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15 healthcare essentials for people with diabetes

15 healthcare essentials for people with diabetes | Diabetes Now | Scoop.it

Diabetes UK offers a list of 15 basic health checks that everyone with diabetes – whether Type 1 or Type 2 – should receive.

 

Based on official NHS guidance across the UK, the 15 healthcare essentials checklist (PDF, 164KB: http://www.diabetes.org.uk/upload/About%20us/15%20measures%20checklist.pdf ;) sets out the minimum standard of care that people with diabetes need to help manage their condition.

 

The 15 checks are:

 

1. Get your blood glucose levels measured at least once a year.

 

2. Have your blood pressure measured


3. Have your blood fats (cholesterol) measured every year.


4. Have your eyes screened


5. Have your feet checked


6. Have your kidney function monitored annually.


7. Have your weight checked


8. Get support if you are a smoker

 

9. Receive care planning to meet your individual needs


10. Attend an education course


11. Receive paediatric care if you are a child or young person.


12. Receive high quality care if admitted to hospital.


13. Get information and specialist care if you are planning to have a
baby


14. See specialist diabetes healthcare professionals to help you manage your diabetes.


15. Get emotional and psychological support.

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"Type 1 and Type 2 diabetes are quite different"

"Type 1 and Type 2 diabetes are quite different" | Diabetes Now | Scoop.it

Kim Pascas writes in response to an article in the Montral Gazette entitled 'Change is hard for disease-stricken: study':

 

"Once again I am very disappointed to see that The Gazette has published another article stating that diabetes is a disease that is “largely preventable with healthier lifestyle habits.” While this is definitely true for Type 2 diabetes, it is not the case for Type 1 diabetes.

 

As a Type 1 diabetic who acquired this unpreventable and incurable disease at the age of 13, I find it extremely insulting to read that my disease could have been prevented had my lifestyle been healthier. I also dread the comments that I will get from people who, after reading articles that fail to specify the type of diabetes being referred to, will continue to confuse the two diseases and offer me advice on how to live healthier.

 

Many Type 1 diabetics would prefer that the there be a different name for this disease, which is too often mixed up with the “largely preventable” Type 2 diabetes. Until that happens, to simply refer to diabetes as either Type 1 or Type 2, not just “diabetes,” would really help to eliminate some of the confusion."

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#gbdoc archive for 21 November

#gbdoc archive for 21 November | Diabetes Now | Scoop.it

Wednesday 21 November 2012 saw the convening of the sixteenth 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 reviewed World Diabetes Day, which occurred last week (14 November). The questions were:

 

* What would you like to have seen organised for WDD?
* What could we do to raise awareness of #WDD?
* What's the all-time best D joke/line you have ever heard?

 

This week's #BGBingo number was 5.9 and the winner was @burtyd79 with 6

 

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

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Airport security X-rays may damage diabetes devices

Airport security X-rays may damage diabetes devices | Diabetes Now | Scoop.it

Full body X-ray scanners and luggage X-rays may damage some insulin pumps and continuous glucose monitors, both used by many people with diabetes to manage their conditions.

 

It's likely that every day, large numbers of travelers expose these diabetes care devices to X-rays while going through airport security "and some may unknowingly experience mild [or worse] malfunctioning as a result," wrote the authors of a recent editorial in the journal Diabetes Technology & Therapeutics.

 

They recommend carrying a letter that details all of the medical supplies someone with diabetes needs to carry on board with them. They also recommend that if someone wears an insulin pump or continuous glucose monitors, the letter specifically state that these devices shouldn't be subjected to X-rays, either from a full body scanner or the X-ray machine that scans carry-on luggage. Instead, these devices should be hand-checked, according to editorial co-authors Andrew Cornish and Dr. H. Peter Chase, from the University of Colorado Denver.

 

Dr. Tracy Breen, director of diabetes care for North Shore-LIJ Health System in New Hyde Park, N.Y., agreed with this advice.

 

"I always recommend that people living with diabetes travel with a letter from their doctorstating their diagnosis of diabetes, what their travel needs are and what supplies they are traveling with," Breen said. "Since we really don't know what can happen to an insulin pump or [continuous glucose monitoring] device when it is passed through an imaging device, it is important to follow the manufacturer's recommendations."

 

Breen added, "It's also important for people and their doctors to be well versed in Transportation Safety Administration (TSA) guidelines and to consider incorporating those guidelines into the text of their travel letter."

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How diabetes affects the heart

How diabetes affects the heart | Diabetes Now | Scoop.it

When Dave was diagnosed with type 2 diabetes in 1985, he never thought about the impact on his heart – until tests done prior to an elective back surgery found blockages in his arteries.

 

“I had no symptoms,” says Dave. “They told me I basically had a silent heart attack.”

