Hugo Rosen, MD, a liver disease specialist and chair at the Keck School of Medicine of USC, has witnessed a startling shift in his practice. There are less individuals coming in for hepatitis C and a lot more people seeking treatment for fatty liver disease.

It is estimated that a quarter of the global population has nonalcoholic fatty liver disease (NAFLD). Results from a Mayo Clinic study and other studies suggests NAFLD is linked to increased risk of liver cancer, and susceptibility to other forms of cancer.

60% of people with type 2 diabetes also have nonalcoholic fatty liver disease. NAFLD is often considered as a manifestation of the metabolic syndrome, especially in those with elevated BMIs and diabetes.

Dr. Rosen says he’s most worried about fad diets like Keto that are attractive to people because they can eat lots of tasty foods like butter, cheese, and red meat, but it encourages a high increase in fat. Rosen says 80% of your calories will generally come from fat on the keto diet.

Studies on mice suggest the uptake in fat in the diet can lead to nonalcoholic fatty liver disease. The hardest part about NAFLD is that most people don’t know they have it and don’t start exhibiting signs of it until it has progressed to cirrhosis or nonalcoholic steatohepatitis (NASH).

What action can people take?

The current recommended treatment includes weight loss (because it helps reduce fat and inflammation in the liver) and eating a well-balanced diet with fiber, and lessening fat intake particularly from processed foods.

Don’t overdo it on fats, Rosen recommends, especially from processed foods. Fructose and other sugars are a major concern as well, especially in sodas, candy, sugary cereals, sweetened juices and fast food. Those kinds of refined foods can increase cholesterol and cause inflammation in the liver.

Vitamin E and Pioglitazone have helped some with NAFLD, but results are inconsistent and there is no FDA-approved drug to specifically treat it yet.

For the full study details and nutrition and lifestyle recommendations for NAFLD, see USC’s article on Rosen here.

Want to learn more?

Join us in January for a full update of Level 1 Diabetes Fundamental courses! Coach Bev will be updating all of Level 1 live throughout this month. See full course schedule here.

Can’t make it live? No problem:

All our courses are recorded and are available for viewing in your online university account. Don’t miss these crucial 2020 updates:

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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Coach Beverly, Taryn and Robert wish everyone a Happy New Year. To get ready for 2020, we have highlighted 10 questions that help to wrap up 2019. Ending the year intentionally helps to savor successes, make peace with mistakes, and allow change in the new year to power those resolutions.

10 Questions to Intentionally Get Ready for 2020

1. What made this year unforgettable?
2. What did you enjoy doing this year?
3. What/who is the one thing/person you’re grateful for?
4. What’s your biggest win this year?
5. What did you read/watch/listen to that made the most impact on you this year?
6. What did you worry about most and how did it turn out?
7. What was your biggest regret and why?
8. What’s one thing that you changed about yourself?
9. What surprised you the most this year?
10. If you could go back to last January 1, what suggestions would you give your past self?

Read more from Simply Magazine and Daisy U by clicking here.

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Our Diabetes Detective Team scans the diabetes news to discover the most relevant info that Diabetes Educators need in their daily practice. We post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

Question of the Week – December 31, 2019

Want more practice? Last Day to Save on the CDCES Prep Bundle!

Use discount code “Prep2020” to save 10% on our test prep bundle – includes Levels 1 (updating in January), 2, and 3 (updating in February).

Start 2020 off right with all the clinical updates you need for exam success!

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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Get Ready for a New Name in 2020.

Every end marks a new beginning. We’re ringing in this New Year with a FREE Preparing for the CDCES Exam Webinar!

If you haven’t heard, starting in 2020, CDE’s will go from being Certified Diabetes Educators to our new name: Certified Diabetes Care & Education Specialists (CDCES).

Learn more about the significance of this new name and how it will impact your specialty.

Join us January 2, 2020 @ 11:30 a.m. PST to learn more about this name change from Coach Beverly. Register now for our FREE Preparing for CDCES Exam Webinar.

Webinar Topics covered include:

• Implications of new certification name, CDCES for our specialty
• Exam requirement updates for 2020
• Exam eligibility and test format
• Strategies to succeed along with a review of study tips and test taking tactics.
• We will review sample test questions, and the reasoning behind choosing the right answers.

Register now for our FREE Preparing for CDCES Exam Webinar January 2nd at 11:30 PST.

Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE!  Sign up below!

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What wisdom can you find that is greater than kindness?

Jean-Jacques Rousseau

Thank you for being a part of our seven days of kindness. Each post reminded me of the power of kindness to improve the lives of our fellow humans. Even the smallest gesture can leave a life long impression. Each spark, each light, each moment of humanness connects us with a hope that when we really see each other, we can do anything. With love, Coach Beverly

7 Ways to Make Kindness the Norm

1. Send an uplifting text to a friend or family member.
2. Let that guy next to you merge into traffic with a wave and a smile.
3. Include intentional moments of kindness, laughter, and delight in your daily routine.
4. Go slightly out of your comfort zone at least once a day to make someone smile.
5. Share a compliment with a co-worker or friend.
6. Reach out to a family member you haven’t spoken to in a while.
7. Treat someone to a cup of coffee.

Read more about the kindness movement at Random Acts of Kindness.

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Continuing our week of kindness, we celebrate Kwanzaa, a holiday dedicated to acknowledging seven guiding principles of life.

Give light and people will find the way.

Ella Baker

Kwanzaa is a week-long annual celebration held in the United States and other nations of the African diaspora in the Americas to honor African heritage in African-American culture. It is observed from December 26 to January 1, culminating in gift-giving and a feast. Kwanzaa has seven core principles. Wikipedia

Each of the seven days of Kwanzaa is dedicated to one of the following principles, as follows:^[13]

• Umoja (Unity): To strive for and to maintain unity in the family, community, nation, and race.
• Kujichagulia (Self-Determination): To define and name ourselves, as well as to create and speak for ourselves.
• Ujima (Collective Work and Responsibility): To build and maintain our community together and make our brothers’ and sisters’ problems our problems and to solve them together.
• Ujamaa (Cooperative economics): To build and maintain our own stores, shops, and other businesses and to profit from them together.
• Nia (Purpose): To make our collective vocation the building and developing of our community in order to restore our people to their traditional greatness.
• Kuumba (Creativity): To do always as much as we can, in the way we can, in order to leave our community more beautiful and beneficial than we inherited it.
• Imani (Faith): To believe with all our hearts in our people, our parents, our teachers, our leaders, and the righteousness and victory of our struggle.

Read more about Kwanzaa here.

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After treat-to-target trial findings showed that mealtime and postprandial treatment with Fiasp resulted in effective glycemic control and safety results similar to slightly slower insulin aspart (Novolog), the FDA has approved Fiasp for use in pediatrics with diabetes.

Fiasp, a rapid-acting human insulin analog, was compared with NovoLog in a randomized trial involving 777 pediatrics (aged 2 to 17 years). There were blind meal injections and open-label postprandial injections. Week 26 of the trial showed both were effective at getting glucose to target.

In children and adolescents with type 1 diabetes, mealtime and postmeal faster aspart with insulin degludec provided effective glycemic control and superior HbA_1c with no additional safety risks versus aspart (Novolog).

Read more at PubMed.

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2020 marks the official release of the updated nutrition label.

To help sort out how this new version is different, the Food and Drug Administration (FDA) released a treasure trove of helpful information, including this label comparison.

The goal of this updated label is to all consumers, including people with diabetes, to make quick, informed food choices to help start eating healthier.

Here are 5 Facts and Label Highlights:

1. Serving size is larger and bolder font and helps quickly answer the question, “how much is one serving” first, to help accurately gauge actual calorie, fat, sugar, and carb, protein and micronutrient intake.
2. Daily value– based on a 2000 calorie diet, the label tells you how much one serving of this food will contribute to the daily value of the most critical nutrients.
3. Fiber – Processed foods have little or no fiber. By encouraging people to choose foods that have 3 or more grams of fiber per serving, they will be choosing less processed, more nutritious foods.
4. Added sugars– In addition to listing the carbs and total sugar, the label calls out how much sugar (sucrose, high fructose corn syrup or other type) has been added. This is an excellent information add on for people interested in limiting added sugar.
   Each 4gms of sugar = 1 teaspoon
5. Important Micronutrients – the nutrients listed further down on the label (Fiber, Vitamin A, C, etc.) are nutrients most Americans don’t get enough of, so looking for labels that have a higher percentage of this can help consumers increase nutrient intake.

Read more on FDA Nutrition Labels here.

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