About.com Type 1 Diabetes

Position of Insulin Pump Can Significantly Affect Insulin Delivery

Thu, 04 Feb 2010 10:09:53 +0000

Researchers have found that insulin delivery rates in conventional insulin pumps can vary significantly depending on the positioning and placement of the pump. Conventional insulin pumps that use tubing and infusion sets appear to be prone to a siphon effect that affects the accuracy of insulin delivery.

For example, insulin delivery over a one-hour period in the study ranged from about 75% of the expected delivery when the pumps were below pipettes and pumping upward to 123% when the pumps were above the pipettes and pumping downward. The most pronounced differences were seen during basal delivery in the Cozmo and MiniMed pumps.

In contrast, the OmniPod, which has no external tubing, was the least affected by pumping orientation and direction. The rate of expected insulin delivery with the OmniPod System over one hour ranged from about 98% when its delivery cannula was in a level pumping position to 101% when the cannula was in an upward pumping position.

Have you suspected or seen these fluctuations in insulin delivery with the pump you use? Post your comments below.

Artificial Pancreas Research Takes Huge Step Forward

Sun, 24 Jan 2010 15:49:12 +0000

It was just announced that the Juvenile Diabetes Research Foundation (JDRF) is partnering with Animas Corporation to develop the first-generation artificial pancreas over the next four years. This is exciting news because it could become the prototype of a fully automated diabetes management system that completely self-regulates the flow of insulin, much like a healthy pancreas.

The goal is to combine the latest technology of the insulin pump with a continuous glucose monitor (CGM) that continuously reads glucose levels in the blood. The CGM would communicate the blood glucose reading to the pump with wireless technology, prompting the pump to release the necessary amount of insulin to keep blood glucose within a target range. A sophisticated computer housed within the pump would slow or stop insulin delivery if blood sugar was going low and increase insulin delivery if blood sugar was going high.

The early system would still require users to manually deliver an extra dose of insulin at mealtimes. But a later model would eliminate this need and be fully self-regulating. We're not there yet, but we're getting closer.

More information is available about the JDRF Artificial Pancreas Project.

Post your thoughts and comments on this new technology below.

Photo courtesy of Medtronic

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Artificial Pancreas Research Takes Huge Step Forward originally appeared on About.com Type 1 Diabetes on Sunday, January 24th, 2010 at 15:49:12.

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Sensor-augmented Insulin Pumps Significantly Improve A1c Results Over Multiple Injections

Wed, 13 Jan 2010 11:26:28 +0000

A recent study has shown that a sensor-augmented pump (SAP), which combines an insulin pump with a continuous glucose sensor, has the potential to significantly lower hemoglobin A1c levels over the more conventional insulin injections, without an increase in hypoglycemia.

The study involved 83 patients with type 1 diabetes who had A1c levels of 8.4% or more. Over 26 weeks of therapy with a SAP, this group lowered their A1c levels to an average 7.2%. The control group receiving multiple insulin injections saw a lowering of A1c levels of only about .1%. The number of hypoglycemic events between the groups was about the same but shorter in duration amount those patients using the SAP.

Researchers believe that the SAP is an important step toward developing what is called a "closed loop system," often referred to as an "artificial pancreas." The artificial pancreas will be a device that can accurately read the glucose in the blood and deliver a precise amount of insulin automatically, much the way the pancreas performs in those without type 1 diabetes.

If the artificial pancreas technology was reliable and available today, would you choose to this method to manage your diabetes? Why or why not? Post your comments below.

photo courtesy of Medtronic

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Sensor-augmented Insulin Pumps Significantly Improve A1c Results Over Multiple Injections originally appeared on About.com Type 1 Diabetes on Wednesday, January 13th, 2010 at 11:26:28.

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ADA Revises Diabetes Guidelines

Thu, 07 Jan 2010 18:20:33 +0000

Each year we learn more about diabetes and this leads to changes in the recommendations of how to diagnose, treat and manage the condition. As a result of recent research the American Diabetes Association has revised its guidelines for the coming year. Among the most important is using the A1c test as a diagnostic tool. Here are some highlights:

Hemoglobin A1c. The hemoglobin A1c test has traditionally been used as way to measure longer-term glucose control over a 2-3 month period of time. While it will still be used for this purpose, it will now also be used to diagnose those suspected of having type 2 diabetes, which includes children.

Hospital care. Conventional wisdom used to be that tight glucose control was preferred for those in hospital settings. The newest research now questions the benefit of very tight glycemic control for critically ill patients in a hospital setting.

Self-management. There have been extensive revisions to recommendations for self-management as it relates to type 1 diabetes. These include:

Glucose monitoring at least 3 times a day for those taking insulin injections or on pump therapy.
Continuous glucose monitoring is recommended as a possible way to improve A1c results for those 25 years and age and younger.
A1c testing every three months, and more often in some individuals.

Read all of the guidelines.

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ADA Revises Diabetes Guidelines originally appeared on About.com Type 1 Diabetes on Thursday, January 7th, 2010 at 18:20:33.

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Make Good Diabetes Management a Priority in 2010

Fri, 01 Jan 2010 18:44:14 +0000

When you have diabetes, perfection with blood sugar management is not the goal. Instead, seek balance, moderation and a problem-solving mindset. Diabetes management is not a destination but a journey; one that you must be mindful of each day.

If you didn't manage your diabetes as well as you would have liked last year it doesn't mean you can't make changes this year. Here are some tips to get you started on the right track to accomplish your goals and improve your health.

1. Make your goal specific, concrete and measurable.
Instead of making a general statement such as, "I want to lower my blood sugar average this year," be more specific. Try, "I want to reduce my A1c from 8.9% to at least 7.5% over the next three months."

