This has been an interesting topic for several years, but along the way, many people have dropped the ball and it is just now that some organizations are realizing that there are better ways to inject insulin. According to a workshop in Athens (TITAN) in September 2009 there is a proper way to inject insulin.
Why it took so many organizations so long to evaluate this report is still a mystery. Why health practitioners have taken so long to adopt the methods in this report make me wonder about the knowledge of many health practitioners. True, there was little consensus prior to this report and most like to use evidence-based guidelines to support what they tell their patients.
At least Joslin Diabetes Center has recognized that there is evidence to be looked at and is in the process of reviewing their own procedures in light of the report and consensus reports available. They report the following from an injection survey: 21% of patients admitted injecting into the same site for a whole day or even for a few days, 50% of patients had symptoms suggestive of lipohypertrophy (a lump under the skin caused by accumulation of extra fat at the site of many subcutaneous injections of insulin), and 35% of patients using NPH don’t remix it prior to use. These findings are important as lipohypertrophy can also cause changes in the action or timing of insulin delivery.
Another factor that should help most people with the potential new standards is the use of shorter needles instead of the half an inch needles most of us are used to. The new recommendations remove the classic pinch most of us have been taught as the shorter needles will not require this. It is also not necessary to use an angle shot unless you are still needing to use the pinch method in areas with little fat and muscle near the surface. Straight-in is now the preferred injection angle except as last mentioned.
This does not affect me, but for anyone using a pen for injecting insulin, please read Joslin's findings for proper use of a pen. A few of their recommendations are something to adapt to and I have even been taught to do with my needles. Never remove the pen needle from the injection site immediately. They recommend counting to 10 before withdrawing the pen to prevent back leakage which can reduce the amount of insulin available.
This blog should be read by everyone that injects insulin and for anyone on oral medications that is considering the switch to insulin. Expect to see or read more as other healthcare organizations adopt new standards.
September 2, 2011
September 1, 2011
Are There Six Million Dollar Guinea Pigs?
No, I don't think you will be that valuable. When they start talking electronics in or on humans all I can think about is the six million dollar man – Lee Majors. I do not anticipate the “electronic tattoos” will be that expensive. There are some interesting ideas being proposed for electronic tattoos that may well have some very real health benefits for many people. Whether something for diabetes will be among them in the near future remains to be seen.
Ultra-thin electronics are being experimented with that may in the near future have applications for monitoring patients that will do away with some of the bulky equipment that is being used today. Some applications may be a little futuristic; however, some real applications are possible in the near future, the FDA doing its job.
One of the applications that may be near is a patch that can be applied to the chest and give doctors access to heart monitoring that is remarkably close to information produced by the electrocardiogram.
John Rogers, PhD, and colleagues at the University of Illinois and other institutions in the U.S., Singapore, and China, have developed a system "of epidermal electronics" that almost exactly match the properties of the skin.
The patch contains electronic monitors that are integrated onto a water-soluble polyester backing (elastomer). It is attached to the body by brushing it with water. Weak forces of attraction between the skin and the backing cause the patch to stick to the skin like super-adhesive cling film. The patch is extremely thin -- less than the diameter of a human hair.
Since the skin represents one of the most natural places to integrate electronics, the researchers note the the patch has been used effectively for 24 hours without skin irritation. The present problem is that the surface skin cells of the skin are shed and renewed, a new patch would have to be attached at least every two weeks. The patch has yet to be tested with a range of skin conditions, from dry to sweaty.
What is interesting is this technology will work in non-medical applications such as a patch attached to the throat incorporating an microphone. This is being developed for the possible use for people with some disabilities so that they can use computers. Read the article here.
Ultra-thin electronics are being experimented with that may in the near future have applications for monitoring patients that will do away with some of the bulky equipment that is being used today. Some applications may be a little futuristic; however, some real applications are possible in the near future, the FDA doing its job.
One of the applications that may be near is a patch that can be applied to the chest and give doctors access to heart monitoring that is remarkably close to information produced by the electrocardiogram.
John Rogers, PhD, and colleagues at the University of Illinois and other institutions in the U.S., Singapore, and China, have developed a system "of epidermal electronics" that almost exactly match the properties of the skin.
The patch contains electronic monitors that are integrated onto a water-soluble polyester backing (elastomer). It is attached to the body by brushing it with water. Weak forces of attraction between the skin and the backing cause the patch to stick to the skin like super-adhesive cling film. The patch is extremely thin -- less than the diameter of a human hair.
Since the skin represents one of the most natural places to integrate electronics, the researchers note the the patch has been used effectively for 24 hours without skin irritation. The present problem is that the surface skin cells of the skin are shed and renewed, a new patch would have to be attached at least every two weeks. The patch has yet to be tested with a range of skin conditions, from dry to sweaty.
