Reducing Type 2 Diabetes Through Weight Loss Alone

This is a bit of a departure for me as I have picked something that’s not necessarily relevant to older people but more relevant I think to the people who might read this Blog. Thanks to UNIVADIS for bringing this to my attention.

We often hear that Type 2 diabetes (T2D) can be avoided by losing weight and altering your diet, See Understand Your Risk but what if you have Type 2 diabetes already!

How much weight reduction is required to achieve T2D remission?

A recent paper published by a team from the University of Cambridge, School of Clinical Medicine, conducted a study that looked at this question and found that achieving weight loss of ≥10% within a few years of getting a T2D diagnosis is strongly associated with remission at 5 years. About a third of people who managed this achieved remission.

Why this matters

  • About 422 million people worldwide have diabetes, a number likely to more than double in the next 20 years. Type 2 accounts for around 90% of all diabetes worldwide. Reports of Type 2 diabetes in children have increased globally (WHO 2019)
  • Previous studies have shown that T2D remission is possible with intensive caloric restriction/lifestyle intervention, but few have addressed less-intensive interventions.

Study design

  • Prospective cohort study of 730 people aged 40-69 years newly diagnosed with T2D

Key results

  • Diabetes remission (HbA1c <48 mmol/mol; 6.5%), without any diabetes medication or bariatric surgery, was achieved in 257 participants (30%).
  • Those achieving remission were more often male, smokers, and with full-time education beyond age 16 years.
  • Compared with no weight change and after adjustments, people who lost ≥10% of body weight in first year after diagnosis were significantly more likely to achieve T2D remission at 5 years (risk ratio, 1.77; P<.01).
  • Remission likelihood was non-significantly increased for 5%-10% weight loss (risk ratio, 1.24; P=.17).
  • In subsequent 1-5 years, ≥10% weight loss was also associated with remission (risk ratio, 2.43; P<.01).
  • No consistent patterns of associations between unit changes in health behaviours (energy intake, physical activity, etc.) and T2D remission.
  • The study was conducted within a primarily white population.
  • Funding was published by Wellcome Trust; Medical Research Council and the UK National Institute for Health Research.

You can access the whole paper via

Dambha-Miller H, Day AJ, Strelitz J, Irving G, Griffin SJ. (2019) Behaviour change, weight loss and remission of Type 2 diabetes: a community-based prospective cohort study. Diabetic Medicine. 2019 Sep 3 [Epub ahead of print] at  doi: 10.1111/dme.14122. PMID: 31479535

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Are You Ready for 64? What about 86 and Maybe More?

I quite liked this as an introduction to this weeks topic. Today’s fifty-year-olds are likely to have an astounding 36 or more years to live. So if you’re approaching later life, you need to think very differently about what those extra years will hold.

So two think you will have to consider plan for your future at work and help in achieving the goal of a fabulous later life. Interesting you can find guides to both on the Centre for Ageing Better’s website this week.

Firstly they have published a new report on Employers, suggesting that they should do more for workers in their 40s and 50s to help them plan for the future.To read more about their findings and to download the full report follow THIS LINK 

The Centre for Ageing Better says

…providing mid-life support is an essential part of how employers can respond to the changing nature of the workforce. Workers over the age of 50 now make up a third of all UK workers, but there are more older people leaving work than younger people coming in to replace them. Supporting staff to plan ahead could help employers avoid potential staff and skill shortages, as well as ‘cliff edge retirements’ where people are working one day and stop work entirely the next.

The second item is a new book that the Centre helped to produce called When We’re 64 by Louise Ansari

The book is a friendly, practical guide to preparing for what could be the best years of your life – from the essentials on work and how to fund retirement, to volunteering, where to live and what kind of housing you’ll need The book aims to provide knowledge, tips and pointers to help you think very differently about opportunities that a long life can bring. You can find out more about the book and how to purchase it by CLICKING HERE. 

#LetsTalkAboutDementia

Today is September 1st and this is the start of World Alzheimer’s Month

World Alzheimer’s Month is an international campaign which aims to raise awareness about dementia and this year it will specifically focus on challenging the stigma about Dementia that persists globally.

The ‘Let’s Talk About Dementia’ campaign encourages that often difficult first conversation and highlights the importance continuing to talk about and discuss dementia – to normalise the language and help to take away the fear.  It encourages people to seek out more information, help, advice and support.

To mark World Alzheimer’s Day on 21 September, Alzheimers Disease International  (ADI) will also be releasing this year’s World Alzheimer Report.

This year the report draws on the results of a survey conducted by ADI and the London School of Economics (LSE), which focuses on attitudes towards dementia. The survey, saw nearly 70,000 responses from 155 countries, is the largest ever undertaken on the subject.

According to ADI CEO, Paola Barbarino: “A key finding in the survey shows that 2 out of 3 people that responded still think that dementia is caused by normal ageing. We must break through the stigma and get people talking openly about dementia to plan well and to access support.”

Alongside further results from the survey, the report will also contain essays from experts and case studies.

Everyday Ageism! Time to #retireageism

According to a new report published last week, which surveyed 4,000 UK adults and analysed thousands of tweets and blogposts in the UK one in 30 people admitted to regularly discriminating against anyone aged over 50 – and more than one in 10 admitted that they don’t even know if they were ageist or not.

More than a third of British people admit that they have discriminated against others because of their age, according to new research on everyday ageism, with those in their 30’s most guilty.

The Ageist Britain? Report published by the Sun Life Group aims to shine a light on the issue of casual ageism and the impact it has.

