Guest guest Posted June 16, 2010 Report Share Posted June 16, 2010 1. MW Corneal Confocal Microscopy Shows Presence, Severity of Diabetic Neuropathy (Reuters Health) May 20 - Corneal confocal microscopy accurately and noninvasively diagnoses the presence and severity of diabetic neuropathy. Although it's not quite ready for widespread adoption, senior author believes " this technique has huge potential, as we have now repeatedly shown that it can detect early nerve damage and stratify the severity in diabetic neuropathy. " [101 diabetics & 17 nondiabetic subjects] Vibration perception threshold increased significantly with severity of neuropathy.Corneal sensitivity was lower in DM patients compared to healthy volunteers, but the difference was significant only in patients with severe neuropathy. Corneal nerve fiber density, branch density, and length were significantly and progressively reduced in the diabetics (including those without neuropathy). " This is a novel but clinically applicable test of neuropathy which we would see sitting alongside retinal screening, " Diabetes Care 2010. 2.%%ADA Low Muscle Mass Ups Diabetes Risk 6/2/10 Researchers at UCLA suggest that sarcopenia, defined as low skeletal muscle mass and strength, often found in older or obese individuals, may increase the risk of T2DM. [14,528 people] Sarcopenia was associated with insulin resistance in both obese and non-obese individuals. The condition was also associated with high blood-sugar levels in obese people but not in thinner individuals. These associations were greater in people age 60 years and under. Based on the results, the researchers suggest that dieting may not be enough, but that good muscle mass and strength should be a focus in preventing diabetes. 3.%% MNTD Two Promising Proteins For Preventing Diabetes 5/25/10 Two human proteins that evolutionary processes have conserved from ancient single-celled organisms appear to provide new targets of opportunity for scientists hoping to thwart the development of DM. In experiments using diabetes-prone mice, blocking the actions of the proteins significantly reduced the development of DM in the mice. Diabetes can occur when the body is unable to produce enough insulin, or when it loses its ability to respond properly to the production of insulin, a hormone the body uses to convert food into energy. No matter the cause, research suggests that inflammatory processes contribute to the development of diabetes. One of the proteins, eIF5A, is believed to be involved with inflammation processes. The team looked at eIF5A because its corresponding gene sits near other inflammation-related genes in both the mouse and human genomes. The team leader said " Because it sat in a hotbed of inflammatory genes, we thought eIF5A might also have role in the progression of diabetes, " But eIF5A doesn't act on its own. Instead, another protein, an enzyme called DHS, is necessary to activate eIF5A .. then inhibiting DHS should block eIF5A, " They used two different approaches to block the activity of eIF5A. Both gave similar results - that the development of DM can be blocked in a mouse - but the DHS approach seems to offer a more promising route to possible treatments. 4.%% MNTD Link Between Viral Infection & Juvenile Diabetes (T1) 5/25/10 Researchers have found a significant association between enteroviral infection and diagnosis of T1DM in children. In T1 the patient's own immune system is somehow activated to slowly destroy insulin-producing beta cells in the pancreas .Approximately 13,000 young people are diagnosed in the US each year. T1 develops in individuals who are genetically susceptible.. exposure to some yet unknown triggering environmental factor or factors may be required. [112 children at the time of diagnosis] Low-level enteroviral infectivity and genome fragments were detected in 83% of T1 patient compared to only 7% of healthy controls. " These data do not provide a causal relationship between enterovirus infections and DM, However, the high prevalence of enteroviral genome sequences in newly diagnosed T1 s cases indicate that different enterovirus types represent a significant biomarker of early stage juvenile diabetes. " 5.%% MW Dialysis Linked to Foot Ulceration in Diabetic Patients 6/1/10 — Dialysis treatment is independently associated with foot ulceration in patients with DM and stage IV or V chronic kidney disease (CKD).[ 326 DM pts with CKD] Patients were evaluated for DM peripheral neuropathy (DPN), peripheral arterial disease (PAD), prior foot ulceration and amputation, and foot self-care. " Dialysis treatment was independently associated with foot ulceration, " the study authors write. " Guidelines should highlight dialysis as an important risk factor for foot ulceration requiring intensive foot care. " 6.