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Docs less enamored with portal diabetes management than patients

Docs less enamored with portal diabetes management than patients | Diabetes Now | Scoop.it

Physicians viewed diabetes management through use of a patient portal less favorably than patients in a Canadian study published last week in the Journal of Medical Internet Research.

 

The research involved open-ended interviews with 17 diabetes patients and with 64 healthcare providers, including general practitioners, nurses, dietitians, diabetes educators and others.

 

Overall, the patients said the portal improved their knowledge of their disease and helped them better manage it. However, patients used the portal primarily to log blood-sugar readings and rarely accessed other features, such as the health library.

 

Providers expressed concern that patients who believed they were managing their disease well enough would skip necessary appointments or fail to alert a provider of a high blood sugar reading. They noted that those who reliably recorded their readings might have done so even without the portal.

 

Interestingly enough, a recent study from Kaiser Permanente Colorado found that patients with online access to their medical records and email communication with clinicians used more medical services, not less.

 

Patients and providers alike viewed content available on the portal positively, but both expressed frustration with the portal interface and reported difficulty in navigating and accessing the information. Both liked the graphs showing the patient's blood-sugar readings over time. The portal was considered especially helpful for new diabetics.

 

As with other studies, use of the portal decreased over time. And while patients indicated they would like to have more communication with their physician, most of their interactions took place with a nurse, dietitian, or other health professional who was monitoring the data. Physicians expressed concern that the portal would cut into the time they had to spend with patients.

 

Both patients and providers expressed the need for an online tutorial for the portal that would allow them to use it at their own pace and go back to the instructions, since they couldn't remember everything from their initial introduction to it. Other barriers included inadequate ongoing support, poor Internet connections (dial-up versus high-speed Internet), poor orientation, slow data entry, access and usability issues, including being able to find what they were looking for.

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We must all fight the deadly ignorance about Type 1 diabetes in the UK

We must all fight the deadly ignorance about Type 1 diabetes in the UK | Diabetes Now | Scoop.it

Fiona Twycross writes:

 

A campaign launched earlier this month by Diabetes UK, and highlighted by the London Assembly, aims to do this and prevent the trauma and long-term health implications of diagnosis at A&E.


Shockingly, young women with Type 1 diabetes are nine times more likely to die than women without diabetes due to largely preventable damage to their health. 

 

It is essential the symptoms of Type 1 diabetes are promoted more widely among healthcare professionals because early diagnoses can help. Charities like Diabetes UK clearly have a role to play in promoting the conditions, but with relatively modest resources, they cannot do this alone.

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People living with diabetes have created a vibrant online community

People living with diabetes have created a vibrant online community | Diabetes Now | Scoop.it

People living with diabetes have created a vibrant online community. Big drug companies are certainly taking notice — and some advocacy groups feel that the Food and Drug Administration should as well.

 

Kerri Sparling (@sixuntilme) chronicles her own journey with the disease on a blog she started in 2005. Other people in the DOC — that's the diabetes online community — share on YouTube. There are videos with advice on everything from removing an insulin pump to telling your date you have diabetes. There are also reviews of products to treat diabetes.

 

A few years ago, drug companies started paying attention to these video testimonials and to bloggers talking about their products. The companies even created their own social media sites.

 

"Our primary platform is our blog Discuss Diabetes," explains Dennis Urbaniak, the head of diabetes at drug giant Sanofi US. They also have a Twitter account, a Facebook page, and a diabetes dictionary, and they're looking into Pinterest and Instagram. "Getting involved in social media is a critical component of serving the diabetes community," says Urbaniak.

 

And it's not just serving the community; it's serving companies' bottom lines. Treating diabetes is extremely profitable. Every year Americans spend more than $100 billion on diabetes care. So, in addition to tweeting about new products, pharmaceuticals are sponsoring bloggers like Sparling.

 

"If we're talking about what we want from our devices, it is in their best interest to be hearing that and making the changes we're requesting so they can improve their sales," Sparling says.

Sparling has a disclosure on her website stating she receives free products from two drug companies, and that one pays her to speak at events and contribute at her site. But critics say that's not enough.

 

"People do not read disclosures. The FDA and [Federal Trade Commission] need to create a whole new system for disclosing when a blogger or group gets paid by pharmaceutical companies," says Jeff Chester of the Center for Digital Democracy. He says pharmaceutical companies are using social media to promote their gadgets and drugs in a deceptive way.

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A hip-hop education in diabetes

A hip-hop education in diabetes | Diabetes Now | Scoop.it

Hip-hop icon Joseph "Rev Run" Simmons and Novo Nordisk, a world leader in diabetes care, have teamed up in a multi-year national education program, Ask.Screen.Know., to encourage people to learn their risk for diabetes and highlight the need for early diabetes detection.

