Category Archives: Diabetes

Type 2 diabetes means a persons pancreas doesnt produce enough insulin to control rising blood sugar levels. Over time, rising blood sugar levels can raise a persons risk of developing heart disease and stroke. Luckily, as the condition is strongly tied to poor lifestyle choices, making healthy tweaks can help to bring blood sugar levels under control. Evidence suggests a certain ingredient may do the trick.

One study found that that consuming garlic could help reduce levels of blood sugar in people suffering from type 2 diabetes, as well as offering other benefits in the treatment of the metabolic condition.

Although the research recommended using garlic for reducing blood sugar levels only under the guidance of a persons doctor, it could provide a range of benefits for diabetics in conjunction with their usual treatments of insulin and diet.

It is know that garlic contains more than 400 chemical components, many of which can help prevent and treat a diverse range of health problems, but it is compounds including allicin, allyl propyl disulfide and S-allyl cysteine sulfoxide that raise insulin levels in the blood through the prevention of the liver's inactivation of insulin, so that more insulin is available in the body.

The scientists found that moderate amounts of garlic supplements could offer benefits to diabetes patients, and that raw or cooked garlic or aged garlic extract can help to regulate blood glucose and potentially stop or lower the effects of some diabetes complications, as well as fighting infections, reducing bad cholesterol and aiding blood flow.

However, it is advised that the consumption of garlic could cause side effects for some people, or for those taking it in extreme amounts, noted the study researchers.

Mounting evidence suggests people with type 2 diabetes should generally stick to a low-carb diet.

Diabetes.co.uk recommended following a keto diet.

A keto diet is a very low-carb diet, considered to be when people eat a level of carbohydrate of around 30g of carbohydrates per day or below.

This encourages the body to get its energy from burning body fat which produces an energy source known as ketones, explained the health site.

On a keto diet, blood glucose levels are kept at a low but healthy level which encourages the body to break down fat into a fuel source known as ketones, noted the health body.

It said: The process of breaking down or burning body fat is known as ketosis.

People on insulin will typically require smaller doses of insulin which leads to less risk of large dosing errors.

The diet helps burn body fat and therefore has particular advantages for those looking to lose weight, including people with prediabetes or those otherwise at risk of type 2 diabetes.

A keto diet usually consists of low carbohydrate, moderate protein and high fat.

According to Dr Oz: The fats should be healthy ones like avocado, olive oil, and nuts. The protein should be lean meat, fish, or legumes. And the carbs you consume should come mostly from vegetables.

The NHS also advises that people aim for at least 2.5 hours of exercise a week to also stave off the risks.

What are the symptoms of type 2 diabetes?

According to the NHS, symptoms of type 2 diabetes include:

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Type 2 diabetes: Eating this herb could lower blood sugar - Express

Irish medtech company Bluedrop Medical has secured 1.2 million in a seed investment round to bring the total raised by the start-up this year to 3.7 million.

The Galway-headquartered company, which was also awarded a 2.5 million European Innovation Council in June, is developing and commercialising an internet of things-enabled device for early detection of diabetic foot ulcers.

This is a medical issue which results in hundreds of thousands of amputations worldwide each year.

In Ireland alone more than 540 amputations are carried out on patients with diabetes each year as a result of foot ulcers caused by nerve damage. Bluedrop believes its device could save the Irish health service 40 million a year on treatments associated with diabetic foot ulcers.

Company founders Simon Kiersey and Chris Murphy estimate the total worldwide market for its device to be more than 3 billion.

The temperature-monitoring device allows for high-risk patients to be easily tested on a daily basis to see if they are showing signs of a developing ulcer. The device performs a daily scan of a patients feet and sends the data to the cloud for analysis through advanced algorithms capable of detecting abnormalities. By detecting skin damage early, thousands of potential amputations could be avoided.

The company secured the new seed investment in a round led by the angel investor network HBAN, a joint initiative of Intertrade Ireland and Enterprise Ireland.

HBANs MedTech Syndicate has invested 340,000 in total with one of its investors, Dr Colin Henehan, also joining Bluedrops board. Other participants in the seed round include Enterprise Ireland and the Western Development Commission.

The newly-secured funds are to be used to enable Bluedrop to further develop its device, carry out clinical trials and bring its product to market in Europe and the United States. The start-up also intends to boost headcount to 10 people.

When we started doing our due diligence on Bluedrop Medical, we were very impressed by the focus and drive of the team and the size of the market that they will be tapping into. Chris and Simon have developed a class-leading device for early ulcer detection, resolving a huge unmet clinical need, said Dr Henehan, who has more than 20 years experience in the pharmaceutical and medtech industries.

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Bluedrop Medical raises 1.2m in seed fund for diabetes device - The Irish Times

DUBLIN--(BUSINESS WIRE)--The "Europe Diabetes Care Devices Market to 2027 - Regional Analysis and Forecasts by Product; End User; and Country" report has been added to ResearchAndMarkets.com's offering.

The Europe diabetes care devices market is expected to reach US$ 11,184.6 Mn in 2027 from US$ 6,853.3 Mn in 2018. The market is estimated to grow with a CAGR of 5.7% from 2019-2027.

The growth of the diabetes care devices market is primarily attributed to the rising incidence of diabetes and rising adoption of insulin injection pens over traditional syringes & vials. However, availability of alternatives for drug delivery and reuse of pen needles are likely to pose a negative impact on the market growth. On the other hand, increasing launch of GLP-1 analogues is likely to have a positive impact on the growth of the Europe diabetes care devices market in the coming years.

