Saturday, 29 October 2011

Pregnant with Type 1 Diabetes

Pregnant with Type 1 Diabetes

Welcome to the second trimester! By now, many type 1s are experiencing fewer hypoglycemic episodes, and insulin resistance is just beginning to rear its head. You're on the other side of the miscarriage worry hump and getting settled into the pregnancy routine. Congratulations! Take a few minutes each day to celebrate your successes and pat your stomach with a smile, knowing you are doing the best you can to give your growing child everything she needs.

You probably have a large support network built by now and are often leaning on those with experience and insight, or just some kind words, to get you through these stressful days. If you haven't already spoken about your concerns and announced your successes to a diabetes online community, I suggest you do so now. Many women on social network sites have already been through pregnancy with diabetes, are muddling their way through it now, or are trying to jump on the bandwagon. I found enormous amounts of support there and couldn't have made it through my pregnancy without it.

After the first trimester was over, around week 15, I switched from NPH back to Levemir, feeling confident that my baby's major organ development was completed. My stresses with NPH during the first trimester nearly cost us both our lives numerous times. I felt it was less of a risk to simply switch back to Levemir than to battle the insulin shocks I dealt with in the first weeks. Research and speak with your doctors to decide if this is an option for you.

Around week 20, most women with diabetes are experiencing insulin resistance. My doctors explained that the placenta gives off hormones that lead to insulin resistance. As your pregnancy progresses, the placenta gives off more and more of these hormones, making your resistance steadily increase. By the third trimester, most women with diabetes are injecting four times the amount of insulin they were taking pre-pregnancy.

If this is just beginning for you, remember: Insulin is not your enemy. It is a tool to keep your body "normal," so take as much as you need to take. Do not starve yourself in order to limit your insulin needs. You and your baby need carbohydrates and calories to keep your body functioning and to keep hers growing. If you have to take a few more units at each meal, don't stress. Your body will return to normal after baby comes.

My insulin resistance began around week 20, after which I began increasing my basals by five units every two days to keep my levels down. By the end of pregnancy, it was normal for me to take 30 units of Apidra at each meal. I was also taking 135 units of Levemir twice per day, compared to before pregnancy, when I took only 35 to 45 units of Levemir twice per day. It was a huge increase, but my baby is six weeks old now, and I'm back down to 8 to 10 units of Apidra per meal and 45 units of Levemir twice per day.

Around week 20, I started taking 500 milligrams of metformin in the mornings to combat my insulin resistance and dawn phenomenon. This may be an option for you. Work with your doctors and discuss the risks of taking this prescription to decide if it's the right choice.

There are a lot of stresses in day-to-day life while pregnant. Add in being an insulin-dependent woman with diabetes, and your days will sometimes go by in a numeric blur. The key is to remember what you're working toward and the fact that this will pass. It takes hard work and determination to check your glucose readings ten times per day, take 20 or more injections per day (or corrections on the insulin pump), measure all of your food intake, and worry over your baby's progress. But in a few more months you will be returned to your diabetes norm while holding that sweet baby in your arms.

Take pride in what you've accomplished so far. It is not easy being pregnant, and it is no small feat to be diabetic. What you've achieved so far is amazing. Stay on top of things and manage your glucose ranges, but remember to celebrate every small success. If she understood, your baby would be dancing inside of you, celebrating too.

Friday, 21 October 2011

BPA Again Tied to Diabetes Risk

BPA Again Tied to Diabetes Risk

Adding to the mixed bag of research on bisphenol A and diabetes, a new study suggests that people with higher urinary levels of the controversial chemical do have a higher risk of diabetes.

Bisphenol A -- better known as BPA -- is a so-called endocrine disruptor, which means it may affect normal hormone activity in the body.

It's also all around us. BPA has been used for decades to make hard plastic containers, as well as linings for metal food and drink cans. Research suggests that most people have some amount of BPA in their blood, including about 95 percent of Americans.

Recent animal studies have hinted that the chemical could play a role in certain cancers, heart disease and abnormal brain development in children. But BPA's true effects in humans remain unknown.

Two large studies have found a link between higher BPA levels and higher heart disease risk. And a 2008 study found that of Americans in a government health survey, those with higher BPA levels showed a higher diabetes risk.

None of that, however, proves cause-and-effect. And a recent study of Chinese adults found no link between BPA levels and diabetes risk.

This latest study is based on data from a federal health study done between 2003 and 2008. Researchers found that of nearly 4,000 U.S. adults involved, those with the highest urinary BPA levels were more likely to have diabetes.

Just under 12 percent of all study participants had diabetes, based on blood sugar tests. And the odds of having the disease rose as urinary BPA increased.

Of people with the highest levels (more than 4.2 nanograms per milliliter, ng/mL), almost 13 percent had diabetes, versus 8 percent of adults with the lowest BPA levels (less than 1.1 ng/mL)

For comparison, the typical urinary BPA level among Americans has stood at about 2 ng/mL in recent years.

The findings, reported in the Journal of Clinical Endocrinology & Metabolism, do not prove that BPA is responsible for the higher diabetes risk.

