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What is Up-and-Coming in Diabetes Technology?

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Posted in Diabetes Research News

 A new year is underway, and with that comes the emergence of advances in diabetes technology. Companies like Tandem, Dexcom, Medtronic, Insulet, and Senseonics are continuing to move forward with projects that have been in the works for several years, as well as new ones. They are constantly striving to improve how diabetes is managed and to enhance the quality of life for those living with the disease.

Here are just a few of the technology changes in the works:

Closed loop systems. Many companies are still working to refine these processes. It is difficult to create an effective system that requires no user interaction, but they are getting closer. Currently, they are focused on reducing the amount of user input necessary and turning to sensor technology to measure and track blood glucose levels, automatically dose according to individual needs, and predict glucose levels. No fully closed loop systems are expected to be released in 2018, however.

Smartwatch and smartphone compatibility. Many people nowadays own smartphones and smartwatches. Companies are leveraging these connections to bring glucose monitoring right to people’s fingertips. With improved sensors and Bluetooth technology, data can be delivered directly to these devices through apps that allow for better tracking and monitoring of glucose levels. Users would also have the option of sharing this data with others, such as healthcare providers. There are a variety of apps in development with features to improve diabetes management.

Improved sensors. Speaking of sensors, they’re changing too. Industry leaders are looking to make sensors smaller yet more effective and accurate. They are also trying to extend the length of wear and reduce the number of daily calibrations needed. In turn, this would allow individuals more freedom and require less interaction with these systems while still managing blood sugar.

Increased FDA approval. There are some devices and technologies that are approved internationally but are not yet available in the United States. Or, approvals in the United States are stricter. International companies are looking to expand the availability of certain products in the U.S. and ensure that their diabetes care technology meets required standards.

Overall, there are numerous collaborations occurring between companies within the diabetes vertical that could have a positive impact on how the disease in managed moving forward. Companies are working together to bring about more advanced technology and monitoring systems that will make it easier for individuals to track not only their glucose levels, but also insulin use, meals, activity, and other factors that impact their diabetes care – and share it with their healthcare providers.

The Diabetes Research Connection is excited to learn more about these advancements in the months to come and see how diabetes care is changing for the future. The organization proudly supports novel research projects by early-career scientists and provides up to $50,000 in funding for studies. Learn more about current projects and how to support these initiatives by visiting http://diabetesresearchconnection.org.

DRC-Funded Scientist Creates New Insulin-Producing Cells to Fight Type 1 Diabetes

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Posted in Diabetes Research News, DRC News

Thanks in part to funding from the Diabetes Research Connection (DRC), Dr. Kristin Mussar was able to conduct an in-depth study regarding how to stimulate the body’s own cells to create new insulin-producing cells that may help treat type 1 diabetes (T1D). In individuals with T1D, the immune system attacks insulin-producing cells, destroying them and leaving the body unable to effectively regulate blood sugar.

The human body is filled with myeloid cells that all differentiate to help grow, maintain, and repair various organs. When these cells are depleted, it impacts organ health. For instance, lack of insulin-producing cells results in diabetes. However, Dr. Mussar and her team discovered that there is a population of macrophages – white blood cells that recirculate throughout the body constantly monitoring the health status of all tissues – that instruct insulin-producing cells to grow in the perinatal stage of pancreas development. During this period of prolific growth, enough insulin-producing cells are created to support glucose homeostasis throughout one’s life.

Dr. Mussar found that there is a special population of these cells that act as cargos of potent growth factors for the insulin-producing cells in the pancreas. If these cells are prevented from entering the pancreas, the growth of insulin-producing cells is arrested and diabetes ensues. This lack of cell growth, as well as cell destruction, are issues that researchers have been trying to remedy through various strategies for treating T1D.

One avenue of treatment that is being explored is finding ways to use the body’s own cells and processes to support insulin production. Current challenges in treatment include the constant monitoring and accurate dosing of insulin, as well as the use of immunosuppressants or other medications to prevent the body from destroying modified cells or specialized therapies. Using the body’s own cells can help reduce risk of immune attack or rejection.

