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A Simple Probiotic Pill May Control Type 1 and Type 2 Diabetes

4 Feb

Over the past few years, scientists have been intensely studying the flora (a.k.a. bacteria) of the human intestine to unlock the secrets it may hold in influencing our health.

probiotcis diabetes

Scientists at Cornell University in New York have discovered a protein secreted by a particular form of bacteria which can shift control of insulin from the pancreas to the upper intestine. The pancreas is the organ which controls blood glucose levels in healthy individuals.

If a person has type 1 diabetes, their pancreas is unable to produce insulin. In type 2 diabetes, the person’s cells are unable to utilize insulin correctly. Yet proper insulin control is crucial to health, as the hormone regulates how cells utilize blood sugar (glucose) to produce energy. If insulin is not produced or not utilized correctly, blood sugar remains in the bloodstream, creating a host of side effects.

The Cornell research team, led by Professor John March, engineered a strain of Lactobacillus, a bacteria found in the human gut, to secrete a hormone that triggers the release of insulin in response to food entering the digestive tract.

The team studied blood glucose levels in two sets of rats. One set received a pill form of the live bacteria, which was administered for a 90 day period. The other group of rats received a placebo. The scientists found that the bodies of diabetic rats which had received the treatment had shifted control of blood sugar levels from the pancreas to the upper intestine. They also found that the diabetic rats’ blood glucose levels were up to 30 percent lower than rats which did not receive the pill. But the scientists also discovered that the cells in the upper intestine of the diabetic rats converted into cells which mimicked pancreatic cells – the same cells which secrete insulin in non-diabetics.

Interestingly, in those rats who were not diabetic, no change occurred in blood glucose levels. “If the rat is managing its glucose, it doesn’t need more insulin,”, Professor March said.

It’s important to note that the probiotic used in the research is different from the probiotic dairy products widely available. The next step is to test higher doses of the medicine to establish if the probiotic could reverse diabetes altogether.

Professor March remarked, “If it works really well in people, it could be that they just take a pill and wouldn’t have to do anything else to control their diabetes. It is likely though that it will be used in conjunction with some other treatment.”

The study was published in the journal Diabetes.

Diabetic Tattoo Monitors Blood Glucose

20 Jan diabetes tattoo

Any diabetic will tell you that checking blood glucose readings is a real pain in the finger. Multiple daily “sticks” with a lancet and forcing a drop of blood onto a test strip connected to a blood glucose meter is to say the least, not appealing. It also can be difficult for some patients to perform and the cost of the test strips can become very expensive.

As a result, some diabetics don’t monitor their blood glucose levels as often as they should. Unfortunately, their diabetes healthcare professionals absolutely rely on this method to make sure blood glucose levels of the patient are within normal range.

diabetes tattoo

For these reasons, scientists have spent years searching for a pain-free way for patients to measure their blood glucose levels. Recently, nanoengineers at the University of California, San Diego, developed a temporary tattoo which just may do the trick. The tattoo holds a flexible, highly sensitive glucose sensor which uses a mild electrical current to measure blood glucose levels. The tattoo is painless, as it simply contains electrodes printed on thin, disposable tattoo paper.

The concept of a wearable blood glucose sensor is not new, however. In 2002, a similar device was marketed, called GlucoWatch. But the device was discontinued because it caused skin irritation in some patients, a reaction to the strength of the electrical current. But the UC San Diego sensor avoids this problem by using a lower electrical current to measure the glucose. None of the test subjects reported any discomfort while using the device.

“Presently the tattoo sensor can easily survive for a day,” says Amay Bandodkar, a graduate student researcher at UC San Diego. “These are extremely inexpensive—a few cents—and hence can be replaced without much financial burden on the patient.”

The diabetic tattoo was tested at UC San Diego and measured blood glucose levels in healthy patients as accurately as a blood glucose meter. The tattoo’s development is only a few steps away from providing the numerical values of glucose levels which diabetic patients and healthcare professionals are familiar with. This is a very promising step forward in noninvasive glucose testing for those with diabetes.

