the suger story2

The Sugar Story – Diabetes in Women

Understanding the Danger of Diabetes

Do you have a sweet tooth and enjoy eating cakes and high-calorie treats frequently? Then we have bad news for you: A high fat and sugar intake can increase the risk for developing diabetes.

But let’s start our blog from the beginning: What is Diabetes and how does it develop?

Diabetes, also known as diabetes mellitus, is a chronic condition that develops when the body either cannot utilise insulin, a hormone that controls blood sugar, or does not produce enough of it. Uncontrolled, it results in hyperglycemia, also known as high blood sugar, which gradually causes substantial harm to the body, including the nerval system, blood vessels, eyes and kidneys.1
Healthcare professionals distinguish between Type 1 and Type 2 diabetes mellitus. Type 1 diabetes mellitus is characterised by an early start in childhood and requires daily insulin medication since the body cannot produce enough insulin on its own.
By altering how your body uses sugar for energy, diabetes mellitus type 2 prevents the body from utilising insulin efficiently. Early diagnosis and effective care can frequently delay the onset of it.1
Besides, Cancer and Cardiovascular Diseases, Diabetes Type 2 is a non-communicable disease, which means that it majorly develops as consequences of a poor Lifestyle.

As type 2 diabetes is thought to be preventable if managed correctly, we will focus on it in this
blog. You may wonder how lifestyle contributes to diabetes development. Let’s explore the
connection together.

Linking Lifestyle and Diabetes

The Diabetes incidence is rising, especially in India, due to genetics, environmental factors, and radically altered lifestyles brought on by economic growth. Particularly, the shift from the traditional diet led to poor nutrition due to the prevalence of processed foods with high levels of refined carbs, fats, and sugars. In former times, healthier cereals, such as millet, were helping to keep the diet varied and healthy. However due to the changes, they were mainly replaced by polished white rice and wheat, in combination with an increased intake of sugar and a high fat intake ranging from 13 to 59 g per day. This text contains 2,3 text.
Additionally, physical inactivity hiked due to television and digital technology and automated transport, led to an unhealthy lifestyle.2
A positive energy balance and weight gain caused by these changes in diet and exercise are detrimental to overall health and increase the risk of developing diseases.
The primary cause for concern is the fast surge in obesity brought on by high levels of saturated fat and carbohydrate consumption, which promote fat to accumulate in the liver. The function of the liver and other key metabolic organs is subsequently compromised, which raises the chance of developing diabetes by progressively developing high blood sugar (hyperglycemia), high blood insulin levels (hyperinsulinemia), and insulin resistance.4
Therefore, it is not surprising that diabetes prevalence skyrocket in India from 2% in 1972 to 9% in 2018.2

Now coming to the grave importance of this:

A statistic from 2021 stated that every 5 seconds one person died because of Diabetes worldwide, accounting for 6.7 million deaths in total.5
India now has 74 million diabetics, accounting for 14% of the global diabetes burden, and by 2045, it is estimated that there will be at least 783 million diabetics worldwide.2,5
According to statistics, 50% of diabetics in India are oblivious of their health status and barely a third of the diabetics have their condition under control.2,6
In order to counteract this grim outlook, the main goal is to raise awareness, highlight the risk factors and educate the population about the consequences.
As we have already discussed bad lifestyle choices as contributors to the development of diabetes, let’s talk about the identification of symptoms and early signs to raise awareness.

Recognising the Signs and Symptoms of Diabetes

Particularly in the case of type 2 diabetes, the symptoms can develop slowly and may not be detected for several years.
According to healthcare professionals, characteristic symptoms of diabetes include:1,7
  •  frequent need of urination
  • feeling tired and thirsty
  •  weakness
  • unclear vision
  • unintended weight loss
  • increased frequency of infections
As explained earlier, the imbalance of blood sugar levels and increasing insulin resistance, have detrimental effects on the human body and give rise to the development of diseases. It is well known that diabetes is associated with a plethora of different diseases:7
  • Cardiovascular disease, such as coronary artery disease, heart attack, stroke and blocking of arteries (atherosclerosis)
  • Nerve damage (diabetic neuropathy) which can cause sensations such as tingling, numbness, burning, or pain because the blood vessels that supply the nerves are damaged.
  • Kidney damage (diabetic nephropathy) by disrupting the sensitive filtration mechanism.8
  • Vision (diabetic retinopathy) and Hearing Impairment due to deterioration of the eye’s and ear’s blood vessels, which may result in blindness and hearing loss.8,9
  • Increased risk of infections, including bacterial and fungal skin infections.
  • Alzheimer’s disease due to increased inflammation and shared genetic risk factors 10
  • Depression is also frequently seen as a consequence of diabetes
  • Cancer
Cancer, however, is now the main cause of mortality in adults with diabetes because of improved treatment and management options. Especially women suffering from diabetes are more likely to develop endometrial, breast, and ovarian malignancies than those without the condition.11

