Everything You Should Know About Coronavirus and Diabetes

Coronavirus and Diabetes: What are the Risks.

The global coronavirus pandemic is looming larger, with news of additional infections and deaths, potential economic fallout and travel advisories. The media has been reporting that people with diabetes and other “underlying conditions” face higher risk of serious complications from coronavirus, the virus associated with COVID-19.

But, why are people with diabetes considered particularly high risk? And how should they manage diabetes during the COVID-19 pandemic?

What is Covid-19 (Coronavirus)?

According to the World Health Organization (WHO) and the Center for Disease Control and Prevention, SARS-CoV-2 is a virus that is common in animal species, and it rarely infects and spreads among humans. However, coronavirus first began infecting and spreading among humans in Wuhan, China in December 2019. From there, the disease has spread all over the globe.

The virus spreads through human to human contact and respiratory droplets (from sneezing and coughing). Therefore, everyone should be cautious. Coronavirus has an incubation period of 2 to 14 days. This means infected people can spread COVID-19 for days or even weeks before developing symptoms. The CDC reports that it might take up to a year to get a vaccine for the virus.

What are the COVID-19 Symptoms?

According to the CDC, recorded cases of coronavirus have included mild to severe symptoms. About 2 to 14 days after getting infected, people may experience:

Dry cough
Shortness of breath
Fever

Emergency warning signs of corona virus include:

Difficulty breathing
Bluish face or lips
Pressure or persistent pain in the chest

Should People with Diabetes (PWDs) be Concerned?

As people with diabetes adjust their routines, it’s extremely important that they follow a few extra safety precautions and plan ahead. According to the American Diabetes Association online Coronavirus resource, people with diabetes are not more likely to get coronavirus than the general population. Instead, they face a greater risk of developing severe complications if they get infected with coronavirus.

For instance, data from COVID-19 cases in China show that diabetes patients have much higher rates of severe complications and fatalities than people without diabetes.

Those with more underlying health conditions, such as heart disease and diabetes, have a higher risk of experiencing severe health complications, the American Diabetes Association (ADA) says. Moreover, being ill makes it even more difficult for people with diabetes to monitor and manage their blood glucose levels.

However, people with diabetes should not panic or worry. Instead, they should take extra precautions, continue monitoring their glucose levels as prescribed by their physician, and practice the recommended hand washing and social distancing guidelines.

Your Risk of COVID-19 with Diabetes

People with diabetes face a higher risk of complication especially when it comes to viral infection like flu, and this is likely true with coronavirus, the ADA said in late February. The fact is that diabetes patients are at a higher risk when dealing with pneumonia, flu (influenza), and now coronavirus because when blood glucose level are elevated or fluctuating consistently, they have lower protection against disease (a lower immune response), so they risk developing complications quicker.

Even if their glucose levels are within the recommended range, there’s an underlying risk of aggravated illness. When you’re ill, fluctuating glucose levels cause symptoms to become much worse and extend recovery time. Although there’s no confirmed connection between deaths from coronavirus and diabetes, data from the JAMA (Journal of American Medical Association) reports shows that there is a higher case-fatality rate among high risk individual (people with underlying conditions):

Cardiovascular disease: 10.5%
Diabetes: 7.3%
Chronic respiratory disease: 6.3%
Hypertension: 6.0%
Cancer: 5.6%

Coronavirus Protection Guidelines for Everyone

The Center for Disease Control’s recommendations for protecting against coronavirus include:

Washing hands regularly with water and soap for at least 20 seconds
Social distancing (at least 6 feet)
Making sure you and your loved ones are up to date with the pneumonia and flu shot
Keeping your hands away from your face (particularly the nose, mouth and eyes which are potential entry points for germs).
Wearing face masks or cloth face coverings in areas where social distancing guidelines are difficult to maintain and areas of community-based transmission
Keep distance and avoid physical contact with people who are coughing, sneezing, or showing other signs of respiratory illness

These guidelines are important to slow the spread of coronavirus and help prevent asymptomatic people from spreading it to others. Authorities including the CDC are emphasizing that people who think they might be sick, self-quarantine.

What About People with Diabetes?

Most doctors who treat diabetes are emphasizing illness precautions and basic hygiene, as well as maintaining good glucose control. It’s also important for people with diabetes to stay hydrated because they are generally more prone to dehydration. Stock up on clean drinking water and liquids that can provide energy and electrolytes in an emergency situation.

