A type 1 diabetic mystery is why do some Type 1s get complications and others seem to never get them? A massive Japanese study of Type 1 diabetics found that those with fulminant diabetes developed complications much faster and more severely than those with non-fulminant diabetes.

The difference between fulminant and non-fulminant is the speed and intensity at which the disease develops. Fulminant Type 1 diabetes typically develops suddenly with near total loss of beta cell function. This type of diabetes is confirmed with testing c-peptide levels. Non-fulminant type 1 diabetes has residual c-peptide levels that eventually taper to undetectable. Sometimes this is seen through many years of the Honeymoon Period.

This study may be the antithesis of conventional wisdom for preventing complications. Staking all hopes on blood sugar control is heavily optimistic. Yes controlling blood sugar does lessen the workload for existing beta cells, and thus extends the lifespan of each beta cell. Research suggests that c-peptide offers protection to beta cells, both from apoptosis (cell death) and encourages new cell growth. This new cell growth applies to beta cells and other cells of the body that endure long-term Type 1 diabetes complications.

Diabetics are instructed that maintaining normal blood sugars is the Holy Grail of preventing long-term complications. Yes and no. The truth is controlling your blood sugar will not allow complications of Type 1 diabetes to develop as quickly, presuming you still had some level of beta cell function upon diagnosis (i.e., c-peptide). That doesn't sound like a reward as much as it does a delayed punishment. I'd like c-peptide with my insulin, please. It's off the à la carte menu? That's fine - serve it up! I want to thank Klausen for bringing this study to my attention.

I contacted Novo Nordisk back in March to tell them about the remarkable effects C-peptide had on reversing complications of Type 1 diabetes. I asked if they would bring the drug to market. A mass of excitement overwhelmed me when I learned about C-peptide missing from insulin all these years. The response from Novo? No thanks, it's not one of our targets. Targets, eh?

C-peptide is a byproduct of the production of insulin. In Type 1 diabetics, the level of C-peptide eventually becomes undetectable due to the body not making any insulin of its own. Long-term complications of diabetes frequently develop despite insulin therapy and optimal blood glucose control. C-peptide could quite possibly be the missing link in perfect diabetes control. I sent the following document to Novo Nordisk and asked them to make C-peptide available to reverse and ameliorate renal and nerve dysfunction for Type 1 diabetics. Read the document and see for yourself the eye-popping beneficial results C-peptide offers Type 1 diabetics. I received it directly from Dr. Wahren, lead researcher for C-peptide.

After 5 months consideration, Novo called me back. They said C-peptide is not a target for their company. I understand and now Levemir is not a target in my diabetes control, either. For all the Type 1 diabetics out there controlling your sugars with insulin not really made with you in mind -- do you understand why Novo does not wish to develop this critically important treatment? I guess insulin is good enough, right? Wrong. It's a tough job but somebody's got to do it. Just not Novo. When you are in the business of diabusiness -- no thank you says so much about what could potentially hurt your business.

In recognition of Foot Health Awareness Month, LifeMasters encourages diabetics to prevent foot complications by following a few simple steps to maintain healthy feet.

As you know, diabetics are more prone to foot complications. These complications include fungal infections, calluses, ulcers, foot deformities, and gangrene -- which may include infection and may in some cases, lead to amputation.

The underlying diabetic cause for these complications is the nerve damage, also called neuropathy and a decrease of blood flow to the foot. Neuropathy causes loss of feeling in the feet, decreasing feeling, affecting balance and leading to a foot injury. Diabetes also causes damage to blood vessels in all parts of the body, including the legs and feet, and can lead to poor circulation. Courtesy of LifeMasters, they are offering some tips protect your diabetic feet:

Control your blood sugar levels! Maintaining normal or near-normal blood sugar levels can reduce blood vessel and nerve damage that often lead to diabetic foot complications. If a wound or foot ulcer does occur, blood sugar control reduces the risk of an amputation. (For fair and balanced review: see Yesterdays Blog)

Wash your feet daily. This goes without say. Who wants dirty feet around? If you are grossed out by feet - pay somebody to do it for you. Get a pedicure or visit a podiatrist.

