topic Re: Nov Diabetes news in Wellness

Nov Diabetes news

cherry — Fri, 26 Oct 2018 16:18:01 GMT

Spectacular' diabetes treatment could end daily insulin injections

Hour-long procedure that stabilises blood sugar levels of sufferers of type 2 diabetes is still effective one year on, study shows

Daniel Boffey in Brussels

Wed 24 Oct 2018 10.27 EDT Last modified on Wed 24 Oct 2018 12.35 EDT

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Woman self-administering insulin with a hypodermic syringe. Photograph: Ian Hooton/Getty Images/Science Photo Library RF

A potential medical breakthrough that could put an end to the daily insulin injections endured by people living with diabetes has been unveiled by Dutch scientists.

By destroying the mucous membrane in the small intestine and causing a new one to develop, scientists stabilised the blood sugar levels of people with type 2 diabetes. The results have been described as “spectacular” – albeit unexpected – by the chief researchers involved.

In the hourlong procedure, trialled on 50 patients in Amsterdam, a tube with a small balloon in its end is inserted through the mouth of the patient down to the small intestine.

The balloon is inflated with hot water and the mucous membrane burned away by the heat. Within two weeks a new membrane develops, leading to an improvement in the patient’s health.

Even a year after the treatment, the disease was found to be stable in 90% of those treated. It is believed there is a link between nutrient absorption by the mucus membrane in the small intestine and the development of insulin resistance among people with type 2 diabetes.

Jacques Bergman, a professor of gastroenterology at Amsterdam UMC, said: “Because of this treatment the use of insulin can be postponed or perhaps prevented. That is promising.”

Bergman added of the procedure that it was “amazing that people suffer very little from this”.

He told the Dutch broadcaster Nederlandse Omroep Stichting: “With those people we see a spectacular improvement in blood sugar levels one day after the operation, before they even lose one kilo, which has put us on the track.

“Because the question now is whether this is a permanent treatment, or whether it is something that you have to keep repeating – something that in theory should be possible. We looked at whether we could stop their insulin, which is still ongoing, but the first results are truly spectacular, with the lion’s share of patients no longer using insulin after this treatment.”

The new discovery initially seems most suitable for borderline patients who already take pills but whose blood sugar level is high enough for doctors to advise that they inject insulin in the short term.

Apart from dispensing with insulin injections, researchers claim that those treated could benefit from a lower risk of cardiovascular disease, kidney failure, blindness and numbness in the hands and feet.

Scientists from Amsterdam UMC who presented their study at a conference in Vienna this week were said to be cautious but “jubilant” about the initial results.

People with type 2 diabetes aged between 28 and 75 are now being recruited for a larger study of 100 people.

n the UK live with a diagnosis of type 1 or 2 diabetes, an increase of 1.9 million since 1998. Type 1 diabetes is where the level of sugar in the blood is too high because the pancreas does not produce insulin.

Those with type 2 diabetes are not producing enough insulin. The impact can be controlled by changes to diet, but it is a progressive disease. Most people will need to take tablets or inject insulin after living with it for five to 10 years.

Nine out of 10 people diagnosed with diabetes have type 2. It is estimated that there are nearly 1 million people currently living with the condition who have yet to be diagnosed and that 12.3 million people are at an increased risk due high levels of sugar in their blood.

Re: Nov Diabetes news

cherry — Fri, 26 Oct 2018 16:19:49 GMT

cientists in Amsterdam trialled a procedure on people with type 2 diabetes to great effect. The researchers have described their findings as spectacular, but the full extent of long-term safety will still need to be shown.

The results come from a study on 50 people and indicate that the technique, which takes an hour to perform, is successful even a year on.

The procedure involves inflating a balloon with hot water inside the small intestine. This burns off the mucous membrane which lines the gut and, two weeks later, a new membrane grows. This process seems to improve blood sugar control and it was found that 90% of the patients still had stable blood sugars even a year after the treatment.

They conducted the experiment to explore the association between the mucus membrane absorbing nutrients in the small intestine and insulin resistance in those with type 2 diabetes.

Professor Jacques Bergman, from the research team, said: "Because of this treatment the use of insulin can be postponed or perhaps prevented. That is promising." Bergman added of the procedure that it was "amazing that people suffer very little from this."

Speaking to Nederlandse Omroep Stichting, a Dutch broadcaster, he added: "With those people we see a spectacular improvement in blood sugar levels one day after the operation, before they even lose one kilo, which has put us on the track.

"Because the question now is whether this is a permanent treatment, or whether it is something that you have to keep repeating - something that in theory should be possible. We looked at whether we could stop their insulin, which is still ongoing, but the first results are truly spectacular, with the lion's share of patients no longer using insulin after this treatment."

The findings from the study were presented at a conference which took place this week in Vienna. Next, the researchers will conduct a bigger study involving 100 people.

Type 2 diabetes can be prevented or placed into remission by lowering carbohydrates. So far over 370,000 participants have signed up to the Low Carb Program developed by Diabetes.co.uk and launched on World Diabetes Day 2015.

One-year results from the Low Carb Program, published in the summer, show one in four users put their type 2 diabetes into remission, with significant reductions in weight, HbA1c and medication use.

Re: Nov Diabetes news

cherry — Fri, 26 Oct 2018 16:26:47 GMT

July 2018 Will the future be needle-free for diabetics? A fear of needles is the obstacle keeping many diabetics from sticking to their medication requirements. There might however be a solution on the horizon.

Injections are daunting for many diabetics. ~

For many diabetics, one of the most dreaded aspects of managing their condition is the need to inject insulin multiple times a day. But Harvard researchers have discovered a way to deliver insulin in a pill, and it appears to work well, at least in rats.