Glucagon like Peptide-1, also known as GLP-1, is a hormone produced in the gut that is released in response to the food consumed by an individual. The peptide reduces the appetite of an individual and helps to secrete insulin in the body among obese patients. In recent years, external injection of GLP-1 has been witnessing a significant traction due to increase in the number of doctor prescription for these hormones. The rising number of novel GLP-1 analogue launches is thus expected to indirectly provide opportunities for the manufacturers to develop therapy specific pen needles with incorporation of features such as bore size, length and material that is not reactive with the biologic.

In 2018, the glucose monitoring devices segment held a largest market share of 53.9% of the diabetes care devices market, by product. The glucose monitoring devices is expected to dominate its market share in 2027 owing to the rise in the prevalence of the diabetes and presence of the several market players that offers technically advanced products. The testing strips segment among the glucose monitoring devices is anticipated to witness the fastest growth rate of 6.6% during the forecast period, 2019 to 2027 owing to the enormous usages in the glucose monitoring devices.

In 2018, the homecare held a largest market share of 59.8% of the diabetes care devices market, by end user. This segment is also expected to dominate the market in 2027 owing to the rise in the demand for the glucose monitoring devices and insulin delivery devices. Increasing diabetic population, the ease of use, availability, and accessibility of insulin delivery devices has also increased the adoption of self-administration among patients is anticipated to grow at a steady rate during the forecast period. Also the homecare segment is also expected to grow at the fastest growth rate of 5.9% during the forecast period, 2019 to 2027.

Key Topics Covered:

Part 1. Introduction

Part 2. Europe Diabetes Care Devices Market - Key Takeaways

Part 3. Europe Diabetes Care Devices Market - Market Landscape

3.1 Overview

3.2 Market segmentation

3.3 PEST Analysis

Part 4. Europe Diabetes Care Devices Market - Key Market Dynamics

4.1 Key Market Drivers

4.1.1 Rising Incidence of Diabetes

4.1.2 Rising Adoption of Insulin Injection Pens Over Traditional Syringes and Vials

4.2 Key Market Restraints

4.2.1 Availability of Alternatives for Drug Delivery

4.2.2 Reuse of Pen Needles

4.3 Key Market Opportunities

4.3.1 Increasing Launch of GLP-1 Analogues

4.4 Future Trends

4.4.1 Rapid Adoption of Safety Pen Needles Over Standard Pen Needles

4.5 Impact analysis

Part 5. Diabetes Care Devices Market - Europe Analysis

5.1 Market Revenue Forecasts and Analysis

5.2 Market positioning

5.3 Performance of Key Players

5.3.1 Medtronic

5.3.2 F. Hoffmann-La Roche Ltd.

Part 6. Europe Diabetes Care Devices Market Analysis - By Product

6.1 Overview

6.2 Europe diabetes care devices Market by Product, 2018 & 2027 (%)

6.3 Revenue And Forecasts to 2027, By Product (US$ Mn)

6.3.1 Europe Glucose Monitoring Devices Market Revenue And Forecasts to 2027, By Type (US$ Mn)

6.3.2 Europe Insulin Delivery Devices Market Revenue And Forecasts to 2027, By Type (US$ Mn)

6.4 Glucose Monitoring Devices Market

6.4.1 Overview

6.4.2 Europe Glucose Monitoring Devices Market Revenue and Forecast to 2027 (US$ Mn)

6.4.3 Glucometers Market

6.4.4 Lancets Market

6.4.5 Testing Strips Market

6.4.6 Other Glucose Monitoring Devices Market

6.5 Insulin Delivery Devices Market

6.5.1 Overview

6.5.2 Europe Insulin Delivery Devices Market Revenue and Forecast to 2027 (US$ Mn)

6.5.3 Insulin Pens Market

6.5.4 Insulin Syringes Market

6.5.5 Insulin Pumps Market

6.5.6 Other Insulin Delivery Devices Market

Part 7. Europe Diabetes Care Devices Market Analysis - By End User

7.1 Overview

7.2 End User, 2018 & 2027 (%)

7.3 Market Revenue And Forecasts to 2027, By End User (US$ Mn)

7.4 Homecare Market

7.5 hospitals & Clinics Market

Part 8. Europe Diabetes Care Devices Market Revenue And Forecasts To 2027

Part 9. Diabetes Care Devices Market - Industry Landscape

9.1 Overview

9.2 Comparative Company Analysis

9.3 Growth Strategies done by the companies in the Market, (%)

9.4 Organic Developments

9.5 Inorganic developments

Part 10. Diabetes Care Devices Market-Key Company Profiles

For more information about this report visit https://www.researchandmarkets.com/r/oaego3

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European $11.18 Bn Diabetes Care Devices Market to 2027 - ResearchAndMarkets.com - Business Wire

THE number of under-40s with diabetes has rocketed by a third in 20 years as a result of the obesity crisis.

Younger adults now make up 12.5 per cent of cases compared to 9.5 per cent in 2000, a study shows.

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Experts warn those in the age group are more likely to be fat, have poor blood-sugar control and high bad cholesterol.

Researchers also found new diagnoses of Type 2 diabetes in those aged 41 to 50 went up from 14 per cent to 17.5 across the two decades.

The findings by Australian scientists looking at 340,000 new NHS cases were presented at an annual meeting of the European Association for the Study of Diabetes in Barcelona.

