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.

Chronic stress may lead to diabetes

Dr S V Madhu, the lead researcher, said increased secretion of the stress hormone—cortisol—leads to redistribution of fat, central obesity and insulin resistance. He added, “Higher stress levels also causes activation of oxidative and inflammatory pathways resulting eventually in development of type II diabetes.”

Dr Madhu, who heads the medicine and the endocrinology and metabolism division at UCMS, said this is the first study that has used different stress scales to characterize chronic psychological stress and evaluate its role in development of diabetes.

Doctors said, among the stress scales, the ability to cope with stress was found to be the strongest independent predictor of diabetes with an odds ratio of 0.77 that translates to a 33 percent lower risk of diabetes. “This is a positive finding. It shows that de-stressing mechanisms such as yoga, listening to music, sports or travelling can reduce the risk factor,” said another senior doctor.

Simply put, diabetes is a condition in which the body has trouble turning food into energy. All bodies break down digested food into a sugar called glucose, their main source of fuel. In a healthy person, the hormone insulin helps glucose enter the cells. But in a diabetic, the pancreas fails to produce enough insulin, or the body does not properly use it. Cells starve while glucose builds up in the blood.

There are two predominant types of diabetes. In Type 1, the immune system destroys the cells in the pancreas that make insulin. In Type 2, which accounts for an estimated 90-95% of all cases, either the body’s cells are not sufficiently receptive to insulin or the pancreas makes too little of the hormone, or both.

With more than 63 million diabetic patients, India is second only to China in the number of people living with the ailment. However, awareness about the disease remains low, says Dr B M Makkar from Research Society for the Study of Diabetes in India, RSSDI.

“Studies show almost 85 percent of type II diabetics are overweight. However, only six to ten percent are aware that being overweight put them at a higher risk for diabetes,” Dr Kakkar added.

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. 

Dog Diabetes: What to Watch For



Dog via Shutterstockby petMD | petMD.com

Diabetes-Related Emergencies

Diabetes in dogs is treated with insulin, much the same way as it is in humans. But if too much or too little insulin is administered, it can be very dangerous for the animal.

What To Watch For Diabetes causes high blood sugar levels and is signaled primarily by excessive urination, excessive drinking, increased appetite and weight loss. In cases where the diabetes is not treated promptly and allowed to progress to the point of a crisis, symptoms may include a loss of appetite, weakness, seizures, twitching, and intestinal problems (diarrhea or constipation).

Primary Cause

Diabetic emergencies can be caused by either injecting too much or too little insulin, or not treating the diabetes in the first place. Both cases are equally dangerous for the dog and can cause coma or death. In cases where the diabetes is not treated, it can progress to diabetic ketoacidosis, a very serious condition that can cause death of your pet. Diabetic ketoacidosis can also be seen in dogs where the diabetes had been regulated and yet in which another condition has developed affecting the body’s ability to regulate the diabetes.

Immediate Care

If signs of an insulin dosage problem are noticed, it should be treated as an extreme emergency. The following steps may provide aid to your dog until you are able to bring her to a veterinarian (which should be as quickly as possible):

Syringe liquid glucose into the dog’s mouth. This can be in the form of corn syrup, maple syrup, honey, etc. If the dog is having a seizure, lift its lips and rub glucose syrup on the gums. Be careful not to get bit.

Veterinary Care

Depending on the cause of the crisis, dogs suffering from diabetic emergencies may need to be given glucose or insulin intravenously. In cases of diabetic ketoacidosis, hospitalization is required to provide insulin and electrolyte therapy. Glucose levels will be checked every one to three hours to monitor response of the treatment.

Treatment

Once the emergency has passed, normal insulin treatment will resume.

Living and Management

Always make sure you have a supply of glucose, honey, or corn syrup available for emergencies. Follow your vet’s instructions for the proper schedule and dosage of insulin treatments. Keep the insulin in a fridge and before administering, make sure it has not expired. The insulin should also be rolled — never shaken — prior to administration.

Prevention

Obesity has been linked to diabetes; consult with your veterinarian if weight loss can be of assistance in your dog’s case. Also, be cautious when administering steroids (i.e., prednisone), as chronic use of the drug may cause the onset of diabetes in dogs.

If you are unable to consult with your veterinarian, you can check your dog’s symptoms on petMD.com with the Symptom Checker tool.

More From petMD.com:

petMD’s Symptom Checker

Comatose Dog Care

Dog Seizures and Convulsions

How to Give a Pet Liquid Medication (VIDEO)

Chinese Jerky Treats Causing Pet Deaths Prompts FDA Probe

Grape and Raisin Poisoning in Dogs




Step out this Saturday and walk to stop diabetes at Waterfront Park

LOUISVILLE, Ky. (WHAS11) — This Saturday morning, thousands of people will walk at Waterfront Park to stop diabetes. For the sixth year I’ll be there as WHAS11 sponsors this great family event.

