Blood Glucose Levels, Checking With Diabetic Breath Analysis?

Blood glucose levels, there may be a better and more non-invasive way of monitoring this aspect of diabetes management. This is according to an Irvine study in the University of California. The chemists and pediatricians examined this issue by employing a method of chemical analysis used to test air pollution.

They reported that the type 1 diabetic children when they exhibited hyperglycemia, exhaled considerably increased concentrations of methyl nitrates. This is important news in the sense that it may lead to a breath device that can detect high blood glucose levels.

This will let them know if the diabetics need insulin. This is in contrast to the device now presently in use that breaks the skin. Dr. Pietro Galassetti, a UIC Irvine General Clinical Research Center diabetes researcher, said breath analysis has revealed that it could become a diagnostic tool for other conditions like cystic fibrosis and ulcers but has not investigated this for diabetes until now.

Galassetti, along with Dr. Dan Cooper and Andria Pontello investigated the breath-analysis on type 1 diabetic children. They took air samples while the subjects were on hyperglycemic state and progressively while increasing their subjects' blood insulin levels.

F. Sherwood Rowland and Donald Blake, chemists at the UC laboratory of UC Irvine examined the breath samples and found high concentration of methyl nitrates up to ten times more when the subjects were hyperglycemic compared when it was shown they had normal readings.

The concentration matched the subjects' blood glucose levels in the sense that the higher they went so did the concentration of methyl nitrates go up. Dr. Pietro Galassetti said that there are more fatty acids in the blood of type 1 diabetics during hyperglycemia.

This causes oxidative stress and methyl nitrates maybe its by-product. I hope there will be more news on their progress because I know they are involved in more studies hoping they will have more report on the use of breath analysis to monitor blood glucose levels.

Omega-3 Fatty Acids Lower Risk for Type 1 Diabetes

Omega-3 fatty acids when consumed regularly by the children at risk of developing type 1 diabetes are revealed by a preliminary research to help lower that risk. This was published in the Journal of the American Medical Association.

With type 1 diabetes, the beta cells in the pancreatic islets are destroyed. No one knows why this happens although the hypothesis has been that this is caused by both heredity and environment. Nutritional factors are also thought of as related to type 1 diabetes so Dr. Jill Norris wanted to see if the regular consumption of Omega-3 Fatty Acids were a factor in the destruction of the beta cells that produce insulin.

From 1994-2006, Dr. Norris and her team studied 1770 children who were at high risk for developing type 1 diabetes. They followed this case up for more than six years on the average with the subjects taking polyunsaturated fatty acids since when the children were one year old. They found out that the regular consumption of the Omega-3 Fatty Acids lowered the risk by 55%.

The following are some of the findings related to Omega-3 Fatty Acids:

The tendency of the diabetics to have low HDL and high triglyceride levels makes it essential to consume omega-3 fatty acids found in fish oil. Since they are considered essential to maintain health and are not manufactured by the body, they must be consumed through foods such as tuna, salmon, and halibut, lake trout, mackerel and sardines at least twice a week.

Another essential fatty acid is the omega-6 but the trouble is there has to be the correct balance between these two. An imbalance could contribute to the development of disease while a proper balance will do the opposite, that is, maintain and improve health. For more information on Omega-3 Fatty Acids, scroll down to the second paragraph after the graphic on this page.

The usual American diet in order to be healthy should contain approximately two to four times more omega-6 fatty acids than the omega-3 but the trouble is that is not the case in what we usually eat. What we have instead is a usual diet with 14 to 25 times more of the omega-6 than the omega-3 fatty acids.

Bladder Dysfunction in Women with Type 2 Diabetes

This report is based on a presentation made at the 29th Congress of the Societe International d'Urologie in Paris, France. Study of past literature on this subject showed that older women with diabetes had atonic bladder condition known as diabetic cystopathy.

The trouble with these findings in the past is that the studies were carried out in patients who were going to specialty clinics. In addition, they did not distinguish between men or women and neither did they do so with type1 and type 2 diabetes.

This new study, however, employed well classified subjects based on urine testing. This is the way they did it. Among the 400 women diagnosed with type 2 diabetes, 48 agreed to undertake urine testing. The researchers were able to measure the urinary incontinence through questionnaires, interviews, standard evaluation and physical examination.

The measurements included treatment, duration, diabetic complications, glycemic control and laboratory data on the gravity of the incontinence.
These are their findings. Nobody had bladder cystopathy, about 50% had severe incontinence, and 38% had weekly measurement of the urinary incontinence.

Among the subjects studied, 50% stated they had mild symptoms of the lower urinary tract, 42% of which were average and 8% severe. Almost 75% used insulin and had a mean A1c of 7.5. Among these women, 11% had retinopathy while 54% had neuropathy.

Here are their conclusions. The study showed that bladder sensation was impaired early on. The bladder dysfunction does not appear to show in the majority of the participants. This is found to be not common. It is rather an infrequent end organ outcome of diabetes.

What does this mean to us? We have to soldier on to achieve our ABC targets through lifestyle changes first and then through medications if necessary. And of course let's not forget about increasing our physical activity and other things to do to reach our goals as shown on this page.

Hope for Cure on Diabetes Walks

There are so many walks for diabetes going around. All you have to do is find one in your community and then sign up. An example is the one done about a year ago with hundreds participating to help find a cure for type 1 diabetes.
which is the mission of the Juvenile Diabetes Research Foundation International.

The walk above has a lot of participants so they were hoping they would surpass the $100,000 raised the year before. Lee Smith, who was diagnosed with type 1 diabetes said that JDRF helps with the discovery of medication. The most notable of this is the one that helps protect the kidneys which is called the protease inhibitor.

The Juvenile Diabetes Research Foundation International was established by parents whose children are diabetics. This non profit organization helps raise funds all over the world. The hope is to find a cure and the complications through research. It has already granted over $1 billion to research for a cure for type 1 diabetes since it was established in 1970.

In 2006 alone, the Juvenile Diabetes Research Foundation International donated $122 million dollars. Let us support organizations like this in their fight against diabetes for as the saying goes: United we stand; Divided we fall. Ask your employer to have a campaign fundraiser.

You can even start your own team. There are lot of benefits when the place of employment participates. Not only does it build the spirit of team building and promote teamwork but also it does not cost the company anything because the raising of the funds is on the shoulders of individual donors while it raises awareness to the company and building employee morale.

So go out and start walking for diabetes. It is our very own tour de cure. This will draw people to walk together in a healthy activity and at the same time raise money for a worthy cause. And it is to find a cure for type 1 diabetes.
What are you waiting for?

Galvus and Metformin 4X More Effective Than Metformin Alone

The finding in the aforementioned title was presented at the 43rd annual conference of the European Study of Diabetes. The meeting was held in Amsterdam, in the Netherlands. Type 2 diabetes patients who did not achieve their glycemic targets even though they were taking high doses of metformin were given galvus in addition to their metformin treatment. They were found to be four more times liable to reach the recommended goal.

At that time, this drug was projected to receive approval in Europe for marketing purposes. For awhile I wondered whatever happened to it. This is what I found: EU approved Novartis combo drug eucreas as reported in February 2008. The regulators had given the green light to the new combination diabetes drug called eucreas. This contains the inhibitor galvus that was recently approved.
 
The approval came after Novartis proposed changes to the label. It recommended that liver monitoring should be in place at the beginning of the treatment, and should be conducted every three months for the first year and every so often after this period
 
The approval was given the go-ahead after the European approval of the galvus that was updated. It will be designated for use with metformin or any of the sulphonylureas. The new European Guidelines for Diabetes says that polypharmacy is the best development in the cure of diabetes.

The combination of drugs is meant to make the treatment more efficient and at the same time lessen the side effects. The European guideline recommends an HbA1c goal of 6.5% while the American Diabetes Association suggests a target of 7%. This is the goal of many approaches on how is diabetes treated.


A principal medical officer at Novartis, USA, Dr. Sylvia Dejager and her colleagues examined the effects of galvus as a monotheraphy and in combination with metformin. They presented their findings at the meeting in the Netherlands saying that when combined with metformin four times more patients achieved the A1c level of 7%.

Whatever Happened to the Study That Was Granted $10.8 Million

The Columbia University Medical Center received $10.8 million from National Institute of Health last year to study the link between heart disease and diabetes. This multidisciplinary team will find out why those who have type 2 diabetes are vulnerable to heart disease, which is the top cause of death for people who have diabetes.

This will be a five-year program. This all started when Dr. Elizabeth Nabel, director of the National Heart Lung and Blood Institute and Dr. Allen Spiegel, then director of The National Institute of Diabetes and Digestive and Kidney Diseases asked researchers of other fields to get together to study diabetes and heart disease.

Dr. Ira Tabas, professor and vice-chairman of research at Columbia's College of Physicians and Surgeons, Dr. Alan Tall, a professor at Division of Molecular Medicine and Dr. Domenico a co-director of research at Naomi Berrie Diabetes Center agreed to accept the challenge.

Dr. Tabas said that if they could understand better the function of insulin resistance in the development of atherosclerosis, they would be able to develop the appropriate therapies to prevent the terrible effects from these two diseases. Heart disease is the cause of diabetic deaths by 65%, so did the NIDDK report. The risk for heart disease for diabetics is two to four times higher than those without diabetes. The same is true for stroke.

