Category Archives: Diabetes

Tools of diabetes treatment almost always include improved diet and regular exercise.

When people ask me why I, an applied mathematician, study diabetes, I tell them that I am motivated for both scientific and human reasons.

Type 2 diabetes runs in my family. My grandfather died of complications related to the condition. My mother was diagnosed with the disease when I was 10 years old, and my Aunt Zacharoula suffered from it. I myself am pre-diabetic.

As a teen, I remember being struck by the fact that my mother and her sister received different treatments from their respective doctors. My mother never took insulin, a hormone that regulates blood sugar levels; instead, she ate a limited diet and took other oral drugs. Aunt Zacharoula, on the other hand, took several injections of insulin each day.

Though they had the same heritage, the same parental DNA and the same disease, their medical trajectories diverged. My mother died in 2009 at the age of 75 and my aunt died the same year at the age of 78, but over the course of her life dealt with many more serious side effects.

When they were diagnosed back in the 1970s, there were no data to show which medicine was most effective for a specific patient population.

Today,29 million Americansare living with diabetes. And now, in an emerging era of precision medicine, things are different.

Increased access to troves of genomic information and the rising use of electronic medical records, combined with new methods of machine learning, allow researchers to process large amounts data. This is accelerating efforts to understand genetic differences within diseases including diabetes and to develop treatments for them. The scientist in me feels a powerful desire to take part.

My students and I have developed adata-driven algorithm for personalized diabetes management that we believe has the potential to improve the health of the millions of Americans living with the illness.

It works like this: The algorithm mines patient and drug data, finds what is most relevant to a particular patient based on his or her medical history and then makes a recommendation on whether another treatment or medicine would be more effective. Human expertise provides a critical third piece of the puzzle.

After all, it is the doctors who have the education, skills and relationships with patients who make informed judgments about potential courses of treatment.

We conducted our research through a partnership with Boston Medical Center, the largest safety net hospital in New England that provides care for people of lower income and uninsured people. And we used a data set that involved the electronic medical records from 1999 to 2014 of about 11,000 patients who were anonymous to us.

These patients had three or more glucose level tests on record, a prescription for at least one blood glucose regulation drug, and no recorded diagnosis of type 1 diabetes, whichusually begins in childhood. We also had access to each patients demographic data, as well their height, weight, body mass index, and prescription drug history.

Next, we developed an algorithm to mark precisely when each line of therapy ended and the next one began, according to when the combination of drugs prescribed to the patients changed in the electronic medical record data. All told, the algorithm considered 13 possible drug regimens.

For each patient, the algorithm processed the menu of available treatment options. This included the patients current treatment, as well as the treatment of his or her 30 nearest neighbors in terms of the similarity of their demographic and medical history to predict potential effects of each drug regimen. The algorithm assumed the patient would inherit the average outcome of his or her nearest neighbors.

If the algorithm spotted substantial potential for improvement, it offered a change in treatment; if not, the algorithm suggested the patient remain on his or her existing regimen. In two-thirds of the patient sample, the algorithm did not propose a change.

The patients who did receive new treatments as a result of the algorithm sawdramatic results. When the systems suggestion was different from the standard of care, anaverage beneficial changein the hemoglobin of 0.44 percent at each doctors visit was observed, compared to historical data. This is a meaningful, medically material improvement.

Based on the success of our study, we are organizing a clinical trial with Massachusetts General Hospital. We believe our algorithm could be applicable to other diseases, including cancer, Alzheimers, and cardiovascular disease.

It is professionally satisfying and personally gratifying to work on a breakthrough project like this one. By reading a persons medical history, we are able to tailor specific treatments to specific patients and provide them with more effective therapeutic and preventive strategies. Our goal is to give everyone the greatest possible opportunity for a healthier life.

Best of all, I know my mom would be proud.

Dimitris Bertsimas, Professor of Applied Mathematics, MIT Sloan School of Management

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MIT Mathematician Develops an Algorithm to Help Treat Diabetes - Smithsonian

This is Diabetes Alert Day and Iowans are being urged to take a simple, on-line survey to determine if they might be headed down a hazardous path.

