Single Injection of Insulin for Diabetes – In Future (糖尿病患将只需一剂药 就能产生胰岛素)

糖尿病患日后有望只需注射一剂药物，就能刺激肝细胞生产胰岛素，省去他们每天须注射胰岛素的必要。

这项由新加坡国立大学杨潞龄医学院、英国剑桥大学和伦敦大学学院（UCL）联手展开的基因疗法研究，已证实可在老鼠体内自然无害地生产胰岛素，消除它们的糖尿病病状。

科研人员接下来将对已经患上糖尿病的狗儿进行类似试验，并预计10年内可展开临床试验。

UCL癌症研究院已用同一方式为血友病（hemophilia）患者提供治疗，疗效持续至少4年，因此本地科研人员相信，这个治病模式能沿用在糖尿病患者身上。血友病患者流血时，因血液缺乏凝血因子，身体无法自行止血，导致患者面对凝血障碍的终身出血疾病。接受基因疗法后，患者可生产原本缺乏的凝血因子。

新英科研人员使用的疗法，通过把内附胰岛素基因的病毒载体（vector）注射入体内。科研人员选用的载体倾向附在肝细胞上，多达90％载体会集中到肝脏，且较不会被人体排斥。

病毒载体可促使肝细胞替代胰脏的功能，生产胰岛素，日后可用以弥补糖尿病患胰脏细胞无法生产胰岛素或产量不足的问题，省去病患每天须注射胰岛素的需求。

负责研究的杨潞龄医学院医学系李国安教授说，尽管肝脏将因此增加负担，但根据UCL的血友病研究，这不会导致肝脏负荷过重，而若研究成功，无论是第1型或第2型的糖尿病患都有望从这项基因疗法中受惠。

参与这项有助糖尿病患研究的学者包括国际器官移植学界泰斗罗伊·卡恩教授（左起）、国大杨潞龄医学院科研人员付振营博士、颜舒韵博士、谢境恮博士和李国安教授。

First reported by Ip Wai-Keung of My Paper in February 2016.

I suggest the following Posts for your Reading:

·        Hypoglycaemia

• Post-Transplant, Osteoporosis & Right Diet
• Eating Healthy to Lower Your Blood Pressure
• Type 2 Diabetes – Myths & Facts
• How Will a 15 Minutes of Walking Improve Quality of Life
• Glycosylated Hemoglobin (HbA1c) and Blood Glucose

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验，并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康，我强烈敦促您有规则健康检查以避免未来复杂化。另外，控制您的饮食部分并且有定期运动.)

New Drug May Treat High Potassium Level (新的药物可治疗高钾水平)

New Drug May Treat High Potassium Level (新的药物可治疗高钾水平)

Introduction

I decided to write a topic on Potassium as it is something closed to me.  It is important to me during my dialysis days as well as post-transplant.  In fact, it plays an important role for a healthy individual.

Why Potassium is important?

Potassium is necessary for the heart, kidneys and other organs to work so enabling them to function properly so to transit nerve signals, muscle contractions, fluid balance, and various chemical reactions.

Health problems due to insufficient potassium include leg cramps, muscle weakness, irregular heartbeats, and in serious cases, paralysis.

Doctor has advised a friend to take more bananas to increase his potassium level so to prevent cramps.

What is hyperkalaemia?

People with advanced diabetes will lead to damage to the kidneys.  As a result, it can cause potassium levels to increase to dangerous levels, which is termed hyperkalaemia (高钾血症).

"High potassium is a problem seen in people with advanced kidney disease and advanced diabetes with kidney disease and with people with heart failure," said lead researcher Dr. George Bakris, a professor of medicine at the University of Chicago.

Hyperkalaemia can lead to life-threatening cardiac arrhythmia and sudden death.

Traditional Treatments

Bakris said a change in diet is the traditional approach.  At that times, I have to avoid fruits and vegetables to lower my potassium levels, which include Bananas, tomato, avocados, spinach those that are high in this mineral.

In addition, I have to take Resinsodio and mix with water if the restricted diet did not achieve the desirable results.  It has to be taken continually if the potassium level is deemed high.

Information on the new drug

Relypsa Inc. (NASDAQ:RLYP), a biopharmaceutical company, announced a new drug, Patiromer, will significantly reduce potassium levels when taken for a month and the effect will last for a year, researchers found.

