Archive for the ‘Common Concerns’ Category

Calorie overload sends the brain haywire: study

Saturday, October 4th, 2008

WASHINGTON (Reuters) – Overeating makes the brain go haywire, prompting a cascade of damage that may cause diabetes, heart disease and other ills, U.S. researchers reported on Thursday.

Eating too much appears to activate a usually dormant immune system pathway in the brain, sending out immune cells to attack and destroy invaders that are not there, Dongsheng Cai of the University of Wisconsin-Madison and colleagues found.

The finding, reported in the journal Cell, could help explain why obesity causes so many different diseases. It might also offer a way to prevent obesity itself.

“This pathway is usually present but inactive in the brain,” Cai said in a statement.

Obesity is a growing global problem, with 1.8 billion people estimated to be overweight or obese in 2007. Drugs marketed so far to fight obesity have only limited success and, often, severe side-effects.

Cai’s team worked in mice, seeking to explain studies that have shown that obesity causes chronic inflammation throughout the body. This inflammation is found in a range of diseases related to obesity, including heart disease and diabetes.

They homed in on a compound known as IKKbeta/NK-kappaB.

Immune cells such as macrophages and leukocytes use it but Cai’s team found it in the hypothalamus, a part of the brain linked with metabolism in mice and humans alike.

“The hypothalamus is the ‘headquarters’ for regulating energy,” they wrote.

They found high levels of the compound there but it was normally inactive.

When they fed mice a high-fat diet, it became extremely active. And when it was active, the body ignored signals from leptin, a hormone that normally helps regulate appetite, and insulin, which helps convert food into energy.

Stimulating IKKbeta/NK-kappaB made the mice eat more, while suppressing it made them eat less.

Cai believes his team has discovered a master switch for the diseases caused by overeating.

“Hypothalamic IKKb/NF-kB could underlie the entire family of modern diseases induced by overnutrition and obesity,” his team wrote.

Cai does not know why this compound would be in the brain and in the immune system but suspects it evolved long ago in primitive animals that do not have the same sophisticated immune system as modern animals, including mice and humans.

“Presumably it played some role to guide the immune defense,” Cai said in a telephone interview. “In today’s society, this pathway is mobilized by a different environmental challenge — overnutrition.”

“Knocking out” the gene using genetic engineering kept mice eating normally and prevented obesity. This cannot be done in people but Cai believes a drug, or even gene therapy, might work.

With gene therapy, a virus or other so-called vector is used to carry corrective DNA into the body, but the approach is still highly experimental.

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Overweight Hispanic Kids Show Early Markers for Diabetes

Wednesday, February 27th, 2008

Wednesday, Feb. 27, 2008; 10:00 AM
Copyright © 2008 ScoutNews, LLC. All rights reserved.

WEDNESDAY, Feb. 27 (HealthDay News) — A small U.S. study found that obese Hispanic children and adolescents with normal blood sugar levels had elevated markers for blood vessel inflammation that may put them at risk for both type 2 diabetes and cardiovascular disease.

Researchers at the Joslin Diabetes Center studied 38 Hispanic youngsters, aged 10 to 18. Of those, 17 were lean and 21 were obese but had normal blood sugar levels, which means they had not yet developed diabetes.

The obese children had significantly higher percentages of body fat than the lean children and were already showing signs of insulin resistance, a pre-diabetes condition.

The study also found that the obese children had higher levels of blood markers for subclinical, or asymptomatic, inflammation of the inner layer of blood vessels.

“They are already exhibiting problems with circulation. There is an inflammatory process going on in the vessels,” lead investigator Dr. A. Enrique Caballero, director of Joslin’s Latino Diabetes Initiative, said in a prepared statement.

The findings suggest the obese children may be at increased risk of developing cardiovascular disease at a young age, said Caballero, who is also an assistant professor of medicine at Harvard Medical School.

The study is published in the March issue of Diabetes Care.

Genetic and lifestyle factors put Hispanic children at high risk for developing type 2 diabetes, but they had not previously been studied, Caballero said.

“We have found that overweight Hispanic children and adolescents have elevated markers of endothelial dysfunction and vascular inflammation closely related to excess body fat and increased insulin resistance,” the study authors concluded. “This … may increase their risk of developing type 2 diabetes and cardiovascular disease, further emphasizing the need for obesity prevention strategies.”

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Depression

Saturday, December 15th, 2007

Feeling down once in a while is normal. But some people feel a sadness that just won’t go away. Life seems hopeless. Feeling this way most of the day for two weeks or more is a sign of serious depression.

At any given time, most people with diabetes do not have depression. But studies show that people with diabetes have a greater risk of depression than people without diabetes. There are no easy answers about why this is true.

The stress of daily diabetes management can build. You may feel alone or set apart from your friends and family because of all this extra work.

If you face diabetes complications such as nerve damage, or if you are having trouble keeping your blood sugar levels where you’d like, you may feel like you’re losing control of your diabetes. Even tension between you and your doctor may make you feel frustrated and sad.

Just like denial, depression can get you into a vicious cycle. It can block good diabetes self-care. If you are depressed and have no energy, chances are you will find such tasks as regular blood sugar testing too much. If you feel so anxious that you can’t think straight, it will be hard to keep up with a good diet. You may not feel like eating at all. Of course, this will affect your blood sugar levels.

What to do?

