Help for hypoglycemics?

On July 30, 2010, in Uncategorized, by Andrea

One of my "high's"

There is extensive work being done to help diabetics’ lives easier.  The flipside is that the same research can be used to help hypoglycemics’ lives easier as well.. especially those who tend to drop very rapidly and without warning.

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Heart Disease to kill 400,000 in US in 2010

On February 1, 2010, in Uncategorized, by Andrea

Wow.  That’s sobering.

And we know what the number one cause for heart disease is, right?

(Don’t make me slap you silly.  Cause I will.)


Heart disease to kill 400,000 in U.S. in 2010

Experts: Progress against cutting cholesterol stalled by rising obesity rates

LONDON – Decades of progress in the United States on cutting cholesterol, blood pressure and smoking are being stalled by rising obesity rates, and heart disease will kill around 400,000 Americans this year, experts said on Monday.

A study by British scientists found that around half of those deaths could be averted if people ate healthier food and quit smoking, and experts warned there was no room for complacency when it came to heart health risks.

Simon Capewell of the University of Liverpool said recent weight trends were “alarming,” with 1.5 billion adults worldwide expected to be overweight by 2015.

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“Although (heart disease) death rates have been falling in the United States for four decades, they are now leveling off in young men and women,” he wrote in a study in the World Health Organization’s weekly journal.

“Recent declines in total blood cholesterol have been modest, blood pressure is now rising among women and obesity and diabetes are rising steeply in both sexes.”

The researchers calculated the number of deaths based on lifestyle trends, taking the year 2000 as a base.

They found that almost 200,000 lives could be saved if certain heart risk factors were cut, even modestly, in particular, Capewell said, “if people ate healthier food and stopped smoking.”

Two-thirds of U.S. adults and nearly one in three children are overweight or obese — a condition that increases their risk for diabetes, heart disease and other chronic illnesses.

U.S. health officials last week introduced first lady Michelle Obama as their latest weapon in a fresh campaign against the increasingly-costly weight burden.

But Shanthi Mendis, an expert on chronic disease prevention at the Geneva-based WHO, noted that the United States was not alone in facing an obesity epidemic, and said lifestyle choices now directly affected the health of many of the world’s people.

“Worldwide, nearly one billion adults are overweight and, if no action is taken, this figure will surpass 1.5 billion by 2015,” she said in the study.

“By avoiding tobacco, eating a healthy diet and engaging in regular physical activity, people can dramatically reduce their risk of developing heart disease, stroke or diabetes.”

Diabetes drugs increase fracture risk

On January 22, 2010, in Uncategorized, by Andrea

Hopefully, most of y’all are off diabetes meds, but just in case –

These drugs are those like Avandia and Actos.

From Medscape:

Thiazolidinediones up Risk of Fractures in Older Women

NEW YORK (Reuters Health) Jan 21 – Thiazolidinediones (TZDs) are linked to an increased risk for extremity fractures in women over age 65, findings from a large retrospective cohort study indicate.

Mainly used in diabetics, TZDs are agonists of the peroxisome proliferator-activated receptor-gamma (PPAR-gamma), a nuclear transcription factor. PPAR-gamma is expressed in fat cells, where activation by TZDs improves insulin sensitivity.

But PPAR-gamma is also expressed in osteoblasts, osteoclasts, and bone marrow stromal cells, where activation by TZDs can contribute to bone loss, according to a report of the study in the February Journal of Clinical Endocrinology and Metabolism.

“Given the prevalent use of TZDs in patients with diabetes and that this patient population is already at risk for fractures, it is important to assess the effect of these drugs on fracture risk,” senior author Dr. L. Keoki Williams and her associates write.

The researchers, from Henry Ford Hospital in Detroit, studied claims data and medical records for 19,070 diabetic patients (50% female; mean age 58 years) enrolled at a health maintenance organization between 2000 and 2007. All the patients used oral diabetes medication, and 4511 had filled at least one prescription for a TZD (rosiglitazone and/or pioglitazone).

Ninety-five patients in the TZD group and 382 not treated with a TZD developed a fracture. The unadjusted first event rates were 7.0 and 5.3 per 1000 patient-years. At about a year and a half, the Kaplan-Meier curves began to separate and remained separated for the rest of the study period.

TZD use was associated with an adjusted hazard ratio of 1.34 in analyses controlling for sociodemographics, other medication use, HbA1c levels, and comorbidities.

However, after stratification by age and sex, only women over age 65 were at significantly elevated risk for fracture with TZD use (aHR 1.72). The increased risk was not apparent until after a year of TZD therapy, the researchers note.

A post hoc analysis indicated that TZD use affected fractures of the upper extremity and distal lower extremity, but not fractures of the femur and vertebrae.

Although theirs is one of the largest cohort studies to examine the longitudinal relationship between TZD use and fractures, the investigators note that their analyses did not take into account other important risk factors, including body mass index, smoking, nephropathy, and bone mineral density.

Given that older women are already at risk for fractures, the new findings complicate decisions for when and how to screen for bone density deficits in patients who’ve been taking these drugs.

“For example,” the authors caution, “the increase in bone marrow fat caused by TZDs may result in underestimating dual-energy x-ray absorptiometry-measured bone mineral density.”