 

As an ambassador for the program, the front man for the influential Run DMC rap group will appear in a national public service announcement, host a series of local events across the country, and activate his social media network of nearly 4 million followers to challenge Americans ages 45 or older to learn their own risk for diabetes and talk to a healthcare professional about getting tested.

 

“Watching my dad manage his diabetes, I know firsthand the impact that the disease can have,” said Rev Run. “Your health is worth the time. That’s why I joined the Ask.Screen.Know. campaign. I’m looking at my own risk of diabetes and holding myself accountable for my health. I’m asking others to do the same.”

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Blogging, social media and diabetes

Blogging, social media and diabetes | Diabetes Now | Scoop.it

Angela Mallon writes:

 

At present the Diabetes Online Community (DOC) is one of the world’s most vibrant and influential online communities for people living with a life-long health condition. In the USA, hundreds of diabetes bloggers provide information, support and advocate for improved healthcare solutions for those living with this condition.

 

Four months ago, Australia was one of the first countries outside the USA to develop its own Diabetes Online Community OzDOC.

OzDOC has a rapidly growing membership of people throughout Australia and the world joining in its own weekly ‘tweetchat’ on Tuesday evenings at 8.30 pm (AEDT).

 

Following the establishment of #OzDOC, other chats have started, including GBDOC (UK),CanDOC (Canada), #ESDOC (Spain), ITADOC (Italy) and (DEDOC (Germany).

 

Keynote speaker at the Australian social media summit was Kerri Sparling from the USA. Kerry is one of the first bloggers to enter the ‘diabetes blogosphere’ with her Six Until Me blog which started in 2005. Kerri is a regular speaker at social media and diabetes conferences and is a freelance writer and social media consultant.

 

In her presentation, Kerri talked about how after her diagnosis as a six year old, she found a support network when she attended camps for children with diabetes.

 

As an adult, however, she felt isolated and missed the opportunity to connect with people who were experiencing similar hopes, problems and fears that she had while living with diabetes.

 

She turned to blogging to share her story and hopefully hear from others:

 

“The first week, my mum and my husband were reading. But the next week there were more readers and more readers after that. Sharing stories, offering insight and providing support is what bloggers and their readers get – it’s a mutually beneficial activity!”

 

Kerri highlighted the importance of supporting others within the community, “each and every voice is important, but together it’s certainly more powerful,” she says.

 

Other important topics covered at the Summit included the importance of collaboration with healthcare professionals, industry policy makers and healthcare professionals. Diabetes is a self-managed condition and the person living with diabetes needs to be acknowledged as the expert.

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Video coverage of a debate on the NHS's management of diabetes

Video coverage of a debate on the NHS's management of diabetes | Diabetes Now | Scoop.it

Click on the title link above to be redirected to streamed video of a debate on the NHS's management of diabetes will be led by Labour's Lord Harrison on 29 November 2012 (time TBC; order of business for 29 November 2012: http://www.theyworkforyou.com/calendar/?d=2012-11-29#cal30576 )

 

The charity Diabetes UK estimates there are 3.7 million people in the UK with diabetes, including an estimated 850,000 people who have Type 2 diabetes but do not know it.


Type 1 diabetes develops when the body's immune system attacks the cells that produce insulin. This leaves the body unable to produce insulin and leads to increased blood glucose levels, which can cause serious damage to all organ systems.


Type 2 diabetes occurs when the body does not produce enough insulin to maintain a normal blood glucose level, or when the body is unable to effectively use the insulin that is being produced.


Lord Harrison has previously raised the high incidence of Type 2 diabetes in black and Asian people and has argued health professionals should be tutored in the cultural knowledge and understanding of these ethnic communities.

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Researchers increase understanding of genetic risk factor for type 1 diabetes

Researchers increase understanding of genetic risk factor for type 1 diabetes | Diabetes Now | Scoop.it

As part of their ongoing research on the role of genes in the development of type 1 diabetes, Joslin Diabetes Center scientists, in collaboration with scientists at the University of Würzburg, have demonstrated how a genetic variant associated with type 1 diabetes and other autoimmune diseases influences susceptibility to autoimmunity. The findings appear in the upcoming issue of Diabetes.

 

Recent studies of the human genome have identified genetic regions associated with autoimmune diseases such as type 1 diabetes. Joslin scientists in the Section of Immunobiology seek to understand how genes that are most widely associated with various autoimmune diseases contribute to disease risk.