If you get flu symptoms that progress to pneumonia, get treatment and support fast.

What should people with diabetes do to prepare for Coronavirus?

The Coronavirus pandemic reminds us how poorly we are prepared for emergency and disaster situations. People with diabetes are reliant on the uninterrupted manufacture of glucose monitoring supplies and life-sustaining insulin. Therefore, disaster and emergency planning is a vital component to survival. It is recommended that you have extra diabetes monitoring supplies, along with extra insulin, at least a month’s worth.

See information on Home Supply Delivery HERE!

You can consult your doctor about working through and around barriers of affordability and access to supplies. Thankfully, many pharma and medtech companies are tackling disease preparation and awareness as it relates to coronavirus – notably Roche, Medtronic, and J&J.

More information on the complications of diabetes HERE!

What is Diabetic Myopathy?

Post Updated: 19th April 2023

Diabetic myopathy is a condition that affects people with diabetes, specifically those with type 2 diabetes. It is characterized by muscle weakness, wasting, and pain. This condition can affect any muscle group in the body, but it is most commonly seen in the hips, legs, and feet. In this article, we will explore the causes, symptoms, and treatment options for diabetic myopathy.

Causes of Diabetic Myopathy

The exact cause of diabetic myopathy is not fully understood. However, it is believed to be a result of long-term high blood sugar levels. High blood sugar levels can damage the blood vessels that supply the muscles with oxygen and nutrients. This damage can lead to muscle weakness, wasting, and pain.

In addition to high blood sugar levels, other factors can contribute to diabetic myopathy. These include:

Poor blood circulation: High blood sugar levels can damage the blood vessels that supply the muscles with oxygen and nutrients. This can lead to poor circulation, which can contribute to muscle weakness and wasting.
Neuropathy: Diabetes can cause nerve damage, which can lead to muscle weakness and wasting. This is known as diabetic neuropathy.
Inactivity: People with diabetes may be less active due to pain or other symptoms, which can contribute to muscle weakness and wasting.

Symptoms of Diabetic Myopathy

The symptoms of diabetic myopathy can vary from person to person. However, some common symptoms include:

Dysarthria:

This is a motor speech disorder that is primarily characterized by difficulty expressing and forming words. It is mainly a result of pathology or injury of the nervous system due to diabetes myopathy. The muscles of the respiratory system, face, and mouth move very slowly or do not move at all.

However, severity depends on the areas of the muscular and nervous systems that have been affected. Symptoms include; a slow or rapid rate of speech with a mumbling quality, limited lip, jaw, and tongue movement, changes in vocal quality, abnormal intonation, drooling, and chewing or swallowing difficulty.

Muscle weakness:

This is the most common symptom of diabetic myopathy. Muscle weakness occurs at any age and it can either affect the entire portion or just a portion of the body. Diabetic myopathy affects the nervous system resulting in muscle weakness. It occurs in conjunction with symptoms such as paresthesia, pain, or fever-like symptoms. Complications of muscle weakness vary depending on the stage of diabetic myopathy and they include contractures and muscle atrophy.

Muscle wasting:

Diabetic myopathy can lead to muscle wasting, also known as muscle atrophy. Muscle atrophy is the gradual loss of muscle tissue, which can result in decreased muscle strength and mobility.

Muscle pain:

Diabetic myopathy might also cause pain and aches in the muscles. This may be due to muscle cramps, muscle strains, injury, fatigue, circulatory disorders, and stress. The changes in muscle can be detected with biochemical or molecular techniques or with functional testing mainly because this condition is primarily associated with loss of strength and muscle mass.

Ataxia:

As diabetes progresses, sufferers may also experience failure of voluntary muscle coordination. It implies dysfunction of some parts of the nervous system that usually coordinate movement. Ataxia can cause a person to have difficulty with balance, walking, and other movements that require precise coordination of muscle activity.

Foot drop:

Foot drop is a condition where a person is unable to lift the front part of their foot, which can cause difficulty in walking and increase the risk of falling. Foot drop due to diabetic myopathy is a condition caused by nerve damage that affects the muscles responsible for lifting the front part of the foot.

Treatment options for diabetic myopathy

There are several treatment options available for diabetic myopathy. The most effective treatment will depend on the severity of the condition and the individual’s overall health.

