Diabetes and Coronavirus, CO-VID19

Take charge of your health.

• COVID-19 & diabetes

The COVID-19 outbreak has been declared an international public health emergency. People with diabetes may be more vulnerable to the severe effects of the virus.

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COVID-19 is a new and potentially serious coronavirus. There are many coronaviruses, ranging from the common cold to much more serious viruses such as Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). They are viruses that have been transmitted from animals to people. In severe cases, coronaviruses can cause infection in the lungs (pneumonia), kidney failure and even death.

The World Health Organization (WHO) has declared the COVID-19 outbreak to be a public health emergency of international concern. At present there is no vaccine against COVID-19.

Common signs are typical flu-like symptoms: a fever, cough, breathing difficulties, tiredness and muscle aches. Symptoms usually start within 3-7 days of exposure to the virus, but in some cases it has taken up to 14 days for symptoms to appear.

People of all ages can be infected. For many (more than 80% of cases), COVID-19 is mild, with minimal flu-like symptoms. Some have not shown symptoms or only very mild symptoms, more like a common cold. The majority of people who have caught the virus did not need to be hospitalised for supportive care. However, in approaching 15% of cases COVID-19 has been severe and in around 5% of cases it has led to critical illness. The vast majority (around 98%) of people infected to date have survived.

When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications.

Older people and people with pre-existing medical conditions (such as diabetes, heart disease and asthma) appear to be more vulnerable to becoming severely ill with the COVID-19 virus. When people with diabetes develop a viral infection, it can be harder to treat due to fluctuations in blood glucose levels and, possibly, the presence of diabetes complications. There appear to be two reasons for this. Firstly, the immune system is compromised, making it harder to fight the virus and likely leading to a longer recovery period. Secondly, the virus may thrive in an environment of elevated blood glucose.

Like any other respiratory disease, COVID-19 is spread through air-droplets that are dispersed when an infected person talks, sneezes or coughs. The virus can survive from a few hours up to a few days depending on the environmental conditions. It can be spread through close contact with an infected person or by contact with air droplets in the environment (on a surface for example) and then touching the mouth or nose (hence the common advice circulating on hand hygiene and social distancing).

What can people with diabetes and their loved ones do?

For people living with diabetes it is important to take precautions to avoid the virus if possible. The recommendations that are being widely issued to the general public are doubly important for people living with diabetes and anyone in close contact with people living with diabetes.

• Wash hands thoroughly and regularly.
• Try to avoid touching your face before you have washed and dried your hands.
• Clean and disinfect any objects and surfaces that are touched frequently.
• Don’t share food, glasses, towels, tools etc.
• When you cough or sneeze, cover your mouth and nose with a tissue or use the crook of your arm if you don’t have a tissue to hand (dispose of the tissue appropriately after use).
• Try to avoid contact with anyone showing symptoms of respiratory illness such as coughing.
• Think whether you can make changes that will help protect yourself or loved ones. For example, can you avoid unnecessary business travel? Can you avoid large gatherings? Can you avoid public transport?
• If you are ill with flu-like symptoms, stay at home.

If you have diabetes:

• Prepare in case you get ill.
• Make sure you have all relevant contact details to hand in case you need them.
• Pay extra attention to your glucose control.
• If you do show flu-like symptoms (raised temperature, cough, difficulty breathing), it is important to consult a healthcare professional. If you are coughing up phlegm, this may indicate an infection so you should seek medical support and treatment immediately.
• Any infection is going to raise your glucose levels and increase your need for fluids, so make sure you can access a sufficient supply of water.
• Make sure you have a good supply of the diabetes medications you need. Think what you would need if you had to quarantine yourself for a few weeks.
• Make sure you have access to enough food.
• Make sure you will be able to correct the situation if your blood glucose drops suddenly.
• If you live alone, make sure someone you can rely on knows you have diabetes as you may require assistance if you get ill.

COVID-19 is a new coronavirus. The situation is not fully clear at this point, so keep informed of the latest developments. Look out for updates and advice from your government, national diabetes association and other reliable sources

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Seven Important Corona Virus Tips

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Dr. James Robb is a Pathologist and has extensively studied Coronavirus for years. Below is something he put together for his colleagues in medicine and science. I think it’s excellent.

I think masks are really not helpful other than keeping you from touching your face. Otherwise good stuff.

