Researcher wants gender-based treatment; failure of women to lower LDL cholesterol means more risk for cardiovascular death
June 24, 2014 – A study of senior men and women with Type 2 diabetes, who were fighting to lower their cholesterol with statins, has found that women are much less likely to lower their bad cholesterol, or low-density lipoprotein (LDL) cholesterol. The research leader is calling for gender-based treatment to lower the risk of cardiovascular death in women.
With treatment, only 64 per cent of women lowered their LDL cholesterol to the recommended level compared with 81 per cent of men, the investigators reported.
“The findings suggest the need for gender-based evaluation and treatment of cardiovascular risk factors in these patients,” says Dr. Pendar Farahani.
“We need further study into the gender disparities to tailor drug interventions and we need to increase the inclusion of women in clinical trials.”
Dr. Farahani is an assistant professor in the Department of Medicine and Department of Public Health Sciences at Queen’s University in Kingston, Ontario, Canada.
This study demonstrated women with diabetes are more likely than men to have a LDL-C above treatment goals, according to the study. However, this pattern of gender gap was not observed for HgbA1c goal attainment. It did conclude that the concept of gender gap is useful for identifying at-risk groups for prevention and treatment efforts.
Research has also shown women have poorer adherence to taking their statin medication to treat high cholesterol, perhaps due to somewhat dissimilar pharmacological properties in a woman’s body than a man’s. For example, women often have more side effects such as muscle pain, explains Dr. Farahani.
“The finding that women were not able to lower their so-called bad cholesterol sufficiently is a concern,” he says. “Women with diabetes have a considerably higher rate of cardiovascular-related illness and death than men with diabetes. This pattern is likely related to poorer control of cardiovascular risk factors.”
Dr. Farahani’s research also discovered access to medication is not responsible for this difference. All patients, who were in a database from pharmacies in four Canadian provinces, had social insurance and were able to afford their medications.
To evaluate whether biological sex influenced the results of cholesterol-lowering drug treatment, Dr. Farahani included nearly equal numbers of men and women (101 and 97) in the study.
The average age of participants was 65 years for men and 63 years for women. All patients had Type 2 diabetes and had filled prescriptions for statin medication to treat high cholesterol between 2003 and 2004.
The results were presented on Saturday at the joint meeting of the International Society of Endocrinology and The Endocrine Society: ICE/ENDO 2014 in Chicago.
Original report by Anne Craig, Communications Officer, Queen’s University
Researchers have long understood there is a strong association between diabetes and depression. But new research presented at the American Diabetes Association's 74th Scientific Sessions shows that symptoms of depression in people with type 2 diabetes can be significantly reduced through interventions for "diabetes distress," suggesting that much of what is being labeled as depression may not be a co-morbid psychiatric disorder after all, but rather a reaction to living with a stressful, complex disease that is often difficult to manage.
A second study, of patients with type 1 diabetes, emphasizes the potential importance of treating depressive symptoms regardless of their cause: It found that the greater depressive symptoms a patient reported, the higher that person's mortality risk.
Diabetes distress v. depression
"Because depression is measured with scales that are symptom-based and not tied to cause, in many cases these symptoms may actually reflect the distress that people are having about their diabetes, and not a clinical diagnosis of depression," said lead author Lawrence Fisher, PhD, ABPP, Professor of Family and Community Medicine at the University of California, San Francisco.
Fisher and his team developed measures of diabetes-specific distress that reflect whether a person had been feeling worried about a variety of problems associated with living with their diabetes, such as hypoglycemia. They also asked patients to fill out the Patient Health Questionnaire to measure depressive symptoms. Those who reported high levels of distress and high levels of depressive symptoms were assigned one of three interventions, all of which were designed to reduce the distress associated with managing diabetes, rather than symptoms of depression.
One group took part in an online diabetes self-management program. A second participated in the online program, and received individual assistance to problem solve issues related to their diabetes distress. A third was provided with personalized health risk information and then sent educational material about diabetes through the mail. All groups received personal phone calls during the course of the project.
All three interventions significantly reduced distress as well as depressive symptoms over a 12-month period, and patients maintained those reductions over the course of the study. Overall, 84 percent of those scoring above 10 on the PHQ8 (maximum 27, with 10 being moderate depression) reduced their levels of depression to below 10 following the interventions, Fisher said. Reductions were evenly distributed for all three interventions.
"What's important about this," said Fisher, "is that many of the depressive symptoms reported by people with type 2 diabetes are really related to their diabetes, and don't have to be considered psychopathology. So they can be addressed as part of the spectrum of the experience of diabetes and dealt with by their diabetes care team."