Blood sugar control: The most important treatment for diabetic myopathy is to control blood sugar levels. This can be done through lifestyle changes such as diet and exercise, and medications such as insulin or oral hypoglycemic agents.
Exercise: Exercise can help improve muscle strength and flexibility. People with diabetic myopathy should engage in regular physical activity, such as walking, swimming, or resistance training.
Physical therapy: Physical therapy can help improve muscle strength, flexibility, and coordination. It may also include stretches and massages to help alleviate muscle pain.
Pain management: Pain medication may be prescribed to help manage muscle pain and cramping.
Surgery: In some cases, surgery may be necessary to repair or replace damaged muscles.

How can you help prevent diabetic leg pain?

Prevention of diabetic myopathy involves maintaining good blood sugar control and keeping active with regular physical activity. People with diabetes should aim to keep their blood sugar levels within a healthy range, as this can help prevent muscle damage and other complications.

Good blood sugar levels for the average person with diabetes should be between 60.8 mg/dl and 120.4 mg/dl ( 3.4 to 6.7mmol/L) depending on the time of day and amount eaten at the last meal.

They should also engage in regular physical activity, such as walking, swimming, or resistance training. This can help improve muscle strength, flexibility, and coordination.

In addition to these lifestyle changes, people with diabetes should have regular check-ups with their healthcare provider. This can help detect and treat any complications early on, including diabetic myopathy.

Diabetic myopathy is one of the leading causes of disability among diabetics. Therefore, regardless of how mild these signs and symptoms of diabetic myopathy are, they should never be ignored. In addition to the blood glucose control measures, interventions to improve strength and muscle mass in these patients should also be undertaken.

More info on the complications of diabetes HERE!

Top 5 Diabetes Diet Tips for Creating Healthy Meal Plan

Diet plays a key role in regulating blood glucose. A healthy diet plan tailored to your specific needs will help you do this. Most people with diabetes are overweight or obese

Controlling your diet may be the key to reducing the risk of diabetes as well as improving your symptoms if they are affected by this disease. Maintaining a good diet is a healthy choice for everyone.

You don’t need to buy special foods for Diabetes, you just need to make healthy choices. Before you go out looking for new foods though, conduct a pantry audit to see which foods you already use and if you can make healthier choices.

Tip # 1: Going Shopping as a Diabetic

Be prepared when you go shopping: A shopping list will save you time and money and can help prevent impulse buying. Keep a notepad in the kitchen or a list on your smartphone and note down the items you need as you run out of them

Don’t shop if you are hungry: People who shop on an empty stomach tend to buy more – particularly things they really don’t need. Try to go shopping just after a meal.

Get to know your grocery store: Once you know the layout, write your list in categories that resemble the aisles. This keeps you out of the aisles you don’t need to visit and can eliminate unnecessary shopping time.

Buy fruit and vegetables in season: This is the smartest and cheapest way to reach your goal of eating two serves of fruit and five serves of vegetables a day.

Occasionally take your time: Every so often, take time to compare brands and investigate new products. The quietest times to shop are early in the week and late at night.

Skip that aisle: If you don’t need food from a particular aisle, don’t visit it. This applies especially to the confectionery, biscuits, pastry and soft-drink aisles.

If you are in a hurry, shop on the edges: Foods kept on the perimeter of the supermarket tend to be core foods – meats, vegetables, salads, breads and chilled items such as dairy foods and spreads.

Tip # 2: Use the Diabetes food pyramid.

The Diabetes food pyramid, published by the Department of Agriculture (USDA) has six food groups (in order of what you should eat more and less carbohydrate and protein):

Fats, sweets and Alcohol – try and avoid these as best you can. Perhaps just on rare occasions,
Milk – 2-3 servings per day
Meat, meat substitutes and other proteins – 4-6 oz per day divided between meals. This is equivalent to ¼ cup cottage cheese, 1 egg, 1 tablespoon peanut butter, or ½ cup of tofu.
Fruits – 2-4 servings per day.
Vegetables – 3-5 servings per day.
Cereals, breads, grains and other starches – 6-11 servings per day eg…1 slice of bread, ¼ bagel, ½ and English muffin or pita bread, ¾ cup dry cereal, 1/3 cup of pasta or rice.

