[acb-diabetics] many articles

[Patricia LaFrance-Wolf]

1.%% Diabetes Today 6-OCT-2009   Could Antioxidants Raise Diabetes Risk?
(Reuters) - Instead of protecting against diabetes, antioxidants --
compounds

in foods and supplements that prevent cell damage -- may actually increase
the chances of getting diabetes, at least in the early stages.  Antioxidants

are protective proteins that can prevent cell damage caused by charged
particles known as reactive oxygen species.  oxidative stress is thought to
add

to the progression of several diseases, including T1DM.  Because
antioxidants fight oxidative stress, they have become a popular food
supplement. But the

study leader said the picture appears to be a bit more complicated. "We
think there is a delicate balance, and that too much of a good thing,  might
be

bad," The team studied the effects of oxidative stress in mice fed a
high-fat diet for 12 weeks. One group of mice lacked an enzyme known as
Gpxl, which

helps counter oxidative stress. They found mice that lacked the enzyme were
less likely to develop insulin resistance -- an early sign of DM  -- than
normal

mice. But when they treated the enzyme-deficient mice with an antioxidant,
"they lost this advantage and become more 'diabetic," oxidative stress may
be

working not to damage the body but to inhibit enzymes that hurt the body's
ability to use insulin early on in the development of DM, and that
antioxidants

remove this protective mechanism. Other studies have suggested that
antioxidants can shorten lifespan in both worms and humans. clinical trials
in people

have shown that taking antioxidants does not protect healthy people from
developing diabetes. "My belief is that individuals who are otherwise
healthy

should not take antioxidants, but rather eat healthy and exercise," 

 

2.%% Maternal Arsenic Exposure and Impaired Glucose Tolerance during
Pregnancy 10/9/09   Accumulating evidence has shown an increased risk of
T2DM  in

general populations exposed to arsenic, but little is known about exposures
during pregnancy and the association with gestational diabetes (GD). [ 532

women living proximate to a Superfund Site] Conclusions:  Among this
population of pregnant women, arsenic exposure was associated with increased
risk

of impaired GTT at 24–28 weeks gestation and therefore may be associated
with increased risk of GD. In summary, GD is a major potential complication
of

pregnancy associated with negative health effects for both the mother and
infant.

 

3.%% MW Glycemic Control Better in ED Patients With a Primary Care Provider
10/13/09  — Emergency department patients with diabetes

who said they had a primary care provider had better glycemic control than
patients who did not have one [PCP]"The finding needs to be confirmed ," a
team

leader said "Nevertheless, it is evidence of the importance of PCPs in the
management of chronic illnesses such as DM, an issue that is likely to
become

crucial as the incidence of diabetes in the US increases and the supply of
primary care doctors decreases." [227 diabetics] "The next step is to
determine

what other factors are linked to the absence of primary care, he said. "Do
[these patients] lack money to buy insulin? Do they understand what it takes

to control diabetes?

 

4.%% MW Chinese Women With Gestational Diabetes [GD]at High Risk for Type 2
Diabetes  (Reuters Health) Oct 08 - Chinese women with GD are at
significantly

higher risk for developing T2DM and hypertension compared to pregnant women
with normal glucose tolerance. [139 Chinese women (45 withGD] At 15 years,

with the women at a mean age of 45 years, rates of hypertension and DM were
35.6% and 24.4%, respectively, in those who had GD vs 16.0% and 5.3%,  in
those

who did not. "The conversion rate to T2 increased steadily at an average
rate of 1.6% per year following a pregnancy affected by GD," the presenter
noted.