Professor Sanjoy Ketan Paul, from Melbourne University, said inactivity, poor diet and obesity are fuelling the rise in young adults with the condition.

He added: People are increasingly stuck in front of TVs and phones, and eating junk food. This lazy lifestyle causes obesity and inactivity, which raises Type 2 diabetes risk.

We need to pick up cases earlier and treat them more intensively.

There are 3.7million Brits with diabetes double the number from two decades ago.

Experts estimate a million more are unaware they have the disease, taking the true total closer to 5 million.

Last month, The Sun teamed up with The Low Carb Program to publish a revolutionary eating plan aimed at combating type 2 diabetes.

Doc's top tips on preventing type 2 diabetes

A few simple lifestyle changes could prevent you from developing type 2 diabetes.

GP Dr Dawn Richards, from VitalityHealth, says: "Living a healthier and more active lifestyle can delay or event prevent the onset of Type 2 diabetes."

She offered her five top tips to help mitigate the risk of developing the condition...

1. Get active

Working your muscles more often and making them work harder improves their ability to use insulin and absorb glucose.

Your goal should be to introduce 30 minutes of physical activity that makes you sweat and breathe a little harder most days of the week.

2. Eat well

Following a Mediterranean or other heart-healthy diet can help reduce your risk of developing diabetes.

The type of carbohydrates you eat as well as serving size is key.

Focus on whole grain carbs instead of starchy carbs since theyre high in fibre and digested slowly, keeping blood sugar levels more even.

3. Control your blood pressure

Most people can do this with regular exercise, a balanced diet and by keeping a healthy weight.

In some cases, you might need medication prescribed by your doctor.

4. Cut down on alcohol

Too much alcohol can lead to weight gain and may increase your blood pressure.

Try to keep to a maximum of 14 units a week.

But spread it out to avoid binge drinking, and go several days a week without alcohol.

5. Stop smoking

If you smoke, your chance of getting diabetes and other serious health conditions is even higher.

Contact your GP if you experience the following:

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Dr Faye Riley, from Diabetes UK, said: Type 2 diabetes is serious, and this research stresses the particularly dangerous nature of the condition in those diagnosed at a younger age.

So with numbers risingwe have to stop this upward trend and the potentially devastating consequences.

A spokesperson for the NHS said: Families and other parts of society must step up as part of what needs to be a concerted effort to tackle the growing obesity epidemic.

What is type 2 diabetes?

Type 2 diabetes is the more common form of the disease - accounting for between 85 and 95 per cent of all cases, according to Diabetes UK.

It develops when the insulin-producing cells in the body are unable to produce enough insulin.

It can also be triggered when the insulin that is produced doesn't work properly.

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Number of young people with diabetes rockets by THIRD due to obesity crisis - The Sun

The unnecessary cost of diabetes has been revealed by a new study which found 10 per cent of the NHS hospital budget is being spent on avoidable treatment.

Approximately 3 billion a year may be going towards care that may have been avoided if patients and doctors had managed symptoms better, the analysis found.

It suggests that nearly four in ten diabetics are unable to keep on top of their blood-glucose levels, prompting emergency visits to hospital, as well as long and costly complications when being treated for other conditions.

On average, people with Type 2 diabetes - which is linked to obesity - need care costing over twice as much - 1,291 per person per year - as people without diabetes - 510 - an the 2017/18. Meanwhile with Type 1 diabetes, which usually develops in childhood, require six times more hospital treatment, at 3,035 per person per year.

The findings are being presented at the European Association for the Study of Diabetes (EASD) annual meeting in Barcelona.

Researchers analysed data on planned care as well as A&E visits, emergency hospital admissions and outpatient visits for 58 million people including 2.9 million with Type 2 diabetes and 243,000 with Type 1.

Overall, the NHS in England spent around 5.5 billion on hospital care for people with diabetes, of which an estimated 3 billion could potentially have been avoided, the team said.

They say this represents almost 10 per cent of the NHS hospital budget.

Read more from the original source:
NHS spends 3 billion in 'avoidable' treatments for diabetes each year - The Telegraph

Diabetes mellitus (DM) is the body's inability to regulate the level of glucose in the blood. Glucose is the main form of sugar in the body. The body breaks down food into glucose and uses it as a source of energy. In healthy people insulin helps to regulate the glucose (sugar) levels. Insulin is a hormone produced by the pancreas (a long, thin organ located behind the stomach against the back).

In diabetics, the body does not produce enough insulin or does not use the produced insulin effectively. This results in a high level of glucose in the blood ("hyperglycaemia").

There are three main types of diabetes mellitus:

a) Type 1, earlier known as insulin dependent diabetes mellitus (IDDM) or juvenile-onset diabetes mellitus. People with this type of diabetes make little or no insulin in their body, and need regular insulin injections for survival and management of diabetes. It usually starts in childhood, but can occur at any age. This ususally happen before age of 40.

b) Type 2 (DM2), earlier known as non-insulin dependent diabetes mellitus (NIDDM) or adult-onset diabetes. This is the most common form of diabetes, and is strongly associated with genetic tendency and obesity. The body produces normal or even high levels of insulin, but certain factors make its utilization ineffective ("insulin resistance"). Sedentary lifestyle, unhealthy dietary patterns, and the consequent obesity are common causes. It usually starts in adulthood, but is beginning to be seen in obese adolescents also.

c) Gestational diabetes mellitus, or pregnancy-induced diabetes.

