Friday 29 October 2010

November is American Diabetes Month

November is American Diabetes Month

In the United States, there are many health care concerns that we must face collectively, and we would be wise to pool our knowledge and resources when waging the necessary battles. Diabetes is one such disease that commands the attention of the nation, regardless of sex, race, financial status or age. As November is American Diabetes Month, there is no better time than the present to reflect upon our need to address this disease together.

Diabetes is typically divided into two separate “types.” Type 1 is a chronic disease where the body’s immune system destroys insulin producing cells in the pancreas. Symptoms of type 1 diabetes often include weight loss, polyuria and polydipsia, the metabolic response to insulin deficiency. Type 1 can also increase the risk of ketoacidosis, a complex disease resulting from various genetic and/or environmental factors. Unfortunately, the incidence of childhood type 1 diabetes is on the rise, starting as early as infancy.

Type 2 diabetes is far more common, accounting for over 90% of cases. Often called non-insulin dependent diabetes, it is characterized by chronic hyperglycemia, as the body either does not make enough insulin or cannot adequately process the insulin made. It may lead to a shortened life expectancy as it increases the risk of heart disease, stroke, peripheral neuropathy, renal disease, blindness and amputation.

At the present rate, the Centers for Disease Control and Prevention estimate that as many as one in three Americans could develop diabetes by 2050 unless a significant dent is made in our nation’s obesity epidemic. “The numbers are alarming,” says Ann Albright, PhD, RD, director of the CDC’s division of diabetes translation.

“We really need to focus more attention and effort on prevention,” says Albright. “People are living longer, and we are identifying diabetes earlier in course of the diseases and improving outcomes for those that have the disease. The major negative is the new cases of type 2 diabetes, and that is why prevention is so important. If we don’t work on prevention, these gains will be undermined.”

But recognizing the warning signs is only half the battle. Doctors and hospitals must also work with patients to help them understand and manage the disease on a daily basis. Comprehending the ways in which diabetes assimilates itself into an individual’s life is a critical component in fighting the disease, as is teaching patients to cope with the lifestyle and intellectual challenges the situation demands. Psychological health concerns are more common in people with diabetes than the general population, yet it is the individuals themselves who must ultimately bear the burden of choosing how well they manage their condition, and health care professionals must be mindful of this dynamic.

Thursday 28 October 2010

Obesity & Diabetes Increasing at Alarming Tate in UK

Obesity & Diabetes Increasing at Alarming Rate in UK

As per the recent study report released by the charity Diabetes UK, number of people suffering from obesity and diabetes are increasing at an alarming rate in the country.

The report reveals that nearly ten percent people in the country are obese while five percent of the total population is being treated for diabetes.

Surveyors also noted that there’s a strong link between type 2 diabetes and obesity and approximately 90 percent (2.5 million) of people suffering from diabetes in UK are suffering from the type 2 condition.

While commenting on study findings, Diabetes UK's director of care, information and advocacy, Simon O'Neill called the findings of the report “shocking” and “serious.”

"Once again we see a shocking rise in diabetes and obesity rates in the UK. Many, but not all, people develop type 2 diabetes because they are overweight or obese so we must keep up the mantra of five fruit and veg a day, encourage daily physical activity and warn of the potentially devastating consequences of an unhealthy lifestyle,” said O'Neill.

He added that "Failure to act now means a bleak future of spiraling NHS costs and worsening public health."

Other worrisome findings
Diabetes UK, who collected the figures from GP practices, also revealed that since last year 150000 new cases of diabetes have been registered, which is six percent rise in obesity levels in the country.

Over 2.8 million people over the age of 17 years are being treated for type 2 diabetes and about 1.1 million people are at the risk of suffering from diabetes without even being aware of it.

The obesity rate in people over 16 suffering obesity has also risen to over 5.5 million.

Timely action needed
Medical experts believe that the figures are not just shocking but are worrisome and timely government intervention is needed to successfully combat the situation.

Lack of proper treatment on time puts people with diabetes at the risk of blindness, losing limbs, and an early death, experts say.

As per Tam Fry, charity's honorary chairman as well spokesman for the National Obesity Forum, findings are troublesome because these days these lifestyle related conditions are hitting young generation.

"These figures confirm how appalling the levels of diabetes and obesity are in this country, and they would be even worse if they included children.

"Unfortunately we can expect levels to go up even if in some parts of the country obesity may be being brought under control. The fat are just getting fatter and suffering the consequences of excess weight," said Fry.


Tuesday 26 October 2010

Diabetes to Affect as Many as 1 in 3 Americans by 2050

Diabetes To Affect as Many as 1 in 3 Americans by 2050

The future of diabetes in America looks bleak, according to a new Centers for Disease Control and Prevention report out today, with cases projected to double, even triple, by 2050.

According to the report, one in 10 U.S. adults have diabetes now. The prevalence is expected to rise sharply over the next 40 years with as many as one in three having the disease, primarily type 2 diabetes, according to the report, published in the journal Population Health Metrics.

"There are some positive reasons why we see prevalence going up. People are living longer with diabetes due to good control of blood sugar and diabetes medications, and we're also diagnosing people earlier now," says Ann Albright, director of the CDC's Division of Diabetes Translation.

