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Ho, Ho, No! Holidays can pose a problem for people with undiagnosed type 2 diabetes

Ho, Ho, No! Holidays can pose a problem for people with undiagnosed type 2 diabetes | Diabetes Now | Scoop.it
For most people, overeating and drinking at holiday parties will just result in weight gain. However, for millions of others who do not know they have type 2 diabetes, it could mean something much more serious.

“As tempting and tasty as it might be, eating high fat foods with excess calories, carbohydrates and salt will put people who don’t know they have the disease at great risk,” said Dr. Dale J. Hamilton, an endocrinologist and diabetes specialist with The Methodist Hospital in Houston. “The most common cause of death from type 2 diabetes is heart disease and stroke.”

Some of the symptoms of type 2 diabetes include frequent urination (especially at night), thirst, weight loss (despite eating more food), fatigue, blurred vision, and a high blood sugar level.
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Understanding pancreas size may help unlock cause of type 1 diabetes

Understanding pancreas size may help unlock cause of type 1 diabetes | Diabetes Now | Scoop.it
People at risk for Type 1 diabetes may have fewer insulin-producing “beta” cells than people not at risk, a finding that could help researchers shed light on what causes the disease, a new University of Florida study shows.

The study, which will be published Wednesday (Dec. 12) in the Journal of the American Medical Association, revealed that people at risk for Type 1 diabetes had smaller pancreases than people who were not at risk.

“This is the first time this has been noted,” said Martha Campbell-Thompson, D.V.M., Ph.D., a professor in the UF College of Medicine department of pathology, immunology and laboratory medicine. “We still don’t know what causes Type 1 diabetes, but if people have fewer beta cells to begin with, other confounding factors such as a virus or genetics could help push them over into having clinical diabetes. There are a lot of possibilities.”

Type 1 diabetes occurs when the body’s immune system begins attacking its own beta cells in the pancreas, which are responsible for producing insulin the body needs to convert sugar into energy. The beta cells stop producing insulin, often beginning in childhood. Because of this, patients must take insulin for the rest of their lives. This differs from the more common Type 2 diabetes, which often can be prevented and treated through lifestyle changes, such as improved diet and increased exercise.

Although genetics plays a big role, researchers still don’t know what triggers this autoimmune attack, and after it begins, there is no going back, said Campbell-Thompson, director of the pathology core for the Network for Pancreatic Organ Donors with Diabetes, or nPOD, a human pancreas biorepository housed within the UF Diabetes Center of Excellence.

In the current study, Campbell-Thompson and colleagues at the City of Hope National Medical Center examined 164 pancreases from adult organ donors, including those with auto-antibodies linked to an increased risk for Type 1 diabetes. After examining the organs and comparing them with control samples, the researchers discovered that the people at risk for Type 1 diabetes had pancreases roughly three-fourths the weight of those of patients not at risk for the disease. In addition, patients already diagnosed with Type 1 diabetes had pancreases about half the weight of control samples, Campbell-Thompson said.
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Diabetes 12.12.12 #bgnow awareness

Diabetes 12.12.12 #bgnow awareness | Diabetes Now | Scoop.it
Welcome to Diabetes 12.12.12

Capturing Diabetes One Blood Test at time via the Hashtag #BGnow.

Check out the latest tweets with the hashtag #bgnow!

[AS: Click on the title link above to see the latest #bgnow tweets on diabetes121212.com. A great awareness initiative -- well done, everyone!]
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Diabetic retinopathy may have become less severe in recent years

Diabetic retinopathy may have become less severe in recent years | Diabetes Now | Scoop.it
Type 1 diabetes can cause serious damage to your eyes. Fortunately, there has been much progress over the years in the prevention and treatment of eye damage caused by diabetes, or diabetic retinopathy.

A recent study showed that diabetic retinopathy may not be as severe for patients today than it was for those a few decades ago.

Mari Palta, PhD, of the University of Wisconsin, looked at patients with type 1 diabetes for 20 years who participated in two different studies.

