Drs. Peterson, Silverstein, Kaufman, and Warren-Boulton have published an update on the management of Type 2 diabetes in youth. This is very timely for this is becoming an important disease for the youth. The factors for high risk group are a body mass index of more than the 85th percentile plus family history and high risk ethnicity.
Increased physical activity along with a healthy diet plus a reduction in weight and blood glucose level can prevent or delay the onset of the disease. The American Academy of Pediatrics does not propose that the high risk group be screened but advised the physicians to closely monitor these patients because early diagnosis maybe helpful.
However The American Diabetes Association recommends screening these patients every two years. It was further suggested that those diagnosed with diabetes receive behavioral interventions to encourage eating healthy and physical activity.
Since the treatment of Type 2 diabetes is different between adults and children because the management for the latter group is focused on lower insulin sensitivity with advancing physical growth and sexual maturity and the ability to do self-care, it is good to tailor the treatment for each patient.
It is not enough to use just diet and exercise because this works only for less than 10% of the afflicted youth. Oral medication or insulin is usually necessary. Treatments of blood goals target, type of insulin dose, self-monitoring frequency, meal planning to promote good nutrition
and physical activity will differ from patient to patient.
Doing all the self-care tasks can make the kids feel different and coping may lead to depression and eating disorder so a social worker or psychologist can help with adjustment to lifestyle changes. While kids should be able to do self-care tasks, they need to be supervised until they are able to do them on their own.
Sunday, July 27, 2008
Saturday, July 19, 2008
Mother's Blood Sugar Linked to Kids' Obesity Risk
July 19, 2008
Anita Manning reported in USA Today that women with high blood sugar levels when they are pregnant are two times more likely to have obese children. This is according to the largest study on the same issue. This research is published in the September issue of the journal called Diabetes Care.
It is not all bad news though because Teresa Hillier, an endocrinologist and co-author of the study said that the tendency to have obese children is reversible when the high blood sugar is treated during pregnancy. Reversible is the word to note here.
Teresa Hillier and her colleagues at Kaiser Permanente's Center for Health researched 9439 mother-child pairs who were enrolled at the center's Hawaii and Regions in the Northwest from 1995 to 2000. The result of their examination is that the higher the mother's blood sugar, the greater is the chance for the child to be overweight by the time he is between 5 and 7 years old. They found this true for all ethnic groups.
The key thing to do is to get the child started on healthy lifestyles. Eating healthy is one that will benefit everyone in the family. Don't get the baby started on too much orange juice as it contains a lot of sugar. This has been the findings of the recent studies. Go easy on cookies too.
The other part of lifestyle to take note is to get the child started on some physical activity. I have seen babies in the swimming pool with their mothers. Then as soon as they are in their toddler years, you can get them started on T-ball games. Oh, they will not be too focused but at least they will be active and not become obese. And you will have fun watching them play. I know I have.
Anita Manning reported in USA Today that women with high blood sugar levels when they are pregnant are two times more likely to have obese children. This is according to the largest study on the same issue. This research is published in the September issue of the journal called Diabetes Care.
It is not all bad news though because Teresa Hillier, an endocrinologist and co-author of the study said that the tendency to have obese children is reversible when the high blood sugar is treated during pregnancy. Reversible is the word to note here.
Teresa Hillier and her colleagues at Kaiser Permanente's Center for Health researched 9439 mother-child pairs who were enrolled at the center's Hawaii and Regions in the Northwest from 1995 to 2000. The result of their examination is that the higher the mother's blood sugar, the greater is the chance for the child to be overweight by the time he is between 5 and 7 years old. They found this true for all ethnic groups.
The key thing to do is to get the child started on healthy lifestyles. Eating healthy is one that will benefit everyone in the family. Don't get the baby started on too much orange juice as it contains a lot of sugar. This has been the findings of the recent studies. Go easy on cookies too.
The other part of lifestyle to take note is to get the child started on some physical activity. I have seen babies in the swimming pool with their mothers. Then as soon as they are in their toddler years, you can get them started on T-ball games. Oh, they will not be too focused but at least they will be active and not become obese. And you will have fun watching them play. I know I have.
