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Sleep is important for everyone, but it’s especially important when your body experiences changing blood sugar levels and other symptoms of type 2 diabetes. “Sleep deprivation causes changes in the effectiveness of the body’s control of appetite, which can lead to weight gain, higher blood sugar, and increased resistance to insulin,” says Richard Castriotta, MD, director of the division of pulmonary, critical care, and sleep medicine at the University of Texas Health Science Center at Houston. 

Although sleep is very important when you have type 2 diabetes, you may find you can’t sleep when you need it most. One explanation for the problem seems to be the connection between diabetes and sleep apnea. Sleep apnea is a condition that’s characterized by periods of halted breathing while you’re asleep, which wakes you up repeatedly throughout the night, leaving you fatigued and not well rested in the morning.

Both type 2 diabetes and sleep apnea are health concerns that are linked to obesity, so experts have long recognized a connection between the two. However, only recently has it been realized how closely these conditions are tied to one another. “There’s much more interrelation between the two conditions than we thought,” says Betul Hatipoglu, MD, a physician in the Cleveland Clinic’s department of endocrinology, diabetes, and metabolism. “In fact, one may actually contribute to causing the other, and vice versa. Recent studies have shown that sleep apnea actually increases insulin resistance, hunger, and other type 2 diabetes symptoms,” Dr. Hatipoglu says. “Other studies have shown that treating sleep apnea also improves the symptoms of type 2 diabetes.”

Other Sleep Issues You Might Face

Another problem that disrupts sleep is frequent urination, a common symptom of type 2 diabetes. You can’t sleep if you have to keep getting up to go to the bathroom. Hatipoglu says this problem is usually tied to high blood pressure, which is also common with type 2 diabetes. As your blood pressure goes up throughout the night, the need to urinate increases. “If this occurs more than once a night, we view it as an issue that needs to be treated,” Hatipoglu says.

Having type 2 diabetes may also lead to other disorders that make it harder to sleep. “In addition to sleep apnea, people with type 2 diabetes are at increased risk for restless leg syndrome (RLS) and periodic limb movements in sleep (PLMS), as well as neuropathy and pain-associated sleep disruption,” Dr. Castriotta says. “RLS causes difficulty falling asleep because of strange feelings in the legs beginning in the evening before sleep. PLMS may cause either sleep-maintenance insomnia (difficulty staying asleep) or a feeling of non-refreshing sleep and daytime sleepiness due to slow, rhythmic limb movements during sleep.”

Tips to Get a Good Night’s Sleep

The first step in managing your sleep problems with type 2 diabetes is to see a doctor or a sleep specialist. Sleep apnea is a serious, potentially life-threatening problem that needs medical attention to remedy. Frequent urination and other sleep-depriving issues should also be treated by a medical professional.

In addition to talking to your doctor and seeing a sleep specialist, here are some additional strategies that may help you sleep:

Reduce your caffeine intake. Caffeinated beverages can keep you up at night and increase the urge to urinate throughout the night. If you can’t cut caffeine out entirely, Hatipoglu recommends to at least eliminate your intake in the afternoon and evening.

Curb the use of electronics in the bedroom. Television is a no-no in the bedroom, as it will keep you up when you need to be focusing on resting. Watch TV in another room, and turn it off at least an hour before you want to nod off. Try reading a book or listening to relaxing music instead.

Keep your bedroom cool, dark, and calm. Removing all light from the room, using light-blocking curtains, and outfitting your bed with appropriate bedding helps to create an atmosphere that is conducive to sleep.

Create a regular bedtime schedule. Hatipoglu says you need to train your body to get a good night’s sleep. One of the most important ways you can do this is to create a scheduled bedtime and stick to it as closely as possible each night. You can incorporate things into this routine that get your body ready for bed, such as having a few sips of relaxing chamomile tea, meditating, or doing deep breathing exercises before you close your eyes.

Sleep issues are a troubling side effect of type 2 diabetes that can leave you feeling tired all the time. By taking these steps and working with your medical team, you should be able to have sweet dreams every night.

The more you sit, the higher your risk of chronic diseases.

Kansas State University researcher Richard Rosenkranz, assistant professor of human nutrition, examined the associations of sitting time and chronic diseases in middle-aged Australian males in a study that is published in the International Journal of Behavioral Nutrition and Physical Activity. Collaborators include University of Western Sydney researchers Emma George and Gregory Kolt.

