19 February 2011

More Bariatric Surgery Seems Unnecessary

It is easier to understand why bariatric surgery is being pushed harder for people with lower body mass index. The FDA has now approved the Lap-Band Adjustable Gastric Banding (LBAGB) System for obese adults with at least one obesity-related medical condition. This means that these people will no longer be available for bariatric surgery, and they don't want to lose a lucrative source of income.

The lap-band is an inflatable band that is placed around the upper part of your stomach and it is used to help limit the amount of food that can enter your stomach. The FDA's approval means lap-band surgery will now be available to patients with a body mass index (BMI) of 30 or higher who have at least one obesity-related condition, such as diabetes.

Previously, the lap-band system could only be used in adults with a BMI of at least 40 or a BMI of 35 or higher with at least one severe obesity-related medical condition. Now when the new research is put next to it, current guidelines, bariatric surgery is only indicated for the treatment of severe or morbid obesity, defined as having a body mass index (BMI) of 35 or greater.

By contrast, the new study is open to patients with a BMI as low as 26. Normal-weight individuals have BMI ranging between 19 and 25 and overweight individuals have BMI between 26 and 29, whereas a BMI above 30 defines obesity. Patients with a BMI below 26 and above 35 will not be considered for enrollment in the trial.

Previous research has shown that in severely obese patients (BMI greater than 35) gastric bypass surgery is a safe and effective way to treat Type 2 diabetes. It has been shown to improve or normalize blood glucose levels, reduce or even eliminate the need for medication, and lower the risk for diabetes-related death. Read my blog here about how bariatric surgery may only be masking the problems of diabetes.

The lap band was for BMI of 35 and higher and now is approved for BMI of 30 and higher so the bariatric surgeons who used to operate for BMI of 30 to 35 are investigating 25 to 29 to keep their income from expensive surgeries.

Read both articles, the one on bariatric surgeries here, and the lap-band article here.

18 February 2011

Money Pledged for Final Phase II NZ Porcine Trial

DIABECELL now has the money pledged to the final participants in their phase II trial. Two international charitable foundations, New Zealand-based Cure Kids and U.S.-based Children with Diabetes Foundation, have each pledged to provide US $140,000 to fund the final two patients in a Phase II clinical trial in New Zealand that may well transform the treatment of Type 1 diabetes.

The trial is testing DIABECELL as a treatment for Type 1 diabetes and has been developed by Living Cell Technologies, an Australian company domiciled in New Zealand. DIABECELL is designed to help normalize the lives of people with unstable Type 1 diabetes, especially those suffering from life-threatening episodes of unaware hypoglycemia. Tiny DIABECELL micro-spheres containing live islet cells are implanted into a patient's abdomen using a simple laparoscopic procedure.

Once implanted, DIABECELL works by self-regulating and efficiently secreting insulin in response to the patient's changing glucose levels. DIABECELL islets are protected from the body's immune response by LCT's breakthrough proprietary encapsulation technology, so DIABECELL patients do not require any immunosuppression.

To date, twelve of the approved New Zealand patients with unstable insulin dependent diabetes have received this ground-breaking treatment, which has been shown to safely improve diabetes management and reduce or eliminate episodes of life-threatening low blood glucose levels. The dramatic results to date show DIABECELL’s ability to ameliorate this serious complication of diabetes, known as hypoglycemic unawareness, is an important potential benefit to patients.

Read the full press release here from February 16, 2011.

17 February 2011

Vegans' May Need Omega-3s and B12

Are you a person that follows a vegan lifestyle? If so, please carefully read an article about the study that appears in ACS' Journal of Agricultural and Food Chemistry. The article is here.

The review of dozens of articles published on the biochemistry of vegetarianism during the past 30 years led to the conclusion that those that are strict vegetarians, and that eat no meat or animal products, may be at increased risk of heart problems. They may be likely to develop blood clots and atherosclerosis.

It is known that meat eaters have a significantly higher risk or cardiovascular events than vegetarians; however, lower-risk vegans, may not be immune. Vegan diets tend to be lacking several key nutrients – iron, zinc, vitamin B12, and omega-3 fatty acids.

So if you are a person with diabetes, have a talk with your doctor and have a test for at least B12 to determine if you have a level within the acceptable range. If you are in the low part of the range or just low, make sure that you eat foods rich in B12 or if the doctor recommends it, a B12 supplement.

Also consider adding fish oil supplements or foods rich in omega-3. There is also a test for omega-3. Read David Mendosa's blog here for further information and his blog here for information on the tests and where to obtain them.

16 February 2011

USDA Again Testing Food for Nutrients

USDA is testing foods for nutrients and healthiness issues to update what was done in 2002. The first to be reported is eggs. While the press release emphasizes cholesterol and vitamin D, all it says in addition is that it is testing a host of other nutrients. To date I have not been able to locate the results of the tests.

