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I Am More Than Just A Broken Pancreas & A Human Pincushion...

Kelly's intimate knowledge of living with diabetes makes her the perfect person to poke fun at all of our little eccentricities. If laughter really is the best medicine, then Kelly should be nominated for Sturgeon General."
Gary Scheiner - Certified Diabetes Educator, Owner & Operator of Integrated Diabetes Services, Author of "You Can Control Diabetes" and "How to Think Like A Pancreas."
Marx Brothers Fan for life, T1 for 20 years .


"Kelly Kunik performed her Diabetes Comedy Act at the
Diabetes, Exercise, & Sports Association (DESA) National meeting in Colorado Springs in June of 2007. She had the room laughing all night! It was great to see the light side of Diabetes for once...."

Rick Philbin, Type 1, Board of Directors, DESA

"Kelly was very engaging with her humor and positive attitude in looking at life with Diabetes on a lighter side. Everyone in my Diabetes Support group lowered their glucose levels with laughter that evening!"
Bryony Crane, RD CDE
Virtua Diabetes and Nutrition Svs

"Dr. Kelly keeps you laughing.......Great bedside manner!"
Boston Charlie - T1 30 years

"As a Diabetes Educator, I'm always looking for new ways to help patients. Kelly Kunik offers a unique way of educating patients through laughter.
There's a tremendous validation in Kelly's approach - Everybody thinks that no one once else has diabetes related issues, day & day out. Whether it getting your tubing caught on a door nob; acting out with a low blood sugar, or dealing with the same old questions. Silly or serious, Kelly's observations allow patients to feel better about themselves.
When people feel good about themselves, they practice better
self management. IT'S ALL GOOD.
We all had so much fun the night Kelly spoke to my Type 1 support group."

Cheryl Marco, RD, CDE
Thomas Jefferson University
Division of Endocrinology and Metabolic Diseases

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I'm getting Bald – Find Out What Causes Hair Loss and and get Effective and Natural Treatment


Many people suffer from hair loss & are worried about the cause of baldness. You are not alone if you are having a difficult time finding a balding treatment. Because in order to find an effective baldness remedy, it is important to know what causes hair loss first.

One major cause of baldness is genetics. However, hormones also play a massive part in hair loss & usually caused by hormonal imbalance.

For instance, men tend to make more androgens which affects the hair follicles thus resulting to baldness or thinning hair. For women, hair loss usually happens after the period of menopause where the levels of estrogen is low in production.

Other causes are excessive anxiety, stress, shock & physical stress from chemotherapy or surgery. In case of severe disease, the overall condition of the hair can be affected & result to poor health of the hair.

Tight scalp happens to people who are experiencing starvation when the circulation of blood is not healthy. The result -- a deficiency of natural oil of the hair leading to baldness or hair loss.

Weakened scalp circulation is & a cause of baldness. Tight scalp tends to affect hair follicles.

There is lovely news. Natural ingredients found in a balding treatment have been proven safe & effective.

For women, taking birth control medications can cause hormonal imbalance that leads to thinning hair. Definite diseases such as diabetes are known to be a cause of baldness & even scalp infections.

Natural herb extracts work in synergy to block DHT, boost your circulation & provide nutritional support. A few natural nutrients include Saw Palmetto, Nettle Root & Muira Puama.

& one of the best ingredients is a topical medication approved by the FDA, for both male & female hairloss, is called Minoxidil. This substance doesn't grow new hair, bit it does block the DHT & prolong the growth phase of hair. Because it provides more time for hair to grow out, you'll see a your full head of hair once again.

Also playing an important role are vitamins & minerals like vitamin B6, biotin, zinc & magnesium. Providing nutrition, these nutrients help support natural healthy hair growth and improve your body's health.

Now that you know the cause of baldness, if you are dealing with thinning hair recall that there is an effective & natural balding treatment. It is not an overnight balding cure but if you stick with it over the months you'll gradually see a full head of hair.

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The DOC Goes To Washington, D. C. & Participates In JDRF's Government Day

Kelly's intimate knowledge of living with diabetes makes her the perfect person to poke fun at all of our little eccentricities. If laughter really is the best medicine, then Kelly should be nominated for Sturgeon General."
Gary Scheiner - Certified Diabetes Educator, Owner & Operator of Integrated Diabetes Services, Author of "You Can Control Diabetes" and "How to Think Like A Pancreas."
Marx Brothers Fan for life, T1 for 20 years .


"Kelly Kunik performed her Diabetes Comedy Act at the
Diabetes, Exercise, & Sports Association (DESA) National meeting in Colorado Springs in June of 2007. She had the room laughing all night! It was great to see the light side of Diabetes for once...."

