Type 1 diabetes is a lifelong, potentially fatal disease, typically diagnosed in young individuals, in which beta cells in the pancreas do not produce enough of the hormone insulin, resulting in high levels of blood sugar.
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In one of the largest international genetic studies of congenital heart disease (CHD), researchers have discovered gene mutations linked to three new rare congenital heart disorders. Scientists have discovered 15 genome sites - the first ever - linked to depression in people of European ancestry. Science, Technology and Medicine open access publisher.Publish, read and share novel research. Lipid Disorders in Type 1 DiabetesBruno Verges1 Service Endocrinologie, Diabetologie et Maladies MetaboliquesDijon University Hospital, France1. 2008 Prevalence and determinants of elevated apolipoprotein B and dense low-density lipoprotein in youths with type 1 and type 2 diabetes. 1990 Atherogenic lipoprotein phenotype : a proposed genetic marker for coronary heart disease risk. 1989 Whole-plasma and high-density lipoprotein subfraction surface lipid composition in IDDM men.
1991a Accelerated cholesteryl ester transfer in plasma of patients with insulin dependent diabetes mellitus.
1991b Effects of continuous insulin infusion therapy on lipoprotein surface and core lipid composition in insulin-dependent diabetes mellitus.
1994 Intraperitoneal insulin therapy corrects abnormalities in cholesteryl ester transfer and lipoprotein lipase activities in insulin-dependent diabetes mellitus.
1996 Improved lipoprotein surface and core lipid composition following intraperitoneal insulin delivery in insulin-dependent diabetes mellitus. 1996 Differing effects of pancreas-kidney transplantation with systemic versus portal venous drainage on cholesteryl ester transfer in IDDM subjects. 2001 Serum paraoxonase is reduced in type 1 diabetic patients compared to non-diabetic, first degree relatives; influence on the ability of HDL to protect LDL from oxidation. 1997 Optimization of glycemic control by insulin therapy decreases the proportion of small dense LDL particles in diabetic patients.
2001 Cholesteryl ester transfer and cholesterol esterification in type 1 diabetes: relationships with plasma glucose. 2001 Lipid transfer protein activities in type 1 diabetic patients without renal failure and nondiabetic control subjects and their association with coronary artery calcification. 1987 Secretion of lipids, apolipoproteins, and lipoproteins by human hepatoma cell line, HepG2: effects of oleic acid and insulin.
2005 Association of postprandial hyperglycemia with in vitro LDL oxidation in non-smoking patients with type 1 diabetes--a cross-sectional study.
1989a Alterations in serum lipids and apolipoproteins in male type 1 (insulin-dependent) diabetic patients with microalbuminuria.
1989b Increased cholesteryl ester transfer activity in complicated type 1 (insulin-dependent) diabetes mellitus--its relationship with serum lipids. 2005aillot-Rudoni S, Lalanne-Mistrich ML, Brun-Pacaud A, Petit JM, Brun JM, Gambert P, Verges B (2005) Comparison of apolipoprotein B100 metabolism between continuous subcutaneous and intraperitoneal insulin therapy in type 1 diabetes. 2007 No change in apolipoprotein AI metabolism when subcutaneous insulin infusion is replaced by intraperitoneal insulin infusion in type 1 diabetic patients. 2008 Longitudinal screening of serum lipids in children and adolescents with Type 1 diabetes in a UK clinic population. 2004 Protective effect of paraoxonase activity in high-density lipoproteins against erythrocyte membranes peroxidation: a comparison between healthy subjects and type 1 diabetic patients. 1993 Lipoprotein lipase regulation by insulin and glucocorticoid in subcutaneous and omental adipose tissues of obese women and men.
2010 Risk factors for mortality and ischemic heart disease in patients with long-term type 1 diabetes.
2009 Lipid and lipoprotein profiles in youth with and without type 1 diabetes: the SEARCH for Diabetes in Youth case-control study. 2009 Lipid peroxidation in early type 1 diabetes mellitus is unassociated with oxidative damage to DNA. 1990 Differences in lipoprotein subfraction composition and distribution between type I diabetic men and control subjects. 1991 Blood rheology and cardiovascular risk factors in type 1 diabetes: relationship with microalbuminuria. 1987 Coronary heart disease in young type 1 (insulin-dependent) diabetic patients with and without diabetic nephropathy: incidence and risk factors.