In South Africa, 7% of adults aged 21 to 79 – 3.85 million people – have diabetes. A large proportion of these people remain undiagnosed.

According to the most recently released statistics from Stats SA, diabetes is also the second leading cause of death in South Africa.

There are however still a lot of unanswered questions about the new pill: What is the proper dose compared to injected insulin? Will it be delivered uniformly? And, the biggest, will it work as well in people as in rats?

Delivering insulin through non-invasive means

That's why more research is needed, said the study's senior author, Samir Mitragotri, a professor of bioengineering at Harvard University.

The report was published online June 25 in the Proceedings of the National Academy of Sciences.

"What we have shown is that we can deliver insulin, and that it is safe in the intestine. This would be a non-invasive, patient-friendly, easy-to-use treatment," he said.

Insulin is a hormone that helps usher the sugar from foods you eat into cells for use as fuel. People with diabetes often lack enough insulin to meet the body's needs, though the exact cause varies depending on the type of diabetes.

An oral insulin hasn't been available, because insulin gets digested in the stomach, Mitragotri said. But injectable forms, which can be delivered by a needle or through a small tube inserted under the skin and attached to an insulin pump are painful, which can lead people to skip their medication, he noted.

'It lowered blood glucose for at least 12 hours'

To develop an oral insulin, the researchers had a number of challenges. The first step in moving past these barriers was to put insulin in an ionic liquid, which Mitragotri likened to liquid salts. The insulin-ionic liquid combination was then covered with a coating that allows the pill to pass through the stomach intact. It's then dissolved in the small intestine.

From there, the oral insulin travels to the large intestine. With the help of the ionic liquids, the insulin molecules can get through the intestinal wall into the bloodstream.

Current insulins are good for about 28 days once they're out of the fridge. But the oral insulin is good for at least two months, and probably longer, Mitragotri said.

The researchers found a sustained drop in blood sugar (glucose) of up to 45 percent in the animals. "It lowered blood glucose for at least 12 hours," Mitragotri said.

More studies will need to be done, including in larger animals, before human trials could begin. But if all goes well, Mitragotri said that he expects human trials could begin in three to five years. It's hard to estimate what the cost of oral insulin might be, he added. But the ionic liquid and coating materials aren't expensive, so he expects it would be similar in cost to current insulins.

Image credit: iStock

Re: Nov Diabetes news

software — Fri, 26 Oct 2018 17:21:10 GMT

Diabetes is such a complicated disease.

I'd like to address the treatment of burning off the lining of the small intestine.

Your small intestine naturally produces a hormone when eating.

The hormone, GLP-1, assists pancreatic beta cells in producing insulin, it also regulates the liver in releasing too much sugar. We don't know for sure why beta cells die off, it could be auto-immune related.

The balloon method seems risky and may solve the simple problem but may buy more trouble than it's worth. But I applaud the effort of researchers.

@cherry

Re: Nov Diabetes news

cherry — Fri, 26 Oct 2018 18:07:57 GMT

Time will tell. It is working so far. You can't be afraid to try new things, in research

Re: Nov Diabetes news

cherry — Fri, 26 Oct 2018 18:34:23 GMT

Vaccines are critical if you have diabetes October 13, 2018

(HealthDay)—If you have diabetes, you need all recommended vaccinations, the American Association of Diabetes Educators says.

Diabetes reduces the immune system's ability to fight certain infections. This raises the risk for serious complications from diseases that vaccines protect against—including flu, pneumonia, hepatitis B, tetanus and shingles.

"People with diabetes may be at higher risk of getting certain diseases and also serious problems from diseases that could've been prevented with vaccines," said Evan Sisson, an associate professor at Virginia Commonwealth University.

"Everyone should know what vaccines they need to protect themselves and discuss with their doctor whether they are up to date with the vaccines," Sisson said in an association news release.

The association offers these recommendations if you have diabetes:

The flu shot is the best protection against seasonal flu. For someone with diabetes, health complications from flu can include increased blood sugar levels, pneumonia, bronchitis, sinus infections and ear infections.
The Tdap vaccine protects against three serious diseases caused by bacteria: tetanus, diphtheria and pertussis (whooping cough). You should get the Tdap vaccine every 10 years.
The zoster vaccine reduces the risk of developing shingles and PHN (post herpetic neuralgia), serious illnesses for unvaccinated people as they age. If you're 50 or older, you should get the zoster vaccine.
Diabetes raises the risk for death from pneumococcal infections, which can include infections of the lungs, blood, ear, and lining of the brain and spinal cord. People with diabetes should get the pneumococcal vaccine once before the age of 65 and twice more after.
Hepatitis B can be spread through shared blood glucose meters, finger stick devices and other diabetes care equipment, so it's critical for people with diabetes to be vaccinated against hepatitis B. The vaccine is recommended for people younger than 60. People 60 or older should ask their doctor about the vaccine.

Explore further: Flu shot key for people with diabetes

More information: The U.S. Centers for Disease Control and Prevention has more on diabetes and vaccinations.

Re: Nov Diabetes news

cherry — Fri, 26 Oct 2018 18:39:32 GMT

ompared with multiple daily insulin injections, inhaled insulin was shown to provide benefits for adults with type 1 diabetes, including improved postprandial glucose levels, lower daytime glucose variability and less hypoglycemia, according to a study published in Diabetes Technology & Therapeutics.

