As a global network of medical research charities, the Juvenile Diabetes Research Foundation (JDRF) is driving research into new treatments that present tremendous opportunities to deliver enhanced health and wellbeing for people with type-1 diabetes. The technology I am currently most enthused about is glucose responsive insulin, which I think is going to transform how people treat and live with type 1 in the future.
In type 2 diabetes the body has an increasingly harder time to handle all the sugar in the blood. Large amounts of the blood sugar-lowering hormone insulin are produced, but it’s still not enough, as insulin sensitivity decreases. At the time of being diagnosed with type 2 diabetes, diabetics usually have ten times more insulin in their bodies than normal. As a side effect, this insulin stores fat and causes weight gain, something that has often been in progress for many years before the disease was diagnosed.
Nerve damage from diabetes is called diabetic neuropathy and is also caused by disease of small blood vessels. In essence, the blood flow to the nerves is limited, leaving the nerves without blood flow, and they get damaged or die as a result (a term known as ischemia). Symptoms of diabetic nerve damage include numbness, burning, and aching of the feet and lower extremities. When the nerve disease causes a complete loss of sensation in the feet, patients may not be aware of injuries to the feet, and fail to properly protect them. Shoes or other protection should be worn as much as possible. Seemingly minor skin injuries should be attended to promptly to avoid serious infections. Because of poor blood circulation, diabetic foot injuries may not heal. Sometimes, minor foot injuries can lead to serious infection, ulcers, and even gangrene, necessitating surgical amputation of toes, feet, and other infected parts.
People with glucose levels between normal and diabetic have impaired glucose tolerance (IGT) or insulin resistance. People with impaired glucose tolerance do not have diabetes, but are at high risk for progressing to diabetes. Each year, 1% to 5% of people whose test results show impaired glucose tolerance actually eventually develop diabetes. Weight loss and exercise may help people with impaired glucose tolerance return their glucose levels to normal. In addition, some physicians advocate the use of medications, such as metformin (Glucophage), to help prevent/delay the onset of overt diabetes.
Dr. May currently works as a fulltime endocrinologist and has been in private practice since 2004. He has a variety of interests, predominantly obesity and diabetes, but also sees patients with osteoporosis, thyroid disorders, men's health disorders, pituitary and adrenal disorders, polycystic ovaries, and disorders of growth. He is a leading member of several obesity and diabetes societies and runs a trial centre for new drugs.
Vanadium is a compound found in tiny amounts in plants and animals. Early studies showed that vanadium normalized blood sugar levels in animals with type 1 and type 2 diabetes. When people with diabetes were given vanadium, they had a modest increase in insulin sensitivity and were able to lower their need for insulin. Researchers want to understand how vanadium works in the body, find potential side effects, and set safe dosages.
The United Kingdom Prospective Diabetes Study (UKPDS) was a clinical study conducted by Z that was published in The Lancet in 1998. Around 3,800 people with type 2 diabetes were followed for an average of ten years, and were treated with tight glucose control or the standard of care, and again the treatment arm had far better outcomes. This confirmed the importance of tight glucose control, as well as blood pressure control, for people with this condition.
Christina Kalberg is the Executive Director of the Diabetes Research Connection (DRC). She comes to DRC with over 10 years of experience as a senior-level executive effectively integrating passion and in-depth skill into well-crafted marketing, public relations, communications, operations and fundraising campaigns to directly fuel multi-million-dollar revenue growth. Christina is a strategist, deftly aligning staff and other stakeholders. She has a Bachelor’s degree in Journalism with an emphasis in Public Relations and a Master’s degree in Business Administration. Christina is also an adjunct professor for the marketing program at Point Loma Nazarene University, where she teaches Digital and Social Media Marketing.
There are some interesting developments in blood glucose monitoring including continuous glucose sensors. The new continuous glucose sensor systems involve an implantable cannula placed just under the skin in the abdomen or in the arm. This cannula allows for frequent sampling of blood glucose levels. Attached to this is a transmitter that sends the data to a pager-like device. This device has a visual screen that allows the wearer to see, not only the current glucose reading, but also the graphic trends. In some devices, the rate of change of blood sugar is also shown. There are alarms for low and high sugar levels. Certain models will alarm if the rate of change indicates the wearer is at risk for dropping or rising blood glucose too rapidly. One version is specifically designed to interface with their insulin pumps. In most cases the patient still must manually approve any insulin dose (the pump cannot blindly respond to the glucose information it receives, it can only give a calculated suggestion as to whether the wearer should give insulin, and if so, how much). However, in 2013 the US FDA approved the first artificial pancreas type device, meaning an implanted sensor and pump combination that stops insulin delivery when glucose levels reach a certain low point. All of these devices need to be correlated to fingersticks measurements for a few hours before they can function independently. The devices can then provide readings for 3 to 5 days.