"Since BPA measurements as well as diabetes diagnosis were conducted at the same time, we cannot say for sure that BPA exposure preceded diabetes development," lead researcher Dr. Anoop Shankar, of the West Virginia University School of Medicine, said in an email.

The researchers did account for a number of other factors in diabetes risk -- like body weight, age and race. And the BPA-diabetes link still held; people with the highest levels had a 68 percent greater risk of diabetes than those with the lowest levels.

But what's needed, according to Shankar, are long-term studies that start with diabetes-free adults, measure their BPA levels, then see who develops diabetes over time.

Shankar said he and his colleagues are planning such a study.

Exactly how BPA might promote diabetes is unclear. Lab research suggests that BPA can act like a hormone in the body and, in animals at least, promote weight gain.

In this study, Shankar's team found that BPA levels were related to diabetes risk in both heavy and normal-weight people. But there may be pathways other than weight gain, according to Shankar.

BPA may, for instance, promote body-wide inflammation, which is linked to diabetes and a range of other chronic diseases. Again, though, that's based on animal research.

In general, experts say that people who are concerned about BPA can try cutting down on canned foods and avoiding food containers made of polycarbonate plastics -- especially for reheating food, since high heat may transfer small amounts of BPA into food.

Polycarbonate plastics are usually marked with the recycling code "7."

Due to the controversy over BPA, the major manufacturers of infant bottles and feeding cups in the U.S. have stopped using the chemical.

Monday, 17 October 2011

Men Appear to be at Higher Risk for Diabetes

Men Appear to be at Higher Risk for Diabetes

According to a new study, men who put on excess weight are putting themselves at greater risk of developing type 2 diabetes.

The research found that men do not need to put on as much weight as women in order to develop type 2 diabetes. The research was carried out by a team from the University of Glasgow, who said this may explain why in many parts of the world, diabetes rates are higher among males.

"Previous research has indicated that middle-aged men are at a higher risk of developing diabetes than women and one possible explanation is that men have to gain less weight than women to develop the condition.

“In other words, men appear to be at higher risk for diabetes," explained lead researcher, Prof Naveed Sattar, of the University of Glasgow.

The study looked at almost 52,000 men and over 43,000 whom all had diabetes, and measurements, such as height and weight, were recorded. Factors such as smoking and age were also taken into account.

The study found that men were more likely to develop the disease if their BMI (body mass index) was 31.8 while for women it was 33.6. "The results from this research confirm our hypothesis that men have to gain less weight to develop diabetes," Prof Sattar explained.

The researchers believe this may be down to how fat is distributed around the body. According to Irish Health, men tend to carry more visceral or intra-abdominal fat, which is located deep under the muscle tissue in the abdomen and is considered a more dangerous type of fat. Women on the other hand tend to carry more ‘safe' subcutaneous fat.

Monday, 10 October 2011

Diabetes at Crisis Levels in Ireland

Diabetes at Crisis Levels in Ireland

ONE IN three Irish people has a family member with diabetes, according to new research.

The figures have been described as a “national crisis” by Prof Séamus Sreenan, consultant endocrinologist and medical director of the Diabetes Federation of Ireland.

“We have been saying it for years, but these figures really bring the message home – diabetes is everywhere in Ireland,” he said.

“It’s in urban and rural communities, in rich areas and less well-off areas.”

One in five people has a family member with type 2 diabetes – which is preventable – and 77 per cent of Irish people know somebody with the disease.

The figures are based on a representative sample of more than 700 people carried out by market research company Behaviour and Attitudes on behalf of the Diabetes Federation of Ireland and the healthcare company Sanofi.

The research has been published to coincide with changes to the HbA1C clinical measurements for diabetes which come into effect from January 1st, 2012.

The Know Your Numbers! campaign aims to help people with diabetes minimise their risk of developing a complication relating to the condition.

The campaign is supported by the HSE and the Irish Pharmacy Union.

Currently, the HbA1C test measures the amount of glucose in the blood and monitors how well diabetes has been controlled in the previous two to three months.

HbA1C is the name given to a chemical reaction that causes glucose to stick to the haemoglobin in the red blood cells.

The new unit measurements for reporting HbA1C will prevent any mix-up between glucose and HbA1C results.

Obesity is one of the most common causes of diabetes, and losing weight can be one of the most cost-efficient ways of preventing it.

Other risk factors include not getting enough exercise and being over 45 years of age.

Type 2 diabetes can lead to heart disease and strokes, kidney trouble and also lower limb amputation in some cases.

Prof Sreenan said it takes an average of 12 years between the onset of type 2 diabetes and its diagnosis, by which time it is often too late for many sufferers.

Type 2 diabetes has been described as a ticking timebomb across the developed world as people live longer and obesity continues to increase.

It is estimated that there are 180,000 people in Ireland with type 1 and type 2 diabetes.

That figure is expected to rise to 233,000 by 2020.

It is believed that 146,000 people in Ireland have undetected pre-diabetes and will have type 2 diabetes within five years unless they take action.