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Publication: Diabetes Update
That's The Way

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Diabetic Digest - Wednesday, May 21, 2008
News, updates and help from and for the diabetic community.


My anniversary is very close. On the 25th of May I will 
have lived with diabetes for the past eighteen years. It 
is never easy to deal with an illness. I know I'm not 
perfect, but I think that I have done a pretty good job. 

Diabetes is different for everyone. It can be a real pain 
to manage it or it can be a blessing in disguise. Use 
diabetes as a sign to improve your health and your life. 
That's the way I look at it.  


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 Diabetics' Blood Pressure Often Inadequately Controlled

NEW YORK (Reuters Health) - Uncertainty about a patient's
"true" blood pressure (BP) is the chief reason why doctors
fail to intensify BP-lowering treatment when a diabetic
patient has high BP (hypertension), investigators report.

"Several studies have suggested that 'clinical inertia' --
the failure by providers to initiate or intensify therapy
in the face of apparent need to do so -- is a main
contributor to poor control of hypertension," Dr. Eve A.
Kerr and colleagues explain in a report in the Annals of
Internal Medicine.

To identify factors that underlie "clinical inertia," Kerr
at the Veterans Affairs Ann Arbor Healthcare System in
Michigan and her team studied 1,169 diabetic patients with
hypertension seen by 92 primary care doctors at 9 VA

Before the study, all the patients were found to have high
BP (140/90 mm Hg). Normal BP is anything below 120/80 mm/Hg.

However, despite substantially elevated BP, medication was
intensified or close follow-up was scheduled for just 49
percent of the patients.

"Clinical uncertainty" about the true BP value was a
prominent reason that providers did not intensify therapy,
the investigators found. Specifically, they were less
likely to adjust medication if they themselves recorded a
BP measurement of less than 140/90 versus a higher reading
during the visit, or when patients reported that their BP
readings at home were less than 140/90 rather than higher.

"Unfortunately," primary care doctors are not consistent
in their approach to gauging "real" BP, and are "possibly
placing undue faith in their own repeated measurements or
home blood pressure values," the investigators write.

"This ambiguous approach ... may be a major obstacle to
optimizing management of hypertension and improving
outcomes for high-risk populations," they conclude.

SOURCE: Annals of Internal Medicine, May 20, 2008.

Copyright 2006 Reuters Limited. All rights reserved.

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   Scientists Find Something Good About a Big Bottom

CHICAGO (Reuters) - A type of fat that accumulates around 
the hips and bottom may actually offer some protection 
against diabetes, U.S. researchers said on Tuesday. 

They said subcutaneous fat, or fat that collects under 
the skin, helped to improve sensitivity to the hormone 
insulin, which regulates blood sugar. 

Mice that got transplants of this type of fat deep into 
their abdomens lost weight and their fat cells shrank, 
even though they made no changes in their diet or 
activity levels. 

"It was a surprising result," said Dr. Ronald Kahn of 
Harvard Medical School in Boston, whose study appears 
in the journal Cell Metabolism. 

"We actually found it had a beneficial effect, and it was 
especially true when you put it inside the abdomen," Kahn 
said in a telephone interview. 

Kahn said he started the study to find out why fat located 
in different parts of the body seems to have different 
risks of metabolic disease such as diabetes. 

Researchers have known for some time that fat that collects 
in the abdomen -- known as visceral fat -- can raise a 
person's risk of diabetes and heart disease, while people 
with pear-shaped bodies, with fat deposits in the buttocks 
and hips, are less prone to these disorders. 

Now it turns out that subcutaneous fat -- fat found just 
under the skin -- may be actively protecting people from 
metabolic disease. 

Kahn and colleagues conducted a series of experiments on 
mice where they transplanted subcutaneous fat from donor 
mice into the bellies and under the skin of mice. 

Mice that got subcutaneous fat transplanted into their 
bellies started to slim down after several weeks, and 
they also showed improved blood sugar and insulin levels 
compared to mice that underwent a sham procedure. 

"What we found was that when we put it in either place, 
there was some improvement in metabolism," Kahn said. 

"I think it's an important result because not only does 
it say that not all fat is bad, but I think it points 
to a special aspect of fat where we need to do more 
research," he said. 

Kahn's team is working to find the substances produced 
in subcutaneous fat that provide the benefit with the 
hope of developing a drug that might copy this effect. 
Although fat is known to produce several hormones, Kahn 
said none of the known hormones appeared to be involved 
in this process. 

"If we can capture those (substances), we might have an 
opportunity to convert them into drugs or use them as 
guides to help develop drugs," he said. 

Copyright 2006 Reuters Limited. All rights reserved.

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                     Diabetic Recipe

          Grilled Vegetable and Pesto Sandwiches

                   (makes 4 servings)

olive oil cooking spray

1 red bell pepper, 8 ounces (240 g) quartered

1 yellow bell pepper, 8 ounces (240 g) quartered

1 1/2-pound eggplant (684 g) sliced diagonally 1/4 inch 
(0.6 cm) thick

pesto (see recipe below)
4 whole wheat rolls, 1 ounce each (30 g)

4 ounces (120 g) sliced low fat mozzarella cheese

8 basil leaves

1. Coat the vegetables with cooking spray and grill until 
   cooked through. Cut the peppers into strips

2. Prepare the pesto.

3. Lightly coat the rolls with cooking spray and grill 
   until just browned.

4. Spread 1 teaspoon (5 ml) pesto on each roll. Top with 
   slice of cheese and then the vegetables. Divide the 
   basil leaves between the sandwiches and heat on the 
   grill until the cheese begins to melt. Serve immediately.

Per serving: 205 calories (18% calories from fat), 
             8 g protein, 4 g total fat (1.6 g saturated 
             fat), 36 g carbohydrates, 9 g dietary fiber, 
             10 mg cholesterol, 309 mg sodium 

Diabetic exchanges: 2 1/2 carbohydrate (1 bread/starch, 
                    1/2 skim milk, 3 vegetable), 1/2 fat 

Copyright 1997-2001 Diabetic-Lifestyle. 


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