Day: 02/12/2023

True Love Liberates: Maya Angelou Speaks on Love.

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https://www.purposefairy.com/70215/true-love-liberates-maya-angelou/

Daily caffeine intake temporarily alters your brain structure

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Compared to people who took a placebo, the brains of those who took caffeine pills had a temporarily smaller gray matter volume.

A cup of coffee with a brain silhouette drawn on the foam.

Key Takeaways

  • Caffeine is the most widely used psychoactive drug in the world.
  • Animal studies suggest that caffeine has neuroprotective effects, and can reverse the cognitive decline associated with age, chronic stress, and neurodegenerative disease, but human studies have shown mixed results.
  • A new study shows that caffeine may cause a very slight and temporary decrease in gray matter volume, but the effect of this (if any) remains unknown.

Caffeine is the most widely used psychoactive drug in the world, consumed by billions of people every day in the form of tea, coffee, and energy drinks. It is commonly consumed to boost alertness and focus. 

On the flip side, coffee is widely believed to interfere with sleep, and sleep deprivation is known to reduce brain volume and impair cognitive function. Is it possible that caffeine consumption somehow changes the structure of your brain?

Caffeine on the brain

That’s the question Yu-Shiuan Lin of the University of Basel and her colleagues set out to answer, and their hypothesis was that daily caffeine intake alters gray matter structure by disrupting sleep. Their results — which were based on a neuroimaging study and published in the journal Cerebral Cortex — show that, indeed, coffee temporarily reduces gray matter volume. Surprisingly, though, this was not associated with disrupted sleep. 

The researchers recruited 20 young, healthy people who drink coffee on a daily basis, and gave them tablets to take over two 10-day periods, without drinking any coffee. During one period, they took three tablets per day, each containing 150 milligrams caffeine; during the other, they took placebo tablets containing no active ingredients. This was done in a randomized, double-blind manner, in which neither the researchers nor the participants knew which tablets they took during each period.

After each 10-day period,the researchers used magnetic resonance imaging (MRI) to examine the participants’ brain structure and electroencephalography (EEG) to record their sleep patterns. While they observed no significant differences in sleep duration or quality between the two conditions, they did see a significant difference in brain structure, with larger gray matter volumes being observed following ten days of placebo than after ten days of caffeine tablets.

These differences were most noticeable in the right medial temporal lobe, and especially the hippocampus, a structure that is critical for memory. However, these changes appeared to be temporary and were associated with caffeine-induced changes in cerebral blood flow.

A caffeinated life

Animal studies suggest that caffeine has neuroprotective effects, and can reverse the cognitive decline associated with age, chronic stress, and neurodegenerative disease, but human studies have shown mixed results. The current study is limited by its small sample size, and by the fact that the cerebral blood flow measurements and structural imaging were performed about three hours apart. 

Still, the results warrant further investigation into the effects of caffeine on the brain, particularly comparing its effects in habitual drinkers with those who consume little to no caffeine.

How to Stop Wasting Time

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Figure Out Your Goals

Figure Out Your Goals

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We’re talking about “big-picture” goals for both your work and home life. For example, you may want to find a better work-life balance, get more exercise, and be more involved in your children’s after-school activities. Once you know what they are, you can break them into smaller tasks and focus on how to fit them into your life.

Keep Track

Keep Track

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It can help to take a week or so and note how long it really takes you to do things you do all the time — do laundry, make breakfast, make your bed. Most people overestimate how long it takes to do something simple like take a shower and underestimate the time needed for bigger tasks, like write a term paper. If you know exactly how you spend your time, you may be able to manage it better.

Prioritize

Prioritize

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Put to-do’s in 4 groups:

  • Urgent and important
  • Not urgent but important
  • Urgent but not important
  • Neither urgent nor important

The goal is to have as few things under “urgent and important” as possible. Those cause stress when they pile up. If you manage your time well, you’ll probably spend most of your time on “not urgent, but important” — that’s where you can get the most useful things done and keep from feeling overwhelmed later.

Schedule Your Day

Schedule Your Day

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Once you know just how long things take and what’s most important, start to plan things out. Be flexible. Do you get more done in the late afternoon or early morning? Do you like to have your evenings free to relax? Are you more likely to do yardwork if you have a chunk of time to do it all at once or spread it out over the course of a week? Think about what works best for you, and don’t be afraid to change things up.