%% Ophthalmology 117,6 June 2010 OphSource A Prospective Randomized Trial of Intravitreal Bevacizumab or Laser Therapy in the Management of Diabetic Macular Edema (BOLT Study):Purpose To report the findings at 1 year of a study comparing repeated intravitreal bevacizumab [avastin] (ivB) and modified Early Treatment of Diabetic Retinopathy Study (ETDRS) macular laser therapy (MLT) in patients with persistent clinically significant diabetic macular edema (CSME). [80 eyes of 80 pts] Conclusions The study provides evidence to support the use of bevacizumab in patients with center-involving CSME without advanced macular ischemia. 7.%% Ophth 117,6 June 2010 Vitrectomy Outcomes in Eyes with Diabetic Macular Edema and Vitreomacular Traction [87 eyes] Conclusions After vitrectomy performed for DME and vitreomacular traction, retinal thickening was reduced in most eyes. Between 28% and 49% of eyes with characteristics similar to those included in this study are likely to have improvement of visual acuity, whereas between 13% and 31% are likely to have worsening. The operative complication rate is low and similar to what has been reported for this procedure. These data provide estimates of surgical outcomes and serve as a reference for future studies that might consider vitrectomy for DME in eyes with at least moderate vision loss and vitreomacular traction. 8.%%Ophth 117,6 June 2010 Automated Early Detection of Diabetic Retinopathy Purpose - To compare the performance of automated diabetic retinopathy (DR) detection, using the algorithm that won the 2009 Retinopathy Online Challenge Competition in 2009, the Challenge2009, against that of the one currently used in EyeCheck, a large computer-aided early DR detection project. [16670 pts] Conclusions - Diabetic retinopathy detection algorithms seem to be maturing, and further improvements in detection performance cannot be differentiated from best clinical practices, because the performance of competitive algorithm development now has reached the human intrareader variability limit. Additional validation studies on larger, well-defined, but more diverse populations of patients with DM are needed urgently, anticipating cost-effective early detection of DR in millions of people with DM to triage those patients who need further care at a time when they have early rather than advanced DR. 9.%%Ophth 117,6 June 2010 Prevalence of Refractive Errors and Associated Risk Factors in Subjects with T2DM SN-DREAMS, Report 18 [1080 subjects with DM] Conclusions - The present population- based study from urban India noted a high prevalence of refractive errors (60%) among diabetic subjects >40 years old; the prevalence of astigmatism (47%) was higher than hyperopia (40%) or myopia (20%). 10.%% MW " Puzzling " Lancet Paper Posits Low-Dose Rosiglitazone/ Metformin for Diabetes Prevention 6/3/10 With just over a month to go before rosiglitazone (Avandia) makes its reappearance in front of an FDA review panel, a surprising study---suggests that half-dose rosiglitazone combined with half-dose metformin may help prevent progression to DM. Experts not involved with the study were quick to point out to heartwire that the new study does nothing to alleviate concerns about the drug. Lead author on this new paper stressed that the main point of the research was that reduced doses of available drugs--not necessarily rosiglitazone--may help reduce progression to diabetes. [207 pts;Fup 4 yrs] occurrence of incident DM was significantly lower in patients assigned to the combination drug, One of the most outspoken critics of rosiglitazone, Dr Nissen, said ..Despite the authors' claims, there is no evidence whatsoever that lower doses of rosiglitazone are 'safe.' Any suggestion that serious CV toxicity can be avoided by using a small dose represents pure speculation at best. " ... 11.%% MW Group Medical Clinics Improve BP, But Not Glycemic Control, in Diabetics 6/2/10 The use of group medical clinics (GMCs)--where 7or 8 patients are seen together with a doctor, pharmacist, and nurse educator--resulted in clinically meaningful improvements in blood pressure, but not in glycemic control, compared with usual care in a study in diabetics conducted at two VA medical centers [239 pts with poorly controlled DM] The groups met for half a day every 2 months and each group met with the same care team at each visit. They liked the element of talking to other patients and getting their advice.. The veterans attending the GMC had better BP control than those who received usual care at 6 months, and this difference was sustained at one year. But there was no significant difference between the groups in terms of improvement in HbA1c. 12.%% MW Thiazolidinediones and Sulfonylureas Most Effective in Lowering HbA1C 6/2/10 — Oral antidiabetic drugs (OADs) decrease glycosylated hemoglobin (A1C) levels by approximately 0.5% to 1.25%. The maximal effect is achieved by 3 to 6 months, and thiazolidinediones and sulfonylureas show the greatest efficacy, according to the findings of a systematic review and meta-analysis. The team searched several databases for randomized, placebo- controlled studies [26,367 study participants] The authors concluded that the benefit of initiating an OAD agent is most apparent within the first 4 to 6 months, with A1C levels unlikely to decrease more than 1.5% on average. .. 