As in previous years, cities around Britain also lit up in blue on the day as part of the Blue Monument Challenge and at the request of Silver Star Diabetes. These included the Leicester Mercury Headquarters, the King Power Stadium, home to Leicester City Football Club, the Birmingham Library, Spinnaker Tower in Portsmouth, and Trafalgar Square fountains in London. The lights, in the colour of the iconic blue circle used to signify diabetes awareness, were switched on during the evening of what is the most important day in the diabetes awareness calendar.

Jane Ellison MP, the Diabetes Minister said: “Thank you Silver Star Diabetes for all you’ve done this week to promote awareness. Great work on promoting Type 2 awareness on World Diabetes Day.”

Question
How can I help myself deal with Irritable Bowel syndrome (IBS)?
Answer
IBS is an umbrella term for a variety of symptoms affecting the gut. These symptoms can include constipation, diarrhoea, bloating, belching, flatulence and cramping to name a few. The main cause is usually sensitivity to something in the diet. It can also come from the way we eat our food too. Food sensitivity is difficult to identify and doesn’t always come from unhealthy foods. Sometimes it could be from a food that is considered healthy, but your body physiology means you are sensitive or have an allergic response to it. Junk food and unhealthy food also does create sensitivity and most people are aware of this. The best way to identify the causative food is by elimination. If you notice that the symptoms come on after eating certain food types, then try eliminating those for 10-14 days and waiting to see if the symptoms resolve. If you are unsure of what it could be, write a diet diary for 2 weeks, including every single thing you eat and portion sizes too. Try then to work on eliminating certain food groups as stated earlier. Alternatively, visit a qualified dietician or nutritionist who can perform tests on you to identify the food groups you are sensitive too.

Equally if you are eating very quickly and not chewing your food properly, this makes it very hard for the digestive system to break it down and food goes through the gut being partially digested. If you chew properly, making lots of smaller particles, you create more surface area for the enzymes and stomach acid to act on the food, breaking it down appropriately and you get the best nutritional value out of it. If you drink lots of liquids with your meal, you dilute the acid in the stomach and the concentration of the enzymes, which makes them less affective. This leads to poor digestion. It is better to sip small amounts of liquids to help lubricate and facilitate swallowing, rather than drinking large amounts of liquids with meals.

Equally fizzy drinks, including sparkling water, cause the gas bubbles to remain in the gut leading to bloating, belching and flatulence. Drinking very cold liquids with hot meals that contain fats in them can also disrupt digestion. When fats are hot, they are in liquid form and the digestive system is warm too allowing them to remain in their liquid form for digestion. If you drink lots of ice-cold liquids with these meals, you solidify the fats on the lining of the Oesophagus (food pipe) and gut. This coats the lining of the gut and prevents absorption of nutrients as the food is passing through. The fats eventually melt, but the food has already passed through, preventing the nutrient uptake. Eating fruit and salad after a hot meal can also affect digestion. Fruit and salad is quickly digested, but more complex meals that have multiple cooking processes, sauces, meat or no meat require more time to be digested. If you eat salads or fruit after a meal, they remain on top of the slower digesting food. This causes them to break down and ferment in the warm, moist environment of the gut. The bi-product of fermentation of fruits/salads is gas production. This gas has nowhere to go but to remain in the gut leading to bloating, belching and flatulence. It is better to eat salad or fruit before a meal or at least 2 hours after your meal to allow for complete digestion. Thinking about what we eat and the way we eat can make a huge difference to IBS symptoms.

In 2000, Burns was named senior vice president, Corporate Strategic Services, heading up manufacturing and supply chain operations. Alongside then-CEO Anne Mulcahy, Burns worked to restructure Xerox through its turnaround to emerge as a leader in color technology and document services. A key factor in the company’s turnaround was its research and development of new products and technologies, and at the time Burns was responsible for leading Xerox’s global research as well as product development, marketing and delivery. In April 2007, Burns was named president of Xerox, expanding her leadership to also include the company’s IT organization, corporate strategy, human resources, corporate marketing and global accounts. At that time, she was also elected a member of the company’s Board of Directors.
Burns was named chief executive officer in July 2009 and shortly after, made the largest acquisition in Xerox history, the $6.4 billion purchase of Affiliated Computer Services, catapulting the company’s presence in the almost $600 billion business services market and extending the company’s reach into diverse areas of business process and IT outsourcing. Xerox is on track to have two-thirds its revenue come from Services by 2017.

