Diabetic Live

A new study suggests that more than 50% of all diabetics who must use insulin injections to manage their disease miss injections on a regular basis. Why would someone intentionally bypass the use of medication that can help them in their personal health care?

The role of insulin is especially important to those who have Type 1 diabetes because the pancreas either stops producing insulin or it is created at a less than ideal rate. There are some Type 2 diabetics that use insulin. However, in both cases there seems to be a significant number who risk long-term health complications by skipping insulin dosing.

According to WebMD, “The study showed that people with type 1 diabetes who didn’t follow their recommended diet were most likely to skip their insulin injections. Among those with type 2 diabetes, younger people, those with a lower income, and those who perceived their insulin injections as painful or embarrassing were more likely to skip them.”

According to MedicalNewsToday, “Using an Internet survey of more than 500 U.S. adults, the study found that 57% of survey respondents with either type 1 or type 2 diabetes purposefully failed to take their insulin shots at least occasionally. It also found that older patients, those who were disabled, those who followed a healthy diet and those with higher household incomes were more likely to take their shots at the frequency prescribed.”

A couple of underlying themes that seem to present themselves in noncompliance include low income and an other health issues that would cause the patient to at least consider that it may be less important to manage their diabetes.

However, according to MedicalNewsToday, “Risk factors for failing to comply with insulin regimens differed between those who had type 1 and those who had type 2 diabetes. The researchers found diet non-adherence to be a more prominent risk factor for missing injections in type 1 patients, whereas younger age, lower income, and perceived pain and embarrassment were more prominent as risk factors for people with type 2.”

WebMD reported, “Other factors that increased the likelihood of skipping insulin injections were:

• Not following a healthy diet
• Thinking that the injections interfered with their daily activities
• Feeling that the insulin injections were painful or embarrassing (Source: WebMD)

Roughly one-fourth of all diabetics must rely on insulin injections, but the truth is there is a large number who are not getting the shots they need to manage their health.

What may compound the issue is the number of physicians who may be resistant to prescribing insulin for their patents. While no medical professional wishes to over-prescribe a medication there seems to be evidence to support the claim that many physicians do not view insulin injections as a course of first response. Their lack of willingness to use insulin may cause some diabetics to believe that their primary care physician does not believe this form of medical care is important. If it’s not important then it may be believed that taking the medication may not be especially important either. A patient may even believe that medical advances may cure their condition soon so it may not be as important to work toward daily care.

Physicians working to educate their patients coupled with patients willing to engage in medical warfare against their disease will be needed in order to manage this disease both now and in the future.

Remaining Connected With Diabetes: Why is it that some diabetics seem to shrink into themselves and appear to have given up on life while others reach out and embrace whatever is to come next? One Type 1 diabetic has a thought – and it doesn’t take a dummy to figure out what she’s up to.

Annie Lario lives near Fort Saskatchewan, Canada. Lario is an entertainer specializing in the art of ventriloquism. She also lives with Type 1 diabetes.

Diagnosed with the disease at the age of 16 Lario could have taken her private pain and left the world stage in favor of a struggle less visible. However, Lario always seemed to thrive on entertaining those around her.

She participated in a recent fundraiser for the Juvenile Diabetes Research Foundation (JRDF) in Canada by providing a show featuring four of her ventriloquist puppets including Kittie, Kitango and Henry Kissingher.

Fort Saskatchewan The Record attributed Lario as saying, “Although there can be complications with diabetes, keeping healthy and being 100 percent honest with the doctors is the best way to avoid problems.”

This response indicates a need for action. It also indicates that doctors are there to help, but only if you allow them to.

Success in diabetes is to do the hard work of staying connected with others. This is important because depression is often a companion of diabetes. The reason face-to-face interaction is essential is that the self-talk we speak to ourselves can have us believing we are the only ones experiencing the difficulties associated with diabetes. We can cycle in a downward spiral to a place where others feel unwelcome and we are considered less than desirable to be around.

This condition also seems to follow many who move into retirement. They may have enjoyed interaction with others, but it becomes very easy to simply take the easy road and stay home rather than finding ways to connect with others.