To this effect, Dr. Mussar’s research revealed that there are precursors to these special macrophages that exist within the bone marrow of adults. When these precursors are injected into the blood stream, they are able to signal growth of insulin-producing cells. This discovery raises hopes that, by dispatching these pro-regenerative cells from the bone marrow to injured pancreatic islets, it may be possible to enhance regeneration of insulin-producing cells in individuals with type 1 diabetes. This may in turn help to stabilize blood sugar naturally using the body’s own cells.

The Diabetes Research Connection is proud to have played a role in making Dr. Mussar’s research possible by providing funding that enabled her to continue moving forward with her project and eventually get the results published in the Journal of Clinical Investigation.

Diabetes and Brain Factors!

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Healthy adults can typically recognize when their blood sugar may be becoming too low. It triggers physical symptoms such as dizziness, sweating, weakness, and rapid heartbeat, just to name a few. Plus, their body responds by producing glucose and initiating the brain to signal for food. However, in individuals with type 1 diabetes, the brain does not always respond in this way.

A recent study found that the areas of the brain activated by low blood sugar in adults without diabetes are not the same as those in adults with type 1 diabetes. In brain scans of non-diabetic adults, areas associated with reward, motivation, and decision making showed changes during brain scans. However, only half of the individuals with T1D experienced similar changes, and only in one area of the brain – the area associated with attention – and the other half experienced no changes. Their brain showed no noticeable response to having low blood sugar, which is why individuals may miss cues that others would typically pick up on.

According to Janice Hwang, M.D., assistant professor of medicine and first author on the study, “There is a progressive loss of coordinated brain response to low blood sugar as you go from healthy adult to aware to unaware. The first areas of the brain to go are associated with feeding behavior.” The researchers are hoping that these findings will lead to more effective ways of restoring low blood sugar awareness in individuals with T1D who have lost this awareness.

It is these types of discoveries that help to improve understanding of how T1D affects the brain and body and allows researchers to develop more effective ways of treating and managing the condition. The Diabetes Research Connection supports early career scientists striving to advance research regarding the treatment, prevention, diagnosis, and management of T1D. Researchers can receive up to $50,000 in funding to apply toward their project. To learn more or support these efforts, visit http://diabetesresearchconnection.org.

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“Diabetes Facts” from the Diabetes Focus Magazine

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Small pamphlet-type magazines, such as the quarterly Diabetes Focus hold lots of helpful, healthful, informative information concerning T1Ds and T2Ds.  For instance, I re-wrote four short articles from the Fall/Winter 2017 edition with its appropriate picture, shown below.

1.) How to Win at Weight Loss  “Consistently losing even small amounts of weight in the early days  of a new diet plan can increase your chances of long-term weight loss success.

“A Drexel University study published in Obesity involved 183 participants who were either overweight or obese.  For one year, each participant followed a weight-loss program composed of meal replacements and behavior goals – and recorded food-related behaviors, such as cravings, binge eating, and emotional eating.  Participants also attended weekly weigh-in sessions.  The final weigh-in occurred two years after the weight loss program began.  Those who experienced consistent weight loss in the first six to 12 weeks of the program were more likely to maintain their weight loss at 12 and 24 months than those whose weight fluctuated in the first 12 weeks.

“So, for example, those who consistently lost one pound during the first three-week period were more likely to achieve long-term weight loss than those who lost four pounds, regained two pounds, then lost one pound during the first three weeks.”

Interesting, right?  I was not a part of this story, but want to share it with you.  Wait, there’s more….

2.)  One-Minute Med School…Why you Need Vitamin D  ” Vitamin D deficiency may be associated with peripheral neuropathy, a common complication of type 2 diabetes.  (Note: I’m a type one and have it.)  Symptoms include numbness and tingling or prickling in your feet and/or hands.  A recent study found that patients with peripheral neuropathy had significantly lower vitamin D blood levels and a higher prevalence of vitamin D deficiency than those without it.  If you are diagnosed with vitamin D deficiency, talk to your doctor about taking a supplement.”  (I do and have for years.)

