability to produce insulin, Dr. Jarmi says patients no longer are diabetic.

"I believe every diabetic patient deserves a chance to be evaluated for a pancreas transplant early on in their disease," says Dr. Jarmi. "I want the message to be clear that not every diabetic patient needs a pancreas transplant, but we have to evaluate these patients, give them the information and monitor their disease progress."

He recommends patients who are diabetic contact a transplant center to learn more about pancreas transplants, take the information and discuss it with their primary care provider.

Patients who are diabetic often develop diseases in other organs, such as in their kidneys, Dr. Jarmi says. These complications can result in patients seeking transplants for those organs or a combination of organs. He says these transplants may have been prevented if the core issue ― diabetes ― was resolved using a pancreas transplant.

"It may be very simple to me or to anyone without diabetes that we go and eat ice cream. We don't think about it twice, but diabetic patients do think about it," says Dr. Jarmi. "After a pancreas transplant, that is a huge achievement that they can do that now. They can eat. They can think. They can do whatever they want without the burden of diabetes."

Dr. Jarmi says that unlike other procedures in the U.S. where there are not enough organs to be transplanted, with pancreas transplants, there is a patient shortage. Government statistics show approximately 1,000 pancreas transplants are performed annually. He suspects this lack of patients is the result of a lack of access to medical resources and awareness of transplant benefits.

___________________________________

For the safety of its patients, staff and visitors, Mayo Clinic has strict masking policies in place. Anyone shown without a mask was recorded prior to COVID-19 or recorded in an area not designated for patient care, where social distancing and other safety protocols were followed.

The post How a pancreas transplant can cure diabetes appeared first on Mayo Clinic News Network.

Dear Mayo Clinic: Diabetes runs in my family. My mother was diagnosed in her 20s and requires daily insulin. Last month, my 45-year-old sister was diagnosed and is now on medication. My doctor told me I was a pre-diabetic. I am curious how I might be able to reduce my risk for diabetes, especially since I’ve heard that diabetics are at greater risk of COVID-19. Are there extra steps my sister and I should take to stay safe?

Answer: Diabetes is a chronic health condition that occurs when the level of sugar in the blood is too high. That happens because of a problem with the hormone insulin, which is made in the pancreas. When you eat, the pancreas releases insulin into the bloodstream. This allows sugar to enter your cells, lowering the amount of sugar in your blood.

There are several forms of diabetes, including Type 1, which is an autoimmune disorder, and Type 2, which results from both loss of insulin production and development of insulin resistance in body tissues. Gestational diabetes is another form that may occur during pregnancy.

Patients with type 1 diabetes are completely insulin deficient and require daily insulin injections. Given her age of onset and insulin requirement, your mother likely has Type 1 diabetes.  Despite ongoing research, Type 1 diabetes currently has no cure. Treatment focuses on managing blood sugar levels with insulin as well as diet and lifestyle to prevent complications.

Type 2 diabetes develops when the pancreas does not make enough insulin, and the body can't use insulin as well as it should. That means sugar cannot move into the cells, and it builds up in the blood. Exactly what causes type 2 diabetes is unknown, although genetics and environmental factors, such as being overweight and inactivity, seem to be contributing factors. Your sister most likely has Type 2 diabetes.

Although there's no cure for Type 2 diabetes, studies show it is possible for some people to reverse the condition. For many patients, losing weight, eating well and exercising can help manage the disease. If lifestyle changes are not enough, some people, like your sister, may be prescribed any number of oral medications or even insulin to help them manage their disease.  

Prediabetes is a condition in which blood sugar is higher than normal, but it's not high enough to be considered Type 2 diabetes. If left uncontrolled, prediabetic patients are at high risk to develop Type 2 diabetes.

The good news is that often lifestyle changes alone, such as diet and exercise, can lower your blood sugar level and decrease your risk of developing diabetes.

In general, no matter what type of diabetes a person has, monitoring and managing blood sugar are the most important things to minimize risk for complications. It can be harder to control blood glucose levels during an illness or infection.

