many articles

[Guest guest]

1.%% M 8/19/11 Vildagliptin as an Add-on Agent in T2 HbA1C was reduced in

70% of pts. Conclusions -This observational audit provides real-life

evidence to suggest that vildagliptin [galvus] reduces HbA1C levels when

added to other oral anti-diabetic pills to provide dual, triple & quadruple

combo. Rx. Vildagliptin was weight neutral & well tolerated when added to

other oral anti- DM meds.

2.%% M 8/31/11 Benefits of modest weight loss...T2 [5145pts;37%

ethnic/racial minorities] Conclusions: Modest weight losses of 5 to 10% were

associated with significant improvements in CVD risk factors at 1 year, but

larger weight losses had greater benefits.

3.%% M 8/31/11 Tepilazumid for T1 Small studies have suggested that short

treatments with anti-CD3 monoclonal antibodies ..in pts with recent-onset

T1.[763pt;2yrs].. future studies of immuno-therapeutic intervention with

teplizumab might have increased success if they target pts early after

diagnosis of T1. Funding includes Juvenile DM Research Found, and Eli

Lilly.

4.%% NIH Digest 8/31/11 Uterine Stem Cells [sC] Used to Treat DM in Mice

Scientists have converted SC from the human endometrium [E] the lining of

the uterus into insulin-making cells & transplanted them into mice to

control their DM. E is a source of adult stem cells. these cells generate

uterine tissue each month as part of the menstrual cycle. If this therapy is

perfected, women with DM could provide their own E tissue for such a

transplant, avoiding the chance of rejection posed by tissue from another

person. The authors note that such a Rx would be more useful for people with

T1, where no insulin is produced than in T2, in which cells have difficulty

using the insulin that is available. If warehoused in a tissue

bank..compatible tissue would be available to women without a uterus & for

men.

5.%% ADA a link between T2 in men & increased risk of bowel cancer, [1300

pts;17yr fup] findings -men age 55 - 84 with T2 were 87% more likely than

the general population to develop bowel cancer. Author said " It might be

that the risk factors for the 2 conditions, including obesity, are the same

& that they develop independently of each other or it may be that factors

associated with DM trigger bowel cancer,-- fecal occult blood testing every

1-2years should be considered for men with T2 aged +55.

6.%% MTD 8/31/11 Sweat Meter to warn Patients Of Dangerously Low Blood Sugar

[bS] Some DM pts receive no warning before they pass out from low

BS.[hypoglycemia]. Symptoms may include palpitations, sweating, tingling

feeling in your face, altered sensory experiences and intense hunger. After

many years with DM some pts lose these warnings. It is known that DM pts

change their sweat pattern when their BS levels are too low. A sweat meter

being developed at U.Oslo can send an alert - via a mobile phone before a pt

suffers an attack. All you need to do is paste an electrode on your skin, "

says author...

7.%% Oph 118 Sep 2011 Phase 2 Primary Results of VEGF Trap-Eye in pts with

Diabetic Macular Edema (DME) [221pts] random, double- masked, clinical

trial. Conclusions- Intravitreal VEGF Trap-Eye produced a statistically

significant & clinically relevant improvement in visual acuity when compared

with macular laser photocoagulation in patients with DME.

8.%% 9/6/11 new On-line Course for Managing Diabetes Caring for DM is a

24/7 challenge. Add the complication of low vision or no vision to the mix &

you go from being independent in your DM self-managing to daily dependence

on others. With private foundation funding, The Carroll Center for the Blind

is now offering 2 web-based interactive courses: Diabetes & Visual

Impairment: A New View for Professionals; & Diabetes & Visual Impairment: A

New View for Patients & Families.The curriculum was developed by Margaret E.

Cleary, RN, MS, CVRT®, who has over 30yrs of experience as a rehab nurse, DM

educator & certified vision therapist.. Moodle, a software platform provides

the sighted reader with complete & easily-accessed materials while allowing

the visually impaired student easy access through his/her own adaptive

technology. For more info, or to register, please call Charlson at

ext. 224.

9.%% ADA 9/6/11 Healthy lifestyle lowers risk of Diabetes Scientists

found that even when people had a family history of DM or were overweight,

they were less likely to get DM if they were healthy in other ways.

[200,000 pts;10yrs] Each healthy behavior listed in the study survey - such

as EX for at least 20min a day, 3x a week -- lowered a person's future DM

risk independent of the other lifestyle components. Even though heavy people

were still better off if they were healthy in other ways, the team said

weight was the most important factor in predicting who got DM.