The study’s sample included 63,048 males ages 45-65 from the Australian state of New South Wales. Study participants reported the presence or absence of various chronic diseases, along with their daily sitting time: categorized as less than four hours, four to six hours, six to eight hours, or more than eight hours.

Compared with those who reported sitting four hours or less per day, those who sat for more than four hours per day were significantly more likely to report having a chronic disease such as cancer, [T2] diabetes, heart disease and high blood pressure. The reporting of chronic diseases rose as participants indicated they sat more. Those sitting for at least six hours were significantly more likely to report having [T2] diabetes.

“We saw a steady stair-step increase in risk of chronic diseases the more participants sat,” Rosenkranz said. “The group sitting more than eight hours clearly had the highest risk.”

The study is relevant to office workers sitting at desks and those sitting for long periods of time such as truck drivers, he said.

“We know that with very high confidence that more physically active people do better with regard to chronic disease compared with less physically active people, but we should also be looking at reducing sitting,” Rosenkranz said. “A lot of office jobs that require long periods of sitting may be hazardous to your health because of inactivity and the low levels of energy expenditure.”

Researchers discovered consistent findings in those who had a similar physical activity level, age, income, education, weight and height. Participants who sat more reported more chronic diseases — even if they had a similar body mass index compared with those who sat less.

In general, people should get more physical activity and sit less, Rosenkranz said.

“It’s not just that people aren’t getting enough physical activity, but it’s that they’re also sitting too much,” he said. “And on top of that, the more you sit, the less time you have for physical activity.”

The study focused on males, because they have higher rates of [T2] diabetes and heart disease, but it is probably applicable in adults across gender, race and ethnicity, Rosenkranz said. Little is known about children and sitting with regard to chronic disease.

The research is part of the 45 and Up Study, the largest long-term study of aging in Australia, involving more than 267,000 people.

Researchers said that although most of the current evidence is suggestive of a causal connection, they cannot be certain in this study whether volumes of sitting time led to the development of chronic diseases or whether the chronic diseases influenced sitting time.

Have you ever noticed that what happens during the morning hours often sets the tone for the rest of the day? When things go smoothly, you tend to feel more relaxed and ready to face whatever the day may bring. However, when things get bumpy before you’ve even managed to get dressed, you’re more likely to remain grumpy until bedtime. While some hassles can’t be avoided, you can make mood-enhancing decisions during the a.m. hours that will set the stage for the next 16 or so. We spoke with the experts and combed the latest research for 10 pick-me-ups that will have your mood rising like the morning sun. Try one (or all!) of them for a happier and healthier you.

1. Pick one “spoil-me” task to do. 
When you wake up, give yourself 30 seconds to think of at least one nice thing you can do for yourself that day…and then do it. When Alice Domar, PhD, psychologist and coauthor of Live a Little! Breaking the Rules Won’t Break Your Health, was in Los Angeles for a book tour one winter, she woke up much earlier than usual. But instead of fretting about lost zzz’s, she realized with excitement that she could score some fresh fruit at the nearby farmer’s market, which would’ve been impossible if she were back home in Boston. That impromptu side trip kept her mood lifted throughout the day.

2. Eat a well-balanced meal. 
Start your morning with a nutritious mix of complex carbohydrates and proteins that will last you until lunch, such as oatmeal or toast with peanut butter (include a sprinkle of cinnamon, which one study linked to improved mood and alertness, for an extra boost). Other research found that a moderate amount of caffeine (200 mg, or the amount in about two cups of coffee) elevated mood and mental sharpness, so enjoy some joe or black tea with your breakfast.

3. Get some fresh air. 
Head out for some “green exercise”—physical activity performed in an outdoor setting—even if you only have a few minutes to spare. Researchers found that people experienced an enhanced mood and higher self-esteem after just five minutes of various types of green exercise, including walking and gardening. The study also found that exercising near water amplified the effects, so if you live near a lake, river or waterfall, even better.

4. Listen to the sounds of nature. 
Capture the benefits of the great outdoors, even if you can’t get outside, by listening to recorded nature sounds. In a recent study, participants recovered from a stressful situation more quickly when they listened to a recorded combination of running water and bird sounds. Open your window in the morning so you can hear Mother Nature’s music as you get ready, or invest in an alarm clock that eases you awake with nature sounds.

