Diabetes Awareness

DECEMBER 2019 | FUTUREOFPERSONALHEALTH.COM

An Independent Supplement by Mediaplanet to USA Today

DIABETES AWARENESS Victor Garber

Discover how the prolific actor came to accept his diabetes diagnosis

Learn about the smartphone app preventing amputations See how far diabetes research and treatment has come

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Why It’s Smart to Skip Sugar and Use an Alternative Sweetener Instead Consumers are eating and drinking too much sugar, but natural sweeteners may help cut calories while keeping taste.

Sugar consumption is linked to various health problems and Americans are interested in cutting back. According to a Reuters/Ipsos poll of 1,883 adults living in the United States, 58 percent said they tried to limit sugar in their diets in the previous 30 days. Skipping sweeteners can be tough for consumers, but healthy, natural sugar alternatives like stevia can be a good choice. Stevia, a natural sweetener from the stevia rebaudiana plant is 200 times sweeter than table sugar but it has zero calories.

Research shows stevia may help people with type 2 diabetes manage their blood sugar levels. For example, a small study of 12 diabetics who consumed stevia with a meal had greater decreases in blood sugar levels compared to those in the control group who were given an equal amount of corn starch. “We really feel a responsibility to our consumers to present the finest quality products available in stevia,” says Carol May, CEO and chairman of SweetLeaf Stevia®, the first stevia sweetener to receive Generally Recognized as Safe status from the U.S. Food and Drug Administration. The sweetener, which has won 36 awards for taste and innovation, has no calories, no sugars, zero carbs, a non-glycemic response, and no artificial sweeteners.

Currently SweetLeaf Stevia products include sweetener, sweet drops, water drops, and more. Up next, the company is developing a line of sugar free syrups, baking mixes, drinks, and monk fruit products.

Kristen Castillo

Diabetes Comes in Many Different Forms Diabetes is common in the United States, but many still do not understand the differences between the different types of the disease.

D

iabetes is a disease defined by higher-than-normal blood glucose levels. There are two main types of diabetes: type 1 and type 2, plus a condition called gestational diabetes that occurs during pregnancy. While type 1 and type 2 diabetes are quite different in how they begin, they are very similar in the serious health consequences they can cause — damage to the nerves and to the large and small blood vessels of the body. This damage can result in heart attack, stroke, retinopathy (an eye disease that can lead to blindness), nephropathy (kidney disease) and neuropathy (nerve damage which can lead to amputation). Fortunately, great strides have been made in treating diabetes, and the outlook for someone diagnosed with diabetes today is vastly better than it was even a generation ago.

Type 1 diabetes With type 1 diabetes, the body’s immune system mistakenly destroys the insulin-producing beta cells in the pancreas. Without insulin, other organs in

the body struggle to function properly, which leads to serious complications.

This can happen over a few weeks, months, or years, and type 1 diabetes can develop at any age.

People with type 1 diabetes must have insulin to survive (though many people with type 2 diabetes also use insulin). For decades, insulin was administered via a syringe and injection under the skin. Today, the insulin in those vials has been improved dramatically, and the syringes and needles have improved greatly as well. Many people also use insulin pens, which are self-contained, insulin cartridge-and-needle delivery systems that are more portable than glass vials and syringes. This makes it easier to deliver more precise doses of insulin. Insulin pumps have also become widely used in the past few years. Pumps allow a continuous dose of insulin just under the skin, plus the ability to deliver larger doses at mealtime.

not use insulin properly because of a condition called insulin resistance.

The pancreas produces insulin, but the insulin resistance does not allow the body to process and use the insulin appropriately or efficiently. The degree of insulin resistance varies from person to person; some people with type 2 diabetes have relatively low levels of insulin resistance, and the primary problem is that insulin production of the pancreas is impaired. Lifestyle modification is the cornerstone of managing type 2 diabetes. Most people with type 2 diabetes also need one or more medications to help keep their blood glucose stable. For several decades, metformin has been the first line of treatment and has proven to be very effective, safe, and inexpensive.