Engaging life with a support group can go a long way in helping you overcome your depression or lethargy that may be related to diabetes. Finding ways to help others can allow you to dim the lights that are fixed on your own problems. This doesn’t mean you fail to treat your disease. What it does mean is that you embrace the role of one willing to see the needs of others in a light of equal value with your own.

Finding ways to help others can provide a sense of purpose and joy to your life that can be quickly diminished when your primary consideration is how poorly life has treated you.

This is true whether you struggle with Type 1 or Type 2 diabetes. And as hard as it may be to view yourself as a helper when you may believe you are the one needing help it is a powerful change in thinking that can alter your perspective on living.

Lario has lived with Type 1 diabetes for nearly 30 years. She continues to entertain audience as well as raise awareness and financial support for the JDRF. In recent years this has meant taking her brand of entertainment and walking a JDRF Walk to Cure backwards.

It may not always be easy to stay positive in dealing with your disease, but it is personally beneficial as well as a perceived positive development for those who love you and want the best for your life both now and in the future.

Casey Johnson’s Death Related To Untreated Diabetes: The Los Angeles County coroner came out on Thursday and said the socialite had died due to untreated diabetes. DKA or ketoacidosis was a direct result in her death.

Click here to learn more about ketoacidosis.

Children and Obesity: The Diabetic Connection: What has been suspected for many years is proven true in new research delivered by the New England Journal of Medicine – obese children are more likely to die at a young age.

According to the New England Journal of Medicine (NEJM), “The lifetime risk of type 2 diabetes is now more than one in three in the general U.S. population, and one in six adolescents is now obese, suggesting that prevention should start in childhood. Many consider diabetes and obesity to be ‘common-source’ epidemics that are rooted in our culture, as evidenced by national trends toward larger portion sizes and more meals built around calorically dense fast food, sugar-sweetened drinks, and sedentary behavior. Fighting such a powerful wave with purely clinical and adult-based approaches to prevention may seem like pasting a small bandage on a gaping wound. Rather than focusing on adults who may be set in their ways, we should perhaps target our youth, who may represent a better hope for changing the norms, habits, attitudes, and preferences that define our culture’s collective energy balance.”

The primary struggle with targeting young people is the lack of perceived reward for the effort. Because the risk of Type 2 diabetes among young people is relatively low there would need to be improved lifestyle changes in adulthood in order to justify the expense associated with youth intervention. The NEJM report states, “Impaired glucose tolerance, impaired fasting glucose, and elevated glycated hemoglobin levels are practical targets among adults not only because they indicate a high risk of diabetes but also because structured lifestyle interventions can be highly effective. Segregated interventions may not work as well among youths because the long incubation period from risk factor to disease and unclear positive-predictive value for the development of diabetes and its complications make for inefficient risk stratification and allocation of intervention resources.”

There are other studies being conducted to help determine the actual benefit of childhood intervention with respect to Type 2 diabetes. A secondary study will follow 6,000 children through, “a unique, rigorous test of a model intervention to reduce glucose levels and other risk factors that incorporates thoroughly integrated nutritional, physical-activity, behavioral, and social-marketing components. Other experts suggest that we must reach far outside the schoolhouse to find out whether focusing policies on culturally embedded risk factors — sugar-sweetened beverages, calorically dense foods, excessive television and video watching, the high price and limited availability of healthy foods, and community designs that discourage physical activity — can be as fruitful as targeting tobacco, saturated fat, and trans fats has been for the prevention of cardiovascular disease, “ according to the NEJM.

WebMD suggests, “The American Academy of Pediatrics has a tool parents can use called 5210…It stands for:

• 5 servings of fruits and vegetables daily
• 2 hours or less of television viewing daily
• 1 hour of exercise daily
• 0 or nearly zero sugar-sweetened beverages daily (Source: WebMD)

What this new research seems to tell us is that obesity in childhood is a problem that can lead to diabetes and premature death. However, because these ‘problems’ can be decades away there may be a problem in developing support to address the issue in childhood since the risk of imminent death is not typically an issue. There are those who believe these findings may be used as a foundation for a long-range plan to enable better choices among the world’s youth.

Tackling Diabetes in Rural America: Health care can be a struggle for many Americans, but it can be even more so in rural locations where care can be more difficult to find. What can be done to provide quality care for diabetic patients in rural locations?