Check your feet daily for skin breaks, sores, cuts, bruises, and changes to the toenails (ingrown, coloring, etc.). If you cannot see under your feet, trick a loved one into doing it for you. Promise them you'll be their best friend and I'm sure they'll take you up on it. Who doesn't love a person with Happy Feet?

Have an annual foot check with your doctor or podiatrist. Your doctor will examine your feet, and probably perform a monofilament test (a single strand plastic thread stroked on your feet) to see if you are developing nerve damage.

Wear appropriate shoes: Make sure to wear shoes that fit well, and are not too tight. Tight shoes can cause pressure ulcers to develop. Avoid going barefoot, even in your own home, as it may increase your risk of injury to the foot. Wear clean cotton socks and change them daily. I guess this last step requires you to shop. And is that really such a bad thing?

Knocking out the gene for a peptide associated with insulin was shown to protect mice against the harmful effects of a high-fat diet. Urocortin 3 plays a role in the increased production of insulin in response to high caloric intake in animals.

Scientists found that by removing the urocortin 3 gene from mice, they did not develop the age-related insulin resistance and high blood sugar observed in the normal control mice. The metabolisms of normal mice were compared to the metabolisms of those without the urocortin 3 gene. When placed on a high caloric diet for three months, the mice without the urocortin 3 gene packed on the same amount of weight but had lower insulin levels. But these mice also had lower blood sugar, improved glucose tolerance curves and they did not develop the fatty livers the control mice experienced.

Scientists hypothesize that by curtailing the abnormally high insulin levels, they were able to manipulate insulin sensitivity and avoid some of the untoward consequences of the high food intake and weight gain. Like many of us diabetics already know too well - while insulin is effective at lowering blood sugar it also promotes fat storage. This is a natural protective response to prepare for times when food may not be available. When insulin is produced at too high a level for too long, the body becomes insulin resistant and blood sugar and certain blood lipids gradually creep up, which can cause progressive damage to multiple organs.

Urocortin 2 and urocortin 3 are part of the system that governs the body's response to insulin. Scientists already know that mice on a high-fat diet do better if either urocortin 2 or urocortin 3 is removed. Now they want to know if the mice will respond even better if both are missing. Such results may instruct us how best to develop therapeutic means to exploit these powerful effects.

It is well known that people with type 2 diabetes are at increased risk of pancreatic cancer, and now it seems that the risk extends to those with type 1 diabetes.

The risk was assed as small, but nonetheless - increased compared to those without diabetes. The research found that the likelihood of developing pancreatic cancer was twice as high in subjects with type 1 or young-onset diabetes as in people without diabetes. This increased risk is similar in magnitude to that seen with type 2 diabetes. There are many theories about the link between diabetes and pancreatic cancer. A cancer-inducing role of the insulin-producing beta-cells in the pancreas, is ruled-out because in type 1 diabetes these cells have largely or entirely been destroyed. The researchers want to stress that people with type 1 diabetes should not be overly concerned. The leading scientist issued a statement, "pancreatic cancer is an extremely rare disease, and twice a tiny risk is still a tiny risk."

In light of the study results, the researchers encourage diabetics to stay the course and focus on preventing the common complications of diabetes such as heart disease, eye disease and kidney disease. Good plan, good doctor. Thank you for the reassuring news – phew!

Heralding from High Point, NC, BedFrameParts.com has created a heavy duty, multi-purpose bed frame that has recessed legs to prevent stubbing your toe. It's not as uncommon as you'd think. Proper foot care is essential for diabetics because they are prone to foot problems. BedFrameParts.com is addressing the issue of safety first when it comes to a good night sleep.

The Superframe has deeply recessed legs that can prevent possible foot or toe injury. The unique design of the bed frame has made it a Diabetic Friendly Product. BedFrameParts is offering an introductory special including free shipping along with a free Siltex® Underbed Storage Pod" that is designed to slide under your bed, providing extra storage. Pricing for this unique diabetic-friendly bedframe starts at $129 for twin or full sizes and $159 for Queen, King or California King sizes.

