Category Archives: Information

Woman Living With Diabetes No Longer Needs Insulin After Bioengineered Pancreas Transplant

The major problem with type 1 diabetes is that the body produces antibodies that attack the body’s healthy islet cells in the pancreas which produces insulin. This limits insulin production making the body the body unable to make use of glucose gotten from diet leading to high blood sugar. The patient then has to makes rely on insulin injections or pumps to survive.

Before now, several research works have being aimed at transplanting islet cells from deceased donors into the liver but this has not been ideal The liver can only take few islet cells and with risk of bleeding.
Recently, researchers at the University of Miami Diabetes Research Institute have tried another location – the omentum, a fatty membrane in the belly.

A 43 year old single mother with a 25 year history of type 1 diabetes has been off insulin for over a year following islet cell transplant in the omentum. Before the transplant, she was said to have been on about 33 units of insulin per day. No surgical complications were observed during the procedure.

The researchers said

“The cells began producing insulin faster than expected, and after one year she is doing well and doesn’t need insulin injections”.

“We’re exploring a way to optimize islet cell therapy to a larger population. This study gives us hope for a different transplant approach,”

Dr. David Baidal, assistant professor in the University of Miami Research Institute who led the study said. The research is the first step towards developing a mini organ called BioHub.

The BioHub would be like a home to the islet cells providing it with blood supply and nutrition, making it easier to remove in cases of complications. The researchers plan to test the use of omentum as a site in 5 new patients.

IMPROVED LIFESTYLE
Baidal explained that

“Her quality of life was severely impacted. She had to move in with her parents. And, if she traveled, she had to travel with her father”.

This is indeed good news.
This is a step in the positive direction for about 422 million people worldwide living diabetes. It would also markedly save cost for insulin in the long term.
More information of this ground breaking research headed by Dr David A. Baidal can be seen in the New England Journal of Medicine.

Meanwhile, you can win an all expense paid trip to a Diabetes youth camp in Ghana. Click here for details

Facts You Might Never Have Heard About Diabetes

1. The earliest description of Diabetes is in an Egyptian medical papyrus called Ebers papyrus describing “too great amount of urine”

2. The term diabetes was first used by Apollinus of Memphis 250AD

3. The Greek Physician Aretaeus (30-90CE) recorded a disease that caused ex-cessive thirst, urination and weight loss. The word “diabetes” is Greek for “siphon” describing the excess urine.

4. Galen, a physician and philosopher in the Roman empire commented that he had only seen 2 cases in his career (probably due to better diet and life-style). Galen named the disease “diarrhea of the urine” (diarrhea urinosa).

5. The term “mellitus” or “from honey” was added by the Briton John Rolle in the late 1700s to separate the condition from diabetes insipidus, which is also associated with frequent urination. It is said that some physicians tast-ed the urine in early times to aid in diagnosis.

6. In 1910, an English physiologist Sir Edward Albert Sharpey-Schafer discov-ered that a component was missing from the pancreas of diabetics and he called it “insulin”.

7. Before insulin, the only treatment for type 1 diabetes was starvation, which was of course, ineffective, extending life for only a few years.

8. In 1921, Canadian physician Frederick Banting and medical student Charles H. Best discovered the hormone insulin in pancreatic extracts of dogs. One year later, Banting was awarded the Nobel Prize in Physiology or Medicine. At the age of 32, he was the youngest Nobel laureate ever in this category.

Charles Best and Banting

9. The first people to ever receive insulin were Frederick Banting and Charles Best – they injected insulin into each other’s arms to see if it was safe on humans.

10. Banting was bad at spelling and first spelt diabetes as “diabetus”

11. Banting never profited from insulin and gave the patent for free to provide insulin for all.

12. Friedrick Banting was honored by World Diabetes Day which is held on his birthday, November 14

13. Leonard Thompson, 14, a charity patient at the Toronto General Hospital, became the first person to receive and injection of insulin to treat diabetes in January 1922. He lived another 13 years before dying of pneumonia at age 27.

14. Before the 20th century, tasting urine was the test for Diabetes

15. In 1969-1970, the first portable blood glucose meter was created by Ames Diagnostics.

16. Diabetes also occurs in animals like dogs and cats. It is more common in the female dog and the male cat. It has also been reported in horses, dolphins, foxes and hippopotamus
17.

