Diabetic Retinopathy – Another angle:

Is this the start of new therapies for retinopathy?

Diabetic retinopathy is a complication of uncontrolled diabetes that leads to impaired vision and blindness among people with  diabetes. High blood glucose levels result in the abnormal development of tiny blood vessels in the eye. Research has shown that tight glycaemic control reduces the development and progression of diabetic  retinopathy. However, the way in which high blood glucose levels affect blood vessel development in the eye is not completely understood.

Michael D. Dennis, PhD, is working on the assumption that high blood glucose contributes to retinopathy by altering the genes that get made into proteins in a manner that results in retinopathy.

His laboratory identified a molecular switch that determines which proteins are made in the retina of the eye. The high blood glucose levels in diabetes seem to cause another set of genes to be made into proteins. Among these proteins is one called "vascular endothelial growth factor" (VEGF) that causes blood vessels in the eye to multiply abnormally, and these increased blood vessels lead to the development of retinopathy.

Dr. Dennis has now identified one of the key factors involved in making the change as a protein called "4E-BP1" and it is present at higher levels in the eyes of laboratory animals with diabetes. Dr. Dennis compared laboratory mice that do not have the 4E-BP1 protein with those that have 4E-BP1 and found that diabetic animals lacking 4E-BP1 did not suffer from vison loss; unlike normal mice with 4E-BP1.

The researchers also demonstrated a link between blood glucose levels and the amount of 4E-BP1 present in the retina by testing with a drug that lowers blood glucose levels in diabetic animals. They discovered that reducing blood glucose levels with the drug also reduced the amount of 4E-BP1 in the retina.

How is 4E-BP1 regulated by high blood glucose levels?

Studies demonstrate that high blood glucose prevents 4E-BP1 from being broken down normally. This may be an important step leading to the change that results in the production of proteins that ultimately lead to the development of diabetic retinopathy.

Why are some groups more susceptible to Type 2 Diabetes mellitus?

Is the body’s natural reaction to stress increasing the risk of T2DM?

The result of genetic inheritance, lack of physical activity , poor nutrition and family history of the same have all been regarded as risk factors for T2DM .  However, researchers are of the opinion that the environment seems to play a bigger role than the genetic connection.

“There’s substantial evidence to demonstrate the environment we live in has direct impacts on our health,” says exercise physiologist Rebecca Hasson, PhD, director of the Childhood Disparities Research Laboratory at the University of Michigan.

Stress is not only created due to work related problems or personal relationships.  There are  other stress creating factors such as poverty, discrimination and unfavourable surroundings which can also be a cause for T2DM.

 In times of stress, a hormone called ‘cortisol’ is released as part of the ‘fight or flight ‘ response.It increases the blood glucose in the body, influences cells to oppose insulin’s signals to absorb and store blood glucose so that it is available for muscle activity, and increases the craving for high calorie foods.

 “Cortisol is a biomarker of stress,” Hasson says. “If you don’t, or can’t run away—you’re late for school, you can’t pay your bills you’re always in this high-alert situation, whether or not you’re conscious of it.”

When cortisol levels are consistently high but there’s no physical activity to alleviate the effects of chronic stress, the consequences may contribute to Type 2 Diabetes.The higher the level of cortisol,the higher is the  insulin resistance.The insulin-producing beta -cells wear out because of the insulin resistance , causing Type 2 diabetes.

So, stress makes people ill. Groups that are more susceptible to poverty, discrimination, or unhygienic surroundings are more likely to be exposed to cortisol and its bad effects.
“Overall, ethnic minorities have much higher cortisol levels and exposure than whites,” Hasson says.
Hasson is working with 150 obese children between ages 14 and 18 to measure the links between stress, race, and type 2 diabetes risk directly.

The teenage years, Hasson says, are a “perfect biological and social storm” where school, family, and neighborhood stresses pile on to already raging hormones.

“If there are ethnic differences in the stress pathways, that could help guide our intervention,” Hasson says. “We’d have to start asking ourselves how we can reduce stress in their lives.”

Don’t Skip Breakfast

It is an important meal

Breakfast is an important meal for everyone, and especially so  for people with Type2diabetes. People with Type 2 diabetes who skip breakfast tend to have more problems controlling  their blood glucose levels.

• If a person with diabetes misses  breakfast, it can result in  increased fat storage and weight gain. Studies have shown that people who skip breakfast are more likely to be overweight.
• A healthy breakfast replaces energy stores that burn off during the night . People who do not eat breakfast may have lower energy levels  in the mornings.
• By skipping  breakfast you become very hungry by mid-morning  and  begin to look around for anything to snack on .The next meal is gobbled down  so quickly that you end up  overeating. This causes an immediate spike in blood sugar.  In the long run , this leads to weight gain and increasing the risk of developing diabetes-related complications.

Following  the recommended  quantity of carbohydrate per meal plan , regulates carbohydrate intake while missing a meal makes  it more difficult to  maintain blood glucose levels.

 Also, take care what you eat for breakfast  A typical  Indian breakfast can have  very  high calorie and carbohydrate content  if you do not choose wisely.

What is a Diabetes Diet?

Just diagnosed with diabetes? Are you wondering what changes  you need to make to your diet? As mentioned many times, there's no special diabetes diet.

Healthy eating habits are needed to manage diabetes. You will take some time to get used to the planning and the cooking but if you learn fast you can get good blood glucose control.

There is no standard meal plan. So do not copy what another person with diabetes eats. Plans vary from person to person. The crux of the matter is to control portions, control your blood glucose level and eat a variety of nutritious food.

There are diabetes educators and dietitians at MVH who can help you make an eating plan that fits your needs.

Here are some basic guidelines.

•   Eat whole grains instead of refined, processed grain products. Use wheat bran to increase fibre.

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       •      Add millets to your diet.

        

        • Include a variety of vegetables and fruits.

       

        • Eat lean meats, like chicken and fish . Limit red meats to once a week.

    

        • Try to eat more fish, as it has heart-healthy fats.

  

        • Use monounsaturated oils, such as olive oil, rice bran oil, sun flower oil for cooking.

    

        • Eat meals at fixed hours.

  

        • Eat slowly and chew your food well.

    

        • Drink water instead of fizzy drinks and sweetened fruit juices.

      

        • Reduce the amount of fats and foods with sugar such as cakes and pastries and desserts.

A healthy diet coupled with regular exercise, can help you lose weight, and keep your blood sugar levels under control.

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