I've stubbed my toe a few times throughout my days. In all fairness - it was my fault for not picking my feet up. If the engineering of this frame prevents a stubbed toe, a foot laceration, or the inconvenience of a bump in the night - the decision might be a good one. Sleep on it!

Damage to the retina that sometimes comes with diabetes is associated with an increased risk of having a stroke.

A study involving 1,617 middle-aged people with diabetes led researchers to this conclusion, linking retinopathy and stroke risk. At the start of the study, 197 participants had moderate retinopathy and 44 had severe retinopathy. During an average follow-up of almost 8 years, 75 strokes occurred in the group as a whole. Considering all exacerbating factors -- such as blood pressure, insulin treatment and cholesterol levels -- having diabetic retinopathy more than doubled the likelihood of having a stroke.

Dr. Tien Y. Wong advised Reuters Health, "Diabetes can exert its effects on multiple organs in the body, and damage in the blood vessels seen in the eye -- retinopathy -- is a marker of probably unseen damage occurring elsewhere." Detecting blood vessel damage in the eye is linked to blood vessel damage in the brain, which could result in a stroke. He advises all eye care professionals to perform a more comprehensive assessment of stroke risk if they detect retinopathy in a patient.

Remember the A-Game suggestions I dangled for Eli Lilly to tap for performance enhancement? Well here it comes. I called Eli Lilly headquarters to speak with the Chairman and CEO, Mr. Sidney Taurel but I was directed to their idea submission form (which consequently didn't work). Oh boy, Sid. I'm a little disappointed. So here goes - my idea is going free for all when you could've had it, first. Let's call this new and improved product Beta Juice. It delivers the essential functions of a fully operational beta cell. It produces: insulin, amylin and c-peptide. Here's why insulin should always come equipped with the other two...

Insulin brings sugar to the cells to keep our energy levels sufficient for life, homeostasis and (if we're lucky) some energy for the gym. Amylin is a controlling agent for appetite, gastric emptying and tells the liver to dispatch glucose. It is also shown to have an impact on lipolysis --- the metabolism of stored fat. Until recently C-peptide was nothing more than a number used to decipher if you were a type 1 or a type 2 diabetic. However, recent scientific studies have shown C-peptide protects small vessels from the complications associated with diabetes. The Reuters Health article is titled C-Peptide Replacement Improves Early Diabetic Neuropathy.

The American Diabetes Association promotes the ABC's of Diabetes Care in an effort to educate diabetics on controlling their disease. The ABC's of diabetes care refer to a patient's Hemoglobin A1c, blood pressure, and cholesterol. A diabetic must maintain a hemoglobin A1c less than 7%, their blood pressure must remain below 130/80 and their good and bad cholesterol must be kept in range. The ABCs of Diabetes Care were established in order to reduces the chances of developing diabetic complications like neuropathy (nerve damage), nephropathy (kidney damage) and retinopathy (eye damage).

Here comes the perfect Insulin (code name Beta Juice) -a laboratory engineered balance of insulin, amylin, and C-peptide. Insulin to balance the blood sugar level, amylin to regulate fat and cholesterol levels and C-peptide to control the damage inflicted upon the micro vessels throughout the body. This is a GREAT IDEA!! Not just because it is MY idea, but because this is a huge opportunity to mitigate the complications that insulin by itself can impose, without the checks and balances of the other beta cell hormones. What do you say, Eli Lilly? You're halfway there!! You've already partnered with Amylin Pharmaceuticals. They have one third of this patent pie. Now hop on the horn and join forces with the C-peptide patent holder and ride your stock price to the moon. The diabetic girl has spoken. I know you care, Eli Lilly. Now put your money where your mouth is and make this new and improved insulin a light at the end of the diabetes tunnel.

