New Study Finds Changes in Position of Conventional Insulin Pumps Can Cause Fluctuations in Insulin Delivery Rates

BETHESDA, Md., Nov. 14 /PRNewswire/ -- A new study presented today at the Annual Meeting of the Diabetes Technology Society showed that changes in the position of a conventional insulin pump, relative to its infusion set, can significantly impact expected insulin delivery rates. Such changes may occur during routine daily activities such as getting dressed, sleeping or showering. This siphon effect has been reported previously in hospital IV pumps, but this is the first time it has been investigated in continuous subcutaneous insulin infusion pumps. "Insulin pump therapy allows for precise control of insulin delivery for patients with type 1 diabetes. However, in this study, we saw that a conventional pump's insulin delivery rate can fluctuate significantly due to changes in the pump's height relative to its infusion set and the end of the tubing. This can increase blood glucose variability, which previous research has shown to be a risk factor for the progression of complications of diabetes," said lead investigator Howard Zisser, MD, Director of Clinical Research and Diabetes Technology at the Sansum Diabetes Research Institute in Santa Barbara, CA.
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Should You Refrigerate Your Insulin?

The vials of insulin you’ll use immediately don’t need to be refrigerated, says the American Diabetes Association. Modern insulin is stable for at least one month at room temperature. In fact, you probably don’t need to carry an insulin cooler – your pocket or purse will work just fine. Just don’t leave it in a car, which can quickly become very hot or very cold, or near any heat source or light.
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Novo Nordisk Launches Levemir(R) Satisfaction Guarantee Program

Patients with type 2 diabetes face many challenges, including blood sugar monitoring, maintaining a healthy diet and transitioning to new therapies. Novo Nordisk (NYSE: NVO), the world's largest maker of insulin, is committed to helping new patients make the move to insulin. As part of that commitment, the company is announcing its Levemir® Satisfaction Guarantee for U.S. patients taking Levemir® (insulin detemir [rDNA origin] injection) to treat type 2 diabetes. First-time insulin users have the opportunity to ask their doctors about starting on Levemir® (a basal insulin analog used to control hyperglycemia) and use it for up to three months. Patients who are satisfied with Levemir® can mail in their reply card and receive a free pedometer to encourage healthy exercise habits. Patients who are not satisfied can return their reply card, along with their out-of-pocket receipts. After verification, these patients will receive a full refund of their out-of-pocket expenses and a free pedometer.
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Insulin Doses Different For Everyone

Many people are perplexed by the wide-ranging dosages given to insulin-injecting diabetics. You may be asking, “What is the normal dose of insulin?” Actually, there is no normal dose of insulin, according to the American Diabetes Association. Some bodies are very resistant to insulin and require higher doses. Your own insulin requirement fluctuates depending on your health, physical activity and eating habits. To evaluate your insulin dose, first estimate the amount of insulin you would need if you didn’t have diabetes. Divide your body weight in pounds by 4. For example, if you weigh 200 pounds, your estimated need would be about 50 units. Now, add up all your insulin doses to calculate your total daily dose. Someone without diabetes makes about 40 units of insulin a day. A dose that is much higher than 50 units indicates that your body is resistant to insulin and requires more than the usual amounts of insulin. A dose that is far lower than 50 units suggests that your body is responsive to insulin, and your own pancreas is still making and releasing insulin. Before you modify your insulin dose, always consult your doctor.
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Beneficial effects of insulin in new onset type 2 diabetes with severe hyperglycemia