"We need to educate women with gestational diabetes about their future risks
and suggest lifestyle modifications. We should also offer regular
assessments

for women in this high risk group,"

 

5.%% MW High-Dose Atorvastatin Is a "Clinically Meaningful Intervention" for
Diabetic Foot Ulcers (Reuters Health) Oct 14 - High-dose atorvastatin may

reduce the incidence and recurrence of foot ulcers in DM patients. The lead
author said .[13 patients, 10 with T2]  There was no difference in ulcer
characteristics

or antibiotic use between the groups. In the low-dose group, all 6 ulcers
healed over a median of 49 days. In the high-dose group, 6 of 9 ealed over a

median of 89 days. In the low-dose group, however, 2 healed ulcers recurred
and 6 new ulcers developed within 108 days from baseline. There were no
recurrences

in the high-dose group, and only one new ulcer at 91 days from baseline.
"High-dose statins should be used more liberally among subjects susceptible
to

develop diabetic foot ulcer," J Diabetes 2009;1:

 

6.%% Heartwire  Thiazolidinediones (TZDs)Have a Role for Appropriate
Diabetic Patients Oct 20, 2009  — Although the (RECORD) trial and other
trials found

that  rosiglitazone [avandia] increases risk of heart failure and fractures,
(TZDs) are still useful for appropriate DM patients. This was the message

from 4 speakers at the IDF 2009 World Diabetes Congress.  "What is new is
that we have now looked into not only cardiovascular death and
cardiovascular

hospitalization, but also all types of cardiovascular disease--acute
coronary syndrome, angina, and so on--and still rosiglitazone is not
inferior to standard

glucose-lowering drugs," "I think we shouldn’t get distracted by
meta-analyses that have inherent limitations, one speaker said, and the
large randomized

controlled trials have been very reassuring to date," "The
Thiazolidinediones Intervention with Vit D Evaluation  [TIDE] study is
designed to give us the

definitive answer, but in the meantime, I'm reassured by the data, and I'll
continue to use both thiazolidinediones in appropriate patients --diabetic

patients with high glucose despite metformin and with no contraindications
to a thiazolidinedione such as heart failure," 

 

7.%% Heartwire  - Current Risk Equations May Overestimate CVD Risk in
Diabetic Patients  Oct 21,09 — The Framingham and United Kingdom Prospective
Diabetes

Study  (UKPDS) risk equations overestimate the probability of CV events in
people with T2DM according to IDF reports  "The key observation that seems
to

be emerging is that current risk models overestimate CV event risk in
diabetes patients," the session cochair said."On the one hand, most
countries are

now treating patients with DM as if they are all CHD– risk equivalent, and
clearly, the overestimation of risk scores suggests that that is potentially

wrong," On the other hand, risk scores may be overestimating risk because
clinicians are

treating patients appropriately. Researchers using different international
databases of patients with T2 showed that actual CV outcomes were less than

predicted outcomes."Framingham started to do these risk calculations in the
1970s, and this is a totally outdated population," he said, adding that
researchers

should investigate newer cohorts and redefine key risk factors. A new
risk-equation tool being studied might offer better information. It includes
the

following predictors: age at diagnosis, duration of DM, sex, pulse pressure,
treated hypertension, atrial fibrillation, retinopathy, HbA1c, albumin/
creatinine

ratio, and non-HDL cholesterol at baseline..

 

8.%% MNTD  Initial Research Shows Glucose Levels May Be Measured Painlessly
With Light In The Eye  14 Oct 2009   New non- invasive technology designed

to painlessly measure glucose levels in the human eye shows promise of one
day replacing the finger-stick blood test, according to results of a
pre-clinical

study. The study, using rabbits, showed that the eye-scanning technology
produced non-invasive, in-vivo glucose measurements that tracked blood
glucose

readings with only a 5minute delay. In addition, through validation
analysis, the mean absolute percent error for glucose prediction was below
13%, as

compared to an estimated 32% error commonly derived from the finger stick
blood test. The results of the study were presented at the Biomedical
Engineering

Society's 2009 Annual Fall Scientific Meeting.

 

9.%% MNTD Squeezing Out Diabetes With Substance In Grapes

15 Oct 2009  A naturally produced molecule called resveratrol, found in the
skin of red grapes, has been shown to lower insulin levels in mice when
injected

directly into the brain.. The findings suggest that when acting directly on
certain proteins in the brain, resveratrol may offer some protection against

DM. Prior research has shown that the compound exerts anti-diabetic actions
when given orally to animals with T2 but it has been unclear which tissues

in the body mediated these effects.  "Our study shows that the brain plays
an important role in mediating resveratrol's anti-DM actions, and it does so

independent of changes in food intake and body weight," said senior author."
He emphasized that his study does not support the conclusion that consuming

products made from red grapes, such as red wine, could alleviate DM. "The
main reason is that resveratrol does not cross the blood brain barrier
efficiently," 

he said. "In order for the brain to accumulate the same dose of resveratrol
delivered in our study, the amounts of red wine needed daily would surely
cause

deleterious effects, especially in the liver. The next step is to determine
precisely which neurons in the brain are mediating the effects of the
resveratrol.

