Posted on Jul 07, 2009 under diabetes |
A new study highlights the importance of good long-term control of blood sugar in people with diabetes.
The study found that poor long-term blood sugar control in diabetics is associated with a substantial increase in the risk of dying from ischemic heart disease — the type of heart disease characterized by restricted blood flow to the arteries of the heart.
However, with reasonably good blood sugar or “glycemic” control, the risk of death from ischemic heart disease is comparable to that seen in people without diabetes, the researchers found.
“Due to these findings, good glycemic control in persons with newly diagnosed diabetes should be recommended,” Dr. Ane C. Dale, from the Norwegian University of Science and Technology in Trondheim, told Reuters Health. “In addition, it is necessary to control other cardiovascular risk factors properly.”
In a 20-year follow up study, Dale and colleagues compared death rates from ischemic heart disease in 205 patients newly diagnosed with diabetes and 205 matched subjects without diabetes at the outset.
The researchers report in the European Heart Journal that diabetic patients had nearly a two-fold greater risk of dying compared to nondiabetic patients.
The risk for death from ischemic heart disease was four times higher in diabetic subjects with poor long-term blood sugar control compared to the control group, whereas in diabetes patients with “reasonably good” blood sugar control the risk was almost the same as in subjects without diabetes, Dale said.
These findings, Dale and colleagues conclude in their report, are “compatible with the hypothesis that good glucose control reduces the risk of coronary complications in patients with diabetes.”
SOURCE: European Heart Journal, June 2009.
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Technorati Tags: diabetes
Posted on Jun 09, 2009 under diabetes |
Body chemistry changes that lead to type 2 diabetes begin several years before symptoms become apparent, research has shown.
The researchers pinpointed specific changes in blood glucose levels and sensitivity to the hormone insulin.
They hope this could eventually be used to help identify people at high risk of the disease earlier, meaning action can be taken to delay its progression.
The Lancet study was led by University College London.
It was presented to a meeting of the American Association of Diabetes.
The researchers followed 6,538 UK civil servants over almost 10 years, during which 505 cases of type 2 diabetes were diagnosed.
They examined how the volunteers’ blood glucose levels and the capacity of their tissues to respond to insulin - known as insulin sensitivity - changed over time.
They also looked at how the insulin-producing beta-cells of the pancreas functioned over time.
Rapid acceleration
The researchers showed that in volunteers who did not develop diabetes changes in body chemistry occurred at a steady, even pace over time.
However, patients who developed diabetes showed a rapid acceleration in both fasting and post-meal blood glucose levels starting three years before they were diagnosed with the condition.
Insulin sensitivity decreased steeply during the five years prior to diagnosis among the diabetic group.
And their beta-cell function increased between years four and three prior to diagnosis, as their body tried to compensate for the raised glucose levels, but then decreased in the three years up to diagnosis.
The researchers said their work could help efforts to develop more accurate models to predict an individual’s risk of developing type 2 diabetes.
They said most prevention studies focused on people in the earliest stages of disease, but by that stage changes to body chemistry were already well advanced.
Lead researcher Dr Adam Tabak said: “Our model may help detect people at high risk to develop diabetes, so we can better target these people to prevent the development of the disease.
“We believe that an earlier intervention - before the conventional prediabetes stage - could delay diabetes development substantially.”
More work needed
However, in an editorial in the same journal, diabetes experts Dr David Matthews and Dr Jonathan Levy, from the University of Oxford, warn that much more work is needed.
They wrote: “Does this mean that we find those who are about to get diabetes - perhaps even three or four years ahead? We fear not.
“The sensitivity and specificity of the forward predictions would be poor.
“Now the hunt has to be intensified for the pathology that causes the decompensation that precipitates diabetes.”
Pav Kalsi, of the charity Diabetes UK, said: “Although these markers provide a good indication of future type 2 diabetes the lack of sensitivity and specificity means we cannot know for certain, so we’d welcome further research into this promising area of study.”
Judy O’Sullivan, of the British Heart Foundation, said: “This study provides better data than we have had before to show that those who are going to get diabetes have signs they are at risk for several years before the disease becomes clinically obvious.
“This reinforces the view that more careful and frequent earlier routine screening could lead to a significant gain in preventing or delaying the onset of the disease.”
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Technorati Tags: diabetes
Posted on Feb 24, 2008 under diabetes |
What are the Right Numbers?
Depending on where you look, recommended blood glucose levels can vary. The American Diabetes Association (ADA) numbers differ from the American College of Endocrinology (ACE) guidelines. The ACE recommendations are more strict than the ADA’s. How do you know which to follow? Ask your healthcare provider which goals are right for you. The table below compares the two sets of guidelines for blood glucose, blood pressure and cholesterol.
How many times a day should you check your blood glucose levels?
Checking your blood glucose levels often through out the day will help you to figure out how to keep good control. First thing in the morning before breakfast, two hours after a meal and before bed are good times to test. Other recommended times include before, during and after an exercise session, especially if it is strenuous or if you are feeling like your blood sugar may be low or high.
What is the A1C?
It’s a blood test that helps you and your doctor monitor your overall glucose control.
It gives an average of the amount of glucose in your blood over a few months’ time. It is usually ordered 2 to 4 times a year. If you are newly diagnosed or having trouble maintaining good day-to-day control, it may be ordered more often.
Sources:
“Checking Your Blood Glucose.” American Diabetes Association. ADA. 15 Dec 2006
American Association of Clinical Endocrinologists and the American College of Endocrinology, “The AACE System of Intensive Diabetes Self-Management - 2002 Update.” The American Association of Clinical Endocrinologists Medical Guidelines for the Management of Diabetes Mellitus. Endocrine Practice Vol. 8. 2002.
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Posted on Feb 03, 2008 under diabetes |
BERLIN—Barley beta-glucan reduces serum lipid levels, according to research presented in April at the First International Congress on Pre-Diabetes and Metabolic Syndrome.
In the six-week study, 76 men and 79 women with hypercholesterolemia, aged 25 to 73, completed a four-week lowfat diet prior to baseline. At the beginning of the trial, test subjects were randomly allocated to one of four treatment groups or a control group and assayed for blood lipids and other cardiovascular disease (CVD) biomarkers. During the course of the study, test groups were administered 3 g and 5 g doses of low molecular weight (LMW) or high molecular weight (HMW) barley beta-glucan (from Cargill) twice daily, in cereal and juice.
Post treatment assessment of blood lipids and other CVD biomarkers revealed improvements in low-density lipoprotein (LDL) cholesterol, triglycerides, markers of glycemic control (glycosylated hemoglobin, HOMA model) and a key marker of inflammation (hs-CRP).
The researchers concluded both doses of LMW and HMW barley beta-glucan improved blood lipids over a six-week treatment period.
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