Month: July 2016

Insulin onset and duration

July 9, 2016

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Insulin preparation Onset of action Peak Duration of action
Glusaline (Apidra)  10-30 minutes  1/2- 2 hours  3-5 hours
Lispro (Humalog) <15 minutes 1-2 hours 3-6 hours
Aspart (Novolog) <15 minutes 1-2 hours 3-6 hours
Glulisine (Apidra) <15 minutes 1-2 hours 3-6 hours
Regular (Novolin R, Humulin R) 30-60 minutes 2-4 hours 6-10 hours
Humulin R Regular U-500 (500 units/ml) 30-60 minutes 2-4 hours Up to 24 hours
NPH (Novolin N, Humulin N, ReliOn) 2-4 hours 4-8 hours 10-18 hours
Glargine (Lantus) 1-2 hours Usually no peak Up to 24 hours
Detemir (Levemir) 1-2 hours Usually no peak ** Up to 24 hours**
Glargine Injection (300units/ml Toujeo) 6 hours No true peak 24-36 hours
Degludec (Tresibia 200units/ml) 6 hours No peak Up to 42 hours
Premixed Insulins Onset of action Peak Duration of action
Novolin 70/30,
Humulin 70/30		 30-60 minutes 2-10 hours 10-18 hours
Humalog 75/25,
Novolog 70/30,
Humalog 50/50		 10-30 minutes 1-6 hours 10-14 hours

Peanuts Reduce Mortality

July 8, 2016

Peanuts Reduce Mortality

peanuts in shell-web

We’ve known for some time that Walnuts and almonds reduce heart disease.  Now, researchers at Vanderbilt University and the Shanghai Cancer Institute published research finding that intake of peanuts was associated with fewer deaths, especially from heart disease.

 

Soda-1 a day increases CVD risk 30%

July 8, 2016

Soda-1 a day increases CVD risk 30%

Soda Aisle 2-webA study conducted from NHANES data projects that regularly drinking as little as one 12-ounce sugary soda a day may increase the risk of cardiovascular disease by about 30%—independent of total calories, obesity, or other risk factors[1].

Researchers analyzed data from three National Health and Nutrition Examination Survey (NHANES) surveys—1988–1994, 1999–2004, and 2005–2010—and examined CVD mortality during a mean follow-up of 14.6 years.

More than 70% of the added sugar came from sugar-sweetened beverages (37.1%), grain-based desserts (13.7%), fruit drinks (8.9%), dairy desserts (6.1%), and candy (5.8%).

Sugar and CVD Death

There is disagreement about how much added sugar is acceptable in a healthy diet.

According to the Institute of Medicine, added sugar should be less than 25% of total calories.  The World Health Organization recommends less than 10% of total calories from added sugar. The American Heart Association  less than 100 calories a day  for women (about 5% of total daily calories) and 150 calories a day for men (about 7.5% of total daily calories).

“Yang et al inform this debate by showing that the risk of CVD mortality becomes elevated once added sugar intake surpasses 15% of daily calories—equivalent to drinking one 20-ounce Mountain Dew soda in a 2000-calorie daily diet,” Dr Laura A Schmidt (University of California, San Francisco) writes in an invited commentary[2]. The risk rises exponentially as sugar intake increases, peaking with a fourfold increased risk of CVD death for individuals who consume one-third or more of their daily calories in added sugar, she adds.

“Until federal guidelines are forthcoming, physicians may want to caution patients that, to support cardiovascular health, it is safest to consume less than 15% of their daily calories as added sugar,” she advises.

References

  1. Yang Q, Zhang Z, Gregg EW, et al. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Intern Med 2014; DOI:10.1001/jamainternmed.2013.13563. Abstract
  2. Schmidt LA. New unsweetened truths about sugar. JAMA Intern Med 2014; DOI:10.1001/jamainternmed.2013.12991.Commentary

Urine test for gluten ingestion

July 8, 2016

Urine 1006795_1280Making sure a patient’s diet is completely gluten-free is critical for these patients to avoid gut mucosal damage.  It is thought that perhaps more than half of patients who say they are totally gluten free are actually getting in gluten by accidental contamination.  An article in Gut tells of a new urine test for celiac compliance.

Basically, researchers checked urine samples from 76 healthy individuals and 58 patients with celiac disease under different gluten dietary conditions.

GIP (gluten immunogenic peptides) was detectable in healthy individuals in as little as 4 hours and showed up for 2 days after a single gluten intake.

Results showed, “the urine assay revealed infringement of the GFD in about 50% of the patients. Analysis of duodenal biopsies revealed that most of patients with CD (89%) with no villous atrophy had no detectable GIP in urine, while all patients with quantifiable GIP in urine showed incomplete intestinal mucosa recovery.”