Category Archives: Diabetes

Dr. Marc Weigensberg was having trouble getting his younger diabetes patients to listen to him. Hed repeat advice, but often theyd tune him out. He couldnt get them to open up.

So he decided he might have better luck making them share with someone else: each other.

About a year ago, Weigensberg began leading two-hour group visits with a dozen young adults at Los Angeles County-USC Medical Center to provide them with a place to share tips for living with diabetes and talk about their experiences and problems with the disease.

On a recent Friday, a handful of patients sat in a circle with Weigensberg in a small room at the Boyle Heights hospital, passing around a kaleidoscope only the person holding it can speak. Weigensberg, who has a soothing voice and a silver ponytail, checked in on each of them individually; he knows that injecting insulin several times a day and closely monitoring every meal can be exhausting.

Sometimes it gets to me, said Gabriel Leon, 26, who has had diabetes for two decades. At night, its like, I have to do this again?

Group visits arent new, but theyre gaining traction as health systems look for more efficient ways to treat patients. Plus, such gatherings often focus on things like diet, exercise and self-care, which increasingly are recognized as essential parts of not only preventing diseases but also living with them.

Only 10% of managing diabetes is learning how to inject insulin and check sugars. The other 90% is trying to integrate such an intrusive chronic disease into their life, said Weigensberg, a pediatric endocrinologist. And thats why its not doctors, but people with the condition who might best explain how to do that.

Were experts in diabetes, but were not experts in your diabetes, Weigensberg said at the recent appointment.

The patients signed up for Weigensbergs group visits have Type 1 diabetes, meaning their bodies stopped making insulin when they were children. They have to inject themselves with the hormone that breaks down sugar so their bodies can turn carbohydrates into energy. To do that correctly, they need to know the number of carbohydrates in everything they eat.

Geri Zwicker, a hospital nutritionist, joined the recent meeting to suggest ways to eyeball carbohydrate servings. She recommended the patients help set the table for meals and serving food themselves, so they can count and maybe even measure how much they eat. But she knows thats difficult at restaurants or parties, so its important to be able to estimate.

Fabio Lara, 21, opened a rice cooker Zwicker had brought, releasing steam and the smell of fresh rice into the room. Zwicker told him to scoop about as much as hed normally eat onto a plate. The mound of white rice, a little over a cup, has 50 grams of carbohydrates, so he can assume thats how much he normally eats for dinner, Zwicker said.

Weigensberg doesnt yet have data from the visits, but other studies have found that diabetic patients seen in group environments have lower hospitalization rates and better control over their disease.

The doctor recalled a satisfying moment during one session, when a college student said he wasnt checking his sugar levels at lunch because he didnt want to poke himself at school. Another boy then said he does it anyway because he doesnt care what strangers might think. The next time the group met, the reluctant patient had started testing his sugars.

That simple thing can make a huge difference, Weigensberg said. You dont really know what or when will trigger a new behavior; you just gotta let go of the fact that you cant do everything.

Weigensberg suggests topics to discuss each month but allows the participants to refocus the conversation based on whats bothering them.

Community itself is a healing force and by healing, I dont mean curing; I mean being more at ease with their illness, he said.

People with chronic conditions sometimes feel isolated or ashamed because their body does not work like everyone elses, said Kathleen Ulman, an assistant professor of psychiatry at Harvard Medical School. Group visits offer the comfort of a shared experience, she said.

People dont feel alone anymore, and that is really worth a lot, she said. You become connected with each other and identify with each other, and if one person makes some improvement, then youll feel like, Well I could do it, if they could do it.

The issues that tend to surface in group gatherings, like transportation to doctors appointments or the cost of medicine, arent medical issues per se, but social issues that affect patients medical problems.

But more and more, those boundaries seem to be blurring because so many chronic diseases have lifestyle issues tied to them, said Sherrie Kaplan, assistant vice chancellor for Healthcare Measurement and Evaluation in the UC Irvine School of Medicine.

And since doctors might not always be in tune with these concerns, Kaplan and her colleagues started a program at UC Irvine in which they coach patients to bring up hurdles with doctors. So-called coaches nab patients in the waiting room and talk through their treatment before they meet with their doctor.

Among the concerns: I cant afford my medications. ... My mother-in-law cooks the meals, but then she gets upset if I dont want to eat what she serves, Kaplan said.

Shes found the program dramatically reduces how often patients miss appointments and end up in the emergency room.

The national Agency for Healthcare Research and Quality, a branch of the U.S. Department of Health and Human Services, recommends group visits as a way to address patient concerns that might not be covered in a 15-minute doctors visit.

At Weigensbergs group visit, Cynthia Sanchez, 21, pulled up a photo on her smartphone of a dish her mom makes rice mixed with potatoes, corn, hard-boiled eggs, mayonnaise chicken and shrimp.

Sanchez doesnt know how much insulin to take when she eats it because she isnt sure how many carbohydrates are in it. She passed around the photo, and everyone tried to guess how much was carbs.

Weigensberg suggested she take an insulin dose she thinks might be appropriate, eat the meal and then check her blood sugar levels three hours later to see if her guess was correct.