J Clin Endocrinol Metab 2010.

Live in Cinci and hypoglycemic?

On January 19, 2010, in Uncategorized, by Andrea

Go be a labrat.

UC HEALTH LINE: Be Aware of Blood Sugar Post Gastric Bypass

CINCINNATI—People with type 2 diabetes who have gastric bypass surgery often leave the hospital without the need for previously prescribed diabetes medications.

Researchers and doctors believe this health benefit is related to changes in the body’s circulating hormones—particularly an increase of insulin secretion. Insulin is the hormone that controls the level of glucose (sugar) in the blood.

Marzieh Salehi, MD, a diabetologist with UC Health University of Cincinnati Physicians whose research is focused on the effect of weight-loss surgery on glucose metabolism, cautions that although there can be huge benefits for diabetic patients who undergo gastric bypass surgery, a group of patients experience severely low levels of blood sugar (hypoglycemia)—especially following a meal and typically several years after surgery. Symptoms of hypoglycemia often aren’t recognized until they become debilitating or life-threatening.

Salehi says that many patients with type 2 diabetes who qualify for gastric bypass surgery rely on anti-diabetic medications like insulin injections to regulate glucose in the body. These same patients often leave the hospital following surgery with normal glucose control without taking any medications.

“It’s possible,” says Salehi, “that gastric bypass increases gut hormone secretion or nervous system activity, which in turn increases insulin secretion and improves glucose metabolism in a majority of patients after surgery.

“However,” she adds, “there is a population of gastric bypass patients who, following surgery, develop high levels of endogenous insulin secretion, resulting in dangerously low glucose levels, or hypoglycemia. These glucose abnormalities due to too much insulin secretion represent an extreme effect of gastric bypass surgery.”

Salehi, who sees weight-loss surgery patients with glucose abnormalities at the UC Health Diabetes Center, says symptoms of hypoglycemia include shakiness, sweating, dizziness, light-headedness, weakness, confusion and difficulty speaking. More severe symptoms include seizure and cognitive abnormalities. Hypoglycemia can be life-threatening without proper monitoring or treatment.

“If hypoglycemia goes unnoticed, the body can become accustomed to low sugar and patients can then lose their awareness to low sugar. It is essential to seek help if any of these symptoms develop after gastric bypass surgery.”

Salehi is currently conducting a National Institutes of Health-sponsored study to determine how glucose metabolism is affected by gastric bypass surgery. For more information, call Leslie Baum, registered nurse and study coordinator, at (513) 558-0201.

To schedule an appointment with the UC Health Diabetes Center, call (513) 475-8200.

Tired kids == diabetic kids?

On January 13, 2010, in Uncategorized, by Andrea

Uh-0h.  I’m in trouble then.  Cause my kids never seem to be IN bed.  I’m serious.  I say this as I’m drinking caffeine to try and chase away a migraine (aversion therapy, trying to ignore the elephants marching through my skull) and to try and stay awake since my son, my dear loving son, was awake at 2:30 this morning.  And didn’t go to sleep until about 4.  At least they are both in the 25th percentile for weight..

Of course, I also have read that metabolic syndrome numbers change quite frequently in kids, so I wouldn’t be surprised if this study were to be counterdicted, say, next week.

From Medscape:

By Joene Hendry

NEW YORK (Reuters Health) Jan 11 – Young children who average 8 hours or less of sleep a night may be at higher risk for developing diabetes, report Chinese and American researchers.

This risk may be even greater among obese youngsters, Dr. Zhijie Yu, at the Chinese Academy of Sciences in Shanghai and colleagues note in Archives of Pediatric and Adolescent Medicine.

Moreover, Dr. Yu said in an email to Reuters Health, shorter sleep seemed to influence blood glucose “independently of a large variety of risk factors,” such as age, gender, birth-related influences, early life feeding or later diet, recent illness, physical activity, body mass, and waist girth.

Dr. Yu’s team investigated sleep duration and blood glucose levels in 619 obese and 617 non-obese children who were 3 to 6 years old and free of diabetes.

Parental reports showed a greater percentage of the obese (47%) than the non-obese (37%) kids averaged 8 or fewer hours of sleep nightly. These reports also showed nightly averages of 9 or 10, or 11-plus, hours of sleep less common in obese (37% and 16%) versus non-obese (43% and 20%) kids, respectively.

High fasting glucose levels, defined as 100 mg/dL or greater, were about 1.35-fold and 2.15-fold more likely in the shorter-sleeping non-obese and obese kids, respectively. Overall, 11 children had levels above 126 mg/dL.

Among the children who slept less than 8 hours per night, elevated fasting glucose levels were documented in 23 of the 217 who were non-obese and in 49 of the 291 obese kids. By contrast, among children getting 9 or 10 hours of sleep each night, 21 of the 175 non-obese and 21 of 229 obese kids had high blood sugar.

These findings hint that, similar to adults, adequate sleep may help kids, maintain a healthy body weight and an optimal blood sugar level, Dr. Yu said.

However, Dr. Yu and co-authors emphasize the need for further studies to confirm these findings in both Chinese and other populations of youngsters.

Arch Pediatr Adolesc Med 2010.

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