blood sugar levels

Posted on Diabetes

Empathetic telephone calls improve diabetes control in low-income adults, study shows

Empathy-focused phone calls made by trained, nonmedical community members led to significant improvements in blood sugar control for low-income adults with diabetes, according to a new study from Dell Medical School at The University of Texas at Austin in collaboration with Lone Star Circle of Care. Published today in JAMA Network Open, the study suggests this approach could provide a simple, cost-effective model for managing chronic conditions, particularly for patients with limited access to traditional mental health and support services.
A recent study conducted by Dell Medical School at The University of Texas at Austin, in collaboration with Lone Star Circle of Care, found that empathy-focused phone calls made by trained community members (who are not medical professionals) led to significant improvements in blood sugar control among low-income adults with diabetes. Published today in JAMA Network Open, the study suggests that this approach could serve as a simple and cost-effective model for managing chronic conditions, especially for patients who have limited access to traditional mental health and support services.

In a six-month clinical trial, 260 patients with uncontrolled diabetes were randomly divided into two groups. One group received standard care, while the other received standard care and regular phone calls that emphasized listening and empathy. These calls were made by community members who were trained to provide compassionate support, allowing participants to share their experiences and challenges related to living with diabetes.

“This approach starts by recognizing the real and everyday challenges of living with diabetes,” said Maninder “Mini” Kahlon, Ph.D., the study’s lead author and an associate professor in the Department of Population Health at Dell Med. “By providing sincere and empathetic support, we achieved a health impact equivalent to taking medication. This is because emotional well-being serves as the gateway to the lifestyle changes that enhance the management of the condition—an area where traditional healthcare often falls short.”

Key findings include:

  • Improved Blood Sugar Control: Patients who received empathy-based calls saw an average HbA1c reduction of 0.7%, compared with no significant change in the control group.
  • Greater Impact for Patients With Mild or Greater Depressive Symptoms: Patients reporting mild depressive symptoms saw even larger reductions, with average HbA1c improvements of 1.1%.
  • High Satisfaction: Nearly all participants receiving the calls rated them as very or extremely beneficial to their well-being.

All study participants, who were patients of the Lone Star Circle of Care, had the flexibility to choose how often and for how long they wanted to engage in calls. During the initial stages, they could select between one and five calls per week, gradually tapering as they made progress. This patient-driven approach empowered individuals to receive support at a pace that met their needs and schedules. It helped foster a strong connection with their callers while reinforcing their self-care routines.

“At a time when workforce shortages challenge health care delivery, this study underscores the profound clinical impact nonclinical staff can make,” said Jon Calvin, CEO of Lone Star Circle of Care. “By leveraging trained laypeople, we’re demonstrating that empathy, connection and intentional engagement can lead to measurable health improvements. In a world where medicine is increasingly fast-paced and technology-driven, this work reminds us that human connection remains at the heart of effective care. Empathy not only enhances patient engagement but empowers individuals to take meaningful steps toward better health outcomes.”

This research builds on previous studies highlighting the benefits of empathetic phone calls. In 2021, Kahlon and her team published a study that found “Sunshine Calls”—a series of regular, genuine phone calls made by individuals who were not healthcare professionals—showed promise in alleviating loneliness, depression, and anxiety, as well as improving overall mental health among mainly homebound older adults.

Both studies were funded by the Episcopal Health Foundation, which focuses on person-centered, nonmedical approaches to health.

Looking ahead, researchers hope to explore the long-term effects of empathy-based support on both diabetes control and broader mental health. They also plan to scale this model, aiming to make holistic, empathetic support more widely available to those in need.

Posted on Diabetes, Diet

Jabuticaba peel improves nutritional characteristics of bread and lowers glycemic peaks 

Consumption of bread supplemented with jabuticaba peel flour, which is rich in fiber and antioxidants, lowers glycemic peaks and prolongs satiety.
Consumption of bread supplemented with jabuticaba peel flour, which is rich in fibre and antioxidants, lowers glycemic peaks and prolongs satiety.

Researchers at the State University of Campinas (UNICAMP) in São Paulo, Brazil, have developed a sourdough bread formulation enriched with jabuticaba peel. This bread may serve as an alternative for individuals with diabetes and others who need to manage their blood sugar levels. The research findings and test results are published in the journal Foods.

The article highlights that bread’s high carbohydrate content can significantly increase blood sugar levels, risking hyperglycemia. As a result, there is a growing demand for healthier bread options. Artisanal bakers are responding by diversifying their products with recipes that offer added nutritional value and utilize fermentation methods that promote a milder glycemic response.