While patients in both studies were from the same geographic area, those from one study were diagnosed 8 to 34 years earlier than those in the other study. This gave the researchers the opportunity to study changes in complications.

The first study - called the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) - was conducted between 1980 and 1996. The second study - called the Wisconsin Diabetes Registry Study (WDRS) - was conducted during 2007 to 2011.

Dr. Palta and colleagues found that vision-threatening diabetic retinopathy was less common among patients in the more recent WDRS than in the WESDR. That is, patients today with diabetic retinopathy may be less likely to have serious sight problems or blindness.

Results showed that 18 percent of WDRS patients had vision-threatening levels of retinopathy, compared to 43 percent of WESDR patients. Patients in the WESDR had about 2.2 to 3.0 times the odds of severe retinopathy.

These differences may have something to do with recent advances in diabetes medications and blood sugar control. In other words, blood sugar levels may partly explain the differences.
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Continuous glucose monitoring: the clinical picture, how to interpret and use the data

Continuous glucose monitoring: the clinical picture, how to interpret and use the data | Diabetes Now | Scoop.it

Abstract from Practical Diabetes Volume 29, Issue 9, pages 364–368, November/December 2012:

 

There is a limited evidence base as to the benefits of continuous glucose monitoring (CGM) in clinical practice, but it is clear that in order to realise improvements in glycaemic control when using CGM there is a requirement for both health care professionals and patients to have the ability to interpret the data obtained from CGM.

 

This article describes a personal approach to analysing CGM data using a structured approach and reporting tool, with examples to demonstrate how this system is implemented in practice. By viewing the daily overlay, then breaking the CGM traces into overnight, fasting/pre-meal and post-meal phases, and finally looking at the impact of other factors such as exercise, alcohol and work patterns, the user can be educated to make changes to both their insulin regimen and lifestyle to optimise glycaemic control.

 

Those offered CGM as a real-time adjunct to their intensive insulin regimen need to have such a structured approach to get positive re-inforcement and thus use CGM sufficiently frequently to gain real benefit from it.

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Dating with diabetes: making an impression in the kitchen

Dating with diabetes: making an impression in the kitchen | Diabetes Now | Scoop.it

Kate Brind'Amour writes:

 

Dating with diabetes can be a challenge. It can feel awkward perusing the menu in search of low-carb foods, and simple outings for milkshakes or dessert can turn into a stressful mini-date forcing you to juggle the rest of your day’s diet. Instead of the pressure accompanying a meal out on the town, try impressing your date with your cooking skills—even if you don’t think you have any!


Cooking at home not only shows you know your way around the kitchen—a plus in the dating arena for men and women—it also offers you the chance to share a romantic meal without the last-minute stress of guesstimating carbs. Follow the tips below to offer an impressive diabetes-friendly meal with the least fuss.

 

So, stick to the basics:

 

* Keep it simple
* Opt for few, but high quality, ingredients
* Prep in advance when possible
* Don’t be afraid to let your date assist you
* Keep the focus on the shared experience

 

The next most challenging part of cooking for a date when you have diabetes is selecting foods you will both enjoy that are also appropriate for you to eat. Because you can plan the entire meal ahead of time, no last-minute estimations will be necessary.
Try some of the following carb-friendly, date-friendly meals:


Easy Chicken Curry with a make-ahead side dish of Greek Salad (just assemble when ready to eat). For adventurous dates and ethnic food lovers:

http://www.diabetesdaily.com/recipes/entrees/easy_chicken_curry/ ;

 

Chicken with Apricot Glaze (the birds and glaze can be prepped in advance) or with Asparagus with Lemon and Tarragon. For those with elegant palates:

http://www.diabetesdaily.com/recipes/entrees/cornish_hens_with_apricot_glaze/

http://www.diabetesdaily.com/recipes/sides/asparagus_with_lemon_and_tarragon/ ;

 

 