Rick Philbin, Type 1, Board of Directors, DESA

"Kelly was very engaging with her humor and positive attitude in looking at life with Diabetes on a lighter side. Everyone in my Diabetes Support group lowered their glucose levels with laughter that evening!"
Bryony Crane, RD CDE
Virtua Diabetes and Nutrition Svs

"Dr. Kelly keeps you laughing.......Great bedside manner!"
Boston Charlie - T1 30 years

"As a Diabetes Educator, I'm always looking for new ways to help patients. Kelly Kunik offers a unique way of educating patients through laughter.
There's a tremendous validation in Kelly's approach - Everybody thinks that no one once else has diabetes related issues, day & day out. Whether it getting your tubing caught on a door nob; acting out with a low blood sugar, or dealing with the same old questions. Silly or serious, Kelly's observations allow patients to feel better about themselves.
When people feel good about themselves, they practice better
self management. IT'S ALL GOOD.
We all had so much fun the night Kelly spoke to my Type 1 support group."

Cheryl Marco, RD, CDE
Thomas Jefferson University
Division of Endocrinology and Metabolic Diseases

Read Full Article

Sometimes I feel like I'm on a different planet...

I was in a coffee shop reading for school. I was reading an article about patients writing illness narratives. It was arguing that such stories can be seen as a political act against a biomedical model that sees patient merely as disease and not as an whole being. I have issues with some of what the authors argue. I don't really see one nice neat narrative in illness. It's more like different stories of good days and bad days and, while, there might be a beginning, for people with chronic illness there is no end, or at least not in life.

When I got toward the end of paper I started to tear up... which was kind of weird, because I still wasn't into the article. By the end it argues that nurses are in a position to dialogue with patients and create a sort of co-constructed narrative of illness that suits both the practictioner and the patient. Fair enough, I guess, but I just didn't find it incredibly mindblowing. So, I couldn't really figure out why I was suddenly all choked up...

And then I realized that this was playing in the background:

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New Type of Diabetes Drug Drops Weight With Blood Sugar

SGLT2 Inhibitors Boost Metformin, Can Be Used Even in Late-Stage Diabetes

By Daniel J. DeNoon
from WebMD
Now the first of these so-called SGLT2 inhibitors has been tested in a phase III clinical trial. It's dapagliflozin, being jointly developed by Bristol-Myers Squibb and AstraZeneca.

Study leader Clifford J. Bailey, PhD, is professor of clinical science at Aston University in Birmingham, England. "It works through an entirely different mechanism than any other diabetes drugs currently available," Bailey tells WebMD. "And you can add it on to other treatments and get an additional benefit. Plus as far as we can see, it can be used at any stage in the disease process."

And that's not all. Because dapagliflozin makes the body excrete excess sugar, it makes diabetes patients lose weight. Metformin helps patients lose weight, too, but those adding dapagliflozin to metformin lost about 4 and 1/2 more pounds than those taking metformin alone in the 24-week study.

The lost weight was not just water. Patients taking dapagliflozin had smaller waistlines, so the lost weight appears to have been fat.

Might this new diabetes drug work as a weight loss pill? No, says Bailey.

"The weight loss effect of the drug becomes less and less as the blood-sugar level comes to near normal," he notes. "Therefore the weight loss potential of this drug is very small at normal blood-sugar levels."

Weight loss isn't dapagliflozin's only extra benefit. It lowers blood pressure, too. Another plus is that the oral medication is taken only once a day. And the drug does not lower blood sugar to dangerously low levels -- yet another plus.

On the down side, patients taking dapagliflozin had an increased risk of genital infections. People with diabetes already are at higher risk of genital and urinary infections. Dapagliflozin may increase this risk.

And because the drug changes the way the body excretes fluid, there may be as-yet-unseen long-term consequences, suggests Luigi F. Meneghini, MD, MBA, director of the University of Miami's diabetes treatment center. Meneghini was not involved in the Bailey study.

"If you have more sugar in your urinary tract, you have more risk of infection. This probably has to do with people with diabetes and high blood sugar having more fungal infections," Meneghini tells WebMD. "That said, if your doctor is careful in monitoring for you infections and treating them when they occur, this is still a drug with a relatively low side-effect profile. But we need to see data on lots more people exposed to the drug for a longer time."

The Bailey study enrolled patients whose blood sugar was not adequately controlled by metformin alone. Their blood sugar was too high but not wildly out of control.

