Letter To A Diabetic

Or I Understand What You're Going Through

Month: March, 2013

Do You Have A Broccoli Obsession?

One of my favorite places to eat (as a Diabetic) is California Fresh (formerly Fresh Choice). I’m a produce junkie and even though their fruit selection and quality usually suck, the salad selection is usually pretty good at the location I go to. One of my favorite side dishes is something called Broccoli Obsession. I attempted to duplicate it at home and got it right off the bat. 🙂 Yay me.

 

 

 

 

 

 

 

 

1 bunch broccoli florets

1/4 C raisins

1/4 – 1/2 C red diced onion (how much you use depends on how much you like onion)

1 T roasted sunflower seens

1/4 C shaved carrot

coleslaw dressing to taste (I ought a store ready dressing but I’m sure making your own would make this even better)

Mix it all together in a big bowl. Letting it chill over night will allow the flavors to mix together but eating it right away is good, too.

Enjoy.

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TOP 10 FOODS TO HELP MANAGE YOUR BLOOD SUGAR

Please remember that it is each Diabetic’s responsibility to manage their diet/exercise/blood glucose and that while this video has some great info, it does not replace your doctor’s treatment or your knowledge of YOUR diabetes!

Interesting video on low impact foods can be seen here.

Exercise and Insulin Pump Article

Updated February 27, 2007

Exercising With an Insulin Pump

by Sheri Colberg, Ph.D.
Whether you consider yourself an athlete or an occasional recreational sports participant, you benefit from any activity that you do, because all exercise can improve your body’s ability to use insulin. If you do not inject or infuse insulin to treat your diabetes, exercise should result in a decreased release of insulin by your pancreas and a more efficient uptake of blood glucose by muscle cells. If you use insulin, however, you may be concerned that exercise can complicate the normal maintenance of your blood glucose level.

Active people who use insulin need to make frequent adjustments in their diabetes regimen to maintain blood glucose in target range, especially when doing higher-intensity or longer-duration exercise. But the effort can pay off in improved blood glucose control, reducednighttime hypoglycemia, improved cardiovascular fitness, and weight loss. When it comes to managing exercise effectively, continuous, subcutaneous insulin-infusion therapy (or more simply, insulin pump therapy) is an option to consider.

How insulin pumps work
Scientists attempting to mimic the insulin delivery of a normal, healthy pancreas first developed insulin pumps in the late 1970’s. Today’s pager-size pumps are much more sophisticated and give both basal insulin doses (background insulin delivered every few minutes in small increments to cover your body’s general need for insulin) and boluses (larger doses given to cover meals and snacks or to lower elevated blood glucose at any time).

Currently, over 180,000 individuals with diabetes worldwide wear portable insulin pumps, and this number has been increasing each year. Most pump users have Type 1 diabetes, but some people with Type 2 diabetes who require insulin are choosing to pump insulin as well. A main advantage of insulin delivery via an insulin pump is more reliable insulin action through a constant infusion of short-acting insulin, along with precise dosing and timing of insulin to cover food intake. Many insulin pump users experience improved overall blood glucose control, reduced risk of nighttime low blood glucose, and improved awareness of low blood glucose (hypoglycemia).

Insulin pumps contain a reservoir or cartridge filled with insulin, either Regular or one of the rapid-acting insulin analogs, insulin lispro (brand name Humalog), insulin aspart (NovoLog), or insulin glulisine (Apidra). Compared to Regular insulin, these insulin analogs have a more rapid onset of activity (5 to 15 minutes versus 20 to 30 for Regular) and an earlier peak in activity (90 minutes versus 150 minutes). Their use allows for a blood glucose response following carbohydrate intake that is closer to that of a person without diabetes and for a more rapid correction of hyperglycemia (above-normal blood glucose levels).

All insulin pumps currently on the market deliver insulin subcutaneously (under the skin) in the abdomen, buttocks, legs, or upper arms, either through a needle or through a plastic infusion catheter. Pump users replace the needle or catheter infusion set every two to three days with a new set at a new site.

Pumps and exercise
Pump users with active lifestyles can experience a metabolic response to exercise that is similar to that of people who do not have diabetes. In part, this is simply because of how an insulin pump works, by delivering small amounts of fast-acting or rapid-acting insulin continually. But it also depends on the user monitoring his blood glucose level frequently, adjusting basal and bolus doses to fit the exercise, and learning from experience.

Click here for rest of article.

WE CAN DO IT!!

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Diabetes Emergency Kit

See the video and get more info here.

diabetesandmore.com

 

The Diabetes Tab

5 million more people living with diabetes

By Jacque Wilson and Sophia Dengo, CNN
updated 3:59 PM EST, Wed March 6, 2013

 

(CNN) — Dr. John Anderson isn’t surprised by the rapidly growing cost of diabetes in America. New research from the American Diabetes Association shows the total cost of diabetes was $245 billion in 2012 — a 41% increase from the $174 billion spent in 2007.