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Doctors turn to the power of peer groups to help diabetics - Los Angeles Times

Type 2 diabetes genetic mapping identifies new 'loci' Science Daily Scientists are closer to understanding the genetic causes of type 2 diabetes by identifying 111 new chromosome locations ('loci') on the human genome that indicate susceptibility to the disease, according to a UCL-led study in collaboration with ...

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Type 2 diabetes genetic mapping identifies new 'loci' - Science Daily

John Webb, Special to The Clarion-Ledger 8:26 p.m. CT May 6, 2017

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Jacob Forester, 6, of Starkville is all smiles after Della Matheson, from the University of Miami, finishes drawing blood to check his glucose levels during a camp held Saturday at Twin Lakes in Florence sponsored by the Diabetes Foundation of Mississippi.(Photo: Kathy Matheny/The Clarion-Ledger)Buy Photo

FLORENCEWhile Caleb Warnock, 6, of Florence has many playmates at camp, his best friend may be the one he carries in his pocket and calls Dexter.

That is Caleb's nickname for his Dexcom, a continuous glucose monitor, or CGM, that transmits his blood sugar to a receiver that he carries in his pocket. The CGM can show which way his glucose is headed and can head off emergencies and help fine-tune glucose control, which can ultimately prevent complications in years to come.

When Dexter says his sugar is high, he takes more insulin, and when its low

I come to Mommy and she gives me a piece of candy, said Caleb, who has had type 1 diabetes for two and a half years and whose father, Christopher, was diagnosed at 18 months.

Caleb was among the 33 children with type I diabetes sharing stories that only others with diabetes could understand, laughing and joking about needles and counting carbs, at the Diabetes Foundation of Mississippis Camp Kandu, held Saturday and Sunday at Twin Lakes campgrounds near Florence.

According to the Mayo Clinic, type 1 diabetes, once known as juvenile diabetes or insulin-dependent diabetes, is a chronic condition in which the pancreas produces little or no insulin, a hormone needed to allow sugar (glucose) to enter cells to produce energy. Rates of type 1 are rapidly increasing, in Mississippi and around the world.

I thought my dad and I were the only ones who had diabetes, but then I came here and found out we werent, said Caleb, who helped his cousin, another type 1, overcome his fears of sticking his finger to test his blood sugar.

If you are a child living with diabetes, that may be the most powerful message of this unusual camp, which has been meeting every spring and fall for 15 years.

Diabetes drives children to help others

Diabetes and children: A balancing act

Suddenly maybe for the first time in your life you find out that youre not the only one. Not the only one having to stop what youre doing to check your blood sugar. (Always, it seems, at the most inopportune moment.) Not the only one having to struggle with what to eat. Not the only one whose life is a series of finger sticks and injections, and who must contend with the complex calculus of a disease that requires constant adjustment of insulin pump doses divided or multiplied by carbohydrates and exercise.

And not the only one trying to be a regular kid in spite of it all. At Kandu, amid the games, races and karate lessons, everyone stopped to check their blood sugar together. A few needed a little juice, and then picked up right where they were.

For some, diabetes is an exclusive club whose members intimately understand one anothers challenges. Sarah Fowler, 11, of Jackson, was diagnosed seven years ago (and is friends with the daughter of the Clarion-Ledger reporter who shares her name). She has come to Camp Kandu for six years and is in training to become a counselor.

There are not that many of us with type 1, so when you meet others you immediately know a lot of things about each other, said Sarah, amid the joyful sound of kids who, often for the first time. are meeting others like themselves. Ive made at least three lifelong friends here, because you have the same struggles and you go through them together. Sometimes you have more of a connection with them than with people without diabetes.

Hoping to remain without diabetes, however, are those being tested for antibodies that would indicate that they are at risk for developing the disease. Under the impassive eyes of the fish and deer adorning a rustic room at the lodge a toddler cries as a researcher tries to take his blood for the Type 1 Diabetes TrialNet Study, which is funded by the National Institutes of Health and is investigating interventions for the prevention or delay of type 1 diabetes.

Families of children with type 1 can learn who among them might have the antibody and how to avoid or postpone the onset of diabetes.

Fowler said she was, as a counselor in training, looking forward to being able to help more people like herself. I had someone last year come to me when their sugar was lowand showed them which foods in their backpack would bring it up to normal but not make it go too high, she said, adding that the magic formula was two glucose tablets.

But its not only children who make connections. Cher Crowley, a territory manager for OmniPod tubeless insulin pumps and pump educator at the camp, encountered a child whose family had lost employment and health insurance and who therefore had not seen an endocrinologist in months.

Nicki Nichols, whose child Bella has type 1, just came in and gave the mother not just hope but also a roadmap, Crowley said. Its frightening to have a child with type 1 and no insurance.

And parents say they finally have a place to share their deepest uncertainties with other parents. Having parents you can text or Facebook with a question as simple as, My child is starting swimming, and how can she check her blood sugar? said Kristen Fowler, mother of Sarah Fowler, a swimmer. We learned we had to give her 15 grams of carbs before practice or shed get low. Unless you have a child with type 1 in that activity you are not able to answer that question.