Alcohol: Alcohol can dangerously increase blood sugar and lead to liver toxicity. Research published in Annals of Internal Medicine found that there was a 43 percent increased incidence of diabetes associated with heavy consumption of alcohol, which is defined as three or more drinks per day. (8) Beer and sweet liquors are especially high in carbohydrates and should be avoided.
The word podcast has by now become completely untethered from its namesake—the iPod. Analytics that were once uncapturable have become fairly comprehensive (downloads from Apple Podcasts surpassed 50 billion this year) and specific (Chicago streams more podcasts on Spotify than any other U.S. city does), which has brought new money and possibility to the form. Recipes for how to create a decent series were invented through trial and error, and thousands of producers now understand what makes our ears stand up: cults, cold cases, politics, feminism, and relationships, but most of all: stories.
Weight loss surgery in those with obesity and type two diabetes is often an effective measure. Many are able to maintain normal blood sugar levels with little or no medications following surgery and long-term mortality is decreased. There is, however, a short-term mortality risk of less than 1% from the surgery. The body mass index cutoffs for when surgery is appropriate are not yet clear. It is recommended that this option be considered in those who are unable to get both their weight and blood sugar under control.
Pancreatic islet allo-transplantation is a procedure in which islets from the pancreas of a deceased oran donor are purified, processed, and transferred into another person. Immunosuppressive medications are needed to prevent rejection which is a typical challenge with any transplant. These medications carry a number of serious side effects such as decreased kidney function, high blood pressure, anemia and lowered white blood cells counts.
Type 2 diabetes was also previously referred to as non-insulin dependent diabetes mellitus (NIDDM), or adult-onset diabetes mellitus (AODM). In type 2 diabetes, patients can still produce insulin, but do so relatively inadequately for their body's needs, particularly in the face of insulin resistance as discussed above. In many cases this actually means the pancreas produces larger than normal quantities of insulin. A major feature of type 2 diabetes is a lack of sensitivity to insulin by the cells of the body (particularly fat and muscle cells).
Powerful drugs like oxycodone (Oxycontin) and the opioid-like medicine tramadol (Conzip, Ultram) can treat much stronger pain. But these tend to be a last resort for pain relief. You might use these medications if other treatments aren’t working. However, these drugs aren’t meant for long-term relief because of side effects and the potential for addiction. Work closely with your doctor and use caution when taking opioid medicines.
Other studies have found that people with pre-diabetes or type 2 diabetes can go into remission through changes to their dietary and exercise habits. People who manage to achieve this with food alone will often express their excitement publicly by claiming they “cured” their diabetes with their diet. In reality, the likely put it into remission, though that remission can last a very long time.
"You only need 10 percent of your beta cells to supply sufficient insulin," Roep said. He said there have been a couple of rare cases where a patient had typical type 1 diabetes but could go through long periods without insulin injections. "Insulin needs can be a moving target, and if you have a lifestyle change it's very plausible that you have a lesser need for insulin, and you can deal with [diabetes] with the beta cells you have," Roep said.
Regarding age, data shows that for each decade after 40 years of age regardless of weight there is an increase in incidence of diabetes. The prevalence of diabetes in persons 65 years of age and older is around 25%. Type 2 diabetes is also more common in certain ethnic groups. Compared with a 7% prevalence in non-Hispanic Caucasians, the prevalence in Asian Americans is estimated to be 8.0%, in Hispanics 13%, in blacks around 12.3%, and in certain Native American communities 20% to 50%. Finally, diabetes occurs much more frequently in women with a prior history of diabetes that develops during pregnancy (gestational diabetes).
^ Kyu HH, Bachman VF, Alexander LT, Mumford JE, Afshin A, Estep K, Veerman JL, Delwiche K, Iannarone ML, Moyer ML, Cercy K, Vos T, Murray CJ, Forouzanfar MH (August 2016). "Physical activity and risk of breast cancer, colon cancer, diabetes, ischemic heart disease, and ischemic stroke events: systematic review and dose-response meta-analysis for the Global Burden of Disease Study 2013". BMJ. 354: i3857. doi:10.1136/bmj.i3857. PMC 4979358. PMID 27510511.
Inhalable insulin has been developed. The original products were withdrawn due to side effects. Afrezza, under development by the pharmaceuticals company MannKind Corporation, was approved by the United States Food and Drug Administration (FDA) for general sale in June 2014. An advantage to inhaled insulin is that it may be more convenient and easy to use.
