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Health & Wellness

Study: Higher Risk Of Death In People With Heart Disease and Diabetes

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Findings of a new research from a global study revealed that the combination of Type 2 diabetes and coronary artery disease can be lethal.

Spearheaded by a physician from UConn Health, the study concluded that patients diagnosed with Type 2 diabetes admitted into the hospital for congestive heart disease have a 1-in-4 chance of dying within the next one and a half years. The new findings present a grim picture of the outcome of diabetes patients with severe heart diseases.

Dr. William B. White, who is the study’s principal investigator, said that patients diagnosed with both acute coronary syndrome and Type 2 diabetes require more attention to prevent a cardiac attack. Dr. White is also a professor at the Pat and Jim Calhoun Cardiology Center at UConn Health. He also adds that congestive heart failure is likely for people with Type 2 Diabetes, as reported in a news release.

With these new findings, the U.S. Food and Drug Administration now requires all new diabetes drugs to be formally tested for their potential effects on heart and stroke outcomes.

Patients with Type 2 diabetes are two to three times at risk of heart disease compared to the general population. This is attributed to obesity and other illnesses such as hypertension and high cholesterol levels which can lead to both diseases. The hormone insulin is also reportedly a contributor to heart disease. Insulin is needed by patients with Type 2 diabetes for their treatment.

The results of the new study were presented during the annual meeting of the American Diabetes Association (ADA) in New Orleans. It was also published online in the ADA journal Diabetes Care.

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Health & Wellness

All You Need To Know About Diabetes

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Diabetes is a lifestyle disease that affects millions of Americans and is the 7th leading cause of death in the United States. According to the 2014 National Diabetes Statistics Report prepared by the Centers for Disease Control and Prevention (CDC), approximately 29.1 million people in the country have diabetes. The CDC further estimates that about 8.1 million people have diabetes but are undiagnosed or unaware of their condition.

Though not immediately life-threatening, the disease increases the risk for developing complicated medical conditions including cardiac disease, hypertension, and kidney disease. More severe cases can cause kidney failure, blindness, and loss of limbs to amputation.

However, diabetes can be managed and prevented by making healthy lifestyle choices.

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Types of Diabetes

Diabetes mellitus (DM) is a metabolic disease characterized by elevated blood sugar levels. Glucose builds up in the blood when the hormone called insulin cannot metabolize the sugar from the food that has been ingested. This occurs in either of three ways: when the pancreas cannot produce sufficient insulin, when it overproduces insulin, or when the insulin released cannot be utilized properly by the body because the cells have developed a condition called insulin resistance. Here is a brief discussion of the types of diabetes.

Type 1 Diabetes

In type 1 diabetes, there is underproduction of insulin. The disorder is commonly diagnosed among children and young adults. The disease was previously called “juvenile diabetes.” The American Diabetes Association (ADA) estimates that only about 5 percent of diabetic patients have this form of diabetes.

Insulin is the hormone responsible for breaking down the sugar components, carrying the glucose from the bloodstream to be distributed throughout the cells of the body, and converting it into energy. Because those with Type 1 Diabetes do not produce sufficient amounts of the hormone, they need “insulin therapy” to survive. Thus, type 1 diabetes is also referred to as the “insulin dependent diabetes mellitus.”

Type 2 Diabetes

Type 2 diabetes is more common compared to Type 1. It is estimated that about 90 to 95 percent of all diabetes cases are of this form.

The disorder occurs when the pancreas produces insulin but the body cannot effectively use it. This condition is called insulin resistance. This causes the pancreas to overproduce the hormone in order to keep up with the demands to metabolize the sugar in the food ingested by the body. Over time, the pancreas will simply be unable to produce sufficient amounts to break down the glucose components, causing it to build up in the blood.

Gestational Diabetes

Gestational diabetes is the type that affects women during pregnancy. Most pregnant women develop the condition around the 24th week or after the baby’s body has been formed.

