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Patients with type 1 diabetes and a significant portion of patients with type 2 diabetes must use subcutaneous insulin injections, in order to maintain normoglycemia and to prevent immediate and long-term complications. For these patients, testing blood glucose levels more frequently is necessary to safely achieve glycated hemoglobin targets. In the current study, the effects of a CoolSense™ device (CoolSense Medical Ltd., Tel Aviv, Israel) were examined in relieving pain caused by needle-pricking for glucose measurements in adult patients with diabetes.One hundred seventy-seven patients assessed the severity of pain they experienced during needle-pricking. The patients were randomly divided into an experimental group or a control group that used either a cooled CoolSense instrument or a non-cooled device, respectively. Participants were asked to rank the severity of their pain by a questionnaire developed for this study. Blood glucose levels were monitored as a control.The majority of participants (58.3-71.7%; P0.001) reported significant ache during measurements, the desire for an instrument that relieves pain, and its negative influence on their quality of life. Significant differences were indicated in pain perception between the experimental group and the control group that served as placebo, with no differences in blood glucose measurements in the groups.The CoolSense instrument significantly reduces subjective pain felt by patients and can therefore serve as an additional tool for clinicians to help ease the needle-pricking pain. Future study is needed in order to provide information regarding the practical use of the instrument and its effect on hyper- and hypoglycemia.

Hyperglycemia is a prominent feature among patients exposed to major stress such as in cardiac surgery. The implementation of a continuous glucose monitoring system (CGMS) for glucose monitoring during cardiac surgery was assessed.Fifty-nine consecutive patients who underwent cardiac surgery were monitored by CGMS. Patients' fluid glucose content, drug requirements, and hemodynamic and physiologic parameters were evaluated.Of the 59 patients, 32 completed the monitoring with CGMS. Patients were divided into three groups: diabetes patients, patients without diabetes history who developed significant hyperglycemia perioperatively, and patients who did not develop hyperglycemia. Hyperglycemia was most frequently observed postoperatively. Hyperglycemic patients required significantly more insulin (81±40 vs. 34±37 units, P=0.005) and experienced an increased early complication rate, although this difference was not significant. CGMS erroneously detected late-phase operative and immediate postoperative hypoglycemia in approximately one-third of patients as reflected from venous blood sample measurements.CGMS enables close monitoring and optimal control of blood glucose among patients undergoing major cardiac surgery, although its reliability is limited during the cardiac surgery phase and in the early postoperative period, because of incorrect hypoglycemic readings.

Diabetic foot ulcers are associated with significant morbidity. Conventional treatment modalities are often of limited success in promoting complete wound closure. The aim of the present study was to examine the efficacy of noninvasive ozone-oxygen therapy in the treatment of diabetic foot ulcers.Diabetes patients with a Wagner classification stage 2 or 3 ulcer or a stage 4 ulcer after debridement of at least 8 weeks in duration were included in this double-blind, randomized, placebo-controlled clinical trial. Patients received conventional treatment in combination with either ozone-oxygen treatment or sham treatments for 12 weeks, and after an additional 12 weeks, wound status was re-examined.In total, 61 patients (62% male, 62.6±9.8 years old) participated in the study; 32 were randomized to ozone treatment, and 29 to placebo. The proportion of subjects with full wound closure did not differ significantly by treatment assignment (41% vs. 33%, P=0.34). Among the 34 subjects who completed the study per protocol (PP) (16 in the ozone group, 18 in the placebo group), a significantly higher rate of complete wound closure was observed in the ozone group (81% vs. 44%, P=0.03). Among PP patients with wound size ≤5 cm(2), the rate of total wound closure was 100% versus 50% in the sham treatment group (P=0.006). A nonsignificant, 55.5% relative increase in healed wound area was detected in the ozone group versus the placebo group (4.2±4.9 cm(2) vs. 2.7±1.5 cm(2), P=0.23).Among PP patients, ozone treatment in addition to conventional treatment was superior to conventional treatment alone in promoting the complete healing of diabetic foot ulcers.

Experimental and some clinical evidence suggests that ingestion of cinnamon may improve metabolic measures in individuals with diabetes; however, few human studies have been designed to examine this association as their primary objective. In this study adult subjects 30 years of age or older with type 2 diabetes were randomized to treatment with 1,200 mg/day cinnamon or matched placebo. Blood pressure, hemoglobin A1c, fasting blood glucose, lipid profile, physical examination, and blood and urine chemistry were measured at baseline and at the 12-week follow-up end-of-treatment visit. In total, 59 subjects (40.7% female; mean age, 63.05±10.85 years) were recruited. Systolic blood pressure (SBP) declined from baseline values by 3.4±11.4 mm Hg in the cinnamon group and increased by 1.9±10.2 mm Hg in the placebo group (P=.06). In repeated-measures analysis, a significant by-treatment difference over time was detected (P=.02). However, when baseline SBP was included in the model as a covariate, change from baseline SBP was no longer associated with treatment. Although cinnamon added to the diets of spontaneously hypertensive rats has been shown to decrease SBP in a dose-dependent manner, results of the present study in humans suggest that the by-treatment difference in change-from-baseline SBP was a function of regression to the mean rather than a treatment-associated change.

Control of serum glucose levels is essential for the reduction of complications of diabetes. Telemedicine is one strategy through which serum glucose control can be improved.A total of 35 adult, insulin-treated patients with diabetes (type 1 and type 2) were enrolled in the present study (63.0 +/- 10 years of age, 63% female) and randomized to telemedicine monitoring (including cordless, remote glucose monitor, and transmitter, n = 17), or conventional follow-up (n = 18). Metabolic parameters were evaluated, and a quality of life questionnaire was administered both pre- and post-treatment.Groups were similar at baseline in terms of demographic, quality of life, and metabolic parameters. Significant differences in post-treatment metabolic parameters were not observed, although serum glucose was marginally elevated in the control group compared to the telemedicine group (214 +/- 65 mg/dL vs. 171 +/- 77 mg/dL, P = 0.09). On the other hand, being clinically symptom-free (71% vs. 11%, P = 0.003), having no hypoglycemic events (82% vs. 17%, P = 0.0001), and having no hyperglycemic events (65% vs. 17%, P = 0.004) were all significantly more frequently reported in the telemedicine group compared to the control group. Compared to the control group, the telemedicine group reported experiencing significantly less anxiety, treatment difficulty, depression, disease-associated life complications, and feelings of impotence or ineptitude and significantly greater improvement in personal control over glucose, weight, and overall diabetes.Though post-treatment metabolic differences were not observed between treatment groups, the telemedicine group reported significantly greater post-treatment experiences of improved quality of life and sense of control over the disease. Thus patient satisfaction can be enhanced through the use of telemedicine.