Download - Trends and Issues on Diabetes Care
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ONDIABETES
CARE
MASTERS OF SCIENCE OF NURSING
School of Health Sciences
Graduate School
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Legumes Help
Improve GlycemicControl And
Lower HeartDisease Risk
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Eating plenty of beans, lentils,
chickpeas and other legumes
helps improve glycemic control
and reduce the risk of developingcoronary heart disease in patients
with diabetes type 2, researchers
from the University of Toronto
reported in Arch ives of InternalMedicineafter carrying out a
randomized, controlled trial.
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The participants were randomly
selected into one of two groups:
Low-GI legume group - they
were encouraged to eat more
legumes; by at least one cup a
day for three months
Insoluble fiber group - they were
encouraged to eat more
insoluble fiber, i.e. whole wheatfoods for three months
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The primary outcome was change in
HbA1c (hemoglobin A1c), thesecondary outcome was coronary
heart disease risk score.
The researchers reported thatlegume consumption of about 1 cup
(190 grams) per day appears to
contribute effectively to a low-GI diet,
and to reduce the risk of coronaryheart disease by bringing down blood
pressure.
http://www.medicalnewstoday.com/articles/184130.phphttp://www.medicalnewstoday.com/articles/184130.phphttp://www.medicalnewstoday.com/articles/184130.phphttp://www.medicalnewstoday.com/articles/184130.php -
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Below are some of the trial results:
In the low-GI legume group, HbA1cvalues went down by -0.5%
In the insoluble fiber group, HbA1c
values dropped by -0.3%
In the low-GI legume group, bloodpressure fell much more than in the
insoluble fiber group
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The researchers concluded:
"These findings linking legumeconsumption to both improved
glycemic control and reduced CHD
risk are particularly importantbecause type 2 DM is increasing
most rapidly in the urban
environments of populations in
which bean intake has traditionally
been high (e.g. India, Latin
America, the Pima Indians of
Arizona).
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Topical Simvastatin
Shown To
Accelerate WoundHealing In Diabetes
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A new study has found
that topically applied
simvastatin accelerates
wound healing in diabeticmice, suggesting
important implications for
humans with diabetes.
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An advantage of topicalapplication is that a
suitable concentration of
simvastatin can be appliedwithout risk of serious
systemic effects such as
kidney damage
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The investigators generated
a full-thickness skin woundon the backs of diabetic
mice. Each wound was
treated with a topicalapplication of either
simvastatin in petroleum
jelly or petroleum jelly alone.The application was
repeated on days four,
seven, and ten.
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After two weeks, the simvastatin-
treated wounds were more than90% healed, whereas less than
80% were healed in the wounds
treated by petroleum jelly alone.
The difference in wound closure
was greatest on day seven when
the simvastatin-treated wounds
were 79.26% healed comparedwith 52.45% in the control group.
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This study shows that
topical simvastatinsignificantly accelerates
wound recovery by
increasing bothangiogenesis and
lymphangiogenesis.
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This is a simple strategy that
may have significanttherapeutic potential for
enhancing wound healing in
patients with impairedmicrocirculation, such as
that in diabetes. Further
investigation is needed todetermine its clinical utility
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dermaPACE uses high-energy sound waves
when directed at the ulcer these
sound waves stimulate the
growth of new blood vessels
and creates an inflammatory
response that actually jump-
starts rapid healing of thewound
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Results from the study showed a
distinct difference in results between
the two therapies
dermaPACE andHyperbaric Oxygen Therapy(HBOT):
Overall, 57 percent of the foot
ulcers in the dermaPACE
group completely healed,
versus 25 percent in the
HBOT group.
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Researchers also noted a great
difference in the time and
sessions required for the twotherapies: dermaPACE
required only 15 percent as
many sessions as HBOT andonly three percent as much
time.
This technology is still in clinical
trials and will be for some time.
