Guy's Gotta Talk -- About DIABETES; breast cancer, Azheimer's: 2024

Sunday, December 15, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #27: Eating For Holiday Cheer WITHOUT The Sugar Rush...

I started my Breast Cancer, Alzheimer's, and Type 2 Diabetes blog thirteen years ago. While many people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I reopened my blog rather than starting a new one. I have taken pauses to write about Breast Cancer or Alzheimer’s as medical headlines dictated; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me!I’m sure you’ve got all of your “hacks” for surviving the holiday Food Onslaught! I’m aware of it this year because my wife and I had our FIRST big party – making and decorating sugar cookies, Russian teacakes, with tacos afterward…

Haven’t taken my blood sugars yet, but I’m sure they won’t be great! My stomach is rumbling as well, so it inspired me to do a bit of work for myself, and I’ll share with you:

The A-1 thing to do during the holidays is to PLAN AHEAD! Your eleven-year-old granddaughter can eat six cookies and burn it off the next day. My 67-year-old metabolism DON’T WORK THAT WAY ANYMORE!

Make fruits and veggies a BIGGER part of our holidays than usual; and I CAN make them good so OTHERS will join me in eating healthier.

I need to pay Attention to how MUCH I’m eating.

I’ve tried the “fast-and-binge” method and it doesn’t work well for me – ON THE OTHER HAND, the “ignore-what-I’m-eating-and-it-will-all-go-away” hasn’t been particularly helpful, either.

I need to make sure I DRINK WATER! In our place, with three grandchildren, six kids and their spouses – we lay on the cases of soda. I should be drinking SOME water, at least!

I SHOULD test the blood sugars regularly – the problem with it is that I only get so many test strips each cycle (that insurance pays for), so I have to stick (no pun intended) with taking it once a day. My wife’s got a constant glucose monitor, so that’s one thing she can do regularly!

If I work to spread out the KINDS of carbs I'm indulging in and MAYBE avoid eating 18 sugar cookies with frosting or two bowls of chocolate-dipped pretzels, it's safe to say I might survive the days with only mild sugar rushes. Steer toward oatmeal-raisin cookies, maybe broccoli instead of corn, and bring a lentil stew for everyone to enjoy.

When I toast in the New Year – I can work hard to control the amount. I don’t NEED a bottle of champagne when a fluted glass will do just fine!

One thing about youngsters during the holidays, they WANT to be out in the snow! I'm planning to join them this time (if we have more than a dusting) But we don't have to PLAY in it! It doesn't have to be a LONG walk, but even 10 minutes after a big meal helps. Invite EVERYONE to join you when you're staying active around the holidays.

If the holidays bring sadness with them – and they often do – I need to be aware of that and make a plan for doing something thoughtful that reminds me of happier days. The holidays are SUPPOSED to be a celebration of the things we hold dear. What can WE do or ask others to HELP US DO that will add a spark of peace to the holidays?

Finally, from THE STRAWBERRY POST: Here to Entertain, Educate & Inspire!

“Diabetes isn’t meant to stop you enjoying Christmas, but it’s good to be aware of what can happen during this time. So please be aware in the lead up to Christmas and make sure that you know what could occur and how to fix it so you can enjoy the day as much as possible.”

"Colorful holiday plate on a table: put a new emphasis on DECORATION instead of solely on FOOD."

"Some fairly easy things to try, is to ask your significant others to eat close to your usual times to keep your blood sugar steady.

"Eat a small snack at your usual mealtime if needed and have a little less when dinner is served.

"NO FOOD IS ON THE NAUGHTY LIST! Act like you want to STAY healthy, happy, and wise!

"Hosting? Introduce a tasty NEW and healthy dish.

"Plan your carb choices in advance. For example, if you're going to have sweets, cut back on other carbs like potatoes, bread, or pasta dishes, and take one cookie at a time, circulate, then go BACK for another. I RARELY need to eat a bowl of eight or nine sugar cookies!

"Don't skip meals to save up for a feast. (When you're really hungry you might overeat.)

"When you face a spread of delicious holiday food, make healthy choices easier:
First: fill half your plate with vegetables, then be reasonable with the other half!

Eat slowly. It takes at least 20 minutes for your brain to realize you're full, so set your phone to vibrate and stop.

Drink water!

LASTLY: YOU DON'T HAVE TO DO ALL OF THESE AT THE SAME TIME!!!!

HAPPY HOLIDAYS TO YOU ALL!

Resources During The Holidays: https://our.today/wellness-watch-how-to-maintain-your-diet-as-a-diabetic-during-the-christmas-season/ ; https://www.bannerhealth.com/healthcareblog/better-me/how-can-i-manage-my-diabetes-and-still-enjoy-the-holidays
Image: https://thestrawberrypost.files.wordpress.com/2019/12/table-with-christmas-decoration-and-food.jpg

Sunday, November 24, 2024

DIABETES RESEARCH RIGHT NOW! #23: Latest Type 2 Diabetes News and Research (November 18, 2024 through November 22, 2024)

Sunday, November 10, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #26: Fear That “A CURE!!!” Is A Con?

Every one of you who, like me, would like something MAGIC to happen if I do something simple like drinking lemon water after I get up in the morning.

And just like me, you have a healthy aversion to being conned.

But, maybe like me, I sometime wonder if the Medical Establishment IS conning me to sell Metformin; and in my case…well, it was one of the biggest shocks of my life.

My doctor suggested I start taking the solid form of Ozempic; it’s called Rybelsus. I talked about my adventures with it in this entry: Guy's Gotta Talk -- About DIABETES; breast cancer, Azheimer's: GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #23: Ozempic, Rybelsus, and Me

So, he increased it a couple times, and at this last checkup, I A1c had dropped from 7.7 to 6.8!!! I was thrilled. He upped it one more time, I suppose thinking that “more is better”. I had the prescription for 14 mg (double my most recent prescription) of Rybelsus filled. I went to pick it up, and when the pharmacist tendered it, in addition to my cheaper meds, I had to pay over $535 for the new prescription! I about fainted!

