Category: Diabetes 101

Are you one of the millions who finds it hard to get up and exercise regularly? You’re definitely not alone, and new research shows that those who tend to stay active may have been born with different genes. For years, diet and exercise have been prescribed as the best way to stay in shape and maintain one’s health, but a lack of motivation to exercise could be the result of an unlucky drawing in the genetic lottery.

The research was conducted by Professor Gregory Steinberg and his team at McMaster University in Canada. The team was studying health mice that had been specifically bred for the study; some of the mice had two genes removed which are essential in exercise. The two genes are responsible for controlling a protein called AMP-activated protein kinase, or AMPK. The enzyme is “switched on” when an organism such as a mouse or human exercises.

“Mice love to run,” said Professor Steinberg, who is the associate professor of medicine at the Michael G. DeGroote School of Medicine as well as the Canada Research Chair in Metabolism and Obesity. Steinberg described how the removal of the two exercise genes caused an immediate change in the physical capabilities of the mice: “While the normal mice could run for miles, those without the genes in their muscle could only run the same distance as down the hall and back. It was remarkable. The mice looked identical to their brothers or sisters but within seconds we knew which ones had the genes and which one didn’t.”

Those mice lacking the genes that controlled AMPK had decreased mitochondria — the powerhouses that provide energy to cells — and a subsequent dysfunction in the ability of the muscle cells to utilize glucose to generate energy.

“When you exercise you get more mitochondria growing in your muscle. If you don’t exercise, the number of mitochondria goes down,” says Steinberg. “By removing these genes we identified the key regulator of the mitochondria is the enzyme AMPK.”

While there are many research teams around the world studying AMPK and its implications, Professor Steinberg’s team is the first to outline the importance of its role in exercise. Their findings are published in the Proceedings of the National Academy of Sciences.

According to Professor Steinberg, the team’s findings have important implications for individuals who find it difficult to exercise, including disabled people, asthmatics and the obese. When regular physical exercise is neglected over a long-term period, additional complications such as diabetes and heart disease can occur.

“As we remove activity from our lives due to emerging technology, the base level of fitness in the population is going down and that is reducing the mitochondria in people’s muscles. This in turn makes it so much harder for people to start exercising,” says Professor Steinberg. With the lack of exercise required in our modern lives, and the subsequent reduction of mitochondria in our cells, our risk of developing serious complications has risen as industrial technology has taken over and reduced the need for frequent physical exertion.

Steinberg says that he rides his bicycle or runs to work to stay in shape: “It is the only way that I can manage to make sure I stay fit.” Regular exercise has a variety of health benefits, from reducing weight and fighting illnesses and disease to improving mood, increasing energy levels and encouraging healthy sleep patterns.

According to a new study, a variety of lifestyle factors may independently affect an individual’s chance of developing Type 2 diabetes. Such risk factors include diet, exercise, weight, and alcohol and tobacco use.

The researchers found that individuals were less likely to develop Type 2 diabetes if they had healthy lifestyles overall, even if they had family histories of diabetes or were overweight. In addition, each positive lifestyle choice reduced their chances of developing the disease.

“There are implications certainly for individuals to take one step at a time toward a healthy lifestyle,” said Jared Reis with the National Heart, Lung, and Blood Institute, located in Bethesda, Maryland, and an author on the study. “There is certainly benefit for those who may have a tough time with losing weight if they adopt these other healthy lifestyle factors” such as getting more exercise, eating a healthier diet, and eliminating smoking and alcohol.

The study analyzed data from over 200,000 Americans; the data was collected through surveys that the participants filled out themselves and it asked questions about their health in the years 1995 and 1996. At that time, most of the participants were older aged, in their 50s or 60s; however, none had diabetes at the start of the study.

The researchers followed up with those participants ten years later, asking whether they had developed diabetes since the first survey. On average, one in 10 men and one in 13 women had developed Type 2 diabetes since the beginning of the study.

