|
Pages of Interest
Awareness
Awareness
Presentation
Conferences and events
Quilts
Walks
Carbohydrate info
Recipe Analysis
Treats, fast food and other
foods
General Diabetes Information:
Ask the Expert
Diabetes Books
Diabetes FAQ
Diabetes News
Diabetes Research
Diabetes Terms
Disability Tax Credit for those
with Type 1 Diabetes
Insulin Pumps
Products and
Technology
Glucometers
Taking care of your
diabetes
Taking diabetes to
school
Insulin Pump Therapy
Getting Started
Insulin Pumps
Infusion Sets
Our Pump Journal
Provincial Coverage
Pumping Tips
Pump Studies
Living with Diabetes
Awareness
Our Blog
Faces of Diabetes
Priceless
Diabetes related Tattoos
Diabetes Advocacy Store
Anklets
Bracelets
Ear rings
Kids Products
Necklaces
Support
Online support lists
Rufus the Bear with diabetes
Support groups
Website resources
Advertising and Sponsorship
Privacy Policy
|
|
Research
Findings
More Evidence of why Type 1
Diabetes is a serious disease...
Latest studies....
This is a really neat little
animated thing that teaches about stem cells.
http://gslc.genetics.utah.edu/units/stemcells/whatissc/
August 2008
July 2008
June 2008
May 2008
April 2008
March 2008
February 2008
January 2008
December 2007
November 2007
October 2007
August and September 2007
July 2007
May/June 2007
April 2007
March 2007
February 2007
January 2007
December 2006
November 2006
October 2006
September 2006
Summer 2006
June 2006
May 2006
April 2006
March 2006
February 2006
January 2006
December 2005
November 2005
October 2005
July 2005
June 2005
May 2005
Hyperglycemia Slows Mental Functions.
Drug May Block Brain Damage From Hypoglycemia JDRF funded research
suggests that a naturally occurring byproduct of glucose, pyruvate, may
protect brain cells against permanent impairment in brain function
relating to memory when hypoglycemia occurs.
from February 2005
From Diabetes Care
Care of
Children and Adolescents With Type 1 Diabetes
A Statement of the American Diabetes Association Posted 02/02/2005
Janet Silverstein, MD; Georgeanna Klingensmith, MD; Kenneth Copeland,
MD; Leslie Plotnick, MD; Francine Kaufman, MD; Lori Laffel, MD, MPH;
Larry Deeb, MD; Margaret Grey, DRPH, CPNP; Barbara Anderson, PHD; Lea
Ann Holzmeister, RD, CDE; Nathaniel Clark, MD, MS, RD
Introduction
Postprandial
Hyperglycemia and Diabetes Complications
Is It Time to Treat? Posted 02/02/2005 Antonio Ceriello
Abstract
Increasing evidence suggests that the postprandial state is a
contributing factor to the development of atherosclerosis. In diabetes,
the postprandial phase is characterized by a rapid and large increase in
blood glucose levels, and the possibility that the postprandial
"hyperglycemic spikes" may be relevant to the onset of cardiovascular
complications has recently received much attention. Epidemiological
studies and preliminary intervention studies have shown that
postprandial hyperglycemia is a direct and independent risk factor for
cardiovascular disease (CVD). Most of the cardiovascular risk factors
are modified in the postprandial phase in diabetic subjects and directly
affected by an acute increase of glycemia. The mechanisms through which
acute hyperglycemia exerts its effects may be identified in the
production of free radicals. This alarmingly suggestive body of evidence
for a harmful effect of postprandial hyperglycemia on diabetes
complications has been sufficient to influence guidelines from key
professional scientific societies. Correcting the postprandial
hyperglycemia may form part of the strategy for the prevention and
management of CVDs in diabetes.
Links related to cognitive
decline due to hypoglycemia:
Very Low Blood Sugar Affects Memory in Children Episodes of
extremely low blood sugar (hypoglycemia), particularly at an early age,
can have an impact on spatial memory performance in children with type 1
diabetes.Children who had had more than three episodes of severe
hypoglycemia showed reduced performance on the longer-delayed spatial
response test. This was particularly the case when severe hypoglycemic
episodes began before the age of 5 years.