 

One of these genes is PTPN22, which plays a role in lymphocyte (immune cell) function. A PTPN22 variant (or mutation) has been implicated as a risk factor for type 1 diabetes and several other autoimmune disorders. PTPN22 is involved in the formation of a key protein known as lymphoid tyrosine phosphatase (LYP), which helps control the activity of T and B cells in the immune system. The PTPN22 mutation generates a variation of LYP with a different molecular structure.

 

Most studies of the PTPN22 disease variant have suggested that this variant is a gain-of-function genetic mutation that enhances LYP activity and lessens the activity of T and B cells, which increases susceptibility to autoimmunity. "When immune cells are less reactive during the maturation phase of their development, the cells can evade mechanisms that help protect against autoimmunity," says study lead author Stephan Kissler, PhD, of the Section of Immunobiology. However, one study which analyzed data from humans and genetically modified mice suggested that the LYP variant associated with type 1 diabetes is a loss-of-function mutation that reduces LYP activity.

 

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Presentations from the 2012 DiabetesMine Innovation Summit

Presentations from the 2012 DiabetesMine Innovation Summit | Diabetes Now | Scoop.it

Amy Tenderick (@AmyDBMine) writes:

 

To my mind, the DiabetesMine Innovation Summit I’ve hosted the last two years is not a “conference.” Rather, in the true tradition of a “Summit,” it aims to bring key decision-makers and other folks passionate about diabetes care together in one room for some very frank conversations about where we are now, what needs improvement, and how we can get to a better place as quickly as possible.

 

On that note, the Pharma executives and FDA and ADA officers present at this year’s event — held Friday, Nov. 16 at Stanford University in Palo Alto, CA — certainly got an earful from patient advocates! One of my colleagues from Alliance Health Networks called the event “a focus group on steroids.”

 

This year’s event was less of a design workshop (how to make products that patients actually want and need) and more about breaking the “gridlock” in the diabetes industry: Why does every diabetes tech product have its own clunky cables and not share data with other products?! Why aren’t companies working together to form standards for this stuff, that would also ease the FDA approval process?

 

[AS: Click on the title link above to review a selection of presentations on SlideShare from the 2012 DiabetesMine Innovation Summit]

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You’ve had an episode

You’ve had an episode | Diabetes Now | Scoop.it

Scott Coulter writes:

 

was working one of my typical no-lunch, 10-hour days. I had just conducted a family therapy session, and I had to drive the client’s mother back to the train station. On the whole, this is easier than driving a client, as there’s not much paperwork to be filled out if you’re driving an adult somewhere (adults can take care of themselves in the eyes of managed care).

 

I knew I was “a little low,” but I had become so accustomed to waiting to take care of myself that I made the incredibly poor decision to drive her the few miles to the train station, and then take care of my blood glucose. To top it off, I had used the last of my glucose tablets already that morning, and had nothing on me to take care of a situation like this. Bad decision count for the day: two.

 

We hopped into the van, and made it to the train station. By this point, I was having a hard time responding to simple questions, and I think she even asked me before leaving, “are you OK?”. I responded with, “uh huh”, and decided I could make it BACK to the RTF instead of going into the convenience store about 100 feet from the train station. My reason? I had a mountain of paperwork still to do, and I at least wanted to leave work by 7:00. Bad decision count: three.

 

I turned onto the road leading back to work, but as I drove, panic set in. I wasn’t thinking clearly, I was sweating, and my vision was starting to blur. I drove right past the RTF, knowing I missed it but unable to figure out how to make the turn. I continued down the road, by some miracle avoiding a collision. I saw a large dirt parking lot, and pulled into it. I could see that it was a nursery of some kind, with rows of pine trees, a greenhouse, and a little wooden storefront. I stopped the van, and within 30 seconds all went black...

 

[AS: Click on the title link above to read the rest of Scott's post on the Diabetes Self Management blog.]

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Your Diabetes May Vary: Patient to Patient Support, A Heavily Footnoted Post

Your Diabetes May Vary: Patient to Patient Support, A Heavily Footnoted Post | Diabetes Now | Scoop.it

Diabetes is a chronic condition that requires significant ongoing self management by patients. Self management includes monitoring of blood sugar levels, staying with medication regimes prescribed by health professionals and lifestyle changes. Patients often struggle with all of it. Peer to peer support can help patients face the ongoing challenges of diabetes management. Research demonstrates that patient better follow medication recommendations improves with internet follow up. This follow up support can be provided through social media. Diabetes peer to peer support is something that could and maybe should be recommend by health professionals to patients to support self effective management.

 

Before being recommended by physicians peer to peer support need to be trustworthy. Lay person patient advocates involved with peer support need to practice to ethical standards that specifically focus on emotional support while deferring treatment and medical advice to professionals. I think it is worth noting that a lot of the Diabetes Online Community is already there.

