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Ask D’Mine: On the Way to Insulin + An IOB (Insulin on Board) Pump Question

RESEARCH DESIGN AND METHODS—We followed 135 patients with long-standing type 1 diabetes (>30 years’ duration) over a 7-year period, recording albuminuria and other clinical variables. Among the secondary effects of diabetes, the one that interests the dental surgeon most is diabetic parodontopathy. Hazard ratio (HR) for death was estimated using Cox regression analysis. It was from seeing patients that Fisher first got the hint that this diabetes-specific emotional state exists. A few months later, I found the Atkins Diet and pretty much adopted it as a way of life. The causes of death were similar in patients with normal and abnormal urine albumin excretion. The average periodontal capillary density (DC-P) was clearly superior in diabetic subjects (35.62 ± 10.40 n°loop/mm²) compared to healthy subjects (17.55 ± 3.88 n°loop/mm²).

Subjects with a 2hPG of 10.01-11.09 mmol/l had mortality risks similar to those diabetic subjects defined by an FPG >or=7.0 mmol/l. These feelings are not rare. Cut to end: I went to the lab for the official results and my A1c is now 10.1. The likelihood of progression to persistent proteinuria was significantly greater in those with baseline MA compared with those with normal albumin excretion (P < 0.001). So my question is this: what could possibly be going on? Is this the natural progression? He also found that higher blood glucose levels seemed to raise the risk of distress. Or is it likely that things will return to normal? However, the predictive value of MA in longer-duration type 1 diabetes has been questioned (9). You are on your way to insulin (eventually). Things won't ever return to "normal." Well, actually, that's a lie, because things already are normal. There's a "stigma associated with the disease," Fisher says, and that can take a toll. Type 2 diabetes is progressive. There is also insufficient information on the role of MA in predicting premature mortality in patients with MA and long-standing diabetes. I mean like the relentless march of time progressive. Type 2 diabetes gets a little bit worse every day. With type 1, hypoglycemia can be dramatic, frequent, and sudden. Here's what happened to you: After your diagnosis you made a major change in your lifestyle. There were no other inclusion or exclusion criteria. That's hard work. You started a diet that minimizes the types of foods that turn to sugar quickly. For many people, simply taking things one step at a time can be helpful, Fisher says, rather than tackling a new exercise routine, meal plan, and blood glucose–monitoring regimen all at once. You got your diabetes under control using shear grit. The same group of patients were restudied in 2000. It has a tendency to do that. The lesson here is to never turn your back on diabetes. "The other way is to target the distress directly," with cognitive behavioral "talk" therapy. Always keep one eye and a glucose meter on it. Age, year of diagnosis, current medications, smoking habits, and presence of microvascular and macrovascular disease were recorded. But it always grows. So that's what happened. In this unusual event, someone with type 1 who showed no sign of illness the evening before is found dead in the morning. You asked if you are on your way to insulin. Patients were stratified into three groups based on their urine albumin excretion at baseline. If you live long enough, you'll join our club. This doesn't mean you need insulin tomorrow, although it should be one of the options on the table for you and your doc to kick around. "It has worked out fine. One thing is for sure, you've adopted a pretty radical lifestyle (and please go get your cholesterol checked, OK?) to control your blood sugar, and your diabetes has outgrown it. Normoalbuminuria versus MA: χ2 5.9; P = 0.01. Larry from Virginia, type 3, writes: My daughter has been on the OmniPod for the last two years. As I am sure you are aware, OmniPod calculates on-board insulin differently than the other major pump manufacturers. Basically, OmniPod excludes insulin that was designated for specific carbs from the calculation. I would be curious to know your take on the matter. Wil@Ask D'Mine answers: For non-insulin shooting folks, an executive summary: Insulin can be used to both lower blood sugar or to attempt to keep blood sugar from going too high in the first place (or so we hope). Modern fast-acting insulins take about 20 minutes to start working, hit their peak at two hours and call it a day after four hours. Damn! Where can I find a job like that? Anyway, anyone shooting insulin is theoretically at risk of stacking up too much insulin if they take more than one dose in a four-hour period, and too much insulin can lead to low blood sugar, which can be dangerous. All of that said, there are many, many times when you do need to take insulin twice (or more) in a four-hour period. So you have to try and keep track of how much insulin might still be floating around in your body from the last dose when you think about taking your next one. This is one area where an insulin pump can theoretically excel -- it can keep track of all the insulin given and when, how long it's going to last and how strong any remaining insulin on board (IOB). There're two broad ways to calculate this insulin still on the job; but you're misinformed about the non-OmniPod pumps being different - all the major pump choices here in the States go about keeping track of this already-taken insulin in pretty much the same way. All the current pumps assume that insulin given to cover food will get sucked up by the food, and the only spare insulin is the insulin taken for corrections. So they only track insulin from corrections. Oh, the devil is in the details, of course, and there's quite a bit of difference in the mathematics of how they go about doing that. Ãœber CDE GaryScheiner discusses the finer points in detail here. But back in the day (several years ago) there was a pump called the Cozmo that was radically different than the current choices. Sadly, like the Triceratops, it's now extinct. Well, nearly extinct, anyway. A few of us old-timers are still holding on to our aging Cozmos, and the #1 reason for this is the different way the Cozmo pump calculates on-board insulin. It assumes that all insulin matters and it tracks both meal boluses and correction insulin. Now, I'm a pump vet and a certified pump trainer. My personal, professional, and recreational life is diabetes 24/7/365. You might think I'd be an awesome carb counter, that I always take the right amount of insulin for my food, and would be just fine with any state-of-the-art pumps. The idea that my best-guess carb count will always nicely suck up my meal insulin is crazy. I think a good insulin pump needs to recognize the reality in the trenches, and the reality in the trenches is that, like me, most of us PWDs reliably get it wrong a lot of the time. A pump that keeps track of all the insulin on board is safer, more realistic and a better service to its wearer than a pump that ignores more than half the insulin you take. When your daughter's OmniPod came on the scene, the OmniPod folks apparently surveyed endos to see if the "Medtronic Way" or the "Cozmo Way" was more popular. Apparently, 51% percent of endos preferred the Med-T system so that's what OmniPod went with. Why on earth they didn't just create a way for the user or doctor to choose either is beyond me. When the Solo pump was first approved there was a lot of excitement as they were trumpeting the fact that the new patch pump would use the Cozmo Way of tracking insulin in the bod. But they've since been bought by Roche, and only time will tell if this feature will change by the time the device actually gets to market. There are a lot of reasons to choose one pump over another, but right now the insulin-tracking feature of the current pumps track insulin still on the job is not one of them. This is not a medical advice column. We are PWDs freely and openly sharing the wisdom of our collected experiences — our been-there-done-that knowledge from the trenches. But we are not MDs, RNs, NPs, PAs, CDEs, or partridges in pear trees. Bottom line: we are only a small part of your total prescription. You still need the professional advice, treatment, and care of a licensed medical professional. This content is created for Diabetes Mine, a consumer health blog focused on the diabetes community. The content is not medically reviewed and doesn't adhere to Healthline's editorial guidelines. For more information about Healthline's partnership with Diabetes Mine, please click here.

