trends and issues on diabetes care

7/27/2019 Trends and Issues on Diabetes Care

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ONDIABETES

CARE

MASTERS OF SCIENCE OF NURSING

School of Health Sciences

Graduate School


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Legumes Help

Improve GlycemicControl And

Lower HeartDisease Risk


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Eating plenty of beans, lentils,

chickpeas and other legumes

helps improve glycemic control

and reduce the risk of developingcoronary heart disease in patients

with diabetes type 2, researchers

from the University of Toronto

reported in Arch ives of InternalMedicineafter carrying out a

randomized, controlled trial.


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The participants were randomly

selected into one of two groups:

Low-GI legume group - they

were encouraged to eat more

legumes; by at least one cup a

day for three months

Insoluble fiber group - they were

encouraged to eat more

insoluble fiber, i.e. whole wheatfoods for three months


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The primary outcome was change in

HbA1c (hemoglobin A1c), thesecondary outcome was coronary

heart disease risk score.

The researchers reported thatlegume consumption of about 1 cup

(190 grams) per day appears to

contribute effectively to a low-GI diet,

and to reduce the risk of coronaryheart disease by bringing down blood

pressure.
http://www.medicalnewstoday.com/articles/184130.phphttp://www.medicalnewstoday.com/articles/184130.phphttp://www.medicalnewstoday.com/articles/184130.phphttp://www.medicalnewstoday.com/articles/184130.php


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Below are some of the trial results:

In the low-GI legume group, HbA1cvalues went down by -0.5%

In the insoluble fiber group, HbA1c

values dropped by -0.3%

In the low-GI legume group, bloodpressure fell much more than in the

insoluble fiber group


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The researchers concluded:

"These findings linking legumeconsumption to both improved

glycemic control and reduced CHD

risk are particularly importantbecause type 2 DM is increasing

most rapidly in the urban

environments of populations in

which bean intake has traditionally

been high (e.g. India, Latin

America, the Pima Indians of

Arizona).


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Topical Simvastatin

Shown To

Accelerate WoundHealing In Diabetes


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A new study has found

that topically applied

simvastatin accelerates

wound healing in diabeticmice, suggesting

important implications for

humans with diabetes.


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An advantage of topicalapplication is that a

suitable concentration of

simvastatin can be appliedwithout risk of serious

systemic effects such as

kidney damage


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The investigators generated

a full-thickness skin woundon the backs of diabetic

mice. Each wound was

treated with a topicalapplication of either

simvastatin in petroleum

jelly or petroleum jelly alone.The application was

repeated on days four,

seven, and ten.


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After two weeks, the simvastatin-

treated wounds were more than90% healed, whereas less than

80% were healed in the wounds

treated by petroleum jelly alone.

The difference in wound closure

was greatest on day seven when

the simvastatin-treated wounds

were 79.26% healed comparedwith 52.45% in the control group.


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This study shows that

topical simvastatinsignificantly accelerates

wound recovery by

increasing bothangiogenesis and

lymphangiogenesis.


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This is a simple strategy that

may have significanttherapeutic potential for

enhancing wound healing in

patients with impairedmicrocirculation, such as

that in diabetes. Further

investigation is needed todetermine its clinical utility


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dermaPACE uses high-energy sound waves

when directed at the ulcer these

sound waves stimulate the

growth of new blood vessels

and creates an inflammatory

response that actually jump-

starts rapid healing of thewound


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Results from the study showed a

distinct difference in results between

the two therapies

dermaPACE andHyperbaric Oxygen Therapy(HBOT):

Overall, 57 percent of the foot

ulcers in the dermaPACE

group completely healed,

versus 25 percent in the

HBOT group.


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Researchers also noted a great

difference in the time and

sessions required for the twotherapies: dermaPACE

required only 15 percent as

many sessions as HBOT andonly three percent as much

time.

This technology is still in clinical

trials and will be for some time.


