ECMOFOBIA, porque 14 picadelas por dia deixam qualquer um ecmofóbico...

quinta-feira, 14 de março de 2013

DKA awareness campaign | International Diabetes Federation

DKA awareness campaign | International Diabetes Federation

Diabetic Ketoacidosis (DKA) occurs when there is profound insulin deficiency. It frequently occurs at diagnosis and also in children and youth with diabetes if insulin is omitted, or if insufficient insulin is given at times of acute illness.
DKA results in vomiting, abdominal pain, flushed cheeks, acetone (sweet) smell on breath and dehydration with continued polyuria (excessive urination). Breathing at first is rapid and shallow and later deep sighing respirations (Kussmaul breathing). The level of consciousness decreases and coma and death can ensue.

DKA is a medical emergency and treatment should be initiated at the healthcare site of first contact. The child/youth should be transferred as soon as possible to the best available site of care with diabetes experience.
It is quite likely that some children and youth in developing countries, presenting for the first time in ketoacidosis, die undiagnosed. The symptoms and clinical findings they present with may be diagnosed as more common illnesses such as pneumonia, gastroenteritis, malaria or typhoid. Also, even when the correct diagnosis is made, it is sometimes very late and the child/youth can die or suffer permanent cerebral damage.
This problem has been known for some years, and prompted education campaigns. A project using posters and targeting the community was effective in Parma, Italy, and similar programs have been instituted in South Africa and Australia. Various posters have been used depending on the culture and the target group for education. In 2009, IDF developed a 4-icon poster (frequent urination, weight loss, lack of energy, excessive thirst). The South African paediatric endocrinologists added a fifth icon of bed-wetting.
The Life for a Child Programme has introduced a 6-icon poster - the 6th icon depicting the later stages of DKA - and invited countries supported by the Programme to participate. The campaign was developed to alert health professionals to the signs and symptoms of diabetes in order to make a swift diagnosis and provide appropriate treatment to save lives - championing the vision that no child should die of diabetes.

domingo, 10 de março de 2013

Diurnal Pattern of Insulin Action in Type 1 diabetes

Diurnal Pattern of Insulin Action in Type 1 diabetes

'The results suggest that in contrast to healthy subjects, SI diurnal pattern in type 1 diabetes is individual specific, hence cannot be extrapolated to the type 1 diabetes population as a whole thus implying that Artificial Pancreas algorithms may need to be personalized.'

terça-feira, 5 de março de 2013

DRI BioHub -- The Next Quantum Leap Toward A Biological Cure

A 'Mini-Organ' Delivering Real Insulin in Real Time

With the BioHub, the DRI is taking a quantum leap toward a biological cure.
The BioHub is a bioengineered “mini organ” that mimics the native pancreas. It contains real insulin-producing cells that can sense blood sugar and release the precise amount of insulin needed -- in real time.
To the millions living with diabetes, the BioHub brings the promise of natural insulin production and normal blood sugar levels one step closer to reality.

Building on success

In type 1 diabetes, the immune system mistakenly destroys insulin-producing “islet” cells in the pancreas. The DRI’s focus is to develop a biological cure by replacing those cells.
In clinical trials, our scientists have transplanted islet cells from donor organs into patients with long-standing type 1 diabetes. As a result, recipients achieve insulin independence. Some patients continue to be insulin free for more than a decade after the transplant.

“The BioHub gives us a tool to combine all we’ve learned through the years of clinical testing and take the next leap forward. I am confident that this approach could move cellular therapies and biological replacement strategies for the cure of diabetes to our final goal.”

-- Camillo Ricordi, M.D. Stacy Joy Goodman Professor of Surgery and Director, Diabetes Research Institute

However, islet transplantation has been limited to only the most severe cases of diabetes. Several challenges must be overcome before this strategy can be offered to all who can benefit.
The existing hurdles include:
  • Supply – the need for more insulin-producing cells for transplant
  • Sustainability – the need for the recipient to accept the cells long-term, without the need for anti-rejection drugs
  • Site – the identification of an optimal site within the body to house the new cells

Addressing the challenges

The BioHub platform addresses these challenges by drawing on recent developments in bioengineering, immunology, and decades of transplantation expertise.
Prior to their destruction by the immune system in type 1 diabetes, healthy islets thrive inside the pancreas, where they have sufficient oxygen, adequate space, and all the nutrients needed to perform the demanding job of normalizing blood sugar levels.
The BioHub attempts to closely replicate the cells’ natural environment and allows scientists to fine tune these cellular needs within the transplant site as never before.

“The development of a mini organ would mimic the native pancreas and restore the natural metabolic function of insulin release in immediate response to blood sugar levels-something currently unavailable to patients with diabetes.”

-- Jay Skyler, M.D. Deputy Director of Clinical Research and Academic Programs, Diabetes Research Institute

Among the platforms being tested for a BioHub is a porous, sponge-like material approximately the size of a quarter that is compatible with the human body. Islet cells are gently seeded on this protective platform, allowing cells to nestle within the individual pores.
Researchers are also testing the use of more natural containers, such as a patient’s own vein, that can be tied off to create a “venous sac" complete with its own pre-existing vascular supply.