High Blood Sugar, As Well As
Low, Slows the Mind
Int J Clin Pract Suppl. 2002 Jul(129):20-6. Related Articles, Links
The effects of glucose fluctuation on cognitive function and QOL: the
functional costs of hypoglycaemia and hyperglycaemia among adults with
type 1 or type 2 diabetes.Cox D, Gonder-Frederick L, McCall A,
Kovatchev B, Clarke W.University of Virginia, Charlottesville, USA.
Publication Types: * Review * Review, Tutorial PMID: 12166601 [PubMed -
indexed for MEDLINE]
J Pediatr Endocrinol Metab. 1996
Jul-Aug;9(4):455-61.
Acute hyperglycaemia impairs cognitive function in children with IDDM.
Davis EA, Soong SA, Byrne GC, Jones TW.Department of
Diabetes/Endocrinology, Princess Margaret Hospital for Children, Perth,
Western Australia.Publication Types: * Clinical Trial * Randomized
Controlled Trial PMID: 8910814 [PubMed - indexed for MEDLINE]
Diabetes Care. 1999 Aug;22(8):1318-24.
Comment in: * Diabetes Care. 1999 Aug;22(8):1239-41.Conventional
versus intensive diabetes therapy in children with type 1 diabetes:
effects on memory and motor speed. Hershey T, Bhargava N, Sadler
M, White NH, Craft S. Department of Psychiatry, Washington University
School of Medicine, Washington University, St. Louis, Missouri, USA.
tammy@npg.wustl.edu
Physiol Behav. 1998 Jul;64(5):653-60.
Related Articles, Links
Effect of acute hypoglycemia on visual information processing in adults
with type 1 diabetes mellitus.
Ewing FM, Deary IJ, McCrimmon RJ, Strachan MW, Frier BM.
Department of Diabetes, Royal Infirmary of Edinburgh, University of
Edinburgh, Scotland, UK. Publication Types: * Clinical Trial PMID:
9817577 [PubMed - indexed for MEDLINE]
Publication Types: * Clinical Trial * Randomized Controlled Trial PMID:
10480777 [PubMed - indexed for MEDLINE
Neurocognitive functioning in children with type-1 diabetes
with and without episodes of severe hypoglycaemia
Dev Med Child Neurol. 2003 Apr;45(4):262-8.
Severe hypoglycemia and long-term spatial memory in children
with type 1 diabetes mellitus: a retrospective study
J Int Neuropsychol Soc. 2003 Jul;9(5):740-50
Hypoglycemia in children with type 1 diabetes: current
issues and controversies
Pediatr Diabetes. 2003 Sep;4(3):143-50
From the ADA position statement on
hypoglycemia
http://care.diabetesjournals.org/cgi/content/full/26/6/1902
Hypoglycemia is a fact of life for people with type 1 diabetes. Those
attempting to improve or maintain glycemic control suffer untold numbers
of episodes of asymptomatic hypoglycemia; plasma glucose levels may be
less than 50–60 mg/dl (2.8–3.3 mmol/l) 10% of the time (5,9,10). They
suffer an average of two episodes of symptomatic hypoglycemia per
week—thousands of such episodes over a lifetime of diabetes—and an
episode of severe, at least temporarily disabling, hypoglycemia
approximately once a year (2,11,12). An estimated 2–4% of deaths of
people with type 1 diabetes have been attributed to hypoglycemia
(5,13).
Relevant links related to frequent and nighttime testing:
Nocturnal hypoglycemia detected with the Continuous Glucose Monitoring
System in pediatric patients with type 1 diabetes
J Pediatr. 2002 Nov;141(5):625-30
Decreased consciousness of hypoglycaemia and the
incidence of severe hypoglycaemia in children and adolescents with
diabetes type 1
Endokrynol Diabetol Chor Przemiany Materii Wieku Rozw. 2002;8(2):77-82
The Impact of Severe Hypoglycemia and Impaired Awareness
of Hypoglycemia on Relatives of Patients With Type 1 Diabetes
Diabetes Care 26:1106-1109, 2003
Hypoglycemia unawareness and counterregulatory response failure
-
Hypoglycemia Unawareness: Your patients with diabetes won't always
know when their blood sugar is low. Counterregulatory response
failure refers to the loss of normal hormonal responses to
hypoglycemia. Hypoglycemia unawareness refers to a patient’s
inability to perceive or recognize the usual warning symptoms of
hypoglycemia. 1,2 For example, a person taking insulin who has
hypoglycemia unawareness may have blood glucose levels as low as 40
mg/dL[2.2mmol] while feeling normal. In some cases, the glucose
level may fall so low that it causes changes in mood and behavior. A
patient in this state may behave irrationally or irritably, refusing
to accept juice or glucose tablets, for example. 3 As glucose levels
continue to fall, further cognitive and neurologic dysfunction
results; sometimes, drowsiness and lethargy may lead to the
inability to eat or drink. If blood glucose drops so low that
seizure or coma results, intravenous glucose or an intramuscular
glucagon injection is necessary for recovery.