This does not indicate that the woman had diabetes prior to conceiving. It only means that she has high blood sugar levels during her pregnancy. However, she may be at risk for developing type 2 diabetes later on in life. According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), women who are diagnosed with gestational diabetes have about 35 to 60 percent chances of acquiring type 2 diabetes within 20 years.

Gestational diabetes can be harmful to the fetus. The glucose in the mother’s bloodstream can cross over the placenta which in turn, causes the baby to have high blood sugar levels. The extra sugar is stored as fat. As a result, the fetus may develop “fetal macrosomia,” a term used to describe a baby who is born with a significantly higher birth weight than normal.

Prediabetes

Prediabetes is a condition where a person has blood sugar levels that are higher than normal and yet are not high enough to be considered diabetes. Those with prediabetes are at a higher risk for developing type 2 diabetes compared to those with healthy blood glucose levels.

According to the CDC, about 15 to 30% of those diagnosed with the condition are likely to develop type 2 diabetes within 5 years. However, prediabetes is potentially reversible. Those who maintain a healthy diet and active lifestyle can prevent the onset of diabetes or reduce the chances of progression by as much as 50 percent.

Signs and Symptoms

The symptoms of diabetes vary according to the elevation level of the blood sugar. Some patients may not notice any signs in the early stages and may not detect the disease unless some blood tests are conducted. The symptoms common to both Type 1 and Type 2 diabetes include: increased thirst, frequent urination, food cravings despite having eaten, fatigue, inexplicable weight loss, tingling sensation in the feet, numbness in the feet, blurred eyesight, dry and itchy skin, irritability, slow-healing sores, and infections in the gums or mouth.

Tests and Diagnosis

Early detection and diagnosis are critical to an effective management and treatment of diabetes. A person who suspects that he may be manifesting some of the symptoms should get himself checked immediately. Parents who notice some signs of type 1 diabetes in their children should promptly discuss these with the child’s pediatrician.

Since symptoms of diabetes may not become immediately evident, the American Diabetes Association (ADA) recommends that people with risk factors or genetic predispositions be regularly screened. These include people with a body mass index higher than 25 regardless of age, those aged 45 years and older, and those with additional risk factors such as hypertension. The risk factors are expounded on in the later part of this article.

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Here are the tests to determine if a person has the following types of diabetes:

Type 1, Type 2, or Prediabetes

When either prediabetes or any of the types of diabetes is suspected by the doctor, he may order that the patient undergoes one of the following tests, as reported by Mayo Clinic:

 Glycated hemoglobin (A1C) test

This blood test is used to ascertain the average blood sugar level for the past two or three months. It works by measuring the percentage of blood sugar that has attached to the hemoglobin, a protein that carries the oxygen in the red blood cells.

An A1C level of 6.5 percent or higher on two separate tests indicates diabetes. A level between 5.7 and 6.4 percent indicates prediabetes. A reading belong 5.7 percent is considered a normal or healthy blood sugar level.

Random Blood Sugar

This is performed by taking blood samples at random without regard to the time of the last meal or drink taken. A random blood sugar level of 200 milligrams decilitre (mg/dL) or of 11.1 millimoles per liter (mmol/L) and higher is suggestive of diabetes.

Fasting Blood Sugar (FBS)

In FBS, a patient is first required to fast for at least 8 hours. During the fasting period, even water intake is prohibited. A result that shows an FBS level between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is indicative of prediabetes. An FBS level of 126 mg/dL (7 mmol/L) on two separate occasions suggests that the patient has diabetes. A reading below 100 is considered normal.

2 Hour Glucose Tolerance Test (GTT)

To conduct a GTT, a patient must first undergo an FBS test. Afterward, he is asked to drink a glucose liquid and more blood is drawn to test glucose levels two hours after the drink is taken.

A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal. A GTT reading of more than 200 mg/dL (11.1 mmol/L) indicates diabetes. A GTT reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.