10.%% MP 9/7/11 Metformin [MET] just as effective as other medications for

treating T2 When lifestyle changes, such as diet & EX, are not enough, pts

with T2 often take 1 or more drugs to control their disease. Currently there

are no fewer than 11 different classes of DM meds. A recent major

evidence-based review [166reports] found that the older DM drug MET is just

as good, if not better, than newer classes. In addition, any 2-drug

combination produces similar DM control, but with different adverse events.

Most of the DM meds used alone in the reviewed studies lowered HbA1c by

about 1%. MET did better than several other classes by not increasing body

weight & by lowering LDL-cholesterol. MET had a better safety profile in

terms of risk for low BS. For example, sulfonylureas had a fourfold higher

risk for mild or moderate hypo compared with MET. Increased risks for

congestive heart failure & bone fractures were seen for thiazolid-inediones.

Agency for Healthcare Research & Quality.

11.%% M 8/31/11 Role of Parenting Style in Achieving Metabolic Control in

Adolescents With T1. Parents of 100 adolescents with T1 completed

assessments of their parenting style. Conclusions—An authoritative

nonhelpless parenting style is associated with better DM control in

adolescents. Paternal involvement is important in adolescent DM management.

12. %% MTD 9/5/11 Crippling Condition Associated With Diabetes Is Often

Misdiagnosed & Misunderstood - Charcot foot, is a form of localized

osteoporosis linked to DM that causes the bones to soften and break, often

resulting in amputation. A new article in Diabetes Care Sep 2011 describes

Charcot foot & its treatment with a goal of educating medical professionals

about this painful inflammation of the foot. The " Even though it was first

described in 1883, diagnosis & successful treatment of Charcot foot continue

to be a challenge because this syndrome is not widely known or understood by

the broader medical profession, said author. Charcot foot is now considered

to be an inflammatory syndrome most often seen in pts with DM which can be

successfully treated in its early stages. "

13.%% EASD In Diabetes, Fatty Food Leads to " Leaky Gut " A high-fat meal in

people with T2 & impaired glucose tolerance appears to

trigger the passage of bacterial endotoxins through the intestinal wall,

adding to the load of inflammatory cytokines that have already been

implicated in the disease, [54pts] Research confirms that DM, obesity, & CVD

all have an element of systemic inflammation. Author said this inflammatory

insult could arise, in part, from a compromised gut mucosa that allows

bacterial endotoxins to enter the circulation and initiate a systemic

inflammatory response.

14.%% NatMed 9/8/11 Pathway to DM through reduction of pancreatic beta cell

production & transport of glucose. A team reports a combo of molecular

events in human & mouse pancreatic beta cells, caused by elevated levels of

free fatty acids or by a high-fat diet with obesity, that leads to T2. The

resulting deficit of GnT-4a in beta cells produced signs of metabolic

disease, including high BS, impaired glucose tolerance, elevated insulin

production, & decreased insulin action in muscle & fat tissues. This process

was active in human islet cells obtained from donors with T2 thus,

illuminating a pathway to disease implicated in the diet &

obesity-associated component of T2.

15.%% MTD 9/6/11 Inflammation In Diabetes May Be Part Of The Solution, Not

The Problem Increased low-grade inflam.. in the body due to obesity is

widely viewed as contributing to T2. New research reports that 2 proteins

activated by inflammation are actually crucial for maintaining good blood

sugar levels - & that boosting the activity of these proteins can normalize

BS in severely obese & DM mice. This team previously showed that obesity

places stress on the endoplasmic reticulum (ER), a structure in the cell

where proteins are assembled, folded & dispatched to do jobs for the cell.

This so-called " ER stress " impairs the body's ability to maintain

appropriate BS levels, & is a key link between obesity & T2. Earlier this

year, they showed that activating XBP1s artificially in the liver normalized

high BS in obese, insulin-resistant T2 mice ( & in lean, T1 mice). The new

study shows that a second protein triggered by inflam.. signals, p38MAPK is

involved. the findings suggest that either increasing p38MAPK or XBP-1

activity could represent new therapeutic options for DM. The study also

suggests a new model for understanding T2 in which obesity may interfere

with the ability to respond to inflammatory signals.

16.%% EASD 9/15/11 Postprandial Glucose Predicts CV Risk in T2 [505

pts;14yr] HbA1c & blood glucose levels after lunch, but not fasting blood

sugar, predicted both future cardiovascular events and all-cause deaths.