The blue circle is the universal symbol for diabetes. Amongst other things, it signifies unity showing our combined strength in diabetes campaign. It was designed in 2006 by the International Diabetes Federation. The blue border of the circle reflects the colour of the sky and the flag of the United Nations.

18. An insulin requiring individual would spend 29 percent of his monthly income on insulin in Nigeria with payment being mostly “out of pocket”

19. Currently oral hypoglycemic drugs are readily available in Nigeria but insulin is less so.

20. Common alternative medicine used by Nigerians is vernonia amygdalina (bitter leaf) with the belief that bitter taste would counteract the “ sweetness” of blood. Nigerian researchers have reported lowering of blood glucose in diabetic rats comparable to that diabetic rats on oral hypoglycemic drugs though more research in humans is needed in this area.

21. Inhaled insulin is an emerging 21st century innovation. Companies are also working on insulin tablets that can simply be placed under the tongue.

22. About 422 million people worldwide have diabetes and this is more in low and middle income countries. In 2012, it was the direct cause of 1.5 million deaths.

23. A Nigerian study found that gestational diabetes to occur in 2.98 per 1000 pregnancies.

24. A Harvard study showed that eating one serving of cooked oatmeal two to 4 times a week was linked to 14 percent reduction in type 2 diabetes risk

25. WHO says taking brisk , 30 minutes walk,5 days a week can reduce diabetes risk

26. Men with diabetes are at greater risk of erectile dysfunction than those without it.
27. People with diabetes can live long and healthy lives with their diabetes detected and well managed

28. Celebrities like Nick Jonas, member of Jonas Brothers was diagnosed in 200k but went public in 2007.

29. Halle Berry was diagnosed with type 1 diabetes at 22 years old after she reportedly went into a diabetic coma.

30. About one third of people with diabetes do not know they have the it.

Reference
Diabetes in Nigeria – past, present and future by AO Ogbera

Be our guest blogger. Send your articles to thengdoc@gmail.com

RAMADAN KAREEM

Ramadan_Kareem_2_by_meanart

This is the period where our dear muslim friends, family and colleagues fast for a period of time. Fasting during Ramadan, a holy month of Islam, is an obligatory duty for all healthy adult Muslims and its duration varies between 29 and 30 days. Its timing changes with respect to seasons.

Depending on the geographical location and season,the duration of the daily fast may range from a few to more than 20 hours. Muslims who fast during Ramadan must abstain from eating, drinking, use of oral medications, and smoking from predawn to after sunset; however, there are no restrictions on food or fluid intake between sunset and dawn.

Most people consume two meals per day during this month, one after sunset, referred to in Arabic as Iftar (breaking of the fast meal), and the other before dawn, referred to as Suhur (predawn).
Now the question is, what food or fluid intake do one use to break or start this fasting.

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As we know, fasting is not meant to create excessive hardship on the Muslim individual.
Diabetes is a chronic metabolic disorder which may place one at high risk for various complications if the pattern and amount of meal and fluid intake is markedly altered.

Due to loss of energy, weakness and dehydration. Most people rush for food that contains carbohydrate. Foods like rice, yam, spaghetti etc, inorder to gain their strength back.

This is not right, it only increases blood sugar which makes one restless and dizzy, which only makes matter worse. So how can we live healthy, during this fasting period.

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1.) Water should be the first intake as soon as one wants to break fast. We must ensure we take as much as possible throughout the evening till dawn. It will help the circulation of blood in ones system, reduce dehydration and cleanse it. Avoid drinks with caffeine.

2.) Start meal with fruits. Fruits like watermelon, oranges,blueberries-Blueberries are awesome choice. They are packed with dietary fiber, vitamin C, and flavonoids. Flavonoids are phytonutrients and help to boost ones immune system and fight off infection. They could also help fight off bad cholesterol and keep the heart and arteries healthy.
Grapefruits-They are packed with antioxidants, especially in the ruby red variety. It lowers bad cholesterol by 20% and triglycerides by 17%.

3.) Take in enough protein. Due to not eating anything for over 17-20hrs, the body will be feeding on itself. So there is need to rebuild this areas. Source of protein that will be good includes;
Tofu-Even if not a vegetarian, tofu is a great product to integrate in diet. It is made from soy, which is high in niacin, folate, zinc, potassium, iron, and the fatty acid alpha-linolenic. This can turn into the hugely beneficial omega-3 fatty acid

Beans-Beans are a great alternative because they are high in fiber and protein. They are also packed with vitamins and minerals like folate, iron, magnesium, and potassium.

