Diagnosis And Treatment Of Diabetes Mellitus In Chronic Pancreatitis

Diagnosis and treatment of diabetes mellitus in chronic pancreatitis

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INTRODUCTION
Chronic pancreatitis is a disease characterized by pancreatic inflammatory and fibrotic injury resulting in irreversible parenchymal damage. Progressive nutrient maldigestion and disturbance of the timing and the interactions between nutrient digestion and absorption is observed and may lead to severe metabolic derangements. Glucose intolerance and diabetes mellitus are observed quite frequently in the course of the disease[1,2].
Development of diabetes mellitus in chronic pancreatitis mainly occurs due to the destruction of islet cells by pancreatic inflammation. Additionally, nutrient maldigestion leads to an impaired incretin secretion and therefore to a diminished insulin release of the remaining beta-cells[3]. In contrast to the autoimmune mediated destruction of the beta-cells in type 1 diabetes mellitus, glucagon secreting alpha-cells and pancreatic polypeptide secreting pancreatic polypeptide-cells are also subject to destruction in chronic pancreatitis leading to a complex deranged metabolic situation.
Diabetes mellitus secondary to pancreatic diseases (such as chronic pancreatitis) is classified as pancreatogenic diabetes or type 3c diabetes mellitus according to the current classification of diabetes mellitus (Table 1)[4,5]. Whereas the awareness of type 1 and type 2 diabetes mellitus is rather good, type 3c diabetes mellitus, however, is a condition rarely considered in everyday practice. Yet, recent data on type 3c diabetes mellitus show that it might be more common than generally thought. Studies also suggest that this important condition m Continue reading

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Woman with type 1 diabetes still off insulin one year after cell transplant

Scientists report a step forward in the plan to create a truly artificial pancreas, offering new hope to people with type 1 diabetes.
A 43-year-old single mother with dangerously difficult-to-control diabetes had insulin-producing islet cells transplanted into her omentum -- a fatty membrane in the belly.
The cells began producing insulin faster than expected, and after one year she is doing well and doesn't need insulin injections, the University of Miami researchers said.
"We're exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach," said the study's lead author, Dr. David Baidal. He's an assistant professor in the university's Diabetes Research Institute.
Others voiced optimism as well. "This study was a good start at evaluating a novel site for transplant," said Julia Greenstein, vice president of discovery research for JDRF (formerly the Juvenile Diabetes Research Foundation).
Type 1 diabetes is an autoimmune disease. That means the body's immune system mistakenly damages healthy cells -- in this case, the islet cells found in the pancreas. This leaves people with type 1 diabetes without enough insulin to convert sugars from foods into energy for the body.
As a result, they must take multiple daily insulin injections, or use a pump that delivers insulin via a tube inserted under the skin that must be changed every few days.
Currently, islet cells from deceased donors are transplanted into the liver, but that's not an ideal option.
This new research was a proof-of-concept study expected to be Continue reading

Intermittent fasting could help tackle diabetes – here’s the science

Intermittent fasting is currently all the rage. But don’t be fooled: it’s much more than just the latest fad. Recent studies of this kind of fasting – with restricted eating part of the time, but not all of the time – have produced a number of successes, but the latest involving diabetes might be the most impressive yet.
The idea of intermittent fasting arose after scientists were wowed by the effects of constant calorie restriction. A number of studies in many different animals have shown that restricted eating throughout adulthood leads to dramatic improvements in lifespan and general health.
The reasons for these improvements aren’t yet clear. Part of it seems to be that going without food gives cells in the body a much needed break to perform maintenance and repair. But the lack of food also forces cells to resort to alternative sources of energy. Some of these, such as ketones – molecules created in the liver from recycled fat – appear to be beneficial.
‘Fasting’ without fasting
The problem is that constant calorie restriction isn’t practical: it’s easy for scientists to impose upon lab animals, but hard for humans to impose upon themselves in the real world. Fortunately, we’ve learned that constant calorie restriction isn’t really necessary. Intermittent fasting seems to have many of the same benefits.
There are two main types of intermittent fasting. One type, known as “time restricted feeding”, requires eating only during a few hours of the day – say between 10am and 6pm. This approach gives the body a long break from food each night, Continue reading

New Diabetes Tech on The Horizon: What’s Coming by Mid-2017 in the US?

By Lynn Kennedy, Ava Runge, and Adam Brown
What Abbott, Dexcom, LifeScan, Medtronic, Tandem, and others are bringing to make diabetes easier and less burdensome
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We’re living in the most exciting time ever in diabetes technology, and a slew of soon-to-launch products are going to subtract hassle from living with diabetes – fewer injections and fingersticks, less math, less data overload, less pain, and less worry. Equally important, most emerging technology shows excellent potential to improve glucose outcomes that matter, among them hypoglycemia, time-in-range, hyperglycemia, and A1c.
Curious what’s coming? Read on for a summary of the insulin delivery and glucose monitoring devices expected to launch in the US by mid-2017 or earlier, based on the most recent company timelines (listed chronologically). This list is not fully comprehensive, but does cover the major device launches expected. A more detailed description of each device follows further below.
New Insulin Delivery Devices
Tandem’s t:slim X2 Insulin Pump – October-December 2016. The latest Tandem pump will add a new Bluetooth radio and enable software updates to add future Dexcom G5 connectivity and automated insulin delivery algorithms.
Medtronic MiniMed Pro Infusion Set with BD FlowSmart technology – around late 2016. The long-awaited infusion set has several key improvements, most notably a new catheter that allows insulin to flow out of two holes (less occlusions).
LifeScan’s OneTouch Via – early 2017. The bolus-only, super slim wearable device holds 200 units of Continue reading

Type 2 Diabetes Early Warning Signs

Although 24 million people have been diagnosed with diabetes, it's estimated that an additional 5.7 million people have the disease but don't know it. Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose).
Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel.
If you have diabetes, no matter what type, it means you have too much glucose in your blood, although the causes may differ. Too much glucose can lead to serious health problems.
Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes—when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes—and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered.
Complications
Long-term complications of diabetes develop gradually. The longer you have diabetes—and the less controlled your blood sugar—the higher the risk of complications. Eventually, diabetes complications may be disabling or even life-threatening.
Possible complications include cardiovascular disease, nerve damage (neuropathy), kidney damage (nephropathy), eye damage (retinopathy), foot damage, skin conditions, and hearing impairment.
Type 2 diabetes may also increase the risk of Alzheimer's disease. The poorer your blood sugar control, the greater the risk appears to be. Although there are theories as to how these disorders might be Continue reading