Saturday, July 12, 2008
Heart Attack Raises Diabetes Risk
July 12, 2008
A new study finds that after a heart attack, the risk of developing diabetes and pre-diabetes goes up sharply. Heart attack patients are four-and-a-half times more likely to develop the condition than the general population. The August 25, 2007 issue of The Lancet further reported that the patients are fifteen times more likely to develop high blood sugar.
Before this study, the correlation between diabetes and cardiovascular disease was clear in the sense that people with diabetes are two to four times more at risk to get heart disease. They are also five more times at risk to have a stroke.
Dr. Lionel Opie, director of the Hatter Cardiovascular Research Institute of the University of Cape Town, in South Africa said that having a heart attack means that the chance of getting diabetes later is increased. This has been proven by the study that was conducted.
The study led by Dr. Roberto Marchioli from the Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, in Italy, collected information on 8300 Italian patients who suffered a heart attack.
These patients were not diabetic prior to the heart attack but a third of these patients developed diabetes or had impaired insulin resistance after more than three and a half years after the heart attack. These results showed the correlation between heart attack and high blood glucose.
The risk factors for diabetes are high blood pressure, age, the use of heart medicines like the beta blocker drugs to lower cholesterol levels and diuretics. Being overweight, an unhealthy diet and heavy drinking of alcohol also increase the risk and smoking increases it by 60%.
It is therefore important to change the lifestyle in order to prevent diabetes. Changing the lifestyle means eating healthy. Speaking of healthy eating, a Mediterranean diet can help prevent diabetes so did Marchioli say. This also has been the opinion of some other experts.
A new study finds that after a heart attack, the risk of developing diabetes and pre-diabetes goes up sharply. Heart attack patients are four-and-a-half times more likely to develop the condition than the general population. The August 25, 2007 issue of The Lancet further reported that the patients are fifteen times more likely to develop high blood sugar.
Before this study, the correlation between diabetes and cardiovascular disease was clear in the sense that people with diabetes are two to four times more at risk to get heart disease. They are also five more times at risk to have a stroke.
Dr. Lionel Opie, director of the Hatter Cardiovascular Research Institute of the University of Cape Town, in South Africa said that having a heart attack means that the chance of getting diabetes later is increased. This has been proven by the study that was conducted.
The study led by Dr. Roberto Marchioli from the Laboratory of Clinical Epidemiology of Cardiovascular Disease, Consorzio Mario Negri Sud, in Italy, collected information on 8300 Italian patients who suffered a heart attack.
These patients were not diabetic prior to the heart attack but a third of these patients developed diabetes or had impaired insulin resistance after more than three and a half years after the heart attack. These results showed the correlation between heart attack and high blood glucose.
The risk factors for diabetes are high blood pressure, age, the use of heart medicines like the beta blocker drugs to lower cholesterol levels and diuretics. Being overweight, an unhealthy diet and heavy drinking of alcohol also increase the risk and smoking increases it by 60%.
It is therefore important to change the lifestyle in order to prevent diabetes. Changing the lifestyle means eating healthy. Speaking of healthy eating, a Mediterranean diet can help prevent diabetes so did Marchioli say. This also has been the opinion of some other experts.
Saturday, July 5, 2008
Chief of Endocrinology & Metabolism at Pennsylvania Hospital Recommends Exercise Tips for Diabetics
Dr. Rosen, a known metabolic diseases expert on forefront for research on treatment of diabetes, makes recommendations on exercise guidelines for diabetics. Here they are:
The American Diabetes Association awarded him the Charles H. Best Medal for Distinguished Service when he was its president of the eastern region. Of course you know who Charles Best is. He was Dr. Banting's right hand man when they discovered insulin.
That is why, Dr. Banting was so pissed off when he received the Nobel Prize along with another and Charles Best was not even mentioned. What do you suppose good-natured Dr. Banting did? Well, he shared his award with Charles Best, what else.
Back to Dr. Rosen. He has done significant diabetes research. This has been published in primary journals such as Diabetes and the Journal of Clinical Endocrinology and Metabolism. He said that to make certain that one manages diabetes and stay fit and healthy, follow the exercise tips and consult with your doctor.
