Posts for: August, 2014

Shift Work Linked To Increased Risk Of Type 2 Diabetes

Robert Glatter | July 25, 2014.

Type 2 diabetes is more common in those who work shifts, according to results of a new study.

Data from the study adds to the ongoing concern for those who work shifts, in which known risks already include cancer, digestive diseases, and cardiovascular disease.

Findings of the study were reported July 24 in the Journal, Occupational and Environmental Medicine.

“Physicians have long been aware that sleep is a critical part of our health,” explained Dr. Alan Manevitz, Clinical Psychiatrist at Lenox Hill Hospital in New York City.  “So a new study linking shift work – in which 10 million Americans take part – to type 2 diabetes is not ‘new news’.”

“Since diabetes itself is caused by a combination of genetic and lifestyle factors, including sleep, the results make sense,” added Manevitz.

It is believed that disruption of sleep patterns leading to lack of sleep triggers metabolic and hormonal changes leading to increase in appetite, and subsequent weight gain.

In fact, results of previous sleep studies in laboratory settings have already demonstrated that when people sleep during daylight hours they can develop early stages of type 2 diabetes within a few weeks.

The study, a meta-analysis, evaluating over 226,000 persons, provides an even stronger association between altered sleep patterns and development of type 2 diabetes.

Data from the study, from the Huazhong University of Science and Technology in China showed that overall, shift workers were 9 percent more likely to have type 2 diabetes. In men, the risk rose to 35 percent and in those who rotated between day and night shifts, the risk was even higher—42 percent.

The authors write, “Given the increasing prevalence of shift work worldwide, and the heavy economic burden of diabetes, the results of out study provide practical and valuable clues for the prevention of diabetes.” With the addition that “male shift workers should pay more attention to the prevention of diabetes.”

The reason for increase risk for type 2 diabetes is likely related to altered sleeping and eating patterns as a result of shift work. One explanation is that eating late at night makes one more likely to store the calories as fat, leading to an increase risk for development of obesity, and consequently type 2 diabetes.

Another explanation is that the daytime levels of the male hormone, testosterone, are controlled by the circadian rhythm, essentially the body’s internal clock. Shift work seems to affect the clock, leading to lower testosterone levels, which are ultimately linked to insulin resistance and development of diabetes.

However, other factors beside testosterone may also be at work.

“Study authors implicate the disruption of the male hormone testosterone as one potential trigger of insulin resistance and diabetes in study participants,” Manevitz explains, “but a wide array of other body chemicals are also skewed when normal sleep patterns are disrupted, including leptin and growth hormone.”

But another important syndrome predisposing one to diabetes also deserves special mention in the setting of the discussion about diabetes.

“Metabolic syndrome – a cluster of conditions occurring simultaneously that increase the risk for diabetes, among other serious conditions – is three times higher among individuals working the night shift, according to previous research,” said Manevitz.

Potential ways to combat the elevated risk for developing diabetes associated with shift work include eating a healthy and balanced diet, engaging in regular exercise, along with practicing effective sleep hygiene to promote a more conducive environment to falling and staying asleep for longer periods.

“Sound sleep hygiene is paramount for shift workers,” said Manevitz, “including using blackout curtains and a sound machine to block daytime noises.”

“Shift workers should also be diligent about controlling lifestyle factors such as diet and exercise – important to us all, but especially those whose jobs preclude sleeping during normal nighttime hours,” added Manevitz.

Screening shift workers for elevated cholesterol, blood pressure as well as increasing hemoglobin A1C, a sensitive marker for developing diabetes makes good sense in the workplace.  This can spot those at risk for developing type 2 diabetes, before their blood sugar begins to elevate.


Diabetes leads to damage to blood vessels and nerves while increasing the risk for developing coronary artery disease, potentially leading to heart attacks, as well as strokes.

The authors point out that while the study was large, it was observational. As a result, no direct cause and effect relationship can be established.

Projections are that nearly 380 million people will have type 2 diabetes by 2025, making this an urgent public health issue.