2. Develop a concrete plan of how you intend to accomplish that specific goal. For example, I will test my blood sugar before every meal and snack, review my blood glucose numbers at the end of each week for trends and count carbohydrates for every snack and meal.

3. Record your efforts.
Recording your efforts acts as a check point for your progress. It can create motivation for more empowering change and help you better solve problems when they arise.

If you would like to share your diabetes management goal(s) for 2010, post them below.

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Make Good Diabetes Management a Priority in 2010 originally appeared on About.com Type 1 Diabetes on Friday, January 1st, 2010 at 18:44:14.

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New Drugs Slows Progression of Type 1 Diabetes

Wed, 23 Dec 2009 01:39:59 +0000

Researchers have discovered that the drug called rituximab, typically used to treat autoimmune disorders, may have the ability to slow the destruction of insulin-producing cells in those diagnosed with type 1 diabetes.

All participants in the study had been recently diagnosed with type 1 and those who received the drug were given injections for four weeks. At the one year follow-up, participants who received rituximab needed lower doses of insulin and were able to make more of their own insulin than those who received the placebo.

Though it is not believed that rituximab can reverse type 1, the results do provide evidence that certain cells play a significant role in the development of type 1 diabetes. This knowledge may help researchers to further understand how these cells destroy the beta cells that make insulin.

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New Drugs Slows Progression of Type 1 Diabetes originally appeared on About.com Type 1 Diabetes on Wednesday, December 23rd, 2009 at 01:39:59.

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Mobile Phone Technology Could Help Parents of Children with Type 1

Mon, 14 Dec 2009 10:08:57 +0000

If you had a phone that could collect and transmit your child's blood sugar readings to his or her doctor, would you use it? That is the question many parents of children with type 1 were asked in a recent study. Over two-thirds of the parents surveyed had a "very positive" response to the proposed mobile phone prototype. More than half of parents expressed interest in signing up for a service of this kind.

The incentive for this type of technology and service seems tied to the unmet needs of parents for more access to and information from their healthcare provider to effectively manage their child's diabetes. Of those surveyed:

85% wanted shorter waiting times for appointments
78% would like easier phone access to their physician
78% would also like the option to contact their physician by email

The researchers conclude that the strong response from parents for this type of technology indicates a gap in the medical system to effectively help parents manage their child's diabetes.

Of course, this type of technology is not limited to children with type 1 but could also be used for adults with diabetes. The question for you: If this technology and related service were available to you now, would you use it? If so, what would you find helpful about this technology? If not, why not? Post your responses below.

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Mobile Phone Technology Could Help Parents of Children with Type 1 originally appeared on About.com Type 1 Diabetes on Monday, December 14th, 2009 at 10:08:57.

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Do You Get Enough of Your Doctor�s Time and Attention to Effectively Manage Your Diabetes?

Fri, 04 Dec 2009 14:08:47 +0000

A similar question was recently posed to nearly 200 primary care physicians and 100 endocrinologists. Nearly one-third of those physicians surveyed indicated they did not have enough time and did not receive sufficient reimbursement to provide comprehensive care to their patients with diabetes. A whopping 83% of physicians surveyed said Medicaid reimbursement was inadequate, while 67% said private insurance reimbursement was inadequate.

It takes time to educate patients about diabetes. And time is money. If doctors are not being reimbursed for their time educating patients, many of them are simply not going to go beyond the necessities. Yet, there is so much more to diabetes management than checking blood sugar or correctly drawing and injecting insulin. What about dietary concerns, creating an exercise program, learning to cope with depression or lack of social support or addressing lifestyle habits such as smoking or stress? These all directly relate to diabetes management.

So, what are your thoughts? Do you think you are getting the time and education you need from your doctor and his or her staff? If not, what are the areas you need more help with? Post your comments below.

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Do You Get Enough of Your Doctor�s Time and Attention to Effectively Manage Your Diabetes? originally appeared on About.com Type 1 Diabetes on Friday, December 4th, 2009 at 14:08:47.

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Holiday Depression - A Common Combination

Wed, 25 Nov 2009 00:20:52 +0000

Most of the talk these days revolves around plans for travel, food and family. But the holidays can also be a time of sadness and loneliness for many who are estranged from family or who have lost loved ones recently. Depression is also more common in the winter months when there is less sunlight and more confinement indoors.

Depression also affects blood sugar and can acts as a barrier to effective diabetes management. The good news is that there are ways to combat holiday depression and stay on track with your diabetes management. If you are not certain whether you are depressed, take this quick self-inventory.

If you would like to share some of your perspective on holiday depression, post your comments below.

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Holiday Depression - A Common Combination originally appeared on About.com Type 1 Diabetes on Wednesday, November 25th, 2009 at 00:20:52.

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New Report on Diabetes and Health Reform

Tue, 17 Nov 2009 23:11:30 +0000

As the healthcare reform debate rages on you may be interested in reading a new report called Preventing and Treating Diabetes: Health Insurance Reform and Diabetes in America.

The report brings to light some statistics that need to be kept in mind as health reform is debated. For example, a person with diabetes spends, on average, $11,744 per year on medical expenditure, more than twice what a person without diabetes would spend.

In introducing the report, Health and Human Resources (HHS) Secretary Kathleen Sebelius said: "Americans with diabetes are suffering in our current health care system. Health insurance reform will help ensure these Americans can get the prescription drugs and supplies they need and bring down premiums so all Americans can have high-quality, affordable health insurance."

Time will tell whether the reforms that are eventually passed will accomplish these much needed initiatives. For the time being, read the report and post your comments below.

Prescription Assistance Programs - Financial Help for Diabetes Supplies

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New Report on Diabetes and Health Reform originally appeared on About.com Type 1 Diabetes on Tuesday, November 17th, 2009 at 23:11:30.

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