 

Research has shown diabetes can take a toll on the heart. High glucose levels put abnormal stress on the blood vessels, increases the risk of blood clots, and can cause inflammation that is associated with vascular disease. Diabetes also increases the chance of developing other risk factors for coronary artery disease, including high blood pressure, high cholesterol and obesity.

 

“Seventy-five to eighty percent of people with diabetes will ultimately die of a cardiovascular event,” says Dr. Martin Abrahamson, Chief Medical Officer of the Joslin Diabetes Center, clinical partner of Beth Israel Deaconess Medical Center. “It is the biggest killer of people with diabetes.”

 

According to the American Diabetes Association, some 26 million people in the United States, or 8 percent of the population, have diabetes. Of those, nearly 25% are unaware that they have the disease. The impact on the heart is undeniable. Over the past 30 years, while deaths from heart disease in women, for example, have decreased 27 percent, deaths from heart disease in women with diabetes has increased - 23 percent - over that same timeframe.

 

Dr. Donald Cutlip, interventional cardiologist at The Cardiovascular Institute at Beth Israel Deaconess Medical Center, calls the trend an “epidemic.” About 30 percent of the patients he sees with heart disease now are diabetic.

 

“People with diabetes have more extensive disease, tend to have more areas involved and they’re more likely to die or have a heart attack related to their cardiovascular disease,” explains Dr. Cutlip.

But there is hope – especially when steps are taken to identify heart disease risk factors early on and to prevent damage. Aggressive control of glucose, lipid, and blood pressure can reduce the risk of having a major cardiac event by as much as 50 percent, according to Dr. Abrahamson.

 

“The concerning thing is we’re seeing people develop Type 2 diabetes at younger and younger ages,” he says, adding this puts them at risk for heart disease earlier in life. “There is a certain amount of denial, but we need to empower these patients. We need to get them to seek out education and information so they can make the changes necessary to head off heart disease.”

 

Among the changes that can make a difference - eating better, exercising and getting to a healthy weight.

 

After learning he had heart disease, Dave quit smoking and started working out on a treadmill four days a week. He also takes many medications - nine pills in the morning and eight at night to keep both his diabetes and his heart disease in check.

 

“I have a doctor check out my diabetes twice a year and go to my cardiologist twice a year,” he says. “I’m trying to stay on top of everything. So far, I feel good.”

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Soaring diabetes rates in the UK South Asian community

Soaring diabetes rates in the UK South Asian community | Diabetes Now | Scoop.it

Dr. Wasim Hanif writes:

 

As a diabetologist working in one of Britain's biggest cities I see hundreds of new patients every year.

 

People whose lives are blighted by type 2 diabetes brought on by a whole host of factors but often caused by sedentary lifestyles and being overweight, their condition worsened by poor eating habits and ignorance of diabetes.

 

If trends continue, by 2025 five million Britons will have diabetes. That's 400 new patients every day and a disproportionate number will be people of South Asian origin.

 

South Asians are six times more likely to develop diabetes than their white, European neighbours. One in five over the age of 25 already have diabetes. As someone of Indian origin it's my genetic make-up, as much as any life style choices, that puts me and my South Asian patients at greater risk of diabetes.

 

This elevated risk is compounded by the fact that many South Asians know little about diabetes, how to prevent it and the condition carries a stigma within most communities. If they already have diabetes, many do not know how to manage it so they live as healthy a life as possible or where to get informtion. In South Birmingham, where I work, less than 5% of South Asians with diabetes get any kind of validated diabetes education.

 

Knowing this has spurred me and my colleagues in the health advocacy group, the South Asian Health Foundation, to develop grassroots diabetes health education tailored for Britain's diverse South Asian communities.

 

Last year the Foundation launched 'SACHE Diabetes'. SACHE, in Hindustani, means 'truth' and we took the truth about diabetes out to the UK's South Asian communities.

 

The Foundation delivered a uniform educational programme, but tailored for each community, in temples, mosques and gurdwaras from Birmingham to Glasgow. In most cases, the programme was delivered in multiple languages by locally trusted healthcare professionals, who often come from the communities served.

 

We provided factual information and attempted to dispel myths and address the stigmatisation related to diabetes in these communities in the 10 sessions we ran, which reached more than 800 people.

The reception at these programmes was amazing and we were able to get the whole family involved. We also screened for diabetes and in Bromsgrove nearly 75% of people where referred to their GP with a risk of diabetes that they had been unaware of.

 

Working on it confirmed many of the things me and my colleagues knew from daily practice. People of South Asian origin are fearful about diabetes and largely ignorant about it, but they are not what health education professionals call 'hard to reach'. It's more conventional health promotion programmes do not know how to reach out to these communities.