Additional Tests for Type 1 Diabetes

To confirm a diagnosis of Type 1 diabetes, other tests specifically designed to establish the presence of certain antibodies that would indicate the condition are performed. These are:

C-Peptide

The test measures C-peptide levels in the blood. A low level suggests that a person has type 1 diabetes because C-peptide levels correlate to the amount of insulin being produced by the pancreas.

Glutamic Acid Decarboxylase Autoantibodies (GADA)

The GADA test is used to verify the presence of autoantibodies directed against beta cells in the pancreas which produce insulin.

Insulin Autoantibodies (IAA)

In type 1 diabetes, the immune system produces antibodies that attack the insulin produced by the body. The IAA test is used to ascertain whether such antibodies are present.

 Insulinoma-Associated-2 Autoantibodies (IA-2A)

This is similar to GADA the sense that the test aims to locate antibodies. What makes IA-2A different is that it searches for the presence of antibodies that attack specific enzymes in the beta cells.

Gestational Diabetes Tests

A pregnant woman may be asked to undergo some blood tests to check for gestational diabetes. These are:

Initial Glucose Tolerance Test (GTT)

To perform a GTT, the patient is asked to drink a glucose solution. After an hour, blood is drawn to check the blood sugar level. A blood sugar level below 140 mg/dL (7.2 to 7.8 mmol/L) is considered normal. A higher reading indicates a potential risk for gestational diabetes. A follow-up test needs to be done to conclude the diagnosis.

Follow-up Glucose Tolerance Test

This is done if the initial GTT result is suggestive of gestational diabetes. The pregnant woman is asked to fast overnight and then the FBS is measured. Afterward, she is asked to consume a syrupy sweet solution of higher glucose concentrations. The blood sugar levels will be checked every hour for a period of three hours. When at least two out of the three test results show a blood sugar level reading that is higher than normal, she is conclusively diagnosed to have gestational diabetes.

Treatment and Management

Diabetes is a lifelong condition that requires effective management. The goal of treatment is to lower and stabilize the patient’s blood sugar levels. To accomplish this, doctors advise patients to religiously take the prescribed medications and to incorporate changes in lifestyle.

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A healthy diet is a major component in the management of diabetes. Meals should consist mainly of foods that are high in fiber and nutrition such as whole grains, white or lean meat, vegetables, and fruits with a low glycemic index. Foods consisting of refined or processed sugars and starch should be avoided. It is recommended that a dietitian is consulted to help the patient draw the proper meal plans.

Patients diagnosed with type 1, type2, and prediabetes could significantly benefit from incorporating some form of physical exercise in their daily routines. Aerobic exercises lower the blood sugar levels and improve the cells sensitivity to insulin.

Medications for type 2 diabetes aim to increase insulin output, reduce the amount of glucose released from the liver, and increase the cells’ insulin sensitivity. A drug called Metformin is usually prescribed for this disorder. In some cases, insulin therapy is prescribed in addition to oral medications.

Those who have type 1 diabetes need insulin therapy. Insulin is injected with a needle and syringe or an insulin pen. An insulin pump may also be used. A doctor may prescribe a combination of insulin types, depending on the patient’s needs and lifestyle.

The treatment for gestational diabetes and prediabetes are similar to the therapies prescribed for type 2 diabetes. Those diagnosed with prediabetic conditions must observe a healthy diet and aim to have at least 150 minutes of aerobic activities per week to delay or prevent progression to type 2 diabetes.

Regardless of the form of diabetes, patients should monitor their blood glucose levels several times a day to make sure they maintain the target blood sugar level.

Risk Factors

The cause of type 1 diabetes is unknown and it is difficult to prevent. Among the diabetes risk factors are family history, race, the presence of autoantibodies, and a diet low in vitamin D.

Some people are more predisposed to type 2 diabetes than others. Certain factors elevate the chances of developing the disorder. These include family history, race, age, weight, high body mass index, physical inactivity, and a diet rich in sugar and carbohydrates. Those with health conditions such as hypertension, polycystic ovary syndrome (PCOS), and high levels of triglyceride and cholesterol are also predisposed to the disease.