Do the Hard Stuff First

Do the Hard Stuff First

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Mark Twain said, “If it’s your job to eat a frog, it’s best to do it first thing in the morning. And If it’s your job to eat two frogs, it’s best to eat the biggest one first.” In other words, if you have something hard to do, get it out of the way so you don’t have to worry about it the rest of the day. At least that’s how the author of one prominent time management book understood it. They titled it “Eat That Frog!”

Write It Down

Write It Down

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A “to-do” list is tried and true. But you can use other tools, too — the main thing is to write it down somewhere. Whatever you use to keep track of things you need to do, it’s better to have just one and keep it with you wherever you go — on your cell phone for example. Some kind of list keeper or calendar app is probably on your phone already.

Is It Worth Your Time?

Is It Worth Your Time?

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Remember your big-picture goals and ask yourself if what you’re doing is likely to help you get there.  For example, that extra hour spent at work on something no one asked you to do might have been better spent at the gym or on the piano or at your child’s baseball game.

Don’t Cheat

Don’t Cheat

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If you schedule a work session at 9 a.m., stick to it — 9:17 a.m. won’t do, even if you work alone. Missing one start time will make you more likely to miss others. If you want some flexibility, allow yourself a choice — return emails or file papers, for example — but stick with the schedule as if it’s set in stone. If you try it and find it doesn’t work for you, you can always change it.

Just Start It!

Just Start It!

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If you feel a strong urge to put things off, find a way to push past it and take even a small step forward. You’ll feel better once you make a little progress and may soon find yourself in a real groove. That’s because your attitude often comes from your behavior — and your results — rather than the other way around.

All Your Time Counts

All Your Time Counts

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You’ve got a free 15-minute chunk of time before you have to be somewhere — time to surf the Web and check social media, right? You might be surprised by what you can get done in that time. Four 15-minute chunks spread through the day is an hour of productivity. And you’ll feel better about kicking back later.

Your Computer Can Help

Your Computer Can Help

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Technology — the Web, email, social networking sites — can distract you for hours on end. But it can help too. Look for tools to help you track and schedule your time, remind you when you need to do something, or even block you from the time-sucking websites that tempt you most.

Set Time Limits

Set Time Limits

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That is, set the most allowable time for the task. You may get it done sooner, but if not, the limit helps keep you from overdoing it. Once you hit the limit, move on.

Email: The Black Hole of Time Wasting

Email: The Black Hole of Time Wasting

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It can be a huge time suck and a source of stress. Try “The Four Ds”:

Delete: If it doesn’t concern you or isn’t something you need to know, get rid of it.

Do: If it’s about something urgent or something that can be done quickly, respond to it.

Delegate: If an email asks you something that’s better taken care of by someone else, forward it to that person and move on.

Defer: If it’s going to take more time than you have at the moment, set aside time for it later.

Take a Lunch Break

Take a Lunch Break

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It may seem “efficient” to work through lunch, but it can backfire. As a general rule, 30 minutes away from your job will help you work better in the afternoon. If you’re not hungry, go for a walk outside or do some stretching. You’ll likely come back with more energy and focus.

Schedule Good Stuff

Schedule Good Stuff

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The whole point of getting better with your time is to make more time for the things you want to do. Sprinkle fun, healthy, non-work stuff throughout your week to keep you positive about your schedule and motivated to keep going. This includes breaks, snacks, recreation, exercise, even vacations — especially when you finish an important task.

Specific Gene Changes Predispose Women to Cancer in Both Breasts

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Researches from the Mayo Clinic Comprehensive Cancer Center have discovered why women with cancer in one breast may be at higher risk of developing cancer in the opposite breast—they are carriers of specific genetic changes that predispose them to develop breast cancer. The findings, published in the Journal of Clinical Oncology, will help personalize approaches to breast cancer screening and risk factors, study authors say.

Using data from 15,104 prospectively followed women in the CAnceR Risk Estimates Related to Susceptibility (CARRIERS) consortium, the researchers found that patients who carry a germline BRCA1, BRCA2 or CHEK2 mutation have at least a twofold increased risk of developing cancer in both breasts, known as contralateral breast cancer.

