As the type 2 diabetes epidemic continues to grow, the most emphasized treatment may surprise you. In the latest update to the Standards of Medical Care in Diabetes, the guidelines put forward by the American Diabetes Association elevate the role of metabolic surgery (also called “bariatric surgery” or “weight-loss surgery”) as a recommended treatment for diabetes.

Experienced centers around the world have achieved complete or substantial remission of Type 2 diabetes in a majority of patients who undergo laparoscopic sleeve surgery, a less-invasive, 45-minute procedure with an overnight hospital stay and four small Band-aids.

The Results Are Remarkable

Metabolic surgeons and centers have known for decades that gastric bypass – and in the past 15 years, gastric sleeve surgery – both deliver remarkable improvement in blood sugar regulation and a high rate of complete reversal of type 2 diabetes.

Better still, individuals with type 2 diabetes enjoy reduced risks of diabetes-related problems including blindness, stroke, heart attack, and kidney failure. Large, high-quality studies have accumulated, demonstrating these results in diabetes improvement across the world.

An early scientific paper, which most notably tipped medical opinion, reported the five-year results from the prospective, randomized STAMPEDE study from the U.S. trial at the Cleveland Clinic.

Patients randomized to either intensive medical management of diabetes or surgery, and the surgery patients fared much better, with many of them still enjoying a healthier life free of diabetes five years after their sleeve procedure. The Swedish Obese Subjects study has shown even better results in 30 years of follow-up.

The ADA and other endocrine society guidelines now acknowledge the proven success of bariatric surgery in treating diabetes. In the published guidelines, bariatric surgery is now referred to as “metabolic surgery.”

As the ADA guideline describes, “A substantial body of evidence has now accumulated, including data from numerous randomized controlled clinical trials, demonstrating that metabolic surgery achieves superior glycemic control and reduction of cardiovascular risk factors in obese patients with type 2 diabetes compared with various lifestyle/medical interventions.”

Here are the latest published ADA recommendations:

BMI 40 or Greater

“Metabolic surgery should be recommended to treat type 2 diabetes in appropriate surgical candidates with BMI 40 kg/m2 (BMI 37.5 kg/m2 in Asian Americans), regardless of the level of glycemic control or complexity of glucose-lowering regimens.”

What this means is that the ADA now states that medical providers should recommend weight-loss surgery to patients with both type 2 diabetes and obesity over a BMI of 40 regardless of other treatments and the patient’s present blood sugar levels.

BMI 35–39

“…and in adults with BMI 35.0–39.9 kg/m2 (32.5–37.4 kg/m2 in Asian Americans) when hyperglycemia is inadequately controlled despite lifestyle and optimal medical therapy.”

This means that for those patients with more moderate levels of obesity, BMI of 35–39, and poorly controlled Type 2 diabetes, providers should now be recommending weight-loss surgery.

BMI 30–34

Finally, the ADA guidelines address the lower level of obesity with type 2 diabetes, those with a BMI of 30–34. In this group, studies have also demonstrated superior results with surgery. The new ADA guidelines state that providers should consider weight-loss surgery when the blood sugar is not well-controlled.

ADA Recommendations

A metabolic surgery should be considered for adults with type 2 diabetes and BMI 30.0–34.9 kg/m2 (27.5–32.4 kg/m2 in Asian Americans) if hyperglycemia is inadequately controlled despite optimal medical control by either oral or injectable medications (including insulin).

The ADA guidelines further comment that “metabolic surgery should be performed in high-volume centers with multidisciplinary teams.” A multidisciplinary team includes professional psychologists, Physician Assistant providers, Registered Dietitians, and a team of multidisciplinary support personnel.

There has in the past been resistance in the medical and dietitian communities to bariatric surgery, but that’s steadily changing.

Many people now feel that these strong evidence-based recommendations from the American Diabetes Association and over 50 international leading endocrinology societies will result in improved treatment of diabetes and improved health for many patients battling diabetes through greater utilization of bariatric surgery.