 

It is not me making up the value of peer to peer connections. Studies demonstrate that technology based communications can improve all types of diabetes compliance. These studies have examined people with diabetes from a variety of age ranges, economic backgrounds and nations. Patients who have received internet support have better health outcomes, typically measure by HbA1c. Studies also show improved patient quality of life measures.

 

Research matters so brief overview of key points form a few studies follows. Bandura (2004) observes, “The field of health is changing from a disease model to a health model.” It is no longer enough to treat the sick, health he writes, “is heavily influenced by lifestyle habits” and “health promotion should begin with goals not means.” To me that can be seen to say the goal is living better with diabetes and maybe the doctor’s office is only part of the way to get to better.

 

[AS: Click on the title link to read the rest of this post on the Your Diabetes May Vary blog.]

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Type 2 diabetes rates higher in countries using lots of high fructose corn syrup: study

Type 2 diabetes rates higher in countries using lots of high fructose corn syrup: study | Diabetes Now | Scoop.it

In the United States and elsewhere, high fructose corn syrup is ubiquitous in soft drinks, sweet baked goods and many processed foods. But a new study shows that as a nation's rate of fructose intake rises, so do levels of type 2 diabetes.

 

The study cannot prove a cause-and-effect link, but it does conclude that diabetes prevalence is about 20 percent higher in countries where use of the sweetener is high, relative to those where it is not.

The association between high fructose corn syrup intake and diabetes risk persisted regardless of an individual's overall sugar intake or obesity status. According to the study authors, that suggests that there's something special about the sweetener that's boosting diabetes risk beyond what other sugars would.

 

"The 20 percent higher prevalence of type 2 diabetes in countries using a lot of high fructose corn syrup was not explained by population differences in terms of obesity [levels]," said study lead author Michael Goran, professor of preventive medicine and director of the Childhood Obesity Research Center at the University of Southern California in Los Angeles.

 

"So, there's some other factor, maybe several interrelated factors, over and above obesity, that contributes to diabetes," he said. "High fructose corn syrup and the way it is metabolized may very well be one of them," he added.

 

The findings were published online Nov. 27 in Global Public Health.

Type 2 diabetes, which is typically tied to obesity, remains one of the most common causes of death worldwide. According to Goran's team, nearly 8 percent of people worldwide could be diabetic by 2030. Much of the rise is taking place in the developing world, as diets shift to more Western fare high in carbohydrates and sugars.

But are all sugars created equally? Goran and his team say prior studies have suggested that fructose follows a different digestive path than glucose, metabolizing in the liver independently of insulin. From there, they said, it can readily turn into fat.

 

In their study, the researchers analyzed data on diabetes prevalence and body mass index (BMI, a measurement based on height and weight) collected in 2000, 2004 and 2007 by the Global Burden of Metabolic Risk Factors Collaborating Group. This information came from adults over the age of 20 across 199 nations.

 

The team also collected United Nations data on food consumption across various countries to assess to what degree various sugars and cereals were staples of local diets. In the end, Goran's team was able to get information on high fructose corn syrup intake from 43 countries.

 

The investigators found that BMI, daily calories and total sugar intake (including sugars of any kind) were comparable across countries, regardless of the level of high fructose corn syrup intake.

Still, countries that ranked high in use of the sweetener also had significantly higher rates of diabetes than countries with lower rates, Goran's group reported.

 

Americans were by far the biggest consumers of high fructose corn syrup, at 55 pounds per person per year. According to the researchers, beginning in the late 1990s, the sweetener had comprised about 40 percent of all sugars found in food products in the United States and it remains the number one sweetener in soft drinks.

 

Hungary came in a distant second (consuming 46 pounds of high fructose corn syrup per capita annually), followed by Slovakia, Canada, Bulgaria and Belgium. Countries with the lowest consumption included India, Slovenia, Latvia, Ireland and Sweden.

 

Countries in the highest category of intake were found to have an average type 2 diabetes prevalence of 8 percent, compared with just 6.7 percent among those in the lowest consumption category, the team found. That difference equates to roughly a 20 percent jump in actual number of cases of diabetes, the researchers explained.

 

[AS: Addressing the same research, the Daily Mail notes that 'UK consumption was very low at less than 0.5kg per person per year, placing it alongside Australia, China, Denmark, France, India, Ireland, Italy, Sweden and Uruguay.'

http://www.dailymail.co.uk/health/article-2239302/Syrup-biscuits-ice-cream-energy-drinks-fuelling-diabetes-global-scale.html#ixzz2DRcKlcSm]

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Improving the management of type 1 diabetes in the UK: The DAFNE programme

Improving the management of type 1 diabetes in the UK: The DAFNE programme | Diabetes Now | Scoop.it

This research programme was commissioned as part of the first competition of Programme Grants for Applied Research (PGfAR). It is building on the education tool evaluated as part of the Dose Adjustment For Normal Eating (DAFNE) trial. DAFNE is a way of managing Type 1 diabetes and provides people with the skills necessary to estimate the carbohydrate in each meal and to inject the right dose of insulin.