 

My colleague Dr Kiran Patel, chair of the Foundation's trustees, told the Health Select Committee that you cannot tackle health inequalities by having an equitable health service for all. For some communities it is necessary to present information that is relevant to their culture.

 

The SACHE diabetes programme has shown it is possible to engage and raise awareness of diabetes in the South Asian community but to be successful it has to be delivered in a culturally sensitive way. I'm sure that the messages delivered have been received and acted on by many of the individuals at high risk of diabetes we met. We hope to reach many more British Asians over the coming months to reduce their risk of diabetes and make an impact on the health of the nation.

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Diabetes app review: OnTrack

Diabetes app review: OnTrack | Diabetes Now | Scoop.it

OnTrack’s layout has six buttons and a summary of recent entries.

The buttons allows users to:

 

* add entries
* edit entries
* see reports
* see graphs
* use tools
* change settings

 

Add functions:

Glucose, Foods, Exercise, Medication, Weight, Blood Pressure, Pulse and HbA1c

 

A categories drop-down offers additional entry classifications. Notes may be appended here.

 

Category name fields are customisable.

 

Reporting options include a log book, glucose average statistics, glucose by category, food by category, and medication by subtype.

 

The graphs function presents the report data visually, with all the usual chart options. Colours and labels of the chart format chosen are customisable. 

 

Tools options include data backups to internal SD card, as well as a data restore of previously archived data from the SD to the app. Data can also be exported to email.

 

Price: Free

Format: Android

 

Google Play link:

https://play.google.com/store/apps/details?id=com.gexperts.ontrack&hl=es 

 

[AS: Has anyone tried OnTrack? What did you make of it? Click on the title link above to read the full review of iMedicalApps]

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Living with diabetes: four behaviours to avoid

Living with diabetes: four behaviours to avoid | Diabetes Now | Scoop.it

Diabetes can be a scary, intimidating diagnosis to get. But it can be a manageable disease if you follow a healthy lifestyle and listen to your doctor.


It’ll also help if you do your body a favor and avoid the following bad habits that may worsen your diabetes symptoms and increase your complication risks:


1. Watching TV

One study found that for every two hours people spend glued to the tube, their risk of developing type 2 diabetes, or worsening their symptoms if they already had it, increases by 20 percent.

 

2. Skipping sleep

Not getting enough shut-eye can cause night sweats, which can worsen symptoms by dehydrating your body. Being tired or stressed can also increase your appetite for sugar and other diabetes no-no’s.

 

3. Not tracking blood glucose

Gauging whether medication or insulin shots are working to control the disease requires frequent blood tests.

 

4. Improper dieting

Diabetes maintenence centers around proper nutrition — not diets. Losing and re-gaining weight all the time may throw off your metabolism.

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Focus on diabetes: a resource from the National Institute for Health Research

Focus on diabetes: a resource from the National Institute for Health Research | Diabetes Now | Scoop.it

Chief Medical Officer for England Professor Dame Sally Davies writes:

 

"The National Institute for Health Research supports research in almost every medical area, but on this website we are focusing on the research we are doing to help combat diabetes.

 

You can read about some of the important issues in diabetes research from Professor Edwin Gale - a leading expert in the field.

 

You can discover what researchers in this important area are working on, with support from the NIHR, and how it can contribute to our knowledge of diabetes care.

 

Most importantly, you can hear from diabetes patients about what it is like to take part in clinical research, and help scientists and NHS doctors to push the boundaries of our knowledge.

 

I hope you find this website useful, and that it gives you an insight into the work that the NIHR does behind-the-scenes to make a difference for every patient, and improve the health and wealth of the nation through research."

 

Dame Sally's address to Focus on Diabetes readers on YouTube:

 

http://youtu.be/zN6OW2VcUWk

 

 

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Dental issues may be early diabetes indicators

Dental issues may be early diabetes indicators | Diabetes Now | Scoop.it

“For a long time, dentists treated the mouth as if it was disconnected from the rest of the body,” says Floridian Dr. PhilBilger. “Of course, that’s not the case. Each affects the other.”


For example, Bilger cites aggressive, persistent gum and periodontal disease as often being associated with Type 2 diabetes.


“Gum and periodontal diseases are diseases of inflammation that trigger a response in the immune system,” Bilger explains. “But, because diabetes can inhibit the immune system, these diseases in a person with diabetes might be more resistant to treatment than they would be in a non-diabetic person.”

 

Thus, whenever gum- or periodontal-disease patients don’t respond as quickly, or successfully, to typical protocols, Bilger suggests that they also visit their medial doctor in order to determine their diabetes status.


A previously undiagnosed patient will often be made aware of his or her own diabetic, or pre-diabetic, condition because of what he or she may believe is a seemingly unrelated dental condition, Bilger says.


