Author: Staff Writers

New Information for Diabetics in Critical Care: Diabetics anticipate hearing physicians call for tight control over their blood glucose levels. That’s what makes a March 24th, 2009 article by the New England Journal of Medicine interesting with respect to their conclusion. This report suggests that in critically ill patients it may actually be counterproductive to effective recovery to insist on blood glucose control. The medical journal indicates mortality rates are higher among critically ill diabetics when hyperglycemia is treated using strict blood glucose oversight.

On the same day the American Diabetes Association (ADA) and the American Association of Clinical Endocrinologists (AACE) issued a press release indicating, “Findings of the Normoglycemia in Intensive Care Evaluation-Survival Using Glucose Algorithm Regulation (NICE-SUGAR) study should NOT lead to an abandonment of the concept of good glucose management in the hospital setting. Uncontrolled high blood glucose can lead to serious problems for hospitalized patients, such as dehydration and increased propensity to infection.”

Dr. Etie S. Moghissi, AACE Chair of Inpatient Glycemic Control Task Force said, “Since 2003, AACE and the ADA have worked together to provide recommendations for treatment of inpatient hyperglycemia, and these efforts have contributed to a growing national movement viewing the management of hyperglycemia in hospitals as a quality care measure.”

Further recommendations from the ADA and AACE in regards to this issue will be made available later in the spring. Dr. Mary Korytkowski, ADA Chair of Inpatient Glycemic Control Task Force indicated, “The central goal of the ADA/AACE inpatient task force is to identify reasonable, achievable, and safe glucose targets, and to describe the protocols, procedures, and system improvements needed to achieve inpatient optimal glucose control efficiently and safely.”

The NICE-SUGAR study suggests that mortality rates in patients with intense glucose control while also in critical condition was 14% higher than those receiving standard or conventional glucose care.

The ADA or AACE press release stated, “More than 6,100 patients with hyperglycemia in critical care units were randomized to either intensive glucose control (insulin infusion with target blood glucose between 80-108 mg/dl) or to conventional glucose control (insulin infusion begun if blood glucose was over 180 mg/dl, and discontinued if blood glucose dropped below 144 mg/dl). Severe hypoglycemia (blood glucose below 40 mg/dl) occurred in approximately 6.8 percent of intensively treated patients compared to 0.5 percent of conventionally treated patients. The study showed no difference in length of time in the intensive care unit or in the hospital, or in other major outcomes such as time on ventilators or need for dialysis.”

It seems clear from the information provided by these two health organizations that they are asking for caution in the wake of these new findings.

For those unfamiliar with the American Association of Clinical Endocrinologists (AACE) it is a, “Professional medical organization with more than 6,200 members in the United States and 92 other countries.

Mary Tyler Moore Speaks Out on Diabetes: “Chronic disease, like a troublesome relative, is something you can learn to manage but never quite escape. And while each and every person who has type 1 prays for a cure, and would give anything to stop thinking about it for just a year, a month, a week, a day even, the ironic truth is that only when you own it–accept it, embrace it, make it your own–do you start to be free of many of its emotional and physical burdens.” That’s how Mary Tyler Moore started her new book, Growing Up Again: Life, Loves, and Oh Yeah, Diabetes.

For the last four decades this well loved actress has been living with Type 1 diabetes. This new book was not an idea she pitched to a publisher, but rather the other way around. BuffaloNews.com reports that Philip Revzin, senior editor at St. Martin’s Press was the one who convinced Mary to write the book.

The idea for the book was apparently hatched during a conversation Revzin had with his daughter who just so happens to have Type 1 diabetes. The preface to Mary’s book relates the young lady’s words, “I wish I had a diabetic best friend, someone to talk to about what it’s like to have diabetes, Sometimes I feel, I don’t know, alone. Ya know?”

So Mary Tyler Moore wrote a book about life with diabetes and added memorable moments from her life along the way. The book seemed a better response to Revzin’s daughter than a simple phone call or conversation over tea. It’s also something that can be shared with thousands of others who also suffer from Type 1 diabetes.

