The Genetics of Diabetes

MOD recently went to the UMB Wellness Fair to educate the public about diabetes. One person stopped by the Operation Diabetes booth and asked "How likely am I to get diabetes since my Mom has diabetes?" This inspired MOD to do some more research into the genetics of diabetes.

Both diet and exercise play a big role in your risk of developing diabetes, but genetics also play a role. The following facts were found on the American Diabetes Association website
http://www.diabetes.org/diabetes-basics/genetics-of-diabetes.html.

• In general, if you are a man with type 1 diabetes, the odds of your child developing diabetes are 1 in 17
• If you are a woman with type 1 diabetes and your child was born before you were 25, your child's risk is 1 in 25; if your child was born after you turned 25, your child's risk is 1 in 100.
• In general, if you have type 2 diabetes, the risk of your child getting diabetes is 1 in 7 if you were diagnosed before age 50 and 1 in 13 if you were diagnosed after age 50.

Farxiga for type 2 diabetes will soon hit shelves

By Stephanie Yager, Student Pharmacist

Invokana

By Stella Chan, Student Pharmacist

MOD does another health fair!

Last week, MOD had a diabetes education booth at a health fair at the Genesis Bible Fellowship.



35 people stopped by our booth to learn about diabetes and diabetes prevention. Our most frequent question was if it is possible to cure diabetes. Once you are diagnosed with diabetes there is no cure. However; you can control your diabetes so that you need fewer medications or no medications at all.

Cici Takes on Diabetes- a diabetes educational video

Check out this video that Operation Diabetes put together this year!  

MOD does blood pressure screenings

MOD conducted blood pressure screenings at Professional Pharmacy and at a local health fair as part of the Million Hearts Initiative. The initiative is to prevent 1 million heart attacks and strokes by 2017.

It is especially important for people with diabetes to control their blood pressure.

 

 

Below you can see a section of the fact sheet from the million hearts website. It explains what the blood pressure numbers mean. People can reduce their blood pressure by eating less salt. Try to eat no more than 1500mg of sodium a day. That is less than 1 teaspoon of salt! Most people with high blood pressure need 2 or 3 medicines to lower it. Work with your pharmacist and doctor to find the medications that are best for you. 

 

MOD goes to the UMB Wellness Fair

MOD went to the wellness fair to educate University of Maryland staff, students, and the community about diabetes. We talked to 62 people and conducted the diabetes risk assessment. We also provided hand-outs on how to prevent type 2 diabetes and about blood glucose.

Below you can see clips from the handout we gave up on how to delay type 2 diabetes. The handouts came from the American Diabetes Association website. http://www.diabetes.org/

Sleep Deprivation Could Increase The Risk for Type 2 Diabetes

I read an interesting article recently relating sleep to Diabetes.

We have been taught that sleep is important for our brain function, but it turns out that sleep is also important for our fat cells. When you feel groggy, your metabolism also feels 'groggy' and this can lead to insulin resistance.

A recent study published October 16th, 2012 in Annals of Internal Medicine conducted by the University of Chicago Medical Center professors indicated that a lack of sleep could also lead to obesity, type 2 diabetes, heart disease, stroke, and high blood pressure. This is the first study involving sleep on a cellular level. It was a very small study with only 7 healthy young adults. They were randomly assigned to sleep either 8.5 or 4.5 hours a night for four nights and repeated these sessions in four week intervals. After the four days, scientists measured how fat samples from their abdomen processed glucose. The people who were sleep deprived had a 30% reduction in their response to insulin. Their insulin levels were close to 3 times higher than the well rested participants. The high insulin levels suggest that the pancreas was trying to compensate for the insulin resistance by making more insulin. If this sleep deprivation cycle continued chronically, type 2 diabetes could develop. The next project for these researchers will involve studying if treating sleep apnea in overweight people will improve their metabolism.

Sleep may be another important lifestyle modification that we will have to tell our patients about in the future. However; since this was such a small study we will have to wait and see if it will be verified by other studies. One researcher claimed that sleep should be considered as important as diet when you are trying to prevent weight gain and diabetes.