Also, other meals like brown rice, amala (instead of yam flour try plaintain flour), wheat flour( easily digested), non- starchy vegetables, fish, skinless chicken etc.

While the iftar meal is a celebration time, try not to overeat.
Keep sensible portions in mind and follow the same guidelines for healthy eating done during the rest of the year with emphasis on whole grains, lean sources of meat, fish and poultry and small amounts of heart healthy fats.

This Article is written by Damilola Shobiye a Student of Nutrition and Dietetics from Babcock University, Ilishan-Remo, Ogun State, Nigeria.
To be our Guest Blogger on the Nigeria Diabetes Online Community kindly send your article to us on thengdoc@gmail.com, follow us on @theNGdoc and like our facebook page www.facebook.com/NGDOC

Merck Diabetes and Hypertension Awards

Merck Diabetes Award

All medical undergraduates and postgraduates are invited to apply for the

Merck Diabetes Award 2017
Theme: Every Day is a Diabetes Day

Please submit a concept paper about:

  • How to improve the awareness about Diabetes Early Detection and Prevention in your country.
  • How to encourage your society, scientific community, local authorities, media and relevant stakeholders to Think and Act on Diabetes Every Day.
  • Your ideas of developing new policies, strategies, social media campaigns and more.

 

Merck Diabetes Award 2017

is:

“Postgraduate Diabetes Diploma with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October, 2017 in Cairo, Egypt to receive the award”.

Merck Diabetes Award is being rolled out in many of the African and Asian universities as part of our commitment to building diabetes capacity and improving access to quality and sustainable healthcare solutions in developing countries.

The aim of Merck Diabetes Award is to create a Diabetes Experts Platform across the globe.

Please submit your one page concept paper to:
submit@merckdiabetesaward.com

Submission deadline is 31st July 2017

Entry requirements:

Postgraduate Diploma

Health professionals, both UK and overseas, with an honors degree or equivalent (including international qualifications) are eligible to apply for the PG Diploma Diabetes course online.

Non graduates are also encouraged to apply (applicants will be asked to submit a piece of work for assessment to confirm that they are able to work comfortably at degree level).

Applicants should submit copies of the following with their application:

  • qualification certificates
  • one written reference
  • English language qualification (IELTS 6.5 or equivalent) please see University of South Wales for further details

Merck Hypertension Award

All medical undergraduates and postgraduates are invited to apply for the

Merck Hypertension Award 2017

Theme: What the Healthy Heart needs

Merck Hypertension Award is being rolled out in many of the African and Asian universities as part of our commitment to building healthcare capacity and improving access to quality and sustainable healthcare solutions in developing countries.

The aim of Merck Hypertension Award is to create a Hypertension Experts Platform across the globe.

To raise the required awareness to control and prevent hypertension, countries need systems, policies and services in place to promote universal health coverage and support healthy lifestyles: eating a balanced diet, reducing salt intake, avoiding harmful use of alcohol, getting regular exercise and stopping the use of tobacco.

Please submit a concept paper about:

  • How to improve the awareness about hypertension control and prevention in your country.
  • How to encourage your society, scientific community, local authorities, media and relevant stakeholders to think and act on Hypertension Every Day
  • Your ideas of developing new policies, strategies, social media campaigns and more.

Merck Hypertension Award 2017
is:

“Postgraduate Diploma in Preventive Cardiovascular Medicine with University of South Wales. Winners will be invited to attend the Merck Africa Luminary on 24th-25th October 2017 in Cairo, Egypt to receive the award”.

Please submit your one page concept paper to:
submit@MerckHypertensionAward.com

Submission deadline is 31st July 2017

Entry requirements:

Postgraduate Diploma

Health professionals, both UK and overseas, with an honors degree or equivalent (including international qualifications) are eligible to apply for the PG Diploma Diabetes course online.

Non graduates are also encouraged to apply (applicants will be asked to submit a piece of work for assessment to confirm that they are able to work comfortably at degree level).

Applicants should submit copies of the following with their application:

  • qualification certificates
  • one written reference
  • English language qualification (IELTS 6.5 or equivalent) please see University of South Wales for further details

For more information visit Merk’s Official website

MYTH 2: DIABETES IS A DEATH SENTENCE by Opawale Damilola

We recently started the discussion about Myths and Facts on Diabetes. If you missed the last post, kindly click here.