The 72 year-old Moore continues to act, but what most television viewers may not know is that her diabetes has given her what she describes as “Tunnel Vision”. The BuffaloNews.com report related an event Mary attended and the difficulties she faced due to her vision problems caused by diabates. “The chic Manhattan restaurant where the soiree is held is dimly lighted, and the partygoers are almost all dressed in black. After climbing a set of stairs in the dark and bumping into people she can’t see, Moore turns to talk to someone, only finding out later that “I was facing away from her, the side of my head being all she could see, as I chatted easily with the darkness. Heaven knows what she thought of the encounter!”

The Internet Movie Database reports that Moore, “Recently testified before Congress calling for an increase in funding for diabetes research and support embryonic stem cell research, which she called ‘truly life affirming.’”

Moore’s new book is not a straight shot at Type 1 diabetes, but how diabetes fit into the life she has lived. In times past Moore was quoted as saying, “Diabetes is an all-too-personal time bomb which can go off today, tomorrow, next year, or 10 years from now – a time bomb affecting millions like me and the children here today.”

Growing Up Again: Life, Loves, and Oh Yeah, Diabetes is part memoir and part cautionary tale. More has endured more than her fair share of pain losing both siblings and her only son to a variety of incidents. The common thread of forty years has been her diabetes. It appears this has simply been a very heavy thread weaved in her personal tapestry that has created a fond brilliance we always see when Mary takes the stage – or writes a book.

Schizophrenia and Diabetes: A Bigger Picture: We recently reported that the schizophrenia drug Seroquel might be linked to cases of diabetes due to what appears to be noticeable weight gain in patients that use the AstraZeneca drug. Since obesity is often linked to diabetes the research indicated the weight gain might be the causal link to diabetes.

While many have considered hidden research on the subject to cast a very negative light on the drugs effectiveness there is new research that may point to a bigger picture. ScienceDaily.net reported that, “People with schizophrenia are at increased risk for type 2 diabetes.” This was the finding of researchers at Medical College of Georgia along with scientists at the University of Barcelona in Spain and the University of Maryland.

This research was conducted on 50 patients newly diagnosed with schizophrenia prior to taking any medications used for the treatment of the condition. What researchers found was, when no other risk factors were present, “16 percent [of patients] had either diabetes or an abnormal rate of glucose metabolism.” This was the finding of Dr. Brian Kirkpatrick, vice chair of the MCG Department of Psychiatry and Health Behavior.

This is significant because a separate control group of similar size, utilizing patients without schizophrenia, indicated no signs of diabetes.

Kirkpatrick told ScienceDaily.net, “These findings point toward there being some shared environmental factors or genetic factors between the development of schizophrenia and diabetes.” Those conditions had to be something other than a drug used to treat schizophrenia since none in the control group had ever used the drug.

The information concerning Seroquel and other drugs was important to researchers because they knew that the drug seemed to have a weight gain side effect. Catching patients before drug treatment for schizophrenia seemed to be the only logical way to determine what links might exist between schizophrenia and diabetes.

It has long been thought that depression and diabetes go hand in hand. It has also been long believed that schizophrenia and diabetes might be connected. This research sought to answer that question in some definitive way.

A second study indicates, “The prevalence rate of metabolic syndrome, a group of risk factors that include abdominal obesity, high lipid and cholesterol blood levels and insulin resistance, is more than 50 percent in women and about 37 percent in men with schizophrenia.” These factors are significant in the development of diabetes.

There is a third facet to the potential development of schizophrenia. This dynamic happens before a child is born. Dr. Kilpatrick noted, “Many people focus on the brain function part of the disease, but patients also have other medical problems that can’t be attributed to other factors. Bad things that happen in utero and at birth, such as prenatal famine and low birth weight, have both been shown to increase the risk of diabetes and schizophrenia. Problems in early development can leave a lasting impact.”

Add to this the recent discovery that Alzheimer’s may be diabetes of the brain and you can begin to see the impact insulin has on every facet of the body.

It appears the care of the human body must begin in utero. Low birth weight babies and the care the mother takes with her own health appear to be common threads in the long-term health success of the child. In most cases this is simply common sense, but it’s interesting to see research that tends to support many of the ideals passed along by earlier generations. The advantage we have is the accumulated knowledge of why the care is important and how it may affect all individuals involved.