Its given her confidence knowing there are all these kids like her. Camp has made her more open to trying new things, like new pump infusion sites.

Sarah Joy Sudduth, 13, of Starkville treasures her independence and shares that with friends at camp. I tell them that diabetes is just a part of life and that learning to check their own blood sugar can keep them from having to depend on others, Sara Joy said, on the sidelines as a karate instructor chopped through a stack of flaming boards.

Its an appropriate image for those with diabetes for what may look impossible is in fact something that they can do.

Hence the name, Kandu. We were brainstorming and one of our former employees came up with the spelling of can-do, said Irena McClain, associate director of the Diabetes Foundation of Mississippi.

One camper knows what she wants to do with her life. I want to become a pediatric endocrinologist, because my doctor is one and she is my role model. She has type 1, too.

And that, it seems, is the Kandu spirit.

The Diabetes Foundation of Mississippi cares for all children adults in Mississippi with diabetes. Contact the foundation at 601-957-7878 for more information.

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Kids with diabetes show a 'Kandu' spirit - Jackson Clarion Ledger

Hollidaysburg, Blair County, Pa. - The community gathered together in Hollidaysburg to raise awareness and money for diabetes research.

A boy scout made it his mission to make it the best day for everyone there.

14 year-old Aaron Saylor dedicated three months of work to the Blair County Diabetes Walk.

He's doing it in honor of his sister who was diagnosed withtype 1 diabetes 5 years ago.

Saylor put together the kid zone for the event as part as his eagle scout project.

"I made different types of games from Plinko to duck game, 25 multi purposes boxes, the podium and more games."

Saylor says it's an important day for his sister and other kids in the region who suffer from diabetes.

Organizer Llisa Treese agrees.

"All these kids that have type 1 come and meet each other and they know other kids that have type one so they know they're not the only kid that has it."

Treese's son also has diabetes.

He was diagnosed ten years ago and it changed her family's life completely.

"We need other people to understand what they're going through and now that we have all these families here, and the word is getting out other people will understand. The kids don't look sick but their bodies are going through huge adjustments because their bodies can't regulate it."

Saylor says he spent more than 150 hours working on the games for the kid zone, the podium, and the boxes for the basket raffle.

It was all for one common goal.

"I just wanted the kids to have a fun day and just enjoy themselves."

Organizers of the walk hope to raise $10,000.

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Hollidaysburg, Blair County, Pa. - The community gathered together in Hollidaysburg to raise awareness and money for ... - WTAJ

Stay active and track your reactions

Starstuff/ShutterstockWhen David Weingard was diagnosed with type 1 diabetes at the age of 36, he faced with some tough adjustments. From taking his new medication to monitoring his blood sugar, he fought to stay active and fit, eventually founding his diabetes coaching company, Fit4D. For Weingard, exercising had to remain a part of his life and he encourages other diabetics to do the same.

"Exercise is critical to long-term physical and mental health. Mentally, we need positive energy (and endorphins) to combat the 24/7 strain of the condition. Physically, we need to help our bodies stay strong and avoid the long-term effects and complications of diabetes," he says.

But to figure out how much you can withstand and what works for your body, he also notes that keeping track your reactions will help create a plan that works uniquely for you. "Detailed record keeping is a key factor in realizing the benefits of exercise and minimizing blood sugar swingsespecially highs and lows. You can reference these records to repeat workouts and your body should yield similar results most of the time," he says. Find out what the best exercises are for people with diabetes.

g stockstudio/ShutterstockThough Rachel Zucker is only 24 years old, she's been managing her type 1 diabetes diagnosis since she was four years old, making her quite the expert. She described diabetes as a full-time job: She had to accept that there are no days off, no breaks or vacations. That's why she recommends having supportive friends and family around you who will move with your highs and lowsthey're essential to keeping a good attitude and mindset. Instead of hiding your diagnosis, Zucker says wear it with pride. "I tell anybody and everybody close to me that I'm diabetic. Making sure people around you know you're diabetic can be life-saving in an emergency situation. In college, I made sure everybody around me knew I had type 1 diabetes, so when I went out to a party or to a sorority fundraising event, there was always someone looking out for me. Some people are afraid or embarrassed to tell others about their medical condition; I would highly encourage them not to be. Nobody has to do this alone," she says. Find out how fruit can lower yourdiabetes risk.

Andrey Popov/ShutterstockNow 67, Carol Geewasn't diagnosed with type 2 diabetes until her late 50s. Although her new life was scary at first, she says that leaning into the unknown helped her manage her new lifestyle and adjust her habits, ensuring that she lived vibrantly throughout middle age. "Diabetes is scary, but with knowledge comes power. Take the medications the way you are supposed to and it will get easier. I was afraid of needles, so I considered it a great victory when I injected myself without passing out. Know that you 'can' survive and thrive with diabetes. You just have to say itand more importantlybelieve it." (Learn what interval training can do for diabetes.)