“I know of no other disease that’s increasing at (about) 8% per year,” said Anderson, president of medicine and science for the American Diabetes Association. “That to me isn’t surprising, it’s troubling.”

What is surprising, Anderson said, is that the increased price isn’t due to rising health care costs. It’s due instead to the “sheer number” of Americans who have diabetes.

“Medication costs have gone up, but overall they haven’t gone up significantly,” said Matt Petersen, the American Diabetes Association’s managing director of medical information and professional engagement. “We have more people with diagnosed diabetes. A lot more of them. That’s the burden we face.”

An estimated 22.3 million people were living with type 1 or type 2 diabetes in 2012, according to the new report, up from 17.5 million in 2007.

The growing population is due to several factors, Petersen said. Diabetes prevalence increases with age, so the aging baby boomer population is attributing to rising costs. The obesity epidemic also plays a role. Being overweight or obese is a risk factor for type 2 diabetes, according to the Centers for Disease Control and Prevention.

Unfortunately, not all risk factors can be controlled, Petersen said. African-Americans, American Indians and Asian-Americans are all at a greater risk of developing diabetes than Caucasians, leading researchers to believe there is a genetic link.\

“People fundamentally can’t do anything about susceptibility,” he said.

Diabetes can cause serious health problems such as heart disease, kidney failure and blindness, according to the CDC. If it’s not kept under control, diabetes also can cause infections that may lead to leg or foot amputations.

Approximately 246,000 deaths were attributed to diabetes in 2012, according to the American Diabetes Association’s report.

There is good news, Petersen said. Although our diabetes costs are growing, we’re spending the dollars effectively.

“We’re picking it up earlier and caring for it better,” he said. “We’re getting the right value for our money.”

Anderson and the association hope to continue to spread awareness about diabetes. Addressing the disease on the front end, before it leads to serious complications, will help lower overall costs, he said.

“That’s a great way of preventing the growth of this epidemic.”

Diabetes Cured in Dogs?

There are some obvious ethical issues here but in the end, I suppose the forward progress may be worth it. Still though…

Written By: 
Posted: 03/6/13 7:56 AM

http://singularityhub.com/2013/03/06/scientists-cure-diabetes-with-gene-therapy-in-dogs-will-it-work-on-humans/

Scientists have now cured diabetes – at least in a group of dogs – and they used a gene therapy to do it. Amazingly, only a single therapy session was needed to return the dogs’ blood sugar levels to normal. It wasn’t the first time the researchers used the therapy to cure diabetes – they’d done the same previously in a group of mice. But the fact that the treatment worked in the larger canine is a promising sign that it might also one day work in those even much larger animals: humans.

The therapy used in the study actually included two different genes: one for glucokinase, an enzyme that acts as a “glucose sensor” in the muscle, and another for insulin, the hormone that causes sugar in the blood to be absorbed into cells to be used for energy. The genes worked in concert to detect high blood sugar levels and then produce insulin to promote the uptake of blood glucose into cells.

The study included five beagles between 6 and 12 months old with type 1 diabetes, which means their pancreases made little or no insulin. Dogs do develop diabetes naturally, but the diabetes cured in this study was chemically induced, after which they began receiving daily injections of insulin. They then received the gene therapy and insulin injections were stopped. After a single administration of the gene combination that included several injections to the hind leg, the dogs’ blood glucose levels were effectively controlled for the over four years that they were monitored. In fact, the therapy was better at controlling their blood glucose levels than daily doses of insulin. Furthermore, their body weights returned to normal and they were generally healthy, lacking any complications from the gene therapy.

Scientists in Spain needed only a single treatment session to renormalize blood glucose levels in dogs with chemically induced diabetes type 1. [Source: Universitat Autònama de Barcelona]

The study, which was published earlier this month in the journal Diabetes, was “the first to demonstrate a long-term cure for diabetes in a large animal model using gene therapy,” according to Fàtime Bosch who led the study at the Universitat Autònama de Barcelona’s Centre for Animal Biotechnology and Gene Therapy.

A one time gene therapy would be a much welcomed alternative to a lifelong dependence on insulin injections. Type 1 diabetes is thought to be an autoimmune disorder by which the insulin-producing beta cells of the pancreas are attacked by the body’s own immune system. Incapable of producing insulin the body’s blood sugar levels rise, which, left unchecked can wreak havoc on multiple organs and cause heart problems, kidney damage, and nerve damage which can result in blindness. A person with type 1 diabetes needs to receive insulin injections or have an insulin pump to survive.

