Archive for the ‘Type 1 Diabetes’ Category

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FROM THE BEGINING…

Saturday, October 4th, 2008

Do you have diabetes? Are you struggling to live with diabetes? Are you looking for information online about diabetes? Are you unsure as to what types of foods you should now be eating to help keep a check on your glucose levels? If you have answered yes to any of these questions this article may well be of interest and benefit to you.

Diabetes is a disease in which the body does not produce or properly use insulin. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles.

There are 20.8 million children and adults in the United States, or 7% of the population, who have diabetes. While an estimated 14.6 million have been diagnosed with diabetes, unfortunately, 6.2 million people (or nearly one-third) are unaware that they have the disease.

In order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes.

With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes.

In the OGTT test, a person’s blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

Major Types of Diabetes

Type 1 diabetes
Results from the body’s failure to produce insulin, the hormone that “unlocks” the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.

Type 2 diabetes
Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.

Medications for Type 2 Diabetes

Sulfonylureas:
- GLUCOTROL XL (Glipizide)
- AMARYL (Glimepiride)

Meglitinides:
- PRANDIN (Repaglinide)
- STARLIX (Nateglinide)

Biguanides:
- GLUCOPHAGE (Metformin)

Thiazolidinediones:
- ACTOS (Pioglitazone)
- ACTOPLUS MET (Pioglitazone/Metformin)
- AVANDIA (Rosiglitazone)
- AVANDAMET (Rosiglitazone/Metformin)

Other medications:
- KARELA and DIABECON

Gestational diabetes
Gestational diabetes affects about 4% of all pregnant women – about 135,000 cases in the United States each year.

Pre-diabetes
Pre-diabetes is a condition that occurs when a person’s blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 54 million Americans who have pre-diabetes, in addition to the 20.8 million with diabetes.

Additional Information

Recently Diagnosed
You or someone you love has just been diagnosed with diabetes — chances are you have a million questions running through your head. This area of our Web site can help ease your fears and teach you more about living with diabetes or caring for someone with diabetes, and connect you with others affected by diabetes who will listen and share their own experiences.

Diabetes Symptoms
Often diabetes goes undiagnosed because many of its symptoms seem so harmless. Learn what they are in this section.

Diabetes Risk Test
More than 20 million Americans have diabetes — nearly one in three does not know it! Take our diabetes risk test to see if you are at risk for having diabetes. Diabetes is more common in African Americans, Latinos, Native Americans, Asian Americans and Pacific Islanders.

Diabetes Myths
Find the truth about some of the most common myths about diabetes.

The Genetics of Diabetes
You’ve probably wondered how you got diabetes. You may worry that your children will get it too. Unlike some traits, diabetes does not seem to be inherited in a simple pattern. Yet clearly, some people are born more likely to get diabetes than others.

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Posted in Actoplus Met, Actos, Amaryl, Avandamet, Avandia, Diabetes Myths, Diabetes Symptoms, Genetics, Gestational diabetes, Glucophage, Glucotrol XL, Medications, Prandin, Pre-diabetes, Recently Diagnosed, Starlix, Type 1 Diabetes, Type 2 Diabetes | 2 Comments »

Uric Acid May Help Spot Diabetic Kidney Disease Early

Friday, April 4th, 2008

Saturday, Apr. 5, 2008; 4:00 AM
Copyright © 2008 ScoutNews, LLC. All rights reserved.

FRIDAY, April 4 (HealthDay News) — Elevated levels of uric acid in the blood may be an early sign of diabetic kidney disease in people with type 1 diabetes, a new study suggests.

Researchers at the Joslin Diabetes Center in Boston noted that increased uric acid levels may appear before any significant change in urine albumin levels, the standard screening test for diabetic kidney disease.

In the study, the researchers checked serum uric acid concentration and urine albumin levels in 675 patients with type 1 diabetes. The results showed that 311 patients had microalbuminuria (small amounts of the protein albumin in the urine), an early sign of diabetic kidney disease. The other 364 patients had normal urine albumin levels.

While none of the patients had higher levels of albumin (albuminuria), one in five did have some impairment of kidney function.

