Warning Signs for Insulin Dependent Diabetics

December 10th, 2010

Most type 1 diabetics get very good at managing their disease. They can identify when their blood glucose is too high or too low, and skillfully balance a mixture of short, intermediate and long-lasting insulin. They stay up to date on the latest innovations in diabetes control - from the insulin pen through the insulin pump to the implantable glucose monitor. They know the importance of the glycemic index and staying physically active. They deftly adjust their diabetes medication to counteract changes in diet, activity level, stress, illness, and even their menstrual cycle.

Another often overlooked aspect of successful diabetes control is educating family, friends and co-workers about diabetes danger signs that may require medical attention. An unexpected insulin spike or rise or drop in blood sugar can cause a medical emergency for an insulin dependent diabetic, and those close to them should know what to watch for and how to respond. According to WebMD, the following are diabetes symptoms that should never be ignored:

1) Extreme thirst or hunger, blurry vision or frequent urination. These are all warning signs of uncontrolled blood sugar which, if left unchecked, could lead to serious, even life-threatening, conditions.

2) Appearing "drunk". Appearing intoxicated can be a sign of low blood sugar. Low blood sugar can result from a medication such as long-acting insulin working too well. A diabetic in this condition may not realize the seriousness of the situation, and lose consciousness.

3) Infections, gum problems and foot wounds. Diabetics are prone to infection, including fungal infections and foot ulcers, and even a small cut or sore can be risky. It's important for diabetics to watch for skin rashes, practice proper foot care, and to see a doctor if a wound gets infected or is slow to heal.

4) Eye problems and changes in vision. Diabetics are also prone to retinopathy (damage to the retina of the eye), which can cause vision loss. Talk to your doctor about any changes in vision, eye pain, or visual disturbances like seeing spots or lights, and see an ophthalmologist yearly.

5) Symptoms of heart disease. Diabetics are at increased risk of heart disease, heart attack and stroke, and they and those close to them should be aware of and alert for symptoms such as chest pain, shortness of breath, nausea, anxiety, dizziness, sweating, and a rapid or irregular pulse. It's also possible to have heart disease and not have obvious symptoms, so your doctor should evaluate your risk factors regularly.

Advances in diabetes treatment and diabetes medication continue to increase both the quality of life and the life expectancy of both insulin dependent and non insulin dependent diabetics. And promising treatments such as an artificial pancreas, islet cell transplants, glucose monitoring "tattoos", novel ways of delivering insulin without insulin injections and even a diabetes vaccine are in the early stages or on the horizon. While it will never be a good thing to be diabetic, it's no longer the tribulation it used to be.

Injection-Free Insulin Inhaler Awaiting FDA Approval

January 24th, 2011

A new injection-free insulin inhaler is awaiting FDA approval for the treatment of both type 1 and type 2 diabetes. Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously.

AFREZZA is an ultra-rapid acting inhaled insulin developed by MannKind Corporation. It uses patented Technospere technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a single tennis court).

AFREEZA is a short-acting mealtime insulin, meaning type 1 diabetics will need to combine it with long-acting insulin for complete diabetes control. Clinical trial participants using the new insulin inhaler experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting glargine insulin and twice a day 70 30 insulin injections.

Generex Biotechnology Corporation also has a rapid-acting insulin spray in clinical trials. Oral-lyn is a buccal spray insulin which is absorbed through the buccal mucosa (mucous membranes on the inside of the cheeks), bypassing the lungs and quickly entering the blood stream. The inhaled insulin is sprayed in the mouth just before meals, delivering about one unit of human insulin per spray. If approved, it may be the only medication needed by many type 2 diabetics.

Oral-lyn's patented inhalation device resembles an asthma inhaler. Steven Elkman was an Oral-Lyn study participant who successfully managed his type 2 diabetes with the experimental spray insulin. Elkman loved how discreet the inhaler is. "Nobody really notices because so many people use inhalators for asthmatic medication," he says, "It doesn't really attract any attention."

The FDA actually approved the first inhaled insulin, called Exubera, to treat type 1 and type 2 diabetes in 2006. It was a short-acting powdered form of recombinant human insulin, delivered into the lungs through an insulin inhaler. But the new system of insulin delivery never really caught on, and Pfizer dropped the novel diabetes medication from the market a year later. AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve better insulin levels using smaller amounts.

Patients in clinical trials of the new inhaled insulins have reported enhanced quality of life, overall satisfaction, and greater acceptance of being insulin dependent. Dr. Larry Deeb, a pediatric endrocrinologist from the University of Florida College of Medicine, says that finding an alternative to insulin injections is crucial, especially for children and the needle-phobic. "Insulin administration is a huge issue for people with diabetes," he stresses, "You have to appreciate the fear [of injections]. Insulin omission is one of the major issues in diabetes."

Glucose Test Tattoo in Development

January 24th, 2011

Type 1 diabetics may soon be free of the need to prick their fingers up to a dozen times a day to perform blood sugar tests, thanks to researchers at the Massachusetts Institute of Technology (MIT). The researchers are testing a continuous glucose monitoring "tattoo" in which florescent nanoparticle ink is injected under the skin. The ink is made from carbon nanotubes that reflect light when an infrared light is shone on them.

"Carbon nanotubes will fluoresce in infrared light, and we can decorate the tubes so they fluoresce in response to glucose," explains senior MIT researcher Michael Strano. "When you shine a light on the nano tubes, they'll shine light back at a different wavelength to a diode that could tell how much glucose is around." The infrared glucose monitor diode is expected to be smaller than a watch.

This is a big improvement on even the latest continuous glucose monitoring technology, which involves small sensors implanted in the skin that must be calibrated several times a day, and replaced every few days to a week to avoid infection. Most existing continuous glucose monitors work by injecting an enzyme which breaks down glucose and then measuring a by-product of the breakdown (hydrogen peroxide) to indirectly determine glucose levels. Because the blood sugar testers are implanted into the skin, the body sees the sensors as foreign objects, and frequently forms scar tissue around them. The non-invasive MIT glucose monitor tattoo simply absorbs and re-emits light, which scientists believe to be safer.

Blood glucose control is vital to successful diabetes management. "The most problematic consequences of diabetes result from relatively short excursions of a person's blood sugar outside of the normal physiological range, following meals for example," says Strano, "If we can detect and prevent these excursions, we can go a long way toward reducing the devastating impact of this disease."

The nanoparticle blood glucose test "tattoos" are expected to be self administered weekly with a device resembling an insulin pen. If tests in animals are successful, the resulting next generation continuous glucose monitor tattoo could revolutionize how we manage glucose testing in insulin dependent diabetes.

Artificial Sweeteners Assist in Diabetes Control

January 24th, 2011

sugar cubes

Historically, diabetics have been warned to avoid eating sugar, an almost impossible challenge for those with a sweet tooth. Nowadays, the emphasis has shifted to eating complex carbohydrates with a low glycemic index, and limiting total carbohydrate intake - known as an insulin resistance diet. Diabetics can indulge in the odd sugary treat, but do need to limit their sugar intake more than non-diabetics (especially those who are struggling with diabetes control). Artificial sweeteners provide a convenient way of doing that.