This is not the only female-specific difference regarding diabetes. Let’s take a closer look at
gender-specific differences of Diabetes and its complications.

Focus on Women

Since diabetes can negatively affect our blood vessels and nerves that control the heart, it is linked to heart diseases such as heart failure. 12 A study reported that up to 30% of patients with heart failure have also type 2 diabetes.13 Surprisingly, detailed results indicated a gender- specific risk associated with type 2 diabetes which was 9% higher for females.
Similarly, a pooled investigation revealed that women had a 27% higher relative risk of stroke than men.14,15
Diabetes management differences between men and women, undertreatment of diabetic women, as well as the fact that women have prediabetes longer may explain these differences.13 However, women are also more at risk, due to woman-specific diabetes subtypes, such as gestational diabetes mellitus.
As far as pregnancy is concerned, healthcare professionals differentiate between diabetes in pregnancy, which is diagnosed for the first time during pregnancy, gestational diabetes mellitus, which may develop at any time during pregnancy and is unlikely to remain after birth, and pre- gestational diabetes, which was already diagnosed before pregnancy.16
Maternal hyperglycemia influenced one out of every six pregnancies worldwide in 2019, according to the International Diabetes Federation. 17 This increases the risk of unfavourable pregnancy outcomes, like high blood pressure (including pre-eclampsia) and macrosomia, which can make normal births risky and difficult because the infant is bigger than normal and more likely to suffer fractures and nerve damage. 16
Gender disparities may result from distinct actions of men and women, exposure to certain environmental variables, different types of diet, lifestyles, or stress, or attitudes towards treatments and prevention, according to research.18

After we have now learned about the complications of diabetes and its differences between the
genders, let’s have a look at how to treat and manage this disease.

Current Treatment and Management options

The fundamental pillars of type 2 diabetes care are a nutritious diet, regular physical exercise, conserving a normal body weight and refraining from tobacco use.1 If measures to improve the lifestyle are not effective to regulate blood sugar levels, oral medication is typically administered, with metformin as the first-line drug. In more severe situations and if treatment with a single medicine is not adequate, a range of combination therapy options or Insulin injections may be indicated. Besides maintaining blood glucose levels, it is also necessary to control blood pressure and blood cholesterol levels as risk factors on a regular basis.16

Let’s further focus on important lifestyle changes and dieting as preventive measure for the development of diabetes and the delay of it.

Healthy Diet as the First Step in the Right Direction

The human body benefits greatly from a wholesome diet: A balanced diet high in nutrients can help you achieve a healthy weight, lower your chance of developing chronic diseases, and improve your general wellness. Generally fruits, vegetables, whole grains, lean proteins, and healthy fats are advised.19
  • Whole grains: These include unrefined grains like oats, brown rice, wheat, ragi, quinoa.
  • Fiber-rich foods: Fruits, nuts, legumes like beans and peas, whole grains, and vegetables are high in fibre.
  • “Good” Oils: Control your cholesterol levels by eating foods with monounsaturated and polyunsaturated fats, such as avocados, nuts, canola, olive, and peanut oils.
  •  Fat-free or low-fat foods, including Milk, yoghurt, cheese, and fortified soy products with calcium, vitamin A, and vitamin D.
Aside from avoiding processed meals and minimising sugar intake, healthcare authorities also advise to roast, boil, or steam your food rather than frying it. They also recommend not using too much salt and instead suggest using herbs to season your meal.20
However, our modern life is very stressful and only few people have the time to always prepare and cook wholesome food and stick to a healthy lifestyle. Therefore, a new trend in healthcare is arising: Nutraceuticals.

Let’s explore this new approach towards a healthier life together.

