Diabetic Digest - Wednesday, September 5, 2012

Readers:

Another year gone by means that I'm due for my yearly physical.

It happens about the same time each year so I shouldn't be surprised, but I can't help it. However, what I'm surprised about this year is much different than the ones prior.

Since my son was born I have been taking much better care of myself. I've been eating less, but I'm eating better. I've lost more than 20 pounds since May because of my new eating habits. Also I've decreased the amount of insulin I use because of my new diet, plus the fact that I'm way more active with a baby in the house.

So wish me luck. The results will be in the next issue.

Regards,
Steve

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Questions? Comments? Email Steve


*-- Diabetic News --*
Testosterone Tx Stymied by Depression
By: Kristina Fiore
MedPage Today

CHICAGO - Testosterone therapy may be useless in men with type 2 diabetes and hypogonadism who also have depression, researchers said here.

In a randomized controlled trial, diabetic men who weren't depressed had significant improvements in blood glucose and other metabolic parameters with hormone therapy, but those with depression gained no benefit, Geoffrey Hackett, MD, of Good Hope Hospital in Sutton Coldfield in England, and colleagues reported at the World Meeting on Sexual Medicine.

"All [parameters] improved in the nondepressed group, and there was a worsening of all symptoms in the group with depression," Hackett said.

Men with type 2 diabetes tend to have a high burden of co-occurring hypogonadism and depression, Hackett explained.

To assess whether treatment of low testosterone is affected by depression, the researchers conducted the randomized controlled BLAST Study -- an acronym for the included towns of Birmingham, Lichfield, Atherstone, Sutton Coldfield, and Tamworth - in 200 men from seven primary care practices who had type 2 diabetes and hypogonadism.

The study lasted 30 weeks, with about half the men continuing in a 52-week, open-label follow-up phase.

Participants were given either 1,000 mg testosterone undecanoate (Nebido) or matching placebo at baseline and at weeks 6 and 18.

The prevalence of hypogonadism was 50%. Almost a quarter of the population with type 2 diabetes (23%) was depressed, and these men tended to be younger and more obese, Hackett said.

For men who weren't depressed, testosterone therapy significantly reduced HbA1c levels (P=0.045).

It was also tied to significant reductions in weight (P=0.038), body mass index (P=0.02), and waist circumference (P=0.02), the researchers reported.

Yet they didn't see similar improvements in any of these parameters for patients who were depressed, Hackett said.

"We saw a highly significant treatment effect in the nondepressed group, and in the depressed group there was no response whatsoever," he said during the presentation.

"The take-home message," he continued, "is that it's important to screen for depression when initiating testosterone therapy, as both the metabolic and psychologic complications will be [affected]."

"You'll save yourself trouble if you detect those patients early," he said.

He added that clinicians should consider concomitant treatment of patients' depression when they go on hormone therapy, but that this trial would have been underpowered to study that endpoint.

Jacques Buvat, MD, of the Centre d'Etude et de Traitement de la Pathologie de l'Appareil Reproducteur et de la Psychosomatique in Lille, France, who moderated the session during which the study was presented, said the findings were "very important" for the treatment of low testosterone in diabetic patients.

Original Article: Testosterone Tx Stymied by Depression


*-- Diabetic Recipe --*
Apple Crumb Cake
Servings: 16
Prep time: 20 minutes
Cook time: 30 minutes
Total: 50 minutes

Ingredients
vegetable cooking spray
1 cup all-purpose flour
1/3 cup rolled oats
1/3 cup one-to-one sugar substitute
1/4 cup brown sugar substitute
1 teaspoon ground cinnamon
1/8 teaspoon ground nutmeg
1/8 teaspoon salt
4 tablespoons cold margarine, cut into small pieces
1/2 teaspoon baking powder
1/2 teaspoon baking soda
1/3 cup unsweetened apple juice
1 teaspoon vanilla extract
1/4 cup egg substitute
2 Braeburn apples, about 1 pound total, peeled, cored, and chopped

Directions
1. Preheat oven to 350 Degrees F. Lightly coat an 8-inch square baking pan with cooking spray.
2. In a bowl combine the flour, oats, sugar substitutes, cinnamon, nutmeg, and salt. Cut in the margarine with a pastry blender, or two knives, until the mixture looks like coarse meal. Set aside 1/2 cup.
3. Combine the remaining flour mixture with the baking powder, baking soda, apple juice, vanilla, and egg substitute. Beat at a medium speed with an electric mixture until blended. Fold in the apples.
4. Spoon the cake mixture into the pan and level out. Sprinkle with the reserved flour mixture. Bake for 30 to 35 minutes until the cake springs back in the center when lightly touched. Cool the cake until warm. Cut into 16 squares. Serve warm or cooled.

Nutrition Information
Per serving: 88 calories (30% calories from fat), 2 g protein, 3 g total fat (0.5 g saturated fat), 14 g carbohydrates, 1 g dietary fiber, 0 cholesterol, 116 mg sodium
Diabetic exchanges: 1 carbohydrate (bread/starch), 1/2 fat

Original Recipe: Apple Crumb Cake

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