Living With Type 1 Diabetes – a Forgotten Disease US News

One difference between Type 1 and Type 2 diabetes is the former usually develops at a young age while the latter appears much later in life.

By Amir KhanSept. 19, 2014 | 12:26 p.m. EDT+ More

Type 2 diabetes has become an epidemic, with 28.5 million Americans diagnosed as of 2012 and the number expected to continue growing. Lost in the discussion on how to reverse this mounting problem, however, is the plight that nearly 1.5 million Americans with Type 1 diabetes deal with.  

Even though Type 1 and Type 2 diabetes seem similar at first glance, the two are actually worlds apart. Type 1 diabetics usually develop the disease at a young age, which is why it used to be known as juvenile diabetes, in contrast to Type 2 diabetes, previously referred to as adult-onset diabetes. Both diseases are a result of problems with insulin, a hormone used by the body to regulate blood sugar, but that’s where the similarities end. “The simplest way to think about the difference between Type 1 and Type 2 is that Type 1 diabetics have a deficiency of insulin,” says Kevin Goist, an assistant professor of clinical medicine at The Ohio State University's Wexner Medical Center, “while in Type 2 diabetes, the major problem is insulin resistance. The body does not use insulin properly.”

Type 1 diabetics rely on insulin injections to lower their blood sugar level, whereas Type 2 diabetics can try to manage theirs through a combination of diet, exercise and medication before resorting to insulin injections. Derek Rapp, CEO of JDRF, a research foundation dedicated to finding a cure for Type 1 diabetes, has a 20-year-old son with Type 1 and says watching him constantly test and retest his blood sugar is heartbreaking. “He has all these different variables that he’s trying to adjust for," Rapp says, "so it’s a constant balancing act to try and hit the mark with regards to ​what his insulin needs are.”

[Read: 15 Sneaky Sources of Sugar.]

In the short term, Rapp worries that his son Turner is at risk for seizures and shock if his blood sugar isn’t managed properly, but in the long term, he worries about much more. “There’s this nagging fear of the complications that can come with the disease – blindness, kidney failure and limb amputation, to name a few," Rapp says. "These are all very real and experienced by many people with Type 1 every year.”

That’s not all Type 1 diabetics experience, says Camillo Ricordi​, director of the ​University of Miami's Diabetes Research Institute. Due to a wealth of misinformation surrounding the disease, people just assume that, like some Type 2 diabetics, Type 1 diabetics developed the disease due to poor lifestyle choices. “If you ask the general public why they think [people] get Type 1 diabetes, the overwhelming number of answers would be because they eat too much, eat too many sweets, don’t get enough exercise or spend too much time in front of a TV – almost like it's their fault or the fault of their parents,” Ricordi says. “Many [Type 1 diabetics] are now advocating even a change in the name​ of the disease to better differentiate the two conditions.” One petition asking the medical community to devise new names for the two diseases garnered more than 9,000 signatures.

Type 1 diabetics are also calling for more awareness of their condition, Goist says. “When one person hears of another adult with diabetes, they [might] assume it is Type 2,” he says. “It is often a source of confusion for some patients as well.”

[Read: How to Manage Type 1 Diabetes As You Age.]

Brian Herrick, JDRF's communications manager, has lived with Type 1 diabetes since he was 3 years old and says he hopes to one day not have to explain to people​ what Type 1 diabetes is. "People find out I have diabetes, and I have to explain that no, I don’t have Type 2," he says. "I’m looking forward to ​a world where people are more informed."
  
But even if some diabetics feel like the public has forgotten about them, researchers have not, Rapp says, and major breakthroughs in Type 1 diabetes treatment are around the corner – the most promising of which is an artificial pancreas.​ “This is a combination of two devices that can work to help a person have really greatglucose control, without having to worry about the lows and highs or actively managing the condition as we do today,” he says.

The device entails a sensor, called a continuous glucose monitor, which a diabetic wears on his or her abdomen, and​ a small probe that gets inserted under the skin​. The sensor detects insulin levels on a real-time basis and is connected to an insulin pump that automatically releases the amount needed​.

The artificial pancreas is primarily aimed at Type 1 diabetics, but it may also work for some Type 2 diabetics. In addition to eliminating the need to inject insulin, it cuts down the number of times diabetics need to prick their fingers to check their blood sugar levels​. “I once saw Turner prick his finger over 100 times in one day,” Rapp says. “This machine may bring that down to the single digits.”