Wearable Technology Saving Limbs of Diabetes Patients

American Innovation


The Center for Disease Control and Prevention reports someone loses a limb from diabetic complications every 20 seconds.

Diabetes causes a loss of sensation, leaving ulcers to go unnoticed and become infected. If not treated soon enough, the limb has to be amputated.

But doctors at the University of Arizona Medical Center, in Tucson, Arizona, have found a way to prevent the development of these ulcers, and it's as simple as putting on a pair of socks.

'Smart Socks' use fiber optics and sensors to monitor pressures in the patient's feet.

"These Smart Sox were designed to identify both locations of the foot and ranges of motion that could be problematic. We can then get information to can give us a warning sign of hotspots, which cause complications" said Dr. Bijan Najafi of The University of Arizona Medical Center.

Foot ulcers affect many of the nearly 26 million people in the US suffering from diabetes.

"It's among the most common reasons that someone with diabetes will be admitted to the hospital; not the heart attack, not the stroke, not the high blood sugar, but a foot problem," said Dr. David Armstrong.

Dr. Armstrong heads the University's Southern Arizona Limb Salvage Alliance, an organization dedicated to preventing amputations in diabetes patients. His patients are especially grateful for the advancements made by the group.

Donna Flinz suffers from neuropathy, and has lost all sensation in her feet.

"I have no idea what's going on down there. I could cut myself easily, I could jab myself with a stone. There's just so much going on down there that I don't know because my nerve endings are basically destroyed. So the socks will do that for me. It tells me what my feet should've told me," said Flinz

Patient Carlos Davila is a flight attendant, and works on his feet for hours each week. He is worried about the possibility of diabetic foot ulcers.

"My father and my brother both lost legs to diabetes so I try to keep a real close eye on it, " said Davila.

The socks draw their inspiration from video game technology, using aspects of virtual reality to draw medical conclusions.

"PlayStation isn't just for kids anymore. These technologies are completely changing the game," said Dr. Armstrong.

The socks came to light through the medical expertise of Dr. Armstrong, and the engineering expertise of Dr. Najafi. They believe the socks are just the beginning of a new future in disease prevention.

"We're starting to see medical tech and consumer tech merge. And this year, it's been happening more than any other year in our existence," said Dr. Armstrong.

The study is funded by the Qatar National Research Fund, which donated more than $2 million in grants to the University.

Researchers expect Smart Socks to be available to the public by 2019.


Trendy fitness sandals could harm your back




If you are unfit, have poor posture or any kind of existing hip or knee problems, then they are best avoided.



London - They’re the summer shoes that promise to correct your posture, improve your fitness, alleviate back pain and strengthen muscles.

And many of us have been persuaded by that message, with fitness sandals, such as FitFlops, MBTs and Skechers Tone-Ups to name but a few, selling in their millions.

Unlike a lot of fashionable shoes, they certainly look sturdy and sensible. But are they really as good as they seem?

Experts are warning that on the wrong feet, these fashionable fitness shoes — which can cost up to £150 (about R2 700) a pair — can lead to ligament strain and muscle injuries, and may even cause rather than alleviate back pain.

Most of these sandals have a heel pitched lower than the toe area. This creates an unstable, rocking sole that is meant to force the buttocks, calf and thigh muscles to work harder.

Others have a very flat, thin sole, designed to mimic the bare foot, helping the feet and lower legs to move in the way nature intended. The theory is that this corrects pain caused by poor posture in other parts of the body.

However, Lucy Macdonald, a chartered physiotherapist specialising in musculo-skeletal injuries at the Octopus Clinic in London, says she has seen “a lot of problems” and warns the sandals are not suitable for everyone.

“They are fine for a small percentage of people who are young, strong and fit,” she says.

But if you are unfit, have poor posture or any kind of existing hip or knee problems, then they are best avoided. “They could lead to injuries such as back and knee pain, and strains,” she says.

Michael O’Neill, a consultant in podiatric surgery at the Princess Margaret Hospital in Windsor, explains: “Some of these sandals do make the muscles of the lower leg work harder, but that is not necessarily a good thing.