Researchers then looked back at the data collected during the first survey, breaking down the questions according to five categories: body mass index (BMI), exercise, diet, and the use of alcohol and tobacco. According to the results, each healthy behavior that appeared on the survey, such as getting regular exercise or stopping smoking, reduced the participant’s risk of developing diabetes, even when accompanied by other unhealthy lifestyle choices.

As such, a participant who ate a well-rounded diet and avoided unhealthy fats and low-quality refined grains had a lower risk of developing diabetes even if he or she exercised little, smoked cigarettes and drank alcohol regularly.

The results proved consistent even among those who had a family history of diabetes, which put them at a higher risk overall.

The study found that normal weight women who answered positively to adopting healthy lifestyle choices, such as eating healthy, getting regular exercise, and avoiding alcohol and tobacco were 84% less likely to develop diabetes than overweight women who engaged in the opposite unhealthy activities. Similarly, men who made healthy choices were 72% less likely to develop diabetes compared with their less healthy peers.

Although the data pointed to the fact that healthy choices could counteract the risk of developing diabetes, the researchers noted that weight was still the most important determining factor in the development of diabetes.

“While the message is that all these things matter… the number one top-of-the-list take-home is, don’t be overweight in the first place,” said Dr. Lawrence Phillips, an endocrinologist at Emory University in Atlanta. “It’s important not to confuse the baby with the bathwater here,” added Phillips, who was not involved with the study.

While the study is encouraging in its predictions that healthy choices reduce the risk of diabetes, it cannot prove definitively that removing alcohol, tobacco or saturated fats can reduce any one individual’s risk of developing the disease.

Good news for diabetics who love the calming and relaxing influence of yoga — a recent study suggests that yoga classes could help Type 2 diabetics lose some weight and, more importantly, help regulate their blood sugar levels. The study was published in the journal Diabetes Care.

The study was conducted on 123 middle-aged and older adults, and it showed that the patients who participated in yoga classes as a type of supplemental treatment for their existing diabetes care lost a few pounds over the three-month period of the study. In addition, their average blood glucose levels held at a steadier level than the control group of Type 2 diabetics who did not add yoga sessions to their diabetes care.

The study participants who took yoga classes several times a week — 60 of them in all — showed an average decrease in body mass index, or BMI, from 25.9 to 25.4. On the BMI scale, the “overweight” range is from 25 to 30.

While the findings were encouraging in suggesting yoga as a form of supplemental treatment for diabetes, they did not suggest that yoga should replace the typical exercise regimen that is prescribed for Type 2 diabetics.

Shreelaxmi V. Hegde with the Srinivas Institute of Medical Science and Research Center in Mangalore, India was the lead researcher on the study. According to Hedge, although yoga showed some positive benefits, Type 2 diabetics would benefit even more from vigorous exercise such as running.

“In our study the effect of yoga on BMI (body mass index) and blood sugar control was marginal,” said Hegde. “But, it should be noted that yoga controlled the blood sugar levels which otherwise rose in the control group.”

The study also found signs of decreased oxidative stress in the group that participated in yoga. Oxidative stress is the condition where free radicals — dangerous leftovers from cellular energy production — increase to levels that the body cannot handle. Oxidative stress, when present over long periods of time, is known to contribute to the development of several chronic diseases.

The research team studied the participants’ bloodstreams for the presence of chemicals that are indicative of oxidative stress. These results showed that the presence of these chemicals was reduced by an average of 20 percent in the group that took yoga classes.

According to Hedge, if this reduction in oxidative stress could be maintained over a long period of time, the patient could lower his or her risk of developing diabetes complications, including heart disease, kidney disease, and nerve damage. However, more research is needed to determine whether yoga could actually be used to curb oxidative stress in the long term.

In the meantime, Hedge has a theory on why yoga could reduce oxidative stress: yoga stimulates the parasympathetic nervous system, or the part of the nervous system responsible for unconscious activities such as breathing and digestion.