13.%% ADA Total fat mass and central adiposity increase the risk of cognitive impairment in older subjects with diabetes 6/2/10 The association between adiposity parameters and body fat distribution with cognitive impairment was evaluated in a longitudinal study enrolling (253 DM pts & 440 subjects with normal glucose tolerance [NGT])aged 65-85 yr;Fup 2yr. the researchers observed that waist-hip ratio and waist circumference significantly correlated with MMSE (Mini Mental State Examination) and a composite score of executive and attention functioning. In addition, total fat mass and greater central adiposity increased by 2- and 1.5-fold, respectively, the risk of global cognitive decline in diabetics.., no significant impact was observed in NGT subjects. PLoS One 2010, 5(4 14.%% ADA Study Links Air Pollution With Diabetes in Women 6/2/10 Traffic-related air pollution has been shown to increase T2 risk in a German study of 1,775 women. The team compared those who lived in highly polluted industrial areas with those who lived in rural, less-polluted regions. Components of traffic pollution, especially nitrogen dioxide and soot in fine particulate matter, were significantly associated with a higher T2. Residence within 100 meters [328 ft] of busy roads was also found to increase the diabetes risk. The team reports their findings in Environmental Health Perspectives. 15.%% JH Promising Therapies for Macular Edema 6/4/10 Laser therapy, also called laser photocoagulation, is more effective and produces fewer side effects than corticosteroids injected into the eye for the treatment of diabetic macular edema [DME] according to a large, 2-year multicenter study. Swelling around the macula (macular edema) caused by the leakage and accumulation of fluid can occur in people with DM. The swelling alters the position of the retina and causes blurred vision. Loss of vision is more pronounced when the center of the macula is affected. Photocoagulation uses lasers to help close leaking microaneurysms (weak spots that bulge outward from the blood vessels), fostering the regression of new blood vessels. Laser helps to halt or slow vision loss in most people if performed before too much damage has occurred. [693 people with DME to undergo laser treatment or to receive a 1- or 4-mg injection of triamcinolone (a corticosteroid) into the eye, each repeated at 4month intervals, as necessary. At the first 4-month check, vision was sharpest in those who had received a 4-mg injection of triamcinolone. At one year, vision was about the same in all 3 groups. But at 2 years, vision was significantly better in the laser treatment group. Of those who received laser 19% had substantial vision loss compared with 28% in the corticosteroid treated groups. Cataract surgery was required in 13% of eyes in the laser group compared with 23% in those who received 1 mg of triamcinolone and 51% in those who received 4 mg. Eye pressure increased by a significant amount in 4% of the laser group compared with 16% & 33% in the corticosteroid groups, respectively. Researchers are now studying combination therapy, since triamcinolone had better initial results and laser treatment was more effective over two years. 16.%% MW New Statement Urges Caution for Primary-Prevention Aspirin in Diabetics 6/3/10 The joint statement from ADA, Am Heart Assoc, and Am College of Cardiology recommends that low-dose aspirin is " reasonable " in diabetics with no history of vascular disease but who are at an increased 10-year risk of CV events. The organizations state that only men older than 50 and women older than 60 who have one or more additional major risk factors should be treated with aspirin for primary prevention of CV events. " The guidelines are more conservative, and this is based on some of the newer studies that have come out, " a member of the writing committee said. " The previous recommendations had been that pretty much anybody with diabetes over the age of 40 should be on aspirin. " The group recommends low-dose aspirin, 75 mg/d to 162 mg/d, for adults with DM and no history of cardiovascular disease but who are at an increased risk based on age and at least one additional CVD risk factor, such as smoking, dyslipidemia, hypertension, family history of disease, and albuminuria. Aspirin is not recommended for high-risk diabetic patients who are also at risk for bleeding and is not recommended for individuals at low risk of CV events. With no single study providing definitive results, the ommittee attempted to reconcile the findings by examining existing meta-analyses, such as the one performed by the Oxford Antithrombotic Treatment Trialists' (ATT) [4000 DM pts] Heartwire © 2010 17.