 

10.%% IDF Insulin Delivered by Buccal Spray (Oral-lyn)Shows Promise
Oct/23/09 — Twelve puffs per day from a buccal spray unit can help
individuals with

impaired glucose tolerance (IGT) keep their blood glucose levels down. This
insulin delivery method provides hope that a new noninjectable type of
insulin

delivery system is on the way for both T1 & 2. "We are experimenting with
new routes for administering insulin because the most important problem in
DM

patients is injections," the lead author said. [they are] not accepted by
patients; they're painful and they're difficult to manage." "The device
delivers

the insulin to the oropharyngeal mucosa, so it doesn't go to the lungs .
.the absorption is very good, giving a peak 10min  after administration." In
the

puffer, regular acting human DNA insulin is dissolved in a buffer at neutral
pH, identical to injection. [31 patients with IGT; randomized to take 4, 6,

or 12 buccal spray insulin puffs in 2 doses. One dose before a standard oral
glucose tolerance test, and the other was taken 30 min later. One puff is

equivalent to 1 unit of insulin. 2 hours after ingestion of glucose,
patients who had taken the 12-puff dose had blood glucose levels that were,
on average,

29.6% lower than patients who did not receive any treatment. No hypoglycemia
or other adverse events were noted during the study. The buccal spray has

already been tested successfully in short-term trials among patients with T1
and T2 Long-term studies are currently in the works.

 

11.%% IDF Releases New Guidelines on Diabetes Management

Oct 26,09 These include the first-ever international guidelines on the
management of diabetes in pregnancy and guidelines on the use of

self-monitoring of blood glucose (SMBG) among T2DM  not being

treated with insulin.

Pregnancy and Diabetes Guidelines Call for Universal Screening

 "The guidelines were created with evidence-based medicine. Then we asked an
international group [of experts] to give us their opinion," the presenter

told Medscape Diabetes & Endocrinology. "There was no international standard
[for the diagnosis and management of gestational diabetes GDM ], there was

a lot of confusion,  women were suffering, and their pregnancy outcome was
affected by having no standard by which to judge whether their diabetes was

worth treating or not. This is the first time there is a worldwide
consensus."

A key message of the new guidelines is the importance of universal
screening. "Look for hyperglycemia in pregnancy, Preconceptional

counseling [also] has to be universal.

.Self-Monitoring of Blood Glucose in Noninsulin-Treated T2  highlights
include the following: SMBG should be considered at the time of diagnosis
but should

only be used when patients, their caregivers, and/or their healthcare
providers have the knowledge and willingness to incorporate findings into
the DM

management plan. SMBG should be considered a part of ongoing diabetes self-
management education.  protocols should be individualized. Patients and
their

healthcare providers should agree on how to use SMBG data. Tools used to
measure SMBG must be easy to use and accurate.  Both sets of guidelines have
key

features that differentiate them from guidelines on the same topics put out
by other diabetes associations, such as the ADA, right now they don't
subscribe

to the philosophy of universal screening [in pregnancy]. They talk about
selective screening. Our guidelines not only talk about universal screening
but

almost assume that every woman has diabetes [and] doing the testing is to
reassure her that she doesn't.  a unique feature of the IDF SMBG guidelines
is

that they clarify the role of SMBG in DM patients who are not receiving
insulin therapy. "For the noninsulin-treated individuals, [other guidelines]
say

that it's a good idea to incorporate SMBG, . . . but there is no real
clarity as to what to do about it.

 

12.%% MW Advancing Therapies for T2DM: Physiologically Based Approaches
10/16/2009  The societal and financial burdens associated with DM are
immense.