Hedge did state that the type of yoga used in the study was a gentle form that excluded certain poses because they could exacerbate the patients’ complications. However, some yoga classes provide a more intense workout that could be dangerous to those with potential complications while being more beneficial to individuals who can handle the extra stress. Many hospitals and community centers around the U.S. are beginning to offer yoga classes tailored specifically for those with chronic illnesses such as cancer and diabetes, as well as yoga classes for older individuals who want to stay in shape.

Beans and rice are two ingredients that are common to many meals in the typical Western diet. However, a study conducted in Costa Rica has found that lightening up on the rice and eating more beans could be better for overall health.

The study, which was conducted on almost 2,000 men and women, found that those who regularly replaced a serving of white rice with a serving of beans were 35% less likely to display precursor symptoms for diabetes. The researchers reported their results in the American Journal of Clinical Nutrition.

“Rice is very easily converted into sugar by the body. It’s very highly processed, it’s pure starch and starch is a long chain of glucose,” said Frank Hu, one of the researchers with the study. Hu is a professor of nutrition and epidemiology at Harvard School of Public Health in Boston, Massachusetts. “Beans compared with rice contain much more fiber, certainly more protein and they typically have a lower glycemic index — meaning they induce much lower insulin responses,” continued Hu. Though beans do contain significant amounts of carbohydrates, the body must work more to break them down, resulting in slower digestion time and a reduced impact on insulin production and blood sugar.

Hu’s research team analyzed the diets of almost 2,000 men and women from Costa Rica, who were participating in a study lasting from 1994 to 2004 that looked at risk factors for heart disease. At the beginning of the study, none of the participants were diabetic.

As with many industrialized nations, Costa Rica has seen its diabetes rates begin to soar. The urbanization of the country, along with its increased wealth, has caused increases in the consumption of white rice; simultaneously, consumption of beans has decreased, according to Hu. This increase in rice consumption could be part of the reasoning behind the nation’s rising diabetes rates: study participants who ate more white rice over a long-term period had higher blood pressure in addition to lower levels of good cholesterol and increased levels of fat and sugar in their blood.

These are well-known risk factors for metabolic syndrome, a series of conditions that dramatically increase risk of developing Type 2 diabetes and heart disease.

While those who ate more rice were at higher risk for metabolic syndrome, individuals who ate two servings of beans for every serving of white rice were usually at lower risk. Such practices of replacing rice with beans reduced the risk of metabolic syndrome by 35%.

While rice generally makes up a significantly larger portion of the average diet in countries outside the U.S., Americans have been consuming more and more rice every year, according to the U.S. Department of Agriculture. In 1980, Americans consumed 9.5 pounds of rice per person every year; in 2008, that number rose to 21 pounds per person. At the same time, Americans have consumed less dry beans — about 7 pounds per year.

Hu says that such an increase in consumption of white rice is dangerous, especially when compared to brown rice. According to Hu, eating white rice “is like eating a candy bar — the fiber and other nutrients are stripped away.” The increases in consumption of white rice “will have long-term metabolic effects,” added Hu. “It would be useful to introduce more legumes, including beans, into our diet to replace white rice and some of the red meat.”

New research findings relating to low-grade inflammation are sure to cause controversy, as they seem to contradict current mainstream views of diabetes. While increases in low-grade inflammation are commonly believed to be a contributing factor in the development of Type 2 diabetes, a team of researchers at Children’s Hospital in Boston have reported that two proteins activated by inflammation are actually vital in regulating blood sugar levels; not only that, but increasing the activity of these proteins leads to better blood glucose stability in obese and diabetic mice.

The findings were reported in the October issue of Nature Medicine. The research team was headed by Umut Ozcan, M.D., with the Division of Endocrinology at Children’s Hospital.

“This finding is completely contrary to the general dogma in the diabetes field that low-grade inflammation in obesity causes insulin resistance and type 2 diabetes,” said Ozcan. “For 20 years, this inflammation has been seen as detrimental, whereas it is actually beneficial.”

