Healing and Hope

A Newsletter of the Diabetes Institutes Foundation

October 2006

Greetings from the Foundation

Dear Readers,

Fall is definitely here with all its activities: fall festivals, football and health fairs. this is also the season when the United Way and state and federal campaigns gear up and ask you to support local charities. If you are planning to give, please consider making the Diabetes Institutes Foundation your charity of choice. As you can see from this newsletter, exciting things are happening here where diabetes research, education and patient care happen all under one roof!

In this issue, read about the Research Institutes collaborative studies on neuropathy, along with the growing use of the Education Institutes groundbreaking Quality of Life Index, now being used around the world. On the Clinical side, learn how inhaled insulin and continuous glucose monitoring are making a real difference in the management of diabetes.

As always, we appreciate your support and look forward to hearing your comments.

Hope you are enjoying the cooler temperatures and outdoor activities.

Best,
Michelle B. Charters
Executive Director

FOUNDATION NEWS

A Wealth of Health Fairs

On Sept. 28th, the Foundation participated in the Norfolk Community Services Board's Substance Abuse Services Second Annual Provider and Wellness Fair, which was held at the Norfolk Workforce office at Ward's Corner. On Saturday, Sept. 30th, we were out once again, conducting blood sugar screenings at the Norfolk Botanical Gardens, as part of the Norfolk YMCA Activate America Family Walk. Both events were well coordinated and attended, and our efforts were much appreciated.

Coming up - our second year participating in Ferguson's Women's Wellness Day at Ferguson Enterprises in Newport News on October 18th.

Send a Tribute

The Diabetes Institutes Foundation Tribute program is an easy way to honor the special people in your life. Send us a donation and we’ll mail out a card to the honored person or their family, then send you an acknowledgment of your gift. Your donation is tax- deductible while helping to fund research, education and patient care at the Strelitz Diabetes Institutes. Call 757-446-8420 or visit www.dif.org.

Don’t Forget DIF When Giving!

In this season of annual giving, please remember the Diabetes Institutes Foundation in this year’s United Way and Community Health Charities Campaigns when choosing a contribution designation. Support the fight against diabetes in at the Strelitz Diabetes Institutes of Eastern Virginia Medical School.

For United Way of South Hampton Roads write in:

For United Way of South Hampton Roads write in:
Diabetes Institutes Foundation
Norfolk, VA

For United Way of the Virginia Peninsula

The Diabetes Institutes Foundation will be located in the Peninsula brochure under Community Health Charities.

For Community Health Charities Combined Charities Campaign:
(CCC) #6065

Combined Federal Campaign
(CFC) # 6065

Combined Virginia Campaign
(CVC) #6065

MEDICAL NEWS

Institutes Updates

The Institutes continues its important research into the prevention of the falls, fractures and mortality associated with neuropathy. In conjunction with the National Institute on Aging, SDI has been conducting multi-center studies at universities in Pittsburgh, Memphis and San Francisco which investigate the role of vascular disease in relation to neuropathy and the predisposition to falls, as well as Health, Aging and Body Composition (Health ABC). Another collaboration, with the American Diabetes Association and the YMCA, studies the effects of strength and balance training in people with diabetes.

The FDA now requires that all new drugs submitted for review for use in clinical trials be accompanied by a quality of life survey. The Norfolk Quality of Life tool, developed by the Education Institute and copyrighted in 1997, has now been translated into seven languages. This patient questionnaire is an important evaluator for diabetic neuropathy.

Lastly, the SDI is involved in a joint program with the University of Virginia to determine if there is an enhanced rate of effectiveness in animals using both INGAP and an anti-inflammatory agent.

Kinexum is speaking with the governments of Canada, Ecuador, Brazil and Argentina in the hopes of furthering INGAP clinical trials in those countries until enough money can be raised to continue them in the U.S. The SDI will be overseeing the International Diabetes Federation's Neuropathy Symposium in Cape Town, South Africa at the end of this year.

New Products For Diabetes Management at SDI

NOTE: THIS ARTICLE'S PURPOSE IS PURELY TO DISSEMINATE INFORMATION - THE INSTITUTES DO NOT PROMOTE SPECIFIC BRANDS.

Normalizing one’s blood sugar is usually done through finger stick testing with a self monitored glucose meter, a process which, pardon the pun, has its ups and downs. One disadvantage is that it sometimes isn’t convenient or comfortable, and the results only provide a snapshot of a person’s blood sugar, which may not provide enough data to make the most appropriate treatment decisions.

New technologies continue to make the monitoring process easier and more accurate. Although continuous glucose monitoring (CGM) systems have been around for several years, a new one manufactured by DexCom® records glucose levels throughout the day and night, which produces a trend in numbers that are visible to the patient (older systems recorded levels, but necessitated a trip to the doctor to get the reading). The device works via a sensor inserted under the skin that transmits glucose values to a cellphone-sized device worn outside the body.

For insulin pump users, the MiniMed Paradigm® Real-Time insulin pump and CGM system is a similar option. The benefits are clear – real time readings help users take action sooner, and identifying glucose level trends that show the effect of diet, exercise, medication and stress on levels are an invaluable tool for managing your diabetes.

Other good news is that the first FDA-approved inhaled version of insulin, Pfizer Inc.’s new Exubera® is now available. This product, a short-acting powder form of insulin inhaled at mealtimes, may be used by any person with diabetes over the age 18; although realistically, it’s only appropriate for Type 1’s who are on larger doses of insulin, (i.e., 60 or more units per day), or Type 2’s who can tolerate larger doses of insulin.

It is not approved for smokers or anyone with lung disorders, because almost twice as much of the inhaled insulin can enter the bloodstream and increase the possibility of an overdose - insulin via the lungs transports across a surface area the size of a singles tennis court. Exubera does not get rid of shots - a long-acting insulin still needs to be injected each day. The inhaler weighs around 4 ounces and is about the size of an eyeglass case when closed. Side effects include coughing, shortness of breath, sore throat and dry mouth.

Call the Institutes at 757-446-5908 to see if you are eligible for any of these new treatments.

NUTRITION TOPICS

The 1700 Rule for Determining Your Correction Factor

Phyllis Woodson, MS, RD, CDE, Clinical Dietitian

* Determine how much TOTAL insulin you take in an average day. Count long-acting as well as short-acting insulin (NPH, Ultra Lente , Lantus , Regular, Novolog , Humalog , etc.). For example, if you usually take 22 u Lantus + 7 u Novolog at the am meal + 5 u Novolog at the pm meal, the total insulin used in the average day is 34 units (22 + 7 + 5 = 34 ).

* Divide 1700 by the total amount of insulin, eg : 1700/34 = 50. This means that one unit of short- acting insulin ( Novolog ) will reduce your blood glucose by 50 points; 50 is your Correction or Sensitivity Factor.

* If your blood glucose before a meal is 240 and your goal is 150, the difference is 240 less 150 = 90 and 90 divided by your Correction Factoris 90/50 =~2. You will need 2 u Novolog insulin to reduce your elevated blood glucose from 240 to 150. You would give this extra insulin to reduce the elevated blood glucose at the time you give insulin for the carbohydrate you plan to eat at a meal.

* Remember, your long acting insulin (NPH, Ultra Lente , Lantus , etc.) is generally not affected by the above procedure for reducing an elevated blood glucose or determining how much insulin you need for the carbohydrate you plan to eat at a meal.