insulin

Title: insulin
Category: Medications
Created: 3/26/1998 12:00:00 AM
Last Editorial Review: 8/24/2016 12:00:00 AM

Source MedicineNet Diabetes General http://ift.tt/1AHY8KN

Your Rights, One Voice: Jennifer and Allie’s Story

Allie, left, with her brother at Tour de Cure.

It was surreal. Unimaginable. I still remember my daughter Allie’s type 1 diabetes diagnosis like it was yesterday.

My name is Jennifer Holdgreve, and that day in May 2011 changed my life forever.

Allie was only 6 years old, and she exhibited all the signs of diabetes: frequent urination, nonstop exhaustion, drinking tons of water and losing weight. When my husband and I eventually took her to the doctor, it took him all of one minute to hear the symptoms, smell her breath and realize what was wrong. We were whisked away from Centreville, Maryland, to a hospital in Baltimore via pediatric transport. We spent days in the intensive care unit getting her blood glucose under control and learning about this disease and our daughter’s new world.

We were sent home trying to comprehend that we were now responsible for literally keeping Allie alive, in addition to the regular demands of day-to-day parenting. We realized that we also needed to inform others about this new world, including Allie’s school—even when we still knew so little about diabetes ourselves. Since only one month of the school year remained, I spent my vacation time in the classroom with her. I did not know what else to do about her diabetes care at the time.

During the summer we were even more lost. We became increasingly concerned about the upcoming school year—we knew we could not spend each day in class with Allie. My husband and I felt as though we were drowning in a sea of uncertainty and confusion.

Then, one evening in August, we found our life raft. We attended a Safe at School meeting, having received a promotional flyer in the mail from the American Diabetes Association®. There, I met Crystal Jackson, Director of the Safe at School program, as well as staff from the local Association office.  All of a sudden, we were pulled back onto a boat, a big boat full of people who understood the challenges of diabetes—people who could help. We learned about 504 Plans, how to open up the lines of communication with school staff and ensure that school personnel were trained in managing Allie’s blood glucose.

From that moment, we developed a relationship with the American Diabetes Association office in Maryland and worked with them to raise awareness of type 1 diabetes. We recognized this need because we were that family who did not originally understand the causes and complexities of diabetes. Because we did not know the signs, we just as easily could have let Allie go to sleep the night of her diagnosis—and might not still have her with us today. We were that family who believed the misconceptions and did not realize there were multiple types of diabetes. We wanted to make sure others understood, so no one else would become that family. The American Diabetes Association gave us a voice to do this.

We recently used that voice to pass Safe at School legislation in our state. Just last year, we testified before our Maryland State House committee, sent letters, made phone calls and watched the governor sign the Safe at School bill. We also used that voice to improve our relationship with school staff, which enabled Allie to become her own advocate at school and guaranteed she would receive appropriate diabetes care while she’s there. Her school now has designated a Diabetes Awareness Day to recognize her and the other students living with diabetes. It was amazing see our legislative process in action and how we as advocates can make a difference.

Much like that day five years ago when Allie was first diagnosed, the night of the Safe at School meeting changed my family’s life—but this time for the better. We were finally rescued from the sea of uncertainty and given a voice to improve our daughter’s life.

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View Jennifer’s Safe at School Facebook LIVE chat with Crystal Jackson to learn more about her legislative experiences and the rights of students with diabetes.

The American Diabetes Association leads the effort to prevent and eliminate discrimination against people with diabetes at school, at work and in other parts of daily life. If you need help, call 1-800-DIABETES or visit http://ift.tt/1zCIiW2.

Through our nationwide Safe at School program, the Association is dedicated to making sure that all children with diabetes are medically safe at school and have the same educational opportunities as their peers. Visit our Safe at School website for information and resources.

Give the gift of fairness — donate now to help people with diabetes facing discrimination, just like Allie.

Source Diabetes Stops Here http://ift.tt/2bNfYZs

Mouse Study Suggests Antibiotics in Kids Might Help Spur Type 1 Diabetes

Title: Mouse Study Suggests Antibiotics in Kids Might Help Spur Type 1 Diabetes
Category: Health News
Created: 8/22/2016 12:00:00 AM
Last Editorial Review: 8/23/2016 12:00:00 AM

Source MedicineNet Diabetes General http://ift.tt/2blujNj

Identification of Novel Changes in Human Skeletal Muscle Proteome After Roux-en-Y Gastric Bypass Surgery