Mayo’s New Diabetes Reference Guide: The crew aboard the Apollo 13 discovered a “Main B bus undervolt.” I don’t have to know what that means to understand that when astronaut John Swigert, Jr. said, “Houston, we’ve had a problem,” he meant every word.

Today the phrase has been recast to “Houston we have a problem” and the line has become a bit cliché, but it remains a strong reminder that when the words are uttered there are difficulties being faced.

In their own way the Mayo Clinic has uttered those words – and they were directed toward all of us in response to the epidemic that is diabetes.

A Voice Of America report quotes Dr. Maria Collazo-Clavell of the Mayo Clinic as saying, “Probably the No. 1 cause of diabetes becoming so common, [as well as] pre-diabetes, is definitely our lifestyle. Most of us are heavier than we have been in the past and less active. So definitely being conscious about our eating habits, weight and activity become very important to preventing type 2 diabetes, particularly.”

Collazo-Clavell is the medical editor for a new manual called the Essential Diabetes Book. It has been described by VOA as a, “Comprehensive and up-to-date manual on diabetes, intended for the general public.”

The book asserts that there are twice as many pre-diabetics as there are those who have actually been diagnosed with the disease. Pre-diabetes has been described as a condition where, “Blood glucose levels are higher than normal, but not high enough for a type 2 diabetes diagnosis. Pre-diabetes is also dangerous because long-term damage to the heart and circulatory system might already have begun to occur.”

The book touches on diabetes as it relates to various ethnicities. For example Type 1 diabetes is more common among Caucasian youth while Type 2 is more prevalent among African American and Hispanic adults. As we’ve reported here before another primary concern for diabetics is being able to access healthy meals and exercise is often difficult to manage due to the fact that diabetes can make an individual feel very tired.

However Collazo-Clavell suggests, “Whatever physical activity someone can do, it is worth doing. What often happen is that people have so many other limitations that keep them from adhering to this perfect, beautiful 30- to 45-minute program that they are supposed to do four to five times per week. But what we learned is that short bouts of activity are just as helpful as prolonged bouts of activity.”

You may remember a recent report here that indicates short bursts of intense physical exercise may do more to flood blood sugar from your body that longer, but less intense exercise.

Collazo-Clavell even commented on President Obama’s recent decision to allow embryonic stem cell research. “Once you accomplish, for example, stem cells that can produce insulin and that are viable, often the application to a diverse population of patients becomes quite challenging. So I still feel that we have to focus on helping our patients manage their diabetes day in and day out and not wait for that cure that we have been waiting for for a long time.” The VOA report indicates she does not expect any breakthroughs from embryonic stem cell research anytime soon.

The hard cover book, Essential Diabetes Book is available for around $25 or less and provides a comprehensive look at Diabetes and it’s long-term care.

Offering her own encouragement Collazo-Clavell adds, “”It is never too late to start caring for your health and protecting your health, but the sooner somebody does it, the better a life they will lead.”

Mariners Pitching Duo Deal With Type 1 Diabetes: Many diabetics find encouragement by participating in a support group. We all tend to find comfort in engaging others who experience the same things we do. It may seem strange, but it is a notion that has brought two Seattle Mariners pitchers together.

Brandon Marrow was diagnosed with Type 1 diabetes while still in high school. While he had been a starting pitcher he recently made the decision to head to the bullpen as part of the relief squad. He told Sports Illustrated his diabetes was a factor in that decision. Morrow must test his blood glucose regularly to remain at the peak of his abilities.

Little did Marrow realize his difficulties would be useful in helping someone else. In this case, Mark Lowe, another pitcher for the Mariners found help in someone who had been there before. Lowe had poked good natured fun at Morrow for all the diabetic testing he had to do, but this duo are now finding a kinship neither expected.

According to a HeraldNet.com report Lowe began experiencing some difficulties with his health. There were times when he couldn’t seem to see straight, he lost a lot of weight and when he lost energy he lost it very quickly. The diagnosis? Type 1 diabetes.

Lowe was originally diagnosed with Type 2 diabetes, but the correct diagnosis was eventually made.