Asian Grilled Salmon will also impress, with snap peas or Balsamic Arugula and Escarole on the side. For those who love fresh flavors and lighter menus:

http://www.diabetesdaily.com/recipes/fish/grilled_asian_copper_river_salmon/

http://www.diabetesdaily.com/recipes/vegetarian/balsamic_arugula_and_escarole/ ;

 

For dessert, impress your date with Figs with Ricotta, Honey, and Pistachios or fancy but easy Roasted Berries with Whipped Cream. For those who love delicious, fruity goodness

http://www.diabetesdaily.com/recipes/appetizers/figs_with_ricotta_honey_and_pistachios_/ ;

http://www.diabetesdaily.com/recipes/low-fat/roasted_berries_with_whipped_cream/ ;


Diabetes doesn’t have to be a hurdle in your dating life! Enjoy the ride.

 

[AS: A great article. More, please!]

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New Google+ community: diabetes

New Google+ community: diabetes | Diabetes Now | Scoop.it

A brand new diabetes presence using Google+ Community, founded by Mike Young (@elgringoinspain)

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“Howzit Bru?” Living with type 1 diabetes in South Africa

“Howzit Bru?” Living with type 1 diabetes in South Africa | Diabetes Now | Scoop.it

Mark Koekemoer writes: 

 

Firstly, let me just clear a few things up:

 

1. In South Africa, we do not live in huts.

 

2. There are no elephants or lions that roam freely in the streets or nearby said huts.

 

3. There ain’t no barbecue like a braai. (South African “barbecue”)

 

[Mark continues... :)]

 

Stats on diabetes in South Africa aren’t as well-documented as they are in the U.S., but some local community stats from the website Sweetlife show this:

 

* According to the International Diabetes Federation (IDF), the estimated number of people with diabetes in South Africa is around 840 000, but other studies say there may be as many as 1.5 million diabetics.


* The World Diabetes Foundation says that in developing countries (like South Africa), less than half of people with diabetes are diagnosed. Without diagnosis and treatment, complications from diabetes rise at an alarming rate. This same foundation says that 85% of those with diabetes in South Africa are undiagnosed!


* Most at risk of developing diabetes in South Africa are the black community because of rapid lifestyle and cultural changes, and people of Indian descent because of their hereditary genes and diet.


* 90% of people with diabetes in South Africa have type 2 diabetes; 10% have type 1 diabetes.


* In South Africa 1 in 5 people older than 35 have type 2 diabetes; more than 50% are unaware of this.

 

[AS: Loved this! Read Mark's post in full on Diabetes Mine by clicking on the title link above]

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The sound of diabetes in the wild

The sound of diabetes in the wild | Diabetes Now | Scoop.it

Alison writes:

 

Avid diabetic spotters like myself are always on the look out for our fellow pancreatically challenged types. It brightens up our day to spot another of our species out in the wild. But it’s not always the visual clues that give us away. Sometimes it’s the sounds…

 

* The slurp of a juice box being emptied at speed
* The rustle of fruit pastilles wrappers being opened
* The clunk of the finger pricker
* The bleep of the meter
* The anguished screams of fury when the result isn’t quite what I was expecting
* The space invader-esque CGM alarms indicating you’re rising or falling quickly
* The kerklunk of the infusion set inserter, which reminds me of the terrifying clunk of the Autolet, the vicious guillotine style finger * pricking device from the dark ages
* The buzzes and beeps of my insulin pump
* The bang of insulin pump colliding with doorframe
* The sigh as I realise we’re going to have to repaint the doorframes again soon
* The groans of disappointment as I miss the test strip in the middle of the night and put another spot of blood on the bedsheets
* The muffled middle of the night conversation “You ok?” “I’m a six” “Snore”

 

Any more?

 

[AS: Click on the title link above to read the responses to Alison's post on Shoot Up Or Put Up.]

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#gbdoc archive for 5 December

#gbdoc archive for 5 December | Diabetes Now | Scoop.it

Wednesday 28 November 2012 saw the convening of the seventeenth meeting of the UK's diabetes online community tweetchat using the hashtag #gbdoc.

 

The conversation convenes every Wednesday at 9pm UK time, and is chaired by @theGBDOC.

