Increase your physical activity. Exercise is a very important tool to help lower your blood glucose. Prior to starting any exercise program, you will need to consult with your doctor. Make exercise routine with activities you enjoy. In addition to helping manage your blood glucose, exercise helps lower blood pressure and improves balance, flexibility and muscle strength. Exercise may even help to reduce anxiety and depression. Go out and play!
In the U.S., there are nearly 26 million people living with diabetes, and more seniors have diabetes than any other age group. Currently, one in four Americans (10.9 million, or 26.9 percent) over the age of 60 is living with diabetes. With age comes an increased risk for specific complications that require diligence and care to properly mitigate them.

New Zealand has a population of approximately 4.4 million people, the majority being of European descent. Auckland, the largest city in New Zealand, is the most ethnically diverse, with approximately 11% of people identifying themselves as indigenous Maori, 14% as Pacific, and 19% as Asian [12]. By international standards, the incidence of type 1 diabetes in young New Zealanders was assessed as moderate at 17.9 per 100,000 [13]. However, this figure was obtained from a 2-year snapshot, and did not provide information on possible time trends on type 1 diabetes incidence. In addition, previous studies on type 1 diabetes incidence in New Zealand are out of date or refer to a specific geographical region [14], [15], [16].
Diabetes Depot carries a full line insulin pump supplies, including all major insulin infusions sets, insulin reservoirs and cartridges available in Canada, all at significant discounts below the manufacturer's list price. Our product line of diabetic supplies, required daily by people living with diabetes, include blood glucose meters, glucose test strips, lancets, insulin pen needles, insulin products, Dex-4 glucose tablets and Emla anesthetic cream. We also carry accessories such as pump clips, pump cases & pouches, prep pads, battery caps, diabetic socks, and helpful books on diabetes… everything an insulin pump user would require. Plus, because the Diabetes Depot is located within Stutt's Pharmacy, we also offer a complete prescription service.
Stutt's Diabetes Depot carries all the well-known brands of insulin pump supplies, including Accu-check infusion sets, Deltec Cozmo insulin cartridges/reservoirs, Animas infusion sets, Lantus Solostar Pens, Medtronic MiniMed Paradigm infusion sets, pen needle tips, Lifesource blood pressure monitors and ErecAid vacuum devices for erectile dysfunction.
The incidence of type 1 diabetes was higher in New Zealand Europeans than other ethnic groups throughout the study period (Figure 2, p<0.0001). There was little difference in incidence among non-European ethnic groups. The annual incidences (per 100,000) by 2009 were: Europeans 32.5 (95% CI 23.8–43.3), Non-Europeans 14.4 (95% CI 9.2–21.4), Maori 13.9 (95% CI 5.2–29.7), Pacific Islanders 15.4 (95% CI 7.3–28.5), and Other 13.5 (95% CI 5.8–26.8). The rate of increase in incidence over the study period was very similar across all ethnicities, as illustrated by the slopes in Figure 2. However, while the average increase in incidence was higher for Europeans than Non-Europeans in children of all age groups (Table 1), the increase was proportionally lower in Europeans (2-fold) than Non-Europeans (3-fold) due to a lower baseline incidence in the latter group (Figure 2). Nonetheless, in both ethnic groups type 1 diabetes incidence in children 10–14 yr increased at a higher rate than in the youngest 0–4 yr group, with a >2-fold difference observed among both Europeans and Non-Europeans (Table 1). Age at diagnosis across the study period was similar in both ethnic groups (p = 0.47).
Diabetes is a metabolic disorder, which is accompanied by high blood glucose levels. It is a result of improper functioning of the pancreas, which secretes the insulin hormone. Lack of insulin, result in ketoacidosis. Makhana or Fox nut is a sweet and sour seed, which is also known as Euryale ferox. These seeds contain starch and ten percent of protein. There is no supporting literature for its positive association with diabetes. Therapeutic effects of fox nut involve its strengthening of kidney. It also helps to relieve the dampness, associated with leucorrhoea. It also regulates hypertension or high blood pressure. It is also beneficial for individuals with impotence and arthritis. Fox nuts are effective for individuals with high risk of premature ageing. It is also known as gorgon nut, is also helpful.