According to a new report from the American Diabetic Association (ADA), “Because of its widespread prevalence and potentially debilitating impact, diabetes has become an international and national priority area of health concern. Although the importance of addressing diabetes is well recognized, translating clinical, evidence-based management interventions for practical implementation has proven difficult, particularly for rural communities. Individuals living in rural communities often encounter difficulties obtaining appropriate health care because of distance from health clinics, financial limitations, cultural barriers, mistrust, communication issues, and high rates of health illiteracy.”

Rates in diabetes cases are 17% higher in rural areas, yet access to health care may be limited by many factors. The ADA report suggests, “Significant challenges such as small sample size, technology and staffing limitations, and data collection issues have made quality of care comparisons between rural and urban centers difficult at best. There is ample evidence, however, that rural communities grapple with system-level barriers such as high rates of poverty; limited access to insurance, specialty medical care, and emergency services; and minimal exposure to diabetes education, all of which exacerbate the associated complications of detecting and managing diabetes. For example, it is not uncommon for rural diabetes patients to have difficulty affording glucose meter strips for routine glucose self-monitoring or to have foregone screenings, such as eye examinations, that are crucial to the detection of diabetes-associated comorbidities. These system-level barriers may exert a more profound effect on rural racial and ethnic minorities, whose household incomes are 40-50% less than that of rural white households and 50-60% less than suburban white households.”

Technology is considered a front-runner in providing the support many rural diabetics may need. This includes online tracking as well as access to live support from qualified medical providers who can answer questions via the Internet or phone. For those who prefer a face-to-face visit with someone the ADA report suggests, “One increasingly popular approach to addressing diabetes care in remote or underserved communities is to involve trained lay individuals who understand their communities and who themselves have diabetes or are intimately familiar with its day-to-day management. Community Health Advisors (CHAs), “natural helpers” from the community who are trained to deliver health information and facilitate health care access, are increasingly involved in health-promotion strategies to reach underserved communities.”

To a greater or lesser degree these strategies are being used in various ways in multiple rural locations. The ADA report concludes, “Significant strides have been made toward addressing the diabetes epidemic in rural areas. However, there remains much work to be done to optimize self-management and improve outcomes for those living with diabetes in rural communities. Several strategies have been identified, including telemedicine, telephone help lines, Web-based interventions, and CHAs, each with its own set of strengths and limitations. Future research is needed to delineate which strategy or combination of strategies will be best suited for broad-based implementation.”

The development of a synergistic approach to health care in rural locations is going to be important as a means of maintaining a lifestyle consistent with rural living within the context of healthy outcomes using multiple resources to alter end results.

An Oceanic Light Switch for Type 2 Diabetes: What if medical science could find a way to allow humans to turn diabetes on and off again? Would there be benefits? If so, where did the idea come from?

You may have watched the television show Flipper when you were young or perhaps you’ve seen reruns. What you may not have realized was that this dolphin (and others like him) could become diabetic and then return to a non-diabetic state as needed.

The way this works is that in times when food is scarce the dolphin will develop a condition that mimics diabetes. When there is plenty of food the situation reverses and the diabetic condition goes away.

This ability allows for significant blood sugar levels to maintain energy for mental function.

Right now diabetes is responsible for five in every one hundred human deaths. In fact, the prominence of diabetes is expected to double in the next ten years, as is the overall rate of obesity.

Dr, Stephanie Venn-Watson made the discovery off the coast of San Diego, California according the Telegraph.co.uk. This article reported, “By taking regular blood samples of the dolphins, she discovered that they could induce type II diabetes at times of fasting and then almost immediately turn it off again when food became available.”

The report suggests a ‘fasting gene’ exists in humans, but isn’t currently called upon to provide a similar function as observed in dolphins. The hope is that if this gene can be accessed it is possible to essentially shut off diabetes. In fact Dr. Venn-Watson suggests this ability may be the “smoking gun” in stopping diabetes in its tracks.

Dr. Venn-Watson believes that, “researching the dolphin’s DNA to work out how they do it could result in therapies in humans to switch on the ability again.”

The Telegraph article quotes Dr. Venn-Watson as saying, “Dolphins in the ocean go in to feast or famine situations. They will eat a bunch of fish at once and then they may go a while and fast and not eat.

“During that fasting state they need a mechanism to keep sugar pumping around their blood.