Spotting depression is the first step. Getting help is the second. If you have been feeling really sad, blue, or down in the dumps, check for these symptoms:

  • Loss of pleasure You no longer take interest in doing things you used to enjoy.
  • Change in sleep patterns You have trouble falling asleep, you wake often during the night, or you want to sleep more than usual, including during the day.
  • Early to rise You wake up earlier than usual and cannot to get back to sleep.
  • Change in appetite You eat more or less than you used to, resulting in a quick weight gain or weight loss.
  • Trouble concentrating You can’t watch a TV program or read an article because other thoughts or feelings get in the way.
  • Loss of energy You feel tired all the time.
  • Nervousness You always feel so anxious you can’t sit still.
  • Guilt You feel you “never do anything right” and worry that you are a burden to others.
  • Morning sadness You feel worse in the morning than you do the rest of the day.
  • Suicidal thoughts You feel you want to die or are thinking about ways to hurt yourself.

If you have three or more of these symptoms, or if you have just one or two but have been feeling bad for two weeks or more, it’s time to get help.

Getting Help

If you are feeling symptoms of depression, don’t keep them to yourself. First, talk them over with your doctor. There may a physical cause for your depression.

Diabetes that is in poor control can cause symptoms that look like depression. During the day, high or low blood sugar may make you feel tired or anxious. Low blood sugar levels can also lead to hunger and eating too much. If you have low blood sugar at night, it could disturb your sleep. If you have high blood sugar at night, you may get up often to urinate and then feel tired during the day.

Other physical causes of depression can include

  • alcohol or drug abuse
  • thyroid problems
  • side effects from some medications

Do not stop taking a medication without telling your doctor. Your doctor will be able to help you discover if a physical problem is at the root of your sad feelings.

If you and your doctor rule out physical causes, your doctor will most likely refer you to a specialist. You might talk with a psychiatrist, psychologist, psychiatric nurse, licensed clinical social worker, or professional counselor. In fact, your doctor may already work with mental health professionals on a diabetes treatment team.

All of these mental health professionals can guide you through the rough waters of depression. In general, there are two types of treatment. One is psychotherapy, or counseling. The other is antidepressant medication.

Psychotherapy with a well-trained therapist can help you look at the problems that bring on depression. It can also help you find ways to relieve the problem. Therapy can be short term or long term. You should be sure you feel at ease with the therapist you choose.

If medication is advised, you will need to consult with a psychiatrist (a medical doctor with special training in diagnosing and treating mental or emotional disorders). Psychiatrists are the only mental health professionals who can prescribe medication and treat physical causes of depression.

If you opt for trying an antidepressant drug, talk to the psychiatrist and your primary care provider about side effects, including how it might affect your blood sugar levels. Make sure that the doctors will consult about your care when needed. Many people do well with a combination of medication and psychotherapy.

If you have symptoms of depression, don’t wait too long to get help. If your health care provider cannot refer you to a mental health professional, contact your local psychiatric society or psychiatry department of a medical school, or the local branch of organizations for psychiatric social workers, psychologists, or mental health counselors.

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Tips for Emergency Preparedness

Thursday, October 25th, 2007

We have always needed to be ready for emergencies. Wherever you live, there is the chance of something happening to disrupt your daily life, whether it’s a hurricane, an earthquake, a tornado, or a blizzard. Recent concerns about terrorist attacks have simply increased our awareness of the need to be prepared if a disaster strikes.

Everyone is now advised to have a plan in place in the case of an emergency, and people with diabetes must consider proper diabetes care when they make emergency plans.

Consider storing 3 days worth of diabetes supplies, which, depending on how you take care of your diabetes, could include oral medication, insulin, insulin delivery supplies, lancets, extra batteries for your meter and/or pump, and a quick-acting source of glucose. You may also want to have an extra glucagon emergency kit. All these items should be kept in an easy-to-identify container, and stored in a location that is easy to get to in an emergency.

Your emergency supply kit should also contain a list of emergency contacts and, if you are a parent of a child in school or daycare, physician’s orders that may be on file with your child’s school or day care provider. As always, it is a good idea to wear medical identification that will enable colleagues, school staff members, or emergency medical personnel to identify and address your medical needs.

If you are a parent of a child with diabetes, it is important that your child’s school has clearly identified the school staff members who will assist your child in the event of an emergency evacuation. For those who are away from home, consider informing your colleagues, friends, and family members about your diabetes and where your emergency supply kit is kept. Taking a few minutes right now to gather supplies and inform those around you about your diabetes, may make a world of difference in maintaining blood glucose control and staying healthy under stressful circumstances.

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Common Concerns

Sunday, October 21st, 2007

When You’re Sick
Being sick can make your blood glucose (sugar) level go up very high. It can also cause serious conditions that can put you in a coma. The best way to prevent a minor illness from becoming a major problem is to work out a plan of action for sick days ahead of time.

Flu & Pneumonia Shots
Having the flu can be dangerous for anyone. But it is extra risky for people with diabetes or other chronic health problems.

When You Travel
Planning a trip? Whether you’re camping or cruising, you can go anywhere and do almost anything. It just takes a little planning ahead to handle your diabetes.

Tips for Emergency Preparedness
Recent concerns about terrorist attacks have simply increased our awareness of the need to be prepared if a disaster strikes. People with diabetes must consider proper diabetes care when they make emergency plans.

Anger
Diabetes is the perfect breeding ground for anger. Anger can start at diagnosis with the question, “Why me?” You may dwell on how unfair diabetes is: “I’m so angry at this disease! I don’t want to treat it. I don’t want to control it. I hate it!”

Depression
Feeling down once in a while is normal. But some people feel a sadness that just won’t go away. Life seems hopeless. Feeling this way most of the day for two weeks or more is a sign of serious depression.

Denial
Denial is that voice inside repeating: “Not me.” Most people go through denial when they are first diagnosed with diabetes. “I don’t believe it. There must be some mistake,” they say.

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