In contrast, patients who carry germline ATM mutations did not have a significantly elevated risk of contralateral breast cancer. Among PALB2 carriers, the risk of contralateral breast cancer was significantly elevated only among those with estrogen receptor-negative disease.

“These are the first population-based numbers out there for these three genes beyond BRCA1/2,” says Fergus Couch, PhD, breast cancer researcher at Mayo Clinic Comprehensive Cancer Center, Zbigniew and Anna M Scheller Professor of Medical Research and the principal investigator of the CARRIERS Study. “It is also one of the largest studies to provide estimates of contralateral breast cancer risk by age at diagnosis, menopausal status and race/ethnicity in germline mutation carriers.”

Most patients with breast cancer who carry germline mutations assume they are at high risk of developing cancer in the opposite breast, says co-author Siddhartha Yadav, MD, medical oncologist, Mayo Clinic Comprehensive Cancer Center. While this is true for BRCA1/2 mutation carriers with breast cancer, the risk of contralateral breast cancer in carriers of germline mutation in ATM, CHEK2 or PALB2 had not been previously established. Even for BRCA1/2 carriers, a comprehensive assessment of contralateral breast cancer risk based on age, estrogen receptor status, menopausal status and the effect of treatment for initial breast cancer had not been undertaken.

“The findings reveal important information that will aid in a personalized assessment of contralateral breast cancer risk in our patients who are germline mutation carriers,” Dr Yadav says. “Having this level of detail will help guide decisions between patients and their care teams on appropriate screening and steps to reduce the risk for contralateral breast cancer based on more precise and individualized risk estimates.”

Premenopausal women who carry germline mutations generally have a higher risk of contralateral breast cancer compared with women who are post-menopausal at breast cancer diagnosis, researchers found. Among women with germline mutations in breast cancer predisposition genes, black women and non-Hispanic white women have similar elevated risk for contralateral breast cancer, the study found, suggesting that risk management strategies should be similar.

“Many women will undergo bilateral mastectomy to reduce the possibility of a second breast cancer,” Dr Couch says. “Now we have data to work from when making the decision to remove the second breast, pursue aggressive surveillance or take preventive medication.”

AI Model Detects Future Lung Cancer Risk Based on CT Scans

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An artificial intelligence tool for lung cancer risk assessment being developed by researchers at MIT’s Abdul Latif Jameel Clinic for Machine Learning in Health, Mass General Cancer Center (MGCC), and Chang Gung Memorial Hospital (CGMH) takes a personalized approach to assessing each patient’s risk of lung cancer based on CT scans. The deep-learning model named Sybil is described in a new paper published in the Journal of Clinical Oncology.

“It’s the biggest cancer killer because it’s relatively common and relatively hard to treat, especially once it has reached an advanced stage,” says Florian Fintelmann, MGCC thoracic interventional radiologist and co-author on the new work. “In this case, it’s important to know that if you detect lung cancer early, the long-term outcome is significantly better. Your five-year survival rate is closer to 70%, whereas if you detect it when it’s advanced, the five-year survival rate is just short of 10%.”

Although there has been a surge in new therapies introduced to combat lung cancer in recent years, the majority of patients with lung cancer still succumb to the disease. Low-dose computed tomography (LDCT) scans of the lung are currently the most common way patients are screened for lung cancer with the hope of finding it in the earliest stages, when it can still be surgically removed. Sybil takes the screening a step further, analyzing the LDCT image data without the assistance of a radiologist to predict the risk of a patient developing a future lung cancer within six years.

Jameel Clinic, MGCC, and CGMH researchers demonstrated that Sybil obtained C-indices of 0.75, 0.81, and 0.80 over the course of six years from diverse sets of lung LDCT scans taken from the National Lung Cancer Screening Trial (NLST), Mass General Hospital (MGH), and CGMH, respectively — models achieving a C-index score over 0.7 are considered good and over 0.8 is considered strong. The ROC-AUCs for one-year prediction using Sybil scored even higher, ranging from 0.86 to 0.94, with 1.00 being the highest score possible.

