An online community dedicated to advocacy, education, and assistance for those living with Diabetes
An online community dedicated to advocacy, education, and assistance for those living with Diabetes
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Conferences are a great
way to learn new information and to meet people who "get it". We
encourage everyone to try to attend a diabetes related conference in
your area. If you have a conference or event that you would like
people to know about, please
let
us know in advance. Below are also a few of the things that Diabetes Advocacy has learnt during recent conferences....
Upcoming Events:
CWD Focus on Technology at the Marriott Bethesda North Hotel &
Conference Center in Bethesda, Maryland (September 26-28, 2008) Reports:July 2007: Friends for Life Conference. Orlando Florida, hosted by ChildrenWithDiabetes
Keynote Speaker: Acting Surgeon General of the USA, RADM Kenneth Moritsugu, MD: Dr. Moritsugu has LADA, a form of Type 1 diabetes usually diagnosed later in life. He currently wears an insulin pump that he proudly will show to any adult or child who is interested. Dr. Moritsugu views diabetes as a challenge not a limitation. In his speech he quotes E. Rosevelt who said "you must do the thing you think you cannot do". Its a powerful statement that stays with you throughout the event. He states that the US is looking to move towards a preventative approach to medicine rather than simply waiting and treating complications. He stresses the importance of helping before that stage is reached. Dr. Moritsugu brings up a wonderful concept that must be further explored in all countries. Its the issue of "low health literacy". He states that people with a low health literacy are less likely to know how to navigate the medical system. They are less likely to know how to use preventative measures. The result is expensive. These people end up burdening the system in their use of Emergency care. Dr. Moritsugu tells us that only 10% of the US population is health literate. There is a large chasm between what doctors know and what patients understand. This chasm is growing. We must work to educate our health illiterate. Knowledge is power. Notes from "Stress and the Heart Breaking Heart" presented by Robert J. Bulgarelli: A1c in adolescence can be reduced by mediation alone. It is vital to address one's self image and create affirmations to live by. Positive thought, relaxation and time for one's self is equally important to a healthy life with diabetes. Strike the Spike presented by Gary Scheiner: The goal is to see a bg level of 10 mmol (180) 1-2 hours after a meal. In children, the more realistic targets are 13.7 mmol (250mg/dl) for those under 5yr, 12.5 (225) for 5-12 year olds, and 11.1(200) for teens. It is vital to remember that post meal highs actually increase a person's hunger! It is also important to note that post meal bg levels have large impact on the A1c. Decreasing this spike will increase the risk of heart disease by 50%. During this talk the issue of AST was brought up. It was noted that in the case of Alternate Site Testing, there is a mix of blood with intrastial fluid which can impact bg readings. It was further advised that no corrections be made before the 2 hour mark despite readings that may be found at the 1 hour point. The issue of Glycemic Index was also broached in this session. It was noted that a GI of 37 means that only 37% of hte carbs have been broken down in that first hour. Almost 70% of the carbs are still left to spike. One wants to try to keep your diet filled with more low GI foods and high fiber to reduce postprandial (post meal) spikes. Remember that larger meals will take longer to digest. Meals like pizza often require and extended bolus and in increased basal for 6-8 hours. Gary Scheiner suggests that for meals that are high on the Glycemic Index (like pankcakes and cereal), one look at bolusing up to 20 minutes BEFORE you eat. He reminds us that "fast acting" insulin is still no where near as fast as the human body. In the case of low GI foods, one can bolus after the meal and there is no need to prebolus if the bg level before the meal is below 4.4 (80) Gary Scheiner also spoke briefly on the use of Amylin. Beta cells produce insulin AND amylin. Amlyin is what prevents the spike after eating. Its major effect is to keep food in the stomach for longer. The drug Symlin is the pharmaceutical form of this hormone. It may cause nausea for the first few weeks of use. A more natural way to combat post meal spikes of course remains the use of physical activity. The Future of Treating Type 1 Diabetes presented by Irl Hirsch: There is an 80-90% loss of islet cell functioning before reaching the actual onset of Type 1 diabetes. The drug exenatide (byetta) seems to preserve beta cell function in animals that are new diagnosed. Autologous Human Stem Cell Transplant is another potential treatment. It in a recent study 14 out of 15 people involved were off of insulin for an average of 18 months and C-peptide levels increased. Dr. Hirsch further notes that rapid acting insulins are not that rapid. Time is a very important tool when dealing with insulin. He points to Biodel (Viajet) which is a "faster" insulin. The most important treatment is the ability to test frequently. He sites the STAR1 paper reported June 23, 2007 at the ADA in Chicago as proof. In closing Dr. Hirsch notes that technology is only as good as the people who use it and that high A1c levels correlate to higher levels of depression. August 2007 Focus on Pumping,
Toronto Ontario, Canada. Hosted by
ChildrenWithDiabetes
Dr. Henry Anhalt opened the conference asking the question "Why We Pump?". He feels that regimens of NPH and Regular insulin combined with 3 bg tests per day are not flexible enough for today's lifestyle. In his opinion, NPH should simply fall off of the formularies. Dr. Anhalt further noted that being "out of control" or "non-compliant" is the result of the human condition. It is what happens when one lives with diabetes! He feels that all toddlers should be on a pump. It is his belief that to teach a person to pump requires little more effort than to teach them to use injections. Doctors must learn how to educate individual families. Other speakers such as John Walsh and Natalie Bellini spoke on the logistics of pumping, how to get started, how to deal with issues that arise when pumping. The conference was well attended and the first of its kind in Canada. It afforded an incredible amount of time for interaction and discussion. This was our focus. We spent much of our time speaking with individuals, learning from reps, and being amazed by our children with diabetes.
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