[See: Pharmacists Top Recommended Blood Glucose Monitors.]

The first iteration of the device, the​ MiniMed 530G, was approved by the Food and Drug Administration in September 2013. Rapp says new and improved models are expected to be available in the near future. “Blood sugar can vary significantly from the time someone goes to bed to the time they wake up,” Rapp says. “To have a device that can take the worry out is a great relief, especially for parents.”

Herrick doesn't use an artificial pancreas, but does use a continuous glucose monitor, and says the ability to track trends in his blood sugar has helped him manage his disease better. "When you’re just checking your blood sugar, you’re not getting a dynamic result," he says. "You’re getting a result of that moment in time. Having trends and knowing what my blood sugar was, what it is and what it will be changes how I approach my treatment."

But it’s not just insulin-administering devices that are getting smarter – the insulin itself is as well. A new treatment called Smart Insulin, funded by JDRF, may one day help diabetics stop worrying about calculating how much insulin they need. “It‘s a form of insulin that will continuously circulate in the bloodstream and turn itself on when blood sugar levels are high and off when the levels are in a safe range,” Rapp says.

Smart insulin is a number of years away from being commercially available, but clinical trials are slated to begin later this year.

Rapp’s goal as CEO of JDRF is to find a cure for diabetes, because even though he’s proud of how well his son is managing his condition, Rapp can’t help but think about how much easier Turner's life would be if he didn’t have to. “It’s a truly life changing disease, and there are so many implications that come with it,” he says. “It’s difficult to find words for how much a cure would mean to me and other parents."

If you or someone you love wants to go beyond diabetes, please call us at (206) 909-8022 or visit us at www.RameyNutrition.com

Epidemic proportions: Diabetes on the rise due mostly to poor diet

The incidence of type 2 diabetes in Victoria is spiralling. Picture: PA

DIABETES is reaching epidemic proportions in Victoria with as many as one in four hospital patients suffering from the chronic health condition.

The Australian-first study of more than 2200 patients at 11 hospitals reveals the prevalence of diabetes has been grossly underestimated.

The findings, published in the Medical Journal of Australia, show a quarter of inpatients had diabetes, putting them at increased risks of a longer hospital stay and readmission.

Most of the patients suffered from type 2 diabetes, which is linked to poor diet and lack of exercise, for about a decade. It showed diabetic patients were more likely to be over 40, heavier and taking medication for high cholesterol or blood-thinning drugs.

Based on diabetes prevalence in the Victorian community, the research indicates diabetes increased the risk of hospitalisation threefold.

The patients were receiving treatment for heart disease, infections, diabetes-related surgery or unrelated conditions. They were more likely to spend almost three days longer in hospital than other patients.

The Alfred’s deputy director of endocrinology and diabetes, Professor Leon Bach, said doctors were seeing an “extraordinary number of patients” with diabetes. He said improving assistance given to patients with complex conditions could decrease hospital stays and prevent or delay future complications.

Fewer than 60 per cent of patients in the study could recall being seen by a diabetes educator and or dietitian.

If you or someone you love is ready to go beyond diabetes to a life they love call Ramey Nutrition at (206) 909-8022, or visit is at www.RameyNutrition.com 

What You Should Know About Gestational Diabetes

Despite prenatal care, around five percent of women will develop diabetes during pregnancy. Gestational diabetes is a temporary, but potentially serious problem.  

In this edition of Vital Signs, Dr. Brian Casey, an obstetrician with Parkland Hospital, explains gestational diabetes is part of the physiology of pregnancy.

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From Dr. Casey’s interview…

What is gestational diabetes? The placenta releases a hormone during pregnancy. Some women respond to those hormones quite well, and some women cannot deal with the increased insulin resistance and produce enough insulin. So their blood sugar go up during the pregnancy.

How serious or dangerous a condition is this? 

• For the mother:  "...the risks are associated with the delivery and are isolated to the pregnancy. With the higher blood sugar levels in the mother, the fetus sees those blood sugar levels and releases insulin to respond to that. And the insulin release can increase the size of the baby. And that translates into difficulties Mom would have with the delivery and could result in an overgrown baby and increased risk for caesarian delivery."
• For the baby:  "..the risks are immediate. You can very low blood sugars in the baby after the cord is cut. The high blood sugar of the mother is cut off, and the baby’s pancreas is still producing insulin and that drives the blood sugar of the baby down, so the pediatricians need to be very aware of that as well."