Enhancing the environment

In addition to housing transplanted insulin-producing cells, a BioHub will also allow scientists to enhance the immediate transplant environment withadditional oxygen, specific types of “helper” cells or other agents to promote the cells’ long-term survival and function.

“If we can identify an optimal place within the body to place a BioHub, then I believe this disease is totally reversible, which has been the DRI’s ultimate goal since our inception.”

-- Luca Inverardi, M.D., Deputy Director of Translational Research, Diabetes Research Institute

Additionally, a BioHub platform can be used to house not just islets, but any future insulin-producing cell type that scientists create.
The components that comprise the BioHub are in various stages of development and testing, with pre-clinical trials currently underway.

sábado, 2 de março de 2013

Fazemos, hoje, 4 anos de diagnóstico...

Hoje fazemos 4 anos de diagnóstico...
Para assinalar a data, partilho convosco o desabafo de uma mãe que vive a nossa realidade...
E vocês... sabiam a sorte que tinham? E agora? Sabem a sorte que têm?
Não deixem de ler...

The Princess and The Pump: A Type 1 Diabetes Blog: Lucky

'Do you know how lucky you are?

If you've never had to pierce your child's flesh.

If you've never entered your child's bedroom with baited breath, waiting to know they are alive before you exhale.

If you have - but know that that possibility is remote and highly unlikely. 

If you don't see your child's blood every single day.

If you can feed your child without thinking twice. 

If you don't have to count every morsel that goes into their mouths.

If you can send your child to school without any extra care, notification, preparation.

If you can let your child go off to play at a friends house with any added stress or explanation or directions.

If you can sleep for more than 3 hours at a time.

If the medicine cabinet on your bathroom is still functioning and has just about enough room.

If you don't have a sharps container in your house.

If your pharmacy does not know you well enough to call you by first name.

If you don't have to BEG your insurance company to give you
enough supplies to keep your child healthy.

If you don't visit a hospital every 3 months.

If you don't worry when your child falls down when playing or falls asleep in the car that he or she is actually passed out from a hypoglycemic episode.

If you don't carry around an enormous amount of medical supplies every where you go.

If you don't know what normal blood sugar is.

If your life has never been divided into before and after.

If you never spent a week in the hospital learning to keep your child alive.

If you don't fear a simple cold or a 24 hour stomach bug.  If you'd never even imagine that it could land you in the ER.

If you don't have to FIGHT so that your child can be like everyone else.

If you don't know what insulin smells like.

If you don't know how to fill a syringe.  

If you don't juggle carb counts, carb rations, ISF's, and IOB information at the same time. 

If you have no idea what any of that means.

If you've never had to hold your child down to give her a shot.  Multiple times a day.  Every day. 

If you've never listened to your child cry and scream, "NO!  Mommy, Don't hurt me."

If you've never had to answer your child when she asked, "Why me?  Why am I different?  Will it ever go away?"

If you don't stare death in the face every day.

If you don't really know anything about Type 1 diabetes.

Do you know how lucky you are?  Do you know how much you take for granted every day?  Do you know how much easier life is without diabetes?

Do you?

Before April 27, 2009 - I didn't.  I had no idea.  I had no idea how lucky I was. 
I had no idea how easy meal times were.  I had no idea how simple it was to get my child a glass of juice or milk.  I had no idea what a "bad cold" or "illness" was REALLY like.  I didn't know anything about carbs.  Or insurance.  Or needles.  Playing, dancing, going to school... it was all so easy. 
I had no idea.  I took so much for granted.
But now....
Now I'm on the other side. 

And do you know how lucky I am?

I know how to fill a syringe.

I know how to give a shot and insert a cannula.

I know how to count carbs and calculate insulin doses. 

I have insulin to give my child.

I have a pharmacy staff that is caring and kind.

I have a top rate children's hospital to treat my child.

I have a closer family.

I have deeper relationships. 

I have enough supplies to keep my child alive and healthy.

I have been humbled by something bigger than me.

I have a school and teachers who love my child and care for her like she's their own.

I have learned to ask for help.

I have learned that I can't do it all.

I have learned to cherish the good days.

I have learned to enjoy the moment.

I have learned how fragile life is.

I have learned how strong I really am.

There are days that I hate diabetes.  I hate what it does to my child and me and my family.  I hate what it means.  I hate all that we have to do to just to appear normal and live a normal life.  I hate all that it takes away.  I hate all that it demands of us.
There are days.... days when I wish it had never entered our lives.  Days when I am so incredibly jealous of those whose lives are so much easier.  Of those who don't deal with diabetes.  Of those who don't worry daily about their child's mortality.
And when I have one of those days.....  I try to think of lucky I am.  Of all the good D has brought into our lives. 
Because I can't make it go away. 
All I can do is look for the blessings.  And feel lucky.'