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Diabetes: Symptoms, Treatment and Latest Research - SunilNagpal - 04-26-2015

Diabetes is a disease characterized by a 'prolonged' increase in blood sugar level, leading to an array of physiological disorders. Uncontrolled increase in blood sugar level (also termed as: Hyperglycaemia) if left untreated, eventually culminates into damaging various organs of the body. According to recent reports of WHO, about 347 million people worldwide have been affected by diabetes!

Causes and Types of Diabetes
Cause of diabetes may be linked to two factors. The two factors have lead to classification of diabetes into two types as well.

a) Type I Diabetes
Type 1 Diabetes occurs under the lack of production of the hormone that controls blood sugar. That hormone is "Insulin" and it is produced by Pancreas ( a glandular organ in the digestive and endocrine system of vertebrates). When body is unable to produce enough insulin, the blood sugar levels tend to rise up, but it can be controlled by external administration of insulin. This type of diabetes is thus also referred to as insulin-dependent diabetes. Type-1 diabetes often begins before the age of 40 and affects youngster mostly, hence also called Juvenile/child-onset diabetes.
Following is a very intuitive depiction of Type-1 diabetes (source: medicinenet)
[Image: 42943_type1diabetes.jpg]

Symptoms of Type-1 diabetes:
Type-1 diabetes is often characterized by polyuria (excessive urination) , polydipsia (high thirst), constant hunger, weight loss, vision changes and fatigue.

a) Type II Diabetes
Type 2 diabetes results from body's resistance to insulin and thus inability to use it, despite adequate production of the same. It's thus often dubbed as non-insulin-dependent diabetes. According to WHO, type 2 diabetes comprises 90% of people with diabetes around the world. It's genereally a result of unhealthy lifestyle, obesity, physical inactivity; which tends to be prevalent with age. Type-2 diabetes is thus dubbed as adult-onset diabetes as well.
Following is a very intuitive depiction of Type-1 diabetes (source: medicinenet)
[Image: diabetes_basics_bloodvessels2.jpg]

Symptoms of Type-2 diabetes:
Symptoms are often similar to Type 1 diabetes, but generally less marked than those in type-1. It's due to this less marked nature of the symptoms that, Type-2 diabetes may be diagnosed several years after onset post complications.

Recently, Children have also been observed to be affected by it.


Other types of Diabetes:

Gestational diabetes

Gestational diabetes, as the name suggests occurs during pregnancy. Hyperglycaemia does occur in this type of diabetes with blood glucose values above normal but below those diagnostic of diabetes. It often leads to increased risk of complications during pregnancy and at delivery with risk of type 2 diabetes in future.

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG)

Impaired glucose tolerance (IGT) and impaired fasting glycaemia (IFG) are termed as intermediate conditions in the transition between normality and diabetes. Althought not necessary, people with IGT or IFG are at high risk of progressing to type 2 diabetes.

Diagnosis of Diabetes

Diagnosis of Diabetes in general:
1. Glycated hemoglobin (A1C) test
A1C test is used to index the average blood sugar level of past two to three months of an individual. The A1C test is based on the attachment of glucose to hemoglobin (the oxygen carrying protein in RBCs). The typical life span of an RBC in body is around 3 months. Thus, the A1C test helps indexing the average of a person’s blood glucose levels over the past 3 months. Reported as a percentage. The higher the percentage, the higher a person’s blood glucose levels have been. A normal A1C level is below 5.7 percent.

2. Random blood sugar test
Irrespective of the time of meal, a person's random blood sugar level shouldn't be at or above 200 mg/dL (11.1 mmol/L). Above the 11.1 mmol/L level, a person can be suspected of diabetes, especially when observed to report symptoms of diabetes, such as frequent urination and thirst. Thus, Random Blood Sugar test is aimed at probing the concentration of sugar in blood at any random time.

3. Fasting blood sugar test
Fasting blood sugar test is done to observe the level of sugar in the blood of a person who has fasted for atleast 12 hours (often overnight). Fasting blood sugar levels less than 100 mg/dL (5.6 mmol/L) are considered normal, while those between 100 to 125 mg/dL (5.6 to 6.9 mmol/L) are considered prediabetes. Levels at 126 mg/dL (7 mmol/L) or above on two separate tests indicate that the person is having diabetes.

Diagnosis of Type-1 Diabetes vs Type 2 Diabetes
Once diagnosed with diabetes, it becomes important to ascertain the exact type of diabetes one is suffering from, as it is extremely significant in getting right line of treatment.

