Eli Lilly Diabetes Drug

Eli Lilly is a global pharmaceutical company, developing a new drug for the treatment of obesity and type 2 diabetes. The drug, known as tirzepatide, is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1) receptor agonist.

It is intended to help patients with type 2 diabetes lose weight and improve their glycemic control. Tirzepatide is currently in phase 3 clinical trials and has shown promising results so far.

The Need for a Diabetes Drug for Weight Loss

Eli Lilly Diabetes drugObesity is a major risk factor for type 2 diabetes, and both conditions are becoming increasingly prevalent worldwide. According to the World Health Organization, the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014.

In addition, more than 1.9 billion adults were overweight, and of these, over 650 million were obese in 2016. These statistics highlight the urgent need for effective treatments for obesity and diabetes.

Current Treatments for Obesity and Diabetes

The current treatments for obesity and type 2 diabetes are often inadequate, with limited effectiveness and significant side effects. Bariatric surgery can achieve significant weight loss but is invasive and carries the risk of complications.

Lifestyle interventions, such as diet and exercise, can also be effective, but long-term adherence is challenging. Pharmacological therapies, such as orlistat and liraglutide, have modest weight loss effects and require long-term use to maintain benefits.

Tirzepatide: A Promising New Treatment for Obesity and Diabetes

Tirzepatide is a new drug in development that has shown promising results in clinical trials. It is a dual GIP and GLP-1 receptor agonist that targets two gut hormones involved in the regulation of glucose and energy homeostasis.

The drug works by reducing appetite, increasing satiety, and improving glycemic control. Tirzepatide is administered once a week subcutaneously and has been shown to produce significant weight loss in patients with type 2 diabetes.

Clinical Trials of Tirzepatide

Tirzepatide is currently in phase 3 clinical trials, and the results so far have been promising. In a 26-week randomized controlled trial of 1,879 patients with type 2 diabetes and obesity, tirzepatide produced greater weight loss than placebo or semaglutide, another GLP-1 receptor agonist.

The mean weight loss was 11.3% with the highest dose of tirzepatide, compared to 2.4% with placebo and 9.7% with semaglutide. Tirzepatide also produced greater improvements in glycemic control, blood pressure, and lipid profiles.

What are the side effects of Tirzepatide?

Tirzepatide has been generally well-tolerated in clinical trials, with the most common side effects being gastrointestinal symptoms such as:

  • nausea,
  • vomiting,
  • and diarrhea.

These side effects are similar to those seen with other GLP-1 receptor agonists and usually resolve with time. There have been reports of pancreatitis and diabetic retinopathy in patients taking tirzepatide, but the incidence appears to be low.

Potential Impact of Tirzepatide on Obesity and Diabetes

If approved, tirzepatide could have a significant impact on the treatment of obesity and type 2 diabetes. The drug has shown greater weight loss effects than current treatments, and its dual GIP and GLP-1 receptor agonist activity may offer additional benefits for glycemic control and cardiovascular risk reduction.

Tirzepatide may also offer an alternative to bariatric surgery for diabetes patients.

Eli Lilly Diabetes drug

Continue ReadingEli Lilly Diabetes Drug

What are the Risks of Bariatric Surgery for Diabetes?

According to a 2021 report from the CDC (Centers for Disease Control and Prevention), up to 13% of people in the United States have diabetes. Moreover, nearly 50% of people with diabetes are also obese.

Being overweight or obese increases your risk of developing diabetes or worsening its symptoms, and weight loss is one of the key elements of managing diabetes. Bariatric surgery can result in weight loss and prevention or remission of type 2 diabetes in more than 75% of patients. After the procedure, glycemic control improves as a result of calorie restriction, increased insulin sensitivity, and enhanced insulin sensitivity.

Doctors often recommend bariatric surgery as a long-term weight loss solution for type 2 diabetes patients with a BMI (body mass index) of 35 or higher. The procedure improves type 2 diabetes by lowering blood sugar levels, which could also result in a change in diabetes medications. In some cases, bariatric surgery may even result in permanent or long-term remission from type 2 diabetes.

However, it is important to note that bariatric surgery is a major surgery, and it may have some short-term or long-term risks.