Subject: What I am doing for the upcoming COVID-19 (coronavirus) pandemic

Dear Colleagues, as some of you may recall, when I was a professor of pathology at the University of California San Diego, I was one of the first molecular virologists in the world to work on coronaviruses (the 1970s). I was the first to demonstrate the number of genes the virus contained. Since then, I have kept up with the coronavirus field and its multiple clinical transfers into the human population (e.g., SARS, MERS), from different animal sources. The current projections for its expansion in the US are only probable, due to continued insufficient worldwide data, but it is most likely to be widespread in the US by mid to late March and April.

Here is what I have done and the precautions that I take and will take. These are the same precautions I currently use during our influenza seasons, except for the mask and gloves.:

1) NO HANDSHAKING! Use a fist bump, slight bow, elbow bump, etc.
2) Use ONLY your knuckle to touch light switches. elevator buttons, etc.. Lift the gasoline dispenser with a paper towel or use a disposable glove.
3) Open doors with your closed fist or hip - do not grasp the handle with your hand, unless there is no other way to open the door. Especially important on bathroom and post office/commercial doors.
4) Use disinfectant wipes at the stores when they are available, including wiping the handle and child seat in grocery carts.
5) Wash your hands with soap for 10-20 seconds and/or use a greater than 60% alcohol-based hand sanitizer whenever you return home from ANY activity that involves locations where other people have been.
6) Keep a bottle of sanitizer available at each of your home's entrances. AND in your car for use after getting gas or touching other contaminated objects when you can't immediately wash your hands.
7) If possible, cough or sneeze into a disposable tissue and discard. Use your elbow only if you have to. The clothing on your elbow will contain infectious virus that can be passed on for up to a week or more!

What I have stocked in preparation for the pandemic spread to the US:

1) Latex or nitrile latex disposable gloves for use when going shopping, using the gasoline pump, and all other outside activity when you come in contact with contaminated areas.

Note: This virus is spread in large droplets by coughing and sneezing. This means that the air will not infect you! BUT all the surfaces where these droplets land are infectious for about a week on average - everything that is associated with infected people will be contaminated and potentially infectious. The virus is on surfaces and you will not be infected unless your unprotected face is directly coughed or sneezed upon.  This virus only has cell receptors for lung cells (it only infects your lungs) The only way for the virus to infect you is through your nose or mouth via your hands or an infected cough or sneeze onto or into your nose or mouth.

2) Stock up now with disposable surgical masks and use them to prevent you from touching your nose and/or mouth (We touch our nose/mouth 90X/day without knowing it!). This is the only way this virus can infect you - it is lung-specific. The mask will not prevent the virus in a direct sneeze from getting into your nose or mouth - it is only to keep you from touching your nose or mouth.

3) Stock up now with hand sanitizers and latex/nitrile gloves (get the appropriate sizes for your family). The hand sanitizers must be alcohol-based and greater than 60% alcohol to be effective.

4) Stock up now with zinc lozenges. These lozenges have been proven to be effective in blocking coronavirus (and most other viruses) from multiplying in your throat and nasopharynx. Use as directed several times each day when you begin to feel ANY "cold-like" symptoms beginning. It is best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx. Cold-Eeze lozenges is one brand available, but there are other brands available.

I, as many others do, hope that this pandemic will be reasonably contained, BUT I personally do not think it will be. Humans have never seen this snake-associated virus before and have no internal defense against it. Tremendous worldwide efforts are being made to understand the molecular and clinical virology of this virus. Unbelievable molecular knowledge about the genomics, structure, and virulence of this virus has already been achieved. BUT, there will be NO drugs or vaccines available this year to protect us or limit the infection within us. Only symptomatic support is available. I hope these personal thoughts will be helpful during this potentially catastrophic pandemic. You are welcome to share this email.

Good luck to all of us!

James Robb, MD FCAP

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Memory Food

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Date:

February 18, 2020

Source:

University of Technology Sydney

Summary:

A healthy diet is essential to living well, but should we change what we eat as we age? Researchers have found strong evidence of the link between food groups and memory loss and its comorbidities. Her findings point to a need for age-specific dietary guidelines as the links may vary with age -- people aged 80+ with a low consumption of cereals are at highest risk of memory loss and comorbid heart disease.

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A healthy diet is essential to living well, but as we age, should we change what we eat?

