How diabetic women's pregnancy chances can be boosted

Watching what you eat, exercising properly and ensuring adequate nutrition with a vitamin supplement which has adequate amounts of folic acid may improve chances of conception in diabetic women.

Women with diabetes face a special challenge-getting and then staying pregnant. Poor glucose control may create an environment where the high sugars prevent both conceiving as well as maintaining the pregnancy, Diabetic Living India reported.

Women who develop diabetes can be prone to developing other disorders such as thyroid disease or autoimmune premature ovarian failure.

Miscarriage rates among women with poorly controlled diabetes can be as high as 30 to 60 percent during that crucial first trimester of pregnancy. The risk of birth defects is also high, and also stems from uncontrolled blood sugar levels around the time of conception.

A baby’s brain, heart, kidneys and lungs form during the first eight weeks of pregnancy, therefore high blood glucose levels are especially harmful during this early stage.

The main diabetes complication, including gestational diabetes, related to pregnancy is macrosomia – or a big baby (higher than the 90th percentile in birth weight).

Women with Type 1 diabetes will require insulin before, during and after their pregnancy.

However, if a woman has type 2 diabetes then she will require oral medications with or without insulin to achieve appropriate control of your diabetes.

In order to enhance chances of delivering a healthy baby, diabetic women should work with health care team to get their blood glucose under control before getting pregnant.

Let's link hands against diabetes

A 68-year old Mrs. S. developed high fever and had to be hospitalised since her blood sugars were very high. With no personal income or medical insurance, she had to depend on her son for paying hospital expenses for which he was not too willing.

Mr. S, 58, a watchman in a company, developed fever and infection in the foot. He had very high blood sugars and was hospitalised. Despite all efforts, his left leg had to be amputated and he had to use his entire savings which he had kept aside for his daughter’s wedding. This was a sad story of a man who lost his leg and his personal savings because he had diabetes, of which he was unaware. Innumerable are such pathetic cases.

Diabetes is one of the major health and development challenges of the 21st century. In India, it is estimated that around 62 million people have diabetes. One in two people with diabetes doesn’t know he/she has it. But diabetes and its complications are largely preventable, and proven, affordable interventions available. Everyone is concerned and everyone has a role to play in helping to turn the tide of diabetes to protect our future.

What can be done?

There are two major components of the burden of diabetes in India — genetic and environmental factors. Environmental factors such as physical inactivity and unhealthy diet pattern play an important role. There is an immediate need to seek the involvement of several stakeholders in prevention and control of diabetes.

To start with, the media plays a major role in not only creating awareness of the risk factors but also making policymakers and others focus on various avenues leading to a better living environment. The existing knowledge of prevention of diabetes can be disseminated to all with the help of the Ministry of Information and Broadcasting, NGOs and healthcare centres in both the private and public sectors.

Next, to put the knowledge into practice, it is necessary to create a conducive environment for the public to increase their physical activity. This needs earmarked funding for construction of parks, safe footpaths and cycle pathways.

In order to ensure healthy eating habits, retail shops, fast food outlets and chain restaurants should be encouraged to provide alternative healthy food choices. An additional tax could be levied on junk food. Regulation of pricing policy for fruits and vegetables is necessary.

The government should encourage small entrepreneurs to manufacture nutritious and palatable snacks for people belonging to different economic strata at an affordable cost. Agricultural research is also required for producing low glycemic cereals and grain. More operational research is necessary to develop strategies to reduce the burden of diabetes and its risk factors. Allocation of funds for such projects has to be given high priority by the funding agencies.

In order to help people with pre-existing diabetes, insurance companies should introduce policies which will cover both outpatient and hospitalisation costs.

This will help a large number of people in India with diabetes to have good control of their blood sugar levels and thus prevent dreadful complications.

Although various stakeholders are required to build the web of partnership for diabetes prevention, the most essential is individual commitment to a better living.

(The writer is Head and Chief Diabetologist, MV Hospital for Diabetes, and Prof. M Viswanathan Diabetes Research Centre, Chennai. Email: drvijay@mvdiabetes.com)

New Drug May Someday Battle Obesity and Diabetes – WebMD

New Drug May Someday Battle Obesity and Diabetes

Researchers find slim evidence to support many

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, Oct. 30 (HealthDay News) — A new diabetes drug may one day perform double duty for patients, controlling both their blood sugar levels and helping them lose weight, researchers report.

In mouse trials, doctors found the drug prompted weight loss, in addition to managing blood sugar levels.

“That [weight loss] is not what this drug was designed to do, but it’s a very attractive additional benefit,” said study co-author Richard DiMarchi, a research chemist at Indiana University in whose lab the drug was created.

