Stricter Air Pollution Standards Could Prevent Millions of Diabetes Cases

Air pollution limits set by the U.S. Environmental Protection Agency (EPA) are too high, needlessly contributing to disease. In fact, by making them stricter, more than 100,000 people in the U.S. might avoid developing Type 2 diabetes each year. [1]

Air pollution was found to have contributed to 3.2 million new diabetes cases in 2016 alone – 14% of the worldwide total. Pollution was linked to 150,000 cases in the United States per year. Additionally, the study found that 8.2 million years of healthy life were lost in 2016 due to pollution-linked diabetes. [2]

Senior study author Dr. Ziyad Al-Aly, an assistant professor of medicine at Washington University, said of the findings:

“There’s an undeniable relationship between diabetes and particle air pollution levels well below the current safe standards. Many industry lobbying groups argue that current levels are too stringent and should be relaxed. Evidence shows that current levels are still not sufficiently safe and need to be tightened.” [1]

How Air Pollution can Contribute to Disease and Diabetes

Particulate air pollution is composed of microscopic pieces of dust, dirt, smoke, and soot. The finest particles regulated by the EPA are 2.5 micrometers. By comparison, a single strand of human hair is 30 times bigger than that – 70 micrometers.

Particles smaller than 10 micrometers can enter the lungs and pass into the bloodstream, which carries them to different organs, sparking a chronic inflammatory reaction believed to cause disease.

Dr. Philip Landrigan, dean for global health at Icahn School of Medicine at Mount Sinai in New York, who was not involved in the study, said:

“Ten of 15 years ago, we thought that air pollution caused pneumonia, asthma, and bronchitis and not much more than that. We now know that air pollution is a very important cause of heart disease and stroke and contributes to chronic lung disease, lung cancer, and chronic kidney disease.”

The majority of Type 2 diabetes cases are caused by obesity, lack of physical activity, and genes. However, studies have pointed to a direct link between Type 2 diabetes and air pollution. This is because air pollution is thought to trigger inflammation and reduce the pancreas’ ability to produce insulin.

For the study, researchers examined the relationship between fine particulate matter (FPM) and the risk of diabetes by first analyzing data from 1.7 million U.S. veterans. [2]

The data showed that when a population of the vets was exposed to pollution at a level of between 5 to 10 micrograms per cubic meter of air and about 21% developed diabetes. When that exposure was increased to between 11.9 to 13.6 micrograms per cubic meter of air, 24% of the group developed the disease.

A 3% increase doesn’t sound like much, but it represents an increase of 5,000 to 6,000 new diabetes cases per 100,000 people in a given year, according to the researchers.

The team then linked the data to the EPA’s land-based air monitoring systems and space-borne satellites operated by NASA.

They used several statistical models to test the validity and the risk of developing Type 2 diabetes and found a strong link to air pollution.

From there, the scientists created a model to evaluate diabetes risk across various pollution levels using all studies linking diabetes to air pollution.

Read: Thousands of Lives Could be Saved by Stricter Air Pollution Standards

Lastly, they analyzed data from the Global Burden of Disease study. The research is conducted on a yearly basis and includes contributions from researchers located all over the world.

Al-Aly said:

“Our research shows a significant link between air pollution and diabetes globally. We found an increased risk, even at low levels of air pollution currently considered safe by the U.S. EPA and the World Health Organization.

This is important because many industry lobbying groups argue that current levels are too stringent and should be relaxed. Evidence shows that current levels are still not sufficiently safe and need to be tightened.”

The risk of pollution-linked Type 2 diabetes was found to be higher in low-income countries such as India, Afghanistan, Papua New Guinea, and Guyana.

People living in wealthier countries like France, Finland, and Iceland have a lower risk of diabetes because they have what they need in terms of environmental mitigation systems and clear-air policies.

The commission found that 92% of pollution-related deaths occurred in low- and middle-income countries among minorities and the poor. Children face the greatest health risks from pollution, even at low doses. [1]


[1] CNN

[2] Daily Mail

Text-Messaging as Effective as Medication for Improving Type 2 Diabetes?