What is interesting is this technology will work in non-medical applications such as a patch attached to the throat incorporating an microphone. This is being developed for the possible use for people with some disabilities so that they can use computers. Read the article here.
August 31, 2011
Zinc Can Assist in Preventing Diabetes Damage
Because of the toxic nature of zinc, please do not do any supplemental zinc intake without knowledge of a doctor and only on his advice. For information on zinc and health problems read this – a little more than half way down the page under the heading “Health Risks from Excessive Zinc”. The rest of the article is good also. Bookmark it and go back to it after you read the following.
This is an interesting study about zinc and does deserve some attention as the National Institutes of Health provided funding for the research. The University of Michigan did the research and the findings appear in the July 8 issue of the Journal of Molecular Biology.
The findings showed that Amylin can display two characteristics. In people that have normal levels of zinc and are otherwise healthy, amylin assists in blood glucose management. An analog of amylin, named Symlin is used with insulin to manage blood glucose levels in people with diabetes. In molecular language, zinc prevents amylin, which is also known as Islet Amyloid Polypeptide, from forming clumps which can lead to the formation of ribbon-like structures called fibrils.
This happens in an environment that is zinc-starved and the fibrils become linked to some human diseases, many of them in the area of dementia. The important part is that zinc binds to amylin, at a point near the middle of the amylin molecule, the amylin molecule kinks, which interferes with the formation of toxic clumps. In the current work, they show that the binding of zinc in the middle makes one end of the amylin molecule, called the N-terminus, become more orderly.
In addition, the researchers found that before amylin can begin forming fibrils, zinc must be rousted from its nesting place. This eviction is costly in energetic terms, and the sheer expense of it discourages fibril formation. And because a single zinc molecule can bind to several amylin molecules, it ties up the amylin in assemblages that, unlike certain other aggregations, are not intermediates in the pathway that leads to fibril formation.
However zinc, like amylin, has a dual nature. At conditions similar to those outside islet cells, where even a tiny amount of amylin aggregates in the blink of an eye, zinc inhibits fibril formation. But in conditions resembling the inside of the cell, the inhibitory effect begins to wane and other factors, like insulin, take on zinc's security guard duties.
Amylin has not one, but two binding sites for zinc. Zinc prefers to bind at the first site -- the one in the middle of the amylin molecule, where its binding discourages fibril formation. But when there's too much zinc around, all the binding sites in the middle positions are occupied and zinc must attach to amylin at the second site, which counteracts the effect of the first site. This may explain why decreased levels of insulin -- the backup security guard -- inside islet cells of diabetics result in islet cell death.
Also read this blog about natural sources of zinc.
This is an interesting study about zinc and does deserve some attention as the National Institutes of Health provided funding for the research. The University of Michigan did the research and the findings appear in the July 8 issue of the Journal of Molecular Biology.
The findings showed that Amylin can display two characteristics. In people that have normal levels of zinc and are otherwise healthy, amylin assists in blood glucose management. An analog of amylin, named Symlin is used with insulin to manage blood glucose levels in people with diabetes. In molecular language, zinc prevents amylin, which is also known as Islet Amyloid Polypeptide, from forming clumps which can lead to the formation of ribbon-like structures called fibrils.
This happens in an environment that is zinc-starved and the fibrils become linked to some human diseases, many of them in the area of dementia. The important part is that zinc binds to amylin, at a point near the middle of the amylin molecule, the amylin molecule kinks, which interferes with the formation of toxic clumps. In the current work, they show that the binding of zinc in the middle makes one end of the amylin molecule, called the N-terminus, become more orderly.
In addition, the researchers found that before amylin can begin forming fibrils, zinc must be rousted from its nesting place. This eviction is costly in energetic terms, and the sheer expense of it discourages fibril formation. And because a single zinc molecule can bind to several amylin molecules, it ties up the amylin in assemblages that, unlike certain other aggregations, are not intermediates in the pathway that leads to fibril formation.
However zinc, like amylin, has a dual nature. At conditions similar to those outside islet cells, where even a tiny amount of amylin aggregates in the blink of an eye, zinc inhibits fibril formation. But in conditions resembling the inside of the cell, the inhibitory effect begins to wane and other factors, like insulin, take on zinc's security guard duties.
Amylin has not one, but two binding sites for zinc. Zinc prefers to bind at the first site -- the one in the middle of the amylin molecule, where its binding discourages fibril formation. But when there's too much zinc around, all the binding sites in the middle positions are occupied and zinc must attach to amylin at the second site, which counteracts the effect of the first site. This may explain why decreased levels of insulin -- the backup security guard -- inside islet cells of diabetics result in islet cell death.
Also read this blog about natural sources of zinc.
August 30, 2011
Portfolio Diet Better Than Low-Fat Diet
This is difficult topic for me to write about, but people still need to know about the Portfolio diet and that it is better for you than the low-fat diet. I hesitate to recommend this diet since I do not like soy or soy based products and margarine of any type. The portfolio-diet over the low fat diet helps lower cholesterol by 13 percent after six months on the diet whereas the results of the traditional low-fat diet can only give a three percent decrease in cholesterol.