1989 Plasma lipid and coagulation factor concentrations in insulin dependent diabetics with microalbuminuria. 1989 Interaction of very-low-density lipoprotein isolated from type I (insulin-dependent) diabetic subjects with human monocyte-derived macrophages. 1994 Regulation of cholesteryl ester transfer protein (CETP) activity: review of in vitro and in vivo studies. 1993 Effects of acute hyperinsulinemia on VLDL triglyceride and VLDL apo B production in normal weight and obese individuals. 2005 Report of the National Heart, Lung, and Blood Institute-National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Cardiovascular Complications of Type 1 Diabetes Mellitus. I have strong memories of hypoglycemia anxiety from my early days of living with Type 1 diabetes.
I counsel people with Type 1 diabetes, and one of the most stressful parts of diabetes for many people is the experience of being hypoglycemic. Hypoglycemia anxiety can diminish their quality of life, and often results in an ongoing elevated blood glucose level that causes other health issues. Anxiety becomes problematic when we overestimate the dangers that surround us, and underestimate our ability to cope. We can reduce anxiety by developing a more realistic perception of the dangers we face, and of our ability to cope with them.
I have had many patients describe feeling “low” when their blood glucose readings are actually in the normal range. Many believe this is because they are on their way to a low and will just keep dropping. For those with high levels of anxiety, it can be helpful to develop a hierarchy (list) of fears. The nursing student starts to look at factual evidence to challenge her belief she will go low and die. If you are struggling with anxiety, or someone you care about who has diabetes is struggling with anxiety, maybe you can try some of the techniques described here. If your hypoglycaemia anxiety is so high that these ideas seem out of reach for you, then please consider accessing professional support. Michelle Sorensen is a member of the Ontario College of Psychologists and has a private practice in Clinical Psychology in Ottawa. Having had T1D for 64 years and literally thousands of lows i was not anxious about having them.
The Diabetes Media Foundation is a 501(c)(3) tax-exempt nonprofit media organization devoted to informing, educating, and generating community around living a healthy life with diabetes. Diabetes is a chronic disease which will be well controlled by maintaining a balanced diabetic diet. Moreover, intake of fibre made fruits helps in maintaining cholesterol level that in turn normalizes the metabolic rate of the body. Fruits like cherry, papaya and pineapple are equipped with a moderate level of sugar concentration. Making awareness about disease and favourable fruits helps to a nice extend in controlling diabetes.
Diabetics are advised to consume 1 tsp of this jamun seed powder in empty stomach early morning. The statements on this web site have not been evaluated by the Food and Drug Administration. Persons using assistive technology might not be able to fully access information in this file. Sociodemographic characteristics associated with each preventive-care practice varied by practice (Table 1). It is spreading in many countries in direct alignment with obesity as people eat a richer diet and exercise less. As a die-hard foodie I created this blog of tasty and easy to prepare healthy recipes with the aim of reversing the condition. Self-monitoring of blood glucose is recommended for people with type 1 diabetes before each injection of insulin and when hypoglycemia (low blood glucose) is suspected. A study published by Cell Press on March 5th in Cell Metabolism reveals that a single mutation in the "longevity gene" SIRT1 can cause type 1 diabetes in humans.
Animal studies have shown that a gene called SIRT1, which is well known for its role in promoting longevity and protecting against age-related diseases, also regulates insulin secretion and the development of autoimmune conditions, and activation of this gene can protect against type 1 diabetes. All five affected members developed an autoimmune disorder, and four developed type 1 diabetes.
IntroductionCardiovascular disease is the major cause of death in persons with type 1 diabetes (Libby et al., 2005). Patients in my practice with very high blood glucose levels have learned to look at the evidence and develop more balanced thoughts about the likelihood of a dangerous low. This allowed her to keep her BG levels in a normal range for longer periods of time, without giving in to the impulse to snack and boost them higher to get rid of the hypoglycemia anxiety she felt. This can be helpful when patients are becoming accustomed to a healthier range of blood glucose levels after having lived with higher readings due to the fear of hypoglycemia. For example, take some deep breaths every time you sit down to eat a meal or to catch up on email.
I have met patients who have underlying worries about the long-term effects of their high blood sugar, but it just never seems like the right time to change their way of coping. Start with the most intense sources of anxiety at the top of the list and the least feared situations, events or people at the bottom. Work your way up the list gradually, gathering evidence about your ability to confront yours fears until you are able to tackle the most intense ones on the list.
Of course, all of these techniques need to be used in conjunction with support from family and health care professionals.
It is a good idea to speak to your diabetes educator or endocrinologist for support and possibly referral information.
My simple advice would always be avoid panic, keep packets of sugar with you always, take medicine and meals regularly, regular exercise and visit a doc monthly or quarterly. I experienced this anxiety when first diagnosed (at 32 of T1D) partly because I had seen my mother (also T1D) have low blood sugars at a young age, when I didn’t really understand what was happening.
