Adiponectin and All-Cause Mortality in Elderly People With Type 2 Diabetes

ATVB in Focus Metabolic Syndrome and Insulin Resistance: Mechanisms and Consequences

atvb.ahajournals.org: 9/1/12

Insulin resistance is a characteristic feature of obesity and type 2 diabetes mellitus and impacts the heart in various ways. Impaired insulin-mediated glucose uptake is a uniformly observed characteristic of the heart in these states, although changes in upstream kinase signaling are variable and dependent on the severity and duration of the associated obesity or diabetes mellitus. The understanding of the physiological and pathophysiological role of insulin resistance in the heart is evolving. To maintain its high energy demands, the heart is capable of using many metabolic substrates. Although insulin signaling may directly regulate cardiac metabolism, its main role is likely the regulation of substrate delivery from the periphery to the heart. In addition to promoting glucose uptake, insulin regulates long-chain fatty acid uptake, protein synthesis, and vascular function in the normal cardiovascular system.  Read more

Diabetes and death

hhs.gov: August 21, 2012.
From the U.S. Department of Health and Human Services, I’m Nicholas Garlow with HHS HealthBeat.

More people have diabetes now than ever before. People with diabetes often have other health risk factors, like obesity and high blood pressure. But data from the National Health Interview Survey shows that death rates are declining in both men and women with diabetes.

Dr. Edward Gregg is with the Division of Diabetes Translation at the Centers for Disease Control and Prevention.

“From the time period of 1997 to 2006, death rates for any cause and for cardiovascular disease in particular declined in people with diabetes.”

Those with diabetes can prevent their risk of cardiovascular disease by maintaining a healthy weight, healthy cholesterol levels, and by not smoking.

The study in the journal Diabetes Care was supported by CDC and the National Institutes of Health. Read more

Translating the Research in Insulin Injection Technique

tde.sagepub.com: August 15, 2012.

Glucose variability leading to suboptimal glycemic control is common among people using injection therapies. Advanced technology and new studies have identified important issues related to injection technique: needle length and gauge, body mass index, skin and subcutaneous tissue thickness, adequate resuspension of cloudy insulins, leakage, choice of injection site and rotation, pinching a skinfold, and lipohypertrophy. All these issues can affect pain and bruising, insulin absorption, and blood glucose levels. The purpose of this article is to review current and past research regarding insulin injection therapy and to provide practical, translational information regarding injection technique, teaching/learning techniques specific to insulin administration, and implications for diabetes self-management education and support. Read more

Supporting self-management after attending a structured education programme: a qualitative longitudinal investigation of type 1 diabetes patients¿ experiences and views

biomedcentral.com: 8/14/12

Structured education programmes for patients with diabetes and other chronic conditions are being widely adopted. However, follow-up studies suggest that course graduates may struggle to sustain the self-care practices taught on their courses over time. This study explored the support needs of patients with type 1 diabetes after attending a structured education programme promoting an empowerment approach and training in use of flexible intensive insulin therapy, a regimen now widely advocated and used to manage this condition. The objective was to inform future support offered to course graduates.

Methods

Repeat, in-depth interviews with 30 type 1 diabetes patients after attending Dose Adjustment for Normal Eating (DAFNE) courses in the UK, and six and 12 months later. Data were analysed using an inductive, thematic approach. Read more

Outcomes with various drug eluting or bare metal stents in patients with diabetes mellitus: mixed treatment comparison analysis of 22 844 patient years of follow-up from randomised trials

bmj.com: August 10, 2012

To evaluate the efficacy and safety of currently used drug eluting stents compared with each other and compared with bare metal stents in patients with diabetes.

Design Mixed treatment comparison meta-analysis.

Data sources and study selection PubMed, Embase, and CENTRAL were searched for randomised clinical trials, until April 2012, of four durable polymer drug eluting stents (sirolimus eluting stents, paclitaxel eluting stents, everolimus eluting stents, and zotarolimus eluting stents) compared with each other or with bare metal stents for the treatment of de novo coronary lesions and enrolling at least 50 patients with diabetes. Read more

Mortality Among Low-Income African Americans and Whites With Diabetes