HbA1c, A Diabetes Marker For The Past And For The Future?

HbA1c, a diabetes marker for the past and for the future?

HbA1c, a diabetes marker for the past and for the future?
Ever since large clinical outcome studies in the 1990s demonstrated that tight blood glucose control, as measured by glycated haemoglobin (HbA1c), is able to slow down the progress of diabetes-related complications, HbA1c is regarded as the gold standard to evaluate the clinical efficacy of new anti-diabetes compounds in clinical trials as well as the most important biomarker to guide the individual treatment of patients with diabetes. Furthermore, much more recently (since 2010), various diabetes societies and the World Health Organization (WHO) have accepted the use of HbA1c in screenings to diagnose diabetes, mainly type 2 diabetes (T2D). Despite its long-time status as gold standard parameter to assess diabetes therapy, many limitations of the HbA1c-value have been discussed in literature and experts in the field of diabetes are now saying that HbA1c alone is not enough and other parameters have to be considered for drug approval and treatment success. In this text the strengths and limitations of HbA1c and its role in future diabetes therapy are discussed.
Discovered by Iranian doctor Samuel Rahbar in 1968, HbA1c is a minor component of human haemoglobin formed by condensation of glucose to alpha- and beta-chains of the haemoglobin Hb A variant. In principle, the higher the blood glucose concentration, the more haemoglobin will be glycated. As the lifespan of red blood cells in which the haemoglobin is present is 120 days, HbA1c provides an estimate of the average glucose control in a human being over that p Continue reading

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Vitamin D Supplementation Improves Mood in Women with Type 2 Diabetes

Vitamin D Supplementation Improves Mood in Women with Type 2 Diabetes
1Loyola University Chicago, Health Sciences Campus, 2160 S. First Avenue, Maywood, IL 60153, USA
2Advocate Medical Group, 3825 Highland Avenue, Suite 400, Downers Grove, IL 60515, USA
Correspondence should be addressed to Sue Penckofer ; [email protected]
Received 28 April 2017; Accepted 27 July 2017; Published 7 September 2017
Copyright 2017 Sue Penckofer et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Objective. The aim of this study was to determine the effect of vitamin D supplementation on improving mood (depression and anxiety) and health status (mental and physical) in women with type 2 diabetes mellitus (T2DM). Methods. Fifty women with T2DM and significant depressive symptomology were enrolled into the Sunshine Study, where weekly vitamin D supplementation (ergocalciferol, 50,000 IU) was given to all participants for six months. The main outcomes included (1) depression (Center for Epidemiologic Studies Depression, CES-D, and Patient Health Questionnaire, PHQ-9), (2) anxiety (State-Trait Anxiety), and (3) health status (Short Form, SF-12). Results. Forty-six women (92%) completed all visits. There was a significant decrease in depression (CES-D and PHQ-9,
). An improvement in mental health status (SF-12,
) was also found. After controlling for covariates (race, season of enrollment, baseline vitamin D, baseline depr Continue reading

7 Ways to Beat the Diabetes Blues

Written by Susan McQuillan, MS, RDN, CDN
Up to 29% of people with diabetes also suffer from major depression. Those who have type 2 diabetes and use insulin have higher rates of depression than those with type 1 or with type 2 not using insulin. Women are almost twice as likely as men to succumb to major depression, which hits hardest between the ages of 30 and 59. If you become depressed, it can affect your ability to manage your own health. Heres what you can do to control your emotions before they control you.
Talk to your family and friends about what it means to have diabetes so they understand your needs, concerns and frustrations. Describe what it feels like when your blood sugar goes out of range. Let them know exactly how they can help. Explain that you are not always able to control your blood sugar , even when youre doing everything right, so you may need some empathy. If you are changing your diet and making healthier food choices, you may want to ask them to join you, and keep junk food out of the house. Try to find an exercise buddy.
Taking steps to manage your blood sugar levels and generally taking good care of yourself is obviously essential for your own physical and mental health, but staying in control also helps strengthen your relationships, because it puts less pressure on your loved ones, who may worry about you or have to help take care of you. When you are consistent, and your blood sugar routinely stays within an acceptable range, diabetes can become just one more thing in your life; it doesnt have to be the big thing that takes over your lif Continue reading

Meal Replacements - Diabetes Self-Management

Call them what you will nutritional supplements, meal replacements, or shakes theyre everywhere. Magazines and television commercials tout their benefits. Sections of drugstores and grocery stores are dedicated to them. They sound promising and they come in tasty flavors. But do they deliver? Whats the best one? And, most importantly, are they something you should try?
The meal replacement (MRP) industry is big business. In the 1970s, nutrition in a can became widely used in hospitals and nursing homes to help nourish patients who could not eat or had difficulty eating solid food. Ensure was introduced by Ross Laboratories in 1973. In 1977, SlimFast was introduced to help with weight loss, sparking the use of meal replacements to address the obesity epidemic. And who can forget Oprah Winfrey, in 1988, pulling a wagon laden with fat across the stage to demonstrate her 67-pound weight loss on the Optifast plan? In the 1990s, Ensure and other drinks such as Sustacal, Boost, and Resource were marketed to healthy adults to supplement their nutrition. Since then, meal replacements have continued to corner the market, expanding to meet a variety of nutritional needs. Meal replacements are used for many reasons and take different forms, including shakes and bars. As a result, sales have exceeded $3 billion per year in the United States.
Meal replacements are beverages or foods that can be consumed in place of or as part of a meal. They provide a specific amount of calories, macronutrients (carbohydrate, protein, and fat) and micronutrients (vitamins and minerals). Some meal r Continue reading

BCG vaccine - can it reverse type 1 diabetes mellitus?

Type 1 diabetes is an autoimmune disease characterized by the destruction of pancreatic islet cells , which are critical to glucose metabolism by producing insulin,by autoreactive T cells. These lymphocytes mistakenly attack pancreatic islet cells as if they were a foreign body, like a viral or bacterial infection.
In addition, regulatory T-cells (which are often called Tregs) modulate the immune system and would generally reduce the effect of an autoimmune attack. Tregs act like brakes that normally prevent the mistaken attacks, like on the pancreatic islet cells, without affecting the whole immune system. A branch of diabetes research has suggested that Tregs could be the key to treating type 1 diabetes.
Once the pancreatic islet cells are damaged, they no longer produce hormones, especially insulin , that help regulate the levels of blood glucose. Without insulin, the blood glucose levels increase rapidly leading to long-term damage to eyesight, kidneys, limbs, heart and other organs. In fact, type 1 diabetes can be deadly if the uncontrolled blood sugar leads to a life-threatening condition called diabetic ketoacidosis . Without regular insulin injections, a patient has little chance of living beyond a short period of time, and even then it could be a horrifically painful demise.
It is not known what causes this autoimmune disease, although there is strong evidence that genetics is the most important factor. However, other things may be implicated, like vaccine-preventable diseases , which could be important co-factors in the development of the disease. Just to be Continue reading