Tip # 3: Balance Your Diet

What you choose to eat can be powerfully important for your health and well being. Your diet can make a huge difference to your Blood sugar levels, and also you blood pressure and cholesterol levels.

It used to be thought that a diet for controlling diabetes was all about cutting out sugar. Nowadays the nutritional recommendations focus more on weight control and a healthy eating pattern low in saturated fats and high in fiber, with a moderate intake in less refined wholegrain carbohydrate foods and of healthy fats such as those in oils and nuts.

A small amount of added sugar is not a problem, since we now know that starchy carbohydrate foods cause a greater increase in blood glucose levels than does sugar. The quality of the carbohydrate foods you choose and the type of fats you eat are important.

Tip # 4: Food labels

Nutritional information panels on food packaging allow us to compare products of the same nature. Always check the ‘per 100g’ column. The serving size given on the label is determined by the manufacturer and in not necessarily the right one for you.

DAIRY

For dairy products, check the fat and saturated fat content and choose lower-fat varieties. If you do choose full-fat versions, simply eat smaller amounts. As a general rule, choose foods with less than 10 grams total fat per ‘100 grams’, but with dairy products choose foods with less than 2 grams total fat per ‘100 grams’. Aim for as low a saturated fat content as possible.

BREADS

For breads, you need to check whether it is a wholegrain, and is high in fiber (more than 5 grams fiber per 100 grams.) Or has a low GI. For breakfast cereals, check the fiber content and choose higher-fiber cereals (3 grams fiber per serve).

CEREALS

Some cereals are higher in fat but this comes from nuts which contain healthy fats. Don’t let the fat content of these foods put you off – as they can be healthy choices in controlled amounts. Do look out for the sugar content – some breakfast cereals are very high in sugar.

Tip # 5: A word about Sugar Substitutes

A moderate intake of sugar (10 per cent of your total daily energy needs) is acceptable in a healthy diet, but diabetic diets often include sweeteners to replace sugar in foods and beverages. There are two types of sweetener: non-nutritive (which is also referred to as ‘artificial’ or ‘intense’) and nutritive.

Non-nutritive sweeteners, such as saccharin, have a minimal or no effect on blood glucose levels, making them popular among people trying to lose weight and control their blood sugar levels. They are generally much sweeter than sugar, so you need to use much less of them

Nutritive sweeteners, still contain calories and can affect blood glucose levels. Some such as honey and fructose, should be considered as providing plentiful energy without much nutritional value.

Non-nutritive sweeteners:

Saccharin: (954) Available in table-top powder, liquid or tablet.

Aspartame : (951) Used in diet products such as sugar-free gum, soda, cordial, yogurts.

Cyclamate : (952) Not suitable for cooking

Acesulfame K : (950) Suitable for cooking – stable at high temperatures.

Sucralose : (955) Very heat stable and no aftertaste.

Steviol glycosides : (960) Heat stable – does have an aniseed aftertaste.

More information HERE on artificial sweeteners!

Are You at Risk of Developing Diabetes?

So what does it mean to be pre-diabetic?

The people most likely to develop diabetes are those with impaired glucose tolerance or prediabetes. They are more than 1.5 times more likely to develop diabetes in the next five years than people with normal blood glucose levels.

The most powerful contributor to developing diabetes is becoming overweight or obese. Diabetes is not caused by eating too much sugar or other carbohydrates. Excess energy from too much fat, sugar and protein alone or in combination will all work the insulin-producing cells in the pancreas much harder. Anytime the intake of your kilojoules is greater than your body’s energy needs, the excess is stored as fat, initially under the skin and in the buttocks and breasts.

If the excess kilojoules continues, the body creates additional storage, particularly around the internal organs, called visceral fat. This kind of fat is far more dangerous. All fat, but especially visceral fat, leaks chemical factors that hold back or resist the glucose-lowering effects of insulin. This ‘insulin resistance’ makes the pancreas work even harder, even when it should be resting between meals. Eventually something has to give.

Unless they are very old, few people whose waist circumference is within the healthy reference range, will become diabetic. If you are obese however, you are four times more likely to develop type 2 diabetes than people whose waist circumference is within the healthy reference range.