Depressive symptoms associated with higher mortality
A second, unrelated study that analyzed data from a cohort of people with type 1 diabetes in the Pittsburgh area, the Pittsburgh Epidemiology of Diabetes Complications study (EDC), showed why it is so important to recognize depressive symptoms in people living with diabetes: Those who exhibit the highest level of depressive symptoms are most likely to die prematurely.
In this study, the Beck Depression Inventory was used to measure depressive symptoms such as low mood, losing interest in doing things, loss of appetite, feeling worthless and having suicidal tendencies. Participants in the study had been diagnosed with diabetes as children between 1950 and 1980, and were first studied in 1986. They are now in their 25th year of follow-up as part of a large, prospective cohort study.
"For every 1-point increase on the Beck Depression Inventory scale, participants showed a 4-percent increase in risk for mortality – after controlling for other factors that might increase the risk of death," said Cassie Fickley, the lead author who analyzed these data as part of her PhD degree.
"These data are very consistent with earlier findings from EDC which showed that greater depressive symptomatology predicted the incidence of heart disease in this cohort," said Trevor Orchard, MD, M.Med.Sci., FAHA, FACE, Professor of Epidemiology, Medicine and Pediatrics at the Graduate School of Public Health, University of Pittsburgh, and the EDC study principal investigator.
The earlier analysis was conducted by Cathy Lloyd, PhD, a co-author on the current paper, and currently a senior lecturer at the Open University in the UK. Lloyd noted that "the data are relatively unique as the consequences of depression in type 1 diabetes are an understudied area of research."
Novo Nordisk's big-selling diabetes drug Victoza appears to be an effective weight loss therapy, data from a late-stage clinical trial presented on Saturday demonstrated.
In the 56-week study of 846 overweight or obese adults with type 2 diabetes, a daily injection of 3 milligrams of Victoza led to significantly greater weight loss than did a placebo.
Patients taking the 3 mg dose of the drug, known chemically as liraglutide, had a mean loss of 5.9 percent of body weight. That compared with a loss of 4.6 percent for a 1.8 mg dose and just 2 percent loss for those who got a placebo. All patients were also put on a diet and exercise program.
The results were presented at the American Diabetes Association meeting in San Francisco.
Weight loss had been viewed as a beneficial side effect of Victoza as obesity is a leading cause of type 2 diabetes. But with obesity becoming a global health crisis, Novo Nordisk now sees the medicine as a potentially lucrative weight loss drug at a higher than currently approved dose. Some two thirds of Americans are classified as overweight or obese.
Victoza had global sales of about $542 million in the first quarter. Danish drugmaker Novo Nordisk is awaiting approval decisions from U.S. and European regulators for 3 mg liraglutide for weight loss. It is approved to treat type 2 diabetes in the United States at 1.2 mg and 1.8 mg.
In the study, called Scale, 50 percent of patients taking 3 mg Victoza lost at least 5 percent of body weight and 22 percent dropped more than 10 percent.
On that measure, "it stacks up very favorably against other medications that are out there or likely to be approved," Dr. Robert Kushner, an obesity specialist and one of the trial's investigators, said in a telephone interview.
The efficacy should easily satisfy U.S. Food and Drug Administration weight loss drug criteria, leaving safety as the main hurdle to approval. A lively debate is likely when a panel of experts meets in September to discuss the drug before the FDA makes a decision.
The FDA has defended Victoza's safety against calls for its removal from the market by consumer watchdog Public Citizen, which says it raises the risk of thyroid cancer and pancreatitis.
Kushner said there were no cases of either during the trial. He believes the benefits outweigh the drug's risks.
"We currently cannot predict who's going to respond to which medication and that's why it's so helpful to have multiple medications," he said. "Even individuals without diabetes may be very responsive to this hormonal approach", compared with drugs that work on the brain to suppress appetite, he added.
There was a 9.2 percent drop out rate in the 3 mg group, with more than half due to gastrointestinal disorders, such as nausea and diarrhea, which are common to drugs in this class.Nausea typically diminishes after four to eight weeks, Kushner said.
Perelman School of Medicine at the Univ. of Pennsylvania
team led by researchers from the Perelman School of Medicine at the Univ. of Pennsylvania found that a susceptibility gene for type 1 diabetes regulates self-destruction of the cell's energy factory. They report their findings this week in Cell.
The pathway central to this gene could be targeted for prevention and control of type-1 diabetes and may extend to the treatment of other metabolic-associated diseases.
The team found that the gene, Clec16a, when in pancreas cells, is required for normal glucose-stimulated insulin release. What's more, people with a variation in the gene sequence near Clec16a have reduced expression of the protein in their islet cells and therefore reduced insulin secretion.