It’s a disease striking 400,000 Kentuckians and is hitting people of so many ages, that diabetes specialists say they are overwhelmed with patients.

A diabetic must think about everything they eat and how that will affect their body, requiring even young people to figure out quickly, how they will cope.

At 14 Caleb Williams, a freshman at Eastern High School, is a standout. 

You can point to many things as to why but if you ask his parents they’ll tell you right away his attitude.

“He doesn’t complain. He does not complain about having to do it,” Amanda Jacobs, Caleb’s mom, said.

Caleb’s been dealing with type one diabetes since sixth grade.

“I think he’s doing wonderful job. Caleb is always positive never complaining. Never says why is it me? I have to deal with this,” Travis Williams, Caleb’s father, said.

Caleb said he was stunned when he learned about this diagnosis.

“I didn’t know how to accept it at first, but I learned quickly,” Caleb said.

Did he ever; Checking blood sugar levels is what he lives with each day of his life.

“These are my strips. I just get one and put it in my meter and you push this,” Caleb said as he pricks his finger.

“Then I just touch this. It’ll come up on the screen…160. OK, so it’s a little high but not bad. I feel good,” Caleb said.

Normal blood sugar levels for people without diabetes range from 70-130.

Being type one means Caleb’s pancreas no longer produces any insulin. Insulin essentially breaks down food and keeping your energy levels consistent.

It’s the see-saw life of a type one diabetic and it requires constant checking. Amanda Jacobs is thankful that Caleb is taking charge.

“It’s so hard to think about a 14-year-old having to give themselves insulin for everything that you eat,” Amanda Jacobs said.

So how does he get insulin so crucial for survival?

He injects it several times a day, with a device called the NovoPen that he carries everywhere.

“According to what I’m eating I’ll turn the dial and then insert it into my arm and push it down, my arm or stomach area,”

Travis Williams, Caleb’s dad, says diabetes runs in his family telling me his family members didn’t take care of it or treat it well.

“Just the long term effects; getting him to understand it’s not about right now it’s about 5-15 years from now,” Williams said.

A hard sell to a 14-year-old who is on the run but fortunately for Caleb and his parents, this diabetic is smart about his future.

“I just haven’t let it get to me and I’ve taken care of myself pretty well,” Caleb said. “I hope someday there will be a cure.”

This is more than a walk. The event offers free vision and blood sugar screenings plus vendors with the latest diabetes technology.

WHAS11 is proud to support the Step Out: The Walk to Stop Diabetes. It’s a fundraiser for the American Diabetes Association. It is this Saturday; registration at 9 a.m., the walk begins at 10 a.m. You can find us on the Great Lawn at Waterfront Park.

For more information on the walk and to register, call this local toll free number 1-888-diabetes ext: 3317.
 

Tom Hanks reveals he has Type 2 diabetes

Dr Holly Phillips, medical contributor for America’s CBS TV network, said: “In
dramatic weight gain and dramatic weight loss, the equilibrium of the body
is just completely off. So that might predispose him to developing Type 2
diabetes later.”

“He’ll have to watch what he eats very closely, he’ll need to exercise
regularly, but there’s no reason he can’t live a perfectly normal life,”

Hanks revealed his diagnosis after Letterman commented on how “trim”
he was looking.

The actor added: “It’s controllable. Something’s going to kill us all,
Dave. My doctor said ‘If you can weigh as much as you weighed in high school
you will essentially be completely healthy and will not have Type 2
diabetes. I said ‘Well, I’m gonna have Type 2 diabetes because there is no
way I can weigh as much as I did in high school.'”

Asked what he weighed in high school the actor joked that he had been “96
pounds then,” adding: “I was a very skinny boy.”

It is estimated that at least 366 million people worldwide suffer from
diabetes, with the vast majority having Type 2, a condition in which the
body does not produce enough insulin to maintain normal blood sugar levels,
or the insulin produced does not work properly.

The condition has been linked to obesity, poor diet and sedentary lifestyles
and can lead to serious complications including kidney damage, blindness,
nerve damage, heart disease and limb loss. Experts believe most cases could
be prevented by a healthy lifestyle.

Other high profile figures who suffer from Type 2 diabetes include the actress
Halle Berry, who was diagnosed at the age of 19 after collapsing into a
diabetic coma on the set of a TV show.