Drop the Can! 3 Soda Substitutes After Pop Linked to Aggression in Kids

Yes. Since then, many people have compared chimpanzee intergroup aggression to primitive warfare, and have argued that chimpanzee violence is an adaptive strategy that gives the perpetrators an edge. The research is part of a larger effort to incorporate big data into science, rather than relying on the time- and cost-intensive process of collecting representative samples and conducting surveys. Why? Your dog could encounter hormonal imbalance, some dog breeds are prone to an increase in thyroid abnormalities, for example. For example, hip dysplasia which is very common in dogs will either make aggression worse, or cause it to occur in dogs that have had no previous history of being aggressive. As a result, almost all men with PSA-detected cancer opt for treatment, which can leave long-lasting physical and emotional scars.

In our modern society with ample food, the carriers of the mutation who have normal or low levels of testosterone may be better protected from metabolic

I want to know more on impotence due to diabetis?


Male impotence is also known as erectile dysfunction and is the lack of a person’s physiological sexual ability. Irwin Goldstein, from Boston University School of Medicine in a study published in the August 2000, issue of Urology. Organic or physical causes for sexual dysfunction in men include vascular, hormonal and neurologic factors. An appointment will be made for you to see a primary care physician. It can happen once or many times and the majority of men (regardless of what they may tell one another) experience it at some time. My blood sugar levels are fasting 94 mg/dl and PP 147 mg/dl. But if this remains above normal, even at rest then it is classed as high blood pressure.