 

This week's chat focused on the management of diabetes over the Christmas period. The questions were:

 

* what effect does cold weather have on your diabetes?

* does being cold and/or being wrapped up in extra layers effect your sensitivity to hypos?

* what are your favourite 'snack' foods over Christmas?

* what are your top for D Parents on how to cope with D kids during the holidays?

* how do you 'de-D'? What are your tips to relaxing & enjoying Christmas?

* what are your tips for travelling over Christmas?

 

This week's #BGBingo number was 7.3 and the closest was @fred_bear with 6.8

 

[AS: Click on the title link above to review the complete transcript c/o Symplur.]

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Cycling Team Type 1 becomes Team Novo Nordisk with an all-diabetic roster in 2013

Cycling Team Type 1 becomes Team Novo Nordisk with an all-diabetic roster in 2013 | Diabetes Now | Scoop.it

Months-long rumours that the Team Type 1 – Sanofi squad would be comprised entirely of diabetic riders from 2013 onwards were confirmed today when the team was re-launched with that modified focus and a new title sponsor on board.

 

Backed by the Danish-based Novo Nordisk brand, a global healthcare company, some details emerged of the new setup. Titled Team Novo Norisk, the pro cycling squad will be just one element of a global sports team which will include more than 100 athletes in total; apart from cyclists, these will also include triathletes and runners.

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People with type 2 diabetes benefit from more supervised exercise sessions per week

People with type 2 diabetes benefit from more supervised exercise sessions per week | Diabetes Now | Scoop.it

Exercise plays a key role in any diabetes patient's effort to control blood sugar levels. Still, questions remain about the type, intensity and amount of exercise that is best for people with diabetes.

 

Both aerobic exercise (e.g. walking, running, swimming) and resistance exercise (e.g. weightlifting) can help patients with type 2 diabetes control their blood sugar, according to a recent study.

 

Researchers found that diabetes patients had larger drops in blood sugar the more exercise sessions they attended each week.

More specifically, it was aerobic exercise and combined exercise (aerobic plus resistance) that led to these reductions in blood sugar; not resistance training alone.

 

Research has shown that supervised exercise programs can improve blood sugar control in type 2 diabetes. However, it remains unclear what aspects of exercise are associated with reductions in HbA1c (a measure of blood sugar over time), explained the authors in background information to their study.

 

Daniel Umpierre, MSc, of Hospital de Clínicas de Porto Alegre in Brazil, and colleagues looked at past studies to better understand the link between the intensity and amount of exercise training and changes to HbA1c in patients with type 2 diabetes.

 

The HbA1c test shows how well patients have been controlling their blood sugar over the past 3 months. An HbA1c level of 5.6 percent or less is considered normal. Diabetes patients have an HbA1c of 6.5 percent or more. The goal for many diabetes patients is to keep their levels at or below 6.5 to 7 percent.

 

They found that each additional session of aerobic exercise per week may reduce HbA1c by 0.39 percent.

 

While the amount of resistance exercise alone did not seem to affect levels of HbA1c, the amount of resistance exercise in combined training was associated with changes in HbA1c.

 

According to the authors, these finding highlighted the importance of exercise volume (frequency of exercise sessions) in improving blood sugar.

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People with type 2 diabetes see a clinical benefit from online disease management

People with type 2 diabetes see a clinical benefit from online disease management | Diabetes Now | Scoop.it

Patients with uncontrolled type 2 diabetes benefited from an online disease management program in a randomized controlled trial conducted at the Palo Alto Medical Foundation (PAMF) in northern California. Equally important, the study showed that a nurse-led, multidisciplinary care team could use such a program to manage a population of diabetic patients, the report concluded.


In the 12-month trial, the 189 patients in the control group received usual care. The 193 patients in the intervention group used a wireless home glucometer that uploaded readings through a smartphone to PAMF's electronic health records (EHR) system. The patients could view the data in their Web-based personal health record and log in information relevant to diabetes management, such as dietary intake, physical activity, home blood pressure, insulin doses and weight. Nurse case managers and a registered dietician communicated with patients primarily through secure online messaging. Patients received regular feedback about their clinical variables and were provided educational materials online.