Despite its success, the 3D nature of lung CT scans made Sybil a challenge to build. Co-author Peter Mikhael, an MIT PhD student in electrical engineering and computer science, and a iliate of Jameel Clinic and the MIT Computer Science and Artificial Intelligence Laboratory (CSAIL), likened the process to “trying to find a needle in a haystack.” The imaging data used to train Sybil was largely absent of any signs of cancer because early-stage lung cancer occupies small portions of the lung — just a fraction of the hundreds of thousands of pixels making up each CT scan. Denser portions of lung tissue are known as lung nodules, and while they have the potential to be cancerous, most are not, and can occur from healed infections or airborne irritants. 

To ensure that Sybil would be able to accurately assess cancer risk, Fintelmann and his team labeled hundreds of CT scans with visible cancerous tumors that would be used to train Sybil before testing the model on CT scans without discernible signs of cancer.

MIT electrical engineering and computer science PhD student Jeremy Wohlwend, co-author of the paper and Jameel Clinic and CSAIL a iliate, was surprised by how highly Sybil scored despite the lack of any visible cancer. “We found that while we [as humans] couldn’t quite see where the cancer was, the model could still have some predictive power as to which lung would eventually develop cancer,” he recalls. “Knowing [Sybil] was able to highlight which side was the most likely side was really interesting to us.”

Co-author Lecia V Sequist, a medical oncologist, lung cancer expert, and director of the Center for Innovation in Early Cancer Detection at MGH, says the results the team achieved with Sybil are important “because lung cancer screening is not being deployed to its fullest potential in the U.S. or globally, and Sybil may be able to help us bridge this gap.”

Lung cancer screening programs are underdeveloped in regions of the United States hardest hit by lung cancer due to a variety of factors. These range from stigma against smokers to political and policy landscape factors like Medicaid expansion, which varies from state to state.

Moreover, many patients diagnosed with lung cancer today have either never smoked or are former smokers who quit over 15 ago — traits that make both groups ineligible for lung cancer CT screening in the United States.

“Our training data consisted only of smokers because this was a necessary criterion for enrolling in the NLST,” Mikhael says. “In Taiwan, they screen nonsmokers, so our validation data is expected to contain people who didn’t smoke, and it was exciting to see Sybil generalize well to that population.”

“An exciting next step in the research will be testing Sybil prospectively on people at risk for lung cancer who have not smoked or who quit decades ago,” says Sequist. “I treat such patients every day in my lung cancer clinic and it’s understandably hard for them to reconcile that they would not have been candidates to undergo screening. Perhaps that will change in the future.”

There is a growing population of patients with lung cancer who are categorized as nonsmokers. Women nonsmokers are more likely to be diagnosed with lung cancer than men who are nonsmokers. Globally, over 50% of women diagnosed with lung cancer are nonsmokers, compared to 15 to 20% of men.

MIT Professor Regina Barzilay, a paper co-author and the Jameel Clinic AI faculty lead, who is also a member of the Koch Institute for Integrative Cancer Research, credits MIT and MGH’s joint e orts on Sybil to Sylvia, the sister to a close friend of Barzilay and one of Sequist’s patients. “Sylvia was young, healthy and athletic — she never smoked,” Barzilay recalls. “When she started coughing, neither her doctors nor her family initially suspected that the cause could be lung cancer. When Sylvia was finally diagnosed and met Dr Sequist, the disease was too advanced to revert its course. When mourning Sylvia’s death, we couldn’t stop thinking how many other patients have similar trajectories.”

Connection Between Multiple Sclerosis and Depression Uncovered

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Using MRI and clinical data, researchers have uncovered a connection between multiple sclerosis (MS) and depression. Patients with MS are at nearly three times the risk for depression than the general population.

Utilizing a recent study that outlined a depression circuit in the brain, a team from Brigham and Women’s Hospital attempted to localize MS depression, comparing lesion sites in the brains of MS patients to lesion sites in this previously described circuit and finding new connections and potential therapeutic targets. Their results are published in Nature Mental Health.

“If we want to find specific locations of brain damage that cause specific symptoms, it sometimes works, but only for simpler brain functions like vision or movement. When it comes functions like those associated with depression, it’s not that simple,” said corresponding author Shan Siddiqi, MD, an assistant professor of psychiatry at Harvard Medical School and director of psychiatric neuromodulation research at Brigham and Women’s Center for Brain Circuit Therapeutics. “When a patient has lesions all over the brain, we used to assume they were unrelated to depression, because they seemed so disconnected. But with lesion network mapping (LNM), we can see even when lesions don’t directly overlap with each other, they may overlap with the same circuit.”

