Exenatide is an injectable drug that reduces the level of sugar in the blood. It is used for treating type 2 diabetes. Exenatide belongs in a class of drugs called incretin mimetics because these drugs mimic the effects of incretins. Incretins are hormones that are produced and released into the blood by the intestine in response to food. It increases the secretion of insulin from the pancreas, slows absorption of glucose from the gut, and reduces the action of glucagon. Glucagon is a hormone that increases glucose production by the liver. All three of these actions reduce levels of glucose in the blood. In addition, it helps reduce appetite. Exenatide is a synthetic hormone that resembles and acts like incretins. In studies, exenatide-treated patients achieved lower blood glucose levels and experienced weight loss. Exenatide was approved by the FDA in May, 2005.
It is prescribed when patients with type 2 diabetes have not achieved adequate blood glucose reduction while taking metformin or a combination of metformin and a sulfonylurea. Exenatide is not used in patients with type 1 diabetes or as a substitute for insulin in patients who require insulin. There has been some side effects the most common is nausea. Other common side effects include hypoglycemia (excessively low blood glucose), vomiting, diarrhea, headache, nervousness and stomach discomfort. Patients may also experience decreased appetite, acid reflux and increased sweating. Most side effect decreases over time.
The findings from a Veterans Affairs Diabetes Trial have showed that lowering blood sugar levels to near normal through intensive treatment may reduce the risk of cardiovascular disease and heart attacks for Type 2 diabetics, but only if treatment is begun relatively soon after diagnosis and if severe episodes of low blood sugar can be avoided. Data from three studies were presented over the weekend at a San Francisco meeting of the American Diabetes Assn., and although many questions remain unanswered, some generalizations are becoming possible.
All three studies suggest that the greatest reduction in the risk of heart attacks and cardiovascular disease is achieved by lowering cholesterol levels and by controlling high blood pressure. Controlling glucose can at best provide only a small further reduction in risk that may take many years to become apparent. But that does not mean that control of blood glucose levels is not a good idea.
Data from two of the studies confirmed that such control reduces the risk of kidney and eye disease, also complications of diabetes. New data from the VA study also show that severe hypoglycemic events should be avoided at all costs. And finally, data from the three studies may ease concerns about the oral diabetes drug rosiglitazone. An analysis last year of many previous studies suggested that the drug, sold under the brand name Avandia, increases the risk of heart attacks and death. But the new studies showed no such effects from the drug, which is still in wide use
Pre-diabetes means that the cells in your body are becoming resistant to insulin and your blood glucose levels are higher than they should be. Since the levels aren’t as high as they would be if you had Type 2 diabetes, the term “pre-diabetes” is used. Your doctor may also call this condition “impaired fasting glucose” or “impaired glucose tolerance. According to the Center of Disease Control and Prevention, 41 million adult Americans between the ages of 40 and 74 have pre-diabetes.
There are several risk factors. The risk factors are the same for pre-diabetes as they are for Type 2 diabetes. Some of them are being overweight or obese, having a sedentary lifestyle, family history, age, or having a previous diagnosis of gestational diabetes.
Often there are no signs or symptoms for pre-diabetes. Many times it is discovered during a routine physical with basic screening for fasting blood glucose levels. The normal level is below 100 mg/dl. If it’s 100 to 125 mg/dl, this indicates that you have impaired fasting glucose or pre-diabetes. Over 126 mg/dl most likely means a diagnosis of Type 2 diabetes.
If you are diagnosed with pre-diabetes, it will put you at a higher risk for Type 2 diabetes in the future. But it doesn’t have to mean that you will get Type 2 diabetes. A healthy lifestyle change can lower your risk and improve the way your body uses insulin. A low fat diet and calories can help you lose weight. The less fat and more muscle you have, the less resistant to insulin you will be. Exercising regularly not only helps you to lose weight, but also help lower your blood glucose level by using glucose as energy.
