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bookDiabetes articles about daily topics that affect those living with diabetes. There is a lot of information about diabetes and hopefully you find this information useful in your everyday life. Here we have compiled a list of older articles from our previous "The Diabetes Network" along with links to blogs and articles, an extended reading archive. You can use the search in the top-right menu to search for specific articles.

 

Feeling Cold, pt. 2 - effect of insulin on body temp


As you may recall, I recently started doing some data recording of my basal body temperature at waking and before bed. Through that data, it was pretty obvious that my core body temperature (CBT) is more than a bit lower than the normal 98.6 degrees (F). I have consistently run 96.5. Having established my initial baseline for my A-B-A data set test for my upcoming experiments on increasing my own CBT, I was doing some Google-research when I stumbled upon a preview of an article to be published this coming October in the medical journal, Diabetes.

The article is entitled "Insulin Causes Hyperthermia by Direct Inhibition of Warm-Sensitive Neurons." The objective of the research was to examine the role of the metabolic signal insulin in the control of core body temperature. The findings demonstrated that insulin can directly modulate hypothalamic neurons that regulate thermogenesis and CBT which indicated that insulin plays an important role in coupling metabolism and thermoregulation at the level of anterior hypothalamus. Since I myself don't have a subscription to the Diabetes medical journal nor feel like spending $45 to read something I probably can't understand in the first place, I'll just assume they are correct until one of you readers points me to contrary medical research.

According to a summary medical article on Medical News Today "New Link Discovered Between Core Body Temperature and Insulin," while much research has been conducted on insulin since its discovery in the 1920s, this is the first time the hormone has been connected to the fundamental process of temperature regulation:

The scientists found that when insulin was injected directly into a specific area of the brain in rodents, core body temperature rose, metabolism increased, and brown adipose (fat) tissue was activated to release heat. The research team also found that these effects were dose-dependent - up to a point, the more insulin, the more these metabolic measures rose.

"Scientists have known for many years that insulin is involved in glucose regulation in tissues outside the brain," said Scripps Research neurobiologist Manuel Sanchez-Alavez, who was first author of the new paper with Bartfai lab colleagues Iustin V. Tabarean and Olivia Osborn (now at the University of California, San Diego). "The connection to temperature regulation in the brain is new."

...

In work coordinated by Osborn to characterize these neurons and their transcriptome (all of the messenger RNA molecules in a cell, which reflect the genes being expressed), the team noticed something unexpected - a messenger RNA for an insulin receptor.

"We were surprised to find the insulin receptor," said Tabarean. "The insulin receptor is very well documented in the pancreas and in other peripheral tissues. But in the brain, it was not clear and we definitely did not know about its existence in warm-sensitive neurons."

The article goes on to explain the methodology, then draws some conclusions:

The authors note that while their new paper illuminates a key piece of the puzzle of the body's metabolic processes, it also raises many intriguing questions: How does insulin get to the brain's preoptic area - does it cross the blood-brain barrier or is it produced locally? Are diabetics, who are insensitive to insulin in peripheral tissues, still sensitive to insulin in the brain; if so, could this dichotomy be used in the development of a new therapy? Could scientists find a way to use these new insights to increase energy expenditure for the purpose of weight loss?

Unlike the rodents in the medical tests, I'm not really in much of a position to stick a syringe into my brain and inject a bit of humalog to see what happens. So, I thought I'd ask for volunteers. Just kidding!

It does, however, give me an idea for an experiment to try: determining the effect deprivation of all insulin from my system would have on my CBT. Given the above, would my CBT actually be lower if I had, say, 24 hours of no insulin whatsoever? It would be a pretty simple test to complete, perhaps at my next scheduled site change. Don't worry, I'd couple it with a complete fast as well so my blood sugar levels shouldn't rise too high... that in and of itself would be pretty interesting to know as well: what is the rising rate of one's blood sugar if nothing is ingested?

As always, please don't try this at home. I don't mind screwing up my own body processes in the name of science, but I don't want to worry that I'm messing with your own. But, if you do decide to give it a try, don't hesitate to share the data!

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Insulin resistance linked to Alzheimer's brain plaques

by CTV.ca News Staff

Updated: Thu. Aug. 26 2010

A new study has more bad news for people with pre-diabetes or type 2 diabetes: researchers have found evidence they may be at increased risk for developing the brain plaques linked to Alzheimer's disease.

In the new study, which appears in the journal Neurology, 135 Japanese men and women underwent diabetes screening tests in 1988. They were then followed for up to 15 years for signs of Alzheimer's disease.

After they died, researchers conducted autopsies on their brains to look for plaques, and brain "tangles," another brain abnormality seen with Alzheimer's disease. While 16 per cent had symptoms of Alzheimer's disease while alive, a total of 65 per cent had brain plaques. Plaques were found in 72 per cent of people with insulin resistance and 62 per cent of those with no indication of insulin resistance, the researchers wrote.

