Type 2 diabetes can wreak havoc on your health. While lifestyle changes can help keep diabetes under control, many patients require oral medications or insulin injections as forms of treatment, too. Watch the video for how diabetes affects your body. Time

Pharmaceuticals maker Roche introduced a new blood glucose monitoring system called Accu-Chek Guide, paired with a savings card that allows patients to get the device for free as well as discounted test strips.(Photo: Roche)

Pharmaceuticals maker Roche overhauled its blood glucose monitoring system and introduced a new discounting offer that it says could save uninsured diabetics by thousands of dollars per year.

The move could help alleviate political pressure as the drug industry faces mounting scrutiny over prices. It also comes amid increasing competition among blood glucose monitoring makers as diabetes rates rise.

The new system pairs a free blood glucose meter with a smartphone app and discounted test strips. With some diabetics paying as much as $2 a strip for other offerings, the new Roche system paired with a free savings card could cut costs to as little as 40 cents per strip in the first 50-count box, then 20 cents per strip in subsequent boxes.

The nation's 29-million diabetics pay widely varying prices for testing products, in part because many of them are covered by insurance. Roches' move is likely to provide the biggest help to the uninsured.The average American diabetic paid $1,922 in out-of-pocket expenses for care in 2013, compared to $738 for someone without the condition,according to the Health Care Cost Institute.

For "the average patient, managing diabetes and acquiring all of the testing and therapy supplies can be very difficult to navigate, really complex and very often very expensive," said Brad Moore, head of Rochediabetes care in North America.

The new system offers a spill-resistant vial, a larger blood application area on upgraded strips and a light on the strip port for improved visibility when testing. The device wirelessly transmits data through Bluetooth technology to a free smartphone app that logs data.

Moore said Roche technicians worked on the new Accu-Chek Guide Systemfor at least three years, including a "very significant investment in capital."

Test strips read by devices to monitor blood glucose data are typically a significant source of profit for the pharmaceutical industry, which is under fire for its contribution to increasing health care costs. President Trump has threatened to battle drug companies over costs, while many Washington lawmakers have decried health care's effect on the average American's budget.

Although industryprices can be more than $2per strip, manufacturing costs don't typically top 15 cents, DiabeticInvestor.com analyst David Kliff told Diabetes Forecast magazine in 2012.

Roche had 8.5% market share in the blood glucose monitoring industry, trailing only Johnson & Johnson at 22.5%, according to an October 2016 report by market-research firm IBISWorld analystJonathan DeCarlo.

But competition is increasing, as big-box retail chains Target and Walmart and other retailers have introduced low-cost, private-label options. Consequently, the blood glucose monitoring industry's profit as a percentage of revenue was projected to fall from 10.1% in 2015 to 9.5% in 2016, IBISWorld'sDeCarlo estimated.

Moore declined to discuss the profitability of Roche's new test strips, which contain a new chemical makeup.

"We knew that access was a problem. We heard that from our patients," Moore said. "So the timing was perfect in that weve developed a new technology platform that the Accu-Chek Guide System is based on."

Meanwhile, drug companies are under pressure to shield patients from increasing costs, though they often blame insurers and other health care intermediaries for saddling patients with additional expenses.

With a free savings card available online, through pharmacies and at health care centers, the new Roche monitoring meter is free, the first box of 50 test strips is $19.99 and all additional boxesare $10.That's cheaper than major competitors atAmazon, Rite Aid, Walgreens, CVS and Walmart with the exception of the ReliOn Prime option at Walmart, according to data collected by USA TODAY.

Most options are more than $40 for a box, with some significantly more expensive. Accu-Chek's previous box of Aviva Plus strips ranged from $44.99 at Amazon to $109.99 at Walgreens.

The average patient tests once a day but some must test eight to 10 times a day. At those rates, savings from typical diabetes tests could range from hundreds to several thousands of dollars per year.