How to make it through Thanksgiving with diabetes

24 Nov

Oh it’s so tempting: the turkey, the gravy, the stuffing, the mashed potatoes, the carrots with brown sugar, and then of course,…. THE DREADED PUMPKIN PIE!

thanksgiving turkey and mashed potatoes

Careful on that gravy, sir!

 

The traditional Thanksgiving feast is basically a carb-fest, which is why we fall asleep on the couch and miss the last quarter of the Detroit game every year (it isn’t the tryptophan in the turkey that makes you sleepy, it’s all of the carbohydrates you eat). For a non-diabetic, it’s a fun day of gluttony. But for a diabetic, it can be downright dangerous.

Not to harsh your Thanksgiving buzz, but…

The turkey part of the Thanksgiving feast is just fine for those with diabetes, within reason, as long as you take it easy on the gravy. It’s everything else that will send your blood sugar into parts hitherto unknown. But if you learn what’s bad for your blood sugar and what’s not, you’ll make it through Thanksgiving and the holidays in general without a trip to the ER.

Make a Plan. Whether you’re doing the cooking or Aunt Bessie is doing the honors, know what’s on the menu and make a plan for what you’ll eat and what you definitely won’t. Anyone who’s spent a few holidays with family has a good idea of who’s bringing what to the feast, as we’re all creatures of habit. “Diabetes or not, excessive amounts of anything unhealthy should be avoided,” says Aaron Kowalski​ of the Juvenile Diabetes Research Fund, an organization that supports Type 1 diabetes research. “The challenge for people with diabetes is that they need to match the insulin they give themselves to the food they eat. People with diabetes need to plan ahead with their insulin when eating high carbohydrate foods.”

Eat in moderation. Too much of a good thing can be troublesome for diabetics. Having small portions of gravy, mashed potatoes, and candied sweet potatoes shouldn’t be a problem. They key is to follow the My Plate recommendation from the USDA: Make half of your plate vegetables, one-quarter protein, and one-quarter carbohydrates. Opt for fresh vegetables without toppings whenever possible.

Learn to love vegetables – the right ones. You can have a free-for-all with carrots, green beans, brussels sprouts, and broccoli. But corn and anything in the squash family – squash, winter squash, butternut squash, acorn squash, or pumpkin is actually a carbohydrate and needs to be accounted for in your carb allowance. Starchy vegetables like these fill the same space on your plate as mashed potatoes and desserts, and while they don’t have to be completely avoided, they should only be eaten only in small amounts. Learn to count your carbohydrates with the American Diabetes Association.

Check your blood sugar more than once on Thanksgiving. Those with diabetes should normally check their blood sugar once or twice a day. On Thanksgiving Day, diabetics should check their blood sugar two hours after eating, and every hour after that. “This will give a picture of how you’re responding to the meal”, says Paula Jacobs​, a certified diabetes educator with Methodist Charlton Medical Center in Texas. “About two hours is required for the food to be digested and enter the blood stream, so this time frame gives a good picture of how the meal is being processed by the body,”

Eat dessert if you want to, just don’t overdo it. Until recently, the medical advice for diabetics was to avoid carbohydrate-heavy desserts at all costs. Now the recommendation is to be reasonable with portion size and account for those carbohydrates in your meal plan for the day. “If you had turkey and non-starchy vegetables like green beans or carrots, then there are no carbohydrates accounted for and you’d be able to have dessert,” says Amy Kimberlain​, a registered dietitian with Diabetes Research Institute Foundation. “What you wouldn’t want to do is have the stuffing, the corn casserole, the dinner roll and dessert, because you will have well exceeded your carbohydrates allotment.”

If you’re diabetic, it’s okay to enjoy yourself at Thanksgiving, but don’t overindulge. Eat in moderation and keep track of your carbohydrates, and you can enjoy the day like the rest of the family.

Philadelphia Top U.S. City For Percentage Of Residents With Diabetes

18 Nov

philadelphia love statue

The news for the residents of Philadelphia is not great when it comes to diabetes. Between 2002-2010, diabetes rates in the most impoverished neighborhoods of the City of Brotherly Love skyrocketed to an unprecedented percentage of population. So much so in fact, that Philadelphia now holds the not-so-wonderful title of largest city in the U.S. with the highest per capita diabetes rate.

