Nutrition Recommendations for Special Diabetic Situations / 임상당뇨병

Diabetic patients encounter a number of difficulties in blood glucose control for special situations such as illness, travel, eating away from home and physical activity. These patients should be provided with diabetes self-management skills for such special situations. During acute illnesses, insulin and oral glucose-lowering medications should be continued. Also, testing of plasma glucose and ketones, drinking adequate amounts of fluids, and ingesting carbohydrates are all important. Diabetic patients should adjust their meal plans in accordance with their travel plans and should carry a food kit at all times. They should learn guidelines for dining at restaurants, including food substitutes, portion control, and adapting one's meal pattern when eating away from home. Most people with diabetes do not need snacks during physical activity, but people with diabetes who take insulin or an insulin secretagogue may need snacks to prevent hypoglycemia during or after exercise. The need for a snack is dependent on the duration and intensity of the activity, the timing of recent meals and medication peaks. Using data from blood glucose, food, exercise, and medication records, dietitians can provide diabetic clients with critical self-management skills.

Prolonged survival of islet allografts in mice treated with rosmarinic acid and anti-CD154 antibody

Pancreatic islet transplantation can correct the abnormal glucose metabolism of Type 1 diabetes. Although immunosuppressants greatly reduce the acute rejection rate in transplant patients, the long-term side effects can be debilitating. Therefore, researchers are seeking to develop new immunosuppressive regimens that induce maximal levels of immunosuppression with minor side effects. Rosmarinic acid (Ros A) is a secondary metabolite of certain herbs and has multiple biological activities, including anti-inflammatory effects. Here, we have investigated whether treatment of mice with a combination of Ros A and anti-CD154 monoclonal antibody (MR1) improves islet allograft survival in a murine model. After transplantation, the mice were treated with either Ros A, MR1, or both (the "double" treatment). Allograft survival was prolonged in the double-treated animals compared to animals that received only Ros A or MR1. As is the case with the single-treated animals at 15 days after transplantation, the double-treated recipients did not display a significant decrease in the expression of cytokines or the population of activated T cells. Infiltrating CD3+ T cells were reduced in the MR1- or double therapy relative to control or RosA group. However, at the same time point, double-treated graft showed fewer apoptotic cells and increased expression of insulin and glucagons, compared to the single-treatment groups. Furthermore, long-term (>150 days) allografts that were received with double therapy exhibited larger islet clusters and contained more insulin- and glucagon-positive cells, relative to the MR1-treated grafts. In conclusion, treatment with both Ros A and MR1 has a synergistic effect in murine islet allotransplantation.