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Insulin Pump Therapy For Kids

Insulin Pump Therapy for Kids

Insulin Pump Therapy for Kids

There’s no doubt that interest in insulin pumps is up among people with diabetes. In fact, the most commonly asked question of the staff at the Yale Children’s Diabetes Program in New Haven, Connecticut, is, “Am I a candidate for the pump?” or “Is my child a candidate for the pump?” In many cases, the answer is yes.
Let’s have a look at what makes a child a good candidate for a pump and what’s involved in getting started using one. As you read, keep in mind that this article describes primarily how the Yale Children’s Diabetes Program operates. As in all aspects of diabetes care, there are many “right” ways of doing things, and the diabetes center in your area may do things differently. If you are interested in any of the methods or products mentioned in this article, please check with your health-care team before making changes in your child’s diabetes-care routine.
Who’s a pump candidate?
The children who are most likely to be offered a pump at Yale are those who are working very hard to maintain normal blood glucose levels, those who are not meeting goals, those who ask about pump treatment and how it might help them, and those whose episodes of hypoglycemia or high blood glucose are affecting their school work, sports performance, and normal, day-to-day living.
However, pump treatment will succeed only if both child and parents are motivated and have reasonable expectations of what a pump can and can’t achieve. They must understand that a pump is only as good as the person operating it. In addition, parents need to be reliable, and a child mu Continue reading

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Are Obesity-Related Insulin Resistance and Type 2 Diabetes Autoimmune Diseases?

Are Obesity-Related Insulin Resistance and Type 2 Diabetes Autoimmune Diseases?

Obesity and associated insulin resistance predispose individuals to develop chronic metabolic diseases, such as type 2 diabetes and cardiovascular disease. Although these disorders affect a significant proportion of the global population, the underlying mechanisms of disease remain poorly understood. The discovery of elevated tumor necrosis factor-α in adipose tissue as an inducer of obesity-associated insulin resistance marked a new era of understanding that a subclinical inflammatory process underlies the insulin resistance and metabolic dysfunction that precedes type 2 diabetes. Advances in the field identified components of both the innate and adaptive immune response as key players in regulating such inflammatory processes. As antigen specificity is a hallmark of an adaptive immune response, its role in modulating the chronic inflammation that accompanies obesity and type 2 diabetes begs the question of whether insulin resistance and type 2 diabetes can have autoimmune components. In this Perspective, we summarize current data that pertain to the activation and perpetuation of adaptive immune responses during obesity and discuss key missing links and potential mechanisms for obesity-related insulin resistance and type 2 diabetes to be considered as potential autoimmune diseases.
Traditional autoimmune diseases involve a wide spectrum of clinical pathology and include diseases such as systemic lupus erythematosus, multiple sclerosis, Sjögren’s syndrome, rheumatoid arthritis, and type 1 diabetes. A disease is considered autoimmune if its pathology is dictated by a se Continue reading

Diabetes And Influenza: A Dangerous Combination

Diabetes And Influenza: A Dangerous Combination

Nov. 14, 2017 is World Diabetes Day, the world’s largest diabetes awareness campaign that aims to unite the global diabetes community to produce a powerful voice to highlight the realities and threats of dealing with this chronic medical condition.
Diabetes is a major threat to health globally.
In the U.S., diabetes rates have almost doubled in the past two decades, from 5.5 percent in 1994 to 9.3 percent in 2012. An estimated 30.3 million people, or 9.4 percent of the U.S. population, had diabetes in 2015. The CDC projects that one in three adults could have diabetes by 2050. More than one-quarter of seniors (ages 65 and older) has diabetes (25.9 percent, or 11 million seniors). In the European region, about 60 million people have diabetes, or about 10.3 percent of men and 9.6 percent of women aged 25 years and over. In Africa, the rate of diabetes remains low, but the number of people living with diabetes has dramatically increased from 4 million in 1980 to 25 million in 2014. More than 60 percent of those with diabetes live in Asia, with nearly half in China and India combined. The Asia Pacific region has 138 million people with diabetes, and the number may increase to 201 million by 2035.
The prevalence of diabetes is increasing mostly due to increases in obesity, unhealthy eating habits and decreased physical inactivity. Globally, diabetes kills about 3.4 million people annually. WHO projects that diabetes deaths will double between 2005 and 2030.
Diabetes itself is not a major problem unless the blood glucose is uncontrolled and either rises too high or drops too lo Continue reading

Diabetes-Related Leg Cramps: How to Prevent and Treat

Diabetes-Related Leg Cramps: How to Prevent and Treat

Being suddenly woken up by a painful knot in your calf—or frozen toes—isn't fun. Here's what diabetes has to do with it and what you do to stop the pain.
Perhaps you’ve been there—in the middle of a perfectly restful night of sleep you are abruptly woken up by an intense pain from a cramping muscle, typically in your foot or calf.
Although the exact cause of muscle cramps is still up for debate, they are frequently linked to poor flexibility and muscle fatigue. A smaller body of research also suggests that diabetes can increase your risk of experiencing leg cramps, potentially due to swings in blood sugar levels, certain medications, and long-term complications such as diabetic neuropathy (nerve damage).1,2 With or without diabetes, these cramps are characterized by the sudden, involuntary, and painful tightening (contraction) of a muscle. They occur most frequently in the evenings in the following muscle groups:
Calf muscles (back of the lower leg)
Hamstrings (back of the thigh)
Quadriceps (front of the thigh)
Cramps can also occur in the hands, feet, arms, neck, and abdomen
What causes these painful cramps and how can I prevent them?
“Although the exact cause of muscle cramps remains unknown, they are not inevitable,” says Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE. While cramps may seemingly come on without warning, knowing the factors and situations that can cause muscle cramps can help you understand them, prevent them, and treat them. Here, some reasons for cramps and what you can do to avoid them:
Uncontrolled blood sugar levels. Glucose is required for mu Continue reading

Eat Carbs Last to Reduce After-Meal Blood Sugar Spikes?

Eat Carbs Last to Reduce After-Meal Blood Sugar Spikes?

Amazing but apparently true: Eating carbohydrates AFTER some protein, fat, or possibly fiber causes much lower after-meal blood sugar spikes than eating the carbs first.
Two small new studies from Cornell University in New York and the University of Pisa in Italy, respectively, showed the same thing. At Cornell, two groups of people with Type 2 diabetes ate the same meal: some bread, fruit juice, meat, and green salad. One group started with the bread and juice; the other with the meat and salad. A third group ate everything together as a sandwich.
At the beginning of the meal, and every 30 minutes thereafter for three hours, subjects had their glucose and insulin levels checked. The group that started with the bread had after-meal glucose spikes about 50% higher than the group that started with protein and vegetables. Those who ate everything together as a sandwich had about a 40% higher glucose spike than those who started with the protein and vegetables.
All three groups repeated the meals in different orders after a week and again a week later, said lead researcher Alpana Shukla, MD. In all groups, eating protein first led to much smaller glucose spikes, “comparable to what we see with diabetes medication.”
The Pisa study was longer-term and done “free-range,” not in a lab. Each group of people with Type 2 diabetes was given a meal plan and allowed to choose the specific foods they wanted, as long as the foods added up to the same number of calories. One group was told to eat their protein or fat food first, the other to eat their carbs first.
After four months, Continue reading

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