Katie Jones, program manager at the Iowa Department of Public Health, says it only takes a minute to complete the test. Jones says, This is really to see if youre at risk for a condition called prediabetes which is basically where blood glucose levels or blood sugar levels are higher than normal but not high enough yet to be considered diabetes.

The website is: DoIHavePrediabetes.org. Jones says about one in every three Iowans is prediabetic and most of them dont know it.

The test asks things like your age, because age is a big risk factor, Jones says. Simply getting older increases your risk. It also asks things like family history of diabetes, things like that. About one in 12 Iowans has diabetes and one in four has it and doesnt know it. By knowing your risk level, Jones says Iowans can make a few key lifestyle changes to stave off type 2 diabetes.

The good news is, if you do have prediabetes, you can take steps to help prevent developing type 2 diabetes and even getting rid of prediabetes, Jones says. The National Diabetes Prevention Program can help you actually curb that progression.

People with type 2 diabetes are at higher risk for heart disease, stroke and other serious complications. Prediabetes can often be reversed through modest weight loss 5 to 7 percent of body weight and making small changes to increase healthy eating and moderate physical activity.

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Have you checked yourself for diabetes? - Radio Iowa

Jeff Mitchell, Community Health Reporting Project Published 4:27 p.m. PT March 28, 2017 | Updated 6 hours ago

community health reporting project logo(Photo: Provided)

Realizing that the Salinas Valley, like much of America, is about to get hit with a tsunami of pre-diabetes and diabetes cases, a handful of local healthcare organizations joined Tuesday to fight the chronic disease that shortens lives and regularly robs people of limbs through amputation and dims or extinguishes their eyesight.

The countywide initiative is a partnership among Salinas Valley Memorial Healthcare System, Community Health Innovations, Montage Health, Monterey Independent Physicians Association and Central Coast YMCA.

The announcement was made at the Salinas Valley Medical Clinic Diabetes & Endocrine Center currently under construction at the Primecare Medical offices on Abbott Street.

The Diabetes Initiative was started in 2015 by Community Hospital, SVMH, Community Health Innovations (CHI) and the Monterey Bay Independent Physician Association to move the dial on diabetes.

The driver behind todays event is the bold effort by the partners to work together to move the dial on diabetes in Monterey County," said Dr. Anthony Chavis, chief medical officer of Montage Health, parent company of Community Hospital of the Monterey Peninsula.

The effort comes not a minute too soon. According to the UCLA Center for Health Policy Research Chronic Disease Program, diabetes and pre-diabetes in Monterey County affect:

57% of the population has diabetes and pre-diabetes

28,000, or 12% of the population, have diabetes

105,000, or 45% of the population, have pre-diabetes.

In 2015, about 13.8% of Monterey County Hispanics/Latinos reported having been diagnosed with diabetes, compared to 4.8% of Whites and 4.4% Asians (CHIS).

The partners supporting the initiative have increased the number of endocrinologists serving the community. The YMCA introduced a yearlong Pre-Diabetes Program for people considered pre-diabetes or are on the verge of becoming pre-diabetic.

This year, SVMHS is opening an expanded Diabetes & Endocrine Center in Salinas with a state-of-the-art kitchen and education room. Also this year, Montage Health is opening a new medical office building at Ryan Ranch ideally suited for diabetes care.

Construction of the expanded Salinas Valley Medical Clinic Diabetes & Endocrine Center will be completed this summer. The new Diabetes & Endocrine Center will be located on the second floor of the PrimeCare office building at 355 Abbott St.in Salinas.

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Groups gather to fight diabetes - The Salinas Californian

Crestwood Medical Center is owned by CHS.

Crestwood Medical Center is owned by CHS.

HUNTSVILLE, Ala. March 28represents Diabetes Alert Day, sponsored by the American Diabetes Association. Its a disease that affects millions of people in the United States.

In an effort to remind Americans about the seriousness and prevalence of this disease, Crestwood Medical Center is taking action against it.

Diabetes is a part of life for 30-million people in the United States.

Actually in Alabama, were a little bit higherwere actually one in seven people in Alabama has diabetes, said registered nurse and diabetes educator, Cynthia Roberts. Unfortunately, about one in four people are walking around un-diagnosed.