-
The best defense against hypoglycemia is to recognize it: is
caffeine useful? Watson J, Kerr D. Bournemouth Diabetes and
Endocrine Centre, Royal Bournemouth Hospital, Castle Lane East,
Bournemouth BH7 7DW, United Kingdom. Caffeine may increase an
individual's sensitivity to hypoglycemia through the combined
effects of reducing substrate delivery to the brain via constriction
of the cerebral arteries, whilst simultaneously increasing brain
glucose metabolism and augmenting catecholamine production
The Effects of
Hyperglycemia
Hyperglycemia Slows Mental Functions in People with Diabetes
(Alexandria, VA) – A temporary rise in
blood glucose (sugar) levels in people with both types of diabetes can
interfere with their ability to think quickly and solve problems,
according to a study in the January issue of Diabetes Care.
Researchers at the University of Virginia Health System (UVHS) found
that people who had both type 1 and type 2 diabetes performed poorly on
math and verbal tests when they became hyperglycemic, a condition in
which blood glucose levels are higher than normal. Symptoms of
hyperglycemia include high blood glucose, high levels of sugar in the
urine, frequent urination, and increased thirst. Roughly 55 percent of
the people in the study showed signs of cognitive slowing or increased
errors while hyperglycemic, suggesting that the consequences of
hyperglycemia vary among individuals. However, among those whose
cognitive performance deteriorated when blood glucose levels rose, the
negative effects consistently appeared once levels reached or exceeded a
threshold of 15 mmol/l or 270 mg/dl.
Because hypoglycemia (when blood glucose levels are too low) can cause
dizziness and an inability to focus, many people consume large amounts
of carbohydrates to avoid this state prior to school exams and other
cognitive-sensitive tasks. But this study suggests that
carbohydrate-loading could be counterproductive, the researchers
conclude, because hyperglycemia often occurs after overeating.
“The best way to minimize any negative effects on cognitive functioning
is to keep blood glucose levels tightly controlled,” said lead
researcher Dr. Daniel J. Cox, of the Center for Behavioral Medicine
Research at UVHS. “People who have diabetes should pay careful attention
to the warning signs of hyperglycemia so that they can quickly take
action to treat it.”
Treatment for hyperglycemia can include increasing insulin or reducing
food intake.
To reach lead researcher Dr. Daniel J. Cox, send email to:
djc4f@virginia.edu.
Diabetes Care, published by the American Diabetes Association, is the
leading peer-reviewed journal of clinical research into the nation’s
fifth leading cause of death by disease. Diabetes also is a leading
cause of heart disease and stroke, as well as the leading cause of adult
blindness, kidney failure and non-traumatic amputations. For more
information about diabetes, call 1-800-DIABETES (1-800-342-2383).
High Blood Sugar, As Well As
Low, Slows the Mind
on Tuesday, December 28 @ 13:41:30 EST
Virginia researchers say a temporary rise in blood sugar levels
in people with diabetes can inhibit their ability to think quickly
and solve problems.
Dr. Daniel J. Cox stated that, “most people with diabetes are aware
of problems when their blood sugar levels drop too far.” However,
patients also often report not feeling well when their blood glucose
levels are high.” But lacking "a clear theory as to why that happens,
patient complaints were typically being ignored," he said.
While laboratory studies have shown that mental performance
declines when blood glucose is artificially raised, "this is not a
realistic environment," the researcher added.
Cox, at the University of Virginia Health System in Charlottesville, and
his colleagues therefore conducted a field study with 196 subjects with
type 1 diabetes and 34 with type 2 diabetes.
The team instructed the participants to complete tests assessing
verbal and mathematical skills using hand-held computers immediately
before routine self-monitoring of blood glucose, three to four times
daily. Approximately half the subjects made more errors and had
slower responses when blood glucose exceeded a certain point, the
researchers reported.