 

The objective of this programme is to assess what elements of the DAFNE course, patient characteristics or experiences are critical to success.

 

The main aims of this programme are to:

 

1) to explore whether it is possible to identify the critical success factors and the right timing for training individuals in self management of Type 1 diabetes (which might inform self management of other long-term conditions).

 

2) Develop training in the use insulin infusion pumps (an expensive but potentially more effective form of delivering insulin) as part of a DAFNE self management course in a pilot trial compared to training in the use of insulin injections. This was in advance of an application to run a full trial to evaluate the use of insulin pumps in the UK.

 

3) The programme will compare a standard 5 consecutive day DAFNE course with one delivered over 5 weeks. If the longer course is as effective this will enable those who cannot take a full week off to undertake DAFNE, and allow centres where staff work part-time to deliver courses.

 

4) The programme will also develop a new course, based on psychological work undertaken by the research team, for those people who are experiencing problems with hypoglycaemia.

 

5) To develop a health economic model which applies to Type 1 diabetes and which can be used to assess the cost effectiveness of new technology in the management of Type 1 diabetes

 

The research examined patient experiences following patients’ conversion to flexible intensive insulin therapy (FIIT), a regimen in which quick acting doses of insulin are matched to flexibility in the intake of dietary carbohydrate. This approach is an alternative to strict management of diet and fixed regular doses of insulin.

 

The research in this programme included a series of semi-structured interviews with type 1 diabetes patients and a mixed methods exploration of the barriers. The interviews identified a number of reasons why information and education gaps exist among people with type 1 diabetes. These include a failure in the past to equip individuals with Type 1 diabetes with the skills to apply insulin treatment successfully, difficulty in sustaining successful self management in the absence of on-going and readily available professional support; and difficulties in interacting with other health care professionals such as GPs and practice nurses who also lack training in insulin self management.

 

The research highlights a need for ongoing patient education that does not assume that patients are equipped to maintain their knowledge and keep up with changes or advances in the knowledge base, a finding that might apply to other long term conditions. Other research findings show that despite the flexibility in diet offered by FIIT most patients, after an initial period of flexibility gradually reverted to a more rigid pattern of carbohydrate intake due to concerns that they will miscalculate carbohydrate and administer the wrong does of insulin. One possible consequence of FIIT is the increased consumption of pre-packaged, processed food since the carbohydrate content is easier for the patient to assess.

 

The work has found that there is no suitable scale measuring diabetes self management activities and has obtained a grant to develop an appropriate measure.


The group have used the successful pump pilot work to apply successfully for funding to conduct a large multicentre trial in the UK involving around 300 patients to measure the effectiveness of pump therapy in Type 1 diabetes (the REPOSE Trial).

 

Chief investigator: Professor Simon Heller, Sheffield Teaching Hospitals NHS Foundation Trust
Institutions: Sheffield Teaching Hospitals NHS Foundation Trust; University Hospitals Of Leicester NHS Trust; University College London; Northumbria Healthcare NHS Foundation Trust; University of Sheffield; King’s College London

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On the connection between gum disease and diabetes

On the connection between gum disease and diabetes | Diabetes Now | Scoop.it

Dr. Shannon Mills, a scientist and vice president of professional relations with Northeast Delta Dental, said research suggests a two-way relationship between serious periodontal (or gum) disease and diabetes.

 

Not only are people with diabetes more susceptible to severe gum disease, but gum disease may have the potential to affect blood glucose control and contribute to the progression of diabetes. People with diabetes tend to develop periodontal disease earlier in life, and more severely. Instead of losing their teeth from gum disease in their 60s, they might begin losing teeth in their mid-40s. Mills said that smokers with diabetes are especially at risk for gum disease and tooth loss and that stopping smoking can help in the treatment of both diabetes and gum disease.

 

"It's the single-most important thing one can do," he said about the importance of smoking cessation on oral health.

 

According to the ADA, people with diabetes are at an increased risk for serious gum disease because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums. If blood glucose levels are not properly controlled, people are more likely to develop serious gum disease and lose more teeth than non-diabetics. Like all infections, serious gum disease may be a factor in causing blood sugar to rise and may make diabetes harder to control. Oral problems associated with diabetes can also include thrush, an infection caused by fungus that grows in the mouth, and dry mouth which can cause soreness.

