Category: Diabetes 101

It’s a sport you may not follow and his is a name you may never have heard of, but this world champion is diabetic and he’s facing struggles he did not imagine when he took up his sport. This is the story of Raymond van Barneveld.

“Barney’s” sport is professional darts – and he takes it very seriously. He’s won multiple world championships and is a favorite among fans. He hails from the Netherlands and is that countries most celebrated darts player.

In his early 40’s Barney was diagnosed with diabetes in August 2009. He tells the Daily Star, “It’s getting worse.” Barney clarified his diagnosis in mirror.co.uk, “While on holiday in Spain, I discovered I was diabetic. I was waking up every morning with needles and pins in my arms, and it turned out my blood sugar level was four times higher than it should be. It’s Type 2 diabetes, which means I don’t have to inject insulin or take pills, but it’s becoming worse and sometimes I’m so tired… I find it hard to focus.”

As he worked toward his 6th world championship his struggle was not against his competition, but with the effects of his diabetes. Barney is quoted by the Daily Star as saying, “When I’m on stage, I can’t focus as it costs me so much energy every time. I am tired, too tired. The diabetes is my biggest obstacle.”

Mirror.co.uk reported on the recent championship round, “The five-times world champion was so shattered at one stage he could barely retrieve his darts from the board, and was only able to complete his victory after taking sugar tablets and apple juice backstage during the break.”

It is commonly discussed among fans that professional dart players are not always the most fit individuals, but fans are cheering on Raymond van Barneveld as he continues his fight to manage his diabetes.

Barney admits that his greatest struggle is with himself, “I like my food, I like a drink,” he told Mirror.co.uk.

Barney’s response may not be entirely uncommon when a diagnosis of diabetes has been given. Habits are hard to change and restrictions can seem like a sentence of death or lifelong punishment. However, in order to improve your health picture a change in personal direction is needed.

There is a psychological component in determining to roll with new changes related to self-management in diabetes. While it is often initially resisted there will come a time when an individual is tired of being tired, weary of feeling sick and wants to change simply to reengage with life.

You will find many articles here that describe the success stories of men and women who were diagnosed with diabetes and made the hard choices necessary to become a better picture of health and a greater asset to their families.

The next chapter on Raymond van Barneveld hasn’t been written, but the pride of the Netherlands could choose to use his platform as a way to help share the message of diabetes prevention. He could choose to alter lifestyle choices in order to manage his disease better. Barney has choices – and so do you. What will your next chapter look like?

“Somehow I managed to win, but while my brain was telling me everything was all right, my body was shutting down, saying ‘No, I can’t do it any more, forget it’.” – Raymond van Barneveld

Recent analysis from the National Center for Health Statistics indicate there may be a leveling off of obesity cases in the United States. While this is good news there are still roughly a third of Americans who are obese and another third that are overweight.

The recent ten-year average shows an increase of 5% over decade earlier figures. This figure is an increase, but less of an increase than experts had anticipated.

This research also pointed to information that may be startling to some. It is possible to be overweight and not see any prominent health issues as a result of the excess weight. However, that weight had to be located in the arms, legs and buttocks. Excess weight here actually seems to provide some protection. Weight that collected around the stomach was the troublesome weight that seems to cause individuals the most medical difficulty.

The primary reason this seems to be true is that stomach fat places added stress and strain on organs located in the stomach and chest area. The fat here is much harder to get rid of and often very easy to put back on.

Exercise and diet are both keys to managing excess weight, but there appear to be rules that go along with weight management that you may not have realized. For instance you can actually work out too much. The hunger you feel from losing so many calories in an extended workout can cause you to engage in eating that you may feel is justified given the extensive effort you just endured. This hunger can actually cause you to pack on more weight than you are losing in long workouts.

Some experts recommend a light snack before and after exercise that can help curb the appetite and add some help to blood sugar regulation – especially for those who are diabetic. It can be easy to crash following exercise because your blood sugar is too low – just make sure to resist the urge to ‘pig out’.

Sleep is also a perfect companion to weight loss goals. When you sleep less than 6 hours a night or more than 9 hours your body begins to recognize the deficiency or excess as signs of stress. This is when your body releases a hormone called Cortisol. This hormone follows the advice of squirrels in winter. It seeks to store fat so that in the event that you need to react to whatever is causing you stress you will have the energy stores to manage the emergency. The trouble is you may not have a point of physical stress and there may be no reason to have the excess stores of energy. By seeking to remove stress agents form your life you are also decreasing the effects of Cortisol. Sleeping more than 9 hours a night may allow you to feel great when you first wake up, but you will often feel very tired as the day goes on. So, even on the weekend 7-9 hours of sleep is still the right amount.