%% MW High-Dose B Vitamin Therapy May Not Be Helpful in Diabetic Nephropathy 6/3/10 Compared with placebo, high doses of B vitamins were actually associated with a greater decrease in glomerular filtration rate (GFR) and an increase in vascular events. " Hyperhomocysteinemia is frequently observed in patients with diabetic nephropathy, " writes a team member. " B-vitamin therapy has been shown to lower the plasma concentration of homocysteine. " [238 patients with T1 or T2 & DM nephropathy] Participants were randomly assigned to receive a single tablet daily of B vitamins containing folic acid (2.5 mg/day), vitamin B6 (25 mg/day), and vitamin B12 (1 mg/day), or matching placebo. " There is an expected decline in homocysteine levels in the treatment group compared to the placebo group, but despite this the active treatment turns out to have detrimental effects on both renal function and vascular complications. " " Clearly, the results call for caution in using high dose B vitamins (pharmacological doses) in high risk patients like DM patients with diabetic nephropathy, On the other hand it is important to stress that the results do not imply that multivitamins containing usual low doses of B vitamins are harmful. " 18.%% Heartwire More Evidence Against Concept of " Metabolic Syndrome " 5/21/10 Patients with metabolic syndrome are no more at risk of future MI than those with diabetes or hypertension alone, a new study suggests. " Our study examined whether we need to look at metabolic syndrome as a distinct entity or whether we should instead be focusing on the individual risk factors, and we found that the individual risk-factor approach is probably best. the researchers explain that the common clustering of metabolic abnormalities, including abdominal obesity, elevated glucose, abnormal lipids, and elevated BP is often referred to as the metabolic syndrome.[12, 297 cases;14,606 controls] Results showed that metabolic syndrome was associated with a 2-3times increased risk of MI, but the same risk was conferred by having either hypertension or DM alone. 19.%% Am J Oph 149,6 June 2010 Nocturnal Intermittent Serious Hypoxia & Reoxygenation in Proliferative Diabetic Retinopathy (PDR) [68 non-PDR;151(PDR) subjects] Pulse oximetry was conducted overnight and mean oxygen saturation by pulse oximeter (SpO2; %),. Conclusions - This study indicated that PDR cases had episodes of nocturnal intermittent hypoxia and reoxygenation as a result of sleep-disordered breathing and that low-value lowest SpO2 were the risk factors for PDR development. 20.%% Am J Oph 149,6 June 2010 Barely Visible 10-Millisecond Pascal Laser Photocoagulation for Diabetic Macular Edema: (DME) Observations of Clinical Effect and Burn Localization Conclusions The technique of lower-fluence barely visible 10-millisecond laser may reduce retinal edema within affected sectors and effectively treat DME with minimization of scar formation. 21.%% MW 5/28/2010 — Increases in waist circumference and weight may predict incident diabetes. " Individuals with impaired fasting glucose (IFG) are at high risk for T2, " the research team writes. [979 subjects;Fup 9yr] After adjustment for risk factors at baseline, increases in both waist circumference and weight were significantly associated with DM incidence. " In IFG individuals, it is important to monitor and prevent increases in waist circumference. " We speculate that an increase in waist circumference may induce further alterations in insulin secretion beyond that inherent in a worsening insulin resistance. Potential mechanisms may involve ß-cell lipotoxicity through enhanced free fatty acid release from adipose tissue. " 22.%% MW Urinary Incontinence in Diabetic Women Is Often Neglected 6/3/10 Physicians need to pay closer attention to the possibility of urinary incontinence (UI) in their female diabetic patients, because 35% of this population reports at least weekly episodes, a group said at the Am Urological Assoc Annual Scientific Meeting. The study found that DM women with weekly UI episodes seek treatment less often than nondiabetic women with UI and have less understanding of UI and more UI-related depression. " The good news is that effective treatments are available for UI. It's unfortunate that diabetic women are often denied such treatments simply because we don't know they suffer from UI. " [488 pts with DM;1784 nondiabetic women]. 23.