Study Shows Big Improvement in Diabetes Control Over Past Decades

At the Stark Diabetes Center, one of the ways we strive to improve the health and quality of care for Texans is through  a specific emphasis on prevention of diabetes and its complications. So, we’re very encouraged when we hear more people are meeting recommended goals in the three key markers of diabetes control, according to a recent study conducted and funded by the National Institutes of Health and the Centers for Disease Control and Prevention.

The report, recently published online in Diabetes Care, shows that, from 1988 to 2010, the number of people with diabetes able to meet or exceed all three of the measures that demonstrate good diabetes management rose from about 2 percent to about 19 percent. Each measure also showed substantial improvement, with over half of people meeting each individual goal in 2010.

The measures are A1C – which assesses blood sugar (glucose) over the previous three months – blood pressure and cholesterol. They are often called the ABCs of diabetes. When these measures fall outside healthy ranges, people are more likely to be burdened by complications of diabetes, including heart disease, stroke, kidney disease, blindness, and amputation.

Despite improvement, the results show continued need for better diabetes control. In particular, young people and some minority groups were below average in meeting the goals. Read more and access the full report…

Lynn Maarouf is a registered dietician offering diabetes education and nutrition counseling at the Stark Diabetes Center at the University of Texas Medical Branch at Galveston.

Prevention is best medicine against kidney disease

Earlier this month, we at UTMB Health joined others around the globe in celebrating World Kidney Day. Our kidneys are crucial and a hardworking organs. Here are a few tips to help keep yours in top form:

What is CKD?
Chronic kidney disease (CKD) is a condition where the kidneys are damaged and lose the ability to keep you healthy. As kidney disease gets worse, body waste can build up in your blood and make you feel sick by creating a host of health problems. Problems caused by CKD typically happen slowly over a long period of time.

What causes CKD?
The two main causes of CKD are diabetes and high blood pressure.

What are the symptoms of CKD?
Most people do not have symptoms until their kidney disease is fairly advanced. Lack of energy, poor appetite and nausea are some of the common symptoms of advanced CKD.

Five things you can do to keep your kidneys healthy:

  • Exercise regularly and eat a healthy diet
  • Have an annual physical exam especially after age 40
  • If you have diabetes or high blood pressure, make sure you follow your doctor’s instructions
  • Avoid regular use of medications that may harm your kidneys
  • Ask your primary care physician if it is necessary to see a kidney doctor

Dr. Pradeep V. Kadambi is a nephrologist and associate professor and medical director of kidney and pancreas transplantation at the University of Texas Medical Branch at Galveston. He serves patients at UTMB Health’s Multispecialty Center, in League City.

Making diabetes care less costly

Dr. Victor Sierpina

Dr. Victor Sierpina

Some good news came out recently for those with type 2, non-insulin dependent diabetics that will lower the burden and costs of your care. If your hemoglobin A1C (HbA1C) level is under 8 and you are on oral medications, you don’t need to monitor your glucose daily beyond the first 6 months of starting therapy. This is also true of those on medical nutrition therapy. A review of multiple studies by the Cochrane Collaboration found that monitoring home blood sugars 4-7 times a week in such patients does not reduce the HbA1C more than less frequent self-monitoring of 1-2 times a week.

This is good news since the cost of glucose strips and the discomfort and inconvenience of daily finger sticks has long been a nuisance to patients. Diabetes is a costly disease already in terms of human suffering from serious issues such as heart disease, kidney failure, blindness, and circulatory problems sometimes requiring amputation. It is also expensive to manage diabetes due to the costs of medications, monitoring, doctor visits, testing supplies, special shoes, and hospitalizations.

So at least, this one component of perhaps reducing your monitoring frequency should make your life easier.  Consult with your doctor about this change in recommendations to make sure it is appropriate in your case. (more…)

7 simple steps for a healthy, happy 2013

By Lynn Maarouf

Statistics tell us the “average” American gains a lot of weight over the holidays. Many people who usually eat well are pressured by loving hosts to eat high-calorie foods they would never choose on an ordinary day.

Let’s look at a few simple steps to stay healthy and make it a lucky 2013:

1. Move it! The best time to exercise is before a holiday meal. It gets your metabolism revved-up to burn those calories off faster. Take a trip to the gym or spend an hour walking before you eat. A nice piece of cake will be at least 300 calories. It would take a minimum of 50 minutes of walking for most of us to burn that off.

2. Fill up with fiber and water. Eat a high-fiber cereal with at least 8 grams of fiber in the morning. This helps you feel less hungry and decreases the temptation to overeat. Aim for 20 grams of fiber a day and a big appetite won’t be a big problem. Break out those sandwich thins for five extra grams of fiber. And drink enough water to help that fiber swell and take up lots of room. (more…)

Study shows antidepressant could do double duty as diabetes drug

UTMB researchers have discovered that the commonly used antidepressant drug paroxetine could also become a therapy for the vascular complications of diabetes. The scientists made their discovery after screening 6,766 clinically used drugs and pharmacologically active substances.

“We developed this assay and used it to test literally every single existing drug and a good selection of other biologically active compounds,” said UTMB professor Csaba Szabo, senior author of a paper on the research published online by Diabetes. “We were quite surprised when paroxetine came out as an active compound—a result, we later determined, of what seems to be a completely new effect unrelated to its antidepressant actions and not shared by any other known antidepressant drug.”

The initial screening process tested the ability of different compounds to protect the cells that make up the inner linings of blood vessels from the destructive effects of the high sugar levels produced by diabetes, known as hyperglycemia. In people with diabetes, hyperglycemia causes these endothelial cells to generate toxic molecules known as reactive oxygen species (ROS), which ravage blood-vessel linings and lead to diabetic endothelial dysfunction, the key factor in such destructive diabetic complications as heart attacks, strokes, retinopathy, nephropathy and neuropathy.

In subsequent test-tube studies, researchers found that paroxetine — which is sold as an antidepressant under the trade name “Paxil” — prevents hyperglycemia-initiated ROS damage to endothelial cells in two ways. [read more]