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Diabetes Developments - A blog on latest developments in diabetes by David Mendosa

This New Meter Is Accurate and Can Be Yours Free

September 18th, 2016 · Comments Off

I hope you are already using a blood glucose meter, if you have diabetes or prediabetes. Using one of these meters is the only way that you can know how you are doing with the food you eat, the exercise you get, and the medicine you take may be sending your levels too low or too high.

Do you already have a meter? If you do, you may want to consider a new one. I remember an endocrinologist telling me 20 years ago that we should get a new one every year. Because the technology is much better nowadays, we probably can keep using a meter longer than that. But any meter can go out of whack — for example, if you drop it. And the newer ones keep getting better.

The new Jazz Wireless 2 meter from AgaMatrix of Salem, New Hampshire, is likely to be superior to the one you are using. It’s one of the most accurate and certainly the smallest blood glucose meter that you can use. It’s also one of the least expensive on the market.

AgaMatrix isn’t one of the Big Four meter companies. LifeScan, Accu-Chek, Abbott, and Panasonic Healthcare (which early this year bought Bayer Diabetes) dominate the health insurance formularies, so many people with diabetes fail to look beyond them.

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The Stigma of Having Type 2 Diabetes

August 28th, 2016 · Comments Off

Many of us who have Type 2 diabetes feel the stigma of our condition. For most of the 22 years that I have known I had it, I was reluctant to tell anyone that I have diabetes. Until a few years ago, I would describe myself, if asked, as a medical writer, even though my full-time work is writing about diabetes and advocating for people who have it.

Likewise, only recently have researchers begun the scientific study of the stigma of diabetes and the physical and mental effects that it has on us. Until now, quantitative research has been limited by the absence of reliable and validated measures of perceived and experienced diabetes stigma.

Serious study of diabetes stigma is just beginning

Compared to what we know about the stigma affecting people with other chronic conditions, the diabetes evidence is sparse. We know much more about how people with HIV/AIDS, obesity, and epilepsy are stigmatized. I know directly about the stigma of having epilepsy because my mother was so ashamed of having it that she never told her children.

Now, researchers can use the new Diabetes Stigma Assessment Scales to systematically study the effects of stigma on people with Type 1 or with Type 2 diabetes. These scales were reported in a late-breaking poster presented at the American Diabetes Association’s convention of about 16,000 professionals in New Orleans this June. I represented Health Central there.

We do have some quantitative research about diabetes stigma. I also found narrative reviews and reports of personal experiences, including job discrimination, restricted opportunities in life, and unfair judgments.

Three-fourths feel judged

A survey just reported that 76 percent of adults with diabetes have felt judged by family members or friends for how they manage their diabetes. And 54 percent of them frequently feel judged. I obtained a copy of this survey of 500 adults with diabetes from a representative of Roche, which commissioned it from Wakefield Research.

In 2013, the researchers who developed the new assessment scales reported what they think was the first qualitative study of diabetes stigma. Noting then that they needed more research in how to measure stigma, they published their findings of this small study in the professional journal BMJ Open. Their key conclusion was that of the 25 adults with Type 2 diabetes in the study, 84 percent reported that they felt their condition was stigmatized or they reported evidence of stigmatization.

The things we need to do can lead to stigma

When someone has Type 2 diabetes, it’s not immediately obvious, the study points out. But needing to take diabetes drugs or insulin injections, checking blood glucose levels, and following a different diet may be conspicuous. When people inject insulin in public, others may assume they are drug addicts. The symptoms of low blood glucose can include confusion and dizziness, which can be mistaken for drunkenness. Any of these activities can lead to diabetes stigma.

But what do researchers mean by stigma? The research often quotes what Professors Mitchell Weis and Jayashree Ramakrishna published a decade ago in the influential journal The Lancet:

“A social process or related personal experience characterised by exclusion, rejection, blame, or devaluation that results from experience or reasonable anticipation of an adverse social judgment about a person or group identified with a particular health problem. The judgment is medically unwarranted.”

Stigma can lead to poor self-management

The most comprehensive narrative review that I discovered was a 2013 study in the journal Patient, “Social Stigma in Diabetes.” It concluded that the stigma “has a significant impact on psychological well-being.” But that is hardly all. Depression often can lead us to ignoring the diabetes with the inevitable result that we stop managing our condition well.

This narrative review also noted the ironic consequence of the landmark Diabetes Prevention Program. This study reported 15 years ago that “changes in lifestyle” can often stop the progression of prediabetes to diabetes. Type 2 diabetes is now widely known as a “lifestyle disease,” blaming the victim and further contributing to the stigma of the condition.

Education is the best hope

The best hope for reducing the stigma of diabetes, the narrative review concluded, will likely be education. Another ironic consequence, this time a positive one, is that as the diabetes epidemic continues to grow, diabetes knowledge will spread along with the condition itself.

This article is based on an earlier version of my article published by HealthCentral.


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Manage Your Diabetes with Yoga

August 27th, 2016 · Comments Off

Is your blood glucose level is higher than you and your doctor would like it to be? Then, a yoga practice may be just what you need for your diabetes management.

In the past few months, three different diabetes professional journals coincidentally published separate review studies of yoga for diabetes. Each of these studies reached the tentative conclusion that doing yoga will probably help you to have better health.