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Sergey Nivens/ShutterstockAuthor and diabetes advocate, Quinn Nystrom first watched her younger brother get diagnosed with type 1 diagnosis. Then, two years later, she got the news herself at the age of 13. While that day was one of the worst of her life, she says, it's taught her many life lessons and led her to help others. Even though living with diabetes is a 24/7 job, she encourages those who are newly diagnosed to not let it define them. Instead, she says, allow it to refine you. "We are not just a broken down pancreas. We're more than a label that a doctor gives us, society tells us, and even sometimes what we tell ourselves. Seek to understand how the diagnosis of diabetes has brought light into your life. Find the positives," she says.

wavebreakmedia/ShutterstockThough it can be difficult to focus on anything but your blood sugar, Mella Barnes has found that keeping all parts of her health top of mind helps keep her more satisfied and balanced. She discovered her type 1 diabetes at the age of eight, and has been managing the illness ever since. She says that focusing on each day has been helpful. She also discovered that staying in touch with her emotions is crucial. "Take care of your mental and emotional health. This impacts your diabetes more than you think! Stress causes a lot of issues as well as a lack of sleep. If you're depressed or anxious about your diabetes, find a therapist or free support group. Do something that makes you happy every day," she says.

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Rawpixel.com/ShutterstockFred Winchar discovered he was a type 2 diabetic six years ago and has worked hard to manage his diagnosis. A successful businessman who knows the importance of good advice, he quickly realized that he needed to talk to someone who had been through the struggle. "When I first was diagnosed, I told a friend who was a type 1 diabetic, and he helped me learn how to test and monitor my sugars. He was one of the most energetic and happy people I have ever met. He was delighted to help another person on the same journey. Not only did I learn but I was able to bond in a special way with someone who knew what I was going through," he says.

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Simple Tricks for Living Well with Diabetesfrom People Who Have It - Reader's Digest

Study measures effects of apps on weight reduction.

As the prevalence of obesity continues to rise in the United States (35% in males, 40% in females in 2016), the risks of type 2 diabetes rises as well, supporting the need for ongoing weight control as a simple means of reducing diabetes risk. This concern is especially important in the aging adult population, where at least 66% of those over 65 meet current Centers for Disease Control (CDC) criteria for obesity or being overweight, while 51% of the same population is at risk for type 2 diabetes (US Census Bureau, 2014). The practice of healthy eating and regular exercise in overweight patients reduces the risk of progression from prediabetes or metabolic syndrome to diabetes. Several studies that support this notion have led to the American Association of Clinical Endocrinologists and the American College of Endocrinology including these lifestyle modifications in their first clinical practice guidelines in 2016.

Over time, lifestyle intervention programs were traditionally conducted in a face-to-face environment, typically with an in-person coach. While highly effective, patient barriers to participation (lack of access or lack of interest in this type of program) have demonstrated lack of response in patients who were unable to partake when compared to outcomes in patients who were able to do face-to-face sessions. Recent advances in technology have afforded patients with tools to remotely achieve high-level interaction with a live coach for behavioral counselling, group support, self-paced education, and development of important skills geared toward success. However, very few data are available looking at the Diabetes Prevention Program combined with technology use in older adults. With the rise of Internet availability to the aging population, C.M. Castro-Sweet et al. retrospectively observed a group of Medicare prediabetic patients, examining the effects of an Internet-based DDP digital application on weight status and progression to diabetes.

Subjects were selected from the Humana Medicare Advantage insurance program in the United States. High-risk participants were invited through a 3-week marketing campaign of direct mail, phone call and email contacts describing eligibility for the study as a benefit of their insurance plan. A total of 9,498 members were contacted, of which 501 eligible patients were enrolled. Eligibility was defined as presence of metabolic syndrome, or a combination of three of the following: prediabetes, hypertension, hyperlipidemia, and obesity. Weights were measured and electronically uploaded with an electronic scale. Using Internet-enabled devices (smart phones, computers, tablets), the participants partook in a 16-week intensive curriculum of weekly interactive lessons. Each module was available to all participants for one week at a time, allowing the patients to learn asynchronously but on the same schedule. The program application allowed participants to track weight loss, physical activity, and daily food intake. Following the 16-week weight loss program, a 36-week program focused on weight maintenance was started, for a total intervention length of 12 months. Throughout the duration of the study, all patients were monitored for psychological markers and overall progress using three different approved surveys: The World Health Organization-5 (WHO-5) Well-Being Index (measures subjective well-being), the Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and the Summary of Diabetes Self-Care Activities (SDSCA) scale (reports self-management behaviors relating to diabetes).