Bariatric surgery encompasses several surgical procedures that change the digestive system in a bid to help patients lose weight. These procedures usually reduce the size of the stomach, helping you feel fuller sooner. In addition to helping you eat less food, these procedures also limit the absorption of calories by the small intestines and improve how your body uses insulin and metabolizes fat.

Some studies indicate that besides helping type 2 diabetes patients lose weight, bariatric surgery also improves kidney function, cholesterol levels, blood pressure, and overall blood sugar control.

Types of bariatric surgery

       1.  Gastric bypass

Gastric bypass surgery is typically recommended for people with a body mass index (BMI) above 40 or a BMI above 35 with obesity-related health conditions such as type 2 diabetes, high blood pressure, or sleep apnea.

Also known as Roux-en-Y, gastric surgery is a permanent surgical procedure that involves stapling off the upper section of the stomach in order to reduce the organ’s size. As a result, you’ll eat less and the food will spend less time in the small intestine. Therefore, the small intestine will absorb fewer calories, leading to weight loss.

It’s important to note that gastric bypass surgery is not a quick fix for weight loss and requires a long-term commitment to lifestyle changes, including a healthy diet and regular exercise, to achieve and maintain successful results.

       2.  Vertical sleeve gastrectomy

This procedure is also known as stomach stapling. Vertical sleeve gastrectomy works by removing up to 80% of your stomach, leaving behind a smaller, tube-shaped “sleeve” or “banana-shaped” stomach.

This new stomach is about the size of a banana and can hold significantly less food compared to the original stomach. By reducing the stomach’s capacity, the procedure helps in restricting the amount of food a person can consume, resulting in reduced calorie intake.

Vertical sleeve gastrectomy has become a popular weight-loss procedure because it offers several benefits. In addition to limiting food intake, it also causes hormonal changes that can help reduce appetite and improve blood sugar control – however, the intestines are not rerouted and so the procedure is permanent.

       3.  Laparoscopic adjustable gastric banding.

This surgical procedure involves inserting a band on the top side of the stomach to reduce the amount of food your stomach can hold as well as the amount you can eat.

Find out more on gastric banding HERE

Risks and side effects of bariatric surgery

Some of the most common risks associated with bariatric surgery include:

Short-term risks

  • Anesthesia-related risks
  • Infection
  • Acid reflux
  • Dilation of the esophagus
  • Nausea and vomiting
  • Inability to eat specific foods
  • Failure to lose weight
  • Weight gain
  • Obstruction of the stomach

Long-term risks

  • Dumping syndrome (commonly associated with symptoms such as dizziness, nausea and vomiting after surgery)
  • Ulcers
  • Hernias
  • Low blood sugar
  • Vomiting
  • Malnutrition
  • Bowel obstruction

Bariatric surgery risks by procedure:

Risks and complications may vary depending on the type of bariatric surgery procedure. Your surgeon will help you understand the potential risks and side effects of the specific procedure you want to undergo

1.  Gastric bypass risks and side effects

  • Gallstones (risk may increase with substantial or rapid weight loss)
  • Leakage
  • Hernia
  • Dumping syndrome
  • Leakage
  • Internal bleeding
  • Bleeding of the wound
  • Perforation of intestines or stomach
  • Bowel or pouch obstruction
  • Skin separation
  • Spleen injury
  • Calorie or protein malnutrition
  • Cardiac problems
  • Pulmonary problems
  • Stricture
  • Intestine or stomach ulceration
  • Iron or vitamin deficiency

2.  Potential risks and complications of gastric sleeve surgery

  • Gall stones
  • Internal bleeding
  • stricture
  • Blood clots
  • Hernia
  • Skin separation
  • Leakage
  • Perforation of intestines or stomach
  • Iron or vitamin deficiency

How can you reduce your bariatric surgery risks?

You can reduce some of the risk and side effects of surgery by taking measures such as:

  • Stopping smoking
  • Decreasing your BMI (body mass index)
  • Exercising regularly (as recommended by your doctor)

The bottom line

Risks of bariatric surgeryBariatric surgery is highly effective against type 2 diabetes and obesity. It is often recommended for people with diabetes who are unable to achieve and maintain a healthy weight with medications or lifestyle changes.

Although bariatric surgery offers many potential health benefits, it is just one tool for managing diabetes and obesity.

Long-term success still demands regular exercise and a healthy diet.  If you want to undergo bariatric surgery, you should also commit to regular healthcare visits as well as lifelong maintenance of exercise and diet.

