Fatty Pancreas And The Development Of Type 2 Diabetes

Fatty Pancreas and the Development of Type 2 Diabetes

The English friar and philosopher William of Ockham (1287-1347) is credited with developing the fundamental problem solving principle known as lex parsimoniae or Occam’s Razor. This principle holds that the hypothesis with the fewest assumptions is most often right. The simplest explanation is usually the most correct.
Albert Einstein is quoted as saying, “Everything should be made as simple as possible, but not simpler.” With that in mind, let’s remember that type 2 diabetes reflects two fundamental problems:
Insulin resistance
Beta cell dysfunction
Insulin resistance, an overflow phenomenon, is caused by fatty infiltration of the liver and muscle. Without dietary intervention, defect #2 virtually always follows #1, albeit by many years. Also, #2 is almost never found without #1.
Yet somehow, we are asked to believe that the mechanism behind insulin resistance and beta cell dysfunction are completely and utterly unrelated? Occam’s razor suggests that both defects must be caused by the same underlying mechanism.
Searching for the mechanism
Hyperinsulinemia stimulates de novo lipogenesis transforming excess dietary carbohydrate into new fat. The liver packages and exports this new fat as VLDL making it widely available for other organs. The new fat deposits in skeletal muscles takes up much of this fat, as do the fat cells in and around the abdominal organs leading to the central obesity that is an important component of metabolic syndrome.
As fat begins to deposit within the organs, specifically the liver and muscles, insulin resistance develops, gradually leading Continue reading

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The risky bet behind the first ‘artificial pancreas’ for diabetes patients

Twelve years ago, a dotcom millionaire stood at a patient advocacy group’s board meeting and made an offer.
I’ll give you $1 million, he said. But only if you commit to getting an artificial pancreas on the market.
That challenge set JDRF, formerly known as the Juvenile Diabetes Research Foundation, on a costly, and risky, campaign to enlist academic researchers, global companies, members of Congress, and even federal regulators to embrace the concept of a device that could take over much of the process of regulating blood sugar in patients with diabetes.
The campaign worked: The Food and Drug Administration last week approved the first artificial pancreas, from Medtronic, for patients over age 14 with type 1 diabetes.
JDRF’s long crusade mirrors a trend in the patient advocacy world: Such groups are increasingly moving beyond traditional activism to fund research at drug and device companies.
Those close ties with industry have sparked some criticism — mostly out of concern that advocacy groups won’t be able to freely fight for patients if their finances are tied to the fate of a corporate partner. But the expanding model may also help patients, if the advocacy groups succeed in pushing industry to get new treatments to market quicker.
In the case of the artificial pancreas, JDRF was taking a very big chance.
Academics had been trying for years to develop algorithms to power a fully automated system for regulating blood glucose, a task that again and again proved unfeasible. Device makers were squeamish about letting a computer control an insulin delivery system Continue reading

San Francisco biohackers are wearing implants made for diabetes in the pursuit of 'human enhancement'

Chrissy Ensley, head of operations and supply chain at Nootrobox, shows off her continuous glucose monitor. Melia Robinson/Business Insider
Paul Benigeri, a lead engineer at cognitive enhancement supplement startup Nootrobox, flexes his tricep nervously as his coworkers gather around him, phones set to record the scene. He runs his fingers over the part of the arm where Benigeri's boss, Geoff Woo, will soon stick him with a small implant.
"This is the sweet spot," Woo says.
"Oh, shit," Benigeri says, eyeing the needle.
"Paul's fine," Woo says. "K, ooooone ..."
An instrument no bigger than an inhaler lodges a needle into the back of Benigeri's arm. Woo removes his hand to reveal a white plate sitting just above the implant. Benigeri smiles.
Paul Benigeri breathes a sigh of relief after a mysterious device is implanted under his skin. Melia Robinson/Business Insider
"You are now a tagged elephant," Woo says, admiring his handiwork.
"A bionic human," says Nootrobox cofounder Michael Brandt.
In San Francisco, a growing number of entrepreneurs and biohackers are using a lesser-known medical technology called a continuous glucose monitor, or CGM, in order to learn more about how their bodies work. They wear the device under their skin for weeks at a time.
CGMs, which cropped up on the market less than 10 years ago and became popular in the last few years, are typically prescribed by doctors to patients living with diabetes types 1 and 2. They test glucose levels, or the amount of sugar in a person's blood, and send real-time results to a phone or tablet. Unlike fingerstick tests, Continue reading

31 Nurses & Experts Answer 3 Important Diabetes T1 & T2 Questions

We have asked 31 Nurses and Experts to answer the 3 following important diabetes related questions.
Do you think diabetes is on the rise or decline?
What mistakes do you see most newly diagnosed patients with Type 2 diabetes make? What tips would you offer to them?
Lastly, most people talk about the role a Certified Diabetes Educator (CDE), Registered Dietician (RD), Endocrinologist play when it comes to managing one’s diabetes. In what ways do you believe that specialised nurses play a role in the management and prevention of diabetes in patient cases?
And here are the answers we have got.
1. Keith Carlson RN, BSN, NC-BC
A1: While I don’t currently work in the clinical sphere, the news from the public health sector make it clear: diabetes is on the rise in the United States in 2017, as well as in other countries around the world. A recent article by Kaiser Health News shows that health claims for Type 2 diabetes in children more than doubled between 2011 and 2015. The inherent risks of a life with diabetes is certainly a factor to take into account when it comes to the financial burdens shouldered by the healthcare system.
A2: Newly diagnosed diabetics are likely to feel understandably fearful; some might decide that they simply can’t eat anymore, and will erroneously begin dieting without the guidance of a skilled healthcare professional. My strongest advice is to engage the services of a knowledgeable dietitian, nutritionist, or diabetes educator, and begin to make daily choices and lifestyle modifications that will improve your health and keep your diabetes under Continue reading

Diabetes Mellitus: Part III – Monitoring & Insulin Handling

This week I present the third and final installment in our discussion about diabetes mellitus (DM). Previously we reviewed this disease as it relates to both dogs and cats. Now we will chat about proper handling of insulin and taking care of your diabetic pet at home.
Diabetes Mellitus Issue #1: Proper insulin handling
All insulins must be kept in the refrigerator, and should never be frozen or heated. As you learned in the first two posts of this three-part series, dogs and cats can be treated with any number of insulins. Some are of animal origin and some are from humans. Your pet’s primary care veterinarian and/or a board-certified veterinary internal medicine specialist with help you pick the best insulin for your pet. All insulins have expiration dates, but many of those dates were established specifically for humans and don’t necessarily apply to dogs and cats. Your pet’s medical team should advise you how often you should replace your fur baby’s insulin bottle. Additionally you should obtain a new bottle of insulin if it changes appearance.
Diabetes Mellitus Issue #2: Insulin administration points
All diabetic pet parents should spend a meaningful amount of time with their pet’s veterinarian to learn about diabetes mellitus, particularly how to properly administer insulin to diabetic pets. As a board-certified veterinary internal medicine specialist, I work with diabetic pet parents essentially on a daily basis. In addition to spending time with me learning about this disease, new diabetic pet parents often spend 60-90 minutes with my licensed veterinary te Continue reading