If you have type 2 diabetes, chances are very good that you can beat your diabetes and live a healthy and productive life. There more than one aspect to controlling any chronic disease and diabetes is no exception. If there is one word that gives you the key to beat diabetes that word is CHANGE.

Making changes in your attitude…the way you approach your diabetes and making change in your lifestyle will allow you to win your war with diabetes. If you’ve done much searching on the Internet you know there are tons of sites promoting quick cures and lots of pill and potions to get rid of your diabetes. Understand now that there are no magic cures. Don’t misunderstand, there are alternative therapies that do help control blood sugar… but they are not the cure.

Real results in diabetes control come from setting your attitude to a “I can do it!” mindset and then taking the appropriate actions to reach your goal of controlling your diabetes and having more normal blood sugars. Once you’re ready mentally to do what it takes to get good control, the next step is to identify your plan of action.

Almost every diabetic must make permanent lifestyle changes in order to beat diabetes. These lifestyle changes must come in the areas of eating a healthy diet, getting regular exercise, and consistently monitoring and evaluating blood sugars. For most these are major changes and won’t be accomplished all at once. The journey of good diabetes control is day by day. That’s what it takes to achieve the results you’re after. You must take the steps each day to ensure a healthy future without the horrible complications diabetes can cause. Don’t let this over whelm you.

You are not alone. Use every resource you have to learn all you can about controlling your diabetes. Your primary care physician should be at the head of your healthcare team. Your physician can refer you to others who can help you learn about your diabetes, your diet, your medications, and all the other aspects of diabetes life. Use these resources as much as possible. Don’t be afraid to ask questions and learn all you can about your condition.

Remember, you can beat diabetes. Commit today to take the actions for a healthier tomorrow.

A high-mix biphasic insulin aspart (BIAsp) insulin three-times-daily regimen achieves lower blood glucose levels during the day for Type 2 diabetics than a twice-daily premix human insulin regimen, researchers report.

Meal-related glucose excursions can be a problem with both twice-daily injections of premixed (biphasic) human insulin and premixed insulin analogues.

To investigate approaches to improving postmeal blood glucose that do not involve moving to a four injection (mealtime plus basal) regimen, Umesh Dashora and colleagues (Newcastle University, Newcastle, UK) compared BIAsp three times a day (using 70/30 rapid acting: protamine complexed, high-mix) with biphasic human insulin (30/70) twice daily in adults with Type 2 diabetes already treated with insulin.

In the 60-day crossover study, BIAsp three times daily was administered as BIAsp 70/30 before breakfast and lunch, and BIAsp 30 before dinner to ensure sufficient basal insulin overnight. The human premix insulin was given before breakfast and dinner.

The total daily insulin dose of the BIAsp regimen was 110% of the human premix regimen and the doses were not changed during the study.

Blood glucose levels and insulin doses were reviewed every 15 days. In between, participants performed daily self-monitoring of blood glucose before meals. A 24-hour in-patient plasma glucose assessment was performed at the end of each 30-day treatment period.

The results, reported in the journal Diabetes, Obesity and Metabolism, show that the average 24-hour plasma glucose did not differ statistically between BIAsp and human premix regimens (7.3 mmol/l vs 7.7 mmol/l, respectively), but daytime average glucose concentration was 0.9 mmol/l lower with BIAsp (8.3 mmol/l vs 9.2 mmol/l, respectively).

BIAsp was also associated with lower mealtime serum glucose excursions than human premix and significantly less glucose excursions above 7.0 mmol/l.

The authors suggest that these observations might be clinically relevant, particularly as they relate to a reduction in the peaks of glucose after meals, which are the highest and most harmful glucose levels of the day.

The proportion of participants experiencing confirmed hypoglycemic episodes was similar between regimens (42% vs 43%), but the authors note that the study lacks power to provide reliable estimates of hypoglycemia.

“This study suggests that a thrice-daily analogue-based BIAsp regimen using high ratio free: protamine-complexed insulin with about 10% daytime insulin dose increase can trim postlunch glucose excursions when compared with a conventional human premix regimen,” conclude the authors.

“However, the utility of and safety of the regimen would need longer study to define which groups of people with Type 2 diabetes might benefit,” they add.

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a part of Springer Science+Business Media. © Current Medicine Group Ltd; 2009

Free abstract

Just as some people like to believe their current circumstances were preordained in a previous life, or in an alternate reality, scientifically-minded folks may feel certain that their genetic makeup is responsible for their struggles with weight control and diabetes. No doubt our genetics have a dramatic influence on our physical and psychological makeup, but genes are not simple, immutable masters of our realm. Genes respond to their environment, and a gene can be expressed differently at different times throughout an individual’s life.

A critical function of our genes is the issuing of instructions to make important proteins. The genetic instructions change according to the presence of epigenetic marks - chemicals that can be attached to a gene and thus change the rate that it produces a particular protein, or even stop its production altogether. Understanding proteins and their production is a huge and barely tapped area of investigation; how genes influence protein production may offer important clues in understanding, and perhaps even preventing, disease.

Juleen Zierath and her research team at the Karolinska Institute in Sweden are trying to discover how people develop insulin resistance (a precursor to type 2 diabetes). Epigenetic marks seem to play an important role, and their research, published in Cell Metabolism, indicates that these chemical markers are affected by the dietary substances they are subjected to.

In type 1 diabetes, an individual fails to produce sufficient quantities of insulin to control sugar levels in the blood. This is usually because of the failure of the pancreatic cells that should make it. In the case of insulin resistance or type 2 diabetes, however, insulin is being produced but the body has begun to ignore it. As a result, the insulin is ineffective at moving sugar out of the blood.

Dr. Zeirath’s group used muscle biopsies from a small group of type 2 diabetics plus individuals with early signs of insulin resistance, and compared them to biopsies from healthy participants. It turned out that hundreds of genes differed in ways that matched the different types of patients being examined. For this study, they narrowed their research down to one gene (PGC-alpha) that is involved with the development of the mitochondria - the power plants of a cell.

The researchers found extra epigenetic marks on the genes of diabetics and pre-diabetics, which resulted in the production of fewer and smaller mitochondria than normal. Since a poor diet and lack of exercise is strongly associated with insulin resistance, the researchers tested the idea that these circumstances could be causing the extra epigenetic marks on the genes. In their lab, they exposed cells to a bath of glucose, fat and cytokines (proteins that cause inflammation - found at high levels in the obese). It turned out that both fats and cytokines caused the appearance of more epigenetic marks in the PCG-alpha genes. In other words, our diet and lifestyle can actually damage our genes.

Dr. Zierath also tested an inhibiting chemical that was able to prevent the genetic changes. Sadly, perhaps, this could lead to the development of another drug to treat what is foremost a lifestyle disease. So many of us are, after all, ever hopeful for a pill that will undo the abuse we inflict upon bodies through our lifestyle choices. Unfortunately, the quick fix is never as good as preventing the damage in the first place. Here we have more evidence to dump upon the existing pile that our bodies, and many of our diseases, are deeply affected according to the care we give them. As Dr. Zierath concludes, “we are not victims of our genes. If anything, our genes are victims of us.”