A report in the Archives of Disease in Childhood says there are a number of clues suggesting a link between low vitamin D Zipitis of Stockport National Health Service Foundation Trust and Dr. A. K. Akobeng of Booth Hall Children’s Hospital have reviewed all published research on vitamin D supplementation and diabetes risk. Overall, they found, infants who were supplemented with Vitamin D were 29 percent less likely to develop type 1 diabetes than children who had not received supplements.
Proper clinical trials are required to determine the optimal dose and formulation of vitamin D, as well as when and for how long children should be given the supplements, Zipitis and Akobeng conclude. In the meantime, Zipitis said, “I would advise parents to encourage their pediatricians to prescribe vitamin D supplements for their infants. However, parents can also obtain these over the counter and provided they are used as per manufacturer instructions they should be extremely safe to use.”
There are many critical diabetic testing supplies and other important items you should always have readily available. The number one thing would be insulin and if you are insulin-dependent it is vital to always keep several days supply on-hand in case of an emergency. The blood glucose meter is another must-have. Of course your blood glucose meter won’t function without the proper test strips. Always keep plenty of these handy, so that you can test your blood sugar level on time, every time. If your diabetes puts you at risk for hypoglycemia, a supply of glucose tablets should always be kept with your diabetes testing supplies. It will be convenient to have a diabetes supply carrying case to keep everything organized.
There are several other useful things to have on hand. One is to have medical identification to lets people know you have diabetes if you are in an accident and unable to communicate. Everyone should have extra batteries on hand for their testing meter. Stash some sugar free substitute in a handy place, especially if you are going out.
Having these diabetic test supplies readily available will allow you self-monitor your insulin levels, and protect yourself from short and long-term complications that may arise. Situations can arise unexpectedly so always keep a good amount of supplies on hand. This will also help if an emergency happens.
Type 2 diabetes affects over 250 million people worldwide. Intensive insulin therapy through daily injections is typically started late in the course of the disease. But researchers in China found that if this treatment is undertaken before the body loses the ability to control sugar levels in the blood, patients recover normal levels faster and are less at risk of remission.A team led by Jianping Weng of Sun Yat-Sen University in Guangzhou divided nearly 400 patients aged 25 to 70 with Type 2 diabetes into three groups. Two groups received intensive insulin therapy. The third group was given standard oral diabetic drugs. Treatment was stopped when regular blood glucose control had been restored for two weeks, after which patients regulated sugar levels through diet and exercise alone.
The study found that more patients in the two insulin-intensive groups hit normal levels, and did so faster, in four to six days rather than nine, compared to the control group. Also significant, remission rates were nearly twice as high in the first two groups.
A second study showed that a controlled diet and exercise over six years prevented or delayed diabetes onset by up to an additional 14 years. The two studies were published in the British journal The Lancet.
Tanita Corp of Japan, will begin selling a portable digital urine glucose meter that indirectly checks blood glucose level by measuring urine glucose level. The meter is called UG-201 and will go on sale June 20, 2008 in Japan. The company has sold a stationary digital urine sugar meter since 2004.
Tanita Corp have had many request for a portable model because people are always on the go. Although the UG-201 is unable to measure the blood sugar level itself, it contributes to the prevention of metabolic syndrome and diabetes by measuring the urine sugar level, which is closely correlated with the blood sugar level. The product allows easy measurement simply by urinating on the sensor. This meter is convenient and easy to use. Results show in about six seconds.
Although there is no manufacturer’s suggested retail price, the expected market price for the starter set including the main unit, sensor cartridge, etc is about $154.00. Each sensor cartridge is good for 200 uses and will cost $58 to replace. The company is aiming at initial annual sales of 3,000 sets and cumulative sales of 30,000 sets by fiscal 2010.