Health researchers at Philly’s Drexel University have been studying new ways to pinpoint who is most at risk for diabetes and its most common side effect, heart disease. “Just having diabetes actually increases your risk for heart disease almost as if you’ve had a heart attack already, that’s how profound an effect it is,” said Internist Ana Núñez, a lead member of the Drexel team studying health disparities related to cardiovascular disease.

The map below shows the increase in diabetes rates by zip codes in Philadelphia. The red areas of the map represent diabetes density in the neighborhoods as high as 20.41% of the population, tan as high as 13.97 %, green as high as 10.62%, and blue as high as 7.11%. Even with the most cursory glance at the map, it’s easy to see the increase – for instance, note the lack of blue in 2008-2010 (right), compared to 2002-2004 (left). The red zones also happen to be the most underprivileged neighborhoods in the city.

diabetes rates in philadelphia map

Click on map for a larger view

Part of the work at Drexel’s School of Public Health has focused on the health consequences of living in disadvantaged neighborhoods. No one can ignore the glut of fast food restaurants in these neighborhoods, but the diabetes problem runs much deeper and is more complicated than that. It’s partly education, partly cultural, and partly a lack of resources.

“If you are person with diabetes, and you have to store insulin, it has to be in a refrigerator, and there are places in Philadelphia where residents don’t have resources for a refrigerator. But are you going to say at your doctor’s visit as you get your refill, ‘I don’t have a refrigerator?” Núñez said. She is also studying residents of these neighborhoods who manage to maintain good health and exercise regularly “based upon either family support, headset, motivation, or resources.”

The benefit of this information? It may be useful for policy leaders – both at the municipal, state, federal, and NGO levels – to invest in these regions to discover ways to bring down the diabetes rate and improve health overall.

Diabetes Food Myths

12 Nov

diabetes food myths

There are a lot of myths about the foods that diabetics should or shouldn’t eat. If you’ve been newly diagnosed with diabetes, you may hear a lot of input from your friends and family about which of these foods are good or bad for your disease. Unfortunately, much of the advice you’ll hear is just plain wrong and potentially dangerous. There’s a lot of bad info online too, so it’s time to set the record straight.

I can eat all of the fruit I want, because it’s a healthy food.

Well, not exactly. Yes indeed, fruit is a healthy choice. But fruit is a carbohydrate. All carbs, regardless of their source, are broken down in the body and converted into blood sugar for energy. Therefore, all carbs – like fruit, starches, breads, and milk – raise blood sugar. Yes, healthy carbs should be a regular part of your diet, but not in “all you want” quantities. The amount of carbs you eat at any given time should be monitored to avoid a dangerous spike in blood sugar.

I can eat anything I want as long as I take additional medicine

No. More food leads to weight gain, and extra body weight creates more insulin resistance, which requires… more medicine. Extra body weight may also increase blood pressure and elevate cholesterol levels. Your metformin, insulin, or other blood glucose medicine is meant to control your blood sugar, not indulge your overeating.

All white foods are bad for diabetics

No. The initial advice from your dietician when one develops diabetes is to reduce your consumption of potatoes, white flour products, white sugar, white pasta and white rice, to lower your blood glucose levels. It’s a simple leap to include all foods that are white. Unfortunately, healthy choices get thrown in there too, like milk, cauliflower, yogurt, bananas, and bean sprouts. These last foods are actually very healthy choices, but (as above), diabetics must always count their carbohydrates.

Diabetics should definitely substitute white rice for brown rice, white bread for whole wheat or whole grain, and white pasta for whole grain or whole wheat. Whole grains cause blood sugar to rise more slowly than their white flour counterparts, and whole grain products are higher in fiber and B vitamins. But even whole grain products are carbohydrates, and must be counted accordingly.

When it comes to food and diabetes, all things in moderation, even the healthy things.

Can This Drug Reverse Diabetes?

6 Nov

What a thought. A common drug, already on the market to treat a different disease, may be able to reverse the course of diabetes for millions of people.

pancreas-showing-diabetes

In type 1 diabetes, beta cells in the pancreas are attacked by the immune system.