On May 20, 2010, Burns became chairman of the company, leading the more than 140,000 people of Xerox who serve clients in more than 180 countries. Building on Xerox’s legacy of innovation, they’re enabling workplaces — from small businesses to large global enterprises — to simplify the way work gets done so they can focus more on their core business. Burns earned a bachelor of science degree in mechanical engineering from Polytechnic Institute of NYU and a master of science degree in mechanical engineering from Columbia University.

In addition to the Xerox board, she is a board director of the American Express Corporation and Exxon Mobil Corporation. Burns also provides leadership counsel to community, educational and non-profit organizations including FIRST – (For Inspiration and Recognition of Science and Technology), National Academy Foundation, MIT, and the U.S. Olympic Committee, among others. She is a founding board director of Change the Equation, which focuses on improving the U.S.’s education system in science, technology, engineering and math (STEM). In March 2010, U.S. President Barack Obama appointed Burns vice chair of the President’s Export Council.

In October, a damning report suggested that just one in three diabetes patients have correctly managed blood sugar levels, with targets not being met in any areas of treatment. The failures were attributed to the “postcode lottery” of diabetes care and a lack of meaningful action by the NHS to combat the disease. The guidelines attempt to address this issue by focusing on education. They recommend that adults with type 1 diabetes are seen by their doctor every three to six months, and that their blood sugars are measured by a professional. Furthermore, type 1 patients will be supported in monitoring their own blood glucose levels at least four times a day, and even more frequently if they are not reaching targets or undertaking activities such as driving or sport.

NICE also suggests that adults with type 1 diabetes should be sent on a structured education course in order to improve their understanding of the condition. For children and young people with diabetes, the guidelines are an update to recommendations made in 2004. The new recommendations reflect the “major advances” in diabetes care since then.

Children with type 1 diabetes will be offered intensive insulin management, along with dietary advice and educational courses. Regarding children with type 2 diabetes, the guidelines make suggestions that will allow healthcare professionals to diagnose and treat common diabetes complications, including kidney problems, high blood pressure, and high cholesterol.

The NCD for Obesity and Diabetes also contributed to the development of Healthier Lives: Diabetes Hypertension and NHS Health Check. This is a major new online tool which includes information on prevalence of the conditions and their complications, levels of care provided and the quality of care achieved in each area by local authority, clinical commissioning group and general practice, compared to the England average. This has been designed to help local areas improve their services.

An analysis of previous studies revealed removing animal fats from diet helps improve insulin sensitivity. Eating a vegetable-based diet reduced levels of a key blood-protein called glycated haemoglobin (HbA1c). For people with diabetes, the higher the HbA1c in their blood, the greater the risk of developing diabetes-related complications such as nerve damage, eye problems, and heart disease.
The study found a vegan or vegetarian diet lowered HbA1c by an average of 0.4 percentage points, and up to 0.7 points. This is comparable to the effects of drugs given to help patients with diabetes control their blood-sugar levels, researchers said.

Dr Neal Barnard, of the George Washington University School of Medicine and Health Sciences, said ‘We now know that type 2 diabetes is caused by insulin resistance. Getting the animal fat — and fats in general — out of the diet helps repair insulin’s ability to function.’ And he added ‘best of all’, vegan diets remove the tedious routine of taking medication and injecting insulin. Across the world, 347 million people have diabetes, according to the World Health Organization. They predict it will be the seventh leading cause of death by 2030.

