March 23rd is Diabetes Alert Day. Sponsored by the American Diabetes Association (ADA), it's a day dedicated to helping those who could have diabetes recognize that they are at risk. Almost six million Americans don't know they have diabetes and that number is quickly rising.

If you think that you might be at risk or are worried about people you know who might be at risk, the Diabetes Risk Test will let you know whether you have reasons to be concerned. If you determine that you're a high-risk person, you might consider getting a blood test.

Type 2 diabetes is linked to obesity, genetics or memberships in a high-risk group. African-Americans, Hispanics and Native-Americans are among those in high risk groups. Type 1 diabetes has risk factors that include viral infection, environmental triggers and geography.

For more information on diabetes, check out AOL Health.

Eye exams may warn doctors of undiagnosed diabetes, according to the American Diabetes Association.

Diabetes increases your risk for vision loss fourfold, and it's the leading cause of new cases of blindness in people ages 20–74. Retinopathy is a condition that affects the blood vessels in the retina. However, because of delayed diagnosis, about 10 –20 percent of people with type 2 diabetes already have some degree of eye disease when their diabetes is diagnosed.

If ophthalmologists notice that a patient is exhibiting symptoms of retinopathy, they should recommend additional testing.

After 20 years nearly all people with type 1 diabetes and 60% of those with type 2 diabetes have developed retinopathy. To cut back on the chances of developing retinopathy, people with type 1 diabetes should have an annual eye exam by an ophthalmologist beginning five years after diagnosis. Those with type 2 diabetes should see an eye specialist yearly when they learn they have diabetes.

Retinopathy is commonly treated with laser therapy, which is relatively painless and can be done in a doctor's office.

Still, it's incredibly important for diabetics to monitor their eye health. To make sure that your eyes are as healthy as possible, you must monitor your blood sugar levels tightly. People who keep their blood sugar at near-normal levels cut their risk of developing eye diseases by 75%. Retinopathy was also less likely to progress among those who had tight control over their diabetes.

Check out AOL Health for more information on diabetes management.

Does your too-demanding boss have you ready to blow? Or are your co-workers, who dump "team" projects on you, driving you crazy? It's not only annoying, it might be bad for your health.

A British study published in the December issue of Diabetes Care, shows that women who experience high levels of job stress and little work-related social support appear to be at an increased risk for developing type 2 diabetes, which is linked to obesity and other lifestyle choices.

During the study, which lasted nearly 12 years, the research team assessed job-related stressors of 5,895 initially diabetes-free British civil servants.

There was no link between job stressors and diabetes risk in men. In women, 10 percent of all type 2 diabetes cases would have been prevented had the women had more control over their work and less stringent demands placed on them. Social support would have helped the women in the work environment, too.

Most medical professionals agree: People need to find ways to reduce stress in their lives and view it as a health risk factor similar to obesity, low physical activity, and poor diet.

Check out AOL Health for information about prediabetes and ways to prevent diabetes.

Almost 24 million people in the United States have diabetes according to the American Diabetes Association. Think you're not at risk? Think again.

Type 1 diabetes, an autoimmune disease, can be caused by genes, viruses or foods. Type 2 diabetes is more likely to be linked to age, medications, poor nutrition and lack of exercise. Gestational diabetes, which usually occurs around weeks 24–28 of pregnancy, has been linked to the hormones produced by the placenta that hinder the action of the mother's insulin.

Even if you're convinced you're safe, check out these shocking risk factors.

• Breast size: If you're a size D or larger at age 20, you may be up to five times more likely to develop diabetes than your flat-chested friends.
• Birth month: If you're a spring baby, you're more likely to develop type 1 diabetes in the U.S., according to a CDC study.
• Slow-healing cuts: If your cuts stick around longer, it could be a symptom of type 2 diabetes. That's because your blood vessels are a little thinner than they should be while the vessel walls are a little thicker. That means your blood system can't carry infection-fighting white blood cells to the site of the cut, which delays healing time.
• Tooth Loss: If you have periodontal disease or tooth loss, your likelihood for diabetes increases 14 to 29 percent.

Your doctor can provide more information about whether you're at risk for diabetes or you can visit AOL Health to test your risk.

UCLA researchers report Nevada County, California residents have the lowest rate of diabetes in the state -- 2.6 percent. That's about one-third the state-wide average (6.8 percent), and slightly less than one-quarter the prevalence of diabetes in Imperial County (11.2 percent).