Those with Type 2 diabetes, Bilger notes, may also suffer from the following chronic dental conditions:

 

* Xerostomia: Colloquially referred to as “dry mouth,” this occurs when a patient has insufficient saliva. This often happens to diabetics because saliva contains glucose — and managing diabetes means limiting one’s glucose level.
* “Burning mouth syndrome”: Essentially, this is a severe extension of the dry-mouth condition — but far more painful. It may also be accompanied by an inexplicable bitter taste in the mouth, and often worsens as the day passes.
* Thrush: This is the growth of a naturally occurring fungus that the body can’t control. It results in tender red or white patches, usually on the gums, tongue or roof of the mouth.

 

What makes treating and curing dental diseases in diabetics particularly challenging, Bilger explains, is that the separate conditions feed off each other: “Having Type 2 diabetes puts you more at risk for developing significant gum disease; meanwhile, having gum disease often makes it harder to control your blood-glucose level. It can be a vicious cycle.”

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Making strides in the self-management of diabetes with mobile apps

Making strides in the self-management of diabetes with mobile apps | Diabetes Now | Scoop.it

Education and self-awareness are often cited as the biggest challenges in the effective management of diabetes. Achieving good blood sugar control can be assisted by keep your body in check through regular exercise, accurate medication, and the monitoring of diet.

 

Mobile phone apps for managing diabetes can be useful when it comes to providing timely reminders on everything from what to eat to how many calories you ideally need to be burned in a day.

 

“The average person diagnosed with diabetes finds it difficult to cope with the dietary and lifestyle changes the condition brings. It’s common for individuals to miss a dosage of insulin, or wrongly estimate dietary intake. Mobile apps with ready-made information on these matters can prove to be a big boost,” points out Dr Atul Aundhekar.

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Larne diabetes rate rises by 27 percent

Larne diabetes rate rises by 27 percent | Diabetes Now | Scoop.it

Diabetes UK Northern Ireland has warned of the continuing growth of diabetes in Larne as figures collected this month revealed the number of local people living with Type 1 and Type 2 diabetes has increased by 27 per cent during the last five years.

 

The total number of adults with diabetes aged 17 and over who are registered with GPs in Larne is now 1,269 compared with just 1,000 in 2007. This figure has also risen from 1,230 in 2011.

 

The overall number of people in Northern Ireland with Type 1 and Type 2 diabetes is now 75,837; a 33 per cent increase since 2007, and a further 1,038 young people under 17 are known to have Type 1 diabetes. Prevalence in the Northern Ireland population is now over four per cent and it is estimated that around 10,000 people are living with the condition but have not yet been diagnosed.

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#gbdoc archive for 14 November

#gbdoc archive for 14 November | Diabetes Now | Scoop.it

Wednesday 14 November 2012 saw the convening of the fourteenth meeting of the UK's diabetes online community tweetchat using the hashtag #gbdoc, part of an epic 16 hour global tweetchat to mark World Diabetes Day on #wddchat12.

 

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

 

This week's theme addressed the topical question of diabetes and inspiration. The questions were:

 

* Who/what/when have you been inspired by a fellow PWD?
* Who in real life would you point to as a #Dhero - sports, TV, personality etc?
* What #dstory would you tell to inspire or motivate others?
* (lighthearted) Have you ever cunningly used diabetes to your advantage

 

This week's #BGBingo number was 6.7 and the winner was @glucosegirly

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Caffeine-diabetes link still unresolved: study

Caffeine-diabetes link still unresolved: study | Diabetes Now | Scoop.it

Results of a large new U.S. study confirm that sugary drinks are linked to a heightened risk of developing Type 2 diabetes, but shed little light on whether caffeine helps or hinders the process.

 

Among more than 100,000 men and women followed for 22 years, those who drank sugar-sweetened drinks were as much as 23 per cent more likely to develop diabetes than those who didn’t, but the risk was about the same whether the drinks contained caffeine or not. And drinkers of both caffeinated coffee and decaf had slightly lowered diabetes risk.

 

“We found that caffeine doesn’t make a difference at all,” said the study’s lead author Dr. Frank Hu of Harvard University. “Coffee can be beneficial and the caffeine doesn’t appear to have a positive or negative effect on diabetes risk,” Hu told Reuters Health.

 

Numerous past studies have linked regular consumption of soft drinks – both sugar- and artificially-sweetened – to an increased risk of diabetes. Research over the past decade has also suggested that caffeine temporarily prevents the body from processing sugar efficiently. Those who live with diabetes deal with this problem all the time.

 

That at least suggests that caffeine in conjunction with sweetened drinks might raise diabetes risk even further. However, other research has found a protective effect from coffee and tea, suggesting caffeine does the opposite.