17.%% ADA 9/8/11 Researchers testing eye fluid for new way to measure blood

sugar levels Diabetics know the drill. Each finger prick tells them if

their BS levels are too high or too low. A team at Mayo Clinic has been

working on a way that could one day make BS monitoring easier for pts -- by

using tear fluid. The idea is that pts would put the device on the white

part of the eye (conjunctiva.) You get a small volume tears in a few

seconds. The fluid then travels to another region on the test card, where a

sensor reads BS levels. Studies show if it's done correctly, the tear fluid

reading is just as accurate as a BS reading. But there are some challenges.

The test has to be performed quickly & efficiently -- without letting the

tear sample evaporate. " So it's a lot easier to get samples from your eye,

but it's a lot harder to measure them, " said a team member. Doctors hope to

have the device on the market in the next 3-5 years.

18.%% M 9/9/11 Alcohol-Related Deaths Up in some With T1 Survival rates in

pts with early-onset T1 have improved in recent years, while survival in

those with late-onset T1 has decreased since the 1980s. [17,306

pts;diag1970-99] There was an overall improvement in mortality rates over

time in the early-onset cohort. The reverse was true in the late-onset

group: It increased from 1.4 to 2.9 in the 1985 to 1989 group. The team

found that alcohol & drugs were common causes of mortality, especially in

the late-onset cohort The findings highlight " the importance of permanent &

long lasting patient doctor -nurse relationships, close supervision, &

guidance on the short & long term effects of alcohol in young people with

T1, especially in our alcohol permissive cultures, " the authors write. BMJ

Sep 8, 2011.

19.%% ADA 9/13/11 T2 Agents Effective for T1 – Colesevelam and the

incretin-enhancing gliptins are drugs with established roots in the Rx of

T2 but also with preliminary evidence of clinical benefit in T1.

Colesevelam (Welchol) is the only agent approved by FDA both for treatment

of dyslipidemia [abnormal blood fats] & for improving glycemic control in

T2. Colesevelam reduces LDL by binding bile acids in the intestine. It is

not widely prescribed, having been over-shadowed by the statins. But has

proved to be a safe, effective agent according to author. Clinical trials

indicate that colesevelam reduces LDL by 12%-16% while lowering HbA1C by

about 0.5% in T2. Data re this drug in T1 [40pt;12 wk] shows LDL levels in

the Rx group dropped from 108 to 98.3 mg/dL. 3 incretin-enhancing gliptins

are on the market --sitagliptin(Januvia), saxagliptin (Onglyza), &

linagliptin (Tradjenta) They are once-daily oral drugs which lower HbA1c by

0.5%-1% without causing hypoglycemia.

20.%% M 9/13/11 Gentle yoga classes may help people with T2 take off a small

amount of weight & improve their glycemic control[123pts] those who added

yoga classes to standard DM care shed some pounds over 3 months. Meanwhile,

their average blood sugar levels held steady- in contrast to a non-yoga

control group, whose BS rose. ..yoga may curb oxidative stress because it

stimulates the para-sympathetic nervous system. The yoga used in this study

was a gentle form, In the real world, yoga classes vary widely. Some are

vigorous work-outs involving complicated poses that would not be appropriate

for older adults with chronic health conditions.

21.%% M 9/26/11 More Frequent Office Visits Lead to Faster Diabetes Control

— Patients with DM who visited their primary care physicians once every 1-2

wks were more likely to achieve clinical goals than those who visited less

frequently.Elevated levels of hemoglobin A1c, BP, and low-density

lipoprotein cholesterol level (LDL-C) are assoc. with greater risk for DM

complications, but most patients have not achieved target levels for these

factors. [retrospective cohort study 26,496 T2 pts] analysis revealed that

for every doubling of the time between physician visits, the median time to

achieving hemoglobin A1c targets increased, Similar trends were seen in BP &

LDL-C. A randomized prospective study is needed to better understand

optimal visit frequency,

22. %% MP 9/14/11 Abatacept in pts with recent-onset T1 A double- blind,

randomised, placebo-controlled trial. The [development ] of T1 is

associated with T-cell autoimmunity. To be fully active, immune T cells need

a co-stimulatory signal in addition to the main signal. Abatacept has this

action & prevents full T-cell activation. [112 pts] Interpretation: using

abatacept in recent-onset T1 pts slowed reduction in ß-cell function over 2

yrs. The beneficial effect suggests that T-cell activation still occurs

around the time of clinical diagnosis of T1...[see #24]