My research did not show any of the aforementioned study but revealed among other studies from the same university the following:

• Columbia University Medical Center along with the Joslin Diabetes Center and the State University of New York conducted a Telemedicine Research Study.
  


• Naomi Berrie of the Columbia University Medical Center will have a study on Telemedicine Research.
  


• Columbia University Medical Center reveals that diabetes can result in gum disease in children much younger than previously observed.
  

As you can tell, there is no mention of the $10 million dollar study on the
link between heart disease and diabetes. With much anticipation, I await the report on the result of this study. It can only advance the knowledge we have on this important issue.

What Triples the Risk of Developing Diabetes

A major pan-European study reported a while ago that a damaged beta cell in the pancreas that secrete insulin will have a triple risk of developing diabetes even among healthy people. In addition, they also double their risk for developing obese abdomen over a three year period.

These data are arrived at when compared to those whose beta cells are working normally. This RISC (Relationship between Insulin Sensitivity and Cardiovascular risk) study was undertaken to look at the role of insulin resistance in the worsening diabetes and cardiovascular risk factors.

The study observed 1500 middle-aged healthy people from fourteen European countries who are going through regular monitoring for insulin resistance and other risk factors for cardiovascular disease, blood pressure, obesity, lipid levels and physical activity.

After three years, the follow-up data of 784 subjects revealed that insulin resistance was not the only reason for cardiometabolic risk. In addition to insulin resistance, central obesity and obesity contributed to the Insulin Resistance Syndrome with 1% who developed diabetes, 3% having impaired fasting glucose and 12% were observed to have impaired glucose tolerance.

These findings just confirmed the importance of physical activity for this has been found related to better insulin sensitivity . This was found true even in people who have abdominal obesity. And here's another important finding of this study. It also lowered the stiffening of the arterial wall which is age-related.

Mark Walker, professor of molecular diabetes at the University of Castle-Upon-Tyne reported the findings and recommended that the doctors have to persuade all patients whether they are healthy or not to be active physically
as this will lessen the triple risk to develop diabetes.

Do you want to know if you are at risk to develop diabetes? Here's a checklist for you to determine once and for all if you are at risk. The more "yes" responses you have, the more at risk you are. When you find you are at risk, please get tested so you can fight it better:

• Is there someone in your immediate family with diabetes, like your parents or brothers and sisters?
  


• Did you ever have gestational diabetes or have you ever given birth to a baby who weighs more than nine pounds?


• Is your cholesterol level not normal, that is your HDL cholesterol (good type) below 35 mg/dL, or is your triglyceride level above 250 mg/dL?
  


• Are you fairly physically inactive, that is you exercise less than three times a week?
  


• Is your ethnic background American Indian, Hispanic American, African American, Alaskan Native or Pacific Islander?
  


• Is your blood pressure 140/90 mm Hg or higher or have you ever been told you have high blood pressure?
  


• Do you have a history of cardiovascular disease?
  


• Have you ever had impaired glucose tolerance or impaired fasting glucose on your previous test?
  


• Are you over 45 years old?
  


• Are you overweight?
  

Now you know if you are at risk to develop diabetes. What is the next step? Make an appointment to get tested for diabetes. If they find you have pre-diabetes, get going with a strategy to beat the condition and you will have a better chance at stopping this or delaying its coming. This is how to prevent diabetes.

Sleep Apnea Improved After Obesity Surgery?

November 8, 2008

Sleep apnea was the topic at the annual Congress of the European Respiratory Society in Stockholm. Two studies were presented that revealed a benefit from obesity surgery over and above the weight loss. It can considerably lessen or stop apnea during sleep. This breathing disruption in sleep can result in snoring and is a known risk factor for cardiovascular disease.

Since obesity is now recognized as a major problem and contribute to such diseases as diabetes, this finding is of importance. With obese people, the fatty tissue around the neck narrows the airway so when the throat muscles relax when sleeping, the airway is narrowed even more. So it is good to lose weight with exercise and a diet that is low in calories. Obviously, this will also help prevent diabetes and delay or stop the complications.

Here's the other side of the equation. It has been found that obesity surgery may not put sleep apnea to rest. They say that sleep apnea oftentimes continues after obesity surgery. What is sleep apnea? In the obstructive type, breathing stops for a short time several times each night. This happens more often to those who are obese but it can also occur to those who are not overweight.

This shows that if the obstructive sleep apnea continues on after the bariatric surgery, then these people are taking a health risk because often they do not know that the condition is still there and I will tell you why in a while. You see this study included 24 adults who were severely obese who spent a night at the Walter Reed Medical Center's sleep lab in Washington, D.C. before surgery and then a year later.

They all lost weight after the surgery although they were still obese but not as much as before the operation. After a year, only one of the participants reported that he did not have the obstructive sleep apnea. The condition was not really changed except that the symptoms improved in different extent. Scroll down to see Sleep Apnea.


All of the participants still needed the machine for help so they can breathe better at night. However, only six of them were using the machine. So here's the answer to why some do not know if they still have the sleep apnea. It's because they snored less after they stopped using the machine.

November is Declared American Diabetes Month

November 1, 2008

To increase awareness to the millions of Americans who have diabetes or at risk for getting the disease, November has been declared American Diabetes Month. Diabetes is now considered an epidemic so each week in November, the American Diabetes Association will focus on one aspect of the disease. This is what the Vanderbilt Diabetes Center wants to do to spread the news about diabetes awareness, prevention and control.

November 1, 2008
"Dream Big" - Diabetes Family Day
An event for pediatric diabetes patients & their families and friends

November 5, 2008
Brown Bag Lecture
“Diabetes: Who gets it and Why?”
Mike Fowler, M.D.
11:30 am – 12:30 pm
Room 419A Light Hall

November 12, 2008
Brown Bag Lecture
"Diabetes: Basic Information for You & Your Family”
Alvin Powers, M.D.
11:30 am – 12:30 pm
Room C-2209 Medical Center North

November 14, 2008
World Diabetes Day
Wear BLUE with Vanderbilt Diabetes 
Staff & Faculty to show your support!

November 17, 2008
Blood Sugar Screening with Health Plus
10:00 a.m. – 2:00 p.m.
North Lobby of Light Hall

November 19, 2008
Blood Sugar Screening with Health Plus
10:00 am – 2:00 pm
VU Law School, Ray Room #151

Last year the American Diabetes Association had all these activities:

November 1-3 was devoted to the caregivers. These are the main supporters of loved ones who suffer from diabetes and so are faced with so many challenges. Let's hope they will be given the support they need themselves.

The employees was the focus on November 4-10. Encouraging the adoption of healthy lifestyle in the workplace will be the key component of this week. This will not only prevent type 2 diabetes and the complications, but it will also help the companies improve their bottom line each year.

Considering the diabetes around the world was the topic for November 11-17. Over 246 million people are afflicted by diabetes and this number is expected to grow to 350 million by 2020. It is not too late to do something about it. Let us all help stop this trend. The power is in our hands to prevent diabetes.
.

November 18-24 dealt with the population that is at risk. The statistics now stands at one in two members of minority groups born after 2000 will develop diabetes if the present trend keeps going on. Let's accept the challenge and stop this trend by encouraging others to adopt a healthy lifestyle.

The ones who need the most vital care are the youth and Type 1 diabetes. ADA made the resources available for these youth and their families. I didn't see this released. Had I found it, you would have been the first to know. I know they worked hard assembling all the materials and networking facilities for this group.

ADA supports the United Nations' resolution on diabetes which invites everybody to fight this epidemic by making people aware of this. Let's do our share and accept this invitation. Let us let people know of this epidemic by making themselves aware of things they can do now to prevent diabetes and its complications.

Let us spread the word far and wide and reach as many people as we can not only on the United Nations' World Diabetes Day on November 14. In other words, let's make every day a Diabetes Day by contributing in our small way to spread the word to all we know. Our small ways put together equals one giant step to beat diabetes.

Diabetes Patients More Likely to Fracture Hip

Sixteen studies examined 836,941 people who suffered 139,531 hip fractures. The studies found that diabetes will make one susceptible to break the hip. Further results of twelve studies reviewed that type 2 diabetes patients are 70% more likely to sustain hip fracture.

The other six studies showed that people with type 1 diabetes are over six times more vulnerable to hip fracture. No one knows why this is the case although the researchers said it could be a complication of the disease that may make a diabetic patient more likely to break the hip.

Hopefully, there will be more studies on this matter. For now it is good to take notice of this and be alerted so we will be able to cope with any unexpected situation. Now there are more studies on the same issue that have been conducted by researchers. Could neuropathy be a part of this?


The Journal of Clinical Endocrinology & Metabolism, reports that older women with diabetes are 80-90% more likely to have a shoulder or hip fracture than women without diabetes. Researchers also found out that women receiving insulin are two more times likely to have fractures in the feet.

The largest study on the risk for fracture of women with diabetes was conducted in San Francisco's University of California. They analyzed the data on the study of fractures conducted for nine years. They found that during that period 2624 women had at least one fracture during 9.4 years and 388 women suffered a fracture during 3.7 years.

It is therefore suggested that the quality of the bone mass among the subjects with diabetes might show abnormalities that can lead to higher risk of fracture. There is a need to improve the bone strength of these women and so research is needed to see if the current treatments are doing enough.

