Thursday, June 29, 2006
DIABETES ARTICLES. Surgeons elated by heart partient
DIABETES ARTICLES.
Surgeons elated by heart partient
Surgeons who implanted the first self-contained artificial heart on Monday said today that so far the patient's recovery had vastly exceeded their expectations.
The surgeons strongly cautioned that the procedure was an experiment in which a complication could occur at any time because of the patient's severe illness and the complexity of the AbioCor artificial heart that they implanted. But they expressed optimism that their patient, identified only as a man in his 50's, would be able to return to daily activities.
One complication that the surgeons described as ''very minor'' has already occurred; late Monday night, the patient underwent a second operation lasting two hours to stop bleeding caused by one or two loose stitches among the hundreds placed in his chest during the original implant operation. Officials at Jewish Hospital, where the implant was performed, did not mention the problem in Tuesday's announcement of the procedure.
At a news conference today, the surgeons described the patient as a diabetic man in his mid-to-late 50's who was terminally ill with heart failure and who was in dire condition before the implant operation. Another medical center outside the Louisville area had rejected the man as a candidate for a heart transplant because he had significant kidney failure and abnormally high pressure in blood vessels in his lungs, the surgeons said.
But surgeons who implanted his artificial heart say he may eventually be eligible for a heart transplant.
The man had had an 80 percent chance of dying within 30 days because earlier heart attacks had left such extensive scarring that the heart's two pumping chambers were failing badly, they said.
Before the operation, the man's lungs had been drowning from pulmonary edema, a buildup of fluid that occurs in heart failure, said the surgeons, Dr. Laman A. Gray and Dr. Robert D. Dowling, from the University of Louisville. By this morning, the artificial heart, which has been beating about 120 times a minute, had virtually cleared the fluid from his lungs. They said they were surprised that the problem had resolved so quickly.
The man is conscious but sedated, has responded appropriately to commands and recognizes relatives who have been constantly at his side, the doctors said. They said they expected him to resume speaking after doctors removed a breathing tube connected to a mechanical respirator; later they said the tube had been removed.
Dr. Gray said one reason for his optimism was that tests that measure blood levels of creatinine, a substance that reflects kidney function, had shown no deterioration.
The doctors said they hoped to have the man sit in a chair in the next few days. But they said they were reluctant to make predictions about when he might walk and conduct other normal activities because the man's muscles had become so weak in recent weeks as his heart failure worsened and he was forced to use a wheelchair.
''When he came into the hospital, he could only walk a few feet at a time and could not walk down the corridor because he was so weak,'' Dr. Gray said. ''He did not have enough energy to eat'' and digest protein.
Dr. Dowling said his team did not know how long it would take for the man to gain enough strength to resume normal activities if he continued to progress without complications.
The man sought the heart less than two weeks ago, the doctors said.
When he was admitted to Jewish Hospital, the surgeons said, they had to insert a device known as an intra-aortic balloon pump to help his heart pump. They said the man's heart could barely pump enough blood to keep him alive. He was not a good candidate for a ventricular assist device, another type of implanted device that can keep some people with heart failure alive, because of increased blood pressure in his lungs. They said he needed three drugs, which they did not name, to maintain an adequate blood pressure. A standard creatinine blood test was about 3, showing moderately severe kidney failure.
by Laurce K. Altman at New York Times
Surgeons elated by heart partient
Surgeons who implanted the first self-contained artificial heart on Monday said today that so far the patient's recovery had vastly exceeded their expectations.
The surgeons strongly cautioned that the procedure was an experiment in which a complication could occur at any time because of the patient's severe illness and the complexity of the AbioCor artificial heart that they implanted. But they expressed optimism that their patient, identified only as a man in his 50's, would be able to return to daily activities.
One complication that the surgeons described as ''very minor'' has already occurred; late Monday night, the patient underwent a second operation lasting two hours to stop bleeding caused by one or two loose stitches among the hundreds placed in his chest during the original implant operation. Officials at Jewish Hospital, where the implant was performed, did not mention the problem in Tuesday's announcement of the procedure.
At a news conference today, the surgeons described the patient as a diabetic man in his mid-to-late 50's who was terminally ill with heart failure and who was in dire condition before the implant operation. Another medical center outside the Louisville area had rejected the man as a candidate for a heart transplant because he had significant kidney failure and abnormally high pressure in blood vessels in his lungs, the surgeons said.