Risks of Bariatric Surgery for Diabetes

Continue ReadingWhat are the Risks of Bariatric Surgery for Diabetes?

Diabetes and Blindness: Understanding the Link and Preventative Measures

Post updated: 6th May 2023

Diabetes damages the body’s small blood vessels. Diabetic blindness occurs when the blood vessels in the retina are damaged due to high blood sugar. The retina is the part of the eye responsible for sending images to the brain. You can lower your risk of diabetic retinopathy by keeping your blood sugar levels within your target range.

It is essential to keep in mind that diabetic retinopathy can cause poor vision or even blindness. However, it often gets worse over several years.

The small blood vessels of the eye get weak at first and this leads to blood seeping into the retina. This is known as nonproliferative retinopathy and is the most common form of retinopathy.

Diabetes BlindnessIf your blood sugar stays high, retinopathy keeps getting worse. Moreover, new blood vessels growing in the retina will be weak and can easily break open. Once they break open, fluid leaks into the middle of the eye just in front of the retina and alter your vision.

Bleeding can also lead to the formation of scar tissue. Scar tissue in the eye can pull on your retina and cause it to move from the wall of your eye. This is known as retinal detachment. Some people with proliferative retinopathy may have no symptoms at all until it is too late for effective treatment. That’s why it’s very important to have regular eye exams.

Diabetic retinopathy can also lead to swelling of the macula of your eye (macular edema). When this happens, it can worsen your vision and even lead to blindness.

Diabetic retinopathy risk factors

Anyone with diabetes (type 1 diabetes, type 2 diabetes, or gestational diabetes) can develop eye complications, including diabetic retinopathy. Having uncontrolled diabetes for long increases your risk of developing diabetic retinopathy. Other factors that increase your risk include:

  • Poor control of blood sugar levels
  • Tobacco use
  • Pregnancy
  • High cholesterol
  • High blood pressure
  • Being Black, Native American, or Hispanic

Types of diabetic retinopathy

There are two main stages of diabetic retinopathy:

1.     Early diabetic retinopathy (non-proliferative)

Early-stage retinopathy occurs when the small blood vessels in the retina weaken and form tiny pockets. While you may not be able to detect the tiny pouches, your eye doctor can. These tiny pockets can leak fluid, which can cause the macula in the retina to swell (macular edema), leading to vision distortion.

Macular edema is the leading cause of vision loss in people with diabetes. About 50% of diabetes patients with retinopathy develop macular edema at some point.

2.     Advanced diabetic retinopathy (proliferative)

New blood vessels begin to grow in the retina but these vessels are often weak and leak blood and other fluids into the vitreous (the gel between the retina and the lens). Minor bleeding may cause you to see dark spots floating in your vision.  However, if the bleeding increases you may go blind.

The symptoms of diabetic retinopathy can be noticed in the early stage. This is the main reason why you should undergo annual eye exams to catch any problems early enough when treatment is most effective.

Advanced-stage symptoms can include:

  • Floaters (dark shapes or spots in your vision)
  • Blurry vision
  • Trouble seeing colors
  • Empty or dark spots in your vision
  • Blindness (vision loss)

Complications

Complications of diabetic retinopathy (growth of weak small blood vessels in the retina):

1.     Vitreous hemorrhage

The new small blood vessels bleed into the jellylike substance filling the center of the eye. A small amount of bleeding might only lead to a few small floaters (dark spots). However, in severe cases, fluid fills the vitreous cavity, leading to blindness (complete loss of vision).

Vitreous damage does not cause permanent blindness by itself. The fluid (including blood) clears from your eyes within a few days, weeks, or months. If your retina is not damaged, your vision will return to its previous state.

2.     Retinal detachment

The weak small blood vessels associated with retinopathy can stimulate the development of scar tissue, which pulls the retina further away from the back of your eye. This often causes flashes of light, floaters in your vision, or even blindness (severe vision loss).

3.     Glaucoma

New small blood vessels can develop in the iris (the front part of the eye) and obstruct the normal flow of blood and other fluid out of your eye, causing a build-up of pressure in the eye. This pressure damages the optic nerve (the nerve responsible for carrying images from the eye to the brain).