American Diabetes Association Features Dr. John Buse

Last year, The American Diabetes Association announced the election of its president, Medical and Science. Dr. John B. Buse, MD, PhD served as the ADA's main spokesperson and advocate on scientific and medical matters. In addition, he worked with the volunteers and staff to support ADA's mission.

Dr. Buse has a stellar background. He served as chairman of several committees and task forces at ADA and was associate editor of ADA's journals. To fight for a diabetes cure, he is an active fund raiser. He is the chief of the Endocrinology Division of the Department of Medicine of the University of School of Medicine in North Carolina and is an active clinician with a diabetes practice.

As for his research work, Dr. Buse serves as vice-chairman of the National Institute of Health's largest study called Accord. This study's goal is to determine the best treatments for diabetes, blood pressure and cholesterol in type 2 diabetes.

Dr. Buse is also co-investigator in the National Institute of Health's study about changing the school environment as a means of preventing diabetes among children in the middle school. I can't wait to read the findings on these two studies, don't you?

I tried to keep an eye on the results so that as soon as they publish them, you will be the first to know. But alas I could not find it anywhere. But some of you may be more of a scholarly type than I am. So let me know when you find it and I will assess it and see what to impart to others.

We should all celebrate Dr. Buse election for his dedication to the science of how to prevent diabetes is apparent. Diabetes is such a serious disease that affects 21 million adults and children in the US. It is the fifth destructive disease. As of yet, there is no cure and so we need someone like Dr. Buse as an advocate. But cure or no cure, each one of us, individually or together, can fight and beat this deadly disease.

Kids Do Not Have Enough Exercise

A University of Bath study found that 95% of boys and 99.6% of girls did not meet the national target of one hour a day of exercise. This finding led the Archives of Disease in Childhood to issue a warning for the NHS to do more to combat obesity.

This is the way they conducted the study. The researchers examined the physical activity levels of more than 5500 11-year-olds in the South West of England for seven successive days from January 2003 to January 2005. They were interested in the level of physical activity these kids were doing every day. They also observed the amount of moderate and vigorous exercise these kids were doing.

Libby Dowling, Care Advisor at Diabetes UK said that it's disturbing to find that children and young people live a more and more inactive lifestyle. This sedentary lifestyle along with diets that are high in fat, sugar and salt is linked with increasing statistics on obesity and consequently the rise of type 2 diabetes in young people.

If this is not addressed accordingly to stress exercise and healthy lifestyle, young people are in for a life of bad health. That is why weight is important to prevent diabetes. Likewise, it is important to diabetes treatment. So use the arithmetic of energy balance for they are now pointing out the link between exercise and diabetes.

What is this arithmetic all about? It's simple. When the energy that comes in goes over the energy that goes out, we gain weight. It's that simple. When we consume more calories than we use up, we of course gain weight. And this extra energy is stored as fat.

One important use of energy is physical activity. So each time the child moves his arms and legs he uses the energy to provide power to the muscles. Even a simple activity as walking consumes some form of energy. The more strenuous the activity, the more energy is consumed.

So now that the children use the computer more often and play games on it, the energy consumed is less than the energy intake. The result? Weight gain of course. With the aforementioned study finding out that kids do not have enough exercise, what can we expect?

UK's Research on New Insulin Capsule

To make sure insulin taken orally is not useless before entering the blood stream. researchers are trying to find a chemical coating that will protect the insulin from the enzymes that break it down. The researchers from Aberdeen's Robert Gordon University did just that and found a chemical coating called a novel polymer.

The discovery of an insulin capsule is therefore becoming a real possibility. They need to do more testing to find out if it's suitable as an insulin delivery system. Dr. Colin Thompson, Research Fellow at the university's School of Pharmacy said that this will give hope to people living with diabetes.

In fact, researchers are continuing their search for what causes diabetes in the hope that they will find a cure or prevent this disorder. They have already found the genes that may be involved with IDDM and a NIDDM (Non-Insulin Dependent Diabetes Mellitus). They have already identified some genetic markers so they can screen the relatives with this condition.

The above is a good thing, indeed, if used properly. But once greed sets in, there you go. This may be just fiction, but reading Robin Cook's "Marker" just gives me the creeps. It is so scary. I don't want to reveal the source of my displeasure of this novel except it is not due to Robin Cook. In fact, he's such an excellent writer, I couldn't put the book down!

That was a long side-bar and I didn't even give you a warning. But anyway, I'd like to say here that there's been an on-going study where the relatives of IDDM (Insulin Dependent Diabetes Mellitus) are identified and treated with low doses of insulin, hoping this will prevent diabetes.

Anyway, they are being treated now with the goal to see if this will answer the question on how to prevent diabetes. This is a long term study to find out if the therapeutic approach works. They have started this for sometime now but I have not seen the result yet and believe me, I am watching like a hawk, eight hours a day, seven days a week.

New Ways to Fight Obesity and Diabetes

An equipment made for UQ researchers will find out how to manufacture food that's better, healthy-wise as well as tastes good. Professor Bob Gilbert, a UQ researcher said that unhealthy lifestyle is an important factor in the obesity and diabetes epidemics in Australia but is not entirely responsible for the epidemic.

Professor Gilbert said that a significant part of the problem is the change in the starch contained in the food we eat. Starch provides 50% of food energy in Australia and up to 90% on Asian diets. It is therefore helpful to find out what starches are good for us.

There is a new equipment made in Germany for the University of Queensland in Brisbane, Australia that will help do this by measuring the starch structure. This will it make it possible to put the data in a significant framework.

This will enable the researchers to make sense of this information. The new techniques developed by the Centre for Nutrition and Food Sciences at University of Queensland will supply the necessary tools to produce foods that are both healthy and tasteful.

There are some precautionary measures for those who have gestationaldiabetes.
The nutrition therapy for these women is not designed to lose weight but rather it is to eat the right food in the right amount and at the right time in order to manage the blood sugar level.

Exercising will also help lower the blood glucose level. There is really no excuse not to exercise. Many can swim, walk and just be active. This will limit the weight gain during pregnancy especially if one is obese before. Moderate exercise is possible.

The most crucial trigger of diabetes is obesity. How do they define obesity? It is having a mass index of 30 or greater. Mind you, genetics may play a role in becoming obese also. Is it any surprise that genetics may play a role in causing type 2 diabetes? And so, this new study on starch can go a long way in helping us get the nutritious way of eating.

Type 2 Diabetes Treatment - New Drugs?

Researchers used genetically engineered mice whose livers turned like light bulbs at the Salk Institute for Biological Studies. They did this to help them find out more about type 2 diabetes. They found that a protein called Torc2 acts as the key that links feeding, insulin and high blood sugar in the liver. These findings of Torc2 and of the enzyme called SIK can be useful for treating type 2 diabetes.

Drugs taken by mouth in order to treat diabetes are called oral hypoglycemic agents. This is really a wrong name as medications are not given to cause hypoglycemia. The purpose for taking them is to lower the blood glucose level to within normal target.

It is good to remember at this point that oral medications that lower the blood glucose level are not insulin. The ability of the oral medications to lower the sugar level has been known. The same is true with the sugar-lowering ability of some herbs and plants.

The Centers for Disease Control and Prevention says that one of three Americans born in 2000 will develop diabetes. It says further that it is not curable and that it can cause blindness, heart disease, kidney problems and other serious complications. That is why aforementioned studies like the above are most welcome.

There is a caveat here. Diabetic mothers should not take oral hypoglycemic drugs due to possible undesirable effects on the fetus. Dietary control, monitoring of the blood glucose level plus exercise as recommended by the physician will result in successful diabetic pregnancies with healthy babies.

Now the researchers in the aforementioned study found that a protein called Torc2 acts as the key that links feeding, insulin and high blood sugar in the liver. In this case, we may be able to see new drugs coming in to treat type 2 diabetes. And we will welcome this as it will add to our arsenal on how is diabetes treated.


To this, I will add. It is not going to happen if we stay vigilant in lifestyle modification. We will eat healthy, indulge in physical activity and follow the doctor's orders. If we are at risk for diabetes, we will request to be screened for it so that we can start the lifestyle modification to prevent it from coming.

How Cells That Secrete Insulin Keep Sensitivity to Glucose

There's good news from Karolinska Institutet, the leading Swedish Medical University, about the insulin-secreting cells. It appears they have resolved the question as to how these cells keep their sensitivity to insulin. This is important news as we will learn how the body can maintain blood glucose absorption within the normal targets to avoid diabetes.

We know that insulin controls the transport of glucose to muscles and tissues by releasing hormones. It was a mystery how these insulin-secreting cells keep the correct amount that is necessary for the glucose transport. But now the scientists at Rolf Luft Research Center for Diabetes and Endocrinology at Karolinska Institutet have discovered a new traffic way where the sugar helps the insulin secretion controller do its job.

Professor Berggren said this discovery is important as it gives the insulin-secreting cells an effective way to keep up with the correct amount to maintain blood concentration within normal target thus avoiding the development of diabetes.

Let's have some more information about insulin. It is fascinating yet exasperating to know how the body uses insulin. Why? It is because its use is inconsistent. No matter how consistent one is in injecting the same amount of insulin, one can find there is more than adequate amount to do its job on the blood glucose.