A recent study commissioned by Roche of 500 U.S. adults living with diabetes found that 58% "cut corners" to save money in their daily testing regiment, including by skipping tests.

Contributing: Diana Kruzman

Follow USA TODAY reporter Nathan Bomey on Twitter @NathanBomey.

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Roche: Diabetes patients could save thousands with new blood ... - USA TODAY

An experimental foot-temperature monitoring system might one day be able to detect when diabetic patients are developing foot ulcers, a common complication that can lead to infections and amputations, a small study suggests.

Diabetic foot ulcers typically develop on the bottom of the big toe or the ball of the foot, often when people wear ill-fitting shoes. Patients with diabetes frequently have nerve damage that limits their ability to feel pain, and as a result they dont notice developing ulcers.

For the study, researchers tested a so-called smart mat designed to use variations in temperature at different points on the foot as a predictor of recurring foot ulcers in 129 patients who had this problem before. Skin temperature typically increases as ulcers develop.

When the study team tested for variations of 2.22 degrees Celsius (about 4 degrees Fahrenheit), they found the smart mat correctly identified 97 percent of foot ulcers observed by clinicians. But it also had a false positive rate of 57 percent, meaning clinicians didnt find ulcers identified by the mat.

With a larger temperature variation of 3.20 degrees Celsius (about 5.75 degrees Fahrenheit), the false positive rate dropped to 32 percent, but the proportion of correctly identified foot ulcers also declined to 70 percent, researchers report in Diabetes Care.

If we look at this technology as a risk stratification tool with high feasibility to be used at home on daily basis, it could be hugely beneficial to target those who are truly at risk, said senior study author Dr. Bijan Najafi, a researcher at Baylor College of Medicine in Houston.

I dont think the point is having a system with no false-alarm, Najafi said by email.

The device in the study was developed by Podimetrics Inc. in Somerville, Massachusetts, and its approved for sale in the U.S. for the periodic evaluation of temperature variations in the soles of the feet for signs of inflammation. Podimetrics sponsored the study of the mat for predicting diabetic foot ulcers.

In the current experiment, patients used the mat in much the same way they might use a common bathroom scale. Every day, they stepped on it and waited 20 seconds while it measured temperatures at different points on the soles of the feet, then the device wirelessly transmitted the temperature data to servers managed by Podimetrics. The data were saved and analyzed for variations in foot temperature that might signal developing ulcers.

In total, the trial ran 34 weeks, and 37 participants developed 53 foot ulcers during the study period.

For both of the temperature variation settings tested in the study, the mat correctly identified developing ulcers an average of 37 days before they were detected by a doctor.

That lead time might help patients schedule clinic visits and get treatment for ulcers sooner, when theyre easier to treat and less likely to lead to serious complications, Najafi said.

The study wasnt designed to determine whether the mat actually reduced the development of ulcers or curbed costs to treat these ulcers, the authors note. Researchers only followed patients for 60 days, and its possible the rate of false positives or accurately identified ulcers might look different over a longer period of time.

In addition, the study only included patients with a history of diabetic foot ulcers, and the results might be different for people with diabetes who have never had this problem before, the authors point out.

While the high rate of false positives in the study suggests that the device still needs more testing and refinement, the technology holds a lot of potential to aid patients who currently have a high risk of infection and amputation because their developing ulcers go undetected, said Dr. David Armstrong, director of the Southern Arizona Limb Salvage Alliance at the University of Arizona College of Medicine in Tucson.

Whats really attractive about this technology is that it is probably going to get smarter, Armstrong, who wasnt involved in the study, said by email. This technology is probably going to personalize a heat signature for every patient and identify a hot spot for each patient.

SOURCE: bit.ly/2rAPZz6 Diabetes Care, April 29, 2017.

WASHINGTON U.S. Senate Majority Leader Mitch McConnell said on Wednesday he does not yet know how Republicans will amass the votes needed to pass legislation now being crafted to dismantle Obamacare, but expressed some optimism on another top priority, overhauling the tax code.