A report published in Diabetes Care says C-peptide improves sensory nerve function in type 1 diabetic patients with early-stage diabetic neuropathy. Thanks to Scott Strumello's comment, earlier today, I couldn't help but query the world wide web for more information on this C-peptide revelation. If I forget to mention it - thanks a million, Scott!

C-peptide was shown to be a significant factor in the maintenance of microvascular function. In a 6 month study of type 1 diabetes patients receiving replacement C-peptide, their nerve functions improved remarkably. A randomized study of 139 patients received one of 3 daily treatments: 1.5 mg of C-peptide, 4.5 mg of C-peptide, or placebo. At the beginning of the study, the sensory and motor nerve conduction velocities were significantly reduced compared with normal. After 6 months of treatment, peak sensory nerve conduction velocities improved in the groups treated with low-dose or high-dose C-peptide, but not significantly compared with the control group. The study showed a significant advantage in nerve functions for those treated with C-peptide (37%) verses those in the control group (19%). Overall, there were no adverse drug reactions reported from treatment of C-peptide.

At this time, there is strong evidence supporting the belief that C-peptide may be beneficial not only for nerve function, but also for the treatment and prevention of other long-term complications caused by type 1 diabetes such as nephropathy and perhaps retinopathy. Phase II clinical studies are ongoing at this time to demonstrate the safety and efficacy of C-peptide replacement therapy for the treatment of diabetic peripheral neuropathy. I can hear the trumpets playing already. I'll be right there with pen-in-hand ready to sign the dotted line for such a study. Thank you, Scott and thank you, Creative Peptides.

A study shows that men with type 2 diabetes experience pronounced risk of erectile dysfunction (ED) when they have symptoms of depression.

Depression appears to be a vicious cycle that may instigate the development of ED, while the ED symptoms perpetuate the symptoms of depression. Effectively deducing that ED in diabetic patients is not related entirely to organic factors. The study evaluated men with type 2 diabetes who completed questionnaires every 6 months for 3 years. Five hundred men reported ED at the start of the study, and an additional 192 developed the disorder during follow-up. The investigators noted higher prevalence of high blood pressure (46% versus 32%) and lipid abnormalities (23% versus 13%) among men who complained of ED. The researchers also observed higher incidence of retinopathy, neuropathy or heart and vascular disease in ED sufferers. Those with ED were more likely to be treated with insulin or diuretics. Depression and ED was found more often in those with poor physical and psychological health.

The researchers surmised that erectile problems are not necessarily an inevitable outcome of the aging process. The risk factors for ED are modifiable and can be changed to reduce the likelihood of the outcome (or lack thereof). The results should serve as uplifting news for suffers of ED, no pun intended.

A study reveals the drug duloxetine is useful in treating diabetes-related pain, but it may worsen control of blood sugar levels. Diabetes is the number one cause of damage to the peripheral nerves in the United States. Neuropathy will first appear as burning or stinging in the feet, usually worse at night. The nerves to the feet are affected first because the damage is occurring along the entire length of the axons and the axons to the feet are the longest in the body.

Duloxetine is one of only two drugs approved for the treatment of diabetic peripheral neuropathic pain (DPNP), a common problem in diabetic patients, Cymbalta® or duloxetine is the first drug approved by the FDA for painful diabetic polyneuropathy. The drug was previously approved as an antidepressant. The drug is an SSNRI meaning it is both a selective serotonin reuptake inhibitor and a selective norepinephrine reuptake inhibitor. By blocking the reuptake of serotonin and norepinephrine, these neurotransmitters increase in the spinal cord and brain. It is speculated that both increased serotonin levels and norepinephrine levels produce an inhibitory effect on the ascending sensory tracts.

Data was collected from three clinical trials to investigate changes in weight, sugar levels, and cholesterol levels in patients with DPNP treated with duloxetine. Short-term treatment with duloxetine was associated with a modest increase in fasting sugar levels, but not with significant increases in hemoglobin A1c, a measure of long-term sugar control. With longer treatment, however, there was a significant rise in hemoglobin A1c, indicating impaired sugar control. In addition, there were also small changes in cholesterol levels among duloxetine-treated patients, but a small increase in HDL "good" cholesterol was the only statistically significant change. Weight declined with short-term duloxetine treatment, but increased slightly with long-term treatment.