From 1994 onwards, anthropometric data were recorded at each clinic visit, and for the purposes of this study we used data from the first post-diagnosis clinic that usually occurred 3–4 months afterwards. Standard deviation scores (SDS) were calculated based on the British 1990 Growth Reference Data [17] to obtain height SDS, weight SDS, and body mass index (BMI) SDS.

Diabetes Depot carries a full line insulin pump supplies, including all major insulin infusions sets, insulin reservoirs and cartridges available in Canada, all at significant discounts below the manufacturer's list price. Our product line of diabetic supplies, required daily by people living with diabetes, include blood glucose meters, glucose test strips, lancets, insulin pen needles, insulin products, Dex-4 glucose tablets and Emla anesthetic cream. We also carry accessories such as pump clips, pump cases & pouches, prep pads, battery caps, diabetic socks, and helpful books on diabetes… everything an insulin pump user would require. Plus, because the Diabetes Depot is located within Stutt's Pharmacy, we also offer a complete prescription service.
I act as a care giver for my grandparents who both suffer from type 2 diabetes. This article is right on point with having to make changes to one’s diet to help control blood glucose and overall health such as heart disease as well as staying active and exercising. The two naturally go hand in hand, but many diabetics like my grandparents have foot complications with swelling and neuropathy, requiring proper fitting footwear that is hard to find if you don’t know where to look. I found this guide on shoes for diabetics that helps explain what they are and their importance, especially for diabetics. Hopefully others find it as helpful as I did when caring for those diagnosed with diabetes.
The SMS4BG (self management support for blood glucose) intervention was developed to address the need for innovative solutions to support self management in adults with poorly controlled diabetes.28 The individually tailored intervention provides information and support designed to motivate a person to engage in the behaviours required to manage their diabetes effectively for long term health improvement. The development of SMS4BG followed the mHealth Development and Evaluation Framework29 (including extensive formative work and end user engagement to ensure that it met the needs of the population it was designed to reach) is evidence based and theoretically grounded. A previous pilot study found SMS4BG to be acceptable and perceived it as useful.28 This study aimed to determine the effectiveness of the mHealth diabetes self management support programme—SMS4BG in adults with poorly controlled type 1 or type 2 diabetes, in addition to their usual diabetes care.
Additional data on all patients were collected from the hospital management system, including age, and the most recent values within the previous 12 months from date of survey for blood pressure (BP), glycated hemoglobin (HbA1c), urinary microalbumin to Creatinine ratio (ACR), low density lipoprotein cholesterol (LDL), and total cholesterol to HDL ratio (C:HDL). Prescription of lipid lowering drugs, anti-hypertensive drugs, insulin, or other hypoglycemic medication were also extracted from the medication list from the last visit within the sample period. Type of diabetes was self-reported in the survey (type 1 [T1DM], type 2 [T2DM], other or unknown) and in four participants who had selected ‘other’ or ‘unknown’ diabetes type was determined by examination of the clinical records. For categorization of participants by app use, 4 responders who did not indicate if they had a mobile phone or not were included in the non-app group.
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Overall, all five potential app features were considered useful, with more than 60% of responders selecting that these features were useful, very useful, or extremely useful on the scale of scale 1 (not at all useful) to 5 (extremely useful). Equally, the mean usefulness score was higher than 3 for all 5 features. Blood glucose and carbohydrate intake diaries were rated as being the most useful app feature (Figure 1), with the highest mean score of 3.64 (SD 0.948) for usefulness (Table 7).