Hanks is being tipped for a possible third Oscar for his latest film Captain
Phillips. He plays Richard Phillips, captain of the Maersk Alabama which was
captured by Somali pirates in 2009.

Novo Nordisk to invest up to $3.7 bln on diabetes pills


COPENHAGEN |
Mon Oct 7, 2013 8:55am EDT

COPENHAGEN Oct 7 (Reuters) – Novo Nordisk plans
to invest up to 20 billion Danish crowns ($3.65 billion) on
developing diabetes tablets intended to replace traditional
insulin injections, it said on Monday.

The Danish company said it planned to spend the money
through to 2020 on six diabetes pills it has under development
and that the sum included potential production facilities.

It estimates the global market for diabetes tablets could be
worth more than 100 billion crowns a year from the beginning of
the next decade, a spokesperson said, confirming a report in the
Danish business newspaper Borsen.

In the conventional treatment, insulin has to be injected
into the bloodstream, something that scares off many potential
users in the early stages of diabetes.

The challenge for the tablet technology is to get the
insulin through gastric acid and into the bloodstream.

Novo Nordisk, the world’s largest insulin producer, aims to
develop both an insulin and a so-called GLP-1 agonist in tablet
form. The company has around 500 employees working on the
development of the tablets, the spokesperson said.

It will spend around 1 billion crowns on the projects this
year, with investment increasing towards possible product
launches early next decade.

At 1235 GMT, Novo Nordisk shares were flat at 913.5 crowns.

(Reporting by Copenhagen Newsroom; Editing by Mark Potter)

Innovative technologies to manage diabetes better

Many health care solutions today, increasingly, ride on the technology train.

The pills and syringes, devices are still there, sometimes, but now have the ability to do their task faster, better, with greater sophistication, and least intrusion. That’s the way medicine is heading, and certainly in diabetes care.

An expert sitting at the very cusp where healthcare and technology have begun to work together, Satish Kumar Garg, the editor-in-chief, Journal of Diabetes Technology Therapeutics, talks to The Hindu on emerging technologies in diabetes care. He was in Chennai to deliver the 22nd Dr. Mohan’s Diabetes Specialties Centre Gold Medal Oration.

Real problem

“The real problem today,” he begins, “when we manage patients with diabetes is hypoglycaemia or low blood sugar. If we can take that one hurdle away, we can manage diabetes better.”

How does one reduce hypoglycaemia? “One way is to come up with new insulins that will limit low blood sugar conditions. There are some of these insulins that have already been approved in India and Europe, but not yet in the U.S. These are more reliable; they limit hypoglycaemia; effectively control blood glucose; and even help patients shed weight.” But here’s how technology gets a play here. “We ask people to check blood sugars two, three times a day, but what do they do with this. Now, it is possible to have metres that can provide advisories to the patient,” he says.

The moment they check their sugar, this data will show up on the iPhone. The phone has already mapped out their dosage, and based on their blood glucose, the phone will advice them on how much insulin to take.

“Now, if you can check your blood glucose continuously, it will reinforce for patients their actions: what dosage to take, should they eat more or less. This helps improve care.”

When patients start taking the right amount of oral drugs/insulin, this will reduce their glucose excursions both on the high and low end, data has shown.

Insulin pumps

Insulin pumps, very popular in the United States, indicate another way in which technology has come to the aid of the patient. There are over half a million people in the U.S. using insulin pumps, and data clearly shows that those using these devices have better glycated haemoglobin (HbA1C) levels and lower hypoglycaemia. This is because insulin is sent in smaller doses, not a large dose as when one takes insulin shot.

Since it is smart to marry relevant technologies to take on complex tasks; that is precisely what is happening in diabetes research as well. The culmination of that would be, naturally, replacing the human pancreas (which produces insulin) with an artificial one. Work is already on for this.

Dr. Garg predicts that the truly artificial pancreas will be complete in five years.

The artificial pancreas is actually a combination of the insulin pump and sensor. The part that has been approved so far, does the task of keeping a watch on the blood glucose, and when it senses a drop, it immediately sends a message to the pump to suspend insulin supply. This way, patients can avoid episodes of hypoglycaemia. The second innovation is for the sensor to tell the pump to speed up when sugars are high, but this is yet to be approved.

The third innovation already being contemplated is to use predictive algorithms to prevent hypoglycaemia events before they occur. “When we inject insulin, there is a delay in onset of action, for about 30 to 40 minutes. The sensor will know your glucose trends, so if it reads your glucose level at 110 mg, and it can predict that if you don’t act in the next half-hour, you are going down to 60 mg, and drop to hypoglycaemia,” he explains.