With the prevalence of diabetes in our society it makes sense to work at reducing weight (even 5-7%) to make a big difference. Working to reduce stress can also be a great way to engage in a good night’s sleep while allowing long-term health to have the best chance of survival.

Americans may always struggle with weight issues, but the fundamental decisions are the every day choices that either moves us closer or further away from our goals.

While the idea of an artificial pancreas has been discussed before, the idea has now moved past a strong potential to actual development. The new treatment is being called “revolutionary”.

According to ArtificialPancreaseProject.com, “The Juvenile Diabetes Research Foundation announced an innovative partnership with Animas Corporation to develop an automated system to help people with type 1 diabetes better control their disease – the first step on the path to what would be among the most revolutionary advancements in treating type 1 diabetes: the development of an artificial pancreas, a fully automated system to dispense insulin to patients based on real-time changes in blood sugar levels.”

As stated in an earlier report this device can allow Type 1 diabetics profound freedom because data is being sent wirelessly to compensate for blood sugar changes in the diabetic.

The Juvenile Diabetes Research Foundation said, “The objectives of the partnership, a major industry initiative within the JDRF Artificial Pancreas Project, are to develop an automated system to manage diabetes, conduct extensive clinical trials for safety and efficacy, and submit the product to the U.S. Food and Drug Administration for approval.”

The Animas Corporation is owned by Johnson & Johnson. The company has been promised $8 million over 3 years for the development of this product. Alan Lewis, PhD, President and Chief Executive Officer of JDRF said, “Ultimately, an artificial pancreas will deliver insulin as needed, minute-by-minute, throughout the day to maintain blood sugars within a target range. But even this early system could bring dramatic changes in the quality of life for the 3 million people in the U.S. with type 1 diabetes, beginning to free kids and adults from testing, calculating and treating themselves throughout the day.”

ArtificialPancreaseProject.com reports, “The first-generation system would be partially automated, utilizing an insulin pump connected wirelessly with a continuous glucose monitor (CGM). The CGM continuously reads glucose levels through a sensor with a hair-thin sensor wire inserted just below the skin, typically on the abdomen. The sensor would transmit those readings to the insulin pump, which delivers insulin through a small tube or patch on the body. The pump would house a sophisticated computer program that will address safety concerns during the day and night, by helping prevent hypoglycemia and extreme hyperglycemia. It would slow or stop insulin delivery if it detected blood sugar was going too low and would increase insulin delivery if blood sugar was too high. For example, the system would automatically discontinue insulin delivery to help prevent hypoglycemia, and then automatically resume insulin delivery based on a specific time interval (i.e., 2 hours) and/or glucose concentration. It will also automatically increase insulin delivery to reduce the amount of time spent in the hyperglycemic range and return to a pre-set basal rate once glucose concentrations have returned to acceptable levels.”

It is anticipated that first generation devices would still require input from diabetes patients to administer needed doses. Presumably this is intended to provide a human element to the insulin distribution. It is also presumed that at some point the device will be approved to make the changes on its own to allow the greatest amount of freedom to the more than 3 million Type 1 diabetics in the United States. ArtificialPancreaseProject.com adds, “The JDRF-Animas partnership will build upon the progress made since 2006 in the JDRF-funded Artificial Pancreas Consortium, a group of university-based mathematicians, engineers, and diabetes experts that has developed the computer programs needed for an artificial pancreas, and established their scientific feasibility.”

What if getting your body to recognize insulin was something simple – like turning on a light switch? A recent multinational study indicates it might just be that simple.

According to ScienceDaily.com, “A breakthrough by an international team of researchers in Canada, France, the UK and Denmark has uncovered a new gene that could lead to better treatment of type 2 diabetes, as well as a better understanding of how this widespread disease develops.”

This newly discovered gene doesn’t tell your body to develop more or less insulin, but rather, “how the body responds to insulin already in the bloodstream.”

The gene in question is referred to as Insulin Receptor Substrate 1 (IRS1). Dr. Robert Sladek of McGill University and the Génome Québec Innovation Centre in Montreal says, “IRS1 is the first inside the cell that gets activated by insulin. It basically tells the rest of the cell, ‘hey, insulin is here, start taking in glucose from the blood!’ If IRS1 doesn’t work, the whole process is disrupted.”

Sladek explains it another way, “Most of the genes that we’ve identified as diabetes risk genes to date reduce the function of the pancreas, specifically of beta cells in the pancreas that make insulin. IRS1 has to do with the function of the other tissues in the body. Rather than reduce production of insulin, this gene reduces the effect of insulin in muscles, liver and fat, a process called insulin resistance.”