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UTS research fellow Dr Luna Xu has studied data from 139,000 older Australians and found strong links between certain food groups, memory loss and comorbid heart disease or diabetes.

Dr. Xu found high consumption of fruit and vegetables was linked to lowered odds of memory loss and its comorbid heart disease. High consumption of protein-rich foods was associated with a better memory.

Dr Xu also found the link between food group and memory status may vary among different older age groups. People aged 80 years and over with a low consumption of cereals are at the highest risk of memory loss and its comorbid heart disease, her research showed.

"Our present study implies that the healthy eating suggestions of cereals consumption in the prevention of memory loss and comorbid heart disease for older people may differ compared to other age groups," said Dr Xu, who holds a Heart Foundation postdoctoral research fellowship.

She said the study pointed to a need for age-specific healthy dietary guidelines.

Memory loss is one of the main early symptoms for people with dementia, which is the second leading cause of death of Australians. People living with dementia have on average between two and eight comorbid conditions, which may accelerate cognitive and functional impairment. The most common comorbidities in dementia include cardiovascular diseases, diabetes and hypertension.

"The dietary intervention in chronic disease prevention and management, by taking into consideration the fact that older populations often simultaneously deal with multiple chronic conditions, is a real challenge," Dr Xu said.

"To achieve the best outcome for our ageing population, strong scientific evidence that supports effective dietary intervention in preventing and managing co-occurring chronic conditions, is essential."

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Materials provided by University of Technology Sydney. Note: Content may be edited for style and length.

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Drinking 1% rather than 2% milk accounts for less aging in adults

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Drinking 1% rather than 2% milk accounts for less aging in adults

High-fat milk consumption is connected to significantly shorter telomeres

January 15, 2020

Brigham Young University

A new study shows drinking low-fat milk -- both nonfat and 1% milk -- is significantly associated with less aging in adults.

A new study shows drinking low-fat milk -- both nonfat and 1% milk -- is significantly associated with less aging in adults.

Research on 5,834 U.S. adults by Brigham Young University exercise science professor Larry Tucker, Ph.D., found people who drink low-fat milk experience several years less biological aging than those who drink high-fat (2% and whole) milk.

"It was surprising how strong the difference was," Tucker said. "If you're going to drink high-fat milk, you should be aware that doing so is predictive of or related to some significant consequences."

Tucker investigated the relationship between telomere length and both milk intake frequency (daily drinkers vs. weekly drinkers or less) and milk fat content consumed (whole vs. 2% vs. 1% vs. skim). Telomeres are the nucleotide endcaps of human chromosomes. They act like a biological clock and they're extremely correlated with age; each time a cell replicates, humans lose a tiny bit of the endcaps. Therefore, the older people get, the shorter their telomeres.

And, apparently, the more high-fat milk people drink, the shorter their telomeres are, according to the new BYU study, published in Oxidative Medicine and Cellular Longevity. The study revealed that for every 1% increase in milk fat consumed (drinking 2% vs. 1% milk), telomeres were 69 base pairs shorter in the adults studied, which translated into more than four years in additional biological aging. When Tucker analyzed the extremes of milk drinkers, adults who consumed whole milk had telomeres that were a striking 145 base pairs shorter than non-fat milk drinkers.

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Nearly half of the people in the study consumed milk daily and another quarter consumed milk at least weekly. Just under a third of the adults reported consuming full-fat (whole) milk and another 30 percent reported drinking 2% milk. Meanwhile, 10% consumed 1% milk and another 17% drank nonfat milk. About 13% did not drink any cow milk.

"Milk is probably the most controversial food in our country," Tucker said. "If someone asked me to put together a presentation on the value of drinking milk, I could put together a 1-hour presentation that would knock your socks off. You'd think, 'Whoa, everybody should be drinking more milk.' If someone said do the opposite, I could also do that. At the very least, the findings of this study are definitely worth pondering. Maybe there's something here that requires a little more attention."

Somewhat surprisingly, he also found that milk abstainers had shorter telomeres than adults who consumed low-fat milk.

Tucker said the study findings provide support for the current Dietary Guidelines for Americans (2015-2020), which encourage adults to consume low-fat milk, both nonfat and 1% milk, and not high-fat milk, as part of a healthy diet.

"It's not a bad thing to drink milk," Tucker said. "You should just be more aware of what type of milk you are drinking."