Morrow recalls that the friendship between the two happened quickly, “He’d just gotten his glucometer, and we were messing around pricking ourselves and sharing numbers.” The HeraldNet.com report indicates the two would wager over who could come closest to guessing their own personal glucose readings.

Lowe manages his diabetes by injecting insulin as needed while Morrow relies on an insulin pump to regulate his blood glucose.

Team Physician Mark Storey indicates this is the first time the Mariners have had two players who were diabetic. “Mark is new at this and he’s not as comfortable as Brandon is. The diabetes is affected by their activity level, so they have to be a lot stricter on their blood sugar monitoring. If it drops, it can affect their performance.” This might be why both have taken on roles as relief pitchers instead of attempting to maintain starting status. Both pitchers will rely on multiple tests during games to ensure they are ready to play.

According to HeraldNet.com Lowe said, “It was not fun knowing it’s something you’ll have to do the rest of your life, poking yourself with a needle forever, but you get over it and know it could be way, way worse. In the longrun, it’s something that will help you — staying in shape, eating right. You have to look at it in the big picture, and I think it’s going to be a very positive thing.”

The report indicated that both Lowe and Morrow are serious about the care they receive in connection with their diabetes, but they are also serious about living life. Morrow offers this advice, “Don’ t let it [diabetes] hold you back. It’s a serious condition but if you take care of yourself and monitor it, you can be as healthy as anybody else.”

Where Morrow has been through the diabetes trenches Lowe still needs help coping from time to time. When he has questions he knows where to go. Lowe concluded, “Fortunately, when I was diagnosed I had somebody right next to me every day to ask questions to.”

That’s the value of connection when you have diabetes. A support group can be a big help when you’re struggling to make sense of diabetes.

Once Weekly Blood Glucose Control: Once a week glucose control shots are what some drug manufacturers are hoping for. In the most recent phase of testing the results seem to indicate it may be possible. These possibilities would have great meaning for Type 2 diabetics.

Amylin Pharmaceuticals, Inc., Eli Lilly and Company and Alkermes, Inc. have been working together to determine if the drug exenatide is superior to other diabetes drugs sitagliptin or pioglitazone, which are both oral medications.

According to a press release by the manufacturers of exenatide, “This 26-week clinical study compared exenatide once weekly to maximum doses of sitagliptin or pioglitazone in 491 patients with type 2 diabetes taking stable doses of metformin. After completing 26 weeks of treatment, evaluable patients randomized to exenatide once weekly experienced a statistically significant reduction in A1C, a measure of average blood sugar over three months, of 1.7 percentage points from baseline, compared to a reduction of 1.0 percentage point for sitagliptin and 1.4 percentage points for pioglitazone. Treatment with exenatide once weekly also produced statistically significant differences in weight, with weight loss of 6.2 pounds at 26 weeks, compared with a loss of 1.9 pounds for sitagliptin, and a weight gain of 7.4 pounds for pioglitazone.”

The combination of improved blood glucose control and a swing of over 13 pounds between patients who used exenatide verses pioglitazone caused Dr. Jim Malone, global medical director for exenatide to declare, “The results of this study provide us with more insight into the potential profile that may be achieved with exenatide once weekly. As we continue to progress through the series of DURATION studies, our goal is to clearly understand how exenatide once weekly compares to other diabetes therapies and be able to articulate, through the data, these differences to patients and their healthcare providers.”

Eighty percent of patients who started this study went on to complete the 26-week trial. The most common side effect among those who used the exenatide injections was nausea and diarrhea. These were the same side effects common among patients using sitagliptin. In pioglitazone the common side effects included fluid retention and accompanying swelling in the lower limbs along with upper respiratory tract infections.

Richard Bergenstal, M.D., executive director of the International Diabetes Center commented on the findings by saying, “Recognizing the importance of A1C control, it has become clear that health care providers need comparative data to better understand the relative value of therapeutic options. A once-weekly therapy that helps patients achieve A1C targets, with the added benefits of weight loss and no major hypoglycemia, could provide patients with an important option to improve their diabetes care.”