Diabetic men of both types show the same preferences in quality and quantity of treatment after 10 years. In any case, when sexual dysfunction begins to happen on a regular basis it tends to get worse unless it is properly treated, so the psychological element inevitably builds up. The treatment

Integrating data from an online diabetes prevention program into an electronic health record and clinical

Proteins sometimes run amuck. Transition probabilities can be a function of individual characteristics, current disease states or treatment status. Scheme of the glucose–insulin control system. The BDA undertook their own independent assessment of the program, which involved distributing AIDA to a panel of potential end-users (health-care professionals and patients). THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCE OF THE PROGRAM IS WITH YOU. The overall paradigm adopted for this study has endeavored to establish why people are resorting to the Internet to obtain diabetes information. Over a 7(1/2)-month period (from mid-July 2000 to early March 2001) 2437 responses were received.

It is actually a new integration with Abbott Diabetes Care’s CoPilot logging program. The Diabetes Care Value Program features a network of preferred pharmacies that will deliver on a set of quality metrics, including high medication adherence levels for patients with diabetes. In 2008/2009

Understanding Pregnancy-Induced Changes in Glyburide PK/PD for the Improved Management of Gestational Diabetes Mellitus (GDM)

Why is Glyburide prescribed? This off-label use of glyburide by physicians is most likely due to the fact that it is much easier for patients to take a glyburide pill than it is to use a syringe to inject themselves with insulin. My fasting numbers are over 90, usually 98 or so (doctor says they’re high) with my other numbers way below 120 (usually 95-105). “We need to better understand which women can be treated effectively with glyburide, considering not only the short-term but also the long-term effects that these treatments may have on the health of their newborns,” she said. Thus, there is a need for large, randomized, controlled trials with adequate power to evaluate the possibility of increased neonatal metabolic complications as well as the long-term outcome of infants born to mothers treated with glyburide and insulin. In vascular rings from GDM, methiothepin (a 5-HT(1)/5-HT(2) receptor antagonist) significantly reduced 5-HT-induced contraction to a similar

Insulin Levels Vs. Glucose Levels

I had my first testing kit 10 years ago when I was diagnosed type2. Devices such as blood-glucose tests and blood-pressure kits make it easier for people to self-monitor conditions such as diabetes and hypertension. Normal fasting range is 70-130mg/dl. These tests are extremely useful for those people who have less time to spare and even aged people. A Reagent strip is covered with glucose oxidase (an enzyme that interacts with glucose). However, my husband is also borderline and has much more trouble with diet as he travels on business a lot. Provides a quantitative measurement of total cholesterol in whole blood.

Do not adjust your medications unless instructed to do so by your doctor or healthcare provider. Don’t let up, but try to relax a bit and not worry too much. If you’re concerned about your results or have a question we can arrange for you to attend our clinic and see a private doctor or you can take your results to your GP. While there are ideal readings for various

Study: Obesity surgery can cure diabetes

Next Article > Newswise — BOSTON – Nov. The aim of care is to minimise the complications through euglycaemia but in the long term, this is rarely possible. It involves various surgical procedures on the gastrointestinal tract to decrease food intake and modify the physiological changes that drive weight regain. As obesity increased during the last decades, the number of surgeries being performed increased drastically, therefore allowing more studies and comparison. The small stomach means you’ll feel full more quickly, thus reducing the amount of food eaten. These procedures offer much better results in those with more than ideal weight and in those with diabetes of shorted duration (few years), than in those who have already damaged their end organs like kidney, eye, heart etc. At the late 1990s all these procedures were done laparoscopically through very small incisions with very little pain and discomfort and 1 day hospital stay.