 

Hu and his coauthors wanted to know if people who regularly drink sugary and caffeinated beverages might only be exaggerating their risk of developing a disease that affects nearly 26 million adults and children, or about eight per cent of the U.S. population, according to the American Diabetes Association.

 

They examined the health habits of 75,000 women and 39,000 men involved in long-term health studies that began in the mid-1980s.

Compared to people who didn’t consume sugary drinks, the likelihood of developing diabetes over the years for those who did was higher by 13 per cent (caffeinated) or 11 per cent (decaffeinated) among women, and by 16 per cent (caffeinated) or 23 per cent (decaffeinated) among men.

 

Caffeine-free artificially sweetened drinks were also linked to a slight (six per cent) increase in risk among women.

 

However, coffee drinkers showed slightly lower risk compared to non-drinkers. The chances of developing diabetes were eight per cent lower among women, whether they drank decaf or regular coffee, and for men, four per cent lower with caffeinated coffee and seven per cent lower with decaf.

 

Hu and his team have used this same dataset, which contains the health habits of mostly white health professionals, to suggest that regular coffee drinking in general is tied to lower diabetes risk.

But past studies, like the current one, have also found that the risk falls even lower if adults drink decaffeinated coffee.

 

“Our understanding of the body’s tolerance to caffeine is not complete,” said James Lane of Duke University. Lane has done short-term studies that linked caffeine to a disruption of the body’s ability to process glucose, or “blood sugar.”

 

This latest study suggests that people who currently drink sugary beverages could substitute unsweetened coffee or tea – though tea was associated with fewer benefits – instead.

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People with type 1 diabetes had improved blood sugar control during aerobic and resistance exercise

People with type 1 diabetes had improved blood sugar control during aerobic and resistance exercise | Diabetes Now | Scoop.it

When it comes to controlling type 2 diabetes, exercise plays a crucial role. Even resistance exercise like weightlifting can lower blood sugar levels.

 

Now it seems resistance exercise may also be good in type 1 diabetes.

 

Researchers found that both resistance exercise and aerobic exercise (e.g., walking, biking and swimming) lowered blood sugar levels in patients with type 1 diabetes while they exercised.

 

After the workout was finished, however, patients had better blood sugar levels after resistance exercise than after aerobic exercise.

 

For their study, Ronald J. Sigal, MD, MPH, of the Ottawa Hospital Research Institute and the University of Calgary in Canada, and colleagues compared the effects of aerobic exercise and resistance exercise on blood sugar levels in people with type 1 diabetes.

 

They looked at how these two types of exercise affected blood sugar levels during and after workouts. Results showed that blood sugar levels dropped more during aerobic exercise than during resistance exercise.

 

After resistance exercise, blood sugar levels did not change much. However, blood sugar levels increased after aerobic exercise.

From 4.5 to 6 hours after exercise, blood sugar levels were significantly lower after resistance exercise than after aerobic exercise.

 

The authors concluded that resistance exercise causes less initial drops in blood sugar during activity but is associated with more prolonged decreases in post-exercise blood sugar levels compared to aerobic exercise.

 

These results suggest that resistance training is good for you beyond sculpting shapely muscles.

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Eating asparagus may help control blood sugar

Eating asparagus may help control blood sugar | Diabetes Now | Scoop.it

New research suggests that regular consumption of asparagus could help keep blood sugar levels under control and boosts the body’s production of insulin, the hormone that helps it to absorb glucose.


UK consumption of asparagus has soared in recent years to record levels of around 8,000 tonnes a year.


As well as its delicate flavour, it now appears it could have a vital role to play in combating Britain’s looming diabetes crisis.

 

Type two diabetes, which accounts for 90 per cent of all diabetes cases, is emerging as a major health burden.

 

According to the charity Diabetes UK, at the current rate of increase, the numbers affected will rise from around 2.5 million to four million by 2025 and five million by 2030.

 

More than a million people are already affected by the condition but do not realise they have it, perhaps because they do not recognise symptoms, such as fatigue, thirst, frequent urination, recurrent thrush and wounds that are slow to heal.

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Raising awareness of the risk of chronic liver disease in people with type 1 diabetes

Raising awareness of the risk of chronic liver disease in people with type 1 diabetes | Diabetes Now | Scoop.it

People with type 1 diabetes displayed a greater risk for developing chronic liver disease, including a fourfold prevalence for cirrhosis, compared with the general population, according to study data presented at The Liver Meeting.

 

Among a longitudinal cohort of 4,644 patients with type 1 diabetes, researchers in the United Kingdom used a computer database to identify 57 (1.2%) who had undergone 82 liver biopsies. Each was gender-matched with insulin-treated (n=57) and noninsulin-treated type 2 diabetes patients (n=57). Both type 2 diabetes groups also had undergone liver biopsy.