Who’s at high risk for gestational diabetes?  "Asian women, from a ethnicity standpoint, are at the highest risk, followed by African American and Hispanic women, with Caucasian women being at the lowest risk. (Do we know why women of color are prone to this?) No, we just know when you look at the demographics these segments of the population are at increased risk. And teasing out the individual risk factors like obesity can be a bit difficult, but when you adjust for that there seems to be an ethnic propensity."

There are no symptoms: "We routinely test women during the pregnancy and that’s the only way a woman would know during the course of pregnancy that she had gestational diabetes."

Treatment:  "We generally treat women with diet and we give them a glucose meter and ask them to check their blood sugar four times a day. And we spend a great deal of time educating our patients on what the diagnosis means, foods to avoid, portion control – all in an effort to keep their blood sugar down so that we can avoid the byproduct of the diagnosis."

You don’t have to be overweight to suffer from diabetes

If you think losing weight is enough to prevent diabetes, don’t get your hopes up!  What you eat and not just the number of calories is a significant factor in diabetes risk, a new study suggests. The study found that the postprandial (after eating a meal) levels of circulating metabolites in the blood of identical twins tends to be similar after a fast food meal, independent of weight difference.

Researchers compared genetically identical twins – one heavier and one leaner – and found that after eating a fast-food meal, the circulating metabolites, including those related to Type 2 diabetes, were found in both individuals at the same levels. These findings suggest that the onset of this type of diabetes is largely influenced by genetic factors and/or the composition of gut microbiota.

“Our study contributes to better understanding of the genetic and environmental factors influencing several risk factors which are associated with obesity and metabolic disease (eg Type 2 diabetes),” said Matej Oresic, study author from the Steno Diabetes Centre in Gentofte, Denmark. “As such, our study may contribute to the efforts aimed at prevention and treatment of metabolic complications associated with obesity,” said Oresic. Here’s how fibre can help you to prevent diabetes
 
Scientists studied identical twin pairs, where the twins differed in weight. They were healthy young adults from a national (Finnish) study of twins. The twins ate a fast food meal, and then gave many blood samples over several hours. A broad panel of small molecules (ie, metabolites) was measured in blood, including amino acids, fatty acids and bile acids. The diversity of fecal microbiota also was assessed at the baseline. Results showed that twin-pair similarity is a dominant factor in the metabolic postprandial response, independent of obesity. Read more about sedentary lifestyle and diabetes risk.

Branched chain amino acids, known risk factors of diabetes, were increased in heavier as compared to leaner co-twins in the fasting state, but their levels converged postprandially. The research was published in The FASEB Journal. Here are things you should know about prediabetes.

Here are some tips to prevent diabetes

1. Get your sugar levels checked: A lot of people have prediabetes (fasting sugar: 100-125 mg/dl) and are totally clueless about it. A blood sugar test will help you to understand whether you’re prediabetic and what are your chances of developing diabetes. If you get diagnosed with prediabetes, then you can take the right steps and prevent it from transforming into irreversible diabetes. Here are things you should know about prediabetes.

2. Change your lifestyle: Sometimes, small changes can make a huge difference. Lifestyle intervention for preventing diabetes is the best example for this. Several studies on diabetes prevention programme have proved that diabetes can be prevented effectively by giving up sedentary lifestyle and adopting healthier changes. Read more about sedentary lifestyle and diabetes risk.

3. Eat healthy: Eat a healthy diet that has low calories, especially low saturated fats. Trials have shown that fat intake should not exceed 30 percent of the total calorie intake, whereas saturated fats should be restricted to just 10 percent. Include more of vegetables, fresh fruits, whole grains, dairy products and sources of omega 3 fats. Also, increase your fibre intake. Read more about  10 tips to prevent diabetes

If you or someone you love has diabetes please call us at (206) 909-8023 or visit us at www.RameyNutrition.com 

New device designed to eliminate diabetic finger prick

For many patients with diabetes, pricking the finger to measure blood sugar levels is a constant, yet irritating, task.