“Our research showed that loss of kidney function takes place even in the absence of albuminuria in patients with type 1 diabetes,” study author Dr. Elizabeth T. Rosolowsky said in a prepared statement.

But she and her colleagues found that serum uric acid level was consistently related to kidney function. The higher the levels of uric acid in the blood, the lower the kidney function.

“The serum concentration of uric acid in these patients varied in a manner consistent with its having played a role in this early loss of kidney function,” Rosolowsky said.

The findings, published in the May issue of the Clinical Journal of the American Society of Nephrology, suggest that treatments to reduce uric acid may help slow the decline of kidney function in diabetes patients.

“Thus we have the hope of having a means to thwart the loss of kidney function while function is still a relatively preserved stage,” Rosolowsky said.

She noted that serum acid levels can be modified using drugs or by decreasing the amount of protein in a person’s diet.

“If follow-up studies, already under way, demonstrate that serum uric acid concentration predicts the course of early decline in kidney function, then clinical trials would be justified to test whether modifying serum uric acid concentration also modifies the course of renal function decline in type 1 diabetic patients with high normoalbuminuria or microalbuminuria,” Rosolowsky said.

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Posted in Kidney Disease, Type 1 Diabetes | No Comments »

Diabetes Drug Slows Clogging of Arteries

Wednesday, April 2nd, 2008

By Amanda Gardner
HealthDay Reporter Tuesday, Apr. 1, 2008; 4:00 AM
Copyright © 2008 ScoutNews, LLC. All rights reserved.

MONDAY, March 31 (HealthDay News) — The diabetes drug Actos is better than another diabetes drug, Amaryl, at slowing clogging of the arteries in patients with both type 2 diabetes and cardiovascular disease.

The Cleveland Clinic researchers behind the new findings say this is the first time that a diabetes medication has been shown to slow atherosclerosis, giving doctors new insight into which drugs may be most effective and safest for this group of patients.

“As we go forward, the study tells us that we must do comparative effectiveness trials looking at different diabetes strategies,” study author Steve Nissen, chairman of the department of cardiovascular medicine at Cleveland Clinic, said Monday. “We can’t just focus on pricking your finger, getting blood sugar down. The goal in diabetes therapy is to prevent complications, and the most feared complication is heart disease, which will kill 75 percent of all diabetics. I’m thrilled with results.”

Another expert hailed the results.

“The biggest news here is that pioglitazone [Actos] appears safe, does not increase cardiovascular risk, and may even reduce it,” said Dr. Robert Scott III, an assistant professor of internal medicine at the Texas A&M Health Science Center College of Medicine and senior staff cardiologist with Scott&White in Temple, Texas. “It looks safe to use in people with coronary artery disease, and it is well-tolerated. We may need another trial to see how it helps, but at least it doesn’t hurt, and that was our biggest concern.”

The findings are published in the April 2 issue of the Journal of the American Medical Association and were released Monday to coincide with a presentation at the American College of Cardiology annual meeting, in Chicago. The research was funded by Takeda Pharmaceuticals North America Inc., which makes Actos.

Individuals with type 2 diabetes are particularly susceptible to atherosclerosis, as evidenced by the fact that 75 percent of this group eventually die of cardiovascular disease.

Amaryl (glimepiride) belongs to a class of drugs known as sulfulonylureas, which have been prescribed for decades. Actos, along with its cousin Avandia, is a thiazolidinedione, a relatively new class of diabetes drugs.

Both Actos and Avandia appear to increase the risk of heart failure (the entire class now carries a black-box warning to that effect), but Avandia has been associated with an increased risk of heart attack, while Actos has been linked with a reduced risk of negative cardiovascular outcomes.

“Both are associated with heart failure, but there were increased deaths [with Avandia],” said Dr. Stanley Mirsky, an endocrinologist with Lenox Hill Hospital in New York City and co-author of the Diabetes Survival Guide.

For this study, 543 patients with both coronary disease and type 2 diabetes were randomized to receive either Amaryl or Actos for 18 months. Actos works by making the body more sensitive to insulin, while Amaryl works by spurring the body to produce more insulin. All participants were also taking medications for heart disease.

Progression of atherosclerosis was measured by intravascular ultrasonography in the 360 patients who actually completed the study.