“Dolphins can switch off diabetes but people cannot. Could there be gene therapies that control that switch if it exists in humans. If we could control that switch like dolphins it could be a cure.

“Then identifying and controlling such a switch could lead to possibly a cure for type II diabetes in humans.”

As with many types of research one hurdle will be the care and treatment of the dolphins. Many animal rights groups have already expressed outrage that blood samples will need to be taken from dolphins to conduct the research. These animal rights groups are opposed to research on the dolphin for any purpose.

Dr. Venn-Watson told the Telegraph that, “many [dolphins] ‘volunteered’ for research, approaching the beach and putting their tails in the air to have their blood taken.”

One other complication is the fact that others within the medical community are not at all certain that dolphins use blood sugar in the same way humans do. In this regard there are questions as to the validity of the premise from which the study is derived. As with all research there will be disagreements as to the meaning and importance of the findings. For Venn-Watson this is considered a monumental finding that may alter the face of diabetes.

The Lack of Sunshine May Increase Risk for Diabetes: If you’ve reached middle age and are looking for a common dietary supplement that can be taken to help reduce the risk of both cardiovascular disease and Type 2 diabetes you might look no further than Vitamin D. For an effective dose of the vitamin you might just try spending more time outdoors.

According to research at the Warwick Medical School at Warwick University in the UK individuals could reduce their “chances of developing heart disease or diabetes by 43%” when sufficient doses of vitamin D were accessed.

The Warwick study concentrated on, “Cardiometabolic disorders include cardiovascular disease, type 2 diabetes mellitus and metabolic syndrome.”

A press release from Warwick indicates that vitamin D is “a fat-soluble vitamin that is naturally present in some foods and is also produced when ultraviolet rays from sunlight strike the skin and trigger vitamin D synthesis. Fish such as salmon, tuna and mackerel are good sources of vitamin D, and it is also available as a dietary supplement.”

The scope of the research is significant in that there was no singular study. Instead researchers compiled data from 28 separate studies that included nearly 100,000 patients. These patients represent both genders and multiple ethnicities. The studies were conducted over a nearly 20-year period in multiple countries including the U.K., the U.S., and India.

According to the release, “The studies revealed a significant association between high levels of vitamin D and a decreased risk of developing cardiovascular disease (33% compared to low levels of vitamin D), type 2 diabetes (55% reduction) and metabolic syndrome (51% reduction).”

Researcher Dr Oscar Franco said, “We found that high levels of vitamin D among middle age and elderly populations are associated with a substantial decrease in cardiovascular disease, type 2 diabetes and metabolic syndrome.

“Targeting vitamin D deficiency in adult populations could potentially slow the current epidemics of cardiometabolic disorders.”

WebMD defined vitamin D as a supplement that promotes, “the proper use of calcium and phosphorus, thereby producing growth, together with proper bone and tooth formation, in young children; the sulfate, a water-soluble conjugate, is found in the aqueous phase of human milk.”

While we understand this as a benefit in youth and as we age it can be easy to forget the benefits of vitamin D in between. This research suggests it is beneficial to keep the vitamin in mind.

WebMD suggests that the most affordable and easily accessible form of vitamin D is simply in spending more time enjoying the outdoors. Your body absorbs vitamin D via the sun storing it much like a rechargeable battery. WebMD suggests, “Exposure of the hands, face, arms, and legs to sunlight two to three times a week for about one-fourth of the time it would take to develop a mild sunburn will cause the skin to produce enough vitamin D.”

Because we tend to spend so much time indoors we are a world suffering from vitamin D deficiency. WebMD elaborates, “Vitamin D deficiency is more common than you might expect. People who don’t get enough sun, especially people living in Canada and the northern half of the US, are especially at risk. Vitamin D deficiency also occurs even in sunny climates, possibly because people are staying indoors more, covering up when outside, or using sunscreens consistently these days to reduce skin cancer risk.”

This trait is also seen as people age and determine to spend more time indoors. The answer is either more time in the sunshine or the use of a vitamin D supplement. Good health may depend more on enjoying sunshine than you imagined.

Introducing the Monthly Diabetes Test: In an effort to manage the costs of healthcare in a more efficient manner one medical company is touting the benefits of a once monthly test that has now officially received a patent.