Want to know what are the benefits of exercise? Here they are:
With all those benefits, who would not want to do some physical activity? Come on, let's get moving! But first, get a preexercise exam to make sure all is well. Then set a goal, plan how to achieve this goal and have fun with it.
- Wear light clothing.
- Use well-fitted footwear.
- Do warm-up or stretch before exercise.
- Drink often during exercise.
- Have soft candy at hand.
- Talk to your doctor before doing intense exercise.
- Build up exercise.
The American Diabetes Association awarded him the Charles H. Best Medal for Distinguished Service when he was its president of the eastern region. Of course you know who Charles Best is. He was Dr. Banting's right hand man when they discovered insulin.
That is why, Dr. Banting was so pissed off when he received the Nobel Prize along with another and Charles Best was not even mentioned. What do you suppose good-natured Dr. Banting did? Well, he shared his award with Charles Best, what else.
Back to Dr. Rosen. He has done significant diabetes research. This has been published in primary journals such as Diabetes and the Journal of Clinical Endocrinology and Metabolism. He said that to make certain that one manages diabetes and stay fit and healthy, follow the exercise tips and consult with your doctor.
Want to know what are the benefits of exercise? Here they are:
- Lower blood sugar levels
- Lower A1C levels
- Improved HDL cholesterol
- More calories are burned.
- Strength and flexibility are increased.
- Improved quality of life
- Better insulin sensitivity
- Lower triglyceride levels
- Improvement in hypertension
- Cardiovascular system is better conditioned.
With all those benefits, who would not want to do some physical activity? Come on, let's get moving! But first, get a preexercise exam to make sure all is well. Then set a goal, plan how to achieve this goal and have fun with it.
Saturday, June 28, 2008
Diabetes Medications, a Portrait of Cynicism?
Diabetes medications could be insulin or oral drugs. These are drugs taken by mouth. They are also known as oral hypoglycemic agents. This is a wrong term though because these are not given to cause hypoglycemia. Rather they are given to lower the blood sugar level.
By the middle of the 1950's, the diabetes medications called sulfonylureas were developed because they helped lower the blood sugar level of those who could not do so through exercise and diets. Now these are generally known to be effective for type 2 diabetics.
There are other diabetes medications available and they have their own characteristics. Some are long acting while others are intermediate. Still others are short acting. Taking them depends on different factors some of which are physical activity, response to diet and pills, and food intake.
As of last year GlaxcoSmithKline published additional information for Avandia in the US. As per announcement of GlaxoSmithKline. the US FDA has approved the updated prescribing info for thiazolidinediones class of diabetes medications. These are used to treat Type 2 diabetes.
GSK will be able to execute the changes on the Avandia label. This time the label will include a boxed warning in addition to the existing one on the risk for CHF, an acronym for congestive heart failure. One of the most common complications of type 2 diabetes is CHF. In this condition, the heart is unable to pump blood to the other organs.
This can lead to fluid retention or edema which can result in CHF or make it worse. Here's the safety information for Avandia. With diet and exercise, Avandia aids in improving blood sugar control. The possible side effects consist of heart failure or other heart problems.
FDA reviewed more information on this. Consult with your doctor if you have heart failure or heart problems. If you notice swelling or retention of fluid sharpness of breath, rapid increase of weight or feeling unusually tired while taking Avandia, tell your doctor right away.
If you have liver problems, you should not take Avandia. Tell your doctor the diabetes medications you're taking. Avandia may also increase your risk of pregnancy. Don't take Avandia if you're nursing your baby. Also, while taking Avandia, you may experience more fractures and vision changes.
There may be adverse reaction to sulfonylureas which could be in the form of low blood glucose. But the reaction is usually not as severe as those on insulin. The frequency is not as often either. But this does not mean precautions will not be taken into consideration.
When experiencing periods of stress, the doctor may temporarily stop the oral medicine you're taking. Instead he may decide to put you on insulin to control the blood sugar. When the stress is over like in case of an accident or infection, you may be able to go back to the diabetes medications.
By the middle of the 1950's, the diabetes medications called sulfonylureas were developed because they helped lower the blood sugar level of those who could not do so through exercise and diets. Now these are generally known to be effective for type 2 diabetics.