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Foot mat may help predict who will get a common diabetes complication - Reuters

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UT-Austin Researchers Seek to Prevent Diabetes in At-Risk Population Patch.com AUSTIN, TX Researchers at The University of Texas at Austin and The University of Texas Health Science Center at Houston (UTHealth) School of Public Health have received a $2.9 million, five-year award from the National Institute of Diabetes and ...

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UT-Austin Researchers Seek to Prevent Diabetes in At-Risk Population - Patch.com

Northwest Wyoming now claims one of only two health care professionals in the state who holds a certification in Advanced Diabetes Management. West Park Hospitals Registered Dietitian Nutritionist, Liz Fabrizio, has passed the boards for Advanced Diabetes Management from the American Association of Diabetes Educators. Thats an important resource, considering that the adult diabetes rate has almost doubled in Wyoming in the last 15 years. According to West Park Hospital Public Relations Director Ashley Trudo, Fabrizios certification supports her advanced level of knowledge and ability to manage complex patient needs while assisting patients with therapeutic problem-solving. http://dehayf5mhw1h7.cloudfront.net/wp-content/uploads/sites/761/2017/05/24091827/Trudo-Diabetes-Specialist.mp3 In just 15 years, the adult diabetes rate rose from 4.5 percent in 2001 to 8.4 percent in 2016. Christine Revere, Chronic Disease Prevention Program manager with the Wyoming Department of Health, said the trend is not surprising when considered along with several risk factors linked with type 2 diabetes. 65 percent of Wyoming adults are obese or overweight, 83 percent dont eat enough fruits and vegetables, 25 percent engage in no daily physical activity, and 21 percent smoke cigarettes. Uncontrolled diabetes can result in medical difficulties such as blindness, kidney disease and nerve damage. Diabetes is also an important risk factor for heart disease and stroke.

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Diabetes Specialist Now at West Park Hospital - mybighornbasin

May 24, 2017

An innovative method for treating type 1 diabetes based on the transplantation of hematopoietic stem cells taken from the patient's own bone marrow began undergoing testing in Brazil 13 years ago. The results were highly variable. While some of the volunteers were able to stop self-injecting insulin for more than a decade, others had to resume use of the medication only a few months after receiving the experimental treatment.

A possible explanation for this discrepancy in the clinical outcome for the 25 patients included in the study was presented in an article published recently in the journal Frontiers in Immunology. According to the authors, the duration of the therapeutic effect was shorter in the patients whose immune systems had attacked the pancreatic cells more aggressively in the pre-transplantation period.

This research was conducted at the Center for Cell-Based Therapy (CTC) in Brazil. Initially led by immunologist Julio Voltarelli, who died in March 2012, it is proceeding under the coordination of researchers Maria Carolina de Oliveira Rodrigues and Belinda Pinto Simes.

"Because type 1 diabetes is an autoimmune disease, the aim of the treatment is to 'switch off' the immune system temporarily using chemotherapy drugs and 'restart' it by means of the transplantation of autologous hematopoietic stem cells, which can differentiate into every kind of blood cell," Rodrigues explained.

By the time the symptoms of type 1 diabetes appear, she added, around 80 percent of the patient's pancreatic islets have already been damaged. If the autoimmune aggression is interrupted at this point, and the remaining cells are protected, the patient can produce an amount of insulin that is small but nevertheless important.

"Studies with animals and diabetic humans suggest the percentage of insulin-producing cells declines sharply, reaching almost zero between six and eight weeks after diagnosis. Our center has therefore set a six-week limit for patients to start the transplantation process," Rodrigues said.

Twenty-five volunteers aged between 12 and 35 were initially included in the study. The therapeutic effect has lasted an average of 42 months (3.5 years) but ranges overall from six months to 12 years, the longest follow-up period so far. Three patients remain completely insulin-free. One has been insulin-free for ten years, another for 11, and the third for 12.