First author Scott Soleimanpour, a postdoctoral fellow in the lab of co-senior author Doris Stoffers, professor of Medicine, worked out this role of Clec16a in pancreatic beta cells. Soleimanpour is now an assistant professor at the Univ. of Michigan Medical School. Stoffers is also a member of the Institute for Diabetes, Obesity and Metabolism at Penn.
The self-destruction process of the cell's energy factories (mitochondria) is called mitophagy. This literally means the self-eating of mitochondria, the sites for producing the energy molecule ATP. Beta cells within the pancreas are enriched in mitochondria because of their insulin-secreting function, an energy-intensive process.
Mitophagy involves the breaking down and recycling of less well-functioning, old mitochondria to build fresh ones. Clec16a controls beta-cell function in this disposal pathway and is thought to prevent diabetes-related mitophagy.
Little had been known about the function of the Clec16a protein in mammals or of its role in the initiation of disease. The team found that Clec16a interacts with an enzyme called Nrdp1, which works through another protein called Parkin. Normally, Parkin regulates mitophagy by initially tagging unhealthy mitochondria for disposal.
Mice with a pancreas-specific deletion of Clec16a have abnormal mitochondria that produce less ATP, which is required for normal beta cell function, and ultimately insulin secretion. Specifically, they determined that the loss of Clec16a leads to an increase in Parkin, a master regulator of mitophagy. What's more, the team found that the final disposal of unhealthy mitochondria was also defective.
"The ultimate result of the deletion of Clec16a is an accumulation of unhealthy mitochondria, leading to less insulin being secreted by the beta cells," says Stoffers.
Coauthors from the Lund Univ. and Skåne Univ. Hospital in Sweden provided a panel of human islet cells that allowed Soleimanpour to determine whether a small diabetes-risk variation in the DNA sequence near the Clec16a gene directly affected the gene's normal expression and function. Individuals with this short sequence variant had reduced Clec16a expression in islet cells, as well as slightly elevated blood sugar. In addition, tapping into a large, previously published genetic database allowed the investigators to further correlate the same disease-associated sequence variant with reduced beta-cell function. From this the team concluded that, in a normal state, Clec16a controls beta cell function and prevents diabetes by controlling mitophagy.
"In 2007, our genomics team found the first gene in a genome-wide search to play a major role in type 1 diabetes, but we did not know its function," says co-senior author Hakon Hakonarson, director of the Center for Applied Genomics at The Children's Hospital of Philadelphia. "Now we understand how this gene plays a critical role in regulating insulin metabolism."
The novel Clec16a pathway could be targeted for prevention and control of diabetes and may extend to the pathogenesis of other Clec16a and Parkin-associated diseases, conclude the researchers
By Paul Govern
In an observational study by researchers at Vanderbilt University Medical Center, adults with type 2 diabetes who take insulin in addition to the recommended first-line drug therapy, metformin, had a 30 percent higher risk of heart attack, stroke or death when compared to similar patients who instead augment their metformin regimen with a sulfonylurea.
New heart attacks and strokes occurred at similar rates in both groups, but death (from all causes) was 44 percent higher in patients who added insulin compared to those who added a sulfonylurea.
The study appeared this week in the Journal of the American Medical Association (JAMA), highlighted with an accompanying editorial and an online video interview with lead author Christianne Roumie, M.D., MPH, associate professor of Medicine and Pediatrics.
Roumie and colleagues compared medical records of two groups of Veterans Health Administration patients with diabetes: 2,436 who took metformin and insulin, and 12,180 who instead took metformin and one or another type of sulfonylurea. The research team accounted for patient co-morbidities, age, duration of treatment, smoking status, sex, race and physiologic variables, including diabetes control.
Some 26 million Americans have diabetes (type 2 accounts for between 90 and 95 percent of all diabetes in the United States). Diet and exercise often provide an effective first-line intervention for this disease, but many patients require a medication, and metformin is recommended as a first-line treatment. Many patients eventually require additional medicines, and according to Roumie the choice of a second medication has been less clear.
“A couple of small clinical trials have shown that using insulin earlier in a disease course helps preserve beta cells in your pancreas longer,” she said.
On the other hand, “multiple large clinical trials have found either no benefit or potential harm from attempting very tight management of glucose. We wanted to look within a real-world practice at the drugs that patients use and evaluate the outcomes.”
In a statement accompanying the study, Roumie wrote, “Although adding insulin seems a reasonable option for some patients who have very high glucose or who desire flexible and fast blood sugar control, the study findings suggest that for most patients who need a second diabetes drug, adding a sulfonylurea to metformin should be preferred to adding insulin.”
At present, any underlying mechanism that might explain the increased risk of death found in the study remains unknown.
Roumie and colleagues have a number of studies planned to examine possible mechanisms, and are now investigating type 2 diabetes outcomes associated with blood glucose swings and with episodes of hypoglycemia (low blood sugar) tied with insulin use.