In the past 10 to 15 years, a number of new types of type 2 diabetes medications can work in tandem with metformin to reduce blood glucose levels. n

Type 2 diabetes In most cases of type 2 diabetes, the body does

William T. Cefalu, M.D., Chief Scientific Medical and Mission Officer, American Diabetes Association

Publisher Shira Peretz Business Developer Gretchen Pancak Managing Director Luciana Olson Lead Designer Tiffany Pryor Designer Kayla Mendez Lead Editor Mina Fanous Copy Editor Kathleen Walsh Director of Sales Shannon Ruggiero Director of Business Development Jourdan Snyder Director of Product Faye Godfrey Content Strategist Vanessa Rodriguez Cover Photo Robby Klein All photos are credited to Getty Images unless otherwise specified. This section was created by Mediaplanet and did not involve USA Today.

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PLEASE RECYCLE

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IT’S TIME FOR A TAKE 2.

A second chance to lower your risk of heart disease and stroke. A second chance to have more time with loved ones and build the healthy life you love. Begin your Take 2 today by scheduling an appointment with your doctor to learn how you can lower your risk.

Download the discussion guide at

KnowDiabetesbyHeart.org

Š 2019 American Heart Association, Inc. and American Diabetes Association, 501(c)(3) not-for-profits.

All rights reserved. Know Diabetes by Heart is a trademark of the AHA and ADA. Unauthorized use prohibited. 8/19 DS15034

How Islet Transplants Are Transforming Diabetic Treatment For some diabetes patients, islet transplants make insulin injections a thing of the past. Diabetes Research Institute (DRI) scientists have shown that people with type 1 diabetes can be freed from insulin injections after having an islet transplant because they can again produce their own insulin to control blood sugar levels.

Near-normal blood sugar levels But just how good is that blood sugar control? To answer that question, DRI scientists studied a small group of islet transplant patients who were still insulin-independent an average of 10 years later. Using a continuous glucose monitor (CGM), which takes blood sugar readings every five minutes, the researchers collected each patient’s sugar levels for an entire week. They observed that all of the patients’ levels were near normal more than 96 percent of the time, on average. They also had fewer blood sugar swings and reduced risk of hypoglycemia (dangerously low blood sugar levels).

“The CGM data we have obtained from our islet transplant patients clearly demonstrates that islet transplantation can result in glucose levels that are close to those in people who do not have type 1 diabetes, even 10 years or more after undergoing the cell-replacement procedure,” said David Baidal, M.D., of the Diabetes Research Institute at the University of Miami.

Diabetes Research Institute Foundation

Smart Phones Are Improving Treatment for Diabetic Wounds New smart phone tech helps doctors more accurately assess diabetic foot wounds and prevents amputations.

Smartphones powered by artificial intelligence (AI) have become an essential part of modern life. They help us navigate traffic, do business, and find romantic partners. Now, these devices have become a potent force in healing diabetic wounds and preventing amputation. Wounds are a serious health concern. People with diabetes often suffer from reduced sensation, known as diabetic neuropathy, allowing them to walk around with open foot wounds and barely notice. Complicating matters is peripheral artery disease, a condition present in more than half of people with diabetic foot wounds, which makes wounds harder to heal. The result is that even small cuts and abrasions often go unnoticed until they become much more serious. It is estimated that every 1.2 seconds someone on the planet develops a diabetic foot wound and every 20 seconds someone loses a limb to it.

Prevailing methods are failing patients A major issue is the need for more accurate wound information. Current methods of measuring and assessing foot wounds are inadequate. In fact, the standard measurement has more than 30 percent inter-operator error. Tracking the healing process also

means monitoring changes in the proportion of healthy tissue relative to unhealthy which is also prone to subjectivity.

Unreliable wound information creates a variety of challenges and can lead to improper diagnosis and treatment. The consequence is patients who simply do not heal.

Revolutionizing diabetic wound care Diabetes is, of course, a complex disease.

Treatment involves a variety of medical practitioners, from family doctors and specialists to nurses and therapists. Capturing wound data digitally brings the added benefit of making it easy to share this information, allowing teams to provide more holistic care.

Through automation, treatments can also be standardized using checklists and other prompts. This ensures critical procedures and assessments are delivered consistently.