The Portfolio-diet is a plant based diet and for some people will serve them well. Since cardiovascular disease is a major killer, researcher David Jenkins, MD, Canada Research Chair at the University of Toronto says, “If we let people know that they can control their own cholesterol levels themselves, we're putting some of the responsibility but also the power back into the hands of ordinary citizens." Jenkins also says, “The study suggests that the mix of plant-based foods included in the portfolio diet can achieve cholesterol-lowering results similar to what can be achieved through drugs.”
Several others have commented that motivation is key and that going from animal to plant based protein is a change, counseling sessions seemed to work very well and these type of results are very good and people are staying with it. They are hoping the results will continue beyond the six months with more counseling sessions.
In the study, 351 people with high cholesterol were divided in three groups. One group on the portfolio diet received two counseling sections and another group on the portfolio diets received seven sessions over a six month period and the third group followed a standard low-fat diet for six months.
People tend to respond to the positive dietary messages and the nuts, legumes, and plant sterols was well received as being proactive over just taking saturated fat out of the diet.
The second article in Medscape is a little more descriptive and does say that the portfolio diet may well alleviate the need for statins early on and may reduce the dosage of statins needed for many people. All positive steps in reducing the dependance on some medications.
Read about the study in WebMD here and the Medscape article here.
The Portfolio-diet is a plant based diet and for some people will serve them well. Since cardiovascular disease is a major killer, researcher David Jenkins, MD, Canada Research Chair at the University of Toronto says, “If we let people know that they can control their own cholesterol levels themselves, we're putting some of the responsibility but also the power back into the hands of ordinary citizens." Jenkins also says, “The study suggests that the mix of plant-based foods included in the portfolio diet can achieve cholesterol-lowering results similar to what can be achieved through drugs.”
Several others have commented that motivation is key and that going from animal to plant based protein is a change, counseling sessions seemed to work very well and these type of results are very good and people are staying with it. They are hoping the results will continue beyond the six months with more counseling sessions.
In the study, 351 people with high cholesterol were divided in three groups. One group on the portfolio diet received two counseling sections and another group on the portfolio diets received seven sessions over a six month period and the third group followed a standard low-fat diet for six months.
People tend to respond to the positive dietary messages and the nuts, legumes, and plant sterols was well received as being proactive over just taking saturated fat out of the diet.
The second article in Medscape is a little more descriptive and does say that the portfolio diet may well alleviate the need for statins early on and may reduce the dosage of statins needed for many people. All positive steps in reducing the dependance on some medications.
Read about the study in WebMD here and the Medscape article here.
August 29, 2011
Inactivity Linked to Risk for Type 2 Diabetes
I wish I could comprehend some items with the ability of Tom Ross. He has a sense of humor and skepticism that make reading him blog very enjoyable for me. He can rant and vent with the best of them and you will not even know it by the way he writes. That is another reason to read his blog.
Since his blog is not one that you can link to for a specific post, I will just tell you that you need to read his post from Thursday, August 25, 2011. I like the way he boiled done the relationship between obesity and diabetes and then took us to the study which is the topic of this blog – inactivity. You will need to scroll down the page to find the blog, and I think you will enjoy his presentation. He packs a lot of good sense into his discussion and at the same time makes excellent points.
Quote I doubt very much that we are ever going to narrow this down to a simple cause-and-effect relationship between a single issue and diabetes; it is far more likely to be a tangled interaction between multiple factors.
But one factor which could be as important as obesity tends to be mentioned far less often than obesity is, as a possible cause of diabetes: physical inactivity. Unquote.
That is one of the best ways to describe much of the discussion from many articles about diabetes and obesity.
So rather that cover the topic again, it is well worth your time to read Tom's blog and then read two articles covering the topic – here from Science Daily and Medical News Today here.
Since his blog is not one that you can link to for a specific post, I will just tell you that you need to read his post from Thursday, August 25, 2011. I like the way he boiled done the relationship between obesity and diabetes and then took us to the study which is the topic of this blog – inactivity. You will need to scroll down the page to find the blog, and I think you will enjoy his presentation. He packs a lot of good sense into his discussion and at the same time makes excellent points.
Quote I doubt very much that we are ever going to narrow this down to a simple cause-and-effect relationship between a single issue and diabetes; it is far more likely to be a tangled interaction between multiple factors.
But one factor which could be as important as obesity tends to be mentioned far less often than obesity is, as a possible cause of diabetes: physical inactivity. Unquote.
That is one of the best ways to describe much of the discussion from many articles about diabetes and obesity.
So rather that cover the topic again, it is well worth your time to read Tom's blog and then read two articles covering the topic – here from Science Daily and Medical News Today here.
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