The manufacturers provide their own disclaimer on the findings of this DURATION-2 study. [These findings], “contain forward-looking statements about Amylin, Lilly and Alkermes and the investigational drug, exenatide once weekly. Actual results could differ materially from those discussed or implied due to a number of risks and uncertainties, including the risk that exenatide once weekly may be affected by unexpected new data; safety and technical issues; and clinical trials, not being completed in a timely manner, not confirming previous results, or not achieving the intended clinical endpoints; the DURATION-2 superiority study results potentially not being predictive of real world use including results relative to other diabetes medications; pre-clinical trials not predicting future results; label expansion requests or New Drug Application (NDA) filings, including the NDA filing for exenatide once weekly, not being submitted in a timely manner; regulatory approval being delayed or not received; or manufacturing and supply issues. The potential for exenatide once weekly may also be affected by government and commercial reimbursement and pricing decisions, the pace of market acceptance, or scientific, regulatory and other issues and risks.”

Diabetic Eye Care: A Possible Prescription Link: Is it possible that the medicine you are currently taking for diabetes may have links to the development of eye disease? One new research report indicates it’s possible.

The American Journal of Ophthalmology suggests a class of diabetes drugs known as glitazones may increase the risk of vision complications in diabetics. The vision complication noted in the report is Diabetic Macular Edema (DME).

MedicineNet.com defines DME as the, “Swelling of the retina in diabetes mellitus due to leaking of fluid from blood vessels within the macula. The macula is the central portion of the retina, a small area rich in cones, the specialized nerve endings that detect color and upon which daytime vision depends.

“As macular edema develops, blurring occurs in the middle or just to the side of the central visual field. Visual loss from diabetic macular edema can progress over a period of months and make it impossible to focus clearly.

“Macular edema in common in diabetes. The lifetime risk for diabetics to develop macular edema is about 10%. The condition is closely associated with the degree of diabetic retinopathy (retinal disease). Hypertension (high blood pressure) and fluid retention also increase the hydrostatic pressure within capillaries which drives fluid from within the vessels into the retina.”

The research conducted relied on findings from nearly 1,000 patients who were diabetic, but also had DME. The findings showed that patients who relied on glitazones were, “2.6 times more likely to develop DME than those who didn’t take the drugs. Even after adjusting for other factors, the risk of DME remained 60 percent higher for patients who took glitazones”.

Dr. Thomas J. Liesegang, editor-in-chief of the American Journal of Ophthalmology was quoted as saying, “Ocular (eye) complications are an overlooked safety issue of systemic drugs. Long-term safety is not currently monitored, because the [FDA] approval process is based on smaller, shorter-term clinical trials. Safety necessarily requires monitoring of treatment in larger groups of people over longer periods of time. This monitoring is often neglected and should be required of all therapies.”

In January of this year German researchers expressed concern over the glitizones based drug, pioglitazone. The Institute for Quality and Efficiency in Health Care, a German based organization wrote, “There is so far a lack of scientific evidence that glitazones are better than alternative therapies at reducing mortality or complications caused by blood vessel damage in people with type 2 diabetes. As long-term studies are lacking, reliable conclusions on the long-term benefit or harm of these oral antidiabetics are presently possible only to a limited extent. Available studies provide indications that patients could benefit from one of the two currently approved active substances (pioglitazone); however, these studies also provide indications of potential disadvantages, including an increased risk of heart failure.”

One recent clinical trial suggests pioglitazone may cause weight gain and water retention in patients and was less effective in managing blood glucose levels.

While laser eye surgery is available to diabetic patients the recent body of research seems to imply that eye disease in diabetic patients should be strongly considered in the diabetic medications prescribed to patients.

The two primary glitazones generally prescribed to diabetic patients include pioglitazone (Actos) and rosiglitazone (Avandia). Evidence continues to suggest a link between these drugs and issues affecting the vision of diabetic patients who use them.

Decisions Made While Young Impact Diabetes Potential: We’ve all heard that small changes in your lifestyle and eating patterns can pay big dividends. Two recent studies provide the actual statistics involved in change.

The first findings are related to Latino youth. Those who participated in the study were all overweight and were an average of 15 and 16 years of age. A Forbes.com report discusses the three groups studied; “A control group; a group that received nutrition classes once a week, and a group that received nutrition education plus strength training twice a week.”