Female Waist Circumference:

	Non-Asian	Asian
Increased risk	88-100 cm	80-90 cm
Substantially increased risk	More than 100 cm	More than 90 cm

Male Waist Circumference:

	Non-Asian	Asian
Increased risk	102-110 cm	90-100 cm
Substantially increased risk	More than 110 cm	More than 100 cm

Fifty percent of Americans are now overweight or obese and this is the main reason why rates of diabetes are rising. Diabetes is also influenced by generic, hormonal, gender and environmental factors.

What Increases your Risk of Getting Diabetes?

If you are inactive, of course this is going to significantly increase the risk of developing diabetes. Exercise is a very important means of controlling your weight and can burn off dangerous visceral fat. Regular physical activity improves the body’s sensitivity to insulin – so the pancreas doesn’t have to work as hard to do the same job.

Getting older increases your risk of diabetes as people tend to get fatter and less active as they get older. Controlling your weight, eating a healthy diet and some regular exercise are important for us all as we age.

Diabetes does tend to run in families, partly due to genes and partly because of similar lifestyle and diet habits and also the exposure to similar environmental factors. If either of your parents or your siblings has diabetes, you are five to six times more likely to develop diabetes yourself. If three family members are affected, you’re more than fifteen times more likely to develop diabetes yourself than someone without a diabetes history. A third of people with type 2 diabetes also has a close family member with diabetes.

Diabetes is more common in certain ethnic groups, such as Aboriginal and Torres Straight Islanders, Polynesians, Canadian and American Indians, Asians, Hispanics, Afro Americans and people from the Middle East. This is partly due to increased susceptibility to factors that cause diabetes more generally, such as obesity. As an example, a weight gain of 5 Kilos almost doubles the risk of diabetes in Asian people, compared with non-Asians.

Other Factors Associated with Increased Risk of Type 2 Diabetes Include:

Gestational diabetes
Polycystic ovary syndrome
Heart disease and high blood pressure.
Chronic depression.
Heavy smoking
High or low birth weight.
Some medications, including steroids, beta-blockers, diuretics and some antipsychotics.

Do I have Diabetes or Pre-Diabetes?

Quite often, type 2 diabetes will begin as a silent disease and you won’t really be aware that you have it! Some of the symptoms you may be experiencing are:

Vision problems
Lack of energy.
Becoming more irritable.
Going to the toilet a lot more, and having to get up at night for this.
Reduced libido.
Fatigue.

Many people will simply blame these symptoms on ‘just a part of getting older’ or other problems. Most people diagnosed, may have even had the disease for five to ten years already! The sooner you know if you have diabetes, the more you can do to stop the progressions and to avoid complications.

How do I Test for Diabetes?

The most common ways to test for diabetes is an oral glucose tolerance test (OGTT), which involves an initial blood test, then drinking a large amount of glucose, then another blood test two hours later, to determine how quickly the glucose is cleared from your blood and balance restored. The OGTT is usually performed in the morning after fasting overnight. You can drink water beforehand, but not coffee tea or juice.

What should blood glucose levels be in healthy people?

In healthy people the blood glucose level from the second test should be below 7.8mM. Modestly elevated glucose levels – between 7.8 and 11.1 mM indicates impaired glucose intolerance – or prediabetes. Glucose levels above 11.1 mM confirms diabetes.

Two Random blood glucose level results above 11.1 mM, or a fasting glucose result greater than 7.8 mM on separate occasions, confirms a diagnosis of diabetes mellitus.

How do I reduce the risk of Diabetes?

Regular physical activity is an important means of achieving and maintaining weight control. Even without any weight loss, regular exercise can substantially reduce your risk of diabetes. However, you will achieve better results if you manage both. Even a modest change in activity, such as a more walking or bike riding, combined with w weight loss of only 2 kilograms, can significantly reduce your chance of developing diabetes.

Read more on Prediabetes HERE!

Diabetes and Depression

Is there a link between diabetes and depression?

If you’re suffering from diabetes and feeling a little low – well you’re not alone. It’s bad enough that one in four people is estimated to suffer from depression in some point in their adult life, if you have diabetes, according to authorities you are twice as likely to suffer from depression.

Even more worrying is the news that depression increases the risk of diabetic complications. The numbness that comes with depression can easily turn into diabetes burnout, where regular blood glucose testing, taking medication, following a healthy eating plan and getting regular physical activity are neglected or ignored. Thankfully there are plenty of safe and effective natural treatments that can help get your mood back on track, have you enjoying life to it’s fullest and feeling back in control of your health and blood sugars.