Take a few guesses why Nevada County's rate of diabetes is so much lower than Imperial County, and well under the national average of 7 percent. Do families eat less processed food around the dinner table? More jogging trails? Better health insurance coverage? Researcher Theresa Hastert states, "There is no one thing, but higher income is associated with better foods and exercise."

Hastert explained Nevada County is mostly white, affluent, educated and insured. Imperial County has a large population of Latinos and migrant farm workers. Nevada County's numbers support general findings that minorities without affordable, continuous health care are more prone to the disease. Who's got time for the dinner table -- Hastert openly speculates eating more junk food may be a consequence of dodging between three jobs just to get by. Also, Nevada County is a beautiful area -- she wonders if environmental factors play a role.

Is diabetes a socio-economic disease? If so, we're in trouble. The gap is widening between our nation's haves and have nots, and large concentrations of poor minorities may explain the disproportionate rates of diabetes from county to county. Read more in The Union.

Diabetic foot complications are responsible for many lower extremity amputations. But this last drastic step can be prevented up to 85 percent of the time with early diagnosis and proper care.

Now Thai researchers and physicians have shown using a patient's own stem cells can effectively heal chronic foot wounds. Diabetes patients with chronic foot wounds, aged 50-72, were injected with stem cells obtained from their own blood. Most excitedly, the wounds healed nicely within three to four months. The stem cell treatment also makes fiscal sense. According to this article, stem cell treatment for wounds in a patient with diabetes costs about $6,000, one-fifth the cost of conventional treatment for a leg wound.

Studies have shown primary care physicians often fail to examine the feet of patients with diabetes. It's a shame, as this step is the least costly and most effective way to prevent foot wounds and potential amputations. But at the same time, it is nice to know there is a promising, cheaper treatment utilizing patient-donated stem cells.

Aaaahh ... fall will soon deliver golden trees, crisp autumn air, piles of fallen leaves begging to be jumped in, and the stick of the flu vaccine.

The National Foundation for Infectious Diseases (NFID) recently issued a report calling for greater influenza vaccination rates among Americans with diabetes. Turns out more than 50 percent of the 21 million people with diabetes do not receive an annual influenza vaccination. This is contrary to the recommendations of the Centers for Disease Control and the American Diabetes Association.

According to Dr. William Schaffner, NFID's vice president, the impaired immune systems of people with diabetes can result in a higher risk of serious complications from influenza, including impaired blood sugar control. Annually, this infectious disease strikes up to 60 million Americans and kills an average of 36,000 people -- more than all other vaccine-preventable diseases combined. Over 10 percent of deaths linked to influenza and pneumonia are due to diabetes. There are studies citing the benefits of the vaccine for people with diabetes, including reduced hospitalization and death by 72 percent for those with diabetes 18 to 64 years of age, and 80 percent less hospital admissions for children and adults with diabetes.

I'm just speculating, but lack of awareness, lack of access to an affordable vaccine or just plain philosophical disagreement with the need for the vaccine (among other factors) may all play a role in the low influenza vaccination rates for people with diabetes. Just an example, my parents both have type 1, and my mom will stand in line for hours to get a shot (she was hospitalized for influenza in her pre-diabetes days), while my dad always refuses -- he's never had influenza. Read more at Infection Control Today.

New research finds tuberculosis (TB) is more difficult to treat if the patient has type 2 diabetes. The study examined 737 Indonesians with tuberculosis screened for type 2. Nearly 15 percent had type 2, and initially, their TB was as severe as the non-diabetics. After two months of treatment, TB sputum tests were positive 18.1 percent for those with type 2 and only 10 percent in non-diabetics. At the six month mark, 22.2 percent of type 2s had positive sputum results compared to 9.5 percent of the non-diabetics.

The story in Reuters does not address why people with TB and type 2 diabetes do not respond as well to TB treatment. Tuberculosis is a serious infectious disease. Over one-third of the world carries the TB bacterium, and one in ten latent infections will progress to active TB disease. Untreated, active TB is a real threat, it kills more than half of its victims. Experts are examining how rising rates of type 2 are impacting TB control and prevention worldwide.

I just finished reading an excellent book about Dr. Paul Farmer's inspirational work treating tuberculosis in impoverished communities worldwide -- Mountains Beyond Mountains: The Quest of Dr. Paul Farmer, A Man Who Would Cure the World -- masterfully written by Tracy Kidder. I wonder what Dr. Farmer has to say about people with type 2 and TB.