I was even more stunned, when I read on the receipt that the RETAIL price for my three-month prescription of Rybelsus was… $3420.99! (I’d add about thirty exclamation points here, but I don’t feel like wasting perfectly good ranting space!

So, it makes sense that I (who have really good health insurance) was stunned to find out what anyone who does NOT have access to good insurance would have to face. IT WOULD BE IMPOSSIBLE TO ACCES THE MEDICATION. Possibly a medication that would save or extent their lives.

That explains then, the “confidence schemes” set up by people without scruples of any kind that claim to want to “help” others cheaply. Others like me, only with lesser (or even NO) insurance.

It explains the FEAR we have a claims of “amazing stuff” like an artificial pancreas, regrowing our own pancreas, diabetes-damaged cells being regenerated, I react like “I get suspicious that gobbledygook is being written to cover up a lack of facts with absurdly used terms substituted for straightforward language.” I am a suspicious kind of person when it comes to medicine: especially when young doctors – or physicians assistants (whose training, while different from mine in the INTENT, is no more than the education I got my Masters of Science in School Counseling for – both are Masters degrees. A PA cannot practice in the US WITHOUT a MD supervising them.

So, when something DOES come along that sounds FAKE, we shout FAKE and run the opposite direction.

While I am NOT a PA or an MD, I am a reasonably intelligent person who has a Bachelor of Science in Biology, and who reads constantly (journals, biology summary sites, science research, and am in contact with some of my former students who ARE researchers in medical biology or are doctors themselves) in my field as it has advanced since I graduated (when I took an Immunology class in 1977, the textbook had NO MENTION OF AIDS!))

I can only state to you that when I DO report on some new advancement, I’m not getting my information from whacky sites, but from SCIENCE sites. Check the links below each article. I always link to the source of my information.

So, while I am SKEPTICAL BY NATURE, I delight when I am convinced through data that something NEW is coming out to help us with Type 2 diabetes live longer and healthier lives.

EVIDENCE THAT PEOPLE AVOID RESEARCH THAT SOUNDS TOO GOOD TO BE TRUE. So, from my own blog:

Articles on CURES for Type 2 diabetes: 5
Number of hits: 166

NEARBY Articles NOT about CURES for Type 2 diabetes: 5
Number of hits: 314

The numbers speak for themselves -- maybe we're giving up HOPE because of the TRASH out there. But not ALL of it is trash.

THERE IS HOPE THAT THERE MIGHT BE A CURE FOR TYPE 2...

Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, October 20, 2024

DIABETES RESEARCH RIGHT NOW! #22: New Treatment Eliminates Insulin for Most Insulin-Dependent Patients!

Sunday, October 6, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #25: Know What LEAD Stands For? [Neither Did I: Life Expectancy Estimator for Older Adults with Diabetes]

For the first time since I started this blog eleven years ago, it’s going to be about me. I was diagnosed with Type 2 Diabetes two weeks ago. While people are happy to talk about their experiences with diabetes, I WASN’T comfortable with talking about diabetes. My wife is Type 2, as are several friends of ours. The “other Type” of diabetes was what caused the death of my Best Man a year after my wife and I got married. He was diagnosed with diabetes when he was a kid. It was called Juvenile Diabetes then. Today it’s Type 1. Since then, I haven’t WANTED to talk about diabetes at all. But…for my own education and maybe helping someone else, and not one to shut up for any known reason, I’m reopening my blog rather than starting a new one. I MAY take a pause and write about Breast Cancer or Alzheimer’s as medical headlines dictate; but this time I’m going to drag anyone along who wants to join my HIGHLY RELUCTANT journey toward better understanding of my life with Type 2 Diabetes. You’re Welcome to join me!

Did you know that there are medical standards of care that doctors can refer to when they’re working with seniors with Type 2 diabetes?

Neither did I.

Also, while the document was JUST revised in December of 2023, there’s an entire section that applies to seniors. One of the early sections had an interesting statement, and I’ll go through the part that applies to me and wife a bit later.

I was startled to find this: “The recommendations and text of Section 5 were adjusted to place focus on guiding the behavior of health care professionals rather than people with diabetes, thus aligning with the purpose of the Standards of Care as guidance for health care professionals.” (13. Older Adults: Standards of Care in Diabetes—2024)

One of the reasons for greater involvement and expected reliance on a person’s health care professional is something I’m SURE all of you are familiar with (if not with the fancy-pants name), “polypharmacy”. Never heard of it ‘til I read this document: “noun: polypharmacy; the simultaneous use of multiple drugs to treat a single ailment or condition; the simultaneous use of multiple drugs by a single patient, for one or more conditions.” I see it as “make sure you put the right pills in the right box so you can take them at the right time!”

I can see that – even though when I was trying to help my mother self-manage the numerous pills she had to take, the freakin’ condition didn’t have a NAME!) Of COURSE I need the advice of my doctor (who isn’t actually a DOCTOR per se, but a Physicians Assistant) to know when to take what I need to take and HOW to take it! Now the American Diabetes Association has made an official recommendation.

Another thing I’ll be talking to my PA about is this: “Notably, the Life Expectancy Estimator for Older Adults with Diabetes (LEAD) tool was developed and validated among older adults with diabetes, and a high-risk score was strongly associated with having a life expectancy of less-than five years.”

The heck is THIS????

Here’s what I found out: “A tool based on data from the electronic health record (EHR) may help clinicians estimate life expectancy in older adults with diabetes, a recent study found. The tool uses gender, body mass index, serum creatinine level, dementia, metastatic cancer, peripheral vascular disease, albuminuria, home oxygen use, wheelchair use, current smoking, and the interaction between age and heart failure to generate a risk score.”

They noted, “The authors noted that their tool…was not validated in patients younger than age 65 years and was less accurate over longer periods (among other limitations.) They also cautioned that the tool's results should be considered in a broader context along with other factors that influence individualized care, such as patient preferences.”

So…why would I get this test if it offers such limited amount of information? (The “conspiracy theorist in me would say, “So insurance companies can deny MORE seniors health care coverage…”) But, I’m CERTAIN that’s not what it would be used for! It’s a tool to…what?