“Wearing them is like walking uphill all the time, which puts a lot of additional and unnecessary strain on muscles and tendons in the lower leg, and they are likely to cause pain and damage for many.”

Even claims about toning benefits have been questioned. Studies have shown that the effects are minimal, or non-existent, and can be no better than wearing ordinary trainers.

Part of the problem is that some of these sandals lack support for the feet at the sides and heel. In this respect, they may be no better than flip-flops, says Sammy Margoof the Chartered Society ofPhysiotherapy.

She explains that 70 percent of people are “over-pronators”, whichmeans their feet roll inwards excessively as they walk — fitness sandals do little to counteract this.

Long-term, over-pronation can lead to plantar fasciitis, a painful heel condition where the tissue at the bottom of the foot is over-stretched. Not only do they not support the feet, switching to the non-existent heel of barefoot-style sandals or the “negative” lower heel of a rocker-soled pair also stretches and strains the Achilles tendon at the back of the leg.

For women who alternate wearing high heels with toning sandals, this effect could be even worse, as the tendon is repeatedly shortened by high-heeled shoes and then lengthened, causing pain. And far from improving their condition, anyone with existing lower back pain or hip problems such as dysplasia — a problem from birth where the hip joint is the wrong shape — might find their discomfort becomes more severe if they wear fitness shoes.

“You need to be careful in choosing supportive footwear if you have these problems,” says Sammy Margo. “The body has to work harder to adjust to the new positions it is thrown into by this footwear and one effect could be added strain on fragile joints.

“Some people use their feet differently in this type of shoe; others walk differently. If you have problems with posture, they are likely to be exacerbated.”

This is why it may be that back pain worsens.

And if you thought fitness sandals would be a good option for long walks or sightseeing on holiday, think again.

“I’ve seen lots of people who have fallen, stumbled or stubbed toes in this sort of footwear just because they are not used to walking in them or are walking for too long and fatigue sets in, making them stumble,” says Mr O’Neill.

So, what sort of sandal should you wear? It should be flexible around the big toe, which many of the new breed of fitness shoes aren’t, says Lucy Macdonald.

“Sandals should also have a small heel or 1½ in wedge; full moulded support for the heel, which should be cupped and fastened in with a strap; and a little arch support.

“Ironically, I see a lot of cheap sandals in High Street fashion stores that are more foot-friendly than the so-called wellness shoes.

“They have straps to make the sandal fit snugly, a heel cup to keep the foot in place and even some arch support. My advice is not to waste your money on fitness shoes.” - Daily Mail

90% Of Americans With Pre-Diabetes Have No Idea They Have It

Lauren F. Friedman | June 10, 2014.

Most people know that diabetes is a major public health issue in the United States, but the scope of the problem is almost unfathomable. A quarter of the 1 in 11 Americans (29.1 million) who have diabetes don't know that they have it.

What's more, those who are pre-diabetic, where blood sugar is too high but not yet in the diabetes range, are also often in the dark — even though that risky period can be a crucial time to turn things around before diabetes takes hold. While pre-diabetes affects 86 million American adults (1 in 3), 9 out of 10 don't know they have it.

"These new numbers are alarming," said Ann Albright, PhD, of the National Center for Chronic Disease Prevention and Health Promotion. "If these numbers continue to rise, 1 in 5 people could have diabetes by the year 2025, and it could be 1 in 3 people by the year 2050."

Diabetes is most prevalent in Mississippi, West Virginia, Louisiana, Texas, South Carolina, Alabama and Georgia, but common all across the country and among all ethnic and racial groups.

Pre-diabetes may sound like a made-up problem, but it's far from harmless. "Without intervention, prediabetes is likely to become type 2 diabetes in 10 years or less," the Mayo Clinic cautions. "And, if you have prediabetes, the long-term damage of diabetes — especially to your heart and circulatory system — may already be starting." Pre-diabetes raises the risk of heart disease and stroke, even if it does not develop into diabetes.

The good news is that pre-diabetes does not have to be permanent. Exercise and healthy eating cut the risk of developing type 2 diabetes in half.

