Browsing diabetes-related books on Amazon recently, I came across this one: When You're a Parent with Diabetes: a real life guide to staying healthy while raising a family by Kathryn Gregorio Palmer. It caught my eye because 1.) it got very favorable reader reviews and 2.) it addresses a topic that is usually neglected - being a good parent when it's you with diabetes. When You're a Parent was published in September 2006 by Healthy Living Books.

Interesting, that. I mean, there are tons of resources out there about raising children with diabetes and keeping them healthy. This book addresses the needs of parents with diabetes who want to raise healthy happy children, but also have special health needs of their own to remember.

Top 100 Amazon reviewer Manny Hernandez has posted a review to the site and also this site, praising the book. Manny's a good authority, by the way: he has type 1 diabetes and has his own sites including, TuDiabetes and a blog AskManny. Busy!! According to Hernandez, Palmer is informative but never condescending, guiding parents through anecdotes on her own and others' experiences. Palmer covers the gamut from pregnancy to raising teens, adoption, and dealing with depression, diabetes complications, and communicating with your kids about your condition. Sounds like a good resource.

The American Association of Clinical Endocrinologists (AACE) has released its new medical guidelines for diabetes. Needless to say, the 66-page guidelines are intended for your doc, not for you. Unless you are having trouble getting to sleep at night...

But they're important for you to know about. Very. The guidelines are the first reference point for physicians determining the best course of care for diabetes patients. Blood sugar, blood pressure, type 1, type 2, pregnancy, metabolism, prevention etc etc. It's all in there.

So what's new? According to AACE president Dr. Richard Hellman, the focus is, for the first time, on patient safety - specifically, reducing the incidence of medical errors involving diabetes patients. "These guidelines are the first that specifically point to how best to protect the patient with diabetes against mistakes and misjudgments by all those who directly or indirectly impact their diabetes care, including themselves," said Dr. Hellman. "Patient safety is not a given."

The guidelines are being published as a supplement to the latest issue of Endocrine Practice (May/June 2007), the journal of the AACE. They can also be accessed online. Click here to view the pdf.

Women who developed gestational diabetes while pregnant are at a higher risk for pancreatic cancer. Unfortunately, that's the word from a new study. According to this report from Canada's CTV News, past studies have linked type 2 diabetes with increased pancreatic cancer. And, of course, having gestational diabetes puts you at risk for type 2 diabetes. However, this is the first time a link has been made between GD and pancreatic cancer.

The study involved an analysis of health records for a whopping 40,000 women, all of whom gave birth in Jerusalem between 1964 and 1976. Phew, that's a lotta diapers... Of 410 women diagnosed with GD, five developed pancreatic cancer in later years. None of the 137 women with type 1 diabetes went on to develop pancreatic cancer. Want the full story? Results have been published in BMC Medicine.

Now, don't panic if you have had GD. Says lead researcher, Mary Perrin of NYU's School of Medicine, the absolute risk for pancreatic cancer is still very low. Nevertheless, she points out that even a small statistical difference is significant since obesity is on the rise. The implication? If trends continue, we can expect to see more and more moms-to-be with GD in the future.

The babies of women who had diabetes during pregnancy -- be it gestational or type 1 or type 2 -- may have less of an ability to form early memories than children of non-diabetic women, say scientists from the University of California Davis. This could be due to the effect that fluctuating glucose levels have on iron levels in mothers, therefore also leading to an iron deficiency in the fetus -- which can reduce the blood's capacity to carry oxygen.

When oxygen and iron deficiencies occur prenatally, the development of memory may be altered. This belief is supported by studies held by the researchers from UC Davis, wherein it was shown that babies of diabetic mothers could recall two fewer objects (out of a series of nine objects in three levels of difficulty) than those babies of non-diabetic mothers. This applied for the older group of babies, as well as with infants of 12 months.

The study was presented in San Fransisco at the annual meeting of the American Association for the Advancement of Science.