"In this more recent study, we compared the profiles of the volunteers who remained insulin-free for less than and more than 42 months, which was our cutoff point," Rodrigues said.

The variables considered included age, time between diagnosis and transplantation, pre-treatment insulin dose, and post-transplant recovery of defense cells.

"We observed no significant differences between the groups for any of these factors," Rodrigues said. "The only exception was the degree of pancreatic inflammation before the transplant, which did vary significantly."

This discovery was made possible by collaboration with Dutch researcher Bart Roep at the Leiden University Medical Center. Roep's analysis of blood samples taken from all 25 patients before treatment and once per year after the transplant enabled him to quantify their autoreactive T-lymphocytes, white cells that recognize and specifically attack proteins secreted by pancreatic islets.

"This method enabled us to evaluate the extent to which the immune system was attacking the pancreas," Rodrigues said. "We observed a clear association between a larger number of autoreactive lymphocytes before transplantation and a worse response to treatment."

In the group of patients who responded well, Rodrigues went on, stem cell therapy rebalanced the immune system thanks to an increase in the proportion of regulatory T-cells (Tregs), a type of white cell with immunosuppressive action that helps combat autoimmunity.

"In patients with more autoreactive lymphocytes before transplantation, this balance didn't occur," she said. "Despite the increase in the number of Tregs due to the treatment, they were still outnumbered by autoreactive lymphocytes. What we don't yet know is whether these were new cells that differentiated from transplanted stem cells or were a remnant of the autoreactive lymphocytes that weren't destroyed by chemotherapy and resumed multiplication."

Data from the scientific literature show that the latter hypothesis is more plausible, so the group at CTC has begun a second study in which patients are being subjected to more aggressive chemotherapy with the aim of ensuring that no vestiges of autoreactive T-lymphocytes remain.

Explore further: Novel tissue-engineered islet transplant achieves insulin independence in type 1 diabetes

More information: Kelen C. R. Malmegrim et al. Immunological Balance Is Associated with Clinical Outcome after Autologous Hematopoietic Stem Cell Transplantation in Type 1 Diabetes, Frontiers in Immunology (2017). DOI: 10.3389/fimmu.2017.00167

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Success of stem cell therapy for diabetes depends on pre-transplant immune condition - Medical Xpress

The possible complications posed by diabetesheart disease and damage to eyes, feet, nerves and so forthare fairly familiar to the general public. But in recent years, scientists have been scrutinizing a risk that is both less well known and less understoodthe heightened likelihood of dementia.

Researchers have known for several years about diabetes and the higher risk of vascular dementia, the second most common kind. In ways, it seems only logical: Vascular dementia is caused by damaged blood vessels in the brain, just as diabetes hardens blood vessels elsewhere.

The latest research is focused on Alzheimers disease, the most common neurodegenerative disorder and one for which its harder to figure out the precise relationship with diabetes. On this much, many scientists agree: The rate of Alzheimers disease could be cut by close to half if diabetes could be abolished. The connection between the two is so strong that Suzanne M. de la Monte, one of the top researchers in the field, has said that many cases of Alzheimers could be dubbed Type 3 diabetes.

People who havent necessarily developed diabetes might still develop insulin resistance in the brain, said de la Monte, a professor of neurosurgery, pathology and laboratory medicine at Brown University. Thats why she uses the term Type 3 diabetesone doesnt necessarily cause the other. But in both cases, she said, people show certain markers at the cellular level.

Growing evidence supports the concept that Alzheimers disease is fundamentally a metabolic disease with molecular and biochemical features that correspond with diabetes mellitus and other peripheral insulin resistance disorders, de la Monte wrote in 2014 in the journal Biochemical Pharmacology.But the picture is more complicated than that, she wrote, because Alzheimers can occur as a separate disease process, or arise in association with systemic insulin resistance diseases, including diabetes, obesity, and non-alcoholic fatty liver disease.