5. Focus on feeling good. 
Right after waking up, Robyn McKay, PhD, a psychologist based in Tempe, Arizona, and founder of the Smart Girl-Modern Goddess coaching program, recommends taking five deep breaths and making the decision to feel good for the day. “Imagine that, even when you encounter frustrations and surprises, you will remember to breathe and respond mindfully—rather than react mindlessly—to your circumstances,” she says. Dr. McKay also suggests that, throughout the day, you “take five deep, intentional breaths and remind yourself of your decision to feel good.”

6. Drink hot chocolate. 
A recent study found that sipping a drink containing cocoa flavonols improved participants’ moods and levels of alertness—even as they worked on a series of challenging math problems. So go ahead and savor some hot cocoa made with lowfat or skim milk and dark chocolate. The protein and carbs in the milk will help keep your blood sugar levels stable until lunch, which will help you hold on to your mood momentum.

7. Take a moment to assess yourself. 
Don’t jump out of bed right when you open your eyes in the morning. Instead, take five minutes to pay attention to your body and notice if you feel any stiffness, then do some light stretching while breathing deeply, suggests Lynn Louise Wonders, LPC, RPT-S, RYT, a psychotherapist and yoga teacher in Marietta, Georgia. She notes, “Before racing off to the hundred things on the day’s to-do list, it can be tremendously beneficial to claim these five minutes to tune in to your body and your breath. You’ll find that you are more ‘present’ and better equipped to deal with the busyness of the day ahead.”

8. Envision the negative. 
You’ve probably heard that gratitude is a mood elevator, but here’s a surprising twist to that tactic: Think about a positive event from your life—how you got your dream job or met your ideal partner, for instance—and then imagine what your life would be like if the event hadn’t happened. Though it seems like this would have the opposite effect, it actually improved the mood of one study’s participants more so than simply thinking of the positive event itself.

9. Breathe in some mint. 
Researchers found that sniffing peppermint enhanced mood and attention while also fighting fatigue. Try keeping a bottle of peppermint essential oil or bag of peppermint tea on your nightstand so you can inhale the positive scents right as you wake up. Another happiness helper is chewing gum, which elevated the moods, alertness and attention spans of another study’s participants. Pop a piece of peppermint gum after breakfast for a double-duty perk-up.

10. Smile. 
There’s one thing you can do just about anywhere: Smile. “Remember,” says Dr. McKay, “smiling is a simple way to change your mood—and the mood of those around you, too.” So spread your good-mood wealth by baring those pearly whites as often as possible in the morning as well as throughout the day.

If you are diabetic and treat your diabetes with insulin, hypoglycemia whilst driving may be one of your biggest concerns.

Having a hypo whilst driving is both frightening and dangerous so it’s important that hypoglycemia is avoided.

If you have type 2 diabetes and treat your diabetes with certain tablets, there is also the chance that you may experience a hypo whilst driving.

Which diabetes medications can cause hypos?

The following diabetes medications can cause hypoglycemia. The DVLA must be informed if you are a driver and take the following medications:

• Insulin
• Sulfonylureas
• Prandial glucose regulators

How to avoid becoming hypo whilst driving

• Always test your blood sugar before driving
• Take regular breaks to test your blood sugar
• Never drive if your blood sugar is low – under 5.0 mmols/l, or has been within the last 45 minutes
• Avoid driving when tired or on medications that may cause drowsiness
• Have glucose sweets to hand
• Never drink and drive

Even for short journeys hypoglycemia can be dangerous, so test before each journey.

Patients with type 2 diabetes treated with insulin could be exposed to a greater risk of health complications including heart attack, stroke, cancer and eye complications a new study has found. 

Examining the UK Clinical Practice Research Datalink (CPRD) – data that characterizes about 10 percent of the UK population – a team of researchers from Cardiff University’s School of Medicine looked at the risk of death for patients taking insulin compared with other treatments designed to lower blood glucose levels in people with type 2 diabetes. 

The team’s epidemiological study found people have greater risk of individual complications associated with diabetes such as heart attack, stroke, eye complications and renal disease when compared with patients treated with alternative glucose-lowering treatments. 

