We could all benefit from added fiber in our diets. However, it seems the type of fiber consumed is important too. A new study concludes that vegetable fiber is a good defence against type 2 diabetes. The study comes courtesy of researchers at the University of Sydney, Australia, who found that adults eating five grams of vegetable fiber daily were 24 percent less likely than other adults to develop the disease. People over the age of seventy enjoyed a thirty-one percent risk reduction.

The study tracked the eating habits of more than two thousand people over a ten year period. Wow. The researchers also reported that those whose diets contained fiber from mainly cereal or fruit sources did not fare so well - they had a higher risk for type 2 diabetes than those getting lots of fiber from veggie sources. The reason could be that foods high in vegetable fiber produce smaller fluctuations in blood glucose and insulin levels than would cereal or fruits. Lead researcher, Alan Barclay, says legumes are the best fiber source of all.

The results have been published in the latest Diabetes Care.

Pharmaceutical giant GlaxoSmithKline has announced an initiative designed to improve the health of employees with diabetes. Yes, the company's head honchos decided they would take the bull by the horns: if employees have difficulty taking care of their health, they determined to find out why and correct the problem. Result: an internal analysis of healthcare spending within GSK.

Turns out diabetes was one of the biggest problems for Glaxo employees. Glaxo's number-crunchers found the company spends more on diabetes medications, but less on medical care, than the national average. GSK's report states the company spent a total of $26.2 million on diabetes treatment for employees in 2005. Glaxo has now launched what it describes as a multilateral plan to address the needs of employees with diabetes. Leading the charge: a patient education campaign ("Know Your Numbers") and a physician intervention program.

Says Glaxo's US benefits chief, Michael Killian, "As a nation, we are seeing our healthcare costs soar and patients' health decline due to chronic diseases such as diabetes. GSK faces these same challenges and is prepared to meet them." Translation: prevention, prevention, prevention.

Glaxo figures there is nothing to lose, but lots to gain. Healthcare plans for employees already cost a bundle. By targeting the health issues that are hurting employees the most, the company can give those employees a better life and save a lotta money. In addition to making the results of its internal analysis available to the general public, Glaxo has invited other employers to utilize this same approach.

A new study by Kaiser Permanente's Center for Health Research carries both good news and bad news. Bad news first -- research of 9,439 mother-child pairs shows maternal blood sugar is tied to a future risk of obesity in offpsring. Pregnant women with above-normal blood sugar levels were twice as likely to have overweight kids. Across all racial and ethnic groups, the higher the mother's blood sugar during pregnancy, the greater the chance her offspring would develop obesity by 5 to 7 years of age.

Now if you're pregnant and you've been diagnosed with high blood sugar, take a deep breath. The good news is the risk of childhood obesity is reversible if elevated sugars are treated through diet, exercise and insulin (if required). At particular risk are women with sugar levels higher than normal, but not high enough to be deemed gestational diabetes. They were more likely to have obese children than women treated for gestational diabetes or those with normal sugars.

Borderline blood sugars are nothing to ignore. I shared in a previous post that moderately elevated glucose during pregnancy is associated with other problems such as cesarean section and heavier babies. Gestational diabetes criteria may widen. Also, Deanna reported earlier this month that gestational diabetes is linked to pancreatic cancer.

A little something in the news the other day caught my eye: schools in the Charlotte-Mecklenburg area of North Carolina have organized an informational meeting especially for families of diabetic pupils. The meeting was titled "Diabetes: Back to School Basics." Reports The Charlotte Observer, the idea is to prepare parents and children for the school-year, looking specifically at how diabetic kids should expect to deal with their condition during school hours, what parents can and cannot expect of school staff and so on.

Also included on the agenda was a chance for parents and kids to work on personalized care plans for while they're at school. The meeting is also a chance for everyone to meet the diabetes nurse who has just joined the Charlotte-Mecklenburg district. The nurse is trained in diabetes management and will be available to help kids and parents with educational materials and resources.