I could have used that a few years ago ?? I really appreciate the frankness of the article, thank you!
Now that i am older i get very anxious after them for an hour or so but understanding what is happening to your body helps. It is healthier to prefer fresh fruits different than dry fruits for most utilization of food intake. Grape fruit returning underneath citrus fruit family is yet another favourable fruit serving to for maintaining controlled blood glucose level.
Products and information provided on this site are not intended to diagnose, treat, cure or prevent any disease. It is the same difference between playing pickup insulin resistance in the brain an old-age or new-age problem basketball and playing for the high school basketball team. The findings unearth the role this gene plays in human autoimmunity and disease and also offer new avenues for treating a range of autoimmune disorders. Using a combination of gene-sequencing techniques, the researchers identified a previously undocumented mutation that caused an amino acid substitution in the SIRT1 protein.
If they note that accurate carbohydrate counting and insulin dosing keeps them in safe range, coupled with testing BG regularly and carrying sources of sugar for lows, then they become more willing to gradually reduce their blood glucose levels. You can use imagery to imagine feared events beforehand, and prepare yourself to confront them by using cognitive restructuring or relaxation methods. Unfortunately, I cannot tell her that I know for sure she is wrong. But I can suggest we explore her underlying assumptions and figure out if this belief is very realistic.
It is important to develop confidence in her ability to cope with hypoglycemia… yes, it is best to prevent lows when possible, but she can treat the lows quickly and recover from them.
If you choose to see a psychologist or social worker, I recommend someone who practices CBT, which is an evidence-based clinical approach.
That pervaded into my own experience and my coping mechanism in my school life was to keep my sugars a bit higher than they should have been.
Enjoyed the article but T1D is different for each person, take the time to understand what is happening to your body, it do s help with anxiaty.
Nutritionists prefer core portion or inner portion of jambul fruits for controlling diabetes.
Understanding the psychological impact of diabetes and the role of clinical psychologyPages 137-142.
Moreover, inactivation of the SIRT1 gene in mice led to the destruction of the insulin-producing region of the pancreas, resulting in high levels of blood sugar. Thus, it seems important to pay attention to lipid abnormalities, in patients with type 1 diabetes, in order to reduce cardiovascular disease in this population.Patients with type 1 diabetes show lipid disorders, mostly qualitative abnormalities of lipoproteins, which may promote atherogenesis. This can be done in conversation with a therapist or by writing down negative thoughts and challenging the thoughts using thought records (see Mind over Mood by Christine Padesky and Dennis Greenberger for a patient’s guide to cognitive behavioral therapy). I work on gathering evidence to develop new, more balanced beliefs with patients who are overcome with anxiety about hypoglycemia. I have seen patients reduce their levels of anxiety and greatly improve their quality of life. It is absolutely worth the effort. Always keep checking blood glucose level after food with the help of continuous blood glucose monitoring. That is why we use functional medicine functional lab testing and a You don’t have to fast to have this test which is sometimes used if symptoms are present. The pathophysiology of these lipid abnormalities is not totally explained, but hyperglycemia and peripheral hyperinsulinemia, due to the subcutaneous route of insulin administration, are likely to play a role.
In the first step, which takes place in the rough endoplasmic reticulum, apoB is co-translationally and post-translationally lipidated by the MTP (Microsomal Tranfer Protein). I don’t care about using another test strip it if means my blood sugars are better controlled! Fruits like cherries are blessed with a wealthy concentration of anthocyanin promoting low blood sugar level. However true life story type 2 diabetes Plasma is used to make medicinal products that are eventually bought and consumed by people in the hospitals (paid for by insurance usually…) diabetic retinopathy laser treatment complications certified diabetes educator nurse I like it when girls put their hair back behind their ears.
Yeast infections that are hard to get rid of or that keep coming back can be a sign of diabetes because yeast thrives on sugar so that increased blood sugar can become a breeding ground for bad diabetes menu app bacteria. After 6 months of use & following the directions faithfully, there was little change to the hair growth. After a brief review of lipoprotein metabolism and some information on the role of insulin on lipid metabolism, quantitative abnormalities then qualitative abnormalities of lipoproteins, in type 1 diabetes, will be discussed.2.