I suppose looking at ALL of those things, would give a doctor or other caregiver different things to both watch for and begin to work on. For example: body mass index – if I knew my BMI was too high, I could certainly start to work to lose weight. Nothing STUPID, but certainly change the fact that I eat a package of OREO Cookie DoubleStufs before bed once a week! I could stop smoking (if I did, but I didn’t, so let’s just go back to eating Oreos); I could get screened for Alzheimer’s (which I do twice a year); I could make sure I exercise regularly to keep my heart strong (I ride about 12-15 miles a week during the summer; and stationary bike 2-5 hours a week in the winter in addition to walking a couple of miles every other day.)

I could have my PA give me the LEAD: Life Expectancy Estimator for Older Adults with Diabetes (LEAD)…which I will when I go in for my shots in a week or so…I’ll report then!

Source: https://diabetesjournals.org/care/article/47/Supplement_1/S244/153944/13-Older-Adults-Standards-of-Care-in-Diabetes-2024; https://diabetesjournals.org/care/article/47/Supplement_1/S5/153943/Summary-of-Revisions-Standards-of-Care-in-Diabetes; 13. Older Adults: Standards of Care in Diabetes—2024 | Diabetes Care | American Diabetes Association (diabetesjournals.org) Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, September 22, 2024

DIABETES RESEARCH RIGHT NOW! #21: FIRST EVER CURE FOR TYPE 2 DIABETES!!!! (SELF-Harvested Stem Cell) Therapy

From the first moment I discovered I had been diagnosed with DIABETES, I joined a HUGE “club” that has been rapidly expanding since it stopped being a death sentence in the early 20th Century. Currently, there are about HALF A BILLION PEOPLE who have Type 2 Diabetes. For the past 3500 years – dating back to Ancient Egypt – people have suffered from diabetes. Well, I’m one of them now… Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Diabetes research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: Repairing the Pancreas!

While the headline is from a report from China published this past May, the DREAM of restarting a pancreas damaged enough to initiate Type 2 diabetes has been around at least since 2011.

Today, there is not only hope that this might happen, but AT LEAST ONE person whose Type 2 diabetes was reversed using his own treated stem cells to regrow pancreas cells in large enough numbers to reinitiate his body’s production of the correct amount of insulin.

In the September 2011 issue of Genome Medicine, the author wrote: “Stem cells hold great promise for pancreatic beta cell replacement therapy for diabetes. In type 1 diabetes, beta cells are mostly destroyed, and in type 2 diabetes beta cell numbers are reduced by 40% to 60%. The proof-of-principle that cellular transplants of pancreatic islets, which contain insulin-secreting beta cells, can reverse the hyperglycemia of type 1 diabetes has been established, and there is now a need to find an adequate source of islet cells.” At this time, the only real hope was using human embryonic stem cells.

Ten years later, in Amsterdam, the research team discovered that, “all acinar and ductal cells – cells that produce digestive enzymes and transport them to the gut – actually contribute to [the] process [of repairing pancreatic cells]. All cells in the pancreas that produce digestive enzymes and transport them to the gut can contribute to its regenerative capacity.”

The initial study was fifteen YEARS ago, and in genetic research, that’s like decades. The work in Amsterdam took place in 2021. Today, researchers in Shanghai, China, “Utilizing the patient’s own endoderm stem cells (EnSCs), they were able to differentiate these stem cells into functional pancreatic islet cells – cells in the pancreas that secrete hormones, including insulin and glucagon, that help regulate blood sugar levels.”

What does this mean? It means the team in China found that they could use…the patient’s own “undifferentiated cells, found throughout the body after development, that multiply by cell division to normally replenish dying cells and regenerate damaged tissues...” All of us have them, they’re what heals the skin or any kind of internal damage we suffer during routine surgery. These stem cells do not depend on the use of fetal tissue. “[researchers] were able to differentiate [the patient’s own] stem cells into functional pancreatic islet cells – cells in the pancreas that secrete hormones, including insulin and glucagon, that help regulate blood sugar levels then transplant them into the patient’s pancreas.”

What happened? “Following a kidney transplant in 2017, the patient experienced a decline in pancreatic islet function, necessitating daily multi-dose insulin injection.” His stem cells were removed and grown, and after they injected them in the pancreas…”the patient achieved insulin independence within a mere 11 weeks post-transplantation. Oral medication for diabetes management was gradually reduced and ultimately discontinued a year later. Follow-up examinations conducted over a prolonged period revealed restored pancreatic function, with the patient no longer requiring insulin or oral or injectable medications that had become in short supply due to their use as weight-reduction drugs. Additionally, normal kidney function was maintained, suggesting a potential long-term cure for both type 2 diabetes and the underlying complications associated with the initial kidney transplant.”

NOTE! The procedure had been successfully attempted on this single patient at the time of the publication of the article in May of 2024. There may be others in the pipeline; but there’s no further evidence of any wide-spread study or a call for volunteers.

What it SHOULD inspire is HOPE. If not for me, then for anyone else in the future who finds themselves facing Type 2 diabetes for a real cure in our lifetime!

Links: https://cells4life.com/2024/05/stem-cell-therapy-achieves-cure-for-type-2-diabetes/, https://nyscf.org/resources/uncovering-the-unique-way-the-pancreas-regenerates/, https://genomemedicine.biomedcentral.com/articles/10.1186/gm277; https://nyscf.org/resources/uncovering-the-unique-way-the-pancreas-regenerates/ Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, September 8, 2024

GGTA…TYPE 2 DIABETES #24: People Over 65 Have Been EXCLUDED From Diabetic Research!”

Clearly, not worth talking about.

That appears to be changing. Dr. Huang was of the opinion that “…[to the medical world] the sickest patients should get less medication because they're [un]likely to…benefit from [them]…it goes back to insulin: the original trial comparing moderate and intensive glucose control…was conducted during a time when the number of available drug classes were very limited [ie: no Glipizide, Metformin, Ozempic, or any of the other modern treatments]...that trial showed that people do better with lower blood sugar, but you had to live for at least 10 years to see the benefit.” The subtext there of course, is “and all these old people won’t make it that long, so why bother studying them because NOTHING IS GOING TO CHANGE.

