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.

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

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

blood pressure fell much more than in the insoluble fiber group .• Below are some of the trial results: In the low-GI legume group.5% • In the insoluble fiber group. HbA1c values went down by -0. HbA1c values dropped by -0.3% • In the low-GI legume group.

Latin America. the Pima Indians of Arizona).• 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. .

Topical Simvastatin Shown To Accelerate Wound Healing In Diabetes .

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

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

whereas less than 80% were healed in the wounds treated by petroleum jelly alone.26% healed compared with 52.45% in the control group. the simvastatintreated wounds were more than 90% healed.• After two weeks. . The difference in wound closure was greatest on day seven when the simvastatin-treated wounds were 79.

• 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. Further investigation is needed to determine its clinical utility . such as that in diabetes.

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.

This technology is still in clinical trials and will be for some time. .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.

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. requiring regular injections of insulin to maintain blood sugar levels at close to normal levels. The process usually continues until the patient is producing little or none of his or her own insulin. .

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

.• 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.

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

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

Echo Therapeutics The Symphony System .

wireless transdermal continuous glucose monitoring system. F.• It is a non-needle. approval is expected in 2013 and is showing strong successes in clinical trials.A.D. . non-invasive. • 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].

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

• 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.

. including people.• 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.

• 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.

beta cells have died. 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. about 10% of cases.• When that happened to the mice in the study. the most frequent kind. or Type 1. or adult-onset diabetes. beta cells stop producing enough insulin. and in juvenile diabetes.

• "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 .

" ." 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.• An "artificial pancreas.

.worked as intended in a three-month study of 247 patients.• 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 -.

.• This "smart pump. is already sold in Europe." made by Minneapolis-based Medtronic Inc. 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. and the Food and Drug Administration is reviewing it now.

Thank you and God bless!  .

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