Diabetes Archives - Active Healthcare

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Leaving on a Jet Plane: Traveling with Diabetes

Lisa Feierstein Diabetes Leave a comment  

travel by airBelieve it or not, the upcoming travel season is upon us. If you’re diabetic and planning a trip, you may be a bit anxious about how best to manage your condition while away from home. You’re not alone.

Taking a trip will require more preparation, but can still be an enjoyable experience. Below are a few tips to help you with your trip planning:

Before You Travel: Get your documents together

  • Prescriptions from your doctor for any medications, as well as for your medical devices (CGM, insulin pump, etc.)
  • Documentation that specifies that you are a diabetic.
  • If traveling to a foreign country, make sure this document is translated to the language spoken in any of the countries on your itinerary.
  • Make a few copies of this document and distribute them to anyone traveling with you.

Packing Tips

Put medications in your carry-on bag

  1. Store medication in a quart-size plastic container or bag so that airport security can easily identify them at the checkpoint.
  2. Separate them from other liquids in your carry-on luggage.
  3. If possible, keep your insulin bottles or pens in their original packaging, as this will provide airport security staff with the prescriptions they will be asking for.
Packing Suitcase for Travel

Over pack your supplies

When packing your supplies, take twice as much as you think you will need.

Pack non-perishable snacks

Keep a few ready-to-eat snacks in your carry-on luggage for those blood sugar dips.


Additional Travel Resources

  • Visit the Transportation Safety Administration’s (TSA) website – Be sure to check out the requirements of the TSA ahead of time so you will know what to expect at the security checkpoint.
  • Look into loaner pumps – Many pump manufacturers offer loaner programs. Check with your specific pump manufacturer for details.


The 411 on CGM

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The medical device market is always advancing technologically, as with most other industries. One new technological development, the Continuous Glucose Monitor (CGM), provides added peace of mind to diabetics by providing 24-7 information about blood sugar levels. This constant feedback provided by the device allows for better short and long term control of your diabetes, which will also improve your A1C levels.

The device is comfortable to wear and decreases the number of finger pricks you need to perform daily to check blood sugar. Patients who use a CGM often only need to test their blood sugar twice per day. Two finger pricks per day is much better than the typical number of ten times! This is a huge step forward in diabetes management.

CGM Components

A CGM system includes three components:  a sensor, transmitter, and receiver. The sensor inserts into your skin and uses the same enzyme as a test strip (glucose oxidase) to measure blood glucose. The glucose oxidase in the sensor converts the glucose in your blood to hydrogen peroxide, which reacts with the platinum in the sensor. This reaction sends a signal to the transmitter, which inserts into the sensor. The transmitter then communicates with the receiver (or other connected device), notifying you via alerts if your blood sugar is trending high or low. Sensors need to be replaced every seven days.

Here at Active Healthcare, we have a number of patients benefiting from CGM. Our patients appreciate the ability to analyze their blood glucose results and adjust their basal levels accordingly instead of guesstimating from multiple manual tests. We offer two Dexcom (www.dexcom.com) systems, the G4 Share and the G5.  The G5 is Dexcom’s newest model and pairs with a smartphone or any Apple device, eliminating the need to carry your receiver around. This is especially good for patients who already carry a lot of supplies and devices around to manage their diabetes, such as students. Both systems enable the patient to share device information with up to five other people.  We also provide the ongoing supplies for our CGM patients and can send these in the same shipment as your regular diabetic supplies.

Integration with Insulin Pumps

Many insulin pumps are now integrated with CGM including the Animas Vibe and Tandem G4.  The newest Tandem pump, the t-slim X2, will have compatibility with this feature later this year.  Because the CGM is a complex device, it is recommended that patients get as much information and training as possible both from their physician, diabetic educator, and the various manufacturers before beginning its use.


Keeping You in the Loop About the Artificial Pancreas

Lisa Feierstein Diabetes Leave a comment  

If you have Type 1 diabetes, your entire day can be spent treating your condition. Over the past few decades, technology has advanced significantly, making life as a Type 1 diabetic easier than ever before. The FDA approval of a new medical device called the artificial pancreas in September 2016 will continue this trend. Derek Rapp, President and CEO for the Juvenile Diabetes Research Foundation (JDRF) says that the artificial pancreas “is a historical achievement for JDRF and the entire T1D community. After years of laying the ground work, this life-changing breakthrough is a true testament to the reason JDRF exists, which is to accelerate ways to cure, prevent, and treat this disease.”

Smart Phones and Diabetes Control: Mimicking the Pancreas

Researchers at the University of Virginia are developing and testing these devices. This device has two components: a smartphone and an implanted insulin pump. You may be asking yourself, but how does it work? The smartphone component uses an algorithm to deliver just the right amount of insulin into the body, as well as control blood levels. The insulin pump receives the patient’s blood sugar levels from the smartphone every five minutes in a process called “looping.” The device performs the same functions as a healthy pancreas.