Although the results are promising, there are some shortcomings to the model. The fact that the type 1 diabetes was not naturally occurring in the dogs and needed to be induced means there could be some surviving, functioning beta cells in the pancreas that weren’t chemically killed off. Likewise, any effective treatment for humans will need to deal with an immune system that is waging constant attack against its own insulin-producing cells. Another of the study’s limitations is the controlled environment in which the dogs were kept. Their regimented diets and amounts of exercise don’t replicate reality – the varied lifestyles of people with diabetes.

Dr. Massimo Trucco, Head of the Division of Immunogenetics at the University of Pittsburgh, isn’t hopeful that the therapy would be effective in humans. “Dogs get the food you want them to have,” he commented in an NIH report of the study. “They probably spent most of their time in a cage. But kids eat what they want and play when they want, meaning their [blood sugar level] varies dramatically.” He also finds fault with the gene strategy. “Beta cells are more complicated than muscle cells. Muscles just can’t secrete insulin quickly and efficiently like beta cells do.”

To address the behavioral concern, Bosch plans on following up the study with one that uses dogs with naturally occurring diabetes and who are also pets. Their voluntary eating and activity patterns will more closely model that of a person with type 1 diabetes.

All studies have their limitations. At the very least the gene therapy’s longterm safety in the current study is an achievement. We’ll just have to wait for future results to find out if the therapy only works in an artificial model in dogs or it holds promise for dogs with naturally occurring diabetes and their diabetic best friends.

Can stem cell treatment cure type 1 diabetes?

The Conversation: Can stem cell treatment cure type 1 diabetes?

By David Lesher
Special to The Bee
Published: Sunday, Mar. 3, 2013 – 12:00 am | Page 1E

JOIN THE CONVERSATION: How has diabetes affected you and your family, and what would it mean to have a cure? Add your comment below. To write a letter, go tosacbee.com/sendletter. Or comment on our Facebook page at facebook.com/sacramentobee.

If California voters are ever going to be happy with the $3 billion stem cell bond they passed overwhelmingly in 2004, it might be due to a company called ViaCyte. By next year, the modest lab in San Diego hopes to begin human trials for a treatment that could essentially curetype 1 diabetes.

The scientific review panel that recommended it last fall said this could be the “holy grail of diabetes treatment.” And the president of the state stem cell agency, Alan Trounson, declared at a recent board meeting: “This is verification of our program. … I think this will resound in California, I think it will resound in the United States and I think it will resound in the whole world.”

Nearly a decade after the California bond passed, stem cell science is starting to emerge from the laboratories with potential treatments that might approach the high hopes raised by a campaign of celebrities and Nobel laureates.

The California bond is currently supporting 24 experiments targeting chronic and costly conditions like Alzheimer’s, cancer, blindness, HIV and spinal cord injury that are expected to be in human trials during the next four years.

And at an annual State of the Industry conference in January, scientists and investors who often disagree said publicly for the first time that the field has reached an “inflection point” where years of promise are “starting to live up to that potential.”

“The first big success will be a major deal,” Jonathan Thomas, chairman of the stem cell agency, told me. “Whether it’s ViaCyte or whatever, once you’ve established stem cell technology as the route to a cure, you’ll see a shift in public perception, in investor perception, in the regulatory folks.

“I think 15, 20 years from now, when stem cell-related therapies or cures are routine, you’ll look back at this as being a pivotal period really in medical history.”

 

Keeping research afloat

 

As the state agency approaches the end of its bond funding four years from now, ViaCyte may be the best hope of satisfying the high expectations raised by Proposition 71. No project has won more of the bond money than ViaCyte – nearly $40 million total. Without it, the struggling company may not have survived. With it, scientists see the possibility of a historic achievement for medical science. 

As many as 3 million people in the United States suffer from type 1 diabetes at a cost of nearly $15 billion per year nationally and more than $2 billion annually in California. For those suffering from the condition, scientists hope ViaCyte’s treatment will end the need for daily insulin injections and blood monitoring as well as the long-term risk of life-threatening conditions such as blindness,heart disease and kidney damage.

ViaCyte estimated the potential U.S. market for a type 1 diabetes treatment at about $30 billion, which could expand to a market worldwide and to some type 2 patients.

“Obviously we’re hoping that we can hit it out of the park and that this is essentially a cure for patients with type 1 diabetes,” ViaCyte President Paul Laikind told me. “One of the nice things about this program is that the end points are really clear. We’re bringing in patients that don’t make insulin. So if we put this in and they start producing insulin, it’s pretty clear why.”

ViaCyte is located near the University of California, San Diego, just off Torrey Pines Road, a longtime corridor of cutting-edge research that is now a concentration of biotech labs. The company does not have one of the many new laboratories, where stunning, modern architecture perched on a panoramic ocean bluff conveys the big money and futuristic treatments at stake in biotechnology today.