A more diverse America — including growing populations of minority groups such as African Americans and Hispanics, who are more at risk for the disease — factors into the increase as well, Albright says. But an increasing number of overweight Americans also is fueling the stark predictions for diabetes, which should be taken seriously, Albright says.

Diabetes is the No. 1 reason for adult blindness, kidney failure and limb amputation, and it's a large contributor to heart attacks and strokes, she says. "It's also now linked to a form of dementia, some forms of cancer and some forms of lung disease. Diabetes impacts so many systems in the body," Albright says.

Programs and policies to prevent obesity and diabetes need to be put in place at every level, says Duke University Medical Center endocrinologist Susan Spratt, who says schools are a good place to start. Healthful food options in schools and daily physical education classes should be a priority, she says.

"Vending machines should not sell sugar soda or candy bars. School fundraisers should not revolve around unhealthy food," says Spratt, who adds that cities need to be pedestrian-friendly, bike-friendly and safe.

A price will be paid if the projections go unheeded, experts say. The CDC estimates the current cost of diabetes at $174 billion annually — $116 billion of which is in direct medical costs.

Previous research has suggested that the financial burden may easily double in the next 20 years, says David Kendall, chief scientific and medical officer of the American Diabetes Association.

"The financial burden is potentially a very, very troublesome one," Kendall says.

"There's a dual message here: prevention where it's feasible, and critical and early intervention for those already diagnosed," he says.

Monday 25 October 2010

We Must Address the Cause of Diabetes

We Must Address the Cause of Diabetes

By all means, improve access to medications for those already living with the disease. By all means, improve access to treatment for complications. By all means, make quality food available to those living on starch to quiet their hunger.

But if we don't address what exactly is at the heart of this epidemic, this is all just damage control. We will continue to spend billions while rates of diabetes go up.

Type 2 diabetes is a manifestation of metabolic syndrome associated with our modern government-recommended, high-carbohydrate, grain-based diet.

It is an almost completely unnecessary disease.

Sharply restricting carbohydrate intake can normalize insulin production and insulin resistance, and with a little persistence most often fully reverse metabolic syndrome and remove the need for medication in Type 2 diabetics.

The science on this is abundant; it's no secret. Despite that, officials continue to recommend the low-fat, low-protein, high-carbohydrate diets that keep metabolic syndrome going.

And sadly, even if we were to officially recommend the kind of diet that can reverse Type 2 diabetes, I'm fairly certain that many of us would still prefer a pill or an injection over saying goodbye to our pastas and muffins and breads and cereals.

They've become so much a part of what we expect to eat daily, so convenient and available and affordable -- and so satisfying and addictive -- that a switch to the diet of our ancestors is too much a stretch for most.


Friday 22 October 2010

Management of Type 2 Diabetes With ACTOS

Management of Type 2 Diabetes With ACTOS

For those suffering from type 2 diabetes, can manage their insulin levels effectively with Actos. In type 2 diabetes, the body is very much insensitive to insulin. This results in increase in circulating glucose leading to hyperglycemia.

Pioglitazone hydrochloride is marketed as Actos and has its main action on decreasing the insulin insensitivity. It improves the glucose management of the body and also reduces the circulating insulin levels.

Actos is used as mono-therapy for patients with an average daily dose between 15 mg to 30 mg, depending on his/her requirement. Patients who do not respond adequately can be increased up to maximum of 45 mg once a day. Combination with Sulfonylurea, Metformin or Insulin is initiated when mono-therapy does not give the expected response.

One thing that should never be forgotten about Actos is, it pertains to Type 2 diabetics and is not recommended for juvenile diabetics, or type 1 cases, and in diabetic ketoacedosis. Patients with liver disorders and heart problems, and even pregnant women should keep their doctors well informed before starting any drug.

Actos is usually prescribed as once a day dose, with or without food. But, you need to remember, a complete treatment requires addition of exercise and diet into your routine. Regular check up and monitoring of your sugar levels for adjustment of dose is necessary. Besides, stick to your schedule, and if you miss your dose do not double the next, else, you could drop your sugar level and find yourself sunk in hypoglycemia (headache, confusion, drowsiness, weakness, palpitation and sweating and sometimes even fainting and coma). Keep a dose of sugar, like a candy or biscuit in your bag, to avoid such conditions. Fasting, untimely food habits, alcohol, and over exercise are some of the conditions you should avoid if you are diabetic.

Thursday 21 October 2010

Even Well-Controlled Diabetes May Present Post-Surgery Risk

Even Well-Controlled Diabetes May Present Post-Surgery Risk

People with diabetes who had normal blood sugar levels before non-heart surgery had a higher risk of death in the year following surgery compared to people without diabetes, researchers have found.

And, patients who hadn't been diagnosed with diabetes but had high blood sugar readings before surgery had a higher risk of death in the year after a surgical procedure compared to people with lower blood sugar readings, they noted.