Nutraceuticals as New Hope

By providing your body with important nutrients and bioactive compounds, these supplements can support your health and reduce the risk of developing diseases.
Studies have shown that nutraceuticals containing Berberin, Banaba, Curcumin, and Guar gum, have favourable effects on diabetes.21 Several in-vitro and animal studies have demonstrated that Berberin increases insulin sensitivity and enhances pancreatic beta-cell function, reduces the absorption of glucose in the gut, and inhibits hepatic gluconeogenesis due to a decrease in gluconeogenic gene expression.21,22
However, human studies with Nutraceuticals are sometimes difficult to interpret, as bioavailability from the beneficial substances is often low and controls are also hard to set, as diet and baselines differ between patients.
Nevertheless, according to a study involving 148 diabetics, taking a supplement combination of Berberine, Curcumin, Inositol, Banaba, and Chromium Picolinate for three months significantly lowered fasting and post-prandial plasma glucose levels as well as glycated haemoglobin and fasting plasma insulin levels.23 This gives hope for further treatment options for diabetes patients.
Another important Nutraceutical in the fight against diabetes is Mulberry or Morus alba (white mulberry), Morus nigra (blackberry), and Morus rubra (red berry). The phenolic chemicals flavonoids and anthocyanins are used to prevent diseases of the liver and kidneys and damage of the joints. Furthermore, Mulberry leaves are also effective in treating diabetes because they contain sugar-like alkaloids that are known to have hypoglycemic characteristics, lowering sugar levels.

Let’s explore the science behind Mulberries and their beneficial effects in diabetic patients.

Hot Topic: Mulberry leaves for Diabetes Management

In recent years, herbal alternatives, particularly mulberry leaves, have become more popular for treating diabetes.24 Similar to Berberis, the possible mechanisms for the hypoglycemic effect of Mulberries include a reduction in the absorption of glucose in the gut, an increase in insulin sensitivity, the inhibition of gluconeogenic enzymes, and the promotion of glycolytic enzyme activity.21
Additionally, a 12-week clinical trial with obese patients found positive effects of a supplement containing mulberry leaves.25
Mulberry leaves may have even more advantages for diabetic patients, such as regulating the body’s metabolic process of lipids, enhancing the microbiome in the gut, and reducing oxidative stress.26
However, further research is needed to completely understand the underlying mechanism of action, best delivery method and dosage to maximise the benefits of this advantageous nutraceutical plant.

Conclusion

This blog summarises the most important facts about the development of diabetes, its complications, gender-specific factors and current treatment and management options.
Generally, prevention is better than treatment, which involves a change of lifestyle towards a healthy diet, frequent exercises and limitation of smoking. Furthermore, preventive measures, such as an annual health check-up, can facilitate controlling the health status, enable an early diagnosis and are the first step towards adequate management. Nutraceuticals can help to support your body and reduce the risks of developing diseases through their manifold beneficial effects and essential nutrients.
With enhanced awareness and the appropriate management, diabetes can be slowed down or prevented from the beginning, enabling a heathier and better life.

1. Diabetes, available at: https://www.who.int/news-room/fact-sheets/detail/diabetes, accessed on: 11/07/2023.

2. Narayan KMV, Varghese JS, Beyh YS, et al. A Strategic Research Framework for Defeating Diabetes in India: A 21st-Century Agenda. J Indian Inst Sci. 2023;xxx. doi:10.1007/s41745-022-00354-5

3. Misra A, Khurana L, Isharwal S, Bhardwaj S. South Asian diets and insulin resistance. Br J Nutr. 2009;101(4):465-473. doi:10.1017/S0007114508073649

4. Prasad M, Rajagopal P, Devarajan N, et al. A comprehensive review on high -fat diet-induced diabetes mellitus: an epigenetic view. J Nutr Biochem. 2022;107. doi:10.1016/j.jnutbio.2022.109037

5. Diabetes around the world, available at: https://diabetesatlas.org/, accessed on 11/07/2023.

6. Mathur P, Leburu S, Kulothungan V. Prevalence, Awareness, Treatment and Control of Diabetes in India From the Countrywide National NCD Monitoring Survey. Front Public Heal. 2022;10(March). doi:10.3389/fpubh.2022.748157

7. Diabetes, available at: https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc-20371444, accessed on 12/07/2023.

8. Yang J, Liu Z. Mechanistic Pathogenesis of Endothelial Dysfunction in Diabetic Nephropathy and Retinopathy. Front Endocrinol (Lausanne). 2022;13(May):1-19. doi:10.3389/fendo.2022.816400