There are many factors that can affect how much insulin the body needs:

• how much one eats
  


• what foods one eats
  


• how much exercise one does
  


• when the exercise occurs in relation to the schedule of medication
  


• one's overall health
  


• injection site
  


• the stress one has to handle
  

As one can see, it is not easy to manage all the above. No matter how much one tries, the insulin could still be stubborn and work on the blood glucose although the level has fallen too low to the point that hypoglycemia may occur.

Reduce Diabetes Damage

Mandrell, AKA Mr. Diabetes, tried to walk across the nation for diabetes but dropped Saturday morning in Columbia. He said there's no cure for diabetes and that it's a 24-7 life sentence. He was first diagnosed with diabetes when he was forty years old in 1985.

He was in denial so he did not watch his condition carefully and so it got worse. He had to walk with a cane because his feet and legs were numb. Then he had eye surgery because he was going blind. That's why he chose to walk to raise awareness.

He wanted people to take responsibilities for themselves and not wait for cure. He wanted them to know that three things could reduce the damage diabetes can do. What are they? See a doctor regularly, eat healthy and be physically active.

That said, let's see what one of the authorities has to say. From the American Diabetes Association we get the most common treatments for diabetes. What are they? They're not too far away from what Mr. Diabetes recommended. They are:

• Healthy meals to manage blood glucose and blood lipid levels, maintain weight and reduce the need for additional medications.
  


• Exercise to lower blood glucose and blood levels, be physically fit, raise one's sensitivity to medications and maintain healthy weight with the help of the meal plans.
  


• Diabetes medications taken orally to lower blood glucose levels by decreasing resistance to insulin, reducing blood glucose levels and improving the release of insulin.
  


• Injection of insulin to reduce the blood glucose levels and to make-up for the inability of the pancreas to produce insulin.
  

There you are. If we follow those common treatments, we should be able to avoid the complications. We have to be consistent though, to walk the walk instead of just talking the talk. It is very important that we take care of ourselves instead of just waiting for a cure.

More than a Third of Adults With Diabetes Affected by Sleep Apnea

August 30, 2008

When collapsed airways result in impaired breathing, sleep apnea happens. People affected wake up many times during the night. New research now suggests that people with type 2 diabetes may constitute the 36% of diabetics who suffer from sleep apnea.

The Whittier Institute for diabetes in La Jolla, California had their researchers examine the sleeping habits of 279 adults with type 2 diabetes. One of three of these suffered from sleep apnea. They found that men, chiefly those over 62 years old were two times more than women to suffer from sporadic sleep.

This is not a surprise as a prior research has shown the link among glucose intolerance, insulin resistance and interrupted sleep. This is the first research though that examined data from a diabetes clinic. Dr. Daniel Einhorn, the lead researcher said that type 2 patients should be screened on a regular basis for sleep apnea as treatment for this condition has shown to lower the blood pressure and improve the blood sugar level.

We have more information on related matter like sleep deprivation or sleep disorders. There are other studies that link obesity and so to type 2 diabetes to lack of sleep, loss of REM sleep, snoring and other disorders that are related to sleep.

When one does not get enough sleep especially the REM sleep (short for rapid eye movement which happens when one is sleeping deeply), naturally one will be drowsy and perhaps irritable all day long. This will be enough to make one eat more and you know where that leads to. This is considered to be one diabetes risk.


Craving for foods with high sugar content is likely going to be the result of sleep deprivation. To stop the cycle of lack of sleep, then eat fast-energy foods, maybe a visit to a sleep disorder clinic where the problem can be addressed.

Stem Cells into Insulin-Producing Cells

Stem cells? The shortage of donor tissue supply is a major challenge in the islet cell transplantation treatment for type 1 diabetes. Why? Because patients frequently need islet cells after the first treatment and this will require another donor. Have no fear for the researchers at the Diabetes Research Institute of the University of Miami could perhaps ease the problem.

Before, researchers only fairly succeeded in distinguishing either adult stem cells or embryonic stem cells that turn into insulin-producing beta cells. The reason behind this is because they needed to bring on the culture environment to succeed. The islets need a high quantity of oxygen for health and herein lies the problem.

But the UM researchers produced a new device called "oxygen sandwich" to give the cells a better oxygen environment. Chris Fraker, senior research associate in the Tissue Engineering Laboratory at the Diabetes Research Center, designed the oxygen sandwich which is a close copy of the natural oxygen environment. The use of this helps differentiate the insulin-producing cells and opens the way to more treatment.

What is a stem cell transplant? It is the infusion of healthy stem cells into the body. Why is this an option? It is because the bone marrow stops functioning and doesn't produce adequate number of healthy stem cells. A stem cell transplant can aid the body make enough healthy white blood cells, red blood cells or platelets. This will also reduce the risk of infections, anemia and bleeding that could threaten life.

Even though the process to restock the body's supply of healthy blood-forming cells is called a stem cell transplant, it's also known as an umbilical cord blood transplant or a bone marrow transplant. The name will depend on where the stem cells were taken.

The stem cell transplant is called autologous stem cell transplant if the source of the cells is one's own body and allogenic stem cell transplant if the cells used are from other donors. There is more information at this site on diabetes stem cells.

Release of Diabetic Care Product

An old device called Volvelles was first used in the 14th century to calculate and record almost everything has been resurrected in the form of wheel charts. These consist of two or more round disks linked at the center with a hole.

Rotate these disks and voila, the user gets instant information. In this modern age where large amounts of information are available on line, the users actually love these because they are easy to use. The wheel chart has made it possible for diabetics to keep track of the sites of their injection of the insulin.

Rotating the insulin injection site will reduce soreness and infection and avoid scar tissue from developing due to overuse. Sometimes this results in incorrect insulin injection. ADA also advised diabetics not to do their blood testing in the same finger each time.

The Anthony & Associates' EZ Site Tracker is compact. It is only 3.5" in diameter and so fits inside testing kits. It is made of 24 pt covered and toughened paper board with a nickel-plated metal hole center around which two outside discs spin. You can choose 20 glucose testing locations for side 1 and 20 insulin injection sites in Side 2.

Injection site rotation is really the way to go. The usual recommendation for injecting the insulin is in the abdomen although other sites can be used too. The important thing is to inject into a site where there is fat. Usually though people find it easier to inject into the abdomen rather than the thigh. There is more information on insulin therapy.


Whatever is the choice for the injection site, remember to rotate the site in the same area rather than doing the rotation in different areas of the body. Why? The reason is to prevent developing problems in the skin and under it. You know what some people do? They do their morning injection in one site, say the abdomen for example and the evening on the thigh.

Preparation for Natural Disasters Important for Diabetics

There are tips for diabetics when disasters occur like hurricanes, floods, fires. tornadoes, etc. Diabetics will be vulnerable during these disasters as they will need their medications and other things. They may also not have access to their homes and their health care team. It is important to be prepared.

Prepare a disaster kit in advance. Dr. Lawrence Blonde of the Ochsner Clinic Foundation in New Orleans advice all diabetics to do so. In this regard, the American Association of Clinical Endocrinologists (AACE) and Eli Lilly and Company prepared several tips to help get ready for natural disasters. Prepare a diabetes disaster kit that is both insulated and waterproof with the following:

• All medical conditions and surgeries listed.
  


• Information about diabetes like your medication and reactions
  


• List of contact information on your health care team


• Letter from your health care team about your diabetes and routine with your latest laboratory results.


• All medications listed along with the pharmacies


• 30-day supply of medications like insulin, oral medications, glucagon kit if the doctor prescribed this


• Blood glucose testing supplies with extra batteries


• A cooler to store insulin


• Empty plastic bottles to dispose needles and such


• Source of carbohydrate just in case you need to treat hypoglycemic episode and two-day supply of food that does not need refrigeration
  


• Three-day supply of bottled water


• Pen or pencil and notepad to record test results

For an emergency of a different kind, you will have to be prepared with some kind of an emergency card so people around you will be able to summon for immediate and appropriate help. One never knows when an emergency such as a hypoglycemia attack could occur. Here’s an information card you should have with you at all times:

I have diabetes and if I behave in an unusual manner or if I lose consciousness, it may be because of my diabetes, activity and treatment. Please give me some form of sugar in the form of soft drink, fruit juice, candies or table sugar if you think I can swallow. If I become unconscious, please call 911 for help or my doctor and hospital mentioned below:

My Name:

My Address:

My Phone Number:

Please Contact:

Relationship to Contact Person:

My Doctor:

Doctor’s Phone Number:

Hospital’s Phone Number:

Blood Type:

Allergies:

Health Card Insurance Number:

Type 2 Diabetes Found to Have Multiple Genes Implicated In It

Type 2 diabetes and multiple genes? Bruce Goldfarb reported in Doc News on a new research implicating multiple genes in it. He said that the interaction of the genes are multifaceted and on top of this they are influenced by the environment. However, and this is the good news, they may help in the treatment.

A new research has shown that some genes may be implicated in the development of type 2 diabetes. The research group documented seven new genes among 32,000 people composed of four population groups of Asian, African, American and European.

Then the report further said that ten genes are found to be implicated in around 80% of the risks of developing this condition. They explained further though that the effects on individuals were moderate. Francis Collins, MD, who is the director of the National Human Genome Research Institute said that more genes related to diabetes remain to be discovered.

