Readers:
I made a mistake. Last week I said that I was headed to
my doctor’s office for an A1C blood test to check me out
and make sure everything is hunky dory. Actually the test
is today. I got my appointments mixed up and now I will be
getting that taken care of that a few hours from now.
Wish me luck and I’ll give you the details to this lastest
doctor visit soon.
Regards,
Steve
Diabetic Update Newsletter
www.steve@gophercentral.com/comments
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Impaired Ankle Function Seen in Diabetics: Study
NEW YORK (Reuters Health) – People with long-standing
diabetes are prone to impaired ankle function, even
in the absence of diabetes-related nerve damage, or
“peripheral neuropathy,” new research indicates.
Diabetic peripheral neuropathy — a progressive
deterioration of nerve function in the extremities linked
to diabetes — can trigger chronic pain, numbness, weakness,
and tingling sensations in the feet.
Prior research has suggested that this type of nerve
damage is needed for altered foot-ankle biomechanics in
diabetics, but definitive conclusions could not be reached
for a variety of reasons, Dr. Claudia Giacomozzi, from
Istituto Superiore di Sanita in Rome, and colleagues note
in the journal BMC Musculoskeletal Disorders.
Giacomozzi’s team evaluated muscle performance and ankle
mobility in 46 diabetics with and without nerve damage
and in 21 control subjects under controlled conditions.
Compared to controls, ankle mobility and flexing ability
was impaired in all of the diabetic patients, regardless
of the presence or absence of nerve damage, they report.
Further studies, Giacomozzi and colleagues say, are needed
to better understand the mechanisms responsible for the
altered foot-ankle biomechanics in diabetics.
The current findings, they add, may help in the design of
programs aimed at preventing foot and ankle problems in
people with long-standing diabetes.
SOURCE: BMC Musculoskeletal Disorders, online July 4, 2008.
Copyright 2006 Reuters Limited. All rights reserved.
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Benefits of Weight Loss Maintained in Diabetes
NEW YORK (Reuters Health) – The therapeutic benefits
achieved by loosing weight soon after type 2 diabetes
is diagnosed are sustained, even if patients eventually
regain the weight, according to the results of research
conducted at Kaiser Permanente Northwest in Portland,
Oregon.
“The main significance is that on average, patients who
lose weight following diagnosis have better glycemic and
blood pressure control than patients who don’t, even if
they subsequently regain the lost weight,” study co-author
Dr. Gregory A. Nichols told Reuters Health. “This is
encouraging, because people who lose weight often have
trouble keeping the weight off. We’re saying that’s OK,
it’s still worthwhile to lose it.”
Although losing weight is decidedly beneficial in patients
with diabetes, previous research that examined the effects
of weight loss did not separate intentional from un-
intentional weight loss due to disease or examine patterns
of weight change over time.
Nichols and colleagues evaluated these factors in a group
of newly diagnosed type 2 diabetes patients, and excluded
from the study those with severe illness or conditions
associated with unintentional weight loss. The final study
group included 2,574 patients who were weighed at the
beginning of the study and at least five more times over
the next 3 years.
Four groups were defined based on weight pattern: weight
gain, weight loss, higher stable weight, and lower stable
weight.
The “weight-loss” group, which consisted of 314 patients
(12.2 percent), began at an average weight of 241 and
reduced to 213 lb. (9.8 percent loss). After about 18
months, the subjects returned to their original weight,
the authors report in an early online issue of Diabetes
Care.
By contrast, the 300 subjects in the “weight-gain” group
gained 6.4 percent during the first 18 months, followed
by weight loss. “Notably,” the investigators write, “the
weight-gain and weight-loss groups began and ended at
similar (average) weights.”
The “higher stable weight” group, of 418 subjects and the
“lower stable weight” group, of 1,542 averaged 284 lb.
and 196 lb, respectively, at study entry.
At year 4, significantly fewer subjects in the weight-loss
group had higher than normal blood glucose levels (measured
by hemoglobin A1c levels) compared with those in the weight-
gain, higher-stable-weight, and lower-stable-weight groups.
Corresponding average HbA1c values at year 4 were about the
same.
After consideration of the effects of age, gender, initial
HbA1c level and diabetes medication use, at year 4, the odd
of having high HbA1c levels were increased for subjects
without initial weight loss compared with the weight-loss
group.
Patients in the weight-loss group were also significantly
more likely to have normal blood pressures (below 130/80 mm
Hg) compared with the higher-stable-weight and the weight-
gain group.
To explain these findings, Nichols suggested that “there
is a lag between when the weight was regained and when the
adverse effects of weight gain manifested.”
“But it could also be that the weight loss benefits are
indeed long-lasting,” the researcher added. “We’ve seen
this in other clinical trials where an intensively treated
group had long-term benefits well after the intervention
was stopped. Some have called this ‘metabolic memory.’”
In future research, he and his colleagues plan to compare
the outcomes of diabetic patients who maintain weight loss
or continue to lose weight, and those who lose and then
regain weight. SOURCE: Diabetes Care, August 12, 2008
early online.
Copyright 2006 Reuters Limited. All rights reserved.
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Diabetic Recipe
Late Summer Fruit Pie
(makes 8 servings)
1 unbaked pie shell (recipe here)
1/2 cup (95g) one-to-one sugar substitute or the equivalent
in packet substitute
3 scant tablespoons (45 g) instant tapioca
1/8 teaspoon (0.6 ml) salt (optional)
1/4 teaspoon (1.25 ml) ground cinnamon
4 cups (580 g) mixed summer fruit
juice of 1 lemon
topping:
2 tablespoons (10ml) one-to-one sugar substitute
1 teaspoon (5 ml) ground cinnamon
1/4 teaspoon (1.25ml) ground nutmeg
3 tablespoons (45 g) flour
2 tablespoons (30 g) rolled oats
2 tablespoons (30 g) margarine
1. Preheat oven to 425°F (220°C), Gas Mark 7.
2. Line a 9-inch (23 cm) pie pan with pastry dough.
3. Mix together the sugar substitute, tapioca, salt (if
using), and cinnamon. Gently coat the fruit with the
dry ingredients. Add the lemon juice and stir. Pour
into the unbaked pie shell.
4. In a small bowl, combine the topping ingredients. Mix
with your fingers until crumbly. Top the pie with the
mixture covering all of the fruit.
5. Bake about 35 minutes until bubbly, the crust is
browned and the fruit is just done. Serve warm or cold.
Per serving: 223 calories (32% calories from fat),
3 g protein, 9 g total fat (1.5 g saturated
fat), 39 g carbohydrates, 3 g dietary fiber,
0 cholesterol, 103 mg sodium
Diabetic exchanges: 2 1/2 carbohydrate (1 1/2 bread/starch,
1 fruit), 1 1/2 fat
Copyright 1997-2001 Diabetic-Lifestyle.
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