Apart from the indicative parameters of age of onset, precise tests for autoantibodies, C-peptide assay and test for presence of ketone bodies in urine can mark the difference between two types of diabetes.

Diagnosis of Gestational Diabetes
Gestational diabetes is diagnosed through prenatal screening, rather than through the reported symptoms.[/i]

Treatment of Diabetes
Type-1 Diabetes Treatment
External administration of Insulin becomes a necessity in the treatment of Type-1 diabetes. Insulin is injected subcutaneously (under the skin) in the fat layer where it gets absorbed into the bloodstream and thus reaches all body cells. Though the research is on, oral insulin administration hasn't come into practice in current state of art. Being a hormone, insulin is a hormone (protein in nature) oral administration might lead to denaturation (destruction of functional structure of protein) by the acidic environment of the stomach. Scientists are looking for other innovative ways to give insulin as the injections lead to puncturing holes into the skin of the already suffering patients. As of today, shots are the most widely used method.  Recently, insulin pumps as depicted below have also been developed (Image source: nlm.nih.gov):
[Image: 18035.jpg]
Type-2 Diabetes Treatment
Being more related to life-style issues, the first line of treatment of Type-2 diabetes involves:
Exercise (atleast 3-4 hours a week) and appropriate diet (not more than 1800 calories a day being the ideal way to go).

In most cases, insulin administration is not needed and some oral medicines like Metformin (which works by limiting liver's production of glucose and increasing insulin sensitivity) are prescribed.

External administration of insulin might be needed if life style changes and medications aren't able to control blood sugar level.

Some Scientific Updates on Diabetes

1. Stem Cells in Diabetes Treatment (CLICK HERE for updates)


2. Betatrophin, a new hormone for diabetes control (CLICK HERE for updates)


3. Successful use of Gene Therapy in treating Type-1 Diabetes (CLICK HERE for updates)

and many more to come...




RE: Diabetes: Symptoms, Treatment and Latest Research - Greg - 04-28-2015

Being a diabetes patient myself, I would like to add some additional information on ...
How to keep your Diabetes under control.

#1: Every Diabetic is unique and his personal treatment and recommended tests may vary due to many factors. Therefore it is important to get a personalized check dome from a good doctor/diabetologist at least twice a year.

#2: These tests indicate your current health status and health complications that may arise in future. Doctor will prescribe medications accordingly.

#3: Visit your Doctor (once a year): Will check your blood pressure, weight, feet and possible recommend you to a dentist.

#4: Eye exams (once a year): Diabetes can damage the small blood vessels in your retina, which is the back part of your eye. This condition is called diabetic retinopathy. Diabetes also increases your risk of having glaucoma, cataracts, and other eye problems. Smoking can be extremely bad for Diabetics. If you at all find difficulty in dim light, or start developing blind spots, double or hazy vision, get frequent headaches or have problem seeing in the sides, then get a checkup done ASAP. If you develop a problem like glaucoma, your doctor may advice you to get your eye checkups done a lot more frequently. Note: High impact or Heavy weight lifting exercises can make your eye problems worse.

#5: Foot exam (once a year): Doctor will check pulses in your feet and also examine for infections, sores or any loss of feeling.

#6: Hemoglobin A1c tests ( every 3 months): Diabetics should aim for A1c of less than 7%. This test tells how well you are controlling your blood sugar levels.

#7: Cholesterol levels check: If you have high cholesterol, get these tests done twice a year, otherwise an annual test is just fine. A Lipid Panel test will check for your total cholesterol, triglycerides, good and bad cholesterol.

#8: Kidney/Urine test (once a year): Has there been any damage to your kidneys? Doctors specifically look for a protein called Albumin.

#9: Healthy lifestyle: By controlling your sugar intake and doing mild workout every day can be really beneficial. This includes walking and mild running/exercising. Avoiding smoking and reducing alcohol intake.

#10: Other tests: Depending on your personal health indicators or family history other tests may come into play like serum creatinine test, heart disease test, or if you have sexual and fertility problems.

This list might look too exhaustive and scary. Overall a diabetic person will be just fine if they visit doctor/hospital and get recommended tests done every 3 months to 6 months. These tests are not time consuming, all your checkups will be done within a few hours only. So mark your calendars, and start living a healthy life.