3.)  Take a Hike  “Walking may have big benefits for people with chronic kidney disease (CKD).  People with CKD who walked three to four times per week were 27 percent less likely to need kidney dialysis or a kidney transplant over the course of a yearlong study than those who didn’t.”  (Note:  I walk daily, mostly due to my two dogs needing and wanting to get out.   Having a dog or two is great motivation and self-encouragement to just get outside and move!  Walking has also helped to alleviate my neuropathy symptoms.  It’s just plain wonderful!)

4.)  51  “… Percentage of millenials who consider type 2 diabetes to be a serious health condition, compared with 84 percent of older adults.”

5.)  Do the Math….  “Bagging leaves for 45 minutes = 225 calories burned = 1 caramel apple.”

Simply put, M O O O V E!

I hope you enjoyed these small, factual tidbits and I look forward to hearing from you!  #buckroth

 

 

 

 

“Treatment for Ankylosing Spondylitis” Written by Linda Andrews

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Have you ever heard of this, this…”Ankylosing Spondylitis?”  Did I spell that correctly?

Anyway, no, I never heard of it either.  Having seen and read this article written by Linda Andrews [whom I have never heard], I came to this sharing conclusion: You must read this….

Medically Reviewed on March 13, 2017 by Brenda B. Spriggs, MD, FACP

 [ Video Transcript available here: »

Ankylosing Spondylitis: Much More Than Back Pain

Ankylosing spondylitis is a form of arthritis caused by inflammation of the joints.

Patients often begin experiencing painful symptoms in early adulthood, including aches and stiffness in the lower back and hips. These are often the worst after periods of inactivity or immediately after waking up.

Unlike typical back pain one might experience from injury or spending too many hours in a chair, ankylosing spondylitis can affect other joints, particularly joints in the spine at the lower back and pelvis. The hip and shoulder joints can also be affected as well.

The vertebrae in the back are of particular concern because, if left untreated, these joints can fuse together. This can cause a person to have a hunched over posture and may affect a person’s ability to breathe.

While many patients endure these painful symptoms for up to 10 years before receiving a proper diagnosis, those who work with their doctors to find proper treatment experience a much greater quality of life.

Experts agree that ankylosing spondylitis and other related diseases can run in families, so if you have relatives with a history of immune problems, you may be more likely to develop ankylosing spondylitis.

If you’re experiencing lasting pain for more than three months that feels worse in the morning and better with movement, you should talk to your doctor about ankylosing spondylitis as the potential cause of your symptoms.

Your doctor will perform a physical exam and ask you about your symptoms and whether you have a history of injuries in the affected joints. Your doctor may order imaging tests, such as an X-ray or MRI, to get a better look at what’s causing your pain. You can also expect a simple blood test to check for signs of inflammation, as well as to rule out other potential illnesses.

Your family doctor may initially diagnose you with inflammatory back pain, and refer you to a rheumatologist, a doctor who specializes in medicine related to joints and autoimmune diseases. As ankylosing spondylitis is not associated with mechanical issues that occur with injury-related back pain, it cannot be simply remedied with surgery and requires other therapies.

While scientists continue to look for a cure for ankylosing spondylitis, there are many effective therapies that can relieve pain, improve dexterity, and delay advanced complications, such as joint damage.

Doctors often rely on drugs to reduce the painful and destructive joint inflammation with ankylosing spondylitis. These include nonsteroidal anti-inflammatory drugs, known as NSAIDs, and TNF, or tumor necrosis factor, blockers. TNF blockers are part of class of medications called biologics that suppress aspects of the body’s inflammatory response and may slow the progression of ankylosing spondylitis.

Many patients also benefit from regular exercises with a physical therapist. Patients often find that stretching and rage-of-motion exercises, such as yoga or pilates, can help relieve pain, increase flexibility in joints, and improve physical strength.

Ankylosing spondylitis may be a lifelong condition, but it doesn’t have to be a life-limiting one.

Working closely with your doctor about latest treatments and making smart lifestyle choices can help keep painful symptoms at bay so you can live your life as you see fit.

To learn more about Ankylosing Spondylitis, take a look at the information we have here at to breathe.