Gestational diabetes is raised blood glucose levels during pregnancy. It develops in 5 % of all pregnancies but usually disappears when a pregnancy is over. Women who have had gestational diabetes are at increased risk (up to 40%) for later developing type 2 diabetes

Symptoms depend on the type and duration of diabetes. Some of the signs and symptoms are related to the high blood sugar levels.

These include: Increased urination, Increased thirst, Hunger

Other common symptoms:

There may be weight loss, especially if the amount of insulin made by the body is decreasing. If insulin deficiency is marked, the person can become drowsy and then go into coma. This is called Ketoacidosis, and usually occurs in DM1. Rarely, if the diabetes is completely out of control, it can also occur in DM2. Other symptoms of ketoacidosis include: Deep rapid breathing, sometimes with a fruity odour to the breath Pain in the stomach, with nausea and vomiting.

Diabetes mellitus is diagnosed based on a high level of glucose or sugar in the blood. The doctor may suspect diabetes mellitus after taking the medical history and doing a physical examination. There are several blood sugar tests used for diagnosis:

Fasting plasma glucose test: In this test, a person is asked to fast overnight, at least 8 hours, and the level of glucose in the blood is then checked. Normal fasting plasma glucose levels are less than 110 mg/dl. A fasting plasma glucose level of more than 126 mg/dl usually indicates diabetes mellitus. A level of 110-125 mg/dl is called "impaired fasting glucose".

Post prandial (PP) plasma glucose: This is tested two hours after having a meal, which serves as a challenge for the body to regulate the blood sugar. Normal PP levels are <140 mg/dl; a glucose level of more than 200 mg/dl indicates diabetes mellitus, while a level between 140-199 mg/ dl is called "impaired glucose tolerance".

Random plasma glucose test: is that which is done at any other time. A level of 200 mg/dl or higher generally indicates the presence of diabetes.

Oral glucose challenge test (oGTT): The blood glucose is tested 2 hours after giving 75 gm glucose by mouth. This is useful for detecting borderline diabetes and a condition called "impaired glucose tolerance".

Oral glucose tolerance test: is the preferred way to diagnose pregnancy-induced diabetes. Ideally all pregnant women in India should have a blood glucose test done 30 minutes after taking 50 gm gluocse (screening test). If this is abnormal, the lady should undergo an oGTT: with 100 gm glucose (not the conventional 75 gm). Blood samples are then drawn at intervals of one hour upto 3 hours (ie at 1, 2 and 3 hours post-glucose).

Although diabetes cannot be cured, it can be controlled very successfully. The main aim of treatment of all types of diabetes is to achieve blood glucose control, blood pressure and cholesterol levels as near to normal as possible. This, together with a healthy lifestyle, will help to improve wellbeing and protect against long-term complications.

Stay Active

Being active is good for all of us but is especially important for people with diabetes. Physical activity, combined with healthy eating and medication that you may taking will help you to manage your diabetes and prevent long term complications. If you have concerns at all about becoming active, never be afraid to ask for advice.

What are the Medication

People with diabetes often need additional treatment along with making lifestyle changes such as medication to control their Blood Pressure and blood fats. Treatment is decided by your specialist. But you should be aware of timings, dosage and its function in the body.

In diabetes stopping the treatment by your own can create lots of problems.

Hypoglycemia is the common problem which can happen in pt who is being treated with oral medications or Insulin

Hypoglycemia (low blood sugar) can be life threatening condition and its very important to act early.

Low blood sugar: a level below about 60 milligrams per deciliter (mg/dl) occurs when there's too much insulin and not enough sugar (glucose) in your blood. Low blood sugar is most common among people taking insulin, but it can also occur if you're taking oral diabetes medications.

When your blood sugar is low you may feel:

Shaky or nervous, Tired, Sweaty, Hungry, Irritable, Impatient, Cold, Confused

You may also feel tingling around your mouth.

Reasons for blood sugar swings

Although it is frustrating, blood sugar levels can also be too high for no clear reason.

Sometimes these high levels may be the first sign of an infection, illness or stress.

Because blood sugar levels can go very high when you are ill, talk with your health care team about creating a sick day plan to manage your diabetes when you have a cold, flu or other illness.

Pre Diabetes

Pre diabetes is when one has higher than normal glucose level but not high enough to be diagnosed with diabetes. Pre-diabetes is present when hba1c is over 6% -6.4%.

A person with pre-diabetes can be prevented to develop Diabetes by:

1. Improving diet

2. Increasing physical activity at least 30 minutes for 5 days in a week.

3. By reducing body weight, high blood glucose levels can return to normal which reduces the likelihood of developing T2D.

Benefits of weight loss

Benefits of an active lifestyle

Maintaining a healthy weight and eating a healthy balanced diet, low in fat and rich in fiber and fruits and vegetables, as well as being physically active is an important part of managing blood sugar levels and avoiding other health complications.

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Diabetes: Symptoms, Treatments, Causes, Tests & Preventions

March 19, 2018 | More Articles: Symptoms

Type 2 diabetes is one of the major degenerative diseases in the Western world today. It happens when your body cant use insulin properly, or cant make enough insulin. Insulin is a hormone the assists the bodys cells in utilizing glucose. It also helps the body store extra sugar in fat, liver, and muscle cells. If you dont have insulin, your body cant use the sugar in the bloodstream.