This discovery will help learn how diabetes comes about. Collins further said one of the genes is connected to the control of triglyceride and another manufactures a protein involved in carrying zinc into the beta cells in the pancreas.

Mind you the treatment of this condition through genetic correction is still far-off but knowing these genes are there could help the patient. For example, this finding is encouraging the development of new tests that would evaluate the individual risk.

Also this new genetic knowledge may lead to drug treatments that are better targeted. In the future, drugs may be developed that will more closely do the job of the naturally occurring procedure with greater effectiveness and less side effects. There are some more information at this site on type 2 diabetes.

Update on Management of Type 2 Diabetes in Youth

Drs. Peterson, Silverstein, Kaufman, and Warren-Boulton have published an update on the management of Type 2 diabetes in youth. This is very timely for this is becoming an important disease for the youth. The factors for high risk group are a body mass index of more than the 85th percentile plus family history and high risk ethnicity.

Increased physical activity along with a healthy diet plus a reduction in weight and blood glucose level can prevent or delay the onset of the disease. The American Academy of Pediatrics does not propose that the high risk group be screened but advised the physicians to closely monitor these patients because early diagnosis maybe helpful.

However The American Diabetes Association recommends screening these patients every two years. It was further suggested that those diagnosed with diabetes receive behavioral interventions to encourage eating healthy and physical activity.

Since the treatment of Type 2 diabetes is different between adults and children because the management for the latter group is focused on lower insulin sensitivity with advancing physical growth and sexual maturity and the ability to do self-care, it is good to tailor the treatment for each patient.

It is not enough to use just diet and exercise because this works only for less than 10% of the afflicted youth. Oral medication or insulin is usually necessary. Treatments of blood goals target, type of insulin dose, self-monitoring frequency, meal planning to promote good nutrition
and physical activity will differ from patient to patient.

Doing all the self-care tasks can make the kids feel different and coping may lead to depression and eating disorder so a social worker or psychologist can help with adjustment to lifestyle changes. While kids should be able to do self-care tasks, they need to be supervised until they are able to do them on their own.

Mother's Blood Sugar Linked to Kids' Obesity Risk

July 19, 2008

Anita Manning reported in USA Today that women with high blood sugar levels when they are pregnant are two times more likely to have obese children. This is according to the largest study on the same issue. This research is published in the September issue of the journal called Diabetes Care.

It is not all bad news though because Teresa Hillier, an endocrinologist and co-author of the study said that the tendency to have obese children is reversible when the high blood sugar is treated during pregnancy. Reversible is the word to note here.

Teresa Hillier and her colleagues at Kaiser Permanente's Center for Health researched 9439 mother-child pairs who were enrolled at the center's Hawaii and Regions in the Northwest from 1995 to 2000. The result of their examination is that the higher the mother's blood sugar, the greater is the chance for the child to be overweight by the time he is between 5 and 7 years old. They found this true for all ethnic groups.

The key thing to do is to get the child started on healthy lifestyles. Eating healthy is one that will benefit everyone in the family. Don't get the baby started on too much orange juice as it contains a lot of sugar. This has been the findings of the recent studies. Go easy on cookies too.

The other part of lifestyle to take note is to get the child started on some physical activity. I have seen babies in the swimming pool with their mothers. Then as soon as they are in their toddler years, you can get them started on T-ball games. Oh, they will not be too focused but at least they will be active and not become obese. And you will have fun watching them play. I know I have.

Heart Attack Raises Diabetes Risk

July 12, 2008

A new study finds that after a heart attack, the risk of developing diabetes and pre-diabetes goes up sharply. Heart attack patients are four-and-a-half times more likely to develop the condition than the general population. The August 25, 2007 issue of The Lancet further reported that the patients are fifteen times more likely to develop high blood sugar.

Before this study, the correlation between diabetes and cardiovascular disease was clear in the sense that people with diabetes are two to four times more at risk to get heart disease. They are also five more times at risk to have a stroke.

Dr. Lionel Opie, director of the Hatter Cardiovascular Research Institute of the University of Cape Town, in South Africa said that having a heart attack means that the chance of getting diabetes later is increased. This has been proven by the study that was conducted.

The study led by Dr. Roberto Marchioli from the Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, in Italy, collected information on 8300 Italian patients who suffered a heart attack.

These patients were not diabetic prior to the heart attack but a third of these patients developed diabetes or had impaired insulin resistance after more than three and a half years after the heart attack. These results showed the correlation between heart attack and high blood glucose.

The risk factors for diabetes are high blood pressure, age, the use of heart medicines like the beta blocker drugs to lower cholesterol levels and diuretics. Being overweight, an unhealthy diet and heavy drinking of alcohol also increase the risk and smoking increases it by 60%.

It is therefore important to change the lifestyle in order to prevent diabetes. Changing the lifestyle means eating healthy. Speaking of healthy eating, a Mediterranean diet can help prevent diabetes so did Marchioli say. This also has been the opinion of some other experts.

Chief of Endocrinology & Metabolism at Pennsylvania Hospital Recommends Exercise Tips for Diabetics

Dr. Rosen, a known metabolic diseases expert on forefront for research on treatment of diabetes, makes recommendations on exercise guidelines for diabetics. Here they are:

• Wear light clothing.
  


• Use well-fitted footwear.


• Do warm-up or stretch before exercise.
  


• Drink often during exercise.


• Have soft candy at hand.
  


• Talk to your doctor before doing intense exercise.
  


• Build up exercise.
  

The American Diabetes Association awarded him the Charles H. Best Medal for Distinguished Service when he was its president of the eastern region. Of course you know who Charles Best is. He was Dr. Banting's right hand man when they discovered insulin.

That is why, Dr. Banting was so pissed off when he received the Nobel Prize along with another and Charles Best was not even mentioned. What do you suppose good-natured Dr. Banting did? Well, he shared his award with Charles Best, what else.

Back to Dr. Rosen. He has done significant diabetes research. This has been published in primary journals such as Diabetes and the Journal of Clinical Endocrinology and Metabolism. He said that to make certain that one manages diabetes and stay fit and healthy, follow the exercise tips and consult with your doctor.

Want to know what are the benefits of exercise? Here they are:

• Lower blood sugar levels
  


• Lower A1C levels


• Improved HDL cholesterol
  


• More calories are burned.
  


• Strength and flexibility are increased.
  


• Improved quality of life
  


• Better insulin sensitivity
  


• Lower triglyceride levels
  


• Improvement in hypertension
  


• Cardiovascular system is better conditioned.
  

With all those benefits, who would not want to do some physical activity? Come on, let's get moving! But first, get a preexercise exam to make sure all is well. Then set a goal, plan how to achieve this goal and have fun with it.

Diabetes Medications, a Portrait of Cynicism?

Diabetes medications could be insulin or oral drugs. These are drugs taken by mouth. They are also known as oral hypoglycemic agents. This is a wrong term though because these are not given to cause hypoglycemia. Rather they are given to lower the blood sugar level.

By the middle of the 1950's, the diabetes medications called sulfonylureas were developed because they helped lower the blood sugar level of those who could not do so through exercise and diets. Now these are generally known to be effective for type 2 diabetics.

There are other diabetes medications available and they have their own characteristics. Some are long acting while others are intermediate. Still others are short acting. Taking them depends on different factors some of which are physical activity, response to diet and pills, and food intake.

As of last year GlaxcoSmithKline published additional information for Avandia in the US. As per announcement of GlaxoSmithKline. the US FDA has approved the updated prescribing info for thiazolidinediones class of diabetes medications. These are used to treat Type 2 diabetes.

GSK will be able to execute the changes on the Avandia label. This time the label will include a boxed warning in addition to the existing one on the risk for CHF, an acronym for congestive heart failure. One of the most common complications of type 2 diabetes is CHF. In this condition, the heart is unable to pump blood to the other organs.

This can lead to fluid retention or edema which can result in CHF or make it worse. Here's the safety information for Avandia. With diet and exercise, Avandia aids in improving blood sugar control. The possible side effects consist of heart failure or other heart problems.

FDA reviewed more information on this. Consult with your doctor if you have heart failure or heart problems. If you notice swelling or retention of fluid sharpness of breath, rapid increase of weight or feeling unusually tired while taking Avandia, tell your doctor right away.

If you have liver problems, you should not take Avandia. Tell your doctor the diabetes medications you're taking. Avandia may also increase your risk of pregnancy. Don't take Avandia if you're nursing your baby. Also, while taking Avandia, you may experience more fractures and vision changes.

There may be adverse reaction to sulfonylureas which could be in the form of low blood glucose. But the reaction is usually not as severe as those on insulin. The frequency is not as often either. But this does not mean precautions will not be taken into consideration.

When experiencing periods of stress, the doctor may temporarily stop the oral medicine you're taking. Instead he may decide to put you on insulin to control the blood sugar. When the stress is over like in case of an accident or infection, you may be able to go back to the diabetes medications.

Risk of Insulin Resistance Increases With Fat Build-Up

The fat build-up that they refer to here is the one on chest and upper back according to HIV Study. This study led by the San Francisco VA Medical Center says that fat build-up in this area is linked to an increased risk of insulin resistance.