While many clinicians have assumed that certain lesions were more likely to cause depression in MS, it had never been proven before, and neither had a specific pattern that connected those lesions. LNM is fundamental in seeing such a pattern for depression, since LNM allows researchers to envision networks of connectivity rather than just solitary sites of damage. In a 2021 study, the same Brigham team identified a common brain circuit — which connected seemingly disparate brain lesion sites — for patients that experienced depression after stroke or penetrating head trauma. The team set out to determine if MS lesions and depression could be connected through this new circuit.

To conduct their study, Siddiqi, co-first author Isaiah Kletenik, MD, and co-authors relied on a database of 281 patients with MS which has been curated by Drs Tanuja Chitnis, Bonnie Glanz, and Rohit Bakshi of the Brigham Multiple Sclerosis Center in the Department of Neurology. Dr. Charles Guttmann and his team in the  Brigham Center for Neurological Imaging in the Department of Radiology developed a virtual laboratory environment that allows systematic collection and analysis of MRI and clinical data, which greatly facilitated this work. Drs. Guttmann and Bakshi also collaborated to develop an automated lesion detection and outlining protocol, allowing the researchers to locate lesions with relative ease. For each patient, estimated connectivity between lesion locations was determined using a connectome database, a large-scale wiring diagram of the human brain which has been made possible by initiatives such at the Human Connectome Project. Using the connectome database and LNM, the team found significant functional connectivity between MS lesion locations and their  a priori  depression circuit. Additionally, the data-driven circuit for MS depression showed similar topography to the  a priori  depression circuit. Together, these findings provide novel localization of MS depression.

While offering important insight into MS depression, the study had a few key limitations. All patient history was unknown, meaning, on top of other potentially unknown histories, some patients may have had depression prior to MS. Additionally, the sample size — albeit the largest so-far of its kind — was limited. The next step is clinical trials, as this novel localization of MS depression enables a host of possibilities for therapeutic targeting.

“The more we know about the connectivity of lesions that cause symptoms, the better our ability to target an ideal stimulation site for those symptoms,” said Siddiqi. “We’ve already shown the success of targeting our a priori depression circuit in other patients. Now that we’ve shown that the circuit can be applied to MS depression, we should be able to find a treatment target for these patients, too.”

Tool Measures Patient Health, Well-Being After Radionuclide Therapy

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Moffitt Cancer Center researchers have developed a tool to determine how radionuclide therapy (RNT) for prostate cancer impacts patient-reported outcomes with the goal of using this information to guide treatment and improve quality of care. Their findings have been published in The Journal of Nuclear Medicine.

The use of patient-reported outcomes allows patients, caregivers and clinicians to better understand how cancer and its treatment impact quality of life, making cancer care more patient-oriented. The data are measured using patient questionnaires that focus on cancer symptoms, side effects of treatment, and social and emotional well-being. The US Food & Drug Administration encourages the addition of patient-reported outcomes measures in clinical trials. These measures are being incorporated into clinical practice, and results are being used to guide clinical decision-making and treatment planning.  

The Moffitt team wanted to determine how a new type of therapy for patients with advanced prostate cancer affects quality of life. RNT is a new type of radiation therapy that links a radioactive chemical, called a radionuclide, to a cancer patients and has side effects that differ from standard therapy, Moffitt researchers wanted to understand which patient-reported outcomes are most influential for patients receiving RNT.

Moffitt researchers set out to develop a new patient-reported outcomes questionnaire that could accurately identify the key symptoms and side effects experienced by prostate cancer patients receiving RNT. Researchers reviewed the literature of published RNT clinical trials to create a list of symptoms and side effects associated with RNT. The research team also interviewed prostate cancer patients, caregivers, and clinicians to identify the most concerning symptoms and side effects.

“We were thorough in determining which symptoms and side effects are important to patients receiving RNT for prostate cancer,” said Lisa M Gudenkauf, PhD, lead study author and research scientist in the Department of Health Outcomes and Behavior at Moffitt.