%% Diabetes Mellitus and the Haptoglobin 2-2 Genotype 6/1/10; ) Aims: Individuals with both (DM) and the Haptoglobin (Hp) 2-2 genotype are at increased risk of cardiovascular [CV] disease. As the antioxidant function of the Hp 2-2 protein is impaired, we sought to [test whether] antioxidant vitamin E supplementation would provide [this group] CV protection There was a significant reduction in MI in Hp 2-2 individuals with vit E, There was no benefit of vit E on myocardial infarction in non-Hp 2-2 individuals. Discussion In meta-analysis of two independent placebo controlled clinical trials Hp 2-2 DM individuals (representing approximately 36% of all diabetics) derived significant CV protection from vitamin E supplementation, with an overall reduction of over 40% in the combined end point of stroke, MI and CVD death. Conclusion Hp typing represents a once in a lifetime test that identifies those DM individuals at exceptionally high risk of CVD. The Hp type may be used to more effectively focus the attention of the clinician and the utilization of healthcare resources on those DM individuals for whom more aggressive risk factor modification is most needed. The Hp genotype also appears to identify a very large subgroup of DM individuals who may receive marked clinical benefit from an extremely inexpensive therapy. Pharmacogenomics. 2010;11(5): © 2010 Future Medicine Ltd. 24.%% MNTD Team Discovers Important New Player In Diabetes Onset 6/8/10 If you think of DM onset like an elaborate molecular drama, then a research team has unmasked a previously unknown cellular player, which is critical to proper insulin secretion. " Defective insulin secretion is a hallmark of both T1 & 2 , " said the team leader Working in mouse models, the team discovered that the ABCG1 protein is essential for the beta cells of the pancreas to produce sufficient amounts of insulin.. previous findings show that T2 pts have lower levels of ABCG1 than non-diabetics. The team also showed that proper expression of the ABCG1 protein in beta cells could be restored in the mice by treatment with some existing antidiabetic drugs. " " Our research points to the need to investigate this possibility further as well as to explore the potential development of new therapies that boost ABCG1 protein levels and insulin secretion, " " We found that ABCG1 actually sits inside the beta cell and that it's really important for delivering cholesterol to the insulin granule membranes. Without cholesterol the insulin granules do not develop or function properly and, release significantly less insulin. The team believes that boosting the levels of ABCG1 in DM patients may benefit sufferers in 2 ways by aiding in reducing arterial plaque and in improving insulin production. . Editorial comment " This mechanism may be very helpful for people with T2 but also T1 because it may extend the period of time before all insulin-producing potential is gone, " ( La Jolla Institute) 25.%%JH " Bloodless " Glucose Testing: Where We Stand 6/10/10 Self-testing of blood glucose with a blood glucose meter is one of the central elements of caring for your diabetes. Of course, pricking your finger with a needle several times a day is not fun . Recently a reader asked us: Is there a way to check your blood glucose level that doesn't require a needle prick? Here’s what we know … Don't toss out your lancets and test strips just yet. A number of medical-device makers have tried to create methods to measure blood glucose that do not require puncturing the skin with a sharp object to extract a drop of blood. Unfortunately, no one has yet figured out the secret to accurate " bloodless " glucose testing. ..the Dream Beam was supposed to measure blood sugar by passing light through your finger. However, the device did not produce accurate readings and, like many other attempts, failed as an alternative to finger-prick testing. The only noninvasive blood glucose monitor ever to gain approval from FDA GlucoWatch Biographer, caused many users to develop skin rashes and was taken off the market in 2007. Nonetheless, several companies are trying to develop monitors that use infrared light, electromagnetic waves, and other technologies to measure glucose levels. Bottom Line: If you're bothered by finger pricks, don't stop testing; instead, try less painful methods, such as using lancets that don't puncture the skin so deeply. And look also to the real advance over the past few years: availability of continuous glucose monitoring (CGM). 26. %%MNTDPhase 3 Study Showed Macugen® Improved Vision Over Standard Of Care In Patients With Diabetic Macular Edema 6/8/10 Macugen (pegaptanib) significantly improved vision in patients with diabetic macular edema (DME),37 % of patients treated with the drug gained two lines, or 10 letters, on the ETDRS eye chart at 54 weeks, compared to 20 % of patients who received a (placebo-like) procedure. All patients enrolled in the study were eligible to receive laser therapy, the current standard of care for DME, beginning at week 18 of the study at the physician's discretion. [260 patients] 27.%% Eye (2010) 24, Association of intraocular pressure with the metabolic syndrome and novel cardiometabolic risk factors [1112 subjects] Conclusion - Met. syndrome and other insulin resistance- related features, increased left ventricular mass, and proteinuria, are strongly associated with IOP. 28.