4.     Blindness

Glaucoma, macular edema, diabetic retinopathy, or a combination of these eye conditions can cause diabetes blindness, especially if they are poorly managed.

Prevention

Diabetic BlindnessWhile diabetic retinopathy can’t always be prevented, good management of your blood pressure and blood sugar levels, regular eye exams, and early detection and intervention can help prevent blindness.

If you have diabetes, you can reduce the risk of developing diabetic retinopathy by taking the following measures:

·        Controlling your diabetes

Make physical activity and healthy eating part of your routine. It is recommended that you get 20 – 30 minutes of aerobic activity, such as swimming or walking, each day. Take insulin or medications as directed by your physician.

·        Keep track of your blood sugar levels

Monitor and record your blood sugar levels as directed. You may need to do this several times a day if you are stressed or ill.

·        Ask your doctor about a hemoglobin A1C test

A hemoglobin A1C test, or glycosylated hemoglobin test, indicates your average blood sugar for the last 2 -3 months before the test. The goal for most diabetes patients is to be 7%.

·        If you use tobacco, try to quit

Tobacco use increases your risk of diabetes complications, such as diabetic retinopathy.

·        Keep your cholesterol and blood pressure under control

Exercising regularly, losing excess weight, and eating well can help. Some people with diabetes may also need medication.

·        Pay attention to changes in your vision

Seek immediate medical attention if you notice any sudden changes in your vision or if it becomes hazy, spotty, or blurry.

Keep in mind that diabetes does not necessarily lead to blindness. Proper diabetes management can help prevent or delay complications.

Diabetes Blindness

Continue ReadingDiabetes and Blindness: Understanding the Link and Preventative Measures

Essential Tips For Traveling With Insulin

Traveling with Insulin or other medication can be complicated and requires some planning. However, it shouldn’t hinder you from achieving your travel goals and exploring the world.

However, for people with diabetes, traveling requires extra layers of planning beyond researching excursions, making hotel reservations, and booking flights. Whether you are cruising, flying, or driving, you need a plan to cover all your essential health needs.

Some of the most common challenges for diabetes patients involve changes in time zones, diet, environments, and activity levels, all of which may hinder proper blood glucose management. Therefore, whether you are taking an extended trip or just a quick getaway, proper planning is the key to a more enjoyable and safer journey.

Here are some important tips for traveling with insulin:

1.    Pack more insulin and other diabetes supplies than needed.

Different places have different cultures and diets. As a result, you may find yourself eating more often and trying the local cuisine. For instance, you may eat more sugar (in drinks and sauces) and carbs (in foods such as rice and pasta) than intended.

Also, even if you’re keeping track of what you’re eating while traveling, other factors may necessitate a change in your insulin dose. According to the CDC, diabetes patients should bring at least double the amount they think they’ll need while traveling.

This helps ensure that you’ll not run out of insulin and other supplies due to unexpected events such as travel delays.

Be sure to keep spare insulin in different travel bags so you’ll always have a backup if you lose your luggage. Some of the supplies you need include:

  • Alcohol swabs for disinfecting the area where you’ll be injecting insulin
  • A lancing device, lancets, and diabetic test strips for testing your blood glucose
  • A blood glucose monitor for checking your blood sugar
  • Ketone test strips for warnings about DKA (diabetic ketoacidosis)
  • Sugary snacks, glucose gel, or glucose tablets in case you experience low blood glucose.
  • Insulin travel case
  • Pen needles or insulin syringes, if necessary
  • A complete glucagon kit in the case of severely low blood glucose levels
  • Disposal container for your pen needles and syringes

2.    Store insulin and other diabetes supplies correctly while traveling.

Unopened insulin should be stored in the fridge at temperatures between 36 ºF and 46 ºF. However, this might not always be possible, especially while traveling. You can store insulin in a cooler if you are traveling by car. Make sure it is not in direct contact with the ice to prevent the insulin from getting too cold.

There are many insulin storage options while flying. For instance, there are a wide variety of insulin travel cases available on the market designed to store insulin easily and conveniently.

Traveling with Insulin

In fact, many insulin travel cases are designed to store insulin safely for several hours or days. These cases are convenient alternatives to large coolers, and some are designed to fit into carry-on bags.

How does the VIVI Cap work?