Of the 23.6 million Americans estimated to have diabetes in 2007, 90% -95%
have T2DM.  In the US in 2007, medical costs associated with DM totaled $174

billion... one-third of this cost was attributed to disability, work loss,
and premature mortality, with the remaining two-thirds attributed to direct

medical costs. Cardiovascular disease (CVD) is the underlying cause of the
majority of morbidity and mortality in patients with DM. Despite continual
evolution

of nationally recognized treatment guidelines and the advent of new
antidiabetic agents, a significant percentage of patients do not achieve an
acceptable

level of glycemic control according to standards set forth by the (ADA) and
the Amer Asso of Clinical Endocrinologists (AACE). . reappraisal of current

treatment strategies for reducing the burden of T2 and identification of
strategies for overcoming barriers to optimal patient care are warranted.
[54

pg paper]    Summary - Diabetes is a progressive disease with a complex
pathophysiology that includes peripheral insulin resistance, declining
ß-cell function

and mass, declining insulin secretion over time, inappropriate glucagon
secretion and hepatic glucose production, and deficiencies in amylin and
GLP-1.

These defects underlying T2 offer clinicians a number of therapeutic
targets, and a number of available therapeutic interventions target multiple
defects.

Metformin and TZDs improve peripheral insulin resistance, increase glucose
uptake, and suppress hepatic glucose production; sulfonylurea and glinides
stimulate

insulin secretion from pancreatic ß cells; a-glucosidase inhibitors delay
carbohydrate absorption from the GI tract; DPP-4 inhibitors and GLP-1
agonists

stimulate glucose- mediated insulin secretion from pancreatic ß cells and
suppress glucagon release; GLP-1 agonists also delay gastric emptying; and
amylin

agonists suppress glucagon release and delay gastric emptying. Combination
therapy that includes drugs with complementary mechanisms of action is most

effective. Other factors to consider when initiating combination therapy
include the patient's hyperglycemic profile (fasting, postprandial, or mixed
hyperglycemia)

and the efficacy, safety, adverse event profile, tolerability, ease of use,
expense, and nonglycemic effects of the individual drugs. Optimal patient
care

cannot be achieved without recognition of potential patient- and
provider-driven barriers and implementation of strategies to overcome these
barriers.

 

13.%% Heartwire    Less Exposure to Cardiovascular  Risk Factors With
Intensive Diabetes Intervention Oct 26, 09  4-year results from the(Look
AHEAD) study

has shown that an intensive lifestyle intervention designed to achieve and
maintain weight loss over the long term produces sustained weight loss and
improvements

in fitness, as well as improvements in glycemic control, systolic BP, and
HDL-cholesterol levels. The only risk factor that remained unimproved [with
this

program] and a calorie-reduced diet was LDL cholesterol. [5145 overweight or
obese subjectss with T2]. At 4 years, patients assigned to active therapy

lost approximately 6.15% of their body weight, compared with 0.88% in the
control arm.

 

14.%% IDF Optimal Insulin Dosing Regimen for Type 2 Diabetes Identified Oct
26, 09  — T2DM patients requiring insulin will do best if they start with a

basal insulin and then add prandial insulin as

neededl. In a 3-year the team randomized 708 T2 patients who had suboptimal
glycated hemoglobin (HbA1c) levels, despite taking metformin and
sulfonylurea,

to 1 of 3 insulin regimens. "Those commencing therapy with a basal or
prandial based insulin had better HbA1c control than patients commencing
with a biphasic

insulin. Patients commencing therapy with basal insulin had fewer
hypoglycemic episodes, less weight gain, and a smaller increase in their
waist circumference.

. These findings provide clear evidence to support starting insulin therapy
in people with T2 with a once a day basal insulin with the subsequent
addition

of a mealtime insulin if glycemic targets are not met." the presenter said.N
Engl J Med. Pub online October 22, 2009.

 

15.%% MW Depression and Increased Mortality in Diabetes: Unexpected Causes
of Death 10/22/2009  Conclusions:  Patients with DM and coexisting
depression

face substantially elevated mortality risks beyond cardiovascular [CV]
deaths. Depression affects about 20- 25% of patients with diabetes, nearly
twice

as many as in the general medical population.  Recent evidence suggests that
patients with diabetes and coexisting depression have higher all-cause
mortality

relative to DM patients with no depression. Depression -diabetes comorbidity
is characterized by younger age of DM onset; poor management of diet,
exercise,

and medications; less favorable glycemic control; and higher risk of
complications. most research on depression and mortality has focused on CV
disease.

