All About Diabetes

Recent Austrian studies concluded that gastric stimulation could yield significant improvement in glycemic control among morbidly obese type 2 diabetes patients (ODM).

Bohdjalian et al (2009) recruited 24 ODM for a multicenter open-label European feasibility trial. Each of them were treated with insulin and/ or oral hyperglycemic agents and had a body mass index between 33.3 to 49.7 kg/m2. These participants were implanted laparoscopica ly with a TANTALUS system.

The TANTALUS system provided gastric electrical stimulation which is synchronized to the refractory period of gastric electrical activity. It was applied during meals and was evaluated for safety and for improvement of body weight and glucose control in obese type two diabetics.

Researchers from the Medical University of Vienna noted 18 adverse events related to the implant procedure or the device reported in 12 subjects. Accordingly, all were short-lived and resolved with no sequelae.

It was also noted in the large majority of subjects the significant reduction of weight by 4.5 +/- 2.7 kg (p < 0.05) and HbA1c by 0.5 +/- 0.3% (p < 0.05). Moreover, a subgroup (n = 11) on stable or reduced oral medication, registered a weight reduction by 6.3 +/- 3.4 kg (p < 0.05) and HbA1c by 0.9 +/- 0.4% (p < 0.05). The group on insulin (n = 6) had no significant changes in weight and HbA1c.

In conclusion, such findings prove the effectivity of the TANTALUS system among obese type 2 diabetic subjects. “Gastric electrical stimulation can potentially improve glucose metabolism and induce weight loss in obese diabetic patients, who are not well-controlled on oral antidiabetic therapy,” the researchers explained. “Further evaluation is required to determine whether this effect is due to induced weight loss and/or to direct signal dependent mechanisms.”

Cathelyn Sanchez, 32, a doting mother of two, is about to give birth to her first baby girl. However, she never thought that her third pregnancy would be difficult, as she was diagnosed with gestational diabetes. Gestational diabetes is like meeting a stranger for Cathelyn. Before learning of her condition, she didn’t realize she was expecting for the third time until she went to her OB-gyne to confirm her pregnancy. “I was three weeks delayed then,” Cathelyn says. When her doctor asked about her family history of  diabetes, Cathelyn admitted that her family had a history of the said disease. “My father has been diabetic for years and my grandmother died of the same disease,” she reveals.

Knowing her background, her OB decided to include an Oral Glucose Challenge Test (OGCT) with her laboratory tests. The results were way above the normal, so Cathelyn underwent another test. This time she had the Oral Glucose Tolerance Test (OGTT) to confirm her condition. The result of the test made her OB advise her to also see an endocrinologist for her gestational diabetes. Despite her condition, her endocrinologist gave her hope and told her not to worry so much so as not to affect the baby inside her womb.

Cathelyn wondered why she would have the disease only now during her third pregnancy. “I did not suffer from gestational diabetes from my two previous pregnancies. I didn’t know if it was because I first gave birth 11 years ago,” recounts Cathelyn. “Laboratory tests on pregnant womenn were not as rigid as it is today, or maybe I was still young then or because of my genes,” explains Cathelyn. Cathelyn is very happy with the coming of her first baby girl yet she needs to sacrifice to be able to make her and her baby safe and healthy. Her endocrinologist put her on a strict 1,900 calorie diet for blood sugar control. “It was stressful on the pocket than the mind because in order to take 1,900 calorie diet, I must attend diabetes education,” Cathelyn narrates.

The diabetes education program is a three-hour lecture which includes food, diabetes information and blood sugar monitoring guidelines. Aside from the lecture, Cathelyn needed to monitor her blood sugar level four times a day. After a week of doing the 1,900 calorie diet, she returned to her endocrinologist for check-up. The said diet did not work for Cathelyn. Her endocrinologist advised her to take insulin to normalize her blood sugar level. “I started at 12 units of mixed insulin at once because one kind of insulin did not work for me,” she says. Insulin injections gave her so much pain but she still managed to do so. “After six months of. injecting insulin before meals, I’m finally used to it. Although, there are times it hurts especially on the leg area.”