 

Mills said that regular dental checkups and examinations are critical:

 

"If you have diabetes, tell your dentist," he said. "If your dentist sees gum disease developing, he will likely ask if you have diabetes. If not, check with your doctor to be tested."

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Zebrafish study identifies a compound that regulates whole-body metabolism

Zebrafish study identifies a compound that regulates whole-body metabolism | Diabetes Now | Scoop.it

A tiny, translucent zebrafish that glows green when its liver makes glucose has helped an international team of researchers identify a compound that regulates whole-body metabolism and appears to protect obese mice from signs of metabolic disorders.

 

Led by scientists at the University of California, San Francisco (UCSF), the work demonstrates how a fish smaller than a grain of rice can help screen for drugs to help control obesity, type 2 diabetes and other metabolic disorders, which affect a rising 34 percent of American adults and are major risk factors for cardiovascular disease.

 

Described this week in the journal Nature Chemical Biology, the new compound emerged from a panel of 2,400 medications and drug-like compounds tested in the zebrafish. The test was designed to identify key regulators of "fasting metabolism"- a state most people face every day after the lingering remnants of their long-digested meals pass slowly down their digestive tract.

 

Fasting metabolism is the body's way of fulfilling its energy needs between meals by turning to fat and other stored sources. It involves a carefully balanced and coordinated cascade of reactions that see numerous genes in various tissues kick into action and do things like burn fat.

 

In type 2 diabetes and other metabolic diseases, this careful balance is lost.

 

Gut and his colleagues set out to develop the zebrafish screen as an ethical and inexpensive solution, and the new paper demonstrates the validity of this approach, he said. Furthermore, this study illustrates the fact that model organisms should be an integral part of the new roadmap defined by the NIH and other medical research organizations around the world to translate the most advanced laboratory science into benefits for patients, Stainier said.

 

Of the thousands of compounds the team screened, two appeared to turn on a handful of genes that caused the animals to burn fat as a way of producing energy - an end that would be desirable for many people with metabolic disorders.

 

[Click on the title link above to read the full article on medilexicon.com]

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Standing together: the global type 1 diabetes family

Standing together: the global type 1 diabetes family | Diabetes Now | Scoop.it

James Ron writes:

 

Wherever I go in the world, I feel a special bond with other people in the type 1 diabetes community. 

 

No matter where we are from, what our education, background, race, religion, or nationality, we share a secret. We know what type 1 diabetes is; we know how hard it is to live with; and we know that few people outside our small community have a clue.

 

The global type 1 diabetes community is like a family, and we should help each other whenever possible.

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Diabetes may be linked to hearing loss: study

Diabetes may be linked to hearing loss: study | Diabetes Now | Scoop.it

Diabetes has already been tied to an increased risk of kidney and cardiovascular troubles, nerve damage and vision loss, and now a Japanese study finds diabetics to be more than twice as likely as those without the disease to have hearing impairment.

 

In a review of past research on the issue, published in the Journal of Clinical Endocrinology and Metabolism, scientists found that younger diabetics were at even higher risk than older adults, though they could not explain why.

 

"Current meta-analysis suggests that the higher prevalence of hearing impairment in diabetic patients compared with nondiabetic patients was consistent regardless of age," wrote lead researcher Chika Horikawa, at Niigata University Faculty of Medicine, and colleagues.

 

It's not the first time researchers have found a link between diabetes and hearing loss. In 2008, researchers from the U.S. National Institutes of Health (NIH) saw similar patterns in a sample of more than 11,000 people, with people with diabetes twice as likely to have hearing loss as those without.

 

It's thought that high blood sugar levels brought on by diabetes may lead to hearing loss by damaging blood vessels in the ears, said Horikawa.

 

Horikawa and colleagues collected information from 13 previous studies examining the link between diabetes and hearing loss and published between 1977 and 2011. Together, the data covered 7,377 diabetes and 12,817 people without the condition.

 

Overall, Horikawa's team found that diabetics were 2.15 times as likely as people without the disease to have hearing loss. But when the results were broken down by age, people under 60 had 2.61 times the risk while people over 60 hand 1.58 times higher risk.

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Spotlight on diabetes in Hartlepool

Spotlight on diabetes in Hartlepool | Diabetes Now | Scoop.it

Diabetes Research & Wellness Foundation (DRWF) held a Wellness Day at the Hartlepool Maritime Experience to coincide with World Diabetes Day last weekend.

 

University Hospital of Hartlepool consultant physician Dr Susan Jones and lead diabetes nurse specialist Lisa Doughty gave an update on some of the latest research taking place in the region to an audience made up of patients suffering with Type 1 and Type 2 of the condition.