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Self management of type 2 diabetes: can community pharmacies play a supporting role?

Self management of type 2 diabetes: can community pharmacies play a supporting role? | Diabetes Now | Scoop.it
An abstract from the International Journal of Pharmacy Practice, first presented on 06/12/12 in advance of publication (DOI: 10.1111/ijpp.12011):

Objectives

This study aimed to identify issues in diabetes self-management in an Australian Maltese community with type 2 diabetes mellitus, and to identify opportunities for community pharmacies to offer self-management support to these populations.

Methods

Individual, semi-structured interviews were conducted. A maximum variation sample was recruited from La Vallette Social Centre, Sydney, and interviewed by the investigator. Interviews were audio recorded, transcribed verbatim, and iteratively coded into themes by constant comparison using computer software. Cultural predictors of adherence were analysed.

Key findings

Twenty-four participants were interviewed. Themes included diabetes knowledge, self-management behaviours, cultural predictors of adherence and interest in community pharmacy disease management services. Diabetes knowledge was generally limited. Although most participants practised some self-monitoring of blood glucose they lacked knowledge of practice recommendations. Participants generally undertook regular physical activity, though adherence to diet varied according to social influences. Cultural influences on perceptions included attitudes to practitioners, treatment and peer experiences. Enablers included attitudes towards financial independence and social integration while nurturers included family and community support. Participants expressed interest in accessing more support from their community pharmacy due to ease of access and interest in learning more about diabetes.

Conclusions

Patients from different backgrounds experience unique barriers to care, including poor written literacy and limited access to diabetes education, many of which are unrecognised by patients or practitioners. Pharmacists should become more proactive in offering culturally appropriate diabetes self-management support to these populations. Research into pharmacist perspectives of patient issues could identify training needs and guide strategies to improve their cultural competence.
C8 MediSensors UK's insight:

 

 

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"An online diabetes community (#doc) for every country, and in every language"

"An online diabetes community (#doc) for every country, and in every language" | Diabetes Now | Scoop.it
Great Britain Diabetes Online Community (#gbdoc) linchpin Paul Buchanan (@t1hba1c) writes:

"At 9 pm on 15 August 2012, #gbdoc held its first tweet chat. The first topic for discussion was UK National Hypo Awareness Week campaign, and the debate posed a series of questions about our own understanding of hypoglycaemia, the remedies we use, and how we
communicate about this and related issues to others.

This is where the numbers started to get very interesting for #gbdoc. The debate involved 62 people for approximately an hour. It reached a global audience of 483,637 people via Twitter. By week six, #gbdoc had grown from 62 to 319 participants from 10 countries. Amazingly, the group was creating so many tweets that the hash tag was ‘trending globally’. That means, bearing in mind that half a billion people use Twitter actively, that #gbdoc found itself among the most talked-about topics on the planet.

Social media form a tool that uniquely can provide a forum for people with diabetes to share knowledge and experiences to empower and support each other. Platforms like Twitter and Facebook represent a huge opportunity for the global diabetes community, including
healthcare professionals and industry, to help shape the future of our care, therapy and management.

At #gbdoc, our vision is of an online diabetes community (#doc) for every country – and in every language – where there are people with diabetes. That sounds ambitious, but the way things are going, we may be nearer to realizing that vision than we think!"

The full article can be read by clicking on the title link above, then following the link to the December 2012 issue. The article begins on p. 49

[AS: It has been wonderful to watch the #gbdoc community grow so explosively, and its success is a testament to the appetite of each member of the #gbdoc community to advocate, offer support, and share their experience of managing their disease.

It's going to be a great 2013 for #gbdoc, of that there can be no doubt whatsoever.]
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GB DOC's curator insight, December 18, 2012 8:09 AM

#gbdoc - privately funded, no sponsorship, no advertising, no product placement and no tie up with any commercial organisation.  All paid for by the founder, personally.