“Ideally, use of an ultra-rapid-acting prandial insulin that closely mimics the time action profile of normal insulin secretion and human physiology will lower postprandial glucose excursions without any delayed hypoglycemia,” Halis Kaan Akturk, MD, assistant professor of medicine and pediatrics at the Barbara Davis Center for Diabetes at the University of Colorado Denver, and colleagues wrote. “The faster onset of action and shorter duration profile of [inhaled insulin (Afrezza, MannKind)], when compared with [rapid-acting insulin analogues], may provide a flexible approach for patients to optimize postprandial glucose control without an increased risk of hypoglycemia.”

Akturk and colleagues enrolled 60 adults with type 1 diabetes for at least 6 months to a 4-week pilot, randomized, multicenter trial from June to December 2017. All participants had HbA1c between 6.5% and 10%, had stable insulin dose and used insulin degludec (Tresiba, Novo Nordisk) or insulin glargine (Lantus, Sanofi) as basal insulin.

Participants were randomly assigned inhaled insulin (n = 26; mean age, 41 years; mean diabetes duration, 21 years; mean total daily basal insulin dose, 27.9 U; mean total daily bolus insulin dose, 21.8 U) or insulin aspart (n = 34; mean age, 42 years; mean diabetes duration, 19 years; mean total daily basal insulin dose, 22.7 U; mean total daily bolus insulin dose, 21.3 U). During the 4 weeks of the trial, participants wore real-time continuous glucose monitors; there were seven follow-up examinations, including four in-person visits and three by phone. Four participants in the inhaled insulin group dropped out of the trail or had missing data and were not included in the final analysis.

Using linear regression analysis of data from CGM, researchers observed a lower glucose standard deviation (P = .01) and percentage of time spent in hypoglycemia (HbA1c < 60 mg/dL, P = .02; HbA1c < 50 mg/dL, P = .04) in the inhaled insulin group vs. the insulin aspart group. Mean sensor glucose readings, percentage of time with HbA1c less than 70 mg/dL and percentage of time in hyperglycemia were nonsignificantly lower in the inhaled insulin group. Participants in the inhaled insulin group lost more weight (0.83 kg per day) compared with the insulin aspart group (0.57 kg per day; P < .0001).

Participants in the inhaled insulin group were further segmented based on adherence to the study protocol, with 15 of the original group meeting the compliance criteria. The researchers observed more time in range, lower glucose standard deviation and less time in hyperglycemia in the inhaled insulin-compliant group compared with both the insulin aspart (P = .009) and inhaled insulin-noncompliant (P = .03) groups. The inhaled insulin-compliant group also had lower postprandial glucose than the insulin aspart group (P = .05), but a relatively similar level compared with the inhaled insulin-noncompliant group.

Postprandial glucose levels differed the most between the two groups 60 to 90 minutes after a meal, with postprandial glucose levels increasing in the insulin aspart group during the first hour after a meal, and dropping to their lowest point for the inhaled insulin group, and for the inhaled insulin-compliant group, in particular.

The researchers also analyzed the effects of the two treatment types based on meal time. Although postprandial glucose levels were lower in the inhaled insulin group at breakfast (P = .04) and lunch (P = .001), the same significance was not found at dinner (P = .75).

“The potential reasons for this observation at dinnertime include the fear of hypoglycemia overnight — an experience that might be anticipated with an insulin with longer duration of action,” the researchers wrote. “However, as the vast majority of [type 1 diabetes] patients currently use subcutaneous [rapid-acting insulin analogue], many may be reticent to use postprandial corrections later in the day. As [inhaled insulin] has a shorter duration and a faster action profile compared with currently available mealtime injectable insulins, this may offer an advantage to both minimize the risk of nocturnal hypoglycemia and increase the use of supplemental or corrective doses before bedtime.” – by Phil Neuffer

Disclosures: The study was supported by MannKind. Akturk reports he received a research grant from MannKind related to this study. Please see the study for all other authors’ relevant financial disclosures.

Re: Nov Diabetes news

cherry — Sat, 27 Oct 2018 08:51:30 GMT

Would any of you be willing to try the balloon method if you thought it would cure your diabetes?

I am not 100% sure that I would, but, I would like to consider it. If I could live out my life not worrying about blood sugar, I might be tempted

Re: Nov Diabetes news

cherry — Sat, 27 Oct 2018 11:05:57 GMT

A tip I always do is to make just the pumpkin custard ,no crust. It buys you a few less carbs that way. I also use my own spice mixture, which, I think is better than the jarred spice mix..I have never used anything but sugar, however, I am going to try splenda just as an experiment..I have read equal doesn't hold up to oven heat, and stevia has a bitter after taste

1 deep dish pie shell
3 large eggs, Beaten
1 (15 ounce) can solid-pack pumpkin
1 (12 ounce) can evaporated milk
1 cup Splenda granular, sugar substitute
2 teaspoons pumpkin pie spice

Directions

Heat oven to 375 degrees. Allow pie crust to thaw at room temperature for 15 minutes.
Combine eggs, pumpkin, evaporated milk, Splenda, and pumpkin pie spice in a large mixing bowl using an electric mixer on medium speed for approximately 1 minute.
Pour this pumpkin mixture into the thawed pie shell. Bake pie on center oven rack for 35-40 minutes or until a knife inserted in the center comes out clean.
Cool the pumpkin pie before cutting into 8 servings.
Cooking time does not include time to cool.

Re: Nov Diabetes news

cherry — Sat, 27 Oct 2018 11:07:38 GMT

Re: Nov Diabetes news

cherry — Sun, 28 Oct 2018 10:15:23 GMT

I only drink diet coke so ,I am not familair with artificail sweetners, besides aspartame..I am not going to use anything with a tol at the end. It is very hard on your digestive system, but ,the rest of you might like to try some of these

Low-calorie sweeteners, or sugar substitutes, can allow people with diabetes to enjoy sweet foods and drinks that do not affect their blood sugar levels. A range of sweeteners is available, each of which has different pros and cons.