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Materials provided by Brigham Young University. Original written by Todd Hollingshead. Note: Content may be edited for style and length.

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Study finds dopamine, biological clock link to snacking, overeating and obesity

Date:

January 3, 2020

Source:

University of Virginia

Summary:

A new study finds that the pleasure center of the brain and the brain's biological clock are linked, and that high-calorie foods -- which bring pleasure -- disrupt normal feeding schedules, resulting in overconsumption.

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Clock and eating concept (stock image).

Credit: © nehopelon / Adobe Stock

During the years 1976 through 1980, 15% of U.S. adults were obese. Today, about 40% of adults are obese. Another 33% are overweight.

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Coinciding with this increase in weight are ever-rising rates of heart disease, diabetes, cancer and health complications caused by obesity, such as hypertension. Even Alzheimer's disease may be partly attributable to obesity and physical inactivity.

"The diet in the U.S. and other nations has changed dramatically in the last 50 years or so, with highly processed foods readily and cheaply available at any time of the day or night," Ali Güler, a professor of biology at the University of Virginia, said. "Many of these foods are high in sugars, carbohydrates and calories, which makes for an unhealthy diet when consumed regularly over many years."

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In a study published Thursday in the journal Current Biology, Güler and his colleagues demonstrate that the pleasure center of the brain that produces the chemical dopamine, and the brain's separate biological clock that regulates daily physiological rhythms, are linked, and that high-calorie foods -- which bring pleasure -- disrupt normal feeding schedules, resulting in overconsumption. Using mice as study models, the researchers mimicked the 24/7 availability of a high-fat diet, and showed that anytime snacking eventually results in obesity and related health problems.

Güler's team found that mice fed a diet comparable to a wild diet in calories and fats maintained normal eating and exercise schedules and proper weight. But mice fed high-calorie diets laden with fats and sugars began "snacking" at all hours and became obese.

Additionally, so-called "knockout" mice that had their dopamine signaling disrupted -- meaning they didn't seek the rewarding pleasure of the high-fat diet -- maintained a normal eating schedule and did not become obese, even when presented with the 24/7 availability of high-calorie feeds.

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"We've shown that dopamine signaling in the brain governs circadian biology and leads to consumption of energy-dense foods between meals and during odd hours," Güler said.

Other studies have shown, Güler said, that when mice feed on high-fat foods between meals or during what should be normal resting hours, the excess calories are stored as fat much more readily than the same number of calories consumed only during normal feeding periods. This eventually results in obesity and obesity-related diseases, such as diabetes.

Speaking of the modern human diet, Güler said, "The calories of a full meal may now be packed into a small volume, such as a brownie or a super-size soda. It is very easy for people to over-consume calories and gain excessive weight, often resulting in obesity and a lifetime of related health problems.

"Half of the diseases that affect humans are worsened by obesity. And this results in the need for more medical care and higher health care costs for individuals, and society."

Güler said the human body, through thousands of years of evolution, is hard-wired to consume as much food as possible as long as it's available. He said this comes from a long earlier history when people hunted or gathered food and had brief periods of plenty, such as after a kill, and then potentially lengthy periods of famine. Humans also were potential prey to large animals and so actively sought food during the day, and sheltered and rested at night.

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"We evolved under pressures we no longer have," Güler said. "It is natural for our bodies as organisms to want to consume as much as possible, to store fat, because the body doesn't know when the next meal is coming.

"But, of course, food is now abundant, and our next meal is as close as the kitchen, or the nearest fast-food drive-through, or right here on our desk. Often, these foods are high in fats, sugars, and therefore calories, and that's why they taste good. It's easy to overconsume, and, over time, this takes a toll on our health."

Additionally, Güler said, prior to the advent of our electricity-powered society, people started the day at dawn, worked all day, often doing manual labor, and then went to sleep with the setting of the sun. Human activity, therefore, was synchronized to day and night. Today, we are working, playing, staying connected -- and eating -- day and night. This, Guler said, affects our body clocks, which were evolved to operate on a sleep-wake cycle timed to daytime activity, moderate eating and nighttime rest.

"This lights-on-all-the-time, eat-at-any-time lifestyle recasts eating patterns and affects how the body utilizes energy," he said. "It alters metabolism -- as our study shows -- and leads to obesity, which causes disease. We're learning that when we eat is just as important as how much we eat. A calorie is not just a calorie. Calories consumed between meals or at odd hours become stored as fat, and that is the recipe for poor health."

