From Diabetes Today, American Diabetes Association -- Dec. 22, 2004
ALEXANDRIA, Va. -- A temporary rise in blood glucose (sugar) levels in people with both types of diabetes can interfere with their ability to think quickly and solve problems, according to a study in the January issue of Diabetes Care.
Researchers at the University of Virginia Health System (UVHS) found that people who had both type 1 and type 2 diabetes performed poorly on math and verbal tests when they became hyperglycemic, a condition in which blood glucose levels are higher than normal. Symptoms of hyperglycemia include high blood glucose, high levels of sugar in the urine, frequent urination, and increased thirst. Roughly 55 percent of the people in the study showed signs of cognitive slowing or increased errors while hyperglycemic, suggesting that the consequences of hyperglycemia vary among individuals. However, among those whose cognitive performance deteriorated when blood sugar levels rose, the negative effects consistently appeared once levels reached or exceeded a threshold of 15 mmol/l or 270 mg/dl.
Because hypoglycemia (when blood glucose levels are too low) can cause dizziness and an inability to focus, many people consume large amounts of carbohydrates to avoid this state prior to school exams and other cognitive- sensitive tasks. But this study suggests that carbohydrate-loading could be counterproductive, the researchers conclude, because hyperglycemia often occurs after overeating.
"The best way to minimize any negative effects on cognitive functioning is to keep blood glucose levels tightly controlled," said lead researcher Dr. Daniel J. Cox, of the Center for Behavioral Medicine Research at UVHS. "People who have diabetes should pay careful attention to the warning signs of hyperglycemia so that they can quickly take action to treat it."
Treatment for hyperglycemia can include increasing insulin or reducing food intake.
Diabetes Care, published by the American Diabetes Association, is the leading peer-reviewed journal of clinical research into the nation's fifth leading cause of death by disease. Diabetes also is a leading cause of heart disease and stroke, as well as the leading cause of adult blindness, kidney failure and non-traumatic amputations. For more information about diabetes, visit the American Diabetes Association Web site http://www.diabetes.org or call 1-800-DIABETES (1-800-342-2383).
Saturday, January 01, 2005
Pregnancy Can Go Well for Women with Diabetes
From Reuters Health News -- Fri Dec 31, 2004
NEW YORK (Reuters Health) - Women with type 1 diabetes who monitor their blood glucose daily both before and during pregnancy have better outcomes, Danish researchers report.
In the largest study to date of pregnant women with type 1 diabetes, Dr. Dorte M. Jensen of Odense University Hospital and colleagues found that only one-third of women said they monitored their blood sugar levels every day around the time they conceived.
Daily monitoring and good overall control of blood glucose levels were associated with a lower likelihood of infant mortality and birth defects.
The study is published in the medical journal Diabetes Care.
Specifically, the researchers compared rates of pregnancy complications in the general population with rates for 1,218 consecutive pregnancies in 990 women who had type 1 diabetes.
Among the women with diabetes, compared with the general population, the percentage of babies that died soon after birth was higher (3.1 percent vs. 0.75 percent), as was the rate of stillbirths (2.1 percent vs. 0.45 percent) and birth defects (5.0 percent vs. 2.8 percent).
Among the 93 diabetic women who had serious adverse outcomes - meaning babies that died or had malformations - 22 percent monitored their blood glucose daily at conception, compared to 35 percent of the women who had uncomplicated pregnancies.
Also, blood sugar control before and during pregnancy was not as good among the adverse outcome group, on average, and they were less likely to have received pre-conception guidance than the women without seriously affected babies.
In Denmark, where healthcare is free and women with diabetes are entitled to regular visits with diabetes specialists, the researchers note, the low rates of daily monitoring at conception and pre-conception guidance were "disappointing."
"Our data suggest that glycemic control, self-care and education of the patient still need to be improved significantly and that adequate control using daily glucose monitoring in all patients is a crucial step toward reaching the goals of the St. Vincent declaration," Jensen's team concludes.
That 1989 declaration stated that within five years, rates of complications in diabetic pregnancies should be similar to those seen with non-diabetic pregnancy -- a goal that has not been achieved, the researchers note.
NEW YORK (Reuters Health) - Women with type 1 diabetes who monitor their blood glucose daily both before and during pregnancy have better outcomes, Danish researchers report.
In the largest study to date of pregnant women with type 1 diabetes, Dr. Dorte M. Jensen of Odense University Hospital and colleagues found that only one-third of women said they monitored their blood sugar levels every day around the time they conceived.
Daily monitoring and good overall control of blood glucose levels were associated with a lower likelihood of infant mortality and birth defects.
The study is published in the medical journal Diabetes Care.
Specifically, the researchers compared rates of pregnancy complications in the general population with rates for 1,218 consecutive pregnancies in 990 women who had type 1 diabetes.
Among the women with diabetes, compared with the general population, the percentage of babies that died soon after birth was higher (3.1 percent vs. 0.75 percent), as was the rate of stillbirths (2.1 percent vs. 0.45 percent) and birth defects (5.0 percent vs. 2.8 percent).