Have you been affected by obesity or type 2 diabetes? What treatments have you tried? Have you heard of bariatric surgery? Do you know anyone who has undergone this procedure? Would you trust the ADA recommendations if you had these conditions? Please share any questions or comments below.

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor to get specific medical advice for your situation.

Melissa Gorga’s Striped Cardigan Sweater in Flashbacks

Real Housewives of New Jersey Season 11 Episode 9 Fashion

While Melissa Gorga’s striped cardigan only makes a brief appearance on tonight’s Real Housewives of New Jersey, much like Teresa Giudice, I know a good psychic. And it’s me. Because I knew that even if we only catch a glimpse of this cute cardi on tonight’s episode that everyone would want the full details on where to shop a fully stock, seen on Melissa Gorga cardigan for only $60.

The Realest Housewife,

Big Blonde Hair

Click Here to Shop her Elan Cardigan

Originally posted at: Melissa Gorga’s Striped Cardigan Sweater

CBD is everywhere these days, from skincare to haircare to supplements and bath bombs. Hey, it’s even in makeup like mascara and lip gloss. It’s pretty overwhelming and to be honest, it’s not all super legit. I’m not saying they’re not all great products but many don’t contain the amount, type, or any CBD you’re paying for. When it comes to the best CBD skincare, you can be assured each contains cannabidiol, one of the non-psychoactive phytocannabinoids found in the cannabis sativa plant species, so you can reap all its benefits.

Because there’s currently no federal regulation of CBD, brands can throw a pot leaf on their packaging but only put hemp seed oil into their product. That’s not to say hemp seed oil doesn’t have its benefits. It can be seriously hydrating and softening to skin. But it’s also more affordable and doesn’t have the anti-inflammatory and antioxidant benefits of CBD. They’re both great, but you should know what you’re paying for.

These stellar skincare products do contain CBD and even better, they tell you exactly what type and what amount of CBD you’re getting. They’re perfect for use on 4/20 and beyond.

Our mission at STYLECASTER is to bring style to the people, and we only feature products we think you’ll love as much as we do. Please note that if you purchase something by clicking on a link within this story, we may receive a small commission of the sale and the retailer may receive certain auditable data for accounting purposes.

Image: Haoma.

Haoma Preservation Day Cream with CBD & Turmeric

Cannabidiol nourishes skin while Amalaki (vitamin C) evens skin tone and cardamom and turmeric add a boost of brightening action.

Image: Blunt.

Blunt Skincare Moonrock Full Spectrum Renewal CBD Face Oil

Full-spectrum CBD protects skin from free radicals and reduces inflammation, while sea buckthorn, prickly pear and argan nourish.

Image: Bota.

BOTA CBD Calming & Balancing Eye Serum

This cruelty-free CBD eye serum is free of fragrance, gluten, parabens and sulfates so it’s less likely to irritate the delicate skin around your eyes.

Image: Sephora.

Herbivore Emerald CBD + Adaptogens Deep Moisture Glow Oil

This lightweight full-spectrum CBD oil also contains hemp seed oil for hydration and adaptogens to calm redness.

Image: St. Jane Beauty.

Saint Jane Beauty The C Drops

Love vitamin C? This new brightening serum contains 20 percent active vitamin C, 500mg of CBD and citrus AHAs for calm, smooth and glowing skin all at the same time.

Image: Lord Jones.

Lord Jones Acid Mantle Repair Moisturizer With 250mg CBD and Ceramides

We love Lord Jones’ CBD gummies and bath products so it makes perfect sense we’d also fall for its new face cream enriched with CBD, ceramides and hyaluronic acid.

Image: Sagely.

Sagely Naturals Brightening CBD Night Cream

This softening night cream also contains bakuchiol seed oil, hyaluronic acid and meadowfoam seed oil for antioxidants and hydration.

Image: Fitish.

Fitish CBD Gentle Face Cleanser

This hydrating cleanser includes CBD as well as greens (broccoli, kale and spinach) to give skin a boost of nourishment while it cleanses.

Image: Ami Wellness.