Hypothesized mechanisms include biologic, behavioral, genetic, and social
factors,

ranging from inflammatory factors (eg, C-reactive protein) to physical
inactivityand lack of social support.  We sought to determine whether
depression

was associated mainly with mortality caused by CV disease or was also
associated with increased risks of death from other common medical causes.
[4,623

patients with T2] Discussion-  in this study of a primary care cohort of
patients with DM, we found that atherosclerotic CVr disease and cancer were
the

2 leading causes of death.. infection, dementia, renal failure, and chronic
obstructive pulmonary disease, were less common. Depressed patients were
more

likely to be single women and slightly younger, but they had longer duration
of DM, less healthful habits, worse glycemic control, and more medical
comorbidities.

Poor adherence to medications among depressed patients represents one
behavioral pathway to higher mortality across illnesses. Physiologic changes
evident

among depressed patients with CV disease, such as inflammatory processes,
can also play a role in noncardiovascular mortalities, such as dementia. The

association of depression with changes in neuroendocrine system regulation
and immune system function could also increase mortality risks beyond CV
disease.

 

16.%% MRI in Diabetes: First Results  10/20/2009   In a normal state,
glucose uptake by the pancreas causes pancreatic ß cells to secret insulin.
In a

diabetic state, the body does not produce or properly use insulin. This
results in abnormally high blood sugar levels . The cause of T1DM is an
autoimmune

attack of insulin-producing ß cells by the body's own lymphocytes. As a
result, ß cells die and the patient becomes insulin-dependent, requiring
insulin

infusions. T2 results in the improper action of insulin and a relative
insulin  deficiency. While it is often initially managed by increasing
exercise

and by dietary modification, medications typically are needed as the disease
progresses. In recent years it has become clear that to diagnose and treat

DM it will be necessary to implement an integrative approach, which will
include participation of various biologic disciplines ranging from molecular
and

cellular biology to more technology- driven approaches such as molecular
imaging in living systems. However, imaging of insulin-producing ß cells in
the

pancreas represents a challenge even to imaging experts due to the small
size of the object to be imaged. Pancreatic islets are small structures
within

the pancreas and occupy about 2% of its volume

....Conclusions - MRI is a powerful technique capable of detecting small
micron-size objects such as pancreatic islets. It can also provide
information

on the presence of inflammatory cells within the pancreas, changes in islet
vasculature and in BCM during DM s

progression and persistence of transplanted islet grafts. It is likely that
with the development of noninvasive imaging methods and specific probes,
clinicians

will soon be able to obtain this valuable information, which will no doubt
tremendously assist in achieving insulin independence in DM patients DM. Am

J Roentgenol 2009;193(2

 

17.%% Sex Hormone-Binding Globulin and Type 2 Diabetes 10/22/09N Engl J Med.
2009;361:  Summary  Sex hormone-binding globulin (SHBG) regulates the levels

of free sex hormones by sequestering circulating sex hormones and
participates in some of the biological

actions of sex hormones by mediating cellular uptake  Sex hormones have long
been associated with the metabolic syndrome,  and differences in levels of

free and total plasma sex hormones, as well as SHBG levels, have been
associated with T2 in both men and women.  However, it has been difficult to
determine

whether biomarkers such as SHBG can predict the risk for T2. [530 men and
women with  newly diagnosed T2.] Mendelian randomization analysis was
applied.

Results - plasma SHBG levels as well as SHBG polymorphisms were strikingly
predictive of T2 in both men and women -- the risk for T2 among participants

with SHBG levels in the highest quartile was only one tenth of the risk
among those with levels in the lowest quartile.  If these results are borne
out

by additional examination, SHBG polymorphisms could be extremely useful
predictors of T2 risk and excellent biomarkers for early intervention.
Medscape

Genomic Medicine 

 

18.%%Carotid Thickness Testing Improves Cardiovascular [CV] Risk Assessment
in Diabetics  (Reuters Health) Oct 16 - Carotid intima- media thickness
(IMT)

is a key predictor of CV mortality and morbidity in patients with T2DM.
"Carotid IMT and microalbuminuria must be included in the conventional risk
assessment."

the researchers say. [10 years;102 T2 subjects without CV disease.]  Carotid
artery IMT of 0.9 mm or more, urinary albumin excretion of 30 mg/day or
more,

and Framingham risk score of 20 or more together were associated with an
8.8-fold increased likelihood of cardiovascular primary endpoints,. J
Diabetes

2009;1:188-193.

