| Litvin Centers for Diabetes Newsletter |
Volume 25
August, 2007 |
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Welcome! You may find this topical newsletter of great value in managing your diabetes. This issue contains a "hodge-podge" of topics gleaned from the varied sources which happen to cross my desk. More is always available, however space is given consideration.
Please use this information to your benefit, feel free to share with others, and let me know what you think!
Sincerely,
Yair Litvin, MD |
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Diabetic Devices
FDA Approves Device for Continuous Glucose Monitoring ("CGM")
CGM is here! Although in its infancy, it promises to become the standard. The days of the glucometer as we know it, are numbered. Diabetics will have a simple and easy device which will record and illustrate blood glucose minute-by-minute, "on the go". Recently the FDA has approved the STS-7 System (Dex Com) for diabetics aged 18 and older, for use up to 7 days. The system uses a disposable sensor which is placed by the patient subcutaneously in the abdomen. The transmitter snaps onto the sensor, and both are held in place with an adhesive on your abdominal wall. A third component is the receiver, which can be carried separately, and which receives from the transmitter glucose data every 5 minutes. More info can be found at www.dexcom.com.
For the sake of completion, there are other sensors on the market. Specifically, the Navigator by FreeStyle (www.abottdiabetescare.com), and two sensors by MiniMed called the Guardian and the Paradigm (www.minimed.com). The Navigator gives a reading every 1-2 minutes, whereas the other devices, every 5 minutes. All devices are expensive, and until the insurance companies get in on the act, it's a waiting game. |
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Nutrition & Exercise
The Mediterranean Diet Prevents Central Body Fat Distribution
 In a study coming out of Spain, researchers were looking for the effect of different diets on central obesity. As is well known by now, central obesity (beer belly) is much more dangerous and contributes to the onset of diabetes, than subcutaneous obesity (diffuse). The reasons, of course, are complex and poorly understood, but have to do with an elusive set of genes/hormones which control sensitivity/resistance to insulin. Overweight subjects who had family relations that were diabetic were given 3 different diets for a 28 day period each, and the effect on body fat distribution was assessed. The diets were: 1) diet enriched in saturated fat, 2) diet rich in monounsaturated fat (Mediterranean diet), and 3) diet rich in carbohydrates. Although weight and body composition did not change, the investigators observed that when patients were fed a diet rich in carbs, their fat mass was redistributed toward the abdominal depot. Conversely, with that Mediterranean diet, insulin sensitivity was preserved, and body fat did not migrate towards the abdominal cavity. A study that confirms "we are what we eat."
Soft Drink Consumption and Obesity
The obesity "epidemic" of the past 3 decades apparently coincides with the increase in consumption of sugar-sweetened soft drinks. Multiple studies are showing that subjects consuming excess amount of soft drinks, do not compensate for that by reducing their caloric intake from other sources, resulting in greater energy intake. In addition, studies have shown a strong linkage between soft drink consumption and development of diabetes. In fact, in a study following 91,249 women for 8 years, those who consumed 1 or more servings of soft drinks per day were twice as likely as those who consumed less than 1 serving per month to develop diabetes over the course of the study. Consequently, researchers are recommending a decrease in soft drink consumption.
Guidelines Advise for Physical Activity for Diabetics
The American Heart Association in collaboration with the American College of Sports Medicine (ACSM) have come out with a statement that gives guidelines about how to manage physical activity in patients who are at-risk for heart attacks or even death. The general recommendation is that everyone should engage in 30 minutes of moderately vigorous exercise - the equivalent of brisk walking - at least 5 days a week. For asymptomatic (no symptoms) type 2 diabetics, the recommendation is for exercise testing (treadmill stress testing) prior to a moderate to vigorous exercise program. In overweigh and sedentary individuals, 10 to 15 minutes a day is beneficial, with a gradual increase in time and intensity as tolerated. A good rule of thumb is to exercise enough to be mildly to moderately short of breath, but not to the point of breathlessness. Patients with known heart disease should warm up and cool down 5 minutes at each exercise session. More information is available at: www.activeliving.info; www.shapeup.org; and at www.aom.americaonthemove.org. | |
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Medication Information
New Insulin Pen Preferred
 In a recent study, the three currently available insulin pens were compared. The two known pens are the FlexPen by Novo Nordisk, and the Lilly Pen (Humalog, etc.) by Eli Lilly. The third pen is the new SoloStar by Sanofi Aventis, which is used for Lantus insulin. The study was conducted in 24 centers in the US and in Europe, and in all the criteria used, the SoloStar pen came out ahead of the competition. This would be a great boost for Lantus-pen users, since the current pen has its deficiencies. If you're interested, please inquire with us. |
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| LCD News
LCD Podcasts
Dr. Litvin is now hosting a series of Podcasts on Diabetes. Check it out and let us know what you think. Go to Dr. Litvin's Podcasts.
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A special "Thank You" to everyone who participated in the LCD Survey. Your feedback is greatly appreciated and we have already been incorporating your recommendations and will continue to do so. Please keep us posted on how you like the changes.
Also, feel free to Forward our newsletter to your family, friends, colleagues, etc. who might enjoy/benefit from it. To do so, click the "Forward email" link below. | |