Emily Ventura, from the Keck School of Medicine, University of Southern California, Los Angeles, an author of the recent report said, “Latino children are more insulin-resistant and thus more likely to develop obesity-related chronic diseases than their white counterparts. To date, only a few studies have examined the effects of a high-fiber, low-sugar diet on metabolic health in overweight youth, and to our knowledge, none have tested the effects of this type of intervention in a mixed-sex group of Latino youth.”

A Los Angeles Times report states, “Researchers found that 55% of all participants cut their sugar consumption by 47 grams per day — the equivalent of one can of soda — and 59% of all teens upped their fiber by an average of 5 grams a day—the amount in about half a can of beans. That decreased sugar intake accounted for an average 33% decrease in insulin secretion. More fiber resulted in an average 10% less visceral fat, which is known to increase the risk of diseases such as diabetes.”

Researchers report that the majority of the test subjects saw improvement no matter what group they were in. They believe the reason has to do with the teen’s knowledge of what the study was intended to show. Researchers believe that provided the motivation needed for the teens to make meaningful changes that provided beneficial health outcomes.

The official report was recently released in the Archives of Pediatrics & Adolescent Medicine and piggybacks another finding related to youth and self-control.

This secondary report indicates, “Obesity in childhood and adolescence appears to track into adulthood, increasing the risk of developing cardiovascular disease, diabetes mellitus, and certain cancers in adulthood. To mount effective preventive efforts, we need better information regarding the factors involved in the etiology of childhood overweight and obesity. Self-regulation failure is one such factor that has been implicated in the development of obesity.”

Children were subjected to studies that tested their willingness to wait to gain gratification from foods they really liked. In virtually all cases researchers used candy and other treats known to be favorites of the children involved. This report seems to indicate that most children have little motivation to wait to fulfill hunger or they have not been taught how to wait. This tends to lead to eating when there is no biological need to do so. In turn, this leads to weight gain and medical complications that may accompany this gain including diabetes.

The authors from Pennsylvania State University report, “Our findings support recent studies showing that obesity is a problem that has its roots early in life and that early self-regulation failure may play a role in predicting overweight and obesity in the adolescent years. Already at ages 3 and 5 years, children who exhibited signs of self-regulation failure had higher BMI z scores and rapid weight gain into early adolescence. Failure to self-regulate energy balance in the early years is likely to be stable over time. Findings from studies on the same sample of children used in this study showed that 60% of children who were overweight at any time during the preschool years and 80% of children who were overweight at any time during the elementary period were overweight at age 12 years.”

Diabetic Heart Screenings – How Important Are They: It seems that every disease confronting mankind is met with the medical warning to get screenings now and then keep getting regular screenings in order to arrest the potential of life altering difficulties.

That is, until now.

A recent report in The Journal of the American Medical Association indicates that, “Routine screening for coronary artery disease …did not result in a significant reduction in heart attacks or death from cardiac causes among patients with no symptoms of heart or artery disease followed for an average of five years,” according to WebMD.

Study participants had a very small percentage of “cardiovascular events” leading Lawrence H. Young, MD, of Yale University School of Medicine to tell WebMD, “There are about 20 million people living with type 2 diabetes in the United States. While patients with [cardiovascular] symptoms certainly should be screened, as an overall public health measure, generalized screening doesn’t appear to be appropriate.”

For many this news could alleviate separate stress symptoms that may not be necessary in most instances. Individuals who fear heart disease may be able to relax a bit knowing that consistent screenings may not be needed.

The American Diabetes Association (ADA) indicates that adults with diabetes have a risk similar to that of a heart attack victim for a “fatal or life-threatening cardiovascular event.”

The Yale inspired study did not corroborate this finding. They did, however, conclude that more proactive care in responding to symptoms of potential heart disease might be having an impact in management. WebMD posted the following findings.

• Just seven nonfatal heart attacks and eight cardiac deaths occurred among patients who were screened (2.7%), compared to 10 nonfatal heart attacks and seven cardiac deaths among patients who were not screened (3%).
• Based on MPI (myocardial perfusion imaging) testing, fewer than one in four screened patients (23%) showed evidence of cardiovascular disease, and just 6% had evidence of advanced coronary artery blockages.
• Just over 5% of screened patients had surgery to restore blood flow to the heart over the course of the five-year study, compared to 7.8% of patients in the unscreened group.