Here are some important things to keep in mind when getting insulin through airport security checks:

  • Diabetes patients are exempt from the volume limit of 100 mL, or 3.4 oz.
  • Separate diabetes supplies such as insulin and test kits from your other luggage and notify the security personnel before your belongings undergo screening.
  • Consider acquiring a U.S. TSA (Transportation Security Administration) card before traveling. This discreetly notifies security personnel that you have a medical condition that requires special consideration during the screening process. You can also request a letter of medical necessity from your doctor.
  • X-ray machines may damage your CGM device or insulin pumps. Be sure to ask for a hand inspection when traveling with such items.
  • Avoid keeping extra insulin and supplies in your checked bag. This helps prevent the loss of essential supplies and damage due to rough handling.

3.    Store insulin and other supplies correctly when you arrive at your destination.

Although unopened insulin should be ideally stored in the fridge, a range of insulin products can be stored out of the cooler or fridge for a specified period, depending on the product.

Cold insulin is safe to use, but it is painful to inject. You can prevent pain by letting it come to room temperature before use. After opening your insulin product, be sure to follow the manufacturer’s instructions regarding proper storage. Insulin products can be stored at room temperature for periods ranging between 10 and 56 days.

Opened insulin vials can be returned to the fridge after use. However, opened insulin pens should be stored at room temperature. The amount of time it can last at room temperature depends on the specific product. If your insulin pump and product have different directions about the length of time insulin should last in the pump, go with the instructions that recommend a shorter amount of time for changing the insulin product.

Keep in mind that insulin should not be stored in the freezer as this may change its quality, which may be dangerous.

4.    Learn how to adjust your dose accordingly.

Talk to your doctor about how to adjust and administer insulin under different conditions, such as new time zones or different climates. Your healthcare provider may give you instructions for properly adjusting your dose if your blood glucose level gets too high while traveling.

Different time zones or climates that your body is used to may have an impact on your insulin dose. For example, you may need to adjust your insulin schedule if you are traveling through different time zones. Be sure to consult your doctor about whether and how to adjust your insulin dose and schedule before traveling.

5.    Don’t expose insulin products to extreme temperatures.

Once you arrive at your destination, you might be on the move quite a bit. For instance, you may go skiing on snowy mountains or spend time on hot beaches. Therefore, it’s essential to learn some important tips on how to keep your insulin products safe in extreme weather conditions.

Insulin becomes less effective at very low or very high temperatures. It should not be exposed to temperatures exceeding 77ºF to 88ºF, depending on the specific product. Avoid leaving your insulin sitting in a car or outside in the sun for too long. If the temperatures are too low, you can keep your insulin close to your body (like in the inside pockets of your jackets) to protect it from the cold.

6.    Traveling with Insulin – Plan for the unexpected.

Traveling can be hectic sometimes, and things may go wrong at any time. For instance, you may experience delayed flights or lose your insulin and other supplies. In some cases, you may even need medical assistance. Here are some things to keep in mind in case you need medical assistance while traveling.

  • Research reliable healthcare pharmacies and healthcare providers around the places you’ll be traveling to.
  • Wear a legible medical ID that contains information about your medication allergies, medical conditions, and insulin usage.
  • Be sure to carry emergency contact details with you at all times.
  • Travel-related medical expenses are not covered by some insurance plans. Therefore, it is essential to check with your provider and buy travel insurance if it’s not covered.
  • Learn key phrases that may be helpful in the local dialect, such as knowing how to say, “I am a diabetes patient” or “Orange juice, kindly.” This might come in handy if you have low blood sugar (hypoglycemia) during your travels.
  • Carry a copy of your written prescription for the medications you are taking, including insulin. Be sure to include the generic names of your current medications. This may be extremely helpful in case you lose your medications while traveling.

Conclusion

Insulin cooler travel caseIf you need to travel with insulin, it is essential to understand how to store it and the Vivi Cap – thermal insulin pen carrying case offers a practical and convenient solution.

Traveling with Insulin

Carrying double the amount of insulin you need is a great idea due to unexpected events such as canceled flights and other travel delays.

Moreover, you should consider that your insulin dose and schedule may need to be adjusted during travel. Your doctor may recommend administering less or more depending on the climate, diet, as well as physical activities you are engaging in.

Always consult your healthcare provider before traveling so you know how your insulin should be administered.