The team headed by Ozcan has shown in the past that obese individuals experience increased stress on the endoplasmic reticulum, or ER. This cellular structure is involved in the assembling, folding, and releasing of proteins to conduct the operations of the cell. “ER stress,” as it’s called, reduces the body’s efficiency in responding to insulin and regulating blood sugar levels; this deficiency is one of the primary links between Type 2 diabetes and obesity.

Ozcan’s team previously found that proteins called XBP1s, which play a role in mitigating ER stress, are unable to function in overweight mice. Then, they showed that inducing XBP1s to activate in the liver resulted in normalization of the blood sugar levels of obese, Type 2 diabetic mice as well as in Type 1 diabetic mice.

The team’s newest study shows that yet another protein which is activated by inflammation, known as p38 MAPK, is responsible for chemically altering XBP1s to increase their activity. Without the increase in activity from p38 MAPK, XBP1s are unable to maintain normal blood sugar levels. In addition, the study showed that activity of the p38 MAPK protein is reduced in obese mice, and re-activating the protein in the liver reduced ER stress while reducing blood glucose levels and increasing glucose tolerance and insulin sensitivity.

When taken together, the findings of the two studies suggest that new therapies for diabetes could be developed by increasing the activity of the p38 MAPK protein and thereby increase XBP1 activity, or by increasing XBP1 activity directly. Since these proteins are associated with low-grade inflammation, any such therapies will likely be controversial and need further study.

The studies also provide new information about Type 2 diabetes that could help with our understanding of the disease. “It may be that inflammatory pathways are not working optimally and there could be a resistance to cytokines which mediates the inflammation,” said Ozcan. “This could be a paradigm shift for the field.” In other words, obesity could be related to diabetes by causing a disruption in the ability of the individual’s cells to respond to inflammatory signals.

Though the research team is hopeful that their findings could lead to new therapeutics, they warn that there could be downsides to using p38 MAPK inhibitors to treat inflammatory diseases, such as asthma, psoriasis and Chrohn’s disease. “These therapeutic approaches should… be evaluated within the context of our results, and in light of the possibility that inhibition of XBP1s activity also decreases the ability of the cell to cope with the inflammatory conditions,” the study states.

A study conducted at the University of Otago in Dunedin, New Zealand, has found that middle-aged women who consume meals at a slower rate are much less likely to become overweight than women of the same age who eat quickly.

The study was the first of its kind to be conducted on a national level. It examined the link between body mass index, or BMI, and the speed of eating as reported by the 1500 women who participated in the study. The women were from New Zealand and ranged in age from 40 to 50 years old; this demographic is at a high risk of weight gain. The study was conducted by the Department of Human Nutrition at the University of Otago.

When the team adjusted its results to take into consideration other factors such as level of physical activity, whether or not the women had reached menopause, smoking status, and ethnicity, they found that the faster the women ate, the higher their BMI numbers grew.

“For every one-step increase in a five-step scale ranging from ‘very slow’ eating to ‘very fast’ ‘the women’s BMI increased by 2.8 percent, which is equivalent to a 1.95 kg weight increase in a woman of average BMI for this group,” said Dr. Caroline Horwath, head of the study and professor at the University of Otago.

Dr. Horwath did note that there is not enough data to prove that the women’s’ increased eating speed was the actual cause of their higher BMI. For this reason, the research team will be following up with the participants to see if those who reported faster eating will continue to gain weight over a longer period of time. However, if a causal link is discovered between speed of eating and weight gain, then advising individuals to slow down their meals could help them lose weight just as much as a typical weight loss management program.

“The size of the association found in this initial research suggests that if there is a causal link, reduction in eating speed is a very promising way to prevent weight gain and may lead to decreases in BMI similar or greater than those sustained in weight management programs,” said Dr. Horwath.

If the team finds that such a causal link exists, Dr. Horwath plans to conduct additional research, including the use of interventions that encourage women to consume their meals more slowly. The interventions would teach participants how to relax when confronted with stressful situations and how to use techniques to recognize and avoid unnecessary eating triggered by stress.