Diabetes can be a royal pain in the you-know-what. Staying healthy always requires effort, but living with diabetes and staying healthy requires extra effort. No fun. Interestingly, one study claims something quite bizarre related to diabetes managements – texting is just as good as medication at improving blood sugar levels. Hmmm. [1]

The Dulce Digital clinical trial found that low-income Hispanics with Type 2 diabetes who received health-related text messages daily for 6 months showed improvements in their blood glucose levels comparable to those they would have had if they were taking medication.

Athena Philis-Tsimikas, M.D., corporate vice president of Scripps Whittier, said:

“As a low-cost intervention, we believe text messaging has great potential to improve the management of diabetes, especially among patients who struggle, due to employment, transportation and other barriers, to access healthcare services.

The data from our new study proves that this an effective approach.”

About 30 million Americans have diabetes, which costs the United States more than $245 billion a year. Hispanics are at higher risk for the disease – 13.9% compared with 7.6% for non-Hispanic whites.

For the study, conducted between October 2012 and August 2014, researchers recruited 63 low-income Hispanic participants. The volunteers watched a 15-minute diabetes instructional video, and were then given a blood glucose meter and instructions on using it. All participants received access to their normal care, including voluntary visits with a primary care physician, as well as a certified diabetes instructor, and group diabetes self-management education.

The participants who were randomly assigned to the study group received 2-3 short text messages a day at the start of the trial, but received fewer as the study went on. Each individual in the study group received an average of 354 messages over the course of the research. The texts looked something like this:

  • Use small plates! Portions will look larger and you may feel more satisfied after eating.
  • It takes a team! Get the support you need — family, friends and support groups can help you to succeed.
  • Tick, tock. Take your medication at the same time every day!
  • Time to check your blood sugar. Please text back your results.

Researchers focused on a blood test called hemoglobin A1C, which measures average blood glucose during the previous 2-3 months. A normal hemoglobin A1C should be below 5.7%

  • On average, the combined participant groups registered a baseline mean A1C of 9.5%.
  • But 3 months later, the text group’s A1C was down to 8.5%.
  • The control group still had an average A1C of 9.3%.
  • At 6 months, the study group’s mean A1C remained at 8.5%, while the control group’s mean A1C registered a 4.9% mean.

If you’re a diabetic, you know that’s a huge improvement.

At the end of the trial, 96% of those in the study group said the text messages helped them to manage their diabetes “a lot.” The same percentage said that they would continue receiving the messages, if given the option. Ninety-seven percent said they would recommend the program to their friends.

In particular, those who received texts asking them to check their blood glucose and text their readings back had the most success. [2]

The researchers believe the significant drop in the study group’s mean A1C was the result of a higher level of engagement and participation in the program. It’s way too easy to forget to test your blood sugar.

Philis-Tsimikas said:

“These findings suggest that, on a wider scale, a simple, low-cost text message-based approach like the one offered through Dulce Digital has the potential to significantly benefit many people who struggle every day to manage their diabetes and maintain their health.”


[1] Science Daily

[2] Nursing Times

Researchers Develop Swallowable Device that Injects Insulin Painlessly

For many people with diabetes, living with the disease requires multiple needle sticks a day to inject insulin and control their blood sugar. But in the future, diabetics might be able to take their insulin in pill-form. Two groups of researchers are working to make this possible in the future.

The groups, from MIT’s Koch Institute for Integrative Cancer Research and Harvard’s Brigham and Women’s Hospital, have developed an insulin delivery system that still uses a needle, but it’s so small that it can be swallowed, pain-free.

The pea-sized device contains a spring that injects a tiny dart of solid insulin into the wall of the stomach, according to Carlo Giovanni Traverso, an associate physician at Brigham and Women’s Hospital.

Traverso said:

“We chose the stomach as the site of delivery because we recognized that the stomach is a thick and robust part of the GI tract.”