Competing interests: All authors have completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declare: support from Waitemata District Health Board for the development of SMS4BG, and support from the Health Research Council of New Zealand in partnership with the Waitemata District Health Board and Auckland District Health Board, and the New Zealand Ministry of Health for the randomised controlled trial; no financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work.
Owing to time restrictions, longer term follow-up of participants was not feasible within the current study, although it is hoped that a two year follow-up of the present study’s participants is possible. The significant group difference seen at three months, dropping slightly at six months, but reaching significance again at nine months, could be an indication of sustained change. Another limitation of the study design was that secondary outcome assessors were not blinded to treatment allocation, which could have introduced bias in follow-up data collection of secondary variables.
We saw no significant interaction between the treatment group and any of the prespecified subgroups: type 1 versus type 2 diabetes (P=0.82), non-Māori/non-Pacific versus Māori/Pacific ethnicity (P=0.60), high urban versus high rural/remote region (P=0.38). Adjusted mean differences on change in HbA1c from baseline to nine months for patients with type 1 and type 2 diabetes were −5.75 mmol/mol (95% confidence interval −10.08 to −1.43, P=0.009) and −3.64 mmol/mol (−7.72 to 0.44, P=0.08), respectively. Adjusted mean differences for non-Māori/non-Pacific and Māori/Pacific people were −4.97 mmol/mol (−8.51 to −1.43, P=0.006) and −3.21 mmol/mol (−9.11 to 2.70, P=0.28), respectively. Adjusted mean differences for participants living in high urban and high rural/remote areas were −4.54 mmol/mol (−8.40 to −0.68, P=0.02) and −3.94 mmol/mol (−9.00 to 1.12, P=0.13), respectively (table 3).
Statistical analyses were performed by SAS version 9.4 (SAS Institute). All statistical tests were two sided at a 5% significance level. Analyses were performed on the principle of intention to treat, including all randomised participants who provided at least one valid measure on the primary outcome after randomisation. Demographics and baseline characteristics of all participants were first summarised by treatment group with descriptive statistics. No formal statistical tests were conducted at baseline, because any baseline imbalance observed between two groups could have occurred by chance with randomisation.
As published in the protocol, a sample size of 500 participants (250 per arm) was estimated to provide 90% power at the 5% significance level to detect a clinically meaningful group difference of 0.5% (5.5 mmol/mol) in HbA1c at nine months, assuming a standard deviation of 1.7% (18.6 mmol/mol). Despite extensive efforts, recruitment for the study was slower than expected, and with the limited overall study period available, a post hoc power calculation was conducted in September 2016. A revised sample size of 366 participants (183 per arm) was targeted, which would provide 80% power to detect the same effect size under the same assumptions.
To obtain data on HPs’ knowledge and recommendation of apps to people with diabetes, a second survey was conducted of the HPs attending the annual scientific meeting of the New Zealand Society for the Study of Diabetes (NZSSD) in May 2016. Immediately prior to the meeting all registered attendees (n=286) were invited to participate in the online survey via email. The data from the patient survey was presented at the conference in a 15-min oral presentation and attendees were encouraged to complete the survey. Paper copies of the survey were also available at the meeting. This survey remained open for 2 weeks, with a reminder sent at 1 week.

This cross-sectional observational study used two surveys (see Multimedia Appendices 1 and 2), one for people with diabetes attending a secondary care diabetes outpatient clinic and the second for HPs (who treat people with diabetes) attending a national diabetes conference. Both surveys were multi-choice format, collected, and managed using REDCap electronic data capture tools. REDCap (Research Electronic Data Capture) is a secure, Web-based app designed to support data capture for research studies [24]. The survey questions were derived from criteria in the Mobile app rating scale [25] to address attitudes and practices of both the people with diabetes and HPs. The list of apps was compiled by searching Apple and Android App stores and included the first consecutive ten diabetes apps. We eliminated any apps not specific to diabetes by reviewing app store descriptions. We reviewed the main features from these apps to develop the list of app features. The patient survey asked responders to select any useful app features from a list. Responders could select more than one useful app feature. The HP survey listed app features and used a scale to assess usefulness of app features (from 1 [not at all useful] to 5 [extremely useful]) and their confidence in recommending apps (from 1 [not at all confident] to 5 [extremely confident]).


There are a variety of mobile apps for people with diabetes. They can be a useful way to learn about and take control of your diabetes. Many apps have features that enable you to record your blood glucose levels, food, medication and physical activity. By looking for patterns or trends in your results and discussing them with your healthcare team, you can learn how to make changes to your diabetes management plan and better manage your diabetes. The Health Navigator team have reviewed some diabetes apps that you might to consider.   
We are now operating as a Branch of Diabetes New Zealand; previously we had been in operation for more than 30 years, as an independent Incorporated Society. During that time, we have seen some significant changes in the field of diabetes. As times change, we strive to change with them, but our basic mission remains the same: to support the interests of people living with diabetes in the Rotorua region.
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