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Long-term insulin users can still slip up

Long-term insulin users can still slip up | Diabetes Now | Scoop.it
Lynnette Hartwig RN, BSN, CDE writes:

Recently I saw a type 1 diabetes mellitus patient who had been diagnosed in 1980 at 15 years old. She had not seen an educator in quite some time but had changed from NPH/regular insulin to Lantus and regular. She was interested in learning more about the insulin pens that were available. As we were discussing her routine she became less responsive in her answers and started digging into her purse but did not know what she was looking for.

I decided to check her blood sugar and she was 25. We were able to avoid a catastrophic event and her blood sugar came up to 99 after 45 grams of carbs 45 minutes later.

In further discussion, I learned she was mixing her Lantus/regular and was told by her previous PCP that it was ok. She also was dosing her regular insulin based on sliding scale and had not learned carb counting.

Lesson Learned: These are areas that are the most important to assess. Never assume that a seasoned individual with diabetes is injecting without a problem, or has not been updated on the newer ways to manage their disease. It is important to review their technique to see if there is any new information they might benefit from as well as to confirm that their methods are sound.
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The point of accepting your diabetes

The point of accepting your diabetes | Diabetes Now | Scoop.it
Kiki writes:

When you begin to understand the repercussions of not taking care of yourself [as a person with diabetes], the pain you suffer and the pain you cause others due to your suffering is the pivotal point in your life when you force yourself to learn about the disease or the disorder that you have. The more you know about diabetes, the easier it becomes to control it. The more you understand the relationship that insulin and diet plays on the way your body breaks down food and namely carbohydrates, the more you will want to be in control so that you are freed from the jail cell that is your body and, at times, your mind.

There comes a point when you accept the fact that this is a challenge and it will be for the rest of your life. But when you realize that you can control this monster, make it a part of your life instead of a hindrance, that is the day that you become a person with diabetes and revoke the idea that you are defined by it.

[AS: Click on the title link above to read the rest of Kiki's post of Chicago Now]
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Diabetes, and a life: is it possible to have both?

Diabetes, and a life: is it possible to have both? | Diabetes Now | Scoop.it

Catherine Price writes:

 

We’re currently having work done on our house — we’re renovating our bathrooms — and I’m finding that the vocabulary of home improvement has begun to take over my life. I can’t look at our walls without thinking of the names of the paint colors (Clay Pebble, Seattle Mist). I sit at my desk in the library and notice architectural details that I previously didn’t know even had words to describe them, like double-hung windows, or the plinths at the bottom of pedestals. Even my analogies have begun to take on construction-related undertones — editing a paper requires “removing scaffolding.” And I’m spending a lot of time thinking about grout.

 

I bring this up because between the home renovation, book-writing, article-writing, diabetes management, and keeping up with my exercise routine, I’ve been feeling extremely stressed. It reminds me of a mistyped comment my husband once got on a work evaluation: he was doing a great job at keeping “a lot of balls in the area.” The idea seems applicable to my life as well, except that I don’t feel like I’m succeeding.

 

Which gets me back to my home improvement analogies: I’ve recently been thinking about something a contractor told us when we were first starting on this renovation project.

 

“There are three main variables to any construction project: speed, money and quality,” he said. “You can get what you want for two of those things, but probably not all three.”

 

And I think he’s right: if you want a low price and quick turn-around, you’ll sacrifice quality. If you want it to be super fast and high quality, it’ll cost more. If you want quality and a low price, it’ll take more time. You need to prioritize.

 

The same is true, I’ve decided, with diabetes management and the rest of my life....

 

[AS: Click on the title link above to read Catherine's full post on A Sweet Life]

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The radiant smile and inspiring story of 84 year old type 1 Winsome Johnston

The radiant smile and inspiring story of 84 year old type 1 Winsome Johnston | Diabetes Now | Scoop.it

[AS: A really great piece this is from 3 News, and well worth a watch.