Once the device reaches the stomach, the humidity there allows the spring to launch the insulin dart. If the idea makes you cringe, you can relax; it doesn’t hurt, thanks to the lack of pain receptors in the stomach. Once the injection has occurred, the needle breaks down in the digestive tract. [1] [2]

The self-righting capsule orients itself inside the stomach and ejects a tiny dart of solid insulin that’s about a quarter of an inch long. Source: Ania Hupalowska, Alex Abramson, Muhammad Mahdi Karim/Science

That all sounded good, in theory, but the researchers had to overcome the issue of getting the device to orient itself in such a way that it injected the insulin directly into the stomach. If you swallow a pill, you don’t have much control over which direction it lands once it’s in the body. [1]

Fortunately, nature provided the solution.

Traverso explained:

“Leopard tortoises happened to have evolved a way of doing this.”

MIT wrote in the journal Science: [2]

“The researchers drew their inspiration for the self-orientation feature from a tortoise known as the leopard tortoise. This tortoise, which is found in Africa, has a shell with a high, steep dome, allowing it to right itself if it rolls onto its back. The researchers used computer modeling to come up with a variant of this shape for their capsule, which allows it to reorient itself even in the dynamic environment of the stomach.”

Do you remember Weebles – those toys from your childhood that “wobble but they don’t fall down”? Those, too, provided inspiration for how to properly orient the device in the body. [1]

The researchers said in the journal Science that they’ve tested the insulin-delivery device on pigs, where it successfully injects a therapeutic dose of insulin provided the pig has an empty stomach.

Both teams of researchers have partnered with the global healthcare company Novo Nordisk to prepare the device for use in humans. It could be ready for human testing in a few years.


[1] NPR

[2] TechCrunch

Diabetics: STOP Doing This to Cut Risk of Premature Death

Having Type 2 diabetes doesn’t have to mean a life of disability or early death. A few lifestyle changes, such as quitting smoking, can reduce those risks, especially the risk of cardiovascular disease.

Kicking cigarettes to the curb and closely following treatment protocols can reduce the risk of cardiovascular disease “significantly,” according to a study published in The New England Journal of Medicine. In some cases, the risk can be completely eliminated.

Aidin Rawshani, medical intern and doctoral student at the Institute of Medicine, Sahlgrenska Academy, Sweden, and author of the report, said:

“This is definitely good news. The study shows that patients with Type 2 diabetes with all risk factors within therapeutic target range had an extremely low risk of premature death, heart attack, and stroke.”

For the study, researchers culled data from the Swedish National Diabetes Register of approximately 300,000 people with Type 2 diabetes in the period 1998-2015. The team compared the patients with up to 5 times as many gender- and age-matched individuals from the general population as a control group.

Type 2 diabetes patients were 10 times more likely than people without the disease to suffer a heart attack, heart failure, and stroke, the study found. In general, those individuals have a 45% greater risk of heart failure. [2]

These individuals also had 5 times the risk for premature death compared to the control group.

Read: Immediate and Long-Term Benefits of Quitting Smoking

Falling into the first category is dependent upon controlling a number of risk factors – blood pressure, long-term blood sugar, blood lipids, renal function, and smoking – and adherence to medication, the authors wrote. Out of all of these risk factors, smoking was found to be the most important for premature death. Elevated blood glucose was the 2nd most important risk factor for heart attack and stroke.

Read: 5 Blood Sugar-Regulating Foods for Diabetics

Rawshani said:

“By optimizing these 5 risk factors, all of which can be influenced, you can come a long way. We have shown that the risks can be greatly reduced, and in some cases may even be eliminated. [1]

The study also shows that the risk of complications, especially heart failure, is greatest among those under 55 years. This makes it extra important to check and treat risk factors if you are younger with Type 2 diabetes.”


[1] Science Daily

[2] UPI

Signs of Type 2 Diabetes Can be Spotted 20 Years Before it’s Diagnosed

The early signs of Type 2 diabetes can be detected more than 20 years before a person receives a diagnosis, a new study shows. This is great news because it means the disease can be stopped in its tracks before it has a chance to wreak havoc on the body. [1]

Researchers said that they were able to detect increased fasting glucose, higher body mass index (BMI), and impaired insulin sensitivity up to 10 years before a diagnosis of diabetes or prediabetes.