Insulin therapy in patients with newly diagnosed type 2 diabetes may have benefits beyond improved glycemic control. Several studies have suggested that early insulin therapy may improve beta-cell function. Many of us have observed this in clinical practice. In the October 2008 issue of Diabetes Care, Chen et al reported the results of a study comparing the effects of insulin to oral antidiabetic agents on new onset type 2 diabetes with severe hyperglycemia (fasting plasma glucose ≥300 mg/dL or random plasma glucose ≥400 mg/dL). The individuals were treated as inpatients with intensive insulin therapy for 10 to 14 days. After hospitalization, 50 patients were randomly assigned to either twice a day neutral protamine hagedorn insulin or oral antidiabetic drugs (metformin or sulfonylurea). An oral glucose tolerance test was obtained immediately after hospitalization and at six months. Long term glycemic control, beta-cell function and insulin sensitivity were also evaluated. The dose of insulin decreased over the course of the study whereas the dose of oral agents increased. At the end of the six months, the HbA1C was significantly lower in the insulin group than in the oral medication group: 6.78% vs. 7.84% (P=.009). Beta-cell function as measured by oral glucose tolerance testing was improved in both groups but significantly improved in the insulin-treated group compared to the oral medication group. There was no significant difference in the rate of hypoglycemia between groups. These results are consistent with what I have witnessed in my own practice. I am curious about what the effects of newer antidiabetic medications or a more intensive insulin regimen might have been.
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Smartinsulin Insulin That Knows When It's Needed!

SmartInsulin is the idea of Dr Todd Zion, the CEO of SmartCells, Inc., a biotechnology company based in the USA. The concept is simple - deliver insulin in such a way that it is only released into the blood stream when it is needed. The new approach involves using a plant-derived protein that can bind and release insulin in response to glucose levels. The theory is that SmartInsulin could be formulated so that people with type 1 diabetes would only need to inject the drug once each day, as opposed to the multiple daily injections they need currently. Once injected, the molecules would 'stick together', only releasing insulin when blood sugar levels rise above a certain threshold, and stopping when these levels fall again. In this way it, should be possible for people with type 1 diabetes to have much tighter control of their blood sugar levels, reducing the risk of diabetic complications, which include heart disease, kidney disease and eye disease.
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Health Tip: Living With an Insulin Pump

HealthDay News) -- An insulin pump offers many benefits for diabetics, including better blood glucose control and greater convenience. The American Diabetes Association offers these suggestions while getting used to your pump: Take your insulin at the same time each day. Carry an extra insulin pen or additional insulin with you when traveling. Talk to a dietitian about how to adjust your diet when you start using the pump. When you turn off your pump, devise a way to remind yourself to turn it back on. Regularly record and review all of your information, including blood glucose levels, carbohydrates, corrective doses and exercise.
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Researcher Uncovers Important Piece Of Puzzle Of How Insulin Works

PhD student at Sydney's Garvan Institute of Medical Research has uncovered an important piece in the puzzle of how insulin works, a problem that has plagued researchers for more than 50 years. This finding brings us one step closer to explaining exactly how insulin prompts fat and muscle cells to absorb glucose. The novel finding by Freddy Yip was published online today in the prestigious international journal, Cell Metabolism. "Since the 1920s, when Banting and Best discovered insulin, scientists have been battling to discover how it actually works," said Professor David James, head of Garvan's Diabetes Program.
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Diabetics Rescued By Apelin

Sugar is naturally present in the blood in the form of glucose and is stored in the liver or adipose tissue (fat) thanks to the action of insulin. Glucose is stored or directly used to ensure satisfactory function of the heart, brain and so on according to the body's demands. In certain cases, this mechanism may deteriorate either because insulin is no longer produced (type 1 diabetes), or because the receptors located on the surface of liver cells are desensitized (type II diabetes). Consequently, the cell is no longer capable of assimilating glucose. Such a dysfunction causes a rise in blood sugar levels leading to the onset of numerous complications. Philippe Valet's team has just found that our cells are equipped with a second pathway for the assimilation of glucose. This discovery is based on a protein called "apelin".1
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Study: Skipping breakfast, watching too much TV can boost diabetes risk

Skipping breakfast increases our risk as much as 50 percent, and watching TV for two or more hours per day boosts it 14 percent, according to Fitness. Pam O'Brien, the magazine's article director, says the main reason for the story was to point out that people can lower their risk in about a month. As a former no-breakfast type, Ms. O'Brien began forcing herself to eat breakfast a few years ago and has felt much better since. "So many of us skip breakfast because we're busy and just grab a cup of coffee," she says. "It's one of the worst things you can do. People that eat high-fiber cereals respond better to insulin." Diabetes, according to the American Diabetes Association, is caused when the body doesn't produce or properly use insulin. Insulin converts starches and sugars into fuel for the body.
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