Research on a Placard: Fascinating ADA Poster News

The research poster is a clever invention.  It basically allows researchers to pack all the details of a study they’ve conducted — abstract, methodology, graphs and charts, overview of results — on a 30″ x 40″ piece of cardboard to show it off at scientific events, so that colleagues can walk by and absorb their work in 10 minutes or less. Over 1,600 posters like this were presented this year at the American Diabetes Association annual conference (just completed here in Orlando, FL, where I’m still on-site now at CWD).


Here are some highlights, pointed out by the ADA itself as being especially newsworthy, with my own reactions added for a little “reality check” and spice:


* Caffeine Prevents BG Drop During Exercise

According to new research conducted in the UK: “although eating snacks before or after exercise may prevent hypoglycemia, that may counteract the benefits of exercise on weight maintenance.” Right. Who needs all that extra food?  This research suggests “an intriguing way to prevent hypoglycemia from exercise… a shot of caffeine before strenuous physical activity… Data suggest that ingesting caffeine may actually boost glucose production during exercise.”

Hmm, I do wonder: I usually drink about 3 cups of strong German coffee (Jacobs! for those who haven’t discovered its wonders) before I do my 1.5 to 2-hour strenuous workouts a few times a week. I’ve done pretty well avoiding lows. Always thought it was my prowess with the temp basal settings, but maybe the caffeine is also at work. Only way to find out is to do a morning “no-coffee” test. Not happening any time soon! Any of you tried “using” caffeine to avoid lows?

* Insulin Sniff Test

More weird research on the human senses: based on the notion that hunger is driven in part by our sense of smell, as is our sense of when to stop eating.

Researchers in Germany recently conducted a study on eight patients (yes, just 8!) and found that higher levels of insulin — seen with insulin resistance — reduce people’s smelling capacity, “which may dampen the signal to stop eating when full.”  This raises the question, they assert: Can we alter smelling capacity to assist those struggling with obesity?

My first question is this: How much substantive data do we really have on whether or not most obese people experience impaired sense of smell?

Secondly, smell is strongly associated with attraction to food, no? So you’d think if your sniffer didn’t work, you’d be less likely to want to keep eating. That’s how it worked for our next door neighbor, anyway. She lost her ability to smell for several years, and told us that eating became a “chore” because she couldn’t really taste anything.  Anecdotal evidence, I know, but it makes me think that people overeat for other reasons than not being able to “smell” the right time to stop munching.

* Type 1 Diabetes and Heart Health

There’s lots of data to support the notion that people with type 2 diabetes are at increased risk for heart disease, but not so with type 1 diabetes. Until now it’s been more of an assumption than a fact-based finding, apparently.  Looking into this, a new study conducted in Pittsburgh ended up tying heart health in type 1 diabetics to their kidney health, i.e. adults with type 1 “who still have healthy kidneys are no more likely to develop early cardiovascular disease than those without diabetes.”

I’m not sure that finding is such good news, because it implies that if you develop kidney damage, you’re in for a nasty double-whammy. Aargh.

In any case, the type 1 heart health issue was controversial enough to warrant a staged debate here at the ADA Conference – over “whether type 1 diabetes is a real risk factor for heart disease, assuming all other risk factors are kept in good control (glucose levels, lipids and blood pressure levels).” Researchers argued compellingly on both sides.

* Direct and Indirect Costs of Diabetes

The intriguing abstract for this poster states: “How much would it save if we prevented a single case of diabetes over a lifetime? About $170,000 to $210,000 if that person were diagnosed at the age of 50.”

Unlike other diabetes cost studies, this investigation looked at the lifetime direct and indirect costs of disease, also projecting forward to the end of life expectancy. What they found out was that supporting diabetes over a patient’s lifetime is damn expensive. (D’oh – we could’ve told you that). But it’s powerful to document the numbers, of course, to help sway policymakers, insurance providers, and others with the authority to mandate whether preventative care (like diabetes education!) is a worthwhile investment.

* Inhaled & Oral Insulin: What’s New

Several new studies were presented here:

Technosphere (aka Afrezza) inhaled insulin, still under development from the unflappable MannKind Corp. (now under review at the FDA) was shown to be safe for use in type 2 diabetics.  Over 800 patients were studied taking the drug for over two years. It was found to produce fewer hypos than injections and cause zero increase in the patients’ cardiovascular risk. According to the researchers, the only side effect was a mild cough (ahem…)

Technosphere was also shown to be equally effective as injections in patients with type 2 diabetes, and may even provide some advantages.

It’s even safe for people with asthma (diminished lung capacity) to take Technosphere inhaled insulin — as long as they take their asthma meds correctly and regularly.

Still, the company can’t escape the specter of the Exubera debacle (Pfizer’s failed inhalable insulin drug). Industry analysts are still warning to “proceed with extreme caution” here.

A seemingly “magic” insulin pill from OraMed out of Israel is looking good so far (paraphrased by me, of course). Essentially, development of oral insulin “has been stymied by the fact that insulin is a protein, and like food, is broken down in the intestines.” Researchers have developed a unique formulation to protect the insulin in a capsule format as it passes through the gut.  Early studies are finding that it indeed reaches the bloodstream of people with type 1 diabetes, and can effectively lower blood glucose.  This potential wonder-drug is in various phases of research in several countries at this very moment. Cross your fingers for its continued success.

* Drink Your Milk

Because researchers can’t ever seem to stop probing into the effects of dairy: new research out of Boston and Singapore shows that girls who drank their milk during adolescence are less likely to develop type 2 diabetes later in life. “What’s more, women who continue to drink milk in their adult years are the least likely to develop diabetes.”

Two things in response to this:

1. Haven’t I been seeing quite a few reports recently about the link between milk consumption and type 1 diabetes? We really cannot win.
2. For us women-folk, I say: Hooray for Lattés! (how else do you expect grownups to ingest milk? Unless of course milk chocolate counts…)

I assure you that I’m not poking fun at these studies, but rather just making the reporting of them a little more fun. Science can be so complex, which is why it’s nice presented on a poster: condensed to its very essence. Thank you, scientists, physicians and other researchers, for these summaries of your hard work!