關於 type 2 diabetes prevention ，我們在網路上蒐集到這些相關的討論、資訊與評價

#lipid #gdl
Management of Dyslipidemia for Cardiovascular Disease Risk Reduction: Synopsis of the 2020 Updated U.S. Department of Veterans Affairs and U.S. Department of Defense Clinical Practice Guideline 2020

• 治療目標是預後（心血管疾病、健康、住院、死亡），而不是血脂濃度。
• 血脂（膽固醇、LDL-C、HDL-C、TG）：每 10 年檢驗一次，不需要禁食。
• 初級預防：中度劑量的 statins，不要用 PCSK9 抑制劑。高危險群者能加上地中海飲食。
• 次級預防：中度劑量的 statins，高危險群（AMI 之後、ACS 一年內、復發性 AMI/ACS/中風、糖尿病、抽煙、PAOD、PCI、CABG）病人可以用高強度 statins、加上 ezetimibe/PCSK9 抑制劑、禁食 TG > 150 mg/dL（非禁食 TG > 200 mg/dL）者能加上 VASCEPA（Icosapent Ethyl）、地中海飲食。
• 沒有幫助：CAC、CRP、ABI、apolipoproteins。
• 不要用 niacin、fibrates。
Lipitor (atorvastatin 10-20 mg/tablet), Crestor (rosuvastatin 10 mg/tablet).

1. Continue to Treat to Target Dose Not LDL-C Level

2. Use of Additional Tests to Refine Risk Prediction: Evidence Is Still Insufficient
coronary artery calcium (CAC), high-sensitivity C-reactive protein, ankle–brachial index, and apolipoprotein

3. Primary Prevention: Moderate-Dose Statin Therapy Is Still Emphasized; No to Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) Inhibitors
No RCT directly compared high-dose with moderate-dose statin therapy in primary prevention.

4. Secondary Prevention: Moderate Statin Doses Initially, Then Stepped Intensification in Higher-Risk Patients
For higher-risk patients (recent MI or acute coronary syndrome (in the past 12 months); recurrent acute coronary syndrome, MI, or stroke; or established CVD with additional major risk factors (such as current tobacco use, diabetes, peripheral artery disease, or previous coronary artery bypass graft surgery or percutaneous coronary intervention), evidence supports the addition of ezetimibe or PCSK9 inhibitors to moderate- or high-dose statin therapy.

5. Laboratory Testing: No Routine Fasting or Monitoring Is Needed; Less Is More
We recommend measuring lipid levels no more than every 10 years. Note that previously measured lipid levels may be used reliably in serial CVD risk assessments. We do not recommend rechecking lipid levels each time CVD risk is assessed, because lipid levels remain stable within each patient over time and contribute little to predicted risk relative to other factors.

6. Physical Activity: Increased Aerobic Exercise for All and Cardiac Rehabilitation After a Recent CVD Event

7. Nutrition, Supplements, Niacin, and Fibrates: Suggest a Mediterranean Diet for High-Risk Patients, Limit Icosapent Ethyl to Secondary Prevention, Avoid Supplements and Niacin, and Avoid Adding Fibrates to Statin Therapy
https://www.acpjournals.org/doi/full/10.7326/M20-4648

According to China’s National Health Commission, 4 out of 5 patients who died from the coronovirus were over 60 years old and 75% had comorbidities like diabetes and heart disease.

Dr. Juliana Chan, director of the Institute of Diabetes and Obesity at the Chinese University of Hong Kong suggested that, during the new coronavirus epidemic, people with diabetes should monitor blood sugar level and maintain good hygiene.

So let’s do our best to keep ourselves safe.

Prevention is better than cure!

Wash your hands with soap.
Cover your mouth and nose when you are coughing and sneezing.

Remember to stay hygienic and healthy while you are safe at home.

This Accu-Chek Guide meter is so easy to setup and use and has proven accuracy. I perform the tests on the children too and despite the initial fear, they all said the prick from the lancing device didn’t hurt at all.
.
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Hosted ‘Live Well with Diabetes’ Public Forum today where I learned a few shocking things;

• According to Ministry of Health, some 3.6 million Malaysians are suffering from diabetes which is the highest rate of incidence in Asia and one of the highest in the world! 😱

• It is also estimated that 7 million Malaysian adults are likely to have diabetes by 2025!