Here's to the powers-that-be at the Charlotte-Mecklenburg Schools. You can see there is a problem with so many diabetic kids in your schools, (The Observer says around four hundred kids in that school district are diabetic), and you are tackling it head-on. What I'm not clear on is what the schools' policy is on insulin-dependent type 1 kids who need shots during school hours. This has become so problematic of late, with schools concerned about liability issues in having staff assist with supervising/administering shots. But, nevertheless, this is a sign of the times and a good one. In fact, this is so good I'm wondering...why don't all schools do this?

Back in a February '07 post, I described an initiative by New York drug store chain Duane Reade. The chain had announced it was opening a free diabetes center. The idea was to drum up business by meeting customer demand for diabetes-related advice and services. At the time, I thought it was an interesting story - perhaps the sign of a new trend on the rise. And definitely a sign of the commercial clout wielded by diabetics.

A few months down the road and it looks like the concept has really taken off. A Duane Reade press release has announced that the center will be expanding its services to keep pace with demand. Yep. The Duane Reade Diabetes Resource Center will now be offering space in its support groups to anyone from the NY metro area, not just to those who had already enrolled in their education classes. Although registration is required, those educational and support group sessions are all totally free. Partial funding for the center comes from Novo Nordisk.

If you live in the NY area and are interested, call 1-866-913-8486 or email brodink@duanereade.com.

I remember the endocrinologist who diagnosed my diabetes told me there wasn't one body part that wasn't affected by the disease. It also seems the body parts that exist furthest from one another are linked when it comes to diabetes.

The June 2007 issue of Diabetes Care published the results of a recent study out of Britain in which 253 diabetics with their first foot ulcer were assessed for depression. One-third of them suffered from clinical depression; 24.1 percent had major depressive disorder and 8.1 percent had minor depression. Eighteen months later, there had been 40 deaths, 36 amputations, and 99 recurrences of ulcer. Those who were considered depressed were found to be three times more likely to have died.

The study did not indicate whether the subjects were depressed about their foot ulcer, having diabetes, or something else altogether.

For athletes with type 1 diabetes, technological advances have opened up a whole new world. Tell your doctor you want to run a marathon? In past decades, the announcement might have been met with words of caution, even dismay. Exercise wasn't even part of the equation when it came to diabetes management. Being diagnosed with diabetes was a death knell for the careers of budding young athletes. Today, however, docs (well-informed ones, at least) are more likely to say, 'okay, let's come up with a plan.'

Diabetes-related technology is a big reason for this shift in attitudes. An article just out in The New York Times. looks at the extent to which technology has made life easier for type 1 diabetics. Devices like digital meters and automated pumps are not cheap. But they are increasingly efficient, safe, and sleekly high-tech. Above all, they give athletes the tools they need to control blood sugar levels with absolute precision - the kind of precision that was impossible in the days of the urine-glucose test. The down-side, I guess you could say, is the mixed blessing of all that control: "We are essentially the CEOs of our own bodies," observes type 1 diabetic and long-distance cyclist Paul Southerland, "and we don't get a break from them."

British watchdog group The Healthcare Commission just gave diabetes care in the UK a lukewarm review. Its study of the facilities in which British diabetics receive care concludes that care levels overall are basic, at best. Most of the places (73%) surveyed in the study were rated "fair," meaning patients know what medications they are supposed to be on and when they should be taking them. They also know they should be getting annual checkups. Only five percent of facilities were rated "excellent by the Commission.

The system is lacking, however, when it comes to anything beyond those most basic of services. Just like here in the US, most British people with diabetes are not receiving help with diabetes management. Studies suggest that regular consultations with a health "coach" on an individual basis could really improve patient outcomes. One reason they are helpful is because they get patients to come up with a care plan tailored for each person, making it more likely he/she will be able to stick with it.

Diabetes UK head of healthcare policy, Bridget Turner, agrees with the Commission's conclusions: "The NHS [National Health Service] has to focus more on...self-care. For people with diabetes, 95% of diabetes management is self-care."

To read more, click here or visit the Healthcare Commission's own web summary of the report.

Last month Bev addressed a news article that found high tech diabetes management did not equate to better diabetes care. Doctors felt that electronic care is only as good as the patient willing to participate beyond office visits. However, another service is trying to evolve the preconceived notions with a more developed system - and a bigger bang for the buck. How does $14.5 billion sound?