The injectable medication is based on a single molecule that combines the properties of two hormones that send chemical signals to the pancreas, said DiMarchi.

“They signal to the pancreas that you are taking a meal,” DiMarchi said. “The pancreas then responds by secreting insulin and to synthesize additional amounts of insulin for subsequent use.”

People with type 2 diabetes have lower levels of these pancreas-signaling hormones, which are known as incretins, explained Dr. John Anderson, president of medicine and science at the American Diabetes Association.

“The incretin defect in type 2 diabetes is well known, and it’s only within the last few years we have had agents to treat it,” Anderson said.

Human and primate trials revealed that the new drug controls blood sugar with fewer side effects than other diabetes medications. Those side effects can include nausea, vomiting and stomach pain.

“In this study, the degree of gastrointestinal discomfort is much more modest than is experienced in conventional drugs,” DiMarchi said. “We get beneficial glycemic control with this combination drug, and it seems to be with less adverse drug effect.”

The medication combines the action of the hormones GLP-1 and GIP. Current diabetes medications of this sort target GLP-1 receptors in the body; studies involving GIP have produced mixed results.

GLP is known to suppress appetite, and DiMarchi said the weight loss observed in mice might be occurring because the second hormone, GIP, is somehow “turbo-charging” that appetite suppression.

In the mouse trials, a drug based on GLP-1 alone decreased body weight by an average 15 percent. But the new drug combining GLP-1 and GIP decreased body weight by nearly 21 percent, as well as controlling blood glucose and decreasing appetite.

A six-week human trial involving 53 patients with type 2 diabetes found that the medication effectively controlled their blood sugar levels. However, the researchers did not note any change in weight during the relatively short study period.

The higher potency of the combined molecule suggests it could be administered at lower doses than other incretin-based medications, reducing side effects and making the drug easier to take.

“Currently approved drugs are quite effective,” DiMarchi said, “but they are insufficient in normalizing glucose, and they certainly don’t cause much loss of body weight.”

Women with diabetes are at greater risk of death: Experts

More than 250 children and experts from city took part in the workshop and discussed the ways to curb diabetes.

Talking about diabetes, Dr Archana Sharda, diabetes expert from Aurangabad informed that diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in blood. Absence or insufficient production of insulin can also cause diabetes.

Symptoms of diabetes include increased urine output, thirst, hunger and fatigue. Diabetes is diagnosed by blood sugar (glucose) testing.

Talking about the complications, Dr Brij Kishore said that acute complications of this disease are dangerously elevated blood sugar (hyperglycemia), abnormally low blood sugar ( hypoglycemia). The disease affects blood vessels, which can damage feet, eyes, kidneys, nerves and heart.

People suffering from diabetes are almost 50% more likely to have a heart attack.

Women with diabetes are at a greater risk of death than men. The experts said that the increase in prevalence of diabetes in the country is mainly due to factors such as unhealthy food habits, obesity due to lack of exercise and physical fitness, sedentary lifestyles, environmental degradation and its impact on endocrine system.

Dr Bhaskar Ganguli elaborated the importance of exercise for diabetics. He said that all type of exercise are good for diabetics but the aerobics is most affective.

The experts advised tips to the participants to control diabetes by not dieting but making healthier food choices. Regular exercises, quitting smoking and having healthy diet can keep diabetes at bay.

Dispute over data rights forces retraction of obesity paper …

bmcresnotesA group of researchers in South Africa has lost their 2012 article in BMC Research Notes after one of the author’s institutions evidently pulled rank and sought to claim the data as its own.

The article, “Association of body weight and physical activity with blood pressure in a rural population in the Dikgale village of Limpopo Province in South Africa,” appeared last February. Its first author was Seth Mkhonto, who listed two affiliations, the Human Sciences Research Council, in Pretoria, and the University of the Limpopo.

But the latter institution seems not to have given Mkhonto approval to publish the data — a rather strange state of affairs given the whole “publish or perish” ethos of academia.

According to the retraction notice:

This article has been retracted by the Editor because the authors do not have ownership of the data they report. A formal investigation conducted by the University of Limpopo, South Africa, has concluded that the data reported in this article are the sole property of the University of Limpopo.

The abstract of the paper doesn’t shed any light on why it might have been controversial:

Africa is faced with an increasing burden of hypertension attributed mainly to physical inactivity and obesity. Paucity of population based evidence in the African continent hinders the implementation effective preventive and control strategies. The aim of this study was to determine the association of body weight and physical activity with blood pressure in a rural black population in the Limpopo Province of South Africa.