“Insulin treatment remains the most longstanding blood-glucose-lowering therapies for people with type 2 diabetes, with its use growing markedly in recent years,” according to Professor Craig Currie from Cardiff University’s School of Medicine, who led the study. 

“However, with new diabetes therapies and treatments emerging there has been a new spotlight on treatments to ensure what the best and safest form of diabetes treatment is. 

“By reviewing data from CPRD between 1999 and 2011 we’ve confirmed there are increased health risks for patients with type 2 diabetes who take insulin to manage their condition,” he adds. 

The study adds to previous findings which identified potential health risks of insulin in this specific group of people. 

Initial concerns were first raised regarding the use of insulin in type 2 diabetes from a population-based study in Canada, which reported a three-fold increase in mortality. 

A similar study of people in UK primary care with type 2 diabetes treated with insulin also reported a 50 percent risk of increased mortality compared with another common treatment regimen. 

Professor Currie adds: “Patients currently being treated with insulin should not, under any circumstances, stop taking their medications, and it is important to emphasize that this report related to only type 2 diabetes which typically starts in older people who are overweight. 

“Each patient’s individual circumstances are different and treatment decisions are managed by their clinician with all of their medical history fully considered. 

“The vast majority of people who take insulin will experience no adverse effects and it remains a reliable and common form of treatment worldwide but this study shows that we need to investigate this matter urgently and the drug regulatory authorities should take interest in this issue. 

“Anyone who is concerned should speak to their GP first before taking any action on managing their condition.”

Aside from the social embarrassment of belching and passing gas, excessive gas in your stomach can be rather painful.

If you experience this common digestive health concern, your first step in treating it is to find the cause.

Excessive Gas Types and Symptoms

Many terms are used to describe excessive gas: burping, belching, flatulence, bloating. “Most of them are synonyms and describe whether the gas exits from the top or bottom of the gastrointestinal tract,” says Stephen Bickston, MD, professor of internal medicine and director of the inflammatory bowel disease program at Virginia Commonwealth University Health Center in Richmond, Va.

For example, burping and belching usually refer to gas that escapes from the mouth while flatulence, or farting, is intestinal gas that escapes from the rectum. Bloating is used to describe the sensation of excess stomach gas that has not yet been released.

Some gas after eating — and releasing it through belching or flatulence — is normal. According to the National Digestive Diseases Information Clearinghouse, most people produce as many as one to four pints of gas a day, which they pass, on average, about 14 times a day.

However, if you’re experiencing painful gas and the embarrassment of chronic and foul smelling flatulence, you can start to play detective and try to eliminate the cause.

Excessive Gas: Foods to Avoid

Foods such as dairy products, beans, and certain vegetables cause some people to have excessive gas. Foods like these contain fiber, sugars, and starches that don’t get digested and absorbed, eventually causing intestinal gas when they are finally broken down in the large intestine.

One way to manage flatulence and belching is to eat fewer of the well-known gassy foods. Everyone reacts differently, but common gassy foods are fruits, such as apples and pears, certain vegetables including broccoli, Brussels sprouts, and onions, whole grains like bran, and dairy products, from milk to cheese to ice cream.

Foods containing sorbitol, a naturally occurring sugar found in fruits, are on some people’s gassy-foods list. Others are bothered by carbonated soft drinks and fruit drinks. If you discover that these foods are causing you excess gas, eliminate them from your diet or eat them in small portions. When it comes to foods to avoid, the key is to be like the Greeks, Dr. Bickston says. “Everything in moderation.”

Keep in mind that almost any food or combination of foods can cause gas in a particular individual. “Certain foods don’t get along together in certain people,” says Donald Novey, MD, an integrative medicine physician with the Advocate Medical Group in Park Ridge, Ill. “For example, some people find they are gassy if they eat fruits with proteins, or if they eat starches and proteins together. It’s personal and requires a little experimentation to find out what the culprits are.” Dr. Novey suggests keeping a food diary and noting when you feel gassy. “If you find you’re gassy after eating a certain food, eliminate it from your diet and see if it helps.”

Cooking may help with the breakdown of some of the offending ingredients, Bickston says. “But the style of cooking can also decrease healthy chemicals found in vegetables. Boiling seems to breakdown chlorophyll and other desirable ingredients.” Look for recipes that call for steaming as that seems to be a better cooking method for gassy foods.