I just read that the US Food and Drug Administration (FDA) has announced that it is re-classifying the drug NovoLog to allow its use by women with Type 1 diabetes who are pregnant. NovoLog is manufactured by drug-producing giant Novo Nordisk. The change came after a trial which found that pregnant women with T1 diabetes who took NovoLog had HbA1c levels and rates of maternal hypoglycemia comparable to women on regular insulin. The study did not, however, evaluate whether babies whose moms take the drug while pregnant have a greater risk of congenital malformations. On the other hand, women taking NovoLog benefited from a lower risk of diabetes-related pregnancy dangers such as preterm delivery.

Pregnancy and drugs. It's a complicated issue. What's safe? What's not? If only it were so simple as dividing all drugs into one category or the other - the Good or the Bad. Unfortunately, many common medications are in a third category - the Ugly? These drugs, known as category B drugs, constitute a sort of pharmaceutical no-man's land. You see, these meds have not been proven to cause harm to unborn children, like category C drugs. Yet they have not been proven safe, either, like category A drugs. This means, as I discovered when I was pregnant in 2006, if you're sick and could benefit from some specific No-Man's-Land drug, odds are your doc will offer to write you a prescription for it. He or she will warn you that it's possible the drug causes harm and leave the decision of whether or not to take it up to you. Now, I don't want to go back to the Bad Old Days when doctors told patients "do this" or "do that," "take this" or "take that," and, by golly, you did it and didn't ask questions. But wouldn't it be nice to just know what to do? Or to know that your doc knows all the answers? What's a gal to do??

New research is revealing that cells passed from mother to child during pregnancy could be used to treat diabetes. Scientists found these cells can develop into functioning islet beta cells which produce insulin in the pancreas.

Scientists studied 172 individuals and took pancreatic tissue from four deceased males. They found small numbers of female islet beta cells able to produce insulin. There was no evidence the mother's cells were causing damage or becoming the target of an immune response. However, the team found more maternal DNA in the blood of children and young adults with type 1 diabetes than in healthy individuals. Researchers believe the maternal cells may be helping to regenerate tissue in the pancreas.

I heard about this study last year. It sounded quite promising and led me to wonder if I had a child - could the stem cells from the umbilical cord become healthy beta cells for me? Sure. However, the big question still remains - how can I stop the killer Ts from spanking my islets in the first place?

A study suggests that women who breastfeed may be lowering their risk for developing type 2 diabetes. Breastfeeding has always been healthy for babies. This research now shows it does the same for moms. The study found that the longer a woman breastfed, the lower her chances were for developing diabetes. Each year of breastfeeding was associated with a 15% reduction in diabetes risk within the next 15 years.

In the newly published research, nearly 160,000 female nurses were analyzed in two ongoing health studies. All of the women had provided information on their breastfeeding history, and roughly 6,200 developed type 2 diabetes.After consideration of other type 2 diabetes risk factors (obesity, smoking, sedentary lifestyle, etc.) those having breastfed within the past 15 years were found to be less likely to develop diabetes. The likelihood of developing diabetes decreased the longer a woman breastfed. Women with a history of gestational diabetes (diabetes during pregnancy) had an increased risk for developing type 2 diabetes. However, lactation did not have an effect on this risk.

Breastfeeding has clearly been healthy for babies, and now there is evidence that it is just as healthy for moms. In fact, lactation has also been shown to improve blood sugar control, help moms takeoff their pregnancy weight after the birth and this assists in lowering the overall risk for developing type 2 diabetes. We all know there are some things you just shouldn't mess with - Mother Nature is no exception.

Diabetic women face a much greater than average risk of giving birth to stillborn babies. According to those in the know, one problem facing caregivers of diabetic women during pregnancy has been the fact that methods of monitoring their risk for stillbirth have been limited and provide results only during late stages of pregnancy. It is hoped that new research conducted at the University of Warwick's medical school (in the UK) can help to address this problem by coming up with other, more effective methods.