In this article, we look at seven of the best low-calorie sweeteners for people with diabetes.

1. Stevia

Stevia is a popular alternative to sugar.

Stevia is a natural sweetener that comes from the Stevia rebaudiana plant. To make stevia, manufacturers extract chemical compounds called steviol glycosides from the leaves of the plant.

This highly-processed and purified product is around 300 times sweeter than sucrose, or table sugar, and it is available under different brand names, including Truvia, SweetLeaf, and Sun Crystals.

Stevia has several pros and cons that people with diabetes will need to weigh up. This sweetener is calorie-free and does not raise blood sugar levels. However, it is often more expensive than other sugar substitutes on the market.

Stevia also has a bitter aftertaste that many people may find unpleasant. Some people report nausea, bloating, and stomach upset after consuming stevia.

The United States Food and Drug Administration (FDA) classify sweeteners made from high-purity steviol glycosides to be "generally recognized as safe," or GRAS. However, they do not consider stevia leaf or crude stevia extracts to be safe, and it is illegal to sell them or import them into the U.S.

According to the FDA, the acceptable daily intake (ADI) of stevia is 4 milligrams per kilogram (mg/kg) of a person's body weight. Accordingly, a person who weighs 60 kg, or 132 pounds (lb), can safely consume 9 packets of the tabletop sweetener version of stevia.

Various stevia products are available to purchase online.

2. Tagatose

Tagatose is a form of fructose that is around 90 percent sweeter than sucrose. Although rare, tagatose does occur naturally in some fruits, such as apples, oranges, and pineapples. Manufacturers use tagatose in foods as a low-calorie sweetener, texturizer, and stabilizer.

Not only do the FDA class tagatose as GRAS, but scientists are interested in its potential to help manage type 2 diabetes. Some studies indicate that tagatose has a low glycemic index (GI) and may be beneficial in the treatment of obesity. GI is a measure of a food's potential to affect a person's blood sugar levels.

Tagatose may be of particular benefit to people with diabetes who are following a low-GI diet. However, this sugar substitute is more expensive than other low-calorie sweeteners and may be harder to find in stores.

Tagatose products are available to purchase online.

3. Sucralose

People can use sucralose instead of sugar when baking.

Sucralose, available under the brand name Splenda, is an artificial sweetener made from sucrose. Sucralose is about 600 times sweeter than table sugar but contains very few calories.

Sucralose is one of the most popular artificial sweeteners, and it is widely available. Manufacturers add it to a range of products from chewing gum to baked goods.

Sucralose is heat-stable, whereas many other artificial sweeteners lose their flavor at high temperatures. This makes sucralose a popular choice for sugar-free baking and sweetening hot drinks.

The FDA have approved sucralose as a general-purpose sweetener and set an ADI of 5 mg/kg of body weight. A person weighing 60 kg, or 132 lb, can safely consume 23 packets of a tabletop sweetener version of sucralose.

However, recent studies have raised some health concerns. A 2016 study found that male mice that consumed sucralose were more likely to develop malignant tumors. The researchers note that more studies are necessary to confirm the safety of sucralose.

A range of sucralose products is available to purchase online.

4. Aspartame

Aspartame is a very common artificial sweetener that has been available in the U.S. since the 1980s. It is around 200 times sweeter than sugar, and manufacturers add it to a wide variety of food products, including diet soda. Aspartame is available in grocery stores under the brand names Nutrasweet and Equal.

Unlike sucralose, aspartame is not a good sugar substitute for baking. Aspartame breaks down at high temperatures, so people generally only use it as a tabletop sweetener.

Aspartame is also not safe for people with a rare genetic disorder known as phenylketonuria.

The FDA consider aspartame to be safe at an ADI of 50 mg/kg of body weight. Therefore, someone with a body weight of 60 kg, or 132 lb, could consume 75 packets of a tabletop sweetener version of aspartame.

Many different aspartame products are available to purchase online.

Can stevia benefit people with diabetes?

Learn more about the pros and cons of stevia for people with diabetes here.

Read now

5. Acesulfame potassium

Acesulfame potassium, also known as acesulfame K and Ace-K, is an artificial sweetener that is around 200 times sweeter than sugar. Manufacturers often combine acesulfame potassium with other sweeteners to combat its bitter aftertaste. It is available under the brand names Sunett and Sweet One.

The FDA have approved acesulfame potassium as a low-calorie sweetener and state that the results of more than 90 studies support its safety. A 2017 study in mice has suggested a possible association between acesulfame potassium and weight gain, but further research is necessary to confirm this.

The FDA have set an ADI for acesulfame potassium of 15 mg/kg of body weight. This is equivalent to a 60 kg, or 132 lb, person consuming 23 packets of a tabletop sweetener version of acesulfame potassium.

6. Saccharin

Cafes and restaurants may provide saccharin sweeteners.

Saccharin is another widely available artificial sweetener. There are several different brands of saccharin, including Sweet Twin, Sweet'N Low, and Necta Sweet. Saccharin is a zero-calorie sweetener that is 200 to 700 times sweeter than table sugar.

According to the FDA, there were safety concerns in the 1970s after research found a link between saccharin and bladder cancer in laboratory rats. However, more than 30 human studies now support the safety of saccharin, and the National Institutes of Health no longer consider this sweetener to have the potential to cause cancer.

The FDA have determined the ADI of saccharin to be 15 mg/kg of body weight, which means that a 60 kg, or 132 lb, person can consume 45 packets of a tabletop sweetener version of it.