Excessive Gas: Not Just (Hot) Air

Here are other steps you can take to help cut down on painful gas:

• Drink before meals. If you drink liquids with your meals, you lose stomach acids and then can’t break down the foods as well, Novey says. Try drinking about 30 minutes before a meal to help your stomach better digest food, he suggests.
• Eat and drink slowly. When you eat or drink fast, you can swallow a lot of air, which can cause gas, Bickston says. The simple solution? Slow down when you eat — you will swallow less air and be less gassy. If you have dentures, check with your dentist to be sure they fit properly so you’re not gasping air while eating.
• Take over-the-counter digestive aids. Digestive enzymes are available as over-the-counter supplements. “I recommend going to the health-food store and getting a digestive enzyme,” Novey says. “You can take one or two. You will know very rapidly — within a few weeks — if it makes a difference.” Some people also find that activated charcoal helps to reduce and treat excess gas, which is unlikely to cause any harm. However, antacids won’t do much for excessive gas, says Bickston.
• Be a Beano counter. Another over-the-counter digestive aid, Beano, contains an enzyme that can allow the body to digest the sugar in beans and many vegetables. The sugar-digesting enzyme is sold in liquid and tablet form. Add five drops of the liquid form or swallow one Beano tablet per half-cup serving of food before eating. Heating degrades the enzyme in Beano, so adding it to foods while cooking reduces its effectiveness. Beano will not help if excessive gas is caused by fiber or lactose.
• Don’t fill up on air. Habits like smoking, chewing gum, and drinking through a straw may cause your stomach to fill with air, leading to gas.
• Avoid artificial sweeteners. Sorbitol and related sugar alcohols used in many sugar-free versions of foods can also aggravate gas as they are digested by gut bacteria which ferment and release gas and have a laxative effect. “Sorbitol is the first ingredient in every brand of sugar-free gum I’ve found at local grocery stores,” Bickston says. “One to two sticks is akin to eating a prune.” However, the sugar substitutes that are found at a typical coffee stand or in popular soft drinks are not the kind that cause gas. The various packet sweeteners — yellow (sucralose), pink (saccharine), and blue (aspartame) — are not associated with gas or laxative effects.

Related Conditions That Could Be to Blame

If the problem of excessive body gas is persistent or severe, consult your doctor — it could be a sign of a more serious digestive condition. Don’t simply ignore the problem or blame it on indigestion, referred to as dyspepsia by doctors.

Some of the conditions that should be considered if dietary changes don’t help and excessive gas persists:

• Lactose intolerance. People who are lactose intolerant are unable to digest lactose, the sugar that is found in milk and milk products. “I test with a milk challenge,” Bickston says. “The patient drinks a pint or two of milk — it can be any percent fat. What follows tells the patients whether they should limit their milk intake.”
• Irritable bowel syndrome (IBS). “Patients who meet the diagnostic checklist for irritable bowel syndrome suffer more pain at the lower levels of abdominal cavity,” Bickston says.
• Colon cancer. “Excess gas is rarely the presenting symptom for patients with colon cancer,” Bickston says. “But it does trigger my reflex to remind patients to get screened for colorectal cancer.
• Upper gastrointestinal disorders. Occasional belching is normal, but frequent belching may be a sign of an upper gastrointestinal disorder. These include peptic ulcers, gastroesophageal reflux disease (GERD), or gastroparesis, also called delayed gastric emptying.

Also, warns Bickston, if you have had abdominal surgery, a hernia, or significant weight loss or weight gain, never dismiss your gas-like symptoms as normal. Get them checked out.

As annoying as it might be, some gas is a natural by-product of the body’s digestive system. But if your gas is excessive, painful, or chronic, talk to your doctor about possible causes and remedies.

Experts describe the types of pain that require prompt medical attention.

No. 1: Worst Headache of Your Life

Get medical attention immediately. “If you have a cold, it could be a sinus headache,” says Sandra Fryhofer, MD, MACP, spokeswoman for the American College of Physicians. “But you could have a brain hemorrhage or brain tumor. With any pain, unless you’re sure of what caused it, get it checked out.”