Roumie was joined in the study by Vanderbilt investigators Robert Greevy, Ph.D.; Carlos Grijalva, M.D., MPH; Adriana Hung, M.D., MPH; Xulei Liu, M.D., M.S.; Harvey Murff, M.D., MPH; Tom Elasy, M.D., MPH; and Marie Griffin, M.D., MPH.
The study was performed under the aegis of Vanderbilt’s DEcIDE Center (Developing Evidence to Inform Decisions about Effectiveness), and was supported by the Agency for Healthcare Research and Quality, the National Institutes of Health (grant DK092986) and the Department of Veterans Affairs.
Paul Govern, (615) 343-9654
Paul Govern, (615) 343-9654
"Life expectancy would grow by leaps and bounds if green vegetables smelled as good as bacon." –Doug Larson
"Vegetables are a must on a diet. I suggest carrot cake, zucchini bread, and pumpkin pie." —Jim Davis
"I don't want any vegetables, thank you. I paid for the cow to eat them for me." —Douglas Coupland
“The only time to eat diet food is while you're waiting for the steak to cook.”—Julia Child
"My doctor told me to stop having intimate dinners for four. Unless there are three other people." —Orson Welles
"I never worry about diets. The only carrots that interest me are the number you get in a diamond." —Mae West
"As for those grapefruit and buttermilk diets, I'll take roast chicken and dumplings." —Hattie McDaniel
“All you need is love. But a little chocolate now and then doesn't hurt.”—Charles Schulz
“One cannot think well, love well, sleep well, if one has not dined well.”— Virginia Woolf
“Seize the moment. Remember all those women on the 'Titanic' who waved off the dessert cart.”—Erma Bombeck
“I cook with wine, sometimes I even add it to the food.”—W.C. Fields
“There is no love sincerer than the love of food.”—George Bernard Shaw
“Wait. Why am I thinking about Krispy Kremes? We’re supposed to be exercising.”— Meg Cabot
“Humor keeps us alive. Humor and food. Don't forget food. You can go a week without laughing.”—Joss Whedon
“You can't just eat good food. You've got to talk about it too. And you've got to talk about it to somebody who understands that kind of food.”—Kurt Vonnegut
“You can tell a lot about a fellow's character by his way of eating jellybeans. ”—Ronald Regan
“Whoever thought a tiny candy bar should be called fun size was a moron.”—Glenn Beck
“I like a cook who smiles out loud when he tastes his own work. Let God worry about your modesty; I want to see your enthusiasm.”—Robert Farrar Capon
“Vegetarians, and their Hezbollah-like splinter faction, the vegans ... are the enemy of everything good and decent in the human spirit.”—Anthony Bourdain
“Tomatoes and oregano make it Italian; wine and tarragon make it French. Sour cream makes it Russian; lemon and cinnamon make it Greek. Soy sauce makes it Chinese; garlic makes it good.”—Alice May Brock
“All sorrows are less with bread. ”— Miguel de Cervantes Saavedra
“No man is lonely while eating spaghetti: it requires so much attention.”— Christopher Morley
“A gourmet who thinks of calories is like a tart who looks at her watch. ”—James Beard
“My wife and I tried to breakfast together, but we had to stop or our marriage would have been wrecked.”— Winston Churchill
“The preparation of good food is merely another expression of art, one of the joys of civilized living…”—Dione Lucas
By Kristina Fiore,
Out-of-pocket costs for type 2 diabetes patients have risen with wider uptake of insulin analogs, researchers found.
In 2000, patients paid median out-of-pocket costs of $19 per prescription, which jumped to $36 in 2010, Kasia Lipska, MD, MHS, of Yale, and colleagues reported in a special theme issue on type 2 diabetes of the Journal of the American Medical Association.
During that time, use of human synthetic insulin dropped off (from 96% to 15%) while use of short- and long-acting analogs such as glargine, detemir, and aspart increased (from 19% to 92%).
But that change didn't appear to be associated with a significant benefit in deterring hypoglycemia, they found. There was only a small decline in the rate of hypoglycemic events between 2000 and 2010 -- 21.1 versus 17.7 events per 1,000 person-years.
"We found a large increase in the prevalent use of insulin analogs," they wrote. "The clinical value of this change is unclear."
Insulin analogs have gained widespread popularity: short-acting analogs for their flexibility in dosing and convenience, and long-acting analogs for their potential to diminish nocturnal hypoglycemia. But both of these cost more than the old staple of human synthetic insulin.
Sue Kirkman, MD, of the University of North Carolina in Chapel Hill, said that studies showing decreased hypoglycemia with insulin analogs in patients with type 2 diabetes have "had pretty weak results" and that main benefit has been slightly less nocturnal hypoglycemia.