"When we looked at blood sugar levels and the likelihood of complications after surgery, we didn't see a significant difference between diabetics and non-diabetics. But, when we looked at the long-term outcomes, we found significant differences between diabetics and non-diabetics," said Dr. Basem Abdelmalak, director of anesthesia for bronchoscopic surgery at the Cleveland Clinic in Ohio.


Findings from the study were scheduled to be presented Monday at the Anesthesiology 2010 meeting in San Diego.

The researchers collected information from one preoperative blood test to assess fasting blood sugar levels before 61,536 non-cardiac surgeries. Abdelmalak said the surgeries were varied, and included all surgeries that weren't related to the heart.

From this large sample, about 16 percent of the surgical patients had either type 1 or type 2 diabetes.


The average age of the patient population overall was 57, according to Abdelmalak. The average age of the non-diabetic patient was 56, and the diabetic group was slightly older, with an average age of 63, he said.

The researchers compared the one preoperative blood sugar reading to short- and long-term postoperative complications and death.

The investigators found that people with diabetes had between an 8 percent and 11 percent risk of dying in the year following surgery. But those with lower blood sugar levels before surgery -- in the range of about 60 milligrams to 90 milligrams per deciliter (mg/dL), according to Abdelmalak -- had a risk of death between 10 percent and 18 percent.

In people without diabetes, another interesting relationship emerged. Those with a blood sugar level of more than 200 mg/dL had more than an 11 percent risk of death in the year after surgery compared to just 3 percent to 5 percent for non-diabetics with lower blood sugar levels.

Abdelmalak said that one reason the non-diabetics with high blood sugar levels had an increased risk of death might be because they have undiagnosed diabetes. Diabetes, especially type 2 diabetes, can go unrecognized for long periods, but at the same time is still causing damage to the body. So, these people may have already been at a higher risk from complications related to undiagnosed diabetes.

As for the finding that people with a low blood sugar level are more likely to die in the year after surgery, Abdelmalak hypothesized that the body may get used to living with higher blood sugar levels -- in essence, resetting the body's metabolism. If you then try to maintain "normal" blood sugar levels, these may then be too low for you.

"We are still looking for the best way to give advice for managing diabetes during surgery. We're hoping that this study will stimulate further research, and that hopefully, we'll reach agreement on what is the better, or even optimal level of blood glucose," said Abdelmalak.

"We have abundant data that achieving good blood sugars without causing hypoglycemia has many benefits that are still worth striving for," explained Dr. Richard Bergenstal, president of medicine and science for the American Diabetes Association.

"Initially, it seemed that the lower the blood sugars could be recommended for everybody. But, now it looks as if we might need to individualize target blood sugars. However, we are still trying to sort out what are the right targets for which patients," said Bergenstal.

In the meantime, both experts suggested that people who haven't been diagnosed with diabetes, but who have high blood sugar levels before surgery, may need to be followed more closely after surgery since they have a higher risk of death. And, the same holds true for people with diabetes who have lower blood sugar levels.




Tuesday 19 October 2010

Diabetes Software – High Tech Diabetes Management Solutions

Diabetes Software – High Tech Diabetes Management Solutions

A key aspect to successfully living with diabetes is self management and diabetes software has made tracking everything to do with diabetes much simpler.

Diabetes management software helps with monitoring glucose level blood test results, tracking food intake and medication doses. Reports can by emailed to or downloaded by your medical practitioner, direct from the program, allowing them to review graphs and charts that give an instant snapshot of your condition.

With the introduction of smartphones and other handheld electronic devices the use of diabetes software does not mean diabetics need access to a computer. Diabetics can track insulin doses, keep a food and carb log , an exercise log, and record glucose meter readings quickly and easily when on the move using nothing more than their mobile phone. Many diabetes software packages contain a database of useful diabetes related information and data so everything the diabetic needs is instantly available.

Diabetic software systems have been developed in recognition of the fact that successful self management of the disease is the key to minimising complications.

Some programs offer the facility to store your tracking information online with some even offering free electronic logbook facilities.

Whether you choose to use any type of diabetes software will depend on your comfort with the use of technology, your budget and your willingness to contribute to the management of your condition. It will be worth consulting with your doctor to see if he or she has any experience of using any of the various applications and programs now offered by companies such as Bayer. It would make sense to consider using the diabetes management software that is already familiar to your doctor in order that maximum benefit can be extracted from your investment.

Anything that makes the process of self managing blood sugar levels and controlling diabetes is to be applauded and encouraged. It is no coincidence that the lowest rates of complications in diabetes are enjoyed by those who are conscientious about monitoring and controlling glucose. Diabetes software can simplify the whole record keeping process and give instant information when things go wrong. Imagine how much easier it would be for a medical practitioner treating you if he had access to your diabetes logbook if you are taken ill. Not the log book you leave at home and try to remember to update, but the log you keep on your iphone – the device that never leaves your side. Do you think this might speed up diagnosis and enable you to be offered the right treatment more quickly?

Love it or hate it, technology is here to stay and with health conditions such as diabetes, where the condition can worsen suddenly and dangerously, having up to the moment records of everything you have done to manage your condition can only improve your prognosis.