While many patients endure these painful symptoms for up to 10 years before receiving a proper diagnosis, those who work with their doctors to find proper treatment experience a much greater quality of life.

Experts agree that ankylosing spondylitis and other related diseases can run in families, so if you have relatives with a history of immune problems, you may be more likely to develop ankylosing spondylitis.

If you’re experiencing lasting pain for more than three months that feels worse in the morning and better with movement, you should talk to your doctor about ankylosing spondylitis as the potential cause of your symptoms.

Your doctor will perform a physical exam and ask you about your symptoms and whether you have a history of injuries in the affected joints. Your doctor may order imaging tests, such as an X-ray or MRI, to get a better look at what’s causing your pain. You can also expect a simple blood test to check for signs of inflammation, as well as to rule out other potential illnesses.

Your family doctor may initially diagnose you with inflammatory back pain, and refer you to a rheumatologist, a doctor who specializes in medicine related to joints and autoimmune diseases. As ankylosing spondylitis is not associated with mechanical issues that occur with injury-related back pain, it cannot be simply remedied with surgery and requires other therapies.

While scientists continue to look for a cure for ankylosing spondylitis, there are many effective therapies that can relieve pain, improve dexterity, and delay advanced complications, such as joint damage.

Doctors often rely on drugs to reduce the painful and destructive joint inflammation with ankylosing spondylitis. These include nonsteroidal anti-inflammatory drugs, known as NSAIDs, and TNF, or tumor necrosis factor, blockers. TNF blockers are part of class of medications called biologics that suppress aspects of the body’s inflammatory response and may slow the progression of ankylosing spondylitis.

Many patients also benefit from regular exercises with a physical therapist. Patients often find that stretching and rage-of-motion exercises, such as yoga or pilates, can help relieve pain, increase flexibility in joints, and improve physical strength.

Ankylosing spondylitis may be a lifelong condition, but it doesn’t have to be a life-limiting one.

Working closely with your doctor about latest treatments and making smart lifestyle choices can help keep painful symptoms at bay so you can live your life as you see fit.

To learn more about Ankylosing Spondylitis, take a look at the information we have here at Healthline or make an appointment with your doctor.

Ankylosing spondylitis (AS) is a form of arthritis that’s associated with chronic inflammation of the joints in the spine. The result is pain and stiffness in the back and hips — symptoms that tend to get worse as time passes. AS can also lead to complications such as a stooped posture, eye or bowel inflammation, and reduced lung or heart function.

If you have AS, there’s a lot you can do to fight back. Proper treatment helps ease pain and stiffness, and it might also prevent or delay complications. Treatment is generally most effective when started early, before the disease causes permanent joint damage.

Here’s an overview of the treatment options for AS. By working closely with your healthcare team, you can find the best combination of treatments for you.

Medication

Several types of medication are helpful for AS, but some may work better for you than others. You’ll probably wind up taking one or more of the following:

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most widely used type of medication for treating AS. They include:

NSAIDs can help relieve inflammation, pain, and stiffness. Long-acting ones taken at night may improve sleep as well.

High doses and long-acting drugs increase the chance for side effects, such as upset stomach, heartburn, or, less often, bleeding stomach ulcers or kidney disease. However, high doses may be needed to ease symptoms of the disease.

Corticosteroids

When NSAIDs alone don’t provide enough relief, doctors may prescribe a corticosteroid, a potent inflammation fighter.

Sometimes, a corticosteroid such as cortisone is injected into an inflamed joint for fast but temporary relief. Other times, an oral corticosteroid such as prednisone (Rayos) or prednisolone (Omnipred) is prescribed for a short time. This can help calm down a flare or get a new exercise program off to a strong start.

Corticosteroids usually aren’t taken for long due to the risk of numerous side effects.

Tumor necrosis factor inhibitors

Tumor necrosis factor (TNF) inhibitors are genetically engineered drugs that block a particular cell protein that triggers inflammation. Examples include:

These drugs — taken by injection or through an IV line — can help reduce joint pain, stiffness, and swelling. They may be effective even when NSAIDs aren’t. But like other drugs, they can have side effects. The most serious one is an increased risk for infections, especially tuberculosis.