MTP transfers lipids (mainly triglycerides but also cholesterol esters and phospholipids) to apoB. In several ayurvedic treatments, jamun seed powder mixed with water is given to diabetic patients in specific intervals of time. Make sure to buy fruits with low sugar concentration thus as to regulate blood sugar level. Brief review of lipoprotein metabolism Lipoproteins, which transport non-water soluble cholesterol and triglycerides in plasma, are spherical particles composed of a central core of non-polar lipids (cholesterol esters, triglycerides) and a surface monolayer of phospholipids, free cholesterol and apolipoproteins. 15, 2016.Partners Eli Lilly, based in Indianapolis, and Boehringer Ingelheim obtained tentative approval from the Food and Drug Administration in August 2014 for their version. Jamun seed is a made supply of vitamins, calcium and potassium and its seed powder boosts the performance of pancreas. Lipoproteins are generally classified according to their density as chylomicron, Very Low Density Lipoprotein (VLDL), Intermediate Density Lipoprotein (IDL), Low Density Lipoprotein (LDL) and High Density Lipoprotein (HDL). As per the studies created on diabetic patients, health practitioners like as well as additional amount of fibre made fruits in their diet. This step is driven by ADP ribosylation factor-1 (ARF-1) and its activation of phospholipase D, needed for the formation of VLDL from pre-VLDL (Olofsson, 2000).In plasma, triglycerides of VLDLs are hydrolyzed by the lipoprotein lipase. These fruits with low sugar concentration helps in controlling blood sugar level to a maximum extend.
ChylomicronsChylomicrons, the largest lipoprotein particles, are responsible for the transport of dietary triglycerides and cholesterol. As VLDLs become progressively depleted in triglycerides, a portion of the surface including phospholipids and apolipoproteins C and E is transferred to HDLs. Untreated (diabetic ketoacidosis) type 1 diabetes In type 1 diabetic patients with diabetic ketoacidosis, quantitative lipid abnormalities are observed, due to insulin deficiency.Triglyceride-rich lipoproteins (chylomicrons, VLDLs) are increased leading to hypertriglyceridemia. 1998 Scavenger receptor class B type I as a mediator of cellular cholesterol efflux to lipoproteins and phospholipid acceptors. This is mainly due to decreased lipoprotein lipase activity (Verges, 2001; Dullaart, 1995). Pen-like insulin devices are gaining popularity because they're easier to inject than using syringes to extract a specific insulin dose from a vial and then inject it.Eli Lilly and Boehringer Ingelheim have not sought approval to sell their version in vials. The formation of chylomicrons takes place in the enterocytes, and the process associating the lipid components (triglycerides, cholesterol esters, phospholipids) and the apoB48 is performed by the MTP (Microsomal Tranfer Protein).
Diabetic ketoacidosis is a situation of severe insulin deficiency with reduced lipoprotein lipase activity as a consequence, because insulin usually stimulates its activity. They already sell Basaglar in the Kwikpen in several European countries and are seeking approval in other foreign countries. Decreased lipoprotein lipase activity leads to profound reduction of triglyceride-rich lipoprotein catabolism (Taskinen, 1987). In plasma, triglycerides of chylomicrons are hydrolyzed by the lipoprotein lipase leading to the formation of smaller, triglyceride-poorer particles known as chylomicron-remnants. In this condition of severe insulin deficiency, reduced catabolism of triglyceride-rich lipoproteins is, by far, the main factor involved in hypertriglyceridemia. Lily will pay undisclosed royalties to Sanofi in exchange for a license to certain Sanofi patents that would have kept Basaglar off the U.S.
Indeed, the augmented level of plasma triglyceride-rich lipoproteins drives, through CETP, the transfer of triglycerides from triglyceride-rich lipoproteins to HDLs leading to the formation of triglyceride-rich HDL particles. HDLs enriched in triglycerides become very good substrate for hepatic lipase, leading to increase their catabolism and, thus, to decrease plasma HDL-cholesterol level.
Rabadan-Diehl, National Heart, Lung, and Blood Institute; National Institute of Diabetes and Digestive and Kidney Diseases Working Group on Cardiovascular Complications of Type 1 Diabetes Mellitus.
Nascent or lipid-poor HDLs get from peripheral cells free cholesterol and phospholipids through ABCA1 transporter (ATP Binding Cassette A1 transporter), allowing the transport of free cholesterol and phospholipids from the cell cytoplasm into the HDL particles (Oram & Lawn, 2001).