Insulin generally takes glucose from the blood and converts it to energy. If the proverbial light switch hasn’t been turned on then tissue within the body may not know to take in the glucose. This condition allows for the development of diabetes.

What if medical science could find a way to kick-start the process? ScienceDaily.com suggests, “This study, which used genetic material drawn from more than 6,000 French participants divided into two separate groups, represents the final step in a series of collaborations between these researchers that has redrawn our understanding of diabetes genetics. In this instance, not only did the researchers pinpoint a new diabetes-linked gene, they found the genetic trigger, which leads to malfunction, in a totally unexpected place.”

Why is it unexpected? Scientists always look to closely connected issues to address problems they encounter. In this case the answer wasn’t even close to where they should have been looking. Sladek explains, “It’s a single-nucleotide polymorphism (SNP, pronounced ‘snip’), a single letter change in your DNA. What’s interesting about this particular SNP is that it’s not linked genetically to the IRS1 gene in any way; it’s about half-a-million base-pairs away, in the middle of a genetic desert with no known genes nearby. In genetic terms, it’s halfway from Montreal to Halifax. And yet we can see that it causes a 40-per-cent reduction in the IRS1 gene, and even more important, a 40-per-cent reduction in its activity. Which means that even if insulin is present, it won’t work.”

Is it possible that adding extra insulin may be less helpful in Type 2 diabetics than it should be? If the IRS1 gene switch isn’t working correctly than this could be the case. Returning to the light switch analogy Sladek concludes, “It’s possible that in diabetic patients, the signal to turn this gene on and off might be impaired. But we might be able to use one of the other pathways to turn it on.”

This could be a very positive step in disease management or at the very least better personalized diabetic care.

The first in a two-part look at the complications associated with diabetes in the United States by way of information from the Centers for Disease Control (CDC). This report takes a look at the most applicable diseases and conditions that mirror a diagnosis of diabetes.

Heart disease and stroke

• In 2004, heart disease was noted on 68% of diabetes-related death certificates among people aged 65 years or older.
• In 2004, stroke was noted on 16% of diabetes-related death certificates among people aged 65 years or older.
• Adults with diabetes have heart disease death rates about 2 to 4 times higher than adults without diabetes.
• The risk for stroke is 2 to 4 times higher among people with diabetes.

High blood pressure

• In 2003–2004, 75% of adults with self-reported diabetes had blood pressure greater than or equal to 130/80 millimeters of mercury (mm Hg), or used prescription medications for hypertension.

Blindness

• Diabetes is the leading cause of new cases of blindness among adults aged 20–74 years.
• Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.

Kidney disease

• Diabetes is the leading cause of kidney failure, accounting for 44% of new cases in 2005.
• In 2005, 46,739 people with diabetes began treatment for end-stage kidney disease in the United States and Puerto Rico.
• In 2005, a total of 178,689 people with end-stage kidney disease due to diabetes were living on chronic dialysis or with a kidney transplant in the United States and Puerto Rico.

Nervous system disease

• About 60% to 70% of people with diabetes have mild to severe forms of nervous system damage. The results of such damage include impaired sensation or pain in the feet or hands, slowed digestion of food in the stomach, carpal tunnel syndrome, erectile dysfunction, or other nerve problems.
• Almost 30% of people with diabetes aged 40 years or older have impaired sensation in the feet (i.e., at least one area that lacks feeling).
• Severe forms of diabetic nerve disease are a major contributing cause of lower-extremity amputations.

Amputations

• More than 60% of nontraumatic lower-limb amputations occur in people with diabetes.
• In 2004, about 71,000 nontraumatic lower-limb amputations were performed in people with diabetes.

Dental disease

• Periodontal (gum) disease is more common in people with diabetes. Among young adults, those with diabetes have about twice the risk of those without diabetes.
• Persons with poorly controlled diabetes (A1c > 9%) were nearly 3 times more likely to have severe periodontitis than those without diabetes.
• Almost one-third of people with diabetes have severe periodontal disease with loss of attachment of the gums to the teeth measuring 5 millimeters or more.

Complications of pregnancy

• Poorly controlled diabetes before conception and during the first trimester of pregnancy among women with type 1 diabetes can cause major birth defects in 5% to 10% of pregnancies and spontaneous abortions in 15% to 20% of pregnancies.
• Poorly controlled diabetes during the second and third trimesters of pregnancy can result in excessively large babies, posing a risk to both mother and child.

In part two of this series we will look at additional complications along with prevention and control efforts that can be put to effective use in diabetes management.