Their questionnaire, called the Functional Assessment of Cancer Therapy –Radionuclide Therapy (FACT-RNT), includes 15 questions to identify symptoms and side effects associated with RNT, such as dry mouth, nausea, loss of appetite, bone pain, fatigue and feelings of isolation due to illness/treatment.

The Moffitt research team hopes this newly developed assessment tool will help patients, their caregivers, and clinicians understand the effects of RNT, improve patient outcomes, and lead to more patient-centered care.

“The FACT-RNT will help future researchers better understand the impact of RNT and other therapies on quality of life in patients with prostate cancer,” explained Brian Gonzalez, PhD, senior study author and associate member of the Department of Health Outcomes and Behavior at Moffitt.

FDG PET/CT Lowers Risk of Death in Patients with Resectable Non-Small Cell Lung Cancer

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A study published in Radiology has found that the use of preoperative PET/CT is associated with lower risk of death in patients with stage IIIA–IIIB non–small cell lung cancer compared with those without preoperative PET/CT.

The retrospective study used data from the Health and Welfare Data Center established by Taiwan’s Ministry of Health and Welfare. Patients with resectable stage I–IIIB NSCLC who underwent thoracic surgery from January 1, 2009, to December 31, 2018, from the Taiwan Cancer Registry were included.

In the matched cohort, 6754 patients (3349 men and 3405 women) underwent PET/CT and 6754 (3362 men and 3405 women) did not. In adjusted analysis, patients with stage IIIA or IIIB NSCLC and preoperative PET/CT had a lower risk of death versus those without PET/CT (for stage IIIA: hazard ratio [HR] = 0.90 [95% CI: 0.79, 0.94], P = .02; for stage IIIB: HR = 0.80 [95% CI: 0.71, 0.90], P , .01). There was no improvement in a lower risk of death for patients with stage I–II NSCLC (after multivariable adjustment, the HR was 1.19 [95% CI: 0.89, 1.30], P = .65).

In the paper, the authors noted that prior randomized clinical trials with smaller sample sizes have suggested that the use of PET/CT reduced the number of futile thoracotomies, although PET/CT did not improve survival. Their results were in agreement with prior studies, likely due to the relatively low sensitivity and specificity of PET, which can result in false-negative results and miss occult cancer, especially in patients with early-stage NSCLC.

The authors conclude, “The longer overall survival of the patients with stage IIIA–IIIB NSCLC in the preoperative PET/CT group can be attributed to a higher staging accuracy for advanced stages compared with those in the non–preoperative FDG PET/CT group. The recurrence-free survival in the PET/CT group is also superior to that in the non–PET/CT group.” They found no benefit for the use of 18F-FDG PET/CT in clinical stage I and II disease.

How to Get a Good Night’s Sleep with Diabetes

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Interrupted sleep can be a common annoyance when living with diabetes — whether you experience it yourself, or you’re a spouse or caregiver of someone who does. Find out more about how you can improve your sleep and manage these disruptions.

Sleeplessness is an epidemic of sorts, as the CDC suggests that more than 1 in 3 adults regularly do not get enough sleep. Constant diabetes-related sleep disruptions can accumulate over time, potentially leading to negative consequences.  While many with diabetes may have interrupted sleep, there are steps you can take to help you get a full night’s rest.

Sleep quality vs. quantity

When sleep is regularly interrupted, you miss out on the restorative processes that take place overnight. It’s not just the quantity of sleep (how many hours) that matters — the quality (how well) matters also.  Having a goal of 8 hours of sleep per night is great, but even if you get enough hours, your sleep quality may be low.

I can personally attest to years spent as a “diabetes zombie” after my 5-year-old, Emma, was diagnosed with T1D. It was 2007, and she was not yet using a continuous glucose monitor (CGM). But while we weren’t awakened by the bells and whistles of diabetes technology, we had alarms set for blood glucose testing and a baby monitor so she could signal when she was low and we’d come running. It was a tough time, and my sleep hasn’t been the same since.

When assessing sleep, research suggests that quality is a more important measure than quantity. But how do you know if you’re getting enough sleep in the first place?

According to an expert panel convened by the National Sleep Foundation, adults need between 7 and 9 hours of sleep every night, while teenagers need about 8 to 10.