It is important that a patient reveal

subclinical Hyperthyroidism, diabetes, bone loss

In type 1 diabetes, diabetic bone disease (DBD) is characterized by decreased bone mineral density, a state of low bone turnover and an increased risk of fracture. Occlusal trauma (OT) is an injury of the supportive periodontium that results in bone loss. Study groups were as follows: 1) non-ligated control (NL, n = 6); 2) streptozotocin (STZ, n = 8); 3) STZ and melatonin (STZ+Mel, n = 8); 4) ligature (L, n = 6); 5) ligature and melatonin (L+Mel, n = 8); 6) STZ and ligature (STZ+L, n = 8); and 7) STZ, ligature, and melatonin (STZ+L+Mel, n = 8). Optimal therapeutic methods for diabetic bone complication are still lacking. 1.8% in ILI and DSE, respectively; P < 0.01) and increased fitness (6.4% vs. The study was conducted in two endocrinology practices in Midland, Texas, and Buffalo, New York. The mechanisms behind the higher rates of bone loss and fracture risk seen in postmenopausal women remain unclear, but factors such as insulin fluctuations are considered prime culprits, said Naila Khalil, PhD, lead author of the study and postdoctoral research associate with the Department of Community Health, Lifespan Health Research Center, at Wright State University in Kettering, Ohio. At day 20, tibia bone loss was assessed using micro-computed tomography and hematoxylin and eosin staining. The mechanical resistance of femora to fracture was assessed using a three-point bending test, and serum levels of bone metabolic markers were measured. In contrast, 12/39 (30.8%) children from the control group had a Z score below zero, but none had a score below −1. These results suggest that constitutively elevated PSL is associated with bone loss and T2D via a homeostatic interplay between the peripheral 5HT, bone and insulin. Thus, C-peptide may be not only a marker but it may also have an active role in the development of osteoporosis. I was Dx’ed in 2005 with subclinical hyperthyroidism and had an A1C of 8.2. My doctor recommended I consider RAI. The compound increases bone mass by protecting and increasing the activity of bone cells in various stages of normal bone maintenance, utilizing mechanisms that overlap those that regulate whole-body energy metabolism. Whether the direct effect of insulin on osteoblasts has clinical significance, however, is not entirely clear. Today I’m more pro-active with my health. Through diet, exercise, sleep and stress reduction in the last 4 months, my diabetes has come under control with a A1C of 5.6. No medications and my doctor MD/Internist is very supportive. For the last month my interest has turned to addressing my subHyperT. I’m a little hyper, startle easy, about 20lbs overweight but otherwise cope well with some of the mild symptoms. I’m reading about nutrient & mineral losses and will have a lab test for D this week. & Rosen, C. My diet plan is to increase my supplementation of D, calcium, magnesium, beta carotene, K, L-Carnitine and CoQ10, at least up to RDA or higher if needed. Everything was looking rosy until a couple of days ago when I received a dexa lab report that worries me. It says I have bone loss and “significant” osteopenia in my hip and femoral neck. My total hip BMD and Tscore are 0.855 and -1.2. My femoral neck was 0.612 and –2.0. This bone loss is the crux of my question: can subHyperT cause bone loss and, if so, will tweaking on T4/T3 change anything for the better? Like lowering TH slightly until TSH starts to move a little. Is there a known safe level for T4/T3 to be under to prevent bone loss during the long haul? It seems the parathyroid controls bone tear down & rebuilding and the thyroid isn’t in the feedback loop. There doesn’t seem to be a direct hormonal connection between the parathyroid and the hypothalamus-pituitary-thyroid axis. I’m guessing a metabolism that’s really out of whack with high levels of TH causes the bone tear down to be dominant over the parathyroid. But, within normal TH ranges (in my case), the calcium / vitamin D process is a closed loop between the intestines, kidneys, liver and parathyroid and it should be able to compensate for small variations of TH.

Protein and Heart Health

The American Heart Association (AHA) does not officially endorse the American Heart Association 3-Day Diet. Enjoy at least 2 servings of baked or grilled fish each week, especially oily fish. Even if these organization believe their advice is correct, I don’t see how they could feel successful in their missions. Approximately 15% of total daily calories consumed should be derived from protein and ≥70% from carbohydrates. First it’s important to admit that the AHA has a legitimate point: the Lancet study is by no means perfect and it certainly doesn’t “prove” the case against salt restriction. Discard two of the yolks from the hard-boiled eggs, coarsely chop what’s left and sprinkle chopped egg over the top of the lettuce. “Think of your experience in a restaurant after a meal when the dessert cart comes by,” Ryan said.

Your food plan is personalized, based on your age, gender, height, weight, and physical activity level. So, Dr. The chemicals used to create

Post Workout Diabetes Snacks | ADW Diabetes

I’d like to introduce husband and wife, fitness instructors, Christel (who has type 1 diabetes) and Tobias. Very tasty. Swimming, walking. While autophagy occurs at a basal level under normal circumstances, it is also stimulated by starvation and other stressors, enabling cells to adapt to changing conditions and needs. You are so much more. Norepinephrine has been shown to increase both the strength and the frequency of uterine contractions. Find the sugar content of a food on its food label.

For her patients with hypothyroidism, Hatipoglu recommends both aerobic exercise and weight training. Other than extreme anaerobic powerlifting (which I doubt many here are doing), muscle glycogen isn’t really needed – and much less so with keto adaptation. Think of a MET as the fold-change in work rate due to a particular activity. Short, low-impact workouts may not require a snack afterward. We’ve found that a varied supply of music with a strong beat offers good stimulation