Wellness

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Diabetes Alert Day is set for March 27th. The American Diabetes Association offers a Diabetes Risk Test and several area medical-related organizations offer testing and ongoing classes (Rome Memorial Hospital, for example offers free diabetes education classes the first Monday of the month.

The statistics on diabetes are sobering: it's estimated 30.3 million people in the united states have diabetes, and close to a quarter of those people are undiagnosed, which means they're not getting care for what could be a manageable disease. Diabetes is being called a national epidemic.

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More positive research has emerged supporting the effectiveness of continuous glucose monitoring (CGM) devices for people with type 1 diabetes.

A German study has shown the pioneering technology can help reduce the number of hypos (low blood sugar levels) in patients with a recent history of either hypo unawareness or severe hypo episodes.

Hypo unawareness is when people are unable to identify symptoms of low blood sugar levels, which can lead to very low blood sugar levels and increase the risk of a severe hypo. A severe hypo requires treatment from someone else and can lead to seizures or unconsciousness, and should be treated as a medical emergency.

CGM kits are less invasive compared to finger pricking and can be used in conjunction with an insulin pump. They operate 24 hours a day and include alarms that can be set to indicate when glucose levels are either too high or too low.

Researchers from the Diabetes Academy Mergentheim in Bad Mergentheim, Germany, recruited 149 people with type 1 diabetes for the trial, all of whom had a record in the last year of either hypo unawareness or an episode of severe hypo.

All participants were asked to check their blood sugar levels via finger pricking for the first 28 days and wear a CGM without being able to view the data recorded.

They were then randomly split into two groups for a six-month period. One group continued using the finger-pricking blood glucose test to monitor their diabetes and the other group used the CGM devices with full access to the data and alarms.

The findings showed the number of hypos fell from an average 10.8 episodes per 28 days to just 3.5 in the CGM group, whereas there was no change in the finger pricking group.

By the last month of the trial, 33% of the CGM group had not experienced any hypoglycemia episodes, compared with only 7.6% in the other group. The CGM group also experienced a reduction in night-time hypos.

The researchers concluded that using CGM devices "reduced the number of hypoglycemic events in individuals with type 1 diabetes treated by multiple daily insulin injections and with impaired hypoglycemia awareness or severe hypoglycemia."

The study and an accompanying editorial have both been published in The Lancet.

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Here are some potato ideas for you to  use. but remember, they must be refrigerated overnight, after cooking to make them starch resistant.  Don't eat them  right after you make them. Reheat them the next day, or freeze them after refrigerating, to be used when you wish. For the soup, I would prebake to potatoes before making, and adding them, to the soup

It is so hard always saying no to carbs. With Starch resistant potatoes you don't have to, but I wouldn't eat more than  1/3 to 1/2 cup

Starch resistant spuds still have carbs ,they are just digested more slowly ,and won't spike your blood sugar

https://www.tasteofhome.com/collection/potato-recipe-that-arent-mashed/27/

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Rice University graduate student Nicole Carrejo analyzes a sample of K2(SL)6K2, an injectable hydrogel researchers believe may help accelerate the healing of diabetic ulcers.

Credit: Jeff Fitlow/Rice University

A hydrogel invented at Rice University that is adept at helping the body heal may also be particularly good at treating wounds related to diabetes.

The Rice lab of chemist and bioengineer Jeffrey Hartgerink reported this week that tests on diabetic animal models showed the injectable hydrogel significantly accelerated wound healing compared with another hydrogel often used in clinics. The study appears this week in the American Chemical Society journal ACS Biomaterials Science and Engineering. The multidomain peptide (MDP) hydrogel known by its amino acid sequence -- K2(SL)6K2 -- has in a recent study proven useful for the timed release of immunotherapy drugs. It has also been shown to encourage healing all by itself.

That quality may be useful for people with diabetes mellitus who often develop chronic wounds in their lower extremities that take longer to heal than normal wounds.

"This is particularly exciting because the study shows our material has an effect that's positive and better than things that are already out there," Hartgerink said. "This has been a long time coming."

He said the typical treatment for a diabetic foot ulcer has not changed much over the last century.