Natural sugars like fructose, honey, corn syrup, molasses, brown sugar, and cane sugar, are simple carbohydrates that quickly raise your blood sugar levels. Reduced calorie sweeteners like sorbital, lactitol, maltitol, mannitol and xylitol are sugar alcohols often used in sugar-free candy, gum and baked goods. They are also a type of carbohydrate and may raise your blood sugar, although not as much as natural sugars. Low calorie sweeteners are artificial sweeteners created in a lab. They don't contain calories, are low or no carb, and do not affect blood glucose levels.

Artificial sweeteners have gotten a bad rap for being "non-natural" and unpleasant tasting over the years, but today's new and improved sweeteners can be a godsend for diabetics who crave sweets. The FDA and the American Diabetes Association both recommend the following low calorie artificial sweeteners as safe for use by non-insulin dependent and insulin dependent diabetics:

1) Aspartame -sold as NutraSweet and Equal. Aspartame may lose some sweetness at high temperatures. It's 160 to 220 times sweeter than sugar. People with a genetic condition called phenylketonuria can't metabolize aspartame.

2) Acesulfame potassium (acesulfame-K) - also known as Sweet One and Sunett. It's 200 times sweeter than sugar. Ace-K is often mixed with other sweeteners to mask its slightly bitter taste, especially in soft drinks. Can be used for cooking and baking.

3) Saccharin - an old stand by, marketed as Sweet N Low and Sugar Twin. Has a slightly bitter aftertaste. Can be used in both hot and cold foods. It's 200 to 300 times sweeter than sugar. Not recommended for pregnant or breastfeeding mothers.

4) Sucralose - this increasingly popular sweetener is a relative newcomer to the market, sold as Splenda. It's 600 times sweeter than sugar. It can be used in cooking and baking, and is being added to a growing number of processed foods.

5) Neotame - a high intensity sweetener made by Nutrasweet. Chemically similar to aspartame, it's an incredible 7,000 to 13,000 times sweeter than sugar. Unlike aspartame, it can be used for baking. Also unlike aspartame, it's safe for use by people with phenylketonuria. Neotame is popular with food manufacturers because the low quantities needed to add sweetness cut production costs.

In addition, Stevia, an all natural sweetener derived from a South American shrub, is being extoled as the sweetener of choice for diabetics. Stevia has no calories, and a zero glycemic index. It's up to 300 times sweeter than sugar, so a little bit goes a long way. Renowned alternative health guru Dr. Andrew Weil writes, "The only non-caloric sweetener I recommend is stevia. It's safe for diabetics and widely used as a sweetener around the world."

Of particular interest to diabetics, stevia has long been considered a therapeutic herb for hyperglycemia, stimulating the release of insulin and enhancing glucose tolerance. It is used as an inexpensive diabetic medication in South America. Interestingly, although it's been shown to lower blood sugar in diabetics, particularly type 2 diabetics, it does not lower blood sugar in people without the condition. Because of it's affect on blood sugar, it is recommended that diabetics test their blood glucose regularly when they first introduce stevia to their diet. They may need to adjust their diabetes medication - some stevia users insist the herb reduced or eliminated their need for insulin therapy. As an added bonus for diabetics with hypertension, stevia is also known to lower high blood pressure.

"Diabesity" Epidemic Leads to Double Digit Growth in Sales of Diabetes Drugs

January 24th, 2011

Two converging epidemics are striking Americans across the socioeconomic spectrum. Diabetes and obesity are so closely connected that health care professionals have coined the term "diabesity" to describe the connection between the two. "I really believe that it is the obesity epidemic that has driven diabetes", says Dr. Christopher Still, obesity expert from the Geisinger Center for Nutrition and Weight Management, "simply because of the increase in insulin resistance."

Excess weight is linked to insulin resistance. Insulin resistance is a condition in which the hormone insulin becomes less effective at lowering blood sugar levels. The resulting high blood sugar increases the risk of developing type 2 diabetes. In type 1 diabetes, the body produces little or no insulin. In type 2 diabetes, the body still produces insulin, but can't use it effectively. Ninety to ninety-five percent of diabetics have type 2 diabetes, and about 95% of type 2 diabetics are overweight.

The skyrocketing rate of obesity across the socioeconomic spectrum has been referred to as a "public health time bomb". About one-third of Americans are now considered obese (20% or more above normal weight), including nearly 17% of children and teens. Type 2 diabetes typically strikes in middle age, but as the obesity epidemic spreads to our children, doctors are seeing more diabetes in children and teens. A lot more cases - there has been a ten-fold increase in diabetes in children over the last five years.

As more and more diabetic Americans become insulin dependent, sales of diabetes medication and related products like insulin pumps and insulin pens are soaring. The diabetes products market has been "enjoying" double digit growth for years. Novo Nordisk reported an increase of 24% in sales of insulin products in 2009, and is forecasting continuing increases.

Diabetes is the seventh leading cause of death in the US. What health care providers find most frustrating is that both obesity and type 2 diabetes are largely preventable with proper diet and regular exercise. The World Health Organization refers to obesity, diabetes and heart disease as "diseases of affluence," and recommends a low glycemic index diet of foods rich in complex carbohydrates and protein. A US study of 90 years of national data found that the rising consumption of high glycemic index corn syrup (widely used to sweeten soft drinks and processed foods) and decreasing intake of dietary fiber parallels the explosion of type 2 diabetes in America. Dr. Still recommends those with insulin resistance cut sugary beverages like soda and juice out of their diet as a first step. "I tell people who are trying to lose weight to eat their calories, not drink them."

Ten Superfoods for an Insulin Resistance Diet

January 24th, 2011

salmon steak

The key to diabetes treatment is controlling blood sugar (glucose) levels, and diet plays a vital role in that complicated process. The main dietary goals in diabetes are balancing blood sugar and cholesterol levels, and achieving and/or maintaining a healthy weight.

Traditionally, theemphasis in a diabetic diet was on avoiding sugar. Modern guidelines place more emphasis on total carbohydrate intake and the type of carbohydrates eaten - sometimes referred to as an insulin resistance diet. Often, type 2 diabetics can control their disease with diet and exercise alone, avoiding the need for diabetes medications.

The American Diabetes Association has released a list of the top ten "diabetes superfoods". All of the foods on the list have a low glycemic index (a scale of how quickly a carbohydrate raises blood sugar), but rank high in essential nutrients like vitamins, calcium, magnesium, potassium and fiber. The ten diabetic superfoods on the American Diabetes Association's list are:

1) Beans - Kidney, pinto, navy, black and other beans are nutritional powerhouses that are low fat and very high in fiber. One-half cup provides as much protein as an ounce of meat. Rinse canned beans before you serve them to reduce the amount of sodium.

2) Dark green leafy vegetables - As a general rule, the darker in color a vegetable is, the more nutritional value it has. Spinach, chard, kale, collards and other dark leafy greens are low in both calories and carbohydrates.