Of the 501 participants (mean age 68.8 years), 95% completed at least 4 weekly lessons, and 92% completed 9 or more lessons in the initial 16-week phase. Only 2% failed to complete at least one lesson. Weight change from baseline was found to be significant (mean loss: -6.5%, SD 4.0 at 16 weeks, -8.0%, SD 7.7 at 6 months, and -7.5%, SD 7.8 at 12 months; p=0.01 for all). In the subset of patients (n=96) with available HbA1C and cholesterol measurements, the declines from baseline were also statistically significant (12-month improvement: HbA1c -0.14%, p=0.001; cholesterol -7.08 mg/dl, p=0.0001). As the self-reported surveys were optional, 57% (n=285) provided the surveys. The Who-5 Well-Being Index showed improvement in scores (+12%, p=0.0001), while the PHQ-4 Depression and Anxiety showed improvement in depression scores (-0.26, p=0.0001), but not in anxiety scores (-0.10, p=0.1922). The SDSCA also showed improvement in all 5 markers of healthy lifestyle, with statistical significance, with healthy modifications (better diet, exercise habits) increasing, and unhealthy behaviors (fast food consumption) decreasing.

This study found that willing participants enjoyed a high degree of success, meaningful engagement, and important benefits. Weight loss at for 6 and 12 months (8% and 7.5%) exceeded the standards set by the CDCs National Diabetes Prevention Program (5% reduction). Population presence in 37 states shows good geographic generalizability, supporting the scale that this approach could achieve in reaching patients. Limitations included a lack of a control group, although on average the subjects were not meeting physical activity standards, but by week 16, were all meeting the recommendations. A control group would have provided a better comparator for all data collection points in the 12-month period.

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Reference:

Castro Sweet CM, Chiguluri V, Gumpina R, et al. Outcomes of a Digital Health Program With Human Coaching for Diabetes Risk

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Diabetes Risk Reduction Seen with a Digital Health Program, Human Coaching - Diabetes In Control

HARI SREENIVASAN: More than eight million Americans suffer from diabetes, and more than $320 billion are spent every year treating the disease.

But an innovative program in San Diego is trying to improve health and reduce those costs by encouraging better self-management of the disease.

Special correspondent Cat Wise has our report.

CAT WISE: Fifty-one year old Alma Ayala is not a doctor or a nurse, but she is on the front lines of the diabetes epidemic in her community. Shes a peer educator for a program called Project Dulce, which works with people who have diabetes or are at risk of developing the chronic illness.

Her classes are part informational, part support group. Ayala says the goal of the program, which has been held up as a national model, is for people to feel empowered about changing their health. Thats something she didnt feel 30 years ago when she was first diagnosed with the disease.

ALMA AYALA, Peer Educator: I was devastated. I didnt want to hear the word diabetes. I felt that my life was done, that I was signing a certificate of death.

CAT WISE: Here in San Diego County, nearly half the adult population has pre-diabetes and about 8 percent have diabetes. Its a disease that affects all socioeconomic groups and races, but the Latino community has been disproportionately impacted. And thats the population Project Dulce has been targeting for the past 20 years.

ALMA AYALA: There are lots of barriers for the Latino community, language, insurance. Sometimes, doctors dont have the time to spend with them. So the classes that we provide is that extra support, working together with a clinical team to help our participants stay healthy.

CAT WISE: The program is scattered throughout 12 clinics in Latino neighborhoods throughout San Diego County and was designed by several local health care organizations, including the Scripps Whittier Diabetes Institute.

Dr. Athena Philis-Tsimikas is an endocrinologist who oversees the program.

DR. ATHENA PHILIS-TSIMIKAS, Scripps Whittier Diabetes Institute: This is a disease in which you have to do a number of management components, not only every day, but many times a day. And its not that easy to expect someone to remember to test their blood sugar, take their pill, to go out and take that walk, to have exactly the right meal on the table all the time to take care of this.

I dont see any lows there, so I dont think we have to worry that you might dip down too low.

CAT WISE: To help patients, a team is set up at each clinic with a physician, nurse practitioner, a dietitian and multiple peer counselors like Ayala who come from the communities they serve and also have the disease.

DR. ATHENA PHILIS-TSIMIKAS: If you can train these other people and professionals to help you do the other components that take longer, but are still absolutely necessary, then youre using your team to work very synergistically to deliver everything that patient needs in order to improve their care.

CAT WISE: The program is now adding another layer, technology. Last year, Tsimikas conducted a study to see if patients receiving daily text messages could manage their disease even better.

Artist Gloria Favela-Rocha was one of the participants. Shes a muralist who does large scale works for hospitals, schools and private clients. She says, before the study, she often forgot to regularly check her glucose levels. Project Dulce changed that.

GLORIA FAVELA-ROCHA, Diabetes Patient: The text message would come every day at the same time, so if I would lose track of where I was during my day, I would hear it ring, and so I would start checking my blood sugars, send in my result right away. It would send me back a message according to whatever my result was, like good job, or maybe you need to eat something that has a little more protein today.

So, it was just very it was very convenient.

CAT WISE: Dr. Tsimikas team has also been studying the effects of continuous glucose monitoring, which uses Bluetooth technology to send results to the patient and physician in real time.

MAGDALENA HERNANDEZ, Diabetes Patient: This device is reading my sugar levels.

CAT WISE: Magdalena Hernandez wears a small monitor on her stomach.

MAGDALENA HERNANDEZ: I love it. I love it because I dont have to prick my finger many times during the day, and it alerts me when my blood sugar goes high or goes low.

CAT WISE: And what happens if your levels go above 200? What do you do?

