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Seared tuna with butter beans and roasted tomatoes

Preheat the oven to 180ºC / 350ºF / gas mark 4. Mix together the cumin, coriander seeds and chilli flakes, press into both sides of the tuna and set aside for 30 minutes to allow the flavours to develop. Meanwhile, heat the oil in a small pan and fry the onion and garlic for 2-3 minutes. Transfer to an ovenproof dish with the butter beans and tomatoes, place in the oven for 30 minutes until the tomatoes begin to char. Heat a griddle pan until smoking and sear the tuna for about 1 m ...

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25 Jul 2012
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South Sefton Diabetes Group Update - Aug 2012
25 Jul 2012
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Strong HbA1c from diagnosis prevents complications for 20 years
Research has consistently shown that good control of blood glucose levels reduces the risk of long term complications and now a study from Sweden has showed that when good control is achieved in type 1 diabetes from diagnosis, long term complications can be reliably eliminated for at least 20 years. The study involved 451 patients with type 1 diabetes that were newly diagnosed between 1983 and 1987. All participants were under 35 years of age when diagnosed. The researchers recorded rates of the microvascular complications, retinopathy (eye disease) and nephropathy (kidney disease), from screening tests and medical records. Blood glucose control was measured by weighted mean HbA1c levels over the follow up period of 20 to 24 years. Well controlled diabetes was defined as having a long-term weighted mean HbA1c levels below 60 mmol/mol (7.6%) over the 20 plus years of follow up. The researchers compared the well controlled participants with those that had poor diabetes control; that is having a long-term average HbA1c of above 80 mmol/mol (9.5%). The results showed that none of the participants with well controlled diabetes developed proliferative retinopathy or persistent macroalbuminuria (protein in the urine as a result of kidney disease). By contrast, just over half of those with a long term HbA1c of above 80 mmol/mol (9.5%) developed proliferative retinopathy over the follow up period and nearly a quarter had developed persistent macroalbuminuria. The study further illustrates the importance of maintaining a strong HbA1c from diagnosis. The results also provide incentive for newly diagnosed patients to aim to consistently achieve an HbA1c below 60 mmol/mol. Within the UK, the target HbA1c is 48 mmol/mol (6.5%) for people with type 1 diabetes with a wider target of 58 mmol/mol (7.5%) for patients at increased risk of hypoglycemia. Achieving these targets is a reliable way of preventing the complications of diabetes from developing for decades.
20p tax on sugary drinks could reduce diabetes risk
A 20p "sugar tax" on sugary canned drinks would save thousands of children from diabetes, heart disease and cancer late in life, experts claim. This campaign was proposed by the Children’s Food Campaign (CFC) after they published research investigating how a UK government tax on sugary drinks could impact London. The results, calculated by academics from the University of Liverpool showed a 20p levy would reduce the number of people in London who develop diabetes by 6,300. A 20p tax was also found to prevent 1,100 cases of cancer in the capital, with 4,300 people cut from those suffering from coronary heart disease or strokes. Tackling the sugar source Malcolm Clark, campaign co-ordinator of the CFC, explained: "A duty on sugary drinks of 20 pence per litre would be the most practical and effective way of tackling a significant source of unnecessary calories and sugar in children and young people’s diets." The British Dietetic Association, Academy of Medical Royal Colleges and Faculty of Public Health are just three of more than 60 organisations that have already backed the campaign. A tax of 20p a litre would add roughly seven pence to a Coca-Cola or Pepsi can, with soft drinks currently the largest single sugar source for children aged between four to ten and teenagers. France, Hungary and Mexico have implemented similar taxes on sugary drinks, with consumption in Mexico reduced considerably after a year of the tax being introduced. Clark concluded: "We urge London’s mayor and council leaders to include a sugary drinks duty in their review of how London might manage devolved taxation powers, and to make the case to Westminster for the introduction of such a duty nationally." The Children's Food Campaign plans to launch figures for the impact of a sugary drinks duty on the rest of England in early 2015.
GLP-1 hormone linked to dehydration in diabetes
Some drugs that are used to treat diabetes have been found to mimic the behaviour of a hormone that controls fluid intake, raising concerns of dehydration. GLP-1 hormone The GLP-1 hormone increases the release of insulin in the body, which functions in the same way as many injectable treatments for diabetes. However, a paper from psychologist Derek Daniels of the University at Buffalo has cited a notable absence in research on the hormone’s role in fluid intake. Daniels reports that when GLP-1 binds to receptors in the body, a signal is sent to the brain to decrease the intake of fluid. "We blocked that signalling," said Naomi J. McKay, a graduate student and co-author of the paper. "In doing so, we found an elevation in water intake." Licking patterns This blocking became harder when measuring increases in a rat’s fluid intake after consuming the GLP-1 hormone, as they consume fluid in nanolitres. With nearly five million nanolitres required to fill a teaspoon, researchers used a lickometer to study licking patterns. Lickometers measure the number of times a rat’s tongues touches an electrical point, with the number of licks monitored and translated to provide a given fluid volume. "Licking patterns can give us hints about why rats drink more or less after an experimental manipulation," said Daniels. "In this study, we found that the rats were probably drinking more because they were feeling less full from the drinking. "Clearly what we're seeing, is that these substances decrease drinking behaviour," said Daniels. "But we're not saying people shouldn't use these drugs to treat diabetes, and we're not saying they are ineffective tools for the treatment of diabetes. "However for populations already at risk for dehydration it may be something we want to be more concerned about."