Before investing in diabetes software consider your personal requirements and comfort levels. Do you want software that works on a smartphone or Palm Pilot or similar device? Do you want to keep the data on a home computer or somewhere in the ‘cloud’ (this is a newer term to describe information that is stored on web servers owned by software providers). Do you want to be able to transmit reports to your doctor or perhaps print things off you can send or even allow your diabetes clinic access to your logs online? By being clear about what you want to achieve you’ll be able to select the most appropriate diabetes software for you and your condition.

Monday 18 October 2010

Traditional Mediterranean Diet May Cut Diabetes Risk

Traditional Mediterranean Diet May Cut Diabetes Risk

A traditional Mediterranean diet heavy in olive oil and vegetables may help older people lower their risk of adult onset diabetes -- even without counting calories or shedding weight.

Spanish researchers studying more than 400 adults found that those following the traditional diet were less likely to develop diabetes over four years than those instructed to follow a low-fat diet, according to findings published in the journal "Diabetes Care."

A traditional Mediterranean diet is generally high in vegetables, fiber-rich grains, legumes, fish and plant-based sources of unsaturated fat -- particularly olive oil and nuts -- while being low in red meat and high-fat dairy.

For the study, researchers led by Jordi Salas-Salvado of the University of Rovira i Virgili in Reus, Spain, followed 418 adults between the ages of 55 and 80, each of whom had at least three risk factors for heart disease such as high blood pressure or smoking.

They were randomly assigned to one of three diets: a Mediterranean diet with emphasis on more consumption of olive oil, the same diet with a focus on getting unsaturated fats from nuts, and a diet cutting all types of fat.

None of the groups were told to limit calories or get more exercise.

After four years, 10 to 11 percent of those in the two Mediterranean groups had developed diabetes, compared to 18 percent of those in the low-fat diet group.

When researchers accounted for a number of other factors, such as the participants' weight, smoking history and reported exercise levels, the Mediterranean diet itself was linked to 52 percent reduction in diabetes risk compared to the low-fat diet.

The findings support existing dietary advice for people with diabetes and those at risk of developing it, said Constance Brown-Riggs, a spokeswoman for the American Dietetic Association, adding that the Mediterranean diet is a healthy choice for anyone.

But, she told Reuters Health, the study "does not, by any means, say that you don't have to exercise."

She also cautioned against paying attention to calories or seeing olive oil as a magic bullet against diabetes.

"Sometimes individuals can get hung up on one item, like olive oil. But what we're talking about here is an overall eating pattern, and an overall lifestyle."

Friday 15 October 2010

Belly Fat Is Key to U.S. Diabetes Risk

Belly Fat Is Key to U.S. Diabetes Risk

Middle-aged Americans tend to have more belly fat than their English counterparts, and the difference may explain the higher diabetes rate in the U.S. compared to England.

Investigators with the University College London and the nonprofit research group RAND Corporation first reported on health differences between older Americans and people in England in 2006, finding diabetes incidence in the U.S. to be twice as high as in England.

RAND Corporation senior economist James P. Smith, PhD, says even though more people in the U.S. are obese than in England, this did not fully explain the difference in diabetes prevalence.

"In fact, obesity and body mass index (BMI) explained very little of the difference," Smith tells WebMD.

When the researchers further explored the issue, they concluded that belly fat was largely to blame for the higher diabetes incidence in the U.S., especially among women.

On average, waist sizes among the American women included in the study were 5 centimeters larger than their peers in England. American men had waists that averaged 3 centimeters larger than Englishmen.

Even middle-aged and older Americans who were not considered overweight tended to have larger waists than their English peers.

The researchers analyzed data from nationally representative health surveys conducted in the U.S. and in England. The analysis included people between the ages of 52 and 85.

They did not find big differences between the two countries in well-recognized risk factors for diabetes.

Americans included in the analysis had slightly higher BMIs and they were slightly older, while the English smoked more and tended to have less formal education.

"There was not enough difference in these traditional diabetes risk factors to explain the difference we saw," Smith says.

The only major difference between the two groups was waist size. Americans tended to have larger waists, whether their BMI scores put them in the normal, overweight, or obese category.

For example, one in four normal-weight women in the U.S. survey had enough belly fat to put them in the high-risk category, compared to roughly one in 10 women in England.

The findings suggest that BMI is a poor predictor of diabetes risk in people over 50, Smith says.

"Waist size may be much more important than BMI at the age when people are most likely to develop type 2 diabetes," he says.

So why do Americans have more belly fat than the English?

The reasons for this are not clear. But as with most things related to weight and health, diet and exercise probably play a big role.

Eating a high-fat diet and not exercising are risk factors for belly fat. People in the U.S. tend to eat higher-fat diets than people in the England, and they exercise less.

Gerald Bernstein, MD, who directs the Friedman Diabetes Institute at Beth Israel Medical Center in New York City, says people in the U.S. typically walk half as much over the course of a day as people in Europe -- about 5,000 steps compared to 10,000.

Bernstein says fat that accumulates in the belly is particularly dangerous because it affects the organs involved in regulating blood sugar.

Insulin stimulates the liver to store sugar in the blood for later use. Belly fat keeps the liver from doing this efficiently, so blood sugar accumulates in the bloodstream.