Today, we will continue on the discussion

MYTH 2: DIABETES IS A DEATH SENTENCE

FACT

Diabetes is not a death sentence. We established the last time that diabetes is a serious condition and is presently not curable. However, a diabetes diagnosis does not mean that you have been given an “expiry date”. It simply means you have to pay more attention to your health than before. 

There are several people who have lived with the disease for many years, some several decades and still living normal healthy lives without complications. 

We have a few testimonials from some of them:

Miss O.O, 17 years old – “I have been diabetic for 5 years. My living has been managed through regular use of Insulin, daily exercise, controlled diet, regular blood sugar checks and regular clinic visits. I am living well and happy”

Mrs. A.C. 52 year old diabetic diagnosed 9 years ago – “Basically what keeps me going is that I take my medications regularly, I choose my food carefully and I attend clinic regularly”

Mr. J.S – “When I was first diagnosed with the disease, I went online and read articles to educate myself. Diabetes education was a life saver for me. I have relationship with my doctors and that has been of great help”

 I will make attempts to outline a few things people living with diabetes must do to ensure that they live healthy and without complications

1. Have a positive attitude: Many people die not because the disease killed them but because they allowed the diagnosis to overwhelm them. Make up your mind to be happy, positive and active regardless of the fact that you have the disease

2. Get informed – Get information from authentic sources (Your doctors, support groups, books). This will help you understand better about the disease and how it should be managed. 

3. Drug Compliance: Take your medications religiously. Let your doctors prescribe drugs for you.

4. Know yourself – You need to know yourself to be able to recognize signs of when your sugar is going too low (hypoglycemia) or too high (hyperglycemia) and you need to know what to do at those times.

5. Diet Control: Contrary to the old teaching that diabetics have to eat only unripe fruits and vegetables. Studies have shown that diabetics can actually eat most of the food every other person eats, only that they need to eat them in right proportions. It is advisable to eat more of food that are high in fibre and low in calorie. Your doctor should educate you more about this.

6. Regular exercise: This also helps to control your blood sugar better, reduce weight, slows down ageing and improves heart function. However, rigorous exercise is not advised. Exercises recommended include brisk walking, swimming, cycling, Dancing, Playing court games, etc. 

7. Regular Clinic visit

8. Regular blood sugar checks

9. Avoid cigarette and alcohol consumption. These can worsen the disease.

10. Weight loss

11. Participate in support groups. 

People living with diabetes will benefit a lot from family support. 

In conclusion, Diabetes is a serious health condition which may have devastating consequences if not properly managed. 

People living with the disease must be ready to take responsibility for their health and they can live normal healthy lives. 

Please feel free to drop your questions and comments.

Feel free to send your diabetes related articles to thengdoc@gmail.com

Dr Oluwadamilola Opawale is a medical practitioner with interest in Public health and preventive medicine. She has had a stint of experience from the famous St. Nicholas hospital as a clinician.

She is also the President of IBuildAfrica Foundation, an NGO that reaches out to female adolescents, helping them maximize their potentials environment and background notwithstanding.

She has a passion to teach people how to stay healthy by imbibing healthy lifestyle and choices. 

TYPE[1]WRITER TO FACILITATE INSULIN ACCESS TO NIGERIAN CWDS

This was the start of a beautiful friendship and the creation of our diabetes project. Back in 2013 I had the pleasure of meeting Adejumo Hakeem from Nigeria.

We’d been in constant communication prior to the International Diabetes Federation Conference in Melbourne as I’d managed to win their essay competition, ‘Diabetes in Nigeria: Protecting the Future’.

I even went on to write my masters on ‘The Relationship Between Urbanisation and Type 2 Diabetes: a human rights-based approach to health in Nigeria’. So here we were, online friends from New Zealand and Nigeria, finally able to cross the ocean and meet in person.

screen-shot-2016-11-15-at-00-12-43

It’s been 6 months since the book was launched and the sales are still doing great. The profits from my book go directly to Adejumo at NGdoc to aid children with type 1 diabetes in Nigeria who do not have access to the supplies they need to survive. There are already stories of young children who we, and our consumers, have supported. If you have bought a book – YOU helped a child!