Roberts saidthere are a few questions you need to ask yourself regarding diabetes.

Do you have a family member that has diabetes? Are you overweight? If youre over the age of 45 that puts you at risk.

Roberts said there are steps you can take to delay the onset of diabetes or prevent it all together.

Being more physically active, said Roberts. The recommendation is 150 minutes of intentional physical activity per week. Thats just like 30 minutes of walking, 5 times a week.

The second thing to keep in mind is your diet. Roberts said dont cut one food group out all together, instead try to make your meals more balanced.

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Crestwood Medical Center stresses the prevalence of diabetes in Alabama - whnt.com

SCRANTON, LACKAWANNA COUNTY (WBRE/WYOU) Today, Tuesday, March 28, 2017, is American Diabetes Association Alert Day. The goal is to bring awareness about a disease that affects tens of millions of Americans.

While 29 million Americans are dealing with diabetes, another 86 million have prediabetes yet only a fraction are aware of it. A doctor and a diabetic patient spoke about a part of the body that's often the first to signal you may be at risk of having the disease.

42-year-old DavidWanchisen visited his foot doctor Tuesday morning. The Scranton man didn't expect he'd end up here but it's the result of a diagnosis last year that took him by surprise. "I'm dealing with a diabetic ulcer that it's curing but it takes a lot of time and a little bit of pain."

He's wearing an orthowedge shoe to reduce pressure on that diabetic ulcer. Before he had the wound, the first physical sign he had Type 2 diabetes surfaced after a summer day at the beach. "Neuropathy on my feet caused the burning." That burning pain, weakness and numbness were a result of his diabetic condition. "I might have had it for quite some time."

Commonwealth Health Podiatrist Laura Virtue-Delayo, DPM said, "Oftentimes it's that they're getting tingling in their toes or burning." She added that many patients first learn of their diabetes by having a sore on their foot that's not getting better. "When you have a wound, the longer it's open the better chance of getting an infection in the soft tissue, in the bone, which can lead to amputation of the toes, the forefoot or even the lower leg."

Dave's treatment includes having the doctor debride, or scrape, his wound once a week while he has to apply a specialized ointment to that area every day. He's also eating healthier and lost 50 pounds in less than a year. "You have to make a lifestyle change to somewhat cure it or you know improve your lifestyle." Dr. Virtue-Delayo added, "He definitely is working on keeping his sugars in tact so they don't have to be a problem. You can be a diabetic without having foot problems or other problems that go along with diabetes."

Dr. Virtue-Delayo says a diabetic who notices a foot wound, even a blister, should call the doctor as soon as possible. She says delaying treatment even a few days could lead to amputation.

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Signs of Diabetes: Look to the Feet - PA home page

Testing for diabetes started a long, long time ago. The word diabetes comes from ancient Greek and literally means pass through," intended to mean excessive passing of urine.

This characteristic of too much urine was first described 3500 years ago on an Egyptian papyrus. About 1900 years ago, Roman physician Galen called it diarrhea of the urine. The reason for so much passing of urine with diabetes mellitus is because high levels of sugar in the blood overwhelm the kidneys' ability to keep sugar out of the urine. Like a dam on a river, sugar spills over the dam into the urine when sugar gets too high in the blood. Then, with concentrated sugar in the urine, fluid is pulled out of blood into the urine, resulting in dehydration of the diabetic. Indeed, the name diarrhea of the urine seems appropriate.

About 2500 years ago, someone noted flies were attracted to the urine of diabetics. Tasting urine for sweetness may seem disgusting today, but it was how they diagnosed diabetes all the way through the Middle Ages. It was English physician John Rolle who in the 1700's added mellitus to the term diabetes to reflect the age-old understanding of the sweet taste of the urine in diabetic patients. The word mellitus comes from Latin meaning sweetened with honey.

Starting in the 1950's, patients roughly estimated the level of sugar in their blood by testing their urine with a chemical test they could do at home. By determining how much sugar spilled into the urine, people with diabetes mellitus were better able to adjust their insulin dose. Home URINE glucose testing was an improvement for patients with diabetes, but home BLOOD glucose testing, developed in the '80's, took it to the next level. Patients could finally know when sugars were too low, not just too high.

