Finding Ways to Get Insulin to Targets Faster

Getting insulin to targets faster could help improve diabetes control

It would be a glorious thing if we could find a biological cure for diabetes in the next score of years or even if a mechanical device such as the artificial pancreas could be ready for patient use in the foreseeable future.  In the meantime, as researchers and engineers struggle to land the big prize, others are working on making exogenous insulin delivery match more closely what happens in normal pathophysiology.

“It would be a significant advancement when we find a way to improve insulin absorption so that it matches the rapid absorption of carbohydrates from the GI tract,” says William Sullivan, M.D., staff endocrinologist at Joslin Diabetes Center.

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Watch Your Purse: Avoiding Diabetes Con-Artists and Health Scams

When something sounds too good to be true...it probably is! Here are some tips for protecting yourself from diabetes scams.

If you want to make a buck on the wrong side of the law, set your sights on older people with diabetes. Older people are prime targets for scams. The Wall Street Journal reported last December that one in every five Americans age 65 and older has been abused financially. Since one in four older Americans has diabetes, many of those targeted are people with diabetes. Losing money that you have set aside for health care expenses can lead to both financial ruin and poor health outcomes. As the number of people with diabetes continues to climb, so does the potential for scam artists to make a buck.

Maria Koen, N.P., Nurse Practitioner at Joslin Diabetes Center advises her patients to be careful of things that look too good to be true. “I work with many older patients and it dismays me how often they taken in,” says Koen.

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Pump Fashion: Dressing with Your Device

What can you wear that best conceals your pump?

Your health care provider and your educators can give you the inside scoop on how the pump works and how to tweak your pump settings to get the best blood glucose readings possible. But blood glucose numbers aren’t your only concern when wearing a pump; sometimes you have to consider the fashion statement you are making and the operational pointers of living with a device attached to you.

People who use oral agents or take insulin with a syringe or pen don’t have to worry about having a skin-tight personal relationship with an inanimate object fastened to their person. That is not true if you wear a pump. Most pumps have tubing that needs to be securely hidden. After all you don’t want to be the person with yards of plastic trailing behind.

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Joslin Pediatrics’ New Onset Program Offers Alternative to Hospital

The New Onset Program in Pediatrics helps families with their new diabetes diagnosis

The onset of type 1 diabetes can be a difficult transition for children and their families. It can become more difficult if the children are hospitalized at onset. If type 1 diabetes is identified early enough, before any major problems arise, kids are often able to be treated in an outpatient setting, rather than having to be hospitalized. Joslin Diabetes Center piloted the New Onset Program in 2010 to make outpatient treatment possible and now it is fully available for all patients whose condition allows it.

Prior to the beginning of the New Onset Program, all Joslin pediatric patients were hospitalized at the onset of diabetes, even if their medical condition was stable.

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Selecting the Best Hardware

How to choose the best diabetes device for you?

With the start of spring, you might be thinking about freshening up your diabetes hardware. Every year new meters, pens, pumps and continuous glucose monitors come to market.

Whether you decide to stay with your old-standby or upgrade to something new and improved has a lot to do with your personality—are you the type to trade your car in before the tread on the tires is even worn or do you wait until it needs to be pushed into the dealership before you are ready to even look at this year’s models? But whether you are an “if it ain’t broke, don’t fix it” or a “have to have the next great thing” kind of person, knowing the type of questions to ask about the different categories of hardware available will guide you to make an informed choice, even if that decision is to stay right where you are.

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Ask Joslin: Type 1 Diagnosis, No Family History

Why did my child get type 1 diabetes when there is no family history of it?

You are not alone.  In fact, having someone in your family who has type 1 diabetes when you are diagnosed is the exception, rather than the rule.  As Dr. Jason Gaglia , M.D., M.M.Sc. , researcher at Joslin Diabetes Center explains, “At most only 10 to 15 percent of persons with type 1 diabetes have an affected first degree relative (the majority of people diagnosed do not have a known family history of type 1 diabetes). Given that the genes are very common, why some people develop type 1 diabetes and others do not is not clear. It is hypothesized that there may be environmental factors that may play a role (viruses, certain food items, etc.) but this has not been fully answered as of yet and may be different for different individuals.”

Unfortunately at present we don’t have a way to identify those at risk when they don’t have a family history.  As more research is done on type 1 diabetes we may find out more about environmental triggers as well as genetics and be better able to predict who will come down with the disease.

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Taking It Slow: Crock Pots for Dinner

Fill a slow cooker with meat, vegetables and broth for a tasty and healthy stew

Slow cookers (also known as crock pots) are popular again. And no wonder—who wouldn’t want to start dinner cooking before breakfast and come home to a fully made meal?

These cookers take advantage of the flavor-generating effect of braising, while relieving you from having to spend your time around the stove checking the cooking progress of your meal every couple of hours. (Braising requires first sautéing meat and/or vegetables in a bit of oil until they obtain a nice brown color and then slowly cooking them in a small amount of liquid). Round and squat with a tight-fitting lid, the cookers do take up a bit of counter space, but you can leave them fired up all day without worrying about your kitchen catching fire.

“Since it’s a labor saver it can encourage people to cook more at home,” says Karen Lau, M.S., R.D., C.D.E., registered dietitian at Joslin Diabetes Center, which means fewer fat- and calorie-laden meals out.

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Making Beta Cells

A skin cell by any other name would be as fleshy—or so you might think. But a new technique developed over the last decade can take skin cells, or any other cells of the body, and make them into something new. This process, being probed by the lab of Rohit Kulkarni, M.D., Ph.D., Senior Investigator in the Section on Islet Cell and Regenerative Biology at Joslin Diabetes Center, holds promise for the damaged pancreas of people with diabetes.

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Could Translational Research Approach Lead to Kidney Disease Treatment?

Dr. Doria (left) and Dr. Krolewski (right)

The complexities of diabetes can’t be fully understood in a lab or in a clinic alone. Sometimes, information coming from the lab informs clinical researchers about what they should study in people with diabetes. Other times, trends noticed in patient visits can lead to an important study at the bench.

The back-and-forth, cross-disciplinary nature of diabetes research and medical research in general is known as translational research.

“It is a reciprocal journey from initial observation in lab or clinic to understanding the relevance of the finding to patients, practice and population health,” said Allison Goldfine, M.D., Head of the Section on Clinical, Behavioral and Outcomes Research.

Joslin Diabetes Center is dedicated to translational research; so much so that Joslin will soon open the doors to the newly constructed Translational Research Center for the Cure of Diabetes. This center will improve communication and encourage collaboration between basic science researchers and clinical researchers.

But Joslin hasn’t been waiting for the Translational Center’s unveiling to do this type of important work. Translational research has been part of Joslin’s approach to understanding more about diabetes for years.

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Confused About Saturated Fat? You’re Not Alone.

Is saturated fat bad, or isn't it? A new study brings up the question once more.

A study published earlier this month in the Annals of Internal Medicine reopened the question of whether or not saturated fat should be part of a healthy diet. It isn’t only the public whose head is spinning over this latest fat controversy; it’s a good portion of the scientific community.

Just last November the American Heart Association and the American College of Cardiology came out with new guidelines that recommend reducing saturated fat to no more than 5 to 6 percent of total calories.

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