COVID-19 is no exception.

It is important to remember that diabetic patients are not at higher risk of COVID-19 infection. Rather, people with diabetes are experiencing more severe symptoms, particularly those people whose glucose control is not optimal. Among patients who are hospitalized due to COVID-19, a higher proportion has diabetes.

Although it is not yet understood why, COVID-19 seems to affect patients with Type 1 diabetes differently than those with Type 2 diabetes. Although more research is needed, it is believed that Type 2 diabetics are having more complications due to coexisting conditions they often have, including obesity, heart disease and kidney disease.

As the COVID-19 pandemic continues, you should encourage your family to be vigilant about managing their diabetes and maintaining good blood glucose control. Also, encourage your mother and sister not to postpone visits with their endocrinologist or health care provider due to COVID-19. It is important to have regular check-ins so issues can be addressed promptly.

For yourself, commit to move more, improve your diet and monitor your blood sugar. Your family also should continue to practice good infection control, including proper hand hygiene, wearing a mask when out in public and social distancing. Lastly, stay up-to-date on any recommended vaccines to minimize your risk for illness. ­— Dr. Bithika Thompson, Endocrinology, Mayo Clinic, Phoenix, Arizona

Information in this post was accurate at the time of its posting. Due to the fluid nature of the COVID-19 pandemic, scientific understanding, along with guidelines and recommendations, may have changed since the original publication date. 

Check the Centers for Disease Control and Prevention website for additional updates on COVID-19. For more information and all your COVID-19 coverage, go to the Mayo Clinic News Network and mayoclinic.org.

The post Mayo Clinic Q and A: Diabetes management & illness, COVID risk appeared first on Mayo Clinic News Network.

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The authors, Victor Montori, M.D., and Rene Rodriguez-Gutierrez, M.D., of the Knowledge and Evaluation Research Unit at Mayo Clinic, systematically examined journal articles and clinical practice diabetes guidelines published in the last decade (2006 and 2015) for statements related to value of tight glycemic control in the prevention of chronic diabetic complications. The authors then compared them with the body of evidence accrued in the past two decades regarding the effect of tight glycemic control on patient-important micro- and macrovascular outcomes.

The study, funded by Mayo Clinic’s Clinical and Translational Science Award, found that tight glycemic control (maintenance of a hemoglobin A1c value lower than 7 percent) had no statistically significant impact on patient-important microvascular outcomes (end-stage renal disease/dialysis, renal death, blindness and clinical neuropathy). In contrast, all practice guidelines and a majority of published statements (around 80 percent) support tight glycemic control to prevent those complications.

For patient-important macrovascular (cardiovascular) complications, the evidence shows that tight glycemic control reduces the risk of nonfatal heart attack by around 15 percent, but has no impact in all-cause mortality and cardiovascular mortality. Also, the risk of stroke did not seem to be lowered by tight glycemic control and the effect on amputation was imprecise. During the studied time period, statements about tight glycemic control to prevent these complications shifted from largely supportive (85 percent) to skeptical (20-30 percent) after the publication of a single study (the Action to Control Cardiovascular Risk in Diabetes (ACCORD) trial) in 2008 that is not consistent with the results of other studies (body of evidence).

MEDIA CONTACT: Bob Nellis, Mayo Clinic Public Affairs, 507-284-5005, newsbureau@mayo.edu

Overall, the authors suggest that the widespread consensus for tight glycemic control should be re-examined.

Drs. Rodriguez-Gutierrez and Montori write that they hope this paper will spur research into new therapeutic approaches to prevent diabetes complications. They write, “Consider the list of evidence-based therapies recommended … to prevent retinopathy or neuropathy beyond glycemic control: none.”

Instead of focusing on tight glycemic control, the authors suggest glycemic moderation may help advance the individualization of diabetes care, using shared decision making to select glycemic targets and treatments.

The authors point out that patients with Type 2 diabetes seem to live longer and with fewer complications, at least in some parts of the world, and suggest a careful and thoughtful recalibration of treatment could promote patient trust and provide new answers to this pandemic problem.