 

DRWF event co-ordinator Lee Calladine said: “We were really pleased to work with Dr Susan Jones and her specialist diabetes team again to put on an interactive day of talks and discussions for people living with Type 1 and Type 2 Diabetes in the North-East.

 

“It was also great to welcome the many family members and friends that attended, as it is just as important for them to understand what their loved ones are dealing with so they can help support them.”

 

Dr Jones added: “As a diabetes healthcare professional, I was delighted to work with DRWF to support this Diabetes Wellness Day for people in our region.

 

“The day provided talks and networking sessions in a friendly and relaxed environment.

 

“It allowed people to obtain more knowledge through interaction with their peers, as well as having access to our team of healthcare professionals.

 

“Our aim was to provide people with the tools and skills they need to better manage their diabetes, develop their existing knowledge and learn something completely new.”

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Arginase inhibitors may prevent heart disease in people with type 2 diabetes

Arginase inhibitors may prevent heart disease in people with type 2 diabetes | Diabetes Now | Scoop.it

Researchers may have discovered why diabetes leads to heart disease, despite intensive lifestyle interventions. Scientists from the Karolinska Institutet and Karolinska University Hospital have found a key enzyme known as arginase could be responsible for plaque formation and artery constriction that leads to angina for type 2 diabetics.

 

Arginase blocks nitric oxide (NO) that is naturally produced in the body and essential for keeping blood vessels relaxed. Diabetes complications occur when blood vessels become constricted from plaque formation or atherosclerosis.

 

Recently, researchers found even with interventions like weight loss, medications and exercise, heart disease risk remained high for people living with the disease.

 

When the researchers gave patients with type 2 diabetes and angina a known arginase inhibitor they noted a significant improvement in blood vessel functioning. The treatment had no effect on healthy participants used as controls, or on patients with angina who were not diabetic. The study included 48 people.

 

The researchers are planning larger trials in hopes of developing new diabetes treatments. Arginase inhibitors might help prevent a variety of diabetes complications. The presence of the enzyme that blocks nitric oxide to lead to constricted blood vessels could explain why diabetes is a leading cause of stroke and heart attack.

 

Source:
Karolinska Institutet
November 27, 2012

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Urinary tract infections common in type 2 diabetes

Urinary tract infections common in type 2 diabetes | Diabetes Now | Scoop.it

Abstract from the Journal of Diabetes and Its Complications, Volume 26, Issue 6, Pages 513-516, November 2012, Authors:Ishan Hirji; Zhenchao Guo; Susan W.

 

The objective of this observational study was to quantify the incidence of urinary tract infections (UTI) among diabetes patients and compare this risk to patients without diabetes. Type 2 diabetes patients and a matched sample of patients without diabetes were identified from GPRD (general practice research database).

 

Patients were followed for 1-year from their study index date until the first record of a UTI or a censored event. The incidence of UTI was 46.9 per 1000 person-years (95% confidence interval (CI) 45.8–48.1) among diabetes patients and 29.9 (95% CI 28.9–30.8) for patients without diabetes.

 

Compared to the non-diabetes patients, the risk of UTI was 1.53 (95% CI 1.46–1.59) for all diabetes patients; and 2.08 (95% CI 1.93–2.24) for patients with previously diagnosed diabetes.

 

In general practice, across gender and age, the risk of developing a UTI is higher for patients with type 2 diabetes compared to patients without diabetes.

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#gbdoc archive for 28 November

#gbdoc archive for 28 November | 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 good management, and bad numbers in diabetes. The questions were:

 

* When we say 'good management' in diabetes, what does that mean to you?
* What, for you, is a 'good' number and what makes a 'bad' number?
* When you're testing more, do you 'feel' better, and does the info help?

*  What is your advice for the Holiday Season, and top tips for coping with parties, booze & treats?

* Where's the weirdest place you've found a blood glucose test strip?

 

This week's #BGBingo number was 7.3 and the winner was @brunokarlin with 7.2

 

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

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People with diabetes in the UK urged to take up flu jab

People with diabetes in the UK urged to take up flu jab | Diabetes Now | Scoop.it

People with diabetes in the UK are being urged to get their free flu jab this winter.


The NHS is warning that only a third of people with diabetes have claimed their injection.

 

People with diabetes can find it harder to cope with the flu virus, and can suffer serious complications as a consequence.

 

Cathy Beresford, diabetes specialist nurse at Berkshire Healthcare NHS Foundation Trust, said: "The flu jab is completely safe and cannot give you flu.

 

"If you haven’t got round to having your flu jab yet, now is the best time to get it done, before flu starts to spread. Visit your GP to book a jab."

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Little Things.

Little Things. | Diabetes Now | Scoop.it

Kim writes: 

 

It's a pump infusion site that lasts longer than two days, right down to the last drop.