3) Citrus fruit - Oranges, grapefruit, lemons and limes all offer a dose of vitamin C and a helping of soluble fiber. But remember that grapefruit juice can interferes with the action of some medications, including pain relievers and prescription drugs used to treat high blood pressure, cholesterol and abnormal heart rhythms.

4) Sweet potatoes - Sweet potatoes are lower on the glycemic index than regular potatoes, and full of vitamin A and fiber.

5) Berries - Berries are low calorie, low carb, and high in antioxidants and fiber. And several studies have shown that blueberries lessen insulin resistance.

6) Tomatoes - Tomatoes are a versatile superfood containing vitamin C, vitamin E, iron and other nutrients. Cooked tomatoes are even better for you than raw, as cooking makes tomatoes' healthy antioxidant compounds like lycopenes easier for your body to absorb.

7) Omega-3 rich fish - Omega-3's are essential fatty acids found in fish (especially salmon), some nuts, and some plants. Omega-3 oils are credited with reducing inflammation, lowering bad cholesterol and raising good cholesterol, reducing blood clots and playing a crucial role in brain function. Be warned: some type 2 diabetics may have a slight rise in fasting blood sugar when taking fish oils.

8) Whole grains - Avoid processed grains with the fiber-rich bran and germ removed from them. Barley, bran and oats are good grain choices that rate lower on the glycemic index. The fermentation process used for sourdough bread lowers its glycemic index, making it another good choice, especially sourdough rye bread.

9) Nuts - Filling nuts provide protein, magnesium and fiber. Some nuts and seeds, such as walnuts and flax seed, are also a source of omega-3 fatty acids. But they're high in fat and calories, so eat them in moderation.

10) Low fat or fat-free milk and yogurt - Dairy products provide much-needed calcium, and many are fortified with vitamin D.

The bottom line is that a healthy diabetes diet is not much different from that recommended for the general public - high fiber, high protein, and low in fat. Diabetics need to limit their sugar and simple carbohydrate intake more than non-diabetics, and should avoid drinking alcohol. Weight control is especially important for diabetics, as insulin resistance is often associated with excess fatty tissue. Diabetes occurs more frequently in people who eat a lot of fat, and it's recommended that diabetics eat both less overall and less saturated fat, restricting fat to under 30% of their daily calories.

If you are insulin dependent and making changes to your diet or eating patterns, remember that it may have an effect on your blood sugar and insulin levels, and you may need to adjust your insulin therapy accordingly.

Asthma Inhalers Increase Risk of Diabetes and Insulin Resistance

January 25th, 2011

inhaler

Use of asthma inhalers containing corticosteroids has been linked to a 34% increase of developing type 2 diabetes, and to accelerated diabetes progression in those already diagnosed with the condition. Higher dose inhalers were linked to even higher risks - a 64% increase in type 2 diabetes diagnoses, and a 34% increase in existing diabetes progressing to the point of requiring insulin therapy.

Theses figures came out of a large Canadian study of the records of more than 380,000 asthma and chronic obstructive pulmonary disease (COPD) patients treated with inhaled corticosteroids. "Patients instituting therapy with high doses of inhaled corticosteroids should be assessed for possible hyperglycemia, and treatment with high doses of inhaled corticosteroids limited to situations where the benefit is clear," warn the researchers, from the Jewish General Hospital and McGill University in Montreal.

More than 30,000 of the asthma/COPD patients included in the study were diagnosed with diabetes over a span of five and a half years -over 14 patients per 1000 inhalers. Nearly 2100 patients who had been previously diagnosed with diabetes experienced a deterioration in their condition, going from controlling blood sugar with oral diabetes medication torelying on insulin injections.

Dr. Stuart Weiss, an endocrinologist at the New York Medical Center makes the point that the issue may be a common underlying cause of both diabetes and asthma/COPD, rather than corticosteroids. "We know that steroids increase insulin resistance, and that people treated with steroids require more aggressive diabetes management," he says, "What may be at the root of this problem is the fact that those who are most at risk for diabetes are the same people who have the worst asthma and COPD that requires steroid treatment in the first place." Weiss believes that "the overconsumption of processed foods and the lack of consumption of green vegetables" lead to pre-inflammatory conditions that raise the risk of both diabetes and asthma/COPD. He warns that if Americans don't improve their diets "the incidence of both these diseases will continue to go up at a dramatic rate."

DR. Rohit Katial, a professor of medicine at National Jewish Health, is concerned that the study contained no information about obesity, a significant risk factor for both diabetes and respiratory problems. "For the people on higher doses of medications, was their BMI (body mass index) higher? We don't know."

What the medical experts do agree upon is the need for doctors to prescribe the lowest possible dose of corticosteroids to asthma and COPD patients, and to educate patients about the risks of insulin resistance, becoming insulin dependent, and the possible need for more intensive insulin therapy.

Diabetes and Depression are a "Double Whammy" That Lower Life Expectancy

January 25th, 2011

A ten-year study of almost 80,000 women conducted by the Harvard School of Public Health established a disturbing link between diabetes, depression and the risk of premature death. Women with diabetes had a 35% increased risk of death; women with depression had a 44% increased risk of dying; and those with both diabetes and depression were at almost double the risk of death as women with neither condition.

The risk of dying from cardiovascular disease (heart disease) were even more startling, especially for women with diabetes. Diabetics were at a 67% greater risk of dying from heart disease; depressed women were at a 35% increased risk, and women with both conditions faced a 270% greater risk of dying from heart disease than the general population. The study's lead researcher, Harvard Medical School professor Dr. Frank Hu, calls the combination of diabetes and depression "double whammies". "People with both conditions are at very high risk of death," he stresses.

Previous studies have shown that diabetics are more than twice as likely as the average population to suffer from depression, especially diabetics who are insulin dependent. Conversely, depression has been discovered to be a risk factor for diabetes. Women with depression are about 17% more likely to develop diabetes than non-depressed women, and those who taking antidepressant medication are at 25% greater risk.

But the link between diabetes and depression remains "chicken and egg". Does having a chronic illness requiring lifestyle restrictions and complicated insulin therapy like diabetes cause depression, or are people with depression more prone to developing diabetes? Do antidepressants have an impact on blood sugar levels? Does diabetes medication set the stage for depression? Do diabetics who are depressed neglect the self care necessary for effective diabetes control? Or do both conditions have an underlying cause or causes in common, such as stress, smoking, poor diet, and a lack of exercise?

"People usually think of these as two isolated conditions, but there is growing evidence that they are linked behaviorally and biologically," says Hu, "This date provides strong evidence that we should not consider these two isolated conditions any longer."

"The combination of diabetes and depression needs to be addressed," agrees Dr. Luigi Meneghini of the University of the Miami Miller School of Medicine Diabetes Research Institute. Meneghini points out that many diabetics with depression go undiagnosed, and stresses the need for more awareness among both doctors and patients.

Whatever the connections between diabetes, depression, and depression and diabetes medication, it's well established that a healthy weight, a healthy diet and regular exercise reduce the risk and treat the symptoms of both conditions.