Here's a look at pre-diabetes in the U.S., from an infographic released Tuesday by the Centers for Disease Control and Prevention:


cdc prediabetes infographic




And here's a look at what happens when pre-diabetes turns into diabetes:


cdc diabetes infographic


Foot Care Tips to Keep You Moving While on Vacation


February 28th, 2013 | The Tolucan Times

T11-Filler 2

(BPT) – Decongestant, check. Sunscreen, check. Antacids, check. So you’re going on vacation and your bag is well-stocked with remedies for every illness that could possibly derail your good time – from sunburn to an upset stomach. While you’re taking steps to preserve your good health on vacation, don’t overlook the body part that will carry you through all that fun: your feet.

“Foot health is especially important for travelers,” says Dr. Joseph Caporusso, a podiatrist and president of the American Podiatric Medical Association. “If your feet hurt or you sustain an ankle injury, your whole vacation can be ruined. Plus, poor foot health can have a long-term detrimental effect on your overall well-being.”

The approach of warm weather means more Americans will be planning their spring and summer getaways. Before you step out on vacation, APMA offers a few foot health tips for travelers:

On the way

Whether you’re flying or driving to your destination, proper footwear is important. Knowing you’ll have to remove your shoes to pass through airport security screening may tempt you to travel in flip-flops or other footwear that’s easy to slip off. But travelers should not forego safety and support for convenience.

“Flip-flops are never a great walking shoe, and if you have to walk long distances from gate to gate or from your gate to ground transportation, or if you have to hurry, flip-flops could lead to problems,” Caporusso says.

What’s more, flip-flops mean you’ll be barefoot when you step through security – and that can leave your feet exposed to injury from sharp edges, uneven surfaces and germs. If shoes with laces will be too inconvenient for security lines, choose comfortable slip-ons that provide a thick, stable sole. And always wear socks through security.

Drivers also need to be aware of proper footwear on the road. Choose comfortable footwear that minimizes the risk of your foot slipping off a pedal. Never kick off your shoes while driving either; a shoe lodged under the brake pedal could interfere with your ability to stop quickly in an emergency.

On the beach

For many Americans, spring and summer vacations mean time spent on the beach. Whether you’re relaxing in a lounge chair, walking on hot sand or frolicking in the surf, it’s important to protect your feet from the singular risks of beach time.

Since most people wear flip-flops or sandals on the beach, don’t forget to apply sunscreen to your feet. Be sure to cover the tops of your feet, the front of your ankles, and even the soles. Limit the amount of walking you do in bare feet; walking in no shoes at all increases your exposure to sunburn, plantar warts, athlete’s foot, ringworm, other infections and even injury. Never walk barefoot in pool areas or locker rooms.

Always pack an extra pair of sneakers or water shoes so that if your shoes get wet you can have a dry pair. Wearing wet shoes for prolonged periods may lead to bacteria or fungal growth.

On the move

Sometimes, no matter how careful you are, injuries happen. Wherever your vacation takes you, it pays to pack a foot care bag so that you’ll be prepared to treat minor problems that can quickly evolve into major vacation setbacks. Your bag should include:

  • Sterile bandages for covering minor cuts and scrapes.
  • Antibiotic cream to treat minor skin injuries.
  • Emollient-enriched moisturizer to keep feet hydrated.
  • Blister pads or moleskins to prevent blisters and protect sore feet if blisters do form.
  • An anti-inflammatory pain reliever like Motrin or Advil to ease tired, swollen feet.
  • Nail clippers.
  • Emery board in case of broken nails or rough edges.
  • Sunscreen to prevent sunburn.
  • Aloe vera or a similar cream to relieve sunburn.

In case of a serious problem, seek the aid of a podiatrist – doctors who are specially trained to diagnose and treat ailments of the feet and lower extremities. You can find a podiatrist in your area by visiting APMA’s website,

“No one wants to spend their vacation with sore feet – or worse yet, at the doctor’s office,” Caporusso says. “Taking care of your feet while traveling can help ensure your vacation stays on track and the only things you bring home are great memories and souvenirs.”

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