Our very first child was enough to spur us on, the fact that we’d made a difference in someone’s life is very humbling. Oluwatimileyin Daniel was 14 years old and in a state of diabetes ketoacidosis in hospital as his family had no money to buy insulin. Through our partnership we were able to pay for both the insulin and glucometer test strips he needed. He was lucky, many are not.

If you want to help us make a difference you can buy the book, or the cheaper e-book version on Amazon. If your child has type 1 diabetes they will hopefully love the book and be saving another child at the same time

Culled from type1writerblog 

Carrie Hetherington can be contacted here

FDA APPROVES ARTIFICIAL PANCREASE SYSTEM.

According to the American Diabetes Association, the FDA approved the first hybrid insulin delivery system on the 28th of September, 2016. 

This critical step, according to the ADA website in the development of an artificial pancreas is an important milestone for people with type 1 diabetes.

The MiniMed 670G is the first pump-sensor system to automatically adjust basal insulin levels, up or down, based on continuous glucose readings from an integrated continuous glucose monitor.

Patients will continue to make insulin dosing decisions at mealtime, with the MiniMed 670G providing dose recommendations based on the patient’s blood glucose levels and trends.

Patients will also need to perform finger-stick glucose checks for calibration of the device. 

The system is appropriate for anyone who is currently using or is a good candidate for an insulin pump. 

The FDA has approved the MiniMed 670G for people age 14 and older.

We are excited for this advancement, and we look forward to the development of the next phase of automated systems that can provide bolus doses of insulin. We envision that these incremental innovations will lead to a fully automated closed-loop system to provide optimal glucose control and independence for people with diabetes.

HOW DOES A CONTINUOS GLUCOSE MONITOR (CGM) WORK

CGM is a way to measure glucose levels in real-time throughout the day and night. 

A tiny electrode called a glucose sensor is inserted under the skin to measure glucose levels in tissue fluid. 

It is connected to a transmitter that sends the information via wireless radio frequency to a monitoring and display device. The device can detect and notify you if your glucose is reaching a high or low limit.

To engage with the Diabetes Online Community follow The Nigeria Diabetes Online Community on Facebook NGDOC and on Twitter @theNGdoc

– See more at: http://www.diabetes.org/newsroom/press-releases/2016/american-diabetes-association-FDA-approval-first-hybrid.html?referrer=https://t.co/VkIIhiSJFd#sthash.qkMPxHBk.dpuf

Raising a child living with diabetes in Africa: Challenges and Motivations

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On May 27th The Nigeria Diabetes online Community conducted it’s monthly chat dedicated to children living with diabetes in Africa.

The chat that coincides with Children’s day in Nigeria drew participants from Nigeria, UK, South Africa and Ghana.

The children’s day chat reflects the reality that faces us as a nation and africa as a continent on the need for a vibrant healthcare sector to combat the scourge of diabetes.

All our participants have wards living with diabetes (we encourage parents and guardians to get their wards involved in social peer support chats online).

Most wards view living with diabetes as a burden (stressful,frustrating, depressive and expensive – in the words of pearl who has young relatives living with diabetes) with a few having a good insight of the condition.

Large percentage of our wards living with diabetes seemingly initially have a feeling of being the only ones with such condition in the world.
(A typical reflection of poor awareness of other children living with diabetes)

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Living with diabetes for children has been noticed to be emotionally challenging and it’s been suggested by experience that more interaction and peer support works in Ghana with listening ears producing better results  than criticisms.

Parents and guardians have been advised to stay involved in their children’s care even if such wards is able to manage his/her diabetes.

At this point parents should be aware of that their support, respect and love for each other has a direct impact on their child’s metabolism (a good thesis for research)

It was also noted that there’s a constant battle of emotions as the children hit their teens with their tendencies to want to fit in like their friends.

In cases when their emotions are really all over the place, a constant show of love, mentoring and continuous education about diabetes has been noted to be very helpful.

It was unanimously agreed by all participants that interacting with other children living with diabetes worldwide is very helpful with NGO’s and government being actively involved in ensuring living with diabetes for our children doesn’t end up as a death sentence.

We graciously call on the minister of health in all african countries to emulate the South Africa government who is said to provide free medications to include insulin and glucose strips.

The international diabetes federation life for a child has been commended for their active support in resource poor settings where insulin, glucometers and teststrips are provided for free.

We also call on governments to ensure these supplies gets to the children import tax free.