Huang goes on to say, “…cancer and heart disease can disqualify people from participating in [drug treatment] trials. Yet…patients with such conditions are representative of average geriatric diabetes patients, and physicians must be able to treat them.”

Huang concludes: “For many years people have talked quite vaguely about older patients, saying, ‘This older patient is complex,’ ‘This older patient is frail. Now we have tools that are much more specific and reproducible,” Huang said. “And now we can with greater specificity say who is missing from the trials, which could help us reexamine trial data and reshape how we design trials in the future.”

A recent result of this changed attitude led to Mounjaro and Zepbound: “A key study of [tirzepatide, the main ingredient of those two “Brand Name” drugs, discovered that there was] a significant reduction in the risk of progression to type 2 diabetes in adults with pre-diabetes and obesity or overweight…[which] achieved significant results, demonstrating a 93-94% reduction in risk of progression to type 2 diabetes [compared to placebo].”

The implication is that testing the drug on people 65+ discovered that not only could we TREAT Type 2 diabetes, we can now PREVENT it altogether – and avoid the concurrent drain on the cash-payout of the massive profit-driven insurance companies that are required by law to cover us “Golden-Agers”!

Source: https://biologicalsciences.uchicago.edu/news/new-diabetes-drugs-prompt-reassessment-care-strategies-older-patients; https://investor.lilly.com/news-releases/news-release-details/tirzepatide-reduced-risk-developing-type-2-diabetes-94-adults Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, August 18, 2024

DIABETES RESEARCH RIGHT NOW! #20: First-Ever Cure for Type 2 Diabetes??? Through Stem Cell Treatment?

PAUSE. At one time, the ONLY place to get these kinds of cells was through the use of the embryos of aborted fetuses. That has changed in the third decade of the 21st Century. They CAN use the stem cells that are found in all of us, no matter our age. “‘Induced pluripotent stem cells’” are a type of cell that can be generated directly from a somatic (YOUR body cell) with the introduction of four specific genes. Doctor Shinya Yamanaka was awarded the 2012 Nobel Prize along with Sir John Gurdon “for the discovery that mature cells can be reprogrammed to become pluripotent.”

Not ONLY that, Pluripotent stem cells hold promise in the field of regenerative medicine. Because they can propagate indefinitely, as well as give rise to every other cell type in the body (such as neurons, heart, pancreatic, and liver cells), they represent a single source of cells IN EVERY PERSON'S BODY that could be used to replace those cells or organs lost to damage or disease.

“Since these stem cells can be derived directly from adult tissues, they can ALSO be made in such a way that EVERY PERSON could have their own pluripotent stem cell line. The unlimited supplies of these pluripotent cells could be used to generate transplants without the risk of immune rejection. ***This technology has not yet advanced to a stage where therapeutic transplants have been deemed safe.** They ARE being used in personalized drug discovery efforts and understanding the patient-specific basis of disease. And work continues to make the use of these organs an effective and common procedure.

“The hope is that personalized pluripotent stem cells may one day be able to differentiate these cells into functional pancreatic islet cells – cells in the pancreas that secrete hormones, including insulin and glucagon, that help regulate blood sugar levels.”

Another advantage of using these ‘Induced Pluripotent Stem Cells’ is “to generate germ layer/tissue-specific stem cells from PSCs, which proliferate in vitro and are capable of differentiating into mature lineages, in this case, mature, functioning islets of Langerhans – the cells that produce insulin – because they are developmentally close to the desired mature cell type from the beginning, changing them into insulin-producing cells should be more efficient. Also, their restricted developmental potential provides a system to study various cell-cell interactions during differentiation into insulin-producing pancreas cells.

This treatment is NOT coming to a hospital near you any time soon!

HOWEVER, it IS COMING! Maybe not soon enough for me, but MAYBE soon enough for any of my kids or grandkids should they find themselves in the same situation I am!

Source: https://en.wikipedia.org/wiki/Induced_pluripotent_stem_cell
Links: https://cells4life.com/2024/05/stem-cell-therapy-achieves-cure-for-type-2-diabetes/
Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, August 4, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #23: Ozempic, Rybelsus, and Me

Then an explanation...

First, the semiglutide is a molecule that MIMICS the effect of a glucagon-like peptide-1 (GLP-1) receptor agonist. Glucagon is “a hormone formed in the pancreas which promotes the breakdown of glycogen to glucose in the liver”.

Glycogen is “a substance deposited in bodily tissues and is a form of “stored” carbohydrates in the liver and your muscles. It’s an ABSOLUTELY INSANELY complicated molecule formed of zillions of glucose molecules. Glucose is the SIMPLEST sugar and THE energy packet that powers EVERYTHING in your body. It is broken down by “hydrolysis”, which happens when enzymes chop up a glucose molecule and release energy and something called pyruvic acid (don’t worry about it here!)

Ozempic, Rybelsus and all the rest are a molecule that MIMICS the effect of a glucagon-like peptide-1 (GLP-1) receptor agonist…

The #&$%@*!!! Does THAT mean????

I thought you’d never ask, because it’s really simple: “GLP-1 agonists are medications that help lower blood sugar levels and promote weight loss.”

YOU probably don’t really want to know what that means, but me being me (a former science teacher and a biology major in college), I DO want to know…

More specifically, an agonist is a chemical that turns on some kind of reaction in a cell when it hooks up with a receptor. The receptor is a molecule on the outside of a cell’s skin that reacts to a particular kind of molecule. When the two hook up, in the case of active ingredient of Ozempic or Rybelsus or Monjarno, or any one of the others, it does a WHOLE BUNCH OF STUFF:

First, it makes your pancreas dump insulin into your blood, scooping up the extra sugar that gives you high blood sugars.

Second, it blocks glucagon – which is out of whack in anyone that has Type 2 diabetes – from telling your liver, “MORE SUGAR! MORE SUGAR!”

Third, it slows how much food gets digested (turned into glucose) and gets dumped into the blood stream, leading to (duh) high blood sugar!