Ami Wellness Daily Body & Face Oil

Apply this hemp-infused oil all over your face and body before bed and wake up with smoother, hydrated skin.

Image: WLDKAT.

WLDKAT Ginger + Kombucha Skin Tonic

This new CBD beauty brand was created by the former Senior VP of Product Development at Urban Decay and you can tell from the colorful packaging. The skin tonic features a unique blend of broad-spectrum CBD and kombucha to help smooth skin and ginger root extract to fade acne marks and dark spots.

Image: Chantecaille.

Chantecaille Cbd 300 Face And Body Cream

Broad-spectrum CBD is combined with eggplant stem cell extract to soothe, calm redness and enhance hydration.

Image: Sephora.

Josie Maran Skin Dope 100mg CBD Body Butter

If you’ve never used Josie Maran’s body butter, well, you’re in for a treat. With pure argan oil, it softens skin like nothing else. Now, the brand has added CBD to help calm dry, stressed-out skin.

Arrive Market.

Dogwood Botanicals Calendula Rose Face + Body Cream

This sensitive skin-friendly lotion uses organic hemp extract, rose hydrosol, calendula flower-infused grapeseed oil, shea butter and Dogwood essence to hydrate and and nourish skin.

When I first started dating in my late 40s, online dating was in its infancy. There wasn’t a lot known about how it worked. Since my friends didn’t know single men, I thought I’d better figure this new way of dating out if I was going to meet the perfect man for me.

So, here are 3 expectations I advise you to scratch from your book when it comes to dating online.

#1 Don’t Expect to Immediately Meet Mr. Right

I do remember naively thinking I’d just put up a profile and my Mr. Right would show up in my email box. Kind of like in Field of Dreams where Kevin Costner says the famous line, “if you build it, they will come.”

And I do remember crying a LOT when the wrong men showed up in my inbox or sometimes even no men. Today, women still go online excited about the idea of meeting their Mr. Right, and when it doesn’t happen right away, they feel defeated, discouraged and often quit.

About now, you might be wondering why it’s so hard to meet Mr. Right. The reason is you are probably attracting the same type of man over and over again. Why? Because these are the men you feel most comfortable with, and that’s why you reattract them just with different clothes, a different haircut and a different job.

The relationship usually doesn’t work because he has the same issues you just left behind with the last guy you were involved with. Yet you keep drawing this type of man in because this is who you have the greatest chemistry with. The thing is, if this type of man worked for you, you’d be with him right now.

The secret to ending this cycle is to go out of the box and date men who aren’t your type. I find that when clients do this, they end up in a great relationship with a man who turns out to be the love of their life.

#2 Don’t Expect Men to Write Amazing Emails

If you’ve had experience dating online, you know that men often write short intro letters that go something like this: “Hey beautiful” or “Great Profile.” This type of email leaves you wondering how you’re supposed to respond, and when you’re not sure, you pass a man by.

Why do men do this? It’s not that they’re lazy. It’s just men have been rejected so much online that they’ve stopped putting the effort in… until they get a response. What you can do in this type of situation is look at his profile. If you like what you see, write “hi” back and ask a question.

The other type of email you see is one with tons of grammar and spelling errors. My ex was one of the smartest men I knew yet he was dyslexic so his emails would have looked like he never got past third grade.

Beware of quickly making a judgement before saying, “next.” What you can do is take a look at a man’s pictures and profile to see what his world looks like before you make a decision.

And of course, some of those poor grammar emails may come from scammers, so do your research first.

#3 Don’t Expect to Go Online and See Men Who Look Like Richard Gere and Denzel Washington

The first time you go online, you may be shocked at how old men look. I’ve heard women say, “they all look like my uncle, grandfather, or dad.” Then they tell me they are so disappointed by the “QUALITY” of men they see.

Whether we like it or not, Hollywood shapes our view of how everyone should look. Men like Richard Gere and Denzel Washington are handsome, but remember, they have a huge team making sure they always look this way.

Men in real life don’t have this luxury. Men in real life have a paunch or thinning hair or are short, and this turns you off.