People can purchase a range of saccharin products online.

7. Neotame

Neotame is a low-calorie artificial sweetener that is about 7,000 to 13,000 times sweeter than table sugar. Neotame can tolerate high temperatures, which means that it is suitable for baking. It is available under the brand name Newtame.

The FDA approved neotame in 2002 as a general-purpose sweetener and flavor enhancer for all foods except for meat and poultry. They state that more than 113 animal and human studies support the safety of neotame.

The FDA have set an ADI for neotame of 0.3 mg/kg of body weight. This is equivalent to a 60 kg, or 132 lb, person consuming 23 packets of a tabletop sweetener version of neotame.

Considerations when choosing a sweetener

When choosing a low-calorie sweetener, some general considerations include:

Intended use. Many sugar substitutes do not withstand high temperatures so they would make poor choices for baking.
Cost. Some sugar substitutes are very expensive, whereas others have a cost more comparable to that of table sugar.
Availability. Some sugar substitutes are more widely available in stores than others.
Taste. Some sugar substitutes, such as stevia, have a bitter aftertaste that many people may find unpleasant.
Natural versus artificial. Some people prefer using natural sweeteners, such as stevia, rather than artificial sugar substitutes.

Summary

Many people with diabetes need to avoid or limit sugary foods. Low-calorie sweeteners can allow them to enjoy a sweet treat without it affecting their blood sugar levels.

There is a range of sweeteners to choose from, each with different pros and cons. Although the FDA generally consider these sugar substitutes to be safe, it is still best to consume them in moderation.

Re: Nov Diabetes news

cherry — Sun, 28 Oct 2018 10:18:45 GMT

How Could a Diabetes Drug Cause Severe Genital Infections?

By Kimberly Hickok, Reference Editor | August 31, 2018 02:36pm ET

A commonly prescribed drug for treating type 2 diabetes has the risk of a new and highly unpleasant side effect.

Credit: Shutterstock

People with type 2 diabetes who take a certain class of drugs have a very troubling side effect to worry about: The drugs may increase the risk of the genitals becoming infected with "flesh-eating" bacteria.

On Wednesday (Aug. 29), the U.S. Food and Drug Administration (FDA) issued a warning about sodium-glucose cotransporter-2 (SGLT2) inhibitors, which are commonly prescribed medications for treating type 2 diabetes. Over a five-year period, the drugs have been linked to a dozen rare cases of genital infections that cause the skin to die, a condition called necrotizing fasciitis. All 12 patients who developed the infection were hospitalized, and one died, according to the FDA.

More specifically, the drugs have been linked to cases of a flesh-eating bacteria infection that affects the perineum, or the area of skin between the anus and the vulva or scrotum. When this type of infection affects this part of the body, it's referred to as Fournier's gangrene, a rare but potentially fatal condition, according to the Mayo Clinic.

The infection is more common in men than women, and it can spread to other parts of the body, Dr. Amesh Adalja, a senior scholar at the Johns Hopkins University Center for Health Security, told SELF. "It can rapidly progress and involve the entire genital area and even the abdominal wall," he said. [5 Ways Skin Can Signal Health Problems]

There have been enough instances of these severe infections that the FDA now requires all SGLT2 inhibitors to include a warning about this risk in their prescribing information. Medications in this class include canagliflozin, dapagliflozin, empagliflozin and ertugliflozin. The drugs are available as single-ingredient medications or in combinations, such as with metformin, the FDA said.

How do the infections happen?

Type 2 diabetes occurs when the body can't remove sugar from the bloodstream, because cells fail to respond to insulin, the hormone that helps move sugar into the cells. SGLT2 inhibitors work to lower blood sugar by causing the kidneys to remove sugar from the body through urine. This stabilizes blood sugar levels.

So, how can this lead to infections? Anywhere there is higher blood sugar, there's an increased chance of bacterial infection, Jamie Alan, an assistant professor of pharmacology and toxicology at Michigan State University, told SELF. "We have bacteria all over us, and one of the foods that bacteria likes is [sugar]," Alan said. She explained that eliminating more sugar through urine means there is more of bacteria's favorite food in the genital area, so this spot becomes a rather inviting environment for them.

The bacteria become a problem only if there is an entry point to infect, such as a small cut from shaving or a skin ulcer near the genitals. And that's exactly what happens, Adalja told SELF. The infections are serious and often require many surgeries to remove all the infected tissues, Adalja said. (All 12 patients described in the FDA warning required surgery.)

The FDA warning instructs patients taking the drugs to seek medical attention right away if they experience any signs of swelling, itching or irritation in the genitals area or have a fever above 100.4 degrees Fahrenheit (38 degrees Celsius) and generally don't feel well. The bacteria that cause necrotizing fasciitis can spread quickly, so it's important to seek treatment immediately.

But the infections are rare, and it's unwise to stop taking medications without talking it over with a doctor, Alan told SELF. There are other options for treating type 2 diabetes, she said, but practicing good hygiene can help minimize the risk of necrotizing fasciitis.

Original article on Live Science.

Re: Nov Diabetes news

cherry — Sun, 28 Oct 2018 12:13:40 GMT

Voortrekker Monument goes blue for world diabetes day in November

Some of the sites and buildings lit up in blue include the Empire State Building, Sears tower, CN tower, Sydney Opera House; The London Eye, and Table Mountain.

7 hours ago

The Voortrekker Monument will be lit up in blue for the month of November to honour world diabetes day and all who suffer from the condition.

World diabetes day (WDD) is a global awareness campaign focusing on diabetes awareness that is held annually on November 14, with the month of November being labelled diabetes awareness month.