The press release states that the level of cholesterol has dropped by 14 percent and the level of vitamin D has increased by 64 percent. The tests are from regular large-shell eggs selected from a dozen locations across the country. The eggs were then tested by an independent laboratory at Virginia Tech University.

What seems so false in the report is the credit given to farmers for the change in the levels because of feed changes. No mention is made giving credit to feed manufacturing companies that have put research from universities and their own laboratories into better feeds for the farmers to use.

The new information will be updated on nutrition labels on cartons of eggs in the grocery stores and on the menus. With this I had to go and save an egg carton so that I can watch for changes over the next few months to see if the changes are actually made.

Even the eggs are being back some of the good name they used to have. The limit of one egg per day has not changed yet, but at least egg substitutes are receiving less credit for being better than eggs. I am sure there will be a rash of new studies from the anti-egg people insisting that eggs are still not good for you.

With the new information, at least the American Egg Board and other agricultural groups can again promote the eggs as being heart-healthy. Read the article from the press release here.

15 February 2011

Diabetics May Be Getting Second Rate Care

This article is very disturbing. It has to do with women with breast cancer and also diabetes. So I am asking you to think, can this apply to all cancers and diabetes. The findings were published in the January issue of the Journal of Clinical Oncology. This suggests future research could focus on whether high levels of insulin in patients with type 2 diabetes could play a role in promoting tumor growth.

The researchers who conducted the review also found that diabetics tend to be diagnosed with later-stage breast cancers and to receive altered, potentially less effective treatment regimens. This sends shivers up my spine. If this happens for women with breast cancer, who else with cancer and diabetes gets treated like this?

Kimberly S. Peairs, M.D., an assistant professor of medicine at the Johns Hopkins University School of Medicine says "This research suggests we may need to proactively treat the diabetes as well as the cancer." She also suggests “that diabetics diagnosed with breast cancer may get less effective treatment because practitioners may be concerned about these patients suffering more side effects from chemotherapy or radiation treatments as a result of the metabolic condition.”

The research also shows breast cancer patients are nearly 50 percent more likely to die of any cause if they also have diabetes. Dr Peairs is less than complementary about the reasons women with diabetes get possible poor care. She says more research is needed to reveal whether increased insulin production in people with Type 2 diabetes contributes to worse outcomes among breast cancer patients.

There are some studies that do suggest poor outcomes with some diabetes drugs for cancer patients and that other medications may actually improve survival. Metformin is one such drug which makes diabetes patients more insulin-sensitive and thereby lowering the amount of unused insulin in the body.

Read the article here and from the second one here.

14 February 2011

Kidney Dysfunction Prevalent in Western Diets

After losing three friends to kidney failure, this is of interest to me and if you have diabetes, you should be interested too. At the same time, the study is biased toward women as there were no males included in the study. Excellent topic for a study, but then they invalidate the results by limiting the participant pool to elderly white women.

Even the study authors even said it could have been made more generalizable by validation in nonwhites and men. How studies like this are funded leaves me wondering what people that think up and design these studies have on their agenda.

The study compared three types of diets which can be good examples. These are a Western diet high in red and processed meats, saturated fats and sweets, a prudent diet high if fruits, vegetables, legumes, fish, poultry, and whole grains, and a DASH-style dietary pattern.

The study showed that diets similar to the Dietary Approach to Stop Hypertension (DASH) diet may be protective against rapid decline of kidney damage. Previous research of dietary patterns to cardiovascular disease and other chronic diseases have been linked, but none have made any connection between diet and and the likelihood for the development of microalbuminuria or kidney function decrease.

If this is indeed one of the earliest studies of this nature, then more studies should be done immediately for conclusive evidence and allow for actions to reduce the problems in people using Western diets.

Read the article on the study here.

13 February 2011

How to Care for Your Hands for BG Testing

Thank goodness for some media sources. In this, I first have to thank Tom Ross at Not Medicated Yet for his blog and alerting me to this study. Tom links to American Diabetes Association Care section and when I asked, he told me about a medscape article. Further research uncovered the same article at Reuters Health without the spelling error Tom had so much fun with.

If it was not for these two sources, many of us may have missed something important that the ADA wants to keep out of sight for us patients and many doctors will also miss. This subject needs wide distribution and press so that more people will become aware of the proper procedures for hand care before blood glucose testing. Do not expect ADA to say much about this as hand cleaning procedures recommended by the study goes against meter manufacturers recommendations.

First, this is just another reason to not use alcohol swabs, they proved in this study that they are ineffective and do not prevent erroneous readings even with use five times. Washing with tap water is the recommendation of the study. Nothing was said about warm or cold water as well no mention was made of using soap. I personally use warm water and soap and not alcohol swabs which can severely dry and crack your fingers.

Tom covers the facts of the study, so please read his blog of February 11, 2011. Then take time to read the Reuters Health article here. Then think about contacting ADA and asking for them to make the study more public. Studies like this that affect us, the patients, needs to be made public and not hidden from patients and requiring a fee of $45 to see.