Health For Life

Objective

• to evaluate the clinical effectiveness and safety of a device that combines an insulin pump with real-time continuous glucose monitoring (CGM), compared to using an insulin pump with standard blood glucose monitoring systems.

METHODS
6-month- randomized, multicenter, treat-to-target study
146 subjects

• treated with continuous subcutaneous insulin infusion
• age between 12 and 72 years with type 1 diabetes
• initial A1C levels of >or=7.5%.
• Subjects were randomized
  1. pump therapy with real-time CGM (sensor group [SG])
  2. to pump therapy and self-monitoring of blood glucose only (control group [CG])

Clinical effectiveness and safety were evaluated.

RESULTS:

• A1C levels decreased (P<0.001) from baseline (8.44+/-0.70%) in both groups (SG, -0.71+/-0.71%; CG, -0.56+/-0.072%)
• SG subjects showed no change in mean hypoglycemia area under the curve (AUC)
• CG subjects showed an increase (P=0.001) in hypoglycemia AUC during the blinded periods of the study.
• The between-group difference in hypoglycemia AUC was significant (P<0.0002).
• >60% sensor utilization was associated with A1C reduction (P=0.0456).

CONCLUSIONS:

1. A1C reduction was no different between the two groups.
2. Subjects in the CG group had increased hypoglycemia AUC and number of events during blinded CGM use
3. Subjects with greater sensor utilization showed a greater improvement in A1C levels.

Reference: Diabetes Technol Ther. 2008 Oct;10(5):377-83.

The extract of oak bark (QRB7) has been used for years as a topical medication with success. QRB7 is the proprietary oak bark extract in Bensal HP. It is indicated as an external treatment for the inflammation and irritation associated with many common forms of dermatitis, including certain eczematoid conditions. These conditions include complications associated with pyodermas, and in the treatment of insect bites, burns, and fungal infections. In this tightly controlled 6-week study in which no patients were lost to follow-up, Bensal HP seems to be an effective treatment for properly treated diabetic ulcers, outperforming an identical control group whose only difference was SSC as a medication.

Reference: Adv Skin Wound Care. 2008 Oct;21(10):461-5.

They investigated the therapeutic effect of electrical stimulation on plantarflexor spasticity in stroke patients. A randomized controlled clinical trial study was done at a rehabilitation clinic of Semnan University of Medical Sciences. 40 stroke patients (aged from 42 to 65 years) with ankle plantarflexor spasticity was enrolled.

1st group—> Fifteen minutes of inhibitory Bobath techniques were applied.
2nd group—> A combination of 9 minutes of electrical stimulation on the dorsiflexor muscles and inhibitory Bobath techniques.
- 20 sessions daily.

Main measures: Passive ankle joint dorsiflexion range of motion, dorsiflexion strength test, plantarflexor muscle tone by Modified Ashworth Scale and soleus muscle H-reflex.

Conclusion: Therapy combining Bobath inhibitory technique and electrical stimulation may help to reduce spasticity effectively in stroke patients.

Reference: Clin Rehabil. 2008 May;22(5):418-25

Compared with the ADA diet, the low-GI diet achieved equivalent control of HbA1c using less diabetic medication. Despite its limited size, this trial suggests that a low-GI diet is a viable alternative to the ADA diet.

Reference: Nutrition. 2008 Jan;24(1):45-56.

Olmesartan medoxomil/HCTZ 40/12.5 and 40/25 mg/day combination therapy was well tolerated and demonstrated a greater antihypertensive effect than benazepril plus amlodipine besylate 20/5 and 20/10 mg/day and this enabled more patients to achieve targeted BP goals.

Reference:  Am J Cardiovasc Drugs. 2007;7(5):361-72

In patients with type 2 diabetes and coronary artery disease, treatment with pioglitazone resulted in a significantly lower rate of progression of coronary atherosclerosis compared with glimepiride.

Reference:  JAMA. 2008 Mar 31

Long-term treatment with roxithromycin is ineffective in preventing death, amputation, peripheral revascularization, myocardial infarction, stroke, transient cerebral ischaemic attack, thrombosis and decline in ABPI in patients with an established diagnosis of PAD.

Reference: Atherosclerosis. 2008 Feb;196(2):937-42.

Combining aspirin and clopidogrel significantly reduces the odds of major cardiovascular events in patients with acute coronary syndromes or those who undergo percutaneous coronary intervention but at the expense of significant increases in the risk for bleeding.

Reference: Am J Cardiol. 2008 Apr 1;101(7):960-966.

Both exercise and dietary intervention reduced metabolic syndrome prevalence compared with control after 1 year of intervention. However, the combined diet and exercise intervention was significantly more effective than diet or exercise alone in the treatment of the metabolic syndrome.

Reference:  Scand J Med Sci Sports. 2007 Dec;17(6):687-95.

Decrease in circulating levels of adipokines and inflammatory markers was also observed after weight loss. Weight loss altered gene expression of cytokines related to inflammation and the immune response in PBMCs. Changes in IL6 mRNA expression were associated with changes in fasting glycemia. The decrease in IL-1 receptor antagonist expression after weight loss and the strong correlation between the decrease in IL1B expression and the increase in insulin sensitivity suggest a contribution of these genes to insulin-resistant states found in obesity and the metabolic syndrome.

Reference:  Metabolism. 2008 Feb;57(2):192-9.