Clinical Trials for Closed Loop Systems

Trials are being conducted all over the United States and Europe, the first of which is the International Diabetes Closed-Loop trial. This trial will be performed using the device developed by UVA and will be led by Boris Kovatchev, director of the UVA Center of Diabetes Technology. According to Kovatchev, the artificial pancreas is “not a single-function device; it is an adaptable, wearable network surrounding the patient in a digital treatment ecosystem.”

Les Hazelton, a 59 year old type 1 diabetic from Minnetonka, Minnesota, says that until he enrolled in a trial at Park Nicollet’s International Diabetes Center in Minneapolis, he was always chasing his blood sugar. “It was totally mind-blowing. I like being in better control of my body and my disease. The more I know about what’s happening right now, the better I can manage it,” he said.

You are likely wondering when such a device will be available on the market. Diabetes In Control www.diabetesincontrol.com says that with several trials having been conducted in 2016, we could see the first artificial pancreas available sometime this year.


Five Misconceptions About Diabetes

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health Leave a comment   , ,

There are many misconceptions about diabetes. Below are a few of them followed by the truth.

Myth: People get Type 1 diabetes from eating too much sugar

Reality: No one really knows how someone gets the disease.

It does not mean that the patient eats too much sugar. “Type 1 is like being hit by lightning, and it’s not anybody’s fault,” says Steven Griffen, MD who is a vice president for the Juvenile Diabetes Research Foundation (JDRF). Researchers still can’t pin down the real cause of this disease, but it means that the patient’s pancreas is not processing insulin the way that it should.

Myth: It is dangerous for people with diabetes to exercise or participate in sports

you can exercise if you have diabetesReality: Patients can safely participate in sports or any other exercise program.

As long as the patient pays attention to their blood sugar levels, it is possible to participate in sports and even thrive as an athlete. Professional athletes such as tennis star Bill Talbert, boxer Jersey Joe Walcott, and golfer Sherri Turner are all Type 1 patients.

Myth: Diabetics should avoid all sugar and carbohydrates

Reality: Diabetics can and should have some sugar and carbohydrates. 

Did you know that diabetics also experience extreme lows in their blood sugar?  Yes, it’s true.  When a diabetic has a blood sugar nosedive, this is called hypoglycemia.  The highs are referred to as hyperglycemia.  Hypoglycemia can make the patient feel just as bad as if their sugar is too high. Hypoglycemia can be avoided by a regular intake of natural sugars. Diabetics can try eating fruit and complex carbohydrates like whole grain bread and pasta to prevent hypoglycemia.

Myth: Diabetes is caused by being overweight

Reality: There are two very different types of diabetes.

Type 1 is an autoimmune disease that never goes away. Type 2 symptoms can diminish with weight management and dietary changes.  Being overweight puts you at risk for Type 2 diabetes, but Type 1 patients often find it difficult to gain weight.

Myth: Diabetes is easy to control.

Check your blood sugarReality: Diabetes is hard to control, no matter how diligent one is with sticking to his/her meal plan and treatment schedule.

Treatment is ongoing. People often assume that the patient “has it all figured out.”  Stress, hormone changes, growth spurts, and illnesses can all cause a diabetic’s blood sugar to swing.

On the upside, there are so many more ways to combat Type 1 diabetes now than ever before. Patients now have many options available to them to make life with Type 1 diabetes more manageable including insulin pumps, continuous glucose monitors, and even an artificial pancreas.


The Sunshine Vitamin: Diabetes Edition!

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The Sunshine Vitamin
The sunshine vitamin strikes again! Last month, we discussed how important vitamin D can be to reducing children’s risks for asthma. Now we will also look into how the “sunshine vitamin” could be affecting risks for diabetes. First, what exactly is vitamin D?

Not a Vitamin, but a Hormone

Vitamin D is a unique steroid hormone that influences nearly all the cells in your body. It is the only vitamin your body can create – when sunlight is absorbed in your skin. Your body creates this vitamin and turns it into a hormone. Vitamin D is important to your overall health – and low levels have been linked with many chronic diseases. Most recently, diabetes and pre-diabetes have been linked with low levels of vitamin D.

There is a distinct connection between insufficient vitamin D and insulin resistance and diabetes, both type 1 and 2. Findings in recent research indicate that a vitamin D deficiency affects your glucose metabolism. Low vitamin D may actually be more closely linked to diabetes than obesity. In one study of 118 people, it was determined that a vitamin D deficiency and obesity interact synergistically to raise the risk of diabetes and other metabolic disorders.

How Much is Enough?

Researchers also discerned that for every unit increase in vitamin D levels, the probability of progression towards diabetes in people with pre-diabetes went down by eight percent.