Chronic interruptions to sleep can be especially problematic. These patterns can interfere with everyday life, resulting in daytime drowsiness and other health issues related to mood, brain function, and the heart. Simply put, a lack of sleep can affect how you think and feel.

Sleep and diabetes distress

Researchers have been using the term diabetes distress since the mid-1990s. Diabetes distress refers to the emotional implications of living with or supporting a loved one who has diabetes. Because diabetes is a 24/7 condition, it sometimes can’t help but interfere with one’s sleeping hours, potentially causing even more stress and anxiety.

Karen Oller, of Phoenix, Arizona — who was diagnosed with type 1 diabetes 23 years ago — is very familiar with interrupted sleep and the stressful, groggy mornings that follow. “I’d say that my sleep is moderately impacted by diabetes,” Oller said. “I’m only sleeping 2 or 3 nights a week without diabetes interruptions.”

Oller was diagnosed 5 years after marrying her husband Matt — who was diagnosed with T1D at age 14. Because Karen and Matt both have T1D, their son Carson was enrolled in a UCLA T1D Trigger Study at birth, tracking his autoantibodies across time. He also developed T1D just before his 14th birthday.

Sleep and mental health are closely tied together. Research suggests that many, if not all, mental health conditions are associated with disrupted quantity and quality of sleep. Over time, repeated disruptions can lead to changes in the brain’s level of serotonin, a chemical sometimes known as the “happy hormone”, given how it regulates mood, appetite, and sleep.

What are common causes of sleep disturbances with diabetes?

When nighttime blood glucose is out of range, you’re more likely to have a disrupted night’s sleep. If you use diabetes devices, it can be hard to catch a break some nights with the constant alerts.

“My sleep is mostly interrupted by caregiving,” said Oller. “Technology’s great — it’s helping me to sleep better, but it’s not perfect. Take last night for example, Carson (her son) changed his sensor, was eating Cheez-Its — and as a 16 year old, he stays up late. He went to bed after giving insulin for the carbs he ate and at 1:30 a.m., I got a Dexcom alert on my phone. His blood sugar was 49 — and he doesn’t wake up when his blood sugar is low — even when his pump is alarming. Our pediatrician says he should outgrow that, but he hasn’t yet.”

Researchers are increasingly interested in studying secondary disruptions to sleep, or sleep disruptions that result from a separate medical condition (such as diabetes). While more research is needed in this area, common causes of diabetes-related sleep disruptions include:

  • Alarms set to check blood glucose levels
  • Correcting highs and lows
  • CGM alerts (highs, lows, out-of-range alerts)
  • Insulin pump alarming (low insulin levels, occlusions, charging/battery needs)
  • Anxiety or worry about diabetes or your loved one’s diabetes
  • Extra trips to the bathroom
  • Increased thirst

There are a few common sleep disorders that can contribute to sleep issues with diabetes, including sleep apnea and restless leg syndrome. If you think you have one of these conditions, be sure to let your healthcare provider know; both are treatable and can improve the quality of your sleep.

Can interrupted sleep affect diabetes management?

Getting a good night of sleep can potentially have an impact on blood glucose. And in general, interrupted sleep patterns have a wide array of potential health effects. Diabetes interruptions are similar in nature to sharing your bed space with someone who snores. All of the disruptions add up, but with diabetes, these disruptions often require action, like a “midnight picnic.” It’s not just a matter of rolling over and poking someone awake to stop snoring.

My girls are 18 months apart; Emma has T1D, and Hannah, my oldest, had night terrors. With that layered upon my own T1D, I’m certain my cortisol (the “stress” hormone) levels were through the roof for several years. I never discussed this with my providers at the time, but I sure wish I did. While my T1D was well managed, having more insight into the physiology behind these stress-related swings in glucose would have been helpful.

Why does this matter? Because interrupted sleep is stressful and can increase cortisol levels. It’s the body’s half-hearted attempt to increase alertness, but high cortisol levels can actually increase the need for more insulin. Again, this is why healthy sleep habits are important.

How do I improve my quality of sleep?

While sleep experts warn about the potential harm of electronic devices on sleep for people with and without diabetes, as those with diabetes know, their devices don’t just “turn off.” Individuals who use diabetes devices have alarms and alerts that can go off at all times of the day and night. That being said, there are some things you can do to increase the odds for a better pattern of night time rest.