According to a company press release published a year ago, “The Epinex G1A™ Rapid Diabetes Monitoring Index Test is a revolutionary monthly rapid test that uses glycated albumin to measure how much damage has been done to the body by excess sugar. The Epinex G1A™ test will be a significant asset to help keep costs down by introducing a monthly testing paradigm that has been proven effective. This test could allow doctors to take action sooner than current diabetes testing methods, reducing the severity and cost of diabetes and its complications, which include blindness, kidney failure and cardiac disease.”

This information was published in response to President Obama’s initial suggestion that health care needed a major overhaul. At that time Epinex CEO, Asad Zaidi said, “With our current financial crisis, Epinex is working on a product that will help save our already over-burdened healthcare system billions of dollars, while helping diabetics manage their disease more effectively.”

Almost a year to the day since Epinex introduced their G1A™ Rapid Diabetes Monitoring Index Test another report surfaces. “The United States Patent and Trademark Office (USPTO) granted Epinex Diagnostics the patent for its primary technology, the G1A™ Rapid Diabetes Monitoring Index Test. The patent (US7659107B2) is for the first ever rapid glycated albumin test and instrument, which could redefine the way diabetes is monitored for over 250 million diabetics worldwide.”

The Epinex originated press release states that, “Albumin is an ideal monthly marker as it is replaced in the body every 2-3 weeks. Using only a pinprick of blood, the test will simultaneously and rapidly measure glycated albumin and total albumin. Researchers at the Wake Forest University School of Medicine have described glycated albumin as a ‘more robust’ and ‘more accurate’ indicator of long-term glycemic control.”

Albumin is described as, “Any of numerous simple heat-coagulable water-soluble proteins that occur in blood plasma,” by Miriam-Webster Medical.

Epinex describes the standard process for testing, “Diabetics currently monitor themselves with multiple daily blood glucose tests, and HbA1c testing every 4-6 months. Scientific studies have demonstrated that current monitoring methods for type 2 diabetics (95% of all diabetics), are ineffective due to low compliance rates, physiological interference with accuracy, and delayed time frames for therapeutic interventions.”

Zaidi suggests, “Doctors will no longer have to wait 4-6 months to see if treatments are working. “The G1A™ test will allow doctors and patients to adjust their therapeutic and lifestyle interventions on a monthly basis instead.”

The company further indicates, “Several U.S. clinical studies have demonstrated that monthly diabetes management is effective in reducing costs and improving outcomes. Diabetes currently costs the U.S. over $113 billion annually, and costs are projected to triple over the next 25 years. Monthly G1A™ testing has the potential to bring about substantial cost reductions in diabetes care, fewer patient complications, and improved quality of life for over 250 million diabetics worldwide.”

One year ago U.S. President Obama said, “Crushing health care costs…drag down our economy, bankrupt our families, and represent the fastest-growing part of our budget.” Epinex contends their device can play a role in reducing costs and improving the potential of greater diagnostics in patients with diabetes.

Why Prediabetes Isn’t Taken Seriously: Medical staff members suggest that there may be a huge prediabetic population in the United States. Simple steps are offered to these individuals, yet it seems the end result is a failure to acknowledge the condition and to make lifestyle alterations that could prevent diabetes.

According to WebMD, “A new study shows nearly 30% of all adults in the U.S. have prediabetes, yet more than 90% aren’t aware of it. Moreover, only about half of people with prediabetes are taking any steps to reduce their risk, like losing weight or exercising more.”

A diagnosis of prediabetes is a clarion call that asks the patient to turn from the habits that may be allowing diabetic-like symptoms to emerge. Yet for many patients it is simply a diagnosis they feel comfortable ignoring. The reasons may be unclear, but the study does consider some possible reasons, “The results showed only 7.3% said they had been told by a health care provider that they had prediabetes. Less than half (48%) with prediabetes had been tested for diabetes or high blood sugar in the past three years.

“Researchers found adults with prediabetes were more likely to be male, older, and have lower educational status than those without the condition. They were also more likely to have an immediate family member with diabetes.

“When asked if they had taken one of the following three diabetes prevention measures in the last 12 months, only about half said yes,” said the WebMD report.