 

The video not only gives insight into the inspirational story of New Zealand grandmother Winsome Johnston, but also allows us to hear from her diabetes nurse (also a #pwd) who says he has 'learned so much' from her, but also to see her chat with a newly diagnosed type 1 #pwd.

 

What a star Winsome is! I've got a bit of a crush.]

 

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New Google+ Community: GBDOC

New Google+ Community: GBDOC | Diabetes Now | Scoop.it

The GB DOC writes:

 

GB DOC: The home of the GB Diabetic Online Community

 

I am a Beta Cell Replacement worker - Great Britain - here to advocate the use of social media for all things diabetes - hoping to improve lives... one tweet at a time!

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European stem cell bank formed to find new diabetes treatments

European stem cell bank formed to find new diabetes treatments | Diabetes Now | Scoop.it

Ten international drug companies are to team up with scientists from 11 European countries to create a bank of stem cells for a project aimed at speeding up the development of new medicines.

 

StemBANCC,managed by scientists at Oxford University, aims to use so-called human-induced pluripotent stem cells - derived from people with hard-to-treat conditions - as research tools.

 

Martin Graf, who is coordinating the project, said the goal was to generate 1,500 induced pluripotent stem cell lines derived from 500 patients that can then be used by researchers around the world to study a range of diseases, including diabetes and dementia.

 

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A maths test, a white witch and the dark art of diabetes

A maths test, a white witch and the dark art of diabetes | Diabetes Now | Scoop.it

Anne Cooper (@anniecoops) writes:

 

Since I’ve been thinking more about my diabetes I have come to realise that its a lot more complicated than I lead people to believe. As someone once said to me ‘diabetes is a dark art’.

 

Its not just as straightforward as taking insulin to cover the food you eat, even if that’s what many nurses learn. Well, of course at the very simplest level it is, but there are so many other factors to think about.

 

I found out from my sensor that I am more insulin resistant in the morning than the evening so need a different carbohydrate to insulin ratio between 6 am and 12 pm, so not only do you have to be good at sums you have to be able to tell the time too. And of course there are some foods that just don’t seem to work out; for me pastry and fish and chips just guarantee a hike in blood glucose no matter what I seem to do. Other people complain about pizza or pasta which I seem to manage fine – its so individual and therefore there are few hard and fast rules and its a lot of personal learning.

 

I also discovered that I was hypoing at night and getting a resultant rise, which meant I was sometimes waking with an unexplained (till now) high blood glucose. I also have some dawn phenomena, a rise in blood glucose caused by the normal production and release of growth hormone which results in a rise in blood glucose in the mornings. Its common but means that the basal (base amount of insulin given continuously via pump) has to be adjusted to different rates over the day. I currently have a pattern that delivers 5 different amounts in the day. Confused yet?

 

If I am doing something stressful at work then, counter-intuitively (you expect a low blood glucose) I need to take extra insulin. If I am running a workshop all day for example I would increase my basal rate by 25% overall. I’m doing a big presentation this week so I will need to test quite a bit and probably adjust to take account of a probably high otherwise I will feel poorly.

 

There are so many things to think about. It really is, as I’ve said before, very complicated and no one person with type 1 diabetes is completely like another. I don’t think about it all the time but neither can you have a day off. So, I’ve decided that I am really a white witch who struggles to manage the dark art of diabetes. I quite fancy myself as the white witch from Narnia, slaying the dark monster diabetes.

 

[AS: Click on the title link above to read Anne's full post on her anniecoops.com blog]

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India-Britain diabetes summit in Chennai

India-Britain diabetes summit in Chennai | Diabetes Now | Scoop.it

A delegation from Britain comprising of 50 officials from universities and medical technology companies will participate in a diabetes summit by Indo-British Health Initiative (IBHI) in January 2013.


"We are focusing on what we believe will be the largest ever bilateral healthcare event staged between India and the UK," Mike Nithavrianakis, Britain's Deputy High Commissioner and ex-officio president of IBHI, told reporters Wednesday.