We all know the stats behind diabetes: it’s the 7th leading cause of death in the U.S. and contributes to heart disease, kidney disease, eye disease, neuropathy, and a host of other conditions. But researchers at the University of Alabama’s Comprehensive Diabetes Center will soon begin human trials to determine if a common drug prescribed for high blood pressure, verapamil, can stop the progression of diabetes and in some cases reverse it.

More than a decade of research

In 2002, Anath Shalev, M.D., a diabetes researcher at the University of Wisconsin – Madison, started investigating what genes in the human pancreas responded greatest to high levels of blood glucose. In type 1 and type 2 diabetes, certain beta cells in the pancreas – known as islet beta cells – are gradually lost to genetically programmed cell death, for reasons unknown. As these beta cells are lost, diabetes becomes much worse. Shalev’s research on islet beta cells revealed that a gene in these cells was producing a protein called TXNIP, which previous studies showed is overproduced in beta cells in the presence of high blood sugar. Too much TXNIP causes beta cell death and inhibits the body’s natural production of insulin.

For 12 years Shalev continued her research, eventually leaving the U of Wis to head the UAB’s Comprehensive Diabetes Center. Using cell cultures, mouse models, and pancreatic islet cells from humans, Shalev eventually showed that manipulating TXNIP could protect mice against diabetes or make it much worse.

In 2012, building on research from other teams, Shalev started testing verapamil on human islet beta cells. She discovered that the drug reduced TXNIP, and halted the death of beta cells. Shalev also discovered that mice which were fed verapamil in their drinking water actually reversed the course of their diabetes, and the drug protected other mice against diabetes. The following year, Shalev’s team discovered that high levels of TXNIP actually blocked insulin production in beta cells.

Clinical trials begin in 2015

In a recent press release Shalev stated that, “We have shown that verapamil can prevent diabetes and even reverse the disease in mouse models and reduce TXNIP in human islet beta cells, suggesting that it may have beneficial effects in humans as well. That is a proof-of-concept that, by lowering TXNIP, even in the context of the worst diabetes, we have beneficial effects. And all of this addresses the main underlying cause of the disease — beta cell loss.”

Clinical trials will begin soon to see if verapamil has the same effect on human type 1 diabetics as it does on mice. The three-year, $2.1 million trial will be conducted by the UAB Comprehensive Diabetes Center with funding from JDRF, the largest charitable supporter of type 1 diabetes research.

But Shalev expressed caution regarding the research results: “While in a best-case scenario, the patients would have an increase in beta cells to the point that they produce enough insulin and no longer require any insulin injections — thereby representing a total cure — this is extremely unlikely to happen in the current trial, given its short duration of only one year,” Shalev stated. But she also expressed optimism in regards to the research path. “Finally, we have reason to believe we are on the right track.”

This video simply explains what the UAB reserachers discovered and how dibetes effects beta cells in the pancreas.

3 Resources For Diabetes Awareness Month in November

31 Oct

diabetes awareness month november

Among diabetes organizations, November is known as American Diabetes Month, Diabetes Awareness Month, and even National Diabetes Awareness Day (November 14). Regardless of the name, the purpose is to raise your awareness of this epidemic disease and its risk factors, and learn how you can avoid it or control it.

The startling facts about diabetes:

  • One in 12 Americans – more than 30 million – has diabetes
  • Diabetes is one of the leading causes of disability and death in the U.S. and worldwide
  • If not controlled, diabetes can cause blindness, nerve damage, kidney disease, heart disease, vascular problems, and foot and lower leg conditions, some leading to amputation
  • The American Diabetes Association estimates that the total national cost of diagnosed diabetes in the United States is $245 billion

Those statistics are nothing to take lightly. But if that weren’t bad enough, there’s a bigger crisis looming: Eighty-six million of us have prediabetes, which is chronic, elevated blood sugar levels which aren’t yet considered diabetic, but can quickly become so. Just a little bit of education however, can help you avoid developing diabetes and its many complications. For those already diagnosed with type 1 or type 2, use November to educate yourself about lifestyle changes you can make to control your disease, and schedule appointments with your physicians for an annual screening.

