Yes folks, I’ve now launched the membership site, with information, a community forum and structured learning programmes for people with diabetes and their families.
Check it out right now at www.diabetesdietdoctor.com.
A new report, The Link Between Local Food Environments and Obesity and Diabetes, just published by the California Center for Public Health Advocacy (CCPHA), has summarised and confirmed the results of the 2005 California Health Interview Survey (CHIS).
It shows a clear link between High Retail Food Environment Index (RFEI) scores and the amount of both obesity and Type 2 diabetes in a neighbourhood.
The RFEI is made by dividing the total number of fast-food restaurants and convenience stores by the total number of grocery stores and local produce vendors in the area, so reflects the proportion of people eating diets with less fruit and vegetables.
The average Californian has easy access to four times as many fast-food restaurants and convenience stores as grocery stores and produce vendors.
Obesity rates are 20 percent higher for Californians with RFEIs of five and above compared to those with RFEIs below three.
Diabetes rates are 23 percent higher for Californians with RFEIs of five and above compared to those with RFEIs below three.
Nearly half of Californians have three times as many fast food outlets as fresh food outlets near them.
Pretty shocking eh?
Although some people have contested results like this in the past, it seems fairly clear to me that high carbohydrate, high trans-fats diets are a sure-fire recipe for putting on weight. and developing diabetes.
DESIGNED FOR DISEASE: The Link Between Local Food Environments and Obesity and Diabetes. The California Center for Public Health Advocacy, PolicyLink and The UCLA Center for Health Policy. 2008.
One of the conclusions reached from The Efficacy of Self-MONitoring in newly diagnosed Type 2 diabetes (ESMON) study recently published online by the British Medical Journal (BMJ) was that the group allocated to more intensive self monitoring scored significantly higher for depression than the control group. This has also been found in other studies of self monitoring.
Well, maybe so, but in this study, just as in all the others, the approach to self monitoring was such that no real improvements in control were achieved. It’s no good getting people to do the tests without putting the appropriate amount of effort into making sure that they know what to do with the results. In this study, the triallists did give some thought to this, but still certainly not enough.
Because of this, there was no overall improvement in control as assessed by the HbA1C levels. My guess is that the patients were just disappointed in their lack of improvement. And I don’t blame them.
Self monitoring, putting the patients in real control of their condition, has the potential to transform their lives by giving them confidence and hope, and offering real benefits in terms of preventing or even reversing the progress of their condition. Some people figure out how to do it on their own. An awful lot more could do it if properly trained.
BMJ, doi: 10.1136/bmj.39534.571644.BE (published 17 April 2008)
I have written before about the many factors that may contribute towards the development of diabetes, and here is some more evidence to support the idea that there may be many more types of diabetes than two.
A large study co-ordinated by the Broad Institute at MIT in collaboration with the WTCCC/UKT2D and the FUSION consortia have found 6 new single-nucleotide changes that are associated with Type 2 diabetes. These, along with the 8 genetic risk factors previously found by these groups adds to the number of genetic contributors to diabetes.
The collaboration between groups is vital to finding new gene changes, since much larger population samples can be studied to a level at which changes can be found. Below these numbers, significant changes can easily be missed. The differences identified in studies of this type are important guides, which can be used for animal studies to find out whether they might be clinically important in humans, and so offer hopes for completely or partially curative gene therapy.
Zeggini E, et al. Meta-analysis of genome-wide association data and large-scale replication identifies additional susceptibility loci for type 2 diabetes. Nature Genetics. doi:10.1038/ng.120.