MAGDALENA HERNANDEZ: I grab a bottle of water, and I get up and walk for five minutes.

CAT WISE: Thirty miles away, Dr. Tsimikas is also able to keep tabs on Hernandezs levels.

DR. ATHENA PHILIS-TSIMIKAS: This is just over the last three hours, that she probably ate breakfast here, it went up, and is now declining.

CAT WISE: This technology has been on the market for several years, but has not been widely used because of cost and a somewhat complicated user interface. But Tsimikas says those barriers are being reduced and she predicts it will have a big impact on health.

DR. ATHENA PHILIS-TSIMIKAS: It is reinforcement to both the patient and to the provider thats helping to make recommendations on whether this is working or not. I think its really going to revolutionize the way we can take care of patients.

CAT WISE: Dr. Tsimikas says the objective is to prevent the serious complications that can accompany diabetes, including blindness, kidney failure, amputations or heart failure.

MAGDALENA HERNANDEZ: I really love the black beans and all the vegetables in here.

CAT WISE: According to studies conducted by the University of California, San Diego, and elsewhere, Project Dulce has helped lower patients blood sugar and cholesterol levels, while at the same time reduced the number of costly hospitalizations and emergency room visits.

While some elements of the program are being used in other communities, Project Dulce stands out for its comprehensive approach. So, why arent similar initiatives being rolled out in every neighborhood in America?

DR. ATHENA PHILIS-TSIMIKAS: Its probably the way we reimburse for each of these components. Thats probably the biggest hurdle. We traditionally have reimbursed only for physician visits. If we could find a way to actually reimburse for each of these components, it may be more sustainable for the future.

Or maybe we simply reimburse based on our success. If you are successful in achieving better outcomes, maybe then you pay for what led to those better outcomes.

CAT WISE: In the coming weeks, Project Dulce will begin a new study of patients that combines text messaging with continuous glucose monitoring and a wireless pill box that will alert a nurse if a patient isnt taking his or her medication.

From San Diego, Im Cat Wise for the PBS NewsHour.

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Self-empowerment is sweet for diabetes patients in this innovative program - PBS NewsHour

While volunteering in Nepal, I was diagnosed with type 1 diabetes at age 31. It was Valentine's Day 2014, and my wife and I were in the middle of a backpacking trip around the globe. We had just finished a hiking trip in the Himalayas that almost killed me.

I had been losing weight and had to run to the bathroom constantly. And I had never in my life been so thirsty. I dismissed the symptoms as consequences of the dry weather, until I stepped on a scale and saw how much weight I'd lost: about 40 pounds.

A trip to a local doctor gave me the diagnosis that would change my life and land me in two hospitals in Nepal before I was cleared to fly home. I spent a month learning about diabetes and understanding the ins and outs of a chronic autoimmune disease. Then it was time to make my decision.

My wife, Cassandra Kramer, and I resolved to get back on the road and finish what we had started. I knew that if I accepted limitations so early in my life with diabetes, I would always accept limitations, and that was a dangerous state of mind.

We caught a flight to Bangkok and made our way through Southeast Asia, South America and Iceland before coming home.

Diabetes is a disease with which the body no longer produces enough insulin to regulate blood sugar. In type 1 diabetes, the pancreas stops producing insulin altogether, requiring daily injections of artificial insulin and constant blood sugar monitoring. In type 2 diabetes, the body's insulin isn't used effectively, which is sometimes the consequence of being overweight. Type 2 diabetes can require some combination of lifestyle change, medication and insulin injections.

Yet the cause of diabetes is unknown. Although some cases of type 2 may be a result of obesity, that answer does not apply to everyone, and there are no such clues for type 1.

Diabetes still has a stigma attached to it, largely because of a lack of education and awareness. But people are constantly defying it by showing that there is no reason to accept limitations or boundaries when living with diabetes.

It may require more planning, but it's not a reason to say "no" to any experience.

Will Cross was diagnosed at the age of 9 in 1976, when diabetes care was nowhere near what it is today. He became the first person with type 1 diabetes to summit Everest when he scaled the highest peak in the world in 2006. He has also climbed the Seven Summits -- the highest peak on each continent -- and traveled to the North and South Poles.

"I never aspired to be a baseball or football player," Cross told Beyond Type 1, an organization dedicated to living with type 1 diabetes. "I just wanted to climb; diabetes didn't hinder that desire."

One person who did want to play football was Jay Cutler. The former quarterback for the Chicago Bears was 24 when he was diagnosed, making him one of a small but growing number of people with type 1 diabetes diagnosed after puberty. (Type 1 diabetes was traditionally called juvenile diabetes, but that term is becoming outmoded as the number of adults diagnosed with type 1 diabetes increases, though researchers don't fully understand why.) Cutler went on to play nine more seasons in the NFL, and he has become one of the best-known athletes with diabetes but certainly not the only one.

Perhaps the most famous celebrity with diabetes was Mary Tyler Moore, who used her fame to advocate for people with diabetes. Moore served as the international chairman of the Juvenile Diabetes Research Foundation. Her death in January sent shockwaves through diabetes community, which had lost one of its biggest influencers.