"Exercising helps the body burn this fat, but it is not enough," Bernstein tells WebMD. "People who have excess fat around the middle need to do all they can to reduce their waist size. That means exercising, eating a healthy diet, and cutting calories."

Thursday 14 October 2010

Type 2 Diabetes Drug Warning

Type 2 Diabetes Drug Warning

LEADING health charity Diabetes UK Northern Ireland is urging all people with Type 2 diabetes in the Ballymena Borough Council area who are currently taking all forms of the drug Avandia (rosiglitazone) to consult their healthcare team as a matter of urgency.

The warning follows last week’s recommendation by the European Medicines Agency to suspend the treatment with immediate effect.

Previous research suggested people with diabetes who take Avandia have an increased risk of heart failure and heart attack.

Following a long-term investigation into the safety of the treatment, the EMA concluded on Thursday that the risks of the drug no longer outweigh the benefits and is recommending its suspension to the European Commission. All prescriptions for the drug will cease in the meantime.

Avandia is a widely-used drug prescribed to many people with Type 2 diabetes to help control blood glucose levels.

Diabetes UK Northern Ireland warn the EMA’s decision will have a huge impact on the estimated 2,220 people with Type 2 diabetes in the Ballymena Borough Council area and that it is vital those taking Avandia consult their healthcare team as soon as possible to discuss switching to one of a variety of alternative treatments.

Florence Findlay White, National Care Advisor for Diabetes UK Northern Ireland, said: “The EMA no longer believe Avandia is a safe treatment. It’s important for people not to panic, but we are recommending those currently taking Avandia get in touch with their healthcare team as a matter of urgency to discuss their treatment options.

"We would not advise them to stop taking their medication in the meantime even if they are experiencing adverse side effects (such as swollen ankles or breathlessness) as it is very important that people with diabetes keep their blood glucose under control to prevent short and long term complications."

If people have any concerns about how this announcement may affect them, they can call the Diabetes UK Careline on 08451 202 960 or call the Belfast office on 028 9066 6646. More information can also be found at www.diabetes.org.uk

Tuesday 12 October 2010

Is Your Diabetes Treatment The Best One For You?

Is Your Diabetes Treatment The Best One For You?

Diabetes can be difficult to treat. It can be quite difficult to diagnose even. Treating your disease properly presents a whole different set of challenges. The lifestyle changes you choose and the medication your doctor prescribes are only the beginning of getting your disease under control. Some diabetics do get irritated with the length of time it takes for them to figure out which treatment works best for them with the least amount of impact on their lifestyle. Keep reading to see more about how to treat your diabetes, treatments that really work.

End your smoking habits. Even if you hadn’t become a diabetic, you already realize how awful smoking is for you. Now that you have been affected with this aggravation condition, your smoking becomes even worse. Why is this so? Smoking damages your blood vessels. This makes it really troublesome to deal with your blood sugar levels. It makes it more troublesome for your body to direct the diabetes medications to the cells that will benefit from it the most. It also contributes to heart disease, cancer and many other health problems. If that weren’t bad enough, it makes you smell really bad. Halting your smoking habits and tobacco use maybe be really trying in the beginning, but you’ll be so happy once you are at the point where you have quit.

The same as everything else, it is critical for you to have an exercise routine. Exercise can help you regulate your blood sugar levels. It aids your body in processing the foods you have digested. It helps (typically) to maintain a healthy weight. Weight issues are one of the leading causes of Type 2 diabetes and sometimes you can keep the disease at bay by making sure to get enough exercise.Besides all of that, exercise raises your levels of endorphins, which boost your mood and helps your stress level. Confronting diabetes can be an exasperating and irksome process, especially in the beginning stages. Regular exercise will help you deal with all of that.

By recording your blood sugar levels, you will be better prepared for assisting your medical professional in making sure that your selected remedies for diabetes are working the way they’re supposed to. This does not mean that you have to do everything your doctor tells you to do. If you think one of the diabetes remedies your medical professional has mentioned to you will impact your life in a way you don’t want it to, say something. Aside from that, it is essential your work with your physician to cure your condition.

After all, it’s your body the disease is affecting. You can’t rely upon having an intuitive medical professional. Be aware of your sugar levels. Watch your diet and exercise habits. Pay attention to how you feel when you take your medication.This is all information that will help your doctor keep track of how well your treatment is or is not working for you and adjustments can be made accordingly.

Diabetes can be very hard to control. The main reason for this is that there are many different treatments for diabetes but each one will affect each diabetes sufferer differently. What works well for one person could be incredibly harmful for you. It often takes a few tries to get your treatment regimen to work correctly for a long period of time. Try not to let all of the changes get you down. At some point your physician wil get it right and your life will move forward. You will eventually get your regimen set up so that it does not disrupt your life too.

Monday 11 October 2010

Diabetic Foot Ulcers may be Cured by a Vitamin A Compound

Diabetic Foot Ulcers may be Cured by a Vitamin A Compound

A compound of vitamin A called topical Retin-A also known as tretinoin, mainly used to treat acne problems, enhances the healing of foot ulcers in patients with diabetes, according to a report published in Archives of Dermatology. Although previous studies have shown that topical Retin-A has been somewhat useful for improving wound healing in patients with diabetes and some results have been discussed by several scientists, a group of researchers tried to know if tretinoin really helped or not these patients.