The report shows that people over 50 are  bombarded with phrases and behaviours which imply that life as an older person must be awful. Language is particularly revealing with “Old fart”, “little old lady”, “bitter old man” and “old hag” used frequently in conversation and on social media

Everyday ageism has an impact on mental health with growing awareness that this ageist societal narrative negatively impacts on our personal experiences of ageing and perhaps even our health and well being it can also hasten the onset of dementia and even shorten life expectancy.

The report also found that 40% of British people over 50 regularly experience ageism, with one in three commonly experiencing it at work, one in 10 on public transport, and one in seven while shopping.

As Shelley Hopkinson, public affairs manager at Independent Age said, “Part of the problem is that people often don’t even realise that the language they’re using can be ageist or cause offence”

So what should people in the UK do about this. Well the reports says a good bit more but when the public were asked the top 3 most popular ways people think we can combat ageism are:

• If more brands used different models of all ages for their advertising campaigns (37%)
• If the issues associated with ageism had the same level of attention as racism and sexism (33%)
• If people were more aware of the use of ageist language and avoided derogatory terms (33%)

Hospital Admissions of Older People Continue to Rise

This week the SCoOP report was published. Otherwise known as the Acute Hospital Outcomes Report 2017/18; it provides an overview of the outcomes of acute geriatric medicine services in Scotland and is published by Scottish Care of Older People National Audit Project which amongst other things is trying to evaluate the variation in service provision for older people who require health and social care in various settings, to serve as a driver for standardisation and improvement of care across Scotland.

They have reported that admissions to geriatric medical wards in Scotland’s 19 largest hospitals with major emergency departments have risen by 10% for three consecutive years, reaching 43,311 in 2017/18.

The report has also concluded the length of stay dropped across all sites by an average of one day over the same period.

More concerningly they have noted the number of admissions varied widely across sites in Scotland, with some areas showing large increases in activity while others are in decline. There was also a large variation in the typical length of time patients spent in different hospitals. In some cases, there were up to 12-fold differences in the length of stay, while hospitals with higher activity levels usually had lower lengths of stay.

There was also a strong relationship between the time waiting to get to a specialist bed and the overall length of time patients spent in hospital; suggesting that delays in accessing specialist services contribute markedly to longer stays in hospital.

Differences in readmission rates and mortality were less marked between hospitals, broadly remaining stable over the last three years.

The report does not attempt to explain the variations but aims to stimulate discussion, learning and action that could be used to help benchmark some key patient outcomes and encourage interorganisational learning.

Professor Graham Ellis, Co-Chair of SCoOP Steering Group and the National Clinical Lead for Older People, Healthcare Improvement Scotland said:

“The wider goal is to reduce unwarranted and unjustifiable variation in outcomes, which may represent a threat to patient safety and/or a failure to learn from best practice.”

 

Registered Nurses Within Social Care

I’ll make my apologies now I am “borrowing” a lot of this from the latest edition of Nursing Older People but its a subject close to my heart, the lack of recognition given to nurses working in the social care sector (and that includes care homes). Its estimated that around 42,000 UK nurses work in social care for voluntary, private and state sectors employers. Unfortunately the turnover rate in this sector is excessive (around 30%) and about 5,000 post lie vacant, which is not a happy position  to be in.

Last week Skills for Health (England), published a new document called “Registered Nurses: Recognising the Responsibilities and Contribution of  Registered Nurses Within Social Care”. The document sets out to provide a description of the complex role nurses undertake and demonstrates the way that they not only use all of their nursing knowledge, but also contribute to important national health and social care agendas.

It was developed in consultation with registered nurses and the people they support, plus other professionals who work in and with the adult social care sector, and colleagues who work with the nursing regulatory framework. 

You can download the document and accompanying infographic HERE

The Myth busting video is here and well worth a watch

 

More Than 10% of the #UK Population Live in Persistent Poverty

Today the Social Metrics Commission,  founded in 2016 to develop a new approach to poverty measurement because the UK no longer had an official measure of poverty for children, adults or pensioners has published its latest report on UK poverty today

In developing a new set of metrics, the commission wanted metrics that better reflected the nature and experiences of poverty and one which could be used to build a consensus around poverty measurement and action in the UK. So what are they saying this year?

Let’s start by considering the UK total population which was 66.04 million people in 2017 (The most recent accurate estimate).

The key messages in this report indicate that ƒthere are 14.3 million people in poverty in the UK. This includes 8.3 million working-age adults; 4.6 million children; and 1.3 million pension-age adults.ƒIndicating that despite  minor fluctuations, overall rates of poverty have changed relatively little since 2000.

The current rate of poverty is close to 22%, which is the same as last year and only slightly lower than the 24% seen in 2000/01.

However, this trend hides significant changes in rates of poverty among different groups. Poverty rates in pension-age adults fell steadily from 19% in 2000/01 to 9% in 2014/15 but have since risen slightly to 11%.

Similarly, poverty rates among children dropped from 36% in 2000/01 to 31% in 2014/15, but have now risen slightly to 34%.ƒ

On average, those in poverty have moved closer to the poverty line now than would have been the case in 2000/01. However, a third (31%) of people in poverty – 4.5 million people – are more than 50% below the poverty line, and this proportion has not changed since the millennium.

7 million people are living in persistent poverty meaning they have been in poverty for at least two of the previous three years and are still in poverty now with not much chance of an escape given the current economic situation. 

Remember this is the UK has the 5th largest economy in the world by GDP

Two questions pensioner poverty is going up, why? Child poverty is not coming down despite several government attempts to tackle it over the years.

Some thing new the report shows; nearly half of people in poverty live in a family where someone is disabled. This is shocking, and has clearly been overlooked by government for many years. Surely this need to be addressed

To access the full report CLICK HERE