And if you're looking for a celebrity to pick up where Moore left off, singer Nick Jonas has carried the mantle so far, founding Beyond Type 1 and being candid about dealing with diabetes.

"It is very easy to want to hide what diabetes means for us in the workplace, but that just does a disservice to us, to other people with diabetes and to our coworkers," adventure athlete Erin Spineto said.

Diagnosed with type 1 diabetes in college, Spineto has completed a 100-mile standup paddling trip and sailed the Florida Keys solo, all the while proving that anything is possible, despite the disease. "The more real information and firsthand experience people get with this disease, the less stigma will be attached to it."

I was able to use my diabetes diagnosis, in a way, to improve my health. Though I have a chronic disease that requires constant blood sugar checks and insulin injections each day, I also have the most powerful of reasons to eat healthy, exercise and take better care of myself: a functional life.

Failure to stay healthy and keep my blood sugars in check can lead to the severe complications of diabetes: nerve damage, eye damage, cardiovascular disease and much more. Regular exercise and healthy eating help regulate blood sugar levels in people with diabetes.

Diabetes was the catalyst for that change, even if it means I am now walking around with a medical time bomb waiting for me to make a mistake.

Perhaps the most frustrating part about diabetes is the lack of definitive answers. Questions such as "how did I get it?" or "will there ever be a cure?" must remain open-ended for now. Although there are procedures that show promise for reducing or eliminating the need for insulin and an artificial pancreas (a device that manages blood sugar automatically) is on the horizon, a true cure for diabetes remains elusive. The same is true for understanding the cause.

Yet it is a manageable disease. With experience, discipline and a support network, diabetes should never be a reason to say "no." It's just a matter of figuring out what preparations you need to make to be able to say "yes."

Since finishing our backpacking trip, my wife and I have continued to travel when we can. Hiking Kilimanjaro is high on our priority list, and I want to return to the Himalayas to hike once again, this time knowing how to treat my diabetes.

For me, it is an extension of the most important decision I have ever made: the decision to live life without limits.

Maybe I'll even climb Everest.

See the article here:
Diabetes can't stop you from climbing Everest - CNN

While tech giant Google continues to struggle to make a contact lens for monitoring diabetes,researchers at Ulsan National Institute of Science and Technology (UNIST) in South Korea have offered up at least one part of the puzzle: better wearability. Through the use of a hybrid film made from graphene and silver nanowires, the UNIST researchers have made contact lenses for detecting multiple biomarkers that are clear and flexible.

In research described in the journal Nature Communications, the UNIST researchers used graphene-nanowire hybrid films to serve as conducting, transparent, and stretchable electrodes. While the hybrid film alone does not perform any detection, the electrodes do ensure that the electrodes in the contact lenses dont obscure vision and that theyre flexible enough to make wearingthe lenses comfortable.

In addition to offering better transparency and comfort, the contact lenses developed by the UNIST researchers depart from previous contact lens sensors in that theyreable to detect multiple biomarkers. This contact lens should be able to pick up indictorsfor intraocular pressure, diabetes mellitus, and other health conditions, according to the researchers.

To detect intraocular pressure, a dielectric layer is sandwiched between two hybrid films. In this arrangement, the films now become a capacitor that responds to intraocular pressure. At high intraocular pressure, the thickness of the dielectric layer decreases, resulting in the increased capacitance. High intraocular pressure also increases the inductance of the antenna coil by bi-axial lateral expansion.

For detecting glucose, the top hybrid film layeris exposed to tears and detects glucose. In a selected region of the film, the researchers removed the nanowires so only graphene remained. The surface of graphene was then coated with an enzyme that binds selectively to glucose.Thisbinding changes the resistance of the graphene.

The changes of resistance, inductance and capacitance in these two detection modes can be monitored wirelesslyin real-time.

One of the challenging aspects of the research was the glucose sensor, according to the researchers. In tears, there are many interfering ions and molecules that potentially cause false positive responses, explained Chang Young Lee, an assistant professor at UNIST and co-author of the study, in an email interview with IEEE Spectrum. We need to test the selectivity and long-term reliability of the glucose sensor. The effort includes designing and finding a molecule that selectively binds to glucose, which is another large research area.

Lee envisions this research as a novel platform that will enableintegration of glucose sensor onto a soft contact lens. Measuring the glucose accurately and reliably is another large research area, Lee added. A good glucose sensor developed by another researcher, for example, can easily be integrated onto our platform.

In this novel platform, both the graphene and the silver nanowires contribute indispensible properties. The silver nanowires offer a one-dimensional (1D) conducting material, and by creating a network (mesh) of it, its possible to make a transparent, conducting, and flexible film. However, the film made of silver nanowires alone has limitations, such as high contact resistance at the nanowire-nanowire junctions, low breakdown voltages, poor adhesion to flexible substrates, and oxidation in harsh environments.

This is where the two-dimensional (2D) graphene comes in, with its properties of being highly transparent, conducting and flexible. By creating a hybrid structure of graphene and nanowires, the limitations of the nanowires are overcome. The key is in the hybrid of 1D and 2D structures, added Lee.