I summarized the information from this website:

http://consumer.healthday.com/Article.asp?AID=669619

Diabetes Outreach at Johns Hopkins

Operation Diabetes joined up with NCPA (National Community Pharmacists Association) to educate the community about diabetes at Johns Hopkins Outpatient Pharmacy.

 

We played Diabetes Jeopardy with people who came by our table to help them learn about diabetes and clarify common myths. We used the Diabetes Risk Test screening tool below to determine patient's risk of developing Type 2 Diabetes. The test takes into account age, sex, family history, physical activity, and weight to determine risk for diabetes. We enjoyed interacting with the community and felt that we made a positive impact by educating people about diabetes. 

 



Dietitian Comes to University of Maryland

On November 12th, Operation Diabetes brought Annette Hottenstein to speak at the University of Maryland. Annette is a Registered Dietician and is involved with the Academy of Nutrition and Dietetics and the American Diabetes Association. From her presentation, students learned about th history of nutrition therapy in diabetes. She pointed out that being overweight is not the only risk factor for diabetes. People who are not overweight can also be at risk. She taught that diabetics shouldn't skip meals, they should avoid sugary drinks, and eat lots of fruits, vegetables, whole grains, and fish. In fact, the diabetic diet is the same as the recommended American diet. Unfortunately, the typical American diet is far from the recommended diet and she passed around bags showing the typical amount of fat and sugar in a fast food meal.

 Amount of butter in a fast food meal:                                            Amount of sugar in a fast food meal:

 

Annette also talked about foods that are good for diabetics. Oatmeal has been shown to be good for controlling blood sugar. Some diabetics feel that cinnamon is helpful but there is unclear evidence about its benefits. Fenugreek spice has some data showing its benefits and it tastes like maple. Whey has more evidence supporting it, but Alpha Lipoic Acid has the strongest evidence that it will effect glucose levels in the blood.

MOD learned a lot from Annette Hottenstein's talk!

Walk To Stop Diabetes in Baltimore

On October 6th 50 students came together to do the Walk to Stop Diabetes in Baltimore. It was a perfect day for a walk around the harbor with sunny blue skies above. We had pharmacy students from first through 4th year participating and a few PhD students as well. We raised $840 towards the American Diabetes Association. The money will go towards research to prevent, cure and manage diabetes; deliver services to hundreds of communities; and provide objective and credible information. Everyone enjoyed walking and getting to know each other outside of the classroom.

Walking off Diabetes - New, Realistic and FUN exercise goals for Type 2 Diabetes Patients

A common misconception concerning exercise is that physical activity must be vigorous to provide health benefits.  But don't go signing up for any marathons just yet - new guidelines are requiring more realistic goals for Type 2 diabetes patients.   The HHS guidelines state that 150 minutes of brisk walking a week - about 20 minutes a day - substantially reduces the risk of numerous chronic diseases, including diabetes, depression, and breast cancer.

Walking is one of the most popular and widely recommended forms of physical activity for people with diabetes. It’s easy, relaxing and can be done practically anywhere, with anyone! Dr. Regensteiner, professor of medicine and director of the center for women’s health at the University of Colorado at Denver, stresses the important of making exercise goals fun and realistic.  Focusing on this behavioral aspect of exercise will result in more patients following their regimens.


For more information about contemporary exercise guidelines, check out the full article here
http://www.familypracticenews.com/news/more-top-news/single-view/diabetes-patients-require-more-realistic-exercise-goals/97367cbec2.html

Want to start reaping those health benefits right away?? 
Jump start your walking routine with us on October 1st at the Step Out Walk to Fight Diabetes.  For more information or to join our team 
http://main.diabetes.org/site/TR?team_id=514351&fr_id=7809&pg=team

Diabetes Awareness Month

Happy November!! Hard to believe how quickly the month is coming and going, almost Thanksgiving already! :) Well, in case you didn't know... November is Diabetes Awareness Month. This past weekend MOD participated in a health fair in Rockville, MD which was themed 'Knock Out Diabetes' and focused on empowering people to deal with their disease. And just a few short weeks ago, MOD  hosted 'Healthy Halloween' for elementary and middle school aged children at the school of pharmacy. Amongst her efforts to promote diabetes awareness, MOD has also been very busy with pharmacy school exams! Until she can update you with stories, news, and videos(!!)... check out this article written by Operation Diabetes Past Senior Chair, Ashley McCabe. I bet you can learn something about the role of your pharmacist in the management of diabetes. Enjoy!