Putting patients at the center of the healing process A study from the International Wound Journal found that photography is an effective tool in empowering patients in the management of their wounds. Eighty percent of study participants said photographing their wounds, which can be hard for them to see, would help them track progress without relying solely on the physician’s assessment. n David G. Armstrong, M.D., Professor of Surgery & Director of SALSA, Keck School of Medicine, USC

The Most Advanced Digital Wound Care Platform Delivering better outcomes and quality of life for diabetic patients in over 2,000 Hospitals, Skilled Nursing Facilities and Home Health Agencies.

swiftmedical.com

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MEDIAPLANET

A Race Against Time

Health professionals know this race all too well, as they strive to save the lives and limbs of people with diabetes suffering from severe wounds. We are addressing this critical need by providing advanced treatments that help promote healing and offer protection, even in difficult and challenging situations.

Today, more than 30 million Americans have diabetes – with numbers continuing to rise – and 2.9 million of them suffer from chronic wounds.1 This pressing need, touching millions of families, is why our energies are focused on wound care. Our passion to help and heal – together with our advanced treatments – envisions a future when more patients will be treated and better outcomes will result.

We recognize that lives are at stake, and there is no time to waste.

For all of us at MiMedx, waiting is not an option.

1. SmartTRAK / BioMedGPS, LLC . Accessed October 1, 2019.

MiMedx® is a registered U.S. trademark of MiMedx Group, Inc. ©2019 MiMedx Group, Inc. All Rights Reserved. mimedx.com SB821.001

Type 1 diabetes is a challenging disease to manage, but champions are moving us closer to cures.

Type 1 diabetes (T1D) is a difficult disease to manage and live with every day. More than 1.25 million Americans with T1D, including me, have a pancreas that does not produce insulin, so we must take the hormone multiple times — often injected — each day to survive. But insulin is not a cure. T1D remains a life-threatening and life-changing disease. Researchers around the world are working diligently to develop cures that build on decades of progress, and we need your help to increase research funding.

Can we make life better for people with this disease and bring about a cure?

I believe we can, and a big part of that is thanks to T1D Champions. These are not only people living with T1D and their loved ones, but also the researchers, advocates, volunteers, and people who donate to improve lives and develop cures. I meet them in towns and cities all across the United States, and am energized by their commitment to improve the lives of people with T1D. Technology advances have revolutionized how people manage T1D; there is now on the market an artificial pancreas, something that was science fiction when I was a boy. What we need to do is make sure that everyone who needs these tools and the insulin that keeps all of us healthy has access to it and can afford it.

Today, beta cell therapy and immunotherapy are promising avenues toward cures. Scientists are studying treatments that might prevent the immune system from attacking and destroying insulin-producing beta cells in the pancreas.

Researchers also are making progress on ways to replace and regenerate damaged beta cells.

Now is the time for more innovation and research, to move to get cures out of labs and to people. n

Aaron J. Kowalski, Ph.D., President and CEO, JDRF 6 • FUTUREOFPERSONALHEALTH.COM

Victor Garber Never Let Type 1 Diabetes Stand in His Way Life with diabetes was a lot different when Victor Garber was diagnosed as a boy, but he says he never let the disease stop him from achieving his dreams.

Fans may know Victor Garber as the captain from the movie “Titanic”, or perhaps creepy Professor Callahan from “Legally Blonde”, but they may not know that the actor has type 1 diabetes, which he was diagnosed with at “12-years-old”.

Garber emphasizes the importance of finding a cure for the disease but says his daily life has gotten easier with new treatment technologies. The actor now wears a Dexcom G6 glucose monitor and uses the Omnipod pump, “which eliminates syringes altogether.” These wearable medical devices allow people with diabetes to more easily check their blood sugar levels and pump insulin directly into the body without the need to give themselves a shot using a

PHOTO: ROBBY KLEIN

The Time for a Diabetes Cure Is Now

needle. These life-changing technologies weren’t around when Garber was first diagnosed.

“It was so long ago that I was diagnosed with type 1 diabetes, it’s hard to describe how different life was for me as a boy of 12. Somehow, I always adapted and had a determination to achieve my dream of being an actor and singer.”

“I always adapted and had a determination to achieve my dream...”