Another great improvement in monitoring the blood sugar of diabetics was the development of the Hemoglobin A1c (HbA1c) BLOOD test. The hemoglobin molecule within red blood cells becomes more sugarized (the scientific word is glycosylated) when it has extended exposure to higher levels of sugar. Since red cells normally live for about three-months, we can monitor the percentage of Hemoglobin affected by sugar, watching it change slowly according to diabetic control. The HbA1c levels give a three-month average BLOOD sugar, which gives you and your care provider a good measure about how well you are controlling your diabetes over time.

It's a good thing managing diabetes no longer requires tasting urine.

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Diabetes mellitus testing has changed over the years - Rapid City Journal

Type 2 diabetes has been reversed in mice with a new, orally available drug, according to a study led by San Diego scientists. The study suggests a path for developing human therapies based on the drug.

The drug protected mice from high-fat induced diabetes without affecting body weight, according to the study. It also reversed signs of the disease in mice who already had it.

Type 2 diabetes is caused by insulin resistance. While the pancreatic islets still make insulin, the hormone doesnt work as well. Cells sense insulin through receptors, which become less effective in this type of diabetes.

Scientists led by Nunzio Bottini of the La Jolla Institute for Allergy & Immunology countered insulin resistance by designing a drug that restored the effectiveness of insulin receptors.

The drug inhibits an enzyme called a low-molecular-weight protein tyrosine phosphatase, or LMPTP. Its part of a family of enzymes that inactivates the insulin receptor. By inhibiting this particular enzyme in the liver, insulin receptor effectiveness was restored.

Our findings suggest that LMPTP activity plays a key role in the development of insulin resistance and that LMPTP inhibitors would be beneficial for treating type 2 diabetes, the study stated.

While the role of protein tyrosine phosphatases in Type 2 diabetes has been known for years, many enzymes in this family perform other functions,and drugs against these enzymes may also affect other targets. The drug arising from the research is exceptionally selective in its activity, the researchers said, reducing the chance of side effects.

The study was published Monday in Nature Chemical Biology. It can be found at j.mp/diabetestyr. Bottini was senior author. Stephanie M. Stanford, also of the La Jolla institute, was first author. Other local authors are from UC San Diego and Sanford Burnham Prebys Medical Discovery Institute.

We envision that the information we collected about its mechanism of action and binding mode will pave the way for development of LMPTP inhibitors suitable for therapeutic testing in human diabetes, the study stated.

Since LMPTP has also been proposed to promote heart failure and tumor growth, such inhibitors are predicted to have a wide range of therapeutic applications.

Stroke, Alzheimers disease, cognitive decline and polycystic ovary syndrome are among the other diseases that have been linked to insulin resistance.

A researcher not involved in the study told New Scientist that the research is promising.

The elegant studies here provide proof of concept that targeting LMPTP in the liver improves glucose control and liver insulin signalling in animals, Daniel Drucker, a senior investigator at the Lunenfeld-Tanenbaum Research Institute in Toronto, Canada, said in the New Scientist article.

Researchers started their search by screening 364,168 small-molecule compounds from the National Institutes of Health Molecular Libraries Small Molecule Repository. They found three hits, or molecules active against the target. One was selected for further study because of its potency and specificity.

Using medicinal chemistry, the researchers tweaked the molecule to make it more potent. One of the resulting compounds was then tested in live mice.

The La Jolla Institute for Allergy and Immunology and Sanford Burnham Medical Discovery Institute hold a pending patent on the discovery.

The researchers were funded by grants from the National Institutes of Health and the American Diabetes Association.

bradley.fikes@sduniontribune.com

(619) 293-1020

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Type 2 diabetes reversed with new drug in mouse study - The San Diego Union-Tribune

Special to The Times

Diabetes affects nearly 30 million people in the United States a stunning 10 percent of the overall population. And recent research reveals that diabetes is now the third leading cause of death, not the seventh, as was previously thought. Perhaps the most concerning statistic is that one in four persons living with diabetes is unaware that they have the disease.

The American Diabetes Association sponsors Diabetes Alert Day to serve as an annual wake-up call. The organization wants to remind Americans about the seriousness and prevalence of diabetes, particularly when the disease is left undiagnosed or untreated. This year, Diabetes Alert Day is Tuesday.