Fourth, it makes your stomach feel full, so you don’t eat so much. If you don’t EAT so much, there won’t be so much food being digested, and there won’t be as much glucose released into your blood.

So– now that I UNDERSTAND what Rybelsus does to my insides; what Ozempic used to do to my wife’s insides…I can take the (stupid…but LESS stupid now that I know what my meds do…) meds to keep me from getting all the other crap I can get if I don’t try and get my diabetes under control…

The drugs are to HELP ME do something I can’t do anymore. Get it? Got it? Good! (

Me, too!

Source: https://en.wikipedia.org/wiki/Semaglutide, https://www.worksheetsplanet.com/what-is-glycogen/
The Actual Real Science Article: https://www.ncbi.nlm.nih.gov/books/NBK603723/#:~:text=Mechanism%20of%20Action&text=The%20mechanisms%20through%20which%20semaglutide,tract%2C%20pancreas%2C%20and%20brain.

Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Saturday, July 13, 2024

ALZHEIMER’S RESEARCH RIGHT NOW! #19: Slowing Down Alzheimer’s!?!?!?

From the first moment I discovered my dad had been diagnosed with Alzheimer’s, it seemed like I was alone in this ugly place. Even ones who had loved ones suffering in this way; even though people TALKED about the disease, it felt for me like they did little more than mumble about the experience. Not one to shut up for any known reason, I added a section to this blog…

VERY sporadically, I’ll be highlighting Alzheimer’s research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today:
“FDA Approves a Second Alzheimer's Drug That Can Modestly Slow Disease” PLUS “First-of-its-kind test can predict dementia up to nine years before diagnosis”

“Researchers at Queen Mary University of London have developed a new method for predicting dementia with over 80% accuracy and up to nine years before a diagnosis. The new method provides a more accurate way to predict dementia than memory tests or measurements of brain shrinkage, two commonly used methods for diagnosing dementia.”

“U.S. officials have approved another Alzheimer’s drug that can modestly slow the disease, providing a new option for patients in the early stages of the incurable, memory-destroying ailment. The Food and Drug Administration approved Eli Lilly’s Kisunla…for mild or early cases of dementia caused by Alzheimer’s.”

DO YOU SEE THE POSSIBLE SIGNIFICANCE OF THIS???

IF doctors and scientists are able to consistently predict dementia using fMRI scans from 1,100 volunteers taken from a UK database holding a half a million participants. From that study, they can then estimate the strength of connections between ten regions of the brain that make up the most significant parts of the brain.

After they figure out that I’m a candidate for developing Alzheimer’s, they should be able to the new drug to slow the disease SOME during the early stages of the disease – more specifically “for mild or early cases of dementia caused by Alzheimer’s.”

While no use for Dad, and ALSO given that knowing that I had/have a sporadic fear that with my dad diagnosed with Alzheimer’s I’m more likely to be diagnosed with it ANY DAY NOW!!!...

Yeah, I know, my own brain drives me crazy sometimes! (OH! “Crazy” is not the same as “Alzheimer’s”!

Finally, I searched and found this: “…statistics related to the risk of developing Alzheimer’s in your lifetime digs up some 3 million hits from Google!

I COULD pore over them and feed my fear, or I could accept the reality that if I’m 60 years old today (I’m currently 67) the odds of developing Alzheimer’s are 4.8%, or in other words, there is a 95.2% chance that I WON’T develop the disease.”

You (like me) might as, “is that a general chance or does it include people whose parents were diagnosed with Alzheimer’s?” The research reaches the following conclusion, “If you have a first-degree relative with Alzheimer’s disease (e.g. mother, father, sibling), your risk of developing the illness is about two to three times higher than someone else your age who doesn’t have a family member with the illness.”

OK – that seems straightforward. That puts my chance of developing Alzheimer’s at (using 2.5 times 4.8 = as likely) at 12%. That’s two chances in twenty-five or about one in twelve; twelve and a half to be precise. So, if we put twelve and a half people in a room, I will have Alzheimer’s, eleven others will not, and there will be a grisly murder for someone like Hercule Poirot to solve. (Which, being in a writing state of mind, puts an idea into my head…)

So, I live in the decade where it has become to not ONLY figure out if I’ll develop Alzheimer’s, it’s now possible to TREAT that diagnosis.

While I’m certainly not immune, I can add to the reasons that it’s unprofitable to worry about being diagnosed with Alzheimer’s. I hope it helps you as much as it quieted my own heart; ‘cause it helps a bit.

Resources: https://www.sciencedaily.com/releases/2024/06/240606152250.htm,https://www.usnews.com/news/business/articles/2024-07-02/fda-approves-a-second-alzheimers-drug-that-can-modestly-slow-disease
Image: https://www.charities.org/wp-content/uploads/2023/10/ADR.png

Sunday, June 30, 2024

DIABETES RESEARCH RIGHT NOW! #19: After Fasting, Why the @!&%$ Are My Blood Sugars STILL Through the ROOF???

From the first moment I discovered I had been diagnosed with DIABETES, I joined a HUGE “club” that has been rapidly expanding since it stopped being a death sentence in the early 20th Century. Currently, there are about HALF A BILLION PEOPLE who have Type 2 Diabetes. For the past 3500 years – dating back to Ancient Egypt – people have suffered from diabetes. Well, I’m one of them now… Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Diabetes research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: “One of the most confusing aspects for patients with type 2 diabetes is that we have high fasting glucose levels.” So – WHAT’S THE ANSWER???