Methods

A convenient sample of 532 subjects (396 women and 136 men) between the ages 20-95 years participated in the study. Standard anthropometric measurements, blood pressure, and physical activity were recorded by trained field workers.

The paper has been cited once, according to Thomson Scientific’s Web of Knowledge.

What you need to know about diabetes

There are two types of diabetes – type 1 and type 2 – but the one that is usually in the news because of its association with rising obesity rates in America is type 2 diabetes.

Type 1 diabetes: Previously called juvenile diabetes, type 1 is usually diagnosed in children and young adults. In this type, the body does not produce insulin, a hormone needed to convert sugar, starches and other foods into energy. Insulin, by shot or pump, must be started right away. Exercise and nutrition are also important in managing type 1 diabetes. It is caused by one’s immune system attacking and destroying insulin-producing cells in the pancreas. It is thought to be caused genetic and environmental factors.

Type 2 diabetes: This type, which may be prevented through lifestyle changes in diet, weight loss and exercise, accounts for 90 percent to 95 percent of all diabetes cases in the U.S. It occurs when an indivdual’s body doesn’t make enough insulin or use it well. This results in “insulin resistance.” 

Diabetes can be diagnosed using three blood tests – fasting blood sugar test, hemoglobin A1C test and a glucose challenge test.

“Patients are often asymptomatic, but the risks associated with prediabetes and diabetes, like heart attack and stroke, are happening before the diagnosis,” said Dr. Scott Setzer, a family doctor in Lemoyne.

People with prediabetes have blood sugar levels that are higher than normal – between 100 and 125 mg/dl – but not high enough to be called diabetes, the label given when fasting blood glucose is 126 mg/dl or higher. Sometimes, early treatment of prediabetes can return blood glucose levels to normal and prevent escalation to diabetes.

When they do present, symptoms include frequent thirst, extreme hunger, frequent urination as in every two hours, weight loss, blurred vision and fatigue, said Dr. Renu Joshi, medical director of endocrinology at PinnacleHealth System in Harrisburg.

Treatment can include lifestyle change in diet, exercise and weight loss, medications and insulin.

In the past several months, a new medication for type 2 diabetes called Invokana (generically called canagliflozin) was introduced that works by making blood sugar come out in the urine, Joshi said. It holds promise, but it can cause thirst, frequent urination and yeast infections. Patients must have completely normal kidney function to be able to take it, she said.

Get tested

The American Diabetes Association has set these guidelines for diabetes screening:

  • Anyone with a body mass index higher than 25, regardless of age, who has additional risk factors, such as high blood pressure, a sedentary lifestyle, a history of polycystic ovary syndrome, having delivered a baby who weighed more than 9 pounds, a history of diabetes in pregnancy, high cholesterol levels, a history of heart disease, or having a close relative with diabetes.
  • Anyone older than age 45 is advised to receive an initial blood sugar screening, and then, if the results are normal, to be screened every three years thereafter. 

Suffering from Obesity | Dances With Fat

Belly Bump with one of my heroes - Marilyn Wann

Belly Bump with one of my heroes – Marilyn Wann

I decided to repost this blog based on a few conversations I had and saw in the last few days.  I see people talk a lot about how we need to “do something,” and how abusive and exploitative things like The Biggest Loser are justified  because so many people are “suffering from obesity”.  I won’t presume to speak for everyone but I will say that while I sometimes do suffer because I’m obese, I’ve never suffered from obesity.

I’m suffering from living in a society where I’m shamed, stigmatized and humiliated because of the way I look. Where I’m oppressed by people who choose to believe that I could be thin if I tried (even though there’s no evidence for that), and that I am, in fact, obligated to try to be thin because that’s what they want me to do – as if personal responsibility means that I’m personally responsible for doing what they think I should do and looking like they think I should look (though this does not seem to be a two way street as none of these people has ever invited by commentary and suggestions on their life and choices.)

I’m suffering from doctors who have bought into a weight=health paradigm so deeply that they are incapable of giving me appropriate evidence-based healthcare.  I’m not just talking about diagnosing me as fat and giving me a treatment plan of weight loss (which is using a completely unreliable diagnostic and then prescribing a treatment that has the opposite result 95% of the time).  I’m also talking about the two doctors who tried to prescribe me blood pressure medication without taking my blood pressure or looking at my chart to see that it is always 117/70 (which means that taking blood pressure medication would have been dangerous).  I’m talking about a doctor trying to get me to lose weight to treat me for Type 2 Diabetes when I actually had anemia.  I’m talking about a doctor telling me that my strep throat was due to my weight. I’m talking about people who are supposed to be scientists abandoning science and research in a way that strongly resembles the time when the Catholic church told Galileo to sit down and shut up.

