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Diabetes
Quarterly Newsletter
Spring 2006
The mission for this newsletter is to provide current diabetes information
on various diabetes supplies, medications and resources for the
staff of Marquette General Health System. Information given is an
overview. It does not necessarily denote an endorsement of such.
Additional references are provided for more comprehensive information.
Suggestions for future topics as well as feedback about the newsletter
can be submitted to Sarah Balko, Diabetes Education, by phone at
ext. 3473.
New Program Coordinator
You may have noticed some changes with the staff of diabetes education.
Sarah Balko, RD has recently taken over as the program coordinator.
Sarah has been with MGHS for 5 years doing nutrition counseling
for the dietary department. This is the first time MGHS diabetes
education has had a dietitian as a member of their staff.
Sarah will be doing all of the nutrition education for patients
enrolled in the program. In the past this service was contracted
out to the dietary department.
Having a dietitian as part of the diabetes education team means
better, more comprehensive care for the patient. Look for some changes
to the outpatient program in the future.
FDA Approves Inhalable Insulin
The Food and Drug administration approved an inhaled form of insulin
on January 28, 2006. This is the first new way to get the hormone
into the body since its discovery in 1921. The product will be marketed
under the brand name Exubera, made by Pfizer, Inc.
The American Diabetes Association estimates that nearly 21 million
people in the United States have diabetes and about 5 million need
insulin injections. Unfortunately about 15% of those diagnosed with
diabetes do not take the insulin or pills that they should. Pfizer
believes Exubera will encourage diabetics who are squeamish about
needles to take the insulin.
Exubera is a rapid acting human insulin that is inhaled normally
through the mouth into the lungs with a handheld inhaler. Exubera
is FDA approved for both type 1 and type 2 diabetes. Exubera can
be used alone or in conjunction with other medications and longer-acting
insulins.
Studies did show possible decrease in lung function over time. Patients
will need to weigh the risk versus the benefit. Patients with chronic
lung diseases, or that smoke, or have smoked within 6 months are
not recommended to take Exubera. Lung function should be monitored.
Exubera is expected to be made available by this summer. This marks
a new era in insulin administration.
Other News in Diabetes Treatment
By now you have probably heard about 2 new drugs in the management
of Type 1 and Type 2 diabetes, Symlin and Byetta. Both approved
in 2005, they are now starting to be used by patients in our area.
Symlin (Pramlintide Acetate) is a synthetic analog of the neuroendocrine
hormone amylin. Amylin is co-secreted in the beta cells in response
to food intake in normal individuals. Research has shown that amylin
levels are low in the bodies of type 1 and type 2 diabetics. Symlin
is a synthetic version of amylin and is indicated for type 1 or
type 2 diabetics that are currently on a meal time insulin and not
getting the best control. Symlin, when given subcutaneously before
a meal, decreases post prandial hyperglycemia by slowing gastric
emptying, and suppressing glucagon secretion. Symlin should not
be used in patients with a HbA1c above 9%, history of hypoglycemia
unawareness, gastroporesis, or poor compliance with medications.
Byetta (exenatide) is the other new drug on the block. Byetta is
the first FDA-approved incretin mimetic. Byetta is given to replace
the human GLP-1 incretin hormone. GLP-1 is secreted in the intestines
in response to food. It enhances insulin secretion, decreases hepatic
glucose output, and helps to regulate stomach emptying. GLP-1 could
not be given exogenously as the half life was only 2 minutes. Byetta
mimics the glucoregulatory effects of GLP-1 with a much longer action
time in the body. Byetta also helps to increase satiety therefore
causing weight loss during use. Byetta is for use in individuals
with type 2 diabetes who are on oral medications and have not been
able to maintain adequate control. It is given subcutaneously 2
times per day before breakfast and supper. There is a risk of hypoglycemia
with this drug, so other doses of medications may need to be changed.
Symlin and Byetta are not for everyone but they do give us more
tools in our battle to manage a very difficult disease. Contact
Sarah Balko, R.D. at 225-3473 if you would like more information
or to refer a patient for education.
Diabetes and Heart Disease
2 out of 3 people with diabetes will die from heart disease or stroke.
Unfortunately most patients with diabetes are unaware of the connection
between heart disease and blood sugar. We, at the diabetes education
office, are partnering with The Upper Michigan Heart Institute to
form TheLink , a support group for adults with heart disease and/or
diabetes.
The link will meet the 4th Tuesday every month from 3pm –
5pm. Anyone with diabetes or heart disease or an interest in either
of these diseases can attend. Topics will focus on making healthy
lifestyle changes to reduce the ABC’s; A1C, blood pressure,
and cholesterol.
Participants do not need to have been diagnosed with both heart
disease and diabetes to attend. We hope to encourage those with
one diagnosis to make changes to prevent the other. If you have
any questions on this new support group or would like to speak,
please call Sarah Balko, RD at 225-3473.
Distributed
by:
MGHS Education Department
580 W. College Avenue
Marquette, MI 49855
800-562-9753
www.mgh.org
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