Patiromer is a potassium binder, taken orally, twice a day, with a small amount of water, for the treatment of hyperkalemia.

As explained by Dr. Bakris, Patiromer will reliably bind potassium throughout the entire gastrointestinal tract, which helps remove potassium from the body.  Such process compares favorably as to the existing drug where only bind potassium in the lower intestine.

Clinical Trial

A total of 306 patients with CKD stages 3 to 5 and type 2 diabetes had been selected for this one-year trial.  All selected patients had mild-to-moderate hyperkalemia.

Clinical results showed that taking Patiromer has significantly reduced blood potassium levels across all dose groups in patients with either mild or moderate hyperkalemia at week 4 and the effect would maintain throughout the 52 weeks.

Patiromer was well tolerated by all patients over the 52 weeks of treatment.  Some common adverse events:

·      9.2% experienced worsening of CKD

·      8.6% experienced hypomagnesemia

·      7.9% experienced of hypertension (7.9 percent)

·      6.3% experienced constipation (6.3 percent) and

·      5.6% experienced diarrhea

No adverse events of worsening CKD were considered by investigators to be related to Patiromer.

Additional information

Please visit followings for additional information:

Diabetes and kidney disease – American Diabetes Association

Patiromer trial presented by Dr. Bakris and published by JAMA – The Journal of the American Medical Association 

Latest developments

Relypsa announced that the U.S. Food and Drug Administration (FDA) has assigned a Prescription Drug User Fee Act (PDUFA) action date of October 21, 2015 for completion of the review of the New Drug Application (NDA) for the investigational agent Patiromer.

If Patiromer is approved, it will be the first new therapeutic made available for the treatment of hyperkalemia in over 50 years.

I suggest the following Posts for your Reading:

·     Hypoglycaemia

·     Post-Transplant, Osteoporosis & Right Diet

·     Eating Healthy to Lower Your Blood Pressure

·     Type 2 Diabetes – Myths & Facts

·     How Will a 15 Minutes of Walking Improve Quality of Life

·     Glycosylated Hemoglobin (HbA1c) and Blood Glucose

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验，并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康，我强烈敦促您有规则健康检查以避免未来复杂化。另外，控制您的饮食部分并且有定期运动.)

Hypoglycaemia {Update#1} (低血糖症)

Hypoglycaemia {Update#1} (低血糖症)

In this update, I wish to share my recent experience of hypoglycaemia and what is the appropriate ways to treat it under different circumstances.

In one of my meals, I took slice fish and vegetable soup WITHOUT any carbohydrates items, such as brown rice and wholemeal bread, to go along.  At exactly two hours after my meal, my glucose level was 3.9mmol/L.  Please read on how to treat Hypoglycemia.

According to the Dietitian, I have to include a portion of carbohydrates item in all my meals to avoid Hypoglycaemia.  Without any carbohydrates item, the system/insulin will use up the any carbohydrates item as store in my body.

What is Hypoglycaemia?

It is a medical term for Low Blood Sugar.  The principal problems arise from an inadequate supply of glucose to the brain.  The most common forms of hypoglycemia occur as a complication of treatment of diabetes mellitus with insulin.

What is the acceptable glucose level?

In local term, the acceptable glucose is above 4.0 mmol/L. Symptoms of hypoglycaemia will develop when the glucose falls below 4 mmol/L

Symptoms of hypoglycemia that I have experienced:

·      Sweating

·      Shaking or trembling

·      Hunger

·      Mood changes such as sad or angry

·      Confusion

·      Anxiety

Other reports mentioned that if blood sugar drops very low, the person may not be able to respond, becomes unconscious or has a seizure.

How to treat hypoglycaemia under following circumstances:

·      If you experience hypoglycaemia symptom with a blood sugar that is 4.0mmol/L and above, treat it with a small carbohydrates snack.