The mechanisms of metabolic improvements after Roux-en-Y gastric bypass (RYGB) surgery are not entirely clear. Therefore, the aim of our study was to investigate the role of obesity and RYGB on the human skeletal muscle proteome. Basal muscle biopsies were obtained from seven obese (BMI >40 kg/m²) female subjects (45.1 ± 3.6 years) pre- and 3 months post-RYGB, and euglycemic-hyperinsulinemic clamps were used to assess insulin sensitivity. Four age-matched (48.5 ± 4.7 years) lean (BMI <25 kg/m²) females served as control subjects. We performed quantitative mass spectrometry and microarray analyses on protein and RNA isolated from the muscle biopsies. Significant improvements in fasting plasma glucose (104.2 ± 7.8 vs. 86.7 ± 3.1 mg/dL) and BMI (42.1 ± 2.2 vs. 35.3 ± 1.8 kg/m²) were demonstrated in the pre- versus post-RYGB, both P < 0.05. Proteomic analysis identified 2,877 quantifiable proteins. Of these, 395 proteins were significantly altered in obesity before surgery, and 280 proteins differed significantly post-RYGB. Post-RYGB, 49 proteins were returned to normal levels after surgery. KEGG pathway analysis revealed a decreased abundance in ribosomal and oxidative phosphorylation proteins in obesity, and a normalization of ribosomal proteins post-RYGB. The transcriptomic data confirmed the normalization of the ribosomal proteins. Our results provide evidence that obesity and RYGB have a dynamic effect on the skeletal muscle proteome.

Source Diabetes Pathophysiology http://ift.tt/2bE0WrE

Hypothalamic Vitamin D Improves Glucose Homeostasis and Reduces Weight

Despite clear associations between vitamin D deficiency and obesity and/or type 2 diabetes, a causal relationship is not established. Vitamin D receptors (VDRs) are found within multiple tissues, including the brain. Given the importance of the brain in controlling both glucose levels and body weight, we hypothesized that activation of central VDR links vitamin D to the regulation of glucose and energy homeostasis. Indeed, we found that small doses of active vitamin D, 1α,25-dihydroxyvitamin D₃ (1,25D₃) (calcitriol), into the third ventricle of the brain improved glucose tolerance and markedly increased hepatic insulin sensitivity, an effect that is dependent upon VDR within the paraventricular nucleus of the hypothalamus. In addition, chronic central administration of 1,25D₃ dramatically decreased body weight by lowering food intake in obese rodents. Our data indicate that 1,25D₃-mediated changes in food intake occur through action within the arcuate nucleus. We found that VDR colocalized with and activated key appetite-regulating neurons in the arcuate, namely proopiomelanocortin neurons. Together, these findings define a novel pathway for vitamin D regulation of metabolism with unique and divergent roles for central nervous system VDR signaling. Specifically, our data suggest that vitamin D regulates glucose homeostasis via the paraventricular nuclei and energy homeostasis via the arcuate nuclei.

Source Diabetes Pathophysiology http://ift.tt/2bLXqJF

Hyaluronidase 1 Deficiency Preserves Endothelial Function and Glycocalyx Integrity in Early Streptozotocin-Induced Diabetes

Hyaluronic acid (HA) is a major component of the glycocalyx involved in the vascular wall and endothelial glomerular permeability barrier. Endocytosed hyaluronidase HYAL1 is known to degrade HA into small fragments in different cell types, including endothelial cells. In diabetes, the size and permeability of the glycocalyx are altered. In addition, patients with type 1 diabetes present increased plasma levels of both HA and HYAL1. To investigate the potential implication of HYAL1 in the development of diabetes-induced endothelium dysfunction, we measured endothelial markers, endothelium-dependent vasodilation, arteriolar glycocalyx size, and glomerular barrier properties in wild-type and HYAL1 knockout (KO) mice with or without streptozotocin (STZ)-induced diabetes. We observed that 4 weeks after STZ injections, the lack of HYAL1 1) prevents diabetes-induced increases in soluble P-selectin concentrations and limits the impact of the disease on endothelium-dependent hyperpolarization (EDH)–mediated vasorelaxation; 2) increases glycocalyx thickness and maintains glycocalyx structure and HA content during diabetes; and 3) prevents diabetes-induced glomerular barrier dysfunction assessed using the urinary albumin-to-creatinine ratio and urinary ratio of 70- to 40-kDa dextran. Our findings suggest that HYAL1 contributes to endothelial and glycocalyx dysfunction induced by diabetes. HYAL1 inhibitors could be explored as a new therapeutic approach to prevent vascular complications in diabetes.

Source Diabetes Pathophysiology http://ift.tt/2bE0sly

Calling All App Developers – New ChallengeDiabetes App Contest

Diabetes can be a time consuming and expensive disease — and no one understands this better than the people who live with it.