Personal fat threshold theory gives hope for type 2 diabetes remission
An intriguing hypothesis has been put forward by Professor Roy Taylor, the leading academic whose previous work has included running and publishing a groundbreaking study into the effects of very low calorie diets on type 2 diabetes remission, commonly referred to within the diabetes community as the ‘Newcastle diet’. The hypothesis suggests that each individual has their own personal fat threshold (PFT) which determines how much fat they can put on before problems begin to develop such as the accumulation of fat around the liver and pancreas which can then lead on to insulin resistance and then type 2 diabetes. One of the key points of evidence noted in the research paper is data from newly diagnosed patients with type 2 diabetes that took part in the UK Prospective Diabetes Study which ran between 1977 and 1991. Professor Taylor’s team used the data to draw a distribution curve to show at what BMI patients diagnosed with type 2 diabetes had. The data shows that 36% of newly diagnosed patients had a BMI of 25 or under, indicating what is commonly regarded as a healthy weight. Professor Taylor’s hypothesis offers a certain degree of hope as it suggests that if you have been newly diagnosed with type 2 diabetes, by losing a significant amount of weight, you may be able to reset your body back to a state of normal blood glucose levels. If you were to achieve this, you would need to note that putting weight back on would then shift you back into a diabetic state, so strict weight management would need to be maintained to prevent this from happening. Currently, a research study is being run, with funding by the charity Diabetes UK, to test whether a very low calorie diet is effective in achieving long term remission in patients with type 2 diabetes. The study involves 140 patients and is being conducted over a two year period. Remission is when patients with type 2 diabetes on medication improve their condition to a point in which medication is no longer needed. The difference between individuals’ personal fat thresholds also represents an interesting new avenue of research and could be used as a model to test how much genes and other factors, including use of certain medications linked with type 2 diabetes, might play a part in modifying the threshold.
Hypoglycemia linked to increase risk of cardiovascular diseases
Scientists from the University of Leicester have established a link between the increased risk of cardiovascular events and severe hypoglycemia. The results, published in the journal Diabetes Care, could lead to changes in the way some patients with diabetes have their treatment managed. Hypoglycemia study After extracting data from the Clinical Practise Research Datalink database, the scientists examined 3,260 patients with type 1 diabetes, and 10,422 patients with type 2 diabetes who were all treated with insulin. Following severe hypoglycemia (very low blood sugars), insulin-treated patients with diabetes had roughly a 60 per cent higher risk of cardiovascular events. They were also 2-2.5 times more likely to die during the same period as patients who did not experience severe hypoglycemia. Risk of cardiovascular events Cardiovascular disease is a higher risk for people with diabetes due to the formation of atherosclerotic plaques in blood vessels, which was a major cause of early death in these patients. When blood glucose levels become dangerously low, this can potentially trigger fatal cardiovascular events. Kamlesh Khunti, leader of the research and professor of primary care diabetes and vascular medicine at the University of Leicester, said: "This is one of the first studies to report the risk of cardiovascular events and mortality in people with both type 1 and type 2 diabetes. The risks are very significant and we need to identify these patients early with a view to implementing strategies to reduce their risk of severe hypoglycaemia." The research team included researchers from insulin manufacturer Novo Nordisk.
Health bosses wary as diabetic amputations too high
Health bosses have admitted the number of amputations related to diabetes in Cornwall, Dorset, Somerset and Devon is too high. Over 1,500 amputations were conducted in the four counties from 2010-2013, with 528 classed as major procedures – above the ankle. Diabetic amputations The risk of amputation for people with diabetes comes from damage done to nerves and blood vessels, with the feet worst affected. This damage occurs from poor blood glucose management, which can also lead to other serious complications such as blindness and stroke. Devon had the highest rate of the four counties, with Dr. Gary Lenden, from the NEW (Northern, Eastern and Western Devon) Devon Clinical Commissioning Group, saying: "It's something we're clearly concerned about and acutely aware of." Foot care awareness Lenden also added that education needed to be improved by medical teams, but patient awareness in people with diabetes is also essential in avoiding amputations and other complications. Foot care should not be difficult for people with diabetes, and it is important to check your feet every day as any graze or small ulcer can represent a serious risk. People with diabetes are required to get their feet checked once a year, and you should ensure you receive this check at each annual diabetic review.