Among the 93 diabetic women who had serious adverse outcomes - meaning babies that died or had malformations - 22 percent monitored their blood glucose daily at conception, compared to 35 percent of the women who had uncomplicated pregnancies.
Also, blood sugar control before and during pregnancy was not as good among the adverse outcome group, on average, and they were less likely to have received pre-conception guidance than the women without seriously affected babies.
In Denmark, where healthcare is free and women with diabetes are entitled to regular visits with diabetes specialists, the researchers note, the low rates of daily monitoring at conception and pre-conception guidance were "disappointing."
"Our data suggest that glycemic control, self-care and education of the patient still need to be improved significantly and that adequate control using daily glucose monitoring in all patients is a crucial step toward reaching the goals of the St. Vincent declaration," Jensen's team concludes.
That 1989 declaration stated that within five years, rates of complications in diabetic pregnancies should be similar to those seen with non-diabetic pregnancy -- a goal that has not been achieved, the researchers note.
Monday, December 13, 2004
Diabetes vaccine to be tested on humans
From the Guardian Unlimited, London, England
David Batty
Monday December 13, 2004
A vaccine against the most serious type of diabetes will be tested on humans for the first time next year, UK scientists said today.
The clinical trial is due to start in August once scientists have gathered together 18 patients with type 1 diabetes, the life-threatening form of the disease which usually develops during childhood or adolescence.
The researchers, from Bristol University and King's College London, believe the vaccine could prevent the onset of the type 1 diabetes and cure people in the early stages of the disease. If the trial is successful they anticipate a cure could be widely available within a decade.
Diabetes charities said this would be the most significant development in the treatment of the disease since the widespread prescription of insulin began in the 1920s.
There are 300,000 sufferers of type 1 diabetes, which destroys the cells in the pancreas that produce the hormone insulin needed to control blood sugar levels, in the UK. They need daily injections of synthetic insulin for the rest of their lives. Without treatment, glucose builds up in the bloodstream and death is inevitable.
The vaccine involves the injection of a protein, which stops the body destroying the insulin producing cells, known as islets.
The research, led by immunologists Professor Mark Peakman, Dr Colin Dayan and Dr Susan Wong, began four years ago with the identification of the proteins in islets that are attacked by white blood cells in diabetes.
This was followed by the successful inoculation of mice with a protein that stops the white blood cells from attacking the islets. Diabetic animals were protected for the rest of their lives.
The next stage is to conduct a human trial, following 18 patients with type 1 diabetes for 18 months. If successful, this would be followed by a larger scale trial.
Dr Wong, an immunologist at the University of Bristol, said: "In the first instance we will be looking to see an effect in people who already have diabetes. But ultimately the aim would be to prevent those at risk from ever developing the disease."
The research has been funded by the Juvenile Diabetes Research Foundation and Diabetes UK. Georgina Slack, head of research at the charity Diabetes UK, said it appeared to improve the chances of providing a cure for the disease.
She said: "The prospect of finding a way of stopping the body from attacking itself and causing type 1 diabetes is the holy grail of diabetes research. We'll be following any progress with the research into humans very closely."
David Batty
Monday December 13, 2004
A vaccine against the most serious type of diabetes will be tested on humans for the first time next year, UK scientists said today.
The clinical trial is due to start in August once scientists have gathered together 18 patients with type 1 diabetes, the life-threatening form of the disease which usually develops during childhood or adolescence.
The researchers, from Bristol University and King's College London, believe the vaccine could prevent the onset of the type 1 diabetes and cure people in the early stages of the disease. If the trial is successful they anticipate a cure could be widely available within a decade.
Diabetes charities said this would be the most significant development in the treatment of the disease since the widespread prescription of insulin began in the 1920s.
There are 300,000 sufferers of type 1 diabetes, which destroys the cells in the pancreas that produce the hormone insulin needed to control blood sugar levels, in the UK. They need daily injections of synthetic insulin for the rest of their lives. Without treatment, glucose builds up in the bloodstream and death is inevitable.
The vaccine involves the injection of a protein, which stops the body destroying the insulin producing cells, known as islets.
The research, led by immunologists Professor Mark Peakman, Dr Colin Dayan and Dr Susan Wong, began four years ago with the identification of the proteins in islets that are attacked by white blood cells in diabetes.
This was followed by the successful inoculation of mice with a protein that stops the white blood cells from attacking the islets. Diabetic animals were protected for the rest of their lives.
The next stage is to conduct a human trial, following 18 patients with type 1 diabetes for 18 months. If successful, this would be followed by a larger scale trial.
Dr Wong, an immunologist at the University of Bristol, said: "In the first instance we will be looking to see an effect in people who already have diabetes. But ultimately the aim would be to prevent those at risk from ever developing the disease."
The research has been funded by the Juvenile Diabetes Research Foundation and Diabetes UK. Georgina Slack, head of research at the charity Diabetes UK, said it appeared to improve the chances of providing a cure for the disease.
She said: "The prospect of finding a way of stopping the body from attacking itself and causing type 1 diabetes is the holy grail of diabetes research. We'll be following any progress with the research into humans very closely."
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