According to the article’s data, adding jabuticaba peel flour increased the bread’s fibre content by more than 50%. It raised its antioxidant capacity by between 1.35 times and 3.53 times, depending on the proportion of jabuticaba peel flour added to the formulation. This supplementation increased nutrients’ bioavailability and enhanced the final product’s nutritional composition.

The researchers conducted a crossover trial to assess the glycemic peak (the highest blood sugar level reached) after consumption of regular bread made by the long fermentation method (which tends to induce a lower glycemic peak) and consumption a week later of bread containing jabuticaba peel flour. Blood sugar peaked 30 minutes after ingesting the regular bread without jabuticaba peel flour, remaining high for another 15 minutes and then trending down. In the case of the bread supplemented with jabuticaba peel flour, the peak was lower, occurring 45 minutes after ingestion, and blood sugar fell slowly for two and a quarter hours.

Metabolism

Blood sugar rises after ingestion of bread and other carbohydrate-rich foods. Digestion releases glucose, telling the pancreas to secrete insulin, which induces a return to prior blood sugar levels. Flaws in this process lead to health problems, and it is essential to observe the extent to which blood sugar spikes in response to eating.

“If we can lower the spikes in sugar and insulin levels that occur after meals, we reduce the likelihood of developing diabetes and metabolic syndrome. For individuals already experiencing hyperglycemia, managing these post-meal spikes can decrease the risk of heart disease. Additionally, this approach can help extend the lifespan of insulin-producing cells,” said Bruno Geloneze.

The thesis supervisor, who formed the basis for the article, noted that the main challenge in producing the bread for the trials was effectively deploying the technology while preserving its nutritional and functional value. Jabuticaba peel flour has unique sensory characteristics, and its inclusion needs to be evaluated carefully.”

“Jabuticaba peel flour has particular sensory characteristics, and its inclusion had to be evaluated concerning both the technological characteristics of breadmaking and the processing and conservation of the bioactive compounds involved,” she said.

Conservation is relevant because the improvement in blood sugar control and insulin response is associated with the phenolic compounds in jabuticaba peel, such as anthocyanins, which account for the fruit’s dark purple colour. Therefore, it is essential to avoid their “loss” during processing.

Another important finding relates to satiety. The participants felt fuller 60 minutes after eating the bread with jabuticaba peel flour than after they ate the control bread. The authors of the article note that satiety is generally found to improve when blood sugar returns to baseline more slowly, as it does with foods with a low glycemic index.

Antioxidant capacity was monitored for three hours after the bread was consumed. After the bread with jabuticaba peel flour was consumed, the neutralization of free radicals increased significantly and lasted longer. 

“This improvement in antioxidant capacity is important because the development of metabolic disorders, cardiovascular disease and cancer, and the ageing process, involve protein oxidation mechanisms in the body.  The antioxidant capacity of a food can be beneficial in all these mechanisms,” Geloneze said.

Another significant finding was the extension of shelf life to seven days, which, according to the researchers, showed that the bacteria in jabuticaba peel and metabolites formed during the fermentation process can act as natural preservatives in long-fermentation products, inhibiting the growth of pathogenic microorganisms.

Jabuticaba

The article notes that researchers have focused in recent years on the inclusion of ingredients with high biological value in food products, especially agroindustrial byproducts, given the large quantities produced, their nutraceutical potential, and the environmental impact associated with their disposal.

Consumption of jabuticaba (Plinia jaboticaba) and other red and purple berries is known to help prevent or delay the emergence of non-transmissible chronic diseases. “Jabuticaba peel contains phenolic compounds and fibres that have been shown in several studies to contribute to the control of blood sugar and cholesterol,” Maróstica said.

The juice of this berry has also been shown to reduce insulin resistance and increase the production of GLP-1. This hormone helps regulate digestion, satiety and glycemia (as emulated by medications such as semaglutide and liraglutide).

The results of all this research are promising, and the group comprising scientists from UNICAMP’s medical and food engineering schools continue to investigate the fruit’s bioactive compounds. They are now conducting in vivo trials with animal models to find out whether and how these compounds can combat depression and help prevent colorectal cancer.

Posted on Dementia, Diabetes

Earlier diabetes diagnosis linked to dementia risk

Adults diagnosed with type 2 diabetes in mid-life—before age 50—more likely to develop dementia
Adults diagnosed with type 2 diabetes in mid-life—before age 50—are more likely to develop dementia.

Individuals diagnosed with type 2 diabetes at a younger age face a greater risk of developing dementia compared to those diagnosed later in life, according to research conducted by experts at the NYU Rory Meyers College of Nursing.

“Our study indicates that early-onset type 2 diabetes may have cognitive consequences. It highlights the need for prevention strategies for dementia that take both diabetes and obesity into account,” said Xiang Qi, assistant professor at NYU Meyers and the study’s lead author.