Information technology enabled diabetes management (ITDM) was found to be beneficial in avoiding diabetic complications - MILLIONS of cases. This is an overzealous finding - considering the word prevent is permanent and should probably be replaced with delayed. Even the DCCT knew that much. However, the study was conducted over a period exclusive to the program, and not the lifespan of diabetics in the study. However patient compliance did grow from less than 50% to approximately 80%. That would evoke a few halleluiahs from doctors. Another reason in support of ITDM is the fact that an electronic diabetes registry offers Medicare and other payers the ability to save quite a bit. Over 10 years, the overall net savings is estimated to be $14.5 billion. Does that figure include COLA - cost of long-term diabetes complications adjustment? The complications that did not occur in 2008 saved Medicare and payers $1.45 billion. Score! What is the inflation adjusted cost of those delayed complications occurring in 2013?

The headcount standing at 20 million diabetics, at a savings of $1.45 billion per year - I asked for clarification on that figure. The savings is speculative because the company is anticipating saving costs on preventing diabetic complications. That's optimistic but not entirely realistic.

Just out in the new issue of Diabetes Care: a report that diabetic women are more at risk for the various stroke subtypes. (Today is just a day for bad health news, I guess. See my previous blog on trauma injuries.) Stroke, as you may already know, is where blood supply to the brain is restricted or cut off.

The study's authors tracked the progress of 116,316 women through middle age during the period 1976 to 2002. That's a lotta women... They found the women with diabetes were at a higher risk for stroke, generally: four times higher than that of the general population for women with Type 1 diabetes, and twice as high for women with Type 2 diabetes.

That people with diabetes face a higher risk of stroke is not new. What is new? This study also looked at stroke subtypes and relative risk for women with and without diabetes for each of those subtypes. Some results: ischemic stroke (caused by a blood clot to the brain) risk was 6.3 times higher for T1 diabetics, 2.3 times higher for T2 diabetics. The risk for large-artery infarction and lacunar stroke was similar. The study also concluded that while Type 1 diabetic women face a higher risk of hemorrhagic stroke (where bleeding occurs in the brain or between the brain and the skull), Type 2 women did not.

This study was funded by the National Institutes of Health.

Read more about strokes and learn how to recognize signs of stroke by visiting some of the excellent Web-based resources out there. A good starting point is InteliHealth's section on stroke or visit the National Stroke Association's website. You could save someone's life!

French researchers say a slender waistline can pay big dividends for your health. Specifically, weight loss that whittles the waist lowers the risk of metabolic syndrome, which in turn decreases your chances of developing Type 2 diabetes, not to mention heart disease.

Even if you are otherwise healthy with a normal body mass index, having a wider-than-average waist automatically puts you at higher risk for metabolic syndrome. So says Beverley Balkau, the study's lead author, in an interview with Reuters. Balkau and her colleagues found that men and women whose waistlines grew by three or more inches over a period of nine years experienced a measurably greater risk for metabolic syndrome.

The good news is that losing just a little weight can help a lot. Women who lost even an inch or more around the waist during the study period ended up with a reduced risk for metabolic syndrome, unlike those whose waist measurements stayed the same. In addition, many women who began the study already diagnosed with metabolic syndrome but who managed to lose an inch or more from their waists during its course ended up free of symptoms.

The study has been published in Diabetes Care (July 2007).

One minute is all it takes, say developers of a new gadget designed to detect diabetes. This sounds too cool to be true, but here's how the Scout DS works: put your arm on the device (see pic), which is a desktop-friendly size, and let it "read" your skin for pre-diabetes and Type 2 diabetes-related biomarkers. These "biomarkers" are concentrations of advanced glycation endproducts (AGEs) that show up on the skin of diabetics when examined under a beam of light. The light beam contains multiple light wavelengths, which cause the AGEs to glow with a fluorescent light. An additional test would be administered to confirm a positive result.