Then, your blood sugar levels get too high. High blood sugar can have a deleterious effect on many parts of your body, including heart, blood vessels, nerves, eyes, and kidneys. Those who are overweight, dont exercise enough, or have a history of type 2 diabetes in their family are more likely to get the disease. Maintaining a healthy weight, eating a healthy diet, and getting enough exercise can prevent type 2 diabetes. If you have a history of diabetes in your family, or if you are overweight, stay ahead of the disease by making healthy lifestyle choices and changing your diet.

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Frequent urination is an early warning symptom of diabetes. When there is too much glucose in the blood, the kidneys work overtime to flush it out of the blood via urination. So, youll find yourself going to bathroom a lot more often than normal. There is also a bigger risk of urinary tractions in both men and women.

Individuals with diabetes have two times the likelihood of getting a urinary tract infection compared to individuals without the disease. If you find yourself getting up every couple of hours in the middle of the night, and you seem to be expelling a lot more urine than you used to, talk to your doctor and find out whether or not you have diabetes.

Increased urinary frequency is called polyuria, and individuals with diabetes are unable to regulate blood sugar levels. When too much sugars in the bloodstream, more fluids will pass through your kidneys.

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16 Early Signs of Diabetes - diabetics.guide

The importance of insulin

Diabetes is a disease in which your body either can't produce insulin or can't properly use the insulin it produces. Insulin is a hormone produced by your pancreas.

Insulin's role is to regulate the amount of glucose (sugar) in the blood. Blood sugar must be carefully regulated to ensure that the body functions properly. Too much blood sugar can cause damage to organs, blood vessels, and nerves. Your body also needs insulin in order to use sugar for energy.

Eleven million Canadians are living with diabetes or prediabetes. Chances are, diabetes affects you or someone you know.

There are three major types of diabetes. Type 2 diabetes is the most common diagnosis, followed by type 1 diabetes. Gestational diabetes occurs during pregnancy, and is usually temporary. In addition, prediabetes is another important diagnosis that indicates an elevated risk of developing diabetes.

Type 1 diabetes is an autoimmune disease and is also known as insulin-dependent diabetes. People with type 1 diabetes aren't able to produce their own insulin (and can't regulate their blood sugar) because their body is attacking the pancreas. Roughly 10 per cent of people living with diabetes have type 1, insulin-dependent diabetes.

Type 1 diabetes generally develops in childhood or adolescence, but can also develop in adulthood. People with type 1 need to inject insulin or use an insulin pump to ensure their bodies have the right amount of insulin.

People with type 2 diabetes can't properly use the insulin made by their bodies, or their bodies aren't able to produce enough insulin. Roughly 90 per cent of people living with diabetes have type 2 diabetes.

Type 2 diabetes is most commonly developed in adulthood, although it can also occur in childhood.Type 2 diabetes can sometimes be managed with healthy eating and regular exercise alone, but may also require medications or insulin therapy.

If you think you or someone you know may have type 2 diabetes, please speak to a doctor or health-care provider.

See the article here:
What is diabetes? - Diabetes Canada

VA research on Diabetes Introduction

Diabetes is a chronic disease in which the body cannot produce or properly use insulin. Normally, insulin brings sugar out of the bloodstream and into cells. If the body cannot make insulin or does not respond to it, the sugar stays in the bloodstream. As a result of high blood sugar levels, damage eventually occurs to blood vessels and organs.

More than 29 million Americans have diabetes, according to the Centers for Disease Control and Prevention, and 86 million more Americans are at risk to develop the disease. Many Veterans have the disease, including some who developed it as a result of being exposed to herbicides while serving in Vietnam.

Symptoms of diabetes include blurry vision, excessive thirst, fatigue, frequent urination, hunger, and weight loss. Persons with diabetes need to have their hemoglobin A1C levels checked every three to six months.

A1c is a measure of average blood glucose during the previous two to three months. It is one of the markers, along with blood pressure and cholesterol control, of good diabetes care.

There are three major types of diabetes. Type 1 diabetes is usually diagnosed in childhood. In this type of diabetes the body makes little or no insulin, so daily injections of insulin are needed.

Type 2 diabetes usually occurs in adults. In this type of diabetes, the pancreas does not make enough insulin to keep blood glucose levels normal, often because the body does not respond well to insulin. More than 90 percent of adults with diabetes have type 2 diabetes. More are at risk due to overweight or obesity.

The third type of diabetes is gestational diabetes, high blood glucose that develops during pregnancy in a woman who does not have diabetes.

Diabetes affects nearly 25 percent of VA's patient population. The disease is also the leading cause of blindness, end-stage renal disease, and amputation for VA patients.

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VA researchers are studying innovative strategies and technologies, including group visits, telemedicine, peer counseling, and Internet-based education and case management, to enhance access to diabetes care and to improve outcomes for patients.

In addition, VA researchers are working to develop better ways to prevent or treat diabetes, especially in special populations such as the elderly, amputees, minorities, spinal cord injured patients, and those with kidney or heart disease.

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Two of VA's three Nobel laureates have done important work to benefit Veterans with diabetes. The late Dr. Rosalyn S. Yalow received the Nobel Prize for Physiology or Medicine in 1977 for her work in discovering the radioimmunoassay, an extremely sensitive way to measure insulin and other hormones in the blood. The technique made possible major advances in diabetes research and in diagnosing and treating hormonal problems related to growth, thyroid function, and fertility.