Wouldn’t it be great to see life saving medications donated for free exempted from import tax which could be enormous?

We wish to thank all our participants for their contributions and commitments to ensuring an healthy life with diabetes is achievable by our children.

Do you have or know any child living with diabetes?
Kindly get through to us on our platforms and we will be glad to connect.
thengdoc@gmail.com
Facebook: NGDOC
Twitter: @thengdoc

Amputations: the politics behind limb loss

This email was forwarded and we obtained permission to post on our blogs for our visitors.#
A lovely writeup on diabetes and lim salvage by a seasoned HCP.

Do find time to read and enjoy

Cutting off people’s legs is never a pleasant job for the surgeon;

But many times there are, when it’s the only way forward;the only way to save a life.

Apart from limbs lost to trauma via accidents, or to cancers, today the leading cause of limb loss ‎across the world is chronic non communicable disease in one form or another and diabetes ranks a leading offender ;

Diabetes is not a disease until it is made to be.

it is made to be when high sugar is made into high grief ‎;

High grief when mere number set to a higher than normal level by regulatory defects in the body is allowed to hold the body hostage for too long.

A high sugar effectively beaten down and kept so keeps the diabetic away from diabetes : diabetes sans diabetes.

Each time I’ve come across a rotten leg from diabetes, the chances are more often than not

I always opine

there is more than diabetes to blame.

…there is the patient who might have been too slack or not compliant enough,

….the treatment regime that might ‎have become too unsuited to the challenges at hand

Or

….the diabetes that has become part of a larger complex ravaging the particular patient :

in clinical parlance,part of a multimorbidity transcending mere sugariness.

Diabetologists are the sugar experts but any clinician unable or unwilling to offer tangible help with the management of diabetes in its most general sense is likely to come to grief at some point in his career.

Surgeons are regularly sucked into the sugar issue but sadly often to bring bitter pills.

Uncontrolled sugar over a long enough period raids virtually every tissue of the victim, none less so than the blood vessels.
Increasing deterioration in calibre and reflex performance of the blood vessels lead to progressive interference in the circulatory status of the tissues, gradually compromising the nutritional transactions at the tissue interfaces.

Add to this, the simultaneous deterioration in the integrity of the nerves, compromising their sensory efficiencies,

….the stage is more than set for tissue death :

a death that may even be so painless

and thus unnoticed if and when any attendant nerve damage has also come to compromise the ability to feel.

Bacteria lurk everywhere: the good and the bad. When they smell luck, they rush to the spot, and their feeding frenzy only expedites the rate at which tissue is lost and the system beyond poisoned.

The ultimate compound effect is a sore, which no matter how small it started can fester into a huge crater, as deep as it is wide.

To have flesh eating bacteria ( saprophytes) in the vicinity of sugar laden tissues poses a particular danger to the uncontrolled diabetic:

not just to the limb, the entire system.

Any organ can be lost to diabetes but particularly the limbs.

As a clinician and surgeon, , I’ve always ‎favored saving a limb to sacrificing it.

But there are ironically too many patients who are their own worst enemies ‎.

When a bad leg ulcer presents itself to the surgical clinic, what is often required to heal it can involve far more ‎sacrifices than what is required to amputate the leg.

And though some Surgeons might be constitutionally reluctant for protracted involvement with ulcer care,opting instead to dovetail the drama into an amputation, some patients, inspite of the words dripping between their lips are often themselves too indisciplined to withstand the drawn out rigor attendant to limb saving protocols ;

they cheat on themselves or are frankly non compliant with limb saving regimes.

Or

sometimes the cost involved healing an ulcer ( daily dressing, antimicrobials, regular tissue trimmings, restricted activities, regular blood checks, upped dosages etc) might prove too prohibitive to the payer.

An ulcer is any break in the skin lining; But it can very rapidly progress to well beyond the skin to involve underlying fat, muscles and bones.

Surgeons have evolved various ways to classify these ulcers to facilitate communication between and betwixt handlers :

But by and large, most of the classification systems speak to depth or width or more commonly both along with notions about presence or absence of associated infections

For any ulcer to heal,the strategic aim is reverse the very process or processes that led to it in the first instance.

In many cases, such reversal is possible with or without difficulties.

In others, fixed damages to the support system in the particular part, like the blood vessels and nerves prevent reversibility ‎.