“If such interventions prove effective, they could be used alongside other non-dieting approaches we have previously trialled with overweight or obese women. These approaches successfully prevented weight gain in at-risk women and even produced significant weight loss in some. Our interventions included intensive training in relaxation techniques and how to recognize and avoid stress-related triggers for eating,” said Dr. Horwath.

Non-dieting approaches to weight loss appear to be gaining in popularity, according to Dr. Horwath. Dietitians have begun to seek alternatives for weight loss treatment since traditional treatments such as restriction of food intake have not been wildly successful in helping patients keep off lost weight.

“Studies have found that many dieters regain any weight they lose within five years and often end up heavier than when they began,” says Dr. Horwath.

A study recently performed by Israeli researchers and presented in Haaretz, an Israeli daily newspaper, has shown that a 20-minute swim in the Dead Sea could aid diabetics in lowering their blood sugar levels.

The research team was composed of scientists from Ben Gurion University and Soroka Medical Centre of Beersheva. Both are located in the Negev desert in Israel, according to Haaretz.

The study analyzed 14 people who had been diagnosed with Type 2 diabetes, ranging in age from 18 to 65. Results showed that, after sitting in a pool of water taken from the Dead Sea for a full 20 minutes, the patients showed a significant decrease in their blood sugar levels.

Their blood glucose dropped 13.5 percent on average, from 163 milligrams per deciliter to 151mg/dl. Being submerged in the water for an hour caused a further reduction in glucose levels, to 141.3 mg/dl.

Researchers noted that the salty soak did not seem to have any negative side effects on other important characteristics of blood, including insulin levels, c-peptide or levels of cortisone hormones.

The researchers used a control group of six healthy participants, who did not show any changes in their blood glucose levels when exposed to the Dead Sea water for the same amount of time.

Professor Shaul Sukenik led the research team at Ben Gurion University. He said that the results were promising. “In the event that the findings are confirmed in further studies, a drop in blood glucose levels will allow diabetics who bathe in the Dead Sea to use less medication,” said Sukenik in an interview with Haaretz. “We cannot determine this on the basis of the current study, but the findings do suggest this,” he said.

Now that the team has established a possible link between a bath in the Dead Sea and lowered blood glucose levels, they are attempting to secure funding to conduct additional testing and determine whether a daily soak across a three week period would have an even greater effect.

Dr. Sukenik’s research team will publish its findings in HaRefua, the journal of the Israel Medical Association. It is unlikely that a swim in the Dead Sea, even if conducted daily over a period of several weeks, could replace insulin injections or frequent monitoring of blood glucose levels. However, any treatment method that can ease the burden on Type 2 diabetics is worth researching.

Swimming in the Dead Sea is a tradition in Israel, where locals and tourists alike flock to enjoy a relaxing soak. The high salt content of the water — much higher than that of the ocean — means that it’s hard to actually swim, and “floating” is a more accurate description. Many believe that the waters are rich in nutrients and minerals and thus offer healing properties. Additionally, the low pollen and allergen content of the area, along with high atmospheric pressure and reduced ultraviolet component of the sun’s rays have made it a popular spot for treatment of many conditions.

Some of the therapies used at the Dead Sea include thalassotherapy (bathing in seawater for healthful benefits), heliotherapy (using the sun’s rays as a type of treatment), and climatotherapy (using the climatic characteristics of an area, such as barometric pressure, temperature, and humidity as treatment). Some other conditions that are frequently treated at the Dead Sea include cystic fibrosis, psoriasis, osteoarthritis, and rhinosinusitis.

When it comes to texting, teenagers out-type every other age group by a long shot, with some sending thousands of text messages every month. But what if this activity could be used to help teens lose weight? One study aimed to find out whether text messages could be used to promote positive weight management activities in overweight teens, discovering that such at-risk teenagers felt reassured by positive messages but disliked deeper questions.