Anti-TGF-beta 1 therapy trial for diabetic nephropathy terminated
An anti-TGF-beta 1 therapy trial for diabetic nephropathy has been terminated four months before its scheduled completion. Anti-TGF-beta 1 therapy TGF-beta over-activity has been implicated as a key pathogenic factor in diabetic nephropathy, which is the deterioration of proper functioning in the kidneys. Scientists had previously discovered that TGF-beta 1 therapy was effective as an antibody against three TGF-beta isoforms that occur in diabetic nephropathy. The news was revealed by Dr. James R. Voelker of Eli Lilly and Co., Indianapolis, who had been working on the study. Study problems 416 patients with type 1 or type 2 diabetes with diabetic nephropathy were randomised to receive treatment with either placebo, or anti-TGF-beta 1 therapy. The groups had similar demographics, with 75 per cent being men and 90 per cent having type 2 diabetes. All patients were receiving stable renin-angiotensin-system inhibition (RASi) therapy prior to the trial. Treatment at any dose was not significantly more effective than placebo. This was in respect to the mean change in serum creatinine, which was the primary outcome measure. An independent data safety monitoring committee reviewed safety data periodically, calling for an unscheduled utility analysis to be performed in the study’s later stages. The decision was made to prematurely terminate the study based on the results of that analysis. Dr Voelker concluded: "Diabetic nephropathy is a disease of significant unmet medical need, as it is the leading cause of end-stage renal disease in much of the world. It is incumbent upon the nephrology community to identify new and more effective treatments than are currently available."
Shift workers warned of obesity and type 2 diabetes risk
Scientists have raised concerns that shift workers face higher levels of obesity that can lead to type 2 diabetes. 33 per cent of men and 22 per cent of women of working age in England were found to be doing shift work after a report from the Health and Social Care Information Centre. Shifts were defined as employment outside of 0700-1900, with 30 per cent of shift workers found to be obese, compared to 24 per cent of men and 23 per cent of women doing normal hours. Type 2 diabetes risk Obesity is one of the factors that can increase the risk of developing type 2 diabetes, and is believed to account for 80-85 per cent of the risk of type 2 diabetes developing. As well as the additional percentage of shift workers who were obese compared to those working normal hours, 40 per cent of men and 45 per cent of women working shifts were found to have other long-standing health conditions. These included back pain, diabetes and chronic obstructive pulmonary disease, which compared to 36 per cent of men and 39 per cent of women in the rest of the population. Shift work warnings "Overall, people who are doing shift work are not quite as healthy as their counterparts doing regular working hours," said Rachel Craig, the research director for the Health Survey for England. Dr Simon Archer, a body clock scientist at the University of Surrey backed up these findings by warning that shift work is bad for the body. "Shift work is becoming increasingly common and it's causing a lot of problems to a lot of people and in particular the link with cancer is becoming stronger. Obesity is the clear link, and that also leads to type 2 diabetes."
Potato extract may counter obesity and type 2 diabetes, study suggests
A simple potato extract could potentially reduce weight gain, thereby countering obesity and type 2 diabetes, according to a new study. The research, conducted by scientists at McGill University, found that the polyphenols in potatoes reduced weight gain in a group of mice. The mice were fed with an obesity-inducing diet for ten weeks. The mice weighed an average of 25 grams at the beginning of the study, and quickly gained an average of 16 grams. However, the mice that were fed exactly the same diet but with the potato extract didn't gain nearly as much weight: only seven grams were put on by these mice, on average. Obesity increases the risk of a number of conditions, including type 2 diabetes, cardiovascular disease, and cancer. Although the results of this study are promising, they are only a first step. It takes 30 potatoes to get the required daily dose of the extract. Eating 30 potatoes would be a massive intake of calories, and not at all advisable. The researchers hope that the extract could be made available as a dietary supplement or cooking ingredient. Moreover, the study was only conducted on mice. Clinical trials on humans will need to be carried out to assess the viability of the research, even though mice and humans metabolise food in similar ways. Professor Luis Agellon, one of the study's authors, said: "We were astonished by the results. We thought this can't be right - in fact, we ran the experiment again using a different batch of extract prepared from potatoes grown in another season, just to be certain."
Sugar worse than salt for increasing blood pressure, study suggests
Sugar is worse than salt for increasing blood pressure and the risk of cardiovascular disease, new research suggests. The study, published in the online journal Open Heart, suggests that the benefits of reducing salt intake in order to lower blood pressure are "debatable", and recommends that dietary guidelines focus on reducing sugar rather than salt. High blood pressure is a key risk factor in the development of heart disease, stroke, and other complications associated with diabetes. The authors, Dr. James DiNicolantonio and Dr. Sean C. Lucan, said: "Sugar may be much more meaningfully related to blood pressure than sodium, as suggested by a greater magnitude of effect with dietary manipulation. "Compelling evidence from basic science, population studies, and clinical trials implicates sugars, and particular the monosaccharide fructose, as playing a major role in the development of hypertension. "Moreover, evidence suggests that sugars in general, and fructose in particular, may contribute to overall cardiovascular risk through a variety of mechanisms." A number of academics and medical experts have dismissed the study, claiming that the research has been over-exaggerated and not based on any new evidence. Tom Sanders, Professor of Emeritus of Nutrition and Dietetics at King's College London, said: "In my opinion the effects of added sugars are exaggerated in this article. Cutting salt intake and losing weight will lower blood pressure, but the evidence for a direct effect of added sugar is tenuous. "As far as I am aware there is no evidence to show that blood pressure is lowered when sugar-sweetened beverages are replacing by artificial sweeteners."