• Every 8 seconds, someone dies from diabetes.

Now I have to seriously consider my food choices and all the boba milk tea I’ve been consuming 😅

If you’re wondering what your blood sugar level is, you can get a free screening at any Caring Pharmacies!

Remember, prevention is better than cure.
#host #emcee #emceesofmalaysia

Episode 5: CYCLING IN SINGAPORE TOUR WITH GOPRO HERO 9 Health benefits of regular cycling
Health benefits of regular cycling

Cycling is mainly an aerobic activity, which means that your heart, blood vessels and lungs all get a workout. You will breathe deeper, perspire and experience increased body temperature, which will improve your overall fitness level.

The health benefits of regular cycling include:
increased cardiovascular fitness
increased muscle strength and flexibility
improved joint mobility
decreased stress levels
improved posture and coordination
strengthened bones
decreased body fat levels
prevention or management of disease
reduced anxiety and depression.
Back to top
Cycling and specific health issues

Cycling can improve both physical and mental health, and can reduce the chances of experiencing many health problems.
Obesity and weight control

Cycling is a good way to control or reduce weight, as it raises your metabolic rate, builds muscle and burns body fat. If you’re trying to lose weight, cycling must be combined with a healthy eating plan. Cycling is a comfortable form of exercise and you can change the time and intensity – it can be built up slowly and varied to suit you.

Research suggests you should be burning at least 8,400 kilojoules (about 2,000 calories) a week through exercise. Steady cycling burns about 1,200 kilojoules (about 300 calories) per hour.

If you cycle twice a day, the kilojoules burnt soon add up. British research shows that a half-hour bike ride every day will burn nearly five kilograms of fat over a year.
Cardiovascular disease and cycling

Cardiovascular diseases include stroke, high blood pressure and heart attack. Regular cycling stimulates and improves your heart, lungs and circulation, reducing your risk of cardiovascular diseases.

Cycling strengthens your heart muscles, lowers resting pulse and reduces blood fat levels. Research also shows that people who cycle to work have two to three times less exposure to pollution than car commuters, so their lung function is improved. A Danish study conducted over 14 years with 30,000 people aged 20 to 93 years found that regular cycling protected people from heart disease.
Cancer and cycling

Many researchers have studied the relationship between exercise and cancer, especially colon and breast cancer. Research has shown that if you cycle, the chance of bowel cancer is reduced. Some evidence suggests that regular cycling reduces the risk of breast cancer.
Diabetes and cycling

The rate of type 2 diabetes is increasing and is a serious public health concern. Lack of physical activity is thought to be a major reason why people develop this condition. Large-scale research in Finland found that people who cycled for more than 30 minutes per day had a 40 per cent lower risk of developing diabetes.
Bone injuries, arthritis and cycling

Cycling improves strength, balance and coordination. It may also help to prevent falls and fractures. Riding a bike is an ideal form of exercise if you have osteoarthritis, because it is a low-impact exercise that places little stress on joints.

Cycling does not specifically help osteoporosis (bone-thinning disease) because it is not a weight-bearing exercise.
Mental illness and cycling

Mental health conditions such as depression, stress and anxiety can be reduced by regular bike riding. This is due to the effects of the exercise itself and because of the enjoyment that riding a bike can bring.

Health benefits of regular cycling

Cycling is mainly an aerobic activity, which means that your heart, blood vessels and lungs all get a workout. You will breathe deeper, perspire and experience increased body temperature, which will improve your overall fitness level.

The health benefits of regular cycling include:
increased cardiovascular fitness
increased muscle strength and flexibility
improved joint mobility
decreased stress levels
improved posture and coordination
strengthened bones
decreased body fat levels
prevention or management of disease
reduced anxiety and depression.
Back to top
Cycling and specific health issues

Cycling can improve both physical and mental health, and can reduce the chances of experiencing many health problems.
Obesity and weight control

Cycling is a good way to control or reduce weight, as it raises your metabolic rate, builds muscle and burns body fat. If you’re trying to lose weight, cycling must be combined with a healthy eating plan. Cycling is a comfortable form of exercise and you can change the time and intensity – it can be built up slowly and varied to suit you.