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Various researches and clinical studies are being undertaken to find more remedies for the treatment of diabetes. In the meantime, patients can delay the onset of complications and manage their symptoms. The disease is controllable for as long as those diagnosed are committed to change their lifestyle and cooperate with their physicians.

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Health & Wellness

Fruit Drinks For Children May Have Too Much Sugar, Says Study

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Fruit juice boxes flood the groceries and parents are unaware that these boxes of liquid sweetness don’t really provide their kids with healthy doses of vitamins, but instead load them up with unacceptably high dose of sugar.

Fruit juice is camouflaged and is not always as it seems even if it’s labeled as “100% pure” because the production undergoes a process wherein most of the flavor has been removed. This then leads the manufacturer to add “flavor packs” to restore the flavor lost during the processing.

Researchers from the University of Liverpool’s Institute of Psychology, Health and Society assessed sugar content of several fruit juice drink, 100% natural juices, and smoothies marketed specifically to children. According to the findings of the study as reported in a news release, close to 50 percent of the fruit juice products already contains at least 19 grams of sugar, which is already the daily recommended sugar consumption of a child.

In addition, while the fruit juice boxes were labeled safe according to European law, the information is applicable to adult females with average built and active lifestyles. As a result, the nutrient content in these products may not be suitable for kids.

Likewise, since fruit juice is high in calories and sugar, obesity and cavity problems may arise in children. Being in liquid form, it can also give a feeling of fullness to children, so they become less likely to feel hunger for more nutritious foods and beverages.

Details of the study are published in the journal BMJ Open.

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Health & Wellness

Roughly Half of California Residents Found With Prediabetes, Says Study

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This bit of news doesn’t sound good for people of California: A new study says that about 13 million people in the state have prediabetes.

This figure represents about 46 percent of California’s population, according to a news report on a study from the UCLA Center for Health Policy Research. In addition to this statistic, about 9 percent — or 2.5 million people — are diagnosed with diabetes. “This is the clearest indication to date that the diabetes epidemic is out of control and getting worse,” according to the center’s executive director Dr. Harold Goldstein.

The study involved a review of data from the National Health and Nutrition Examination Survey, particularly on fasting plasma glucose and hemoglobin A1c. This was combined with data from the California Health Interview Survey involving more than 40,000 people.

Results showed that about 33 percent of the young adult population (i.e. between age 18 and 39) have prediabetes. In addition, the rate of prediabetes in Pacific Islanders was highest on record at 43 percent of the population, followed by African Americans and American Indians at 38 percent each.

What’s more disturbing is that getting tested for prediabetes is not included in standard insurance policies, especially for people under 45 years old. “There are significant barriers not only to people knowing their status, but getting effective help… A simple blood test for diabetes should be covered by all insurers, as should the resources and programs that can make a real difference in stopping the progression of this terrible disease,” said lead study author Dr. Susan Babey.

Despite the seemingly grim findings, it’s not too late to fight diabetes. “If there is any hope to keep health insurance costs from skyrocketing, health care providers from being overwhelmed and millions of Californians from suffering needlessly from amputations, blindness and kidney failure, the state of California must launch a major campaign to turn around the epidemic of type 2 diabetes,” Goldstein added.

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Health & Wellness

Breast Cancer Risk Heightened By High Sugar Consumption

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Aside from the direct effect of high sugar consumption on diabetes and obesity, a new study also links this to breast cancer.

This was revealed by a team of researchers from the MD Anderson Cancer Center of the University of Texas, who wanted to delve further into earlier studies on a potential link between sugar intake and breast cancer development. The study used lab mice to check whether feeding them with either sucrose, fructose or starch could lead to signs of breast cancer. The diet prepared for each mouse was based on a standard Western meal, which has lots of refined sugars and fat, and less fruits and vegetables.

