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Wednesday, October 27, 2010

Children With Diabetes Endangered by Nurse Shortages

Children with diabetes are the victims of nurse shortages. This was reported last year by Diabetes UK and I wanted to revisit it because of the increased risk on the diabetic kids when it comes to hypoglycemic events and long term complications like kidney failure, amputation and blindness because of the shortage in PDSNs (pediatric diabetes specialist nurses).

After doing an extensive research on this issue, I found that the nurse shortage is still real. Special mention however, must be made on a study that concluded the PDSN has an important role in educating the children with diabetes as well as their parents and others who take care of them.

This key role is not substantiated by the overloaded assignments of the nurses. In England, they look after more than 150 children. This is double than the number of the recommended 70 in order to be able to do a good job. The large number of caseload these nurses have to do will not allow enough time to do everything that has to be done.

Just gathering the data alone on where each kid is at, takes time. Then putting all the data together to arrive at the necessary steps to improve the condition takes time too. Then they have to teach these kids, their parents and those who care for them how to manage the diabetes in a most effective manner.

Each child is different and has therefore his own needs. These individual needs have to be addressed and should be given attention as to the individualized support and advice needed for optimum benefit. It is clear that getting such a huge caseload will not meet the needs of the children with diabetes.

The report shows that the caseload of the PDSN has risen since 2007. In fact, less than 7% of PCTs have improved the caseload. This is not right when one considers that over 80% of children with diabetes have not been able to achieve the blood glucose level that is recommended.

This fact should be considered as a priority. These specialist nurses play a key role in the management and care and without them, these children are going to suffer. Let us therefore hear the cry of those who need this badly so we can help our future generation among these children with diabetes.

Tuesday, October 19, 2010

Exercise May Be Best for Diabetes Prevention

Exercise, experts say, may be the best option to prevent diabetes. They say that an intense workout for a few minutes may do it. Edinburgh’s Heriot-Watt University did a study on this and found that sedentary cases who exercise hard for just 7.5 minutes a week improved their health significantly.

The researchers asked the men to ride a stationary bike for 15 minutes on a two-week period. They found that these men improved the way they metabolize glucose. As a result, they lowered their blood glucose levels. That is why the researchers recommend that people try to do four to six 30-second sessions of intense workout two times a week to obtain the blood glucose benefit.

The question is how does exercise prevent diabetes? Researchers from Yale found that intense workout is more effective than the one done leisurely in controlling and preventing diabetes. They had three groups of healthy but sedentary 72 year old women who were not obese to do some amount of exercise.

They asked one group to do hard training of 80% of aerobics, the second group to do moderate (60%) exercise and the third group to do easy (50%) exercise. They all did the same amount of work and burned 300 calories per bout. The group that did the intense type of workout showed a great improvement to metabolize sugar and curtailed the formation of fat.

Needless to say, but I am going to say it anyway, is that the ones who did the low intensity exercise did not benefit as much as the intense group did. This could only mean that intense workout can aid in helping in not only preventing diabetes but also in treating it. There are some data on diabetes and exercise here.

Here’s how the researchers explained it. As soon as the meal is over is the time when the most tissue damage happens. In other words, this is the time when the blood sugar rises to the highest level. You see, right after we eat, the glucose goes from the intestine into the blood stream. Now we know that the only storage areas for the glucose is the liver and the muscles.

So when the muscles are not exercised, they are full of sugar so the extra glucose after eating has nowhere else to go after it gets into the bloodstream. Now when the muscles are exercised, the stored sugar is emptied out, leaving room for the new glucose.

So after eating, the glucose that goes to the intestines and the blood stream can go to the muscles right away. This therefore prevents the rise in the blood glucose level. This makes sense, doesn’t it? This is indeed an exciting news because it holds some kind of promise that there can be help indeed in making the blood sugar behave better.

The important part of this study is that the more intense the exercise is, the greater the benefit is by way preventing the development of diabetes. And if the diabetes is already present, the greater is the ability to control or manage it. Cautionary measure though should be taken. Intense exercise could be bad for someone with certain kind of conditions so consult with the doctor before embarking on a regimen of intense exercise.