In another study in 2013, researchers gave type 2 diabetics 50,000 IUs of oral vitamin D3 per week for eight weeks. Study participants experienced a meaningful reduction in fasting plasma glucose and insulin. A different study with over 5,000 individuals with impaired glucose intolerance discovered vitamin D supplementation increased insulin sensitivity by 54 percent.

Animal studies have also supported that vitamin D is a foundational factor necessary for normal insulin secretion. They also found that vitamin D improves insulin sensitivity.

Optimizing levels of vitamin D among the general population could help protect against cardiovascular disease, autoimmune disease, and infertility. DNA repair and metabolic processes, migraines, mental disorders, and notably, both type 1 and 2 diabetes, could be improved as well.

As stated in our other Sunshine Vitamin post, all it takes is a few minutes in the sun to absorb some vitamin D. No need to sit in the sun for hours and raise risks for skin cancer! Additionally, supplements with vitamin D3 are also recommended – in particular if they contain vitamin K2, as it has been found to aide in the maximum absorption of vitamin D into your body.

The Sunshine Vitamin is truly invaluable support to your body’s overall health and disease prevention!


Diabetes and the Dopey Effects of Dopamine

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dopamine levels in your brain

Have you ever wondered if there was more as to why it can be so hard to eat well? Insulin has been linked to the pleasure centers of our brain! According to a recent study, insulin has been found to be strongly allied with dopamine, a neurotransmitter that controls pleasure. This can mean a myriad of things for people with diabetes, as well as those at risk.

What is Dopamine?

First, what exactly is dopamine? It is a neurotransmitter that acts as a chemical messenger in the brain. It has many vital roles in our brain and its functions include movement, memory, attention, and most commonly known pleasure and reward seeking behavior.

At New York University Langone, researchers determined that the more insulin in the in the brain, the higher the release of dopamine. Consequently, this creates the need for us to seek out high-carb or sugary foods in order to escalate insulin levels in the brain. That in turn triggers the release of dopamine. Thus, instilling a reward system in the brain.

“Our work establishes what we believe is a new role for insulin as part of the brain’s reward system and suggests that rodents, and presumably people, may choose to consume high-carb or low-fat meals that release more insulin – all to heighten dopamine release,” said Margaret Rice, senior study investigator and neuroscientists at New York University Langone.

Low Calorie Diets = Healthy Levels of Insulin in the Brain Too

Dopamine levels were found to rise between 20 and 55 percent as a group of mice and rats ate and increased their glucose quantities. Rats who were fed a low-calorie diet only needed 10 percent of the insulin needed by rats on a normal diet to elicit an elevated release of dopamine. Essentially, this means that lowering insulin intake lowers the baseline needed to stimulate a dopamine release.

The link between higher insulin levels and diabetes makes this a dangerous discovery for those with a type 2 diagnosis. Higher carb and sugary foods increase insulin levels in the brain. This may explain why many find it difficult or near impossible to follow a healthy diet. Likewise, following an unhealthy diet means that people need more insulin to trigger the dopamine response in the brain. And so, the cycle continues.

The good news is that if these findings continue to hold, diets can be adjusted in healthy ways to manage that dopamine-reward rush! I don’t know about you, but making smart food choices and conscious decisions are much easier for me when I understand the mechanisms working behind it.


5 Natural Remedies to Aide Diabetes

Lisa Feierstein Diabetes Leave a comment   ,

herbs smallI have often thought that there has to be ways to boost my body’s ability to care for itself without adding to my medicine cabinet. There has been a surge in patients seeking naturopathic doctors, as well as traditional medical doctors researching the benefits of naturopathic remedies alongside necessary prescriptions. Many clinical trials have shown that herbs can successfully assist in the treatment of various diseases such as diabetes. The traditional medical system of India, Ayurvedic medicine, finds the following herbs to help manage diabetes. It is still extremely important to maintain your relationship with your doctor and to check in before trying any herbal supplements. However, herbs can become a complimentary support to your regular treatment plan.

1. Gurmar – Translated from Hindi as the “sugar destroyer,” this is a tropical herb native to southern and central India and Sri Lanka. Its leaves have been known in India for centuries for its anti-diabetic and anti-inflammatory uses. Natural Medicines Comprehensive Database (NMCD) states there is developing research suggesting an extract, in combination with diabetic medications, can moderate blood sugar levels in people with type 1 or type 2 diabetes. It is also used to facilitate weight loss.

2. Cinnamon – A familiar spice to Americans, particularly in the fall, some evidence suggests that cinnamon might help people with Type 2 diabetes. In an early study, two daily doses of cinnamon showed that it lowered fasting glucose by 18 to 29 percent, triglycerides by 23 to 30 percent, LDL cholesterol by 7 to 27 percent, and total cholesterol by 12 to 26 percent. Despite this, a few studies still yield mixed results. As it is easy to incorporate into a diet, many doctors still recommend it.

