what we're reading - 2006
We know it's impossible to stay current with all the news in diabetes. The immense flow of information can be contradictory, confusing, and just plain overwhelming. Who has time to read it all?
Well, we do.
It's not just our livelihood. For those of us with diabetes, it's our life, so we look for articles that are smart, useful, and surprising.
We pore over every possible diabetes publication and, in this column, we identify our most important discoveries from recent patient magazines and newsletters. (When possible, we will give you the direct link to the article.) We hope this saves you time, and were pleased to point out to you pieces you might otherwise miss! We also follow the professional scientific journals such as Diabetes Care, JAMA, and the New England Journal of Medicine, and we will report on one diabetes research article each issue.
Our favorite patient articles for this issue:
"The Benefits of Tight Control: No End in Sight", Wayne Clark, Diabetes Self-Management, May/June 2006.
(The site is www.diabetesselfmanagement.com, but the article itself is not available online.) This article presciently reviews what we know about tight control - how many people with diabetes in the U.S. are getting there, and what it means for complications. Clark recounts the details of the Diabetes Control and Complications Trial (DCCT), which proved the hypothesis that tight glucose management reduces the risk of complications. The study also famously proved that there is no glycemic threshold, or point below which a lower HbA1c does not yield additional benefit. The follow-up study to the DCCT, the Epidemiology of Diabetes Interventions and Complications (EDIC) trial, found that even years after the DCCT, when the A1c's of the two patient groups converged, patients from the intensive management cohort still had fewer complications. A similar study, the United Kingdom Prospective Diabetes Study (UKPDS) published in 1998, found that intensive control in type 2 diabetes reduced microvascular complications by 25%.
Special Report: How to Save Your Heart, Hope Warshaw, Diabetic Living, Summer 2006.
(You can read this online at www.diabeticlivingonline.com.) We love articles with information that you can apply to your own life. In this article, you receive guidance on how to lower your risk of cardiovascular disease, the number one cause of death in people with diabetes. As Dr. Francine Kaufman of Children's Hospital of Los Angeles says, "When you have diabetes, your risk of a heart attack is as high as it is for a person without diabetes who's had a heart attack." Near normal glucose levels can reduce the risk of heart attack and stroke.
Learning the ABCs of Beta Cells, Robert S. Dinsmoor, JDRF Countdown, Spring 2006. (www.jdrf.org.)
Beta cell regeneration, dedifferentiation, redifferentiation, isolation, and encapsulation: this article reviews some of the leading curative research, profiling scientists who are furiously trying to replace beta cells as a therapy for type 1 diabetes. Dinsmoor writes about projects across the world. For instance, a group in Denmark is using fluorescent protein tags in mouse models to better understand gene expression in beta cell differentiation, while researchers at Mt. Sinai are looking at how to make endoderm from embryonic stem cells.
Diabetes Research Update
In April 2006, Dr. Louis Monnier and colleagues published an article in JAMA that challenged the conventional wisdom about diabetes management and complications. The article suggests that complications can occur not only because of high blood glucose but also because of fluctuations in glucose.