The publication of this paper was supported by Mayo Clinic’s Center for Clinical and Translational Science through a Clinical and Translational Science Award from the National Center for Advancing Translational Sciences, a component of the National Institutes of Health.

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About Mayo Clinic
Mayo Clinic is a nonprofit organization committed to clinical practice, education and research, providing expert, whole-person care to everyone who needs healing. For more information, visit http://www.mayoclinic.org/about-mayo-clinic or https://newsnetwork.mayoclinic.org/.

The post Tight Focus on Blood Sugar Narrows Options for Diabetes Complications appeared first on Mayo Clinic News Network.

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"If you’ve been diagnosed with pre-diabetes, it means your blood sugar levels are not high enough to be classified as Type 2 diabetes but are high enough to indicate a need for change," says Anne Bauch, registered dietitian at Mayo Clinic Health System.

A normal fasting blood sugar level is below 100, whereas a level of someone with pre-diabetes is between 100 and 126. Once levels have surpassed 126, it is classified as Type 2 diabetes, which indicates that your body resists insulin or doesn’t produce enough of it to maintain normal blood sugar levels.

"When you have pre-diabetes, sugar begins to build up in the blood stream rather than fuel your cells. This is when insulin resistance occurs, which is believed to be the No. 1 cause of pre-diabetes," adds Brauch.

A healthy weight allows insulin to work more efficiently and to keep blood sugars within a normal range. A healthy diet and regular exercise are the best ways to bring your blood sugar levels back to normal.

What are the risk factors for developing pre-diabetes?

• Body mass index (BMI) greater than 27
• Family history of diabetes
• Sedentary lifestyle
• Age 45 or older
• Carrying weight in your abdomen
• Previous diagnosis of gestational diabetes (developed while pregnant)

When should I be tested?

If you’re 45 or older, you should have your fasting blood sugar checked every year during your physical. If you’ve had gestational diabetes, it is important to have your blood sugar checked each year, as there is a 60 percent chance of developing Type 2 diabetes.

Are there any symptoms?

Often, people do not know they have pre-diabetes because they do not experience any symptoms. However, Type 2 diabetes symptoms may include:

• Fatigue
• Blurred vision
• Frequent urination
• Increased thirst

What’s my next step?

"After diagnosis, a referral to a diabetes educator can be initiated to begin a carbohydrate control meal plan along with an exercise routine. Diabetes educators teach lifestyle skills to manage pre-diabetes and Type 2 diabetes. We help patients with meal planning, exercise, medication management and monitoring blood sugars," says Brauch.

Talk to your health care provider if you have any questions or concerns about diabetes or if you develop any Type 2 diabetes symptoms.

The post What is Pre-Diabetes? appeared first on Mayo Clinic News Network.

World Diabetes Day is led by the International Diabetes Foundation to increase global awareness of this international disease that affects millions of people. Diabetes in not just about obesity or sugar levels.

Learn more from Mayo Clinic:

Symptoms: Diabetes symptoms vary depending on how much your blood sugar is elevated. Some people, especially those with prediabetes or type 2 diabetes, may not experience symptoms initially. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Risk factors: Risk factors for diabetes depend on the type of diabetes — type 1 or type 2.

Lifestyle and home remedies: Diabetes is a serious disease. Following your diabetes treatment plan takes round-the-clock commitment. Careful management of diabetes can reduce your risk of serious — even life-threatening — complications.

Diabetes Research: Mayo Clinic is a leader in diabetes research. At the Mayo Clinic Center for Regenerative Medicine researchers are working on ways to regenerate the cells that produce insulin (beta cells).

The post Global Awareness — It’s World Diabetes Day appeared first on Mayo Clinic News Network.

ROCHESTER, Minn. — Mayo Clinic researchers have discovered that the five-year survival of diabetic kidney transplant patients is now on par with the five-year survival of nondiabetic kidney recipients.