But surgeons who implanted his artificial heart say he may eventually be eligible for a heart transplant.
The man had had an 80 percent chance of dying within 30 days because earlier heart attacks had left such extensive scarring that the heart's two pumping chambers were failing badly, they said.
Before the operation, the man's lungs had been drowning from pulmonary edema, a buildup of fluid that occurs in heart failure, said the surgeons, Dr. Laman A. Gray and Dr. Robert D. Dowling, from the University of Louisville. By this morning, the artificial heart, which has been beating about 120 times a minute, had virtually cleared the fluid from his lungs. They said they were surprised that the problem had resolved so quickly.
The man is conscious but sedated, has responded appropriately to commands and recognizes relatives who have been constantly at his side, the doctors said. They said they expected him to resume speaking after doctors removed a breathing tube connected to a mechanical respirator; later they said the tube had been removed.
Dr. Gray said one reason for his optimism was that tests that measure blood levels of creatinine, a substance that reflects kidney function, had shown no deterioration.
The doctors said they hoped to have the man sit in a chair in the next few days. But they said they were reluctant to make predictions about when he might walk and conduct other normal activities because the man's muscles had become so weak in recent weeks as his heart failure worsened and he was forced to use a wheelchair.
''When he came into the hospital, he could only walk a few feet at a time and could not walk down the corridor because he was so weak,'' Dr. Gray said. ''He did not have enough energy to eat'' and digest protein.
Dr. Dowling said his team did not know how long it would take for the man to gain enough strength to resume normal activities if he continued to progress without complications.
The man sought the heart less than two weeks ago, the doctors said.
When he was admitted to Jewish Hospital, the surgeons said, they had to insert a device known as an intra-aortic balloon pump to help his heart pump. They said the man's heart could barely pump enough blood to keep him alive. He was not a good candidate for a ventricular assist device, another type of implanted device that can keep some people with heart failure alive, because of increased blood pressure in his lungs. They said he needed three drugs, which they did not name, to maintain an adequate blood pressure. A standard creatinine blood test was about 3, showing moderately severe kidney failure.
by Laurce K. Altman at New York Times
Thursday, June 22, 2006
Diabetes device to monitor blood sugar
DIABETES ARTICLES - Diabetes device to monitor blood sugar
A new device that monitors blood sugar constantly and lets the patient administer insulin right away if needed might greatly simplify life for people with diabetes.
The Medtronic Inc. device combines an insulin pump and a continuous blood-monitoring system. An alarm sounds if blood sugar goes out of safe ranges.
Patients are clamoring to test and use the device, researchers for the company told participants here at the meeting of the American Diabetes Association.
The device, called the Minimed Paradigm Real Time Insulin Pump and Continuous Glucose Monitoring System, is approved for people older than 18 with insulin-dependent diabetes. People with type 1 diabetes, also known as juvenile diabetes, depend on insulin, as do some type 2 diabetics.
"It's a pretty exciting advance," said Dr. John Buse, vice president of the American Diabetes Association. "I am not sure that it's the best pump ever and the best monitoring device ever. It's not an artificial pancreas...but it's getting pretty close," Buse added in an interview.
Linda Frederickson, a nurse and diabetes educator who tested the device for Medtronic, said she was surprised at how much the device told her.
"I write books and used to write books about food and carbohydrate and I think I am pretty smart...but I found out more about foods using this sensor. You can tell what your favorite food...is going to do to you and when it will do it," she told a briefing for investors and analysts.
Dr. Bruce Buckingham, a Stanford University pediatric endocrinologist who tested this and other monitors, said parents were surprised to watch the monitor's effects on their children with type 1 diabetes.
"It really changed their habits and how they eat and how they deliver their insulin," Buckingham told the briefing.
BETTER CONTROL
Buckingham's study showed that, on average, the children in his study showed a 20 percent decrease in A1c, a commonly used measure of blood sugar.
"It was very easy to recruit for this study. Patients were just wanting to come in," Buckingham said.
"If you have a child with diabetes, 75 percent of seizures occur at night so they have a continuous monitor that alarms them when they are low. For the kids, it allows them to have the alarm and makes them feel more comfortable in trying to bring their blood sugar down."
Nearly 21 million Americans have diabetes and 3 million of them have type 1 diabetes.