But some of these men might make great companions, boyfriends and husbands if you give them a chance. The best way to do this is to adopt the mantra, “I’m going on a date to meet someone new and interesting.”

Ask fun questions like what TV shows he liked when he was a kid. Or what’s his favorite vacation spot. These are the types of questions that bring out the best in a guy. You get to see his personality mixed with his looks and that can make him quite attractive to you.

Do you feel frustrated with dating online? Have you been able to find a nice guy to date? Or perhaps you have expectations that are simply impossible to keep when it comes to online dating? Please share your fun online dating stories or some tips for new beginners.

With menopause, women’s bones lose the protection of estrogen. The decrease in bone mineral density (BMD) that occurs with aging is called osteopenia when it is mild and osteoporosis when it is more severe.

Osteoporosis Prevalence Increases with Age

Approximately 200 million women worldwide suffer from osteoporosis, and its prevalence increases with age. Statistics show that at 60 it’s 10%; at 70, 20%; at 80, 40% and at 90 it goes up to 67%.

Bone fractures, especially of the hip, often trigger a downward spiral in health. Researchers have shown that in comparison to fracture-free individuals of the same age, those with hip fractures face a 3-4 times greater risk of dying.

Medications Can Have Serious Side Effects

A number of pharmaceuticals are available for treating osteoporosis, but they have serious side effects. This includes gastrointestinal distress, femur fractures and jaw disintegration.

Bone is a living tissue with two types of cells. There are osteoblasts that build bone and osteoclasts that destroy bone. The mechanism of action of the medications is to block the osteoclasts, but they don’t build new bone cells. In contrast, weight-bearing exercise stimulates the osteoblasts and the building of new bone.

Daily Yoga Shown to Be an Effective Bone-Building Option

Yoga is a Sanskrit word that means “union” and has been practiced in India for thousands of years. During the last few decades in the U.S., hatha yoga, the physical practice of specified poses, has been demonstrated to offer a range of health benefits. These include enhanced flexibility and range of motion, stronger muscles, better balance and posture, as well as stress reduction.

For more than a decade, Dr. Loren M. Fishman, a Columbia University physiatrist who specializes in rehabilitative medicine, has been gathering evidence to determine whether yoga is an effective therapy for osteoporosis.

In a small pilot study back in 2005, participants showed increased bone density in their spine and hips from 12 minutes of daily practice of 12 specified yoga postures.

Based on those positive results, Fishman expanded his research to include 741 people from 2005-2015. Mostly supported by his own funds, three more researchers from Rockefeller University, Brigham and Women’s Hospital and New York University assisted Fishman in recruiting volunteers worldwide via the Internet.

Of that group of 741, 227 did the 12 assigned yoga poses daily or every other day over the decade, which were the inclusion criteria for the final data analysis. Of the 227 who met the practice frequency criteria, 202 were women. The average age of that group at initiation was 68, and 83% had osteoporosis or osteopenia.

What Does a Decade of Data Show?

Analysis of a decade of data revealed that all 227 participants showed improved bone density in the spine and femur. Hip density also improved, but the changes were not significant. Additional lab results of a study of bone quality of 18 of the participants showed enhanced internal support of the bones. This parameter, not measurable by a scan, is also important in preventing fractures.

Before the study, the 741 participants had suffered a total of 109 fractures. A decade later, there were no fractures or serious injuries reported or detected by x-ray in any of the participants, including those who didn’t meet the practice criteria.

See the 12 postures below and go here to read the 2016 study published in Clinical Interventions in Aging.

Of course, none of the information in this article is intended to be medical advice and you should talk to your doctor before starting any new exercise plan.

Now, let’s get a conversation started!

Have you experienced a bone fracture or been diagnosed with low bone density in your 60s or older? Do you practice yoga? If so, do you find that it helps your body to stay flexible, while strengthening your bones? Please join the conversation.

Medical disclaimer: Nothing in this article is medical advice. Please consult with your doctor before starting any yoga or other exercise program.