The actual numbers may seem insignificant, but they are statistically important because spread over the 20 million Type 2 diabetics in America those small statistics may mean improved lives for thousands of patients.

Dr. Young continued by saying, “People with type 2 diabetes certainly have an increased risk for coronary artery disease, but the doom-and-gloom message of recent years may have been overstated. Patients receiving contemporary [preventive] treatment who are closely followed seem to do pretty well.”

The two key elements to making protracted screenings less necessary seem to be early diagnosis and proactive treatment of diabetes and related symptoms.

WebMD reported, “Two out of three people with diabetes die from heart disease or stroke, and diabetes patients have twice the incidence of heart disease as the general population.”

However, if the medical profession can catch patients before they begin to develop heart disease they may be very effective at reducing the overall number of diabetic patients who have heart attacks or need angioplasties or heart bypass operations.

The study this report is based on followed more than 1,100 patients to determine their ultimate findings. It should be noted that medical organizations like the ADA changed some of their guidelines after the study began. In all cases these organizations began calling for more, “aggressive treatment of cardiovascular risk factors such as high blood pressure and high cholesterol,” according to WebMD.

The collective wisdom seems to suggest better health in proactive medicine.

Diabetics Can Live Longer By Laughing More: There is an ancient proverb that reads, “A merry heart does good, like medicine, but a broken spirit dries the bones.” Many have long believed that a positive outlook on life can improve personal health, but new research points to the fact the humor really is good medicine – and that medicine can be especially important to diabetics.

Depression and diabetes often go hand in hand and the cycle of ineffective control and weariness can place patients on a negative course that could proverbially “dry the bones”.

According to a recent report by HealthDay the study’s author, Lee Berk of Loma Linda University said, “Laughter may be as valuable as the diabetes medicines you are taking.” Berk has research data to back up this claim.

Twenty study participants with an average age of fifty participated in the study. They were assigned to one of two control groups. One encouraged laughter while the other did not.

The HealthDay report indicated, “All had high blood pressure and high cholesterol. Both groups were taking standard diabetes medications, high blood pressure medicines and cholesterol-lowering drugs.”

Those involved in the laughter group were encouraged to select a means of producing personal laughter. This was often accomplished by watching a sitcom or movie. No participant was told what to watch or how to come up with laughter. They were simply encouraged to find a way to laugh for a minimum of 30 minutes a day.

Speaking of the laughter participants, Berk told HealthDay, “Once they got into it, they really liked it.”

This study was conducted over a year long period. The findings were significant. “The laughter group had an increase in “good” HDL cholesterol of 26 percent, compared to just a 3 percent increase in the good cholesterol of the control group, Berk said. Harmful C-reactive proteins declined by 66 percent in the laughter group but just 26 percent for the control group,” according to HealthDay.

Berk explained the reasons for the dramatic improvements this way, “You are decreasing the bad chemicals in the body with laughter and increasing the good chemicals, which help you stay well, may prevent disease and may well have [additional] value relative to the therapies you are taking.”

One of the greatest benefits for patients is that laughter does not cost anything. However, if you do not seek humor you may not find it. The study participants were encouraged to find forms of humor that would encourage laughter. It may seem to some either a waste of time or quack science, but the Loma Linda study showed a dramatic difference between those diabetic patients who laughed and those who did not.

To intentionally find ways to smile and laugh a bit may provide some motivation to engage in improved managed care for diabetes. It takes some effort and energy to laugh and that may supply the motivation to improve other aspects of personal care.
The HealthDay report included a comment from Sue McLaughlin, president of health care and education for the American Diabetes Association (ADA). She said, “It is encouraging to know that something like laughter, which is cost-free and can be shared and promoted by many, has beneficial effects on the well-being of a chronic disease that affects 24 million Americans. People with diabetes are at a two- to fourfold increased risk for cardiovascular disease, compared to their non-diabetic counterparts.”
Maybe finding a reason for laughter is more important to longevity than you thought.