Study Throws Cold Water on Vitamin D Hype

Despite several years of hype, studies continue to temper that enthusiasm surrounding vitamin D supplements. The latest indicates

Low levels of vitamin D don't put older women at greater risk for type 2 diabetes, a large study of U.S. women suggests.

Posted by Diabetologica at 7:30 AM | Comments (0)

Eat more salad!

It appears those green leafy vegetables may have some benefit in preventing Type 2 Diabetes:

Increasing the amount of green leafy vegetables in an individual's diet could help to reduce the risk of type 2 diabetes. An increase of 1.15 servings a day was associated with a 14% decrease in incidence. The data did not show any significant relations between the consumption of fruits, vegetables, or fruit and vegetables combined on the incidence of diabetes. As there was significant heterogeneity between studies, however, we carried out a sensitivity analysis. This showed no significant interactions between the outcomes of variables examined, and thus could not identify differences that occurred between the studies.

Posted by Diabetologica at 8:06 AM | Comments (0)

Islet Transplantation for Type 1 Diabetes

At one time I believed that islet translation would lead to a therapeutic treatment and cure for Type 1 diabetes. Presentations by noted surgeons and their endocrinologist partners were hopeful and suggested that short-term trials were highly successful.

However, long term observations seem to have revealed two key factors: (1) the effectiveness of the transplanted cells diminishes through time and (2) their are risk factors associated with the immunosuppression drugs.

Consider the summary from a recent British Medical Journal Commentary:

Summary points

Islet of Langerhans transplantation is used in a select group of patients with type 1 diabetes with severe glycaemic lability, recurrent hypoglycaemia, and hypoglycaemia unawareness

The procedure is minimally invasive, with few procedure related complications

Two to three islet infusions are usually needed to achieve insulin independence

Most patients need insulin by five years post-transplantation owing to declining graft function; beneficial effects on the frequency of hypoglycaemic episodes and hypoglycaemia awareness remain

Most long term complications are related to systemic immunosuppression

The risk-benefit ratio of islet transplantation should be carefully weighed by the treating physician and the potential recipient, who should be given adequate information

As I understand it, the target population as those individuals with Type 1 Diabetes who are unable to achieve satisfactory (safe) results with conventional therapy. So, islet transplantation is not (yet) the holy grail many of us had hope but it is never-the-less beneficial for some individuals.

Posted by Diabetologica at 11:55 AM | Comments (0)

Gastric Bypass Surgery Reverses Heart Ailments!

This is fairly significant news.... gastric bypass does help lose weight and treat diabetes (more here):

Well- who is a candidate for these procedures? Usually patients with a BMI of over 40 or over 35 with health consequences that are obesity related. Does gastric bypass have any effect on diabetes? In a series of 1000 patients, 150 of whom had diabetes, 83% experienced resolution of their diabetes (defined by a normalization of A1c and coming of medications for diabetes) after the surgery

However, there now appears to be additional benefits:

A new report from the Journal of the American College of Cardiology reports that patients who had received gastric bypass surgery not only lost weight but had maintained healthier cardiac health, while also reducing previous cardiac complications spurred by obesity.

Often times when a patient is obese, an increase in the largest portion of the heart, the left ventricle can become larger in mass causing the heart to work harder to pump blood into the body. According to the study, echocardiograms, or ultrasounds of the heart showed a remodeling of the heart structure which included a reduction of left ventricular mass and right ventricular cavity area in patients that had received Gastric Bypass Surgery, a procedure Texas Bariatric Specialists performs.

â€Å"Patients now have another reason to add to their check-off list of the benefits of a gastric bypass. Why would anyone severely obese wait any longer when the health risks are too high,” says Texas Bariatric Specialists founder Dr. Nilesh A Patel.

A gastric bypass is a bariatric procedure that is the single largest contributor to these findings and is offered at Texas Bariatric Specialists. In the Laparoscopic gastric bypass surgery procedure, the surgeon makes a small stomach pouch at the top of the stomach, the pouch is later connected to the small intestine bypassing the larger stomach. The gastric bypass can result in complete resolution in type 2 diabetes, hypertension, high blood pressure, sleep apnea, and the loss of 65 percent of excess body fat.

Source: press release

Posted by Diabetologica at 5:40 AM | Comments (0)

Sad Case of Hypoglycemia

The dangers are all too real:

A NORTH-WEST man died within hours of being discharged from the North West Regional Hospital in what a coroner has labelled a "regrettable misjudgment".

The diabetic man, known as Mr H, was taken to the emergency department of the North West Regional Hospital in Burnie suffering a low blood-sugar level about 5.30pm on January 10, 2009.

An investigation by Coroner Rod Chandler found the 46-year-old was discharged at 7pm and died at home about 1.45am the next day.

"In these circumstances the decision to permit Mr H to go home about 7pm on 10 January, 2009, was a regrettable misjudgment," he said.