They say that this is the very first time this relationship has been established. The lead author and researcher, Carl Grunfield, M.D., PhD, who is the chief of the metabolism and endocrine sections at the San Francisco VA Medical Center says that the association between visceral fat and insulin resistance risk has been studied before but nobody looked at the upper trunk fat.

We know that insulin is the hormone that controls the blood glucose levels so when the cells become resistant to the insulin action, the end result is high blood glucose which has bad effects on the body. Grunfeld further observes that people with lots of fat in the upper trunk and not much in the stomach are at risk to develop insulin resistance. But if you have both, he says the risk is rather high.

What is the implication of this study? So is this what causes diabetes? Over 3/4 of type 2 diabetics are obese or were obese at one time. But what is obesity anyway? Clinically speaking, anyone who has a body mass index of 30 or over is considered obese. How do you get your body mass index? Google those three words and you will be led to a chart.

The chart will help you determine what is the best weight for you. It takes into account the height and this helps give a good estimate of someone's body fat. Try to adhere as close as possible to the body mass index that is right for you. What am I saying? We should all do that because I myself have a hard time not trying everything at the buffet. Yup, the buffet is still my Waterloo.

The Why of the Diabetes Epidemic, Part 3

We said before that carbohydrates and fats are the main providers of energy to keep it working. The carbohydrates are broken down into smaller sugars in the intestine. These smaller sugars can now be absorbed into the circulation. This is then moved from the blood into the cell.

It is during this transport that it gets to meet Mr. Insulin. There it is broken further making it a main source of energy. The extra sugar or glucose is then stored in the liver or as glycogen in the muscle. This can also be stored in the muscles where they stay until they are needed.

How about the fats? The other main source of energy is dietary fat which produces a breakdown product called fatty acids. The same thing happens to it just like the glucose. They are either used immediately for energy or stored to use later.

Insulin is a hormone that is made in the pancreas. It is a protein that is circulated in the blood stream and while it does, it affects the functioning of the other organs. The pancreas also produces chemicals that help break down the food so that that the intestine can absorb this.

There are also bunches of cells in the pancreas called islets that contain different specialized cells. Phew! Thank goodness for the forefathers who did studies on this and now they're even using it as a new diabetes cure
or we would not even know these cells exist. Anyway, one of the cells in the islets are the beta cells that produce insulin.

The sugar level in the blood is sensed by these beta cells after a meal and as the level goes up, the beta cells make insulin that makes the transport of sugar into the cells faster, thus effectively stopping the blood sugar from going up too high.

When the sugar level falls, what do you think happens? The opposite happens. The insulin production stops and opens up the stored sugar in the cells. Think of the insulin as a traffic policeman who directs the nutrients to the storage when the sugar level is up and then directs them to come out of the storage when the sugar level is down.

Isn't that cool? This is what happens in a person without diabetes. This is a finely tuned machine but just like our cars, when something disturbs the engine, then there is trouble. I should not really call it trouble for it is just a challenge we have to meet head on.

My, my, this is getting too long. We have not halfway covered why diabetes is on the rise but we will. We will just persevere with our weekly sessions and learn as much as we can about this. What is ten minutes (it takes to read this) compared to a life-long knowledge on this which we can pass on to the next generation?

Normal Blood Glucose Levels and Lifestyle Behavior, Part 2

June 7, 2008

Okay, we've covered the three lifestyle behaviors that affect the normal blood glucose levels. Let's review them before proceeding to the others. They are: reducing the consumption of sweetened drinks, managing hypoglycemia well, and matching the insulin injection with the meal schedules. Now let's go to two more.

The lifestyle behavior that is associated with normal blood sugar levels is consistency in eating meals and snacks. And this means eating at regular times a day. That is not all that is related to this behavior for making sure the amount of carbohydrates one eats daily is consistent as well is crucial.

One way of accomplishing the above is through carb counting. This entails counting the number of grams of carbohydrates that is consumed a day. Or the number of servings of carbohydrates can be counted because each serving of carbohydrates is equals to 15 grams.

It should be pointed out here that carbohydrate counting
is different from counting the number of calories and the number of fat grams one consumes. Why? Because for the calories and fat, you keep count of the total consumed for the day whereas for the former it is keeping track of the number consumed at each meal.

Why is this such a big deal? Because carbohydrates effect on the blood sugar peak from one and a half hours to two hours after a meal. That is why one has to eat the same amount of carbohydrates for each meal to ensure the blood sugar level stays stable, that is, not too high nor too low.

If one's consumption of carbohydrates varies a lot, then expect the blood sugar level to be unpredictable. In this case one has to learn how to adjust the insulin dose to match the carbohydrate intake. Have no fear, for your health care team is here. All you have to do is ask them and they will put you on the right track.

Phew! That is one mouthful just for carbohydrate consumption alone. And we still have to cover one more lifestyle behavior that will help keep the blood sugar level normal. I am running out of space but I'd hate to wait till next week to cover the last lifestyle behavior so fasten the seatbelt and don't click me away now. I will make it short and sweet, I promise!

The last lifestyle behavior is learning the effect of food intake, insulin injection and exercise to the different blood glucose levels uncovered from the self-monitoring. Write down each reading and the corresponding food and activity that led to that blood glucose level.

Once this is done a few times, a pattern will emerge and one will master the cause and effect relationship among those three activities. This will help one learn how to adjust the insulin dose to the carbohydrate consumption and the activity level engaged. Pretty soon you will be such a pro, you will be invited as resource person to help the other diabetics. Won't that be grand!

Normal Blood Glucose Levels and Lifestyle Behavior - Part 1

May 31, 2008

Normal blood glucose levels, how do we achieve them? Is there really life after a diagnosis of diabetes? This questions along with others are never far from my mind. My passion, and I am determined to accomplish this, is to show people how simple it really is. Let me try, okay?

1. Lessen or stop the consumption of sweetened drinks. Try not to drink any regular soda and fruit punch unless of course one is having a hypoglycemic episode when one of the treatment options is to drink regular soda. And keep fruit juice intake to just four ounces a day because they make the blood glucose levels go up quickly. Take a lesson from our experience. Thinking orange juice is healthy, we drank it like there was no tomorrow. And then after the diabetes diagnosis we found out that the orange juice we were buying had 37 grams of sugar. Yikes!

2. Speaking of hypoglycemia, manage it properly. This condition is a reading of low blood glucose level, as low as less than 70. The signs are sweating, weakness, excessive hunger, being irritable, trembling and confusion. Sometimes one may even lose consciousness. The treatment for this is to consume a fast-acting carbohydrate that is at least 15 grams. The examples of fast-acting carbohydrates in this case are four ounces of regular soda or apple or orange juice. Five lifesavers or three glucose tablets each containing five grams of carbohydrates or one ounce of raisins will also do the trick. Each of the aforementioned treatment options will usually raise the blood glucose level by 50 in fifteen minutes or so. Check the level then and if it is still below 70, then the treatment can be repeated. If it persists and there is another health concern, one may have to see a doctor.

3. The schedule for both meal times and insulin injection has to match. The health care provider will help in determining the type of insulin to inject with the meal scheduling. For example there are fast-acting insulin that one can take half an hour before meals. But there are even faster acting ones one can take right before a meal.

This is getting too long and readers may get bored reading this so what I will do is write about other lifestyle behaviors that contribute to normal blood glucose levels next week. For clarity sake, I will put Part 1 on the title of this blog,

Myths on Weight Loss

May 20, 2008

Myths on weight loss? Yes, that’s right; they’re all over the place. You won’t believe all they’re saying. Now that we understand the math on weight gain, perhaps, we’re ready to check out the myths surrounding around this very issue.

Here’s one. “I can’t lose weight because my metabolism is slow.” Let’s start with defining what metabolism is. It refers to the amount of energy we burn while we are at rest. The bigger the people are, the higher their metabolic rate is. As we get older, our metabolism rate drops. This is when we limit our activities and lose the muscle mass.

Mind you, it’s true that some people have slow metabolism but this is not common. It is more like the exception rather than the rule. This may explain their weight loss as in the case of a person who has hyperthyroidism. These people spend a lot of energy.

What is surprising to some is that weight loss can lower one’s metabolism rate. This we can understand because the smaller we are, the less food we need. That is why some people who go on a diet of course have some kind of weight loss. And because their metabolism has gone down they may not reach their goal.

So what do they do? In order to reach their desired goal, they will need to eat less to reduce the calories. Some just have to increase their physical activity. This is what is recommended by most weight loss programs. Increase the level of exercise in order to reach the goal of weight loss.

Here’s another myth. I eat like a bird; why am I gaining weight? This is like saying the dog ate my homework. The only way to have weight loss is to eat less food containing less energy and we are spending less of this energy than we are putting in.

So the only way to gain weight is to eat more food with more energy and to move less thus spending less of the energy we brought into our body. It is impossible therefore to eat like a bird and gain weight at the same time. We know very well, that we underestimate the amount we eat. I know I am guilty as charged.

Gain Weight, Can We Avoid It?

To gain weight is something people want to avoid as much as possible. We have all kinds of excuses, do we not? I lost my diet during the holidays is one of them. I got so busy, I didn't have time to exercise. But really the real culprit is... calories!

The thing is we need a certain amount of food in order to survive. We do not want to join the almost cult-like group whose members are dying to be thin. The trouble is, overabundance is a problem. So to address the issue of avoiding food so as not to gain weight, gives us this question: Are we eating to live? Or are we living to eat?