Disease-modifying antirheumatic drugs

Disease-modifying antirheumatic drugs (DMARDs) aren’t considered primary treatment options for AS, but they may be used in severe cases. They target the process that sets the disease in motion.

Sulfasalazine (Azulfidine) is the most commonly prescribed DMARD for AS. It may help control not only joint disease, but also the bowel inflammation that sometimes goes along with it. One rare but serious side effect is bone marrow suppression.

Exercise

Exercise plays a key role in managing AS. Done carefully and consistently, it can help lessen your pain and keep you moving. Your doctor might suggest working with a physical therapist to develop an exercise plan that’s suited to your needs. Two types of exercise are particularly important:

Strengthening exercises

Stronger muscles provide better support for painful joints. To perform strengthening exercises, you could use weights or weight machines. A physical therapist might also show you how to tighten and release your muscles without moving your joints so you can keep building strength even during disease flares.

Range-of-motion exercises

Stretching helps maintain joint flexibility and preserve good posture. A physical therapist can show you how to safely stretch your back even when it’s painful and stiff. In the long run, this can help ward off disability.

Posture training

Practicing good posture is another crucial element of treatment. In some people with AS, long-term inflammation causes bones of their spine to fuse together. Posture training may influence the pattern of fusion so that your spine doesn’t become locked into a hunched-over position. This affects not only how you look, but also how well you’re able to get around.

One component of good posture is awareness. You can learn how to check your posture in a full-length mirror. Done regularly, this helps you detect any changes early and increases the potential for correction. You can also start paying closer attention to how you sit, stand, and walk. This helps you break the habit of slouching and focus on holding yourself up straight.

In addition, you can do posture exercises. One of the simplest and best involves lying face-down on the floor or a firm bed for up to several minutes at a time.

Heat and cold therapy

Applying heat or cold to the affected area may make you more comfortable. Heat helps ease pain and soreness in stiff joints and tight muscles. A warm bath or shower is often a soothing choice. Or you might try a heating pad, hot pack, or heated washcloth.

Cold helps reduce swelling around inflamed joints. A cold pack can also numb a sore area when you’re in the midst of a flare.

Surgery

Surgery is not a primary treatment for AS. However, sometimes inflammation affects joints outside the spine. If you have joint damage to your hip or knee that’s severe enough to make it hard to get around, your doctor might recommend joint replacement surgery.

Rarely, an operation called an osteotomy may be performed to straighten the spine after it has fused into a stooped position. This surgery involves cutting and realigning bones of your spine. Because it’s considered high risk, osteotomy isn’t a common option.

Article Resources
Read more: https://www.healthline.com/health/ankylosing-spondylitis/treatment#ixzz51M4J3vR1

End of Story!  I hoped you enjoyed reading and learning through this article.  I certainly have!

Just sayin’…#buckroth

Resourceful [T1D] Diabetes News – it’s a good thing

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You don’t really get type 1—until you get it. No other disease requires so much daily input and management from patient or caregiver. Our Glu community shares more than T1D—we share a common language and understanding. We crowd-source wisdom, share experiences, and offer perspectives—all to connect and support others living with or caring for others with type 1, while contributing to research.

What Can Glu Do For You?:  A quick overview and how-to guide

T1D Resources & Toolkits:  Tips and Tricks from Glu and others on how to live well with type 1 diabetes.

Glu Content Library:  Links to more than four years worth of Glu articles on a variety of topics.

Our Research & Initiatives:  Glu and T1D Exchange data, findings and research studies

Glu Events & Appearances:  Where to find the Glu team offline and in person!

The New Complication: Aging with Type 1 Diabetes

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Update: You can now listen to our Diabetespeaks podcast episode of this event by clicking here: https://www.podbean.com/media/share/pb-ny8f7-7e17c9

With incredible breakthroughs in diabetes technology, therapy and clinical care, people with type 1 diabetes (T1D) are living longer than ever. But as people age, they take on a whole separate host of challenges that are compounded by T1D. Many fear they will not have the self-reliance, care, support, or financial resources necessary to manage their blood sugar and continue to live well with diabetes in their golden years.