Warnings about Antipsychotics and Diabetic Hyperglycemia Go Unheeded

January 25th, 2011

In 2003, the FDA warned doctors to screen users of antipsychotic drugs for high blood sugar and cholesterol, and to perform ongoing blood glucose monitoring. The American Diabetes Association and the American Psychiatric Association also issued similar warnings. The warnings were a result of accumulating evidence that some atypical antipsychotics caused impaired glucose regulation and increases in cholesterol and body weight, significantly increasing the risk of developing or worsening diabetes.

But a recent analysis of almost 110,000 Medicaid patients from three different states taking antipsychotics found that the recommended screening and monitoring simply never happened.

"The existing baseline screening and ongoing monitoring of glucose and lipid levels in these patients was already pretty low, and the FDA warning really had no impact in changing that," says Daniel Hartung, an assistant professor in Oregon State University's College of Pharmacy, "The side effects that can be caused by these new types of antipsychotic medications, some of which were approved in the 1990s, are not trivial," warns Hartung, "Increases in blood sugar, cholesterol and body weight can lead to diabetes in some cases, and this patient group already has a problem with diabetes that's almost twice that of the average population."

Canadian researchers who studied the use of antipsychotic drugs in seniors with diabetes are also calling for enhanced glucose monitoring in patients beginning antipsychotic therapy, especially insulin dependent seniors. The researchers found diabetic seniors being treated with antipsychotics were at significantly increased risk of hospitalization for high blood sugar. "The risk of diabetes may be partly related to chronic effects of the weight gain associated with antipsychotic agents," wrote the authors of that study, "However, case reports of acute hyperglycemia [high blood sugar] after the initiation of therapy with these drugs suggest that they may also be associated with acute glycemic changes."

The researchers discovered 11% of their almost 14,000 diabetic study participants taking antipsychotics were hospitalized for acute hyperglycemia. The risk of diabetic hyperglycemia was "strikingly high" among those just starting antipsychotic treatment, while the incidence of hospitalization was lower for those patients who had been off antipsychotic medication for at least six months. "Our study indicates that the initiation of antipsychotic therapy represents a critical period during which seniors with diabetes are particularly vulnerable," wrote the researchers.

The large pharmaceutical company Eli Lilly, which markets both antipsychotics and human insulin, has said that the relationship between atypical antipsychotics and diabetic hyperglycemia is not completely understood. The Canadian researchers theorize that the neurotransmitter dopamine plays a role in regulating blood glucose, and that the use of antipsychotics may disrupt it. Other studies suggest that antipsychotics impair glucose regulation by decreasing insulin action, and possibly insulin secretion.

Eli Lilly reports that diabetic hyperglycemia resolves in some patients when they are taken off antipsychotics, but that others need to continue taking diabetes medication. This underlines the importance for doctors to monitor the need to begin or adjust insulin therapy for those patients who have, or are at risk of developing, diabetes who must take antipsychotics.

Injection Port Offers an Alternative for Insulin Delivery

February 1st, 2011

pin cushion

While most insulin dependent diabetics grow used to giving themselves multiple injections each day, there are many who would welcome an alternative insulin delivery system. An insulin pump is one such alternative, but some diabetics dismiss them as too expensive, too prone to malfunction, or just too complicated.

A less high tech (and thus less expensive) insulin delivery system is an injection port. An injection port, also called an indwelling catheter, is an FDA approved disposable medical device that is inserted just under the skin, providing a way to administer insulin injections without multiple skin punctures. The device is suitable for both type 1 and type 2 diabetics who take insulin.

An injection port contains a tiny, flexible plastic tube called a cannula, which is inserted into the skin's fatty tissue with one quick, firm push with an "introducer needle" - said to be equivalent to the prick of an insulin syringe. The introducer needle is then removed, leaving the port attached to the skin with an adhesive, and the cannula just under the skin in the fatty tissue. One manufacturer is about to release the i-port Advance, which combines a port with a built-in injector device to eliminate the need for manual insertion.

Once the port is in place, further insulin injections can be delivered with a syringe or an insulin pen directly into the port and through the cannula, eliminating the need to pierce the skin. The port can remain in place for up to 72 hours, and handle up to 75 injections. It can be worn while bathing, swimming and exercising. As the slogan forthe i-Port says, "It takes the shots for you."

Injection ports are popular with diabetics who are new to injecting insulin, those who are needle phobic, and those who are prone to bruising at the injection site. Diabetics struggling with these issues often skip meals to avoid having to take insulin injections, or skip a needed injection to avoid the discomfort or inconvenience. They are also popular with those who have to administer insulin injections to children.

Ports are small and discreet. They are usually worn on the abdomen, but can also be worn places like the arm, thigh or buttocks. One such port, insuflon, is inserted at a 20 to 45 degree angle and worn like an IV, making it ideal for people with little fatty tissue.

Drawbacks include the risk of infection at the insertion site, and the potential for poor medication delivery if the cannula becomes bent or crimped. The manufacturers suggest diabetics test their blood sugar levels two to four hours after each insulin injection to ensure that the device is working properly. The cost of an insulin port is covered by many insurance companies.

Long-Acting Insulin Best at Controlling Blood Sugar

February 3rd, 2011

blood glucose testing

As type 2 diabetes progresses, oral diabetes medication doses typically need to be adjusted upwards over time, and a good many type 2 diabetics can expect to end up insulin dependent. There does not appear to be any clear consensus on how best to introduce insulin injections in addition to oral diabetes medications - three times a day with meals, twice daily injections, or a single daily long-acting insulin injection.

Professor Rury Holman, director of the Diabetes Trial Unit at Oxford University, was the principal investigator of a large scale study conducted to determine how best to introduce insulin to control blood sugar levels as type 2 diabetes progresses. "Type 2 diabetes is a progressive condition with the majority of patients eventually requiring insulin therapy," Holman explains.

Holman and his fellow researchers recruited over 700 type 2 diabetes patients whose current medications were not effectively controlling their blood sugar levels. The patients were divided randomly into three groups to compare the effectiveness of the different insulin dosing regimens, and monitored for three years. After the first year, those patients who were still not achieving the necessary blood glucose control were moved to a more complex insulin therapy.

At the end of the three years, the researchers concluded that once-a-day basal insulin and three-times-a-day mealtimes injections were both more effective at controlling blood sugar levels than twice-daily insulin injections. In addition, those who took the once-daily basal insulin had fewer incidents of low blood sugar than those taking three-times-a-day mealtime insulin.

As a result, the researchers advise those beginning insulin therapy to start with a basal insulin, and add a mealtime insulin if required for what they term "the best combination of effectiveness, safety, and treatment satisfaction". "This large scale study strengthens guidelines recommending adding a basal insulin to oral agents when glycemic targets are not met," says Holman.

Six Warning Signs of Diabetic Ketoacidosis

February 22nd, 2011

Ketoacidosis is a diabetic emergency which occurs as a result of a lack of insulin. Without insulin, the body is unable to use sugar for energy. Unable to use sugar, the body burns its fat stores for energy.