The research was conducted in 24 subjects with diabetic foot ulcers but who showed no signs of infection or circulation problems in their limbs. Some patients were assigned to 4 weeks of daily treatment with topical tretinoin solution 0.05 per cent in parallel, the Monitoring Group has been assigned to treatment with saline. The two groups were evaluated every 2 weeks. The 22 volunteers who completed the study were affected by a total, *, of 24 foot ulcers. 18 percent of patients in the control group (November 2 ulcers) and 46 percent of patients in the treated group (6 of 13 ulcers) achieved complete healing at the end of 16 weeks.

There was no statistically significant adverse effects, although some patients experienced mild pain at the ulcer site. The researchers were pleased with the results, although they were a little concerned because tretinoin irritate and they thought that patients would become so irritated that it would not be able to continue the investigation. However, this situation does not seem a problem in most cases, they said. One of the conclusions of researchers is expected that diabetic foot clinics know and use Retin-A when other treatments do not work.

Saturday 9 October 2010

Diabetes is Complex but Controllable

Diabetes is Complex but Controllable

Diabetes is unlike any other disease -- it's complicated and the success or failure is in the patient's hands.

Dr. Robert Horvat, an endocrinologist specialist at John C. Fremont Healthcare District in Mariposa, said the disease is so complex that he had to spend two years training specifically to learn about it. Once a person becomes inflicted, diabetes will never go away.

Horvat says about 90 percent of the responsibility to treat the disease falls on the diabetic. "You are responsible for its daily treatment," he said.

There are three types of diabetes. Type I is mostly found in juveniles. Type II is commonly found in adults. Type III, which is gestational, is common in pregnant women. Horvat said type II is the main one, and is mostly caused by lifestyles, such as being overweight or obese.

Some 34 percent of residents in Merced County are obese, according to a UCLA Health Policy Research study. The county has the second-highest obesity rate in the state.

Mariposa County is not so far behind. About 25 percent of the residents in the county are obese, according to the study.

Dr. Kenneth Smith, who works at the emergency room at the health care district in Mariposa, said many of the cases seen in the emergency room related to diabetes stem from high-blood and low-blood sugar, as well as infections. High-blood sugar in diabetics is caused by missing a dose of medication, not following a diet or by infections. Low-blood sugar is often caused by too much medication. "I'm sure it's hard to be perfect," he said about the steps that need to be followed for daily treatment.

People don't die of diabetes, but of complications related to the disease, Smith said.

Horvat said the long-term health complications of diabetes include heart attacks, strokes, amputations, kidney failure and blindness. "The most common reason for blindness in the U.S. is diabetes," he added.

According to Horvat, the longer a person has diabetes, the worse it becomes. The key is learning how to control it.

He has five patients in Mariposa who are over 90 years old, have a 30-year history of diabetes and are still around. "They are still walking," he said. "It can be done."

Most importantly, diabetes can be prevented.

Horvat said a person can avoid the disease with a low-fat diet and at least 30 minutes of exercise every day. "It doesn't matter what kind of exercise," he said. "Just don't sit."

Chuck Newcomb, a consulting dietitian for the health care district, said if a person faces limits in exercising, emphasis should be placed on the nutrition side.

People should spread carbohydrates throughout the day and eat more whole grains and fibers, he said. They also should limit fruit to one portion at a time, and eat no more than one teaspoon of salt a day. "Whatever you do, try to make sure it's something you can do for the rest of your life," he said of a healthy diet.

One in every four Americans has pre-diabetes, and many of them don't even know it, according to Horvat. Latinos suffer a much higher diabetes prevalence.

The experts spoke about the disease during a community wellness program Wednesday evening in Mariposa. The program, meant to educate the community about health issues, was presented by the health district, the John C. Fremont Hospital Foundation and the Mariposa County Health Department.


Thursday 7 October 2010

Diabetes Lessons - Better Health

Diabetes Lessons - Better Health

As doctors, sometimes the biggest lessons that we learn about disease pathology are those that we learn from the people that have that disease. Diabetes is one such disease.

I recently gave a show-and-tell lecture about insulin pumps to the new interns and residents as well as the 3rd-year medical students on their pediatric clerkship with the inpatient endocrine service. We discussed different types of pumps (point A on the picture) and they got to push the buttons and send a bolus or change a basal rate. They also looked at real time CGM (Continuous Glucose Monitors, points C and D on the picture) sensors used to check glucoses levels every five minutes.

However, they were most interested in the insertion devices and gadgets that accompany the pumps and the sensors. Their eyes were wide open and their teeth gritting when they themselves thought about going through this torturous ritual of site insertions and changes every two to three days. As one of the nurse educators that I work with who has diabetes demonstrated his own pump site (point B on the picture) and CGM sensor, the students and young doctors were clearly impressed with the bravery that having diabetes forces you to have.