The day itself marks the birthday of Nobel prize winner, Frederick Banting who, along with Charles Best and JJ Rickard Macleod, discovered insulin in 1922 to treat people with type 1 diabetes. Prior to 1922, a diagnosis of type 1 diabetes was an agonising death sentence for all.

ALSO READ: INFOGRAPHIC: Diabetes remains a deadly scourge worldwide

WDD was launched in 1991 by the international diabetes federation (IDF) and the world health organisation (WHO). World diabetes day is now commemorated each year by about 230 IDF members associations in more than 160 countries and territories, as well as by other organisations, companies, healthcare professionals, politicians, celebrities, and people living with diabetes and their families.

While awareness about diabetes is important, lack of access to insulin and proper healthcare is the number one cause of death for people living with diabetes worldwide. In 2014, the non-profit organisation T1International launched the #insulin4all campaign to unite the diabetes community as a global force standing together to fight for access to diabetes supplies, care, and treatment for everyone.

The campaign grows bigger each year in addition to the annual WDD theme related to diabetes. This year’s world diabetes day theme is diabetes and the family.

The Blue Monument challenge

The “Blue Monument Challenge” was launched in 2007 to mark the first United Nations observed world diabetes day. Blue is the official colour for diabetes and since then more than 1 000 iconic sites and buildings in 84 countries have lit up in blue to raise diabetes awareness on November 14 and in the weeks leading up to the day.

Some of the sites and buildings lit up in blue include Empire State Building, Belfast city hall UK, Brisbane city hall, Sears tower, Blackpool tower UK, Niagara Falls, CN tower in Toronto, Canada; Sydney Opera House; The London Eye, Table Mountain, Cape Town.

The main objective is to draw attention to the increased efforts to understand and manage diabetes through education and prevention; to highlight important issues about diabetes; encourage the public to get screened for diabetes; and to emphasise the fact that this “silent killer” can be managed and treated with the right access, and in some cases prevented.

Re: Nov Diabetes news

cherry — Mon, 29 Oct 2018 11:14:10 GMT

Type 2 diabetes prevalence continues to increase, and despite over a century of study and treatment, the pathophysiology of this disease is incompletely understood. Some patients with diabetes are obese, others as thin as a rail, some run marathons, others put in the same time on the nearest couch. Over time in addition to fasting or provoked fasting glucose levels, we have a range of biomarkers, like insulin levels and HgA1c, that have been used to further categorize patients with diabetes into groups. A new genome study, using our friend, GWAS (genetic-wide association studies) has found five different genetic clusters, leading to five pathways to the phenotype we call diabetes.

The researchers began with 94 genetic variants previously associated with Type 2 diabetes and its biomarkers; additionally, they included variants for anthropomorphic changes, like body mass or the distribution of fat; as well as variants associated with various clinical outcomes, like coronary disease. They used what they described as a “soft clustering” where variants could become a participant in more than one grouping; they were not limited to being evaluated in just one way. This is a methodology based on the idea, that seems to be garnering more evidence, that each gene, except in rare instances, makes little contribution to a phenotype, that it takes a number of different genes to produce a change we can see. Think of it as it “taking a village.” So what villages did they find?

Using a number of genetic datasets [1] they identified five dominant pathways leading to increased risk of diabetes.

Two pathways related to insulin production and processing in the pancreas, by beta cells. One was associated with an increase in proinsulin, a precursor to insulin; the other associated with a decrease in proinsulin.

Three pathways related to mechanisms of insulins response; one with obesity, another termed the lipodystrophy cluster was consistent with that pear-shaped distribution of fat we equate with “insulin resistance,” and the third was a “liver/lipid” cluster involving the metabolism of fats in the liver.

In each case, the clusters “preferentially altered enhancers or promoters in specific cell types.” The different pathways effected not solely pancreatic cells, but fat and liver cells too.

Perhaps the most intriguing finding was that each cluster had differing clinical repercussions. The beta cell and lipodystrophy cluster were associated more with coronary artery disease. But only the beta cell cluster was associated with stroke; a condition often lumped in with coronary disease when studies assess patient’s cardiovascular outcomes. The lipodystrophy cluster was the only one related to hypertension. Finally, the liver/lipid cluster was associated with a form of renal insufficiency.

In correlating their genetic clusters with patients the researchers found that about 30% had a predominant grouping, think of them as the purest representation of the pathway. And indeed, these patients had much higher levels for the biomarkers and clinical alterations of that specific cluster – they were the “poster children,” with distinguishing traits. The remaining 70% of patients had a mixture of clusters.

This is the kind of information that can change our thinking. First, in identifying different pathways, it provides new targets of opportunity for treatment and at the same time helps suggest why some people “fail” standard therapy. You cannot hope to treat a problem of fat metabolism as in the liver/lipid cluster solely by managing glucose, other targets can and will be identified. Second, by fractionating Type 2 diabetes into let’s say Type 2 A through E, we may be better able to define a patient’s clinical risks and look more closely for those changes. We needn’t necessarily screen all patients with diabetes for stroke when we know that their genetics cluster towards lipodystrophy and not a proinsulin “causation.”

What I think the study does point towards is the “omnigenic” theory – that there is no single or even small number of genes “responsible” for “causing” a disease. Many, many genes contribute their small share to changes we ultimately recognize as a phenotype, in this case, type 2 diabetes. Genetic studies will help us to stratify the large phenotypes we treat into hopefully more clinically relevant and manageable groupings. Precision medicine is not going to be as precise as we might imagine, there will remain a fuzzy border that will yield in time to more and more variants, impacted by diet, exercise and the environment. The closer we look, the more there is to see.

[1] A Finnish study of metabolic syndromes in men, data on Ashkenazi Jews, the UK Biobank and the Partners Biobank (part of the Partners Healthcare hospitals in Massachusetts)

Source: Type 2 Diabetes genetic loci informed by multi-trait associations point to disease mechanisms and subtypes: A soft clustering analysis PLOS Medicine DOI: 10.1371/journal.pmed.1002654

Re: Nov Diabetes news

lizzyCeGe — Wed, 31 Oct 2018 18:25:48 GMT

Good of you to share this information @cherry.

Thoughtful ! thank you!

Re: Nov Diabetes news

cherry — Thu, 01 Nov 2018 09:20:23 GMT

While common diabetes medication can help lower blood sugar levels, it may also be able to protect against blindness, according to a new report.

Researchers from health institutions in Taiwan conducted a study, recently presented at an American Academy of Ophthalmology conference, to determine the relationship between metformin, a common diabetes medication, and age-related macular degeneration (AMD), an eye disease that can cause vision loss.

To do so, they used the Taiwan National health Insurance Research Database to examine more than 62,000 patients with type 2 diabetes. About 45,000 of them took metformin, while about 22,000 did not. The analysts then followed the groups for 13 years.

After analyzing the results, they found that individuals on metformin had a significantly lower risk of developing AMD. In fact, half as many patients in the metformin group had the eye condition compared to the control group.

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“Our study is the first to reveal the protective effect of metformin on the development of AMD,” lead investigator Yu-Yen Chen said in a statement. “While more study is required to determine just how metformin protects against the development of AMD, this is an exciting development for patients at risk.”

The scientists noted AMD is the one of the leading causes of blindness in Americans over age 50, and it affects about 2.1 million people worldwide. It occurs when part of the retina called the macula is damaged. While doctors do not yet fully understand how it develops, they believe smoking, diet and systemic diseases like heart disease can be factors.

The researchers now hope to continue their evaluations to better understand how metformin can be used to ward off the eye illness.

Want to learn more about the findings? Take a look here.

Re: Nov Diabetes news

cherry — Thu, 01 Nov 2018 09:36:13 GMT

this might help explain why the new procedure for diabetes has worked, so far

Colostomy associated with increased risk of diabetes ( I think this should read colostomy.. something probably gor lost in translation)

University of Copenhagen The Faculty of Health and Medical Sciences

People who have had a colectomy have increased risk of developing type 2 diabetes, researchers from the University of Copenhagen and Bispebjerg and Frederiksberg Hospitals have shown in a new study analysing data from more than 46,000 citizens. The researchers hope this new knowledge may pave the way for new ways of preventing and treating the disease.

The colon may play a role in regulating the body's blood sugar level, a new study conducted by researchers at the Faculty of Health and Medical Sciences at the University of Copenhagen and Bispebjerg and Frederiksberg Hospitals suggests. In the large study the researchers have shown what happens when patients have parts of or the entire colon removed. The researchers have seen increased risk of developing type 2 diabetes following this type of surgery. This suggests that the colon plays a role in regulating the blood sugar level. The research results have just been published in the scientific journal eLife.

'We know that the colon houses large numbers of gut bacteria and hormone-producing cells, but we still do not know which role they play in regulating the blood sugar level. We hope our study will facilitate further research into the significance of the colon in blood sugar regulation and diabetes development', says co-author Kristine Allin, Head of Section and Staff Doctor at the Center for Clinical Research and Prevention at Bispebjerg and Frederiksberg Hospitals.

The study's first author, Postdoc Anders Boeck Jensen from the Novo Nordisk Foundation Center for Protein Research, has studied data from Danish registers of just over 46,000 patients who have either had the entire colon or parts of it removed. This data was compared to data of just under 700,000 comparable patients who in the same period had undergone surgery for something else than disease in the gastrointestinal tract. The study is an example of how researchers can use real human treatment in the healthcare system as a kind of 'model'.

'The surgical procedures these patients have undergone represent the "trial", and the results are then determined from the many data held in the Danish registers. Researchers often use animal testing to identify a connection, before determining whether the results also apply to humans. Here we are looking directly at surgery on humans, and we do not have to worry about whether the findings also apply to humans. The human as a 'model organism' is a concept that is gaining ground, ensuring that new patients benefit from experience and data collected through 20 years of treatment of previous patients', says co-author and Professor Søren Brunak from the Novo Nordisk Foundation Center for Protein Research.

Left Side of the Bowel Stands out

The data studied by the researchers span an 18-year period beginning at the time of the operation. Patients who had the entire or left side of the colon removed showed increased risk of developing type 2 diabetes in the 18 years following the operation compared to patients who had undergone surgery in different parts of the body. Patients who had had the right or middle horizontal part of the colon removed showed no increased risk of developing diabetes, though.

This suggests that the left side of the colon plays a role in regulating the body's blood sugar level. The colon is full of gut bacteria and microbes, and some other studies indicate that a changed composition of these microbes - like when part of the colon is removed in surgery - may play a role in the development of various diseases, aside from infections.

'The greater majority of the body's microbes are found in the colon, so it is relevant to look at what happens after the colon or part of it is removed. In a previous study we saw no significant connection with the risk of developing cardiovascular diseases. We were therefore rather surprised to see so relatively massive an increase in the risk of developing type 2 diabetes. In fact, the increased risk corresponds to the effect of having three times as high a BMI', says co-author and Professor Thorkild I.A. Sørensen from the Department of Public Health and Novo Nordisk Foundation Center for Basic Metabolic Research.