23.%% EASD A new analysis of glucose management in T2 suggests that poor

glucose [bS] control is a strong predictor of heart failure. (HF)The

presenter noted HF is 2.5 times more common in DM pts than in the general

population, but much of the focus of glucose- lowering has been on ischemic

heart disease [ie MI] despite the rising numbers of HF pts with DM

[83,000pts;7.2yr] Adjusted analyses found an HbA1c level of 10% or greater

was assocwith more than a two-fold risk of HF hospitalization, compared to

pts with a HbA1c level <6%. Those with HbA1c in the range of 6% to 7% to 8%,

however, were not statistically more likely than patients with levels <6% to

develop HF.

24.%% Nature Endo Oct 2011 Type 1 DM—a door opening to a real therapy?

Abstract - T1 is an autoimmune disease caused by selective destruction of

insulin-secreting ß cells by autoreactive CD4+ & CD8+ T lymphocytes.

Presently, management of the disease consists of the chronic adm of

insulin—a replacement therapy which, in spite of major improvements in its

use, does not satisfactorily prevent degenerative complications in the long

term. To read this article.. [see # 22]

25. %% Nat Endo Oct 2011 RAGE—a biomarker for CHD in T2DM?

Abstract - High levels of 2 isoforms of RAGE (receptor for advanced

glycation end products) are associated with an increased risk of coronary

heart disease (CHD) in pts with T2 reveals new data of a nested case–control

study. To read this article in full ..

26.%%MTD 9/15/11Newly Identified Protein Required For Glucose Uptake All

cells need glucose (sugar) [bS] to produce the energy they need to survive.

High BS In the bloodstream (such as after a meal), trigger the pancreas to

produce insulin. In turn, muscle & fat cells respond to insulin by moving

GLUT4, a glucose transporter, from storage out to the cell surface. There,

GLUT4 can take up the glucose the cell needs from the bloodstream. Now, a

new study identifies the protein - CDP138 - responsible for ensuring that

GLUT4 is properly inserted in the cellular membrane. These results provide a

new understanding of glucose metabolism - an important finding considering

that impaired insulin action & glucose metabolism contribute to the

development of T2. Lab studies suggest that mice engineered to be obese

have lower CD138 levels than normal mice. It remains to be seen whether this

is the case in humans & whether CD138's correlation with obesity is a cause

of obesity or an effect - or simply a correlation.,

27.%% EASD 9/13/11 High-Protein Diet Raises T2 Risk [27140 pt T2] the team

found a 37% increased risk for T2 associated with the highest quintile

[fifth of grp] of protein intake...In men, high carbo. intake tended to be

protective, " reducing the risk for T2 by about 23%. There was no significant

effect of carbohydrate intake for women. In summary, presenter said a

protective association exists with a high intake of fiber-rich breads &

cereals. Although high protein intake has been shown to be effective for

short-term weight loss and glycemic control, it is associated with an

increased risk for T2. she said, it is too early to make dietary

recommendations on the basis of observed associations. limitation of the

study is its retrospective nature & its dependence on diary data derived

from self-reports. In the future, we will probably " need various diets for

various genetic backgrounds, but we will have to be able to define it

somehow, "

28.%% EASD Islet Autoantibody Testing Averts Ketoacidosis in Children -

Regular screening for islet autoantibodies in children at high risk for T1

can prevent DM ketoacidosis(DKA) & other morbidities associated with the

onset of the disease. DKA, which affects 10% to 70% of children at the time

T1 is diagnosed, is a life-threatening condition. [2542 pt;17yr fup] pts

were screened as newborns & found to have the human leukocyte antigen

(HLA)-DR & HLA-DQ genotypes assoc with T1 " DKA was present in 7% of reg

screening pts- & 37% of the community controls, " Dr. Rewers said The median

HbA1c at diagnosis were 11.2% in community subjects & 6.6% in active study

participants.