As the fat is broken down, byproducts called ketones are released, building up in the blood and urine. Ketones are acid waste products, and are dangerous at high levels. Blood sugar rises as the liver produces more glucose in an attempt to fuel the body, causing further acidity.

A diabetic who experiences two or more of the following warning signs, and has high glucose readings (over 300mg/dl) should contact their doctor or go to the hospital immediately:

  1. Breath that smells like fruit or nail polish remover
  2. Labored breathing (gasping)
  3. Pronounced thirst
  4. Stomach or abdominal pain
  5. Nausea and vomiting
  6. Flushed complexion

Diabetic ketoacidosis (DKA) usually develops slowly over 24 hours, starting with symptoms such as fatigue, mental stupor, decreased appetite, loss of appetite, headache, and fading consciousness. Often the symptoms of ketoacidosis lead to an initial diagnosis of type 1 diabetes.

Once the patient starts vomiting, their condition can deteriorate very quickly. If treatment is delayed, the diabetic can fall into a life threatening coma. Ketoacidosis is especially dangerous in the elderly.

Immediate treatment involves an insulin injection to reduce blood glucose levels, and the administration of fluids and electrolytes to combat the dehydration that accompanies DKA. The average adult DKA sufferer loses about one and a half gallons of fluid.

Ketoacidosis is a concern for insulin dependent type 1 diabetics, but occurs much less frequently in type 2 diabetics. Diabetics who are Hispanic or African American are more at risk of DKA. DKA is more common in children and adolescents, and, for unknown reasons, slightly more common in women.

DKA is often the result of an illness. Diabetic ketoacidosis can also result from:

  • A missed insulin dose
  • Incorrect insulin dosing
  • A malfunctioning insulin pump
  • An increased need for insulin (sometimes as a result of a growth spurt in children)
  • Infection
  • Surgery
  • Trauma
  • Heart attack
  • Use of cocaine

Diabetics can easily test their urine for ketones are using a test strip similar to a glucose test strip. Ketone testing should be done whenever the blood sugar is higher than 240 mg/dl, during an illness or health crisis such as a stroke, during pregnancy, and whenever a diabetic is experiencing nausea and/or vomiting. Diabetics who are ill should check their ketones every 4 to 6 hours to ensure adequate diabetes control.

DKA can largely be avoided with proper diet and self care when diabetics are ill or otherwise at risk, including adjusting insulin levels when needed. Before the introduction of insulin injections in the 1920's, DKA was almost always fatal. Since the 1950s, the mortality rate has, thankfully, been reduced to between one and ten percent.

Medalists Survive 50 Years without Diabetes Complications

June 10th, 2011

The Joslin Diabetes Center's 50-Year Medal Program honors the accomplishments of those who have survived 50 years or more with diabetes. The Boston-based Center has been following insulin dependent diabetics who have successfully managed their condition over many years.

The Center's 50-year medalists, almost half of which have managed to avoid serious complications such as eye or kidney damage, are being studied in an attempt to determine genetic, physical, psychological and environmental factors that contribute to successful long-term management of the condition.

Years of analyzing data from over 500 long-term diabetes patients have revealed some interesting, and occasionally surprising, information. Perhaps most striking is the fact that almost 70 percent of the medalists still produce some insulin, indicating they may have some defense against beta cell destruction.

Joslin researchers studying the medalists hope to uncover ways to preserve and create insulin-producing beta cells in other insulin dependent diabetics, to develop more effective diabetes medications, or even to find a cure for diabetes.

For some personal survival secrets from two of the medalists who have lived long and healthy lives with diabetes, and some interesting observations on how diabetes control has changed over the years, visit diabeticlifestyle.com.

American Idol Stars Warn Against Neglecting Diabetes

June 21st, 2011

American Idol runner-up singer/songwriter Crystal Bowersox has revealed that she was hospitalized for two days with diabetic ketoacidosis (DKA) during last year's finals. Bowersox now admits to neglecting her disease, sometimes going an entire day without testing her blood sugar.

With her diabetes now under control, she currently checks her blood glucose levels at least 10 times a day. "When you know what your reading is, you know what to do," says Bowersox, who now strives to be a good role model for fellow insulin dependent diabetics, "The only way you can live your life is by monitoring your diabetes."

Bowersox, a type 1 diabetic since age 6, is now an advocate for the Juvenile Diabetes Research Foundation and the Diabetes Research Institute. Fellow Idol contestant Kevin Covais, also a type 1 diabetic, has joined Bowersox in her advocacy for both diabetes organizations.

DKA usually results from not monitoring and controlling blood sugar and insulin levels, especially around mealtimes. Insulin dependent diabetics also need to take into consideration their stress and activity levels when calculating the correct insulin dosage.

To read more about Bowersox's and Covais's experiences and their advice for fellow diabetics, visit Yahoo News

Inexpensive TB Vaccine could be a Revolutionary Diabetes Drug

June 28th, 2011

An inexpensive vaccine that's been used for over 90 years to combat tuberculosis may have the ability to reverse type 1 diabetes. Although the early results were met with skepticism, seven studies in mice over the last ten years have established that the generic drug BCG (bacillus Calmette-Guerin) can prevent immune system T cells from destroying insulin-producing cells, allowing the pancreas to regenerate and once again produce insulin.

A research team from the Massachusetts General Hospital Immunobiology Laboratory led by Dr. Denise Faustman, PhD, successfully reproduced the results in a small group of human subjects, using very small doses of the vaccine. Those diabetics receiving the vaccine, all of whom had been Type 1 for an average 15 years, showed both a decrease in pancreas cell-destroying T cells, and an increase in the insulin precursor C-peptide - an indicator of insulin production.

The results were temporary, and it is likely that the vaccination would have to be repeated on a regular basis. The team believed using higher doses would have led to a more positive effect, but trial dosages were limited by the FDA. They are now negotiating with the FDA to use higher concentrations in a larger trial.

Type 1 diabetes is an auto-immune condition in which the body attacks its own insulin-producing beta cells in the pancreas. The body needs insulin to fuel itself and regulate blood sugar, so type 1 diabetics must take daily insulin injections to manage their blood sugar levels.

BCG works by increasing the levels of an immune system protein called tumor necrosis factor, or TNF. High levels of TNF block other parts of the immune system from attacking the body, especially the pancreas. This is a major shift in direction in diabetes treatment, as it was not previously believed possible to restore pancreas function in insulin dependent diabetics.

Doctors and researchers are surprised and excited at the unanticipated prospect of controlling the immune system to restore the body' ability to produce normal insulin levels. "If this is reproducible and correct, it could be a phenomenal finding," enthuses Dr. Robert Henry of the University of California, San Diego.

The research was largely funded by the Iacocca Foundation, founded in 1984 by auto manufacturer magnate Lee Iacocca and his daughters after his wife died from diabetes complications at age 57. The Foundation has committed to continued financial assistance for phase II clinical testing of the potentially revolutionary diabetes medication.

What is Brittle Diabetes?