One thing Garber found hugely helpful to adapting to life with diabetes was going to Camp Banting in Ottawa, Ontario when he was 13, which is Canada’s longest running camp for children with type 1 diabetes.

He says his mother gave him a “hard sell” on the

camp because she thought it would be an important experience. “She was right,” he says. “It was life-changing and I recommend all parents with type 1 children to encourage any experience that puts them in contact with other people managing this complicated auto-immune disease. It ‘normalizes’ the routine, and, of course, erases any feelings of isolation and loneliness.”

Garber says even with technologies that simplify his day-to-day, nothing really gets easier as you get older, “unless you find a sense of acceptance and gratitude.” He says everyone comes to acceptance in their own way, and for him meditation is a major part of his life.

“I still have a love of acting and being with my close friends, which provides a balance that helps me deal with the intricacy of type 1. When I see this disease as an opportunity to grow, that is usually a very good day.” n Lynne Daggett MEDIAPLANET

The Right Diabetes Care Can Avoid Amputations and Save Lives Diabetes can cause foot ulcers that threaten limbs, but there are steps you can take to mitigate your risk.

Diabetes is the fastest growing disease in the United States.

The Centers for Disease Control and Prevention predict that by 2050, 1 out of 3 Americans will be diabetic.

Anywhere from 1 in 4 to 1 in 6 of those patients will get an ulcer, which is an open sore or wound, typically on the bottom of the foot. Without the proper care, ulcers can lead to infection and amputation.

Patients who suffer a belowknee amputation have a 68 percent five-year mortality rate. That’s higher than the

five-year mortality rate for breast cancer, prostate cancer, and non-Hodgkin’s lymphoma combined.

As a podiatrist, one of my most important jobs is to treat those ulcers and help patients avoid amputations.

Evolving care We’ve seen a lot of evolution in wound care. There have been incredible advances in the products we use to treat serious diabetic wounds. We have products that include stem cells, which differentiate into muscle, tendon, bone, fat, and skin. They also stimulate the growth of blood vessels, which is critically important, because good blood flow promotes healing.

Another important factor in diabetic wound care is biomechanics — simply put, the mechanics of human movement. When an ulcer — or an amputation — changes the way a person moves, those changes put stress on other parts of the body and can cause wounds to develop on other areas of the feet. Podiatrists evaluate a patient’s biomechanics to help prevent more wounds from developing and help existing wounds heal.

Save the toe Some physicians might say, “It’s just a toe, take it off.” Don’t ever say that within 50 miles of me. My philosophy is simple: If you save the toe, you save the

foot; if you save the foot, you save the leg; if you save the leg, you save the life.

If you have diabetes, have a regular foot exam with a physician. Check your feet daily, or, if you can’t, ask a loved one for help or use a mirror.

If you notice any change in your feet, see your podiatrist immediately.

Diabetes is not going away in our lifetimes, but with the proper care team and personal vigilance about changes in your health, you can manage your diabetes and prevent some of its most serious complications. n R. Daniel Davis, D.P.M., Former President, American Podiatric Medical Association

Medela is joining efforts with healthcare providers during Diabetes Awareness Month and supporting chronic and complex diabetic wound healing.

Learn more at www.medelahealthcare.us Email: info-healthcare@medela.com Call: 1.877.735.1626

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REDUCE ADDED SUGARS DELICIOUSLY THIS HOLIDAY

HOLIDAY RECIPES & MORE

S W E E T L E A F.C O M

SWEETLEAF CRANBERRY SAUCE 2 Tbsp. SweetLeaf® Organic Stevia Sweetener 5 to 6 drops SweetLeaf® Liquid Stevia SteviaClear® Sweet Drops™ 4 cups (1 pkg.) cranberries 1/2 cup orange juice 1/2 cup cranberries, dried Zest of 1 orange NUTRITION PER 1 SERVING (1/4 CUP): Calories 37, Carbs 8g, Dietary Fiber 1g, Fats 0g, Cholesterol 0mg, Protein 0g, Sodium 0mg, Sugars 5g (from orange juice) Recipe without SweetLeaf: Calories 110; Sugar 22g; Carbs 25g

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