%%MW Restrictive Lung Disease Linked to Incident Type 2 Diabetes 6/10/10 — Restrictive lung function impairment is associated with incident T2DM and fatal coronary heart disease (CHD)[4434 men aged 40 - 59 years with no history of CHD, stroke or DM ; Fup 20yrs] ] " Restrictive rather than obstructive impairment of lung function is associated with incident T2 (and fatal CHD) with both associations partially explained by traditional and metabolic risk factors and inflammation, " the study authors write. .. 29.%% 6/10/10 NIH News: NEI Hosts Translational Research and Vision Symposium June 24-25 The National Eye Institute (NEI), part of the NIH, is bringing together premier researchers who translate molecular and genetic approaches from the laboratory to visual system diseases in the clinic. This event will feature discussions about cutting-edge treatment strategies as well as the impact of the human genome sequencing on diagnosis and treatment of eye diseases. Speakers will include:-- Ben Barres, M.D., Ph.D., Stanford U-- S. Boyden, Ph.D., MIT-- Y. Chew, M.D., NEI -- Dennis O. Clegg, Ph.D., UCSB-- Mark S. Humayun, M.D., Ph.D., USC-- G. son, M.D., Ph.D., U of Pennsylvania -- Jay Neitz, Ph.D., U Washington -- M. , M.D., Ph.D., U of Penn 30.%% Substituting Whole Grains for White Rice May Lower Risk for T2DM 6/14/10 — Substituting brown rice or other whole grains for white rice is associated with a lower risk for T2.[39765 men;157,463 women] The team estimated that replacing 50 g [1/4 cup] per day of uncooked white rice (one-third serving per day) with the equivalent amount of brown rice was associated with a 16% lower risk for T2. " These data support the recommendation that most carbohydrate intake should come from whole grains rather than refined grains to help prevent T2s. " Arch Intern Med. 2010;170: 31.%% Exenatide, Lifestyle Changes Lead to Weight Loss in Obese Diabetics (Reuters Health) Jun 08 - [194pts;24 wk ] pts on exenatide lost [13.58 vs 8.75 lb av] and had significantly greater mean reductions in HbA1C compared to those taking placebo. They also had greater mean reductions in systolic BP. The rate of nausea was significantly higher with exenatide, but there were no differences in withdrawal rates, adverse events or in hypoglycemia. " Our findings suggest a new paradigm for the treatment of T2, " lead author said. This new paradigm includes more medications like exenatide, " that do not exacerbate insulin resistance and promote weight gain but do the opposite and help diabetics lose weight and reduce insulin resistance, " study was funded by Lilly USA, 32.%% Erectile Dysfunction Drug Trial Meets Goals in Diabetic Patients (Reuters) Jun 08 - Vivus Inc said a second late-stage study of its erectile dysfunction drug met the main goals of improving erectile function score across the two doses that were studied in the trial. [390 subjects] Commonly reported side effects included headache, nasopharyngitis, flushing, sinus congestion, sinusitis and dyspepsia. There were no drug-related serious adverse events in the study. 33.%% Test Foods With Lower Glycemic Load (GL)Fail to Alter Metabolic Risk Markers in Overweight Individuals 6/4/10 — Diets fortified with foods low in (GL) do not lower the risk for metabolic syndrome in high-risk individuals. Together, a food's glycemic index (GI) and its total carbohydrates make up its GL. The GI is a measurement of how much a carbohydrate-rich food will elevate concentrations of blood glucose compared with white bread or a glucose solution. ..[ 9 men;6 women,] Glucose and lipids were not affected by the test foods after weeks 1 and 5. Two limitations to the study stated by the authors. ... a result of a lack of precise information about the participants' overall food intake, the researchers could not determine the GL or GI of the participants' complete diets, Am J Clin Nutr. Published online May 26, 2010. Abbreviations:Fup-follow up; pt - patients; DM - diabetes Mellitus; T1DM - type 1 diabetes mellitus T2DM - type 2; DME - diabetic macular edema; GDM gestational diabetes;PDR - proliferative diabetic retinopathy; FPG - fasting plasma glucose; BP - blood pressure; CVD - cardio-vascular disease; MI -myocardial infarction or heart attack ;HTN - hypertension or high BP; OCT - optical coherence tomography; VA - visual acuity -ADA - Amer Diabetes Ass & ADA Professional Resource Online; JHA - s Hopkins Alerts ; MW Medscape Web MD; NIH - Nat Institutes of Health; MNTD- Medical News Today NREndo;Nature Reviews Endocrinology Definitions via online Medical dictionaries. Disclaimer, I am a BSN RN but not a diabetic or diabetic educator. Reports are excerpted unless otherwise noted. This project is done as a courtesy to the blind/visually impaired and diabetic communities. Dawn Wilcox BSN RN Coordinator The Health Library at Vista Center; an affiliate of the Stanford Hospital Health Library. contact above e-mail or thl@... Quote Link to comment Share on other sites More sharing options...
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