Looking at the multiple sites on the nurse’s abdomen also reminded the students of how diabetes forces you to have a lack of vanity. Diabetes also forces you to have a lack of control over your body, which we all are destined to learn at different points in our life. Finally, diabetes takes a bit of your childhood away. No textbook can teach you that.

Effective Home Remedies for Diabetes to Control Blood Glucose Levels

Effective Home Remedies for Diabetes to Control Blood Glucose Levels

There is no absolute cure for diabetes and one can only control blood glucose level through proper diet, exercise and medication if required. Diabetic patients must realize that they have a complicated disorder that will continue for lifetime. During pregnancy, this disease can be serious and diabetic babies always weigh more than normal.

Older people gradually tend to gain weight and develop a mild form of diabetes because of a strain on their pancreas. Controlling body weight can help control diabetes. There are some simple home remedies that help to control the blood glucose level. The only condition being that it must be followed regularly and for long term.

Diabetes Home Remedies

Consume one tablespoon of bitter gourd (karela) juice every morning. It may not immediately give results, but will definitely decrease the intensity of the condition.

Soak one teaspoon of fenugreek (methi) seeds in water at night, drink that water in the morning and chew and eat the soaked seeds. This helps reduce the blood sugar level.

Wash a green banana and peel it and put the peel in a jar. Now fill with water and drink this water thrice a day. This water will help in lowing sugar level. Change the peel every alternate day and refill the jar with water as you drink.

Take fifteen fresh mango leaves and boil them in one glass of water. Keep them overnight. Filter and drink the mixture the next morning. This is a very common home remedy for diabetes.

Another effective home remedy for diabetes is the grapefruit. Grapefruit is considered quite beneficial in lowering blood glucose level. Eat 3-4 grapefruits thrice in a day for good result.

Take the powder of the fenugreek (methi) seeds two to three times a day to control the sugar in blood and urine.

One can also control diabetes by drinking water kept overnight with the tender leaves of guava tree and sadabahar plant soaked in it.

Boil a teaspoon of black cumin seeds (kalonji) in a glass of water till it reduces to half. If taken consistently for long term, it helps to control the blood sugar.

Prepare a mixture by adding equal quantities of dried gooseberry powder and turmeric powder with honey; or drink a mixture containing equal quantities of fresh turmeric juice and gooseberry juice in an empty stomach regularly.

Prepare herbal tea with powdered fried fenugreek and wheat, taken in equal quantities. This also helps in normalizing blood sugar levels.

Boil few leaves each of tulsi (basil), neem, jamun, bel, along with 4-5 corns of pepper in a glass of water and drink two times a day.

Morning and evening walk for at least 45 minutes is very essential to control the blood glucose level.

Diabetes In Childhood

Diabetes In Childhood

What are the types of Diabetes in childhood?
The types of diabetes in childhood are the same as in an adult, but the proportion of type 1 diabetes is more in childhood. To our surprise, we are seeing more and more cases of type 2 diabetes in children.

Why my child?
It is unfortunate it is your child. The cause of diabetes in childhood is not fully understood. Diabetes is most often associated with a genetically determined predisposition, the presence of autoimmunity and environmental influence. Some viral infection destroying the insulin producing cells of the pancreas have been found in some cases. Most of the cases the damage is permanent meaning the child is dependent on insulin for life.

Is Insulin a must?
Yes. Insulin is a must for type 1 diabetes as their body is deficient of insulin. If insulin is not given the child will progress to a diabetic coma which is a life-threatening condition.

When my child should start injecting?
In the case of diabetes in childhood, insulin treatment should be started as soon as the diagnosis is done to prevent the metabolic disturbances and diabetic coma. From around the age of 8 years your child is expected to inject him- or her-self.

Tuesday 5 October 2010

Garlic May Prevent Heart Disease in People with Diabetes

Garlic May Prevent Heart Disease in People with Diabetes

Many studies have explored the health benefits of garlic, but few have looked at its impact on a form of heart disease that affects people who have diabetes. Now the results of a new study published in the Journal of Agricultural and Food Chemistry indicate that garlic has “significant potential” for preventing diabetic cardiomyopathy.

Garlic provides important health benefits for the heart
Authors of the new study point out that people who have diabetes have at least a twofold risk of dying from heart disease. Specifically, diabetics are susceptible to diabetic cardiomyopathy, in which the heart tissue is inflamed and weakened in response to hyperglycemia (high blood sugar levels).

In 2003 in Diabetes Care, a report on diabetic cardiomyopathy noted that because the disease “is now known to have a high prevalence in the asymptomatic type 2 diabetic patient, screening for its presence at the earliest stage of development would be appropriate in order to prevent the progression to CHF” (congestive heart failure).

Scientists with the current study fed either garlic oil or corn oil to rats that had diabetes. Rats given garlic demonstrated changes that protect the heart against damage. The authors reported that the positive changes seemed to be associated with the antioxidants found in garlic, and noted that they had identified more than 20 substances that may be contributing to the heart-protective properties of garlic.

The scientists concluded that “garlic oil possesses significant potential: for protecting against heart disease, and specifically cardiomyopathy, in people who have diabetes.