One measure found a 0.73 increase in plaque in the Amaryl group versus a 0.16 decrease in the Actos group. A second measure found a 0.64 increase for Amaryl and a 0.06 decrease for Actos.

The study was not designed to measure actual clinical endpoints, meaning cardiovascular events or death.

The authors stated that the exact mechanisms for the decreases associated with Actos were unclear, although several biomarkers linked to atherosclerosis progression were impacted by the drug, including a 16 percent increase in HDL or “good” cholesterol, a 15 percent reduction in triglyceride levels, and a 45 percent drop in C-reactive protein (CRP) levels.

It’s also not clear if the benefits associated with Actos extend to other medications in that class of drugs.

An accompanying editorial found the results “reassuring.”

“You’ve got to take into consideration the benefit of preventing heart attacks may be greater than the few people who get heart failure,” Mirsky said.

If you want to buy Actos click here: http://www.myfamilydrugstore.com/item/anti_diabetic/actos.html

To buy Avandia: http://www.myfamilydrugstore.com/item/anti_diabetic/avandia.html

Amaryl: http://www.myfamilydrugstore.com/item/anti_diabetic/amaryl.html

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Posted in Actos, Amaryl, Avandia, Cardiovascular disease, Medications, Type 1 Diabetes, Type 2 Diabetes | No Comments »

Once-Daily Insulin Shot Proves Effective in Study

Tuesday, April 1st, 2008

By Amanda Gardner
HealthDay Reporter Friday, Mar. 28, 2008; 4:00 AM
Copyright © 2008 ScoutNews, LLC. All rights reserved.

THURSDAY, March 27 (HealthDay News) — Researchers report that a once-daily shot of insulin appears to control blood sugar levels in people with type 2 diabetes just as well as injecting insulin three times a day.

The once-a-day formulation, known as insulin glargine (Lantus), is already on the market, as is insulin lispro (Humalog), which is taken with meals. The new, international study found more patient satisfaction with the glargine.

“This study just confirms that insulin is effective and there are good reasons to use insulin if oral agents are not working,” said Dr. Sue Kirkman, vice president of clinical affairs at the American Diabetes Association. “It’s certainly not that one is good and one is bad.”

The new study did show slight benefits for insulin glargine in terms of patient satisfaction and low blood sugar. But the study was funded by Lantus’ maker, Sanofi Aventis, and other studies funded by makers of other insulin formulations have found slight benefits for those products, too, Kirkman noted.

The results are published in the March 29 edition of The Lancet.

Maintaining strict blood sugar control is critical to avoid the complications of diabetes, which can include blindness, kidney failure, and even amputations.

The American Diabetes Association recommends that concentrations of hemoglobin A1c — a measure of blood sugar control — remain below 7 percent. Lower levels can substantially reduce the risk of diabetes complications.

Type 2 diabetes — often linked to being overweight — is caused by the body’s inability to properly use the hormone insulin, which transports blood sugar to the cells for energy. Type 1 diabetes, which is less common, results from the body’s failure to produce insulin.

Oral medications, along with lifestyle changes such as improved diet and exercise, can often control type 2 diabetes in the beginning. But, in many cases, insulin needs to be added to a patient’s regimen as the disease progresses.

“Diabetes is a worsening epidemic worldwide and studies examining glycemic control are very important,” said Dr. Spyros Mezitis, an endocrinologist at Lenox Hill Hospital in New York City. “Diabetes is not well controlled in many patients and insulin is not used early enough in the treatment algorithm for type 2 diabetes to achieve maximal benefit.”

Lantus is known as a “basal” insulin analogue, meaning it is given once a day either in the morning or at night; it lasts for about 24 hours. Insulin lispro is shorter-acting and is administered with meals.

For the new study, more than 400 men and women with type 2 diabetes that was poorly controlled by oral medication were randomly assigned to receive either Lantus or Humalog. The trial, conducted at 69 study sites in Europe and Australia, lasted 44 weeks. All participants continued to take oral medications.

Blood sugar control was about equivalent in the two groups, with a decrease of 1.7 percent in the Lantus group and 1.9 percent in the Humalog group.