Lead author Dr. Hiroyuki Sagesaka said:

“As the vast majority of people with Type 2 diabetes go through the stage of prediabetes, our findings suggest that elevated metabolic markers for diabetes are detectable more than 20 years before its diagnosis.”

A person with prediabetes will have blood glucose levels that are higher than normal, but not high enough to be considered diabetes. While prediabetes puts a person at higher risk for heart disease and stroke, it is an opportunity to make lifestyle changes, such as losing weight and reducing sugar intake, to stave off full-blown diabetes. Prediabetes is sometimes referred to as “borderline diabetes.” [1] [2]


For the study, the team tracked the trajectories of fasting blood glucose, BMI, and insulin sensitivity in participants who developed diabetes and participants who developed prediabetes. Of the more than 27,000 participants, 15,778 had a normal blood glucose level at the beginning of the study, while 4,781 developed prediabetes during the research. [3]

At the beginning of the study in 2005, the researchers measured the participants’ fasting glucose and average blood glucose (HbA1c) and followed them until they developed Type 2 diabetes or prediabetes, or the end of 2016, whichever came first. [1]

Fasting blood glucose is a measurement of a person’s blood glucose level after fasting for 8-10 hours. HbA1c is a measurement of a person’s average blood glucose levels over 2-3 months. [3] [4]

Past studies have shown that risk factors like obesity and elevated blood glucose may be signs of impending diabetes up to 10 years before a diagnosis. However, it was unclear until now at what point those risk factors developed into prediabetes or diabetes. [1]

Over the 11-year study period, 1,067 people developed Type 2 diabetes. The study showed that those individuals had a higher BMI, elevated blood glucose, and insulin resistance up to 10 years before they were diagnosed. These conditions worsened as the participants inched closer and closer to full-blown diabetes. [3]

For example, participants with a fasting blood glucose level of 101.5mg/dL went on to develop type 2 diabetes 10 years later, unlike those with 94.5mg/dL.

Normal blood glucose is considered less than 100mg/dL; prediabetes is 100-to-125mg/dL; and diabetes is more than 126mg/dL.

In the study, those with a fasting blood glucose of 105mg/dL developed Type 2 diabetes 5 years later, and those with 110mg/dL did so 12 months later.

The study showed that blood sugar levels were a reliable predictor of prediabetes decades before a participant developed the condition.

Sagesaka said:

“Because trials of prevention in people with prediabetes seem to be less successful over long-term follow-up, we may need to intervene much earlier than the prediabetes stage to prevent progression to full-blown diabetes. A much earlier intervention trial, either drug- or lifestyle-related, is warranted.”

Risk Factors for Type 2 Diabetes

  • Overweight or obesity
  • Inactivity
  • Family history
  • Race – African-Americans, Hispanics, American Indians, and Asian-Americans are at higher risk
  • Age – Your risk for Type 2 diabetes increases as you age
  • Gestational diabetes – If you developed gestational diabetes while you were pregnant, you have a greater risk of prediabetes and diabetes
  • Polycystic ovarian syndrome
  • High blood pressure
  • Abnormal cholesterol and triglyceride levels
Source: Mass.Gov Blog

5 Ways to Reduce Your Risk, Naturally

  • Adopt a plant-based diet
  • Start adding ginger to a smoothie, meat dish, curry, salad dressing, or capsule
  • Get enough sleep


[1] Economic Times

[2] WebMD

[3] Daily Mail

[4] Diabetes UK

[5] Mayo Clinic


Mass.Gov Blog

CDC Survey: Obesity is Still Growing in America

One of the largest surveys of health in the United States reveals some sobering, though not entirely unexpected news: Americans are fatter than ever. Ouch.

The CDC has been asking Americans 18 and older about their health and their family members’ health every year since 1957. The National Health Interview Survey, which contains data from 2015 on more than 100,000 people, shows that more Americans had health insurance and smoked fewer cigarettes in 2015 than in previous years, but obesity and diabetes rates are still climbing.