This latter group forms the bulk of cases that may lose limbs. There are many agents on the shelves that are aimed at countering the negatives inside an ulcer;

Those that will kill offensive germs

Or

improve blood flow

Or

expand oxygen supply

Or

bring vital elements to the arena

Or

prevent water logging

Or

retard tissue destruction.

Or

any number of petty but contributary roles towards recovery.

For many years, research has concentrated on stealing ideas from the body itself ;seeking to break into the secrets of the body regulatory pathways ; it’s innate checks and balances.

Luckily the body is getting to yield more and more of its secrets to those researchers who relentlessly knock at its many doors.

And through these unlocked secrets, the applied science at the bed sideis ‎getting richly and confidently relevant .
One thing is clear ; biologically nothing ever happens in the body unless pulled or pushed.

There are no happenstances where the body is concerned.

If my foot turns red,something has pushed or pulled the red to the foot or in the foot ‎.

Every cell is responding to something under a complex but well ordained set of traffic rules ‎.

For a cell to grow, it must be pushed to grow.

And the pushers of such growth are called growth factors.

But the pushers of growth( growth factors) are unable to push if the cell to be pushedhas no handles that can be engaged by pushers’ hands.

These handles when they exist ‎are called receptors.

So growth factors to be fully relevant must have growth receptors granting a hole into which reciprocal key can fit to unlock the handle to the transaction.

The pusher ( growth factor) engages the ‎handle ( growth receptor) on the pushed then the cell grows.

Growth often means multiplication when the process is unfettered.

If an ulcer is loss of tissue anywhere between the skin level and deeper, it also means if the area can be brought under the influence of growth factors, new cells can be produced to replace lost ones:

And like mortar filling up a hole in the floor, the new cells can fill up the hole in say the leg.

This is a simplistic analysis, but as true as it ever gets.

The new drive towards cure of stubborn leg ulcers is now the use of growth factors.

But their use is still patchy,by and large restricted to research centres.

Cuban scientists have for the past nine years been trying to get their newly found products

( herbeprotP) into the wider market but read through below ( in red) and see how politics can retard progress , leaving amputations at run away levels

HerbeprotP is drug formulation composed of epidermal growth factor ; the growth pusher that can stimulate cell production at depleted sites causing tissue defects to fill up and stave off amputation.

But standing in its path is politics.

The embargo is preventing the drug from getting out of Cuba to be tested for claimed impact on the wider market.

wish to know more about the polit‎ics standing in the path of ulcer healing and limb salvage ?
‎…………..

“I don’t know what’s going to happen, but I do know that it may be that American legs are being lost while Cuban legs are being saved because Washington agencies …won’t allow that medicine in,”

said Dr. I. Kelman Cohen, professor emeritus in surgery at Virginia Commonwealth University.

“I think all the American medical community really wants is for Heberprot to be allowed into the country for testing

…Let’s get it tested and see if it will really save the thousands of limbs that many believe it can,” Cohen said.

In December, 2013, 111 members of Congress petitioned the Treasury secretary to allow the drug to be tested in the U.S., but up to now there has been no sign of progress, according to several lawmakers who signed the letter.

Diplomatic talks between Washington and the Castro government on issues such as immigration, travel and commercial ventures are scheduled to start next week.

At a briefing today on Obama’s normalization plans, administration officials were asked about the status of Heberprot but were noncommittal.

A proven drug that will thwart flesh-destroying diabetic wounds is desperately sought by physicians throughout the world, according to Dr. David Armstrong, professor of surgery and director of the University of Arizona’s Southern Arizona Limb Salvage Alliance.

Diabetes researchers at Umeå University in Sweden reported in 2013 that worldwide, a limb is lost every 20 seconds because of a foot ulcer that doesn’t heal.

According to the American Diabetes Association, in the U.S. alone more than 73,000 diabetics undergo amputations every year, or about one every seven minutes.

“It just rips me apart to know that there may be something out there that has the potential to save limbs and we can’t get a chance to test it because of politics rather than public health,”

Armstrong said in an interview.

Each year, he and his team at the Tucson medical center spend hours in operating rooms trying to save the lower limbs of more than 11,000 patients from around the world.

“So far this year, there have been several patients who may have benefited from a study of the type needed for the Cuban drug,” he said.

Dr. Georges Benjamin, executive director of the American Public Health Association, said that “there is politics in everything” but putting public health before politics is of prime importance to his organization, which just last month signed a agreement to work more closely with its Cuban counterparts.

