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Diabetic Digest - The Results of Feeling Better

Diabetic Digest

News and help from and for the diabetic community.

Diabetic Digest - Wednesday, September 5, 2012

Readers:

Another year gone by means that I'm due for my yearly physical.

It happens about the same time each year so I shouldn't be

surprised, but I can't help it. However, what I'm surprised about this year is

much different than the ones prior.

Since my son was born I have been taking much better care of myself.

I've been eating less, but I'm eating better. I've lost more than 20 pounds

since May because of my new eating habits. Also I've decreased the amount of

insulin I use because of my new diet, plus the fact that I'm way more active

with a baby in the house.

So wish me luck. The results will be in the next issue.

Regards,

Steve

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Questions? Comments? Email Steve

*-- Diabetic News --*

Testosterone Tx Stymied by Depression

By: a Fiore

MedPage Today

CHICAGO - Testosterone therapy may be useless in men with type 2

diabetes and hypogonadism who also have depression, researchers said here.

In a randomized controlled trial, diabetic men who weren't depressed

had significant improvements in blood glucose and other metabolic parameters

with hormone therapy, but those with depression gained no benefit, Geoffrey

Hackett, MD, of Good Hope Hospital in Sutton Coldfield in England, and

colleagues reported at the World Meeting on Sexual Medicine.

" All [parameters] improved in the nondepressed group, and there was

a worsening of all symptoms in the group with depression, " Hackett said.

Men with type 2 diabetes tend to have a high burden of co-occurring

hypogonadism and depression, Hackett explained.

To assess whether treatment of low testosterone is affected by

depression, the researchers conducted the randomized controlled BLAST Study --

an acronym for the included towns of Birmingham, Lichfield, Atherstone, Sutton

Coldfield, and Tamworth - in 200 men from seven primary care practices who had

type 2 diabetes and hypogonadism.

The study lasted 30 weeks, with about half the men continuing in a

52-week, open-label follow-up phase.

Participants were given either 1,000 mg testosterone undecanoate

(Nebido) or matching placebo at baseline and at weeks 6 and 18.

The prevalence of hypogonadism was 50%. Almost a quarter of the

population with type 2 diabetes (23%) was depressed, and these men tended to be

younger and more obese, Hackett said.

For men who weren't depressed, testosterone therapy significantly

reduced HbA1c levels (P=0.045).

It was also tied to significant reductions in weight (P=0.038), body

mass index (P=0.02), and waist circumference (P=0.02), the researchers reported.

Yet they didn't see similar improvements in any of these parameters

for patients who were depressed, Hackett said.

" We saw a highly significant treatment effect in the nondepressed

group, and in the depressed group there was no response whatsoever, " he said

during the presentation.

" The take-home message, " he continued, " is that it's important to

screen for depression when initiating testosterone therapy, as both the

metabolic and psychologic complications will be [affected]. "

" You'll save yourself trouble if you detect those patients early, "

he said.

He added that clinicians should consider concomitant treatment of

patients' depression when they go on hormone therapy, but that this trial would

have been underpowered to study that endpoint.

Jacques Buvat, MD, of the Centre d'Etude et de Traitement de la

Pathologie de l'Appareil Reproducteur et de la Psychosomatique in Lille, France,

who moderated the session during which the study was presented, said the

findings were " very important " for the treatment of low testosterone in diabetic

patients.

Original Article: Testosterone Tx Stymied by Depression

*-- Diabetic Recipe --*

Apple Crumb Cake

Servings: 16

Prep time: 20 minutes

Cook time: 30 minutes

Total: 50 minutes

Ingredients

vegetable cooking spray

1 cup all-purpose flour

1/3 cup rolled oats

1/3 cup one-to-one sugar substitute

1/4 cup brown sugar substitute

1 teaspoon ground cinnamon

1/8 teaspoon ground nutmeg

1/8 teaspoon salt

4 tablespoons cold margarine, cut into small pieces

1/2 teaspoon baking powder

1/2 teaspoon baking soda

1/3 cup unsweetened apple juice

1 teaspoon vanilla extract

1/4 cup egg substitute

2 Braeburn apples, about 1 pound total, peeled, cored, and chopped

Directions

1. Preheat oven to 350 Degrees F. Lightly coat an 8-inch square

baking pan with cooking spray.

2. In a bowl combine the flour, oats, sugar substitutes, cinnamon,

nutmeg, and salt. Cut in the margarine with a pastry blender, or two knives,

until the mixture looks like coarse meal. Set aside 1/2 cup.

3. Combine the remaining flour mixture with the baking powder,

baking soda, apple juice, vanilla, and egg substitute. Beat at a medium speed

with an electric mixture until blended. Fold in the apples.

4. Spoon the cake mixture into the pan and level out. Sprinkle with

the reserved flour mixture. Bake for 30 to 35 minutes until the cake springs

back in the center when lightly touched. Cool the cake until warm. Cut into 16

squares. Serve warm or cooled.

Nutrition Information

Per serving: 88 calories (30% calories from fat), 2 g protein, 3 g

total fat (0.5 g saturated fat), 14 g carbohydrates, 1 g dietary fiber, 0

cholesterol, 116 mg sodium

Diabetic exchanges: 1 carbohydrate (bread/starch), 1/2 fat

Original Recipe: Apple Crumb Cake

***

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