3. Fenugreek – A common addition to Indian dishes, this plant’s seeds have been cited to have an affinity for regulating insulin. It contains an amino acid known to increase the body’s production of insulin when blood sugar levels are high. In some studies of animals and humans with both diabetes and high cholesterol levels, fenugreek lowered cholesterol levels as well as blood sugar levels.

4. Shilajit – Every summer as the Himalayan mountains warm, India’s most prized herbal remedy literally oozes from resins in the mountain crevasses in the form of Shilajit. This nutrient-rich biomass has been touted for millennia by Ayurveda’s Materia Medica as the best carrier of energy and nutrition into the human body. As an endocrine tonic, shilajit supports the pancreas in insulin secretion.

5. Artemisia – Also known as “wormwood,” for women with gestational diabetes, a daily extract is associated with improved insulin sensitivity, according to a study. The researchers observed significant reductions in fasting plasma glucose, serum insulin levels, insulin resistance, and beta-cell function in the Artemisia extract group compared with the placebo group.


The 5 Best Apps for Diabetes Management

Lisa Feierstein Children's Health, Diabetes, Men's Health, Women's Health 1 , ,

Smartphone Apps to Track Health

Diabetes Apps AboundWith the advent of apps for smartphones, there’s something nostalgic about using a pen and paper. At meetings, I often find myself still jotting down action items in a notebook instead of in my iPad. But, when it comes to tracking my health, I’m grateful to have so many intuitive and user-friendly apps at my disposal. I can track my sleep habits, exercise and diet easily with my smartphone. There are also a number of useful health tracking apps available for individuals with specific conditions like asthma and diabetes.

Diabetes App Roundup

Here’s a roundup of some of the best diabetes apps available:

  1. Diabetes Logbook: This free app is available on the iPhone and Android platforms; Diabetes Logbook is a personalized way to track meals, blood sugar, carbs and more. The app manages to be both entertaining and educational, making users more motivated to consistently manage their diabetes.
  2. OnTrack Diabetes: A simple, intuitive design makes this app user-friendly. Available for free for Android users, OnTrack Diabetes is a way to log medication use, glucose levels, weight, exercises and more. Tables and graphs can easily be shared with doctors.
  3. Carb Counting with Lenny: This app’s colorful design and built-in mascot, Lenny the Lion, encourages children with diabetes to get in the habit of carb counting. The app also includes educational games that help boost kids’ confidence in better managing their diabetes. This app is free and available to iPhone users.
  4. Diabetik: Individuals with type 1 or type 2 diabetes can easily monitor meal frequency, blood glucose levels, and medication intake via interactive charts with the free iPhone Diabetik app.
  5. HealthyOut: This free app makes eating out easier by providing users with the ability to search for local restaurants that offer more diabetic-friendly meals. Users can search based on filters like “Low Carb” or Low Fat” to find healthy options while eating out.

Thanks to colorful designs, interactive charts, and user-friendly features, these apps streamline diabetes management in intuitive ways. App users can often share key data with doctors and have confidence in experiencing greater control over managing their condition.


Type 1 Diabetes in Children on the Rise

Lisa Feierstein Children's Health, Diabetes Leave a comment  

Diabetes in Children on the RiseThe rate of children with type 2 diabetes has declined since 2002, but unfortunately, the rate of type 1 diabetes in children is on the rise. Researchers used a national database to track the rate of type 1 diabetes amount children in the U.S. and published the results of their study in the journal “Diabetes Care” in December 2015. The rate of type 1 diabetes among children rose nearly 60% since 2002, from 1.5 case per 1,000 children in 2002 to 2.3 cases per 1,000 in 2013. This increase isn’t isolated to the U.S., researchers are noticing the upward trend of type 1 diabetes in other countries.

Possible Causes for Increase in Diabetes in Children

The reason for this change is unknown, but doctors believe some potential causes could be an increase in C-sections, antibiotic use, and processed foods that may be reducing the diversity of gut bacteria. The lack of diversity in these bacteria could trigger type 1 diabetes in children with a higher genetic risk of developing the condition. Gut bacteria have a broad impact on overall health–researchers also recently discovered that a lack of four key gut microbes could increase the risk of children developing asthma.

Stress Increases Diabetes Risk

Another potential influencer on the development of type 1 diabetes is stress. A Swedish study of 10,500 children found that serious stress increased the risk of type 1 diabetes in children threefold. Stressors like a divorce or death in the family, or a serious accident were some of the triggers linked to an increased risk of type 1 diabetes in children.

Type 1 diabetes occurs when the body attacks it’s own pancreatic cells that produce insulin. There is no cure for this form of diabetes, and patients must take insulin their whole lives to manage the condition. Promising new technological advancements, like the bionic pancreas, have improved the treatment of type 1 diabetes, and could make managing the condition simpler and more comfortable for patients.