"It's clear that the marketing for analogs has been very effective," Kirkman told MedPage Today. "Insulin companies have essentially stopped marketing human insulin."
But she noted that the authors couldn't track changes in the frequency of less severe hypoglycemic events, "which could still have a big impact on quality of life."
The data come from the Optum Labs Data Warehouse, an administrative claims database of privately insured enrollees.
The project was supported by a grant for the Agency for Healthcare Research and Quality.
The researchers reported relevant relationships with Medtronic, Johnson & Johnson, and Optum Labs.
Primary source: Journal of the American Medical Association
Source reference: Lipska KJ, et al "Use and out-of-pocket costs for insulin for type 2 diabetes mellitus from 2000 through 2010" JAMA 2014; 311(22): 2331-2333.
• PRESS RELEASE
• June 9, 2014, 8:35 a.m. ET
Lilly Diabetes Adds NASCAR Nationwide Series Driver Ryan Reed to Annual Diabetes Summer Camp Tour
Driver joins 10-year camp vet Kris Freeman to help inspire children with type 1 diabetes nationwide
INDIANAPOLIS, June 9, 2014 /PRNewswire/ --
-- #Lilly #Diabetes boosts Camp Care Package speaker program adding
20-yr-old NASCAR @driverRyanReed; cheers 10 yrs with skier Kris Freeman
When NASCAR Nationwide Series (NNS) driver Ryan Reed set out to plan his summer, canoeing and archery may not have been on his to-do list...but they are now. Today, Lilly Diabetes announced that Ryan will join Olympic cross-country skier Kris Freeman as a Lilly Camp Care Package (LCCP) program ambassador. Both athletes will travel the country to share their personal stories and speak to campers about how type 1 diabetes did not stop them from chasing their dreams. You can follow their summer camp journeys on Twitter: @TeamFreeBirdXC and @driverRyanReed.
Diabetes camps offer unique experiences to children in a traditional camp setting. For many children with diabetes, this can be the first step toward gaining confidence for the future and understanding they are not alone. Campers learn critical diabetes self-management skills, and many find camaraderie in the shared experiences of fellow campers.
"I'm really excited to be part of the Lilly Camp Care Package program and meet with kids face-to-face this summer," said Ryan. "When I was told I wouldn't be able to race because of my diabetes, I knew it was an obstacle I could overcome as long as I had the right people around me to help. That's why I can't wait to get to camp; I can show kids that having type 1 diabetes doesn't mean the end of your dreams."
Ryan, who was diagnosed with type 1 diabetes three years ago at age 17, was told he would never race again. However, once he learned about diabetes and strategies for proper management, he was back on track to pursue his dream of racing cars. In 2014, Ryan became a full-time driver for Roush Fenway Racing and an advocate for diabetes awareness. Ryan is also the ambassador for Drive to Stop Diabetes(SM) , an educational initiative with the American Diabetes Association and Lilly Diabetes.
Skier Kris Freeman was diagnosed with type 1 diabetes at age 19. This year marks his 10(th) camp tour season and 12 years as a Lilly Diabetes ambassador. Since 2004, Kris has traveled more than 120,000 miles and visited approximately 10,000 campers. In February he competed in his fourth Winter Olympics. Like Ryan, Kris was also told to give up his sport when he was diagnosed with diabetes 14 years ago.
"Having speakers come to camp with real-life experience with this disease is so meaningful for campers," said Carol Dixon, Camp Director of the American Diabetes Association's Camp John Warvel, in Indiana. "When Kris shares his story and talks openly about the 'good and bad,' not only do I see the children sit up and listen, they gain valuable lessons about their ability to successfully manage their disease, even with setbacks. We're glad Ryan has joined the program because that's another voice supporting what our children can do. These wonderful speakers give the campers exciting memories they will hold onto for the rest of their lives."
Lilly Diabetes has supported camps for children with diabetes for 14 years and believes that attending a diabetes summer camp is an important milestone for children learning to live fully with diabetes. Since 2001, Lilly Diabetes has donated nearly $23 million in insulin, supplies, scholarships, and camper and caregiver materials.
"Diabetes camps play such an important role in helping children gain confidence and self-sufficiency. Our hope at Lilly is that role models like Kris and Ryan can accelerate the learning by showing what can be accomplished," said Kevin Cammack, senior director, U.S. marketing, Lilly Diabetes. "Through the expansion of the Camp Care Package program, we hope to reach more children in ways that allow them to learn while having fun at camp."
Kris and Ryan's 2014 summer diabetes camp tour begins June 9. To hear or read their stories, or for more information on other Lilly Diabetes support programs, please visit www.lillydiabetes.com. To find a camp in your area, visit www.diabetescamps.org.