Overweight and obese teenagers are a difficult demographic to reach. Weight loss interventions typically have trouble making a difference in their lives as the teens have difficulty adapting to healthier habits in diet and exercise. A research team at the University of Michigan believed that using text messages might be helpful in encouraging overweight and obese teens to make healthier choices. Text messages have previously been used to help individuals overcome other bad habits.

The research team, which published its results in the journal Obesity, conducted its study with four focus groups of 24 teens, both male and female, who were participants in weight management programs. The research team tested six types of text messages for effectiveness, including messages tailored to the individual, healthy eating ideas, targeted tips, testimonials, feedback questions and questions that encouraged introspection on the part of the teens.

The teens were interested in the messages overall, but less excited about certain aspects: they enjoyed the meal and recipe ideas as well as the testimonials, but only when those messages were coming from other teenagers.

The participants favored positive messages with some uses of texting trends such as emoticons. However, certain colloquialisms, such as “LOL,” failed to make a good impression. In addition, any mention of unhealthy foods was not looked upon favorably, even if they were mentioned in the context of discussing healthier choices; even the suggestion of those unhealthy foods might have caused cravings for those foods.

Researchers experimented with broad questions that encouraged self-reflection and introspection, but they did not garner a positive response. Some texts featured several such questions in a row, such as “What does being healthy mean for you? How does screen time fit in with your goals? How could cutting back on it help improve your health?” The teens felt that there were too many questions and weren’t sure which ones they should answer first. When the teens discussed the questions with researchers, they said that they simply wanted to have healthy habits outlined for them instead of having to devise their own diet and exercise systems.

The teens’ reluctance to develop their own plans surprised the researchers, since some studies have shown that people who make their own behavior modifications are more likely to stick with them than if they’re simply being told what to do. However, the researchers noted that the length limitations of text messages may have hindered the progress that those types of questions could make.

According to the research team, their next goal is to conduct additional research to determine if the messages could actually contribute to positive changes in diet and exercise habits along with actual weight loss in overweight and obese teenagers.

Child and teen obesity began a dramatic increase in the 1990s and has climbed to frightening levels. Over 30 states in the United States have child and teen obesity rates above 30%.

Diabetics who receive their prescription medication through the mail have higher rates of adherence to oral diabetes medications, according to a study published in the Journal of Medical Economics.

“This is the first study to show that mail service can help Medicare Part D members achieve better adherence with their diabetes medications,” said Jacqueline Kosecoff, PhD, CEO of OptumRx, in a press release. “Improving adherence has been shown to prevent the worsening of disease outcomes, decrease the use of health resources and control escalating health care costs.”

Adherence is defined as “the extent to which a person’s behavior [in] taking medication corresponds with agreed recommendations from a health care provider,” according to the World Health Organization.

The study, conducted by Prescription Solutions by OptumRx, was a retrospective cohort study that analyzed medication adherence in Medicare Part D beneficiaries who had been diagnosed with diabetes. The team at Prescription Solutions used the data to determine if there is an association between increased medication adherence and the delivery of medication to the patients’ homes through mail-order pharmacy.

Researchers used Prescription Solutions data on pharmacy claims for 22,546 patients; 89% of the patients were 65 or older. The team excluded patients who treated with insulin or exenatide (Byetta and Amylin), those who received low-income subsidies, and those who were taking anti-depressant or anti-dementia drugs during the research period. The group was then divided into two cohorts — one composed of patients who only filled prescriptions at retail pharmacies and the other composed of patients who only received their medications by mail from Prescription Solutions.

The press release from OptumRx states that adherence to antidiabetes medications, including metformin, thioglitazones, and sulfonylureas, was measured by the proportion of days covered throughout the year 2009. Among the diabetic patients in the study, 41.6% achieved good adherence, with the average proportion of days covered being 0.60. When the researchers compared the patients who received medication through the mail versus those who filled prescriptions at a pharmacy, the mail-order patients showed a significantly higher number of days covered at 0.68 versus 0.57. The patients who used mail-order pharmacies achieved a higher adherence percentage at 49.7% versus the 42.8% of retail pharmacy users who achieved good adherence.