Treating Sleep Apnea Reduces Risk of Diabetes

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Photo by ResMed

Photo by ResMed

Untreated sleep apnea is tied to a whole host of other health problems like an increased risk for heart disease, hypertension, stroke and diabetes. The risk goes both ways for sleep apnea and diabetes – type 2 diabetes can increase the likelihood of obstructive sleep apnea (OSA), but having OSA can also increase the chance of developing diabetes. Individuals with severe OSA are at a 30% higher risk of developing type 2 diabetes. A new study reinforced the importance of treating OSA with CPAP therapy because it can reduce the risk individuals with prediabetes face of eventually developing diabetes.

This recent study was published in the American Journal of Respiratory and Critical Care Medicine, and researchers investigated the effect of using CPAP therapy for eight hours a night on the development of diabetes. Thirty-nine study participants that were middle-aged, overweight or obese with prediabetes and sleep apnea were assigned to two weeks of CPAP treatment or given a placebo.

Blood sugar control improved for participants using CPAP, they experienced lower blood pressure, and had 27% lower levels of the stress hormone norepinephrine than the placebo group. In addition to regular use of CPAP machines, OSA patients can also reduce their risk of developing diabetes by practicing healthy eating habits and through weight loss.


Study Shows Breastfeeding Reduces Risk of Type 2 Diabetes in Women with Gestational Diabetes

Lisa Feierstein Children's Health, Diabetes, Women's Health Leave a comment  
Breastfeeding has many benefits for both babies and mothers.

Breastfeeding has many benefits for both babies and mothers.

The decision to breast-feed or use formula is one of those polarizing parenting subjects akin to co-sleeping or hiring a nanny versus using day care. Breastfeeding can be a real challenge for busy moms, but researchers continue to find more and more examples of how breastfeeding benefits a baby’s immune system. In addition ato delivering antibodies, breastfeeding reduces a baby’s risk of asthma. Breastfed babies also have fewer ear infections, respiratory conditions, and hospitalizations. When the topic of breastfeeding comes up, the focus is often on the impact breastfeeding has on the baby. New research published in the Annals of Internal Medicine shows that breastfeeding can also greatly benefit the mother by reducing the risk of developing type 2 diabetes.

The study focused on 900 women two years after they gave birth—the women in the study each had gestational diabetes during their pregnancy. Breastfeeding for over two months reduced their risk of developing type 2 diabetes by 50%. Study participants who both breastfed and used formula experienced a 30% reduction in the risk of developing type 2 diabetes.

Study author Erica Gunderson, a senior research scientist at Kaiser Permanente Northern California, explains how breastfeeding allows the insulin-producing cells in the body to take a break, so to speak, because they don’t have to generate as much insulin to lower blood glucose. Breastfeeding also burns glucose and fat in the bloodstream because those nutrients are used in creating milk. Breastfeeding brings the body’s metabolism back to normalcy “after the metabolic chaos of pregnancy,” says Dr. Alison Strube, assistant professor of maternal-fetal medicine with the University of North Carolina School of Medicine – Chapel Hill.

There are a variety of reasons why some women choose not to breastfeed—busy schedules, difficulty finding a secluded space to breastfeed in public, and because babies digest formula more slowly so bottle feedings may be less frequent. Whatever a mother’s ultimate decision, this study is encouraging in that it shows that mothers who had gestational diabetes can still benefit from a reduced risk of type 2 diabetes by using a combination of breastfeeding and formula. If you’re a new or expecting mom, talk to your doctor about the pros and cons of breastfeeding and using formula to make an informed decision about the best option for you and your baby.


Air Pollution Could Increase Risk of Diabetes

Lisa Feierstein Children's Health, Diabetes Leave a comment  

Air Pollution_CCO_Pixabay_2016_02_04It’s easy to recognize the effects of air pollution on our ability to breathe, but air pollution can cause a myriad of other health conditions. Air pollution is the ninth most important cardiovascular risk factor for heart disease, and new research shows that it could also increase the risk of resistance to insulin in children—a red flag for the onset of diabetes.

A recent study of nearly 400 German children, age 10, revealed that insulin resistance increased 17% for every 10.6 micrograms per cubic meter increase in ambient nitrogen dioxide. Previous studies have revealed a connection between traffic-associated pollutants and the development of diabetes in adults. When individuals breathe in fine particulates from pollution, those particles make there way into heart and blood vessels, and increase inflammation and insulin resistance. A study published in January in the European Review for Medical and Pharmacological Sciences established that “Air pollution is a leading cause of insulin resistance and incidence of type 2 diabetes mellitus.”

To reduce exposure to air pollution, individuals can monitor the Air Quality Index (AQI) and avoid outdoor activities when the AQI exceeds 100. Exercising on greenways instead of next to roadways also reduces exposure to vehicle exhaust. For more tips on how to reduce exposure to air pollution, check out our blog post on “Why Outdoor Air Pollution is Hard on Your Heart.”

