Type 2 Diabetes: Value Of Home Blood Sugar Monitoring Unclear

Type 2 diabetes: Value of home blood sugar monitoring unclear

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It’s a central tenet of diabetes treatment: monitor the blood sugar closely, then adjust your diet, exercise, and medications to keep it in a good range. And that makes sense. Poorly controlled blood sugar is a major risk factor for diabetic complications, including kidney disease, vision loss, and nerve damage.
While efforts to carefully monitor and control the blood sugar in diabetes are worthwhile, “tight control” is not always helpful — and it may even cause harm. For example, in studies of people with longstanding type 2 diabetes, the type that usually begins in adulthood and is highly linked with obesity, those with the tightest control either had no benefit or had higher rates of cardiovascular disease and death. Meanwhile, studies of people with type 1 diabetes — the type that tends to start during childhood due to an immune attack against the insulin-producing cells in the pancreas — suggest that tight control may help protect against cardiovascular disease. So, it seems the benefits and risks of tight control depend on the situation.
Home blood sugar monitoring for type 2 diabetes
People with diabetes are often advised to check their blood sugar levels at home by pricking a finger and testing the blood with a glucose meter. They can review the results with their doctors over the phone, online, or at the next office appointment. The value of this for people with type 2 diabetes is uncertain.
In a study published in JAMA Internal Medicine, researchers enrolled 450 people with Type 2 diabetes, none of whom were taking in Continue reading

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Diabetes drug could help those living with Parkinson's disease, research reveals

A drug commonly used to treat diabetes could help those living with Parkinson’s disease, research has revealed.
By 2020 it is predicted that 162,000 individuals in the UK will be living with the condition. While existing drugs help to control its symptoms, there are currently none available which slow or halt its progression.
But now scientists say they have found that a drug commonly used to treat type 2 diabetes appears to improve movement-related issues.
The benefit persisted even when the drug had not been taken for 12 weeks, suggesting it might be helping to slow the progression of the disease.
“It is not ready for us to say ‘well, everyone needs to start this drug’,” said Thomas Foltynie, professor of neurology at University College London and co-author of the study. “[But] if we can replicate these findings in a multicentre trial, especially with longer follow-up, then this can change the face of our approach to treating Parkinson’s.”
Writing in the Lancet, Foltynie and colleagues in the UK and US describe how they tested the impact of the drug, known as exenatide.
With recent studies suggesting problems with insulin signalling in the brain could be linked to neurodegenerative disorders, hopes have been raised that diabetes drugs could also be used to tackle Parkinson’s, with previous research – including in cell cultures and animals, as well as a recent pilot study on humans by Foltynie and colleagues – backing up the notion..
But the latest study is the first robust clinical trial of the drug, randomly allocating 60 people with Parkinson’s t Continue reading

The Alarming Rise of Type 1 and Type 2 Diabetes in Children and Teens

Having lived with type 1 diabetes since the age of four, I can say with certainty that, while it doesn’t stop me from living a full life, it gets in the way and adds stress and anxiety to what should be normal daily activities. A 20 minute walk can send my blood sugars plummeting on some occasions, while a 30 minute walk on another day might not impact my blood sugar levels at all. I have learned to fine tune and predict as much as possible, but diabetes is still a major obstacle that I have to contend with not only daily, but hourly, sometimes even many times an hour. If I had to calculate the time I spent managing diabetes each day, month or year, it wouldn’t be much less than the same as the amount of time I spend breathing. Diabetes is always on my mind and I’m constantly making decisions based on it, so to read the results of a 10 year study about increasing rates of diabetes in young people is a tough pill to swallow.
The study, recently published in the New England Journal of Medicine, shows that the annual rate of newly-diagnosed cases of both type 1 and type 2 diabetes in young people increased considerably from 2002-2012.
Why is this happening?
In the case of type 2 diabetes, weight is often a contributing factor. But there are unknowns at play. And no one knows what causes type 1 diabetes, let alone why it’s increasing. What I do know is I wouldn’t wish this burden on anyone, even if it’s manageable, so I hope we figure out why rates of are increasing and put a stop to it.
Over the course of a decade the SEARCH study looked at 11,245 youths (0 to 19 y Continue reading

Managing the Cost of Diabetes

Diabetes is one of the most common and costly chronic diseases, affecting more than 30 million Americans, with a total annual cost of $245 billion.1
Prevalence continues to increase as obesity rises, with the highest rates of diabetes found in minorities and older Americans. Consequences of diabetes include hypertension, coronary heart disease, stroke, chronic kidney disease, and blindness.2 Despite significant medical advancement in treatment, diabetes remains the seventh leading cause of death in the United States.3 As a result, health care providers must consider the impact of financial and educational barriers in outcomes associated with diabetic management.
Diabetes is associated with a significant financial burden both to the patient and to the health care system. In 2012, the estimated cost of direct med- ical care in diabetes was $176 billion.1 The cost of prescription medications accounted for 18% of that cost, while diabetic supplies accounted for 12%.1
Individuals with diabetes had more than double the cost of annual medical expenditures compared with those without, with an average annual cost of $13,700.1 Although government and private insurance provide patient assistance in managing these costs, financial barriers may still pose a significant obstacle to patients in optimizing diabetic management. Patients who are unable to afford their medications and diabetic supplies will have less than optimal control of their blood sugar and glycated hemoglobin, putting them at increased risk for diabetic complications.
Current guidelines provide detailed stepwise recomme Continue reading

Study: Most U.S. Adults with Diabetes are Properly Diagnosed

The proportion of diabetes cases that go undiagnosed in the U.S. may be just 11%, much lower than previous, widely accepted estimates of one-quarter to one-third, a new study suggested.
The previous estimates were based on an analysis of national survey data that used only a single test to identify undiagnosed diabetes, but the new study used a second confirmatory test, as per guidelines from the American Diabetes Association (ADA), explained Elizabeth Selvin, PhD, of Johns Hopkins University in Baltimore, and colleagues.
The proportion of undiagnosed diabetes cases has also decreased over time, from 16% in 1988-1994 to the 11% figure in 2011-2014, they reported online in the Annals of Internal Medicine.
"Establishing the burden of undiagnosed diabetes is critical to monitoring public health efforts related to screening and diagnosis," Selvin's group wrote. "When a confirmatory definition is used, undiagnosed diabetes is a relatively small fraction of the total diabetes population; most U.S. adults with diabetes (about 90%) have received a diagnosis of the condition."
"If we're thinking about screening programs, these findings suggest that healthcare providers are doing a good job at diagnosing people when they're coming in contact with the healthcare system," Selvin said in a statement. "It's those people who are not coming in contact with the healthcare system that need to be a focus of our efforts to ensure cases of diabetes are not missed."
Selvin's group analyzed the same data that was used for the previous estimates, which were published by the CDC: the National Healt Continue reading