 

19.%% MedWatch  Accusure Insulin Syringes- Recall  Qualitest Pharmaceuticals
and FDA notified healthcare professionals of a nationwide recall of Accusure

Insulin Syringes. All syringes, regardless of lot number, are subject to
this recall. These syringes were distributed between Jan 2002 and Oct 2009
to

wholesale and retail pharmacies nationwide (including Puerto Rico). The
syringes in these lots may have needles which detach from the syringe. If
the

needle becomes detached from  the syringe during use, it can become stuck in
the insulin vial, push back into to the syringe, or remain in the skin after

injection. Consumers who have any Accusure insulin syringes should stop
using them and contact Qualitest at 1-800-444-4011 for reimbursement.

 

20.%% IDF  "One Size Fits All" May Not Be Best Glucose-Lowering Strategy
New post hoc analyses of the (ACCORD) trial data.  Oct 27, 09 "From the
glucose-lowering

arm of the trial, we now know that treating everybody to a very aggressive
target probably is not safe,..  the analyses suggest that there are very
likely

to be subgroups for whom it is the right treatment, whereas for other
subgroups it's not indicated at all," the presenter said. Speculating on
results

from further research, he said that " 'one size fits all'--attacking lipids,
BP, and glucose with equal fervor--will probably not be the best treatment

approach." ACCORD was stopped due to a 22% excess of all-cause mortality  in
the intensive arm. 3 baseline factors among patients in the
intensive-glucose-lowering

arm emerged as predictors of increased risk of mortality: HbA1c of 8.5% or
greater, neuropathic symptoms, and aspirin use. "it may be hypothesized that

a high HbA1c  is a surrogate for relative severity and metabolic control,
history of neuropathy is a surrogate for established and significant
microvascular

disease, and aspirin use may be a surrogate for known or suspected CVD,"  In
addition, patients who were unable to attain target glucose levels within

one year also appear to have a higher mortality risk. "If patients start
with an HbA1c above 8%, and treatment is intensified, and they are unable to
make

much progress in lowering it even to the 7to7.5% range, that’s a bad
sign,"We still do not know the mechanisms involved in this unfavorable
finding." 

"To me, the clinical message from all this is 'Yes, we want to get HbA1C
down, but at the same time, if you're not succeeding, at a certain point,
one

has to give up; there's no point in just progressively giving more and more
medication if the HbA 1C is not coming down.'"

 

21.%%MNTDA Child's Memory Can Be Affected By Diabetic Episodes

21 Oct 2009  Children who have had an episode of diabetic ketoacidosis, a
common complication of DM, may have persistent memory problems, according to

a new study from researchers at the UC Davis Center for Mind and Brain.
Diabetic ketoacidosis [DK] occurs when the body is lacking insulin and burns
fat

for energy instead of sugar. Apart from nausea, vomiting and fatigue,
patients can feel mentally sluggish. If the condition is not treated,
patients may

fall into a coma.  The new study shows that children known to have had such
an episode in the past performed worse on memory tests than children with DM

who had not had such an episode. Diabetic ketoacidosis -- and its
consequences -- can be avoided with proper glucose control in patients known
to have

diabetes,  Many cases, however, occur at the time of diagnosis of diabetes
and these cases are more difficult to detect early. The team leader said.
"These

results underscore the importance of maintaining control of known diabetes
and prompt diagnosis of new cases should DK symptoms arise," [33 children
with

T1 and hist of DK; 29 with T1 and no hist DK] Children with history of KD
performed significantly worse on the memory tests than children without a
history,

they found. The results back up anecdotal accounts from parents, who
complain of slight but consistent memory deficits in their children with T1
that are

not captured by IQ measures or other typical assessments, such as school
grades.