Cox pointed out that to avoid a drop in performance associated with
low blood glucose, people often load up on carbohydrates
before "cognitively sensitive procedures," such as exams. "But they in
fact could be doing themselves a significant disservice," he said, and
would perform better by avoiding both high and low extremes of blood
glucose levels.
Roughly 55 percent of the people in the study showed signs of
cognitive slowing or increased errors while hyperglycemic, suggesting
that the consequences of hyperglycemia vary among individuals. However,
among those whose cognitive performance deteriorated when
blood sugar levels rose, the negative effects consistently appeared once
levels reached or exceeded a certain threshold.
Diabetes Care, January 2005.
On the need
for psycho-social support:
Quality of life in school-aged children with type 1
diabetes on intensive treatment and their parents
Whittemore R, Urban AD, Tamborlane WV, Grey M
Research
Archives
May 2005
April 2005
Blood
Glucose Monitoring From Forearm Inaccurate During Hypoglycemia
Human blood cells coaxed to produce insulin
Memory Remains Intact in Type 1 Diabetics
The eMosquito
HbA1c Levels
Linked to Erectile Function in Diabetic Men
Fructose
Normalizes Defective Hypoglycemia Response in Type 1 Diabetes
March 2005
Single-Donor, Marginal-Dose Islet Transplantation in Patients With Type
1 Diabetes
February 2005
-
Thu Jan 13, 2005 10:26 AM ET By
Amy Norton NEW YORK (Reuters Health) - Despite the importance of
nutrition in managing type 1 diabetes, eating disorders and
unhealthy weight-control tactics are not uncommon in young women
with the disease -- and the combination can lead to serious
complications, a new study shows.
-
Arterial compliance changes in diabetic normotensive patients after
angiotensin-converting enzyme inhibition therapy The results
demonstrate that ACE inhibition can improve arterial
elasticity and hence risk of cardiovascular complications even in
normotensive diabetics. This short treatment was effective only in
younger patients with type 1 diabetes, suggesting that early
initiation
of therapy before the onset of advanced structural alterations is
likely
to be more cardioprotective.
-
Postprandial Hyperglycemia and Diabetes Complications
Is It Time to Treat? Posted 02/02/2005 Antonio Ceriello
Increasing evidence suggests that the postprandial state is a
contributing factor to the development of atherosclerosis. In
diabetes, the postprandial phase is characterized by a rapid and
large increase in blood glucose levels, and the possibility that the
postprandial "hyperglycemic spikes" may be relevant to the onset of
cardiovascular complications has recently received much attention.
-
Diet and
Diabetic Retinopathy: Insights From the Diabetes Control and
Complications Trial (DCCT) Posted 01/06/2005 David K. Cundiff;
Claudio R. Nigg, PhD Conclusion: Tobacco use and diet,
particularly the consumption of fatty acids and dietary fiber, are
significantly associated with the rate of progression of diabetic
retinopathy and retinopathy-related risk factors.
-
The
Impact of Insulin Glargine on Clinical and Humanistic Outcomes in
Patients Uncontrolled on Other Insulin and Oral Agents: An
Office-Based Naturalistic Study Posted 01/05/2005
Conclusions: Insulin glargine use over a 12-month period in a
clinical practice setting was shown to significantly improve A1C
without adversely impacting weight or the occurrence of
hypoglycemia. Significant improvements were also observed in HRQOL.
-
Glargine
May Be Preferable to Ultralente Insulin for Type 1 Diabetes Mellitus
News Author: Laurie Barclay, MD CME Author: Charles Vega, MD,
FAAFP Jan. 4, 2005 — Glargine is associated with slightly but
significantly lower glycosylated hemoglobin (HbA1c) and with fewer
hypoglycemic events than ultralente insulin used as a basal insulin
for treatment of type 1 diabetes, according to the results of a
randomized study published in the January issue of Diabetes Care.
-
Journal Article - Advances in Diabetes for the
Millennium: Insulin Treatment and Glucose Monitoring
The future will likely see better systems for continuous glucose
monitoring and novel therapies to control glucose through agents
that affect gut hormones.