Diabetes Care reports that the antioxidant alpha-lipoic acid (ALA) assists in alleviating nerve pain in patients with diabetes. Daily treatment with ALA showed the potential to reduce pain associated with diaibetes.

A comparison was made between three doses of oral ALA verses a placebo in 166 patients with diabetic nerve pain (polyneuropathy). The symptoms of different types of pain were significantly reduced after 5 weeks in the ALA treated group as compared with the placebo group. However, ALA treatment had no measurable effect on numbness. Symptoms improved significantly as early as 1 week with the highest ALA dose (1800 mg daily) and within 2 weeks with the other doses (600 mg and 1200 mg daily).

This research is encouraging because it suggests the possibility of repairing impaired sensory function. This is great news for diabetics suffering from foot ulcers, one of leading causes of foot amputation. Researchers concluded that taking 600 mg of alpha-lipoic acid (ALA), once daily would be the most appropriate oral dose with the least amount of gastrointestinal side effects. Stocking stuffer? You bet - in more ways than one!

Heart transplant patients who suffer from diabetes face greater odds to overcome during the recovery process. So says a study published in the Journal of Nuclear Medicine (September 2006). It all comes down to nerves, apparently. When someone undergoes a heart transplant, there's more involved than just sewing it into place and giving it a thump to get the beats going. Just as important is what comes after: the healing, the acceptance of the organ by the body, and also reinnervation - the heart's ability to regenerate its nervous system by growing new nerve fibers that replace old, damaged ones. According to, Frank M. Bengel, one of the study's authors, this process of reinnervation is slower in diabetic patients.

All is not lost, however, for diabetics needing heart transplants. Says Bengel, "Even if a transplant recipient is suffering from diabetes, there is still a chance for reinnervation - just at a slower speed." Problem is, we have to wait for science to catch up; there are, as yet, no techniques available to speed the nerve regeneration process nor is there an imaging technique in existence that precisely monitors nerve damage.

It seems that size is everything - when you're picking out new shoes. Yes, diabetics need to take special care of their feet. Wearing comfortable, supportive shoes is an essential part of footcare for diabetics. Because diabetics are prone to foot ulcers and nerve damage, ill-fitting shoes put them at a high risk for foot damage that can lead to lower limb amputations.

However, a new study just published in the Journal of the American Podiatric Medical Association reports that many diabetics may be playing with fire by wearing incorrectly sized footwear. That's right. They don't even have the right size for their feet to begin with. The study involved 440 US veterans, mostly men. Of that number, only a quarter (!) wear the correct size of shoe for their feet. Says APMA President Dr. David Schofield, diabetics need to be aware that their condition makes them less aware than non-diabetics of pressure and rubbing caused when shoes are too tight or too loose. He recommends diabetics get properly fitted by a professional. I'm thinking he means a staff member at a specialty footwear store, not the college kid at your local Payless Shoes.

The American Diabetes Association (ADA) has announced a set of new treatment guidelines for Type 2 diabetes. The aim is to promote effective management of hyperglycemia, which is essential for Type 2 diabetics hoping to avoid serious diabetes-related health complications such as kidney disease and nerve damage.

The guidelines consist of a consensus statement published in the latest issue of Diabetes Care (July 2006). This is expected to be of use to physicians, helping them counsel their diabetic patients. The ADA urges physicians to try patients on the drug metformin and to encourage diabetic patients to undergo lifestyle changes in order to avoid or reduce the need for prescription medications. The organization also recommends that doctors emphasize to their patients the importance of getting their blood sugar levels back to a level that is considered "normal." However, the ADA also says that physicians should not wait too long to begin insulin therapy if normal blood sugar levels are not achieved quickly, and to combine insulin therapy with regular checkups and adjustments at least every three months.