The Scout DS is manufactured by VeraLight Inc., a New Mexico-based company. According to VeraLight, an early study (published in Diabetes Care) showed the system outperforms the usual diabetes diagnostic standbys: the fasting plasma glucose test and the A1C test. If successful, the Scout could be a boon to doctors and patients alike because it gets results fast, is non-invasive (no blood sample required), convenient (no fasting, no waiting), while the device itself is designed to be portable (it weighs about ten pounds), therefore maximizing the potential situations in which it could be used. Think: mobile clinics of the future visiting under-served parts of rural and urban America.

The Scout has been in the works for a while, but it is being officially unveiled tomorrow at the American Diabetes Association annual meeting, which is currently underway in Chicago. Think of this as a sneak preview: the Scout remains in development for now. While VeraLight would like to have it out on the market by sometime next year, that all hinges on it getting government approval when the testing process is complete.

My family is no stranger to severe hypoglycemic episodes. With four type 1 diabetics living busy, active lives, serious low blood sugars have resulted in pleading cries to "please drink the o.j., now!" ... to emergency glucagon kits, calls to 911, even a cast for broken bones. Whether or not consciousness was lost, episodes of severe hypoglycemia rattle the family cage. It is scary to witness your loved one out of control both physically and mentally. Beyond mental confusion, severe hypoglycemia can even trigger seizures or coma.

A study published this month in Diabetes Care reveals type 1 diabetics who smoke have a 2.6-fold increase in severe hypoglycemic episodes. The study examined 537 participants enrolled in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Experts hypothesize smoking's effect on the regulation of hormones and insulin can result in severe hypoglycemia. Whatever the case, smoking and diabetes are not a good mix, they are a molatov cocktail when it comes to your health. Smoking is associated with increased risk for diabetic retinal defects, nerve damage and impaired-kidney function.

I am downright angry my family has to deal with severe low blood sugars, especially the hypoglycemic unawareness brand. Read more on the study in Reuters.

If you are a woman in your 20s, 30s and early 40s, invest regularly in a healthy lifestyle. Keep the weight off -- a payout awaits you in middle-age.

Researchers reveal a woman's Body Mass Index (BMI) in her late 40s is the strongest predictor for risk of developing type 2 diabetes over the next eight years. An Australian research team from the University of Queensland followed 7,239 women for eight years between 1996-2004. Participants ranged in age between 45-50 at the start of the project, and they completed four health surveys over the duration of the study.

Women identifying themselves as overweight or obese, with BMIs of 25 or greater, were at the highest risk for developing type 2 by the year 2004. The worst risk lie with very obese women carrying BMIs of 35 or more, they were twelve times more likely to develop type 2 than normal-weight peers. Surprisingly, weight gained or lost during the eight-year study window did not alter a woman's risk for diabetes. Physical activity reduced risk for only the most active women.

Authors recommend public initiatives to prevent weight gain before and during early adulthood, as risk for type 2 is more closely related to BMI between 45-50 years than subsequent short-term weight change. While it is never too late to lose weight and reap a myriad of health benefits, it could be too late to lower your risk for type 2 diabetes. Read more about the study in Reuters or the abstract in Diabetes Care.

Novocell is the first company to use polyethylene glycol (PEG) to encapsulate clusters of insulin-producing cells. This biocompatible substance allows glucose and insulin to pass freely through the coating while preventing the body's immune system from destroying the islets.

The encapsulated islets release human insulin through natural mechanisms in response to the recipient's blood glucose. The islet cells used in this study are isolated from human cadavers. The implant procedure is performed under local anesthesia and the encapsulated islets are injected into a surgically formed micropocket in the subcutaneous tissues of the thigh or lower abdomen of the recipient. The patients received temporary low dose cyclosporine (50-100 ng/ml 12hr trough) and did not receive any other form of immunosuppression.

At the American Diabetes Association 66th Annual Scientific Session in June -- Novocell announced the progress of the study. No adverse events had occurred -- no news is good news. In addition, the company also has the fortune of existing in California - where they can prosper on further stem cell research. Novocell has developed a process that efficiently converts human embryonic stem cells into insulin-producing cells. Novocell believes this study will demonstrate the safety and efficacy of the encapsulation technology that can be used with the unlimited source of insulin-producing cells developed from stem cells to treat patients with diabetes.