The National Institute of General Medical Sciences and University of Virginia Brain Institute funded the research.

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Dogs process numbers like humans

Unique experiment explores canine 'numerosity'

Date: December 18, 2019

Source: Emory Health Sciences

Summary

The results of a new canine numerosity study suggests that a common neural mechanism has been deeply conserved across mammalian evolution.

  

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Biology Letters published the results, which suggest that a common neural mechanism has been deeply conserved across mammalian evolution.

"Our work not only shows that dogs use a similar part of their brain to process numbers of objects as humans do -- it shows that they don't need to be trained to do it," says Gregory Berns, Emory professor of psychology and senior author of the study.

"Understanding neural mechanisms -- both in humans and across species -- gives us insights into both how our brains evolved over time and how they function now," says co-author Stella Lourenco, an associate professor of psychology at Emory.

Such insights, Lourenco adds, may one day lead to practical applications such as treating brain abnormalities and improving artificial intelligence systems.

Lauren Aulet, a PhD candidate in Lourenco's lab, is first author of the study.

The study used functional magnetic resonance imaging (fMRI) to scan dogs' brains as they viewed varying numbers of dots flashed on a screen. The results showed that the dogs' parietotemporal cortex responded to differences in the number of the dots. The researchers held the total area of the dots constant, demonstrating that it was the number of the dots, not the size, that generated the response.

The approximate number system supports the ability to rapidly estimate a quantity of objects in a scene, such as the number of predators approaching or the amount of food available for foraging. Evidence suggests that humans primarily draw on their parietal cortex for this ability, which is present even in infancy.

This basic sensitivity to numerical information, known as numerosity, does not rely on symbolic thought or training and appears to be widespread throughout the animal kingdom. Much of the research in non-humans, however, has involved intensive training of the subjects.

Previous research, for example, has found that particular neurons in the parietal cortex of monkeys are attuned to numerical values. Such studies had not clarified whether numerosity is a spontaneous system in non-human primates, because the subjects underwent many trials and received rewards for selecting scenes with greater numbers of dots in preparation for the experiments.

Behavioral studies in dogs that were trained in the task of discriminating between different quantities of objects have also indicated that dogs are sensitive to numerosity.

The Emory researchers wanted to delve further into the neural underpinnings of canine number perception using fMRI.

Berns is founder of the Dog Project, which is researching evolutionary questions surrounding man's best, and oldest friend. The project was the first to train dogs to voluntarily enter an fMRI scanner and remain motionless during scanning, without restraint or sedation.

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Lourenco primarily researches human visual perception, cognition and development.

Eleven dogs of varying breeds were involved in the current fMRI experiments. The dogs did not receive advance training in numerosity. After entering the fMRI, they passively viewed dot arrays that varied in numerical value. Eight of the 11 dogs showed greater activation in the parietotemporal cortex when the ratio between alternating dot arrays was more dissimilar than when the numerical values were constant.

"We went right to the source, observing the dogs' brains, to get a direct understanding of what their neurons were doing when the dogs viewed varying quantities of dots," Aulet says. "That allowed us to bypass the weaknesses of previous behavioral studies of dogs and some other species."

Humans and dogs are separated by 80 million years of evolution, Berns notes. "Our results provide some of the strongest evidence yet that numerosity is a shared neural mechanism that goes back at least that far," he says.

Unlike dogs and other animals, humans are able to build on basic numerosity in order to do more complex math, drawing primarily on the prefrontal cortex. "Part of the reason that we are able to do calculus and algebra is because we have this fundamental ability for numerosity that we share with other animals," Aulet says. "I'm interested in learning how we evolved that higher math ability and how these skills develop over time in individuals, starting with basic numerosity in infancy."

Additional authors of the study include Veronica Chiu and Ashley Prichard, Emory graduate students in psychology, and Mark Spivak, CEO of Comprehensive Pet Therapy. Spivak and Berns co-founded Dog Star Technologies to develop techniques to study how dogs perceive the world.

The work was supported by the National Institutes of Health, the John Merck Fund and the Office of Naval Research.

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Materials provided by Emory Health Sciences. Original written by Carol Clark. Note: Content may be edited for style and length.