Best Diabetes Resource

Artificial pancreas may help control type 1 diabetes

2010-07-30T21:20:00.000-07:00

A two-hormone closed-loop artificial pancreas using a computer algorithm may tighten blood sugar control in patients with type 1 diabetes while lowering risk for hypoglycemia (low blood sugar). This is according to the results of a recent study and editorial published online in Science Translational Medicine.

"We have developed a closed-loop control system that uses frequent measurements of blood glucose concentration along with subcutaneous delivery of both the fast-acting insulin analog lispro and glucagon (to imitate normal physiology) as directed by a computer algorithm. The algorithm responded only to blood glucose concentrations and incorporated a pharmacokinetic model for lispro," says Firas H. El-Khatib, PhD, fom Boston University Massachusettes and colleagues in their research.

Compared with six out of of 11 type 1 diabetes patients who had no episodes of hypoglycemia requiring treatment, five patients who did have hypoglycemia requiring treatment had slower lispro absorption kinetics during the 27-hour experiments.

In another experiment, the investigators set the time-to-peak plasma lispro concentration to 65 minutes resulting in the prevention of hypoglycemia in both groups to achieve an aggregate mean blood glucose concentration of 164 mg/dL.

"These results demonstrate the feasibility of safe blood glucose control by a bihormonal artificial endocrine pancreas," the study authors write. "Near-normal mean blood glucose concentrations without hypoglycemia were achieved without feed-forward information or pretreatment for very high carbohydrate meals in the subjects with faster insulin phramacokinetics. In subjects with slower insulin absorption, adjustments of the algorithm's phramacokinetic parameters prevented hypoglycemia at the cost of modestly higher average blood glucose concentrations."

-DiabetEASE Magazine

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Web-based program improves diabetics' self care

2009-02-16T12:57:00.000-08:00

NEW YORK (Reuters Health) - Giving people with type 2 diabetes the opportunity to help manage their care online can substantially improve their long-term blood sugar control, new research suggests.

Clinic visits alone aren't enough for many people with diabetes, Dr. James D. Ralston of the Group Health Cooperative in Seattle and colleagues note in the journal Diabetes Care.

The researchers tested whether an Internet-based program might help patients to manage their care more effectively.

The intervention gave patients access to the same medical records used by their primary care doctor, as well as the ability to e-mail health care providers. The program also provided feedback on blood sugar readings, a Web site with educational information on diabetes, and an interactive diary that allowed users to record information on diet, exercise and medications.

Ralston and colleagues randomized 83 type 2 diabetics to usual care plus the Internet intervention or usual care only. All study subjects had levels of the blood sugar marker glycohemoglobin (GHb) of 7 percent or above, indicating poor long-term blood sugar control.

After a year, patients participating in the Web program saw an average 0.7 percent drop in their GHb levels compared to those who weren't participating, while 33 percent of Web program users had GHb levels below 7 percent. In contrast, just 11 percent of non-users had brought their GHb levels below 7 percent.

"Compared with other trials of care management outside the office-based setting, the Web technology behind our intervention was relatively low cost and already in use by many patients in other aspects of their daily lives," Ralston's team notes.

Nevertheless, they add, many people with diabetes lack such resources. "Although interventions similar to this study may uniquely address some existing disparities in access to care," they add, "they may also fail to address or may even exacerbate other disparities."

SOURCE: Diabetes Care, February 2009.

Low-fat dairy may aid weight loss

2007-10-02T08:11:00.000-07:00

Overweight diabetic patients can now turn to low-fat diary products to ease their struggle to lose weight, a group of researchers said.

Dr. Danit R. Shanar and colleagues from the Ben-Gurion University of the Negev in Beer-Sheva urged diabetics to try a diet rich in low-fat dairy calcium after discovering in a study that overweight type 2 diabetic patients with a higher intake of dairy calcium increased odds of losing weight twice.

"Such a diet should be tried in diabetic patients," the researchers told diabetics, particulary those who have a tough time sticking to other weight loss diets.

In the study where 259 overweight diabetics participated, the researchers discovered the weight loss promoting effect of diary calcium when overweight type 2 diabetic patients on a calorie-restricted diet enhanced their weight loss process in six months.

Diabetes Prevention

2007-10-01T21:18:00.000-07:00

Nip Diabetes in the Bud

"Intellectuals solve problems,
Geniuses prevent them."
- Albert Einstein

How do you solve a problem like diabetes? You lick it before it starts.

Prediabetes is a condition wherein blood sugar levels are higher than normal but not high enough to be labeled diabetic. In 2003, about 314 million adults worldwide had impaired glucose tolerance (IGT), a form of prediabetes characterized by high blood sugar after a glucose load. This number is expected to skyrocket to 472 million by 2025.

Up to 50 percent of people with IGT will develop type 2 diabetes within 10 years. The risk for heart desease and stroke are 2 to 4 times higher in individuals with diabetes. These complications develop way before diabetes is diagnosed, thus making early and aggressive intervention imperative.

The following serve as fertile ground for diabetes-
- age over 35 years (for Europids, 45 years)
- having relatives with diabetes
- having prediabetes
- high blood pressure
- abnormal cholesterol levels
- gestational diabetes (diabetes diagnosed during pregnancy)
or having delivered large babies (over 8 lbs.)
- taking diabetes-causing medications
- being overweight and physically inactive
- having too much belly fat
(waist circumference of 31 inches and
over for South Asian women, 35 inches for men).

Water this with a diet lacking in fiber but loaded with calories, saturated fat, and simple sugar, and you have a garden full of diabetes weeds.

Prediabetes need not progress to type 2 diabetes. You CAN take steps so diabetes does not take root.

The International Diabetes Federation, American Diabetes Association and American Association of Clinical Endrocrinologists all recommended lifestyle modification as initial strategies in the prevention of type 2 diabetes. All are encouraged to:

- Be physically active at least 30 minutes a day
- Maintain a healthy weight (5-10 percent weight loss if overweight)
- Eat a healthy balanced diet

You don't need Einstein's IQ to help prevent diabetes. See your physician to assess your diabetes risk and have yourself tested. Promote diabetes prevention in your family, school, community and workplace and perhaps the tiny seed of knowledge may just grow and save someone from suffering diabetes.

-DiabetEASE Magazine