“The World Health Organization (WHO) considers type 2 diabetes, one of the pandemics of the 21st century…it is a condition that results in high levels of circulating glucose -- the cellular energy fuel -- due to a deficient insulin response in the body…When blood glucose, also called blood sugar, levels rise after you eat, your pancreas [is supposed to] releases insulin into the blood. Insulin then lowers blood glucose to keep it in the normal range…In T2 patients, the glucose synthesis pathway in the liver (gluconeogenesis) is hyperactivated, a process that can be controlled by drugs such as metformin. ”

But metformin has never CURED T2. It wasn’t meant to. It’s a way to CONTROL T2. This group of researchers noticed something odd. From the beginning of the COVID 19 pandemic, “…factors involved in the control of gluconeogenesis [which is the liver making blood sugars and injecting them into our bloodstream]… sometimes patients hospitalized with COVID-19 showed high glucose levels…[it] seems to be related to the ability of the virus to spark the activity of proteins involved in starting the liver up making glucose and sending it to the bloodstream…”

So, that response of the bodies of people with COVID sometimes made their body react as if they were also Type 2 diabetic. Now, I take FOUR metformin tablets every day. I was SHOCKED to read this: “The mechanisms of action of metformin, the most commonly prescribed drug for the treatment of type 2 diabetes, which reduces how much glucose is in the blood, are still not fully understood.”

In other words, researchers, doctors, and pharmacists DON’T KNOW HOW METFORMIN WORKS!!!!!!! While I intentionally made that more alarm than I could have, the fact is that as researches dig into the method of metformin function, they’re finding out WAY more than they expected, up to and including the effect of metformin in REDUCING AGING!!! “Early evidence highlighted the liver as the major organ involved in the effect of metformin on reducing blood levels of glucose. However, increasing evidence points towards other sites of action that might also have an important role, including the gastrointestinal tract, the gut microbial communities and the tissue-resident immune cells.”

“At the molecular level, it seems that the mechanisms of action vary depending on the dose of metformin used and duration of treatment. Initial studies have shown that metformin targets hepatic mitochondria; however, the identification of a novel target at low concentrations of metformin at the lysosome surface might reveal a new mechanism of action. Based on the effectiveness and safety records in T2DM, attention has been given to the repurposing of metformin as part of adjunct therapy for the treatment of cancer, age-related diseases, inflammatory diseases, and COVID-19.”

Rest assured, I’ll be poking around this paper more as time goes on!

To briefly recap, it seems that HOW metformin works is even deeper than just at the level of CELLS – but deeper still into the “powerhouse” of every cell in your body: the mitochondria…

So, that’s it for now. Obviously I’ll continue to dig deeper into HOW metformin works. (I commented to my wife with a sigh, “Oh, great, now metformin with become as hard to get as Ozempic because the rich will start to pop the pills to stay young and beautiful!”

*sigh* I vote we should just suppress THAT little bit of information!

Links: https://www.sciencedaily.com/releases/2024/06/240607121434.htm; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4214027/; https://fagron.com/news-media/post/exploring-the-multifaceted-benefits-of-metformin-hydrochloride-beyond-diabetes-management/ ; https://www.nature.com/articles/s41574-023-00833-4

Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, June 16, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #22: Getting Older With Type 2

Control your blood sugar – working on it.
Stop smoking – never did.
Eat healthy – I try…
Exercise most days – yes.
Keep your weight in a healthy range – what the heck is THAT??? Ideal weight 177-188…in the name of perfect transparency: I’ve been 250 +/- for a LONG TIME…
Don't drink a lot of alcohol – don’t do this AT ALL…never have.
Limit how much salt you eat – lately I’ve been experiencing water retention (one of the bits of advice in the article referenced below “Your symptoms may be different”. I’ve never experienced water retention – I suppose that’ll be a great subject for my next “GGTA: Diabetes”…
Visit your doctor regularly – done

With that, I bid you adieu…

Source: https://www.healthline.com/health/type-2-diabetes/changes-after-age-50#changing-symptoms , https://www.webmd.com/diabetes/high-blood-pressure
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, June 2, 2024

DIABETES RESEARCH RIGHT NOW! #18: Researchers Discover New, Safer Treatment Using An OUTDATED Diabetes Drug!

Therefore, in the sight of Americans, TZDs were EVIL! HORRIBLE! USELESS! We want our drugs to do everything – including the laundry and make Big Macs calorie free and make beer non-alcoholic and calorie-free (but not different in ANY other way)

Drugs like TZD and others related to it provide other benefits: “…anti-inflammatory and anti-cancer properties…slow the progression…of coronary hyperplasia ( = “the enlargement of an organ or tissue caused by an increase in the reproduction rate of its cells, often as an initial stage in the development of cancer.”)…beneficial effects on endothelial function, atherogenesis, fibrinolysis, and ovarian steroidogenesis ( = “the processes by which cholesterol is converted to steroid hormones”.)

There are several undesirable side effects to thiazolidinediones, particularly with long-term use. The risks versus benefits require discussion with patients, and alternative first-line agents (metformin, using insulin injections) attempted before using TZDs.

But they are very specific and not common.

Edema and Congestive Heart Failure: (20% of patients; lower doses decrease the risk of edema and weight gain); NOT useful for people who have CHF)

Weight Gain and Fluid Retention: TZDs expand fat tissue mass and can increase weight. Fat gain occurs primarily in tissues just under the skin, sparing the belly area.

Fractures: increased risk and decreased bone density, and are most likely in the forearm, wrist, ankle, foot, tibia, rather than in the hip, pelvis, femur).

Bladder Cancer: One of the TZDs has, in some studies, shown correlations with an increased risk of bladder cancer. However, the most recent analyses do not support an increased risk, and only one of the TZDs increased the risk.

Diabetic Macular Edema: IF an individual takes both the TZDs and regularly use insulin, there may be an increased incidence of diabetic macular edema at 1-year and 10-year follow-up. (Macular edema happens when blood vessels leak into a part of the retina, making it swell, causing blurry vision.)

Increased Ovulation and Teratogenic Effects: This may result in ovulation in some premenopausal women, leading to improved rates of spontaneous pregnancy, but TZDs have some fetal abnormality potential.

So, this research led to a way AROUND using the original TZDs in a totally new way.

How? When fat is inflamed, macrophages release tiny bits of instructions to the cells called microRNAs, small fragments of genetic material that help control what the DNA does for the surrounding cells. These are called exosomes. Released into the bloodstream, they’re picked up by the liver and muscles. This can then lead to changes in obesity and insulin resistance – REDUCING BOTH.

