Diabetes And Cardiovascular Disease: A Deadly Duo

Diabetes and cardiovascular disease: A deadly duo

Learn about the vital education patients need to improve their outcomes.
Takeaways:
Both type 1 and type 2 diabetes can lead to multiple complications.
The most common complication of diabetes is cardiovascular disease.
Nurses should use patient-centered communication when educating patients about the risks and challenges of diabetes.
By Charlotte A. Wisnewski, PhD, RN, CDE, CNE
Eugene Jones, age 66, has a 10-year history of type 2 diabetes mellitus; 1 year ago, he suffered a myocardial infarction (MI). During today’s routine clinic appointment, his fasting blood glucose level is 215 mg/dL and his blood pressure is 160/94 mm Hg. He tells the nurse he sometimes forgets to take his diabetes and high blood pressure medications—metformin, metoprolol, and low-dose aspirin. He states that he walks about 15 minutes daily and tolerates the exercise well.
Diabetes mellitus occurs in four main forms, all of them marked by hyperglycemia. The most common forms are type 1, which results from autoimmune destruction of pancreatic beta cells, and type 2, caused by insulin resistance or an insulin secretory defect. Diabetes of all types increases the risk for cardiovascular disease (CVD). (See Diabetes complications.)
Diabetes complications
Both type 1 and type 2 diabetes can lead to:
• cardiovascular disease (the most common complication)
• macrovascular problems of the cardiac vessels, resulting in myocardial infarction
• cerebrovascular damage, causing stroke
• microvascular defects involving the eye and blood vessels, leading to blindness
• vascular involvement of the kidn Continue reading

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Insulin Resistance: What You Need to Know

Chances are, somewhere alone the lines, you’ve read about or heard the phrase “insulin resistance.” It’s one of those terms that some folks in the medical profession — and in the media — often use, but it’s not always explained very well. As a result, it can seem rather vague and even be a little confusing.
Insulin: “do your job”
To understand the meaning and implications of insulin resistance, it helps to first take a look at the hormone insulin. The pancreas makes insulin in special clusters of cells called islets. Within these islets are beta cells that faithfully churn out insulin and release it into the blood where it’s set free to do its job (Coach Bill Belichick would approve!). Like all hormones, insulin has a very specific role: it helps the body use glucose from the carbs that you eat for energy. Specifically, it signals muscle, fat, and liver cells to take up glucose from the blood to be used for fuel. If the body says, “No thanks, I’m good,” that energy (glucose) gets stored as glycogen (and, if glycogen stores are full, fat) for use later on. Insulin is a blood glucose regulator, meaning that it helps keep blood sugar levels at a safe level, preventing it from going too high (hyperglycemia) or too low (hypoglycemia). In addition, insulin puts a halt on glucose release from the liver, which also prevents blood sugar levels from climbing.
When things go haywire
You have to admit — when the body is working as it should, it’s pretty amazing. The pancreas and insulin are no exception. However, things do go awry, unfortunately. Not so mu Continue reading

Elderly A1C Targets: Should Older People Have More Relaxed Glucose Goals?

You may have read that the lower your A1C level, the better. For best health, people with diabetes should aim for glucose as close to normal as possible. But some new research shows this may not be true for older people.
According to these studies, seniors could decide not to shoot for tight control of blood sugar or cholesterol. One study from Japan showed that lower HbA1c levels (a measure of average glucose control over the previous 2–3 months) were actually linked with an increased the risk of frailty in older adults. Frailty was measured in the study as how much help a person needs in living, and how poorly he or she recovers from an illness or injury.
Toshihiko Yanase, MD, PhD of Fukuoka University School of Medicine, Japan, reported, “The risk factors of metabolic syndrome, such as high blood glucose, obesity, high cholesterol, and hypertension, in middle age may shift from an unfavorable risk to favorable factors in old age.” The study was published in the Journal of Diabetes Investigation and reported by the online site Healio.com.
Yanase and colleagues analyzed data from 132 adults aged at least 65 years with Type 2 diabetes Average age was 78. The subjects had had diabetes for an average of 17 years and their mean A1C was 7.3%.
The subjects were categorized as frail or not on a 9-point clinical frailty scale (CFS). The CFS goes from 1 (very fit) to 9 (terminally ill). People who rated 5 or higher were classed as frail. Seventy-seven were not frail; 55 were. In those with higher frailty scores, HbA1c levels were found to be significantly lower.
The causes of Continue reading

Needle-Free Diabetes? European MedTech Inventions which Painlessly Measure Blood Glucose!

Will the daily routine of finger pricking to monitor blood glucose levels finally come to an end for the millions worldwide living with diabetes?
Diabetes mellitus is a chronic metabolic disease that affects over 422 million people worldwide. It is the major cause of blindness, kidney failure, heart attack and stroke. The World Health Organization (WHO) considers it an epidemic and predicts it will become the 7th biggest cause of death worldwide by 2030.
To monitor blood glucose levels, millions of diabetics have to test their blood sugar close to 10 times a day by pricking their finger with a lancet to obtain a small blood sample. But some companies in Europe are trying to find a pain-free alternative that removes the need for needles – here are three startups revolutionizing blood sugar testing.
GlucoSense (London, UK)
GlucoSense is a spin-out of the University of Leeds funded by NetScientific that is developing a non-invasive device based on photonics technology. Its basic component is a nano-engineered silica glass with ions that fluoresce in the infrared region when stimulated by a low power laser.
When the glass is in contact with the user’s skin, the reflected fluorescence signal varies based on the concentration of glucose in their blood and one can acquire the glucose concentration measurement in less than 30 seconds.
NovioSense (Nijmegen, the Netherlands)
NovioSense is a Dutch startup working on an implantable glucose sensor that uses tear fluid to measure glucose levels. The device consists of a 15 mm-long metal coil coated with a hydrophilic gel. Its flexibl Continue reading

Cinnamon and diabetes: Effect on blood sugar and overall health

People with diabetes often face dietary restrictions to control their blood sugar and prevent complications.
Although research is in a preliminary stage, cinnamon may help fight some symptoms of diabetes. It is also unlikely to cause blood pressure spikes, or disrupt blood sugar. So, people with diabetes who miss a sweet pop of flavor may find that cinnamon is a good replacement for sugar.
Can cinnamon affect blood sugar?
Cinnamon has shown promise in the treatment of blood sugar, as well as some other diabetes symptoms.
Research on the effects of cinnamon on blood sugar in diabetes is mixed and in the early stages. Most studies have been very small, so more research is necessary.
People with diabetes who are interested in herbal remedies, however, may be surprised to learn that doctors are serious about the potential for cinnamon to address some diabetes symptoms.
A 2003 study published in Diabetes Care, compared the effects of a daily intake of 1, 3, and 6 grams (g) of cinnamon with a group that received a placebo for 40 days.
All three levels of cinnamon intake reduced blood sugar levels and cholesterol. The effects were seen even 20 days after participants were no longer taking cinnamon.
A small 2016 study of 25 people, published in the Journal of Intercultural Ethnopharmacology, found that cinnamon may be beneficial for people with poorly controlled diabetes. Participants consumed 1 g of cinnamon for 12 weeks. The result was a reduction in fasting blood sugar levels.
However, a 2013 study published in the Journal of Traditional and Complementary Medicine had a differen Continue reading