There are other diabetes medications available and they have their own characteristics. Some are long acting while others are intermediate. Still others are short acting. Taking them depends on different factors some of which are physical activity, response to diet and pills, and food intake.
As of last year GlaxcoSmithKline published additional information for Avandia in the US. As per announcement of GlaxoSmithKline. the US FDA has approved the updated prescribing info for thiazolidinediones class of diabetes medications. These are used to treat Type 2 diabetes.
GSK will be able to execute the changes on the Avandia label. This time the label will include a boxed warning in addition to the existing one on the risk for CHF, an acronym for congestive heart failure. One of the most common complications of type 2 diabetes is CHF. In this condition, the heart is unable to pump blood to the other organs.
This can lead to fluid retention or edema which can result in CHF or make it worse. Here's the safety information for Avandia. With diet and exercise, Avandia aids in improving blood sugar control. The possible side effects consist of heart failure or other heart problems.
FDA reviewed more information on this. Consult with your doctor if you have heart failure or heart problems. If you notice swelling or retention of fluid sharpness of breath, rapid increase of weight or feeling unusually tired while taking Avandia, tell your doctor right away.
If you have liver problems, you should not take Avandia. Tell your doctor the diabetes medications you're taking. Avandia may also increase your risk of pregnancy. Don't take Avandia if you're nursing your baby. Also, while taking Avandia, you may experience more fractures and vision changes.
There may be adverse reaction to sulfonylureas which could be in the form of low blood glucose. But the reaction is usually not as severe as those on insulin. The frequency is not as often either. But this does not mean precautions will not be taken into consideration.
When experiencing periods of stress, the doctor may temporarily stop the oral medicine you're taking. Instead he may decide to put you on insulin to control the blood sugar. When the stress is over like in case of an accident or infection, you may be able to go back to the diabetes medications.
Sunday, June 22, 2008
Risk of Insulin Resistance Increases With Fat Build-Up
The fat build-up that they refer to here is the one on chest and upper back according to HIV Study. This study led by the San Francisco VA Medical Center says that fat build-up in this area is linked to an increased risk of insulin resistance.
They say that this is the very first time this relationship has been established. The lead author and researcher, Carl Grunfield, M.D., PhD, who is the chief of the metabolism and endocrine sections at the San Francisco VA Medical Center says that the association between visceral fat and insulin resistance risk has been studied before but nobody looked at the upper trunk fat.
We know that insulin is the hormone that controls the blood glucose levels so when the cells become resistant to the insulin action, the end result is high blood glucose which has bad effects on the body. Grunfeld further observes that people with lots of fat in the upper trunk and not much in the stomach are at risk to develop insulin resistance. But if you have both, he says the risk is rather high.
What is the implication of this study? So is this what causes diabetes? Over 3/4 of type 2 diabetics are obese or were obese at one time. But what is obesity anyway? Clinically speaking, anyone who has a body mass index of 30 or over is considered obese. How do you get your body mass index? Google those three words and you will be led to a chart.
The chart will help you determine what is the best weight for you. It takes into account the height and this helps give a good estimate of someone's body fat. Try to adhere as close as possible to the body mass index that is right for you. What am I saying? We should all do that because I myself have a hard time not trying everything at the buffet. Yup, the buffet is still my Waterloo.
They say that this is the very first time this relationship has been established. The lead author and researcher, Carl Grunfield, M.D., PhD, who is the chief of the metabolism and endocrine sections at the San Francisco VA Medical Center says that the association between visceral fat and insulin resistance risk has been studied before but nobody looked at the upper trunk fat.
We know that insulin is the hormone that controls the blood glucose levels so when the cells become resistant to the insulin action, the end result is high blood glucose which has bad effects on the body. Grunfeld further observes that people with lots of fat in the upper trunk and not much in the stomach are at risk to develop insulin resistance. But if you have both, he says the risk is rather high.
What is the implication of this study? So is this what causes diabetes? Over 3/4 of type 2 diabetics are obese or were obese at one time. But what is obesity anyway? Clinically speaking, anyone who has a body mass index of 30 or over is considered obese. How do you get your body mass index? Google those three words and you will be led to a chart.