  • Set a specific time or use an alarm for when it’s time to go to bed
  • Identify other health factors that may be affecting sleep
  • Personalize CGM targets and alarms and upload your data to an app to see patterns during sleep
  • Identify behaviors associated with these patterns
  • Reach out to your care team between appointments and make small adjustments regularly
  • If fear of hypoglycemia or diabetes distress may be keeping you awake, communicate this with your healthcare team
  • Turn your personal alarms off and have another loved one or caregiver monitor them instead – take some time off, if possible.
  • Take the night off. Switch duties with another adult. (Caregivers and parents)

Diabetes management is best done in routines. If you do similar things at similar times, you’re more likely to have the same results. This may equate to: exercising, eating dinner, going to bed, or having a similar snack at regular times. Predictability is a good thing. While it may sound boring and it doesn’t have to be all of the time, it simply makes life easier.

Should I see a healthcare provider about my interrupted sleep?

If you’ve made suggested changes, but are still having regular interruptions in your sleep, talk to your diabetes care team. They can help you get to the bottom of why diabetes is keeping you awake. Although CGM and automated insulin delivery (AID) devices are super helpful in addressing overnight lows (and the worry that goes along with it), the alarms can be relentless.

Research suggests that interrupted sleep can cause short- and long-term health consequences and may increase the risk of:

  • Memory issues
  • Stress and irritability factors
  • Mood disorders
  • Increased weight
  • Inflammation

“I haven’t seen a healthcare provider about interrupted sleep, but what helps me is having a regimented sleep schedule,” said Oller. “I go to bed early and get up early. I’m often tired in the morning, but I cowboy up and power through  — there’s no time for naps either. Having a good attitude has been tremendously helpful with the lack of sleep my husband and I deal with.”

It’s easy to think you’re “just fine” and getting enough sleep. But a sleep app, digital tracker, or printable tracker may tell you otherwise. If you find yourself in a pattern of frequent awakenings from diabetes, take action and discuss strategies with your healthcare provider to improve your sleep.

What Is Ozempic Face? Doctors Explain the Side Effect of the Diabetes Drug

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Experts explain that taking medications like Ozempic and Wegovy, for type 2 diabetes and weight loss, can cause an aged appearance in the face

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Medications intended for type 2 diabetes and clinical obesity — like Ozempic, Wegovy and Mounjaro — are trending on social media as drugs for quick weight loss.

However, some have reported the drugs cause an aged appearance, a side effect that is dubbed “Ozempic face.” One of those people is Jennifer Berger, who told The New York Times that she used Mounjaro (tirzepatide) to lose weight following her pregnancy.

Mounjaro, at higher doses, has been proven to be highly effective for weight loss similar to Wegovy.

Berger explained that although using the drug — taken weekly by injection in the thigh, stomach or arm — allowed her to lose 20 lbs. and she loved her results, the 41-year-old said her face started to look very gaunt.

“I remember looking in the mirror, and it was almost like I didn’t even recognize myself,” she told the outlet. “My body looked great, but my face looked exhausted and old.”

man preparing Semaglutide Ozempic injection control blood sugar levels

Dr. Oren Tepper, a New York-based plastic surgeon, explained to the Times that it’s common for weight loss to deflate key areas of the face, which can result in a person looking more aged.

“When it comes to facial aging, fat is typically more friend than foe,” he said. “Weight loss may turn back your biological age, but it tends to turn your facial clock forward.”

Dr. Paul Jarrod Frank, a dermatologist in New York, coined the term “Ozempic face” to describe this side effect, noting that it’s typically people in their 40s or 50s who are concerned about the sagging that occurs as a result of the weight loss in their face.

“I see it every day in my office,” Frank said. “A 50-year-old patient will come in, and suddenly, she’s super-skinny and needs filler, which she never needed before. I look at her and say, ‘How long have you been on Ozempic?’ And I’m right 100 percent of the time. It’s the drug of choice these days for the 1 percent.”

To restore volume in a patient’s face, doctors will often perform noninvasive, but expensive, procedures such as injecting Radiesse and hyaluronic acid-based fillers or Sculptra injections, which stimulates collagen production. Doctors can also restore volume with a face lift or by transferring fat from other body parts to the face.