Deborah Greenwood Discusses Technology Enabled Diabetes Self-management Solutions

Deborah Greenwood discusses technology enabled diabetes self-management solutions

Deborah Greenwood discusses technology enabled diabetes self-management solutions

Deborah Greenwood discusses technology enabled diabetes self-management solutions
Posted on Jul 13, 2017 by Barbara Eichorst
Technologyis now part of a newscience within diabetes care. As diabetes educators, we are partnering with people with diabetes (PWD) to support their efforts in using the digital interventions. I am very excited about the first systematicreview of systemic reviews evaluating the existing evidence and best practicewhile using technology in diabetes care and education.Deborah Greenwood,PhD, RN, BC-ADM, CDE, FAADE Chief Digital Research Officer-Diabetes Mytonomy,is one of the authors of "A Systematic Review of Reviews Evaluating Technology-Enabled Diabetes Self-Management Education and Support" that was published recently. This month, I am happy to share my conversation with Deborah about diabetes and technology.
Deborah, how and why doyouhave an interestin technology as a CDE?
In my doctoral program, I focused all my elective courses in informatics and my independent study/internship opportunities in telehealth and diabetes. For my dissertation study, I conducted a randomized clinical trial using paired glucose checking in people with type 2 diabetes not on insulin supported by a technology-enabled remote monitoring system. The intervention group lowered A1C significantly more than the control group at 6 months. The study incorporated a complete feedback loop where PWD followed structured monitoring principles, shared their data with CDEs, were provided with feedback through the electronic health record and made behavior and medication changes. I Continue reading

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Type 2 diabetes and obesity induce similar transcriptional reprogramming in human myocytes

Type 2 diabetes and obesity induce similar transcriptional reprogramming in human myocytes

Skeletal muscle is one of the primary tissues involved in the development of type 2 diabetes (T2D). The close association between obesity and T2D makes it difficult to isolate specific effects attributed to the disease alone. Therefore, here we set out to identify and characterize intrinsic properties of myocytes, associated independently with T2D or obesity.
We generated and analyzed RNA-seq data from primary differentiated myotubes from 24 human subjects, using a factorial design (healthy/T2D and non-obese/obese), to determine the influence of each specific factor on genome-wide transcription. This setup enabled us to identify intrinsic properties, originating from muscle precursor cells and retained in the corresponding myocytes. Bioinformatic and statistical methods, including differential expression analysis, gene-set analysis, and metabolic network analysis, were used to characterize the different myocytes.
We found that the transcriptional program associated with obesity alone was strikingly similar to that induced specifically by T2D. We identified a candidate epigenetic mechanism, H3K27me3 histone methylation, mediating these transcriptional signatures. T2D and obesity were independently associated with dysregulated myogenesis, down-regulated muscle function, and up-regulation of inflammation and extracellular matrix components. Metabolic network analysis identified that in T2D but not obesity a specific metabolite subnetwork involved in sphingolipid metabolism was transcriptionally regulated.
Our findings identify inherent characteristics in myocytes, as Continue reading

How To Increase Insulin Sensitivity

How To Increase Insulin Sensitivity

Other than the fact that needing less insulin will save you tons of money, it also helps your overall health. The better your body is at using and processing insulin, the less you’ll need, and the more optimally your body will perform as a whole. Personally I saw the biggest improvements when I made the trifecta change: I went paleo, started eating low carb, and changed around my exercise routine. But all five of the tips below have helped increase insulin sensitivity and allowed me cut my insulin needs in half! Yes, half!
1. Go Paleo
The biggest reason for me to go paleo, even before I was diagnosed with Celiac disease, was because of the the Celiac + T1D connection. Type 1 diabetes and celiac disease share similar genes (DQ2 and DQ8) and are both immune-regulated. Typically type 1 diabetes is diagnosed first, even if you developed Celiac before developing T1D. Reason being because T1D symptoms are more obvious than Celiac symptoms especially because only 30% of people with Celiac have symptoms and on top of that celiac disease tends to be asymptomatic in type 1 diabetics (which it was for me).
Once I eliminated grain from my diet I figured I was already halfway to paleo so why not just take the plunge?! This switch, going from processed foods to real whole foods, was jaw dropping in regards to my insulin resistance. Now, even though I haven’t been able to find a solid study proving this, my own personal experience was all the proof I needed to turn me into a full blown Paleo enthusiast. My insulin responded better and my BG was more predictable which gave me more cont Continue reading

Cardiovascular Challenges in Diabetes

Cardiovascular Challenges in Diabetes

Cardiovascular Challenges in Diabetes was recorded during the American College of Cardiology, 66th Annual Scientific Session & Expo, March 17-19, in Washington, DC.
James L. Januzzi, MD, Director, Cardiac Intensive Care Unit, Massachusetts General Hospital; Hutter Family Professor of Medicine, Harvard Medical School, Chair of the ACC Task Force on Consensus Statements, and researcher at the Baim Institute for Clinical Research.
Javed Butler, MD, MPH, Simons Chair in Internal Medicine at Stony Brook University, Chief of the Cardiology Division Stony Brook University Medical Center
Christopher P. Cannon, MD, is a professor of medicine at Harvard Medical School, senior investigator in the Thrombolysis in Myocardial Infarction (TIMI) Study Group, and senior physician at Brigham and Women's Hospital.
Part I: Mechanism
Januzzi: We're coming to you from the American College of Cardiology meetings where we're hearing about diabetes and its effects on the heart. This is a subject that we all as cardiologists would think a little bit about, but often would relegate the topic of diabetes to our endocrine or primary care colleagues.
It's time for cardiologists to rewire their thinking because treatment for diabetes will undoubtedly have a greater impact on cardiovascular outcomes than we realize. One of the open questions, however, is mechanism. Why do specific diabetes drugs appear to improve outcomes in cardiovascular disease while some others may not?
Joining me today in this panel from the ACC are a couple of colleagues who are going to get into a spirited dis Continue reading

Pump May Beat Shots for Type 1 Diabetes

Pump May Beat Shots for Type 1 Diabetes

home / diabetes center / diabetes a-z list / pump may beat shots for type 1 diabetes article
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TUESDAY, Oct. 10, 2017 (HealthDay News) -- In young people with type 1 diabetes , insulin pump therapy may offer better blood sugar control and fewer complications than daily injections of the vital hormone, new German research suggests.
" Insulin pumps work, and they work even somewhat better than multiple daily injections overall," said Dr. Robert Rapaport, chief of the division of pediatric endocrinology at the Icahn School of Medicine at Mount Sinai in New York City.
Dr. Siham Accacha, a pediatric endocrinologist at NYU Winthrop Hospital in Mineola, N.Y., explained why that might be so.
"If the pump is really taken care of, you can micromanage your diabetes ," she said. "You can stop the pump if your blood glucose is coming down, or you can give a bit more insulin if it's going up."
Both Rapaport and Accacha prefer pump use, but if patients would rather do multiple daily injections, the doctors said that excellent control can also be maintained with shots. It's really a matter of patient preference, they noted.
One issue with the pump is price. The start-up cost for a pump can be as much as $5,000, according to Accacha. And there are monthly costs for supplies as well. Insurers, especially Medicaid, sometimes hesitate to pay, both experts said. But studies like this latest one help provide more evidence about the importance of pump therapy.
"Pumps are more expensive, but I don't think expense should guide quality of Continue reading

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