Monday, October 11, 2010

Diabetes Drugs, What’s in the Pipeline

Diabetes drugs have for their goal to get the blood glucose levels of patients under control. There is one that does this with a side effect of weight loss. These drugs are called GLP1 agonists. Mind you, just because they say this, it does not mean that we will take their words as gospel truth. We still have to monitor our body's reaction to this drug.

That said, with approximately 90% of those with type 2 diabetes being obese or overweight, then this side effect could be a blessing as long as we keep our wit about us so that this does not turn out to be more than a blessing in disguise. We have to be careful when it comes to how is diabetes treated.

Are there fewer injections now and more sales of drugs? That's what we hear and that's what studies are telling us. Byetta, for example, just made $679 million in sales one year when it has been in the market since 2005. They say that the main cause for this poor performance (although it is not so in my book) is because it has to be injected two times a day.

I can understand why the twice a day injection will turn people off especially when there are oral drugs that work well at keeping the blood glucose levels within the target range. More especially now with the drug that promises weight loss on top of the blood glucose control.

There are other drugs as well and I am not 100% sure at what stage they are in when it comes to the Food and Drug Administration’s say-so. They have become more cautious and rightly so in the wake of the fiasco involving GlaxoSmithKline's Avandia and the potential heart problems they may cause.

The last time I looked, a number has been trying to develop a once a week version. This should not pose a major challenge except that with the development of any drugs, anything goes or nothing is certain. There are quite a few in the pipeline at different stages of clinical trials but as to which one will ultimately get the FDA nod, I will not hazard a guess.

The article I read has a list of diabetes treatment that I like because it will give us an option as to the form of treatment we need. It could be oral or to be injected and even with the last one, there is a choice as to the number of injections one can tolerate.

Actually those developing a drug that will be injected are taking a chance for people usually do not like sticking a needle in various parts of their body. So those whose researches are underway can still fall flat on their faces. The thing is diabetes is here to stay for awhile so these pharmaceutical companies will keep developing diabetes drugs.

Monday, October 4, 2010

Diabetes Rising Among Children

Type 1 diabetes can double in twenty years. It looks like it is rising at 3% each year. The question is why. This brings me to the book I want to share with you. This book tries hard to demystify this mysterious rise by investigating the scientific hypotheses. Interested? I thought you would.

Let us get to the statistical background first. Type 1 diabetes is now double the figure we had in the 1980s. Compared to 100 years ago, it is ten to twenty times more common. It is widely known and accepted that type 2 diabetes is on the increase as well but the increase in type 1 has not been given much attention.

Enter Dan Hurley who is an award-winning reporter who put together proof from studies that have been published and came out with DIABETES RISING: How A Rare Disease Became A Modern Pandemic, And What To Do About It. He mentioned the studies that documented the rise of type 1 diabetes

While researching for his book, he was shocked to find out that type 1 is rising as quickly as type 2. He thinks that this has not been given much media attention because it does not match the idea that it is a super-disease that is not common and is due to a genetic predisposition.

Genes of course has not changed so it must be something to do with the change in lifestyle or the environment. He sought the explanation with this and so the book looks at some scientific hypotheses that could shed the light on the mysterious increase. Here are the five leading ones:

1. The hypothesis on the cow’s milk exposure in the infant milk formula during the first six months of the baby’s life can inflict harm to the immune system.

2. The accelerator hypothesis claims that the fast increase in children’s height and weight has put the cells that produce insulin under stress and so has increased the propensity to develop type 1.

3. The hypothesis on hygiene claims that the lack of exposure to agents that cause disease that once were common leads autoimmune hypersensitivity which results in the damage to the beta cells that produce insulin.

4. The sunshine hypothesis as the name indicates claims that more time now spent indoors has reduced sunlight exposure and vitamin D is which is now linked to increased risk for type 1 diabetes.

5. The hypothesis on exposure persistent organic pollutants or POP increases the risk not only for type 2 diabetes but for type 1 as well.

There you have the five hypotheses. I have not made up my mind which of those can graduate into becoming theories. What do you think? One thing I am sure though. We have to increase our awareness to this and continue to work on getting them eliminated so that we can stop the rising statistics on type 1 diabetes.