2014 Camp Tour Schedule
Camp John Warvel -- North Webster, Ind., 6/9
Camp Until A Cure -- Noblesville, Ind., 6/10
Friends for Life -- Orlando, Fla., 7/2
ADA Camp Triangle D -- Ingleside, Ill., 7/23
INdependence Diabetes at Camp Carson -- Princeton, Ind., 6/23
Camp WannaCure -- Richmond, Va., 6/24
Camp CoDiaK -- Rincon, Ga., 6/25
Camp Red Jacket -- Orefield, Pa., 6/26
The Rotary Club Camp for Children with Diabetes -- Amarillo, Texas, 6/27
Camp Aldersgate -- Little Rock, Ark., 7/7
K.I.D.S. Day Camp -- Texarkana, Ariz., 7/8
Camp Ho Mita Koda -- Newbury, Ohio, 7/9
Bearskin Meadow Camp -- Miramonte, Calif., 7/10
Camp Conrad-Chinnock -- Angelus Oaks, Calif., 7/11
About Lilly Diabetes
Lilly has been a global leader in diabetes care since 1923, when we introduced the world's first commercial insulin. Today we are building upon this heritage by working to meet the diverse needs of people with diabetes and those who care for them. Through research and collaboration, a broad and growing product portfolio and a continued determination to provide real solutions--from medicines to support programs and more--we strive to make life better for all those affected by diabetes around the world. For more information, visit www.lillydiabetes.com.
About Eli Lilly and Company (NYSE: LLY)
Lilly is a global healthcare leader that unites caring with discovery to make life better for people around the world. We were founded more than a century ago by a man committed to creating high-quality medicines that meet real needs, and today we remain true to that mission in all our work. Across the globe, Lilly employees work to discover and bring life-changing medicines to those who need them, improve the understanding and management of disease, and give back to communities through philanthropy and volunteerism. To learn more about Lilly, please visit us at www.lilly.com and http://newsroom.lilly.com/social-channels.
By Deborah Kotz
More than 29 million American adults have diabetes — up from 26 million in 2010 — yet one in four of them don’t know it, according to a report issued Tuesday from the federal Centers for Disease Control and Prevention. Rates of both type 1 and type 2 diabetes have been increasing for years; while the obesity epidemic has been blamed on the rising rates of type 2 diabetes, the reasons for the rise in type 1 diabetes, an autoimmune condition that typically strikes in childhood, remain unknown.
CDC researchers also can’t explain why so many diabetics remain undiagnosed. Certainly, many without health insurance don’t see doctors until they develop severe complications like kidney problems, nerve damage, and vision loss. But even those with access to healthcare often fail to recognize symptoms like increased thirst, urination, and fatigue — or fail to attribute such symptoms to diabetes.
Continue reading below
“We need people to be more aware of the symptoms and to get screened if they have certain risk factors or are over the age of 45,” said Ann Albright, director of the CDC’s Division of Diabetes Translation.
The American Diabetes Association recommends a screening blood test — to measure the marker hemoglobin A1C or a fasting one to measure blood glucose — for everyone over age 45 every three years. Screening should be done at a younger age in those with certain risk factors like high blood pressure or obesity.
Albright, a registered dietitian, said it’s just as more important for people to know when they’re on the road to diabetes so they can take steps to prevent it. An estimated 1 out of 3 American adults have a condition called prediabetes where their bodies have become less responsive to the hormone insulin. Without taking action to lose weight or increase physical activity, 15 to 30 percent of people with prediabetes will develop type 2 diabetes within 5 years.
“Some of the strongest evidence suggests that small changes — like losing 5 to 7 percent of your body weight if you’re overweight — can make the biggest difference,” Albright said. She’s not a fan of radical eating plans like the low glycemic diet, which eliminates a lot of carbohydrates like certain fruits, cereal, and breads. “White bread isn’t the villain,” she said. “I’d rather see people making calorie adjustments as if they were deciding how to spend money.”
Cutting down on frivolous foods such as sweetened beverages, chips, or candy bars, is akin to cutting out frivolous purchases. “Invest in foods that are nutritious,” Albright said, “like fruits, vegetables, and whole grains.”
The CDC’s National Diabetes Prevention program that teaches nutrition and exercise classes is offered at more than a dozen sites in Massachusetts at little or no cost to participants. Clinical studies suggest that participating in the program often prevents or delays the onset of type 2 diabetes among people with prediabetes.