All the best !!
- Greg


Fish oil reduces nerve damage caused by diabetes - Greg - 05-08-2015

Fish oil reduces nerve damage caused by diabetes

About half of all diabetic patients suffer from nerve damage or neuropathy.


A study conducted at the VA Medical Center in Iowa City, however, found that Resolvin D1, a metabolite produced by an omega-3 fatty acid found in fish, not only stops the progression of neuropathy in mice, but actually reverses it.

http://www.research.va.gov/currents/fall2014/fall2014-31.cfm


FDA warns about Type-2 Diabetes drugs - SunilNagpal - 05-19-2015

FDA has very recently issued a warning on the use of SGLT2 inhibitors that are suspected to be linked to the fatal condition called KETOACIDOSIS.

SGLT-2 inhibitors (sodium-glucose cotransporter-2 inhibitors) like Canagliflozin, Dapagliflozin and Empagliflozin are reported to elevate blood ketones levels, which can lead to diabetic coma or even death!

Some brand names of these drugs include:
  • Invokana (canagliflozin)
  • Glyxambi (empagliflozin and linagliptin)
  • Farxiga (dapagliflozin)
  • Invokamet (canagliflozin and metformin)
  • Xigduo XR (dapagliflozin and metformin)
  • Jardiance (empagliflozin)

It is thus advised to patients of Type-2 diabetes to monitor their ketone levels (ketoacidosis) regulary while consuming SGLT-2 inhibitors. Symptoms like difficulty breathing, nausea, vomiting, abdominal pain, unusual fatigue or sleepiness, confusions should be immediately addressed.

Best wishes


Android Device for Diabetes Management - SunilNagpal - 06-07-2015

Samsung has recently announced its partnership with Medtronic for developing diabetes management devices/tools/softwares. In this partnership, Samsung's first objective is to develop android app for the MiniMed Connect system device developed by Medtronic. Currently operated using Apple OS, the device controls a insulin pump and sensor, which manages the required amount of insulin in the body. Alarms can be preset for Glucose level alerts, the alerts are sent to all family members (if alarm at patient's end is switched off).

Here is an overview of the device taken from medtronicdiabetes.com. Apps and browser based control/management is targeted for this system.

[attachment=250]



Vaccine to Cure Type-1 Diabetes ! - SunilNagpal - 06-10-2015

A preventive and curative vaccine for type-1 diabetes has been claimed by a team of Spanish scientists. The team belonging to Universitat Autonoma de Barcelona (Spain) has used the very familiar "Liposomes" for imitating the apoptotic beta-cells of pancreas, thereby preventing the self-destruction of the beta-cells by the body.

Earlier, the dendritic cells (immune cells) of the subjects used to be extracted and subsequently manipulated and re-injected into the subjects to avoid the destruction of the insulin-producing pancreatic cells (beta cells) in the body. 

The Liposome mediated prevention of type-1 diabetes has been currently tested on mice and is all-set to be tested in Humans through clinical trials.

Following figure gives an idea of the findings in nutshell (taken from the publicly available paper at PLOS ONE):
[attachment=251]
Cumulative incidence (percentage) of T1D in NOD mice treated with PSAB-liposomes (PSAB-lipo, circles, n = 12), PS-liposomes (PS-lipo, squares, n = 18), and sham group (triangles, n = 26). Significant differences were found when compared group treated with PSAB-liposomes versus sham group (*p≤0.05, Kaplan-Meier log-rank analysis).

Full paper on this research may be referred to in PLOS ONE.
Link to paper: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0127057


Diet and Diabetes | Diabetes in Children | Needed answers and opinion - Greg - 06-18-2015

Need answers please:

1) Can high caloric diet induce diabetes in a non diabetic person?

2) If a diabetic person stops taking added sugar in form of Sweets, Soda or Sweet Juices, will his sugar get controlled for sure?

3) What is the root cause of Diabetes in Children?


RE: Diabetes: Symptoms, Treatment and Latest Research - stevewoods - 06-19-2015

High Sugar Intake Leads to Diabetes?
Your first question is actually a very common misconception amongst people. A high caloric diet is not a trigger to diabetes in a non-diabetic person. There are actually two types of diabetes (Type 1 and Type 2), whereas type-1 diabetes is more related to genetic factors, type-2 is influenced by lifestyle (as well). Now, as per established researches, Obese people are more prone to type-2 diabetes, so on those lines one 'can' speculate that a high caloric diet may slowly lead to obesity and eventually "type-2" diabetes. But, a high caloric diet can't lead to type-1 or type-2 diabetes (definitely never type-1) instantly/in short duration.