"Had he remained in hospital for a longer period and been subject to close monitoring and to more intensive investigations then it is likely in my view that the seriousness of his condition would have become evident and life-saving treatment put in place.

"These matters give rise to the question whether the decision to permit Mr H to go home without further monitoring and/or investigation was, in all the circumstances, a reasonable one."

Health authorities implemented new procedures after the man's death.

The man, a self-employed electrical technician, weighed 150kg and was taken by ambulance to the hospital with a very low blood sugar level of 1.5 millimoles per litre.

For those in the United States, the man weight 330lbs and his glucose was measured below 25 mg/dL.

Posted by Diabetologica at 2:32 AM | Comments (0)

Infection and Early Diabetes Risk

We've understood for some time that Type 1 Diabetes is an autoimmune disease in which the beta cells are casualties of a T-cell mediated autoimmune attack. As a result, researchers hypothesized that environmental triggers could play some roll in the onset of the disease. It appears they are one step closer in their understanding, as reported in the British Medical Journal (BMJ 2011; 2011; 342:d35 doi: 10.1136/bmj.d35 (Published 3 February 2011):

There is a clinically significant association between enterovirus infection, detected with molecular methods, and autoimmunity/type 1 diabetes.

First, note that enteroviruses are second only to the "common cold" viruses, the rhinoviruses, as the most common viral infectious with an estimated 10-15 million cases per year in the United States.

Second, the study was a retrospective analysis of published reports. This is a common method and accepted approach although there are limitations due to the difficulty in normalizing results across diverse study protocols.

Third, the study found a clear relationship between the presence of an enterovirus infection and type 1 diabetes. However, causality was not proven --- the results provide 'additional support to the direct evidence of enterovirus infection in pancreatic tissue of individuals with type 1 diabetes'. That is, the two are often observed together.

Posted by Diabetologica at 1:33 AM | Comments (0)

Ten Percent

Recent reports suggest that nearly one in 10 North Carolinians has diabetes. I understand that the incidence of diabetes continues to rise but wonder if the near doubling of presumed cases may be influenced by improved detection/screening and a change in criteria?

Posted by Diabetologica at 8:20 AM

Airborne Gets Nailed

I've used their product for years. Yes, the marketing worked on me but the idea proposed by the company, that one dose can instantly protect you when flying, is incorrect.

The makers of Airborne have agreed to refund money to consumers as part of a $23.3 million settlement of a class-action lawsuit for false advertising. It does not admit wrongdoing or illegal conduct.

Products included are the Airborne Effervescent Health Formula, Airborne On-the-Go, Airborne Power Pixies, Airborne Nighttime, Airborne Jr., Airborne Gummi, and Airborne Seasonal (formerly sold as Airborne Seasonal Relief).

I'm not sure if I'll ask Airborne for a refund and I don't think I'm any worse off for using the product. And, when all is said and done, I really didn't believe that I would be immunized from disease. Rather, I expected an immune system boost.

Posted by Diabetologica at 12:00 AM

Weight Loss May Beat Intensive Insulin Therapy ...

Weight-loss and major lifestyle changes may be more effective than intensive insulin therapy for overweight patients with poorly controlled, insulin-resistant type 2 diabetes, according to a diabetes researcher at UT Southwestern Medical Center.

Continue reading "Weight Loss May Beat Intensive Insulin Therapy ..."

Posted by Diabetologica at 10:36 PM

Get to Sleep - Here's How

We've written for years about the correlation between diabetes, obesity and the lack of sleep. While some prioritize other activities above a good night's rest, others simply have difficulty getting the 7-8 solid sleep that doctors recommend. Here's a list of bedtime ideas from a variety of sources:

Sleep only when sleepy

Don't oversleep or nap during the day.

Have a light snack before bed

Laugh a little. What a comedy, joke with a friend and drop your stress hormones.

Put your work in perspective and get a hobby. A joint study of 314 workers conducted by the University of South Australia and the University of Rotterdam found that workers with higher levels of active leisurely activities, such as exercise, hobbies, and social activity, were able not only to bounce back from workplace stress better than their always-on-the-job coworkers but also sleep significantly better than others.

Use sunlight to set your biological clock

Connect. Studies at UCLA reveal that women's friendships and relationships with their children can block stress hormones.

Stay away from caffeine, nicotine and alcohol at least 4-6 hours before bed. (Nicotine is a stimulant)

Stretch and relaxation - Some people find that a gentle stretching routine for several minutes just before getting into bed helps induce sleep. Others practice relaxation techniques. Libraries or bookstores have books on developing stretching or relaxation routines.

Put yourself on a regular schedule, going to bed and getting up at the same time each day.

Forgive others and let go of the past.

Be realistic. Rather than worrying about what you want to do match your expectations with what can actually be done.

Create a pre-sleep ritual. Ideally, nights should be as relaxing as possible, but try telling this to a working mom who needs to get a million things done.

Wind down for the night at least 30 to 60 minutes before bed.

Exercise early in the day.

Avoid drinking large amounts of fluid late in the day. A full bladder doesn't make for a good nights sleep.

Cut down on alcohol. Alcohol might help you get to sleep, but it results in shallow and disturbed sleep, abnormal dream periods, and frequent early morning awakening.

Check your iron level. Iron deficient women tend to have more problems sleeping, so if your blood is iron poor, a supplement might help your health and your ability to sleep.

Change your lifestyle expectations. According to a poll by the American Psychological Association, 4 of the top 10 stressors we experience are related to money. Do with less, be healthy and be happy.

A good sleep environment can help:

• Make sure your bed is large enough, and comfortable. If you are disturbed by a restless bedmate, switch to a queen- or king-size bed. Test different types of mattresses. Try therapeutic shaped foam pillows that cradle your neck or extra pillows that help you sleep on your side. Get comfortable cotton sheets.


• Make your bedroom primarily a place for sleeping. It is not a good idea to use your bed for paying bills, doing work, etc. Help your body recognize that this is a place for rest or intimacy.


• Keep your bedroom peaceful and comfortable. Make sure your room is well ventilated and the temperature consistent. And try to keep it quiet. You could use a fan or a "white noise" machine to help block outside noises.


• Hide your clock. A big, illuminated digital clock may cause you to focus on the time and make you feel stressed and anxious. Place your clock so you can't see the time when you are in bed.

Posted by Diabetologica at 9:20 PM

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Previous Posts

How many can you do? - Mar 11, 2008
Mechanisms - Knowing and Curing - Mar 10, 2008
Good Side Affects? - Mar 04, 2008
Diabulimia Triples Your Risk - Mar 04, 2008
Skipping breakfast takes its toll - Mar 04, 2008
Your new permanent gadget? - Mar 04, 2008
Do you know diabetes research? - Feb 27, 2008
Go Lo-Carb? - Feb 27, 2008
Studies Confirm the Benefit of Sleep - Jan 20, 2008
No More Needles? - Jan 05, 2008
Get a Good Nights Rest - Jan 01, 2008
Those Terrible Post Meal Highs - Dec 20, 2007
Diabetes Fight May Be Helped By New Molecular Target - Jul 06, 2007
High Glucose Levels Can 'Lock' body's Metabolism In A Diabetic State - Jul 05, 2007
A Stem Cell Treatment for Diabetes - Jun 29, 2007
Stem Cell Treatment for Diabetes? - Jun 27, 2007
Amercian Diabetes Association - Jun 23, 2007
Curing Diabetes with Stem Cells? - May 26, 2007
Diabetes may lead to mild cognitive impairment - May 10, 2007
A Non-invasive Glucose Sensor? - May 07, 2007
Pistachios Help Reduce Stress - May 02, 2007
Lifestyle better than drugs? - Apr 27, 2007
Stem Cell Treatment for Diabetes - Apr 12, 2007
The Harmful Effects of Stress - Apr 12, 2007
Fat Increases Diabetes Risk Factors - Mar 28, 2007
Fourteen Habits of the Overstressed and Unhappy - Mar 27, 2007
The House Diet: Weight Loss for Life - Mar 27, 2007
Cardiac Drug may Provide Treatment for Diabetes - Mar 27, 2007
Are you at risk? - Mar 26, 2007
Top Nine Risk Diabetes Risk Factors - Mar 25, 2007
High Blood Sugars: a Surprising Culprit in the Search for Causes of Diabetic Birth Defects - Mar 22, 2007
Correlations Between Blood Sugar and Cancer - an informal discussion - Mar 22, 2007
Oral Insulin Crystals Could Delay Or Prevent Diabetes In Children - Mar 22, 2007
No Beer for Padres Pitcher David Wells - Mar 19, 2007
Successful Stem Cell Research for Diabetes Treatment - Mar 17, 2007
The Staggering Rise of Type 1 Diabetes - Mar 16, 2007
Promising New Anti-cancer Treatment Approved For HER2-Positive Breast Cancer - Mar 15, 2007
Diabetes Expert Writes Gripping Mystery About Diabetic P.I. - Mar 15, 2007
Exercise is good for your memory too - Mar 13, 2007
The Soda Scandal - Mar 13, 2007
stay-at-home moms are most likely to sleep poorly - Mar 08, 2007
Green Tea Slows Prostate Cancer - Mar 07, 2007
Nine Reasons Why You Should You Eat Less - Mar 07, 2007
Our Obese Children - Mar 06, 2007
the problem ... - Mar 06, 2007
The Return of the Atkins Diet - Mar 05, 2007
The Hacker's Diet - Mar 05, 2007
Indulgences for the Overweight - Mar 04, 2007
Sleep on it - Mar 02, 2007
Go Whole Grain - Mar 02, 2007