In 2015, 30.4% of Americans age 20 and older said they were obese, up from 29.9% in 2014. It’s not a huge increase, but it represents a continuation of a trend that has been going on since at least 1997, when researchers began using the current survey format. At that time, the obesity rate was only 19.4%. [1]

Source: BGR

Brian Ward, health statistician at CDC’s National Center for Health Statistics and one of the authors of the report, told CNN:

“That is not a good trend there. But it is not necessarily anything unexpected.”

However, according to other surveys, the obesity problem is far worse than the CDC’s suggests. In 2012, the National Health and Nutrition Survey found that 34.9% of adults age 20 and over were obese. To reach their conclusions, the researchers behind that survey measured the height and weight of more than 9,000 Americans to calculate their body mass index (BMI). The current survey relied on respondents self-reporting their body size.

Michael W. Long, assistant professor at the Milken Institute School of Public Health at George Washington University, said the National Health and Nutrition Survey is probably more accurate, because people tend to exaggerate their height and downplay their weight.

That’s a discouraging thought. The CDC’s findings show that more than 97 million U.S. adults are grossly overweight, but that number might actually be much higher.

Other findings from the CDC survey included:

  • The rates of obesity among blacks were higher than Hispanics and white adults. About 45% of black women reported that they were obese, compared with 32.6% of Hispanic women and 27.2% of white women. Similarly, 35.1% of black men said they were obese, compared with 32% and 30.2% of Hispanic and white men, respectively.
  • Adults between the ages of 40 and 59 had the highest rates of obesity. In this age group, 34.6% of people said they were obese, compared with 26.5% of adults 20 to 39 years old 30.1% of adults 60 and older.

Long said:

“[The 40 to 59 age group] is really where you see a lot of the effects of obesity on diabetes-related morbidity and mortality, and you see premature deaths related to heart disease and are starting to see some of the cancers related to obesity.”

The survey showed that diabetes is on the rise, too – a natural consequence of rising obesity. Among people 18 and older, 9.5% said they had diabetes in 2015, compared with 9.1% in 2014. Again, the increase isn’t big, but it indicates an ongoing trend.

In 1997, only 5.1% of Americans had diabetes.

Additional Sources:

[1] BGR

Storable Food

Coenzyme Q10 may Be Viable Solution for Many Diabetics

Coenzyme Q10 has long been known for its antiaging properties, especially in the cases of energy production and cardiovascular health. Now, it seems as though we have another use for this not-quite-a-vitamin – the prevention and mitigation of diabetes.

One little-publicized cause of diabetes may be the use of statins, marketed as “prevention” for cardiovascular events. Some statins, such as rosuvastatin, are linked with a 27% higher risk of type II diabetes! Two meta-analyses also found an elevated risk of diabetes, one with a 9% higher risk, and the other showing a 12% higher risk. This disproportionately affects the elderly, who are most likely to be prescribed statins.

So Why May Statins Raise the Risk of Diabetes?

Statins work by blocking an enzyme called HMG-CoA reductase, but this also blocks a precursor to coenzyme-Q10. Depletion of CoQ10 disrupts mitochondrial function. Along with negatively affecting energy levels, this also has a negative impact on insulin signalling, which could lead to the blood glucose dysregulation known as diabetes. To make things even worse, lowering LDL cholesterol also reduces CoQ10 transport into cells. [1]

These effects combined can deplete CoQ10 by as much as 54%.

This is why medical professionals now often recommend CoQ10 supplements to anyone taking statins. In fat cells exposed to statin drugs, the coenzyme can restore the normal glucose uptake mechanism that the drugs also disrupt.

Additionally, CoQ10 has been found to reduce blood sugar and HbA1C levels in diabetic patients. Blood sugar tests only take a picture of how your glucose regulation is doing now; haemoglobin A1C gives an idea of your blood glucose regulation over the past 4 months, as it shows how much sugar has been tangled in the haemoglobin proteins.