Type 2 diabetes is a recognized risk factor for dementia. While the exact mechanisms behind this connection are not completely understood, researchers believe that certain characteristics of diabetes—such as high blood sugar levels, insulin resistance, and inflammation—may contribute to the onset of dementia in the brain.

Type 2 diabetes, once common among older adults, is now increasingly seen in younger individuals. Currently, one in five people with type 2 diabetes globally is under 40 years old.

To investigate how the timing of a type 2 diabetes diagnosis is associated with the risk of developing dementia, a research team analyzed data from the Health and Retirement Study, conducted by the University of Michigan Institute for Social Research. The study, published in PLOS ONE, included 1,213 U.S. adults aged 50 and older who had type 2 diabetes confirmed by blood tests and did not have dementia when they entered the study. The participants were followed for up to 14 years, during which 216 individuals (17.8%) developed dementia, as determined by follow-up telephone interviews.

The researchers found that adults diagnosed with type 2 diabetes at younger ages were at increased risk for developing dementia compared to those diagnosed at 70 years or older. Adults diagnosed with diabetes before age 50 were 1.9 times as likely to develop dementia as those diagnosed at 70 and older, while those diagnosed between 50-59 years were 1.72 times as likely and those diagnosed between 60-69 years were 1.7 times as likely.

Using linear trend tests, the researchers found a graded association between age at diagnosis and dementia risk: for each year younger a person is at the time of their type 2 diabetes diagnosis, their risk for developing dementia increases by 1.9%.

“While we do not know for sure why an earlier diabetes diagnosis would increase the risk for dementia, prior studies show that people diagnosed with type 2 diabetes in mid-life may experience more vascular complications, poor blood sugar control, and insulin resistance—all of which are known risk factors for cognitive impairment,” said Bei Wu, the Dean’s Professor in Global Health and vice dean for research at NYU Meyers and the study’s senior author.

In addition, obesity appeared to influence the relationship between type 2 diabetes and dementia. Individuals with obesity who were diagnosed with type 2 diabetes before age 50 had the highest dementia risk in the study.

The researchers note that this greater understanding of the connection between diabetes onset, obesity, and dementia may help inform targeted interventions to prevent dementia.

“Our study highlights the importance of one’s age at diabetes diagnosis and suggests that specifically targeting obesity—whether through diet and exercise or perhaps medication—may play a role in staving off dementia in younger adults with diabetes,” said Wu.

1 Comment Posted on Diabetes, Patient Talk

Diabetic foot ulcers – treatment and prevention!


Diabetic foot cream

Diabetic foot cream

Welcome to our latest blog post on the subject of diabetes.  This is the first in a series of posts looking at some the complications of faced by diabetics.    You can check out our previous posts on diabetes here.

As with all our blogs we like to encourage our readers to take part in the discussion and share their stories about treatments and successes.  So please feel free to use the comments box below to add anything you think will be of interest to our readers.

The main reason to spotlight foot ulcers that are caused by diabetes is that they can, in some cases, lead to amputation of the foot.

If you or a loved one have any worries at all about a diabetic foot ulcer or indeed a wound on your feet  please see a healthcare professional as soon as possible; as it has been suggested that one in ten diabetics will go on to develop diabetic foot ulcers.  In fact both Type 1 and type 2 diabetics are susceptible to diabetic foot ulcers.

So what is a diabetic foot ulcer and why is it of particular concern to diabetics? 

Clearly foot ulcers can happen to anyone.  That being said the problem here is that the fluctuation of blood sugar levels means that they are considerably harder to heal due to diabetic neuropathy (or nerve pain).  Because neuropathy can lead to deadened pain sensations this in turn means that even very mild injuries can turn into diabetic foot ulcers.

Clearly prevention is the key issue here.  In particular regular inspections of the feet for any signs of injury.  Another suggestion is daily application of a moisturising cream.

As we mentioned above a foot ulcer can lead to amputation or debridement (which is removal of the damaged flesh).  Before that of course antibiotics are often used as well.  Interestingly hyperbaric oxygen therapy can be used to reduce the risk of amputation.

As one of the aims of this post is to help our readers share their experiences of diabetic foot ulcers.  It would be great if you could use the following questions as a guide

  • What kind of diabetes do you have?  How long ago were you diagnosed?
  • Have you ever had a diabetic foot ulcer?
  • How the ulcer was treated and was it successful?
  • Have you used hyperbaric oxygen therapy what was it like?
  • What do you do now to prevent diabetic foot ulcers?

These questions are obviously only a guide so please use the comments boxes below to add any part of your story which you think will be of use to other readers.  Feel free to comment and share advice on other peoples comments.    Any links to other sites would be great as well.