The researchers treated a group of obese mice with a TZD drug. Those mice became more sensitive to insulin, but they also gained weight and retained excess fluid.

When the researchers split the exosomes OUT of the fat tissue, they then injected the macrophages into A DIFFERENT group of fat mice and ALL OF THE positive effects of the TZD worked with none of the bad. The researchers were also able to identify the specific microRNA within the exosomes that was responsible for the beneficial metabolic effects of rosiglitazone. This molecule, called miR-690, could eventually be leveraged into new therapies for type 2 diabetes.

One of the researchers noted, “There's plenty of precedent for using microRNAs themselves as drugs, so that's the possibility we're most excited about exploring for miR-690 going forward.”

It’s NOT today, but because of the discontinued use of one drug, researchers have been able to use increasingly sophisticated procedures to turn it into a NEW drug!

Who knows when? But this is certainly “What’s Next!”

Links: https://www.sciencedaily.com/releases/2024/04/240411130116.htm, https://www.ncbi.nlm.nih.gov/books/NBK551656/

Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, May 19, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #22: WHAT Does “Exercise” ACTUALLY Mean?

I chose this image because for most of my life, that’s how I defined “exercising”:

Let’s look at the WORD itself: exorcise (v.) c. 1400, "to invoke spirits," from Old French exorciser (14c.), from Late Latin exorcizare, from Greek exorkizein "banish an evil spirit (or fatness); bind by oath" (see exorcism).

Oops!!! That’s not EXERCIZE – that’s EXORCISE!!! Like the old/new movie!

Hmmm…truth be told, I have about as much interest in exercising as I taking part in an exorcism…Not even sure how much difference there is between them, to be honest.

At any rate, exercise carries so much weight (pun originally NOT intended, but let’s roll with it), in my mind that even the mention of it or seeing commercials with people exercising in them brings me out in a cold sweat. NOT a hot sweat, so worrying about exercising isn’t gonna do me any good.

Lemme get back on track, I go to an etymological website (no, NOT a bug website!) to explore the ORIGINS of words. In this case, the word exercise has these roots: “…condition of being in active operation; practice for the sake of training," from Old French exercice.”

I’m going to change one word in there – not really change it, but at two letters. Where it says, “…condition of being in active operation; practice….blah, blah, blah”.

I’m going to amend that to a “…condition of being in active COOPERATION…” because you have to cooperate with others if you are actually going to exercise…I suppose you can go it alone, but bringing a cheer squad with you is helpful!

I’m NOT talking about the adolescent acrobatics depicted in the picture above. What I’m THINKING about is the image at the top of the column.

Just start walking…biking…gardening…cleaning up a nearby park…counting hummingbirds for your local or state County or State Park Reserves…band migratory birds or even just COUNT them for population studies. Walk in the winter, too! You don’t have to walk miles – in the winter I started by walking from our house to the graveyard at the top of the hill (TALK ABOUT MOTIVATION!!!) Moving is a good thing. ANY AMOUNT OF MOVING CAN BE GOOD. I’ve said it before and I’ll keep on saying it. So if you don’t want to hear this “moving stuff”, just don’t read my blogs if they have the word “move” in it…

A reasonable read about the benefits of exercise from the Mayo Clinic’s website: https://www.mayoclinic.org/healthy-lifestyle/fitness/in-depth/exercise/art-20048389
Image: https://cathe.com/wp-content/uploads/2017/07/shutterstock_410678884.jpg Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg

Sunday, May 5, 2024

DIABETES RESEARCH RIGHT NOW! #17: Why Do Some Obese People Get Type 2 and Some DON’T? BROKEN CLEANING CELLS!

From the first moment I discovered I had been diagnosed with DIABETES, I joined a HUGE “club” that has been rapidly expanding since it stopped being a death sentence in the early 20th Century. Currently, there are about HALF A BILLION PEOPLE who have Type 2 Diabetes. For the past 3500 years – dating back to Ancient Egypt – people have suffered from diabetes. Well, I’m one of them now… Not one to shut up for any known reason, I added a section to this blog…

Every month, I’ll be highlighting Diabetes research that is going on RIGHT NOW! Harvested from different websites, journals and podcasts, I’ll translate them into understandable English and share them with you. Today: STARTING with a 2014 article, “Diabetes – Will it Ever be cured?”; I check up on the various therapies mentioned…

If I were to ask you what YOU think causes Type 2 diabetes in people…OK, how about I just ask myself?

“Guy, what do you think caused your Type 2 diabetes?”

I’d answer, “I’m fat.”

And I’d be right – but not ENTIRELY! How is it that I’m Type 2 and someone else I know who is JUST as fat NOT Type 2 diabetic????

“It’s just not FAIR!” I wail, weeping, pounding my chest and “Woe-ing-is-me-ing!” to beat the band.

Well, Mr. Me, I don’t know about fairness in biological problems, challenges, and illnesses – but I DO know that science is hard at work at figuring our a way to stop Type 2 from happening; fixing it; or curing it altogether! It’s an expensive disease that is spreading over the entire planet!

“Scientists and physicians have been documenting the condition now known as diabetes for thousands of years.” “in 1675 the word ‘mellitus’, meaning honey, was added to the name ‘diabetes’, meaning siphon. It wasn't until the 1800s that scientists developed chemical tests to detect the presence of sugar in the urine.”

In 1888, a French physician believed that diabetics were either thin or fat. The fat ones were ALWAYS rich and fat and had what was called “adult onset” diabetes. In contrast, thin diabetics always thin, young, desperately ill and, within a year, dead of what was called “adolescent onset” diabetes. Adult Onset was a disease of wealth and laziness; secondary to poor digestion and bad nerves. If you had it, you would die early, albeit you had longer than twelve months to live! The introduction of insulin in 1921 commuted the death sentence to a life sentence but emphasized the difference between insulin-dependent diabetes or adolescent-onset and non-insulin-dependent diabetes. Today, it’s Type 1 and Type 2 diabetes. Rates of type 2 diabetes have increased since 1960 unsurprisingly right along with obesity.