Sources include:
http://diabetes.webmd.com/news/20100625/new-type-diabetes-drug-drops-weight-with-blood-sugar
http://www1.aston.ac.uk/lhs/staff/az-index/baileycj/
http://dddmag.com/news-Dapagliflozin-Achieves-Reductions-in-A1c-Levels-62310.aspx
http://en.wikipedia.org/wiki/Bristol-Myers_Squibb
http://en.wikipedia.org/wiki/AstraZeneca
http://www.findaumdoc.com/Profile.aspx?id=1103&AE=American%20Board%20of%20Int%20Med-Endocrinology%20Diabetes%20&%20Metaboli&PL=

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Lifestyle Counseling Can Reduce Medications and Costs in Diabetes

Effect of the Look AHEAD Study Intervention on Medication Use and Related Cost to Treat Cardiovascular Disease Risk Factors in Individuals with Type 2 Diabetes

Redmon JB, Bertoni AG, Connelly S, et al;
Look AHEAD Research Group
Diabetes Care. 2010;33:1153-1158

Study Summary

Look AHEAD (Action for Health and Diabetes) is a multisite clinical trial of 5145 overweight or obese individuals with type 2 diabetes, age 45-76 years. Participants were randomly assigned to either intensive lifestyle intervention (which involved group and individual meetings to achieve and maintain weight loss through decreased caloric intake and increased physical activity) or to general diabetes support and education (DSE). The goal is to study the effects on cardiovascular morbidity and mortality. In the current analysis, use of medications prescribed to treat diabetes, hypertension, and hyperlipidemia and the costs of those medications were compared at baseline and 1 year. All participants were required to have a primary care clinician who was responsible for any necessary changes in medications. Costs were conservatively estimated through the use of generic drug costs (when available) and the assumption that patients were using about 50% of the maximum dose. In addition to analyses of all participants, a subanalysis of participants who met optimal care goals for diabetes, blood pressure, and lipid control was also conducted.

The mean age of the participants was 59 years, and 59% of participants were women. At baseline, participants in both groups averaged 3.3 prescriptions per month at a mean cost of about $156. After 1 year, medication use for intensive lifestyle intervention was significantly lower than for DSE (3.1 vs. 3.6; P

Viewpoint by Gregory A. Nichols, PhD

The Look AHEAD investigators recently reported beneficial effects of 1 year of intensive lifestyle intervention on weight loss, glycemic control, and cardiovascular risk factors.[1] This, of course, has important implications for long-term morbidity and mortality. In the short term, however, the current study demonstrates that intensive lifestyle intervention can reduce medication use and costs, both of which could be a far stronger motivation for individual patients to undertake lifestyle changes than a small decrease in A1c levels. Furthermore, because lifestyle interventions reduce diabetes incidence among at-risk patients well after the active interventions have ceased,[2-4] the current findings could be extrapolated to suggest that glycemic control among patients with diagnosed diabetes may also endure beyond active intervention. Even if it doesn’t, long-term follow-up of the United Kingdom Prospective Diabetes Study showed a reduction in microvascular complications, myocardial infarction, and all-cause mortality risk even though glycemic control differences between intensive and standard control groups later equalized.[5] Thus, if possible reductions in medication use and cost can indeed motivate patients to make lifestyle changes, the long-term goals of better health and quality of life can still be achieved. Furthermore, the current results have important implications for the cost-benefit ratio of providing lifestyle interventions; medication cost reductions must be factored in as an offset to the cost of the programs themselves. Perhaps lifestyle interventions can help bend the cost curve.

References
1.Pi-Sunyer X, Blackburn G, Brancati FL, et al. Reduction in weight and cardiovascular disease risk factors in individuals with type 2 diabetes: one-year results of the Look AHEAD trial. Diabetes Care. 2007;30:1374-1383.
2.Lindstrom J, Ilanne-Parikka P, Peltonen M, et al. Sustained reduction in the incidence of type 2 diabetes by lifestyle intervention: follow-up of the Finnish Diabetes Prevention Study. Lancet. 2006;368:1673-1679.
3.Diabetes Prevention Program Research Group. 10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet. 2009;374:1167-1186.
4.Li G, Zhang P, Wang J, et al. The long-term effect of lifestyle interventions to prevent diabetes in the China Da Qing Diabets Prevention Study: a 20-year follow-up study. Lancet. 2008;371:1783-1789.
5.Holman RR, Paul SK, Bethel MA, et al. 10-year follow-up of intensive glucose control in type 2 diabetes.

Sources include:
http://www2.niddk.nih.gov/Research/ScientificAreas/Obesity/ClinicalStudies/AHEAD.htm
http://www.medscape.com/viewarticle/724315?src=rss
http://www.kpchr.org/research/public/investigators.aspx?InvID=25
http://care.diabetesjournals.org/

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