Patients usually have to constantly prick their fingers during the day, test their blood sugar level, and then inject insulin or eat something to adjust their blood sugar level.
It requires constant vigilance and discipline. Patients do not show immediate symptoms if they fail to control blood sugar, but over time they may develop serious complications that can result in limb amputation, kidney failure and death.
Frederickson, a lifelong type 1 diabetic who said she had good control of her blood sugar already, said the device improved her levels even more. "I am just thrilled with it," she said. "My A1c has improved. My glucose control was already fairly good but it had gone down half a point," she said.
The company said it is seeking U.S. Food and Drug Administration approval for use of the device in children but doctors are free to prescribe any approved device or drug as they see fit.
A new device that monitors blood sugar constantly and lets the patient administer insulin right away if needed might greatly simplify life for people with diabetes.
The Medtronic Inc. device combines an insulin pump and a continuous blood-monitoring system. An alarm sounds if blood sugar goes out of safe ranges.
Patients are clamoring to test and use the device, researchers for the company told participants here at the meeting of the American Diabetes Association.
The device, called the Minimed Paradigm Real Time Insulin Pump and Continuous Glucose Monitoring System, is approved for people older than 18 with insulin-dependent diabetes. People with type 1 diabetes, also known as juvenile diabetes, depend on insulin, as do some type 2 diabetics.
"It's a pretty exciting advance," said Dr. John Buse, vice president of the American Diabetes Association. "I am not sure that it's the best pump ever and the best monitoring device ever. It's not an artificial pancreas...but it's getting pretty close," Buse added in an interview.
Linda Frederickson, a nurse and diabetes educator who tested the device for Medtronic, said she was surprised at how much the device told her.
"I write books and used to write books about food and carbohydrate and I think I am pretty smart...but I found out more about foods using this sensor. You can tell what your favorite food...is going to do to you and when it will do it," she told a briefing for investors and analysts.
Dr. Bruce Buckingham, a Stanford University pediatric endocrinologist who tested this and other monitors, said parents were surprised to watch the monitor's effects on their children with type 1 diabetes.
"It really changed their habits and how they eat and how they deliver their insulin," Buckingham told the briefing.
BETTER CONTROL
Buckingham's study showed that, on average, the children in his study showed a 20 percent decrease in A1c, a commonly used measure of blood sugar.
"It was very easy to recruit for this study. Patients were just wanting to come in," Buckingham said.
"If you have a child with diabetes, 75 percent of seizures occur at night so they have a continuous monitor that alarms them when they are low. For the kids, it allows them to have the alarm and makes them feel more comfortable in trying to bring their blood sugar down."
Nearly 21 million Americans have diabetes and 3 million of them have type 1 diabetes.
Patients usually have to constantly prick their fingers during the day, test their blood sugar level, and then inject insulin or eat something to adjust their blood sugar level.
It requires constant vigilance and discipline. Patients do not show immediate symptoms if they fail to control blood sugar, but over time they may develop serious complications that can result in limb amputation, kidney failure and death.
Frederickson, a lifelong type 1 diabetic who said she had good control of her blood sugar already, said the device improved her levels even more. "I am just thrilled with it," she said. "My A1c has improved. My glucose control was already fairly good but it had gone down half a point," she said.
The company said it is seeking U.S. Food and Drug Administration approval for use of the device in children but doctors are free to prescribe any approved device or drug as they see fit.
Friday, June 09, 2006
DIABETES ARTICLES
DIABETES ARTICLES.
Americans need more help managing diabetes
U.S. patients and doctors alike show a surprising level of ignorance about diabetes and are not doing nearly enough to manage the condition, diabetes experts said on Wednesday.
A survey found that while patients believe they understand diabetes, they are not doing what they need to do to control it, and their doctors are unable to help much.
A team approach that would add nurses, diabetes educators and pharmacists to the mix might work better, they suggested.
"Diabetes prevalence has almost doubled since 1980 in America," Dr. Sethu Reddy of the Cleveland Clinic in Ohio and the American Association of Clinical Endocrinologists told a news conference.
Nearly 21 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention, with type 2 diabetes accounting for up to 95 percent of the cases. The CDC says another 41 million have pre-diabetes.
Type 2 diabetes develops as a result of diet, exercise and genetic components. Type 1, or juvenile diabetes, is an autoimmune disease in which the insulin-producing cells in the pancreas are destroyed by the body.