Results revealed that mice given a diet rich in sucrose or fructose had a higher risk of developing breast cancer. In terms of percentages, 30 percent of mice in a starch-rich diet were found with breast tumors. Meanwhile, close to 60 percent of those in sugar-rich foods had tumors. In addition, these mice also exhibited faster metastasis, based on tumors found in the lungs. “We determined that it was specifically fructose, in table sugar and high-fructose corn syrup, ubiquitous within our food system, which was responsible for facilitating lung metastasis and 12-hydroxy-5Z,8Z,10E,14Z-eicosatetraenoic acid (12-HETE) production in breast tumors,” said study co-author Lorenzo Cohen in a news item.

The researchers discovered that sugar intake has a definite impact on cancer development. “This study suggests that dietary sucrose or fructose induced 12-LOX and 12-HETE production in breast tumor cells in vivo… This indicates a possible signaling pathway responsible for sugar-promoted tumor growth in mice. How dietary sucrose and fructose induces 12-HETE and whether it has a direct or indirect effect remains in question,” Cohen added.

The study and its findings were published in the journal Cancer Research.

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Health & Wellness Substance Abuse

Natural Human Hormone Affects Affinity to Alcohol and Sweets

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The holidays provide the perfect opportunity to bond with family and friends over dinner, but this is also the time when people tend to eat a lot of sweets and drink alcohol. This recent discovery by researchers from UT Southwestern Medical Center might provide some help.

A compound known as fibroblast growth factor 21 (FGF21) is a naturally occurring liver hormone that has a role in the body’s response to stress such as extreme temperature and nutritional changes. The research team, which includes Dr. Steven Kliewer and Dr. David Mangelsdorf, looked into the hormone’s effects on dietary preferences.

The study, published in the journal Cell Metabolism, involved lab mice with high levels of FGF21 and investigated the animals’ response to water laced with sweetener and alcohol. The results clearly showed that the rodents with high levels of FGF21 had less preference for alcohol and sweets. “This is the first time a hormone made in the liver has been shown to affect sugar and alcohol preference in mammals,” Kliewer said in a news release.

The effect of the liver hormone also included a reduction in the level of dopamine, which is linked to the body’s natural reward system. “Our findings raise the possibility that FGF21 administration could affect nutrient preference and other reward behaviors in humans, and that the hormone could potentially be used to treat alcoholism,” Kliewer added.

The researchers believe that their study could provide significant information on how to reduce the tendency to prefer sweets and alcohol, thereby reducing the risk of diabetes and alcohol abuse. “These findings suggest that additional studies are warranted to assess the effects of FGF21 on sweet and alcohol preference and other reward behavior in humans,” Kliewer expressed.

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Health & Wellness

Risk of Heart Disease Increased By Drinking Sweetened Beverages

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As the U.S. celebrates American Diabetes Month this November to raise awareness on one of the leading diseases in the world, a new study revealed that drinking sweetened beverages on a regular basis not only worsens the risk of diabetes but also of cardiovascular diseases.

A Swedish study conducted by Dr. Susanna Larsson and colleagues at the Institute of Environmental Medicine, Karolinska Institutet in Stockholm involved close to 49,000 males who were asked about their diet, physical activity, lifestyle, and health status. After filtering out those with existing health issues such as heart ailments or cancer, the remaining 42,400 respondents were monitored for about 12 years.

From the survey and continuous monitoring, researchers discovered that “men who consumed at least two servings per day of sweetened beverages had a 23% higher risk of heart failure, compared with non-consumers,” as reported in a news item.

Aside from diabetes, cardiovascular diseases remains one of the top causes of death, affecting roughly 23 million people around the world.

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Early Disease Detection

About Half of Asian and Latino Diabetes Sufferers Remain Undiagnosed

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More than half of Asian Americans and almost half of Hispanic Americans who have diabetes remain undiagnosed, according to the National Institutes of Health and the Centers for Disease Control and Prevention.

Using newly available data from 2011-2012, the CDC’s National Health and Nutrition Examination Survey (NHANES), researchers were able to quantify diabetes prevalence for Asian Americans for the first time and found that they have the highest proportion of diabetes that was undiagnosed among all ethnic and racial subgroups studied, at 51%. Diabetes was also common in Asian Americans, at 21%. Hispanic Americans had the highest prevalence of diabetes at nearly 23%, with 49% of that undiagnosed.

