| Litvin Centers for Diabetes Newsletter |
Volume 28
February, 2008 |
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Dear Patients and Friends,
As the New Year unfolds, events related to developments in the field of diabetes and its complications are and will undoubtedly increase exponentially. More genes are being identified and described by researchers as contributing to the development of this condition, and more novel ways of addressing diabetes are being recognized, as well. Most certainly, this year will see dramatic changes and improvement in our understanding of diabetes. All you have to do is stay tuned.
Sincerely,
YL |
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Recent Diabetes News
American Diabetes Association (ADA) Recommendations for 2008
Diagnosis: The fasting plasma glucose is still the preferred test in children and in nonpregnant adults (<126 mg/dL). Use of A1C is not recommended for that purpose. Testing in asymptomatic people should be considered in adults who are overweight or obese (BMI>25) or have additional risk factors such as physical inactivity; 1st degree relative with diabetes; members of - African American, Latino, Native American, Asian American, and Pacific Islander; women who delivered a baby weighing>9lbs; people with hypertension; women with polycystic ovarian syndrome (PCOS); history of coronary vascular disease; or people with abnormal lipids (fats in blood). If tests are normal, they should be repeated every 3 years - after age 45. In children who are overweight (BMI>85th percentile or weight>120% of ideal for height) and have 2 of the following: 1) family history of diabetes, 2) ethnicity/race as above, or 3) signs of insulin resistance.
Prevention/Delay of Type 2 Diabetes: counseling on weight loss of 5-10% of body weight, as well as increase of physical activity to at least 150 min per week of moderate activity such as brisk walking. Metformin treatment may also be considered for prevention.
Goals: Lowering A1C to an average of 7%, although closer to 6% is even better. Classification - Type 1 diabetes: beta-cell destruction, usually leading to absolute insulin deficiency. This form accounts for 5-10% of cases and was called juvenile-onset diabetes. It is caused by the individual's immune system attacking their own beta cells, however in some cases such an attack cannot be identified. Type 2 diabetes - where there are both insulin resistance (lack of sensitivity to insulin), and at least a partial defect of insulin production. This latter form accounts for 90-95% of cases, and was known as the adult-onset type. The ADA statement continues into the various issues related to treatments and complications which are too complex and voluminous for review here, but are available on their site at: www.diabetes.org.
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Information to Help Manage Diabetes
Smoking and Diabetes
Cigarette smoking is associated with an increased risk of developing diabetes type 2, as per a report reviewing 25 studies conducted world-wide between 1992 and 2006. A total of 1.2 million subjects were reviewed and results even showed a link between the degree of smoking and the level of likelihood. Further analysis suggests that about 12% of all type 2 diabetics in the USA may be attributed to smoking, accounting for $14.9 billion of the total 132 in annual costs.
Adjustable Gastric Banding and Conventional Therapy for Type 2 Diabetes
In an unblinded randomized controlled trial coming out of the Obesity Research Center in Australia, researchers have reported a major outcome in patients who underwent gastric banding. Two groups of obese diabetics were compared as to their remission rate from diabetes when treated with either conventional therapy (diet, exercise and oral medications) or with gastric banding. The surgical group achieved a resounding 73% remission as compared to the conventional group that fared only 13%! This was directly related to the extent of the weight loss, which was 22.7% in the surgical group (of original body weight) vs. a 1.7% in the conventional group at 2 years. Undoubtedly, obesity has a huge impact on the diabetic state. When reversed, the diabetic state gradually goes into remission. In this study it took about six months.
Interestingly, however, utilizing a different method - the Roux-en-Y gastric bypass (RYGB), results in a much more dramatic outcome. This method is used in the USA and causes a resolution of the diabetic state within a few days only! This dramatic change has to do with the fact that in this procedure the intestines are rearranged, thus activating gastrointestinal hormones which cause reversal of the diabetes. The message being that in the not too distant future, we may be looking at a surgical solution to the epidemic of obesity/diabetes in this country and in the world. Please inquire with me if you are interested.
Omega-3 Fatty Acid Soft Gels
Nordic Naturals adds ProOmega Junior to their Physician Exclusive line of Omega-3 fatty acid formulas. This is offered in a smaller strawberry flavored capsule, ideal for children aged 5 through adults. Foods containing omega-3 are: fatty fish such as salmon, albacore, tuna, mackerel, and sardines; green leafy vegetables; walnuts; olive, canola, flaxseed, and walnut oils.
Diabetes Foodsmart
A new newsletter coming from the ADA and HealthCentral Network's FoodFit.com and written by its founder and president Ellen Haas. This is a "fun" newsletter packed full of information for the diabetic patient. For more info or to subscribe: www.diabetes.org/diabetesfoodsmart.
ADA launches Youth Web Site
The ADA has launched a site devoted for diabetics type 1 which it calls:"Planet D:Explore.Discover.Connect." (the D stands for diabetes). In addition to having a wealth of information, the site also provides a secure environment for kids with diabetes. They can interact with other youths, and even build their personal identities. You can access the new site at: www.diabetes.org/planetD.
"Inspired by Diabetes"
A global competition for people to express the impact of diabetes on their lives, through art, essay, poetry, photography, and music. To learn more, visit: www.inspiredbydiabetes.com. |
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Cuisine Corner
Roasted Red Pepper Hummus
2 cans (15 oz. each) garbanzo beans (chickpeas), rinsed and drained with 1/3 cup liquid reserved. 1 jar (12 oz.) roasted red peppers, drained
3 garlic cloves
2 Tbsp. fresh lemon juice
2 Tbsp. olive oil
1 tsp ground cumin
1 tsp. salt
1. In a food processor or blender, combine all the ingredients, including the reserved garbanzo bean liquid. Process until the mixture is smooth and no lumps remain, scraping down the sides of the bowl as needed.
2. Serve immediately, or cover and chill until ready to use.
Nutrition Facts: Serving 14, Serving Size ¼ cup, Starch Exchange 1, Calories 83, Calories From Fat 28, Total Fat 3 g (Saturated Fat 0.4 g), Cholesterol 0 mg, Sodium 281 mg, Carbohydrate 11 g (Dietary Fiber 3 g, Sugars 2 g), Protein 4 g.
This recipe appears in Mr. Food Diabetic Dinners In A Dash by ArtGinsburg and recently in Diabetes Forecast.
Nutrition
In a recent Australian study looking at 40,000 men and women ages 40-69 for over 10 years, researchers have reported that those who ate the most Mediterranean-diet foods had a 30% decreased risk for cardiovascular (heart) mortality compared to those who ate the least amount. In a diabetic sub-group, those consuming predominantly Mediterranean-style diet had a 79% lower risk of dying from ischemic heart disease compared to those who were in the lowest category. The Mediterranean diet comprises higher intake of: vegetables, fruits, legumes, nuts, grains, unrefined cereals, breads, olive oil, and garlic; moderately high intake of fish; and moderate intake of wine consumed primarily with meals. |
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Medication Information
Diabetic Moms at Higher Risk of Having Baby with Hole in the Heart
The chances of delivering a baby with an atrial septal defect were 11-fold higher for mothers with diabetes compared to women without diabetes. This study was reported after screening 5,000 women retrospectively by doctor Don - a cardiologist from the University of Washington, Seattle. This relationship has not been well studied previously and is important. So if you are pregnant, please follow the testing schedule/instructions of your obstetrician. | |