Dr. Andrew V. Schally also received the Nobel Prize in Physiology or Medicine in 1977 for his discovery that the hypothalamus links the nervous system to the endocrine system via the pituitary gland, is currently doing research, along with teams of national and international researchers, on growth hormone-releasing hormone (GHRH). Among other possibilities opened up by Schally's work with GHRH is the possibility of reducing or eliminating the need for diabetics to regularly inject insulin.

In 2013, an international research including Schally devised a way to transplant healthy cells into the body without the usual risk of rejection. The study involved a middle-aged man with diabetes, but it may be relevant to a range of other diseases as well. The researchers developed what amounts to an artificial pancreas (the place where the body makes insulin), which the patient tolerated well without taking drugs to suppress the immune system.

A 2015 study by Schally and his team evaluated newly developed GHRH agonists' ability to promote the growth and function of pancreatic islet cells, and found that these new agonists may provide an improved approach to treating diabetes. Agonists are substances that act like other substances and therefore stimulate an action in the body. Islet cells, also called Islets of Langerhans, sense blood sugar levels and release insulin to maintain normal levels.

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For seven and a half years, researchers involved in a VA cooperative study(CSP 465) looked at nearly 1,800 patients with diabetes. The researchers examined cardiovascular disease, the cause of death in nearly two-thirds of patients with diabetes.

Researchers attempted to determine whether intensive glucose control (using medication and other methods to reduce the level of sugar in the blood in diabetic patients to levels that would be normal in patients without diabetes) reduced heart attacks, strokes, and death from cardiovascular disease.

It had been previously shown that improvements in blood pressure and cholesterol levels can reduce cardiovascular disease in patients with diabetes, but no previous study had shown the beneficial effects of glucose control on cardiovascular disease.

VADT researchers showed that intensive glucose control in patients whose type 2 diabetes had previously been poorly controlled had no significant effect on the rates of major cardiovascular events such as coronary artery disease and stroke, compared to those who were using standard glucose control measures.

The research team also found that the two groups of patients had similar death rates, and that both groups had similar levels of complications such as diabetic neuropathy and retinopathy, except that patients using standard glucose control measures had higher levels of albumin in their urine. (Albumin in the urine is a possible indicator of kidney disease.)

Trial researchers concluded that both very high and very low blood sugar levels can be dangerous, and that big swings between high and low levels are also potentially harmful.

As a follow up to VADT, VA researchers looked at whether the improvements in glucose control made by one of the groups in the trial led to long-term improved consequences. They collected information on the VADT cohort for more than nine years of additional study, using VA's electronic records system.

The team found in 2015 that patients who had been in the intensive-control group had a lower incidence of cardiovascular events after the trial was over, but their survival rates were no better than those of the other group.

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Sleep apnea and poor sleep qualityA 2013 study conducted by researchers at the VA Puget Sound Health Care System that was part of the joint VA-Department of Defense Millennium Cohort Study on the health of service members and Veterans, found that sleep apnea and poor sleep quality predicted diabetes, independent of other diabetes risk factors or mental health status.

Sleep apnea increased the risk of diabetes by 78 percent, and simply having trouble sleeping increased the risk of diabetes by 21 percent. The study included more than 47,000 service members and Veterans who were an average age of about 49.

Statin useResearchers at the VA North Texas Health System and their colleagues examined the health records of tens of thousands of Tricare beneficiaries for a nearly 10-year period. Their study, published in 2015, found that the use of statins to lower cholesterol is associated with a significantly higher risk of new-onset diabeteseven in a very healthy population.

They also found that statin use is associated with a very high risk of diabetes complications in this healthy population, and with a higher risk of obesity. High-intensity statin therapy was associated with greater risks for all outcomes.

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Implantation of insulin-producing cellsInsulin-producing cells that respond to glucose and correct blood-sugar levels in diabetic mice have been created by researchers at the Iowa City VA Health Care System and correct blood-sugar levels in diabetic mice.

The researchers took human skin cells and reprogrammed them to create induced pluripotent stem (IPS) cells, which were then coaxed into forming insulin-producing cells. When these cells were transplanted into diabetic mice, the cells secreted insulin and reduced the blood sugar levels of the mice to normal or near normal-levels.

The study raises the possibility that patients with diabetes could be treated with their own cells, which will accelerate treatment.

GRADE trialVA researchers are participating in a five-year National Institutes of Health study to compare the long-term benefits and risks of four diabetes drugs in combination with metformin. The study, called the Glycemic Reduction Approaches in Diabetes (GRADE) trial, is expected to include some 5,000 participants nationwide.

Metformin is the first medication doctors typically use when treating type 2 diabetes. If metformin does not control the disease, doctors may add one of several other drugs, all of which have been shown to lower blood sugar levels in studies. However, no previous long-term study has focused on which drug combination works best and has the least side effects.

The four drugs being studied are sulfonylurea, dipeptidyl peptidase-4 inhibitor, glucagon-like peptide-1 agonist, and long-acting insulin.

Drug combination causes adverse effectsIn 2013, VA researchers stopped a large multicenter study, part of the Veterans Affairs Nephropathy in Diabetes Study (NEPHRON-D), before its scheduled conclusion. They found that the combination of an angiotensin-converting enzyme (ACE) inhibitor and an angiotensin-receptor blocker (ARB) increases the risk for serious adverse effects in patients with diabetic nephropathy, the leading cause of chronic kidney disease in the United States.

The significant increase in risk caused by taking the combination of drugs overshadowed any benefits taking the drugs may have in reducing the progression of kidney disease.