July 4th, 2011

Brittle diabetes is an uncontrolled form of type 1, or insulin dependent, diabetes. It's also referred to as uncontrolled or labile (open to change) diabetes. While most diabetics experience some fluctuations in blood sugar, brittle diabetics have dramatic, regular, yet unpredictable swings in glucose levels, even when doing their best to control their condition with insulin injections, exercise and diet.

These wildly fluctuating blood glucose levels can result in either high blood sugar (hyperglycemia) or low blood sugar (hypoglycemia). Symptoms of hypoglycemia include:

  • trembling
  • dizziness
  • cold sweats
  • tiredness
  • weakness
  • headache
  • blurred vision
  • racing or pounding heart
  • irritability
  • confusion

Severe low blood sugar can result in disorientation, convulsions, and loss of consciousness.

Symptoms of hyperglycemia include:

  • thirst
  • headache
  • blurred vision
  • frequent urination
  • trouble concentrating
  • fatigue

Hyperglycemia is frequently accompanied by ketosis, or elevated levels of ketones. Ketones are compounds caused by the breakdown of fatty acids in the body.

Ketosis is not normal, but it's not necessarily harmful. However extreme ketosis can lead to ketoacidosis, a dangerous condition in which the blood's ph is lowered to very acidic levels. Ketoacidosis can result in a life threatening diabetic coma. One telltale sign of ketoacidosis is a fruity or nail polish remover-like odor on the diabetic's breath (caused by acetone, a byproduct of ketone breakdown).

Luckily, only about 2 percent of diabetics suffer from brittle diabetes. It is most common in young (aged 15 to 30) women, especially overweight women. Brittle diabetes can be caused or made worse by:

  • poor diabetes control (high sugar diet, missing doses of diabetes medication)
  • gastrointestinal absorption problems
  • poor insulin absorption
  • thyroid problems (hypothyroidism)
  • adrenal gland problems
  • drug and alcohol interactions
  • hormonal imbalances
  • stress
  • depression

Brittle diabetes often has to be treated in a hospital, where food intake, insulin injections, and blood sugar levels can be closely controlled and monitored. As there may be a psychological component to brittle diabetes, psychotherapy is helpful in some cases.

More Progress Made Towards the Development of an Artificial Pancreas

July 7th, 2011

Researchers are continuing to make progress in the development of an artificial pancreas for insulin dependent type 1 diabetics. An artificial pancreas is an automated, closed-loop system consisting of a continuous glucose monitor, a glucose meter to calibrate the monitor, and an insulin pump.

With the help of a sophisticated computer system, an artificial pancreas produces insulin and controls blood sugar in a diabetic much as a normal pancreas does in a person without diabetes. The sophisticated system senses when the body needs insulin, calculates the dose needed, and delivers automatically, eliminating the need for insulin injections.

To read more about several recent advances towards the development of an artificial pancreas on WebMD, >CLICK HERE<.

Helping Friends to Understand Diabetes

August 4th, 2011

explaining insulin dependent diabetes

About.com Diabetes Guide Gary Gilles has written an excellent post titled Helping Friends to Understand Diabetes - Answers to 9 Common Questions. The post is aimed at insulin dependent type 1 diabetics, and tackles common myths and questions about blood glucose testing, insulin injections, diabetes and diet, and episodes of low blood sugar.

The post begins with:

Educating friends about your type 1 diabetes can be challenging. Many myths still exist about diabetes and you can do yourself a big favor by trying to replace those myths with accurate information. Here are nine of the most common questions your friends might be thinking and how to answer them.

To read the 9 common questions and Gilles helpful suggested answers on About.com, >CLICK HERE.<

Arthritis Drug a Future Diabetes Medication?

August 9th, 2011

A collaborative group of researchers including the American Diabetes Association and the Juvenile Diabetes Research Foundation has been testing the medication abatacept (CTLA4 immunoglobin fusion protein) as a possible treatment for type 1 diabetes. Abatacept, better known by its brand name Orencia, is FDA approved to treat autoimmune diseases such as rheumatoid arthritis and multiple sclerosis.

Type 1 diabetes is an autoimmune disease in which T-cells in the body's immune system mistakenly attack the insulin producing beta cells in the pancreas. With the pancreas producing little or no insulin, type 1 diabetics must rely on insulin injections to regulate their blood sugar levels. Those type 1 diabetes who continue to produce some insulin have an easier time keeping their blood sugar in the normal range, and have less risk of diabetes complications.

Abatacept blocks the activation of the immune system's aggressive and destructive T-cells. The researchers hoped the medication would protect the remaining beta cells in the pancreas from being destroyed, allowing them to continue to make at least a little of their own insulin.

Researchers recruited 112 newly diagnosed type 1 diabetics aged 6 to 45, all of whom still had some functioning beta cells. Two thirds of the participants were given abatacept intravenously over two years, and one third was given a placebo. The two-year study ended recently, although participants will be followed up for another two years. Initial results are encouraging, with the participants who received the abatacept showing 59% more insulin production than the control group.

"I have spent my career on the quest to find a treatment and cure for type 1 diabetes, and thus it was very gratifying when we unblinded the clinical results and discovered that abatacept had benefit," said principle investigator Dr. Tihamer Orban. "From my experience though," he cautioned, "abatacept is not likely to be the complete answer, and type 1 diabetes patients will likely benefit from cocktail combinations with other drugs. This synergistic approach has a great future."

Orban's is the CEO of the clinical stage biotechnology company, Orban Biotech. Orban Biotech has launched a pre-clinical study evaluating the combination of abatacept with the company's antigen-based therapy insulin B chain vaccine. The vaccine, which is entering into a Phase II trial, is designed to arrest the autoimmune response and re-establish tolerance towards insulin, preserving the body's own insulin production.

This study is one of several which show promise of novel ways to improve diabetes control, and perhaps free insulin dependent diabetics from the need for frequent insulin injections and other diabetes medication.

Mealtime Insulin Injections May be Replaced by an Insulin Inhaler

August 12th, 2011

There's good news for insulin dependent diabetics who rely on fast-acting mealtime insulin injections to keep their blood sugar under control. MannKind Corporation has the go-ahead to continue clinical testing of its investigational inhaled insulin, AFREZZA. The drug maker and the FDA met to confirm the protocols for two new studies, one in type 1 diabetics, and one in type 2 diabetics.

AFREZZA is an ultra-rapid acting inhaled insulin which uses patented technology to deliver powdered insulin from a thumb-sized device into the lungs. The lungs are an effective option for delivering diabetes medication, largely because of their huge surface area (about the size of a tennis court).MannKind focuses on the discovery, development and commercialization of therapeutic products for patients with diseases such as diabetes and cancer. Now in late stage clinical investigation, AFREEZA is its lead product candidate. Shares of the company jumped 20% at the news that the design of the follow-up clinical trials had been confirmed.

MannKind has been seeking approval for its new generation diabetes medication since March of 2009, but was asked twice to run additional clinical trials in order to provide the FDA with more information. One of the approval delays was due to the drug maker updating the design of its insulin inhaler after applying for approval of the earlier design. The FDA was concerned that there was not enough data to support a switch to the new generation device, and asked that both models be tested together.