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Blocking Type 1Diabetes
Progression UsingPsoriasis Drug
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Type 1 diabetes occurs when the
body's immune system attacks
beta cells in the pancreas thatproduce the insulin needed to
metabolize sugars and other
nutrients into energy needed by
the body. The process usually
continues until the patient is
producing little or none of his or
her own insulin, requiring regularinjections of insulin to maintain
blood sugar levels at close to
normal levels.
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In a multicenter trial of 49patients, those receiving the drug
alefacept were producing the
same amount of insulin one year
after diagnosis, while patientsreceiving a placebo injection were
producing less, consistent with
the deterioration that usuallyoccurs after diagnosis with the
disease.
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Alefacept is an
immunosuppressant drug that
binds to and interferes with the
actions of certain immunesystem Tcells that are believed
to be involved with the
destruction of beta cells in thepancreas.
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Trial participants ranged in age from
12 to 35 and had recently been
diagnosed with type 1 diabetes.Twothirds were randomly assigned
to the group receiving alefacept
injections, with the remaining
patients receiving a placeboinjection of saline solution. The
participants received weekly
injections for three months, followed
by three months of no injections,
then three more months of weekly
injections.
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A year after receiving the
initial injections, the study
participants were tested forinsulin production using a
standard mixed meal
tolerance test, or "shaketest."
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Echo Therapeutics -
The Symphony
System
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It is a non-needle, non-invasive,
wireless transdermal continuousglucose monitoring system.
The Symphony System uses a
biosensor without the need to
prick the skin since it is
transdermal [it is an adhesive
patch placed on the skin].
F.D.A. approval is expected in2013 and is showing strong
successes in clinical trials.
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Testing is being done on
hospitalized critical care
patients who require multiplefinger sticks daily; it is well
documented that blood sugar
control is imperative duringacute illness and trends need to
be monitored. Studies are also
being conducted on out-patientswith diabetes. The transdermal
patch would require changing
every 24 hours.
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The needleless system
technology is a benefit for those
who dread needle placement as
well as having the ability tolower the risk of infection
especially in the hospital critical
care arena.
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HORMONES for
DM
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A newly discovered mouse
hormone may open the doorto better treatment for
diabetes
The hormone, called
betatrophin, triggers the
growth of pancreatic "beta"cells lost or ineffective in
diabetes.
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betatrophin can produce a
roughly seventeenfold increase
in these cells, and its increase
may partly explain the rapidgrowth of these cells seen
during pregnancy to feed
developing fetuses in mammals,including people.
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they cautioned that the
hormone's effects, which
the study team sees asisolated to beta cells,
need to be thoroughly
investigated in animalstudies for safety.
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The hormone was discoveredalmost by accident, as the
Harvard team investigated a
research compound that
basically recreates whathappens in diabetes. The
compound short circuits the
release of insulin in response toincreasing blood sugar.
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When that happened to the mice
in the study, their production of
the hormone betatrophin rampedup and spurred the growth of
insulin producing cells. Diabetics
often need daily insulin injections
to compensate for the condition,where in Type 2, or adult-onset
diabetes, the most frequent kind,
beta cells stop producing enoughinsulin, and in juvenile diabetes,
or Type 1, about 10% of cases,
beta cells have died.
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"Before it can be established if
this finding has any relevance to
human therapy it will need to be
established (that) the moleculedrives beta cell replication in
humans," according to beta cell
experts
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ARTIFICIAL
PANCREAS
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An "artificial pancreas," a device
that would constantly monitor
blood sugar in people with
diabetes and automatically
supply insulin as needed, maybe a step closer to helping
patients in what researchers are
calling a "major advance."
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A new study showed that a key
component of the device -- an
insulin pump programmed to
shut down if blood-sugar dips
too low while people aresleeping -- worked as intended
in a three-month study of 247
patients.
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This "smart pump," made by
Minneapolis-based Medtronic
Inc., is already sold in Europe,and the Food and Drug
Administration is reviewing it
now. Whether it also can be
programmed to mimic a real
pancreas and constantly adjust
insulin based on continuous
readings from a blood-sugarmonitor requires more testing,
but doctors say the new study
suggests that goal is in reach.
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Thank you and
God bless!