Progress in Adult Stem Cell Area which Mitigates Transplant Challenge March 31, 2015

Transplantation

We have closely followed the research involving the transplantation of insulin-producing islets from one individual into another, hoping for a long-term and effective treatment beyond medical devices, insulin injections and medication.

Although the results have been encouraging, there are a number of significant challenges that have tempered our expectations. In fact, while several hundred patients have achieved at least temporary insulin independence after receiving the islet “mini-organs” (containing insulin-producing beta cells), very few patients remain insulin independent beyond 4 years after transplantation.

Side effects

On problem, in particular is that the use of conventional immunosuppressants is not feasible because of long-term side effects. Transplant recipients need to take immunosuppressive drugs that stop the immune system from rejecting the transplanted islets and, even when used, rejection remains the biggest problem. The immune system is programmed to destroy bacteria, viruses, and tissue it recognizes as “foreign,” including transplanted islets. Immunosuppressive drugs are needed to keep the transplanted islets functioning. (more here)

One way to mitigate the problem is to produce beta cells from stem cells originating in the patient’s own pancreas. Because the cells originate from the patients body, the immune system does not recognize them as foreign. This also has the potential for elevating the limited available of islets for transplantation.

Insulin producing cells

Researchers said this week that adult stem cells in the pancreas can be transformed into insulin-producing cells. This newfound ability of endocrine progenitor stem cells in the adult human pancreas provides a major key to developing new treatments for diabetes, said researchers at the Burnham Institute for Medical Research and the Rebecca and John Moores Cancer Center at the University of California at San Diego.

Although the technology is in the feasibility stage (read many years away), and the protocols apparently involved the use of ‘fetal tissue” (which we are very concerned about) the news is encouraging.

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Categories: practical

A little sugar isn’t going to kill anybody and the occasional piece of cheesecake or chocolate chip cookie makes life worth living for March 29, 2015

I occasionally eat a sugar-containing goodie, but I’ve mostly switched to using stevia sweetener, expensive but a lot healthier. However, some stevia products only contain as little as 10% stevia, especially stevia “baker bags”. Also, I’m quite satisfied with substituting fresh or frozen fruit in ice water, instead of drinking sugary sodas.

Why excessive sugar intake can become a problem?

It seems like gradually more people are learning about the effects of dietary choices on their long term quality of life. I want to allow my future self to vote on whether or not it wants to be healthy or saddled with multiple problems related to diabetes and fatty liver – (a condition that articles in The Times have linked to excess sugar consumption). Smart dietary choices will lower your blood sugar levels and will help you get along with diabetes.

Consequences

I really don’t want to have to deal with insulin injections, foot amputations, heart problems, blindness, and kidney dialysis. Would anyone actually CHOOSE these problems if they really understood how to mostly avoid them by eating healthier food?

Chronic sugar consumption causes prolonged elevated insulin levels (in response to the sugar spikes). Elevated insulin causes sugar crashes which then cause sugar cravings. Chronically elevated insulin is like any hormone or drugs. Insulin, over time, will cause you to be less sensitive (more tolerant) to it requiring larger and larger insulin loads to do the same job. Eventually, your pancreas is burned out and diabetes sets in. Sugar, processed carbohydrates, and fructose are the worst things you can eat on a daily basis. One may think the have ice cream or a milkshake every once in awhile, but ask yourself how many times a week you have a soda, a candy bar, potato chips, fast food, bread and pasta or something as simple as a sandwich from subway.

What can and must be done?

I exercise, eat healthy (fruits, veggies, egg whites, greek yogurt, salmon, sometimes multi grain bread) – and then I’m off the wagon, bingeing for days with huge weight gain in short period of time. Then try to work my way back down again. Eating very reasonably – no starvation. Exercise moderately – 30 min aerobics several times a week, with some bicep curls 3x a week, bike ride. Even tried CBT for six months. Sometimes I can work it, and sometimes I cannot.
So, here is a short list of things to be done:

  • exercise more,
  • consume healthy food,
  • avoid sugar.
  • How is it possible researchers found “to their surprise” that the trigger effect of sugar overpowered that of fat? Every woman I know who has ever fought fat (on her body, I mean) could have told them this. It’s sweets and starches that are–or have been–our downfall, not fat. Of course, the combination is irresistible. But, back when dark brown sugar was 21 cents a box and could be counted on to have moist lumps in it, before Brownulated, I was far from the only woman I know who ate it by the box. Researchers, do you know anyone who eats butter by the stick?