These new findings are published on the Kidney International website and will also be printed in a future issue of the journal.

The study findings represent significant improvements in the management of kidney transplant patients who have diabetes and pre-transplant consequences of diabetes such as heart disease and high blood pressure. The study also suggests that improvements in patient management post-transplant have resulted in significant declines in subsequent cardiac events and a reduction in infections. Prior to 2004, the five-year mortality rate of diabetic kidney transplant patients was more than double that of nondiabetic kidney recipients.

To arrive at these latest findings, a Mayo Clinic research team led by Fernando Cosio, M.D., medical director of kidney and pancreas transplantation, analyzed the experiences of 1,688 kidney recipients, including 413 with diabetes prior to transplant between 1996 and 2007.

The survival of patients with diabetes mellitus in the general population has improved in recent years. Post-transplant, patients with diabetes experienced a significant decline in major fatal/nonfatal cardiac events and deaths from infections over time. In contrast, neither cardiac events nor overall mortality declined in recipients who did not have diabetes. The decline in mortality due to diabetes did not relate to a reduced pre-transplant risk profile and was independent of post-transplant variables. The use of cardioprotective medications and glycemic control improved over time post-transplant. Furthermore, graft function and serum albumin significantly improved over time, and these parameters related to better survival.

“We were really encouraged to see this gap improve so dramatically,” says Dr. Cosio. “Diabetic patients who undergo kidney transplantation can expect outcomes equally as successful as nondiabetics, provided that they are diligent in their management of blood pressure, glucose, healthy weight, and other factors that influence their kidney function and overall well-being.”

The Mayo Clinic research team also included Mira Keddis, M.D., Nephrology; Mireille El Ters, M.D.; Emilio Rodrigo, M.D., Ph.D.; Patrick Dean, M.D., Transplantation Surgery; Mariana Wohlfahrtova, M.D.; Yogish Kudva, M.B.B.S., Endocrinology; Elizabeth Lorenz, M.D., Nephrology and Hypertension.

More than 120,000 people are waiting for organ transplant in the United States. Nearly 2,000 of those are children. Every 10 minutes another name is added to the national waiting list. An average of 18 people die each day in the United States waiting for transplants that can't take place because of the shortage of donated organs.

For more information about organ donation, visit http://www.donatelifeamerica.org.

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About Transplantation at Mayo Clinic
Mayo Clinic has one of the nation’s largest and most experienced transplant practices, with campuses in Minnesota, Arizona and Florida. Over 200 doctors in transplant medicine and surgery perform about 1,800 transplants a year, and have a long track record of excellent outcomes. The opportunity to collaborate with multiple transplant programs allows Mayo Clinic patients access to a multidisciplinary transplant team and the opportunity for multiorgan transplantation if necessary. 

About Mayo Clinic
Recognizing 150 years of serving humanity in 2014, Mayo Clinic is a nonprofit worldwide leader in medical care, research and education for people from all walks of life. For more information, visit 150years.mayoclinic.org, www.mayoclinic.org and newsnetwork.mayoclinic.org.

MEDIA CONTACT:
Ginger Plumbo, Mayo Clinic Public Affairs, 507-284-5005, Email: newsbureau@mayo.edu

The post Mayo Clinic Study Shows 5-year Survival of Diabetes and Non-Diabetes Patients Post-Kidney Transplant Now Nearly Equal appeared first on Mayo Clinic News Network.

Join us on Saturday, April 12, at 9 a.m. CT when we discuss the growing problem of diabetes with endocrinologist Dr. Ananda Basu.  We’ll touch on the differences between type 1 and type 2 diabetes, and discuss who’s at risk and what can be done to treat the condition, including the status on the development of an artificial pancreas.  Join us!

Myth or Matter of Fact:  Diabetics need a special diet.

Listen to this week’s Medical News Headlines: News Segment April 12, 2014 (right click MP3) 

Mayo Clinic Radio is a weekly one-hour radio program highlighting health and medical information from Mayo Clinic. The show is taped for rebroadcast by some affiliates.

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