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How to Exercise Safely with Type 1 Diabetes

Lisa Feierstein Diabetes Leave a comment   ,
CCO, Pixabay

Aerobic and anaerobic exercise will have different effects on blood sugar levels.

For many of us, making the decision whether or not to go to the gym after work (or before work for you early birds!) is a daily struggle. There are so many activities vying for your time whether it’s a trip to Target, happy hour with friends, or that new season of your favorite show that was just released on Netflix. For individuals with type 1 diabetes, making it to the gym is much more than a matter of willpower. Exercising with type 1 diabetes means carefully taking into consideration blood sugar levels before, during and after exercise. Although exercise presents a unique challenge for individuals with type 1 diabetes, it improves quality of life, reduces the risk of complications related to type 1 diabetes like heart conditions, and can make it easier to control blood sugar levels. If you have type 1 diabetes, you’ve probably found that different exercises, the time of day you exercise, and what you ate before and after exercising all have an impact on how your body handles physical activity.

Since there are a lot of variables at play that can impact your blood sugar levels, begin your journey to better fitness by trying out one exercise at a time. That way, you can adjust for other variables—like food consumed and time of day—that affect how your body responds to exercise.

Ginger Vieira, author of “Dealing with Diabetes Burnout,” knows first hand the challenge of exercising with type 1 diabetes. She suggests keeping an exercise diary and writing down “the time of day, your pre-exercise blood sugar, anything you just ate, and any insulin you just took. Then write down exactly what kind of exercise you’re doing and for how long you’re doing it.” Vieira also recommends checking your blood sugar midway through the exercise and after exercising. She prefers exercising first thing in the morning before breakfast when her blood sugar is in-range and her energy is at its highest.

In addition to what you’re eating, how much insulin you’ve taken, and when you’re exercising, the type of exercise you do will also impact your body’s response. Cardiovascular or aerobic exercise, like swimming or running, uses more glucose so it tends to lower your blood sugar. You may need to eat extra carbohydrates before exercising to keep your blood sugar in a safe range. Strength training or anaerobic exercise, like weight lifting, is fueled by fat, and according to Vieira, can “increase your sensitivity to insulin later in the day while it works to repair and build those muscles.”

As you add to your exercise journal and learn what does and doesn’t work for you, remember that it’s normal to get frustrated sometimes. It’s called a workout for a reason, right? Exercising regularly is hard work, but the benefits are lasting and will boost not only your physical but also your mental health. To avoid those days when Netflix wins out over the gym, build up a support system. Workout with a friend and keep each other accountable in regard to your fitness and diet goals. If you’re schedule doesn’t mesh with your friend’s, try out a group fitness class or work with a personal trainer who can tailor a fitness plan to your needs.

Sources:

Exercise and Type 1 Diabetes, by the American Diabetes Association

5 Tips for Exercise with Type 1, by Ginger Vieira, Insulin Nation

Type 1 Diabetes and Exercise, by Daphne E. Smith-Marsh, edocrineweb


Women with Diabetes at Higher Risk of Heart Attacks than Men

Lisa Feierstein Diabetes, Men's Health, Women's Health Leave a comment  

In the Chinese study, Dr. Xue Dong of the Affiliated ZhongDa Hospital of Southeast University of China and his team looked at studies from 1966-2014 and analyzed health data of nearly 11 million individuals. Their research revealed that women diagnosed with diabetes are 40% more likely to have acute coronary syndromes than men with diabetes. An Italian study, led by Dr. Giuseppe Seghieri from the Regional Health Agency in Florence, looked at reports from 2005-2012 and over three million individuals. Researchers found that women with diabetes had a 34% higher risk of a heart attack than men with the condition.

About one-third of the 16 million Americans with diabetes don’t know that they have the condition. Women with gestational diabetes also have a greater risk of developing type 2 diabetes later in life, and research has shown that women with diabetes are three times as likely to develop heart disease than women without it. Men with diabetes also experience adverse changes to their heart, but not to the same degree as in women with diabetes. Although diabetes affects men and women differently, both genders should take the condition seriously and work with their doctors on a treatment plan.

 

 


Bionic Pancreas Improves Control of Blood Sugar Levels for Diabetics

Lisa Feierstein Diabetes 1


A big challenge for individuals with type 1 diabetes is having to continually check blood sugar levels and administer insulin throughout the day. A new device called the “bionic pancreas” would alleviate the need to both manually check glucose levels and administer insulin. A research team at the University of Cambridge, and another team at Boston University and Massachusetts General Hospital are both developing bionic pancreases.

Roman Hovorka, Director of Research at the University of Cambridge has been developing the artificial pancreas with colleagues Professor David Dunger and Dr. Carlo Acerini. The artificial pancreas consists of a sensor that communicates with an algorithm to regulate blood sugar levels. The sensor is implanted in the abdomen and synchs wirelessly with an algorithm installed on a mobile device, like a cell phone or tablet. If the patient’s blood sugar rises, the algorithm alerts their insulin pump to administer the exact amount of required insulin. Because the sensor continually monitors glucose levels, individuals with type 1 diabetes can literally rest easy—the bionic pancreas alleviates the need to wake up at night and check blood sugar levels.

