A Dilemma For Diabetes Patients: How Low To Push Blood Sugar, And How To Do It?

A Dilemma for Diabetes Patients: How Low to Push Blood Sugar, and How to Do It?

Heart disease is the leading cause of death for people with Type 2 diabetes. Surely, then, the way to dodge this bullet is to treat the disease and lower blood sugar.
Well, maybe. Growing evidence suggests that the method by which blood sugar is lowered may make a big difference in heart risk. That has raised a medical dilemma affecting tens of millions of people with Type 2 diabetes — and for the doctors who treat them.
Some diabetes drugs lower blood sugar, yet somehow can increase the chances of heart attacks and strokes. Other medications have no effect on heart risk, while still others lower the odds of heart disease but may have other drawbacks, like high cost or side effects.
It’s becoming clear, researchers say, that there’s far too little evidence on how diabetes drugs affect the heart to make rational evidence-based judgments. “If you think the landscape is confusing, it really is,” said Dr. Leigh Simmons, an internist in Boston.
“Daunting” is how Dr. JoAnn Manson, the chief of preventive medicine at Brigham and Women’s Hospital, describes the situation for patients and their doctors. She explained the option and uncertainties in a recent commentary in JAMA.
There are 12 classes of drugs on the market and two or three different agents in each class. The drugs range in price from about $4 a month for older drugs to $700 a month for newer ones, and they have varying side effects. Many patients take more than one drug.
The older, cheaper and more popular diabetes drugs were never tested for their effects on the heart — they were approved before any Continue reading

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World's first diabetes app will be able to check glucose levels without drawing a drop of blood and will be able to reveal what a can of coke REALLY does to sugar levels

The world's first health app could monitor people's glucose levels without breaking the skin - a development which has been described as the 'holy grail' in diabetes care.
The Epic app could also help people find out if they could develop diabetes and need to make lifestyle changes to avoid it becoming a reality.
Users will be able to find out how different food types affect their body; for example, what a can of coke will do to their sugar levels or heart rate or how a plate of broccoli lowers their blood pressure.
It will also be possible to see how exercise or supplements affect vital statistics.
Users will only have to place one fingertip over the camera lens of their smartphone, the London-based firm has stated.
A series of close-up images are taken which accurately show information about the user's blood flow.
These are then sent to the cloud for analysis and can provide feedback on all kinds of vital information - from heart rate to temperature to blood pressure.
It can also tell people about their respiration and blood oxygen saturation.
SMBG (self-monitored blood glucose) is recommended for all people with diabetes and the clinical benefits are widely accepted.
Developers say the app will be available to download - free of charge - on Android smartphone devices and iOS at the end of this year.
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Users have to place one fingertip over the camera lens of their smartphone, the London-based firm says.
A series of close-up images are taken which accurately show information about the user's blood flow.
These are then sent to the cloud for analysis and Continue reading

Is Routine Testing For Gestational Diabetes Necessary?

High blood sugar during pregnancy, known as gestational diabetes mellitus (GDM), used to be a rare condition, occurring in about 3% of pregnancies.
In recent years, the rate has doubled – up to 8% of pregnant women are diagnosed with GDM.
With new recommendations lowering the cutoff point for diagnosis, a dramatic increase in GDM rates is expected; experts predict it could be up to 15%.
Not all medical professionals agree with routine testing to diagnose GDM, however, and question whether GDM is a pathological problem in such high numbers, or simply part of pregnancy.
Is Routine Testing For Gestational Diabetes Necessary?
Dr. Sarah Buckley, author of Gentle Birth, Gentle Mothering recommends most women avoid the routine test.
Dr. Michel Odent, world-renowned obstetrician and birth specialist, and Henci Goer, expert on evidence-based maternity care, both believe diagnosis of GDM increases risk and stress unnecessarily.
Most pregnant women will have to decide whether or not to take the gestational diabetes screening test.
Women who are offered the test might not know anything about GDM, the risk factors, the accuracy of the screening tests, or what failing the test could mean.
For many women, negotiating their way through GDM screening is a challenge, especially for those who decide to forgo having the test, or want to know what their options are. Unfortunately, there aren’t many doctors or midwives who support alternative testing for GDM.
What Is Routine GDM Screening?
The test for GDM has traditionally been two-tiered and occurs around 24-28 weeks gestation.
Glucose cha Continue reading

The Final Frontier: How Does Diabetes Affect the Brain?

Our understanding of the impact of diabetes on organ function has been evolving since the discovery of insulin in the 1920s. At that time insulin was a miracle drug that appeared to cure diabetes, but over time it became clear that death and disability from diabetes complications involving the eyes, kidneys, peripheral nerves, heart, and vasculature could occur even with treatment. With the improvement in diabetes care over the past 20 years, fewer patients are developing the traditional diabetes complications. However, as people live long and well with the disease, it has become apparent that diabetes can alter function and structure in tissues not typically associated with complications such as the brain and bone. Alteration in brain structure and function are particularly of concern because of the impact of dementia and cognitive dysfunction on overall quality of life.
From large epidemiological studies, it has been demonstrated that both vascular and Alzheimer's dementia are more common in patients with type 2 diabetes (1). Why this might be true has been difficult to define. Certainly these patients can be expected to have more risk factors such as previous cardiovascular disease, history of hypertension, and dyslipidemia than aged matched control subjects, but when these variables are controlled, the risk for patients with diabetes appears to be higher than that of other subject groups. Persistent hyperglycemia appears to play an important role in cerebral dysfunction. Many years ago, Reaven et al. (2) demonstrated that performance on cognitive tasks assessing learnin Continue reading

Drinking wine or beer up to four times a week can protect against diabetes, researchers say

Drinking some types of alcohol up to four times a week can significantly protect against diabetes, a study has suggested.
Compared to teetotallers, men who drink three to four days a week are 27 per cent less likely to develop the condition, and women 32 per cent less likely, researchers said.
The Danish scientists, led by Professor Janne Tolstrup from the University of Southern Denmark, publishing their findings in the journal Diabetologia.
They said wine had the most substantial effect—probably because it contains chemical compounds that improve blood sugar balance.
But gin and some other spirits had a massively converse effect on women, with just one drink a day increasing the risk of diabetes by 83 per cent.
The study examined the habits of 70,551 men and women in Denmark across five years.
A total of 859 men and 887 women from the study group developed diabetes.
The investigation did not distinguish between the two forms of diabetes, Type 1 and the much more common Type 2.
"Our findings suggest that alcohol drinking frequency is associated with the risk of diabetes and that consumption of alcohol over 3 to 4 weekdays is associated with the lowest risks of diabetes, even after taking average weekly alcohol consumption into account," the authors wrote.
In terms of the amount of alcohol consumed, men who consumed 14 drinks per week were 43 per cent less likely to develop diabetes than those who drank nothing, the scientists claimed.
And the diabetes risk to women who consumed nine drinks per week was said to be 58 per cent lower than it was for non-drinkers.
For both me Continue reading