The fuel that runs the body comes from food. We need it in order to be able to work, think, play and in all the other things we have to do. The question is we take in more fuel than we need. The extra fuel in the car sits there until we use it but the extra fuel we have is stored in our body as fat. Bummer, why can't it just sit there until we need it?

This really is the simple math on why we gain weight. Fuel in minus fuel out is equals zero if the activities use up the same amount of fuel that was taken in from all that eating of the meal plan we did. So we have to make sure there is no imbalance between these two. It can't be any simpler than that.

This fuel brought into the body is burned from all the daily processes in the body even if we are at rest to keep the body working like the beating of the heart, maintaining body temperature and all the work that the different parts of the body have to do. We need around 2000 calories for these even if we're just watching TV all day long.

We also need 50 to 100 calories spent just to be eating. We really need these calories for everything we do, even just for walking to the fridge, opening it and getting the food out. And more calories are needed for more strenuous physical activity like jogging or swimming.

So when we have more energy coming in than the energy going out to maintain the bodily functions, what do you suppose happens? Simple, we just gain weight. So if we decide to take the car to go to the store that is just a few blocks away or take the elevator rather than use the stairs, then we are just spending around 100 fewer calories a day.

Diabetes Forecast: We're Vulnerable Due to Our Lifestyle - Part 7

Diabetes forecast was not difficult to comprehend. Look at how the diabetes statistics multiplied. Globally, there were 30 million diabetics in 1985. That number has exponentially risen to 177 million in 2000. And now the prediction is not any better: 370 million by 2030.

Some of the diabetes forecast we do not totally understand. There are uncertainties there, so the doubting Thomases will assert. More research is needed to fully assess the relation between diet and health. The same is true with the long term effects of childhood diets.

Being able to afford the western cuisine which used to be available only to the well-heeled is certainly a mixed blessing. Why? Because the fat in these diets are singularly blamed for the increasing obesity in the developed world. So now because the diabetes forecast is so dire, they’re scrambling to make cuisines healthier.

Can you believe the food pyramid is wrong? Apparently, they have led us down the garden path. The 1992 food pyramid told us to minimize oils and fats as if they were the devils that all were not. For now we know that some fats are healthy and are essential for health. That left the food pyramid due for a general overhaul.

The old food pyramid also told us to consume six to eleven servings daily of complex carbohydrates including potatoes. But now they’re finding out that a boiled potato raises the blood glucose level more than consuming the same amount of calories from sugar at the table.

Because potatoes are mostly starch, they easily metabolize to glucose. The quick rise in blood glucose stimulates insulin. The high levels of insulin and blood glucose can negatively affect the cardiovascular health, reducing the good cholesterol and raising the triglyceride levels.

Wow! That is quite a revelation. Now I feel guilty for eating all those potatoes that I thought were the most complete food, nutrient-wise, only second to milk. No wonder the diabetes epidemic is on the rise. So what do we do now?

Well, the new food pyramid is an improvement in the sense that it is saying that some fats are worse than others but and here is the big but: it regards both the trans and saturated fats the same way when some are two times more harmful. So what will this do to the diabetes forecast? I leave that to you to decide.

Eating More: The Why of the Diabetes Epidemic, Part 6

There is more food available now with the mechanization and all. Fish and vegetables are more plentiful. This is very good indeed but the trouble is this leads to overeating. The intake of saturated fat is highest in Europe and North America and where does this lead us? Yes, heart disease.

All these calories we are taking in should be spent to balance everything out, but no. Unlike our farmer ancestors who spent the calories they ate by working hard growing food, sometimes we do not even have to cook in order to eat. Why, we do not even have to wash the dishes; heaven forbid, we have dishwashing machines for that.

Just consider this: our ancestors had to wake up at dawn to farm in order to grow the food to eat. They had to tend to the animals in order to have the protein and milk. They even had to churn the milk to get cheese. They had to do back-breaking work to harvest the food they needed.

Back at home, they needed to pump water to wash the food. They had to cut wood to fuel the fire they needed to maintain to cook their food and heat their homes. Sometimes they had to hunt to supplement their food. And they had to work hard to store that food.

How about us? How do we obtain our food? Well, you know the routine. We jump into the car and drive to the grocery stores. There things are laid out for us to make everything as convenient as possible. Then our bags are put in a conveyor belt to take to our car.

Now with the advance in technology, we do not even have to go to the grocery stores. We just make a list in the computer and send it to the grocery store where they put the supplies we need together and put them in a delivery truck to send to our homes.

We have large freezers at home too so our poor fingers will not get tired making those lists as often. Then for every meal, we take out boxes of frozen foods from the freezers, popped them into the microwave oven and voila, we have food on the table. Then so that we don't get too tired, we eat out!

Eating out? Don't remind me. Think of the evolution of the hamburger. It started with one patty, then two patties, then a cheese on top, then a bacon on top. What will they think of next? A fried egg on top? Don't laugh because I think it's already here. I don't know where but I would like to have one, just a taste I swear, okay? Is it any wonder then that there is such thing as an epidemic?

Then as we eat more, our stomachs expand and get larger. The better it is to make room for more food. Right? Wrong, no not wrong on the stomach expansion but wrong in making more room for more food. Why? Because that would lead us to nutrition disaster. And now they want the schools to do something about the link between nutrition and diabetes.

Metabolic Syndrome: The Why of the Diabetes Epidemic, Part 5

Metabolic syndrome, what is it? Well, it is a group of problems or conditions that could lead to prediabetes and diabetes. How does one know if he has this condition? It is easy to recognize this but here are the signs that two or more of the following will indicate a positive answer: (not in a good way)

. High blood pressure greater than 130/85 mmHg

. A big waist of forty inches or greater for men and thirty-four or greater for women

. Low HDL or good cholesterol of lower than 40 mg/dL for men or below 50 mg/dL for women

. High level triglycerides of more than or the same as 150 mg /dL

It is a big mistake to ignore the presence of the above or the metabolic syndrome as this could have a great impact on one's health. It could certainly lead to diabetes and this is one thing I am very passionate about to prevent.

And diabetes could lead to cardiovascular problems, two to five times more than those without this condition. It is also the chief cause of kidney failure, blindness, limb amputation, and neurological complications. Life span is also lowered by seven to twelve years. Now you know why I am so passionate about preventing diabetes complications.
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Now type 2 diabetes is on the rise. Our industrialized lifestyle certainly contributed to this. We are eating more (and the wrong food at that) and moving less with all those energy-saving machines we have at our disposal. We are living the dream life of a coach potato. Give me that remote, I need to lie down.

Yeah, right! Just look at how our forefathers lived their life. Some were farmers who got up at dawn to tend to their animals and growing their own food. Now this automated the production of food and the hard-working slim farmer is replaced by an overweight one driving an air-conditioned tractor, planting and harvesting all by himself.

Now don’t get me wrong. I am not against labor-saving devices; they’re great to have and should free us to pursue other leisure time activities like playing balls and such. But no, we were reduced to becoming sports spectators instead of going out there and playing the game ourselves. Is it any wonder metabolic syndrome is here to stay?

The Why of the Diabetes Epidemic, Part 4

Now we come to the 20th and 21st century epidemic of type 2 diabetes. Before, this was called adult-onset diabetes because it used to appear in grown-ups. Lately though, teenagers and children have been afflicted by this condition and this is greatly due to lifestyle.

One cause of this is insulin resistance which makes the body tissues less sensitive to insulin. This lets the sugar circulating in the blood stay there instead of entering the body cells. This requires more insulin in order to lower the blood sugar.

The other cause of type 2 diabetes is the incapacity to produce more insulin to meet the demand. The reasons for this are growing old, overweight, inherited tendency, lack of physical activity and some other hormonal condition.

As to why insulin resistance develops is not clearly understood but researches have suggested that fat cells make chemicals that result in the tissues becoming resistant to insulin. The more fat cells one has, the more chemicals are produced. This makes the sugar unable to enter the body cells where they are sorely needed.

The beta cells in the pancreas cannot meet the demand no matter how hard they work and as years pass, they slowly lose their capacity to make insulin. They can still make some but not adequate enough to keep the blood glucose levels within normal target.

The rise of the blood glucose levels sometimes results in the symptoms like increased hunger and thirst, frequent urination, unexplained weight loss and fatigue but sometimes there are no symptoms at all and this is what is dangerous. The condition may not be diagnosed until some complications have already occurred.

That is why about 33% of people who have this condition do not know they have it so please if you are at risk, get yourself tested so that strategies can be in place to fight this. Sometimes it takes twelve years before the symptoms appear.

It is good to know if you have this condition before it has the time to wreck havoc in your life. Once you know you have it, you can start taking care of it. Controlling the blood glucose level is a must to prevent the diabetes complications from setting in.

Why of the Diabetes Epidemic, Part 3

We said before that carbohydrates and fats are the main providers of energy to keep it working. The carbohydrates are broken down into smaller sugars in the intestine. These smaller sugars can now be absorbed into the circulation. This is then moved from the blood into the cell.

It is during this transport that it gets to meet Mr. Insulin. There it is broken further making it a main source of energy. The extra sugar or glucose is then stored in the liver or as glycogen in the muscle. This can also be stored in the muscles where they stay until they are needed.