 

In the type 2 diabetes cohort (n=9,571), 270 patients (2.8%) underwent 301 liver biopsies. Compared with both type 2 diabetes arms, type 1 diabetes patients had lower occurrence of nonalcoholic fatty liver disease (OR=0.35; 95% CI, 0.15-0.82), but they showed higher diagnoses of glycogenosis (OR=9.1; 95% CI, 1.10-75.75).

 

Researchers said 14 type 1 diabetes patients were diagnosed with cirrhosis during follow-up, which equated to a prevalence of at least 301.5 (170-520) per 100,000 individuals compared with an estimated cirrhosis prevalence of 76.3/100,000 (OR=3.96; 95% CI, 2.24-7.01) in the general UK population. Type 1 diabetes patients displayed a lower diagnosis rate of cirrhosis than type 2 diabetes patients using insulin (OR=0.46; 95% CI, 0.23-0.91) and type 2 nonusers (OR=0.42; 95% CI, 0.21-0.84).

 

Twenty-two type 1 diabetes patients (38.6%) who had liver biopsy died during follow-up, which equated to an estimated crude death rate of 6,539/100,000 person-years, compared with an anticipated 1,878/100,000 person-years based on the National Diabetes Mortality Analysis 2007-08.

 

“A person with type 1 diabetes is at a significant risk of developing liver disease, and I don’t think that was something that was previously realized,” David J. Harman, PhD, hepatology research fellow at Nottingham Digestive Diseases Centre Biomedical Research Unit in England, told Healio.com. “Prospective cohorts are needed to confirm this data and for new algorithms to develop type 1 diabetes. But I think this is the first step in demonstrating that they’re at substantial risk of liver disease as well as their type 2 diabetes colleagues.”

 

For more information:

Harman DJ. P1467: Prevalence and natural history of histologically proven chronic liver disease in a longitudinal cohort of patients with type 1 diabetes. Presented at: The Liver Meeting 2012; Nov. 9-13, Boston.

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Getting a grip on spiraling rates of diabetes in Wales

Getting a grip on spiraling rates of diabetes in Wales | Diabetes Now | Scoop.it

The Welsh Government and the NHS need to get a grip on spiraling rates of diabetes as a matter of urgency, a leading charity has warned.

In its State of the Nation report published today,Diabetes UK Cymru says the condition is getting out of control with a increase of 35,000 people diagnosed in the last five years, bringing the total to 160,000.

 

By 2025, the number of people in Wales with diabetes is forecast to top 250,000, the charity warns.

 

The report also highlights failings in patient care with almost one-in-three diabetic inpatients in Wales experiencing at least one NHS medication error.

 

Meanwhile, 70% of adults with Type 1 diabetes and 43 % with Type 2 diabetes do not receive all the recommended annual tests.

Concerns are also raised about foot care, with 18% of people with diabetes not getting annual foot checks, in spite of diabetes being a major cause of ulceration and amputation.

 

The report says: “An urgent national grip needs to be taken of the situation. The alternative is an NHS swamped by demand and a massive toll in human misery.

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C8 MediSensors, Dexcom receive approval for next generation diabetes monitoring

C8 MediSensors, Dexcom receive approval for next generation diabetes monitoring | Diabetes Now | Scoop.it

Brian Edwards writes:

 

Two companies, C8 MediSensors and Dexcom, have received regulatory approvals for their Continuous Glucose Monitoring (CGM) systems in the EU and US respectively, though each company relies on very different technology to do its job of providing users access to real-time glucose levels.

 

San Jose, CA-based C8 MediSensors has received CE Mark approval for its Optical Glucose Monitor System, opening the door for distribution of the wearable sensor in the EU.

 

The device utilizes Raman spectroscopy, which involves a beam of light shone into the skin to scatter the glucose molecules, which generate a highly unique “fingerprint” that can be measured with a high degree of precision and distinguished from other substances in the body. The device communicates with a smartphone via Bluetooth and can be programmed to automatically send alerts when glucose levels move dangerously high or low.

 

According to C8′s press release (the first I have ever seen with 20 references) a definitive 10-year Diabetes Control and Complications Trial (DCCT) has demonstrated that individuals with type 1 diabetes who kept blood glucose levels as normal as possible for as long as possible had less chance of developing disease-related complications.

 

For example, the risk of eye disease reduced by 76 percent, kidney disease reduced by 50 percent, and nerve disease reduced by 60 percent. Other studies cited show CGM to have these same results related to reducing disease-related complications for type 2 diabetics as well.