How come type 2 diabetes does not affect all obese people? A study recently published in the Journal of Clinical Investigation may explain why. Adiponectin is a hormone that controls insulin sensitivity. Leptin is a hormone which lessens appetite. Too much adiponectin allows mice to store excess calories in fat tissue instead of in more dangerous areas -- the liver, heart or muscle tissue -- where extra fat may lead to inflammation, diabetes and heart disease. Unfortunately adiponectin levels decline as people get fatter. So researchers wondered "what if overeating mice had high levels of adiponectin?"

Researchers genetically engineered mice to produce lots of adiponectin and a lack of leptin. The mice overate and became obese, but their high levels of adiponectin enabled them to dump their fat into fat tissue, which has antidiabetic effects. Dr. Philipp Scherer, senior author, stated the inability to appropriately expand fat mass while overeating may be an underlying cause of insulin resistance, diabetes and cardiovascular disease. Low adiponectin levels don't allow fat cells to accept fat, so the fat builds up in inflammatory locations.

Considering 66 percent of American adults are overweight or obese, Dr. Scherer stated researchers need to find way to deposit extra calories in the least harmful places. He plans to investigate how to maximize good fat areas and shrink bad ones. This solution is disturbing to me -- don't we need to get rid of the fat in the first place? Read more in Health News Digest and check out Diane's recent post on upper body fat's link to insulin resistance.

Scientists from all over the world will meet up in Seattle October 22-23 to attend the Warren G. Magnuson Congress for a Global Diabetes Alliance. The initiative is intended to help fight the rapid rise of type 2 diabetes worldwide. International Diabetes Federation past president Pierre Lefebvre, who will be a speaker at the conference, says the need for such an alliance to fight the T2 global epidemic "could not be more urgent."

More than one hundred diabetes experts hailing from over twenty countries will attend the congress. There's one main goal: the discussion of how to help under-served populations, such as indigenous peoples. However, the more general problems - prevention, treatment and the possibility of a cure - will also be on the table. It is also hoped that the alliance can help change public perception of type 2 diabetes as a disease associated with affluence, when in fact it is spreading faster in poor, developing countries where people frequently lack access to medical care.

Organizers say this is the first global alliance on diabetes. Speaking of organizers: who's behind this anyway? Well, it's being convened by the Pacific Northwest Research Institute (PNRI). Incoming president of the American Diabetes Association, Dr. Paul Robertson, is president and scientific director of the PNRI. Warren G. Magnuson, for whom the conference is named, was a US senator and supporter of the sciences who died from diabetes complications in 1989.

The ADA and PNRI's Dr. Robertson is optimistic the organization can effect change: "The response from top experts from around the world to develop a global, multidisciplinary, collaborative endeavor focused on clinical research on diabetes has been overwhelming."

Way back in my middle school years, students taking Home Economics had to carry around a five pound sack of flour for a week to illustrate mother/fatherhood. Kids drew cute baby faces on their lumpy sacks and proudly carried them around. It was novel for a day or two, then you'd start to see the flour babies left in lockers or simply forgotten at home. Parenthood sounds easy, until you have to rise to the responsibility day in and day out. Same with diabetes.

This past week, Representative Michael Castle (R-DE) and Representative Zack Space (D-OH) signed on for the American Diabetes Association's "Day With Diabetes" -- a demonstration designed to raise awareness of the immense personal impact of the disease. Castle was 'diagnosed' with type 1 and Space with 'type 2.' Both met with a certified diabetes educator and a registered dietician to devise a treatment plan. The Representatives attempted to control their 'diabetes' for a day -- pricking their fingers for blood glucose checks, taking their medications and considering every meal choice. They were also shadowed by people with the real deal -- CJ Jones has had type 1 for 30 years and Berth Garbrandt, has had type 2 diabetes for nine years.

Next month Castle and Space will hold a Congressional briefing to report on their experiences living with diabetes for a day. Space has a good idea, his son has type 1 diabetes. Castle is co-chair of the Congressional Diabetes Caucus. A pretty interesting publicity stunt for diabetes awareness. We need to keep diabetes funding and research on the top of every legislator's mind. Here is the full story.

Our guts don't really have a tongue, but researchers have identified two taste receptors in the human intestines -- T1R3 and G protein gustducin. The receptors operate within taste cells that sense glucose within the intestine. These same receptors are used by our tongues to taste sugary stuff, even artificial sweeteners. Turns out the research team hypothesized the sugar sensors in the tongue might also be the same ones in the gut. They were right. Hey, nice guess!