How about the fats? The other main source of energy is dietary fat which produces a breakdown product called fatty acids. The same thing happens to it just like the glucose. They are either used immediately for energy or stored to use later.

Insulin is a hormone that is made in the pancreas. It is a protein that is circulated in the blood stream and while it does, it affects the functioning of the other organs. The pancreas also produces chemicals that help break down the food so that that the intestine can absorb this.

There are also bunches of cells in the pancreas called islets that contain different specialized cells. Phew! Thank goodness for the forefathers who did studies on this and now they're even using it as a new diabetes cure or we would not even know these cells exist. Anyway, one of the cells in the islets are the beta cells that produce insulin.

The sugar level in the blood is sensed by these beta cells after a meal and as the level goes up, the beta cells make insulin that makes the transport of sugar into the cells faster, thus effectively stopping the blood sugar from going up too high.

When the sugar level falls, what do you think happens? The opposite happens. The insulin production stops and opens up the stored sugar in the cells. Think of the insulin as a traffic policemen who directs the nutrients to the storage when the sugar level is up and then directs them to come out of the storage when the sugar level is down.

Isn't that cool? This is what happens in a person without diabetes. This is a finely tuned machine but just like our cars, when something disturbs the engine, then there is trouble. I should not really call it trouble for it is just a challenge we have to meet head on.

My, my, this is getting too long. We have not halfway covered why diabetes is on the rise but we will. We will just persevere with our weekly sessions and learn as much as we can about this. What is ten minutes (it takes to read this) compared to a life-long knowledge on this which we can pass on to the next generation?

The Why of the Diabetes Epidemic, Part 2

Last week, we had over 400 words and we barely covered our topic. My, this will take many parts, won't it? I don't mind because this is my passion but you probably will get tired of this. But you never know you might pick up something good for you or your loved one with diabetes. So, keep tuned in, will you? And please spread the word.

Reading this blog will benefit those with diabetes or prediabetes in these ways:

• make the blood sugar level better


• cut back on some of the medications


• take control of the condition

Learning the why of the diabetes epidemic will lead to a program of living healthy. Don't worry, you will not have to make severe changes. Nor do you have to spend money to do this. There will be suggestions on diet and exercise but these will not be extreme. Whatever changes you make though, let your health care team know. You may have a condition that needs special care.

This discussion will help us understand better what diabetes is, how we ordinarily manage the food nutrients and how metabolism affects the overall health. This will answer the question why there is such an epidemic of diabetes, prediabetes and obesity.

Once we understand the above, we will have a better understanding of how important lifestyle is. Perhaps then we will be more motivated to change the lifestyle to turn the statistics around. This is really the basis for the change that those in the know are advocating.

Now I mentioned metabolism and I wonder if we really understand that. Why is this important? Learning what it is and what it does will give meaning to why many are afflicted by prediabetes. And when this is not addressed, it leads to diabetes.

We know that the body directs the energy into storage as in fat, or let the body use it for normal growth or to use it for any physical activity. All these are represented by metabolism. If we understand this as the normal metabolism, then we will have an idea when metabolism goes awry.

What is this energy that the body processes and directs to store, use for growth or fuel Physical Activity?
There are three of them: protein, fat and carbohydrates. Carbohydrates and fats are the principal providers of energy to keep the body working.

We will discuss how these three nutrients met Mr. Insulin. For now, it is enough that we know the three nutrients that metabolism represents when the body's processes direct them to different channels. We will see what happens to these three nutrients when that occurs.

The Why of the Diabetes Epidemic, Part 1

Everyone is saying the statistics for the diabetes is on the rise. But if we are to understand this topic in the true sense of the word, we have to dig deeper, delve into the reason behind this. So I decided that in the next posts this is what we are going to talk about.

It is no mystery that the skyrocketing numbers of type 2 diabetics have gone up and up into the stratosphere. And the number is not only true in the US but also globally. I suspect though that the statistics include those who have the condition known as prediabetes.

What is this prediabetes all about? Well, one who is in the state of prediabetes is not diabetic yet but he is on the road to becoming one. This condition is also called glucose intolerance. It means that the blood glucose levels are not high enough to be diagnosed with diabetes but high enough to be healthy.

So if you have prediabetes, consider yourself lucky for you can do some steps to keep diabetes away for good. You can protect your health from those complications that come with diabetes. With symptoms not appearing until the damage has been done, I'd say I have a reason to call you lucky.

Now, how about those with type 2 diabetes already? Does it mean it is too late already? Not on your life it isn't. It is never too late to do something to maintain one's health no matter what stage we are in. The question is how many will protect their health knowing that they can.

Come on, confess. What were your first thought when you found out you had diabetes? Some people thought it was the end. Others were devastated. Many cried, "Why me, what did I do wrong?" And the fear of the unknown was just unbearable.

Okay, why don't you give me some feedback by going to Type 2 Diabetes? There is a contact form there you can fill in. That way, you can tell me too what topic you want to see next time after we finish this.

Thank goodness you woke up and started seeing the light. First, you read everything in sight. You tried to do everything right. You quit smoking, ate healthy meals, exercised like crazy and tried to lose weight. Now you're winning the battle.

But we went off topic so next week, we will continue the discussion on the rise of diabetic cases, explain what diabetes is and actually delve on what made the statistics go crazy like it has done. And perhaps at the end of this discussion of several parts, we will solve this mystery. Well, it's not really a mystery, but it's good to get all the whys in the open.

Did Ernest Lose Weight?

March 18, 2008

Since to lose weight was his goal in order to prevent diabetes, Ernest concentrated on doing just that. The Diabetes Prevention Program that advocates a change in lifestyle in order to put a stop on the obesity problem that plagues the nation was kind of a solution for Ernest.

He attended the sixteen sessions but Ernest found that to lose weight was easier said than done. He liked the DPP program though better than the ones his wife attended before because with this, he only had to lose 7% of his weight and he could take his time doing it.

He encountered problems both on the healthy eating part of the program and the exercise part as well. For the former, the problem was when he had cookouts with friends and when he went on vacations where he was sorry to say sometimes turned out to be pig-out days.

He tried to work around this dilemma by eating less the day before and the day after. By eating less didn't mean he starved himself. No, not at all for that would not have worked out. What he did was substituted some lower fat variety of dressings and other stuff for the rich ones his friends used and the food served on his vacations.

As for his physical activity quandary, while he could only play basketball once a week, he added some activities into his everyday routine. He biked to and from work and enlisted the help of a friend to jog with him after work several times a week.

As you can see, Ernest developed a schedule that he liked. He is still eating his favorite Italian dishes but this time he and his wife used low-fat oils and stuff. The homemade pizza he liked was now made with low-fat cheese and low-fat tomato sauce.

Now do you think he reached his goal to lose weight of 7%? You bet he did over time. He now weighs 186 pounds but he is not sitting on his laurels. No sir! He plans to go down to 180 to 184 pounds. Now why do you think a guy will think this way? Is he a stickler for punishment? Hmm, let's see what he says.

Aha! Now I get it. He wants to lose a little bit more weight to make room for when he goes on those tailgating parties with his friends and going on vacations with his wife. He has to have a cushion there, you see. Smart man, don't you think? Not only did he change his lifestyle and lost weight, but also he's preventing diabetes.

Now that we're done with the Diabetes Prevention Program, I will have to think of other things to blog about, all diabetes-related of course. Perhaps I will surprise you or go to some other physical activity, and fill out a contact form there so I can email you and then you can tell me what you want for our next topic.

Was Ernest Successful at the DPP Lifestyle Change Program?

Weighing 200 pounds at five feet eleven inches, with BMI of 27, Ernest joined the Diabetes Prevention Program. He wanted to prevent diabetes especially so his brother was already diagnosed with type 2 diabetes. His doctor told him he probably will have diabetes so he signed up for the DPP lifestyle intervention program.

Ernest had never tried to lose weight before so everything was new to him. his wife supported him 100% and in fact joined him in this intervention program. The 7% weight loss goal would bring his weight down to 186 pounds.

His goal for fat gram was to consume not more than forty-two grams of fat each day. He found it interesting to have to read the nutrition labels on the food they purchased. He was bent on making changes on his fat gram intake by reducing fat from salad dressings and butter. How did he do this?

He substituted lower fat variety of the butter and salad dressings. His wife started preparing food using less cooking oil and on days when they ate their favorite food with more fat content, Ernest looked ahead by consuming less fat at breakfast and next day's lunch so he won't go over his goal of the forty-two grams of fat per day when calculating his weekly consumption.

As for his physical activity, Ernest enjoyed playing basketball but he could do this only once a week. So he was not consistent with the 150 minutes per week that he would like to have. In order to get around this, Ernest thought he should put in lifestyle activities into his every day routine. How did he do it?

He decided to ride his bike to work every day. He also rode his bike to go home from work. He also asked a buddy of his to jog with him several times a week. Slowly but surely, he started to lose weight over the sixteen sessions of the lifestyle intervention program.

He observed a problem though. Every time he went on vacation he would gain some weight back. The same thing happened whenever he went to barbecues with his friends. His favorite food was Italian dishes which were sometimes high in fat. Do you think he will solve this problem? Tune in next week and let's see what happens to Ernest.