American Diabetes Association Applauds the Passage of Ohio House Bill 264
ALEXANDRIA, VA--(Marketwired - Jun 12, 2014) - The American Diabetes Association (Association) is pleased to announce the passage of Ohio House Bill 264, a key piece of legislation in the fight to keep children with diabetes medically safe at school. This bill, which was signed in to law today by Governor John Kasich, allows school staff to volunteer to be trained to assist children with diabetes with insulin administration and, in an emergency situation, to administer glucagon. In addition, the bill allows children, if they are capable to do so, to self-manage their diabetes while at school.
The bill was sponsored by Ohio State Representatives Lynn Wachtmann (R-District 81) and John Barnes (D-District 12). Both sponsors are members of the Health and Aging Committee and together, championed this legislation to keep children with diabetes safe at school in Ohio. In addition to support from within the state house, for two years, volunteer diabetes advocates from the American Diabetes Association have helped to raise awareness and build critical support to ensure the successful passage of the bill.
"The American Diabetes Association appreciates the support of House Bill 264's sponsors, Representative Lynn Wachtmann and Representative John Barnes," said Gina Gavlak, RN, BSN, Chair, National Advocacy Committee, American Diabetes Association. "With Governor John Kasich's signature, this vital legislation provides students living with diabetes across Ohio access to the support and care they need to manage their diabetes and stay medically safe at school."
An estimated 208,000 children are living with diabetes in the United States. These children have a disease that must be managed 24/7, including the many hours spent at school. Every day, children with diabetes are put at serious risk if no one, including a school nurse, is present at school to help with daily and emergency diabetes care. House Bill 264 will remove that risk by allowing school staff to volunteer to be trained in school throughout Ohio to provide the diabetes care these children need and deserve to learn and be healthy.
To address barriers to diabetes care at school, the Association created its Safe at School campaign. Through this campaign, the Association is dedicated to making sure that all children with diabetes are medically safe at school and have the same educational opportunity as their peers.
The American Diabetes Association is leading the fight to Stop Diabetes® and its deadly consequences and fighting for those affected by diabetes. The Association funds research to prevent, cure and manage diabetes; delivers services to hundreds of communities; provides objective and credible information; and gives voice to those denied their rights because of diabetes. Founded in 1940, our mission is to prevent and cure diabetes and to improve the lives of all people affected by diabetes. For more information please call the American Diabetes Association at 1-800-DIABETES (1-800-342-2383) or visit www.diabetes.org.
(703) 549-1500 ext. 1637
June 10, 2014 by mateusztylicki
At TrialReach, we believe that patient advocates are vitally important to the overall continuity of healthcare at a fundamental level. Last month we celebrated HIV activists and HIV bloggers by launching TrialReach’s “Top HIV Voices for 2014.” The response from these health advocates was amazing and humbling. We also asked our own social media community to share with us the names of other blogs and communities deserving of the “#TopVoices” recognition by TrialReach. Today, we continue that mission announcing our celebration of Type 1 and Type 2 Diabetes bloggers and online communities.
TrialReach.com’s “Top Diabetes Voices for 2014”
We asked one of our favourite voices in the diabetes community, Alexis Pollak from I Run on Insulin, to assist us in selecting an amazing mix of top voices. We chose Alexis for many reasons, but this statement on her blog sums it up pretty nicely: “Diabetes advocacy and supporting people with diabetes is my passion.” Although she wasn’t promised anything for her assistance, she certainly embodies the type of advocates that we are highlighting. So thank you Alexis, and congratulations on making the list yourself!
The following blogs and digital influencers all share the commitment and focus to live a full and rewarding life with diabetes, while contributing to the much larger global diabetes online community.
1. I Run on Insulin – Combining her passion and her career working for a diabetes device company, Alexis has created a very strong network around her, influencing others as a top voice for type 1 diabetes. “I hope this blog allows other people with diabetes and those that care about someone with diabetes to connect, to offer hope, to commiserate, to laugh, and to know that there are other people who get it.”
2. Rolling in the D – Scott is ‘just a family man with Type 1 diabetes’ but you will quickly realize that this blog is full of personality and humor. For proof, check out his popular “You Might Be A DOCaholic” blog.
3. Sweet Success: Life with Diabetes – Kate is a PWD, Type 2. “Does that define me? Yes and no. I’m so much more, but my blog is about life with diabetes.”
4. Snack on a Bike – Florian is a German Type 1 diabetic trying to cycle more by offering tips for other cyclists. This simply designed, but effective platform is rich with images making riding with him on his journey beautiful.
5. The Butter Compartment – Lee Ann is an active Type 1 diabetes blogger and art therapist using her blog to share insightful posts about the mental health issues associated with diabetes. What about the name of the blog? It’s actually where she stores her insulin!
6. Cranky Pancreas – Bea is a Colombian living in the greater Chicago area. She was diagnosed with type 2 diabetes in April 2001. She also writes for the Type 2 Experience.
