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A New Perspective On Metformin Therapy In Type 1 Diabetes

A new perspective on metformin therapy in type 1 diabetes

A new perspective on metformin therapy in type 1 diabetes


, Volume 60, Issue9 , pp 15941600 | Cite as
A new perspective on metformin therapy in type 1 diabetes
Metformin is quite frequently used off-label in type 1 diabetes to limit insulin dose requirement. Guidelines recommend that it can improve glucose control in those who are overweight and obese but evidence in support of this is limited. Recently-published findings from the REducing with MetfOrmin Vascular Adverse Lesions (REMOVAL) trial suggest that metformin therapy in type 1 diabetes can reduce atherosclerosis progression, weight and LDL-cholesterol levels. This provides a new perspective on metformin therapy in type 1 diabetes and suggests a potential role for reducing the long-term risk of cardiovascular disease.
AtherosclerosisCardiovascularCarotid intima-media thicknessCholesterolMetforminReviewType 1 diabetes
Carotid Atherosclerosis: MEtformin for insulin ResistAnce
Epidemiology of Diabetes Interventions and Complications
National Institute for Health and Care Excellence
REducing with MetfOrmin Vascular Adverse Lesions
The complete member list for The REMOVAL Study Team is provided in the electronic supplementary material ( ESM ).
The online version of this article (doi: 10.1007/s00125-017-4364-6 ) contains peer-reviewed but unedited supplementary material, which is available to authorised users.
Over the last three decades, the Diabetes Control and Complications Trial (DCCT) and its Epidemiology of Diabetes Interventions and Complications (EDIC) post-randomisation follow-up have confirmed that the risk of microvascular and cardiovascular complications i Continue reading

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How to Live With Type 1 Diabetes

How to Live With Type 1 Diabetes


Being diagnosed with a chronic disease like diabetes is daunting, even more so when the disease affects every single activity in your life, including the pleasurable ones, such as eating a great meal, having a cocktail with your friends or going for a hike.
Diabetes can essentially be divided into two types: Type 1 diabetes (T1D) is most often diagnosed in children or young adults and requires daily insulin injections. Type 2 diabetes (T2D) is the more common type that's often diagnosed in older people and in those who are somewhat overweight.
Type 1 diabetes is autoimmune in its origin, which means that your body destroys the very cells needed to produce the insulin we all need to survive. Before the discovery of insulin in 1921, people with T1D didn't live very long, and in many developing countries where there is a lack of insulin supply, people can die from it.
Type 2 diabetes accounts for 90 percent of individuals with diabetes and may, in some cases, be reversible if lifestyle changes are implemented.
[Read More: What You Need to Know About Diabetes ]
So what can you do to live a healthy, happy life after being diagnosed? I was diagnosed with T1D as a teenager and did many things right, but also many things wrong. Here are some important lessons that I learned:
1. Learn as much as you can. Don't hesitate to bombard your health care professionals with questions. They've seen many cases like yours and can guide you through your struggles and toward small victories.
I also recommend that people with diabetes share their story with fellow patients -- something I Continue reading

Educators can raise awareness of sexual complications in diabetes

Educators can raise awareness of sexual complications in diabetes


Educators can raise awareness of sexual complications in diabetes
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In this issue, Susan Weiner, MS, RDN, CDE, CDN, talks with diabetes educators Janis Roszler, MS, RD, LD/N, CDE, FAND, and Donna Rice, MBA, BSN, RN, CDE, FAADE, about recognizing and treating diabetes-related sexual issues.
How widespread are sexual complications among people living with diabetes?
Rice and Roszler: About 50% of men and 38% of women with diabetes develop some form of sexual complication. In men, the most common problems are erectile dysfunction, premature ejaculation, and reduced self-esteem and libido. Women with diabetes may have inadequate vaginal lubrication, reduced libido, difficulty climaxing, dyspareunia, low self-esteem and frequent vaginal infections, which can interfere with sexual activity.
As diabetes-focused health care providers, why should we care about the sexual well-being of our patients?
Rice and Roszler: First and foremost, sexual health issues are a red flag that can alert us to an array of serious issues that may have gone unnoticed, such as cardiovascular disease, poorly controlled diabetes and psychosocial changes. Erectile dysfunction may be a sign of coronary artery disease. Sexual issues can also affect our patients moods, motivation and self-esteem in such a profound way that, if unaddressed, they may limit our ability to successfully achieve our desired clinical goals as well as our patients personal Continue reading

Did you know these 6 celebrities have diabetes?

Did you know these 6 celebrities have diabetes?

By the year 2025, the World Health Organisation (WHO) estimates that globally 380 million people will have diabetes. Affecting the body’s use or production of insulin, diabetes is a disease that, if not managed well, can lead to kidney failure, heart attack, stroke, loss of limbs and blindness.
Key to staying healthy as a diabetic is eating better, getting into the habit of exercising, keeping a close eye on your blood sugar levels, and – for type 1 diabetes – taking your insulin.
Take your cues from these celebrities who’ve reconsidered their lifestyle choices and are living healthy, full lives with this chronic ‘lifestyle’ disease.
1. Anthony Anderson
In 2001, the actor was diagnosed with type 2 diabetes – a condition that claimed his father’s life and also affects his mother.
The diagnosis led the shocked actor to rethink his approach to health. “One day you’re not feeling well and the next thing you know, the doctor’s telling you that you have this life-changing condition,” he told Parade magazine. “Nothing can prepare you for that, but I rolled through the punches, and I’m making the most of it. I took it seriously from the beginning, and that’s what I’ve been doing the past 13-plus years.”
Through eating healthily and incorporating exercise into his life he lost almost 20 kilograms. “I run on the treadmill, I ride my bike, I still play basketball on occasion and even though golf isn’t a sport that gives me a lot of cardio, I play it as much as I can,” he told Parade.
He also become a spokesperson for F.A.C.E (Fearless African Am Continue reading

Type 1 Diabetes and Intimacy: Reducing Burden in the Bedroom

Type 1 Diabetes and Intimacy: Reducing Burden in the Bedroom

Here on Glu, we offer people living with type 1 diabetes the chance to be open and honest, sharing challenges and gaining support from others who know how much this disease can get in the way of life. Having an anonymous forum allows us to gain real perspective on some deeply personal matters.
Several months ago, we polled the community on one of our most personal topics to date: physical intimacy.
In response, 63% of the community reported that T1D has had a negative effect in this area of their lives, blaming devices, sudden swings in blood sugar, and recurrent infections. Likewise, there is at least one published research study proving that people with diabetes and poor glycemic control reported significantly reduced intimacy and satisfaction in their marriages(1).
In a follow-up question, we learned how people’s sex lives have been affected. Here is a list of the most commonly reported problems, and potential strategies for solving them.
“My blood glucose is too low for sex.”
Having low blood sugar (BG) can interrupt anything; you just have to put everything else on hold and deal with it immediately. As the most commonly mentioned barrier to sex (one user commented that low blood sugar can “really kill the moment”), knowing your BG prior to sex is always a smart idea, as is adjusting any dose of rapid insulin prior to activity. Additionally, having a small snack before any physical activity may help prevent a low. You can also keep some ‘fast carbs’ near the bed, such as juice, gummy snacks, or glucose tabs. If you do experience a low during sex, despite y Continue reading

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