    Didn’t think so. But, cream a cup of sugar, brown or white (with/without a pinch of cinnamon, a drop of vanilla) into it and you’ve got half the ingredients of cookie dough! (@ Susan: yes, processed foods are worse–if for no other reason, because they taste lousy. Ever notice that HFCS has no flavor whatever, that it’s just cloying sweetness? It is to real sugar as lab alcohol is to real booze–even as trans fat (including margarine) is car grease, compared to butter. What has happened to our taste buds??)

    Conclusion

    Anyway, the anecdotal evidence for sugar’s addictive qualities has been out there for 300+ years. See “Sweetness and Power: The Place of Sugar in Modern History” by Sidney W. Mintz (Penguin, 1985), written way before any brain studies had been done. Scholarly, a page-turner, a revelation–it’s also creepily prescient.

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    Categories: advice

    Diabetes and related issues March 23, 2015

    In any case, a diabetic with proper handling may prevent acute exacerbations of diabetes (diabetic ketoacidosis syndrome), which can be fatal if not timely assisted. Severe hypoglycemia may increase chronic complications or other diseases.

    Despite careful handling it is often the case that diabetic patients need medical assistance or even hospital care. It is therefore appropriate that each planning of your vacation is very carefully carried out as low blood sugar in vacation may mean big problems. As a general recommendation that patients with diabetes mellitus traveling to towns and cities where health care is organized at the appropriate level. Avoid uncivilized and exotic areas (Africa or Asia). Only in this way you will have your travel enjoyable. These tips will contribute to your success. However, the diabetic may leave before consulting with personal doctor and this may be dangerous. Blood sugar levels will not be under control during the whole travel.

    Diabetic patient with a diet

    Diabetic who has prescribed a diet actually has no restrictions. They may leave anywhere, travel anywhere, but should not forget about proper nutrition. More movement (skiing, hiking, etc..) during vacation will benefit diabetes patients as it will regulate blood sugar levels more efficiently. Rough diet, especially if you join kaka disease, may even worsen the condition of those with diabetes and it may require hospitalization to put blood sugar levels back under control.

    Diabetic patients with prescribed oral antidiabetic agents

    Those who have Prescriptive pills for diabetes should be able to treat themselves even during holidays. Keep your own pace and at the same apply unchanged quantity of tablets.

    blood glucose meter

    If adequate nutrition is not available, you have to organize yourself. If you are opting for less food and more exercise (for example, mountaineering, swimming, cycling) this will lower blood sugar levels and hypoglycemia may occur. In this case, it will be necessary to temporarily reduce the amount of antidiabetic tablets.

    It is usually necessary to reduce or abolish the evening dose of sulfonylurea (Daone, Euglucon, Glurenorm, Predian, Amar Glukotrol), and where appropriate, also the morning dose. Metformin (Aglurab, Glucophage) or acarbose (Glucobay) tend not to be abandoned if they are consumed alone or in combination with a sulphonylurea.

    Diabetic patients treated with insulin

    Diabetic patients treated with insulin (self-performed) are more likely to respond correctly. As a rule, keep your own pace and amount of food and prescribed insulin doses. If the amount of food is modified to correct insulin doses do not modify evening diet (additional meals, snacks).

    It is usually necessary to change only short-acting insulin before a meal because it is different from the ordinary. It may be necessary to change the dose of long-acting insulin before bedtime, especially if nocturnal hypoglycemia happens or morning blood sugar level is low.

    Those who receive pre-mixture of insulins, if necessary, should change the total dose in the morning. If you receive a combination of short and long-acting insulin in the morning, it will probably be amended to take only short-acting insulin. If you receive a pre-mixture of insulin or a combination of short and long-acting insulin twice a day, you will be amended to take only an evening dose. It will also be necessary to change the dose of insulin in a greater effort (hiking, biking, swimming). We must change the insulin before exercise, this is usually due to a short-acting insulin.

    All of these instructions take into account the results of self-control.

    Diabetic driver of a motor vehicle

    Many diabetics travel with car and the drivers are under great danger. Driver is particularly dangerous if hypoglycemia occurs resulting in a diabetic issue which can cause accident or damage.