“We recognize that there is opportunity for allowing them to learn from us, but even more importantly, for us to learn from them and that would include any technological advances they may have made that still need to be studied and validated,”

Benjamin said.

There is nothing mysterious about the path between diabetes and the loss of a limb.

Untreated or poorly treated, diabetes often interferes with blood flow to the extremities, causing vascular disease, a failure in anti-bacterial defenses and nerve damage.

Because of this loss of protective sensation, diabetic ulcers form but often go undetected. Without a proper blood supply, the tissue around the ulcer becomes infected, continues to die and the wound grows.

Hyperbaric oxygen treatment is sometimes useful, say diabetes specialists, but surgical removal of the dead flesh is the typical treatment. And at a certain point, amputation becomes the only option to save the life of the patient.

Dr. Elof Eriksson, a Harvard University professor and chief of plastic surgery and a wound care expert at Boston’s Brigham and Women’s Hospital, last month returned from an international meeting of hundreds of wound specialists near Havana.

He called the results of studies presented at the conference on Heberprot’s effectiveness to treat severe diabetic ulcers “impressive.”

“The only definite answer can come from a large clinical trial,” Eriksson said.
‎.

‎When Republicans continue to threaten reversing obama ‘s thaw of US- Cuban relationship, the public health implications are numerous : this is just one.

Building walls between nations, the type Cruz and Trump want to do retard intellectual and scientific diffusion of knowledge and skills ; those of us who know this too well have no choice but fight against a Republican victory by any means.

Basil jide fadipe.
Justin fadipe centre.
He is a Surgeon in the Carribeans.
His hobbies includes writing on anything about life and living.
West indies.

Why Africa needs the Global DOC

It is with a heavy heart that I share the tragic story of a promising young boy with type 1 diabetes.

I met Durojaiye Bola through the Pediatric Endocrinologist of The Olabisi Onabanjo University Teaching Hospital (OOUTH) a year ago. This meeting coincided with our peer support program for children living with diabetes at the same institution where we met online with Jack Terschluse of Penpals United.

Although Durojaiye was diagnosed with Type1 diabetes his family was without the means to support the expense of his treatment and medication. He was on our list for support, next in line to Omolade who, thanks to T1International through its diabetes warrior initiative underwent a vocational training to help her pay for her insulin needs and later a partner NGO called Priceless Jewel, now supports with her insulin and university education from a kind philanthropist.

If only we had been able to support Durojaiye sooner. Last Friday I followed a friend to the ER of the teaching hospital and found him with burn scars on all of his limbs.

Apparently Durojaiye had fallen into an hypoglycemic coma at a religious center. In a bid to bring him back to life, his digits were burnt badly in fire by the religious members. This shock reminded me of the huge importance of educating religious leaders on diabetes. The NGdoc submitted a project proposal 2 years ago to a foundation for support of such an education initiative but unfortunately we never got the funding.

Right now Durojaiye has been referred to a plastic surgeon in a bigger hospital with the possibility of amputation. With tears on their eyes his parents told me categorically that they cannot afford it. They said that sending him to another hosptial will be like a death sentence.

A team was constituted by NGdoc with initial finances being given by the association. The team also has support from T1international.

The aim of the team is to ensure:

1) Optimal care for Durojaiye, including psychotherapy and rehabilitation

2) Financial support to cater for a substantial part of his bills

3) A strategy to prevent such occurrences from happening again

4) An advocacy plan to ensure liable children with diabetes have access to insulin and other essential consumables.

The team is comprised of:

Adejumo Olamide – NGdoc/Access Alliance

Elizabeth Rowley – T1International/Access Alliance

Odewale Ibironke – NGdoc

Dr Adekoya Adesola – Pediatric Endocrinologist/NGdoc Social peer support for CWD in OOUTH coordinator

Dr Ajose Femi – Surgery

Dr Safiriyu Isreal – Medicine (Endocrinology)

Adesanya Adebukonla – Medical Student

This is a clarion call to the Global DOC. There must be more focus on Africa. How many young boys and girls in Africa must go through the same traumatic experience before our community takes action?

We need to address poverty, lack of access and lack of diabtetes education. We must support community based organizations centered around caring for people with diabetes, encourage social peer support and help make the lives of children living with diabetes a meaningful one.

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