ViaCyte is about two blocks away on the urban-facing side of the bluff in a cramped cinder-block office that was built by the military to study peaceful uses for nuclear power soon after the first atomic bomb was dropped. Today, those labs are a nursery for human embryonic stem cells.

 

Stem cells in an envelope

 

The power of embryonic stem cells is that they can grow into any cell in the body. In this case, the recipe and schedule of nutrients provided to the cells is designed to mimic the growth of the human pancreas. After about two weeks of precise and patented nurture, the stem cells develop into precursor pancreas cells, which are expected to produce insulin in response to blood sugar levels when they’re placed in a human body. 

Part of the excitement about ViaCyte’s approach is that the cells would be contained in a porous and synthetic envelope that is inserted just under the skin. The circulatory system plugs into the device, called Encaptra, which is smaller than a business card and performs like an artificial pancreas. It would contain insulin-producing beta cells while it allows blood to flow in and insulin to flow out. With the cells inside, it also can be frozen and stored or shipped to doctors anywhere.

The device resolves two of the greatest challenges facing most stem cell treatments. First, it protects the cells from the body’s immune system, which often rejects stem cell treatments. Second, regulators are expected to be more comfortable – and perhaps quicker to approve – a treatment that contains the experimental cells in a retrievable package instead of letting them roam around the body.

In hundreds of experiments with mice and rats over the last few years, the device has successfully managed the blood sugar levels of animals with experimentally induced diabetes. They’ve shown that it will release insulin in proportion to the body’s need even when scientists triggered extreme high or low blood sugar levels.

Type 1 diabetes is the best application for the ViaCyte device because it is a disorder in which the immune system attacks and kills insulin-producing beta cells in the pancreas. About 90 percent of diabetics suffer from type 2, where the device might be helpful to those who need insulin treatments. For most, however, type 2 diabetes means that cells have grown resistant to insulin, requiring a different type of treatment.

 

Still a funding gap

 

ViaCyte has had two meetings with federal regulators as it prepares for Phase I human trials, which are expected to include about 50 patients and last for up to two years. If all goes well, Laikind said, the treatment could be commercially available in five to 10 years. 

The biggest challenge is obviously to prove that the treatment will work in humans as it did in animals. But another is funding. Surprisingly, even with a promising treatment in a state that passed a bond for stem cell research, ViaCyte is scrambling to pay its bills.

Last fall, pharmaceutical giant GlaxoSmithKline indicated that it would shepherd the project through the expensive and uncertain human trials. Unexpectedly, however, the company dropped its interest in December, pointing again to the increasingly risk-averse posture of private investors that has become a major threat to biotech research.

In response to an email question, GlaxoSmithKline said it “remains very interested in the ViaCyte technology. We made a business decision based on timing that was not related to scientific or technical issues.”

The funding gap is well known to scientists as the “Valley of Death,” a period of high cost and high risk before a treatment is proven to work. The failure rate of treatments that reach human trials is very high. At a conference last year about a variety of diabetes treatments under study, ViaCyte’s project was called “extremely promising” with the caveat that “it’s often the last mile that proves the most difficult.”

As private investors have grown more reluctant to take such risks, the valley has widened. So, unexpectedly, the state bond that passed because of federal restrictions has instead become a critical replacement for disappearing private money.

 

Stakes are high

 

ViaCyte was at a pivotal point in 2009, the start of the Great Recession, when it won a $19 million grant from the state stem cell agency. Laikind said it’s difficult to imagine another source for the money at that time, and without it the company was at risk. With the grant, the company doubled in size to about 50 employees and is now completing the safety tests required for human trials. 

Those trials have high stakes for ViaCyte, of course, but also for the stem cell agency.

The California Institute for Regenerative Medicine, as the agency is known, has been under significant pressure to demonstrate success. Recently, it was stung by controversy once again when a report from the prestigious Institute of Medicine echoed earlier complaints that too many board members represent institutions that receive grants from the agency.

It’s a conflict inherent in Proposition 71, which ordered that most of the 29 board members be selected from California universities and research institutions, the same places where most of the money must be sent. And it’s another lesson about the inevitable flaws of California’s ballot-box budgeting.

Three other initiatives that passed around the same time – for mental health, preschool children and after-school programs – have cost the state more than $20 billion and counting. None of them have received the kind of scrutiny paid to the stem cell agency. If they did, we’d likely find flaws.

Proposition 71 has yet to achieve its goals. But nobody doubts that it established California as a global leader in this emerging science. It also seeded two dozen treatments headed to human trials soon and many more under development in 12 new laboratories that the bond funded around the state.

There should be concern about conflicts of interest with public funds. But Californians should also know there is much more going on with their bold investment in a risky science. They passed a flawed ballot measure that created an imperfect organization that is expected to save lives and boost the economy through an unprecedented state industrial policy.

And it just might work.

 

JENN McCOLLUM

Victorianist. Scholar. Professor.

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