I’m suffering from a societal witch hunt where instead of putting me in a river they put me on a scale.  People look at my body and feel comfortable blaming me for everything from global warming to healthcare costs despite a lack of evidence for either. People send me ridiculous hate mail, say nasty things to me at the gym (although making fun of a fat person at the gym is something I will never understand).  People who are drenched in thin privilege try to use that position of privilege to make me feel bad about myself.

I’m suffering from the misinformation campaign that is led by the diet industry, weight loss pharmaceutical industry and surgeons who profit from mutilating people who look like me, none of whom are willing to be honest about the risks or horrible success rates of their interventions long term, and some of whom just don’t seem to care.

I am suffering from living in a society that tells me that the cure for social stigma, shame, humiliation and incompetent healthcare is for me to lose weight, when the truth is that the cure for social stigma is ending social stigma.

What has lessened my suffering is that I now realize that this isn’t my fault – although it becomes my problem. One of the reasons that I choose to pursue a life of social justice work is that nothing makes me feel better than knowing that I am doing what I can to fight this and making some kind of difference – whether it’s in the lives of individuals or in society, or just in my own life.  I deserve better and so does everyone else and I and lots of others are fighting for it and we’re going to win.  But to be clear, we shouldn’t have to.  Nobody should have to fight to be treated with basic human respect.   And that’s what I find so sad – all of this suffering of fat people could end right this second and nobody needs to lose a pound – society just needs to stop trying to shame, stigmatize, humiliate and hate people healthy.  We can work on access to healthy foods, we can work on access to safe movement options that people enjoy, we can work on making sure that people have access to appropriate, evidence-based healthcare.  If we give up being a horribly failed example for making people thin, we could be a successful example for giving people options for health.

Like my blog?  Here’s more of my stuff!

The Book:  Fat: The Owner’s Manual  The E-Book is Name Your Own Price! Click here for details

Become a member: For just ten bucks a month you can keep this blog ad-free, support the activism work I do, and get deals from cool businesses Click here for details

Interviews with Amazing Activists!!  Help Activists tell our movement’s history in their own words.  Support In Our Own Words:  A Fat Activist History Project!

Dance Classes:  Buy the Dance Class DVDs or download individual classes – Every Body Dance Now! Click here for details 

If my selling things on the blog makes you uncomfortable, you might want to check out this post.  Thanks for reading! ~Ragen

Cyborg gel implant fights diabetes with light

Light can now be used to heal diabetes in mice. By implanting a transparent gel that contains genetically modified light-sensitive cells, researchers have demonstrated a new type of implant that could one day be used to treat disease and monitor toxins in people.

“Light is a great tool to interface with biological systems, but there is a fundamental problem. It gets scattered when it hits tissue, and at depths much thinner than our skin,” says lead author Myunghwan Choi of Harvard Medical School in Boston.

Choi and his colleagues designed an implantable gel that could get around this, by guiding light under the mouse’s skin. In experiments, the team impregnated the gel with different types of genetically modified cells before implanting it.

To control diabetes, the team shone light into the mouse and at the implanted gel using a fibre optic cable attached to its head. The light triggered cells in the gel to produce a compound that stimulated the secretion of insulin and stabilised blood glucose levels. Separately, the team also showed they could monitor for cadmium poisoning using cells that fluoresced when the mouse was under stress from the toxin.

Cut the cord

Though still at the prototype stage, the ultimate idea is to reduce the need for doctors to perform repeated injections and blood tests to monitor or treat patients.

“The promise is there,” agrees Fiorenzo Omenetto, a biotechnologist at Tufts University in Medford, Massachusetts. But he adds it will have to get a little easier to live with than the current implant. “The tough thing here is the presence of a large implant and a fibre sticking out of your head. Not something I’d want if I were diabetic.”

Choi’s team plans to work on making the gel more user-friendly. For example, he says, “we are thinking of adding a micro-LED with a wireless power receiver [to the gel implant].”

“Genetically modified cells have been engineered for a variety of applications ranging from the treatment of cancer to the prevention of gout,” wrote Warren Chan of the University of Toronto, Canada, in a comment piece published alongside the work. “This suggests that the implantable hydrogel could be used for many biological and clinical applications.”

Journal reference: Nature Photonics, DOI: 10.1038/nphoton.2013.278





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UNC-Chapel Hill will test new device aimed at diabetes and obesity

— UNC-Chapel Hill researchers are testing a promising device that fights two of the most common health problems that Americans face – obesity and diabetes.

The EndoBarrier is a thin sleeve made of a plastic-like material that lines part of the upper digestive tract so that food simply passes through that section rather than undergoing full digestion.