Researchers estimate that, if current trends continue, one in three Americans will have diabetes by the year 2050. Left untreated, diabetes can lead to kidney failure, limb amputations, blindness and even death. Early diagnosis and treatment is critical to preventing irreversible damage to your health and longevity, so awareness and access to care are the key areas of focus.

Here are the top five ways to keep blood sugar at healthy levels, and to keep Type 2 diabetes from impacting you and your loved ones:

1. Get more physical activity. You dont have to run marathons for physical activity to add years to your life. Just 30 minutes of intentional activity, at least five times per week, can make a huge difference for insulin resistance. A mix of aerobic, heart-pumping activity with some resistance training is the best plan.

2. Get plenty of fiber. Fiber has many benefits, including improving blood sugar management. Sources of fiber include fruits, vegetables, beans, whole grains and nuts.

3. Choose whole grains. Make sure at least half of your grain intake is whole grains. Whole grains are prepared as close to the source from the Earth as possible. Look for labels that say whole grains, and opt for organic when possible.

4. Lose a little weight. Losing even 5 or 10 pounds appears to have an impact on reducing blood sugar levels and insulin resistance. Dont focus on huge goals celebrate the small wins!

5. Skip the fad diets. Yo-yo dieting and fad diets are hard on the heart, the mind, and your organs. Just make good, whole food choices 80% of the time, and your body will work the way it was designed.

If you have a family history of diabetes, you are at increased risk for developing Type 2 diabetes yourself. Also, the condition is more common in African-Americans, Hispanics, Native Americans, Asians and Pacific Islanders. Above-average body weight increases diabetes risk for people of all backgrounds.

Only your doctor can tell for sure if you are diabetic or pre-diabetic. As part of your annual health physical, be sure to talk to your doctor about the results of your fasting blood sugar and A1C tests. If your numbers are heading in the wrong direction, you can act quickly to get back on the right track.

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Five ways to ward off Type 2 Diabetes - Gadsden Times

Scientists discover new class of anti-diabetes compounds that reduce liver glucose production Science Daily Suppressing this overproduction makes PGC-1 a target ripe for exploitation in anti-diabetes treatments. "After the screening process found several potential candidates, the TSRI team designed derivatives of those initial hits," Griffin said. "We ... and more »

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Scientists discover new class of anti-diabetes compounds that reduce liver glucose production - Science Daily

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Normally, our bodies break down the food we eat into sugars, or glucose, which is a necessary nutrient for our cells. When you have diabetes, the glucose doesnt move into your cells as quickly, causing a backup of sugar in the blood, commonly known as high blood sugar. To manage your blood sugar levels, its important to understand which foods will raise your levels and to spread them out throughout the day to avoid a spike.

Taking steps to treat or manage diabetes doesnt mean living in deprivation; it just means eating a balanced diet. The biggest difference in a diabetics eating plan and a healthy diet for non-diabetics is that you need to pay more attention to some of your food choicesmost notably the carbohydrates you eat such as starches, fruits and milk products. The body needs carbohydrates as an energy source, but they turn completely into glucose and can spike your blood sugar if they arent spread out. Vegetables, meat and fat have less of an impact on your blood sugar levels and should be part of your daily intake.

Food labels are an extremely important tool when managing diabetes. The very first thing you should look at is the serving size, as serving sizes vary greatly among different foods. The serving size serves as your reference point when reviewing the rest of the nutritional information on the label. For carbohydrates, it helps to consider a serving size as about fifteen grams, and decide from there how well the food will fit in your nutritional plan. The team of registered dieticians and diabetes educators at the Cone Health Nutrition and Diabetes Management Center is dedicated to educating diabetic patients throughout the community how to manage their disease through proper diet and exercise.

Spokesperson Background:

Beverly Paddock is a registered dietitian and certified diabetes educator at Cone Health Nutrition and Diabetes Management Center. Paddock received a Bachelor of Science from the University of Georgia in 1979. She became a registered dietician through a work-study program in Florida in 1982 and became a certified diabetes educator in 1983.

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Diabetes: Nutrition | myfox8.com - myfox8.com