Diabetic kidney diseaseIn 2015, researchers participating in the NEPHRON-D study found that in patients with proteinuric diabetic kidney disease, a mean systolic blood pressure greater than 140 and a mean diastolic blood pressure greater than 80 were associated with a higher risk of kidney failure and death.

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The Veterans Affairs Implantable Insulin Pump Study; effect on cardiovascular risk factors. Duckworth WC, Saudek CD, Giobbie-Hurder A, Henderson WG, Henry RR, Kelley DE, Edelman SV, Zieve FJ, Adler RA, Anderson RJ, Hamilton BP, Donner TW, Kirkman MS, Morgan NA. Implantable insulin pump therapy in insulin-requiring patients with type 2 diabetes has advantages over multiple-dose insulin therapy in decreasing the requirement for antihypertensive therapy and for decreasing total and free insulin and insulin antibodies. Diabetes Care, 1998 Oct;21(10):1596-602.

Glucose control and vascular complications in veterans with type 2 diabetes. Duckworth W, Abraira C, Moritz T, Reda D, Emanuele N, Reaven PD, Zieve FJ, Marks J, Davis SN, Hayward R, Warren SR, Goldman S, McCarren M, Vitek ME, Henderson WG, Huang GD, VADT investigators. Intensive glucose control in patients with poorly controlled type 2 diabetes had no significant effect on the rates of major cardiovascular events, death, or microvascular complications with the exception of progression of albuminuria. N Engl J Med. 2009 Jan 8;360(2):129-39.

Agonist of growth hormone-releasing hormone as a potential effector for survival and proliferation of pancreatic islets . Ludwig B, Ziegler CG, Schally AV, Richter C, Steffen A, Jabs N, Funk RH, Brendel MD, Block NL, Ehrhart-Bornstein M, Bornstein SR. Evidence that agonists of GHRH represent a promising pharmacological therapy aimed at promoting islet graft growth and proliferation in diabetic patients. Proc Natl Acad Sci USA, 2010 Jul 13;107(28);12623-8.

Sleep characteristics, mental health, and diabetes risk: a prospective study of U.S. military service members in the Millennium Cohort Study. Boyko EJ, Seelig AD, Jacobson IG, Hooper TI, Smith B, Smith TC, Crum-Cianflone NF; Millennium Cohort Study Team. Trouble sleeping and sleep apnea predict diabetes risk independent of mental health conditions and other diabetes risk factors. Diabetes Care. 2013 Oct;36(10):3154-61.

Combined angiotensin inhibition for the treatment of diabetic nephropathy. Fried LF, Emanuele N, Zhang JH, Brophy M, Connor TA, Duckworth W, Leehey DJ, McCullogh PA, O'Connor T, Palevsky PM, Reilly RF, Seliger SL, Warren SR, Watnick S, Peduzzi P, Guarino P; VA NEPHRON-D investigators. Combination therapy with an angiotensin-converting-enzyme (ACE) inhibitor and an angiotensin-receptor-blocker (ARB) was associated with an increased risk of adverse events among patients with diabetic nephropathy. N Engl J Med. 2013 Nov 14;369(20); 1892-903.

Human iPS cell-derived insulin producing cells form vascularized organoids under the kidney capsules of diabetic mice. A pancreatic organ can be created in vivo, providing evidence that human iPS cells might be a novel option for the treatment of type 1 diabetes. PLoS One, 2015 Jan 28;10(1):e0116582.

Enriching the diet with menhaden oil improves peripheral neuropathy in streptozotocin-induced type 1 diabetic rats. Coppey LJ, Davidson EP, Obrosov A, Yorek MA. Enriching the diet with n-3 fatty acids may be a good treatment strategy for diabetic neuropathy. J Neurophysiol. 2015 Feb 1;113(3):701-8.

Follow-up of glycemic control and cardiovascular outcomes in type 2 diabetes. Hayward RA, Reaven PD, Wiitala WL, Bahn GD, Reda DJ, Ge L, McCarren M, Duckworth WC, Emanuele NV, VADT Investigators. After nearly 10 years of follow-up, patients with type 2 diabetes who had been randomly assigned to intensive glucose control for 5.6 years had 8.6 fewer major cardiovascular events per 1000 person years than those assigned to standard therapy, but no improvement was seen in the rate of overall survival. N Engl J Med. 2015 Jun 4; 372(23):2197-206.

Dipeptidyl peptidase-4 inhibition ameliorates Western diet-induced hepatic steatosis and insulin resistance through hepatic lipid remodeling and modulation of hepatic mitochondrial function.Aroor AR, Habibi J, Ford DA, Nistala R, Lastra G, Manrique C, Dunham MM, Ford KD, Thyfault JP, Parks EJ, Sowers JR, Rector RS. Mice fed a diet that includes a DPP-4 inhibitor were found to have less insulin resistance than those not given the inhibitor. Diabetes. 2015 Jun;64(6):1988-2001.