29.%% EASD 9/16/11 High-Dose Insulin at 2 Sites Improves Glucose Control

For patients who are severely insulin-resistant and who have poorly

controlled T2, especially those who do not have access to U-500 insulin,

splitting the dose & injecting it into 2 symmetrical sites might provide

significantly better metabolic control & might increase patient

satisfaction. The presenter said this is probably the result of better

insulin absorption. [31pts random study] For pts requiring insulin doses

greater than 2 IU/kg [2.2lb] of body weight, simply increasing the dose

might not achieve adequate control of BS. In addition, insulin pens might

need to be refilled and injected a second time because of limited capacity.

no major hypoglycemic episodes occurred. Body weight remained stable in both

groups. Session chair agreed that giving insulin in 2 sites could be a good

way to improve control in patients with T2. It might also be safer than a

single-site injection because of more stable drug absorption, blood levels,

and consequently more stable blood glucose levels.

30.%% EASD Outpatient Test Discriminates MODY From T1 — A measure of the

postprandial ratio of urinary C-peptide to creatinine (UCPCR) can

distinguish maturity-onset DM of the young (MODY) from T1, allowing some

children who would otherwise be treated with insulin to receive oral

antidiabetic agents alone, Dr. Besser said the UCPCR test is 100% sensitive

for identifying MODY,and it may be useful even close to the time of

diagnosis. MODY, an autosomal dominant condition that alters beta-cell

function, is the most common monogenic [one gene] cause of DM & accounts for

1% to 3% of cases. Various genes have been implicated, & the HNF1A and HNF4A

forms are sensitive to treatment with sulfonylurea drugs, whereas the

glucokinase form is not. Onset is typically at ages younger than 25yrs

About 30% of pts are misdiagnosed as having T1DM and are therefore treated

with insulin. Persistent insulin secretion occurs in MODY but not in T1.

Patients [uK] can do the test at home & drop the sample in the mail the next

morning. The study received no commercial funding.

31.%% MP 9/19/11 More Evidence Links Diabetes, Dementia Findings point up

another reason to keep blood sugar levels in check. Team says

[1017pt;11yr] 27% of those with DM developed dementia, compared to 20 % of

those with normal BS. Further, the study showed that pre-diabetes -- higher

than normal BS levels -- also raised the risk of dementia. Even having high

levels of sugar 2hrs after taking glucose was linked to dementia.. Another

expert noted that diabetes could be connected to dementia because it

contributes to vascular disease, disrupting the flow of oxygen to the brain

and other organs.

32.%% ADA 9/23/11 Maggots may help heal diabetes wounds To allow difficult

DM wounds to heal, doctors remove infected or dead tissue with scalpels or

enzymes, a process they call debridement. But these tools often fail, say

researchers in Hawaii. " These problem pts with DM really need better

treatments in order to salvage their limbs, " [37pts with DM & poor

ciculation] 50-100 maggots applied in a mesh cage for 2 days; then replaced

with new ones . 21 pts had successful outcomes, defined as eradication of

infection, complete removal of dead tissue, formation of robust connective

tissue in the wound & more than three-quarters closure of the wound. " A lot

of pts might be somewhat wary of having live insects placed into their

wounds so we explain how it works and what possible problems might occur, "

Maggots secrete substances into the wounds that liquefy dead tissue and then

they ingest the material. The wounds are cleaned, & other substances

contained in the maggot secretions allow development of granulation tissue,

a type of connective tissue that forms during wound healing. " After this, we

go on to do further Rx with hydrogels, grafts of cell culture tissue etc.

Findings haven't yet been vetted by independent researchers.

33.%% M 9/27/11 Super-Tight Blood Sugar Control May Not Ease Mental Decline

in T2- Super-strict BS control actually appeared to increase study

participants' risk of death. While the study didn't confirm cognitive

advantages, many other health benefits are associated with well-controlled

BS, author said. [2,977 pts;55-80yrs at high risk for heart disease]

Intensive BS lowering meant reducing blood sugar to less than 6 % as

measured by an A1c test. The current standard is to maintain BS at between

7- 7.5 %. 614 pts also had an MRI to measure brain volume and took cognitive

ability tests at the beginning & end of the study. After about 39 months, no

difference in cognitive ability existed between the groups. pts in the

intensive care group had a significantly larger brain volume than patients

in the standard treatment group But, this didn't translate to better

thinking abilities. The part of the ACCORD trial involving intensive

lowering of BS was halted earlier than planned. increased risk of death, the

finding of no overall benefit on CV disease, problems caused by too-low

blood sugar and weight gain were all factors in stopping.