These surgeries, even today, come with significant side effects. People have to be vigilant about getting their needed nutrients, since many aren’t as easily absorbed through food anymore. Other substances are too easily absorbed by the body, particularly drugs like alcohol. This vulnerability can then lead to alcohol abuse and may even help explain the slightly higher rates of suicide and self-harm seen in patients soon after surgery. Also distressing is that an estimated one of every 10 patients will fail to lose weight or regain the weight back in the long term, while others will require additional operations to fix complications like stomach leakages.
Khodneva, Y., Shalev, A., Frank, S. J., Carson, A. P., & Safford, M. M. (2016, May). Calcium channel blocker use is associated with lower fasting serum glucose among adults with diabetes from the REGARDS study. Diabetes Research and Clinical Practice, 115, 115-121. Retrieved from http://www.diabetesresearchclinicalpractice.com/article/S0168-8227(16)00070-X/abstract
Bruce C., from Katy, has been a type 2 diabetic for 20 years and has experienced neuropathy and retinopathy for four years. Within weeks of receiving care at Diabetes Relief, Bruce said, “I began to feel my feet again!” Michael W., from Crosby, a type 1 diabetic who also has neuropathy and thyroid disease, said Diabetes Relief “has given me my life back.”
One benefit of these foods is that they generally promote weight loss, which is a major factor in reversing diabetes. A study following 306 diabetic individuals found that losing weight under a structured program (with the supervision of a primary care physician) resulted in almost half of the participants going into total diabetes remission. This means they were able to stay off their medications permanently (assuming they stayed on a healthy diet). Quality of life also improved by over seven points on average for the patients on the dietary regimen, while it decreased by about three points for the control group. (13)
Most universities and colleges have health centers that offer counseling services to enrolled students. You can take advantage of counseling services and/or medical services for stress and other areas of mental wellness. It’s in your best interest – and that of your patients – if you are the healthiest version of yourself. Find information on the health center at your dental school.
Treatment for gastroparesis can include dietary changes such as eating less fiber and eating smaller, more frequent meals. Medications are available as well that can spur muscle contractions in the stomach or help control nausea. Another option for some people is to have a gastric pacing device, similar to a heart pacemaker, surgically implanted to stimulate stomach movements.
Let’s face it, when you’re a college-educated 57-year-old slinging parcels for a living, something in your life has not gone according to plan. That said, my moments of chagrin are far outnumbered by the upsides of the job, which include windfall connections with grateful strangers. There’s a certain novelty, after decades at a legacy media company—Time Inc.—in playing for the team that’s winning big, that’s not considered a dinosaur, even if that team is paying me $17 an hour (plus OT!). It’s been healthy for me, a fair-haired Anglo-Saxon with a Roman numeral in my name (John Austin Murphy III), to be a minority in my workplace, and in some of the neighborhoods where I deliver. As Amazon reaches maximum ubiquity in our lives (“Alexa, play Led Zeppelin”), as online shopping turns malls into mausoleums, it’s been illuminating to see exactly how a package makes the final leg of its journey.
People with diabetes may also worry about trying new foods; traveling; diabetes complications; the toll the condition takes on their family; and healthcare costs, which are 2.3 times higher than for someone without diabetes. For Sandi, she worries about the cost of medication and, if her kidneys worsen, the possibility that she’ll have to go on dialysis. “That’s a really scary thought,” she says.
A major feature of the disease is a condition known as insulin resistance. Insulin is a hormone that moves glucose (sugar), from the bloodstream into the body’s cells where it is used for energy. For a variety of reasons that are not fully understood, the body’s tissues don’t respond adequately to insulin and glucose then becomes elevated in the bloodstream.
In animals, diabetes is most commonly encountered in dogs and cats. Middle-aged animals are most commonly affected. Female dogs are twice as likely to be affected as males, while according to some sources, male cats are also more prone than females. In both species, all breeds may be affected, but some small dog breeds are particularly likely to develop diabetes, such as Miniature Poodles.
Acute pain is a lifesaver. Without it, we would have to watch out all the time to keep from injuring or killing ourselves accidentally. This is why people with diabetes are advised to check their feet visually or manually every day: If a person has peripheral neuropathy, particularly if it causes numbness in his feet, the acute pain nerves in his feet may not be working, and if they aren’t, they can’t warn him about injuries or other, normally painful foot problems.
How does high blood sugar (hyperglycemia) feel? To maintain the right amount of blood sugar, the body needs insulin, a hormone that delivers this sugar to the cells. When insulin is lacking, blood sugar builds up. We describe symptoms of high blood sugar, including fatigue, weight loss, and frequent urination. Learn who is at risk and when to see a doctor here. Read now