June 1, 2019 : Issue #992

TOP STORIES — Diabetes News and Research

Interpretation and Management of Hyperglycemia and Exercise

by Sheri R. Colberg, PhD, FACSM

Why Low Carb Diets for Type 1 Patients?

Lower BMI for Type 1 Patients Improves CVD Outcomes

There are a lot of reasons why type one diabetes patients may gain weight. One of the most prominent is increased insulin use. This insulin use is often increased because the patient is controlling their glucose with the goal of an 80%TIR and an A1c target of 6.0 or lower. This week our focus is on these patients and insulin using type two patients.

Our exercise Guru, Dr. Sheri Colberg, starts us off on how to maximize insulin use during exercise, while this week’s featured intern Emma Kammerer shares her findings on Low Carb diets and how BMI affects cardiovascular outcomes in type one patients.

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We can make a difference!

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Dave Joffe

Editor-in-chief

By Sheri R. Colberg, PhD, FACSM
In some circumstances, elevated blood glucose levels can be indicative of medical concerns like insulin deficiency. People with type 1 diabetes are more susceptible to insulin deficiency since they have almost no ability to produce any insulin; therefore, they need to receive instruction on why and when to check for ketones. This is especially important if the individual is using an insulin pump. If ketones are present, then the higher blood glucose levels are a result of insulin deficiency, and corrective action should be taken immediately.

Why patients with type 1 diabetes are more likely to spend time in hypoglycemia.

Obesity has  been a leading cause of mortality and morbidity of cardiovascular disease.

A goal of 10 000 steps/d is commonly believed by the public to be necessary for health, but this number has limited scientific basis. Additionally, it is unknown whether greater stepping intensity is associated with health benefits, independent of steps taken per day. To examine associations of number of steps per day and stepping intensity with all-cause mortality this study took 17,000 older women to wear a hip accelerometer for 7 days to collect step counts. Participants were then divided into quartiles based on the median number of daily steps: 2700, 4400, 5900, and 8400. During roughly 4 years’ follow-up, 3% of the women died. After adjustment for confounders like age, smoking, and comorbid conditions, women in the three higher quartiles of daily steps had significantly lower mortality risks — reductions of 46%, 53%, and 66%, respectively — than those in the lowest quartile. From the results it was concluded that walking at least 4400 steps daily might help improve survival in older women, a JAMA Internal Medicine study suggests — welcome news for people who don’t hit the much-promoted goal of 10,000 steps daily.  Mortality declined with increasing steps until roughly 7500 steps per day, at which point the benefit leveled off.  The researchers conclude, “These findings may serve as encouragement to the many sedentary individuals for whom 10,000 steps/d pose an unattainable goal.”  JAMA Intern Med. Published online May 29, 2019. doi:10.1001/jamainternmed.2019.0899

Diabetes in Control gratefully acknowledges the assistance of the following pharmacy doctoral candidates in the preparation of this week’s newsletters:

Emma Kammerer, PharmD Candidate, Class of 2020, L|E|C|O|M Bradenton School of Pharmacy

Maya Rudolph, PharmD Candidate, Florida A&M University College of Pharmacy & Pharmaceutical Sciences

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Steve and Dave
Diabetes In Control
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