34.%% MV Voice 9/26/11 Local student's science project makes an impact on

study of disease It's not everyday that progress is made in DM research,

let alone by a high school student. When St. Francis High School student

Shubha Raghvendra was recognized by the City Council last week for a

research project which has won her awards at county, state & international

science competitions, Mayor Jac Siegel couldn't pronounce the title of her

research paper: " Effects of Diabetes Mellitus on Vasculogenesis Capacities

of Mesenchymal Stem Cells. " Raghvendra, the 17-year-old daughter of two

computer engineers, owes her success not just to her knack for science, but

her social networking skills. For several years now, doctors and researchers

at Stanford have given her valuable guidance.

Raghvendra has been competing in science fairs since she was in first grade.

In middle school she realized that science projects could have a greater

impact on the world, & it was about that time that she began looking for

some mentors in academia. She first contacted Dr. Geoff Gurtner, a Stanford

plastic surgeon & researcher " on the cutting edge " of regenerative medicine,

when she was 14. But because of university rules, Raghvendra had to wait

until she was 16 to start doing research on campus. Other mentors include

Dr. Glotzbach and Dr. Sorkin, both researchers at Stanford.

With their help, this year Raghvendra was able to demonstrate that DM hurts

the ability of certain bone marrow cells to heal wounds in the body, which

could contribute to complications, including heart attacks & strokes..

Someday her work could help in the treatment of diabetics, including five of

her uncles who suffer from the disease.

At the 2011 Intel International Science & Engineering Fair, which draws

students from 60 countries, Raghvendra topped the health and medical

sciences category. and placed third overall. The project won fourth place in

its category in the California state science fair and the grand prize for

medicine and health category in the Santa Clara Valley Science and

Engineering Fair. What's next for Raghvendra? She wants to be a doctor, and

as one might expect, she hopes to get into Stanford University. Find this

article at:

www.mv-voice.com/news/show_story.php?story_id=4765

35.%% ADA 9/28/11.. people with diabetes have a somewhat increased risk of

colon cancer -- but the reasons for the connection, and what should be done

about it, remain unclear. Combining the results of 14 international

studies, researchers found that overall, people with DM were 38 % more

likely to be diagnosed with colon cancer than those who were DM-free. There

was also a 20% increase in the risk of rectal cancer, though that appeared

to be confined to men. The findings, do not prove that DM directly

contributes to colon cancer in some people. In most of the studies, the

teams adjusted for some factors that might explain the link -- like older

age, obesity & smoking -- and the diabetes-cancer connection remained.

However, there could still be other explanations. " I think we can make the

statement that DM is is consistently associated with colorectal cancer, " an

independent expert said. " The cause-and-effect aspect is a bit difficult to

consider since diabetes is such a complex disease, " One theory is that

hormones are involved. People with diabetes tend to have high levels of the

BS-regulating hormone insulin, as well as related hormones called

insulin-like growth factors. Those hormones cause cells to grow & spread,

and that may include cancer cells. People with DM are not advised to get

colon cancer screening any more often,or at a younger age, than people

without diabetes, said study leader. Experts recommend that most people

start colon cancer screening at the age of 50, with any of several tests --

including stool tests that look for hidden blood, or invasive tests like

sigmoidoscopy or colonoscopy. People with certain risk factors for colon

cancer -- like inflam bowel disease (Crohn's disease or colitis) or a strong

family history of the cancer -- are told to start screening earlier.

Diabetes is not currently considered one of those risk factors...

EASD European Assoc for Study of DM 47th Annual Meeting Sep 2011

%%Abbreviations & acronyms

fup-follow up; pt - patients; DM - diabetes Mellitus; T1DM - type 1

diabetes mellitus T2DM - type 2; DME - diabetic macular edema;DR - diabetic

retinopathy; BS - blood sugar or glucose level;HbA1C, glycated haemoglobin

A1C; BP - blood pressure; NV- neovascular-ization; CVD - cardiovascular

disease; CHD -coronary heart disease; MI -myocardial infarction/ heart

attack ; OCT - optical coherence tomography; BCVA - best corrected visual

acuity ;ADA - Am Diab Ass ; M- Medscape Web MD; MP- Medline Abstract,

Medline Plus & Health Day; MTD- Med News Today;NEI - Nat Eye Institute;

Definitions via online Medical dictionaries. Disclaimer, I am a BSN RN but

not a diabetic or diabetic educator. Reports are excerpted unless otherwise

noted. [translations, explanations by thl] This project is done as a

courtesy to the blind/visually impaired & diabetic communities. Dawn Wilcox

RN BSN Coordinator The Health Library at Vista Center; an affiliate of the

Stanford Hospital Health Library. contact above e-mail or

thl@...