The root cause of many diabetes complications is loss of endothelial function (the lining of the blood vessels), which leads to poor blood flow and tissue destruction in parts of the body such as the eyes, kidneys, and toes. Worse still, this can even affect the heart, causing something known as diabetic cardiomyopathy (heart muscle damage).

Fortunately, supplementation with 200mg of CoQ10 has been found to significantly improve loss of endothelial function in diabetes, which may spare many from crippling complications.

Are Statins Even a Necessity?

But do we even need these CoQ10-depleting statins? Research has actually shown that statins may be more harmful than beneficial for the heart, even if there were no alternatives. Statins have been found to increase the risk of microalbuminuria, which is a known marker of blood vessel dysfunction.

Other studies have found that some statins could worsen heart function, increase LDL oxidation (which is the cause of plaque!), cause heart failure and/or atrial fibrillation (a fluttering movement that does not pump blood!), reduce blood flow to the heart, and weaken the heart muscle. [2]

The CoQ10 depletion may also be behind the increase in congestive heart failure in the USA. It is very fortunate that even “mere” diet advice can also protect against cardiovascular deaths, such as eating an apple every day – which may reduce LDL cholesterol by an impressive 40%!

Overall, CoQ10 deficiency can be debilitating and even dangerous, but you don’t have to suffer.


[1] LifeExtension

[2] GreenMedInfo

Storable Food

Poor Diet Caused Nearly Half of All Deaths in the U.S. in 2012

A study released earlier this year reveals that some 45% of all deaths in the U.S. in 2012 were due to “cardiometabolic disease,” or CMD – all because of the average diet. CMD encompasses heart disease, stroke, and type 2 diabetes. [1]

Researchers say that the largest number of diet-related CMD deaths are due to high consumption of sodium, processed meats, and sugar-sweetened drinks, and low intake of nuts and seeds, seafood omega-3 fats, and fruits and vegetables.

Related: Drinking ANY Sugar Increases Your Risk of Diabetes

Says first author Renata Micha, R.D., Ph.D., assistant research professor, Tufts Friedman School of Nutrition Science & Policy in Boston, Massachusetts:

“These results should help identify priorities, guide public health planning, and inform strategies to alter dietary habits and improve health.

Increased intakes of specific minimally processed foods, such as fruits, vegetables, nuts, whole grains, fish, vegetable oils, and decreased intakes of salt, processed meats and sugar-sweetened beverages appear to be key relevant priorities for dietary and policy recommendations. Future studies should evaluate the potential effects of specific interventions to address the diet-related cardiometabolic mortality and reduce disparities.” [2]

Published on 7 March 2017 in JAMAthe study found that more men than women die from diet-related causes. The researchers say that, generally speaking, the findings are consistent with the fact that men tend to have unhealthier eating habits. Additionally, there were a greater number of diet-related deaths among African-Americans and Hispanics compared with non-Hispanic whites. [1], [3]

According to Micha, the estimated number of deaths that were linked to not getting enough of the healthy foods listed was at least as substantial as the number of deaths associated with eating too much of the unhealthy foods listed.

Researchers report that the highest number of deaths was linked to high sodium intake; about 66,500 CMD deaths in 2012 were linked to eating too much salt, followed by (in order):

  • Not eating enough nuts and seeds (59,000 deaths)
  • Eating too much processed meats (58,000 deaths)
  • Eating too little seafood omega-3s (55,000 deaths)
  • Not eating enough vegetables (53,000 deaths)
  • Not eating enough fruits (52,500 deaths)
  • Drinking too many sugar-sweetened beverages (52,000 deaths) [1]

Read: Omega-3 Fatty Acids May Be the Key to Preventing Most Disease

The study did have its limitations. For instance, the studies the researchers used were observational, which don’t prove cause-and-effect. In addition, other dietary factors may have been at play, such as saturated fat and added sugar. And some dietary factors are potentially linked, like sodium and processed meats.

On a positive note, the researchers say that from 2002 to 2012, there were fewer diet-related CMD deaths due to insufficient polyunsaturated fats, nuts and seeds, and to excess sugary drinks. [1]


[1] Live Science

[2] Medscape

[3] CNN

Storable Food