In 1985, there were 30 million Type 2 diabetics in the US by 2015 there were some 392 million people who were Type 2; by 2030, they expect some 600,000,000 people will be diagnosed as Type 2. But how is it that some people who gain weight suffer from the disease and others do not. The reasons for these differences are not clear, but they are related to what you body USES the fat it gets for rather than HOW MUCH body fat your body has.

The research below noticed that “Healthy fat tissue protects against new fat getting in deposited in the WRONG places. Human beings ALL need fat! The main purpose is that fat is laid down DIRECTLY underneath the skin. THAT fat protects the body from injury.

But it serves a second job: when you need energy, fat breaks down into sugar and goes to the cells so that can “burn it” to keep running. In PARTICULAR, muscle cells need sugar to keep you moving. You’re sleeping at night, so you don’t need as much instant energy, so the body stuffs your LIVER full of fat just waiting to be broken down and used as energy.

Most of you have heard the word “collagen” and you probably know that collagen is a protein in the body. Different kinds of collagen show up in many body parts like hair, skin, fingernails and toenails, bones, ligaments, tendons, cartilage, blood vessels, and intestines. IOW: It’s IMPORTANT!

Your body MAKES fat to story energy, right? The body breaks down collagen to build up fat reserves.

Scientists have found that the rise in collagen breakdown during adipose tissue expansion is done by large microscopic cells called “macrophage” (it literally means “big eater”! However, if you get OVERLY FAT, the macrophages BREAK, losing their ability to turn fat cells into energy ready for the body to use. The broken pieces of collagen are not just waste products, but they stimulate the making of MORE macrophages. That causes inflammation effects in the cells.

The most amazing discovery was still to come. Those macrophages and collagen fragments.: IT APPEARS LIKE if we can TARGET them, we JUST MIGHT BE ABLE TO PREVENT Type-2 diabetes and other conditions of impaired tissue remodeling!”

In science language: “In conclusion, this study highlights the importance of collagen-degrading macrophages and efficient removal of collagen fragments in adaptive, weight gain–induced adipose tissue remodeling. Our data suggest that impaired macrophage-mediated intracellular collagen degradation in obese SAT cannot be fully compensated for by extracellular collagen degradation. We conclude that collagen fragments, rather than being inert metabolites and solely markers of tissue remodeling, actively participate in shaping the SAT microenvironment. Further research in this area may identify novel targets in the prevention of type-2 diabetes in subjects with obesity and in other areas of impaired tissue remodeling.”

In plain English? Not ONLY can macrophages themselves help prevent Type-2; but the FRAGMENTs of the collagen from that the macrophages made when they attacked collagen, just might help as well.

Links: https://www.sciencedaily.com/releases/2024/02/240201212856.htm; https://www.pnas.org/doi/10.1073/pnas.2313185121 ; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6946720/ Image: https://asploro.com/wp-content/uploads/2019/12/Diabetes-Research_Open-Access.jpg

Sunday, April 21, 2024

GUY’S GOTTA TALK ABOUT…TYPE 2 DIABETES #21: How To Happily Eat Summer – WITHOUT Your Glucose Hitting 600!

If you use insulin, BEWARE: heat makes the insulin absorb into your skin faster; it can also be damaged by high temperatures; also, heat alters the accuracy of your glucose monitors -- and even the test strips. Just be aware of where and how you carry your "gear".

A) Try NOT to sit around at summer parties -- move around, chat with people, even volunteer to bring foods in and out, or bring cans of pop out.

B) Be aware of how fluid Summer-eating times can be! Lunch can easily slide to supper on a hot day, and the evening meal can show up after 10 pm! We don't have the luxury of a stable metabolism that can handle eating a box of Dunkin Donuts after midnight!

C) Don't load up on carbs and sugar after the sun goes down! You might be alarmed at your glucose readings when you check them first thing in the morning like I do!

D) Don't power load on carbs! (This is me reminding myself, I'm sure you have better control than I do!!!)

E) Sit down and eat a plateful rather than grazing the tables and bags of chips and dips and coolers and...well, you know what I mean! I'm going to try next week at my nephew's wedding: HALF the plate is veggies and meats; the other half can be carbs: buns, cakes, cookies, candies. Keep that balance! (I might try (I) as well...)

F) If possible, pick the grilled chicken breast rather than the grilled burger -- oh, and use half a bun instead of the whole thing -- in either case!

G) If you're eating with close family: ASK FOR OPTIONS! They love you (presumably) but as non-Type Twos, they don't THINK OF HAVING TO CHOOSE healthy options! They WANT you to be around to change diapers and go to concerts and basketball games!

H) DON'T SKIP MEALS BEFORE THE BIG BBQ!!!! I try not to do that anymore! Or if I do, I work extra hard to balance the "big meal" like the plate up in E.

I) Grab the nearest loved one you haven't seen for a while and take a survey of the SPREAD with them noting what's there, what's not there, and what you look forward to eating! Being AWARE of our eating is more important than just about ANYTHING we can do to remain healthy while being happy, too!

Lastly, bring a HEALTHY DISH you can share – scan the recipe website below for suggestions. Even the most sugar-addled, carbohydrate magnet young adult might be open to trying something new and tasty (make SURE you test the recipes before you bring them!) The majority won’t even notice if your deviled eggs have egg whites substituting for HALF the usual six yolks; mixed in low-fat mayo; and checking the mustard content – just skip adding the half cup of sawdust most people assume low-carb, low fat foods will taste like!

Lastly, have fun! Take the grandkids to the park at the end of the street; go for a walk about the block after the meal (better yet, BEFORE the meal!)

These are mostly easy things! I’m certainly going to deploy them in defending my body against the ravages of Type 2!

Source: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/cooking-for-people-with-diabetes/seasonal-cooking/summer-eating-and-diabetes,
Summer Type Two Dining: https://www.eatingwell.com/gallery/7968046/easy-summer-diabetes-friendly-dinners/#:~:text=Dinners%20with%20bright%20ingredients%20from,a%20diabetes%2Dfriendly%20eating%20pattern.
Image: https://www.hcd.com/wp-content/uploads/2021/01/living-well-with-diabetes.jpg