A team led by Dr. Laura Young of the UNC Diabetes Care Center is part of a nationwide, 500-patient, 20-site study of the device. It has begun seeking local volunteers to participate.

The EndoBarrier has been approved for use in Europe and various countries elsewhere, including Australia, Chile and Israel. It must undergo a large-scale test here, though, before the U.S. Food and Drug Administration will allow it to be marketed in this country.

Diabetes, which is characterized by problems controlling high glucose levels in the blood and often closely tied to obesity, is a big cause of heart disease, stroke and complications that include loss of eyesight and kidney failure.

In patients elsewhere, the EndoBarrier has substantially reduced patients’ weight and lessened and even reversed the symptoms of Type 2 diabetes, by far the most common type.

The device’s effects are similar to those triggered by gastric bypass surgery. One advantage, though, is that it doesn’t require surgery. Instead, it is put in place via the mouth and throat by a relatively simple procedure involving a flexible instrument .

The procedure usually takes about 15 minutes, Young said. And unlike surgery, it’s easily reversible if it causes problems.

If it is effective, she said, the device could also reduce a patient’s need to use various medications for diabetes.

More than 650,000 people in North Carolina have been diagnosed with diabetes, according to the U.S. Centers for Disease Control and Prevention. Nationwide, the number of new cases has been climbing since 1992 and has nearly tripled since then.

The study is focused on the device’s effect on Type 2 diabetes, Young said, with weight loss a secondary interest.

Once the EndoBarrier is installed, improvements in patients’ diabetes symptoms often come within days, before the gradual weight loss that the device causes even kicks in, according to earlier studies and results with patients in other countries.

The effects on diabetes appear to come by not just blocking the body from digested food but also altering hormonal signals that part of the digestive tract sends to other parts of the body, Young said.

“We think it’s a way to help the body respond to the food that comes through it in a different way,” she said.

In earlier, smaller studies, it was effective helping patients controlling blood glucose levels and effective in reducing weight by often double-digit percentages.

It also caused various problems for some patients, including abdominal pain, bleeding and obstructions by the device.

The EndoBarrier was developed by GI Dynamics, Inc., a 10-year-old company based in Lexington, Mass.

Dr. David Maggs, the chief medical officer for the company, said that both the device and the technique of putting it in place have been improved since the early studies. Those changes have significantly reduced the complications, he said.

Another issue with the device is whether its effects last. The EndoBarrier will remain in study participants only for 12 months, the standard period for use in patients elsewhere in the world.

Researchers will continue to follow patients’ conditions for several weeks after the device is removed, Young said, in hopes of learning more about what happens after it is out.

At this point, more than 1,000 patients have had the device implanted, Maggs said. After it is taken out, there seems to be a “legacy effect” that keeps blood glucose at improved levels and weight down, but there is only limited data so far on that.

If the trial proves that the device works and is safe, it is expected to be widely available by 2017.

Price: 919-829-4526

Local Researchers Make Link Between Night Shift Work & Diabetes

PITTSBURGH (KDKA) — If you regularly worked the night shift, even if you’re retired now and keep a normal daytime schedule, you’re at higher risk of a common disease: diabetes.

Researchers at the University of Pittsburgh interviewed 1,000 retired night shift workers, classified them into 0 to 7 years, 8 to 14 years, 15 to 20 years, and more than 20 years.

“Our definition was any non-overtime work that fell within the midnight to 6 a.m. window,” says University of Pittsburgh’s Dr. Timothy Monk.

Both body mass index, or BMI, and diabetes rates were higher for night shift retirees compared to day workers.

Even when BMI was taken into account, the risk of diabetes was 1.4 to 2 times greater and there was no difference among the groups, suggesting that any time on night shift might be associated with a higher risk.

The way the body processes energy and uses the hormone insulin can be affected by sleep deprivation and disrupted circadian rhythms, which is your internal clock.

Just about everyone works the night shift at some point in their career, and many jobs are crucial in the overnight hours.

So eliminating night shift is impractical. But it could be made more sensible.

“In many cases, there are situations where it is not always vital that people work through the night. There are ways of having them, for example, work in the evening, or share the work, rather than have them do an overnight. Because there is a cost,” Monk says.

And just because you’ve worked a night shift doesn’t mean diabetes is a done deal.

“Even with this increased likelihood of getting diabetes, 75 percent of the retired shift workers did not get diabetes. So that gives us hope.” Monk said.

If you work night shift, you might want to pay attention to this risk.

Watch your diet, get regular exercise, and ask your doctor about testing your blood sugar at check-ups.

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