BP and Renal Outcomes in Diabetic Kidney Disease: The Veterans Affairs Nephropathy in Diabetes Trial. Leehey DJ, Zhang JH, Emanuele NV, Whaley-Connell A, Palevsky PM, Reilly RF, Guarino P, Fried LF; VA NEPHRON-D Study Group. In patients with proteinuric diabetic kidney disease, mean systolic blood pressure greater than or equal to 140 mmHg and mean diastolic blood pressure greater than or equal to 80 mmHg were associated with worse renal outcomes. Clin J Am Soc Nephrol. 2015 Oct 19. pii: CJN.02850315. [Epub ahead of print]

Beneficial effects of growth hormone-releasing hormone agonists on rat INS-1 cells and on streptozotocin-induced NOD/SCID mice. Zhang, X, Cui T,He J, Wang H, Cai R, Popovics P, Vidaurre I, Sha W, Schmid J, Ludwig B, Block NL, Bornstein SR, Schally AV. This study provides an improved approach to the therapeutic use of GHRH agonists in the treatment of diabetes mellitus. Proc Natl Acad SCi USA, 2015 Nov 3; 112(44):13651-6.

Practical telemedicine for Veterans with persistently poor diabetes control: a randomized pilot trial. Crowley MJ, Edelman D, McAndrew AT, Kistler S, Danus S, Webb JA, Zanga J, Sanders LL, Coffman CJ, Jackson Gl, Bosworth HB. A comprehensive telemedicine intervention improved outcomes among Veterans with persistently poor diabetes control despite clinic-based care. Telemed J E Health. 2015 Nov 5. (Epub ahead of print.)

Statins and New-- Mellitus and Diabetic Complications: A Retrospective Cohort Study of US Healthy Adults. Mansi I, Frei CR, Wang CP, Mortensen EM. Diabetes, diabetic complications, and overweight/obesity were more commonly diagnosed among statin users than similar nonusers in a healthy cohort of adults. J Gen Intern Med. 2015 Nov;30(11):1599-610.

Rates of deintensification of blood pressure and glycemic medication treatment based on levels of control and life expectancy in older patients with diabetes mellitus. Sussman JB, Kerr EA, Saini SD, Holleman RG, Klamerus ML, Min LC, Vijan S, Hofer TP. Physicians are not likely to cut back on blood pressure and glycemic medication treatments in older patients with diabetes after they reach low BP or hemoglobin A1c levels. JAMA Intern Med. 2015;175(12):1942-1949.

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Diabetes - research.va.gov

Diabetes mellitus, usually called diabetes, is a disease in which your body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in your blood. A high blood sugar level can cause problems in many parts of your body.

The most common ones are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, your pancreas does not make enough insulin and you have to take insulin injections for the rest of your life.

Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. In Type 2, your pancreas makes insulin, but your body does not use it properly. The high blood sugar level often can be controlled by following a diet and/or taking medication, although some patients must take insulin. Type 2 diabetes is particularly prevalent among African Americans, American Indians, Latin Americans and Asian Americans.

With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

Diabetes also may cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.

About 30 percent of patients with Type 1 (juvenile onset) diabetes and 10 to 40 percent of those with Type 2 (adult onset) diabetes eventually will suffer from kidney failure.

The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in your doctor's office show evidence of kidney disease, so it is important for you to have this test on a yearly basis. Weight gain and ankle swelling may occur. You will use the bathroom more at night. Your blood pressure may get too high. As a person with diabetes, you should have your blood, urine and blood pressure checked at least once a year. This will lead to better control of your disease and early treatment of high blood pressure and kidney disease. Maintaining control of your diabetes can lower your risk of developing severe kidney disease.

As your kidneys fail, your blood urea nitrogen (BUN) levels will rise as well as the level of creatinine in your blood. You may also experience nausea, vomiting, a loss of appetite, weakness, increasing fatigue, itching, muscle cramps (especially in your legs) and anemia (a low blood count). You may find you need less insulin. This is because diseased kidneys cause less breakdown of insulin. If you develop any of these signs, call your doctor.

Signs of Kidney Disease in Patients with Diabetes

First, the doctor needs to find out if your diabetes has caused the injury. Other diseases can cause kidney damage. Your kidneys will work better and last longer if you:

If no other problems are found, your doctor will try to keep your kidneys working as long as possible. The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function.

The kidney doctor, called a nephrologist, will plan your treatment with you, your family and your dietitian. Two things to keep in mind for keeping your kidneys healthy are controlling high blood pressure in conjunction with an ACE inhibitor and following your renal diabetic diet. Restricting protein in your diet also might be helpful. You and your dietitian can plan your diet together. For Kidney and Diabetes friendly recipes click here to visit our Kidney Kitchen.

End stage renal failure, or kidney failure, occurs when your kidneys are no longer able to support you in a reasonably healthy state, and dialysis or transplantation is needed. This happens when your kidneys function at only 10 to 15 percent.

Three types of treatment can be used once your kidneys have failed: kidney transplantation, hemodialysis and peritoneal dialysis. To learn more about treatment options for kidney failure click here.

Yes. Once you get a new kidney, you may need a higher dose of insulin. Your appetite will improve so your new kidney will break down insulin better than your injured one. You will use steroids to keep your body from rejecting your new kidney. If your new kidney fails, dialysis treatment can be started while you wait for another kidney. To learn more about kidney transplant click here.

Sometimes it is possible to perform a pancreas transplant along with a kidney transplant. Your doctor can advise you about this possibility.

Today, more and more research dollars are spent on diabetes research. Hopefully, the prevention and cure of diabetes is in our future. In the meantime, you can manage your diabetes better with:

If you would like more information, please contact us.

2015 National Kidney Foundation. All rights reserved. This material does not constitute medical advice. It is intended for informational purposes only. Please consult a physician for specific treatment recommendations.

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Diabetes - A Major Risk Factor for Kidney Disease | National ...