Lantus was associated with a lower risk of low blood sugar. It also offered the advantages of fewer injections and less blood glucose monitoring throughout the day (only once before breakfast). People taking Lantus also experienced less weight gain, the study authors said.

Certainly, Lantus seems to present another, viable option for people with type 2 diabetes, and one that fits with current treatment recommendations, Kirkman said.

“The American Diabetes Association has a consensus treatment algorithm for type 2 diabetes and insulin is suggested as a second- or third-line treatment,” she said. “The suggestion is to start with basal insulin, but that’s really primarily because it tends to be easier to convince a patient to go on one shot a day.”

Dr. Juan Castro, director of the Texas A&M Health Science Center Coastal Bend Health Education Center, said, “I don’t think it [the new study] is going to revolutionize what we’re doing but, to clinicians, it really supports what we have seen in the Hispanic population. Historically there has been a lot of resistance with Hispanic patients to accept the idea of being on insulin. This basal insulin gives us a good transition to help patients accept insulin because it’s only once a day. If, two to three months later, we need to give them lispro, it’s easier for them to accept it.”

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Posted in A1C Test, Insulin Therapy, Type 1 Diabetes, Type 2 Diabetes | No Comments »

Tweaking Insulin Might Help Fight Aging

Thursday, March 20th, 2008

By Randy Dotinga
HealthDay Reporter Friday, Mar. 21, 2008; 4:00 AM
Copyright © 2008 ScoutNews, LLC. All rights reserved.

THURSDAY, March 20 (HealthDay News) — Scientists have gained new insight into the workings of insulin, potentially laying the groundwork for an anti-aging treatment.

The research has only taken place in worms, a common model for this type of research, and it’s too early to know if it will translate to humans. But worms whose insulin levels were adjusted lived a week longer than their typical two-week lifespan, the scientists said.

“It doesn’t sound like much for a worm, but those percentages would be a lot for us,” noted study co-author Dr. T. Keith Blackwell, senior investigator at Harvard Medical School’s Joslin Diabetes Center, in Boston.

According to Blackwell, the findings — which explore a genetic pathway in the worms — provide new information about how insulin and lifespan might be related.

“We’re understanding more and more about how cellular processes can really influence how we defend ourselves against challenges from the environment,” he said.

The new findings are published in the March 21 issue of the journal Cell.

Insulin is best known as the hormone that allows healthy people to regulate blood sugar and is linked to a variety of problems in diabetics.

Insulin has other jobs, such as helping to regulate the burning of fuel by cells to provide energy, noted Blackwell, an associate professor of pathology at Harvard Medical School and faculty member at the Harvard Stem Cell Institute. Insulin also serves as a taskmaster, telling cells to process glucose, suppress tumors and respond to the daily challenges that our bodies face, he said.

In the new study, researchers looked into the effects of changing insulin levels in a species of tiny worm known as Caenorhabditis elegans. The worm has long been used in cutting-edge genetics research — in fact, hundreds of the critters survived the 2003 Space Shuttle disaster intact, although their tiny lifespans prevented them from appreciating their brush with death for very long.

The Joslin researchers found that more insulin results in less activity by a gene-regulating protein called SKN-1. So, by lowering insulin levels, the study authors were able to boost levels of the protein and make the worms live longer.

The mechanism at work here seems to relate to how well cells defend themselves against damage. “From just being alive, your body is creating its own free radicals that can cause damage,” Blackwell explained. “Your body has its own antioxidant systems that clean up damage and protect you from damage. We were able to push the activity of that system upward and make the animals live longer.”

Previous research has shown that insulin controls the activity of another protein, known as FOXO, that also regulates genes.

The potential impact on people with diabetes is unclear. Diabetics are unable to produce enough insulin: people with the rarer type 1 diabetes produce no insulin, while those with type 2 diabetes don’t produce enough.

Blackwell believes that the research does hold hope for people with a variety of diseases. “We’re understanding more about mechanisms that can be harnessed in a way that pushes back this tide of cellular damage,” he said. “There’s a lot of therapeutic potential to defend against chronic diseases and potentially expand lifespans.”

More information

There’s more on insulin at the U.S. Food and Drug Administration.

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