Clinical trials of the initial design of the insulin inhaler were promising. Participants reported being pleased with the innovative insulin delivery device, and experienced less hypoglycemia and weight gain than did controls using a standard combination of long-acting insulin glargine and twice a day 70 30 insulin injections.

Insulin can't be taken orally, as digestive juices break it down before it can be used by the body. Currently, the only means of delivering insulin are subcutaneous insulin injections or intravenously. Because AFREEZA is a short-acting mealtime insulin, type 1 diabetics will need to combine it with long-acting insulin injections for complete diabetes control.

Dr. Larry Deeb, a pediatric endocrinologist from the University of Florida College of Medicine, says that failure to comply with regular insulin dosing is one of the major issues in diabetes, often because of the discomfort and inconvenience of insulin injections. Deeb says that finding an alternative insulin delivery method is crucial, especially for children and the needle-phobic.

Should it be approved, AFREEZA would be the second inhaled insulin to hit the market. Pfizer received approval to market a similar product, Exubera, several years ago, but, surprisingly, the product never caught on with diabetics, and was withdrawn from the market a year later.

AFREZZA is easier to use, faster acting and boasts better bioavailability than Exubera, enabling diabetics to achieve more satisfactory insulin levels using smaller amounts. Despite Exubera's unexpected failure, AFREEZA is expected to be a blockbuster diabetes drug when it becomes available.

Security Flaws in Insulin Pump Technology

August 19th, 2011

A security researcher who is diabetic has identified flaws that could allow an attacker to remotely control insulin pumps and alter the readouts of blood-sugar monitors. As a result, diabetics could get too much or too little insulin, a hormone they need for proper metabolism.

Jay Radcliffe, an insulin dependent diabetic who experimented on his own equipment, shared his findings with The Associated Press before releasing them Thursday at the Black Hat computer security conference in Las Vegas.

The full article is published on the News Tribune.

Flying Can Cause Changes in Insulin Pump Performance

August 30th, 2011

Diabeticlive.com is warning insulin dependent diabetes planning to take a plane that changes in cabin air pressure while flying may alter the functioning of insulin pumps. The research arose out of an incident involving a young diabetic traveler using an insulin pump whose blood sugar levels dropped unexpectedly one hour into a flight.

After uncovering reports of similar incidents involving insulin pumps delivering incorrect insulin doses while being used on planes, a team of researchers from John Hunter Children's Hospital in Australia decided to perform some tests.

They placed ten insulin pumps on a commercial flight. When they analyzed them later, they found the pumps delivered 1 to 1.4 extra units of insulin after take-off, and that a small amount of insulin was drawn back into the pumps when descending for a landing.

To read the entire story on diabeticlive.com, including the researchers' suggestions for diabetics with insulin pumps who plan to travel byplane, >CLICK HERE.<

Does Using Long Acting Insulin Increase Cancer Risk?

September 6th, 2011

long acting insulin

According to the FDA, five recent studies of a possible link between insulin glargine (marketed as Lantus long acting insulin) and the growth of cancerous cells have failed to shed more light on the subject. Calling the studies "inconclusive", the FDA said it was continuing to work with the long acting insulin manufacturer, Sanofi-Aventus, to determine whether there is an increased risk of cancer for users of insulin glargine.

The concerns arose because Lantus' ability to act as a long acting insulin arises from its prolonged interaction with the insulin-like growth factor-I receptor (IGF-IR). IGF-IR overactivity has been linked to many types of cancer. That begs the question - could long acting insulin glargine be associated with cancer because of its continual interfacing with IGF-IR?

While the debate about the possible cancer risk associated with long acting insulin continues, the American Diabetes Association, the American Association of Clinical Endocrinologists and two similar European governing bodies are reassuring insulin dependent diabetics that there is no need to change their insulin glargine treatment.

To read more about the controversial long-acting Lantus insulin clinical studies on diabeticlive.com, >CLICK HERE.<

Successful Pilot Study for Implanted Continuous Glucose Monitor

September 13th, 2011

Sensors for Medicine and Science Inc (SMSI) is developing a new approach to glucose monitoring that promises to be a long-awaited improvement over present methods, which typically require several finger prick blood tests a day. This inconvenient and uncomfortable method of collecting blood samples results in many diabetics not testing their blood sugar as often as they should.

The new glucose monitoring method involves a small sensor that is implanted under the skin. The sensor automatically monitors glucose levels every few minutes, and transmits the information wirelessly to a small wrist-watch-like external reader. The sensor will also warn the wearer of an impending episode of low or high blood sugar.

The sensor would be of obvious benefit to insulin dependent diabetics whose diabetes is not well controlled or whose blood sugar levels swing unpredictably. It would also be ideal for children with diabetes.

Sensors for Medicine and Science will be presenting the results of a successful pilot study of the glucose monitor at the next meeting of the European Association for the Study of Diabetes. "Based on the promising results obtained," says CEO Tim Goodnow, PhD, "We plan to initiate more clinical trials in the very near future."

The company also hopes to collaborate on artificial pancreas research, with many questions to be answered.

Diabetic Emergency: Treating Hypoglycemia with Glucagon

September 19th, 2011

glucagon kit

Like insulin, glucagon is a hormone made in the pancreas. But the two hormones have opposite effects - insulin lowers blood sugar, while glucagon raises it. This means glucagon can be used to treat an episode of severe hypoglycemia (low blood sugar) in diabetics.

Severe hypoglycemia is rare in most insulin dependent diabetics, but can cause a loss of consciousness and should be considered a medical emergency. Type 1 diabetics are advised to have a glucagon kit on or near them at all times, as are the parents and caregivers of children with diabetes.

About.com diabetes coach Gary Gilles has written a valuable guide to treating severe low blood sugar with glucagon, describing when and how glucagon should be used. Glucagon is administered as an injection, but unlike an insulin injection, it should be injected deep into the muscle.

To read Gilles' article on About.com, >Click Here.<

Overcoming Injection Anxiety

September 20th, 2011

Have you or someone close to you been newly diagnosed as an insulin dependent diabetic? Are you anxious about giving yourself or your dependent insulin injections? Many diabetics say that giving themselves an insulin injection is the hardest part of the condition.

Or perhaps you're an experienced diabetic who hasn't kept up to date on the latest insulin delivery methods like spring loaded syringes, insulin pens and insulin jet injectors. Skipping doses of diabetes medication can lead to poor blood sugar control and diabetes complications. WebMD feature writer Stephanie Watson offers some practical advice in an article titled Overcoming Objections to Injections.

Edible Film a Possible Insulin Delivery Platform

September 22nd, 2011

In another promising development in the world of diabetes medication, the specialty pharmaceutical company MonoSol Rx is testing its unique PharmFilm as a possible oral insulin delivery platform. PharmFilm is a quick-dissolving film that can be impregnated with medication and placed under the tongue or against the inside of the cheek. The medication is quickly absorbed into the bloodstream through the mouth's mucosal membranes.