Missing part

If these innovations are also approved, then the only part that will be missing is glucagon. Dr. Garg says. “Glucagon is a hormone secreted by the pancreas to increase blood sugar levels. The artificial pancreas cannot do this as yet, but it will be a matter of time, I guess.”

Just as is the norm, technology which starts out expensive, will become cost-effective eventually. “It will make things easier for the patient. Imagine if he can control everything with his mobile phone. But the issue now is whether we can put this data on the cloud.”

Flip side

The problem with putting all this information on the cloud is leaving all of it open to those who can hack into it. “If someone hacks into the cloud, and we do have some crazy people, then, he can hack into your pump and increase the insulin dosage.”

You Can Now Manage Diabetes With a Wearable, Artificial Pancreas

We’ve been relying on artificial insulin injections for diabetes management for over 30 years now—which is practically ancient in modern medicine terms. But now, the FDA (presumably pre-shutdown) has approved an artificial, wearable pancreas that may finally kick all those painful insulin injections to the curb.

Made by Minneapolis-based medical device company Medtronic, the palm-sized pancreas helper continuously reads the users glucose levels and lessens the flow of insulin as need be—just a like a real pancreas would—almost. The difference between the two is that the pump doesn’t increase the amount of insulin in the presence or raised blood sugar. And while both glucose monitoring devices and insulin pumps are both currently available to diabetics, there was no system that combined the two until now.

You Can Now Manage Diabetes With a Wearable, Artificial Pancreas

And more than just being easier to use, this combined system may actually do more to save a patient’s life. Because both the monitor and pump are connected, if the beeper-like device notices that the wearer’s blood sugar is becoming dangerously low, it will automatically shut itself off for up to tow hours in order to prevent a diabetic coma.

Of course, no new technology is perfect, and the artificial pancreas does have a false alarm rate of 33 percent, according to Medtronics. Even with that, though, this is still one of the more accurate sensors we have available and is almost certainly one of the best ways to manage diabetes that we have available to us today. Plus, this is a major advancement that could, on day, lead to the production of an in-body artificial pancreas that really does work just like the ones Mom used to make.

Medtronic will start selling the device over the next few weeks, and they already have their eyes set on the next model: a fully automated version that requires absolutely zero input from the wearers themselves. [Singularity Hub]

Oregon Faith-Healing Parents Charged With Manslaughter In Daughter's Death …

On Friday, Travis and Wenona Rossiter were brought before a judge in Linn County, Ore., and plead not guilty to charges of manslaughter for their daughter Syble’s death. In February, the 12-year-old girl died in their home because of complications due to type 1 diabetes. She did not receive medical treatment for the condition.

“The 12-year-old had a treatable medical condition and the parents did not provide adequate and necessary medical care to that child,” said local police Captain Eric Carter. “And that, unfortunately, resulted in the death of her on February 5 of this year.”

Although unconfirmed, the couple is rumored to have withheld medical treatment in favor of faith-based healing.

The Rossiters attend the Church of the First Born, a church that allegedly encourages its members to seek faith-based interventions for illnesses instead of modern medical treatment. Its website cites biblical verse James 5:14, “If any be sick, call for the elders of the church, let them pray over him, anointing him with oil in the name of the Lord.”

Syble suffered from type 1 diabetes, formerly known as juvenile diabetes, a condition in which a person is unable to produce insulin. Without insulin therapy, type 1 diabetes is fatal. The most common cause of death among pediatric diabetics is diabetic ketoacidosis. Resulting from the buildup of fat metabolites called ketones, diabetic ketoacidosis  is characterized by vomiting, dehydration, confusion, and eventually leads to coma and death if left untreated. The clinical details of Syble’s death have not been made public.

With insulin therapy administered through injections or an insulin pump, people with type 1 diabetes can live nearly as long as the general population. 

The church websites explains that its members should comply with local health officials. “If you choose not to take your child to a doctor, then we urge you to immediately notify the county health department and the state department of human services using our corporate forms.”

Tragically, if the Rossiters are found guilty, they would not be the first parents deemed liable in the death of a child within the church. In 2012, Brandi and Russel Bellew, also of the Church of the first Born, pleaded guilty to criminally negligent homicide after their son, Austin Sprout Creswell, died at age 16 from an untreated infection secondary to a burst appendix. At least 22 children associated with the Church of the First Born have died from lack of medical treatment since 1964, according to the group Children’s Healthcare Is a Legal Duty.

A neighbor interviewed by local CBS affiliate KOIN 6 News described Syble as a quiet girl who enjoyed riding her bike. “She seemed shy to talk to people because they picked apples out of my yard,” the neighbor said.