The summit is targeted at several hundred private and public sector experts across India and Britain and would cover prevention, diagnosis, treatment of diabetes, obesity, wound care and others.


The summit will bring together experts from India and Britain to find solutions to the crisis of diabetes. Senior diabetologists and endocrinologists are expected to speak at the summit.


Prithvi Mohandas, founder-secretary of IBHI and joint managing director of MIOT Hospitals, said IBHI helped Indian healthcare institutions to build on their relationship with Britain's healthcare sector and forge partnerships in academics, healthcare delivery, technologies and innovative solutions.

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Benefits of smartphone management of diabetes: type 2 study

Benefits of smartphone management of diabetes: type 2 study | Diabetes Now | Scoop.it

In a randomized control trial conducted at the Palo Alto Medical Foundation (PAMF) in California, researchers showed that patients with uncontrolled type 2 diabetes benefited from an online disease management program conducted with wireless blood glucose equipment and a smartphone.

 

The trial, conducted over twelve months, involved 415 patients, 193 of which received a wireless home glucometer that uploaded readings through a smartphone to PAMF’s integrated EHR. The patients could view their information online and log in to information about diabetes management, including tips on diet, blood pressure, exercise, insulin management, and weight control. Dieticians and nurse managers communicated with the test group through secure messaging, and the participants received regular feedback about their progress.


After six months, the test subjects had significantly better control over their glycosylated hemoglobin (AC1) values as compared to the control group, and showed an overall decrease in AC1 levels after 12 months. Paul C. Tang, MD, VP and chief innovation and technology officer at PAMF, told InformationWeek Healthcare that it was important that more patients in the test group achieved a lower average AC1 level though the test program. In fact, he said, it’s a better quality measure than looking at the average A1C of a group of patients with diabetes, because it is a more accurate indicator of population health.


An additional finding of the study was that patients in the wireless monitoring group had their medications adjusted more frequently than those who received standard care. Tang noted that one of the problems for patients with uncontrolled diabetes is a lack of properly adjusted medications. Patients may not be using the right medicines or taking the right doses, since standard care only schedules appointments two to four times a year. With the constant monitoring and direct nurse involvement of the wireless care program, patients had more frequent contact with their providers, facilitating changes when needed.


Tang concludes that patients could safely reduce the number of necessary appointments as long as they continue with the online monitoring system. “In between visits with the doctor, the nurse is watching over you and giving you advice. If you’re out of control and are getting worse, the nurse can intensify your medication, for example. You can safely manage people and improve on the outcomes using primarily online tools,” Tang said. “The nurses still could call patients and see them physically, but most of the interactions were online. That’s important.”

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"One of the most difficult parts of being off the pump is doing the D-math"

"One of the most difficult parts of being off the pump is doing the D-math" | Diabetes Now | Scoop.it

Allison writes:

 

Switching from a pump to multiple daily injections (MDI) isn’t nearly as common as people who switch from shots to a pump. But people do it. And I’m one of them. It’s not that I don’t like insulin pumps or that they don’t work. It’s just that when my pump happened to break back in March, I decided to take advantage of the opportunity to have a “pump vacation.”

 

I’ve discovered that one of the most difficult parts of being off the pump is doing the D-math that my pump used to do for me.

 

When I first started my break, I used my iPhone’s calculator to do all my calculations. First, I’d enter my blood sugar and figure the correction factor. Then, I would enter my carbs and use my I:C ratio to figure the bolus dose needed. I’d then add them together, do some rounding, and inject. It worked really well for several weeks.

 

And then I got lazy.

 

Instead of taking out my calculator, I just started estimating how many units of insulin I needed, and let me tell you, my mental math skills have never been that good. I also could never accommodate for Insulin On Board (IOB) properly, which was frustrating.

 

Thanks to our columnist, Wil Dubois, another pump renegade, I discovered RapidCalc, a new mobile app designed to work like a Bolus Wizard calculator. A couple of weeks later, I found out about a similar tool, ManageBGL, when the company followed me on Twitter. Apps to replicate a Bolus Wizard? Genius!

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