November is Diabetes Awareness Month

In support of American Diabetes Month, sponsored by the American Diabetes Association, pharmacists in Maryland and Nationwide want to remind Marylanders of the pharmacists’ role in combating the illness, saving lives and saving patients’ money.

Diabetes is a confusing, complicated and frustrating disease that affects over 24 million Americans (1). It takes teamwork and dedication to battle Diabetes. This is where a pharmacist has the most value. As the most accessible healthcare provider and as the medication experts, pharmacists are on virtually every street corner with knowledge and resources to keep patients with diabetes on track to a long, healthy and happy life.

Pharmacists are the medication experts. They know all about diabetes medications as well as the medications for the diseases that often accompany diabetes, such as high blood pressure, high cholesterol, and heart disease. To successfully manage medications, side effects, outcomes and complications, pharmacists are one of the best resources at your disposal. Some pharmacists have specialized to become Certified Diabetes Educators (CDE) and can have an active role in diabetes care. Others have skills in Medication Therapy Management (MTM), ensuring the most effective and affordable care for their patients. Furthermore, all pharmacists can educate about medications, demonstrate glucometers, take blood pressure, and explain lab results.

Involving a pharmacist in Diabetes care also has proven financial benefit. In 2007, Diabetes cost the United States $176 billion1 in direct and indirect costs. Controlling and managing Diabetes while preventing complications with help save money. Pharmacists can help with this.

Pharmacists have proven their value. An example is the Asheville Project, a 5 year study in Asheville, North Carolina where pharmacist provided pharmaceutical care services through community pharmacies. The results showed improved health outcomes and cost savings (2). Another study that expands this theory is currently taking place ‐ the Diabetes Ten City Challenge. This study similar to the Ashville Project, but expands the concept of pharmacists managing Diabetes to ten cities across the United States. One of those cities is Cumberland, Maryland, which in association with local pharmacist through the Maryland P3 Program (Pharmacist, Patients, Partnerships), the Maryland Pharmacists Association and The University of Maryland School of Pharmacy, is helping over 250 Maryland residents (3).

Chances are you know someone with Diabetes or you yourself have Diabetes. Young, middle‐aged, pregnant women and older Americans are all burdened with daily blood glucose checks, multiple medications, and insulin injections.

Help friends, family members or yourself get the most benefit from your medications and improve overall quality of life.
 
If you know or think you are at risk for Diabetes, talk to your local pharmacist today!
 
Know Your Medicine, Know Your Pharmacist.

References:
1. National Diabetes Fact Sheet. Department of Health and Human Services Centers for Disease Control and Prevention. 2007.
2. Cranor CW, Bunting BA, Christensen DB. The Asheville Project: Long‐Term Clinical and Economic Outcomes of a Community Pharmacy Diabetes Care Program. J Am Pharm Assoc. 2003;43:173–84.
3. Cumberland, Maryland Diabetes Ten City Challenge Fact Sheet. American Pharmacists Association Foundation. Washington, D.C.

For more information look to the following resources:
www.mpha.org
www.diabetes.org

Ashley McCabe, Student Pharmacist, University of Maryland Class of 2011

Use of Avandia in diabetes patients significantly restricted

Less than a month ago, the U.S. Food and Drug Administration (FDA) decided to severely restrict the use of Avandia in diabetes patients. Avandia was approved by the FDA in 1999 and soon after it became the top selling diabetes drug in the world. But in 2007, after Avandia, marketed by GlaxoSmithKline, was shown to cause cardiovascular events such as heart attacks and strokes in patients with diabetes instead of preventing it, drug sales pummeled.