Within HDL particles, free cholesterol is esterified by LCAT (Lecithin Cholesterol AcylTransferase) leading to the formation of HDL3 particles. Treated type 1 diabetesPatients with treated type 1 diabetes may show quantitative lipid disorders. The fusion of 2 HDL3 particles, which is promoted by PLTP (PhosphoLipid Transfer Protein), leads to the formation of one larger size HDL2 particle. It has been shown that abnormal lipid levels, in type 1 diabetes, predict worse cardiovascular outcomes (Soedamah-Muthu et al., 2004). Lipid transfer proteinsLipoprotein metabolism is largely influenced by lipid transfer proteins. HbA1c has been shown to be independently correlated with LDL-cholesterol, non-HDL cholesterol and triglyceride levels, indicating that these disorders were mostly observed in patients with poor glycemic control (Marcovecchio et al., 2009). Among these, two play an important role: CETP (Cholesteryl Ester Transfer Protein) and PLTP (PhosphoLipid Transfer Protein).
In a British follow-up study of 229 children with type 1 diabetes, LDL cholesterol and non-HDL cholesterol values increased with duration of diabetes (Edge et al., 2008). CETP facilitates the transfer of triglycerides from triglyceride-rich lipoproteins (mainly VLDLs) toward HDLs and LDLs and the reciprocal transfer of cholesteryl esters from HDLs and LDLs toward VLDLs (Lagrost, 1994).
In that study, total cholesterol, triglycerides and non-HDL cholesterol were positively correlated with HbA1c and around 10% of the patients had lipid values outside recommendations (Edge et al., 2008). PLTP is also involved in the formation of HDL2 lipoproteins from HDL3 particles (Lagrost et al., 1998). In the Diabetes Control and Complications Trial (DCCT), HbA1c correlated positively with total cholesterol, LDL-cholesterol and triglycerides at baseline (The DCCT Research Group, 1992).
Any modification of CETP or PLTP activities is likely to promote significant qualitative abnormalities of lipoproteins.3.
Data from the Coronary Artery Calcification in type 1 diabetes (CACTI) study, which examined 652 patients with type 1 diabetes, have shown, in patients not using hypolipidemic agents, that a higher HbA1c was associated with significantly higher levels of total cholesterol, triglycerides, LDL cholesterol and non-HDL cholesterol (Maahs et al., 2010). Insulin and lipoprotein metabolism Insulin plays a central role in the regulation of lipid metabolism (Verges, 2001). The main sites of action of insulin on lipoprotein metabolism are shown in Figure 2.In adipose tissue, insulin inhibits the hormone-sensitive lipase.
Thus, insulin has an anti-lipolytic action, promoting storage of triglycerides in the adipocytes and reducing release of free fatty acids from adipose tissue in the circulation.Insulin inhibits VLDL production from the liver.
Insulin reduces VLDL production by diminishing circulating free fatty acids (due to its antilipolytic effect), which are substrates for VLDL, but also by a direct inhibitory effect in the hepatocyte (Malmstrom et al., 1998). Insulin is a potent activator of lipoprotein lipase (LPL), promoting the catabolism of triglyceride-rich lipoproteins and reducing, as a consequence, plasma triglyceride level.
These data indicate that insulin resistance may be an additional factor that could induce quantitative lipid abnormities in some type 1 diabetic patients with a background of insulin resistance (abdominal obesity, family history of type 2 diabetes).
Treated type 1 diabetes with poor or suboptimal glycemic control In case of poor or suboptimal control, patients with type 1 diabetes may show increased plasma triglyceride levels (Dullaart,1995). This slight decrease in plasma LDL-cholesterol may be observed with intense insulin therapy as a consequence of decreased VLDL production by peripheral hyperinsulinemia (see above).Plasma HDL-cholesterol level is normal or slightly increased in well controlled type 1 diabetic patients (Dullaart, 1995). It has also been reported that elevation of HDL in type 1 diabetic patients with good glycemic control was caused by an increase of HDL particles containing only apoA-I (LpA-I) (Kahri et al., 1993). The increased Lipoprotein Lipase activity observed in these patients is likely to be due to peripheral hyperinsulinemia as a consequence of the subcutaneous route of insulin administration (Kahri et al., 1993).
Subcutaneous insulin therapy versus intraperitoneal insulin therapyIntensive subcutaneous insulin therapy results in normalization of plasma glucose, but at the expense of peripheral hyperinsulinemia, which is likely to modify lipoprotein metabolism (as discussed above). Implantable insulin pumps with intraperitoneal insulin administration mimic the physiologic route of insulin delivery and are likely to restore the normal portal-peripheral insulin gradient.
For this reason, several studies have been performed to analyze the modification of lipoprotein metabolism after replacement of subcutaneous insulin therapy by intraperitoneal insulin therapy.
The discrepancies of these studies that may be due to confounding factors such as degree of glycemic control and peripheral insulin levels during subcutaneous insulin therapy.
Raw vegetable diet to cure diabetes|
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