Monday 4 October 2010

Lifestyle Intervention Program Cuts Risk of Type 2 Diabetes

Lifestyle Intervention Program Cuts Risk of Type 2 Diabetes

Four-year results of the Look AHEAD study have shown that an intensive lifestyle intervention program designed to achieve and maintain weight loss improves diabetes control and cardiovascular disease risk factors in overweight and obese individuals with type 2 diabetes.

Look AHEAD (Action for Health in Diabetes) is a multi-center, randomized clinical trial investigating the effects of an intensive lifestyle intervention program.

It will evaluate the effect of reduced caloric intake and increased physical activity on the incidence of major cardiovascular events such as heart attack, stroke, and cardiovascular-related death.

At study entry, 5,145 participants at 16 centers across the United States were randomly assigned to one of two interventions.

Those in a so-called "intensive lifestyle intervention group" met regularly with a lifestyle counselor in a combination of group and individual sessions.

They were given specific caloric consumption and exercise goals, were encouraged to maintain a diet and exercise diary, and were taught behavioral skills such as problem solving and goal setting. After the first year, participants were seen individually at least once monthly, had at least one additional phone or email contact each month, and were invited to attend additional group classes.

Those in the "diabetes support and education group" were invited to group sessions each year focused on diet, physical activity, or social support. They were not weighed at these sessions or counseled on behavioral strategies.

At the time of enrollment, participants were between 45 and 76 years of age. Most were obese with a mean body mass index (BMI) of 36. BMI is a measure of weight in relation to height.

A BMI of 18.5 to 24.9 is considered healthy, a BMI of 25 to 29.9 is overweight, and 30 or more is obese.

Thirty-seven percent of participants were from racial and ethnic minority groups, and approximately 60 percent were women. Over 94 percent of participants remain involved after four years and will continue to be followed for up to 13.5 years.

Over the first four years of Look AHEAD, participants in both groups showed positive changes in their health. On average, members of the lifestyle group lost 6.2 percent of their initial body weight, and members of the support and education group lost 0.9 percent of their initial body weight.

The intensive intervention group also experienced greater improvements in fitness, diabetes control, blood pressure, HDL (good) cholesterol, and triglycerides.

The diabetes support group showed larger reductions in LDL (bad) cholesterol, a change associated with the increased use of cholesterol-lowering medications.

The study results do not break down results by demographic groups such as gender, age, race or ethnicity.

"This important study shows that lifestyle changes have long-term favorable effects on diabetes control and cardiovascular disease risk factors in overweight or obese individuals with type 2 diabetes," said Griffin P. Rodgers, M.D., director of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the primary sponsor of the study.

Saturday 2 October 2010

Natural Diabetes Supplements to Help Diabetics

Natural Diabetes Supplements to Help Diabetics

According to the World Health Organization, diabetes is estimated to affect 150 million people worldwide, with the figure expected to sharply increase within the next decade. While insulin injections and other medications are a key part of treatment, the past twenty years has seen much interest in the use of natural supplements.

All diabetics require regular eye examinations, due to the increased risk diabetes is recognised to have in terms of developing eye disease. This is mainly down to the damaging affects of high blood glucose levels, leading to a condition known as diabetic retinopathy, which may result in blindness. The best way to prevent eye disease is to learn how to control blood glucose levels well and attend regular check-ups, while there are also several supplements identified as offering extra eye protection, such as vitamin C, vitamin E and B vitamins.

In Natural Approaches to Diabetes, Brewer (2005) recommends key supplements to help protect the eyes of diabetes sufferers, to include the following:

  • carotenoids
  • bilberry
  • ginkgo

Supplements Help Prevent Diabetic Nephropathy

Diabetes sufferers are at a far greater risk of developing kidney disease than the general population, a condition known as diabetic nephropathy. This is because diabetes may cause atherosclerosis, where the arteries harden and fur up, limiting blood supply to the kidneys. An increase in protein combined with raised glucose levels will also cause further kidney problems. In addition to dietary changes, managing blood glucose levels and blood pressure, B vitamins have been recognised as beneficial in reducing the risk of developing diabetic nephropathy.


Brewer (2005) recommends taking alpha-lipoic acid (ALA), which is a powerful form of antioxidant and is available from both health food stores and health-care pharmacies. This supplement is able to increase energy levels and reduce fatigue, with the latter being common in diabetes.

Prevent Diabetes-Related Foot Problems with Supplements


Another health issue commonly affecting sufferers of diabetes is foot problems, where ulcers can result in multiple hospital admissions. Foot problems in diabetics are down to the reduction of blood supply to the feet, nerve problems and infection. Regular check-ups with a chiropodist may be advisable in some sufferers and wearing supportive shoes which fit well is also important. In addition to these approaches, five nutritional supplements, identified by Brewer (2005) as being beneficial in preventing diabetes-related foot problems, include as follows:

  • vitamin C
  • B vitamins
  • bilberry
  • garlic
  • ginkgo

As highlighted above, diabetes sufferers may benefit from a range of nutritional, natural supplements to protect against eye, kidney and foot problems. Key supplements worth considering, include alpha-lipoic acid (ALA), bilberry, ginkgo, vitamin C and B vitamins. Before commencing any form of natural supplement or herbal remedy, always seek medical advice.