That Snickers bar you're eating? Your gut tastes it, too. Even the artificially sweetened glass of chilled Crystal Light is tasted by the gut. It is important to understand how the gut is sensing, since these taste cells regulate secretion of insulin and hormones that control appetite.

Researchers say discovering the identity of the gut's sweet tooth receptors may pave the way for new treatments for obesity and diabetes. Lead author, Dr. Robert F. Margolskee, stated the study may explain why today's artificial sweeteners may not help with weight loss. New zero-calorie sweeteners could be developed to better control weight. The findings were published online in the August 20, 2007 "Early Edition" of the proceedings of the National Academy of Sciences. Read the full article in Medical News Today.

The American Association of Clinical Endocrinologists (AACE) has released its new medical guidelines for diabetes. Needless to say, the 66-page guidelines are intended for your doc, not for you. Unless you are having trouble getting to sleep at night...

But they're important for you to know about. Very. The guidelines are the first reference point for physicians determining the best course of care for diabetes patients. Blood sugar, blood pressure, type 1, type 2, pregnancy, metabolism, prevention etc etc. It's all in there.

So what's new? According to AACE president Dr. Richard Hellman, the focus is, for the first time, on patient safety - specifically, reducing the incidence of medical errors involving diabetes patients. "These guidelines are the first that specifically point to how best to protect the patient with diabetes against mistakes and misjudgments by all those who directly or indirectly impact their diabetes care, including themselves," said Dr. Hellman. "Patient safety is not a given."

The guidelines are being published as a supplement to the latest issue of Endocrine Practice (May/June 2007), the journal of the AACE. They can also be accessed online. Click here to view the pdf.

Do not miss this recent NY Times article by Gina Kolata, Looking Past Blood Sugar to Survive With Diabetes. It is a must read for anyone associated with type 2 diabetes, including patients, family caregivers and doctors. I am very encouraged to see a feature on type 2 diabetes in such a well-read newspaper. Many doctors are uninformed on the best ways to treat a person with type 2 diabetes, they spend much more time with type 1 patients. Furthermore, type 1 and type 2 are very different diseases, but since they both end in 'diabetes' there is deep confusion -- see Diane's previous post on this topic. Undoubtedly, we need Big Media to provide greater coverage on the differences and unique treatments for both type 1 and type 2 diabetes.

First off, type 2 diabetes is a form of the disease that usually appears in adulthood where the body does not produce enough insulin or the cells are resistant to insulin. Kolata's article focuses on one man's battle with type 2 diabetes, as well as the importance of other treatments beyond blood sugar control that can markedly prevent heart disease -- the number one threat to a person with type 2. Dave Smith, a pastor from Fairmont, Minnesota, has dealt with type 2 diabetes for nine years. From the start, his doctor advised him to control his blood sugar, so he was a faithful carbohydrate counter, finger pricker, type 2 pill taker. Nothing worked, so he added insulin.

Unfortunately, his fixation on controlling blood sugar ignored the most crucial treatment of all -- lowering cholesterol. According to Kolata's article, heart disease kills nearly everyone with diabetes. The second treatment Smith did not consider was the importance of controlling blood pressure. The third treatment is taking aspirin to control blood clots. Last October, Smith had a major heart attack and nearly died. He had never thought about heart disease, and his doctor never advised him to take a cholesterol-lowering statin or a blood pressure drug. The American Diabetes Association reports only 18 percent of people with diabetes know their increased risk for cardiovascular disease. Grrrr! This lack of awareness among patients and doctors must change for lives to be saved. It took a near-fatal heart attack for Smith to receive the combination of drugs he should have been prescribed at diagnosis: a statin, two drugs to lower blood pressure, aspirin, insulin and two drugs to reduce his blood sugar level.

Shhh. Big Pharma scientists hard at work. On what, you ask? Why, on Novo's new "baby" - a drug designed to treat type 2 diabetes. Liraglutide, a hormone analogue, is supposed to improve blood sugar control. It's also supposed to get you that coveted magic bullet (a la Byetta): weight loss. Ooh, baby. Now that's medication!

Novo Nordisk has been working on Liraglutide for a while now. Here's the latest: Novo announced Monday that two Phase III studies were successful in demonstrating the aforementioned blood sugar control and weight reduction. Novo is riding high on the news: its shares rose six percent on the announcement. According to a pharmaceutical industry analyst quoted by Reuters, the shares surged so healthily because the positive news was expected.

The powers-that-be at the drug giant say they hope Liraglutide can be submitted for regulatory approval by mid-2008. They hope it will become another blockbuster, with estimated annual sales topping one billion. Stay tuned.