-
Journal Article - Current Status of the
Development of Inhaled Insulin
Is a feasible alternative route for insulin administration finally
within reach?
from January 2005
Twice-Daily
Insulin Yields Suboptimal Metabolic Control in Diabetic Preschoolers
By Megan Rauscher
NEW YORK (Reuters Health) Dec 27 - In preschool children with type 1
diabetes, twice-daily insulin injections fail to provide adequate
glycemic control, with frequent and prolonged episodes of either hypo-
or hyperglycemia, the results of a new study indicate.
The study also suggests that use of a continuous glucose monitoring
system (CGMS) reveals daily glucose trends missed by self-monitoring of
blood glucose (SMBG) and is well tolerated by patients and their
families.
Dr. George S. Jeha, from Texas Children's Hospital in Houston, and
colleagues used the Medtronic MiniMed CGMS to evaluate the degree of
metabolic control in 10 children younger than age 6 with type 1 diabetes
that was considered "well controlled" based on SMBG and HbA1c. All of
the children underwent two 72-hour periods of CGMS monitoring separated
by 1 month. All of the children were on lispro insulin.
Dr. Jeha noted in comments to Reuters Health that "most of children
spent a significant amount of time (6% of a 24-hour period) with
hypoglycemia. Each child on average had at least one hypoglycemia
episode per day lasting close to 1 hour." These hypoglycemic episodes
occurred mainly over night when the children were asleep and therefore
went undetected.
Equally concerning, Dr. Jeha said, is that when those children are not
hypoglycemic they were typically running high glucose values. "Almost
50% of a 24-hour period is spent with values greater than 200 mg/dL with
the normal range being 80-120 mg/dL" he said, with postprandial
hyperglycemia an almost universal finding.
"The third important finding is that all of these kids have an
acceptable HbA1c for age and are considered well controlled," Dr. Jeha
emphasized.
This study shows that HbA1c "is not a very reliable predictor of good
control and only reflects the average of extreme high and extreme low
glucose values thus giving a false reassurance that the patient is doing
well when in fact he or she is not," Dr. Jeha said.
He believes that the management of young children with type 1 diabetes
needs to change to improve the control of their disease. He said that
his team has just completed a study showing that insulin pump therapy
significantly improves metabolic control and lifestyle in diabetic
children.
The team's current study results are published in the December issue of
Diabetes Care.
Diabetes Care 2004;27:2881-2886.
Mortality
Boosted in Insulin-Using Diabetics With Heart Failure NEW YORK
(Reuters Health) Dec 30 - Patients with advanced heart failure (HF) and
insulin-treated diabetes have about a fourfold greater risk of dying
compared with non-diabetic HF and non-insulin treated diabetic HF
patients, researchers report in the January issue of the American Heart
Journals.
"The magnitude of the effect was pretty surprising," investigator Dr.
Gregg C. Fonarow from the Ahmanson-UCLA Cardiomyopathy Center in Los
Angeles said in a telephone interview with Reuters Health.
Previous studies have shown that diabetes is associated with a moderate
increase in mortality risk in HF patients. "But none of these prior
studies have really looked at the way the diabetic patients had been
treated with regard to insulin and oral medications, so this really is a
new and dramatic finding," Dr. Fonarow added.
Among a cohort of 554 patients with advanced systolic HF, 132 (23.8%)
had diabetes. Forty-three (32.6%)were on insulin therapy and 89 (67.4%)
were non-insulin treated diabetics.
One-year survival rates were 89.7% for non-diabetic patients and 85.8%
for non-insulin-treated diabetic patients compared with 62.1% for
insulin-treated diabetic patients (p<0.00001).
On multivariate analysis, insulin therapy was an independent predictor
of mortality and "highly statistically significantly so," Dr. Fonarow
said. The hazard ratio was 4.30. Non-insulin treated diabetes was not an
independent predictor of death (hazard ratio, 0.95).
"There may be residual confounders," he continued, "so we can't be sure
that it is the insulin itself leading to this dramatic increase in
mortality risk, but certainly there is an urgent need for further
investigation to see whether we should try to avoid insulin in these
patients."
"In the near term," Dr. Fonarow concluded, "clinicians need to recognize
that heart failure patients with diabetes who are treated with insulin
are at particularly high risk for mortality and deserve increased
attention."
Am Heart J 2005.
|
This
site does not supply clinical treatment information or medical advice
and is not hosted by medical persons.
Any advice or information you may receive through this website or our
mailing lists is not guaranteed and should always be discussed with your
health care provider . All links are provided for your convenience
and further do not signify any endorsement on our behalf. 