Last month, this concerning issue was presented at T1D Exchange’s Annual Meeting. Four individuals currently or soon facing this dilemma spoke on a patient panel, bringing to light a new complication of type 1 diabetes rarely discussed in a public forum.

“This is a new problem, based on our recent success in treating T1D,” said Dr. Nick Argento, an endocrinologist and person with diabetes (PWD). “The Joslin 50-year survivors used to be sort of an elite group. That’s not true anymore. Now, it’s expected, not the exception.”

Joining Argento on stage was Paul Madden, Bunny Kasper, and Sandy Brooks, each with a different diabetes experience, but all in their later stages of life.

Bunny Kasper, who is in her mid-seventies and has lived with diabetes most of her adult life, volunteers as a support group leader for families with children who have T1D. She shared that this group of parents recently commented that she should find diabetes management easier because she’s been doing it for so long. But what they didn’t understand was how much more tired she is at this age, and that it’s actually harder, not easier, after all these years.

“There’s just very little understanding about the elder generation and what we deal with,” said Kasper.

In addition to physical wear and tear, the panelists shared how much fear plays a role in their daily lives with T1D, and how vulnerable they all feel about their future.

“I’m afraid of being alone, and not being supported with my care,” said Paul Madden, 66, diagnosed 55 years ago.

Argento shares the same fear, and has already seen this issue in his own T1D patients.

“Their network has broken down. They’ve had a spouse who was their advocate and assistant, but then has a stroke or develops dementia or dies and suddenly, they’re not present anymore.”

Not only is a caregiver or partner helpful at home for everyday diabetes tasks, but also as an advocate in hospitals or other institutions. Argento and others on the panel shared stories of healthcare providers ignoring their T1D needs during surgery or other hospitalizations, and highlighted the importance of the greater medical community to become more educated about diabetes in order to care for all people with T1D.

“What if I can’t advocate for myself?” said Argento. “I’m deathly afraid of that, and I’ve seen some horrible outcomes, unfortunately, for my patients in the same situation. It creates tremendous anxiety.”

Sandy Brooks, a registered nurse and surgical type 1, says nursing homes are even less prepared and educated about insulin dependency.

“There are great people there who work hard, but T1D adds an aspect that you don’t learn about in nursing or medical school.”

The cost of diabetes management and access to technology, therapies and care, are also a big worry for these panelists, especially as many of them are or will soon be eligible for Medicare. Argento has advocated fiercely for CMS coverage of continuous glucose monitoring (CGM) systems, including representing the Endocrine Society before the FDA to approve non-adjunctive use of Dexcom, which was a necessary step towards CMS’ decision to cover CGM. He was also in a pivotal meeting with CMS on the Dexcom approval, which came through earlier this year.

“There was a huge population of type 1 patients who were depending on CGM, and couldn’t live without it. They’d hit Medicare age and they’d lose it,” said Argento, who encourages all people with diabetes to persist, and insist, on the care and therapies they need. “They should have gotten a medal for making it to Medicare age, not a denial from CMS.”

Kasper pointed out that the way she planned financially for her retirement over the previous decades now won’t cover her diabetes costs under the current landscape, and that older people like her cannot make up this shortfall by earning more income.

“If you don’t have the money you need, you’re not going to get the supplies or the care,” said Kasper.

Madden had one piece of advice for seniors facing these unchartered waters with T1D. He spoke of the importance of having a good relationship with one’s providers and finding one that will listen to your concerns, whether they’re related to aging, diabetes, or both.

“It’s amazing how important that relationship is,” said Madden, whose current endocrinologist looks at him as an individual, listens to his questions, and helps him refine his questions before answering, because, he says, sometimes he doesn’t know how to ask them. “That’s powerful when that happens. That’s access at the fullest level.”

We thank our patient panel for sharing their perspective, and opening the community’s eyes to this very important topic. As always, Glu and T1D Exchange need feedback from our patient community in order to research critical issues in type 1 diabetes like this one, so please comment and share your thoughts on aging with type 1 diabetes and other topics you feel are important.

—Amy Bevan/GluMom

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