9. Gioacchini FM, Pisani D, Viola P, et al. Diabetes Mellitus and Hearing Loss: A Complex Relationship. Med. 2023;59(2):1-9. doi:10.3390/medicina59020269

10. Meng L, Wang Z, Ji HF, Shen L. Causal association evaluation of diabetes with Alzheimer’s disease and genetic analysis of antidiabetic drugs against Alzheimer’s disease. Cell Biosci. 2022;12(1):1-16. doi:10.1186/s13578-022-00768-9

11. Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022;18(9):525-539. doi:10.1038/s41574-022-00690-7

12. Diabetes and Your Heart, available at: https://www.cdc.gov/diabetes/library/features/diabetes-and-heart.html, accessed on: 11/07/2023.

13. Ohkuma T, Komorita Y, Peters SAE, Woodward M. Diabetes as a risk factor for heart failure in women and men: a systematic review and meta-analysis of 47 cohorts including 12 million individuals. Diabetologia. 2019;62(9):1550-1560. doi:10.1007/s00125-019-4926-x

14. Peters SAE, Huxley RR, Woodward M. Diabetes as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 64 cohorts, including 775,385 individuals and 12,539 strokes. Lancet (London, England). 2014;383(9933):1973-1980. doi:10.1016/S0140-6736(14)60040-4

15. Yoon CW, Bushnell CD. Stroke in Women: A Review Focused on Epidemiology, Risk Factors, and Outcomes. J Stroke. 2023;25(1):2-15. doi:10.5853/jos.2022.03468

16. IDF Diabetes Atlas 2021, 10th Edition, Available at: Https://Diabetesatlas.Org/Atlas/Tenth-Edition, Accessed on: 12/07/2023. doi:10.1016/j.diabres.2013.10.013

17. Fu J, Retnakaran R. The life course perspective of gestational diabetes: An opportunity for the prevention of diabetes and heart disease in women. eClinicalMedicine. 2022;45:101294. doi:10.1016/j.eclinm.2022.101294

18. Kautzky-Willer A, Harreiter J, Pacini G. Sex and Gender Differences in Risk, Pathophysiology and Complications of Type 2 Diabetes Mellitus. Endocr Rev. 2016;37(3):278-316. doi:10.1210/er.2015-1137

19. Diabetes diet: Create your healthy-eating plan, available at: https://www.mayoclinic.org/diseases-conditions/diabetes/in-depth/diabetes-diet/art-20044295, accessed on: 12/07/2023.

20. The American Heart Association Diet and Lifestyle Recommendations, Available at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations, accessed on: 11/07/2023.

21. Derosa G, D’Angelo A, Maffioli P. The role of selected nutraceuticals in management of prediabetes and diabetes: An updated review of the literature. Phyther Res. 2022;36(10):3709-3765. doi:10.1002/ptr.7564

22. Zhang H, Wei J, Xue R, et al. Berberine lowers blood glucose in type 2 diabetes mellitus patients
through increasing insulin receptor expression. Metabolism. 2010;59(2):285-292.
doi:10.1016/j.metabol.2009.07.029

23. Derosa G, D’Angelo A, Vanelli A, Maffioli P. An Evaluation of a Nutraceutical with Berberine,Curcumin, Inositol, Banaba and Chromium Picolinate in Patients with Fasting Dysglycemia. Diabetes Metab Syndr Obes. 2020;13:653-661. doi:10.2147/DMSO.S232791

24. Chen S, Xi M, Gao F, et al. Evaluation of mulberry leaves’ hypoglycemic properties and hypoglycemic mechanisms. Front Pharmacol. 2023;14(April):1-20. doi:10.3389/fphar.2023.1045309

25. Thaipitakwong T, Supasyndh O, Rasmi Y, Aramwit P. A randomized controlled study of dose-finding, efficacy, and safety of mulberry leaves on glycemic profiles in obese persons with borderline diabetes. Complement Ther Med. 2020;49:102292. doi:https://doi.org/10.1016/j.ctim.2019.102292

26. Lee CJ, Chen LG, Liang WL, Wang CC. Multiple activities of punica granatum linne against acne vulgaris. Int J Mol Sci. 2017;18(1). doi:10.3390/ijms18010141

Understanding Vaginal Symptoms and Decoding the Management Trends

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