    It should be noted that hypoglycemia in an accident is not a mitigating circumstance. Diabetic patients should be managed in a way that hypoglycemia would no occur while driving, otherwise they are not allowed to drive. This diabetics are educated about this. Instructions to a diabetic driver of a motor vehicle anyone can obtain in any clinic.

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    Categories: conditions

    Going on a long vacation – but what about your diabetes?

    Going on a long vacation?

    Travel and holidays in distant lands is not uncommon nowadays. Some problems may cause your trip to be shorter.

    Flights across the Atlantic may take up to six hours (east coast of America) and up to ten hours (west coast America). Diabetic patients receiving insulin several times a day or twice-daily (long-acting insulin) may need to take extra injections to overcome time-gap. If you receive a ready mixture of insulin, require an additional injection to bridge the extended day.

    Those who receive the combination of short and long-acting insulin once or twice a day may extend to bridged day by an additional injection of insulin (short acting). With these additional injections of insulin you must provide additional meal.

    Long and short lasting insulin shots

    Those who receive the pills usually do not need an extra dose. The next day both switched to its steady rhythm of treatment. In all these decisions much help self-control. In return, the shortened day for the indicated number of hours. Drain evening dose of short and long-acting insulin. If the need for additional insulin, always add a short acting one. Such additions or corrections is very suitable for ultras-hort insulin (NovoRapid, Humalog). Also omit evening dose of tablets.

    On the second day when you are already in Europe you can return to your home and to your established method of treatment. The same is true when traveling east (China, Japan, Australia). In flight, there is shortened day for eight to ten hours, so it should be an evening dose of insulin released in return when the day is extended, but the daily dose of insulin add another dose of short-acting insulin.

    Diabetic patients with chronic complications

    Diabetic patients may have already developed chronic complications and other chronic diseases that must be be taken into account when planning holidays and trips. For those with diabetes more recommendation applies (only traveling to places with adequate health service).

    Those diabetics who need hemodilizo drug must stay near the hemodialysis centers where the tourist can have a dialysis.

    Even before going on holiday you must provide dialysis measures. Patients with peritoneal dialysis can have lightly more freedom, but must ride with all the necessary equipment. You must also foreseen possible complications of peritoneal dialysis when they need a specialist or hospital medical assistance. Diabetic patients with coronary artery disease or heart failure should be especially careful. Those with stage I or II NYHA (New York Heart Association) have no limitations. Patients with stage III and IV (heart failure, frequent stenocardia stenocardia) are advised against travel, especially long airplane flight.

    If the flight is necessary, such a diabetic patient needs a companion who has the necessary medicines and oxygen to control blood sugar levels.

    Vaccination

    For diabetics who travel to countries with infectious diseases, the same rules apply as for non-diabetic subjects. It should be vaccinated against tetanus, yellow fever, typhoid, polio, smallpox and medication against malaria, cholera, etc. For more information about compulsory vaccination on an annual basis for each country SZD, you can check it on the regional Institute of Public Health, which carried out the vaccination and have a stock of prophylactic drugs.

    Convenient traveling pharmacy

    Every diabetic should think of a short walk to a pharmacy if needed – adapted to his diabetes and others of his illness, but should also have quick access to general medicine. All medicines should have sufficient quantity of insulin which regulates blood sugar levels. Patients should be aware that many countries are not so well stocked with drugs, as you are in your country.

    You need to know which medications will be used and must also be familiar with drugs chemical names, whether you write or take with you a pack of medicine, if necessary, to receive parallel medicine.

    Convenient traveling pharmacy diabetic patient should include:

  • insulin or diabetic pills in sufficient quantity,
  • needles for injection of insulin, alcohols,
  • glikometer, lancets and sensors
  • medicines that you take regularly to lower blood pressure, blood lipids, etc.,
  • dressings (dressings, adhesive plasters), scissors, tweezers,
  • thermometer and tablets to heat (paracetamol: Lekadol)
  • darvel against various pain (Buscopan, Voltaren, Nalgesin, Naklofen etc.)
  • anti-diarrheal (animal charcoal powder Nelit to replace electrolytes)
  • protection against insects (Autan)
  • sunscreen.
  • If you need any other medication (anti-allergy, anti-emetics, antacids, etc.) it is smart to about discuss with your doctor who will also prescribed you longer acting medicine.

    Remember: Diabetic patients should write about a method of treating their diabetes in at least two languages just so you are safe in case of hypoglycaemia and needed assistance. Also do not forget the international health insurance.

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    Categories: practical