A new study published in the June 3 issue of the Journal of the American College of Cardiology (JACC), suggests that cocoa can actually help blood vessels to function better and might soon be considered part of a healthy diet for the prevention of cardiovascular disease. A natural plant compound, Flavanols, is responsible for cocoa’s healthful benefits. Flavanols can also be found in tea, red wine, and certain fruits and vegetables.
The study revealed that after a diabetic patients drank specially formulated high-flavanol cocoa for one month, blood vessel function went from severely impaired to normal. Cardiovascular disease is the number one cause of death in diabetic patients.
“Medical treatments alone often do not prevent complications of diabetes that are associated with atherosclerosis and cardiovascular disease,” said Malte Kelm, M.D., a professor and chairman of cardiology, pulmonology and vascular medicine at the University Hospital Aachen and the Technical University Aachen, in Aachen, Germany. “Physicians should be increasingly looking to lifestyle changes and new approaches to help in addressing the cardiovascular risks associated with diabetes.”
“Patients with type 2 diabetes can certainly find ways to fit chocolate into a healthy lifestyle, but this study is not about chocolate, and it’s not about urging those with diabetes to eat more chocolate. This research focuses on what’s at the true heart of the discussion on “healthy chocolate”—it’s about cocoa flavanols, the naturally occurring compounds in cocoa,” he said. “While more research is needed, our results demonstrate that dietary flavanols might have an important impact as part of a healthy diet in the prevention of cardiovascular complications in diabetic patients.”
According to the small study conducted at the University of Guelph in Ontario, drinking caffeinated coffee an hour before eating a bowl of cereal can significantly affect the body’s blood-sugar response. The researchers recruited 10 healthy men. On different occasions they drank decaffeinated coffee or caffeinated coffee one hour before eating the cereal. Two cereals were involved in the study – Kellogg’s All-Bran, considered to have a low glycemic index, and Kellogg’s Crispix, which is considered a high glycemic index cereal.
“If you have caffeinated coffee what you find is that the insulin levels go higher than they would’ve if you didn’t have the caffeinated coffee with that particular cereal,” said Terry Graham, chair of the department of human health and nutritional sciences. Graham has been working with caffeine and insulin resistance in the lab for more than a decade.
“When you got up, you had your coffee and then you thought, ‘Well, I had better behave myself and I’ll have All-Bran,’ and in fact the blood-sugar response to the All-Bran exceeded what the subjects showed if they had decaf and Crispix,” he said. “So by simply combining what you might think of as a more optimal cereal with coffee ended up giving you a response that was larger than what you would have expected from the less optimal cereal.” He added that caffeine levels just barely start to go down in a person three hours after drinking coffee.
The research paper was published online last week by the American Journal of Clinical Nutrition. Although, it calls for more research in the area and also notes a number of limitations to the study.
Can enjoying a dip in a hot tub be good for diabetics? According to a pilot study that appeared in the September 16 issue of The New England Journal of Medicine, “hot tub therapy” helped a group of type 2 diabetics reduce their blood sugars, lose weight and improve sleep patterns.
Another study was done by Philip L. Hooper, MD, of the McKee Medical Center in Loveland, Colorado. He studied five type 2 men and three type 2 women. The patients had been suffering from diabetes from three to 14 years. The subjects sat in the hot tub by themselves with water up to their shoulders for 30 minutes per day, six days per week, for three weeks. Most patients had reduced blood glucose levels and had even lost some weight. Although, “Most subjects found that their blood sugars went back up two to three weeks after stopping the study,” says Hooper.
“These results suggest that hot tub therapy should be further evaluated as a therapy for patients with type 2 diabetes mellitus,” says Hooper. “It may be especially helpful for patients who are unable to exercise.”
Hooper is in the process of writing a grant for further research in this area from the National Institutes of Health, the American Diabetes Association and possibly the American Heart Association. “My study was a pilot study, which was published in order to provide a new thought in the management of diabetes,” says Hooper. “It cannot be endorsed as an ‘approved’ method of therapy at this time.”