The FDA has already approved two applications of the edible film - Zuplenz to treat nausea and vomiting, and Suboxone to treat opiod dependence. MonoSol Rx is now testing two new applications for PharmFilm, one dispenses a drug to treat ADHD, and the other delivers insulin for diabetics.

Currently, insulin can only be administered through injection, as it is destroyed by acids in the digestive system. Because the postage stamp sized insulin film dissolves so quickly in the mouth, the diabetes medication bypasses the digestive tract and passes directly into the circulatory system.

MonoSol Rx and Midatech are just two of many companies racing to develop different ways to administer insulin without injections, including insulin patches, insulin inhalers, and insulin nasal sprays.

The insulin film can be manufactured in different sizes to accommodate different insulin dosages. The advantages of a dissolving insulin film for insulin dependent diabetics (especially children with diabetes and their caregivers) are obvious - no insulin injections; precise insulin dosing; a convenient, discreet and portable medication, and instant onset of action.

MonoSol Rx is collaborating with Midatech Group Ltd, a leading edge nanotechnology company which develops biocompatible nanoparticles (tiny synthetic molecules that are designed to carry and deliver drugs) to bring the oral diabetes medication to market. The insulin film has been successfully tested transbuccally (inside the cheek) in pigs and monkeys, and the partners plan to begin human trials this year.

A spokesperson for Midatech Group said, "The results of insulin PharmFilm in our primate study validate the film delivery of active insulin across the buccal mucosa for the first time. In addition, we have preclinical proof-of-concept that these results can be achieved in a controlled dose precisely tailored to suit individual needs. We anticipate results from our human clinical trials, slated to commence in the second quarter of 2011, to revolutionize treatment methods and insulin delivery for diabetics worldwide."

According to the Centers for Disease Control, nearly 24 million people in the United States are currently living with diabetes - the seventh leading cause of death in the country. Many of these diabetics (about 30%) are, or will become, insulin dependent and require insulin injections. Many are struggling with complications involving their heart, kidneys, nerves, eyes, and circulation.

Insulin is a hormone which moves blood sugar into the cells to give the body energy. Diabetics either don't produce any insulin (type 1 diabetes), can't make enough insulin, and/or can't properly make use of the little insulin they do produce (type 2 diabetes).

$100,000 Reward Offered for Glucose-Sensitive Insulin

October 3rd, 2011

The Juvenile Diabetes Research Foundation (JDRF) announced a $100,000 Challenge for the development of a new glucose-sensitive insulin medication that will be used in the treatment of patients with diabetes. The JDRF is a global organization that promotes awareness of Type 1 diabetes in addition to sponsoring research into new treatments for diabetes and educating diabetics about how to properly manage the disease.

The JDRF is utilizing the InnoCentive.com platform to issue the challenge. InnoCentive is a service that connects businesses and organizations seeking solutions to problems in a wide variety of fields with scientists and research teams who develop solutions custom-tailored for the "challenge."

The best solution is awarded a cash prize, usually between $10,000 and $100,000. The JDRF's challenge will award $100,000 to any research group that develops a diabetes medication that improves blood sugar management, lessens the need for frequent blood sugar testing, and reduces the risk of diabetic complications.

The winning solution will be a glucose-responsive insulin medication that senses glucose levels in the blood of the patient and automatically releases insulin into the bloodstream when necessary. A glucose-sensitive medication would require fewer insulin doses - a single dose a day, or even less - and would reduce the burden of frequent blood sugar testing and insulin injections for diabetics.

According to Aaron Kowalski, Ph.D., assistant Vice President of Treatment Therapies at the JDRF, "Insulin treatment requires diligent monitoring and burdensome administration, often several times a day, every day. This remains the only way to regulate blood sugar levels for the millions of individuals with insulin dependent diabetes worldwide. Although research has propelled the development of better and faster-acting insulins, the disease is still hard to control because of the way insulin is administered to patients."

"What we need is sophisticated insulin that will take the guesswork out of managing diabetes by developing a novel insulin that works in the same way insulin works in people without diabetes," continued Dr. Kowalski. "By fostering novel approaches from diverse problem solvers within and outside the diabetes field, we hope this Challenge with InnoCentive will help speed progress toward the development of glucose-responsive insulin - progress urgently needed by people with diabetes."

InnoCentive.com is headquartered in Waltham, Massachusetts. The company's founders were first inspired to create a service connecting businesses with qualified researchers in 1998, and launched InnoCentive in 2001.

Eating Too Quickly Doubles the Risk of Insulin Resistance

November 8th, 2011

Yet another reason to listen to your mother and slow down and chew your food properly - eating too quickly has been associated with a doubled risk of developing impaired glucose tolerance, or pre-diabetes. As the name suggests, pre-diabetes is the forerunner to developing type 2 diabetes. Most diabetics have type 2 diabetes - a form of diabetes where your body no longer responds properly to insulin (called insulin resistance). Type 2 diabetes used to be described as non insulin dependent diabetes.

Insulin is the hormone that moves sugar (glucose) from the blood to the body's cells to provide them with energy. If your cells do not use insulin properly, the pancreas produces more insulin that normal to cope with the body's demands. Eventually, the pancreas cannot keep up, and excess glucose builds up in the bloodstream. Type 2 diabetes is characterized by high levels of glucose in the blood.

A recent Japanese study followed over 170 healthy individuals for three years, monitoring their eating habits. Snacking, eating late at night, skipping meals and eating out were not associated with developing pre-diabetes. The one and only eating habit associated with the development of insulin resistance was eating too quickly.

The researchers aren't sure why eating faster makes an individual more likely to develop pre-diabetes and type 2 diabetes, but suspect that eating rapidly results in higher post-meal blood glucose levels. Some doctors also point out that eating too quickly results in an overall increase in the amount of calories taken in. Since it takes about 20 minutes for the brain to receive the signal that the stomach is full, those who eat quickly continue eating without realizing that their stomach is filled.

Previous research has also shown that eating quickly results in increased weight gain. Insulin resistance generally increases with increased body fat, and there is a pronounced connection between obesity and diabetes. The two are so closely connected that it gave rise to the term "diabesity". Diabesity is currently epidemic across the developed world.

Insulin resistance has no symptoms. Pre-diabetes is sometimes called impaired glucose tolerance, and can be diagnosed with a fasting glucose test or a glucose tolerance test. The American Diabetes Association recommends that adults who are overweight and have one or more additional risk factors for diabetes should consider being tested. Additional risk factors include:

  • Having a parent or sibling with diabetes
  • Being physically inactive.
  • Being African American, Alaska native, American Indian, Asian American, Hispanic or Latino, or a Pacific Islander
  • Giving birth to a baby weighing more than 9 pounds or being diagnosed with gestational diabetes
  • Having high blood pressure or being treated for high blood pressure
  • Low HDL ("good") cholesterol levels or high triglyceride levels
  • Having polycystic ovary syndrome
  • Having a history of cardiovascular disease

People with pre-diabetes can avoid becoming diabetic and the need to take diabetes medication by losing weight, being physically active, eating a healthy diet, and, as we now know, not eating too quickly.