Abbott has invented a device designed to eliminate those routine finger pricks, the FreeStyle Libre Flash Glucose Monitoring System, and it is now approved to be sold in Europe, the company said Wednesday.
The device was developed by the Illinois biotechnology company’s diabetes arm, Abbott Diabetes Care, which is in Alameda.
The technology works like this: the user wears a small, round sensor on the back of the upper arm, for example, and through a tiny tube inserted just under the skin, it measures the blood sugar levels of tissue fluid. A reader is scanned over the sensor to get a readout in less than one second — one that shows the real-time result, a historical trend and the direction the glucose is heading, so the user can adjust his or her insulin intake accordingly. Disposable and water-resistant, the sensor can be worn on the back of the upper arm for up to two weeks, Abbott said.
So no finger pricks are needed, even to calibrate the system.
More than 382 million people worldwide have diabetes, including 56 million in Europe, and that number is projected to increase by more than 20 percent by 2035, according to the International Diabetes Federation. Wells Fargo analysts noted in an Aug. 21 note that Abbott’s technology could bring in $1 billion in revenue.
“The FreeStyle Libre System fulfills a major need for people living with diabetes,” said Robert Ford, Abbott Diabetes Care’s senior vice president, in a statement. “Our customers told us that the pain, inconvenience and indiscretion of finger pricking were the key reasons they weren’t managing their diabetes as well as they should.”
If you or someone you love struggles with diabetes, please call (206) 909-8022 to go beyond diabetes as an identity and move on with your life. www.RameyNutrition.com

Hispanics don’t let diabetes dampen their day

Feeling more empowered about metabolic disease has given Hispanics high diabetes-related stress. (Photo: Shutterstock)

Hispanic subgroups have some of the highest diabetes rates in the United States, and as a collective whole, Hispanics see a rate of diabetes at 16.9 percent compared to the rest of the U.S. population which see an 11.3 percent prevalence rate.

Despite the numbers, new research shows Hispanics and other minorities living with diabetes, such as positive psychological well-being, better quality of life, and a feeling of empowerment when it comes to their metabolic disease compared to non-Hispanic whites.

SEE ALSO: The health data that shows Hispanics can’t be lumped into one group

Minority groups do, however, still suffer higher levels of diabetes-related stress, which may be one reason for health outcome disparities, say researchers.

“Despite the fact that minority populations are at increased risk for diabetes-related physical health problems and complications, minority groups in this study reported better quality of life and increased empowerment compared with non-Hispanic whites, but they struggle with diabetes distress,” said Professor Mark Peyrot, principle investigator of the study in a press release.

“It is important that diabetes care teams be aware of the differences among the diverse populations living with the disease in the United States in order to tailor their approaches to improve the psychological well-being of people with diabetes.”

(Photo: Shutterstock)

More specifically, researchers observed that:

• Minorities receiving patient-centered care reported the greatest feelings of empowerment concerning diabetes.
• Those individuals who felt more empowered reported higher levels of stress regarding weight, low blood sugar and discrimination. This may suggest awareness brings about diabetes stress by providing more factors for an individual to focus on in regards to health.
• All three minority groups evaluated–Hispanics, African Americans and Chinese Americans–reported higher levels of diabetes-related stress compared to non-Hispanic whites.
• African Americans reported the most positive psychological outcomes, including well-being, quality of life, and impact of diabetes on various aspects of daily life, and the lowest distress of the three minority groups.

The findings were gathered from data pulled by the Novo Nordisk’s Diabetes Attitudes, Wishes and Needs 2 (DAWN2™) study, published recently in Current Medical Research and Opinion.

“DAWN2™ represents Novo Nordisk’s commitment to identifying and addressing gaps in diabetes care beyond providing appropriate medicines,” said Todd Hobbs, US Chief Medical Officer, Novo Nordisk Inc.

“The psychological impact and burden of diabetes on people living with the disease, especially minority groups, is not fully recognized. We continue to learn from the DAWN2™ study and hope that these insights will bring light to many important issues facing the diabetes community.”

Experts suggest the findings further encourage health care providers to look for culturally-relevant ways to treat diabetes. While awareness about the disease had certainly led to minorities feeling empowered about their options, it has also given them more reason to worry.

Health care providers must be aware that diabetes-related stress is a real concern even among people who have a greater understanding of metabolic disease.

SEE ALSO: Mexican-Americans have the highest diabetes risk among Hispanics

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‘Cantinflas’ Movie Premiere (8-29-14)

Aug 28, 2014 

By Daniel Lastra

The legendary Mexican actor and comedian Mario Moreno, popularly known as “Cantinflas,” is honored with a biopic out in theaters August 29th.