The chart will help you determine what is the best weight for you. It takes into account the height and this helps give a good estimate of someone's body fat. Try to adhere as close as possible to the body mass index that is right for you. What am I saying? We should all do that because I myself have a hard time not trying everything at the buffet. Yup, the buffet is still my Waterloo.
Saturday, June 14, 2008
The Why of the Diabetes Epidemic, Part 3
We said before that carbohydrates and fats are the main providers of energy to keep it working. The carbohydrates are broken down into smaller sugars in the intestine. These smaller sugars can now be absorbed into the circulation. This is then moved from the blood into the cell.
It is during this transport that it gets to meet Mr. Insulin. There it is broken further making it a main source of energy. The extra sugar or glucose is then stored in the liver or as glycogen in the muscle. This can also be stored in the muscles where they stay until they are needed.
How about the fats? The other main source of energy is dietary fat which produces a breakdown product called fatty acids. The same thing happens to it just like the glucose. They are either used immediately for energy or stored to use later.
Insulin is a hormone that is made in the pancreas. It is a protein that is circulated in the blood stream and while it does, it affects the functioning of the other organs. The pancreas also produces chemicals that help break down the food so that that the intestine can absorb this.
There are also bunches of cells in the pancreas called islets that contain different specialized cells. Phew! Thank goodness for the forefathers who did studies on this and now they're even using it as a new diabetes cure
or we would not even know these cells exist. Anyway, one of the cells in the islets are the beta cells that produce insulin.
The sugar level in the blood is sensed by these beta cells after a meal and as the level goes up, the beta cells make insulin that makes the transport of sugar into the cells faster, thus effectively stopping the blood sugar from going up too high.
When the sugar level falls, what do you think happens? The opposite happens. The insulin production stops and opens up the stored sugar in the cells. Think of the insulin as a traffic policeman who directs the nutrients to the storage when the sugar level is up and then directs them to come out of the storage when the sugar level is down.
Isn't that cool? This is what happens in a person without diabetes. This is a finely tuned machine but just like our cars, when something disturbs the engine, then there is trouble. I should not really call it trouble for it is just a challenge we have to meet head on.
My, my, this is getting too long. We have not halfway covered why diabetes is on the rise but we will. We will just persevere with our weekly sessions and learn as much as we can about this. What is ten minutes (it takes to read this) compared to a life-long knowledge on this which we can pass on to the next generation?
It is during this transport that it gets to meet Mr. Insulin. There it is broken further making it a main source of energy. The extra sugar or glucose is then stored in the liver or as glycogen in the muscle. This can also be stored in the muscles where they stay until they are needed.
How about the fats? The other main source of energy is dietary fat which produces a breakdown product called fatty acids. The same thing happens to it just like the glucose. They are either used immediately for energy or stored to use later.
Insulin is a hormone that is made in the pancreas. It is a protein that is circulated in the blood stream and while it does, it affects the functioning of the other organs. The pancreas also produces chemicals that help break down the food so that that the intestine can absorb this.
There are also bunches of cells in the pancreas called islets that contain different specialized cells. Phew! Thank goodness for the forefathers who did studies on this and now they're even using it as a new diabetes cure
or we would not even know these cells exist. Anyway, one of the cells in the islets are the beta cells that produce insulin.
The sugar level in the blood is sensed by these beta cells after a meal and as the level goes up, the beta cells make insulin that makes the transport of sugar into the cells faster, thus effectively stopping the blood sugar from going up too high.
When the sugar level falls, what do you think happens? The opposite happens. The insulin production stops and opens up the stored sugar in the cells. Think of the insulin as a traffic policeman who directs the nutrients to the storage when the sugar level is up and then directs them to come out of the storage when the sugar level is down.
Isn't that cool? This is what happens in a person without diabetes. This is a finely tuned machine but just like our cars, when something disturbs the engine, then there is trouble. I should not really call it trouble for it is just a challenge we have to meet head on.
My, my, this is getting too long. We have not halfway covered why diabetes is on the rise but we will. We will just persevere with our weekly sessions and learn as much as we can about this. What is ten minutes (it takes to read this) compared to a life-long knowledge on this which we can pass on to the next generation?
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