The research team tested the device on 33 adults and 25 children over a period of three months. The team compared the study participants’ use of both the bionic pancreas to sensors and pumps that aren’t connected to the algorithm. Adult participants stayed in the “ultrasafe” blood sugar target zone 68% of the time, compared to 57% with current systems on the market. Children only used the artificial pancreas at night and stayed in the target zone 64% of the time as opposed to 34% of the time with other systems. The research team is working with a medical device company to move forward with commercialization of the algorithm.

Boston University and Massachusetts General Hospital are also working together on a bionic pancreas called the iLet, as part of their Bionic Pancreas Project. The iLet also uses an algorithm to monitor blood sugar levels and administer insulin, but differs from the device under development by Hovorka’s team because it doesn’t need to synch with a smart phone or laptop. A Dexcom CGM sensor and transmitter communicates with the iLet device that contains two pumping systems to administer insulin and glucagon. The iLet team says, “Until a cure is found, the goal of the Bionic Pancreas Project is to reduce the impact of diabetes for people who have to live with it.” Their goal is to bring the device to market in 2017.


Type 1 Diabetes Vaccine Under Development

Lisa Feierstein Children's Health, Diabetes Leave a comment  
Researchers are testing a new vaccine for type 1 diabetes.

Researchers are testing a new vaccine for type 1 diabetes.

The CDC recommends children get vaccinated for 16 diseases including polio, the flu, chickenpox, and the measles. A vaccine for type 1 diabetes may be added to that list in the near future–researchers at the University of Florida are currently developing a vaccine for type 1 diabetes.

When tested on mice, the type 1 diabetes vaccine prevented 40% of the mice from developing the disease. Developing this vaccine was different than creating a vaccine for a disease like the flu. Vaccines for the flu signal the immune system to attack the virus, but with a type 1 diabetes vaccine, researchers had to find away to train the immune system to identify and accept insulin, rather than to fight it. The goal of this vaccine is different because it needs to stop an immune response, rather than to trigger one.

Researchers used two methods to deliver the vaccine and found both to be equally effective. Their goal is to identify which approach will be safest and require the least amount of injections. Scientists also hope to implement clinical trials as they better identify the best method to administer the vaccine.

Nearly 10% or about 30 million Americans had diabetes in 2012, and of those with the condition, 1.25 million have type 1 diabetes, according to the National Diabetes Statistics Report, 2014. Type 1 diabetes occurs when the body doesn’t make insulin, which is a hormone that extracts glucose from the bloodstream and delivers it to the body’s cells to use for energy. A viable vaccine would be a boon to the medical field since type 1 diabetes is treatable with medication, but there is no cure.


Diabetes Service Dogs Sniff Out Changes in Blood Sugar Levels

Lisa Feierstein Children's Health, Diabetes 3 Comments
Diabetes alert dogs are able to smell changes in blood sugar levels.

Diabetes alert dogs are able to smell changes in blood sugar levels.

I’m always impressed by the skills dogs can learn—skills that save lives in some cases. Service dogs help sight-impaired individuals better maneuver through their environment, are used in search and rescue missions, and protect soldiers over seas. Perhaps a less-widely known role for service dogs is assisting individuals with diabetes.

ABC News recently published a unique story about 15 year-old Elle Shaheen, a type 1 diabetes patient, and her service dog Coach, a yellow Labrador Retriever. Diabetes alert dogs are able to smell changes in blood sugar and can alert their owner right away by nudging or scratching their owner. Shaheen felt immediately reassured the first time Coach alerted her to a change in blood sugar. She was testing her blood sugar up to a dozen times a day, but now Coach can let her know right away if she needs to take a test. However, there is a waiting list for diabetes alert dogs and it took two years before Elle was matched with Coach.

The American Diabetes Association (ADA) encourages diabetics to do their homework when researching a diabetes alert dog to make sure the dog is properly trained. There isn’t a standardized training method, so it’s important to ask a lot of questions about how the dogs are trained. Diabetes alert dogs also aren’t a replacement for monitoring blood sugar levels with a blood glucose meter and continuous glucose monitor, but they can add an additional level of comfort and security to keeping up with blood sugar levels. Also, finding a diabetes alert dog can be a long and pricey process, but non-profit organizations often provide dogs at low to no cost to the owner. For a full list of qualifications to look for in a diabetes alert dog, as well as suggestions of organizations to go through, take a look at this buyers guide by the American Diabetes Association.