I think one of the psychological risk factors in not dealing with a diagnosis of prediabetes is denial. If a person doesn’t feel sick they may assume there really is nothing wrong and certainly nothing worth worrying about.

You’ll notice in the above quote that many prediabetics who do nothing to alter their lifestyle actually had other family members with diabetes. These individuals may fall into one of two arenas of thought. The first may be that there is no way to avoid the disease so why try. The other thought suggests that perhaps the individual can dodge a bullet and be the one to avoid the disease. This mentality hinges on the idea of ‘what you don’t know won’t hurt you.’ In the end these individuals will be the ones who do not return for follow-up doctor visits and consider their lack of full diagnosis to indicate they don’t have diabetes.

What you may find interesting is that for those patients who were told they absolutely needed to make lifestyle changes because the doctor was up front about the condition and didn’t hold back the end result in most cases was that the individual was more serious about losing weight and adding exercise to their daily routine.

It is believed that the incidence of diabetes, and by extension prediabetes, may double in the next ten years. This is reason enough for primary care physicians to be very clear when discussing what prediabetes is and what it can lead to. Suggestions should become recommendations and educational programs might need more development in the arena of psychological responses to the news.

It can be easy to disregard the advice of a physician, but in the case of prediabetes the ones you hurt have names. I’m not just talking about your partner and or children, but also you. If you knew someone was going to try to break into your house today you would do whatever you could to stop it. Why isn’t the same concern given to prediabetes. You can replace your material possessions – can you replace your own life?

American Idol and Diabetes: Diabetic news has a decidedly American Idol influence this week with news both stateside as well as from earthquake ravaged Chile.

On February 27th an 8.8 magnitude earthquake struck the South American country of Chile. Amazingly fewer than 1,000 people were reported dead, but many others were stranded including former American Idol contestant Elliott Yamin. Using the social networking tool, Twitter, Yamin sent tweets to his followers telling of the devastation he saw and the people he encountered.

It didn’t take long for Yamin to realize he had his own crisis developing. He tried not to overplay the potential problem, but his plight did become newsworthy. Yamin is a type 1 diabetic and he had only packed enough insulin to last through March 1st (when he expected to be back home). It became clear that outbound flights were not going to be happening anytime soon because relief efforts meant more than usual inbound air traffic. In essence Yamin’s only way out of Chile did no coincide with his need for diabetic medical supplies.

One of Yamin’s tweets read, “I thought this was the end of my life.” As of the 3rd of March Yamin was still in Chile, but due to the assistance of the U.S. Embassy and the manufacturer of his insulin he was able to receive the required medication. He has also ventured to the city of Santiago where he has access to improved medical assistance. It is expected that Yamin will be back in the United States by the time this article is read.

Meanwhile, for the first time in American Idol (AI) history the order of a telecast was altered because of a contestant struggling with diabetes. Idol hopeful Crystal Bowersox was hospitalized as a result of diabetes complications. AI producers made the decision to reverse performance schedules to allow the possibility that Bowersox could still perform. The men performed Tuesday, March 2nd and the women performed the next night.

Bowersox was the first to perform and she seemed fully in control of herself and her performance as she tackled a Credence Clearwater Revival classic.

When Bowersox made no mention of her medical difficulties the American Idol judges took note and praised her for managing such a difficult ordeal without trying to use the instance as a means of enlisting a sympathy vote. Virtually all the judges spoke of her illness and then glowingly about her performance. Ellen DeGeneres went so far as to say the competition needed her.

Bowersox seems intent on encouraging votes in her direction based entirely on her ability as a singer and not because of the disease she lives with. Her performances seem to indicate she is a fan favorite this season.

Yamin and Bowersox are not the only individuals attached to the program to live with diabetes. Judge Randy Jackson was diagnosed with Type 2 diabetes and responded by undergoing a gastric bypass surgery. Jackson is quoted as saying, “It’s like the largest wake up call in your life.” He’s written a book about his experience that was just released through Penguin books.

In 2006 Yamin shared the stage with another Idol hopeful, Kevin Corvais. Both men struggled with Type 1 diabetes.

Perhaps the best news is that both types of diabetes are represented in emerging stories surrounding American Idol. In all cases the individuals involved continue to work at making appropriate choices and controlling their glucose levels. They are determined to not allow the disease to stop them from reaching their goals.