The SA Journal Diabetes & Vascular Disease Volume 19 No 2 (November 2022)

38 VOLUME 19 NUMBER 2 • November 2022 diabetes news SA JOURNAL OF DIABETES & VASCULAR DISEASE include both aerobics and resistance training.2 This can be spread over three days of the week with a gap of no more than two days. Remember to record the hours and type of activity and share it with your doctor. L: Low, good-quality calorie intake Calories are a measure of energy that your food supplies. What is important to understand is that both the quantity and the quality of these calories affect the sugar level in your blood. Calories from complex carbs, proteins and healthy fats are considered ‘good calories’, while those that come from simple carbs and unhealthy fats are said to be ‘bad calories’. People with diabetes need to count the calories they consume and know the source from which they come. They should do this regularly and for every meal. F: Follow up, regularly For people with diabetes, the importance of regular follow ups with their doctors and therapy adherence cannot be stressed enough. Even if your blood sugar level is under control, regular visits to your doctor are necessary. Along with this, one must also regularly do eye, glycated haemoglobin (HbA1c) and kidney and liver examinations to detect early on-set of co-morbidities related to diabetes in order to provide timely medical intervention. Roche Diabetes Care encourages South Africans from all walks of life to get screened for diabetes, work with their healthcare professional to manage their diabetes and strengthen the care process through an integrated personalised diabetes management. References: 1. https://idf.org/our-network/regions-members/africa/members/25-south-africa. html 2. https://www.cdc.gov/diabetes/basics/diabetes.html 3. https://www.healthline.com/health/diabetes/diabetes-warning-signs#risk-factors 4. https://www.healthline.com/health/diabetes/diabetes-warning-signs#risk-factors 5. https://www.mayoclinic.org/diseases-conditions/diabetes/symptoms-causes/syc20371444 6. https://diabetesatlas.org BMI strongly associated with all-cause mortality Body mass index (BMI), a measure of body fat, is linked to risk of death from every major cause except transport accidents, according to an analysis of 3.6 million people in The Lancet. Overall, both low and high BMI were associated with an increased risk of death. Led by the London School of Hygiene & Tropical Medicine and funded by the Wellcome Trust and the Royal Society, the research suggests a BMI of between 21 and 25 kg/m2 is associated with the lowest risk of dying from cancer and heart disease. The study is one of the largest studies of its kind to look at how BMI is associated with the risk of death both overall, and from a full spectrum of different causes – 3.6 million people and 367 512 deaths were included in the analysis. Overall, both low and high BMI were associated with an increased risk of death. The researchers say that while BMI is recognised as a risk factor for mortality overall, the findings from this study will support the public and health workers to understand how underweight and excess weight might directly affect different aspects of health, or be indicative of underlying health problems. Obesity (BMI of 30 kg/m2 or more) was associated with a loss of 4.2 years of life in men and 3.5 years in women with excess weight associated with a higher risk of death from the two leading causes of death, cancer and heart diseases, as well as deaths in several other major categories including respiratory diseases, liver disease and diabetes. Low body weight was also associated with a higher risk of death from a wide range of causes including cardiovascular disease, respiratory disease, dementia and Alzheimer’s and suicide, suggesting that low BMI may be an important indicator of poorer health. The research team used anonymised data from the UK Clinical Practice Research Datalink (CPRD) which includes data on BMI from general practitioners’ primary care records covering about 9% of the UK population. This is linked to data from the Office of National Statistics mortality database, which includes information on causes of death as recorded on death certificates. Risks of death from each major cause was calculated according to BMI, adjusting for other important factors such as age, gender, smoking status, alcohol use and socio-economic status. Deaths from transport-related accidents were not associated with BMI, but excess weight was associated with a higher risk of deaths in every other category except for mental health- related and neurological deaths, while low body weight was associated with deaths from every category except for liver cirrhosis. The lowest risk of cardiovascular death was at a BMI of 25 kg/m2 – every 5 kg/m2 increase in BMI above this was associated with a 29% higher risk. The lowest risk of cancer death was at 21 kg/m2, with every 5 kg/m2 increase in BMI above this level being associated with a 13% higher risk. Lead author and associate professor in statistical epidemiology at LSHTM, Krishnan Bhaskaran, said: ‘BMI is a key indicator of health. We know that BMI is linked to the risk of dying overall, but surprisingly little research has been conducted on the links to deaths from specific causes. We have filled this knowledge gap to help researchers, patients and doctors better understand how underweight and excess weight might be associated with diseases such as cancer, respiratory disease and liver disease. ‘We found important associations between BMI and most causes of death examined, highlighting that body weight relative to height is linked to risk for a very wide range of conditions. Our work underlines that maintaining a BMI in the range 21 to 25 kg/ m2 is linked to the lowest risk of dying from most diseases.’ The authors acknowledge limitations of the study, including that there was no information available on the diet or physical activity levels of people included in the study so it was not possible to look at the interplay between BMI and these related factors. Source: MedicalBrief 2018

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