Blood Sugar Level	4.0mmol/L and above	<4.0mmol/L		<2.8mmol/L
Treatments	Take a small carbohydrates snack	Take 15-20g of rapid-acting carbohydrates, e.g.: Ø Take 3-4 teaspoons of sugar / glucose power Ø 4-5 glucose tablets Ø 150-200ml sweetened soft drinks / juice		Take 30g of rapid-acting carbohydrates, e.g.: Ø Take 6 teaspoons of sugar / glucose power Ø 8 glucose tablets Ø 300ml sweetened soft drinks / juice
Further actions	No further actions are required	Re-test after 15 minutes – is the blood sugar >4.0mmol/L?
Follow-up actions	Not Applicable	YES – Depend on when is the next as a starchy carbohydrate may be necessary		NO!! Ø Repeat the above step until blood sugar >4.0mmol/L Ø Seek treatment immediately if blood sugar <4.0mmol/L for 2 cycles
Follow up treatment POST hypoglycaemia
Within 1 hour			NO additional carbohydrates snack.  Go ahead to have meal.
More than 1 hour			Take long acting carbohydrates, e.g.: biscuits or bread. Personally, I take one slice of wholemeal bread.
Do note that this is only a general guideline.  Discuss with your doctor and adjust according to requirements.

As a diabetic, I always carry my Nano, needed strips and lancets wherever I go.

My other Relevant Posts for your Reading (您能读其他相关的博克):

·      Post-Transplant, Osteoporosis & Right Diet (后移植、骨质疏松症 & 正确的饮食)

·      Eating Healthy to Lower Your Blood Pressure {Update#1} (吃健康降低您的血压)

·      Type 2 Diabetes - Myths& Facts [神话&事实关于第二类型糖尿病]

·      How Will a 15 Minutes of Walking Improve Quality of Life (15分钟走步行怎么将改进生活水平?)

·      Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的别)

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验，并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康，我强烈敦促您有规则健康检查以避免未来复杂化。另外，控制您的饮食部分并且有定期运动.)

FDA Approved Humalog KwikPen® for Type 1 & 2 Diabetes (粮食与药物管理局批准Humalog KwikPen® 治疗糖尿病)

In May 2015, The U.S. Food and Drug Administration (FDA) approved Eli Lilly’s Humalog U-200 KwikPen (insulin lispro 200 units/mL; U-200) for people with type 1 and type 2 diabetes.  It is a prefilled insulin pen containing a double strength formulation of the rapid acting insulin Humalog – This offers patients a pen that lasts longer between pen changes, allowing for fewer changes every month.

According to David Kendall, M.D., Vice President of Medical Affairs, at Lilly Diabetes. "Humalog U-200 KwikPen represents a new option for people with diabetes. Fewer pen changes per month may help people who require higher daily doses of mealtime insulin better fit their treatment in their daily lives."

The approval of Humalog U-200 KwikPen was based on a demonstration of the bioequivalence of Humalog 200 units/mL relative to Humalog 100 units/mL in a pharmacokinetic / pharmacodynamic study. The most common side effect of Humalog is Hypoglycemia (low blood sugar) that may be severe and cause unconsciousness, seizures and death.  See my post on Hypoglycemia.

Once opened, Humalog prefilled pens should be thrown away after 28 days, even if insulin remains.

Humalog U-200 KwikPen was approved in the European Union since October 2014.

The Humalog U-200 KwikPen is expected to hit the shelves of U.S. pharmacies in August 2015.

For more information about the Humalog U200 KwikPen, click here for Full Prescribing Information from Eli Lilly.

My other Relevant Posts for your Reading (您能读其他相关的博克):

·      Post-Transplant, Osteoporosis & Right Diet (后移植、骨质疏松症 & 正确的饮食)

·      Eating Healthy to Lower Your Blood Pressure {Update#1} (吃健康降低您的血压)

·      Type 2 Diabetes - Myths& Facts [神话&事实关于第二类型糖尿病]

·      How Will a 15 Minutes of Walking Improve Quality of Life (15分钟走步行怎么将改进生活水平?)

·      Difference between Glycosylated Hemoglobin (HbA1c) and Blood Glucose (葡基化的血红蛋白 (HbA1c) 和血糖之间的别)

Disclaimer: I am not a Medical Doctor. All my blog postings are based on my personal experience that I've went thru and what I've read up from the internet. If you've any symptoms of diabetes OR want to better manage your health, I strongly urge you to have regular medical-ups to avoid future complications. In addition, control your diet portions and have regular exercise. 

(我不是一位医生。所有我的博克投稿是我的个人经验，并且我从互联网读了。如果您有糖尿病的任何症状或要更好处理您的健康，我强烈敦促您有规则健康检查以避免未来复杂化。另外，控制您的饮食部分并且有定期运动.)