Cathelyn’s husband sees to it that she eats a well-balanced diet consisting of a serving of fruit every meal, a measured amount of rice and plenty of vegetables. She also does exercise for her condition. Cathelyn is very thankful of the support she’s getting from her family especially from her husband. “He eats what I eat. He also follows my 1,900 calorie diet and he keeps on hiding foods which will elevate my sugar level,” Cathelyn recounts. Her kids were also trained by her husband not to give her sweet food when Cathelyn asked for a portion size of it.

Cathelyn is on her ninth month already. Despite her grueling condition, she is still hopeful that she and her baby can surpass this condition. Cathelyn said she just had her ultrasound and the result is great. Her baby is of normal size. Meanwhile, Cathelyn’s HbAI c revealed that her sugar level is also normal. Her sacrifices, including insulin injections, are working wonders for her and her baby.

Although, Cathelyn knows that her baby is not spared from this ,killer disease, the family is still praying that it won’t happen to their unica hija. Cathelyn realizes that discipline is very important to be able to manage diabetes. “It is very rude to satisfy yourself when you know that complications of diabetes may strike and affect you and your baby anytime. It is important to know more about the disease. Read and be aware of the complications of diabetes for it is seriously fatal,” Cathelyn explains. She adds that gestational diabetes can happen to any mother with no signs and symptom yet it can be controlled. “Gestational diabetes can be controlled with proper food, care, and information.” Now that’s great advice from one great mom.

Mothers who develop high blood sugar levels first detected during pregnancy are diagnosed as having Gestational Diabetes Mellitus or GDM. Unfortunately, we Filipinos are among the people at high risk for developing this disease. With timely detection, proper nutrition, close monitoring, and the use of insulin when necessary, the outcome of pregnancies complicated with GDM is just about the same as normal pregnancies. But after one gives birth, what happens next? Are there still existing health issues a mother should worry about – both for her and her new beloved bundle? Should she be afraid to breastfeed? Would future babies be at risk? Pray tell, would there ever be normalcy in life after GDM? Read more… »

Exubera, manufactured by Pfizer, Inc., became the first inhaled insulin to get approval from the United States Food and Drug Administration (US FDA). The FDA approval came late January this year, giving the makers of Exubera license to market the product for the treatment of adults with type I and type 2 diabetes. It has been found in clinical trials that Exubera is as effective as short-acting insulin injections, and that it significantly improves blood sugar control when added to diabetes pills. Read more… »

Too lazy to lose weight? A study published in the American Journal of Clinical Nutrition gives another reason why getting rid of extra fats does wonders to the body, especially for obese older women. Dr. Gloria Mazzali and her co-researchers from the University of Verona examined 35 obese women aged 58 to 83 years old. The figure includes 15 women who shed five percent of their body weight through diet. The researchers discovered that the subgroup developed more desirable body fat distribution and insulin sensitivity. Read more… »

Type 2 diabetes mellitus is a blood sugar disorder due to a relative lack of insulin or the lack of insulin effectiveness, also known as insulin resistance, or both. Insulin is the hormone that lowers blood sugar. Patients with type 2 diabetes often respond well to oral medications, especially early in the disease process, unlike those with type 1 diabetes. As the disease progresses, the oral agents may become less and less effective and at some point the patient may require insulin therapy (injections). It is also possible to start treatment with insulin even in type 2 diabetes. Read more… »

A solution to diabetes is finally within reach, according to Geron Corporation, a US-based company that specializes in developing cures for the treatment of cancer and other degenerative diseases. The company has also pioneered the use of human embryonic stem cells for therapeutic claims. With the knowledge that human embryonic stem cells were found to produce insulin, Geron hand-in-hand with Canadian researchers, formulated a technique that restores insulin-producing cells in patients with Type l diabetes. They called this project the Edmonton Protocol. Geron is now working on purifying and perfecting these cells and testing them on animals. Read more… »

Be it in the form of a pump, vial and syringe, or pen, an insulin device is a must for every diabetic in need of insulin. However, insulin devices aren’t the same in terms of yielding positive results. Based on a recent study, an insulinfilled pen is regarded as the best device in a number of aspects. Researchers found patients with Type 2 diabetes who use insulin pens achieved better adherence to medication and experienced fewer instances of hypoglycemia or low blood sugar compared to conventional vial and syringe delivery. As a result, this group went to see the doctor less often and spent less for medication expenses. Read more… »