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Blocking Type 1Diabetes

Progression UsingPsoriasis Drug


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Type 1 diabetes occurs when the

body's immune system attacks

beta cells in the pancreas thatproduce the insulin needed to

metabolize sugars and other

nutrients into energy needed by

the body. The process usually

continues until the patient is

producing little or none of his or

her own insulin, requiring regularinjections of insulin to maintain

blood sugar levels at close to

normal levels.


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In a multicenter trial of 49patients, those receiving the drug

alefacept were producing the

same amount of insulin one year

after diagnosis, while patientsreceiving a placebo injection were

producing less, consistent with

the deterioration that usuallyoccurs after diagnosis with the

disease.


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Alefacept is an

immunosuppressant drug that

binds to and interferes with the

actions of certain immunesystem Tcells that are believed

to be involved with the

destruction of beta cells in thepancreas.


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Trial participants ranged in age from

12 to 35 and had recently been

diagnosed with type 1 diabetes.Twothirds were randomly assigned

to the group receiving alefacept

injections, with the remaining

patients receiving a placeboinjection of saline solution. The

participants received weekly

injections for three months, followed

by three months of no injections,

then three more months of weekly

injections.


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A year after receiving the

initial injections, the study

participants were tested forinsulin production using a

standard mixed meal

tolerance test, or "shaketest."


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Echo Therapeutics -

The Symphony

System


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It is a non-needle, non-invasive,

wireless transdermal continuousglucose monitoring system.

The Symphony System uses a

biosensor without the need to

prick the skin since it is

transdermal [it is an adhesive

patch placed on the skin].

F.D.A. approval is expected in2013 and is showing strong

successes in clinical trials.


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Testing is being done on

hospitalized critical care

patients who require multiplefinger sticks daily; it is well

documented that blood sugar

control is imperative duringacute illness and trends need to

be monitored. Studies are also

being conducted on out-patientswith diabetes. The transdermal

patch would require changing

every 24 hours.


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The needleless system

technology is a benefit for those

who dread needle placement as

well as having the ability tolower the risk of infection

especially in the hospital critical

care arena.


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HORMONES for

DM


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A newly discovered mouse

hormone may open the doorto better treatment for

diabetes

The hormone, called

betatrophin, triggers the

growth of pancreatic "beta"cells lost or ineffective in

diabetes.


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betatrophin can produce a

roughly seventeenfold increase

in these cells, and its increase

may partly explain the rapidgrowth of these cells seen

during pregnancy to feed

developing fetuses in mammals,including people.


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they cautioned that the

hormone's effects, which

the study team sees asisolated to beta cells,

need to be thoroughly

investigated in animalstudies for safety.


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The hormone was discoveredalmost by accident, as the

Harvard team investigated a

research compound that

basically recreates whathappens in diabetes. The

compound short circuits the

release of insulin in response toincreasing blood sugar.


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When that happened to the mice

in the study, their production of

the hormone betatrophin rampedup and spurred the growth of

insulin producing cells. Diabetics

often need daily insulin injections

to compensate for the condition,where in Type 2, or adult-onset

diabetes, the most frequent kind,

beta cells stop producing enoughinsulin, and in juvenile diabetes,

or Type 1, about 10% of cases,

beta cells have died.


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"Before it can be established if

this finding has any relevance to

human therapy it will need to be

established (that) the moleculedrives beta cell replication in

humans," according to beta cell

experts


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ARTIFICIAL

PANCREAS


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An "artificial pancreas," a device

that would constantly monitor

blood sugar in people with

diabetes and automatically

supply insulin as needed, maybe a step closer to helping

patients in what researchers are

calling a "major advance."


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A new study showed that a key

component of the device -- an

insulin pump programmed to

shut down if blood-sugar dips

too low while people aresleeping -- worked as intended

in a three-month study of 247

patients.


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This "smart pump," made by

Minneapolis-based Medtronic

Inc., is already sold in Europe,and the Food and Drug

Administration is reviewing it

now. Whether it also can be

programmed to mimic a real

pancreas and constantly adjust

insulin based on continuous

readings from a blood-sugarmonitor requires more testing,

but doctors say the new study

suggests that goal is in reach.


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Thank you and

God bless!

trends and issues on diabetes care

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