"The current gold standard of treatment is to debride the wound, which means to remove necrotic tissue. The wound is washed, bandaged and patients are told to keep pressure off the foot," said Nicole Carrejo, a Rice graduate student and the paper's lead author. "Various treatments and materials may be tried, but oftentimes, everything fails, which can lead to amputation."

The researchers reported that Rice's MDP hydrogel significantly accelerated the healing of wounds in genetically diabetic rodents. Treatment led to wound closure in 14 days, the formation of thick granulation tissue, including dense growth of blood vessels and nerve cells, and the regeneration of hair follicles.

They compared their results with a control group treated with a commercial hydrogel that required twice as long to reach the same degree of wound closure. "Unlike our MDP hydrogel, the control hydrogel does not get infiltrated by cells," Carrejo said. "Although the control results in the healing of wounds, we believe cellular infiltration of our MDP helps lead to the acceleration of wound healing."

Hartgerink hopes to move the hydrogel toward clinical trials as a material rather than a drug to ease the federal approval process. "That would make it much more practical to do a clinical trial," he said. "These preclinical experiments have been exciting enough to warrant that thought process."

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Story Source:

Materials provided by Rice University. Note: Content may be edited for style and length.

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You had lots of questions about diabetes for our Answer Desk panel. Here's a summary of our Monday evening call=in:

Most questions were about diabetes symptoms, and about specific diabetic medications (especially Metformin)

Dr. Runa Archarya, with Upstate :Medical University's Joslin Diabetes Center, says finger pricks to test for blood sugar levels will soon be a thing of the past, with a new device that avoids the sometimes-painful testing. ( Abbott Laboratories' FreeStyle Libre got FDA approval last fall)
Joslin maintains an extensive website with easily searchable information (click the link above), and Dr Archarya also recommends talking to your pharmacist if you have questions about a specific medication.

Stephanie Michaels-Collins runs the Diabetes Prevention program at the Greater Syracuse YMCA. It is part of a National YMCA effort, which she describes as healthcare to selfcare. She says many goals in managing diabetes match the Y's goals, including understanding that exercise should be joyous and not a punishment, and that all people can control their activity and their food, even if they need a little support and help.

Patty Downey Palladino is an advocate for diabetics, whose website/facebook page 'What's your Type? Operation Awareness' offers advice. She also works on diabetics' students rights in the schools and helps parents advocate for their children. Of concern: students who monitor diabetes with cell phones, which are often banned in classrooms and testing (Parents can get exemptions, but she advises not to wait til the day of a test to start the paperwork!) Also, that parents ensure their children will be cared for if the school has an emergency (what are the contingencies to keep diabetic supplies available?)

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Sanofi has unveiled real-world data from the UK showing the efficacy of its long-acting basal insulin analogue Toujeo in treating patients with type I diabetes.

The data, presented for the first time at ENDO 2018, the Endocrine Society’s 100th Annual Meeting & Expo, in Chicago, showed that the drug is linked with statistically significant improvements in HbA1c in patients with the condition, with a mean difference of from baseline to month six of –4.4 mmol/mol.

The study also showed no change in the number of patients reporting either diabetic ketoacidosis (DKA) or severe hypoglycaemia after starting treatment with Toujeo (Gla-300).

The total number of hypoglycaemic and DKA episodes reported by patients during the six months post-initiation of Gla-300 were 31/299 (10 percent) and 7/299 (2 percent), respectively, Sanofi noted.

“Gla-300 is well-established as a cornerstone treatment for type II diabetes and its use is supported by extensive clinical data. However, this evidence is not so abundant for the treatment of type I diabetes,” noted Terence Pang, Dudley Group NHS Foundation Trust and lead study author.

“These findings provide strong real-world evidence that can provide evaluations of the effectiveness of a medicine in daily use, and augment clinical data to further help [health care professionals] make clinical decisions.”

Toujeo was approved in Europe in April 2015 after Phase III data showed that while blood sugar control was comparable to that of Sanofi’s older insulin Lantus, its safety profile was favourable, with lower incidence of confirmed hypoglycaemia day and at night in patients with type II forms of the condition.

Hypoglycaemia is one of the most frequently reported side effects in people taking insulin.