 

22.%% IDF Schizophrenia Plus Diabetes Linked With Higher CAD Yet Lower
Revascularization Rates 10/28/09 — In a large cohort study, individuals with
both

schizophrenia and diabetes had a higher prevalence of CAD [coronary artery
disease]than individuals with DM only, yet they were 54% less likely to
undergo

revascularization [surgery to enhance blood flow] (CABG or PCI) "This
warrants further investigation in terms of whether this is an access-to-care
issue–

patients are not being referred for revascularization--or a  healthcare
-system issue--patients are not showing up for their appointments and are
not being

followed up," a study author said. The study reflects the concerns behind
the recently issued joint statement that "outlines clearly that DM and CVD
in

severe mental illness is a major problem, and it is not being adequately
treated,"

 

23.%% ADA Diab Professional Resources  HbA1c levels during the first year of
diabetes correlate with HbA1c levels during adulthood

Oct/ 28/09  Standardized electronic documentation from 6,518 diabetic
patients was evaluated to determine the long-term tracking of metabolic
control in

patients with T1DM of pediatric onset. Averaged HbA1c levels were 6.99
during the first 3-12 months after the onset of diabetes and 8.35 during
adulthood.

In addition, HbA1c during adulthood could significantly be predicted by
HbA1c levels during the first year of DM, irrespective of the age of
diabetes onset

(i.e., preschool, elementary or high school onset). These results confirm
the relevance of early metabolic control in T1 (Holl, R.W. et al. 45th Annu
Meet

Eur Assoc Study Diabetes (EASD)  Vienna  2009, Abst 54).

 

24.%% Diab Profess Resources   Poor glycemic control is associated with
poorer quality of life in young patients with T1 10/27/09

Data from 2,601 T1DM patients aged 5-23 years were analyzed to determine the
correlation between glycemic control and quality of life among youths with

T1;  20.1% of participants had poor glycemic control and 47.6% had
intermediate glycemic control. When evaluating the results of a child
self-report pediatric

quality-of-life

diabetes (PedsQL-DM) module, the investigators observed an association
between glycemic control and PedsQL-DM scores, both in unadjusted and in
adjusted

linear regression models . In addition, significantly lower PedsQL-DM scores
were reported by girls and participants without private insurance. These
findings

indicate that

poor glycemic control is significantly associated with poorer
diabetes-related quality of life in young patients with T1.(EASD) , Vienna
2009, Abst 53

 

25.%% Diab Pro Resources:  At least one out of every five U.S. children from
ages one to 11 years are not getting enough vitamin D, putting them at risk

of serious diseases, such as diabetes, as well as weak bones and infections.
This analysis, used data from 3,000 children. Some estimates also indicate

that almost 90% of African- American children and 80% of Hispanic children
may be vitamin D deficient.  About 6.4 million children have vitamin D blood

levels

that are too low, the analysis said, using the American Academy of
Pediatrics' measurement of healthy vitamin D levels.

 

International Diabetes Federation (IDF) 20th World Diabetes Congress

European Association for the Study of Diabetes (EASD)

- Abbreviations:  DM - diabetes Mellitus;T1DM - type 1 diabetes mellitus
T2DM - type 2; DME - diabetic macular edema; FPG - fasting plasma glucose BP
-

blood pressure; CV - cardio-vascular; MI -myocardial infarction or heart
attack ;HTN - hypertension or high BP; OCT - optical coherence tomography;
VA

- visual acuity  -ADA - Amer Diabetes Ass; CDC:  US Centers for Disease
Control and Prevention; FDA Federal Drug Administration; JH - Johns Hopkins
; MW

Medscape Web MD; NIH - National Institutes of Health;  MNTD- Medical News
Today    Definitions - Dorlands 31st Ed and Google.  Disclaimer, I am a BSN
RN

but not a diabetic or diabetic educator. Reports are excerpted unless
otherwise noted. This project is done as a courtesy to the blind/visually
impaired

and diabetic communities. Dawn Wilcox Coordinator The Health Library at
Vista Center contact above e-mail or 

thl at vistacenter.org         

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