 

It's catching that low before you brush your teeth, for once.

 

It's helping yourself feel better by helping someone else feel better.

 

It's a pretty number when you didn't expect to see one.

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Majority of gastric bypass patients have no long-lasting remission of type 2 diabetes

Majority of gastric bypass patients have no long-lasting remission of type 2 diabetes | Diabetes Now | Scoop.it

Researchers at Group Health Research Institute in the US followed 4,434 obese adults from 1995 to 2008, all of whom had type 2 diabetes and were candidates for gastric bypass surgery.

 

They found that in two-thirds of cases, the patient's diabetes initially went away after surgery.

 

However, more than a third of these patients developed diabetes once again within five years of having gastric surgery.

 

In cases where a patient's diabetes went away following surgery, it typically did not return for a median of eight years.

 

Overall, more than half (56 per cent) of patients had no long-lasting remission of their diabetes following their gastric bypass.

 

Principal investigator Dr David Arterburn, a general internist and associate investigator at Group Health Research Institute, revealed: 'Our results suggest that, after gastric surgery, diabetes stays away for longer in those people whose diabetes was less severe and at an earlier stage at the time of surgery.'

 

The findings, which are published in the journal Obesity Surgery, underline the importance of preventing diabetes in the first place, he added.

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Air travel and diabetes

Air travel and diabetes | Diabetes Now | Scoop.it

The Independent's Simon Calder writes:

 

Before you go abroad, look at the excellent advice for travellers with diabetes from the NHS, for which I have created the following short link: bit.ly/NHSTravel.

 

The main points: before you travel, ask your GP for a covering letter that explains why you have to carry insulin, needles and syringes, etc. This will make life much easier at airport security and overseas customs.

 

When choosing travel insurance, declare your condition to the insurer. Diabetes UK has some good policies (bit.ly/DiaTrav) – though the NHS points out, “Many regular insurance companies do not charge extra for insuring people with diabetes, if they have no complications”. In any event, for European travel you should obtain a European Health Insurance Card (EHIC, through dh.gov.uk).

 

Now to flight delays: hope for the best but prepare for the worst. Assume you will never see your checked-in baggage again, and carry all your essentials in hand luggage (with that letter from your GP). Don’t pack your extra supplies of insulin in baggage for the hold, in case temperature changes cause degradation.

 

Some airlines will take items such as insulin and syringes away from you during the flight and return them at the end. “Be prepared for any eventuality e.g. delays, cancellations, re-routing or stopovers,” says the NHS – advising that you “Carry extra food and snacks to ensure adequate intake or perhaps supplement airline food”.

 

[AS: On the one hand: bravo to the Independent for this awareness piece. On the other: I'd have preferred it if Simon Calder has stated that it might be a good idea to consult with your care team and other #pwd regarding best practice, but at least he name-checks the NHS and Diabetes UK :)]

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Online diabetes management program shows gains

Online diabetes management program shows gains | Diabetes Now | Scoop.it

A nurse-led, multidisciplinary health team working through an online disease management program helped Type 2 diabetes patients achieve better A1C results at six months, though the gains were not sustained at 12 months. Still, the researchers found the program a viable way to help patients manage their disease.

 

In the study, published at the Journal of American Medical Information Association clinicians at the Palo Alto Medical Foundation in California sought to engage and motivate patients through an online monitoring system that included features including wirelessly uploaded home glucometer readings, online messaging with the health team, advice from a nurse care manager and dietician and personalized text and video clips sent to patients.

 

The online care management program was built upon a leading, commercially available EHR product, according to a summary at ClinicalTrials.gov.

 

At six months, the 193 patients who had used the online system had significantly reduced A1C levels, compared with the 189 patients who underwent usual care. But there was no significant difference in their level of control at 12 months, though more of the intervention group showed improvement than the controls.

 

A recent report by the eHealth Initiative found that interventions such as telemedicine, mobile health and patient web portals show "tremendous promise" to help socially disadvantaged populations manage diabetes. In an analysis of more than 100 peer-reviewed articles, it found sustained improvements in glucose levels attributed to the use of telemedicine and mobile health initiatives. While web portals are growing more popular, it remains unclear how patients are using them, it said.

 

Diabetes care has been among the most prolific areas of smartphone app development as providers seek new ways to motivate patients to take self-care more seriously. Big improvements in glucose levels through the use of apps were shown in a University of Maryland School of Medicine study. And Norwegian researchers reported a sense of empowerment among teenagers who manage their disease with apps.

 

Meanwhile, Swedish researchers, in a paper published at BMC Medical Informatics and Decision Making, describe how they used a collaborative approach to write content for a website for pregnant women and new mothers with Type 1 diabetes.

 

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