People who had abnormal results on their blood sugar tests were more likely to have plaques in their brain, the study shows. This relationship was more pronounced among people who also had a form of the ApoE gene that's been linked to a higher risk of developing Alzheimer's disease.

There was no link between insulin resistance and type 2 diabetes and risk for developing brain tangles, the study found. The researchers say it's not clear if insulin resistance is a cause of brain plaques. But if it is, that leaves the door open to perhaps preventing Alzheimer's disease by controlling or preventing diabetes. The study's findings are significant, the authors say, given the rising prevalence of both type 2 diabetes and Alzheimer's disease.

"With the rising obesity rates and the fact that obesity is related to the rise in type 2 diabetes, these results are very concerning," study author Dr. Kensuke Sasaki, with Kyushu University in Fukuoka, Japan, said in a news release.

As for why diabetes and Alzheimer's might be linked, the researchers suggest that having high levels of glucose and insulin in the blood may damage neurons.

It may also hinder the brain's ability to clear out amyloids, a protein normally produced by the body. These proteins can then form the beta-amyloid plaques that are a hallmark of Alzheimer's disease.

Sources include
http://www.ctv.ca/servlet/ArticleNews/print/CTVNews/20100826/diabetes-alzheimers-100826/20100826/?hub=Health&subhub=PrintStory
http://www.sciencedaily.com/releases/2010/03/100315161921.htm
http://www.neurology.org/
http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm
http://ghr.nlm.nih.gov/gene/APOE
http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance
http://hyoka.ofc.kyushu-u.ac.jp/search/details/K002449/e

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Multiple Diabetes Injections Could Yield to Injections Just 3 Times a Week

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Excerpted from ABC NewsMarch 10, 2011

A new study, published in the Lancet, found that a longer acting form of insulin, known as degludec, is just as effective as the existing long-lasting insulin, glargine.

One injection of glargine lasts 18 to 26 hours, but study participants who used degludec had the same amount of blood sugar control as glargine while only getting injected three times a week instead of daily.

Sticks and Pricks of the Study

Participants who took degludec had lower rates of hypoglycemia.

"This would give patients the same level of control in insulin with much less chance of hypoglycemia," said Dr. Bernard Zinman, director of the Leadership Sinai Center for Diabetes and lead author of the study. "It was so long-acting that we looked at administering it less frequently, and even under those circumstances we had an excellent response with respect to lowering glucose."

Researchers enrolled 245 people aged 18 to 75 years old with type 2 diabetes onto the preliminary trial. Patients were randomly assigned to receive the three-times-a-week or the daily insulin injection.

"This was a proof-of-concept study," said Zinman. "We need to wait for much larger studies involving more patients under different circumstances to see whether this would be valuable in the clinical setting."

Dr. Gerald Bernstein, director of the Diabetes Management Program at Beth Israel Medical Center in New York, said that other "basal-like," or background, insulins, like NPH and Levemir, already are being used today.

"In my mind, there is no question that, with hundreds of millions of people with Type 2 diabetes, there will be subgroups that would benefit and respond to one of these insulins," said Bernstein.

"If this new preparation would get more people to take insulin earlier, that would be a plus," said Bernstein. "As it proves itself out, it may be of significant value in the future."

According to the American Diabetes Association, nearly 26 million people have diabetes in the United States. Type 2 diabetics often do not have indicating symptoms of the disease but sometimes they will suffer from frequent infections in the skin, gums or bladder, blurred vision, bruises that are slow to heal and tingling in the extremities.

Type 2 diabetics do not produce enough insulin or the cells ignore the insulin.

Potential Breakthrough When Lowering Hypoglycemia

Most diabetic patients who take insulin need about two shots per day to control blood sugar levels. But it is not uncommon for people to inject insulin four times a day.

"Another long-acting basal insulin that might be effective when given every three days could improve adherence and reduction in hypoglycemia, [which] is always an important goal in that hypoglycemia deters adherence with and acceptance of insulin therapy in type 2," said

While study authors warned that the insulin is not ready for clinical use, many doctors remain hopeful that the drug will cut down insulin maintenance for diabetic patients in the future.

"This is a promising advance in the management of diabetic patients, easy to take, less cumbersome, perhaps cheaper and, if indeed [it] has less hypoglycemia episodes, even better," said Dr. Albert Levy, assistant professor of medicine at Albert Einstein College of Medicine in New York. "The most common side effect of practically all insulin injections is hypoglycemia, and if this unwanted side effect is minimized it would be a major breakthrough."