Sharon Brangman, MD, FACP, spokeswoman for the American Geriatrics Society, tells WebMD that when someone says they have the worst headache of their life, “what we learned in medical training was that was a classic sign of a brain aneurysm. Go immediately to the ER.”

No. 2: Pain or Discomfort in the Chest, Throat, Jaw, Shoulder, Arm, or Abdomen

Chest pain could be pneumonia or a heart attack. But be aware that heart conditions typically appear as discomfort, not pain. “Don’t wait for pain,” says cardiologist Jerome Cohen, MD. “Heart patients talk about pressure. They’ll clench their fist and put it over their chest or say it’s like an elephant sitting on their chest.”

The discomfort associated with heart disease could also be in the upper chest, throat, jaw, left shoulder or arm, or abdomen and might be accompanied by nausea. “I’m not too much worried about the 18-year-old, but if a person has unexplained, persistent discomfort and knows they’re high risk, they shouldn’t wait,” says Cohen. “Too often people delay because they misinterpret it as [heartburn] or GI distress. Get to an emergency room or physician’s office. If it turns out to be something else, that’s great.”

He tells WebMD that intermittent discomfort should be taken seriously as well. “There might be a pattern, such as discomfort related to excitement, emotional upset, or exertion. For example, if you experience it when you’re gardening, but it goes away when you sit down, that’s angina. It’s usually worse in cold or hot weather.”

“A woman’s discomfort signs can be more subtle,” says Cohen, who is director of preventive cardiology at Saint Louis University School of Medicine. “Heart disease can masquerade as GI symptoms, such as bloating, GI distress, or discomfort in the abdomen. It’s also associated with feeling tired. Risk for heart disease increases dramatically after menopause. It kills more women than men even though men are at higher risk at any age. Women and their physicians need to be on their toes.”

No. 3: Pain in Lower Back or Between Shoulder Blades

“Most often it’s arthritis,” says Brangman, who is professor and chief of geriatrics at SUNY Upstate Medical University in Syracuse, N.Y. Other possibilities include a heart attack or abdominal problems. “One danger is aortic dissection, which can appear as either a nagging or sudden pain. People who are at risk have conditions that can change the integrity of the vessel wall. These would include high blood pressure, a history of circulation problems, smoking, and diabetes.”

No. 4: Severe Abdominal Pain

Still have your appendix? Don’t flirt with the possibility of a rupture. Gallbladder and pancreas problems, stomachulcers, and intestinal blockages are some other possible causes of abdominal pain that need attention.

No 5: Calf Pain

One of the lesser known dangers is deep vein thrombosis (DVT), a blood clot that can occur in the leg’s deep veins. It affects 2 million Americans a year, and it can be life-threatening. “The danger is that a piece of the clot could break loose and cause pulmonary embolism[a clot in the lungs], which could be fatal,” says Fryhofer. Cancer, obesity, immobility due to prolonged bed rest or long-distance travel, pregnancy, and advanced age are among the risk factors.

“Sometimes there’s just swelling without pain,” says Brangman. “If you have swelling and pain in your calf muscles, see a doctor immediately.”

No. 6: Burning Feet or Legs

Nearly one-quarter of the 27 million Americans who have diabetes are undiagnosed, according to the American Diabetes Association. “In some people who don’t know they have diabetes, peripheral neuropathy could be one of the first signs,” says Brangman. “It’s a burning or pins-and-needles sensation in the feet or legs that can indicate nerve damage.”

No 7: Vague, Combined, or Medically Unexplained Pains

“Various painful, physical symptoms are common in depression,” says psychiatrist Thomas Wise, MD. “Patients will have vague complaints of headaches, abdominal pain, or limb pain, sometimes in combination.”

Because the pain might be chronic and not terribly debilitating, depressed people, their families, and health care professionals might dismiss the symptoms. “Furthermore, the more depressed you are, the more difficulty you have describing your feelings,” says Wise, who is the psychiatry department chairman at Inova Fairfax Hospital in Fairfax, Va. “All of this can lead the clinician astray.”

Other symptoms must be present before a diagnosis of depression can be made. “Get help when you’ve lost interest in activities, you’re unable to work or think effectively, and you can’t get along with people,” he says. “And don’t suffer silently when you’re hurting.”

He adds there’s more to depression than deterioration of the quality of life. “It has to be treated aggressively before it causes structural changes in the brain.”