Here's the Warwick finding in a nutshell: researchers examined levels of a molecule known as adiponectin as well as leptin levels in pregnant women with Type 1 diabetes. They measured these levels again after the women had given birth. Voila! Leptin levels were unchanged, but adiponectin levels were higher in diabetic women than in non-diabetic women during pregnancy. It is thought that monitoring changing adiponectin levels during pregnancy could help assess which babies are especially at risk for stillbirth. That's the theory, anyway.

And now, more on the topic of diabetes and pregnancy: an article in the UK Telegraph reports on the risks to babies born to Type 2 diabetic mothers. Because these women are more likely to be obese and in poor health, they develop diabetes. The result? According to the experts, thousands of newborns are dying or arriving with birth defects. The babies are four times more likely to die shortly after birth than are babies born to healthy moms. They are also three or four times more likely to suffer from heart, brain or spinal cord defects.

As horrifying as this is, it's even scarier because researchers don't expect the numbers to taper downwards anytime soon. As long as people are overeating, eating unhealthy foods, and not getting exercise, the problem will continue its spiral out of control, say researchers from the UK's Royal College of Obstetrics and Gynaecology.

Part of the solution, they say, is to start being open about the dangers of a "couch-potato" lifestyle. Says one obstetrician interviewed by the Telegraph, "We have these hugely obese girls who are getting Type 2 diabetes and we're seeing more and more of them getting pregnant. I can't remember ever seeing a young woman with Type 2 diabetes when I started practicing. Now I'm seeing them in my clinic all the time. This is an extremely serious problem." Another obstetrician weighed in with this comment: "Political correctness demands that we handle the issue sensitively, but the fact is: people from lower socio-economic backgrounds and certain ethnic groups are more likely to be affected and we need to make them aware of the dangers."

The results of some medical studies, ones that track patient behavior, can be really disturbing. I'm thinking of the ones where patients either don't know or don't seem to care that following the treatment prescribed by their doctors could make a huge difference to their health - now and in the future. An example: a new study has shown that women who develop gestational diabetes during pregnancy are not well-motivated to take good care of themselves. In a nutshell, the study reports that these women are more likely to smoke and less likely to eat healthfully after diagnosis than other pregnant women.

If it's possible to change these womens' behavior through education (and those who conducted this study say yes, it is), then let's do it. Having gestational diabetes is not just a risk during pregnancy; it actually raises your risk of developing Type 2 diabetes down the road. (Women who develop gestational diabetes are more likely to be obese and to have diets low in fruit and vegetable content.) For this reason, it's crucial that women take it seriously. I have to wonder if these women realize gestational diabetes puts them at greater risk for Type 2 diabetes, but most of all I wonder if they really understand the very serious health consequences of having Type 2 diabetes.

The results of this study have been published in Diabetes Care.

Women with Type 1 diabetes are more likely than non-diabetics to experience complications during pregnancy and to have babies with health problems. It's therefore absolutely critical that this segment of the population receive excellent medical care. Interestingly, according to a new report, it makes a big difference if women get that medical care before they become pregnant, if possible. This new study indicates that doing so makes it much more likely that diabetic women will be able to keep their blood sugar under control in early pregnancy. However, it did not affect blood sugar control later in pregnancy, nor did it reduce the risk of giving birth to very large babies, which is common in diabetic women.

The study also indicated that pre-pregnancy care can reduce the risk of complications during pregnancy and risk to the babies by quite a large margin. The study measured the progress of 290 women during pregnancy. 110 of the women received pre-pregnancy care for their diabetes. The researchers found that this group, consisting of the women who received pre-pregnancy care, had a 2.9 percent rate of adverse outcomes, including stillbirth, infant deformities or infant death. This compares with 10.2 percent of the women who did not receive pre-pregnancy care. That's a pretty significant difference, wouldn't you say?

The study in question has been published in Diabetes Care and was conducted by Dr. Rosemary C. Temple and colleagues at Norfolk and Norwich University Hospital in the UK.

A popular article from The New York Times is worth a look. It's all about how people are so much more robust and healthy than were previous generations, particularly comparing today's Americans with those from the mid-1800s or the early 1900s. One of the topics discussed at length in the feature is disease, specifically chronic diseases that used to be commonplace and affected people from relatively early ages.

