Pharmacy Times

DIABETES WATCH



Thermometers May Save Limbs

A special thermometer that measures the soles of diabetics' feet may help prevent foot ulcers, which can lead to amputations if not caught early.

A study of 225 veterans with diabetes found that using the thermometer reduced, by nearly two thirds, the number of high-risk patients who developed foot ulcers. The study is the third in a series of government-funded research. With the thermometer, patients measure a certain number of spots on each foot. Once the thermometer signals a hot spot, patients get off their feet for about a day or until the temperature normalizes. Taking pressure off prior to the skin cracking allows the body to heal more easily, compared with a full wound.


Can Obesity Surgery Cure Diabetes?

Weight-loss surgery was more effective as a treatment for type 2 diabetes, according to a new study of 60 patients.

The study found that 73% of patients who had adjustable gastric banding surgery had total remission of their diabetes, compared with 13% of those given conventional treatment.

Researchers noted that the results do not apply to all patients with type 2 diabetes. The participants had fairly mild cases and received the diagnosis within the previous 2 years. For patients with more severe and more years with diabetes, the disease may not be reversible. The findings were reported in the January 23, 2008, issue of the Journal of the American Medical Association.


Diabetes Costs Skyrocket

The uncontrolled diabetes epidemic is taking a heavy financial toll?$174 billion a year, according to the January 23, 2008, study released by the American Diabetes Association (ADA). The price tag is as much as the wars in Iraq, Afghanistan, and the global war on terrorism combined. It costs $24 billion more than the damages caused by Hurricane Katrina.

The financial burden also falls on individuals without the disease through rising health insurance premiums and copays, stated Paul Fronstin of the Employee Benefit Research Institute, who was not involved with the report. The study showed that about half of the patients with diabetes have medical insurance through government programs. Routine care for patients with diabetes cost relatively little. The real cost comes from uncontrolled diabetes, said Ann Albright, PhD, RD, president of health care and education at the ADA, which funded the study.

Dr. Albright anticipates the number of patients diagnosed with diabetes to rise, taking into account that many Americans have prediabetes, with trouble handling insulin and sugar. For more information on the report, visit www.diabetes.org.


Diabetes Linked to Blood Vessel Inflammation

A study, reported in the November 20, 2007, online issue of the Journal of Clinical Endocrinology & Metabolism, found a new pathway that increases a dangerous inflammation of blood vessels in patients with diabetes. The researchers believe that good control of the disease may reduce this inflammation and possibly lower the risk of heart disease.

The investigators found that patients with type 1 diabetes have increased expression and signaling of 2 main receptors within the innate immune system. These Toll-like receptors, known as TLR2 and TLR4, are part of a family of pattern-recognition receptors. The investigators concluded that an increased expression of TLR2 and TLR4 in patients with type 1 diabetes adds to blood-vessel inflammation.


Sleep Disruption Ups Diabetes Risk

Interrupting sleep damages the body's ability to regulate blood-sugar levels and increases the odds of type 2 diabetes, especially in young adults. The current study, reported in the December 31, 2007, issue of the Proceedings of the National Academy of Sciences, provides the first evidence linking poor sleep quality to an increased diabetes risk. Nine lean, healthy individuals (between the ages of 20 and 31) were observed for 2 nights of uninterrupted sleep to establish their normal sleep patterns, then for a 3-night study period, during which the researchers purposely disturbed their sleep when their brain waves showed the beginning of slow-wave sleep.

At the study's conclusion, the researchers administered intravenous glucose to each participant and took blood samples every few minutes to measure the levels of glucose and insulin. They found that the participants were 25% less sensitive to insulin following nights of interrupted sleep.

F A S T   F A C T : Foot ulcers strike 600,000 patients with diabetes in the United States each year.