As part of the new study, researchers analysed the dietary patterns of 255 adults with type 2 diabetes in the U.S, Brazil, and the Czech Republic. They found people who ate low-fat vegan diet, or a diet of egg and dairy products but no meat, lowered HbA1c by an average of 0.4 percentage points and up to 0.7 points in some studies. This is comparable to the same effect of alpha-glucosidase inhibitors, drugs given to patients that help control their blood-glucose levels by preventing the digestion of carbohydrate, they said. Therefore, a vegetarian diet could be used as a ‘treatment alternative for type 2 diabetes’, they concluded. The research was published in the journal Cardiovascular Diagnosis And Therapy.

Question
How does diabetes affect travelling? Can I still travel on long trips? 
Answer
Foreign travel across time zones or to countries where medical supplies are unreliable can pose particular problems if you have Type 1 diabetes. If you’re planning a trip far afield, your diabetes clinic can give you appropriate advice.
The main issues are meal and insulin dosing when travelling, and ensuring you take all the supplies you need before setting off.
Pharmaceutical companies are international and insulin treatment is available in most parts of the world. If you are going somewhere really out of the way, check first. Insulin is inactivated if frozen, so you should take it in your hand luggage. Travel sickness causes extra problems with all types of diabetes, because vomiting can lead to hypoglycaemia. If you know you suffer, take an anti-emetic beforehand. Make sure your travel insurance is comprehensive and covers you for any diabetes-related conditions – many policies exclude pre-existing medical conditions. Having diabetes does not influence what vaccinations you need – these are dictated by the country you’re visiting. To find out what vaccinations are required, get advice from your GP or pharmacist.
When you are on holiday, the normal rules about blood sugar levels apply. So be aware of any changes to your activity levels – whether you do more or less – and adjust your treatment accordingly

Beatriz Torres Flores, PhD, and colleagues at the Centre for Research and Health Services at UV observed students’ habits for 25 years. They reported that around 37 per cent of their participants were overweight or obese, and when combined with certain risk factors, this could lead to the development of diabetes. The risk factors included a lack of physical activity, skipping breakfast and psychological stress, which can develop from bad sleeping habits and tension.

Missing breakfast led to metabolic stress among students, with specialists at the Mexican Diabetes Federation reporting this leads the body to believe no short-term food will be consumed, so it adapts to conserve energy and therefore weight is gained. UV specialists have developed programs of nutritional intervention and studied diabetes risk factors over the last 25 years, but more needs to be done according to Dr. Flores. “We find college students with glucose levels over 100 or blood pressure over 120, that clearly some of these cases represent a risk of developing a chronic degenerative disease” said Dr. Flores.

Many adults in the UK spend more than seven hours a day sitting or lying, and this typically increases with age to 10 hours or more. This includes watching TV, using a computer, reading, doing homework, travelling by car, bus or train – behaviours referred to as sedentary – but does not include sleeping. Experts believe there is something specific about the act of sitting or lying for too long that is bad for our health.

One of the largest pieces of research to date on the subject – involving almost 800,000 people – found that, compared with those who sat the least, people who sat the longest had a:
112% increase in risk of diabetes
147% increase in cardiovascular events
90% increase in death caused by cardiovascular events
49% increase in death from any cause

The strength of the evidence is such that the government issued new recommendations in 2011 on minimising sitting for different age groups. The Start Active, Stay Active report recommends breaking up long periods of sitting time with “shorter bouts of activity for just one to two minutes”. A panel of leading experts who reviewed the evidence on sitting for the report recommended taking “an active break from sitting every 30 minutes”. The advice applies to everyone, even people who exercise regularly, because too much sitting is now recognised as an independent risk factor for ill health.

Tips to reduce sitting time:
• stand on the train or bus
• take the stairs and walk up escalators
• set a reminder to get up every 30 minutes
• alternate working while seated with standing
• place a laptop on a box or similar to work standing
• stand or walk around while on the phone
• take a walk break every time you take a coffee or tea break
• walk to a co-worker’s desk instead of emailing or calling
• swap some TV time for more active tasks or hobbies