A 2015 pilot study published in the Journal of Alzheimers Disease found that doses of nasal insulinbypassing the blood/brain barriersignificantly improved memory in people with early Alzheimers disease and mild cognitive impairment. A larger, five-year clinical trial is now underway.

Inflammatory response appears to play a role, de la Monte said. Both diabetes and Alzheimers are inflammatory diseases. And yet, other forms of brain inflammation are not associated with cognitive problems later on.

Multiple sclerosis, encephalitis, none of these lead to dementia, she said. What is the cause of all this, where is the problem? Because Alzheimers disease was not that common before. We can link a lot of the extra cases to diabetes and obesity. So if we have that, is it just because people are fatter? I dont think its just that. But then if you talk about metabolic syndrome, fatty liver, PCOS, infertilityhow many diseases are linked to the same problem of insulin resistance and an inflammatory process?

People need a lot more help in learning how to stave off Type 2 diabetes and other metabolic diseases through diet and exercise, de la Monte said. And because testing can find the same precursor conditions for both brain insulin-resistance and diabetes, theres reason to think more people should be screened earlier, with these more sensitive tests.

Melissa Schilling, a professor at the New York University Stern School of Business, came to a similar conclusion after conducting a review of the relationship between diabetes and Alzheimers.

Her 2016 paper in the Journal of Alzheimers Disease estimated that 40% of all Alzheimers cases were connected to hyperinsulinemia, or excess levels of insulin relative to glucose in the blood. That would include not just people with diabetes but the 86 million Americans estimated by the CDC to have prediabetes.

If we can raise awareness and get more people tested for hyperinsulinemia it could significantly lessen the incidence of Alzheimers disease and vascular dementia, as well as other diabetes-related health problems. Schilling said in a press release.

Research by Margaret Gatz, a professor of psychology at USC, further refined the relationship between the two. She and fellow researchers in Sweden found that not only was diabetes strongly associated with dementia, but that people who are first diagnosed with Type 2 diabetes in middle age, rather than after age 65, are at much higher risk. And that finding was independent of how long people had diabetes before developing dementiain other words, it was the age at diagnosis, not how long they lived with diabetes, that determined their risk.

At this point, Gatz is particularly interested in the role that stress might play in the equation.

One theory is Ive been intrigued by involves the HPA (hypothalamic-pituitary-adrenal) axis, she said. The HPA axis controls the immune system, digestionand reactions to stress. Its what fires when someone is stressed, Gatz said. After its heavily activated, it might potentiate diabetes and hippocampal damage, inflammation and oxidative damage.

Maybe this whole stress process is basically inflammatory damage, oxidative damage.

She agreed that earlier, more sensitive testing might warn people away from the kind of eating and sedentary habits that can cause prediabetes and diabetes. Stress management might be part of the picture, too, she suggests.

Im heavily a physical exercise proponent. When people ask me, Whats the biggest thing I can do to avoid dementia? my answer is exercise. But also workplaces are more stressful, people describe themselves as not handling stress as well. All of these are risk factors.

At Brown, de la Monte is planning to publish a paper that looks at what kinds of testing might best be used as early indicators of future dementia. Were looking at peripheral markers that indicate brain disease, she said. If you look at blood, can you find evidence of inflammation in people who have no inflammatory disease but they have mild cognitive impairment and they also have markers of insulin resistance? We can pick out from that who is at risk. At least to inform them so they can start using lifestyle measures.

Karin Klein is a freelance journalist based in Southern California who specializes in writing about health and medicine, education, environment and food. For 27 years, she covered those topics at the Los Angeles Times as an editor and editorial writer. Karin is a graduate of Wellesley College, where she majored in linguistics, and she studied journalism at UC Berkeley's Graduate School of Journalism. When she's not writing, she's usually found on hiking trails and is the author of an interpretive hiking book, "50 Hikes in Orange County." Follow her on Twitter athttps://twitter.com/kklein100

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