IEEE Spectrums nanotechnology blog, featuring news and analysis about the development, applications, and future of science and technology at the nanoscale.

Controlling the electrical current for heating graphene allows sound frequencies to be mixed together, amplified, and equalized 5May

Technique opens up potential of tailoring material properties nearly atom-by-atom 2May

Discovery could be the answer to the demands for increasing information storage density as device feature sizes decrease 26Apr

Technique could reduce costs for compound semiconductor circuits and lead to new devices 24Apr

The new molybdenum disulfide microprocessor has 115 transistors 11Apr

A graphene photodetector can pinpoint the position of light that falls far from it 10Apr

Researchers at SLAC are leveraging X-rays to enable the next generation of batteries and photovoltaics 5Apr

Diamondoids are showing promise in applications as divergent as electron guns and quantum computing 31Mar

The electronic skin is touch-sensitive and could be inexpensively manufactured 30Mar

Stanford researchers are getting a lot of mileage from nanomaterials by analyzing market needs 29Mar

The elliptical shape makes the lasing process easier 20Mar

Japanese materials company prototypes a 26.3 percent efficient silicon cell, steps away from the 29 percent theoretical maximum 20Mar

Otherlabs self-fluffing fabric changes its insulation in response to temperature 18Mar

Development is incremental in molecular nanotechnology, but it is coming along slowly 14Mar

New encoding method makes it possible to come close to the theoretical maximum for DNA data storage 2Mar

Replacing high-voltage power source with nanogenerators increases sensitivity to new records 27Feb

First borophene-based heterostructure should guide future work with borophene in nanoelectronic applications 23Feb

Five teams, four rockets, and 380,000 kilometers togo 22Feb

Current can literally blow copper interconnects away, but graphene could keep them intact 17Feb

Biocompatibile inks open up medical devices for inkjet-printed devices 2Feb

Continue reading here:
Smart Contact Lens Detects Diabetes and Glaucoma - IEEE Spectrum

This Saturdays Notorious Nick Memorial Shotgun Match sponsored by the Single Action Shooting Society and the Founders Ranch Shotgun Sports Club will raise funds for the Juvenile Diabetes Research Foundation.

Sign up starts at 8:30 a.m. and shooting begins at 10 a.m. for the event at Founders Ranch at 74 Barton Road. Cost is $50 for 100 target sporting clays, $25 for 50 target 5 stand sporting and $12.50 for 25 target cowboy clays.

The event in its fifth year also brings attention to the causes of juvenile diabetes and diabetes in general, which is a health concern for the area and statewide. According to advocates, more than 12 percent of the states adult population is living with diabetes, which is more than 248,000. Another 615,000 are estimated to have prediabetes, which means their blood sugar levels are higher than normal but not yet high enough to be type 2 diabetes.

Prediabetic is now the new term for people who will likely get diabetes in the future without making changes now to their diet and sedentary lifestyles, said Dr. Linda Stogner, medical director of the Esperanza Family Health Center. Doctors used to call the condition borderline diabetic, but people didnt take the diagnosis serious enough to make significant lifestyle changes.

Brenda Richter, who has been attending a weekly diabetes self-management workshop in Moriarty, said she had been diagnosed as borderline diabetic, which quickly blew up into full diabetes, changing her life. Participants in the workshops held Monday afternoons at Bethel Community Storehouse say the classes have helped them get focused on what they can do to successfully change their lifestyles and diet to better manage the disease.

Danielle Berrien of the Cooperative Extension Service, which sponsored the workshops with the state Department of Health and state Aging and Long Term Services Department, said there is a lot of misunderstanding about the disease, which can lead to kidney failure, blindness, loss of limbs and heart disease. The workshop aims to teach participants about what they can do to better manage the disease by coming up with an action plan with measurable goals to successfully make better food choices and work in more exercising into their daily lives.

You pretty much have to say good bye to processed food, Richter said.

Jennifer White said the workshops have helped her feel less isolated and Effie Zirnheld said the workshops were able to go into more detail than advice given at a doctors office. Participants said it helped that the workshop has Margie Snare as facilitator as she is a person living with diabetes. Berrien said she wants to hold the diabetes workshop twice a year.

Stogner, who has been treating patients in the East Mountains for 30 years, said the disease is one that cuts across all walks of life from mountains residents to flatland farmers. But Stogner said she has patients she has been working with since coming to the area who have been successful in making the necessary lifestyle changes to manage the disease.

I have patients in their 80s who I first saw in their 50s, Stogner said. Im happy to say that none of them have lost their vision, no amputations and no one on dialysis.

Stogner acknowledges that it can be hard for people in rural areas to get good access to unprocessed food. On the exercise side, even taking short walks daily can do a lot to prevent the disease, she said.

Berrien said there are good online resources, such as the websites for the American Diabetes Association, the International Diabetes Center, the Joslin Diabetic Foundation and the National Diabetes Education Program.

Originally posted here:
Fundraiser, program shine light on diabetes - Mountain View Journal