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Reduce Your Risk of Weight Loss Surgery

August 26th, 2016 · Comments Off

Do you have diabetes and a BMI above 35? If you do and decide to get bariatric surgery to help you manage your diabetes, it could be an excellent idea.

But will you to go to your nearest hospital for the procedure? That might not be the safest thing to do.

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The Stress of Managing Diabetes When You Are the Prime Minister

August 25th, 2016 · Comments Off

Do you think that managing your diabetes is too hard because of all your responsibilities? Then, you might want to consider the tasks facing a 59-year-old woman named Theresa May.

She just became the UK’s Prime Minister. This makes her among the first—if not the first—current heads of a government who has diabetes.

Three years ago, when she was the country’s Home Secretary, Ms. May made an appointment with her doctor to treat a bad cold. She mentioned that she had been losing a lot of weight, so the doctor ordered a blood test. Her blood glucose level showed that she had diabetes.

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Does Weight Loss Surgery Keep Working for Diabetes Management?

August 24th, 2016 · Comments Off

Does your weight makes it difficult for you to manage your diabetes? Check out bariatric surgery, because it’s likely to help you to lose many pounds.

But how well will it help you manage your diabetes over the long term?

Until now, nobody knew the answer to this question. That’s why researchers have been studying a group of 120 adults with Type 2 diabetes at three teaching hospitals in the U.S. and one in Taiwan. Half of them got bariatric surgery, and half got intensive lifestyle medical management.

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Why You May Want To Take Early Control of Your Diabetes

August 23rd, 2016 · Comments Off

If having heart failure or getting a stroke or dying soon are the only diabetes risks that concern you, then you don’t need to start managing your diabetes right away. But if you would rather not get diabetic retinopathy, diabetic nephropathy, or diabetic neuropathy, you may want to get down to a normal blood glucose level right after your doctor diagnoses it.

This is the good news/bad news summary of a study by researchers at the University of Chicago’s Department of Medicine and colleagues at the Kaiser Permanente Division of Research, and Northwestern University’s Feinberg School of Medicine. They presented their findings in late breaking abstract 184-LB, “Early Glycemic Control after Type 2 Diabetes Diagnosis Is Most Critical for Future Health and Survival,” at the American Diabetes Association recent convention, the world’s largest annual meeting of diabetes professionals.

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Metformin Pro and Con

August 5th, 2016 · Comments Off

Metformin, the most popular diabetes medicine, figured in about 200 of the presentations at the recent annual convention of the American Diabetes Association. Two of these presentations show good news for its likely role in degenerative nerve disease and in dispelling concerns about its possible role in neuropathy. One presentation, however, brought some disturbing results, and the rest are of less interest to most people with diabetes.

This convention, which the ADA calls its 76th Scientific Sessions, attracted more than 16,000 attendees, including more than 13,000 professionals who went to New Orleans to see and hear almost 3,000 presentations about diabetes. I represented HealthCentral there.

Dr. Liu presents her poster on metformin

(Photo by David Mendosa)

A team of researchers from Tulane University’s School of Public Health and Tropical Medicine presented one poster and one oral presentation about metformin. Shuqian Liu, MD, presented the poster and told me that she designed both of these studies. The poster 570-P reported a retrospective study that examined the effect of high doses of metformin on neuropathy, a complication for 60 to 70 percent of people with diabetes.

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Exercise Harder, But Not Hard

August 1st, 2016 · Comments Off

Hard exercise, like high-intensity interval training, undoubtedly can provide metabolic, heart disease, and fitness benefits. But a leading expert on diabetes fitness says that it’s too hard for almost all people with diabetes.

The best exercise is the hardest exercise than you will do. High-intensity interval training may be the current fitness craze, says Sheri Colberg-Ochs. “Its health efficacy is not in question,” she says. But “despite its current popularity, there is no evidence supporting HIIT as a viable public health strategy.”

Sheri Colberg-Ochs, Left, Receives Outstanding Educator Award

Credit: American Diabetes Association

Dr. Colberg-Ochs addressed the recent annual convention of the American Diabetes Association in New Orleans on “The Feasibility of Doing High-intensity Interval Training (HIIT) in Persons with Diabetes” in a presentation that I had the opportunity to hear. Dr. Colberg-Ochs was diagnosed with Type 1 Diabetes almost 50 years ago, when she was 4. Recently retired from Old Dominion University in Norfolk, Virginia, where she was a professor of exercise science, Dr. Colberg-Ochs is best known for her book Diabetic Athlete’s Handbook. During the convention, Margaret Powers, the American Diabetes Association’s president health care, presented her with the 2016 Outstanding Educator in Diabetes award.

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You Can Stop NASH Before Your Liver Fails

July 30th, 2016 · Comments Off

You may be able to stop a serious liver disease called nonalcoholic steatohepatitis, but better known as NASH, when you take the diabetes drug pioglitazone. NASH is a common complication of type 2 diabetes. But a three year long randomized, double-blind, placebo-controlled trial concludes that pioglitazone, sold here as Actos as well as in a generic version, is a safe and effective treatment.

Kenneth Cusi, MD, is the lead author of the study, which the journal Annals of Internal Medicine published online ahead of print. Only the abstract of the study is free online. But a spokesperson for the University of Florida, where Dr. Cusi is a professor of medicine, sent me the full-text.

My Wife Catherine Died of Liver Failure

NASH usually has few or no symptoms, according to the National Institute of Diabetes and Digestive and Kidney Diseases. It is “usually a silent disease.”

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