Natural Treatments for Depression in Diabetics

FOLATE

Most people think folate is just for women who are pregnant of thinking about starting a family, but apparently it’s also a very safe and effective treatment for depression.

Before you rush out to the health food store however, not just any old folate or folic acid supplement will help depression. You need a special form of folate called methyl folate. Folic acid itself is inactive: first your body needs to convert it into it’s active form called 5-methyltetrahydrofolate, referred to as 5-MTHF.

Methylfolate is safe to take with standard antidepressant medications and in fact can make them even more effective.

SAM-e

SAM-e (S-adenosyl-L-methionine) is a naturally occurring molecule found throughout the body and has been studied extensively as an antidepressant and found to be effective as medication for mild to moderate depression.

SAM-e has one distinct advantage over medication: it can improve mood after just a few days. Most antidepressants, including herbal products such as St johns wort, can take tow to four weeks to start working. It can also be as effective as non-steroidal anti-inflammatories for the pain of osteoarthritis.

5HTP

5 hydroxytryptophan, or 5HTP is a naturally occurring amino acid sourced from the seeds of Griffonia simplicifolia. Amino acids are the building blocks of protein. 5HTP is able to cross the blood brain barrier where, in conjunction with vitamin B6, it is converted into the happy hormone, serotonin. 5HTP is very safe and your body will only use it to make serotonin if levels are low. If levels are normal, it is simply excreted.

However, it’s best not to take it while taking SSRI (Selective serotonin reuptake inhibitors) antidepressant medications such as Prozac and Zoloft.

FISH OIL

Your brain is around 60% fat so it should come as no surprise that the fatty acids found in fish oil can have a positive effect on your mood. Your hunter-gatherer ancestors consumed large amounts of these omega-3 fatty acids via wild game, fish, insects and eggs.

Your brain now faces challenges that your ancestors never faced in their thousands of years of development, such as modern fats – especially trans fatty acids. T

hese modern fats found in potato crisps, margarine, and anything with ‘partially hydrogenated’ on the label, disrupt communication signals in your brain – and if your brain is constructed from the wrong type of fats, just like a building is constructed from shoddy materials, it’ll find it difficult to weather the storms and increasing stresses of modern life.

ZINC

The mineral zinc is essential for communication between brain cells in your hippocampus, the part of your brain responsible for mood control, learning and memory. Studies in recent years have noted that the hippocampus is shrunken in people with major depression. Zinc is also required, along with B6 and tryptophan, for the production of serotonin.

It’s also a potent anti-inflammatory and many researchers are now suggesting that depression is simply another manifestation of excessively high levels of inflammation throughout the body. The recommended dosage of zinc for depression is 30-40mg per day.

HERBAL SUPPORT St John’s Wort.

St John’s Wort is a herb traditionally used for the treatment of nervousness, melancholia, wounds, sciatica, fevers and even snake bites. Today it’s best known for a herbal remedy for depression and clinical studies have shown it’s as effective as medication for mild to moderate depression.

GINKO BILOBA

Most people think of the herb Ginko Biloba as a treatment to help improve memory and blood flow to the brain and legs. However, it’s also been shown as an effective treatment for the symptoms of peripheral vascular disease (PVD) where circulation is reduced to parts of the body other than the brain or heart due to narrowed or blocked blood vessels.

Some things to remember if you are a Diabetic with Depression.

Surround yourself with positive people who understand. Now is not the time to keep feeding emotional vampires.
Don’t focus on the foods you can’t eat anymore: Instead, choose to focus on the scrumptious and tasty foods that are part of your new diabetes friendly way of eating.
Forgetting to take your supplements? Divide them into snack-sized zip-lock bags so you only have to open the one bag to take all your supplements, instead of several containers.
Aim to walk for at least 10-30 minutes each day. Listen to something that motivates, inspires or just makes you smile while you walk.
Limit your alcohol intake.
Make getting to bet on time and a good nights sleep, priorities. Set your alarm and get up each day at the same time.
Eat breakfast and lunch outside, to allow bright sunlight to help stimulate feel good chemicals.
Talk to your GP about seeing a counsellor.
Find a doctor, naturopath and pharmacist who are experienced with both diabetes and depression and are happy to talk with one another and have your health and happiness as their main priority.

Can stress cause diabetes? Read More Here!