Sources include
http://abcnews.go.com/Health/diabetes-study-finds-times-week-insulin-improves-glucose-levels/story?id=13097090&page=3
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)62305-7/fulltext
http://www.novonordisk.com/include/asp/exe_news_attachment.pdf?sAttachmentGUID=eb95fd24-0fdc-4f82-9d64-9dd748c78c0f
http://www.lantus.com/
http://www.lunenfeld.ca/researchers/zinman
http://www.friedmandiabetesinstitute.com/
http://www.aolhealth.com/2010/08/24/meet-diabetes-expert-dr-gerald-bernstein/
http://www.diabetes.org/
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001423/
http://www.einstein.yu.edu/home/faculty/profile.asp?id=3017
http://www.einstein.yu.edu/home/default.asp

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I'm Not a Doctor, But I Play One When I Watch TV

I'm a regular viewer of Army Wives. It's a cheesy, soapy kind of series on Lifetime, but I like it.

A couple of episodes ago, Claudia Joy would mention how thirsty she was and take a swig of water. It was very subtle and not much attention was brought to it on the show. Not another mention was brought about it following her swig.

But, I immediately zoned in on it and thought, "Ha, I bet she has diabetes."

On the next episode, they alluded to her being told devastating news after a car accident.

I thought, "I'll bet she's diagnosed with diabetes. Now will it be Type 1 or 2. What a cliffhanger!"

During that episode, she complained she wasn't feeling well. And then she asked someone for some water because she was thirsty.

She and one of the Army Wives were driving at night and her vision blurred. They got into an accident after she swerved out of the way of a car whose lane she passed into.

At the hospital, they did regular blood work that night. The next morning, the doctor mentioned that they saw her blood sugar was high and thought maybe stress from the accident caused it, so they did another blood work up that morning and found it to be high again. He told her to follow up with her physician.

I was like, "Damn! I should be a doctor! I'm feeling so House right now."

So, at the end, she's diagnosed with Type 2. It was an educational scene for the viewers. I was impressed that the TV doc was very thorough and pretty accurate with the info she gave Claudia Joy about Type 2 and the fact that even though she is thin and fit, she could still get Type 2.

This past episode shows Claudia Joy taking insulin because the doc wanted to get her started on that therapy right away.

So of course, I'm making sure that the technical part to this scene is accurate, LOL.

She didn't exactly get the air in correctly, but I'll let that pass. No biggie.

She did draw out the insulin correctly, did not tap out bubbles though, and she didn't go nuts over pushing out the insulin to get the correct dosage.

I remember eyeballing the bejeesus out of that syringe to make sure the plunger met up with the correct markings on the syringe. I was always cross-eyed.

OK, anyway, not much TV time can be taken up measuring out the insulin.

But when she injected it into her stomach, she rubbed the spot afterwards.

I was thinking, "Don't rub it! You're not supposed to rub it!"

Anywho, yeah...I'm a stickler for accurate diabetes portrayal. This will probably play out for a few episodes and then be forgotten about. But, I will watch like a hawk in the meantime to see if they do the Type 2 justice.

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Letter to a New Diabetic: Lowering Blood Sugar

Dear Concerned:

Welcome to the wonderful (and head scratching) world of blood sugar prediction. What works once may not work again the next time and what works for one person may not work for another. That's because reducing a high blood sugar is part science, part art and part luck.

The science is in doing the calculations. If your blood sugar is 200 and you want to lower it to be at 100, you need to know how much 1 unit of insulin will reduce your blood sugar (value of "x"). Then just take 100 / "x" to get the number of units to take. This is a fairly simple algorithm that you and your Endo (diabetic doc) can determine by fasting and doing food/insulin tests. You probably have a "basic" rule for reduction but the more you can do to make it specific to you, the more accurate and hence the better.

The art of treating a high blood sugar comes from knowing how YOUR body reacts to insulin, particularly when your blood sugar is at a higher level ( i.e., 1 unit = x reduction, but if the blood sugar is over 300, 1 unit only = 1/2 of x.) The only person that can take the time to figure that out is you. The other aspects that you have to consider include what you are doing at the time, e.g. exercising, moving, sleeping; how you are feeling at the time (as sometimes being sick = high blood sugar); and when and what you last ate and the amount of food still being digested in your system.

As for the luck in lowering your blood sugar, well, there is a dash of that as well. Sometimes you do everything right and "by the book" and then look at the numbers, scratch your head and wonder if it was all just a waste of time. It's not, of course, but it can certainly be frustrating.

Keep in touch,

Niko

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An original video - why everyone should be on the insulin pump

6 month review of insulin pump, click HERE

Medtronic Revel insulin pump review, click HERE

P90x & the pump, click HERE

Complaining never helps, click HERE

A visual aid (graph) to prove the point, click HERE

What I regret about choosing the pump, click HERE

My family explains the benefits of the pump (a video), click HERE

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