Type 2 diabetes can be prevented or managed with careful diet, regular exercise and in some cases with drugs.
Reddy and colleagues held a meeting they called the Diabetes Roundtable and agreed that for various reasons type 2 diabetes is not managed properly.
"We all agreed that the future of good diabetes care will not rely on a single doctor," he said. "Realistically, one doctor can't do everything for a patient."
Insurers, Medicare and other payers will often cover visits to a nurse or a diabetes educator, who can work more closely and personally with a patient, but patients need to know to ask for this care, and primary care doctors need to know to refer patients, Reddy said.
NOT CONNECTING THE DOTS
The endocrinologists' group and the American Association of Diabetes Educators commissioned a Harris poll of 780 patients and more than 400 primary care physicians.
The findings suggest a "disconnect" between what patients know and what they actually do, said Donna Rice of the educators' association.
For instance, 69 percent of the patients said they felt knowledgeable about managing their condition. But 81 percent of the doctors said they were frustrated with the number of their type 2 diabetes patients who did not follow their treatment regimens.
Half of the patients surveyed showed little or no understanding of their A1C level -- a measure of a protein that can indicate how well their blood sugar has been controlled for the past three months.
And 59 percent of patients admitted their diabetes was somewhat or not at all well-controlled.
"It's like knowledge doesn't equate to behavior change," said Rice, a registered nurse and wellness program manager at Botsford General Hospital in Novi, Michigan.
The doctors also showed they do not fully understand diabetes, according to the survey.
The majority of the primary care physicians surveyed -- 78 percent -- said insulin resistance is the most important contributor to progression of type 2 diabetes.
Yet the experts said the insulin-producing beta cells are progressively damaged in type 2 diabetes and that this process may be a more important factor than insulin resistance.
"This suggests that primary care physicians do not consistently focus on how beta cells in the pancreas work," Reddy said.
Diabetes is the sixth leading cause of death in the United States and patients have a high risk of heart disease, kidney disease, blindness and nerve damage.
Worldwide more than 194 million people have diabetes.
Americans need more help managing diabetes
U.S. patients and doctors alike show a surprising level of ignorance about diabetes and are not doing nearly enough to manage the condition, diabetes experts said on Wednesday.
A survey found that while patients believe they understand diabetes, they are not doing what they need to do to control it, and their doctors are unable to help much.
A team approach that would add nurses, diabetes educators and pharmacists to the mix might work better, they suggested.
"Diabetes prevalence has almost doubled since 1980 in America," Dr. Sethu Reddy of the Cleveland Clinic in Ohio and the American Association of Clinical Endocrinologists told a news conference.
Nearly 21 million people in the United States have diabetes, according to the U.S. Centers for Disease Control and Prevention, with type 2 diabetes accounting for up to 95 percent of the cases. The CDC says another 41 million have pre-diabetes.
Type 2 diabetes develops as a result of diet, exercise and genetic components. Type 1, or juvenile diabetes, is an autoimmune disease in which the insulin-producing cells in the pancreas are destroyed by the body.
Type 2 diabetes can be prevented or managed with careful diet, regular exercise and in some cases with drugs.
Reddy and colleagues held a meeting they called the Diabetes Roundtable and agreed that for various reasons type 2 diabetes is not managed properly.
"We all agreed that the future of good diabetes care will not rely on a single doctor," he said. "Realistically, one doctor can't do everything for a patient."
Insurers, Medicare and other payers will often cover visits to a nurse or a diabetes educator, who can work more closely and personally with a patient, but patients need to know to ask for this care, and primary care doctors need to know to refer patients, Reddy said.
NOT CONNECTING THE DOTS
The endocrinologists' group and the American Association of Diabetes Educators commissioned a Harris poll of 780 patients and more than 400 primary care physicians.
The findings suggest a "disconnect" between what patients know and what they actually do, said Donna Rice of the educators' association.
For instance, 69 percent of the patients said they felt knowledgeable about managing their condition. But 81 percent of the doctors said they were frustrated with the number of their type 2 diabetes patients who did not follow their treatment regimens.
Half of the patients surveyed showed little or no understanding of their A1C level -- a measure of a protein that can indicate how well their blood sugar has been controlled for the past three months.
And 59 percent of patients admitted their diabetes was somewhat or not at all well-controlled.
