Diabetes Complications

We already knew that diabetes and inflammation often go together. But now a study by researchers in Sweden shows us how to reduce our level of inflammation and bring down our blood sugar level as well.

Localized inflammation, like that caused by periodontal infection, is susceptible to localized treatment. But generalized, or systemic, inflammation can also bedevil those of us who have diabetes. The new study addresses this previously intractable problem.

“To simplify somewhat,” writes Dr. Richard K. Bernstein in Dr. Bernstein’s Diabetes Solution, “inheritance plus inflammation plus fat in the blood feeding the liver causes insulin resistance, which causes elevated serum insulin levels, which cause the fat cells to build even more abdominal fat, which raises triglycerides in the liver’s blood supply and enhances inflammation, which causes insulin levels to increase because of increased resistance to insulin.” Does this sound like a vicious cycle to you too?

Continue Reading

Of the many possible complications of uncontrolled diabetes, erectile dysfunction is the one we talk about the least. Unlike essentially all of the other complications, it doesn’t bring us physical pain, but the emotional trauma it often brings can be devastating.

It doesn’t have to be that way. If you were the only guy who had erectile dysfunction, having it might well embarrass you. But now we know that perhaps 30 million American men have it and that it increases with age. “About 4 percent of men in their 50s and nearly 17 percent of men in their 60s experience a total inability to achieve an erection,” according to estimates by the National Institutes of Health. “The incidence jumps to 47 percent for men older than 75.”

Continue Reading

Is managing diabetic neuropathy so difficult that we need more drugs? Some, but not all, of our diabetes professionals say that it is.

“We have no licensed treatment for diabetic neuropathy,” Rayaz A. Malik, professor of medicine at the University of Manchester, in December told the World Congress of the International Diabetes Federation World. “We have witnessed failure after failure of numerous clinical trials despite great experimental data. None of these drugs has been translated into therapies that we can prescribe to our patients.”

He explained that the treatments we have for neuropathy offer only symptomatic relief. He says that at best only half of the people with diabetic neuropathy get just 50 percent pain relief. And the drugs we have don’t reverse the nerve damage that causes the pain.

Continue Reading

In December, a panel of experts released new guidelines regarding when people over 60 should take drugs to reduce their blood pressure. But the guidelines for those of us with diabetes remain the same.

The panel of 17 academics reported its findings in the Journal of the American Medical Association, after reviewing data from the last five years. The full text of its report, “2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults,” is free online. It concluded that people over 60 need to keep their blood pressure below 150/90, rather than the 140/90 level previously recommended.

The guideline for people with diabetes remains at 140/90, meaning a systolic blood pressure of no more than 140 and a diastolic pressure of less than 90. The systolic pressure reflects the pressure on our blood vessels when our hearts contract, while the diastolic number reflects the pressure when our heart relaxes between beats.

This is actually less stringent than some experts had previously recommended. Many doctors tell those of us with diabetes to keep our blood pressure at a level no higher than 120/80.  And if we don’t, they will tell us to take our medicine, usually angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs).

Continue Reading

The dawn phenomenon is one of the most disturbing challenges for those of us who have diabetes. Many of us wonder about the puzzle of why our blood sugar level spontaneously rises during the last hours of sleep each night.

This has also mystified our doctors and medical researchers, so much that they have published at least 187 articles in the professional literature during the past three decades since the first study of the subject appeared. But four new studies by European researchers just published in American professional journals have shown a bright light that clarifies the major questions we have had about the dawn phenomenon. We now know who gets it, how bad it is, how much it impacts our A1C levels, and how to prevent it.

Whether you have type 1 or type 2 diabetes you are likely to have the dawn phenomenon. However, dawn levels among people who don’t have diabetes rise only slightly, if at all, “because they secrete insulin to prevent it,” according Francesca Porcellati, MD, and her associates at Italy’s University of Perugia. Their study, “Thirty Years of Research on the Dawn Phenomenon: Lessons to Optimize Blood Glucose Control in Diabetes,” appears in the December 2013 issue of Diabetes Care, a professional journal of the American Diabetes Association. The full-text of this study is free online.

Continue Reading

The usual ways we have to bring our blood sugar levels down to normal work well. But they may not be the best means for about half of us who have diabetes and pre-diabetes.

The usual ways are diet, exercise, and reducing stress. These are the cornerstones of diabetes management, but anyone who has sleep apnea has to do more.

A great many of us who have diabetes also have sleep apnea, and a new study indicates that when we start to manage sleep apnea, we manage our diabetes better at the same time.

Continue Reading