7. Despite My Pancreas - Jennifer was diagnosed with Type 1 diabetes at the age of 7. This blog shares her adventures in running, cooking and eating with diabetes with honesty and personality.
8. T minus 2 - Bob shares, among many other topics, his experience living with type 2 diabetes. Check out his popular, award-winning post “The Basis of Self-Esteem.”
9. Six Until Me – Living with Type 1 diabetes, Kerri is also an author and blogger. Simply stated, she shares “diabetes doesn’t define me, but it helps explain me.”
10. Scott’s Diabetes – Diagnosed with type 1 diabetes, Scott shares that he recognizes “the incredible mental struggle of living with diabetes.” He also co-hosts internet radio broadcast DSMA Live!
11. Diabetes Ramblings – Sue is a mother of five, wife of one, and a type 2 diabetic blogger. One of her latest blog posts shares what mobile apps she uses to help manage her condition. And Sue, we love the name change! Congratulations!
12. Diabetes Mine – “This site was created by patients for patients as a ‘diabetes newspaper with a personal twist.’” Founder and editor, Amy was diagnosed with type 1 diabetes in May 2003 and uses her experience in digital media and journalism to lead this fantastic and deeply insightful, innovative advocacy platform.
13. D-Mom Blog – Leighann shares her experience of being a mother of a child living with type 1 diabetes (thus, the “d-mom” title) with other parents offering tips and a very deep resource and insight. She also penned a book: Kids First, Diabetes Second.
14. My Diabetic Heart – Mike shares his journey living with type 2 diabetes and Congestive Heart Failure. Through his honest blog he reminds us, “the important thing to remember is that no two people experience type 2 diabetes in the same way and, as such, what works for me may not work for you.”
15. Diabetes Dad – Tom has been known as “Diabetes Dad” for years, even signing all of his blog posts with “I am a diabetes dad.” One recent post acknowledges his social reach– saying he received not hundreds, but “thousands” of messages of support after he shared that he wasn’t having the best day. His reaction: “Just wow!”
16. The Angry Type 2 Diabetic – Lizmari is a type 2 diabetes blogger and although her blog name may lend itself to a bit of dismal impression, she promises “I’m not really THAT angry; just some of the time.” We do love The Moldy Cupcake Award given to those that perpetuate misinformation in the diabetes health community.
17. This is Caleb - Lorraine shares her stories and the journey of her son, Caleb, who lives with type 1 diabetes. She started this resourceful blog for parents of those newly diagnosed and she “happy to reach out to them, to provide support and share our experiences.”
18. Diabetes Sisters – Through their sisterTALK section, Diabetes Sisters host an “outstanding network of women who share their thoughts and feelings about the nuances of living with diabetes in weekly blogs.” Be sure to check out their type 2 diabetes section.
19. Curemoll - This blog is a “‘life of a diabetic’ and personal/music blog of Mollie Singer and twin sister and Diabetic Angel, Jackie. Normally, Mollie writes about her daily life as a diabetic, how-to tutorials about diabetes, insulin pumps, sensors, etc, and music related blog posts.’” Mollie was diagnosed with type 1 diabetes when she was 4.
20. College Diabetes Network – As a resource for college students living with type 1 diabetes, “CDN’s mission is to empower and improve the lives of students… through peer support and access to information and resources.”
21. Diagnosed Not Defeated – By bringing the African American perspective to the diabetes online conversation, Dr. P’s blog is a great resource for those living with type 2 diabetes. She also is the founder of Black Diabetic Info.
22. Shell’s Journey – Living with type 2 diabetes, this Australian mum of two wants to “give others hope that it can be controlled and it isn’t a “life Sentence” if you do the right thing.” Her latest blog post is honest and you should read it: Life Can Give You Many Up’s and Down’s.
23. The Dirty Diabetic – This cleverly funny and poking type 2 diabetes blog recognizes that we aren’t all perfect. So much so that the author of this blog shares “pictures of all the things we can’t have anymore and a confessions page about cheating on your diabetic diet.”
24. My Diabetes and Me – Shannon, a type 2 diabetic from Tennessee has the camo and feisty Southern personality that we would expect. The great surprise is her blunt, realistic view of her journey living with diabetes and she proudly shares her weightloss success as the header. Great job, Shannon!
25. Diabetes CGM Blog – Dave, a type 2 diabetic and guru for CGM-Continuous Glucose Monitors, shares his thoughts and experiences on his journey living with diabetes. Want to nerd out on all the gadgets, be sure to visit this blog.
26. Rich the Diabetic – Rich lives with type 1 diabetes and is very active in the diabetes community online. His blog also includes one unique page that helps navigate the sometimes confusing array of Twitter hashtags [ #dblog for example