 

“C8 MediSensors was co-founded by a father trying to help his son living with diabetes, and as a company, we remain dedicated to helping those with the disease,” said Paul Zygielbaum, CEO of C8 MediSensors. “CE Mark approval is a landmark step for this unique technology. Our team is hugely excited to be working to make nCGM and the Optical Glucose Monitor System available throughout Europe.”

 

[AS: Thanks to Brian for this. Click on the title link above to read the rest of his post on the iMedicalApps site. Just a note re. hastags: we are using #nCGM to signify the non-invasive nature of the C8 MediSensor device. Nice that you noticed the footnotes, too. We like to share!]

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Diabetic emergencies: Hypoglycemia caused by insulin

Diabetic emergencies: Hypoglycemia caused by insulin | Diabetes Now | Scoop.it

Excerpted from Stavros Liatis, Nikolaos Katsilambros, Diabetic Emergenices: Diagnosis and Clinical Management (John Wiley & Sons, Ltd, 2011)

 

-- Classification of iatrogenic hypoglycemia

 

A confirmatory blood glucose test during an episode of hypoglycemia is often unavailable while, in other cases, a discrepancy may be observed between self-measured blood glucose values and clinical presentation of hypoglycemia (usually due to defective counter-regulation). These situations often create confusion both in clinical practice and in clinical studies. In 2005, an American Diabetes Association (ADA) workgroup on hypoglycemia proposed certain criteria to define and classify hypoglycemic events in patients with diabetes

 

-- Severe hypoglycemia

 

Any hypoglycemic episode that the patient is unable to self-treat, requiring the assistance of another person to deal with it. Subdivisions of this category are cases requiring medical assistance and those that lead to seizures or/and coma. A low blood glucose measurement is not necessary, as recovery attributable to the administration of carbohydrates (either orally or parenterally) and/or glucagon is considered sufficient evidence that the event was induced by a low blood glucose concentration.

 

-- Documented symptomatic hypoglycemia

 

An event with typical symptoms of hypoglycemia, accompanied by a measured plasma glucose concentration ≤ 70 mg/dl (3.9 mmol/L).

 

 

-- Asymptomatic hypoglycemia

 

An event not accompanied by typical symptoms of hypoglycemia but with a measured plasma glucose concentration ≤ 70 mg/dl (3.9 mmol/L). It has been argued by some experts that defining hypoglycemia as any value ≤70 mg/dl (3.9 mmol/L) may lead to overestimation of clinically important events.11 The European Agency for Evaluation of Medicinal Products (EMEA) proposed a respective value of ≤ 54 mg/dl (3.0 mmol/L) when assessing the hypoglycemic risk of different treatment regimens, as this might have the advantage of better clinically detecting significant hypoglycemia. This approach, however, could result to an underestimation of true hypoglycemic events.

 

 

-- Probable symptomatic hypoglycemia

 

A self-reported event that is not confirmed by a measured low plasma glucose value. This is a common situation in patients who experience frequent hypoglycemic episodes and often neglect to measure their blood glucose, despite typical symptoms, choosing to directly consume carbohydrates in order to treat the event.

 

-- Relative hypoglycemia

 

A situation "opposite" to the previous one. It refers to a symptomatic event interpreted by the patient as hypoglycemia but accompanied by a plasma glucose value higher than 70 mg/dl (3.9 mmol/L). This situation can be explained by the fact that when glycemic control is poor, symptoms of hypoglycemia may appear at higher plasma glucose levels.

 

Summary:

 

In clinical practice the most important discrimination lies between severe and mild hypoglycemia, the latter including all non-severe hypoglycemic event.

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Raising awareness of diabetes

Raising awareness of diabetes | Diabetes Now | Scoop.it

-- What is diabetes?

 

Diabetes comes in two forms: Type 1 and Type 2. It is a chronic disease that occurs when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin it produces.

 

Hyperglycaemia, or raised blood sugar, is a common effect of uncontrolled diabetes. Over time this leads to serious damage to many of the body's systems, especially the nerves and blood vessels.

Having a family history of Type 2 diabetes increases your chances of developing diabetes.

 

You can find out more at the following nidirect page:

http://www.nidirect.gov.uk/index/information-and-services/health-and-well-being/illnesses-and-conditions/health-conditions/diabetes.htm

 

-- Effects

 

The effects of diabetes and its complications cannot be underestimated. A person living with the condition is five times more likely to die of a heart attack than a non-diabetic and three times more likely to die of a stroke.

 

It is also one of the most common causes of limb amputation and the leading cause of blindness among people of working age.

 

-- Prevention

 

If you are overweight or obese, the key step to preventing or delaying the onset of Type 2 diabetes is to lose weight. You can do this by making healthy food choices and being physically active for 30 minutes a day, five days a week.

 

If you don't have a healthy diet and don't take appropriate exercise, obesity may develop into diabetes over a relatively short period of time.