The article discusses various studies that link health and longevity to health in early childhood (and, specifically, the availability of good food, vaccinations and antibiotics). These studies have also identified a link between individuals' health and longevity and the state of their mothers' health during pregnancy.

One example: researchers studied the health of babies born to women who were pregnant during the Dutch famine, which occurred during World War II, between November 1944 and May 1945. These babies seemed no worse for their mothers' terrible suffering - their birth weights were normal, for example. However, it was found that now, as age catches up with those people, they are developing chronic diseases, including diabetes, at unusually high rates.

Similarly, a study of children born to mothers who were pregnant during the influenza epidemic of 1918-19 found that they were also more likely to suffer from chronic illnesses than were children born to women pregnant before or after the epidemic. Again, the incidence of diabetes was higher than for other people - in this case, twenty percent higher by the age of sixty-one.

The conclusion? When a mother is ill or starved during pregnancy, the danger is not just the health of the baby, but for that child as he or she grows, and even for the rest of his/her adult life. That is, the experience of the mother may predispose the child to illnesses that typically do not develop until later in life (middle age or later).

I always think that being well-informed about health issues is about more than just reading up. It's also a matter of getting a sense of perspective. Excellent case in point: diabetes and pregnancy. On the one hand, it is known that pregnant women who have diabetes need to take special care to maintain good health. On the other hand, you want to take care of your health without worrying yourself sick the entire time!

Alas, a new study from the UK indicates that the risk level for pregnant women with diabetes is pretty darn high. Both Type 1 and Type 2 diabetics are at serious risk of complications, the researchers say. They say the risk of congenital abnormalities is twice that found in the general population when the mother is diabetic, while the risk of infant death is four times as high as the general population. Consequently, their recommendation is that diabetic women be offered fetal heart scans and that they take plenty of folic acid before and after conception. Most important? Education. The researchers fear that diabetic women are not aggressively seeking specialist care during pregnancy because they have not been fully informed about the dangers they could face. Bottom line: there are things women can do to minimize the risks associated with diabetes and pregnancy.

Shannon Lewis, whose little boy Brendon was diagnosed with diabetes while still a toddler, blogs Mom Wants A Diabetes Cure ... pure and simple. In a recent post, she shared the moment of realization of what she needed to do to be the mother Brendon needed her to be.

Shannon did all the rights things that mothers do when they are pregnant and avoided all the things mothers are supposed to avoid when they share the same heartbeat with another human being, sustaining their life until they enter the world and can sustain life on their own.

When your baby is born, you listen for the cry. Then you check the fingers and toes. Then you wait while the doctor and nurses run your newborn through a quick series of tests. Brendon was born with all his fingers and toes, and he aced the APGAR. Brendon was home-free to the beginning of a healthy life. Shannon's efforts during her pregnancy to be healthy for both herself and her baby had served them well.

Two and a half years later, Brendon lay on a gurney in the ER, limp, seemingly lifeless, with shallow breath and sallow skin. What had gone wrong to such a perfect beginning for Brendon? He was diagnosed with diabetes and Shannon's idealistic concept of motherhood and her child's health became forever altered. She writes poignantly about the threshold from one reality to the next and touches your heart in the passage. It's a must-read post for all mothers.

Richard Kahn, Chief Scientific & Medical Officer for the American Diabetes Association, is blogging the American Diabetes Association's 66th Annual Scientific Sessions. From June 9 - 13, the annual convention brings together leading scientists and health professionals to present the latest study findings and to discuss the current and future progress in the field of diabetes prevention and care.

So far, some of Kahn's posts have covered such topics as: insulin and longevity; endocannabinoids, oral insulin, the new A1C test, who is responsible for optimal diabetes care; the worm study; and you are what your mother ate during her pregnancy. The posting is written in a light and easy manner, not requiring the average person to being a textbook of medical definitions to make sense out of what is being said. I assume Kahn will continue blogging through June 13. You can read Richard's D.C. Diary here.