Resources:

Diabetes Alert Dogs: Buyers Beware, by Jennifer Cattet and Dana Hardin, American Diabetes Association

Diabetic Girl and Yellow Lab Bond While He Works to Keep Her Alive, by Sarah Kunin, ABC News


Chronic Inflammation Increases Diabetes Risk

Lisa Feierstein Diabetes Leave a comment   , , ,

When we get hurt or have an infection, the body’s natural response is to trigger inflammation. Short-term inflammation helps the body heal as white blood cells fight off bacteria and viruses. Normal inflammation manifests as pain, swelling, redness, and a sensation of heat. Chronic inflammation, on the other hand, can occur in conjunction with some diseases, like arthritis, and it can also raise the risk of developing diabetes. In these cases, inflammation continues for years and damages body tissue. Individuals suffering from chronic sleep deprivation, gum disease, poor diet or obesity are among those at risk for long-term inflammation.

Researchers have found that chronic inflammation raises the risk of developing diabetes because it interferes with insulin’s ability to regulate glucose, which can cause high blood sugar. Inflammation damages beta cells that produce insulin in the pancreas, and inflammation is also a result of the main diabetes risk factors – obesity, smoking, and diets high in fat and sugar. High-carb, low protein diets are inflammatory for many people, but low-carb diets and diets higher in fruits and vegetables have been known to reduce inflammation. In observational studies, participants on the Mediterranean diet – high in fish, whole grains, beans, nuts and vegetables – have reported low inflammatory markers.

Gum disease, air pollution and cigarette smoke, and lack of exercise are all threats that can lead to chronic inflammation. These risk factors can be reduced through good dental hygiene, the use of indoor HEPA filters and by avoiding cigarette smoke, and with regular exercise. There are also some foods, spices and teas that can help to reduce inflammation. One of my favorite anti-inflammatory foods is dark chocolate! One square of dark chocolate (at least 70% cocoa) a day can help reduce inflammation. You can also reduce inflammation by drinking a few cups of rose hip tea a day, and by adding the spice turmeric to food. If you would prefer to take a rose hip or turmeric supplement, talk to your doctor to make sure these supplements don’t conflict with any medication you’re taking. Your doctor can also test for inflammation and work with you to develop a treatment plan.


Diabetes Drug Maker Owes Billions in Settlement

Lisa Feierstein Diabetes Leave a comment  

Type 2 diabetes patients should check with their doctor if they’re taking Actos – the medication has been linked to bladder cancer in several medical studies. Takeda Pharmaceuticals, the maker of Actos, didn’t admit liability but settled around 9,000 lawsuits related to the drug and owes $2.37 billion as part of the settlement. Patients taking Actos filed lawsuits for a number of reasons including Takeda’s failure to warn the public and health care providers that taking Actos could increase bladder cancer risk if taken for longer than a year, failing to properly test the drug, distributing the drug despite knowledge of dangerous side effects, and withholding research data on Actos from the public.

Actos has been banned in France, Germany and India, but is still on the market in the U.S. with a Food and Drug Administration warning about bladder cancer. Symptoms of bladder cancer include abdominal pain, frequent or painful urination, and blood in urine. Bladder cancer usually occurs in individuals over the age of 55, and the average age of diagnosis is 73. In 2015, 74,000 new cases of bladder cancer were diagnosed in the U.S. and men have 3 to 4 times the risk of developing bladder cancer to women. If you take Actos, talk to your doctor about any concerns you may have after reading this blog.

 


Introducing the Smart and Painless Insulin Patch

Lisa Feierstein Diabetes Leave a comment  

Imagine having to self-administer medication with a needle multiple times a day. This is a reality for diabetics that have to regularly inject insulin. Diabetes currently affects over 387 million people worldwide, and that number is projected to reach 592 million by 2035. Researchers recently made some headway that could create a break in the insulin injection cycle. Scientists at the University of North Carolina and North Carolina State University developed a “smart” insulin patch that could make painful injections a thing of the past. The tiny penny-sized patch contains over 100 needles, but the needles are each the size of an eyelash and can painlessly deliver insulin. The needles also contain glucose-sensing enzymes that are released when blood sugar levels spike.

The patch worked well in a study of mice with type 1 diabetes, and researchers hope to mirror those positive results in human trials. The patch lowered blood glucose levels in mice for up to nine hours, but since humans are more sensitive to insulin than mice, the patch could last longer for humans.

The patch is “smart” because it can be personalized to the patient based on their weight and sensitivity to insulin. Injecting the wrong amount of medication can cause serious problems anywhere from limb amputation to comas to death. The “smart” patch could reduce the risk of human error and improve the accuracy of medication delivery. Researchers can also customize the patch to only alter blood glucose levels within a certain range. When administered too frequently, insulin injections can cause blood sugar levels to lower at a dangerous rate, so the customized patches would alleviate this problem.

Additional Resources:

Smart insulin patch could replace painful injections for diabetes, by Mark Derewicz, UNC Health Care and UNC School of Medicine


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