Research suggests you should be burning at least 8,400 kilojoules (about 2,000 calories) a week through exercise. Steady cycling burns about 1,200 kilojoules (about 300 calories) per hour.

If you cycle twice a day, the kilojoules burnt soon add up. British research shows that a half-hour bike ride every day will burn nearly five kilograms of fat over a year.
Cardiovascular disease and cycling

Cardiovascular diseases include stroke, high blood pressure and heart attack. Regular cycling stimulates and improves your heart, lungs and circulation, reducing your risk of cardiovascular diseases.

Cycling strengthens your heart muscles, lowers resting pulse and reduces blood fat levels. Research also shows that people who cycle to work have two to three times less exposure to pollution than car commuters, so their lung function is improved. A Danish study conducted over 14 years with 30,000 people aged 20 to 93 years found that regular cycling protected people from heart disease.
Cancer and cycling

Many researchers have studied the relationship between exercise and cancer, especially colon and breast cancer. Research has shown that if you cycle, the chance of bowel cancer is reduced. Some evidence suggests that regular cycling reduces the risk of breast cancer.
Diabetes and cycling

The rate of type 2 diabetes is increasing and is a serious public health concern. Lack of physical activity is thought to be a major reason why people develop this condition. Large-scale research in Finland found that people who cycled for more than 30 minutes per day had a 40 per cent lower risk of developing diabetes.
Bone injuries, arthritis and cycling

Cycling improves strength, balance and coordination. It may also help to prevent falls and fractures. Riding a bike is an ideal form of exercise if you have osteoarthritis, because it is a low-impact exercise that places little stress on joints.

Cycling does not specifically help osteoporosis (bone-thinning disease) because it is not a weight-bearing exercise.
Mental illness and cycling

Mental health conditions such as depression, stress and anxiety can be reduced by regular bike riding. This is due to the effects of the exercise itself and because of the enjoyment that riding a bike can bring.

FB粉絲專頁：https://www.facebook.com/GoVeganTW
提倡一種新的生活態度，透過動畫宣導"動物權利"！
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感謝【台灣素食營養學會】整理資料、提供贊助
【台灣素食營養學會 官網】http://www.twvns.org/
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【補充資料】
大型研究證實素食降糖尿病機率 https://goo.gl/ohCJdg

1. 糖尿病的世界趨勢
IDF - 2015 Diabetes Atla.

2. 引發糖尿病的食物排行
Ley, S. H., et al. (2014). "Prevention and management of type 2 diabetes: dietary components and nutritional strategies." Lancet 383(9933): 1999-2007.

3. 戰勝糖尿病：馬希爾島的經驗
Davis, Brenda (2008). Defeating Diabetes: Lessons From the Marshall Islands. Today’s Dietitian. Vol. 10 No. 8 P. 24

4. 素食預防糖尿病 (台灣研究)
Chiu, T. H., et al. (2014). "Taiwanese vegetarians and omnivores: dietary composition, prevalence of diabetes and IFG." PLoS One 9(2): e88547.

5. 素食預防糖尿病 (美國研究)
Tonstad, S., et al. (2013). "Vegetarian diets and incidence of diabetes in the Adventist Health Study-2." Nutr Metab Cardiovasc Dis 23(4): 292 - 299.

6. 低脂純素飲食，可改善第二型糖尿病的血糖控制、心血管疾病危險因子
Barnard, N. D., et al. (2006). "A low-fat vegan diet improves glycemic control and cardiovascular risk factors in a randomized clinical trial in individuals with type 2 diabetes." Diabetes Care 29(8): 1777-1783.

7. 逆轉心血管疾病
Ornish, D., et al. (1990). "Can lifestyle changes reverse coronary heart disease? The Lifestyle Heart Trial." Lancet 336(8708): 129-133.

8. 素食對糖尿病的預防與治療
Kahleova, H. and T. Pelikanova (2015). "Vegetarian Diets in the Prevention and Treatment of Type 2 Diabetes." J Am Coll Nutr 34(5): 448-458.