Control over Sugar Intake can cure a diabetic?
Whereas diet control does help in controlling the blood sugar levels, "one should not STOP" taking calories! It's very common for diabetic people to get "Hypoglycemia shock" due to in-adequate sugar intake. But yes, excess sugars if controlled do help a diabetic person, but they still need insulin (if not insulin resistant diabetes) to manage the blood sugar. Diet control coupled with exercise is best way to curtail Type-2 diabetes.

Diabetes in Children
Diabetes in Children is solely a result of "genetic factors". It's Type-1 diabetes, so it's genetic!


Diabetes in Dolphins | How Dolphins Manage Diabetes? - SunilNagpal - 08-06-2015

Curious to read the title?? Well you read it right! Dolphins have been known to develop health problems which very much relate to "Pre-Diabetes" condition. But unlike humans who enter into weight loss programs, daily exercises, medications etc.; Dolphins are supposed to manage it on their own. And it has also emerged as a fact that Dolphins do manage it successfully to escape any full-blown diabetes through out their lives!

So, How do they do it?
Amongst the curious persons in the scientific community was :'Stephanie Venn-Watson, Director of Translational Medicine and Research at the National Marine Mammal Foundation in San Diego,  who wanted to dwell into the details of "How Dolphins avoided developing diabetes?". During the journey of her research for seeking the answers she suspected that the ability to avoid Diabetes was related to the diet controls of Dolphins!.

Through a thorough research of eating habits of Wild Dolphins and those kept in captivity, she discovered that the ability came from a certain type of fat the dolphins eat, and that too a SATURATED FAT! (saturated fats are otherwise considered harmful!).

The fat was a [b]Heptadecanoic acid or C17, [/b] which can be found in  fatty dairy products, certain fish types and rye.

So is it possible that we are depriving ourselves of C17 or Heptadecanoic acid by consuming No-Fat or Low-Fat dairy products?? The research is yet to be conducted to check the metabolic consequences of low consumption of C17, before making any recommendation to start eating high fat milk products to get enough dosage of C17 in diet.

Let's hope that a conclusive statement on this research comes sooner, as it has huge implications on diabetics and those who  might be vulnerable to it.

A balanced diet with good exercise regime can go a long way in curbing diabetes. Even if you consume fatty milk products, ensure that you exercise well.This way you will attack prospective/present diabetes with two blows at a time. One can opt for C17 rich fishes and rye too, without consuming much of dairy fats. But stay alert on this research, and stay healthy!

Will post further updates soon!

Read the full research in PLoSONE journal under title:
Increased Dietary Intake of Saturated Fatty Acid Heptadecanoic Acid (C17:0) Associated with Decreasing Ferritin and Alleviated Metabolic Syndrome in Dolphins




Yoga to Control Diabetes | Yoga for Diabetes - SunilNagpal - 08-11-2015

Topics covered: Yoga to Control Diabetes, Yoga for Diabetes

Yoga has a great positive influence on overall health of an individual. Goes without saying that there are some arsenals for fighting Diabetes specifically as well! Following are the 4 popular Yogasanas that can improve your resistance to diabetes:

a) Ardha Matsyendrasana | Yoga to Control Diabetes, Yoga for Diabetes
This asana helps in efficient functioning of pancreas, liver, excretory and digestive system through gentle massaging of the associated organs.
Following is a useful video (tutorial) for Ardha Matsyendrasana (half spinal twist):

b) Halasana (the Plow pose) | Yoga to Control Diabetes, Yoga for Diabetes
This asana also has a good impact on Pancreas apart from strengthening the abdominal muscles. Liver and digestive organs are also improved through this asana.
Following is a useful video (tutorial) for Halasana (the Plow pose):

c) Dhanurasana (the Bow pose) | Yoga to Control Diabetes, Yoga for Diabetes
This asana helps in bringing out a focused (good) impact on the functioning of Pancreas and Stomach, hence controlling blood sugar levels too.
Following is a useful video (tutorial) for Dhanurasana:

d) Vrikshasana (the Tree pose) | Yoga to Control Diabetes, Yoga for Diabetes
Vrikshasana specifically helps in modulating secretion of pancreatic hormones, hence the impact on controlling diabetes.
Following is a useful video (tutorial) for Vrikshasana: