Showing posts with label Type 1 diabetes. Show all posts
Showing posts with label Type 1 diabetes. Show all posts

January 31, 2015

Young People with Type 1 Diabetes

This video in the NY Times is somewhat frightening and I have viewed it several times to get that out of my mind, but I can't. The young girl, Grace, at 15 has type 1 diabetes and is having wild swings in her blood glucose levels. As with most parents, Mr. and Mrs. Chamberlain are all over her and her testing schedule. They set alarms to check her blood glucose at midnight, three AM, and six AM. She tests the rest of the day.

They may have good reason for concern as apparently she is on a high carbohydrate/low-fat food plan and also seems hypoglycemia unaware. She does have a diabetes service dog and this has eased the concern some. The dog does go with her to school and anyplace she goes away from her parents.

David Mendosa says she and her family have apparently never heard of Dr. Richard K. Bernstein and the law of small numbers. For the brief time when her blood glucose numbers flashed across the screen, I would have to agree with David and say she and her family need to read Dr. Bernstein's book, “Diabetes Solutions.”

Hopefully, the link above will allow you to see the video. It is not the best video and jumps from point to point without any narrative or controls to allow you to pause the video, which I could get to work.

She has had three or four friends or acquaintances that have died from type 1 diabetes. This does concern the entire family and has left a lasting impression on the daughter.

Below the video is a brief write-up about the Chamberlain family in Fort Worth, Texas. Grace was diagnosed with type 1 diabetes in 2006. Grace’s experience with the disease has been particularly volatile. Her blood glucose levels must be checked and managed constantly; if they get too low, she could die within minutes. Grace’s parents have devoted their lives to keeping their daughter healthy. Their kitchen has been transformed into an arsenal of diabetes-regulating equipment and food. Because she often can’t feel the fluctuations in her blood sugar levels, they got her a diabetes service dog, Jackie, who can sense when Grace’s glucose levels may be getting too low, and urge her to go check and correct them.

Grace’s main hope is for an artificial pancreas, which would mimic the biological function of the organ by regulating insulin and other hormone delivery and helping maintain healthy blood glucose levels. Research for this technology is ongoing in the United States, but a 4-year-old in Australia has received the world’s first artificial pancreas last week; Grace has a fund-raising campaign of her own. Once the artificial pancreas is perfected and approved for use by the FDA, Jackie the dog can focus on being a dog, and Patricia and her husband can sleep. More important, Grace will have the best shot possible at the pursuit of a stable, independent, and almost normal life.

June 9, 2011

Victoza for Type 2, Helps Type 1 As Well

Who would have thought of this? People with Type 1 diabetes taking a medication developed for people with Type 2 diabetes. Apparently it works! While this is a very small study, only 14 adults, the results are surprising. We have had Type 1 people take Metformin and this is well documented (but still off-label use).

The people included in the study had well controlled Type 1, but found that they had even better control with Victoza and lost an average of 10 pounds in six months. They also required less insulin. Those that continued this treatment for a full year continued to see improvement and felt much better overall. This is according to the study leader Paresh Dandona, MD, of the State University of New York. Buffalo.

This was reported at the annual meeting of the Endocrine Society in Boston. Of the 14 adults, all used the insulin pump for their insulin and received Victoza for either one week or 24 weeks. Continuous glucose monitoring showed tight control with insulin, yet all had highs and lows at unusual times.

When Victoza was added to the insulin regimen, the highs and lows were eliminated and after one week the average fasting and blood sugar levels each dropped by approximately 15 percent. Then the added benefits for preprandial insulin decrease of 30 percent and long acting insulin decrease of 32 percent make for further success.

The groups in the 24-week treatment had further decreases in insulin doses and lost an average of 10 pounds. HbA1c levels dropped from 6.5 percent to 6.1 percent. According to Dandona, the patients that have now been treated for up to a year are continuing to have the good effects that they had at the beginning.

Neither Victoza nor Byetta is approved for use in Type 1 diabetes. Dandona says that doctors could prescribe these medications for Type 1 diabetes as “off-label” use, but should only be tried by an endocrinologist specializing in diabetes, and only with careful and frequent monitoring of the patient.

Dandona says the study was done without any drug company support, but that Novo Nordisk is paying for a larger clinical trial. Dandona has asked the National Institutes of Health to support a large-scale study if this larger study yields similar results compared to the pilot study.

Read the report here.