 

-- Symptoms

 

For Type 1 diabetes, watch out for the following six symptoms:

* feeling thirsty all the time
* blurred vision
* frequent need to urinate
* extreme tiredness
* weight loss (especially in Type 1 diabetes)
* itchiness, especially around the genitals

 

Sometimes with Type 2 diabetes, there might be no symptoms. Early diagnosis is important. If you think you have diabetes, speak to your GP or pharmacist.

 

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The Lost Tribe: highlighting the needs of people with type 1 diabetes

The Lost Tribe: highlighting the needs of people with type 1 diabetes | Diabetes Now | Scoop.it

[Hover over and scroll down the image above to view it in its entirety]

 

The Association of British Clinical Diabetologists (ABCD) launched their Lost Tribe campaign on the 8 November. The aim of the campaign is to highlight the differences between the types of diabetes and the fact that patients with type 1 have special needs which are easily overlooked because type 2 diabetes is so much commoner. In particular the campaign will suggest that people with type 1 diabetes deserve unhindered access to specialist care, when they need it, throughout their lives.

 

Dr Helen Hopkinson, Chair of the DAFNE Executive Board said; "The UK DAFNE Collaborative is pleased to support the ABCD Lost Tribe campaign for people with Type 1 diabetes. We seek a central specialised commissioning process for structured Type 1 diabetes patient education that meets the NICE criteria. We believe this could end the postcode lottery that currently limits access to this vital component of Type 1 diabetes care for up to 50% of the UK."

 

To find out more about the Lost Tribe campaign visit the ABCD website: http://www.diabetologists-abcd.org.uk/Type1_Campaign.htm ;

 

[AS: Whilst I appreciate the action-oriented outcomes this awareness campaign from the ABCD is endeavouring to stimulate, for me the directionless 'lost tribe' monicker does not adequately speak to the empowered, connected, motivated, purposeful and determined character of the people living with type 1 of my acquaintance. What's your impression of the way this vital campaign is being presented?]

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Monitoring your diabetes using digital tools

Monitoring your diabetes using digital tools | Diabetes Now | Scoop.it

Katie Freeman writes:

 

'Diabetes is a chronic condition that results from defects in insulin production, insulin action or both. There are two main types of diabetes — Type 1 and Type 2. Type 1 usually occurs before the age of 20 and is a result of the pancreas no longer making insulin. This type of diabetes requires taking insulin and possibly other medication. Type 2 diabetes, often called adult onset diabetes, is the most common form of diabetes and can be controlled with proper diet, medication and exercise.

 

Having a smartphone might make monitoring your glucose numbers and carbohydrates throughout the day a bit easier. Don’t have a smartphone? There are a number of web tools, too.'

 

The article offers brief introductions to the following platforms, apps and devices:

 

* Diabetic Connect

* Glucose Buddy

* Diabetes Tracker by MyNetDiary

* MyFoodAdvisor

* iBGStar

 

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Psychological support can help people living with diabetes

Psychological support can help people living with diabetes | Diabetes Now | Scoop.it

Medical advances are important but we believe the key to living successfully with diabetes is something else entirely. Paying attention to the behavioural and psychological aspects of the condition is crucial to managing diabetes and preventing its complications.

 

Once diagnosed, type 1 and type 2 diabetes are lifelong conditions. Each imposes a complex self-care regimen that can be difficult to sustain. Optimal self-care includes healthy eating, regular physical activity, taking medications as recommended, checking blood glucose levels, and attending medical appointments.

 

New technologies such as insulin pumps, continuous glucose monitors, and smart-phone apps are enticing but they are not a panacea. Studies typically show that people who do well with these put more time and effort into their self-care, not less. And while technologies can make self-care easier for some, they can make it more challenging for others.

 

Despite or perhaps because of medical and technological advances, the fundamental issue in diabetes now concerns human behaviour – how to improve self-care and how to provide better support for people living with diabetes.

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Vitamin D deficiency linked to type 1 diabetes

Vitamin D deficiency linked to type 1 diabetes | Diabetes Now | Scoop.it

A study led by researchers from the University of California, San Diego School of Medicine has found a correlation between vitamin D3 serum levels and subsequent incidence of Type 1 diabetes. The six-year study of blood levels of nearly 2,000 individuals suggests a preventive role for vitamin D3 in this disease. The research appears the December issue of Diabetologia, a publication of the European Association for the Study of Diabetes (EASD).


“Previous studies proposed the existence of an association between vitamin D deficiency and risk of and Type 1 diabetes, but this is the first time that the theory has been tested in a way that provides the dose-response relationship,” said Cedric Garland, DrPH, FACE, professor in UCSD’s Department of Family and Preventive Medicine.

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