***All diabeteics should receive an annual screening from a podiatrist to look for early signs of numbness or hypersensitivity in the feet, which can be early warning signs of diabetic peripheral neuropathy. Visit our website to learn how to prevent diabetc complications in your feet.

Resource 1: The American Diabetes Association’s America Gets Cooking to Stop Diabetes

America Gets Cooking to Stop Diabetes is an initiative designed to engage and inspire people to live a healthier and more active lifestyle. The initiative encourages and empowers you to cook nutritious and delicious food and to be more active, with ideas like Get Moving Mondays and Tasty Tip Tuesdays. Get more info on America Gets Cooking to Stop Diabetes.

Resource 2: The National Diabetes Education Program

NDEP is a partnership of the National Institutes of Health, the Centers for Disease Control and Prevention, and more than 200 public and private organizations. Throughout National Diabetes Month, the NDEP will promote “Be Smart About Your Heart: Control the ABCs of Diabetes” to help people with diabetes learn they are at greater risk for heart disease, and how they can lower that risk by managing the diabetes ABCs: the A1C test, Blood Pressure, Cholesterol and Stop Smoking. Get more info on the National Diabetes Education Program.

Resource 3: JDRF and Thunderclap

JDRF, also known as the Juvenile Diabetes Research Fund, is an advocacy organization for raising awareness of Type 1 diabetes, the autoimmune disease one inherits from one or both parents. This November, JDRF is teaming with Thunderclap, a “crowdspeaking” social media platform that integrates with your facebook and twitter accounts. The concept behind Thunderclap is for everyone to share the exact same message on the same days on their social media accounts so that the JDRF posts have a chance to rise above the usual noise of cat memes and “5 Things You Can Do Right Now To…”  posts. Get more info on how you can help JDRF raise awareness for Type 1 diabetes.

Please join us in November in raising awareness of type 1 and type 2 diabetes.

Read our posts about diabetes

Schedule an appointment with one of our podiatrists for a diabetic foot exam.

Add Green Tea To Your Diet To Prevent Type 2 Diabetes

24 Oct

Tea, especially green tea, is the second-most popular beverage in  the world after water (take that, Coke and Pepsi!). You’ve probably heard that green tea has health benefits ranging from sharpening mental focus to helping to prevent cancer, but now it’s also been discovered to help prevent type 2 diabetes.

green tea for diabetes

“People with diabetes have problems metabolizing sugar,” says Suzanne Steinbaum, DO, a cardiologist and director of women’s heart health at Lenox Hill Hospital in New York City. “Through a complex biochemical reaction, tea — especially green tea — helps sensitize cells so they are better able to metabolize sugar. Green tea is good for people with diabetes because it helps the metabolic system function better.”

Research published in Diabetes and Metabolism Journal reviewed a Japanese study which found that people who drank six or more cups of green tea each day were 33 percent less likely to develop type 2 diabetes than were people who drank less than one cup of green tea a week. The study authors also highlighted research from Taiwan which found that people who drank green tea regularly for more than a decade had smaller waists and a lower body fat composition than those who did not drink green tea frequently.

How green tea helps prevent type 2 diabetes

Tea contains substances called polyphenols, a type of antioxidant found in many plants, and a magic bullet for good health. Polyphenols help regulate glucose, which helps to prevent or control diabetes. But polyphenols also help reduce oxidative stress and cause arteries to widen, which decreases blood pressure, prevents clotting, and reduces cholesterol. These actions reduce the risk for heart disease, which is a serious concern for diabetics.

All teas, black and green, contain polyphenols. But in green tea, the level of poyphenols is substantially higher. Look for bright colors in fruits and vegetables, and you’ll find high levels of polyphenols. Foods which pack a lot of polyphenols include pomegranates, berries, apples, grapes, broccoli, onions, tomatoes, spinach, red beans, and rhubarb. And oh yea, red wine. And cocoa (dark chocolate only).

Add brightly colored fruits and vegetables to your diet, along with nuts, fish, and green tea, and your diabetes management (and possibly prevention) will be much more successful. A little dark chocolate and red wine won’t hurt either.

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