In the United States, diabetes and prediabetes cost us a staggering $322 billion each year in direct medical expenses and reduced productivity. And studies have shown that people with diabetes spend 2.3 times more on their health each year compared to people without diabetes, making it one of the most costly conditions plaguing communities and straining health systems — not just here, but around the world.

People living with diabetes are at an increased risk of many serious health complications, such as blindness, kidney failure, hypertension, amputation and heart attack. It’s because of this that the day-to-day management of diabetes is so critical. The amount of information people living with diabetes need to keep track of can become overwhelming, from monitoring food intake, exercise and blood glucose levels to managing medication and doctors’ visits. There is no cure for diabetes, but it can be managed, and technology is helping to rapidly improve the quality of life for individuals with diabetes.

In the spirit of innovation and as part of our mutual commitment to the diabetes community, the American Diabetes Association^® (Association) and IBM Watson Health have launched the ChallengeDiabetes App Contest to kick-start the development of cognitive mobile apps to support people living with diabetes and prediabetes. (Developers: Work fast, because the deadline for submitting is Sept. 15! More here: http://ift.tt/1tt0lyx.)

Dr. Jane Chiang, Senior Vice President of Medical Innovation

We spoke with our Senior Vice President of Medical Innovation, Dr. Jane Chiang, about the cognitive app challenge to hear how these new technology solutions could help the diabetes community — from patients to caregivers to health care providers — to improve clinical, research and lifestyle decisions for better diabetes management.

Can you give an overview of the current tools available to people with diabetes today?

Most people today use traditional tools like the glucose meters and insulin syringes to treat diabetes. Continuous glucose meters (CGMs) and insulin pumps are higher-tech tools, with an artificial pancreas soon on the horizon.

A big part of living with diabetes is self-management. What are some of the challenges a person living with diabetes experiences every day?

The daily and sometimes minute-by-minute issues, like counting carbs, dosing insulin and managing lows, are the toughest part. Technology can help with the tough decisions and ease the burden.

Why should a mobile app developer want to participate in this challenge?

Developers and companies should apply because if they have a wellness app currently on the market with a good tool to support people with diabetes or prediabetes, the Association’s and IBM’s expertise and technology can amplify its capabilities and reach. We will provide advice from diabetes experts and access to diabetes related content, and IBM Watson Health will provide insights from cognitive analysis of the data collected by the app. We will also provide consulting on business and market models.

We want to see the innovative ways app developers can empower individuals to manage their diabetes or help their loved ones. We know there are many useful apps out there already. The goal of this challenge is to showcase the most effective ones. The Association and IBM will also offer consulting on the apps go-to-market strategy, to help accelerate visibility and process for the winning app.

Why is it important for diabetes patients, caregivers and providers to have access to cognitive tools?

Technology tools and mobile apps need to be personalized in order to be most effective. Each individual is different. If tech tools can be customized and hyper-personalized to an individual’s exact situation, then we anticipate that the outcomes would be better.

For patients and caregivers, cognitive tools for people living with diabetes or prediabetes could be developed to provide tailored information and insights, reflecting individual factors such as demographics, disease stage, treatment regimen and behaviors.

Why is a cognitive app challenge like this important for the diabetes community?

This is the future of health care. “Cognitive” computing refers to systems that learn at scale, reason with purpose and interact with humans naturally. Rather than being explicitly programmed, these systems learn and reason from their interactions with us and from their experiences with their environment to provide relevant, actionable insights.

Nowadays, there is so much information that it’s tough for us to process it all. Cognitive apps have the ability to bring together siloed data, or data from a variety of sources, so that providers, caregivers and even patients themselves can get the insights they need, when they need, to make better health decisions.

What do you think developers bring to the table that the medical community wouldn’t traditionally offer to people with diabetes?

The medical community is rich with content experts and expertise — they tell you what to do. The tech community is filled with experts at the delivery — they can help with how you do something . . . like manage your diabetes.

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The ChallengeDiabetes App Contest is officially open! Developers are invited to apply for the opportunity to enhance their current cognitive mobile apps by leveraging the Watson APIs and the Association’s deep data repository of clinical and research data. The purpose of the contest is to advance the use of technology to promote health and to ultimately help improve the lives of those living with diabetes or prediabetes.

 The contest is open for submissions, and developers can visit http://ift.tt/1tt0lyx to obtain an application and learn more. Deadline to submit an application is Sept. 15, 2016.

 

Source Diabetes Stops Here http://ift.tt/2beRWFi