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Publication: Diabetes Update
Pre-Diabetes

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Diabetic Digest - Wednesday, June 18, 2008
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News, updates and help from and for the diabetic community.
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Readers:

A whopping 54 million Americans have impaired fasting 
glucose, the pre-cursor to the potentially-deadly disease 
diabetes. Because over half of them go on to develop 
diabetes, getting the 411 on pre-diabetes is vital. 

Click the link below to watch this very important and 
informative video clip on Pre-Diabetes. 

View: Pre-Diabetes

After viewing the clip don't forget to enjoy the rest of 
today's issue. Read the informative articles and check out 
this week's recipe for Easy Sticky Buns. Delicious! 

Regards,
Steve

Diabetic Update Newsletter
Send Your Comments

Visit the Diabetic Update Forum and post your comments at: 
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Diabetic Weight-loss Plan Yields Long-term Success

SAN FRANCISCO (Reuters Health) - Researchers at the Joslin
Diabetes Center report that a 12-week weight-loss program
they devised for patients with type 2 diabetes continues
to have a positive, long-lasting effect on weight loss
1 year later, long after patients are off on their own.

The findings of a 1-year follow-up of the 12-week "Why
WAIT" weight-loss program were presented here this week
at the 68th Annual Scientific Sessions of the American
Diabetes Association by principal investigator Dr. Osama
Hamdy.

The study involved 85 patients with type 2 diabetes,
average age 54 years and a disease duration of
approximately 10 years. The average weight was 235 pounds,
average body mass index (BMI) was 38.4, average hemoglobin
A1C was 7.5 percent, and average waist circumference was
46.7 inches.

Patients completed the 12-week diet and exercise program
and were followed for another year without structured
intervention.

Twelve weeks of the intervention resulted in an average
weight loss of 24.6 pounds -- more than a 10 percent
reduction -- a waist circumference reduction of 3.6 inches,
and an average drop of 0.9 percent in A1C to 6.6 percent,
indicating good control of blood sugar.

After 1 year of follow-up, weight remained lower than
before the patients began the diet by more than 18 pounds
-- a long-term loss of 7.6 percent. However, A1C levels
increased to approximately 7.4 percent.

Overall, 55 percent of participants continued to lose
weight on their own, Hamdy said. The other 45 percent
gained back approximately 5 pounds, but their final
weight remained 2.0 percent lower than their pre-diet
weight.

Blood pressure, both top and bottom readings, were
significantly lower at 12 weeks and 1 year compared with
pre-diet readings, he added. Cholesterol levels improved
significantly at 12 weeks, but had returned to pre-diet
levels at 1 year, except for HDL, the "good" cholesterol,
which remained significantly higher.

Hamdy said there was evidence that kidney function improved
as well, with a small decrease in protein in the urine.

"The clinical implications are enormous," Hamdy told
Reuters Health. "We've been glucose-focused for a long
time. We need to be weight-focused. We need to focus
on the cause of the problem and not the result of the
problem."

The mainstays of the "Why WAIT?" program are a low carb
diet and tailored exercise. "We use significant calorie
reduction and reduce carbohydrates to 40 percent of
calories and increase protein to 30 to 40 percent of
calories -- this is key for patients to maintain muscle,"
Hamdy said. "In addition, we teach patients how to
exercise, especially the type and the amount, and make
sure it is age-appropriate. This is very important."

He added, "The main reason that patients regain weight
is that they decrease their protein intake and don't
exercise as much. The weight they gain is mostly fat,
and visceral fat."

There is also an economic benefit. "Weight reduction
leads to a reduction in need for medications. We saw
a 65 percent-reduction in medical costs, or about
$560 per year per patient -- and patients feel better,"
Hamdy reported.

Copyright 2006 Reuters Limited. All rights reserved.

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Men And Women May Metabolize Fructose Differently

NEW YORK (Reuters Health) - Men and women appear to differ 
in how they metabolize high levels of fructose, a simple 
sugar commonly used to sweeten drinks and foods. 

Short-term high fructose intake among young men resulted 
in increased blood triglycerides (fats) and decreased 
insulin resistance, factors associated with an elevated 
risk for cardiovascular disease and type 2 diabetes, report 
Dr. Luc Tappy and colleagues. 

Whereas, "women get rid of the excess sugar load in a 
(likely) less deleterious way," said Tappy, of Lausanne 
University School of Biology and Medicine in Switzerland. 

"Hence, gender has to be taken into consideration in 
studies evaluating the relationship between nutrition 
and metabolic disorders," Tappy told Reuters Health. 

Tappy and colleagues enlisted 16 healthy, nonsmoking men 
and women of normal weight and about 23 years of age, to 
follow two different 6-day diets separated by a 4-week 
wash-out period. 

The 8 men and 8 women did not participate in sports or 
exercise while following either the "control" diet or 
the diet that included a lemon-flavored drink containing 
3.5 grams of fructose. 

"The fructose load used in this study was quite large 
(corresponding to several liters of sodas per day)," 
noted Tappy. He and colleagues tested 12 fasting metabolic 
parameters the day after participants completed each diet, 
they report in Diabetes Care. 

In the men, fructose supplementation caused significant 
increases in 11 of the 12 factors, including a 5 percent 
increase in fasting glucose and 71 percent increase in 
triglyceride levels. 

By contrast, women showed a 4 percent increase in glucose 
and a "markedly blunted," 16 percent increase in 
triglycerides after the high fructose diet, the 
investigators said. Overall, the women showed significant 
increases in only 4 of the 12 factors tested. 

Further studies should more accurately identify gender 
differences in metabolic pathways and confirm these 
observations in a larger population, the investigators 
note. 

"One burning question is whether fructose may have more 
deleterious effects in individuals at high risk for 
metabolic disorders," Tappy surmises. 

SOURCE: Diabetes Care, June 2008.

Copyright 2006 Reuters Limited. All rights reserved.

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                     Diabetic Recipe

                    Easy Sticky Buns

       (Recipe courtesy of Butter Buds ~ 10 Servings)

1 packet Butter Buds Mix, dry
1/4 cup hot water
3 tablespoons packed light brown sugar
1/2 teaspoon ground cinnamon
1 1/2 tablespoons chopped walnuts
1 package (7.5 ounces) refrigerated biscuits

1. Preheat oven to 375°F. Spray an 8-inch round baking pan
   with nonstick cooking spray.

2. In a small bowl, combine the Butter Buds, water, brown
   sugar, and cinnamon. Pour into the prepared pan.
   Sprinkle with nuts. Arrange the biscuits in a single
   layer on top of the nuts.

3. Bake 15 to 20 minutes or until well browned. Immediately
   invert onto a serving plate.

Per serving: 80 calories, 1 g protein, 2 g total fat
             (<1 g saturated fat), 16 g carbohydrate,
             0 cholesterol, 240 mg sodium

Exchanges: 1 carbohydrate (1 bread/starch)

Copyright 1997-2001 Diabetic-Lifestyle.

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