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HISTORY OF DIABETES

admin — Fri, 20 May 2011 11:30:13 +0000

1922After 3,000 years with no effective treatment, diabetes is no longer a quick death sentence. Canadian researchers extract insulin from a dog, inject it into a 14-year-old diabetic boy, and extend his life.
1935Researchers advance the theory that diabetes is not a single disease and divide it into two categories: insulin sensitive (what we call Type I) and insulin insensitive (Type II).
1956The first anti-diabetes pill, an “oral hypoglycemic agent” called Orinase, is introduced in the United States, making it possible for some diabetics to control their blood sugar without insulin injections.
1966The first successful pancreas transplant is performed by Dr. Richard Lillehei at the University of Minnesota. The body rejects the organ, but doctors have new hope—and much work still to do.
1970Dr. Paul Lacy of Washington University in St. Louis proves that transplanted insulin-producing cells can survive and control blood sugar in rats. Is this an alternative to pancreas transplants?
1975Dr. Gian F. Bottazzo, of Middlesex Hospital in London, develops the Islet Cell Antibody Test. This test determines the presence of antibodies in the blood that attack and destroy the insulin-producing cells in Type I diabetics several years before the onset of the disease. This indicates that diabetes may be caused by the body’s own immune system.
1977The Hemoglobin А! с Test, the “report card” of blood tests, gives diabetics a more complete picture of their condition by indicating blood sugar control over the previous 90 days.
1978Improvements in the form and features of the insulin pump make the use of these “mechanical syringes” more common and desirable. Today, about 8,000 diabetics nationwide wear pumps round-the-clock. . . . The first successful long-term pancreas transplant is performed by Dr. David Sutherland at the University of Minnesota. The woman patient seems healthy and free from diabetes.
1980Human insulin is produced in the lab through genetic engineering. For the first time, diabetics can be treated with insulin identical to that made in the body, instead of from cows and pigs.
1981Dr. David Jenkins and his colleagues at the University of Toronto discover that different forms of starches raise blood sugar at different rates. Time-honored diabetic diets must be reevaluated.
1984Dr. Daniel Mintz and colleagues at the University of Miami transplant islet cells into diabetic dogs and “cure” them. Hopes are rekindled that such transplants will soon be possible in humans. . . . Doctors at the University of Western Ontario “cure” newly diagnosed diabetics with cyclosporin. This advances the theory that diabetes may one day be wiped out by treating the patient’s immune system.
1991Results of a nationwide study reveal that diabetics who take tight control of their blood sugar levels suffer fewer complications of the disease, such as heart attacks, vision difficulties, and kidney problems.*2/266/5*

TYPE I DIABETES: WHAT GOES WRONG

admin — Sun, 13 Mar 2011 10:28:11 +0000

Normally, the pancreas sends out just enough of the right hormone to keep the blood glucose level within the narrow range of “just enough.” But in diabetes something has gone wrong. The blood sugar rises far above the normal limit—perhaps up to 200, 300, or even 1000 mg% or more. This condition (too much sugar in the blood) is called hyperglycemia.
Damage to the beta cells is usually the cause of Type I diabetes. Ironically, scientists believe that islet cells are destroyed by the person’s own body in an autoimmune response. Normally the body’s immune system works to defend it against foreign invaders, such as disease germs. Its weapons include proteins called antibodies, which attack foreign substances. But in Type I diabetes the body produces antibodies that attack and destroy the beta cells in the pancreas. The pancreas can no longer produce enough insulin to keep the blood sugar level in check.
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WHAT’S HOT IN DIABETES: HISTORICAL PERSPECTIVE

admin — Sun, 27 Feb 2011 10:27:24 +0000

For many years, physicians who dealt with diabetic patients were often passive in their treatment strategies. There were reasons for this. Many type 1 diabetics were very difficult to manage, alternating between hyper- and hypoglycemia, and progressing with complications of visual impairment, renal insufficiency, and neurologic disabilities. Assessment of results was crude, and action steps were based upon urine glucose levels or on occasional blood glucose determinations done during infrequent office visits. Inaction often was the result.
Concomitantly, the much larger population with type 2 diabetes did not do well. There were limited choices for drug therapy—older insulin preparations which were antigenic and poorly timed for the demands of the disease, and an oral agent formulary which was limited to the sulfonylurea drug class. Huge doses of insulin were needed for glycemic control and some questions had been raised about cardiotoxicity of sulfonylurea drugs. There was little recognition of the input of dyslipidemia, hypertension, or a prothrombotic state to the cardiovascular complications of type 2 diabetes. Further, there was a paucity of effective drugs to address these critical cardiovascular risk factors.
The picture was clouded by a tendency for apathy on the part of the patients. Physicians spoke of “noncompliance,” while patients were not certain what to comply with or how to do it effectively. To many physicians and patients, management of diabetes was a nightmare. Fatalism prevailed.
All of this changed dramatically in the last decade. A proactive climate now prevails. Evidence-based guidelines have emerged, and the tools for effectively dealing with type 1 and type 2 diabetes and preventing progression of complications are now generally available. The key issue now is translation of the findings of this revolution in diabetic care to positive action by physicians and patients.
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THE G.I. FACTOR AND WEIGHT REDUCTION: WHAT FOODS DO CAUSE PEOPLE TO BECOME OVERWEIGHT?

admin — Fri, 08 May 2009 13:51:29 +0000

It was widely (and wrongly) believed for many years that sugar and starchy foods like potato, rice and pasta were the cause of obesity. Twenty years ago, every diet for weight loss advocated restriction of these carbohydrate-rich foods. One of the reasons for this carbohydrate restriction stemmed from the ‘instant results’ of low carbohydrate diets. If your diet is very low in carbohydrate, you will lose weight. The problem is that what you primarily lose is fluid, and not

fat What’s more a low carbohydrate diet depletes the glycogen stores in the muscles making exercise difficult and tiring.

Sugar has been blamed as a cause of people becoming overweight largely because it is often found in high fat foods, where it serves to make the fat more palatable and tempting. Cakes, biscuits, chocolate and ice-cream contain a mixture of sugar and fat. However, the primary sources of fat in our diet are not sweet. Fatty meat, cheese, French fries, crisps, butter and margarine contain no sugar.

Current thinking is that there is little evidence to condemn sugar or starchy foods as the cause of people becoming overweight. Overweight people show a preference for fat-containing foods rather than a preference for foods high in sugar. In a survey performed at the University of Michigan where obese men and women listed their favourite foods, men listed mainly meats (protein-fat sources) and women listed mainly cakes, biscuits, doughnuts (combinations of carbohydrate-fat sources). Other studies have found that obese people habitually consume a higher fat diet than people who have a healthy weight. So, it appears that a higher intake of fatty food is strongly related to the development of obesity—not carbohydrate-rich foods.

Whether you are going to gain weight from eating a particular food really depends on how much that food adds to your total kilojoule intake in relation to how much you burn up. To lose weight you need to eat fewer kilojoules and burn more kilojoules. If your total kilojoule balance does not change—there will be no change in your weight People who consume a high fat diet automatically eat a high kilojoule diet because there are more kilojoules per gram in fatty foods. This is why eating low-fat foods makes weight loss much easier.

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