Re: Nov Diabetes news

cherry — Thu, 01 Nov 2018 09:39:23 GMT

It seems I was wrong, but ,I have never heard of this term before

Colectomy for colorectal cancer

Colectomy

A colectomy is the removal of all or part of the colon. The resection may be performed as a less invasive laparoscopic colectomy. If open surgery is needed, a long incision in the abdomen may be required. With open surgery, patients may need to stay in the hospital for a week or more and may have a longer period of recovery.

When possible, a surgical oncologist will perform a laparoscopic colectomy to remove the cancerous portion of the colon and nearby lymph nodes, and then reattach the healthy ends of the colon. A laparoscopic colectomy may result in less pain, a shorter stay in the hospital and a speedier recovery.

With a laparoscopic colectomy, approximately four to five small incisions are made around the abdomen. The surgical oncologist then inserts a laparoscope, a thin tube equipped with a tiny video camera that projects images of the inside of the abdomen on a nearby monitor. The surgical oncologist then inserts instruments through the incisions to perform the surgery.

What is a colectomy?

A colon resection (also known as a colectomy) is an inpatient procedure in which the cancerous portion of the colon is removed. To ensure all of the cancerous tissue is removed, a small portion of healthy colon tissue adjacent to the cancerous tissue may also be removed. On average, one-fourth to one-third of the colon may be removed during a colectomy. The remaining portions of the colon are then connected.

Your surgical oncologist will also perform a procedure called a lymphadenectomy, in which he or she removes several nearby lymph nodes to properly stage the cancer and determine if the disease has spread. A pathologist, who is often present in the surgical suite, analyzes the lymph nodes under a microscope to check for the presence of cancer. He or she provides pathology results immediately so that your surgical oncologist can remove as much of the diseased tissue as possible during the surgery.

Re: Nov Diabetes news

Trinity11 — Thu, 01 Nov 2018 20:53:27 GMT

@cherry wrote:
Would any of you be willing to try the balloon method if you thought it would cure your diabetes?

I am not 100% sure that I would, but, I would like to consider it. If I could live out my life not worrying about blood sugar, I might be tempted

@cherry, If I suffered from Type 2 diabetes, I would give it time before I tried anything new. If I had numerous complications and could not get my A1C down to under 8, I guess it would be tempting. I am always a skeptic on new treatments that rarely come to fruition.

Thanks for all the informative posts about the subject. It is always good to read positive threads.

Re: Nov Diabetes news

cherry — Fri, 09 Nov 2018 12:48:43 GMT

Pot Use Tied to Serious Diabetes Complication

By Serena Gordon

HealthDay Reporter

THURSDAY, Nov. 8, 2018 (HealthDay News) -- People with type 1 diabetes who use marijuana may double their risk of developing a life-threatening complication, a new study suggests.

Called diabetic ketoacidosis (DKA), the condition occurs when there is not enough insulin to break down sugar in the body, so the body burns fat for fuel instead. This triggers a build-up of chemicals known as ketones, which make blood more acidic and can lead to coma or death.

"About 30 percent of our patients are using some form of marijuana, and they should be careful when using," said study author Dr. Halis Akturk. "They should be aware of the DKA risk, and recognize the symptoms -- nausea, vomiting, abdominal pain and confusion."

Akturk is an assistant professor of medicine and pediatrics at the University of Colorado School of Medicine and Barbara Davis Center for Diabetes in Aurora, Colo.

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Colorado is one of nine U.S. states that legally allow recreational use of marijuana.

Type 1 diabetes is an autoimmune disease that develops when the body's immune system mistakenly attacks the insulin-producing cells in the pancreas. Insulin is a hormone that channels the sugar from foods into the body's cells to be used as fuel.

People with type 1 diabetes no longer make enough insulin on their own. They must take shots or use an insulin pump to deliver the insulin they need to their bodies. However, getting the dose right is a difficult balancing act.

Too much insulin can cause dangerous low blood sugar levels that make people shaky, confused and irritable, and if not treated, can cause someone to pass out and possibly to die.

But too little insulin can lead to high blood sugar levels. Over years, high blood sugar levels can cause the serious complications associated with diabetes, such as heart and kidney disease, vision problems and amputations. Too little insulin can also lead to DKA in as little as a few hours, according to the American Diabetes Association.

In the new study, the researchers invited adult type 1 diabetes patients at a Colorado hospital to complete a survey on marijuana use. Of 450 survey participants, 134 said they used marijuana.

The average age of the survey respondents was 39, but among marijuana users it was 31. Cannabis users tended to have lower incomes and education levels.

Pot users chose to use it in a variety of ways, including smoking, vaping or consuming it in edible products, the investigators found.

Non-users seemed to have better blood sugar control overall. HbA1C levels -- a blood test that estimates two to three months of blood sugar levels -- were slightly higher in people who used marijuana.

However, the study only found an association and could not prove a cause-and-effect relationship.

Dr. Joel Zonszein, director of the clinical diabetes program at Montefiore Medical Center in New York City, said, "I was not surprised that the use of cannabis is associated with DKA. Individuals with type 1 diabetes need to be engaged with their disease and manage insulin dosing constantly, even those on the pump with closed loop systems."

Zonszein said that getting high on marijuana may impair people's ability to give themselves the correct insulin dose.

"This study is a warning of the serious and potentially life-threatening 'side effect' of marijuana. This is particularly important due to the ever expanding use of cannabis after its legalization," Zonszein added.

It's also possible that because marijuana users had lower income and education, an unmeasured factor, such as access to health care or health insurance, may also play a role in raising the risk of DKA, he said.

The study was published online Nov. 5 as a research letter in JAMA Internal Medicine.