The results were published Sept. 8 in JAMA, the Journal of the American Medical Association.

The data also found that Asian Americans often develop type 2 diabetes at a lower body mass index (BMI). The NHANES data showed the average BMI for all Asian Americans surveyed was under 25. For the U.S. population overall, the average BMI was just below 29. A BMI of 25 to under 30 is considered overweight, and a BMI of 30 or greater is considered obese. The American Diabetes Association recommends Asian Americans get tested for diabetes at a BMI of 23 or higher, a lower BMI threshold than the general population.

“The large proportion of people with undiagnosed diabetes points to both a greater need to test for type 2 diabetes and a need for more education on when to test for type 2 diabetes, especially since populations such as Asian Americans may develop type 2 at a lower body mass than other groups,” said the study’s senior author, Catherine Cowie, Ph.D., director of diabetes epidemiology programs at the NIH’s National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

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Health & Wellness

Drinking Sweet Beverages Leads To Higher Risk of Fatty Liver Disease

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A team of researchers discovered a link between regular consumption of sugar-containing drinks and non-alcoholic fatty liver disease (NAFLD). Study lead author Jiantao Ma, Ph.D. of Tufts University’s Jean Mayer USDA Human Nutrition Research Center on Aging explained the significance of their research. “Our study adds to a growing body of research suggesting that sugar-sweetened beverages may be linked to NAFLD and other chronic diseases including diabetes and cardiovascular disease,” Ma said in a news release.

The research was conducted through a survey of more than 2,600 enrolees of the Offspring and Third Generation cohort study of the National Heart Lunch and Blood Institute Framingham Heart Study, asking them about their consumption of sugar-sweetened beverages, which include colas and fruit-based drinks. The respondents were checked for the amount of liver fat via CT scan.

Results showed a higher risk of developing the liver disease when drinking more than one sweet drink a day. However, there was no link found between NAFLD and consumption of diet sodas.

The researchers have not determined a cause-and-effect relationship, though. “The cross-sectional nature of this study prevents us from establishing causality. Future prospective studies are needed to account for the changes in beverage consumption over time as soda consumers may switch to diet soda and these changes may be related to weight status,” said study senior author Nicola McKeown, Ph.D.

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Health & Wellness

World Diabetes Day on November 14: Interesting Facts

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The global recognition of World Diabetes Day November 14 allows people around the world to understand and gain more awareness about the disease. The annual event is being carried out by the World Health Organization and the International Diabetes Federation as a way to make people aware of diabetes and to address the increasing risk of the disease.

Diabetes continues to be one of the most prevalent diseases globally. In 2013, more than 380 million people were diagnosed with diabetes, with most of the cases having Type 2 Diabetes. Projections estimate the cases to increase to almost 600 million by the year 2035. It has also become one of the leading causes of death, which is probably the reason why world governments spend a lot of money on diabetes treatment and studies.

As we recognize World Diabetes Day today, here are some interesting facts about the awareness campaign:world diabetes day logo

  • November 14 is the birthday of Canadian scientist Frederick Banting who discovered insulin (together with colleague Dr. Charles Best) as a treatment for diabetes.
  • The first World Diabetes Day was celebrated in 1991 as a response to the increasing risk of the disease.
  • The event’s simplistic logo is a blue circle, which is considered the global symbol for diabetes. The circle shape signifies life, health and unity. The color blue is aligned with the color of the United Nations flag.
  • The World Diabetes Day focuses on a different theme every year. This year will focus on “healthy living and diabetes”, particularly on eating healthy. Key messages to be used in this year’s campaign are the following: “Make healthy food the easy choice,” “Healthy eating: make the right choice,” and “Healthy eating begins with breakfast.”
  • The International Diabetes Federation has more than 230 member associations across 160 nations.