AND ISSUES ON DIABETES CARE

MASTERS OF SCIENCE OF NURSING School of Health Sciences Graduate School

Legumes Help Improve Glycemic Control And Lower Heart Disease Risk

 Eating plenty of beans, lentils, chickpeas and other legumes helps improve glycemic control and reduce the risk of developing coronary heart disease in patients with diabetes type 2, researchers from the University of Toronto reported in Archives of Internal Medicine after carrying out a randomized, controlled trial.

 The participants were randomly selected into one of two groups: Low-GI legume group - they were encouraged to eat more legumes; by at least one cup a day for three months Insoluble fiber group - they were encouraged to eat more insoluble fiber, i.e. whole wheat foods for three months

 The primary outcome was change in HbA1c (hemoglobin A1c), the secondary outcome was coronary heart disease risk score. The researchers reported that legume consumption of about 1 cup (190 grams) per day appears to contribute effectively to a low-GI diet, and to reduce the risk of coronary heart disease by bringing down blood pressure.

 Below are some of the trial results: In the low-GI legume group, HbA1c values went down by -0.5% In the insoluble fiber group, HbA1c values dropped by -0.3% In the low-GI legume group, blood pressure fell much more than in the insoluble fiber group

 The researchers concluded:

"These findings linking legume consumption to both improved glycemic control and reduced CHD risk are particularly important because type 2 DM is increasing most rapidly in the urban environments of populations in which bean intake has traditionally been high (e.g. India, Latin America, the Pima Indians of Arizona).

Topical Simvastatin Shown To Accelerate Wound Healing In Diabetes

 A new study has found that topically applied simvastatin accelerates wound healing in diabetic mice, suggesting important implications for humans with diabetes.

 An advantage of topical application is that a suitable concentration of simvastatin can be applied without risk of serious systemic effects such as kidney damage

 The investigators generated a full-thickness skin wound on the backs of diabetic mice. Each wound was treated with a topical application of either simvastatin in petroleum jelly or petroleum jelly alone. The application was repeated on days four, seven, and ten.

 After two weeks, the simvastatintreated wounds were more than 90% healed, whereas less than 80% were healed in the wounds treated by petroleum jelly alone. The difference in wound closure was greatest on day seven when the simvastatin-treated wounds were 79.26% healed compared with 52.45% in the control group.

 This study shows that topical simvastatin significantly accelerates wound recovery by increasing both angiogenesis and lymphangiogenesis.

 This is a simple strategy that may have significant therapeutic potential for enhancing wound healing in patients with impaired microcirculation, such as that in diabetes. Further investigation is needed to determine its clinical utility

dermaPACE
uses high-energy sound waves when directed at the ulcer these sound waves stimulate the growth of new blood vessels and creates an inflammatory response that actually jumpstarts rapid healing of the wound

Results from the study showed a distinct difference in results between the two therapies dermaPACE and Hyperbaric Oxygen Therapy(HBOT):

Overall, 57 percent of the foot ulcers in the dermaPACE group completely healed, versus 25 percent in the HBOT group.

Researchers also noted a great difference in the time and sessions required for the two therapies: dermaPACE required only 15 percent as many sessions as HBOT and only three percent as much time.
This technology is still in clinical trials and will be for some time.

Blocking Type 1 Diabetes Progression Using Psoriasis Drug

Type 1 diabetes occurs when the body's immune system attacks beta cells in the pancreas that produce the insulin needed to metabolize sugars and other nutrients into energy needed by the body. The process usually continues until the patient is producing little or none of his or her own insulin, requiring regular injections of insulin to maintain blood sugar levels at close to normal levels.

In a multicenter trial of 49 patients, those receiving the drug alefacept were producing the same amount of insulin one year after diagnosis, while patients receiving a placebo injection were producing less, consistent with the deterioration that usually occurs after diagnosis with the disease.

 Alefacept is an immunosuppressant drug that binds to and interferes with the actions of certain immune system Tcells that are believed to be involved with the destruction of beta cells in the pancreas.

 Trial participants ranged in age from 12 to 35 and had recently been diagnosed with type 1 diabetes. Twothirds were randomly assigned to the group receiving alefacept injections, with the remaining patients receiving a placebo injection of saline solution. The participants received weekly injections for three months, followed by three months of no injections, then three more months of weekly injections.

 A year after receiving the initial injections, the study participants were tested for insulin production using a standard mixed meal tolerance test, or "shake test."

Echo Therapeutics The Symphony System

 It is a non-needle, non-invasive, wireless transdermal continuous glucose monitoring system. The Symphony System uses a biosensor without the need to prick the skin since it is transdermal [it is an adhesive patch placed on the skin]. F.D.A. approval is expected in 2013 and is showing strong successes in clinical trials.

 Testing is being done on hospitalized critical care patients who require multiple finger sticks daily; it is well documented that blood sugar control is imperative during acute illness and trends need to be monitored. Studies are also being conducted on out-patients with diabetes. The transdermal patch would require changing every 24 hours.

 The needleless system technology is a benefit for those who dread needle placement as well as having the ability to lower the risk of infection especially in the hospital critical care arena.

HORMONES for DM

 A newly discovered mouse hormone may open the door to better treatment for diabetes The hormone, called betatrophin, triggers the growth of pancreatic "beta" cells lost or ineffective in diabetes.

 betatrophin can produce a roughly seventeenfold increase in these cells, and its increase may partly explain the rapid growth of these cells seen during pregnancy to feed developing fetuses in mammals, including people.

 they cautioned that the hormone's effects, which the study team sees as isolated to beta cells, need to be thoroughly investigated in animal studies for safety.

 The hormone was discovered almost by accident, as the Harvard team investigated a research compound that basically recreates what happens in diabetes. The compound short circuits the release of insulin in response to increasing blood sugar.

 When that happened to the mice in the study, their production of the hormone betatrophin ramped up and spurred the growth of insulin producing cells. Diabetics often need daily insulin injections to compensate for the condition, where in Type 2, or adult-onset diabetes, the most frequent kind, beta cells stop producing enough insulin, and in juvenile diabetes, or Type 1, about 10% of cases, beta cells have died.

 "Before it can be established if this finding has any relevance to human therapy it will need to be established (that) the molecule drives beta cell replication in humans," according to beta cell experts

ARTIFICIAL PANCREAS

 An "artificial pancreas," a device that would constantly monitor blood sugar in people with diabetes and automatically supply insulin as needed, may be a step closer to helping patients in what researchers are calling a "major advance."

 A new study showed that a key component of the device -- an insulin pump programmed to shut down if blood-sugar dips too low while people are sleeping -- worked as intended in a three-month study of 247 patients.

 This "smart pump," made by Minneapolis-based Medtronic Inc., is already sold in Europe, and the Food and Drug Administration is reviewing it now. Whether it also can be programmed to mimic a real pancreas and constantly adjust insulin based on continuous readings from a blood-sugar monitor requires more testing, but doctors say the new study suggests that goal is in reach.

Thank you and God bless!