“Medication adherence is a multi-faceted problem that requires a multi-faceted approach,” said Brian K. Solow, MD, chief medical officer of OptumRx. “Our study provides convincing evidence that mail-order pharmacy would be one way to help improve adherence for patients with chronic diseases.”

Failure to achieve medication adherence can put patients at greater risk of developing complications associated with their conditions, especially those suffering from chronic conditions. Poor adherence can result in worsening of the condition, death, and increases in the cost of health care. Of the medication-hospitalizations that occur in the United States, approximately 33% to 69% of them occur because of nonadherence to a prescription plan. Unfortunately, it can be difficult for physicians to detect such nonadherence.

Some ways that physicians can monitor medication adherence include determining the rate of prescription refill, measuring physiological markers such as the levels of a metabolite in the blood, counting pills, directly observing the patient taking the medication, and asking the patients to keep track of their dosages, such as with a medication diary. Data has shown that adherence rates are inversely proportional to the frequency of dosing; in patients taking medication that required four doses daily, adherence rates fell to about 50%.

Type 2 diabetics don’t always receive advanced warning that they are about to lose consciousness from a drop in blood glucose levels. Common symptoms of passing out include sweating, tingling or numbness in the face, a feeling of intense hunger and heart palpitations. But in patients who have lived with diabetes for a long period of time, the symptoms aren’t always present before an episode. Performing a finger prick test is still the most reliable way to determine if blood sugar levels are dropping too low.

However, that may change within a few years. Research has shown that a diabetic’s sweat pattern undergoes changes when blood glucose levels drop too low. Now a sweat meter developed jointly at the University of Olso in Norway and the National Hospital may be able to monitor sweat patterns to determine irregularities in blood glucose levels and send an alert via text message before the patient suffers an attack.

Better yet, the sweat meter could supercede finger pricking as the primary mechanism for quickly testing blood glucose levels in diabetics. “The advantage of the sweat meter is that the patient doesn’t have to prick themselves,” said Professor Ørjan G. Martinsen with the Department of Physics at the University of Oslo. “All you need to do is paste an electrode on your skin.”

“We envisage that the device will be able to measure sweat activity continuously, providing an indication of whether the patient is about to experience low blood sugar,” said Christian Tronstad, a medical technology researcher at the Oslo University Hospital. “It can communicate directly or via a smartphone. The warning system will then not be very bothersome for the patient.”

The project is being supported by the Norwegian Diabetes Association. Researchers are now conducting studies to determine if changes in sweat patterns can be viable indicators of dangerous blood glucose levels. “In the study we will compare the continuous measurements of sweat activity and blood sugar in patients to see if we can get a good enough warning of a low sugar level in the blood,” said Tronstad.

Kåre Birkeland, head of the medical council of the Norwegian Diabetes Association, believes that the sweat meter holds exciting possibilities in streamlining blood glucose testing and providing advance warning of attacks from low blood sugar for diabetics. “It can be developed into a practical, usable device that can help those who have a hypo when their blood sugar gets too low. The patient can then take the necessary precautions,” said Birkeland.

The sweat meter was actually developed to diagnose hyperhidrosis, or a condition that causes excessive sweating. It sends a small electrical current through the outermost layers of skin, which moves into the sweat glands and then returns to the surface of the skin. When the skin has sweat on it, the electrical current reacts to its salt content and notifies the meter that sweat is present on the skin.

Professor Martinsen leads a team that is at the forefront of research dealing with the electrical properties of the skin. Martinsen has worked for over 20 years with Sverre Grimnes, professor emeritus of medical technology at the University of Oslo, on researching and studying bioimpedance, or the electrical resistance properties of biological tissues. The research team calls itself the Bioimpedance Group; they have started a scientific journal to present their findings.