"It's like knowledge doesn't equate to behavior change," said Rice, a registered nurse and wellness program manager at Botsford General Hospital in Novi, Michigan.
The doctors also showed they do not fully understand diabetes, according to the survey.
The majority of the primary care physicians surveyed -- 78 percent -- said insulin resistance is the most important contributor to progression of type 2 diabetes.
Yet the experts said the insulin-producing beta cells are progressively damaged in type 2 diabetes and that this process may be a more important factor than insulin resistance.
"This suggests that primary care physicians do not consistently focus on how beta cells in the pancreas work," Reddy said.
Diabetes is the sixth leading cause of death in the United States and patients have a high risk of heart disease, kidney disease, blindness and nerve damage.
Worldwide more than 194 million people have diabetes.
Sunday, June 04, 2006
Recognizing Early Symptoms Diabetes
Diabetes Articles - Recognizing Early Symptoms Diabetes
Stay alert in recognizing early symptoms of diabetes. Certain symptoms put you on notice and you'll want to decrease the chance of developing into complications. You'll do yourself a lot of good with early treatment if necessary to maintain optimum health. If you don't have the early symptoms of diabetes looked your risking more than you need too.
Some of the early signs of the diabetic issue are frequent urination, blurry vision, irritability, extreme hunger, excessive thirst, unusual weight loss and increased fatigue. Sometime these show up together so be attentive and sensitive to your how you feel. Unfortunately over 20 + million people now have various forms of the disease. That's almost 25% or 1 out of 4 of our population. Of those one-third don't even know it.
If you are of member of Pacific Islanders, African American, Latino, Native American you'll be a little more cautious since diabetes is more common among these groups. Weight, age, hereditary issues, and lack of exercise are factors. Symptoms are similar in juveniles. Keeping alert about your child certainly is important along with the many other issues that already occupy your mind for their well being.
Type 1 generally is found in child and young adults with heart disease, blindness and kidney damage are of the biggest concerns. Type 2 is the most common where the body doesn't produce enough insulin so the body is able to use up the sugar intake. With the depletion of the food chain, fast foods with highly processed ingredients the problem will continue to grow. All ages are effected and it's scary to find out a person has it.
Although serious, people can certainly live long and happy lives. So spending some time today taking care of yourself is really a great investment. Firm up with some liquid quality vitamins and minerals to keep the immune system strong as possible for as long as possible. Get adequate rest, exercise at least some and try to cut down on the processed foods and turn to fruits and vegetables as well. By having some understanding of early symptoms diabetes you'll just that much better equipped to deal with the issues.
by Rolf Rasmusson at http://ezinearticles.com
Stay alert in recognizing early symptoms of diabetes. Certain symptoms put you on notice and you'll want to decrease the chance of developing into complications. You'll do yourself a lot of good with early treatment if necessary to maintain optimum health. If you don't have the early symptoms of diabetes looked your risking more than you need too.
Some of the early signs of the diabetic issue are frequent urination, blurry vision, irritability, extreme hunger, excessive thirst, unusual weight loss and increased fatigue. Sometime these show up together so be attentive and sensitive to your how you feel. Unfortunately over 20 + million people now have various forms of the disease. That's almost 25% or 1 out of 4 of our population. Of those one-third don't even know it.
If you are of member of Pacific Islanders, African American, Latino, Native American you'll be a little more cautious since diabetes is more common among these groups. Weight, age, hereditary issues, and lack of exercise are factors. Symptoms are similar in juveniles. Keeping alert about your child certainly is important along with the many other issues that already occupy your mind for their well being.
Type 1 generally is found in child and young adults with heart disease, blindness and kidney damage are of the biggest concerns. Type 2 is the most common where the body doesn't produce enough insulin so the body is able to use up the sugar intake. With the depletion of the food chain, fast foods with highly processed ingredients the problem will continue to grow. All ages are effected and it's scary to find out a person has it.
Although serious, people can certainly live long and happy lives. So spending some time today taking care of yourself is really a great investment. Firm up with some liquid quality vitamins and minerals to keep the immune system strong as possible for as long as possible. Get adequate rest, exercise at least some and try to cut down on the processed foods and turn to fruits and vegetables as well. By having some understanding of early symptoms diabetes you'll just that much better equipped to deal with the issues.
by Rolf Rasmusson at http://ezinearticles.com