A good number of patients with diabetes die due to heart problems, and antidiabetic drugs like Avandia are supposed to prevent them. With these new restrictions in place, Avandia, just like Accutane, will have to undergo FDA’s stringent monitoring program called Risk Evaluation and Mitigation Strategies (REMS). Health care providers will have to let the patients know about the risks before prescribing the drug.

While US decided to restrict the use of Avandia, the European Union (EU) decided to withdraw the drug from European market.

Source: http://www.fda.gov/Drugs/DrugSafety/PostmarketDrugSafetyInformationforPatientsandProviders/ucm226956.htm

http://abcnews.go.com/Health/DiabetesNews/fda-restricts-avandia-patients/story?id=11709403

New Recipe Cards from MOD!

Happy October 1st!! Today marks the beginning of American Pharmacist Month, an exciting time for MOD and everyone at the University of Maryland School of Pharmacy!

Just this afternoon 2/3 of the MOD leadership + many of her fellow student Pharmacists went to Washington, DC to participate in a healthfair at the APhA national headquarters. They were educating APhA employees as well as members of the US State Department. We just posted a video diary entry of the day to kick off American Pharmacist Month, check out our videos scrolling to the left or here http://www.youtube.com/watch?v=qjFweceonKI

We made some recipe cards today to hand out at the health fair, and I thought I would upload them here for everyone to see! Enjoy :)

Alcohol and Diabetes? Can MOD Still Enjoy a Night Out on the Town?

It's a saturday night and as I was considering a beer to accompany the college football, I got the idea for a blog post! How do your social habits have to change if you have diabetes? 

Even if you've counted carbs, cut out candy, and mastered the exchange system to get a dietary handle on your diabetes, alcohol may be the hardest "food group" to manage since social drinking is such a pervasive part of our society. And you'll be darned if you're going to give up what may seem like one of the few pleasures you have left—drinking. Whether it be green beer at the bar on St. Patrick's day, a champagne toast at your freind's wedding, or a glass of wine at dinner with friends, is it OK when you have diabetes?

Let's get to the bottom of it: Is drinking acceptable if you have diabetes? The answer is yes, in moderation, providing that you take the proper precautions. The American Diabetes Association (ADA) asserts that alcohol can be incorporated into a diet plan, provided that blood sugar control is already well established and other conditions that aren't compatible with alcohol consumption (such as pregnancy or certain diabetic complications) don't exist. And you must be 21 of course! ;)
How It Works
When you drink, your liver decreases its ability to release glucose so that it can instead clean the alcohol from your blood. Because glucose production is shut down, hypoglycemia (low blood sugar) becomes a risk for people with diabetes, particularly if you drink on an empty stomach or shortly after taking insulin or glucose-lowering oral medications. And because it takes two hours for just one ounce of alcohol to metabolize and leave your system, the risk continues long after you've emptied your glass.
A Two-Drink Maximum
For individuals with well-controlled diabetes, alcohol intake should follow the same guidelines the United States Department of Agriculture (USDA) has established for the general population. This means a maximum of two drinks per day for men and one drink daily for women. (A higher alcohol intake is allowed for most men because women have a lower body water content then men and also metabolize alcohol more slowly.) In addition, due to physiological changes such as loss of lean body mass that occur as the body ages, the National Institute on Alcohol Abuse and Alcoholism recommends that anyone over age 65 should not consume more than one alcoholic drink daily.

 One drink is defined as
- 12 ounces of regular beer (150 calories)
- 5 ounces of wine (100 calories)
- 1.5 ounces of 80-proof distilled spirits (100 calories)


[One drink equals 2 fat exchanges; regular beer is an additional 1 starch exchange.]
Alcohol has no nutritional value.

 Source: http://www.dlife.com/diabetes/information/daily_living/diabetes_alcohol/