Traveling with insulin

Continue ReadingEssential Tips For Traveling With Insulin

Managing Diabetes through a Healthy Diet: What to Eat and Avoid

Diabetes is a chronic metabolic disorder characterized by high blood sugar levels that can cause a range of complications if left unmanaged. One of the most important ways to manage diabetes is through dietary intervention. Proper nutrition can help individuals with diabetes maintain healthy blood sugar levels, prevent complications, and improve overall health and quality of life.

In this article, we will provide a comprehensive overview of diabetes diet guidelines, including what to eat if you are diabetic, foods to avoid, and tips for meal planning and preparation.

What to eat if you are diabetic

Complex Carbohydrates:

Complex carbohydrates are an essential component of a healthy diet for individuals with diabetes. These carbohydrates are broken down slowly in the body, which helps regulate blood sugar levels. Foods that are high in complex carbohydrates include whole grains, legumes, vegetables, and fruits.What to cook for diabetics

Some examples of complex carbohydrates include:

  • Brown rice
  • Quinoa
  • Whole grain bread
  • Oatmeal
  • Sweet potatoes
  • Lentils
  • Chickpeas
  • Black beans
  • Apples
  • Berries
  • Oranges
  • GrapefruitWhat foods to eat for diabetics

Lean Proteins:

Protein is an essential nutrient that helps build and repair tissues in the body. However, not all proteins are created equal. When choosing protein sources, it’s important to opt for lean options that are low in saturated fat.

Some examples of lean proteins include:What foods to eat for diabetics

  • Skinless chicken or turkey
  • Fish, such as salmon, tuna, and cod
  • Legumes, such as lentils, chickpeas, and black beans
  • Low-fat dairy products, such as Greek yogurt and skim milk
  • Tofu
  • Egg whites

Healthy Fats:

Contrary to popular belief, not all fats are bad for you. In fact, healthy fats are essential for overall health and can help to regulate your blood sugar levels.

Some examples of healthy fats include:What foods to eat for diabetics

  • Avocado
  • Nuts, such as almonds, walnuts, and pistachios
  • Seeds, such as chia seeds and flaxseeds
  • Olive oil
  • Canola oil

Fiber:

Fiber is a type of carbohydrate that cannot be digested by the body. However, it plays an essential role in regulating blood sugar levels and promoting digestive health.

Some examples of high-fiber foods include:

  • Whole grains, such as brown rice, quinoa, and whole-grain bread
  • Fruits, such as apples, oranges, and berries
  • Vegetables, such as broccoli, carrots, and sweet potatoes
  • Legumes, such as lentils, chickpeas, and black beans
  • Nuts and seeds, such as almonds, chia seeds, and flaxseeds

Water:

Staying hydrated is essential for individuals with diabetes. Drinking enough water can help regulate blood sugar levels and prevent dehydration, which can lead to a range of complications.

Foods to avoid if you are diabetic

Simple Carbohydrates:

Simple carbohydrates are quickly broken down in the body, which can cause a rapid increase in blood sugar levels. If you have diabetes, you should avoid or limit foods that are high in simple carbohydrates, such as:

  • Candy
  • Soda
  • Juice
  • Pastries
  • White bread
  • White rice
  • Potatoes
  • Pasta

Saturated and trans fats:

Saturated and trans fats are unhealthy fats that can increase the risk of heart disease and other diabetes complications in people with diabetes. Foods that are high in these types of fats include:

  • Red meat
  • Processed meats, such as bacon and sausage
  • Butter
  • Cheese
  • Fried foods
  • Margarine
  • Shortening

What about salt? Can you eat salt if you are diabetic?

If you have diabetes, it’s important to monitor your sodium intake, but you don’t necessarily have to avoid salt altogether.

While salt doesn’t directly affect blood sugar levels, it can raise blood pressure and increase the risk of cardiovascular disease, which is already a concern for people with diabetes. Therefore, it is recommended that people with diabetes limit their salt intake to 2,300 milligrams per day or less.

However, this amount may vary depending on individual health needs, so it’s always best to consult with a healthcare provider or registered dietitian to determine the appropriate amount of sodium for your specific condition.

Additionally, there are ways to flavor food without adding salt, such as using herbs, spices, or other low-sodium seasonings.

Diabetic Complications

Continue ReadingManaging Diabetes through a Healthy Diet: What to Eat and Avoid