Diabetes Is Already Psychologically Demanding, So Cut the Stigma Too

 

By Matt Petronzio

When Rachel Kerstetter woke up the morning of Aug. 11, 2011, she knew something was wrong. She had risen multiple times during the night. She was extremely thirsty and her vision was blurry. She needed to go to the bathroom more often than usual.
She could trace some of the symptoms back a couple of weeks, but she thought it was just stress. She and her husband, Brad, had just married that May, and were adjusting to life as newlyweds; they were both searching for jobs right out of college; and Kerstetter was dealing with family drama, all while her father was hospitalized with cancer.
But after she experienced nausea and vomiting that particular night, Brad made her go to the doctor — and it ended up saving her life.
Kerstetter was diagnosed with type 1 diabetes, an autoimmune disease that causes a person's pancreas to produce little or no insulin — a hormone that converts sugar into the energy we need to survive. Doctors found high glucose and ketones in her urine, and after a three-night stay in the hospital, she was released with basic instructions for insulin shots, along with some dietary guidelines. For the past few years, she has used an insulin pump and a continuous glucose monitor to keep her blood sugar in check.
But even after her third "diaversary" earlier this month, Kerstetter, now 25, continues to deal with a less talked-about side effect of diabetes: stigma.

See also: 7 Mobile Apps to Help Manage Diabetes

As with other diseases, such as mental illness, a general lack of information causes many to misunderstand and judge those with diabetes. People often combine the disease's different types under one umbrella term, and hold various misconceptions, like the idea that diabetes results from unhealthy eating habits.
"People assume I have type 2 because I was diagnosed as an adult, or they ask if I used to be fat and if that's why I have diabetes," Kerstetter, who weighs 95 pounds and has always been small, tells Mashable.

People often ask her if she has "the bad kind of diabetes."

People often ask her if she has "the bad kind of diabetes." To which she says, "There is no good kind."
Type 1 diabetes used to be called "juvenile diabetes," because diagnoses usually (but not always) occur in young children and adolescents. The term drives Kerstetter crazy.
"Many people have the idea that it can be outgrown, and I have been asked if my diabetes will ever go away when I'm 'done growing' ... [It] puts type 1 diabetes into a neat little box called 'childhood illness,'" she says.

An insulin pump, like the one pictured, delivers insulin through a catheter In a steady dose and as directed. A small needle allows the catheter to be inserted in fatty tissue, and it's taped in place.

Image: Flickr, Alan Levine

In contrast, type 2, formerly known as "adult onset diabetes," occurs when a person's body resists the effects of insulin or doesn't produce enough insulin to maintain a normal blood glucose level. Obesity and diet, which come with their own stigmas, are risk factors that can trigger type 2 diabetes; however, genetics, ethnicity and age play a larger role. With both type 1 and type 2, a person inherits a predisposition to the disease, while environmental factors, such as viruses or obesity, can trigger it. Latinos, American Indians and Asian-Americans are more at risk for type 2 diabetes than whites are, and the risk increases with age.
There's also gestational diabetes, surgically induced diabetes, chemically induced diabetes and latent autoimmune diabetes in adults (LADA, or type 1.5).
According to the latest National Diabetes Statistics Report,

29.1 million Americans had diabetes in 2012. Of those 29.1 million people, only 21 million were diagnosed

29.1 million Americans had diabetes in 2012. Of those 29.1 million people, only 21 million were diagnosed (5% of whom had type 1).
That means 8.1 million were undiagnosed. Martin J. Abrahamson, medical director and senior vice president at Harvard's Joslin Diabetes Center, attributes this to the fact that many people don't know they have type 2, as the disease often doesn't have visible symptoms.
But stigma can prevent people from getting diagnosed and seeking proper treatment, too. Some diabetics may avoid taking shots and tests in public (a very dangerous negligence) in fear of being different. Patients routinely face challenges in their social lives, prejudice in the workplace (employers may think people with diabetes are unfit to perform certain tasks) and an increased risk of depression.
And in the digital age, people easily spread misinformation and stigma online with ignorant memes, though people with diabetes often fight them with blogs and Facebook pages with memes of their own.

If you or someone you love struggles with diabetes, please call us at (206) 909-8022, or visit www.RameyNutrition.com to go beyond Diabetes as an identity and regain your life!